COVID-19 disease and autoimmune disorders: A mutual pathway.
COVID-19 disease and autoimmune disorders: A mutual pathway.
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DOI：
10.5662/wjm.v12.i4.200
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发表时间：
2022-07-20
期刊：
影响因子：
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通讯作者：
Bediwy, Adel Salah
中科院分区：
文献类型：
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作者：
Al-Beltagi, Mohammed;Saeed, Nermin Kamal;Bediwy, Adel Salah
2019冠状病毒病（COVID-19）是人类面临的真实的挑战，发病率和死亡率都很高。尽管COVID-19主要是一种呼吸道疾病，但它几乎可以影响人体的每一个组织，导致许多疾病。病毒感染后，免疫系统可以识别由免疫细胞呈递的病毒抗原。这种免疫反应通常是控制和终止一旦感染中止。然而，在一些患者中，随着自身免疫性疾病的发展，免疫反应变得失控。几种人类组织抗原与针对许多严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）蛋白（如SARS-CoV-2 S、N和自身免疫靶蛋白）的抗体显示出强烈的反应。SARS-CoV-2的免疫原性效应是由于相当大的病毒RNA分子具有中断的转录，增加了表位库，增加了分子模拟和与宿主免疫系统相互作用的机会，一些病毒和人肽之间的重叠，病毒诱导的组织损伤，以及sACE-2和SARS-CoV-2 S蛋白之间强大而复杂的结合。因此，COVID-19及其疫苗可能会在易感患者中引发许多自身免疫性疾病的发展。本文就COVID-19与自身免疫性疾病的相互关系、相互影响、COVID-19疫苗在引发自身免疫性疾病中的作用、影响自身免疫性疾病患者COVID-19严重程度的因素以及降低自身免疫性疾病患者COVID-19风险的不同方法进行了综述。
Coronavirus disease 2019 (COVID-19) is a real challenge for humanity with high morbidity and mortality. Despite being primarily a respiratory illness, COVID-19 can affect nearly every human body tissue, causing many diseases. After viral infection, the immune system can recognize the viral antigens presented by the immune cells. This immune response is usually controlled and terminated once the infection is aborted. Nevertheless, in some patients, the immune reaction becomes out of control with the development of autoimmune diseases. Several human tissue antigens showed a strong response with antibodies directed against many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proteins, such as SARS-CoV-2 S, N, and autoimmune target proteins. The immunogenic effects of SARS-CoV-2 are due to the sizeable viral RNA molecules with interrupted transcription increasing the pool of epitopes with increased chances of molecular mimicry and interaction with the host immune system, the overlap between some viral and human peptides, the viral induced-tissue damage, and the robust and complex binding between sACE-2 and SARS-CoV-2 S protein. Consequently, COVID-19 and its vaccine may trigger the development of many autoimmune diseases in a predisposed patient. This review discusses the mutual relation between COVID-19 and autoimmune diseases, their interactive effects on each other, the role of the COVID-19 vaccine in triggering autoimmune diseases, the factors affecting the severity of COVID-19 in patients suffering from autoimmune diseases, and the different ways to minimize the risk of COVID-19 in patients with autoimmune diseases.