Hospitalist and Specialty Medicine, Department of Veterans Affairs, Puget Sound, Seattle, WA 98108;
Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA 98195; and.
J Immunol. 2020 Aug 15;205(4):892-898. doi: 10.4049/jimmunol.2000554. Epub 2020 Jul 10.
SARS-CoV-2, the virus causing COVID-19, has infected millions and has caused hundreds of thousands of fatalities. Risk factors for critical illness from SARS-CoV-2 infection include male gender, obesity, diabetes, and age >65. The mechanisms underlying the susceptibility to critical illness are poorly understood. Of interest, these comorbidities have previously been associated with increased signaling of Th17 cells. Th17 cells secrete IL-17A and are important for clearing extracellular pathogens, but inappropriate signaling has been linked to acute respiratory distress syndrome. Currently there are few treatment options for SARS-CoV-2 infections. This review describes evidence linking risk factors for critical illness in COVID-19 with increased Th17 cell activation and IL-17 signaling that may lead to increased likelihood for lung injury and respiratory failure. These findings provide a basis for testing the potential use of therapies directed at modulation of Th17 cells and IL-17A signaling in the treatment of COVID-19.
导致 COVID-19 的 SARS-CoV-2 病毒已感染数百万人,并导致数十万人死亡。重症 SARS-CoV-2 感染的危险因素包括男性、肥胖、糖尿病和年龄>65 岁。导致易患重症疾病的机制尚不清楚。有趣的是,这些合并症以前与 Th17 细胞信号的增加有关。Th17 细胞分泌 IL-17A,对于清除细胞外病原体很重要,但不当的信号转导与急性呼吸窘迫综合征有关。目前针对 SARS-CoV-2 感染的治疗选择很少。本综述描述了将 COVID-19 重症危险因素与 Th17 细胞激活和 IL-17 信号转导联系起来的证据,这可能导致肺损伤和呼吸衰竭的可能性增加。这些发现为测试针对 Th17 细胞和 IL-17A 信号转导的治疗方法在 COVID-19 治疗中的潜在用途提供了依据。