Aspectos imunológicos da resposta inflamatória no COVID-19: da defesa à tempestade de citocinas
DOI:
https://doi.org/10.34119/bjhrv8n6-029Keywords:
COVID-19, SARS-CoV-2, resposta imune, tempestade de citocinasAbstract
A pandemia de COVID-19, causada pelo coronavírus SARS-CoV-2, evidenciou um amplo espectro de manifestações clínicas, que variam desde casos assintomáticos e leves até formas graves, envolvendo síndrome do desconforto respiratório agudo (SDRA) e falência múltipla de órgãos. Nesse contexto, esta revisão de literatura analisa os aspectos imunológicos da resposta inflamatória na COVID-19, enfatizando a progressão de uma resposta imune protetora para um estado exacerbado conhecido como “tempestade de citocinas”.Inicialmente, o foco está na resposta imune protetora, que envolve a ativação coordenada da imunidade inata com interferons e células sentinelas controlando a infecção viral juntamente com a resposta imune adaptativa, na qual os linfócitos T e B atuam para eliminar o vírus e gerar memória imunológica.Em seguida, são discutidos os desequilíbrios imunológicos que levam à hiperinflamação sistêmica. Destacam-se os principais componentes celulares (como células T, células B, macrófagos, monócitos e neutrófilos) e mediadores (citocinas IL-6, IL-1β, TNF-α, interferons, entre outros) envolvidos tanto na defesa antiviral quanto na imunopatologia.Os mecanismos pelos quais uma resposta inicialmente protetora torna-se desregulada culminando em uma cascata inflamatória descontrolada conhecida como tempestade de citocinas são analisados. Para isso, são apresentados estudos clínicos e experimentais recentes (2020–2025) que ilustram essas dinâmicas, incluindo perfis de citocinas correlacionados com a gravidade da doença e fenômenos como linfopenia, tempestade de citocinas e formação de armadilhas extracelulares de neutrófilos (NETs).Discute-se o equilíbrio entre uma resposta imune eficaz e uma inflamação excessiva, bem como as implicações terapêuticas por exemplo, o uso de corticosteroides e bloqueadores de citocinas no manejo de pacientes com COVID-19 grave. Em conclusão, reforça-se a importância de uma resposta imune equilibrada na COVID-19, capaz de eliminar o vírus sem causar danos exacerbados ao organismo hospedeiro.
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