Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Eur J Immunol. 2021 May;51(5):1071-1075. doi: 10.1002/eji.202149173. Epub 2021 Mar 22.
Cytokine signaling, especially interferon (IFN) signaling is closely linked to several aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. During initial SARS-CoV-2 infection, symptomatic patients present with impaired type I/III IFN-mediated antiviral responses. Interestingly, IFNs regulate the cellular entry receptor for SARS-CoV-2 on epithelial and endothelial cells. As reported recently, critically ill COVID-19 patients show genetic polymorphisms in one IFN receptor gene (IFNRA2) and in a gene locus near the Janus kinase (JAK) TYK2, which is key for IFN, interleukin (IL)-12 and IL-23 signaling, and T helper (Th) 1/Th17 cell-mediated antiviral immune responses. In the advanced stage of the disease, critically ill COVID-19 patients develop a cytokine storm where many inflammatory mediators using the JAK/STAT signaling pathway such as IL-6, IFN-γ, the granulocyte colony-stimulating factor (G-CSF) or IL-2, and chemokines result in an influx of macrophages and neutrophils damaging the lung tissue. The knowledge on the cytokine and JAK/STAT signaling pathways in severe COVID-19 disease explains the promising first results with JAK inhibitors like baricitinib, which not only dampen the inflammation but in the case of baricitinib also affect virus replication and endocytosis in target cells. Here, we summarize the current immunological associations of SARS-CoV-2 infection with cytokine signaling, the JAK/STAT pathway, and the current clinical stage of JAK inhibitors for improving severe COVID-19 disease.
细胞因子信号转导,尤其是干扰素(IFN)信号转导,与严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的几个方面密切相关。在 SARS-CoV-2 感染的初始阶段,有症状的患者表现出 I 型/III 型 IFN 介导的抗病毒反应受损。有趣的是,IFNs 调节上皮细胞和内皮细胞上 SARS-CoV-2 的细胞进入受体。最近有报道称,危重症 COVID-19 患者在一个 IFN 受体基因(IFNRA2)和靠近 Janus 激酶(JAK)TYK2 的基因座中存在遗传多态性,这对于 IFN、白细胞介素(IL)-12 和 IL-23 信号转导以及 T 辅助(Th)1/Th17 细胞介导的抗病毒免疫反应至关重要。在疾病的晚期,危重症 COVID-19 患者会发生细胞因子风暴,其中许多炎症介质(如 IL-6、IFN-γ、粒细胞集落刺激因子(G-CSF)或 IL-2)和趋化因子利用 JAK/STAT 信号通路,导致巨噬细胞和中性粒细胞涌入,损害肺组织。关于严重 COVID-19 疾病中细胞因子和 JAK/STAT 信号通路的知识解释了 JAK 抑制剂(如巴瑞替尼)的有希望的初步结果,这些抑制剂不仅能抑制炎症,而且在巴瑞替尼的情况下,还能影响病毒在靶细胞中的复制和内吞作用。在这里,我们总结了 SARS-CoV-2 感染与细胞因子信号转导、JAK/STAT 通路以及 JAK 抑制剂改善严重 COVID-19 疾病的当前临床阶段的免疫相关性。
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