Carter Immunology Center, University of Virginia, Charlottesville, Virginia, USA.
Department of Microbiology, Immunology and Cancer Biology, University of Virginia, Charlottesville, Virginia, USA.
J Med Virol. 2023 Jan;95(1):e28122. doi: 10.1002/jmv.28122. Epub 2022 Sep 13.
The clinical manifestation of coronavirus disease 2019 (COVID-19) mainly targets the lung as a primary affected organ, which is also a critical site of immune cell activation by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, recent reports also suggest the involvement of extrapulmonary tissues in COVID-19 pathology. The interplay of both innate and adaptive immune responses is key to COVID-19 management. As a result, a robust innate immune response provides the first line of defense, concomitantly, adaptive immunity neutralizes the infection and builds memory for long-term protection. However, dysregulated immunity, both innate and adaptive, can skew towards immunopathology both in acute and chronic cases. Here we have summarized some of the recent findings that provide critical insight into the immunopathology caused by SARS-CoV-2, in acute and post-acute cases. Finally, we further discuss some of the immunomodulatory drugs in preclinical and clinical trials for dampening the immunopathology caused by COVID-19.
新型冠状病毒病 2019（COVID-19）的临床表现主要针对肺作为主要受影响的器官，这也是严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）激活免疫细胞的关键部位。然而，最近的报告也表明，COVID-19 病理学涉及肺外组织。固有免疫和适应性免疫反应的相互作用是 COVID-19 管理的关键。因此，强大的固有免疫反应提供了第一道防线，同时，适应性免疫中和感染并为长期保护建立记忆。然而，固有免疫和适应性免疫的失调都可能导致急性和慢性病例中的免疫病理学偏向。在这里，我们总结了一些最近的发现，这些发现为 SARS-CoV-2 引起的急性和亚急性病例中的免疫病理学提供了重要的见解。最后，我们进一步讨论了一些在临床前和临床试验中用于抑制 COVID-19 引起的免疫病理学的免疫调节药物。
