Abstract A hypothesis is proposed that the cytokine storm syndrome, which complicates COVID-19 in some patients, is a consequence of antibody-dependent enhancement of virus infection, which is in turn happens due to a change in dominant antigenic determinants of SARS-CoV-2 S-protein. The antibody-dependent enhancement of virus infection is a phenomenon in which virus-specific antibodies that are not neutralizing enhance the entry of infectious virus into immune cells causing their death. Antibody-dependent enhancement has been reported for different coronaviruses. This phenomenon happens due to a decrease in the binding strength of neutralizing antibodies to the virus, which converts these antibodies into suboptimal—not neutralizing ones. According to our hypothesis, such a decrease in affinity may be associated with a change in the conformation of the viral S-protein. We believe that this conformational change is the major factor in the switching of antibodies affinity, which triggers antibody-dependent enhancement. However, other factors that contribute to antigen drift and antigenic determinant changes may also play a role.

中文翻译：

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SARS-CoV-2 病毒 S 蛋白抗原决定簇的变化是病毒感染和细胞因子风暴的抗体依赖性增强的可能原因


摘要提出了一种假设，即细胞因子风暴综合征（使某些患者的 COVID-19 复杂化）是抗体依赖性病毒感染增强的结果，而病毒感染增强又是由于 SARS-CoV 的显性抗原决定簇的变化而发生的。 2 S-蛋白。病毒感染的抗体依赖性增强是一种非中和性的病毒特异性抗体增强感染性病毒进入免疫细胞导致其死亡的现象。据报道，不同的冠状病毒具有抗体依赖性增强作用。这种现象的发生是由于中和抗体与病毒的结合强度下降，从而将这些抗体转化为次优抗体，而不是中和抗体。根据我们的假设，这种亲和力的降低可能与病毒S蛋白构象的变化有关。我们认为这种构象变化是抗体亲和力转换的主要因素，从而触发抗体依赖性增强。然而，导致抗原漂移和抗原决定簇变化的其他因素也可能发挥作用。