The therapeutic potential of regulatory T cells in reducing cardiovascular complications in patients with severe COVID-19

Abstract

The SARS coronavirus 2 (SARS CoV-2) causes Coronavirus Disease (COVID-19), is an emerging viral infection. SARS CoV-2 infects target cells by attaching to Angiotensin-Converting Enzyme (ACE2). SARS CoV-2 could cause cardiac damage in patients with severe COVID-19, as ACE2 is expressed in cardiac cells, including cardiomyocytes, pericytes, and fibroblasts, and coronavirus could directly infect these cells. Cardiovascular disorders are the most frequent comorbidity found in COVID-19 patients. Immune cells such as monocytes, macrophages, and T cells may produce inflammatory cytokines and chemokines that contribute to COVID-19 pathogenesis if their functions are uncontrolled. This causes a cytokine storm in COVID-19 patients, which has been associated with cardiac damage. Tregs are a subset of immune cells that regulate immune and inflammatory responses. Tregs suppress inflammation and improve cardiovascular function through a variety of mechanisms. This is an exciting research area to explore the cellular, molecular, and immunological mechanisms related to reducing risks of cardiovascular complications in severe COVID-19. This review evaluated whether Tregs can affect COVID-19-related cardiovascular complications, as well as the mechanisms through which Tregs act.

Overview of multifunctional Tregs in cardiovascular disease: From insights into cellular functions to clinical implications

“…Adoptive transfer of Tregs has been shown to prevent the development of atherosclerosis and induce a shift in plaque composition toward a more stable phenotype 181 . This involves either isolating Tregs that have differentiated in vivo and expanding them ex vivo, or generating iTregs cells in vitro, and then transferring the Tregs/iTregs into the body 195 . The potential prevention of atherosclerosis may be achieved by the adoptive transfer of CD4 + CD25 + Tregs into ApoE −/− mice 182 .…”

“…181 This involves either isolating Tregs that have differentiated in vivo and expanding them ex vivo, or generating iTregs cells in vitro, and then transferring the Tregs/iTregs into the body. 195 The potential prevention of atherosclerosis may be achieved by the adoptive transfer of CD4 + CD25 + Tregs into ApoE −/− mice. 182 Additionally, the therapeutic benefits of transferring Tregs into patients have been widely acknowledged.…”

Evaluation of the Genes and Molecular Pathways Involved in Skin Lesions in Patients with COVID-19: Systems Biology and Bioinformatics Analysis Approach

“…However, depending on the patient's underlying disease and the strength of the immune system, some of the symptoms would be different in the patients (8,9). Based on the studies and evidence, the stimulation of the immune system in COVID-19-infected patients can eventually lead to a cytokine storm (10). The inflammation caused by cytokine storms can damage the main organs in the patient's body (11).…”

Dysfunctional phenotype of systemic and pulmonary regulatory T cells associate with lethal COVID‐19 cases

“…Few studies have appreciated the role of Treg on SARS‐CoV‐2 infection [ 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. It has been found that Tregs in severe COVID‐19 patients display increased expression of PD‐1 and several disturbances in transcriptional signatures [ 29 ].…”