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从人类疱疹病毒 6 再激活到针对紧密连接和神经元抗原的自身免疫反应,再到因长新冠导致的炎症、抑郁和慢性疲劳综合征。

From human herpes virus-6 reactivation to autoimmune reactivity against tight junctions and neuronal antigens, to inflammation, depression, and chronic fatigue syndrome due to Long COVID.

机构信息

Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China.

出版信息

J Med Virol. 2024 Aug;96(8):e29864. doi: 10.1002/jmv.29864.


DOI:10.1002/jmv.29864
PMID:39158051
Abstract

Inflammation and autoimmune responses contribute to the pathophysiology of Long COVID, and its affective and chronic fatigue syndrome symptoms, labeled "the physio-affective phenome." To investigate whether Long COVID and its physio-affective phenome are linked to autoimmunity to the tight junction proteins, zonulin and occludin (ZOOC), and immune reactivity to lipopolysaccharides (LPS), and whether the latter are associated with signs of human herpes virus-6 (HHV-6) reactivation, autoimmunity directed against oligodendrocyte and neuronal proteins, including myelin basic protein. IgA/IgM/IgG responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), HHV-6, ZOOC, and neuronal proteins, C-reactive protein (CRP), and advanced oxidation protein products (AOPPs), were measured in 90 Long COVID patients and 90 healthy controls. The physio-affective phenome was conceptualized as a factor extracted from physical and affective symptom domains. Neural network identified IgA directed to LPS (IgA-LPS), IgG-ZOOC, IgG-LPS, and IgA-ZOOC as important variables associated with Long COVID diagnosis with an area under the ROC curve of 0.755. Partial Least Squares analysis showed that 40.9% of the variance in the physio-affective phenome was explained by CRP, IgA-myelin basic protein (MBP), and IgG-MBP. A large part of the variances in both autoimmune responses to MBP (36.3%-39.7%) was explained by autoimmunity (IgA and IgG) directed to ZOOC. The latter was strongly associated with indicants of HHV-6 reactivation, which in turn was associated with increased IgM-SARS-CoV-2. Autoimmunity against components of the tight junctions and increased bacterial translocation may be involved in the pathophysiology of Long COVID's physio-affective phenome.

摘要

炎症和自身免疫反应导致长新冠的病理生理学及其情感和慢性疲劳综合征症状,被标记为“生理情感表现”。为了研究长新冠及其生理情感表现是否与紧密连接蛋白(zonulin 和 occludin,简称 ZOOC)的自身免疫以及对脂多糖(lipopolysaccharides,简称 LPS)的免疫反应有关,以及后者是否与人类疱疹病毒-6(human herpes virus-6,简称 HHV-6)再激活的迹象有关,针对少突胶质细胞和神经元蛋白(包括髓鞘碱性蛋白)的自身免疫,我们检测了 90 名长新冠患者和 90 名健康对照者的 IgA/IgM/IgG 反应。生理情感表现被概念化为从身体和情感症状领域提取的一个因素。神经网络确定针对 LPS 的 IgA(IgA-LPS)、IgG-ZOOC、IgG-LPS 和 IgA-ZOOC 是与长新冠诊断相关的重要变量,ROC 曲线下面积为 0.755。偏最小二乘分析表明,生理情感表现的 40.9%的方差由 CRP、IgA-髓鞘碱性蛋白(myelin basic protein,简称 MBP)和 IgG-MBP 解释。针对 MBP 的自身免疫反应的大部分方差(36.3%-39.7%)由针对 ZOOC 的自身免疫(IgA 和 IgG)解释。后者与 HHV-6 再激活的指标密切相关,而后者又与 IgM-严重急性呼吸综合征冠状病毒 2(severe acute respiratory syndrome coronavirus 2,简称 SARS-CoV-2)的增加有关。针对紧密连接成分的自身免疫和细菌易位的增加可能与长新冠生理情感表现的病理生理学有关。

相似文献

[1]
From human herpes virus-6 reactivation to autoimmune reactivity against tight junctions and neuronal antigens, to inflammation, depression, and chronic fatigue syndrome due to Long COVID.

J Med Virol. 2024-8

[2]
Reactivation of herpesvirus type 6 and IgA/IgM-mediated responses to activin-A underpin long COVID, including affective symptoms and chronic fatigue syndrome.

Acta Neuropsychiatr. 2024-6

[3]
Chronic Fatigue, Depression and Anxiety Symptoms in Long COVID Are Strongly Predicted by Neuroimmune and Neuro-Oxidative Pathways Which Are Caused by the Inflammation during Acute Infection.

J Clin Med. 2023-1-8

[4]
Persistent SARS-CoV-2 Infection, EBV, HHV-6 and Other Factors May Contribute to Inflammation and Autoimmunity in Long COVID.

Viruses. 2023-1-31

[5]
In myalgic encephalomyelitis/chronic fatigue syndrome, increased autoimmune activity against 5-HT is associated with immuno-inflammatory pathways and bacterial translocation.

J Affect Disord. 2013-5-10

[6]
Closing the serological gap in the diagnostic testing for COVID-19: The value of anti-SARS-CoV-2 IgA antibodies.

J Med Virol. 2021-3

[7]
Lowered Quality of Life in Long COVID Is Predicted by Affective Symptoms, Chronic Fatigue Syndrome, Inflammation and Neuroimmunotoxic Pathways.

Int J Environ Res Public Health. 2022-8-19

[8]
SARS-CoV-2 antibodies: IgA correlates with severity of disease in early COVID-19 infection.

J Med Virol. 2021-9

[9]
Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affective symptoms due to Long COVID: A precision nomothetic approach.

Acta Neuropsychiatr. 2023-4

[10]
Analytical and clinical validation of an ELISA for specific SARS-CoV-2 IgG, IgA, and IgM antibodies.

J Med Virol. 2021-2

引用本文的文献

[1]
Neuroimmune, metabolic and oxidative stress pathways in major depressive disorder.

Nat Rev Neurol. 2025-7-14

[2]
Core features and inherent diversity of post-acute infection syndromes.

Front Immunol. 2025-6-3

[3]
A short story of long COVID.

Wien Klin Wochenschr. 2024-11

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