Immunoediting in SARS-CoV-2: Mutual relationship between the virus and the host

Abstract

Immunoediting is a well-known concept that occurs in cancer through three steps of elimination, equilibrium, and escape (3Es), where the immune system first suppresses the growth of tumor cells and then promotes them towards the malignancy. This phenomenon has been conceptualized in some chronic viral infections such as HTLV-1 and HIV by obtaining the resistance to elimination and making a persistent form of infected cells especially in untreated patients. Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a heterogeneous disease characterizing from mild/asymptomatic to severe/critical courses with some behavioral aspects in an immunoediting setting. In this context, a coordinated effort between of innate and adaptive immune system leads to detection and destruction of early infection followed by equilibrium between virus-specific responses and infected cells, which eventually end up with an uncontrolled inflammatory response in severe/critical patients. Although the SARS-CoV-2 applies several escape strategies such as mutations in viral epitopes, modulating the interferon response and inhibiting the MHC I molecules similar to the cancer cells, the 3Es hallmark may not occur in all clinical conditions. Here, we discuss how the lesson learnt from cancer immunoediting and accurate understanding of these pathophysiological mechanisms helps to develop more effective therapeutic strategies for COVID-19.

Androgen deprivation therapy in men with prostate cancer is not associated with COVID‐19 infection

“…[23][24][25][26] An immunosuppressive environment may in addition benefit SARS-CoV-2. 27 Indeed, recent data suggest that SARS-CoV-2 can decrease the effector function of CD8 + T cells and increase the infiltration of immune cells with suppressive phenotype. 28 Small numbers and a substantial overlap between ADT treatment and advanced prostate cancer, however, precluded informative analyses in this setting.…”

“…Multiple immunosuppressive cell types have been associated with higher Gleason scores and poor prognosis in prostate cancer 23‐26 . An immunosuppressive environment may in addition benefit SARS‐CoV‐2 27 . Indeed, recent data suggest that SARS‐CoV‐2 can decrease the effector function of CD8 + T cells and increase the infiltration of immune cells with suppressive phenotype 28 .…”