Delayed Viral Clearance Accompanied by Early Impaired Humoral and Virus-Specific T-Cell Response in Patients with Coronavirus Disease 2019 and Interstitial Lung Disease.

IF 5.2 3区 医学 Q1 IMMUNOLOGY
Vaccines Pub Date : 2025-06-19 DOI:10.3390/vaccines13060655
Jiaying Zhong, Juan Li, Rui Wei, Bingpeng Guo, Tingting Cui, Peiyu Huang, Zhongfang Wang, Qun Luo, Qian Han
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Abstract

Objectives: Patients with interstitial lung disease (ILD) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at high risk of severe coronavirus disease 2019. It is unclear whether anti-viral cellular and humoral immunity is impacted in patients with ILD in the presence of immune disorders and immunosuppressive therapy. This results in poor control of viral infections following SARS-CoV-2 infection. We aimed to highlight the clinical management of patients with ILD with regard to the adjustment of anti-inflammatory therapy during SARS-CoV-2 infection.

Methods: We compared viral clearance, antibody levels, and T-cell immune response between healthy controls and patients with connective tissue disease-related ILD (CTD-ILD) or interstitial pneumonia with autoimmune features (IPAF).

Results: Patients with ILD exhibited a higher viral load than the control group (1.58 × 106 vs. 2.37 × 103 copies/mL, p = 0.018), as well as a significantly lower level of neutralizing antibodies against the wild-type (WT) virus (7.01 vs. 625.6, p < 0.0001) and Omicron BA.5 (7.19 vs. 128.4, p < 0.001). Similarly, a lower virus-specific T-cell (VST) immune response was observed 14 days post-symptom onset in the ILD group (CD4+ VSTs: 0.018 vs. 0.082, p = 0.005; CD8+ VSTs: 0.0008 vs. 0.047, p = 0.004). The ILD group had no other heightened inflammatory biomarkers compared with the control group.

Conclusions: Our study provides novel evidence of the underlying interaction between virus clearance and host immune status and sheds light on the clinical management of patients with ILD with regard to the adjustment of anti-inflammatory therapy during SARS-CoV-2 infection.

2019冠状病毒病和间质性肺疾病患者的延迟病毒清除伴早期体液和病毒特异性t细胞反应受损
目的:间质性肺疾病(ILD)和严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染患者是2019年严重冠状病毒病的高危人群。目前尚不清楚,在存在免疫障碍和免疫抑制治疗的ILD患者中,抗病毒细胞和体液免疫是否受到影响。这导致SARS-CoV-2感染后病毒感染控制不佳。我们的目的是强调在SARS-CoV-2感染期间ILD患者的临床管理与抗炎治疗的调整。方法:我们比较了健康对照组和结缔组织病相关性ILD (CTD-ILD)或具有自身免疫性特征的间质性肺炎(IPAF)患者之间的病毒清除率、抗体水平和t细胞免疫反应。结果:ILD患者表现出比对照组更高的病毒载量(1.58 × 106比2.37 × 103拷贝/mL, p = 0.018),以及对野生型(WT)病毒(7.01比625.6,p < 0.0001)和Omicron BA.5(7.19比128.4,p < 0.001)的中和抗体水平显著降低。同样,在症状出现后14天,ILD组观察到较低的病毒特异性t细胞(VST)免疫应答(CD4+ VST: 0.018 vs 0.082, p = 0.005;CD8+ VSTs: 0.0008 vs. 0.047, p = 0.004)。与对照组相比,ILD组没有其他炎症生物标志物升高。结论:我们的研究为病毒清除与宿主免疫状态之间潜在的相互作用提供了新的证据,并为ILD患者在SARS-CoV-2感染期间调整抗炎治疗提供了新的思路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Vaccines
Vaccines Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
8.90
自引率
16.70%
发文量
1853
审稿时长
18.06 days
期刊介绍: Vaccines (ISSN 2076-393X) is an international, peer-reviewed open access journal focused on laboratory and clinical vaccine research, utilization and immunization. Vaccines publishes high quality reviews, regular research papers, communications and case reports.
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