Basic Medical Sciences Department, Faculty of Medicine, Taibah University, Medina, Saudi Arabia.
Front Immunol. 2024 Aug 14;15:1433452. doi: 10.3389/fimmu.2024.1433452. eCollection 2024.
Mucosal immunity plays a crucial role in defending against coronaviruses, particularly at respiratory sites, serving as the first line of defense against viral invasion and replication. Coronaviruses have developed various immune evasion strategies at the mucosal immune system, hindering the recognition of infected cells and evading antibody responses. Understanding the immune mechanisms and responses is crucial for developing effective vaccines and therapeutics against coronaviruses. The role of mucosal immunity in COVID-19 is significant, influencing both local and systemic immune responses to the virus. Although most clinical studies focus on antibodies and cellular immunity in peripheral blood, mucosal immune responses in the respiratory tract play a key role in the early restriction of viral replication and the clearance of SARS-CoV-2. Identification of mucosal biomarkers associated with viral clearance will allow monitoring of infection-induced immunity. Mucosally delivered vaccines and those under clinical trials are being compared and contrasted to understand their effectiveness in inducing mucosal immunity against coronaviruses. A greater understanding of lung tissue-based immunity may lead to improved diagnostic and prognostic procedures and novel treatment strategies aimed at reducing the disease burden of community-acquired pneumonia, avoiding the systemic manifestations of infection and excess morbidity and mortality. This comprehensive review article outlines the current evidence about the role of mucosal immune responses in the clearance of SARS-CoV-2 infection, as well as potential mucosal mechanisms of protection against (re-)infection. It also proposes that there is a significant role for mucosal immunity and for secretory as well as circulating IgA antibodies in COVID-19, and that it is important to elucidate this in order to comprehend especially the asymptomatic and mild states of the infection, which appear to account for the majority of cases. Moreover, it is possible that mucosal immunity can be exploited for beneficial diagnostic, therapeutic, or prophylactic purposes. The findings from recent studies on mucosal immunity in COVID-19 can be used to develop effective vaccines and treatments that can effectively target both mucosal and systemic immune responses.
黏膜免疫在抵御冠状病毒方面起着至关重要的作用，特别是在呼吸道部位，作为抵御病毒入侵和复制的第一道防线。冠状病毒在黏膜免疫系统中发展了多种免疫逃避策略，阻碍了对感染细胞的识别并逃避了抗体反应。了解免疫机制和反应对于开发针对冠状病毒的有效疫苗和治疗方法至关重要。黏膜免疫在 COVID-19 中的作用是显著的，影响着对病毒的局部和全身免疫反应。尽管大多数临床研究集中在周围血液中的抗体和细胞免疫上，但呼吸道黏膜免疫反应在早期限制病毒复制和清除 SARS-CoV-2 方面发挥着关键作用。鉴定与病毒清除相关的黏膜生物标志物将允许监测感染诱导的免疫。正在比较和对比黏膜递送疫苗和正在临床试验中的疫苗，以了解它们在诱导针对冠状病毒的黏膜免疫方面的有效性。对肺组织免疫的更深入了解可能会导致改进诊断和预后程序以及新的治疗策略，旨在减轻社区获得性肺炎的疾病负担，避免感染的全身表现和过度发病率和死亡率。这篇综述文章概述了目前关于黏膜免疫反应在清除 SARS-CoV-2 感染中的作用的证据，以及针对（再）感染的潜在黏膜保护机制。它还提出黏膜免疫以及分泌型和循环型 IgA 抗体在 COVID-19 中起着重要作用，阐明这一点对于理解感染的无症状和轻度状态尤其重要，因为这些状态似乎占大多数病例。此外，黏膜免疫可能被用于有益的诊断、治疗或预防性目的。最近在 COVID-19 黏膜免疫方面的研究结果可用于开发有效的疫苗和治疗方法，这些方法可以有效地靶向黏膜和全身免疫反应。
