新型冠状病毒(SARS-CoV-2)概述

2019冠状病毒病(coronavirus disease 2019,COVID-19)是由严重急性呼吸综合征冠状病毒-2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染引起的新型肺炎.SARS-CoV-2具有高传染性、高致病性以及高死亡率的特...     

严重急性呼吸综合征冠状病毒诊断标志物动态变化及检测方法的研究进展

2019-冠状病毒病(coronavirus disease 2019, COVID-19)在全球范围内流行,患者出现严重急性呼吸系统疾病,传染性高于2003年暴发的严重急性呼吸综合征(severe acute respiratory syndrome, SARS)。COVID-19严重影响了人类的健康,同时引起了人们的恐慌。因此,快速、精准地诊断COVID-19患者,阻断病毒快速传播至关重要,但是在COVID-19诊断中存在早期漏检和后期复阳等情况。现综述严重急性呼吸综合征冠状病毒(severe acute respiratory syndrome coronavirus, SARS-CoV)感染后各标志物的动态变化及检测意义,并将其与严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)进行比较,以期为SARS-CoV-2等冠状病毒的高效诊断提供借鉴。     

新型冠状病毒致病机理及其疫苗的研发进展

新型冠状病毒(severe acute respiratory syndrome coronavirus-2, SARS-CoV-2)是一种可引起人新型冠状病毒肺炎(novel coronavirus pneumonia, NCP;亦称为COVID-19)的新发呼吸道病原体,与中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus, MERS-CoV)和严重急性呼吸综合征冠状病毒(severe acute respiratory syndrome coronavirus, SARS-CoV)同属β-冠状病毒,其受体与SARS-CoV的受体相同,均利用血管紧张素转化酶2(angiotensin-converting enzyme 2, ACE2)受体入侵人体细胞。SARS-CoV-2主要通过呼吸系统和消化系统感染,具有较高的传染性和致死率。目前,新冠病毒引起的肺炎已在全球范围内大规模蔓延,接种疫苗是根除病毒性传染病最有效的方法,国内外各大科研机构已快速展开COVID-19疫苗的研制工作,这是有效控制疫情的重点和难点。现就新冠病毒的致病机理、感染途径及疫苗研发作一综述,旨在为相关研究人员提供参考。     

关于新型冠状病毒动物宿主和动物感染的研究进展

新型冠状病毒（Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）是一种全新的病毒,是继严重急性呼吸综合征冠状病毒（Severe acute respiratory syndrome coronavirus, SARS-CoV）和中东呼吸综合征冠状病毒（Middle East Respiratory Syndrome Syndrome Coronavirus, MERS-CoV）之后引起人类大范围感染的第三种冠状病毒。目前不少研究提示SARS-CoV-2可能来源于动物,动物在疫情的发生与传播过程中起着重要作用。这篇综述总结了目前关于SARS-CoV-2动物宿主和动物易感性的最新研究进展。现有研究提示,SARS-CoV-2很可能起源于蝙蝠,穿山甲是中间宿主。恒河猴,水貂、白尾鹿,动物园里的老虎、狮子,以及宠物猫、狗等动物可能在暴露后发生SARS-CoV-2感染,此外实验室动物感染实验也证明了一些动物对SARS-CoV-2易感,提示下一步需要加强对动物宿主中的SARS-CoV-2监测,为病毒溯源、变异进化规律与传播机制分析...     

严重急性呼吸系统综合征冠状病毒2感染/疫苗接种引起的免疫印记

先前发生的病毒感染或疫苗接种引起的免疫应答,强烈影响机体对该病毒后续暴露的免疫应答,这种现象被称为免疫印记。免疫印记也可出现在感染严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)或接种SARS-CoV-2疫苗的个体。发生了免疫印记的个体对再次遇到的完全相同的SARS-CoV-2毒株发动更强的免疫反应,而对新暴露的SARS-CoV-2变异株仅能发动微弱的免疫反应。免疫印记是SARS-CoV-2变异株在以前感染SARS-CoV-2或接种SARS-CoV-2疫苗的人群形成突破感染的一个不可忽略的原因。克服免疫印记是研制能预防未来SARS-CoV-2突变株感染的SARS-CoV-2疫苗的迫切任务。     

冠状病毒疫苗的研究进展

严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)自被发现以来就引起了人们的广泛关注,开发针对该病毒的安全、有效疫苗成为近期的研究热点。本文以高致病性冠状病毒疫苗(包括灭活疫苗、重组亚单位疫苗、重组病毒载体疫苗和核酸疫苗)的研究展开综述,为研制SARS-CoV-2疫苗提供参考。     

从肠道菌群角度再认识血管紧张素转换酶2在严重急性呼吸综合征冠状病毒2致病机制中的潜在作用

2019冠状病毒病(coronavirus disease 2019,COVID-19)的病原学和临床表现多有报道。该病在病原学和临床表现上与发生在2003年的严重急性呼吸综合征(severe acute respiratory syndrome, SARS)有诸多相似性。本文通过对比两者异同,尝试从其共同受体血管紧张素转换酶2(angiotensin converting enzyme 2,ACE2)角度,提出并探讨患者肠道菌群可能参与其致病的潜在机制,旨在为深入探索新型冠状病毒,即严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)的致病机制及加速研发重症肺炎预测指标提供一种可能的新思路。     

MERS-CoV动物模型研究进展

中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus,MERS-CoV)最早发现于2012年,是继严重急性呼吸窘迫综合征冠状病毒(severe acute respiratory syndrome coronavirus,SARS-CoV)之后,引起人类严重感染的又一种重要冠状病毒。对于该种新发现、致病性强、病死率高的感染性疾病,开发有效的动物模型对于研究疾病的发病过程、致病机理、评估预防与治疗措施的效果等具有重要理论和现实意义。到目前为止,非人灵长类动物如恒河猴、狨猴,小型动物如小鼠、仓鼠、雪貂、新西兰白兔等均被尝试作为MERS-CoV感染的动物模型。其中一些已经用于评估疫苗或药物的干预效果。本文就MERS-CoV动物模型研究进展作一综述。     

新型冠状病毒肺炎的诊断、治疗和预防

新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）是一种由严重急性呼吸系统综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）引发的传染病. 此种病毒传染性强，患者感染后会出现严重的急性呼吸道感染症状，部分患者感染后预后极差甚至死亡，其严重地影响到人们的正常生活. 现阶段各个国家正在积极地进行相关研究，并对疫情爆发后所要采取的应对方案进行了深入探讨. 本文围绕SARS-CoV-2的病原学特点、致病机理和检测方法以及COVID-19的治疗和预防等方面进行重点讲述.     

2019冠状病毒病对肺外系统的影响及可能机制探讨

2019冠状病毒病(coronavirus disease 2019,COVID-19)是由严重急性呼吸综合征冠状病毒2 (severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)导致的感染性疾病。SARS-CoV-2感染人体后除作用于肺部的SARS-CoV-2功能受体外,还可以作用于心脏、消化道、肝脏、肾脏、中枢系统的SARS-CoV-2功能受体,引起肺外脏器的损伤,诱发多器官功能衰竭,增加COVID-19的病死率。但目前对SARS-CoV-2引起肺外各脏器损伤的具体作用机制还不是很清楚,需要更多临床和实验室数据支持。通过检索COVID-19相关的文献,对SARS-CoV-2导致的肺外系统影响及其可能作用机制作一综述。     

A cytokine super cyclone in COVID-19 patients with risk factors: the therapeutic potential of BCG immunization

The seventh human coronavirus SARS-CoV2 belongs to the cluster of extremely pathogenic coronaviruses including SARS-CoV and MERS-CoV, which can cause fatal lower respiratory tract infection. Likewise, SARS-CoV2 infection can be fatal as the disease advances to pneumonia, followed by acute respiratory distress syndrome (ARDS). The development of lethal clinical symptons is associated with an exaggerated production of inflammatory cytokines, referred to as the cytokine storm, is a consequence of a hyperactivated immune response aginst the infection. In this article, we discuss the pathogenic consequences of the cytokine storm and its relationship with COVID-19 associated risk factors. The increased pro-inflammatory immune status in patients with risk factors (diabetes, hypertension, cardiovascular disease, COPD) exacerbates the Cytokine-storm of COVID-19 into a ‘Cytokine Super Cyclone’. We also evaluate the antiviral immune responses provided by BCG vaccination and the potential role of ‘trained immunity’ in early protection against SARS-CoV2.     

免疫系统：严重急性呼吸综合征冠状病毒2型感染后的一把双刃剑

免疫系统是人体内的一把双刃剑,它一方面能清除侵染的各类病原体,但另一方面其异常调控又能在人体中引发各类免疫性疾病,甚至导致死亡。本文将简要讨论人体免疫系统与新的冠状病毒﹝即严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)〕感染的相互关系。一方面免疫系统能全方位地预防病毒感染,进化出一整套从分子到细胞、从短期到长期的病毒清除机制;另一方面,免疫系统又可能引发“细胞因子风暴”,给SARS-CoV-2的感染患者带来负面作用。本文还将讨论受到广泛关注的免疫相关的治疗策略,着重探讨抗体依赖的增强效应(antibody-dependent enhancement, ADE)可能给疫苗研发带来的困难与挑战。     

Interferon and cytokine responses to SARS-coronavirus infection

The sudden emergence of severe acute respiratory syndrome (SARS) has boosted research on innate immune responses to coronaviruses. It is now well established that the causative agent, a newly identified coronavirus termed SARS-CoV, employs multiple passive and active mechanisms to avoid induction of the antiviral type I interferons in tissue cells. By contrast, chemokines such as IP-10 or IL-8 are strongly upregulated. The imbalance in the IFN response is thought to contribute to the establishment of viremia early in infection, whereas the production of chemokines by infected organs may be responsible for (i) massive immune cell infiltrations found in the lungs of SARS victims, and (ii) the dysregulation of adaptive immunity. Here, we will review the most recent findings on the interaction of SARS-CoV and related Coronaviridae members with the type I interferon and cytokine responses and discuss implications for pathogenesis and therapy.     

Antibody-dependent SARS coronavirus infection is mediated by antibodies against spike proteins

The severe acute respiratory syndrome coronavirus (SARS-CoV) still carries the potential for reemergence, therefore efforts are being made to create a vaccine as a prophylactic strategy for control and prevention. Antibody-dependent enhancement (ADE) is a mechanism through which dengue viruses, feline coronaviruses, and HIV viruses take advantage of anti-viral humoral immune responses to infect host target cells. Here we describe our observations of SARS-CoV using ADE to enhance the infectivity of a HL-CZ human promonocyte cell line. Quantitative-PCR and immunofluorescence staining results indicate that SARS-CoV is capable of replication in HL-CZ cells, and of displaying virus-induced cytopathic effects and increased levels of TNF-α, IL-4 and IL-6 two days post-infection. According to flow cytometry data, the HL-CZ cells also expressed angiotensin converting enzyme 2 (ACE2, a SARS-CoV receptor) and higher levels of the FcγRII receptor. We found that higher concentrations of anti-sera against SARS-CoV neutralized SARS-CoV infection, while highly diluted anti-sera significantly increased SARS-CoV infection and induced higher levels of apoptosis. Results from infectivity assays indicate that SARS-CoV ADE is primarily mediated by diluted antibodies against envelope spike proteins rather than nucleocapsid proteins. We also generated monoclonal antibodies against SARS-CoV spike proteins and observed that most of them promoted SARS-CoV infection. Combined, our results suggest that antibodies against SARS-CoV spike proteins may trigger ADE effects. The data raise new questions regarding a potential SARS-CoV vaccine, while shedding light on mechanisms involved in SARS pathogenesis.     

新型冠状病毒基因组G-四链体结构的初步研究

21世纪以来,冠状病毒频频引起危害人类健康的重要传染病,其中包括2003年严重急性呼吸综合征冠状病毒(SARS-CoV)、2012年中东呼吸综合征冠状病毒(MERS-CoV)和新型冠状病毒(SARS-CoV-2),目前对这些病毒引发的疾病并无特效的治疗药物。G-四链体(G-quadruplex,G4)是在DNA或RNA的鸟嘌呤富集区形成的非典型二级结构,可存在于人类和病毒基因组中,G-四链体的不同位置对病毒复制和感染等过程发挥重要调控作用。本研究针对七种与人类疾病相关的冠状病毒以及与SARS-CoV-2同源性较高的三种蝙蝠相关病毒,通过全基因组序列分析潜在四链体形成序列(Potential quadruplex-forming sequences,PQS),结果发现,十种病毒中均存在一定数量的PQS基序,同时对SARS-CoV-2 G-四链体存在位置及形成潜力进行评估,并分析了不同变异株间G-四链体基序的保守性。本研究对SARS-CoV-2基因组中G-四链体进行初步预测与探讨,旨在为COVID-19治疗提供一种新的药物靶点,使其更好地应用于临床研究。     

Severe acute respiratory syndrome and the innate immune responses: modulation of effector cell function without productive infection

Severe acute respiratory syndrome (SARS) caused by a novel human coronavirus (CoV), designated SARS-CoV, is a highly contagious respiratory disease with the lungs as a major target. Although the exact mechanism of SARS-CoV pathogenesis remains unknown, an intense, ill-regulated local inflammatory response has been suggested as partially responsible for the devastating lung pathology. We investigated the interaction of SARS-CoV with human macrophages (Mphi) and dendritic cells (DC), two key innate immune cells of the host immune system, by focusing on their susceptibility to viral infection and subsequent responses (e.g., phenotypic maturation, T cell-priming activity, phagocytosis, and cytokine production). We found neither cell to be permissive for SARS-CoV replication. However, incubation of Mphi and DC with live, but not gamma irradiation-inactivated, viruses appeared to better sustain their viability. Also, exposure to infectious SARS-CoV led to the phenotypic and functional maturation of DC, with regard to MHC class II and costimulatory molecule expression, T cell-stimulatory capacity, and cytokine production, respectively. Cytokine production was also observed for Mphi, which were refractory to cell surface phenotypic changes. Strikingly, live SARS-CoV could further prime cell types to respond to a suboptimal dose of bacterial LPS (100 ng/ml), resulting in massive release of IL-6 and IL-12. However, the endocytic capacity (e.g., Ag capture) of Mphi was significantly compromised upon exposure to infectious SARS-CoV. This study is the first demonstration that although SARS-CoV does not productively infect human Mphi or DC, it appears to exert differential effects on Mphi and DC maturation and functions, which might contribute to SARS pathogenesis.     

An Impaired Inflammatory and Innate Immune Response in COVID-19

The recent appearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people around the world and caused a global pandemic of coronavirus disease 2019 (COVID-19). It has been suggested that uncontrolled, exaggerated inflammation contributes to the adverse outcomes of COVID-19. In this review, we summarize our current understanding of the innate immune response elicited by SARS-CoV-2 infection and the hyperinflammation that contributes to disease severity and death. We also discuss the immunological determinants behind COVID-19 severity and propose a rationale for the underlying mechanisms.