CoViD-19 Immunopathology & Immunotherapy
CoViD-19 Immunopathology & Immunotherapy
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DOI：
10.6026/97320630016219
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发表时间：
2020-03-01
期刊：
影响因子：
1.9
通讯作者：
Greenberg, Gillian
中科院分区：
文献类型：
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作者：
Chiappelli, Francesco;Khakshooy, Allen;Greenberg, Gillian
Diao等人在MedRxiv上报道了2019冠状病毒病（CoViD-19）患者t细胞免疫病理的新证据（doi: 10.1101/2020.02.18.20024364）[1]。报告了522名确诊CoViD-19患者的观察结果，而对照组为40名。总之，流式细胞术记录了CD4+和CD8+人群中明显的T细胞减少，这与血清中促炎细胞因子IL-6、IL-10和TNF-a水平的显著升高呈显著负相关。流式细胞术发现，随着14例患者从前体症状恶化为需要重症监护的症状性CoViD-19，程序性细胞死亡标志物-1 （PD-1）和T细胞免疫球蛋白和粘蛋白结构域3 （Tim-3）的表达逐渐增加。在这里，我们从我们目前对持续病毒感染形式的免疫挑战（如CoViD-19）后T细胞免疫生理学和免疫病理学的理解来解释Diao等人的这些观察结果，重点是耗尽的T细胞（Tex）。最近拯救特克斯的临床试验显示出有希望的结果。讨论了这些干预措施与预防和治疗CoViD-19的相关性。综上所述，Diao等人的数据可以为CoViD-19患者的免疫病理和可能的免疫治疗提供初步线索。
New evidence on the T-cell immuno-pathology in patient's with Corona Virus Disease 2019 (CoViD-19) was reported by Diao et al. in MedRxiv (doi: 10.1101/2020.02.18.20024364) [1]. It reports observations on 522 patients with confirmed CoViD-19 symptomatology, compared to 40 control subjects. In brief, notable T cytopoenia was recorded by flow cytometry in the CD4+ and the CD8+ populations, which were significantly yet inversely correlated with remarkably increased serum levels of the pro-inflammatory cytokines IL-6, IL-10 and TNF-a. Flow cytometry established a progressive increase in the expression of programmed cell death marker-1 (PD-1) and T cell immunoglobulin & mucin domain 3 (Tim-3) as patients (n=14) deteriorated from prodromal to symptomatic CoViD-19 requiring intensive care. Here, we interpret these observations of Diao et al from our current understanding of T cell immunophysiology and immunopathology following an immune challenge in the form of sustained viral infection, as is the case in CoViD-19, with emphasis on exhausted T cells (Tex). Recent clinical trials to rescue Tex show promising outcomes. The relevance of these interventions for the prevention and treatment of CoViD-19 is discussed. Taken together, the data of Diao et al could proffer the first glimpse of immunopathology and possible immunotherapy for patients with CoViD-19.