Wang Yifei, Zheng Jingbin, Islam Md Sahidul, Yang Yang, Hu Yuanjia, Chen Xin
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR 999078, China.
Int J Biol Sci. 2021 Apr 10;17(6):1507-1520. doi: 10.7150/ijbs.59534. eCollection 2021.
The severe cases of Coronavirus Disease 2019 (COVID-19) frequently exhibit excessive inflammatory responses, acute respiratory distress syndrome (ARDS), coagulopathy, and organ damage. The most striking immunopathology of advanced COVID-19 is cytokine release syndrome or "cytokine storm" that is attributable to the deficiencies in immune regulatory mechanisms. CD4FoxP3 regulatory T cells (Tregs) are central regulators of immune responses and play an indispensable role in the maintenance of immune homeostasis. Tregs are likely involved in the attenuation of antiviral defense at the early stage of infection and ameliorating inflammation-induced organ injury at the late stage of COVID-19. In this article, we review and summarize the current understanding of the change of Tregs in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and discuss the potential role of Tregs in the immunopathology of COVID-19. The emerging concept of Treg-targeted therapies, including both adoptive Treg transfer and low dose of IL-2 treatment, is introduced. Furthermore, the potential Treg-boosting effect of therapeutic agents used in the treatment of COVID-19, including dexamethasone, vitamin D, tocilizumab and sarilumab, chloroquine, hydroxychloroquine, azithromycin, adalimumab and tetrandrine, is discussed. The problems in the current study of Treg cells in COVID-19 and future perspectives are also addressed.
2019冠状病毒病（COVID-19）重症病例常表现出过度炎症反应、急性呼吸窘迫综合征（ARDS）、凝血病和器官损伤。重症COVID-19最显著的免疫病理学特征是细胞因子释放综合征或“细胞因子风暴”，这归因于免疫调节机制的缺陷。CD4FoxP3调节性T细胞（Tregs）是免疫反应的核心调节因子，在维持免疫稳态中发挥不可或缺的作用。Tregs可能在感染早期参与减弱抗病毒防御，并在COVID-19后期改善炎症诱导的器官损伤。在本文中，我们回顾并总结了目前对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者中Tregs变化的认识，并讨论了Tregs在COVID-19免疫病理学中的潜在作用。介绍了包括过继性Treg转移和低剂量白细胞介素-2治疗在内的Treg靶向治疗的新兴概念。此外，还讨论了用于治疗COVID-19的治疗药物，包括地塞米松、维生素D、托珠单抗和萨瑞鲁单抗、氯喹、羟氯喹、阿奇霉素、阿达木单抗和粉防己碱的潜在Treg增强作用。还阐述了目前COVID-19中Treg细胞研究存在的问题及未来展望。
