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Immunometabolic Status of COVID-19 Cancer Patients.
Physiological Reviews ( IF 33.6 ) Pub Date : 2020-07-28 , DOI: 10.1152/physrev.00018.2020 A Sica 1 , M P Colombo 1 , A Trama 1 , L Horn 1 , M C Garassino 1 , V Torri 1
Physiological Reviews ( IF 33.6 ) Pub Date : 2020-07-28 , DOI: 10.1152/physrev.00018.2020 A Sica 1 , M P Colombo 1 , A Trama 1 , L Horn 1 , M C Garassino 1 , V Torri 1
Affiliation
Cancer patients appear to be more likely to be diagnosed with COVID-19. This is supported by the understanding of immunometabolic pathways that intersect patients with infection and cancer. However, data derived by case series and retrospective studies do not offer a coherent interpretation, since data from China suggest an increased risk of COVID-19, while data from United States and Italy show a prevalence of COVID-19 in cancer patients comparable with general population. Noteworthy, cancer and COVID-19 exploit distinct patterns of macrophage activation, which promote disease progression in the most severe forms. In particular, the alternative activation of M2-polarized macrophages plays a crucial role in cancer progression. In contrast, the macrophage-activation syndrome (MAS) appears as source of M1-related cytokine storm in severe COVID-19 disease, thus indicating macrophages as a source of distinct inflammatory states in the two diseases, nonetheless as a common therapeutic target. New evidence indicates that NAMPT/NAD metabolism can direct both innate immune cells effector functions and the homeostatic robustness, in both cancer and infection. Moreover, a bidirectional relationship exists between the metabolism of NAD and the protective role that ACE2, the COVID-19 receptor, can play against hyperinflammation. Within this immunometabolic framework, the review considers possible interference mechanisms that viral infections and tumours elicit on therapies and provides an overview for the management of patients with cancer affected by COVID-19, particularly for the balance of risk and benefit when planning normally routine cancer treatments and follow-up appointments.
更新日期：2020-07-29
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