Jordan S C
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Clin Exp Immunol. 2021 Jun;204(3):310-320. doi: 10.1111/cei.13582. Epub 2021 Mar 4.
The factors responsible for the spectrum of coronavirus 19 (COVID-19) disease severity and the genesis and nature of protective immunity against COVID-19 remain elusive. Multiple studies have investigated the immune responses to COVID-19 in various populations, including those without evidence of COVID-19 infection. Information regarding innate and adaptive immune responses to the novel severe respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved rapidly. Data are accumulating defining disease phenotypes that aid in rational and informed development of new therapeutic approaches for the treatment of patients infected with SARS-CoV-2 and the development of novel vaccines. In this paper, data on important innate immune responses are summarized, including cytokines, specifically interleukin (IL)-6 and complement, and potential treatments are explored. Adaptive immune responses and derivative therapeutics such as monoclonal antibodies directed at spike proteins are also examined. Finally, data on real-time assessments of adaptive immune responses are explored, which include CD4 /CD8 T cells, natural killer (NK) T cells, memory B cells and T follicular cells with specificities for COVID-19 peptides in infected and normal individuals. Data of two novel vaccines have been released, both showing > 95% efficacy in preventing SARS-CoV-2 infection. Analysis of humoral and cellular responses to the vaccines will determine the robustness and durability of protection. In addition, long-term assessment of SARS-CoV-2 memory B and T cell-mediated immune responses in patients recovering from an infection or those with cross-reactive immunological memory will help to define risk for future SARS-CoV infections. Finally, patients recovering from SARS-CoV-2 infection may experience prolonged immune activation probably due to T cell exhaustion. This will be an important new frontier for study.
导致新型冠状病毒肺炎（COVID-19）疾病严重程度谱以及针对COVID-19的保护性免疫的起源和本质的因素仍然难以捉摸。多项研究调查了不同人群对COVID-19的免疫反应，包括那些没有COVID-19感染证据的人群。关于对新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的固有免疫和适应性免疫反应的信息发展迅速。有助于合理、明智地开发治疗感染SARS-CoV-2患者的新治疗方法和新型疫苗的疾病表型数据正在积累。本文总结了重要的固有免疫反应数据，包括细胞因子，特别是白细胞介素（IL）-6和补体，并探讨了潜在的治疗方法。还研究了适应性免疫反应和衍生疗法，如针对刺突蛋白的单克隆抗体。最后，探讨了适应性免疫反应实时评估的数据，包括感染个体和正常个体中对COVID-19肽具有特异性的CD4/CD8 T细胞、自然杀伤（NK）T细胞、记忆B细胞和滤泡辅助性T细胞。两种新型疫苗的数据已经公布，两者在预防SARS-CoV-2感染方面均显示出>95%的疗效。对疫苗的体液和细胞反应分析将确定保护的稳健性和持久性。此外，对从感染中康复的患者或具有交叉反应性免疫记忆的患者中SARS-CoV-2记忆B细胞和T细胞介导的免疫反应进行长期评估，将有助于确定未来感染SARS-CoV的风险。最后，从SARS-CoV-2感染中康复 的患者可能会经历长时间的免疫激活，这可能是由于T细胞耗竭所致。这将是一个重要的新研究领域。
