Pecado antigênico original entre os coronavírus humanos comuns e o SARS-CoV-2: implicações clínicas da COVID-19
DOI:
https://doi.org/10.22579/22484817.1311Palavras-chave:
Células de memória, Coronavírus humano endêmico, Efeito Hoskins, Memória imunológica, Reatividade cruzadaResumo
O objetivo foi realizar uma revisão sistemática sobre o fenômeno do pecado antigênico original (OAS) em pacientes com coronavírus 2019 que apresentam anticorpos ou células T de reatividade cruzada previamente gerados por coronavírus humanos endêmicos (HCoV), bem como as implicações na resposta humoral, gravidade da doença e eficácia da vacinação. Essa revisão sistemática foi estruturada de acordo com o protocolo PRISMA e a pesquisa foi feita em três bancos de dados: NCBI, BVS e EMBASE, seguindo os seguintes termos: Original antigenic sin, SARS-CoV-2, immunological memory, cross-reactivity, human coronavirus 229E, human coronavirus NL63, and human coronavirus OC43. 956 artigos científicos foram recuperados por meio da estratégia de busca. Entre eles, 724 artigos do MEDLINE, 200 artigos do EMBASE e 28 artigos do BVS. Em seguida, as duplicatas foram removidas, seguidas pela implementação dos critérios de inclusão e exclusão. Foram incluídos 60 artigos que se enquadravam na revisão sistemática. A memória imunológica gerada pelo HCoV endêmico tem a capacidade de induzir a imunopatologia por meio de OEA, aumentando as imunoglobulinas (Ig) classe G ou títulos de classe que descrevem a reatividade cruzada com epítopos não neutralizantes do coronavírus 2 da Síndrome Respiratória Aguda Grave e diminuindo a resposta de novos anticorpos contra epítopos neutralizantes. O quadro clínico pode piorar graças ao aprimoramento dependente de anticorpos (ADE). Por fim, não há evidências de que as vacinas existentes contra o SARS-CoV-2 induzam a ADE ou sejam influenciadas pela OAS.
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