Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Centre for Experimental and Molecular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
Eur J Immunol. 2020 Dec;50(12):1998-2012. doi: 10.1002/eji.202048908. Epub 2020 Nov 16.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the current coronavirus disease 2019 (COVID-19) pandemic. Understanding the immune response that provides specific immunity but may also lead to immunopathology is crucial for the design of potential preventive and therapeutic strategies. Here, we characterized and quantified SARS-CoV-2-specific immune responses in patients with different clinical courses. Compared to individuals with a mild clinical presentation, CD4 T-cell responses were qualitatively impaired in critically ill patients. Strikingly, however, in these patients the specific IgG antibody response was remarkably strong. Furthermore, in these critically ill patients, a massive influx of circulating T cells into the lungs was observed, overwhelming the local T-cell compartment, and indicative of vascular leakage. The observed disparate T- and B-cell responses could be indicative of a deregulated immune response in critically ill COVID-19 patients.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是导致当前 2019 年冠状病毒病（COVID-19）大流行的病原体。了解提供特异性免疫但也可能导致免疫病理的免疫反应对于潜在的预防和治疗策略的设计至关重要。在这里，我们对不同临床病程的患者的 SARS-CoV-2 特异性免疫反应进行了特征描述和量化。与临床表现较轻的个体相比，危重症患者的 CD4 T 细胞反应在质量上受损。然而，令人惊讶的是，在这些患者中，特异性 IgG 抗体反应非常强烈。此外，在这些危重症患者中，观察到循环 T 细胞大量涌入肺部，超过局部 T 细胞区室，并表明血管渗漏。观察到的 T 细胞和 B 细胞反应的差异可能表明 COVID-19 危重症患者的免疫反应失调。
