有证据表明,适应性或获得性免疫系统是区分2019年冠状病毒病(COVID-19)病程的关键变量之一,由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起。这项工作旨在分析与该疾病进展有关的适应性免疫的免疫病理学方面。
这是一个系统的综述,基于包括体外试验的实验证据的文章,队列研究,reviews,来自PubMed的横断面和病例对照研究,SciELO,MEDLINE,还有英文的丁香花数据库,葡萄牙语,或2020年1月至2022年7月之间的西班牙语。
本综述定稿了56篇文章。与B细胞和CD8T淋巴细胞相比,CD4T细胞在健康疾病过程中最具决定性。重症患者T辅助淋巴细胞(Th)的主要亚群为Th1、Th2、Th17(无主要特征)和调节性T细胞(Treg),而在轻度病例中,Th1,Th2,Th17和滤泡T辅助细胞(Tfh)的流入。这些细胞负责细胞因子的分泌,白细胞介素(IL)-6、IL-4、IL-10、IL-7、IL-22、IL-21、IL-15、IL-1α、IL-23,IL-5,IL-13,IL-2,IL-17,肿瘤坏死因子α(TNF-α),CXC激发配体(CXCL)8,CXCL9和肿瘤生长因子β(TGF-β),与上述前8种炎症介质相关的临床益处,而其他人则预后不良。一些CD8+T淋巴细胞标志物与疾病的严重程度有关,例如人类白细胞抗原(HLA-DR)和程序性细胞死亡蛋白1(PD-1)。在SARS-CoV-2产生的抗体中,免疫球蛋白(Ig)A因其与更严重的临床形式相关的有效释放而脱颖而出。
结论是,通过这项研究,可以对SARS-CoV-2感染期间特定细胞类型的主要免疫生物标志物及其功能进行简要概述。在重症患者中,适应性免疫是多种多样的,异常妥协,而且迟到了.特别是,T细胞应答也是免疫记忆中的一个重要和必要的组成部分,因此应在疫苗制剂策略中加以解决.
There is evidence that the adaptive or acquired immune system is one of the crucial variables in differentiating the course of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This work aimed to analyze the immunopathological aspects of adaptive immunity that are involved in the progression of this disease.
This is a systematic
review based on articles that included experimental evidence from in vitro assays, cohort studies, reviews, cross-sectional and case-control studies from PubMed, SciELO, MEDLINE, and Lilacs databases in English, Portuguese, or Spanish between January 2020 and July 2022.
Fifty-six articles were finalized for this
review. CD4+ T cells were the most resolutive in the health-disease process compared with B cells and CD8+ T lymphocytes. The predominant subpopulations of T helper lymphocytes (Th) in critically ill patients are Th1, Th2, Th17 (without their main characteristics) and regulatory T cells (Treg), while in mild cases there is an influx of Th1, Th2, Th17 and follicular T helper cells (Tfh). These cells are responsible for the secretion of cytokines, including interleukin (IL) - 6, IL-4, IL-10, IL-7, IL-22, IL-21, IL-15, IL-1α, IL-23, IL-5, IL-13, IL-2, IL-17, tumor necrosis factor alpha (TNF-α), CXC motivating ligand (CXCL) 8, CXCL9 and tumor growth factor beta (TGF-β), with the abovementioned first 8 inflammatory mediators related to clinical benefits, while the others to a poor prognosis. Some CD8+ T lymphocyte markers are associated with the severity of the disease, such as human leukocyte antigen (HLA-DR) and programmed cell death protein 1 (PD-1). Among the antibodies produced by SARS-CoV-2, Immunoglobulin (Ig) A stood out due to its potent release associated with a more severe clinical form.
It is concluded that through this study it is possible to have a brief overview of the main immunological biomarkers and their function during SARS-CoV-2 infection in particular cell types. In critically ill individuals, adaptive immunity is varied, aberrantly compromised, and late. In particular, the T-cell response is also an essential and necessary component in immunological memory and therefore should be addressed in vaccine formulation strategies.