Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Genomics and Microarray Core Facility, University of Texas Southwestern Medical Center, Dallas, TX.
Immunohorizons. 2024 Aug 1;8(8):577-585. doi: 10.4049/immunohorizons.2400033.
Patients with long COVID can develop humoral autoimmunity after severe acute SARS-CoV-2 infection. However, whether similar increases in autoantibody responses occur after mild infection and whether vaccination prior to SARS-CoV-2 breakthrough infection can limit autoantibody responses is unknown. In this study, we demonstrate that mild SARS-CoV-2 infection increases autoantibodies associated with rheumatic autoimmune diseases and diabetes in most individuals, regardless of vaccination status prior to infection. However, patients with long COVID and persistent neurologic and fatigue symptoms (neuro-PASC) have substantially higher autoantibody responses than convalescent control subjects at an average of 8 mo postinfection. Furthermore, high titers of systemic lupus erythematosus- and CNS-associated autoantibodies in patients with neuro-PASC are associated with impaired cognitive performance and greater symptom severity. In summary, we found that mild SARS-CoV-2 primary and breakthrough infections can induce persistent humoral autoimmunity in both patients with neuro-PASC and healthy COVID convalescents, suggesting that a reappraisal of mitigation strategies against SARS-CoV-2 is warranted to prevent transmission and potential development of autoimmunity.
患有长新冠的患者在严重急性 SARS-CoV-2 感染后可能会产生体液自身免疫。然而，轻度感染后是否会出现类似的自身抗体反应，以及在 SARS-CoV-2 突破感染前接种疫苗是否可以限制自身抗体反应，目前尚不清楚。在这项研究中，我们证明，轻度 SARS-CoV-2 感染会增加与风湿性自身免疫性疾病和糖尿病相关的自身抗体，大多数感染者无论感染前的疫苗接种状态如何都是如此。然而，患有长新冠和持续神经和疲劳症状（神经-PASC）的患者在感染后平均 8 个月时的自身抗体反应明显高于恢复期对照患者。此外，神经-PASC 患者体内高滴度的系统性红斑狼疮和中枢神经系统相关自身抗体与认知功能受损和症状严重程度增加有关。总之，我们发现轻度 SARS-CoV-2 原发和突破感染可在患有神经-PASC 的患者和健康 COVID 康复者中引起持续的体液自身免疫，这表明有必要重新评估针对 SARS-CoV-2 的缓解策略，以预防传播和潜在的自身免疫发展。
