Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Department of Pediatric Hematology and Oncology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Eur J Pediatr. 2021 Mar;180(3):983-986. doi: 10.1007/s00431-020-03841-y. Epub 2020 Oct 13.
A new type of coronavirus named as SARS-CoV-2 pandemic has begun to threaten human health. As with other types of coronaviruses, SARS-CoV-2 affects children less frequently, and it has been observed that the disease is mild. In the pathogenesis of a standard viral infection, the pathogen's contact with the mucosa is initially followed by an innate immunity response. T cells are the primary decisive element in adaptive immunity capability. For this reason, the adaptive immune response mediated by the thymus is a process that regulates the immune response responsible for preventing invasive damage from a virus. Regulatory T cells (T-reg) are active during the early periods of life and have precise roles in immunomodulation. The thymus is highly active in the intrauterine and neonatal period; it begins to shrink after birth and continues its activity until adolescence. The loss of T-reg function by age results in difficulty with the control of the immune response, increased inflammation as shown in coronavirus disease (COVID-19) as an inflammatory storm. Also, the thymus is typically able to replace the T cells destroyed by apoptosis caused by the virus. Thymus and T cells are the key factors of pathogenesis of SARS-CoV-2 in children.Conclusion: We speculated that thymus activity and T lymphocyte function in children protect them against the virus effects. Stimulating and preventing the inhibition of the thymus can be possible treatment components against COVID-19. What is Known: • The SARS-CoV-2 infection does not often progress with an invasive clinic in children. • Thymus activity and T lymphocyte functions are highly active in children. What is New: • Effective thymus activity and T lymphocyte function in children protect them against the invasive SARS-CoV-2 infection. • Stimulating and preventing the inhibition of the thymus can be possible treatment components against COVID-19.
一种名为 SARS-CoV-2 的新型冠状病毒已开始威胁人类健康。与其他类型的冠状病毒一样,SARS-CoV-2 对儿童的影响较小,并且观察到该病较为温和。在标准病毒感染的发病机制中,病原体首先与黏膜接触,随后发生固有免疫反应。T 细胞是适应性免疫能力的主要决定因素。因此,由胸腺介导的适应性免疫反应是一个调节免疫反应的过程,该反应负责防止病毒的侵袭性损害。调节性 T 细胞(T-reg)在生命早期活跃,并在免疫调节中具有精确的作用。胸腺在宫内和新生儿期高度活跃;出生后开始萎缩,并持续活跃至青春期。随着年龄的增长,T-reg 功能丧失会导致免疫反应控制困难,如冠状病毒病(COVID-19)中所见的炎症风暴。此外,胸腺通常能够替代由病毒引起的细胞凋亡破坏的 T 细胞。胸腺和 T 细胞是 SARS-CoV-2 在儿童发病机制中的关键因素。结论:我们推测儿童的胸腺活性和 T 淋巴细胞功能可保护其免受病毒的影响。刺激和防止胸腺抑制可能是针对 COVID-19 的治疗方法。已知:• SARS-CoV-2 感染在儿童中通常不会引起侵袭性临床症状。• 儿童的胸腺活性和 T 淋巴细胞功能高度活跃。新发现:• 儿童有效的胸腺活性和 T 淋巴细胞功能可保护其免受侵袭性 SARS-CoV-2 感染。• 刺激和防止胸腺抑制可能是针对 COVID-19 的治疗方法。