ABSTRACT
RESUMEN Las células T helper-17 (Th17) y la interleuquina (IL) IL-17 desempeñan funciones biológicas relacionadas con la protección contra infecciones por bacterias extracelulares y hongos. En algunas enfermedades inflamatorias y autoinmunes hay una secreción persistente y estas participan en su patogénesis. Recientemente, se ha postulado la participación de las respuestas IL-17/Th17 en la patogénesis de la enfermedad por coronavirus 2019 (COVID-19). El objetivo de esta revisión es resumir la evidencia del papel de la IL-17/Th17 en la inmunopatogénesis del COVID-19, como sustento de la possible utilización de los inhibidores de IL-17 en el manejo terapéutico de esta infección.
SUMMARY Interleukin 17 (IL-17)-producing helper T cells (Th17) and IL-17 play an important role in the defense against extracellular bacteria and fungi; however, persistent secretion of IL-17 is also an important component in the pathogenesis of many inflammatory and autoimmune diseases. Recent evidence suggests that Th17 cells and IL-17 are also involved in the immunopathogenesis of COVID-19. This review summarizes the evidence related with the role of Th17/IL-17 in severe COVID-19, which support the possible use of IL-17/IL-17R inhibitors in the treatment of this infection.
ABSTRACT
Background: The ongoing corona virus disease 2019 (COVID-19) pandemic is having a worldwide impact. Valuable information on the clinical characteristics of COVID-19 in pregnant patients with an autoimmune disease, such as systemic lupus erythematosus (SLE), is currently lacking. Methods: Herein, we describe the clinical presentation of 2 pregnant patients with SLE and mild symptomatic COVID-19 infection. Results: In both pregnant SLE patients, a watchful-waiting approach without initiation of treatment for COVID-19 was taken. No adverse outcomes were reported and both pregnancies resulted in healthy neonates born at term. In one patient we observed a flare in SLE disease activity, most likely attributed to discontinuing SLE treatment. Conclusion: Our report highlights the importance of multidisciplinary collaboration between health care professionals as well as individualized treatment decisions during unprecedented periods such as the current COVID-19 pandemic. Discontinuation of immunosuppressive drugs during the acute phase of a COVID-19 infection should be considered on a case-by-case basis. Maternal treatment decisions should be in line with current recommendations for treatment of rheumatic and musculoskeletal diseases during COVID-19 infection and in line with treatment of COVID- 19 during pregnancy.
Subject(s)
COVID-19/diagnosis , COVID-19/therapy , Lupus Erythematosus, Systemic/complications , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , Adult , COVID-19/complications , Female , Humans , Lupus Erythematosus, Systemic/therapy , Pregnancy , Pregnancy Complications, Infectious/virologyABSTRACT
The current COVID-19 pandemic began in December 2019 in Wuhan (China) and rapidly extended to become a global sanitary and economic emergency. Its etiological agent is the coronavirus SARS-CoV-2. COVID-19 presents a wide spectrum of clinical manifestations, which ranges from an asymptomatic infection to a severe pneumonia accompanied by multisystemic failure that can lead to a patient's death. The immune response to SARS-CoV-2 is known to involve all the components of the immune system that together appear responsible for viral elimination and recovery from the infection. Nonetheless, such immune responses are implicated in the disease's progression to a more severe and lethal process. This review describes the general aspects of both COVID-19 and its etiological agent SARS-CoV-2, stressing the similarities with other severe coronavirus infections, such as SARS and MERS, but more importantly, pointing toward the evidence supporting the hypothesis that the clinical spectrum of COVID-19 is a consequence of the corresponding variable spectrum of the immune responses to the virus. The critical point where progression of the disease ensues appears to center on loss of the immune regulation between protective and altered responses due to exacerbation of the inflammatory components. Finally, it appears possible to delineate certain major challenges deserving of exhaustive investigation to further understand COVID-19 immunopathogenesis, thus helping to design more effective diagnostic, therapeutic, and prophylactic strategies.
Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Age Factors , Antibodies, Viral/immunology , Antibody-Dependent Enhancement/immunology , Betacoronavirus/classification , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/diagnosis , Cytokines/blood , Humans , Immunoglobulin A, Secretory/immunology , Inflammation/pathology , Macrophages/immunology , Pandemics , Pneumonia, Viral/diagnosis , SARS-CoV-2 , T-Lymphocytes/immunologyABSTRACT
Las células T helper-17 (Th17) y la interleuquina (IL) IL-17 desempeñan funciones biológicas relacionadas con la protección contra infecciones por bacterias extracelulares y hongos. En algunas enfermedades inflamatorias y autoinmunes hay una secreción persistente y estas participan en su patogénesis. Recientemente, se ha postulado la participación de las respuestas IL-17/Th17 en la patogénesis de la enfermedad por coronavirus 2019 (COVID-19). El objetivo de esta revisión es resumir la evidencia del papel de la IL-17/Th17 en la inmunopatogénesis del COVID-19, como sustento de la posible utilización de los inhibidores de IL-17 en el manejo terapéutico de esta infección.Alternate : Interleukin 17 (IL-17)-producing helper T cells (Th17) and IL-17 play an important role in the defense against extracellular bacteria and fungi;however, persistent secretion of IL-17 is also an important component in the pathogenesis of many inflammatory and autoimmune diseases. Recent evidence suggests that Th17 cells and IL-17 are also involved in the immunopathogenesis of COVID-19. his review summarizes the evidence related with the role of Th17/IL-17 in severe COVID-19, which support the possible use of IL-17/IL-17R inhibitors in the treatment of this infection.