What is it about?
We draw attention to the lack of studies on the mucosal immune response to SARS-CoV-2 infection, which first infects the upper respiratory tract. Mucosal immune inductive site tissues are present in the nasal cavities and pharynx, and can lead to the generation of secretory IgA (SIgA) antibodies in nasal secretions and saliva, which might contain and eventually eliminate the virus before it causes serious disease.
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Why is it important?
Mucosal immune responses, including secretory IgA (SIgA) antibodies in nasal and respiratory secretions as well as saliva, might have an important role in limiting SARS-CoV-2 infection to the upper respiratory tract and eliminating it before it descends into the lower respiratory tract where the serious inflammatory disease develops. If correct, this could help to explain the relatively large number of asymptomatic and clinically mild infections. It would further suggest that efforts to develop mucosally (e.g., intranasally) applied vaccines might be advantageous in eliciting protective mucosal immune responses that are not usually induced by conventional injected vaccines.
Perspectives
Most efforts to study the response to SARS-CoV-2 infection have focused on systemic immunity, including circulating IgG antibodies, and the cellular and cytokine responses that are involved in the dysregulated inflammatory responses of COVID-19 disease. These have been important in order to comprehend the pathology and to find ways of treating the disease and save lives. However, because SARS-CoV-2 first enters the human body through the nasal passages, and possibly also the eyes followed by drainage into the nasal passages, or through the mouth, the virus makes its first contact with the immune system in these locations. This should result first in mucosal immune responses, such as SIgA antibodies in saliva and nasal secretions, which could play a critical role in the subsequent course of the infection. It is therefore important to investigate these responses in all manifestations of the infection and in all age and populations groups.
Professor Michael W Russell
University at Buffalo Department of Microbiology & Immunology
Read the Original
This page is a summary of: Mucosal Immunity in COVID-19: A Neglected but Critical Aspect of SARS-CoV-2 Infection, Frontiers in Immunology, November 2020, Frontiers,
DOI: 10.3389/fimmu.2020.611337.
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