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1.
Trends Immunol ; 43(2): 117-131, 2022 02.
Article in English | MEDLINE | ID: covidwho-1654629

ABSTRACT

The mammalian immune system packs serious punch against infection but can also cause harm: for example, coronavirus disease 2019 (COVID-19) made headline news of the simultaneous power and peril of human immune responses. In principle, natural selection leads to exquisite adaptation and therefore cytokine responsiveness that optimally balances the benefits of defense against its costs (e.g., immunopathology suffered and resources expended). Here, we illustrate how evolutionary biology can predict such optima and also help to explain when/why individuals exhibit apparently maladaptive immunopathological responses. Ultimately, we argue that the evolutionary legacies of multicellularity and life-history strategy, in addition to our coevolution with symbionts and our demographic history, together explain human susceptibility to overzealous, pathology-inducing cytokine responses. Evolutionary insight thereby complements molecular/cellular mechanistic insights into immunopathology.


Subject(s)
COVID-19 , Adaptation, Physiological , Animals , Biological Evolution , Cytokines/genetics , Humans , Immune System , SARS-CoV-2
2.
Science ; 373(6562): eabj7364, 2021 Sep 24.
Article in English | MEDLINE | ID: covidwho-1361961

ABSTRACT

Vaccines provide powerful tools to mitigate the enormous public health and economic costs that the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic continues to exert globally, yet vaccine distribution remains unequal among countries. To examine the potential epidemiological and evolutionary impacts of "vaccine nationalism," we extend previous models to include simple scenarios of stockpiling between two regions. In general, when vaccines are widely available and the immunity they confer is robust, sharing doses minimizes total cases across regions. A number of subtleties arise when the populations and transmission rates in each region differ, depending on evolutionary assumptions and vaccine availability. When the waning of natural immunity contributes most to evolutionary potential, sustained transmission in low-access regions results in an increased potential for antigenic evolution, which may result in the emergence of novel variants that affect epidemiological characteristics globally. Overall, our results stress the importance of rapid, equitable vaccine distribution for global control of the pandemic.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/prevention & control , Global Health , COVID-19/epidemiology , COVID-19/immunology , COVID-19/transmission , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Emigration and Immigration , Evolution, Molecular , Humans , Immune Evasion , Models, Theoretical , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Strategic Stockpile , Vaccination Coverage
4.
Science ; 372(6540): 363-370, 2021 04 23.
Article in English | MEDLINE | ID: covidwho-1125155

ABSTRACT

Given vaccine dose shortages and logistical challenges, various deployment strategies are being proposed to increase population immunity levels to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Two critical issues arise: How timing of delivery of the second dose will affect infection dynamics and how it will affect prospects for the evolution of viral immune escape via a buildup of partially immune individuals. Both hinge on the robustness of the immune response elicited by a single dose as compared with natural and two-dose immunity. Building on an existing immuno-epidemiological model, we find that in the short term, focusing on one dose generally decreases infections, but that longer-term outcomes depend on this relative immune robustness. We then explore three scenarios of selection and find that a one-dose policy may increase the potential for antigenic evolution under certain conditions of partial population immunity. We highlight the critical need to test viral loads and quantify immune responses after one vaccine dose and to ramp up vaccination efforts globally.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Evolution, Molecular , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Adaptation, Physiological , Adaptive Immunity , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Disease Susceptibility , Humans , Immune Evasion , Immunization Schedule , Immunogenicity, Vaccine , Models, Theoretical , Mutation , Selection, Genetic , Vaccination
5.
PLoS Pathog ; 16(12): e1009105, 2020 12.
Article in English | MEDLINE | ID: covidwho-972196

ABSTRACT

Health outcomes following infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are remarkably variable. The way the virus spreads inside hosts, and how this spread interacts with host immunity and physiology, is likely to determine variation in health outcomes. Decades of data and dynamical analyses of how other viruses spread and interact with host cells could shed light on SARS-CoV-2 within-host trajectories. We review how common axes of variation in within-host dynamics and emergent pathology (such as age and sex) might be combined with ecological principles to understand the case of SARS-CoV-2. We highlight pitfalls in application of existing theoretical frameworks relevant to the complexity of the within-host context and frame the discussion in terms of growing knowledge of the biology of SARS-CoV-2. Viewing health outcomes for SARS-CoV-2 through the lens of ecological models underscores the value of repeated measures on individuals, especially since many lines of evidence suggest important contingence on trajectory.


Subject(s)
COVID-19/metabolism , Host-Pathogen Interactions , Models, Biological , SARS-CoV-2/physiology , Virus Replication , Humans
6.
Science ; 370(6518): 811-818, 2020 11 13.
Article in English | MEDLINE | ID: covidwho-787984

ABSTRACT

The future trajectory of the coronavirus disease 2019 (COVID-19) pandemic hinges on the dynamics of adaptive immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, salient features of the immune response elicited by natural infection or vaccination are still uncertain. We use simple epidemiological models to explore estimates for the magnitude and timing of future COVID-19 cases, given different assumptions regarding the protective efficacy and duration of the adaptive immune response to SARS-CoV-2, as well as its interaction with vaccines and nonpharmaceutical interventions. We find that variations in the immune response to primary SARS-CoV-2 infections and a potential vaccine can lead to markedly different immune landscapes and burdens of critically severe cases, ranging from sustained epidemics to near elimination. Our findings illustrate likely complexities in future COVID-19 dynamics and highlight the importance of immunological characterization beyond the measurement of active infections for adequately projecting the immune landscape generated by SARS-CoV-2 infections.


Subject(s)
Adaptive Immunity , Betacoronavirus/immunology , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Vaccination , Viral Vaccines/immunology , Antibodies, Viral/blood , Antibodies, Viral/immunology , Antibody-Dependent Enhancement , COVID-19 , COVID-19 Vaccines , Communicable Disease Control , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross Reactions , Disease Susceptibility , Forecasting , Humans , Immunity, Innate , Models, Theoretical , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2 , Seasons , T-Lymphocytes/immunology , Time Factors , Vaccination Refusal
7.
Elife ; 92020 02 03.
Article in English | MEDLINE | ID: covidwho-774702

ABSTRACT

Bats host virulent zoonotic viruses without experiencing disease. A mechanistic understanding of the impact of bats' virus hosting capacities, including uniquely constitutive immune pathways, on cellular-scale viral dynamics is needed to elucidate zoonotic emergence. We carried out virus infectivity assays on bat cell lines expressing induced and constitutive immune phenotypes, then developed a theoretical model of our in vitro system, which we fit to empirical data. Best fit models recapitulated expected immune phenotypes for representative cell lines, supporting robust antiviral defenses in bat cells that correlated with higher estimates for within-host viral propagation rates. In general, heightened immune responses limit pathogen-induced cellular morbidity, which can facilitate the establishment of rapidly-propagating persistent infections within-host. Rapidly-transmitting viruses that have evolved with bat immune systems will likely cause enhanced virulence following emergence into secondary hosts with immune systems that diverge from those unique to bats.


Bats can carry viruses that are deadly to other mammals without themselves showing serious symptoms. In fact, bats are natural reservoirs for viruses that have some of the highest fatality rates of any viruses that people acquire from wild animals ­ including rabies, Ebola and the SARS coronavirus. Bats have a suite of antiviral defenses that keep the amount of virus in check. For example, some bats have an antiviral immune response called the interferon pathway perpetually switched on. In most other mammals, having such a hyper-vigilant immune response would cause harmful inflammation. Bats, however, have adapted anti-inflammatory traits that protect them from such harm, include the loss of certain genes that normally promote inflammation. However, no one has previously explored how these unique antiviral defenses of bats impact the viruses themselves. Now, Brook et al. have studied this exact question using bat cells grown in the laboratory. The experiments made use of cells from one bat species ­ the black flying fox ­ in which the interferon pathway is always on, and another ­ the Egyptian fruit bat ­ in which this pathway is only activated during an infection. The bat cells were infected with three different viruses, and then Brook et al. observed how the interferon pathway helped keep the infections in check, before creating a computer model of this response. The experiments and model helped reveal that the bats' defenses may have a potential downside for other animals, including humans. In both bat species, the strongest antiviral responses were countered by the virus spreading more quickly from cell to cell. This suggests that bat immune defenses may drive the evolution of faster transmitting viruses, and while bats are well protected from the harmful effects of their own prolific viruses, other creatures like humans are not. The findings may help to explain why bats are often the source for viruses that are deadly in humans. Learning more about bats' antiviral defenses and how they drive virus evolution may help scientists develop better ways to predict, prevent or limit the spread of viruses from bats to humans. More studies are needed in bats to help these efforts. In the meantime, the experiments highlight the importance of warning people to avoid direct contact with wild bats.


Subject(s)
Chiroptera/virology , Disease Reservoirs/veterinary , Virus Diseases/veterinary , Viruses/growth & development , Zoonoses/virology , Animals , Cell Line , Chiroptera/immunology , Disease Reservoirs/virology , Host Microbial Interactions , Humans , Immunity, Cellular , Kinetics , Models, Biological , Phenotype , Risk Assessment , Virulence , Virus Diseases/immunology , Virus Diseases/transmission , Virus Diseases/virology , Viruses/immunology , Viruses/pathogenicity , Zoonoses/immunology , Zoonoses/transmission
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