T Helper 17 Response to Severe Acute Respiratory Syndrome Coronavirus 2: A Type of Immune Response with Possible Therapeutic Implications

Viral Immunol. 2021 Apr;34(3):190-200. doi: 10.1089/vim.2020.0177. Epub 2021 Feb 23.

Abstract

The initial immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) includes an interferon-dependent antiviral response. A late and uncontrolled inflammatory response characterized by high activity of proinflammatory cytokines and the recruitment of neutrophils and macrophages develops in predisposed individuals and is potentially harmful in some cases. Interleukin (IL)-17 is one of the many cytokines released during coronavirus disease 2019 (COVID-19). IL-17 is crucial in recruiting and activating neutrophils, cells that can migrate to the lung, and are heavily involved in the pathogenesis of COVID-19. During the infection T helper 17 (Th17) cells and IL-17-related pathways are associated with a worse outcome of the disease. All these have practical consequences considering that some drugs with therapeutic targets related to the Th17 response may have a beneficial effect on patients with SARS-CoV-2 infection. Herein, we present the arguments underlying our assumption that blocking the IL-23/IL-17 axis using targeted biological therapies as well as drugs that act indirectly on this pathway such as convalescent plasma therapy and colchicine may be good therapeutic options.

Keywords: COVID-19; Th17 cells; colchicine; inflammasomes; severe acute respiratory syndrome coronavirus 2.

MeSH terms

  • Adaptive Immunity
  • Adult
  • COVID-19 / classification
  • COVID-19 / immunology*
  • COVID-19 Drug Treatment
  • Humans
  • Immunity, Innate
  • Interleukin-17 / antagonists & inhibitors
  • Interleukin-17 / physiology
  • Interleukin-23 / antagonists & inhibitors
  • Middle Aged
  • SARS-CoV-2 / immunology*
  • Th17 Cells / immunology*

Substances

  • Interleukin-17
  • Interleukin-23