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Impact of SARS-CoV-2 infection and COVID-19 on patients with inborn errors of immunity - 13/12/22

Doi : 10.1016/j.jaci.2022.11.010 
Stuart G. Tangye, PhD
for the

COVID Human Genetic Effort consortium

  Members of the COVID Human Genetic Effort consortium are listed in the Acknowledgments at the end of the article.

 Garvan Institute of Medical Research, Darlinghurst, Darlinghurst, Australia 
 St Vincent’s Clinical School, University of New South Wales Sydney, Randwick, Randwick, Australia 
 Clinical Immunogenomics Research Consortium of Australasia (CIRCA) 

Corresponding author: Stuart G. Tangye, PhD, Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010 Australia.Garvan Institute of Medical Research384 Victoria StDarlinghurstNSW2010Australia

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Abstract

Since the arrival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, its characterization as a novel human pathogen, and the resulting coronavirus disease 2019 (COVID-19) pandemic, over 6.5 million people have died worldwide—a stark and sobering reminder of the fundamental and nonredundant roles of the innate and adaptive immune systems in host defense against emerging pathogens. Inborn errors of immunity (IEI) are caused by germline variants, typically in single genes. IEI are characterized by defects in development and/or function of cells involved in immunity and host defense, rendering individuals highly susceptible to severe, recurrent, and sometimes fatal infections, as well as immune dysregulatory conditions such as autoinflammation, autoimmunity, and allergy. The study of IEI has revealed key insights into the molecular and cellular requirements for immune-mediated protection against infectious diseases. Indeed, this has been exemplified by assessing the impact of SARS-CoV-2 infection in individuals with previously diagnosed IEI, as well as analyzing rare cases of severe COVID-19 in otherwise healthy individuals. This approach has defined fundamental aspects of mechanisms of disease pathogenesis, immunopathology in the context of infection with a novel pathogen, and therapeutic options to mitigate severe disease. This review summarizes these findings and illustrates how the study of these rare experiments of nature can inform key features of human immunology, which can then be leveraged to improve therapies for treating emerging and established infectious diseases.

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Key words : SARS-CoV-2, COVID-19, inborn errors of immunity, primary immune deficiencies, immune dysregulation, type I IFN signaling, cytokine storm

Abbreviations used : APECED, AR, BTK, CFR, COVID-19, CVID, GOF, ICU, IEI, JAK, mAb, SARS-CoV-2, XL, XLA


Plan


 S.G.T. is supported by an Investigator Grant awarded by the National Health and Medical Research Council of Australia, the Allergy & Immunology Foundation of Australia, the Jeffrey Modell Foundation, and a University of New South Wales Sydney COVID Rapid Response Initiative grant. H.C.S. and L.D.N. (listed under the COVID Human Genetic Effort consortium) are supported by the Division of Intramural Research of the National Institute of Allergy and Infectious Diseases, NIH. J.L.C. (listed under the COVID Human Genetic Effort consortium) is supported by the NIH (R01AI088364, R01AI163029, UL1TR001866), Fisher Center for Alzheimer’s Research Foundation, Meyer Foundation, JPB Foundation, French National Research Agency (ANR-10-IAHU-01, ANR-10-LABX-62-IBEID, ANR-20-CE93-003, ANR-20-CO11-0001, French Foundation for Medical Research (EQU201903007798), the ANRS-COV05, European Union’s Horizon 2020 Research and Innovation Program (824110; EASI-genomics), HORIZON-HLTH-2021-DISEASE-04 Program (01057100; UNDINE), the ANR-RHU COVIFERON Program (ANR-21-RHUS-08), the Square Foundation, Grandir - Fonds de solidarité pour l’enfance, the Fondation du Souffle, the SCOR Corporate Foundation for Science, and French Ministry of Higher Education, Research, and Innovation (MESRI-COVID-19).
 Disclosure of potential conflict of interest: The author declares no relevant conflicts of interest.


© 2022  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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