Id |
Subject |
Object |
Predicate |
Lexical cue |
T273 |
0-64 |
Sentence |
denotes |
Proinflammatory Molecules Released by Infiltrating Myeloid Cells |
T274 |
66-112 |
Sentence |
denotes |
Circulating inflammatory monocytes/macrophages |
T275 |
113-236 |
Sentence |
denotes |
A detailed account of the role of inflammatory macrophages in the pathogenesis of SARS-CoV is reported by He et al. (2007). |
T276 |
237-466 |
Sentence |
denotes |
Animal studies have demonstrated extensive recruitment and accumulation of these cells in the lungs, which correlated with the release of TNF-α, IL-1β, and IL-6 and the development of ARDS, reviewed by Gralinski and Baric (2015). |
T277 |
467-692 |
Sentence |
denotes |
Interestingly, depletion of these inflammatory macrophages in animals infected with SARS-CoV was associated with a high recovery rate, thus suggesting their critical role in disease pathogenesis (Channappanavar et al., 2016). |
T278 |
693-874 |
Sentence |
denotes |
Similarly, SARS-CoV infection in animals with STAT1 knockout in alternatively activated macrophages displayed attenuated lung damage and protection from disease (Page et al., 2012). |
T279 |
875-1043 |
Sentence |
denotes |
Besides, a large number of clinical studies support an integral role of IMMs in SARS-CoV infected patients (Wong et al., 2004; Tisoncik et al., 2012; Liu et al., 2019). |
T280 |
1044-1249 |
Sentence |
denotes |
Recent studies from BALF from COVID-19 patients have also demonstrated the critical role of circulating monocyte-derived macrophages in the induction of robust proinflammatory reaction (Liao et al., 2020). |
T281 |
1250-1375 |
Sentence |
denotes |
Blood cell analysis of 18 COVID-19 patients revealed an activated status of inflammatory macrophages (Zhang D. et al., 2020). |
T282 |
1376-1532 |
Sentence |
denotes |
In line with these findings, scRNA-seq followed by immune cell profiling of blood cells revealed an increased number of CD14++ monocytes (Wen et al., 2020). |
T283 |
1533-1670 |
Sentence |
denotes |
Severe and critically ill patients also exhibit macrophage activation syndrome (MAS) in some cases (Giamarellos-Bourboulis et al., 2020). |
T284 |
1671-1825 |
Sentence |
denotes |
Thus, all the evidence directs towards a critical role of inflammatory macrophages in disease severity during COVID-19 and a potential therapeutic target. |
T285 |
1826-2002 |
Sentence |
denotes |
Intervention which reduces the impetus to induce MAS like antibodies directed against IL-6 and IL-1β has shown promising clinical outcomes, reviewed by Otsuka and Seino (2020). |
T286 |
2004-2031 |
Sentence |
denotes |
Proinflammatory neutrophils |
T287 |
2032-2261 |
Sentence |
denotes |
Like other innate immune cells, neutrophils are protective in the early phases of infection by neutralizing the viral particles and release of protective molecules to interfere with the viral propagation (Drescher and Bai, 2013). |
T288 |
2262-2399 |
Sentence |
denotes |
However, in severe cases, the number of these cells increases at the sites of infection and they become the leading damage-causing cells. |
T289 |
2400-2650 |
Sentence |
denotes |
Excessive infiltration of these cells in the lungs is associated with secretion of TNF-α, IL-6, IL-1β, IL-7, IL-23, and IL-36, along with a broad range of other cytokines and damage-causing neutrophil extracellular traps (NETs; Tecchio et al., 2014). |
T290 |
2651-2830 |
Sentence |
denotes |
Additionally, these neutrophils also secrete a range of chemokines like CCL2/3/4, CXCL1-13 to attract more neutrophils and monocytes from the circulation (Sokol and Luster, 2015). |
T291 |
2831-2920 |
Sentence |
denotes |
Emerging evidence suggests a pivotal role of neutrophils in the pathogenesis of COVID-19. |
T292 |
2921-3135 |
Sentence |
denotes |
Immune cell profiling revealed activated status of these cells which was associated with increased levels of NETs and correlated with acute-phase reaction (Chen G. et al., 2020; Qin et al., 2020; Zuo et al., 2020). |
T293 |
3136-3283 |
Sentence |
denotes |
Similarly, an increase in the number of activated neutrophils was present in the BALF of COVID-19 patients (Liao et al., 2020; Xiong et al., 2020). |
T294 |
3284-3446 |
Sentence |
denotes |
Thus, based on these recently published studies, the neutrophil number in the blood can be used as a predictive marker for disease severity (Zhang et al., 2020a). |
T295 |
3448-3468 |
Sentence |
denotes |
Natural killer cells |
T296 |
3469-3671 |
Sentence |
denotes |
Natural killer cells are essential in the early phase of viral infection to assist in the clearance of the virus by interacting with death receptors expressed on the infected cells (Vidal et al., 2011). |
T297 |
3672-3819 |
Sentence |
denotes |
Previous clinical studies have shown decreased NK cell number in SARS-CoV patients, which was more pronounced in severe cases (Wang and Xia, 2004). |
T298 |
3820-4062 |
Sentence |
denotes |
A recent blood profile of COVID-19 patients suggested a similar decline in the number of NK cells in severe cases, along with an increased expression of exhaustion markers (Chen X. et al., 2020; Tan L. et al., 2020b; Zheng H.Y. et al., 2020). |
T299 |
4063-4209 |
Sentence |
denotes |
On the contrary, no significant difference was found in the number of total NK cells, in non-ICU vs 10 ICU admitted patients (Zhou et al., 2020a). |
T300 |
4210-4366 |
Sentence |
denotes |
This discrepancy in number could probably be due to differential temporal immune response and the underlying prevailing disease conditions in some patients. |
T301 |
4367-4595 |
Sentence |
denotes |
Immune cell profiling data from early recovery stage (ERS) and late recovery stage (LRS) COVID-19 patients revealed a biphasic effect, with fewer NK cells during early recovery ERS, which recovered during LRS (Wen et al., 2020). |
T302 |
4596-4768 |
Sentence |
denotes |
Thus, besides the underlying disease state, the NK cell number may also be sensitive to the time of sample collection and hence may not serve as a potential disease marker. |
T303 |
4769-5059 |
Sentence |
denotes |
Further, these studies could also suffer from the limitation of the variation in the age of the patients studied which may make it difficult to provide a definite role of these cells concerning COVID-19 disease severity (Nikolich-Zugich et al., 2020), necessitating more conclusive studies. |
T304 |
5061-5111 |
Sentence |
denotes |
Lung resident and monocyte-derived dendritic cells |
T305 |
5112-5259 |
Sentence |
denotes |
Lung resident dendritic cells majorly have a protective role during the early onset of the disease by activating the adaptive immune cell response. |
T306 |
5260-5534 |
Sentence |
denotes |
Under the influence of PAMPs, DAMPs, and inflammatory cytokine signaling, lung resident dendritic cells are conditioned and migrate to the draining lymph node under the influence of CCR7 where they prime naïve CD4+ and CD8+ T cells (Braun et al., 2011; Thaiss et al., 2011). |
T307 |
5535-5697 |
Sentence |
denotes |
In contrast, monocyte-derived dendritic cells generate under the influence of GM-CSF, IFN-γ, and IL-4, along with other proinflammatory signals (Qu et al., 2014). |
T308 |
5698-5882 |
Sentence |
denotes |
Previous studies have shown elevated secretions of CCL3, CCL5, MCP-1, IP-10, TNF-α, and IL-6 by activated inflammatory dendritic cells (DCs) in response to SARS-CoV (Law et al., 2005). |
T309 |
5883-5974 |
Sentence |
denotes |
Recent reports also suggest the presence of activated dendritic cells in COVID-19 patients. |
T310 |
5975-6226 |
Sentence |
denotes |
Notably, meta-transcriptomic sequencing of BALF obtained from 8 COVID-19 patients revealed an activated status of these cells along with neutrophils, as compared to other innate and adaptive immune cells (Yang A.P. et al., 2020; Zhou Z. et al., 2020). |
T311 |
6227-6652 |
Sentence |
denotes |
Thus, based on previous clinical studies on SARS-CoV infection and recent emerging studies on SARS-CoV-2, it is evident that hyperinflammatory immune response in severe and critically ill COVID-19 patients is mainly mounted by infiltrated innate immune cells at the site of infection with a substantial contribution by the adaptive immune cells as discussed below in the section on the dysfunctional adaptive immune response. |