Elsevier

Cytokine

Volume 136, December 2020, 155256
Cytokine

Review article
ADE and hyperinflammation in SARS-CoV2 infection- comparison with dengue hemorrhagic fever and feline infectious peritonitis

https://doi.org/10.1016/j.cyto.2020.155256Get rights and content

Highlights

  • ADE increases viraemia in DHF and in FCoV infections.

  • In SARS-CoV infections ADE promotes inflammation.

  • The underlying cause of hyperinflammation is not clear in Covid-19.

Abstract

The COVID-19 pandemic has rapidly spread around the world with significant morbidity and mortality in a subset of patients including the elderly. The poorer outcomes are associated with ‘cytokine storm-like’ immune responses, otherwise referred to as ‘hyperinflammation’. While most of the infected individuals show minimal or no symptoms and recover spontaneously, a small proportion of the patients exhibit severe symptoms characterized by extreme dyspnea and low tissue oxygen levels, with extensive damage to the lungs referred to as acute respiratory distress symptom (ARDS). The consensus is that the hyperinflammatory response of the host is akin to the cytokine storm observed during sepsis and is the major cause of death. Uncertainties remain on the factors that lead to hyperinflammatory response in some but not all individuals. Hyperinflammation is a common feature in different viral infections such as dengue where existing low-titer antibodies to the virus enhances the infection in immune cells through a process called antibody-dependent enhancement or ADE. ADE has been reported following vaccination or secondary infections with other corona, Ebola and dengue virus. Detailed analysis has shown that antibodies to any viral epitope can induce ADE when present in sub-optimal titers or is of low affinity. In this review we will discuss ADE in the context of dengue and coronavirus infections including Covid-19.

Keywords

Covid-19
Cytokine storm
SARS-CoV2
ADE

Abbreviations

ACE2
Angiotensin I converting enzyme 2
ADE
antibody dependent enhancement
DENV
dengue virus
DHF
dengue hemorrhagic fever
FcγR
Fc gamma receptor
FCoV
feline corona virus
FECV
feline enteric corona virus
FIPV
feline infectious peritonitits virus
HIV
human immunodeficiency virus
IHC
immunohistochemistry
MERS
Middle East respiratory syndrome virus
MLN
mesenteric lymph nodes
RBD
receptor binding domain
SARS
severe acute respiratory syndrome
TMPRSS2
Transmembrane serine protease 2
YFV
yellow fever virus
ZIKV
Zika virus

Cited by (0)

1

Equal contribution.

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