Aix-Marseille University, CNRS, INSERM, Centre d'Immunologie de Marseille-Luminy, Marseille, France.
CNRS UMR 7257, Aix-Marseille University, Marseille, France.
Trends Immunol. 2021 Jan;42(1):31-44. doi: 10.1016/j.it.2020.11.003. Epub 2020 Nov 13.
The majority of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals remain paucisymptomatic, contrasting with a minority of infected individuals in danger of death. Here, we speculate that the robust disease resistance of most individuals is due to a swift production of type I interferon (IFNα/β), presumably sufficient to lower the viremia. A minority of infected individuals with a preexisting chronic inflammatory state fail to mount this early efficient response, leading to a delayed harmful inflammatory response. To improve the epidemiological scenario, we propose combining: (i) the development of efficient antivirals administered early enough to assist in the production of endogenous IFNα/β; (ii) potentiating early IFN responses; (iii) administering anti-inflammatory treatments when needed, but not too early to interfere with endogenous antiviral responses.
大多数严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染个体表现为症状轻微，而少数感染个体则有死亡的危险。在这里，我们推测大多数个体具有强大的疾病抵抗力，是由于迅速产生了 I 型干扰素（IFNα/β），大概足以降低病毒血症。少数存在慢性炎症状态的感染个体未能产生这种早期有效的反应，导致延迟的有害炎症反应。为了改善流行病学状况，我们建议结合：（i）开发有效的抗病毒药物，尽早使用以帮助产生内源性 IFNα/β；（ii）增强早期 IFN 反应；（iii）在需要时给予抗炎治疗，但不要过早，以免干扰内源性抗病毒反应。
