Lotti Virginia, Lagni Anna, Diani Erica, Sorio Claudio, Gibellini Davide
Microbiology Section, Department of Diagnostic and Public Health, University of Verona, Verona, Italy.
General Pathology Section, Department of Medicine, University of Verona, Verona, Italy.
Front Microbiol. 2023 May 11;14:1162470. doi: 10.3389/fmicb.2023.1162470. eCollection 2023.
SARS-CoV-2, the etiological cause of the COVID-19 pandemic, can cause severe illness in certain at-risk populations, including people with cystic fibrosis (pwCF). Nevertheless, several studies indicated that pwCF do not have higher risks of SARS-CoV-2 infection nor do they demonstrate worse clinical outcomes than those of the general population. Recent studies indicate cellular and molecular processes to be significant drivers in pwCF lower infection rates and milder symptoms than expected in cases of SARS-CoV-2 infection. These range from cytokine releases to biochemical alterations leading to morphological rearrangements inside the cells associated with CFTR impairment. Based on available data, the reported low incidence of SARS-CoV-2 infection among pwCF is likely a result of several variables linked to CFTR dysfunction, such as thick mucus, IL-6 reduction, altered ACE2 and TMPRSS2 processing and/or functioning, defective anions exchange, and autophagosome formation. An extensive analysis of the relation between SARS-CoV-2 infection and pwCF is essential to elucidate the mechanisms involved in this lower-than-expected infection impact and to possibly suggest potential new antiviral strategies.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是2019冠状病毒病大流行的病原体，可在某些高危人群中引起严重疾病，包括囊性纤维化患者（pwCF）。然而，多项研究表明，pwCF感染SARS-CoV-2的风险并不更高，其临床结果也不比普通人群更差。最近的研究表明，细胞和分子过程是导致pwCF感染率低于预期且症状比SARS-CoV-2感染病例更轻的重要驱动因素。这些过程包括细胞因子释放、生化改变，这些改变导致与囊性纤维化跨膜传导调节因子（CFTR）功能障碍相关的细胞内形态重排。根据现有数据，pwCF中报告的SARS-CoV-2感染低发生率可能是与CFTR功能障碍相关的几个变量的结果，如浓稠黏液、白细胞介素-6减少、血管紧张素转换酶2（ACE2）和跨膜丝氨酸蛋白酶2（TMPRSS2）加工和/或功能改变、阴离子交换缺陷以及自噬体形成。对SARS-CoV-2感染与pwCF之间的关系进行广泛分析，对于阐明这种低于预期的感染影响所涉及的机制以及可能提出潜在的新抗病毒策略至关重要。
