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The bm12 Inducible Model of Systemic Lupus Erythematosus SLE in C57BL/6 Mice
Published on: November 1, 2015
COVID-19 and Systemic Lupus Erythematosus: Focus on Immune Response and Therapeutics
Allison P Spihlman1,2, Nirupa Gadi1,2, Samantha C Wu1,2
1Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Insights
Systemic lupus erythematosus (SLE) patients, often immunocompromised, face increased vulnerability to COVID-19. Understanding the immune response in SLE is crucial for managing this infection and preventing severe outcomes.
Area of Science:
- Immunology
- Infectious Diseases
- Rheumatology
Background:
- COVID-19 pandemic caused by SARS-CoV-2 has disproportionately affected vulnerable populations, including the elderly and those with comorbidities.
- Black and Hispanic populations experience higher COVID-19 rates, mirroring disparities seen in systemic lupus erythematosus (SLE).
- Individuals with compromised immune systems are at higher risk for severe infections and complications.
Purpose of the Study:
- To explore the complex interplay between the immune response in systemic lupus erythematosus (SLE) and susceptibility to SARS-CoV-2 infection.
- To highlight the potential increased vulnerability of lupus patients to COVID-19 due to their autoimmune condition and immunosuppressive treatments.
- To emphasize the need for understanding immune responses for effective management of COVID-19 in SLE patients.
Main Methods:
- Review of existing literature on COVID-19, SARS-CoV-2, and systemic lupus erythematosus (SLE).
- Analysis of immune system dysregulation in SLE, including autoantibodies, lymphopenia, and cytokine profiles.
- Examination of the impact of immunosuppressive therapies on infection risk in SLE patients.
Main Results:
- Lupus patients exhibit aberrant immune responses, characterized by autoantibodies, lymphopenia, and pro-inflammatory cytokines.
- Immunosuppressive treatments common in SLE management further compromise immune function, increasing infection susceptibility.
- An uncontrolled inflammatory response in COVID-19 can lead to cytokine storms, causing severe organ damage, a risk potentially amplified in SLE patients.
Conclusions:
- Systemic lupus erythematosus (SLE) patients are a vulnerable group for COVID-19 due to immune dysregulation and immunosuppression.
- Understanding the dual role of the immune response—antiviral defense versus detrimental inflammation—is critical for managing COVID-19 in SLE.
- Further research into immune responses and therapeutic strategies is essential for guiding clinical management in co-infected patients.
Abstract:
The SARS-CoV-2 novel coronavirus has caused the COVID-19 pandemic with over 35 million cases and over a million deaths worldwide as of early October 2020. The populations most affected are the elderly and especially those with underlying comorbidities. In terms of race and ethnicity, black and hispanic populations are affected at disproportionately higher rates. Individuals with underlying conditions that cause an immune-compromised state are considered vulnerable to this infection. The immune response is an important determinant in viral infections including coronaviruses, not only in the antiviral defense but also in the disease progression, severity, and clinical outcomes of COVID-19. Systemic lupus erythematosus is a chronic autoimmune disease which also disproportionately afflicts black and hispanic populations. In lupus patients, an aberrant immune response is characterized by the presence of circulating autoantibodies, lymphopenia, aberrant T cells, and proinflammatory cytokines along with defective regulatory mechanisms, leading to immune-mediated damage to tissues. Lupus patients are often treated with immune-suppressants and therefore are immune-compromised and more susceptible to infections and may be vulnerable to coronavirus infection. While the anti-viral immune response is important to protect from coronavirus infection, an uncontrolled proinflammatory cytokine response can lead to cytokine storm which causes damage to the lungs and other organs, causing significant morbidity and mortality. Better understanding of the underlying immune response and therapeutic strategies in lupus and COVID-19 is important to guide management of this deadly infectious disease in the context of lupus and vice-versa.
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