Front Immunol 11: 1580

Severe COVID-19: NLRP3 Inflammasome Dysregulated

Amsterdam UMC, Academic Medical Center, Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, Netherlands

Edited by: Alexis M. Kalergis, Pontificia Universidad Católica de Chile, Chile

Reviewed by: Julie McAuley, The University of Melbourne, Australia; Fayyaz S. Sutterwala, University of Iowa, United States

*Correspondence: Anje A. te Velde ln.cmumadretsma@edlevet.a.a

This article was submitted to Viral Immunology, a section of the journal Frontiers in Immunology

Amsterdam UMC, Academic Medical Center, Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, Netherlands

Edited by: Alexis M. Kalergis, Pontificia Universidad Católica de Chile, Chile

Reviewed by: Julie McAuley, The University of Melbourne, Australia; Fayyaz S. Sutterwala, University of Iowa, United States

Received 2020 May 13; Accepted 2020 Jun 15.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

SARS-CoV-2 might directly activate NLRP3 inflammasome resulting in an endogenous adjuvant activity necessary to mount a proper adaptive immune response against the virus. Heterogeneous response of COVID-19 patients could be attributed to differences in not being able to properly downregulate NLRP3 inflammasome activation. This relates to the fitness of the immune system of the individual challenged by the virus. Patients with a reduced immune fitness can demonstrate a dysregulated NLRP3 inflammasome activity resulting in severe COVID-19 with tissue damage and a cytokine storm. We sketch the outlines of five possible scenarios for COVID-19 in medical practice and provide potential treatment options targeting dysregulated endogenous adjuvant activity in severe COVID-19 patients.

Keywords: COVID-19, NLRP3 inflammasome, therapy, endogenous adjuvant activity, HMGB1

Footnotes

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