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A new perspective for mitigation of SARS-CoV-2 infection: priming the innate immune system for viral attack
Open Biology ( IF 5.8 ) Pub Date : 2020-07-29 , DOI: 10.1098/rsob.200138
Oren Kolodny 1 , Michael Berger 2 , Marcus W Feldman 3 , Yoav Ram 4
Affiliation  

The course of infection by SARS-CoV-2 frequently includes a long asymptomatic period, followed in some individuals by an immune dysregulation period that may lead to complications and immunopathology-induced death. This course of disease suggests that the virus often evades detection by the innate immune system. We suggest a novel therapeutic approach to mitigate the infection's severity, probability of complications and duration. We propose that priming an individual's innate immune system for viral attack shortly before it is expected to occur may allow pre-activation of the preferable trajectory of immune response, leading to early detection of the virus. Priming can be carried out, for example, by administering a standard vaccine or another reagent that elicits a broad anti-viral innate immune response. By the time that the expected SARS-CoV-2 infection occurs, activation cascades will have been put in motion and levels of immune factors needed to combat the infection will have been elevated. The infection would thus be cleared faster and with less complication than otherwise, alleviating adverse clinical outcomes at the individual level. Moreover, priming may also mitigate population-level risk by reducing need for hospitalizations and decreasing the infectious period of individuals, thus slowing the spread and reducing the impact of the epidemic. In view of the latter consideration, our proposal may have a significant epidemiological impact even if applied primarily to low-risk individuals, such as young adults, who often show mild symptoms or none, by shortening the period during which they unknowingly infect others. The proposed view is, at this time, an unproven hypothesis. Although supported by robust bio-medical reasoning and multiple lines of evidence, carefully designed clinical trials are necessary.



中文翻译:

缓解 SARS-CoV-2 感染的新视角:启动先天免疫系统应对病毒攻击

SARS-CoV-2 感染过程通常包括很长的无症状期,随后在某些个体中出现免疫失调期,可能导致并发症和免疫病理学诱导的死亡。这种病程表明病毒经常逃避先天免疫系统的检测。我们建议采用一种新的治疗方法来减轻感染的严重程度、并发症的可能性和持续时间。我们建议,在病毒攻击预计发生之前不久启动个体的先天免疫系统以应对病毒攻击,可能会预先激活免疫反应的最佳轨迹,从而及早发现病毒。例如,可以通过施用标准疫苗或引发广泛的抗病毒先天免疫应答的另一种试剂来进行引发。当预期的 SARS-CoV-2 感染发生时,激活级联将会启动,对抗感染所需的免疫因子水平将会升高。因此,与其他方法相比,感染将被更快地清除,并发症也更少,从而减轻个体水平上的不良临床结果。此外,启动还可以通过减少住院需求和缩短个体的感染期来减轻人群层面的风险,从而减缓传播速度并减少流行病的影响。考虑到后者,我们的建议即使主要适用于低风险个体,例如经常表现出轻微症状或没有症状的年轻人,通过缩短他们在不知不觉中感染他人的时间,也可能会产生重大的流行病学影响。目前,所提出的观点是一个未经证实的假设。尽管有强有力的生物医学推理和多方面证据的支持,但精心设计的临床试验是必要的。

更新日期:2020-07-29
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