Volume 30, No 9, Sep 2020

ISSN: 1001-0602 
EISSN: 1748-7838 2018 
impact factor 17.848* 
(Clarivate Analytics, 2019)

Volume 30 Issue 9, September 2020: 814-816   |  Open Access

LETTERS TO THE EDITOR

Dysregulated adaptive immune response contributes to severe COVID-19

Kuai Yu¹ , Jingjing He¹ , Yongjian Wu² , Baosong Xie³ , Xuefei Liu¹ , Bo Wei^4,5 , Haibo Zhou⁶ , Bingliang Lin⁷ , Zhixiang Zuo¹ , Wen Wen⁸ , Wenxiong Xu⁷ , Bin Zou⁹ , Lai Wei^9,* , Xi Huang^2,* , Penghui Zhou^1,*

¹State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China
²Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
³Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
⁴Infectious Disease Department, The Second Affiliated Hospital of Naval Military Medical University, Shanghai 200003, China
⁵Huoshenshan Hospital, Wuhan, Hubei 430000, China
⁶The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, Guangdong 511500, China
⁷Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China
⁸Department of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Fuzhou, Fujian 350025, China
⁹State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
Correspondence: Lai Wei(weil9@mail.sysu.edu.cn)Xi Huang(huangxi6@mail.sysu.edu.cn)Penghui Zhou(zhouph@sysucc.org.cn)

Dear Editor,

The outbreak of the new coronavirus SARS-CoV-2 has resulted in a global pandemic. Due to the lack of a specific drug against this virus, the current clinical management of this disease mainly depends on supportive care to reduce inflammatory responses and to keep the lung functioning.1 Understanding the underlying immunopathology of coronavirus disease 2019 (COVID-19) is therefore of paramount importance for improving the current treatment. In this study, we found a distinct feature of adaptive immunity in severely affected patients, the coincidence of impaired cellular and enhanced humoral immune responses, suggesting that dysregulated adaptive immune responses advanced severe COVID-19. Interestingly, expression of Prothymosin alpha (PTMA), the proprotein of Thymosin alpha-1 (Tα1), was increased in a group of CD8 T memory stem cells accumulated during severe disease. We further showed that Tα1 slightly reduced T cell activation in vitro and promoted proliferation of effector T cells. Moreover, Tα1 treatment relieved the lymphopenia in COVID-19 patients. Our data suggest that early intervention of adaptive immune response might be critical for the prevention of severe COVID-19.

https://doi.org/10.1038/s41422-020-0391-9

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