Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, United States.
DIvision of Medical Research, Mackay Children's Hospital, Taipei, Taiwan.
Front Immunol. 2021 Jul 15;12:690976. doi: 10.3389/fimmu.2021.690976. eCollection 2021.
Different emerging viral infections may emerge in different regions of the world and pose a global pandemic threat with high fatality. Clarification of the immunopathogenesis of different emerging viral infections can provide a plan for the crisis management and prevention of emerging infections. This perspective article describes how an emerging viral infection evolves from microbial mutation, zoonotic and/or vector-borne transmission that progresses to a fatal infection due to overt viremia, tissue-specific cytotropic damage or/and immunopathology. We classified immunopathogenesis of common emerging viral infections into 4 categories: 1) deficient immunity with disseminated viremia (e.g., Ebola); 2) pneumocytotropism with/without later hyperinflammation (e.g., COVID-19); 3) augmented immunopathology (e.g., Hanta); and 4) antibody-dependent enhancement of infection with altered immunity (e.g., Dengue). A practical guide to early blocking of viral evasion, limiting viral load and identifying the fatal mechanism of an emerging viral infection is provided to prevent and reduce the transmission, and to do rapid diagnoses followed by the early treatment of virus neutralization for reduction of morbidity and mortality of an emerging viral infection such as COVID-19.
不同的新发病毒性感染可能出现在世界不同地区，并具有高病死率的全球大流行威胁。阐明新发病毒性感染的免疫发病机制可为新发感染的危机管理和预防提供方案。本文从新发病毒性感染如何由微生物突变、人畜共患和/或媒介传播引起，发展为明显病毒血症、组织特异性细胞毒性损伤或/和免疫病理学导致致命感染的角度进行阐述。我们将常见新发病毒性感染的免疫发病机制分为 4 类：1）播散性病毒血症伴免疫缺陷（如埃博拉）；2）肺细胞嗜性伴/不伴后期过度炎症（如 COVID-19）；3）增强的免疫病理学（如汉坦病毒）；和 4）抗体依赖性感染增强伴免疫改变（如登革热）。本文提供了一种实用的早期阻断病毒逃逸、限制病毒载量和识别新发病毒性感染致命机制的方法，以预防和减少传播，并进行快速诊断，随后进行病毒中和的早期治疗，从而降低 COVID-19 等新发病毒性感染的发病率和死亡率。
