tetano
Editor, Senior Moderator
Med Princ Pract
. 2021 Apr 21.
doi: 10.1159/000516693. Online ahead of print.
Antibody-Dependent Enhancement and the Critical Pattern of COVID-19: Possibilities and Considerations
Fatemeh Farshadpour, Reza Taherkhani
Abstract
Coronavirus disease 2019 (COVID-19), a pandemic infection with profound effects on human society, has been emerged recently and rigorously challenged our ability to control viral infections. Although at the beginning of the COVID-19 outbreak, the epidemic seems controllable in Southern Iran, the disease presents a critical pattern as of May 2020. After a few months of COVID-19 emergence, in a twisted turn of events, the severity and mortality of COVID-19 increased dramatically. It has been proposed that the antibodies obtained from previous exposure to local circulating human coronaviruses or possibly SARS-CoV-2 might contribute to the development of more severe and lethal presentations of COVID-19 possibly by triggering antibody-dependent enhancement. The binding of virions complexed with antibodies to Fc? receptors on the target cells initiates receptor-mediated signaling events leading to enhanced expression of inflammatory cytokines and suppression of intracellular antiviral responses at the transcriptomic level, followed by endocytosis of the virus and subsequent activation of immune cells. The activated immune cells might accumulate in the lung and promote cytokine storm and lymphopenia. Furthermore, the formation of immune complexes can promote complement activation and subsequent tissue damage. Although there are currently no clinical data to support this hypothesis, a better understanding of these immunopathologic phenomena and their relation to disease course and severity might give insight into the development of the most efficient prophylactic and therapeutic approaches. This review demonstrates the critical pattern of COVID-19 in Southern Iran and highlights the possible interplaying factors leading to this condition.
. 2021 Apr 21.
doi: 10.1159/000516693. Online ahead of print.
Antibody-Dependent Enhancement and the Critical Pattern of COVID-19: Possibilities and Considerations
Fatemeh Farshadpour, Reza Taherkhani
- PMID: 33882487
- DOI: 10.1159/000516693
Abstract
Coronavirus disease 2019 (COVID-19), a pandemic infection with profound effects on human society, has been emerged recently and rigorously challenged our ability to control viral infections. Although at the beginning of the COVID-19 outbreak, the epidemic seems controllable in Southern Iran, the disease presents a critical pattern as of May 2020. After a few months of COVID-19 emergence, in a twisted turn of events, the severity and mortality of COVID-19 increased dramatically. It has been proposed that the antibodies obtained from previous exposure to local circulating human coronaviruses or possibly SARS-CoV-2 might contribute to the development of more severe and lethal presentations of COVID-19 possibly by triggering antibody-dependent enhancement. The binding of virions complexed with antibodies to Fc? receptors on the target cells initiates receptor-mediated signaling events leading to enhanced expression of inflammatory cytokines and suppression of intracellular antiviral responses at the transcriptomic level, followed by endocytosis of the virus and subsequent activation of immune cells. The activated immune cells might accumulate in the lung and promote cytokine storm and lymphopenia. Furthermore, the formation of immune complexes can promote complement activation and subsequent tissue damage. Although there are currently no clinical data to support this hypothesis, a better understanding of these immunopathologic phenomena and their relation to disease course and severity might give insight into the development of the most efficient prophylactic and therapeutic approaches. This review demonstrates the critical pattern of COVID-19 in Southern Iran and highlights the possible interplaying factors leading to this condition.