Cañas Carlos A
Unit of Rheumatology, Fundación Valle del Lili, Cra.98 No.18-49, Cali 760032, Colombia.
Med Hypotheses. 2020 Dec;145:110345. doi: 10.1016/j.mehy.2020.110345. Epub 2020 Oct 14.
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.
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。