1. Enhancing innate immunity against virus in times of COVID-19: trying to untangle facts from fictions
- Author
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Alan Estrada-Cardona, María Isabel Rojo-Gutiérrez, Désirée Larenas-Linnemann, César Fireth Pozo-Beltrán, Ernesto Onuma-Takane, Blanca Estela Del Río-Navarro, María Virginia Blandón-Vijil, Jorge A. Luna-Pech, J. E. Gereda, Noel Rodríguez-Pérez, Alfredo Arias-Cruz, and Elsy Maureen Navarrete-Rodríguez
- Subjects
BV, Bacterial vaccine ,mindfulness ,ACE2, Angiotensin converting enzime-2 ,Systemic inflammatory response syndrome, TCR :T-cell receptor ,APC, Antigen-presenting cell ,Heat shock proteins, HLA-DR ,bacterial vaccine ,Immunoglobulin, IGFBP6 ,immune response ,DLE, Dialyzable leukocyte extract ,PPD, Purified protein derivative (tuberculin) ,trained immunity ,MCP-1, Monocyte chemoattractant protein-1 ,NK, Natural killer ,Gαs: G protein coupled receptor alfa-subunits, HSP ,Rapid eye movement, RIPK2 ,Pandemic ,Immunology and Allergy ,TNF-α, Tumor necrosis factor alpha ,R0 : Basic reproduction number, REM ,PUFA, Polyunsaturated fatty acid ,NOD2, Nucleotide-binding oligomerization domain-containing protein 2 ,Toll-like receptor ,Reactive oxygen species, SARS-CoV-2 ,Respiratory tract infections ,exercise ,CNS, Central nervous system ,Interferon, IG ,MMR ,DC, Dendritic cell ,Bacterial vaccine ,Reactive nitrogen species, ROS ,PKC, Protein kinase C ,BCG, Bacillus Calmette-Guérin ,DAMPs, Damage-associated molecular patterns ,TLR, Toll-like receptor ,Pulmonary and Respiratory Medicine ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Interleukin, MBSR ,CCL-5, Chemokine (C-C motif) ligand 5 ,Immunology ,Insulin-like growth-factor-binding-protein 6, IL ,Major histocompatibility complex class II cell surface receptor, ICAM-1 ,COVID-19, Coronavirus disease-2019 ,Article ,OxPhos: Oxidative phosphorylation, PAMPs ,Immune system ,Immunity ,NK-cell ,URTI, Upper-respiratory tract infection ,Bacillus Calmette-Guérin ,medicine ,innate ,Intercellular adhesion molecule type 1, IFN ,MODS, Multi-organ dysfunction syndrome ,NF-κB, Nuclear factor kappaB ,sleep ,Intensive care medicine ,Innate immune system ,Severe acute respiratory syndrome coronavirus 2, SIRS ,business.industry ,CI, Confidence interval ,Pathogen-associated molecular patterns, PBMC ,COVID-19 ,Mindfulness-based stress reduction, mCa++: Intramitochondrial calcium ,Review article ,MyD88, Myeloid differentiation primary response 88 ,TRPV, Thermolabile calcium channels ,CXCR3A, CXC chemokine receptor 3A ,Receptor iteracting serine/threonine kinase 2, RNA ,Ribonucleic acid, RNS ,business ,lcsh:RC581-607 ,Peripheral blood mononuclear cell, PI3K/Akt: Phosphatidylinositol 3-kinase pathway ,OR, Odds ratio ,Th, T helper-cell - Abstract
Introduction In light of the current COVID-19 pandemic, during which the world is confronted with a new, highly contagious virus that suppresses innate immunity as one of its initial virulence mechanisms, thus escaping from first-line human defense mechanisms, enhancing innate immunity seems a good preventive strategy. Methods Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we discuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections. Some of these interventions can also stimulate the adaptive T- and B-cell responses, but our main focus is on the innate part of immunity. We divide the reviewed interventions into: 1) lifestyle related (exercise, >7 h sleep, forest walking, meditation/mindfulness, vitamin supplementation); 2) Non-specific immune stimulants (letting fever advance, bacterial vaccines, probiotics, dialyzable leukocyte extract, pidotimod), and 3) specific vaccines with heterologous effect (BCG vaccine, mumps-measles-rubeola vaccine, etc). Results For each of these interventions we briefly comment on their definition, possible mechanisms and evidence of clinical efficacy or lack of it, especially focusing on respiratory tract infections, viral infections, and eventually a reduced mortality in severe respiratory infections in the intensive care unit. At the end, a summary table demonstrates the best trials supporting (or not) clinical evidence. Conclusion Several interventions have some degree of evidence for enhancing the innate immune response and thus conveying possible benefit, but specific trials in COVID-19 should be conducted to support solid recommendations.
- Published
- 2020