Journal
EUROPEAN JOURNAL OF IMMUNOLOGY
Volume 51, Issue 7, Pages 1652-1659Publisher
WILEY
DOI: 10.1002/eji.202048959
Keywords
COVID-19; SARS-CoV-2; complement; C5a; cytokine storm
Categories
Funding
- European Research Council (ERC) [694502, 875102]
- Agence Nationale de la Recherche including the PIONEER Project [ANR-17-RHUS-0007]
- MSDAvenir
- Innate Pharma and institutional grants
- Marseille Immunopole
- European Research Council (ERC) [694502, 875102] Funding Source: European Research Council (ERC)
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The overactivation of the complement system in severe cases of COVID-19 can lead to serious complications, and immunotherapies show promise in the treatment of the disease. Complement blockade, particularly targeting the C5a-C5aR axis, may help prevent the worsening of ARDS.
The complement system is an essential component of the innate immune system. The three complement pathways (classical, lectin, alternative) are directly or indirectly activated by the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). In the most severe forms of COVID-19, overactivation of the complement system may contribute to the cytokine storm, endothelial inflammation (endotheliitis) and thrombosis. No antiviral drug has yet been shown to be effective in COVID-19. Therefore, immunotherapies represent a promising therapeutic in the immunopathological phase (following the viral phase) of the disease. Complement blockade, mostly C5a-C5aR axis blockade, may prevent acute respiratory distress syndrome (ARDS) from worsening or progression to death. Clinical trials are underway.
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