COVID-19 and immunological regulations – from basic and translational aspects to clinical implications

Michael P. Schön, Carola Berking, Tilo Biedermann, Timo Buhl, Luise Erpenbeck, Kilian Eyerich, Stefanie Eyerich, Kamran Ghoreschi, Matthias Goebeler, Ralf J. Ludwig, Knut Schäkel, Bastian Schilling, Christoph Schlapbach, Georg Stary, Esther von Stebut, Kerstin Steinbrink

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations

Abstract

The COVID-19 pandemic caused by SARS-CoV-2 has far-reaching direct and indirect medical consequences. These include both the course and treatment of diseases. It is becoming increasingly clear that infections with SARS-CoV-2 can cause considerable immunological alterations, which particularly also affect pathogenetically and/or therapeutically relevant factors. Against this background we summarize here the current state of knowledge on the interaction of SARS-CoV-2/COVID-19 with mediators of the acute phase of inflammation (TNF, IL-1, IL-6), type 1 and type 17 immune responses (IL-12, IL-23, IL-17, IL-36), type 2 immune reactions (IL-4, IL-13, IL-5, IL-31, IgE), B-cell immunity, checkpoint regulators (PD-1, PD-L1, CTLA4), and orally druggable signaling pathways (JAK, PDE4, calcineurin). In addition, we discuss in this context non-specific immune modulation by glucocorticosteroids, methotrexate, antimalarial drugs, azathioprine, dapsone, mycophenolate mofetil and fumaric acid esters, as well as neutrophil granulocyte-mediated innate immune mechanisms. From these recent findings we derive possible implications for the therapeutic modulation of said immunological mechanisms in connection with SARS-CoV-2/COVID-19. Although, of course, the greatest care should be taken with patients with immunologically mediated diseases or immunomodulating therapies, it appears that many treatments can also be carried out during the COVID-19 pandemic; some even appear to alleviate COVID-19.

Original languageEnglish
Pages (from-to)795-807
Number of pages13
JournalJDDG - Journal of the German Society of Dermatology
Volume18
Issue number8
DOIs
StatePublished - 1 Aug 2020

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