Xie Bing, Zhang Jiancheng, Li Yuwen, Yuan Shiying, Shang You
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA, United States.
Front Immunol. 2021 Jan 29;11:607583. doi: 10.3389/fimmu.2020.607583. eCollection 2020.
The ongoing pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly spreading and has resulted in grievous morbidity and mortality worldwide. Despite the high infectiousness of SARS-CoV-2, the majority of infected individuals are asymptomatic or have mild symptoms and could eventually recover as a result of their balanced immune function. On the contrary, immuno-compromised patients are prone to progress into severe or critical types underpinned by the entanglement of an overexuberant proinflammatory response and injured immune function. Therefore, well-coordinated innate and adaptive immune systems are pivotal to viral eradication and tissue repair. An in-depth understanding of the immunological processes underlying COVID-19 could facilitate rapidly identifying and choosing optimal immunotherapy for patients with severe SARS-CoV-2 infection. In this review, based on current immunological evidence, we describe potential immune mechanisms and discuss promising immunotherapies for COVID-19, including IL-6R blockades, convalescent plasma, intravenous gamma globulin, thymosin alpha1, corticosteroids, and type-I interferon, and recent advances in the development of COVID-19 vaccines.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的持续性大流行冠状病毒病2019(COVID-19)正在迅速传播,并已在全球范围内导致严重的发病率和死亡率。尽管SARS-CoV-2具有高传染性,但大多数感染者无症状或症状轻微,由于其免疫功能平衡,最终可能康复。相反,免疫功能低下的患者容易发展为重症或危重症类型,其原因是过度活跃的促炎反应和受损的免疫功能相互纠缠。因此,协调良好的先天免疫和适应性免疫系统对于病毒清除和组织修复至关重要。深入了解COVID-19背后的免疫过程有助于快速识别并为重症SARS-CoV-2感染患者选择最佳免疫疗法。在本综述中,基于当前的免疫学证据,我们描述了潜在的免疫机制,并讨论了针对COVID-19的有前景的免疫疗法,包括白细胞介素-6受体阻断剂、康复期血浆、静脉注射丙种球蛋白、胸腺肽α1、皮质类固醇和I型干扰素,以及COVID-19疫苗研发的最新进展。