ABSTRACT
The initial immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) includes an interferon-dependent antiviral response. A late and uncontrolled inflammatory response characterized by high activity of proinflammatory cytokines and the recruitment of neutrophils and macrophages develops in predisposed individuals and is potentially harmful in some cases. Interleukin (IL)-17 is one of the many cytokines released during coronavirus disease 2019 (COVID-19). IL-17 is crucial in recruiting and activating neutrophils, cells that can migrate to the lung, and are heavily involved in the pathogenesis of COVID-19. During the infection T helper 17 (Th17) cells and IL-17-related pathways are associated with a worse outcome of the disease. All these have practical consequences considering that some drugs with therapeutic targets related to the Th17 response may have a beneficial effect on patients with SARS-CoV-2 infection. Herein, we present the arguments underlying our assumption that blocking the IL-23/IL-17 axis using targeted biological therapies as well as drugs that act indirectly on this pathway such as convalescent plasma therapy and colchicine may be good therapeutic options.
Subject(s)
COVID-19/immunology , SARS-CoV-2/immunology , Th17 Cells/immunology , Adaptive Immunity , Adult , COVID-19/classification , Humans , Immunity, Innate , Interleukin-17/antagonists & inhibitors , Interleukin-17/physiology , Interleukin-23/antagonists & inhibitors , Middle Aged , COVID-19 Drug TreatmentSubject(s)
Betacoronavirus , Coronavirus Infections/physiopathology , Cytokine Release Syndrome/etiology , Interleukin-17/physiology , Pandemics , Pneumonia, Viral/physiopathology , Animals , Antibodies, Monoclonal, Humanized/pharmacology , Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/physiopathology , Humans , Influenza, Human/physiopathology , Interleukin-17/antagonists & inhibitors , Interleukin-6/physiology , Mice , Mice, Knockout , Models, Immunological , Multiple Organ Failure/etiology , Multiple Organ Failure/prevention & control , Orthomyxoviridae Infections/physiopathology , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Receptors, Interleukin-17/deficiency , SARS-CoV-2 , COVID-19 Drug TreatmentABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus responsible for the pandemic named coronavirus disease 2019 (COVID-19). The disease causes SARS with a significant morbidity and mortality. We provide a review with a focus on COVID-19 in dermatology. We discuss triage of suspected infectious patients, protection of medical doctors and nurses. We discuss the available data on cutaneous symptoms, although disease-specific symptoms have yet not been observed. COVID-19 is a challenge for the treatment of dermatologic patients, either with severe inflammatory disorders or with skin cancer. The consequences for systemic treatment are obvious but it will be most important to collect the clinical data for a better decision process. Last but not least, education in dermatology for students will not be temporarily possible in the classical settings. COVID-19, although not a skin disease, by itself has an immense impact on dermatology.