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Review
. 2023 Apr 15:319:121531.
doi: 10.1016/j.lfs.2023.121531. Epub 2023 Feb 27.

Covid-19 a triggering factor of autoimmune and multi-inflammatory diseases

Emina Karahmet Sher  1 , Adnan Ćosović  2 , Amina Džidić-Krivić  3 , Esma Karahmet Farhat  4 , Emma Pinjić  5 , Farooq Sher  6
Affiliations
Review

Covid-19 a triggering factor of autoimmune and multi-inflammatory diseases

Emina Karahmet Sher et al. Life Sci. .

Abstract

SARS-CoV-2 virus has attracted a lot of attention globally due to the autoimmune and inflammatory processes that were observed during the development of Covid-19 disease. Excessive activation of immune response and triggering of autoantibodies synthesis as well as an excessive synthesis of inflammatory cytokines and the onset of cytokine storm has a vital role in the disease outcome and the occurring autoimmune complications. This scenario is reminiscent of infiltration of lymphocytes and monocytes in specific organs and the increased production of autoantibodies and chemoattractants noted in other inflammatory and autoimmune diseases. The main goal of this study is to investigate the complex inflammatory processes that occur in Covid-19 disease and to find similarities with other inflammatory diseases such as multiple sclerosis (MS), acute respiratory distress syndrome (ARDS), rheumatoid arthritis (RA) and Kawasaki syndrome to advance existing diagnostic and therapeutic protocols. The therapy with Interferon-gamma (IFN-γ) and the use of S1P receptor modulators showed promising results. However, there are many unknowns about these mechanisms and possible novel therapies. Therefore, the inflammation and autoimmunity triggered by Covid-19 should be further investigated to improve existing diagnostic procedures and therapeutic protocols for Covid-19.

Keywords: Autoimmune diseases; B-cell tolerance and T-cell tolerance; Covid-19; Cytokine storm; Immunological reaction; Inflammatory reaction; Therapeutic protocols.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Unlabelled Image
Graphical abstract
Fig. 1
Fig. 1
The graphic displays the structure of SARS-CoV-2 virus particles and its most important structural parts .
Fig. 2
Fig. 2
The activation of innate and adaptive immune response and cytokine release in asymptomatic, mild clinical and severe clinical manifestation .
Fig. 3
Fig. 3
The entry of SARS-CoV-2 virus in the cell by the interaction of S1 and S2 proteins with receptor-binding domain for angiotensin-converting enzyme 2 .
Fig. 4
Fig. 4
Different types of cells are included in the development of central immune tolerance through positive selection, neglect, clonal deletion and Treg differentiation .
Fig. 5
Fig. 5
Representation of the development of peripheral tolerance of T cells and the processes of anergy and apoptosis .
Fig. 6
Fig. 6
Detail mechanism underlying the development of B cells, starting from the common lymphoid precursor (CLP) to the mature B cell that synthesis antibodies .
Fig. 7
Fig. 7
Central B cell tolerance occurring in the bone marrow and peripheral B cell tolerance .
Fig. 8
Fig. 8
The number of cases noted and organs affected by the new-onset rheumatic autoimmune diseases reported during or after Covid-19 .
Fig. 9
Fig. 9
Proposed mechanisms of APS pathophysiology and potential therapeutic targets for coronavirus disease .
Fig. 10
Fig. 10
Presentation of the most common symptoms and signs accompanying systemic immune disease in patients with Covid-19 .
Fig. 11
Fig. 11
One of the possible neuropathological mechanisms of SARS-CoV-2 .
Fig. 12
Fig. 12
Touchpoints of SARS-CoV-2 and blood-brain barrier .
See this image and copyright information in PMC

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