Imunidade na Infeção pelo SARS-CoV-2: O que Sabemos
DOI:
https://doi.org/10.24950/rspmi/COVID19/CHUSJ/S/2020Palavras-chave:
Anticorpos Neutralizantes, Betacoronavírus, COVID-19, Imunidade Celular, Infecções por Coronavírus/imunologia, PandemiaResumo
Sobre a pandemia provocada pelo SARS-CoV-2, muito conhecimento tem sido produzido e dado a conhecer, mas muitas dúvidas permanecem por esclarecer acerca da sua interação com o ser humano, nomeadamente sobre se a resposta imune contra este novo coronavírus humano é protetora a longo prazo e qual a possibilidade de re-infeção. A COVID-19 pode assumir diferentes espetros clínicos, desde infeções assintomáticas até formas graves da doença, que resultam da inter-relação entre a patogenicidade própria do vírus e a resposta imune do hospedeiro. Esta revisão foca-se na imunologia da infeção, reunindo não só o conhecimento acumulado com as epidemias associadas ao SARS-CoV e MERS-CoV, mas também o que já se sabe sobre o SARS-CoV-2. Este conhecimento é fundamental e tem implicações quer para o controlo e prevenção da doença quer para o seu diagnóstico e tratamento.
Downloads
Referências
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5:536-44.
Silva C, Tavares M. Da emergência de um novo vírus humano à disseminação global de uma nova doença - Doença por Coronavírus 2019 (COVID- 19). Capítulo 2 - SARS-CoV-2: Virologia [dissertação Apresentada ao Instituto de Saúde Pública da Universidade do Porto] Porto:ISPUP;2020.
World Health Organization. Who.int [homepage na internet]. Emergency Preparedness Response. Pneumonia of Unknown Cause - China. Disease Outbreak News; 2020 [consultado1 de maio de 2020]. Disponível em: https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/).
World Health Organization. Who.int [homepage na internet]. Statement on the second meeting of the International Health Regulations (2005) Emer- gency Committee regarding the outbreak of novel coronavirus (2019- nCoV); 2020 [consultado 1 de maio de 2020]. Disponível em: https:// www.who.int/news-room/detail/30-01-2020-statement-on-the-second- -meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)
World Health Organization. Who.int [homepage na internet]. WHO Director-Generel's opening remarks at the media briefing on COVID-19 - 11 March 2020; 2020 [consultado 1 de maio de 2020]. Disponível em: https://www.who.int/dg/speeches/detail/who-director-general-s- -opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
Paules CI, Marston HD, Fauci AS. Coronavirus Infections-More Than Just the Common Cold. JAMA. 2020 (in press). doi: 10.1001/jama.2020.0757. 7. Perlman S. Another Decade, Another Coronavirus. N Engl J Med. 2020;382:760-2. doi: 10.1056/NEJMe2001126
Chen Y, Liu Q, Guo D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020 ;92:418-23. doi: 10.1002/jmv.25681.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 (in press). doi: 10.1001/jama.2020.2648.
Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Trans- plant. 2020;39:405-7.
Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P, et al. Coronavirus infections and immune responses. J Med Virol. 2020;92:424-32.
Lokugamage KG, Hage A, Schindewolf C, Rajsbaum R, Menachery VD. SARS-CoV-2 is sensitive to type I interferon pretreatment. 2020. Artigo em pré-publicação: disponível em bioRxiv.
Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID- 19: immunity, inflammation and intervention. Nat Rev Immunol. 2020 (in press). doi: 10.1038/s41577-020-0311-8.
Liao M, Liu Y, Yuan J, Wen Y, Xu G, Zhao J, et al. The landscape of lung bronchoalveolar immune cells in COVID-19 revealed by single-cell RNA sequencing. 2020. Artigo em pré-publicação. Disponível em: medRxiv.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. doi: 10.1093/cid/ciaa272.
Liu J, Li S, Liang B, Wang X, Wang H, Li W, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 ;395:1054-62. doi: 10.1016/ S0140-6736(20)30566-3
Zheng HY, Zhang M, Yang CX, Zhang N, Wang XC, Yang XP, et al. Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-
patients. Cell Mol Immunol. 2020;17:541-3. doi: 10.1038/s41423-020-0401-3.
Ong EZ, Chan YFZ, Leong WY, Lee NMY, Kalimuddin S, Haja Mohideen SM, et al. A Dynamic Immune Response Shapes COVID-19 Progression. Cell Host Microbe. 2020 (in press). doi: 10.1016/j.chom.2020.03.021
Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L, et al. Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia. J Infect Dis. 2020;221:1762-9. doi: 10.1093/infdis/jiaa150.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-20. doi: 10.1056/NEJMoa2002032.
Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020 (in press). doi: 10.1093/cid/ciaa248.
Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D, et al. Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol. 2020;17:533-5. doi: 10.1038/s41423-020-0402-2.
Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis. 2020 (in press). doi: 10.1093/cid/ciaa344.
Guo L, Ren L, Yang S, Xiao M, Chang, Yang F, et al. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Dis. 2020 (in press). doi: 10.1093/cid/ciaa310.
To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20:565-74. doi: 10.1016/S1473- 3099(20)30196-1.
Liu W, Liu L, Kou G, Zheng Y, Ding Y, Ni W, et al. Evaluation of Nucleo- capsid and Spike Protein-based ELISAs for detecting antibodies against SARS-CoV-2. J Clin Microbiol. 2020 (in press). doi: 10.1128/JCM.00461- 20.
Okba NM, Müller MA, Li W, Wang C, GeurtsvanKessel CH, Corman VM, et al. Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibody Responses in Coronavirus Disease 2019 Patients. Emerg Infect Dis. 2020 (in press). doi: 10.3201/eid2607.200841
Lin Q, Zhu L, Ni Z, Meng H, You L. Duration of serum neutralizing antibodies for SARS-CoV-2: Lessons from SARS-CoV infection. J Microbiol Immunol Infect. 2020 (in press). doi: 10.1016/j.jmii.2020.03.015.
Ferrara F, Temperton N. Pseudotype Neutralization Assays: From Laboratory Bench to Data Analysis. Methods Protoc. 2018;1. pii: E8. doi: 10.3390/mps1010008.
Yolken RH. Enzyme-linked immunosorbent assay (ELISA): a practical tool for rapid diagnosis of viruses and other infectious agents. Yale J Biol Med. 1980;53:85-92.
Koczula KM, Gallotta A. Lateral flow assays. Essays Biochem. 2016;60:111-20. doi: 10.1042/EBC20150012.
Chen Y, Liu Q, Guo D. Emerging coronaviruses: Genome structure, replication, and pathogenesis. J Med Virol. 2020;92:418-23. doi: 10.1002/ jmv.25681.
Qiu M, Shi Y, Guo Z, Chen Z, He R, Chen R, et al. Antibody responses to individual proteins of SARS coronavirus and their neutralization activities. Microbes Infect. 2005;7:882-9.
Chen S, Lu D, Zhang M, Che J, Yin Z, Zhang S, et al. Double-antigen sandwich ELISA for detection of antibodies to SARS-associated coronavirus in human serum. Eur J Clin Microbiol Infect Dis. 2005;24:549-53.
Long QX, Liu BZ, Deng HJ, Wu GC, Deng K, Chen YK, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020 (in press). doi: 10.1038/s41591-020-0897-1.
Wu F WA, Liu M, Wang Q, Chen J, Xia S, et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. 2020. Artigo em pré-publicação: disponível em medRxiv.
Yuan M, Wu NC, Zhu X, Lee CD, So RTY, Lv H, et al. A highly conserved cryptic epitope in the receptor-binding domains of SARS-CoV-2 and SARS-CoV. Science. 2020;368:630-3. doi: 10.1126/science.abb7269.
Ou X, Liu Y, Lei X, Li P, Mi D, Ren L, et al. Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nat Commun. 2020;11:1620. doi: 10.1038/s41467-020-15562-9.
Zinkernagel RM. On natural and artificial vaccinations. Annu Rev Immunol. 2003;21:515-46.
Wong VW, Dai D, Wu AK, Sung JJ. Treatment of severe acute respiratory syndrome with convalescent plasma. Hong Kong Med J. 2003;9:199-201.
Zhou B, Zhong N, Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection. N Engl J Med. 2007;357:1450-1.
van Griensven J, Edwards T, de Lamballerie X, Semple MG, Gallian P, Baize S, et al. Evaluation of Convalescent Plasma for Ebola Virus Di- sease in Guinea. N Engl J Med. 2016;374:33-42. doi: 10.1056/NEJ- Moa1511812.
Bao L DW, Gao H, Xiao C, Liu J, Xue J, et al. Lack of Reinfection in Rhesus Macaques Infected with SARS-CoV-2. 2020. Artigo em pré-publicação: disponível em bioRxiv.
Callow KA, Parry HF, Sergeant M, Tyrrell DA. The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect. 1990;105:435-46.
Memish ZA, Perlman S, Van Kerkhove MD, Zumla A. Middle East respiratory syndrome. Lancet. 2020;395:1063-77. doi: 10.1016/S0140- 6736(19)33221-0.
Liu W, Fontanet A, Zhang PH, Zhan L, Xin ZT, Baril L, et al. Two-year prospective study of the humoral immune response of patients with severe acute respiratory syndrome. J Infect Dis. 2006;193:792-5.
Cao WC, Liu W, Zhang PH, Zhang F, Richardus JH. Disappearance of antibodies to SARS associated coronavirus after recovery. N Engl J Med. 2007;357:1162-3.
Wu LP, Wang NC, Chang YH, Tian XY, Na DY, Zhang LY, et al. Duration of antibody responses after severe acute respiratory syndrome. Emerg Infect Dis. 2007;13:1562-4.
Tang F, Quan Y, Xin ZT, Wrammert J, Ma MJ, Lv H, et al. Lack of peripheral memory B cell responses in recovered patients with severe acute respira- tory syndrome: a six-year follow-up study. J Immunol. 2011;186:7264-8.
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
Acesso livre
