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严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染及2019冠状病毒病(COVID-19)严重程度中先天免疫和炎症反应的失调

Dysregulated Innate Immune and Inflammatory Responses in SARS-CoV-2 Infection and COVID-19 Severity.

作者信息

Ghosh Poulami, Nagaraja Sahana, Basavaraju Sharath, Kesavardhana Sannula

机构信息

Department of Biochemistry, Indian Institute of Science, Bengaluru, Karnataka 560012, India.

出版信息

Crit Rev Immunol. 2021;41(3):43-56. doi: 10.1615/CritRevImmunol.2021039716.

Abstract

Pathogenic coronaviruses (CoVs) have caused human respiratory infections and severe disease outbreaks in the past two decades. Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in humans shows high transmissibility causing a wide range of clinical outcomes, named coronavirus disease-2019 (COVID-19), which emerged into an ongoing pandemic. Innate immune sensing of SARS-CoV-2 infection is critical for mounting antiviral and inflammatory responses to restrict the viral spread and initiate lung tissue repair processes. However, excessive cytokine and chemokine levels and dysregulated inflammatory immune cell function in the lungs are associated with respiratory failure and severe COVID-19. Thus, there is a tremendous need for understanding SARS-CoV-2-host interactions determining the aberrant inflammatory responses and loss of respiratory function. In this article, we discuss host innate immune responses determining dysregulated inflammation and immunopathology during SARS-CoV-2 infection. We also provide the perspective for the inflammatory cell death contribution for this immunopathology. Virus-induced acute host responses are complex, and elucidating this complex mechanism facilitates safe therapeutic interventions to alleviate inflammation-mediated immunopathology during pathogenic virus infections.

摘要

在过去二十年中,致病性冠状病毒(CoV)已导致人类呼吸道感染和严重疾病爆发。近期人类感染的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)显示出高传播性,引发了一系列临床症状,即冠状病毒病-2019(COVID-19),并演变成一场持续的大流行。对SARS-CoV-2感染的先天性免疫感知对于启动抗病毒和炎症反应以限制病毒传播并启动肺组织修复过程至关重要。然而,肺部细胞因子和趋化因子水平过高以及炎症免疫细胞功能失调与呼吸衰竭和严重的COVID-19相关。因此,迫切需要了解决定异常炎症反应和呼吸功能丧失的SARS-CoV-2与宿主的相互作用。在本文中,我们讨论了决定SARS-CoV-2感染期间炎症失调和免疫病理学的宿主先天性免疫反应。我们还提供了炎症细胞死亡对这种免疫病理学作用的观点。病毒诱导的急性宿主反应很复杂,阐明这一复杂机制有助于采取安全的治疗干预措施,以减轻致病性病毒感染期间炎症介导的免疫病理学。

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