Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
CNRS-Strasbourg University Unit Biotechnology and cell signaling/Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, France; Federation Hospital-University (FHU) OMICARE, Federation of Translational Medicine of Strasbourg (FMTS), Strasbourg University, Strasbourg, France; University of Strasbourg Institute for Advanced Study, Strasbourg, France.
Autoimmun Rev. 2021 Apr;20(4):102792. doi: 10.1016/j.autrev.2021.102792. Epub 2021 Feb 19.
Autoimmunity may be generated by a variety of factors by creating a hyper-stimulated state of the immune system. It had been established long ago that viruses are a substantial component of environmental factors that contribute to the production of autoimmune antibodies, as well as autoimmune diseases. Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) are viruses that withhold these autoimmune abilities. In a similar manner, SARS-CoV-2 may be counted to similar manifestations, as numerous records demonstrating the likelihood of COVID-19 patients to develop multiple types of autoantibodies and autoimmune diseases. In this review, we focused on the association between COVID-19 and the immune system concerning the tendency of patients to develop over 15 separate types of autoantibodies and above 10 distinct autoimmune diseases. An additional autoimmunity manifestation may be one of the common initial symptoms in COVID-19 patients, anosmia, the complete loss of the ability to sense smell, and other olfactory alterations. We summarize current knowledge on principal mechanisms that may contribute to the development of autoimmunity in the disease: the ability of SARS-CoV-2 to hyper-stimulate the immune system, induce excessive neutrophil extracellular traps formation with neutrophil-associated cytokine responses and the molecular resemblance between self-components of the host and the virus. Additionally, we will examine COVID-19 potential risk on the new-onsets of autoimmune diseases, such as antiphospholipid syndrome, Guillain-Barré syndrome, Kawasaki disease and numerous others. It is of great importance to recognize those autoimmune manifestations of COVID-19 in order to properly cope with their outcomes in the ongoing pandemic and the long-term post-pandemic period. Lastly, an effective vaccine against SARS-CoV-2 may be the best solution in dealing with the ongoing pandemic. We will discuss the new messenger RNA vaccination strategy with an emphasis on autoimmunity implications.
自身免疫可能是由多种因素引起的,这些因素会导致免疫系统过度兴奋。很久以前就已经确定,病毒是导致自身抗体产生以及自身免疫性疾病的环境因素的重要组成部分。爱泼斯坦-巴尔病毒(EBV)、巨细胞病毒(CMV)和人类免疫缺陷病毒(HIV)是具有这种自身免疫能力的病毒。类似地,SARS-CoV-2 也可能具有类似的表现,因为有大量记录表明 COVID-19 患者有可能产生多种类型的自身抗体和自身免疫性疾病。在这篇综述中,我们重点关注了 COVID-19 与免疫系统之间的关联,以及患者发展超过 15 种不同类型的自身抗体和 10 种不同自身免疫性疾病的倾向。另一种自身免疫表现可能是 COVID-19 患者的常见初始症状之一,即嗅觉丧失,即完全丧失嗅觉能力,以及其他嗅觉改变。我们总结了当前关于可能导致疾病中自身免疫发展的主要机制的知识:SARS-CoV-2 刺激免疫系统的能力、诱导过度形成中性粒细胞细胞外陷阱以及宿主自身成分与病毒之间的分子相似性。此外,我们将检查 COVID-19 对新出现的自身免疫性疾病(如抗磷脂综合征、吉兰-巴雷综合征、川崎病等)的潜在风险。认识到 COVID-19 的这些自身免疫表现对于正确应对大流行期间及其后的长期后果非常重要。最后,针对 SARS-CoV-2 的有效疫苗可能是应对当前大流行的最佳解决方案。我们将讨论新的信使 RNA 疫苗接种策略,并重点讨论其对自身免疫的影响。