COVID-19患者的免疫反应:对细胞因子风暴和适应性免疫动力学的见解。

Immune responses in COVID-19 patients: Insights into cytokine storms and adaptive immunity kinetics.

作者信息

Zhang Junguo

机构信息

Pulmonology Department, Fengdu General Hospital, Chongqing, 408200, China.

出版信息

Heliyon. 2024 Jul 14;10(14):e34577. doi: 10.1016/j.heliyon.2024.e34577. eCollection 2024 Jul 30.

Abstract

SARS-CoV-2 infection can trigger cytokine storm in some patients, which characterized by an excessive production of cytokines and chemical mediators. This hyperactive immune response may cause significant tissue damage and multiple organ failure (MOF). The severity of COVID-19 correlates with the intensity of cytokine storm, involving elements such as IFN, NF-κB, IL-6, HMGB1, etc. It is imperative to rapidly engage adaptive immunity to effectively control the disease progression. CD4 T cells facilitate an immune response by improving B cells in the production of neutralizing antibodies and activating CD8 T cells, which are instrumental in eradicating virus-infected cells. Meanwhile, antibodies from B cells can neutralize virus, obstructing further infection of host cells. In individuals who have recovered from the disease, virus-specific antibodies and memory T cells were observed, which could confer a level of protection, reducing the likelihood of re-infection or attenuating severity. This paper discussed the roles of macrophages, IFN, IL-6 and HMGB1 in cytokine release syndrome (CRS), the intricacies of adaptive immunity, and the persistence of immune memory, all of which are critical for the prevention and therapeutic strategies against COVID-19.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染可在一些患者中引发细胞因子风暴,其特征是细胞因子和化学介质过度产生。这种过度活跃的免疫反应可能导致显著的组织损伤和多器官功能衰竭(MOF)。2019冠状病毒病(COVID-19)的严重程度与细胞因子风暴的强度相关,涉及干扰素(IFN)、核因子κB(NF-κB)、白细胞介素-6(IL-6)、高迁移率族蛋白B1(HMGB1)等因素。迅速启动适应性免疫以有效控制疾病进展势在必行。CD4 T细胞通过改善B细胞产生中和抗体以及激活CD8 T细胞来促进免疫反应,而CD8 T细胞在根除病毒感染细胞中起重要作用。同时,B细胞产生的抗体可中和病毒,阻止宿主细胞进一步感染。在从该疾病中康复的个体中,观察到了病毒特异性抗体和记忆T细胞,它们可提供一定程度的保护,降低再次感染的可能性或减轻疾病严重程度。本文讨论了巨噬细胞、IFN、IL-6和HMGB1在细胞因子释放综合征(CRS)中的作用、适应性免疫的复杂性以及免疫记忆的持久性,所有这些对于COVID-19的预防和治疗策略都至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c04/11325674/6090ef07249e/gr1.jpg

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