Department of International Medicine, Faculty of Medicine, Health Sciences University, Istanbul, Turkey.
Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Int Immunopharmacol. 2020 Dec;89(Pt B):107082. doi: 10.1016/j.intimp.2020.107082. Epub 2020 Oct 10.
Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) is responsible for recent ongoing public health emergency in the world. Sharing structural and behavioral similarities with its ancestors [SARS and Middle East Respiratory Syndrome (MERS)], SARS-CoV-2 has lower fatality but faster transmission. We have gone through a long path to recognize SARS and MERS, therefore our knowledge regarding SARS-CoV-2 is not raw. Various responses of the immune system account for the wide spectrum of clinical manifestations in Coronavirus disease-2019 (COVID-19). Given the innate immune response as the front line of defense, it is immediately activated after the virus entry. Consequently, adaptive immune response is activated to eradicate the virus. However, this does not occur in every case and immune response is the main culprit causing the pathological manifestations of COVID-19. Lethal forms of the disease are correlated with inefficient and/or insufficient immune responses associated with cytokine storm. Current therapeutic approach for COVID-19 is in favor of suppressing extreme inflammatory responses, while maintaining the immune system alert and responsive against the virus. This could be contributing along with administration of antiviral drugs in such patients. Furthermore, supplementation with different compounds, such as vitamin D, has been tested to modulate the immune system responses. A thorough understanding of chronological events in COVID-19 contributing to the development of a highly efficient treatment has not figured out yet. This review focuses on the virus-immune system interaction as well as currently available and potential therapeutic approaches targeting immune system in the treatment of COVID-19 patients.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是目前全球正在发生的公共卫生紧急事件的元凶。SARS-CoV-2 与它的祖先(SARS 和中东呼吸综合征(MERS))具有结构和行为上的相似性,但致死率较低,传播速度较快。我们在认识 SARS 和 MERS 方面已经走过了漫长的道路,因此我们对 SARS-CoV-2 的了解并非是原始的。免疫系统的各种反应导致了 2019 冠状病毒病(COVID-19)临床表现的广泛差异。鉴于先天免疫反应是防御的第一道防线,它会在病毒进入后立即被激活。因此,适应性免疫反应被激活以消灭病毒。然而,并非在所有情况下都会发生这种情况,免疫反应是导致 COVID-19 病理表现的主要罪魁祸首。疾病的致命形式与细胞因子风暴相关的低效和/或不足的免疫反应有关。目前 COVID-19 的治疗方法倾向于抑制极端炎症反应,同时保持免疫系统对病毒的警觉和反应。这可能有助于在这些患者中联合使用抗病毒药物。此外,还测试了补充不同化合物(如维生素 D)来调节免疫系统反应。对导致 COVID-19 高效治疗的时间顺序事件的全面了解尚未明确。这篇综述重点关注病毒-免疫系统相互作用以及目前针对 COVID-19 患者免疫系统的治疗方法。