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Review

Immunopathology of SARS-CoV-2 Infection: Immune Cells and Mediators, Prognostic Factors, and Immune-Therapeutic Implications

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Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, 98125 Messina, Italy
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COVID Centre AOU Policlinic G. Martino, 98125 Messina, Italy
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Department of Medicine and Science of Ageing, G’ d’Annunzio University, 66100 Chieti, Italy
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Institute for Clinical Immunotherapy and Advanced Biological Treatments, 65100 Pescara, Italy
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Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), 56124 Pisa, Italy
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School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(13), 4782; https://doi.org/10.3390/ijms21134782
Received: 20 May 2020 / Revised: 30 June 2020 / Accepted: 3 July 2020 / Published: 6 July 2020
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
The present is a comprehensive review of the immunopathology of Covid-19. The immune reaction to SARS-CoV-2 infection is characterized by differentiation and proliferation of a variety of immune cells with immune mediator production and release, and activation of other pathogen resistance mechanisms. We fully address the humoral and cellular immune changes induced by the virus, with particular emphasis on the role of the “cytokine storm” in the evolution of the disease. Moreover, we also propose some immune alterations (i.e., inflammatory parameters, cytokines, leukocytes and lymphocyte subpopulations) as prognostic markers of the disease. Furthermore, we discuss how immune modifying drugs, such as tocilizumab, chloroquine, glucocorticoids and immunoglobulins, and blood purification therapy, can constitute a fundamental moment in the therapy of the infection. Finally, we made a critical analysis of a number of substances, not yet utilized, but potentially useful in SARS-CoV-2 patients, such as IFN lambda, TNF blockers, ulinastatin, siponimod, tacrolimus, mesenchymal stem cells, inhibitors of mononuclear macrophage recruitment, IL-1 family antagonists, JAK-2 or STAT-3 inhibitors. View Full-Text
Keywords: SARS-CoV-2; immune response; cytokine storm; IL-6; prognostic factor; T lymphocyte SARS-CoV-2; immune response; cytokine storm; IL-6; prognostic factor; T lymphocyte
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MDPI and ACS Style

Allegra, A.; Di Gioacchino, M.; Tonacci, A.; Musolino, C.; Gangemi, S. Immunopathology of SARS-CoV-2 Infection: Immune Cells and Mediators, Prognostic Factors, and Immune-Therapeutic Implications. Int. J. Mol. Sci. 2020, 21, 4782. https://doi.org/10.3390/ijms21134782

AMA Style

Allegra A, Di Gioacchino M, Tonacci A, Musolino C, Gangemi S. Immunopathology of SARS-CoV-2 Infection: Immune Cells and Mediators, Prognostic Factors, and Immune-Therapeutic Implications. International Journal of Molecular Sciences. 2020; 21(13):4782. https://doi.org/10.3390/ijms21134782

Chicago/Turabian Style

Allegra, Alessandro, Mario Di Gioacchino, Alessandro Tonacci, Caterina Musolino, and Sebastiano Gangemi. 2020. "Immunopathology of SARS-CoV-2 Infection: Immune Cells and Mediators, Prognostic Factors, and Immune-Therapeutic Implications" International Journal of Molecular Sciences 21, no. 13: 4782. https://doi.org/10.3390/ijms21134782

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