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自身免疫性疾病与新型冠状病毒肺炎

Autoimmune Disorders & COVID-19.

作者信息

Freire-de-Lima Leonardo, Scovino Aline Miranda, Barreto Menezes Camilla Cristie, Marques da Fonseca Leonardo, Santos Dos Reis Jhenifer, Rodrigues da Costa Santos Marcos André, Monteiro da Costa Kelli, Antonio do Nascimento Santos Carlos, Freire-de-Lima Celio Geraldo, Morrot Alexandre

机构信息

Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil.

Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil.

出版信息

Medicines (Basel). 2021 Sep 28;8(10):55. doi: 10.3390/medicines8100055.

Abstract

Coronavirus disease 2019 (COVID-19) can progress to severe pneumonia with respiratory failure and is aggravated by the deregulation of the immune system causing an excessive inflammation including the cytokine storm. Since 2019, several studies regarding the interplay between autoimmune diseases and COVID-19 infections is increasing all over the world. In addition, thanks to new scientific findings, we actually know better why certain conditions are considered a higher risk in both situations. There are instances when having an autoimmune disease increases susceptibility to COVID-19 complications, such as when autoantibodies capable of neutralizing type I IFN are present, and other situations in which having COVID-19 infection precedes the appearance of various autoimmune and autoinflammatory diseases, including multisystem inflammatory syndrome in children (MIS-C), Guillain-Barré syndrome, and Autoimmune haemolytic anaemia (AIHA), thus, adding to the growing mystery surrounding the SARS-CoV-2 virus and raising questions about the nature of its link with autoimmune and autoinflammatory sequelae. Herein, we discuss the role of host and virus genetics and some possible immunological mechanisms that might lead to the disease aggravation.

摘要

2019冠状病毒病(COVID-19)可进展为伴有呼吸衰竭的重症肺炎,免疫系统失调导致包括细胞因子风暴在内的过度炎症会使病情加重。自2019年以来,世界各地关于自身免疫性疾病与COVID-19感染之间相互作用的研究不断增加。此外,由于新的科学发现,我们实际上更清楚地了解了为什么某些情况在这两种情形下都被视为更高风险。存在自身免疫性疾病会增加对COVID-19并发症易感性的情况,比如存在能够中和I型干扰素的自身抗体时;也有其他情况,即COVID-19感染先于各种自身免疫性和自身炎症性疾病出现,包括儿童多系统炎症综合征(MIS-C)、吉兰-巴雷综合征和自身免疫性溶血性贫血(AIHA),因此,这增加了围绕严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒的谜团,并引发了关于其与自身免疫性和自身炎症性后遗症联系本质的疑问。在此,我们讨论宿主和病毒遗传学的作用以及一些可能导致疾病加重的免疫机制。

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本文引用的文献

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Diverse functional autoantibodies in patients with COVID-19.COVID-19 患者中的多种功能性自身抗体。
Nature. 2021 Jul;595(7866):283-288. doi: 10.1038/s41586-021-03631-y. Epub 2021 May 19.
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Covid-19 and autoimmunity.新冠病毒与自身免疫
Autoimmun Rev. 2020 Aug;19(8):102597. doi: 10.1016/j.autrev.2020.102597. Epub 2020 Jun 11.

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