Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Front Endocrinol (Lausanne). 2023 Aug 15;14:1139692. doi: 10.3389/fendo.2023.1139692. eCollection 2023.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is potentially pathogenic and causes severe symptoms; in addition to respiratory syndromes, patients might experience other severe conditions such as digestive complications and liver complications injury. The abnormality in the liver is manifested by hepatobiliary dysfunction and enzymatic elevation, which is associated with morbidity and mortality. The direct cytopathic effect, immune dysfunction, cytokine storm, and adverse effects of therapeutic regimens have a crucial role in the severity of liver injury. According to aging and immune system alterations, cytokine patterns may also change in the elderly. Moreover, hyperproduction of cytokines in the inflammatory response to SARS-CoV-2 can lead to multi-organ dysfunction. The mortality rate in elderly patients, particularly those with other comorbidities, is also higher than in adults. Although the pathogenic effect of SARS-CoV-2 on the liver has been widely studied, the impact of age and immune-mediated responses at different ages remain unclear. This review discusses the association between immune system responses in coronavirus disease 2019 (COVID-19) patients of different ages and liver injury, focusing on cytokine alterations.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）具有潜在的致病性，并导致严重症状；除了呼吸道综合征外，患者还可能出现其他严重情况，如消化并发症和肝损伤。肝脏的异常表现为肝胆功能障碍和酶升高，这与发病率和死亡率有关。直接细胞病变作用、免疫功能障碍、细胞因子风暴以及治疗方案的不良反应在肝损伤的严重程度中起着关键作用。根据年龄和免疫系统的改变，细胞因子模式也可能在老年人中发生变化。此外，SARS-CoV-2 炎症反应中细胞因子的过度产生可导致多器官功能障碍。老年患者，特别是有其他合并症的患者，死亡率也高于成年人。虽然 SARS-CoV-2 对肝脏的致病作用已被广泛研究，但不同年龄的免疫系统反应和免疫介导反应的影响尚不清楚。本综述讨论了不同年龄 COVID-19 患者的免疫系统反应与肝损伤之间的关系，重点讨论了细胞因子的改变。
