The severe cases of Coronavirus Disease 2019 (COVID-19) frequently exhibit excessive inflammatory responses, acute respiratory distress syndrome (ARDS), coagulopathy, and organ damage. The most striking immunopathology of advanced COVID-19 is cytokine release syndrome or “cytokine storm” that is attributable to the deficiencies in immune regulatory mechanisms. CD4 + FoxP3 + regulatory T cells (Tregs) are central regulators of immune responses and play an indispensable role in the maintenance of immune homeostasis. Tregs are likely involved in the attenuation of antiviral defense at the early stage of infection and ameliorating inflammation-induced organ injury at the late stage of COVID-19. In this article, we review and summarize the current understanding of the change of Tregs in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and discuss the potential role of Tregs in the immunopathology of COVID-19. The emerging concept of Treg-targeted therapies, including both adoptive Treg transfer and low dose of IL-2 treatment, is introduced. Furthermore, the potential Treg-boosting effect of therapeutic agents used in the treatment of COVID-19, including dexamethasone, vitamin D, tocilizumab and sarilumab, chloroquine, hydroxychloroquine, azithromycin, adalimumab and tetrandrine, is discussed. The problems in the current study of Treg cells in COVID-19 and future perspectives are also addressed.
【저자키워드】 COVID-19, SARS-CoV-2, CD4+FoxP3+ regulatory T cells, immunopathology, 【초록키워드】 Dexamethasone, Treatment, coronavirus disease, severe acute respiratory syndrome coronavirus 2, Respiratory distress syndrome, Coronavirus disease 2019, ARDS, Cytokine storm, coronavirus, immune response, Chloroquine, Azithromycin, Hydroxychloroquine, acute respiratory distress syndrome, Inflammatory responses, Vitamin D, Antiviral, Tocilizumab, T cells, Infection, sarilumab, cytokine, immunopathology, severe acute respiratory syndrome Coronavirus, CD4, immune, Cytokine release syndrome, Coagulopathy, Regulatory, Regulatory T cell, immune responses, low dose, Patient, Immune homeostasis, severe cases, therapeutic agent, therapeutic agents, attenuation, mechanisms, respiratory, early stage, regulatory T cells, FOXP3, Treg, Therapies, adalimumab, IL-2, acute respiratory distress, Tregs, maintenance, respiratory distress, deficiency, acute respiratory syndrome, tetrandrine, acute respiratory syndrome coronavirus, problems, deficiencies, Perspective, syndrome, transfer, organ injury, Severe case, problem, organ damage, late stage, Treg cells, Defense, involved, introduced, addressed, “cytokine storm”, Treg cell, 【제목키워드】 Treatment, CD4, Regulatory, T cell, Immunopathogenesis, implication,