Pathogenic Human Coronavirus Infections: Causes and Consequences of Cytokine Storm and Immunopathology

Semin Immunopathol. 2017 Jul;39(5):529-539. doi: 10.1007/s00281-017-0629-x. Epub 2017 May 2.

Abstract

Human coronaviruses (hCoVs) can be divided into low pathogenic and highly pathogenic coronaviruses. The low pathogenic CoVs infect the upper respiratory tract and cause mild, cold-like respiratory illness. In contrast, highly pathogenic hCoVs such as severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV) predominantly infect lower airways and cause fatal pneumonia. Severe pneumonia caused by pathogenic hCoVs is often associated with rapid virus replication, massive inflammatory cell infiltration and elevated pro-inflammatory cytokine/chemokine responses resulting in acute lung injury (ALI), and acute respiratory distress syndrome (ARDS). Recent studies in experimentally infected animal strongly suggest a crucial role for virus-induced immunopathological events in causing fatal pneumonia after hCoV infections. Here we review the current understanding of how a dysregulated immune response may cause lung immunopathology leading to deleterious clinical manifestations after pathogenic hCoV infections.

Keywords: Cytokine storm; Immunopathology; Interferon; MERS-CoV; Monocyte-macrophage; SARS-CoV.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology
  • Chemokines / metabolism
  • Combined Modality Therapy
  • Coronavirus / drug effects
  • Coronavirus / physiology*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / metabolism*
  • Coronavirus Infections / virology
  • Cytokines / metabolism*
  • Disease Models, Animal
  • Disease Susceptibility
  • Humans
  • Immune System / cytology
  • Immune System / immunology
  • Immune System / metabolism
  • Immunity, Innate
  • Interferons / metabolism
  • Interferons / pharmacology
  • Lung / immunology
  • Lung / metabolism
  • Lung / pathology
  • Lung / virology
  • Macrophages / immunology
  • Monocytes / immunology
  • Monocytes / metabolism
  • Phenotype
  • Severity of Illness Index
  • Virus Replication / drug effects
  • Virus Replication / immunology

Substances

  • Antiviral Agents
  • Chemokines
  • Cytokines
  • Interferons