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Harnessing immunity:Immunomodulatory therapies in COVID-19

World Journal of Virology 2024年第2期13卷 34-47页

作者： Tsvetelina Velikova Hristo Valkov Anita Aleksandrova Monika Peshevska-Sekulovska Metodija Sekulovski Russka Shumnalieva Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Department of Gastroenterology University Hospital“Tsaritsa Yoanna-ISUL”Medical University of SofiaSofia 1527Bulgaria Department of Immunology SMDL RamusSimitli 6000Bulgaria Department of Gastroenterology University Hospital LozenetzSofia 1407Bulgaria Department of Anesthesiology and Intensive Care University Hospital LozenetzSofia 1407Bulgaria Department of Rheumatology Clinic of RheumatologyUniversity Hospital"St.Ivan Rilski"Medical University-SofiaSofia 1612Bulgaria

An overly exuberant immune response,characterized by a cytokine storm and uncontrolled inflammation,has been identified as a significant driver of severe coronavirus disease 2019(COVID-19)cases.Consequently,deciphering the intricacies of immune dysregulation in COVID-19 is imperative to identify specific targets for intervention and modulation.With these delicate dynamics in mind,immunomodulatory therapies have emerged as a promising avenue for miti-gating the challenges posed by COVID-19.Precision in manipulating immune pathways presents an opportunity to alter the host response,optimizing antiviral defenses while curbing deleterious inflammation.This review article compre-hensively analyzes immunomodulatory interventions in managing COVID-19.We explore diverse approaches to mitigating the hyperactive immune response and its impact,from corticosteroids and non-steroidal drugs to targeted biologics,including anti-viral drugs,cytokine inhibitors,JAK inhibitors,convalescent plasma,monoclonal antibodies(mAbs)to severe acute respiratory syndrome coronavirus 2,cell-based therapies(i.e.,CAR T,etc.).By summarizing the current evidence,we aim to provide a clear roadmap for clinicians and researchers navigating the complex landscape of immunomodulation in COVID-19 treatment.CS Glucocorticoids are among the most widely prescribed drugs with their immune-suppressive and anti-inflammatory effect[84].The current guidelines for the treatment of COVID-19 recommend against the use of dexamethasone or other systemic CS in non-hospitalized patients in the absence of another indication[70].The RECOVERY trial demonstrates the reduced 28-d mortality among hospitalized patients with COVID-19 using dexamethasone compared to the usual standard of care,along with other investigators,such as Ahmed and Hassan[85].The benefit of dexamethasone was seen only among participants receiving either oxygen alone or invasive mechanical ventilation at randomization but not among those receiving no respiratory support at enrollment[85].In a systematic

关键词： Immunomodulation COVID-19 SARS-CoV-2 Immunotherapy antiviral immune response Cytokine storm Adaptive immunity Therapeutic strategies immune modulators Viral infection Host immune response

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HIV reservoir: antiviral immune responses and immune interventions for curing HIV infection

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Chinese Medical Journal 2022年第22期135卷 2667-2676页

作者： Shuang Li Christiane Moog Tong Zhang Bin Su Beijing Key Laboratory for HIV/AIDS Research Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV InfectionClinical and Research Center for Infectious DiseasesBeijing Youan HospitalCapital Medical UniversityBeijing 100069China Laboratoire d’ImmunoRhumatologie Moléculaire Institut national de la santéet de la recherche médicale(INSERM)UMR_S 1109Institut thématique interdisciplinaire(ITI)de Médecine de Précision de StrasbourgTransplantex NGFacultéde MédecineFédération Hospitalo-Universitaire OMICAREFédération de Médecine Translationnelle de Strasbourg(FMTS)Universitéde StrasbourgStrasbourg 67000France

Antiretroviral therapy against human immunodeficiency virus (HIV) is effective in controlling viral replication but cannot completely eliminate HIV due to the persistence of the HIV reservoir. Innate and adaptive immune responses have been proposed to contribute to preventing HIV acquisition, controlling HIV replication and eliminating HIV-infected cells. However, the immune responses naturally induced in HIV-infected individuals rarely eradicate HIV infection, which may be caused by immune escape, an inadequate magnitude and breadth of immune responses, and immune exhaustion. Optimizing these immune responses may solve the problems of epitope escape and insufficient sustained memory responses. Moreover, immune interventions aimed at improving host immune response can reduce HIV reservoirs, which have become one focus in the development of innovative strategies to eliminate HIV reservoirs. In this review, we focus on the immune response against HIV and how antiviral immune responses affect HIV reservoirs. We also discuss the development of innovative strategies aiming to eliminate HIV reservoirs and promoting functional cure of HIV infection.

关键词： antiviral immune response Functional HIV cure HIV reservoir Human immunodeficiency virus immune interventions

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