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揭示 COVID-19 的复杂性:自身免疫、多器官表现和自身抗体的作用。

Unveiling the intricacies of COVID-19: Autoimmunity, multi-organ manifestations and the role of autoantibodies.

机构信息

Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

出版信息

Scand J Immunol. 2024 Feb;99(2):e13344. doi: 10.1111/sji.13344. Epub 2023 Dec 10.

DOI:10.1111/sji.13344
PMID:39007954
Abstract

COVID-19 is a severe infectious disease caused by a SARS-CoV-2 infection. It has caused a global pandemic and can lead to acute respiratory distress syndrome (ARDS). Beyond the respiratory system, the disease manifests in multiple organs, producing a spectrum of clinical symptoms. A pivotal factor in the disease's progression is autoimmunity, which intensifies its severity and contributes to multi-organ injuries. The intricate interaction between the virus' spike protein and human proteins may engender the generation of autoreactive antibodies through molecular mimicry. This can further convolute the immune response, with the potential to escalate into overt autoimmunity. There is also emerging evidence to suggest that COVID-19 vaccinations might elicit analogous autoimmune responses. Advanced technologies have pinpointed self-reactive antibodies that target diverse organs or immune-modulatory proteins. The interplay between autoantibody levels and multi-organ manifestations underscores the importance of regular monitoring of serum antibodies and proinflammatory markers. A combination of immunosuppressive treatments and antiviral therapy is crucial for managing COVID-19-associated autoimmune diseases. The review will focus on the generation of autoantibodies in the context of COVID-19 and their impact on organ health.

摘要

新型冠状病毒肺炎(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染引起的一种严重传染病。它已造成全球大流行,并可能导致急性呼吸窘迫综合征(ARDS)。除呼吸系统外,该疾病还会在多个器官中表现出来,产生一系列临床症状。疾病进展的一个关键因素是自身免疫,它会加剧疾病的严重程度,并导致多器官损伤。病毒的刺突蛋白与人蛋白之间的复杂相互作用可能通过分子模拟产生自身反应性抗体。这会进一步使免疫反应复杂化,并有可能演变为明显的自身免疫。也有新的证据表明,COVID-19 疫苗接种可能会引起类似的自身免疫反应。先进的技术已经确定了针对多种器官或免疫调节蛋白的自身反应性抗体。自身抗体水平与多器官表现之间的相互作用强调了定期监测血清抗体和促炎标志物的重要性。免疫抑制治疗和抗病毒治疗的联合应用对于管理 COVID-19 相关自身免疫性疾病至关重要。本综述将重点关注 COVID-19 背景下自身抗体的产生及其对器官健康的影响。

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