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新冠病毒感染后自身免疫现象的触发可能与易感个体的短暂免疫抑制和不适当的免疫重建形式有关。

The triggering of post-COVID-19 autoimmunity phenomena could be associated with both transient immunosuppression and an inappropriate form of immune reconstitution in susceptible individuals.

作者信息

Cañas Carlos A

机构信息

Unit of Rheumatology, Fundación Valle del Lili, Cra.98 No.18-49, Cali 760032, Colombia.

出版信息

Med Hypotheses. 2020 Dec;145:110345. doi: 10.1016/j.mehy.2020.110345. Epub 2020 Oct 14.

Abstract

With the progression of the COVID-19 pandemic, there have been different reports about the development of autoimmune diseases once the infection is controlled. After entering the respiratory epithelial cells, SARS-CoV-2-the virus that causes the disease-triggers a severe inflammatory state in some patients known as "cytokine storm" and the development of thrombotic phenomena-both conditions being associated with high mortality. Patients additionally present severe lymphopenia and, in some cases, complement consumption and autoantibody development. There is a normalization of lymphocytes once the infection is controlled. After this, autoimmune conditions of unknown etiology may occur. A hypothesis for the development of post-COVID-19 autoimmunity is proposed based on the consequences of both a transient immunosuppression (both of innate and acquired immunity) in which self-tolerance is lost and an inappropriate form of immune reconstitution that amplifies the process.

摘要

随着新冠疫情的发展,有不同的报道称感染得到控制后会出现自身免疫性疾病。进入呼吸道上皮细胞后,导致该疾病的病毒——严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在一些患者中引发一种严重的炎症状态,即“细胞因子风暴”,以及血栓形成现象——这两种情况都与高死亡率相关。患者还会出现严重的淋巴细胞减少,在某些情况下,会出现补体消耗和自身抗体产生。感染得到控制后,淋巴细胞会恢复正常。此后,可能会出现病因不明的自身免疫性疾病。基于短暂免疫抑制(先天免疫和获得性免疫均受抑制,导致自身耐受性丧失)以及不适当的免疫重建形式(会放大这一过程)的后果,提出了一种关于新冠后自身免疫性疾病发生的假说。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6018/7556280/63ec6861428c/gr1_lrg.jpg

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