Abstract
Introduction: The SARS-CoV-2 infection has been advocated as an environmental trigger for autoimmune diseases, and a paradigmatic example comes from similarities between COVID-19 and the myositis-spectrum disease associated with antibodies against the melanoma differentiation antigen 5 (MDA5) in terms of clinical features, lung involvement, and immune mechanisms, particularly type I interferons (IFN).
Case report: We report a case of anti-MDA5 syndrome with skin manifestations, constitutional symptoms, and cardiomyopathy following a proven SARS-CoV-2 infection.
Systematic literature review: We systematically searched for publications on inflammatory myositis associated with COVID-19. We describe the main clinical, immunological, and demographic features, focusing our attention on the anti-MDA5 syndrome.
Discussion: MDA5 is a pattern recognition receptor essential in the immune response against viruses and this may contribute to explain the production of anti-MDA5 antibodies in some SARS-CoV-2 infected patients. The activation of MDA5 induces the synthesis of type I IFN with an antiviral role, inversely correlated with COVID-19 severity. Conversely, elevated type I IFN levels correlate with disease activity in anti-MDA5 syndrome. While recognizing this ia broad area of uncertainty, we speculate that the strong type I IFN response observed in patients with anti-MDA5 syndrome, might harbor protective effects against viral infections, including COVID-19.
Keywords: COVID-19; anti-MDA5 syndrome; autoimmune disease; cytokines; immunology; inflammatory myositis; type I interferon signature.
【저자키워드】 COVID-19, immunology, Cytokines, Autoimmune disease, anti-MDA5 syndrome, inflammatory myositis, type I interferon signature., 【초록키워드】 viruses, immunology, immune response, Cytokines, antibody, SARS-COV-2 infection, severity, lung involvement, interferons, COVID-19 severity, viral infections, Symptoms, immune, type I interferon, Clinical features, Pattern recognition, Autoimmune disease, Protective effects, Viral, Features, MDA5, Patient, Melanoma, Manifestations, IFN, type I interferons, Autoimmune, mechanisms, Cardiomyopathy, Autoimmune diseases, synthesis, disease, protective effect, Disease activity, Inflammatory, similarity, Trigger, skin manifestations, Type I IFN, pattern recognition receptor, myositis, in some, Activation, constitutional symptoms, differentiation antigen, SARS-CoV-2 infected patients, syndrome, similarities, signature, while, antiviral role, immunological, virus, example, elevated, searched, contribute, correlated, induce, recognizing, explain, with COVID-19, 【제목키워드】 review, literature, report, Type,