Asymptomatic COVID-19 Individuals Tend to Establish Relatively Balanced Innate and Adaptive Immune Responses.
Asymptomatic COVID-19 Individuals Tend to Establish Relatively Balanced Innate and Adaptive Immune Responses.
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DOI：
10.3390/pathogens10091105
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发表时间：
2021-08-30
期刊：
影响因子：
--
通讯作者：
Wei L
中科院分区：
文献类型：
--
作者：
Li M;Zhang Y;Lu J;Li L;Gao H;Ma C;Dai E;Wei L
无症状病例比例的急剧增加和病毒传播的潜在风险大大增加了COVID-19大流行的控制难度。个体免疫应答与COVID-19的临床结局和致病机制密切相关。然而，无症状个体的临床特征和免疫细胞的免疫表型特征仍然有些神秘。为了更好地了解和预测疾病的状态和进展，我们对41例SARS-CoV-2患者（其中24例无症状病例和17例有症状个体）的临床资料、实验室指标和免疫表型特征进行了综合分析。一是从人口学特征来看，年龄越小的人群，无症状感染者的比例明显越高。实验室检查结果显示，无症状组的CRP（急性时相反应蛋白）、D-二聚体和纤维蛋白原（凝血标志物）等指标均较低。最后，有症状的个体倾向于通过异常降低淋巴细胞计数和百分比、异常增加Th 17百分比和降低Treg百分比来建立非保护性免疫表型，这因此导致中性粒细胞/淋巴细胞比率（NLR）、单核细胞/淋巴细胞比率（MLR）和Th 17/Treg比率增加。另一方面，无症状个体倾向于通过维持正常水平的淋巴细胞计数和百分比以及高水平的NK细胞来建立更有效和保护性的免疫表型。同时，无症状个体可以通过维持较低水平的单核细胞、较低水平的Th 17和较高水平的Treg来建立相对平衡的免疫应答，从而导致MNKR和Th 17/Treg比值降低，最终避免过度的炎症反应。这可能是他们无症状状态的原因之一。该研究有助于揭示无症状个体的免疫学特征，了解COVID-19的免疫发病机制，更准确地预测临床结局。然而，由于样本量较小，未来仍需要进行更大样本量的研究。
The sharp increase in the proportion of asymptomatic cases and the potential risk of virus transmission have greatly increased the difficulty of controlling the COVID-19 pandemic. The individual immune response is closely associated with clinical outcomes and pathogenic mechanisms of COVID-19. However, the clinical characteristics and immunophenotyping features of immune cells of asymptomatic individuals remain somewhat mysterious. To better understand and predict the disease state and progress, we performed a comprehensive analysis of clinical data, laboratory indexes and immunophenotyping features in 41 patients with SARS-CoV-2 (including 24 asymptomatic cases and 17 symptomatic individuals). Firstly, from the perspective of demographic characteristics, the rate of asymptomatic infection was significantly higher in those with younger age. Secondly, the laboratory test results showed that some indexes, such as CRP (acute phase reaction protein), D-Dimer and fibrinogen (the marker for coagulation) were lower in the asymptomatic group. Finally, symptomatic individuals were prone to establishing a non-protective immune phenotype by abnormally decreasing the lymphocyte count and percentage, abnormally increasing the Th17 percentage and decreasing Treg percentage, which therefore cause an increase in the neutrophil/lymphocyte ratio (NLR), monocytes/lymphocytes ratio (MLR) and Th17/Treg ratio. On the other hand, asymptomatic individuals tended to establish a more effective and protective immune phenotype by maintaining a normal level of lymphocyte count and percentage and a high level of NK cells. At the same time, asymptomatic individuals can establish a relatively balanced immune response through maintaining a low level of monocytes, a relatively low level of Th17 and high level of Treg, which therefore lead to a decrease in MNKR and Th17/Treg ratio and finally the avoidance of excessive inflammatory responses. This may be one of the reasons for their asymptomatic states. This study is helpful to reveal the immunological characteristics of asymptomatic individuals, understand immune pathogenesis of COVID-19 and predict clinical outcomes more precisely. However, owing to small sample sizes, a future study with larger sample size is still warranted.
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影响因子：
158.5
作者：
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通讯作者：
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影响因子：
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168.9
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影响因子：
4.8
作者：
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