Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology

• Published in: Seminars in immunopathology Vol. 39; no. 5; pp. 529 - 539
• Main Authors: Channappanavar, Rudragouda, Perlman, Stanley
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2017; Springer Nature B.V
• Subjects: Animals; Antiviral Agents - pharmacology; Biomedical and Life Sciences; Biomedicine; Chemokines - metabolism; Combined Modality Therapy; Coronaviridae; Coronavirus - drug effects; Coronavirus - physiology; Coronavirus Infections - diagnosis; Coronavirus Infections - immunology; Coronavirus Infections - metabolism; Coronavirus Infections - virology; Coronaviruses; Cytokine storm; Cytokines; Cytokines - metabolism; Disease Models, Animal; Disease Susceptibility; Humans; Immune response; Immune System - cytology; Immune System - immunology; Immune System - metabolism; Immunity, Innate; Immunology; Infections; Inflammation; Interferons - metabolism; Interferons - pharmacology; Internal Medicine; Lung - immunology; Lung - metabolism; Lung - pathology; Lung - virology; Lungs; Macrophages - immunology; Monocytes - immunology; Monocytes - metabolism; Phenotype; Pneumonia; Replication; Respiratory diseases; Respiratory distress syndrome; Respiratory therapy; Respiratory tract diseases; Review; Severe acute respiratory syndrome; Severity of Illness Index; Virus Replication - drug effects; Virus Replication - immunology; Monocyte-macrophage; Immunopathology; MERS-CoV; Interferon; Cytokine storm; SARS-CoV
• ISSN: 1863-2297; 1863-2300; 1863-2300
• DOI: 10.1007/s00281-017-0629-x

Human coronaviruses (hCoVs) can be divided into low pathogenic and highly pathogenic coronaviruses. The low pathogenic CoVs infect the upper respiratory tract and cause mild, cold-like respiratory illness. In contrast, highly pathogenic hCoVs such as severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV) predominantly infect lower airways and cause fatal pneumonia. Severe pneumonia caused by pathogenic hCoVs is often associated with rapid virus replication, massive inflammatory cell infiltration and elevated pro-inflammatory cytokine/chemokine responses resulting in acute lung injury (ALI), and acute respiratory distress syndrome (ARDS). Recent studies in experimentally infected animal strongly suggest a crucial role for virus-induced immunopathological events in causing fatal pneumonia after hCoV infections. Here we review the current understanding of how a dysregulated immune response may cause lung immunopathology leading to deleterious clinical manifestations after pathogenic hCoV infections.