COVID-19: The Emerging Immunopathological Determinants for Recovery or Death.
COVID-19: The Emerging Immunopathological Determinants for Recovery or Death.
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DOI：
10.3389/fmicb.2020.588409
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发表时间：
2020
影响因子：
5.2
通讯作者：
Ali SM
中科院分区：
文献类型：
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作者：
Ahmad T;Chaudhuri R;Joshi MC;Almatroudi A;Rahmani AH;Ali SM
SARS-CoV-2感染期间宿主免疫系统的过度激活是COVID-19患者死亡的主要原因。同样明显的是，出现轻度/中度症状并成功恢复的患者显示出功能性和调节良好的免疫应答。而延迟的初始干扰素反应与严重的疾病结局相关，并且可能是免疫病理学恶化的临界点，通常在COVID-19患者死亡之前。此外，COVID-19期间的适应性免疫反应是异质的，并且知之甚少。与此同时，一些研究提示重症和危重症患者存在活化的T和B细胞应答，并存在SARS-CoV 2特异性抗体。因此，理解这个问题和宿主免疫功能/功能障碍中涉及的潜在分子途径对于设计有效的治疗干预是必要的。在这篇综述中，我们讨论了新出现的免疫病理学决定因素和宿主细胞免疫系统逃避病毒的机制。利用从以前的呼吸道病毒和新出现的临床和分子研究结果SARS-CoV-2的知识，我们试图提供一个整体的理解宿主的先天性和适应性免疫反应，可能会决定疾病的结果。考虑到适应性免疫系统在病毒清除过程中的关键作用，我们提出了在COVID-19不同阶段T细胞功能/功能障碍受损的合理机制的分子见解。
Hyperactivation of the host immune system during infection by SARS-CoV-2 is the leading cause of death in COVID-19 patients. It is also evident that patients who develop mild/moderate symptoms and successfully recover display functional and well-regulated immune response. Whereas a delayed initial interferon response is associated with severe disease outcome and can be the tipping point towards immunopathological deterioration, often preceding death in COVID-19 patients. Further, adaptive immune response during COVID-19 is heterogeneous and poorly understood. At the same time, some studies suggest activated T and B cell response in severe and critically ill patients and the presence of SARS-CoV2-specific antibodies. Thus, understanding this problem and the underlying molecular pathways implicated in host immune function/dysfunction is imperative to devise effective therapeutic interventions. In this comprehensive review, we discuss the emerging immunopathological determinants and the mechanism of virus evasion by the host cell immune system. Using the knowledge gained from previous respiratory viruses and the emerging clinical and molecular findings on SARS-CoV-2, we have tried to provide a holistic understanding of the host innate and adaptive immune response that may determine disease outcome. Considering the critical role of the adaptive immune system during the viral clearance, we have presented the molecular insights of the plausible mechanisms involved in impaired T cell function/dysfunction during various stages of COVID-19.
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DOI：
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发表时间：
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期刊：
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影响因子：
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影响因子：
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DOI：
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