Abstract
The costs of coronavirus disease 2019 (COVID-19) are devastating. With millions of deaths worldwide, specific serological biomarkers, antiviral agents, and novel therapies are urgently required to reduce the disease burden. For these purposes, a profound understanding of the pathobiology of COVID-19 is mandatory. Notably, the study of immunity against other respiratory infections has generated reference knowledge to comprehend the paradox of the COVID-19 pathogenesis. Past studies point to a complex interplay between cytokines and other factors mediating wound healing and extracellular matrix (ECM) remodeling that results in exacerbated inflammation, tissue injury, severe manifestations, and a sequela of respiratory infections. This review provides an overview of the immunological process elicited after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Also, we analyzed available data about the participation of matrix metalloproteinases (MMPs) and transforming growth factor-beta (TGF-β) in immune responses of the lungs. Furthermore, we discuss their possible implications in severe COVID-19 and sequela, including pulmonary fibrosis, and remark on the potential of these molecules as biomarkers for diagnosis, prognosis, and treatment of convalescent COVID-19 patients. Our review provides a theoretical framework for future research aimed to discover molecular hallmarks that, combined with clinical features, could serve as therapeutic targets and reliable biomarkers of the different clinical forms of COVID-19, including convalescence.
Keywords: ARDS; COVID-19; MMPs; SARS-CoV-2; TGF-β; pulmonary fibrosis.
【저자키워드】 COVID-19, SARS-CoV-2, ARDS, MMPs, TGF-β, pulmonary fibrosis., 【초록키워드】 Treatment, coronavirus disease, respiratory infections, Inflammation, Coronavirus disease 2019, ARDS, immune response, therapy, Biomarker, Biomarkers, Cytokines, severe COVID-19, Immunity, Prognosis, knowledge, pulmonary fibrosis, Infection, Diagnosis, fibrosis, cytokine, severe acute respiratory syndrome coronavirus-2, severe acute respiratory syndrome Coronavirus, Clinical features, Severe acute respiratory syndrome, Participation, COVID-19 pathogenesis, immune responses, Lungs, Antiviral agents, Research, death, Manifestations, convalescence, matrix metalloproteinases, molecular, respiratory, serological, therapeutic targets, convalescent COVID-19 patients, Coronavirus-2, TGF-β, Extracellular matrix, ECM, therapeutic target, tissue injury, transforming growth factor, matrix metalloproteinase, acute respiratory syndrome, Factor, sequela, available data, acute respiratory syndrome coronavirus, growth, other respiratory infections, acute respiratory syndrome coronavirus-2, complex interplay, wound healing, hallmark, paradox, implication, immunological, remark, analyzed, the disease, required, exacerbated, provide, reduce, other respiratory infection, elicited, clinical form, mandatory, pathobiology of COVID-19, 【제목키워드】 matrix, role,