Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy.
Int J Mol Sci. 2021 Jun 29;22(13):7017. doi: 10.3390/ijms22137017.
The vulnerability of humankind to SARS-CoV-2 in the absence of a pre-existing immunity, the unpredictability of the infection outcome, and the high transmissibility, broad tissue tropism, and ability to exploit and subvert the immune response pose a major challenge and are likely perpetuating the COVID-19 pandemic. Nevertheless, this peculiar infectious scenario provides researchers with a unique opportunity for studying, with the latest immunological techniques and understandings, the immune response in SARS-CoV-2 naïve versus recovered subjects as well as in SARS-CoV-2 vaccinees. Interestingly, the current understanding of COVID-19 indicates that the combined action of innate immune cells, cytokines, and chemokines fine-tunes the outcome of SARS-CoV-2 infection and the related immunopathogenesis. Indeed, the emerging picture clearly shows that the excessive inflammatory response against this virus is among the main causes of disease severity in COVID-19 patients. In this review, the innate immune response to SARS-CoV-2 infection is described not only in light of its capacity to influence the adaptive immune response towards a protective phenotype but also with the intent to point out the multiple strategies exploited by SARS-CoV-2 to antagonize host antiviral response and, finally, to outline inborn errors predisposing individuals to COVID-19 disease severity.
在人类缺乏预先存在的免疫的情况下,人类对 SARS-CoV-2 的易感性、感染结果的不可预测性以及高传染性、广泛的组织嗜性和利用及颠覆免疫反应的能力,构成了重大挑战,并可能使 COVID-19 大流行持续存在。然而,这种特殊的感染情况为研究人员提供了一个独特的机会,他们可以利用最新的免疫学技术和理解,研究 SARS-CoV-2 初治和恢复期患者以及 SARS-CoV-2 疫苗接种者的免疫反应。有趣的是,目前对 COVID-19 的理解表明,先天免疫细胞、细胞因子和趋化因子的共同作用,精细地调节了 SARS-CoV-2 感染的结果和相关的免疫发病机制。事实上,新出现的情况清楚地表明,针对这种病毒的过度炎症反应是 COVID-19 患者疾病严重程度的主要原因之一。在这篇综述中,不仅描述了 SARS-CoV-2 感染的先天免疫反应,说明了其影响适应性免疫反应向保护性表型的能力,还指出了 SARS-CoV-2 拮抗宿主抗病毒反应的多种策略,并最终概述了导致个体易患 COVID-19 疾病严重程度的先天错误。