Tissue Engineering and Applied Cell Sciences Department, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Tissue Engineering Department, School of Advanced Technologies in Medicine, Fasa University of Medical Sciences, Fasa, Iran.
Immunopharmacol Immunotoxicol. 2021 Jun;43(3):259-264. doi: 10.1080/08923973.2021.1925906. Epub 2021 May 21.
Coronavirus disease 2019 (COVID-19) is associated with irreversible effects on vital organs, especially the respiratory and cardiac systems. While the immune system plays a key role in the survival of patients to viral infections, in COVID-19, there is a hyperinflammatory immune response evoked by all the immune cells, such as neutrophils, monocytes, and includes release of various cytokines, resulting in an exaggerated immune response, named cytokine storm. This severe, dysregulated immune response causes multi-organ damage, which eventually leads to high mortality. One of the most important components of hypersensitivity is immunoglobulin E (IgE), which plays a major role in susceptibility to respiratory infections and can lead to the activation of mast cells. There is also a negative association between IgE and IFN-α, which can reduce Toll-like receptor (TLR) nine receptor expression and TLR-7 signaling to disrupt IFN production. Moreover, anti-IgE drugs such as omalizumab reduces the severity and duration of COVID-19. In addition to its anti-IgE effect, omalizumab inhibits inflammatory cells such as neutrophils. Hence, blockade of IgE may have clinical utility as an immunotherapy for COVID-19.
2019 年冠状病毒病（COVID-19）与重要器官的不可逆损伤有关，尤其是呼吸系统和心血管系统。虽然免疫系统在患者对病毒感染的存活中起着关键作用，但在 COVID-19 中，所有免疫细胞（如中性粒细胞、单核细胞）都会引发过度的炎症免疫反应，包括各种细胞因子的释放，从而导致过度的免疫反应，称为细胞因子风暴。这种严重的、失调的免疫反应导致多器官损伤，最终导致高死亡率。超敏反应的最重要组成部分之一是免疫球蛋白 E（IgE），它在呼吸道感染易感性中起主要作用，并可导致肥大细胞的激活。IgE 与 IFN-α之间也存在负相关，IFN-α 可降低 Toll 样受体（TLR）九受体的表达和 TLR-7 信号转导，从而破坏 IFN 的产生。此外，奥马珠单抗等抗 IgE 药物可降低 COVID-19 的严重程度和持续时间。奥马珠单抗除了具有抗 IgE 作用外，还能抑制中性粒细胞等炎症细胞。因此，IgE 阻断可能具有作为 COVID-19 免疫疗法的临床应用价值。
