tetano
Editor, Senior Moderator
JCI Insight
. 2020 Jun 18;140711.
doi: 10.1172/jci.insight.140711. Online ahead of print.
The Complement System in COVID-19: Friend and Foe?
Anuja Java[SUP] 1 [/SUP], Anthony J Apicelli[SUP] 2 [/SUP], M Kathryn Liszewski[SUP] 3 [/SUP], Ariella Coler-Reilly[SUP] 3 [/SUP], John P Atkinson[SUP] 3 [/SUP], Alfred Hj Kim[SUP] 3 [/SUP], Hrishikesh S Kulkarni[SUP] 4 [/SUP]
Affiliations
Abstract
COVID-19, the disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in a global pandemic and a disruptive health crisis. COVID-19-related morbidity and mortality has been attributed to an exaggerated immune response. The role of complement activation and its contribution to illness severity is being increasingly recognized. Here, we summarize current knowledge about the interaction of coronaviruses with the complement system. We posit that: (a) coronaviruses activate multiple complement pathways; (b) severe COVID-19 clinical features often resemble complementopathies; (c) the combined effects of complement activation, dysregulated neutrophilia, endothelial injury, and hypercoagulability appear to be intertwined to drive the severe features of COVID-19; (d) a subset of patients with COVID-19 may have a genetic predisposition associated with complement dysregulation; and (e) these observations create a basis for clinical trials of complement inhibitors in life-threatening illness.
. 2020 Jun 18;140711.
doi: 10.1172/jci.insight.140711. Online ahead of print.
The Complement System in COVID-19: Friend and Foe?
Anuja Java[SUP] 1 [/SUP], Anthony J Apicelli[SUP] 2 [/SUP], M Kathryn Liszewski[SUP] 3 [/SUP], Ariella Coler-Reilly[SUP] 3 [/SUP], John P Atkinson[SUP] 3 [/SUP], Alfred Hj Kim[SUP] 3 [/SUP], Hrishikesh S Kulkarni[SUP] 4 [/SUP]
Affiliations
- PMID: 32554923
- DOI: 10.1172/jci.insight.140711
Abstract
COVID-19, the disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in a global pandemic and a disruptive health crisis. COVID-19-related morbidity and mortality has been attributed to an exaggerated immune response. The role of complement activation and its contribution to illness severity is being increasingly recognized. Here, we summarize current knowledge about the interaction of coronaviruses with the complement system. We posit that: (a) coronaviruses activate multiple complement pathways; (b) severe COVID-19 clinical features often resemble complementopathies; (c) the combined effects of complement activation, dysregulated neutrophilia, endothelial injury, and hypercoagulability appear to be intertwined to drive the severe features of COVID-19; (d) a subset of patients with COVID-19 may have a genetic predisposition associated with complement dysregulation; and (e) these observations create a basis for clinical trials of complement inhibitors in life-threatening illness.