An international consortium of researchers, coordinated by the National Institute of Allergy and Infectious Diseases (NIAID), Rockefeller University (New York) and the University of Paris, has described the essential role of interferons in the correct immune response to the disease, as individuals who have antibodies that neutralise these molecules (autoantibodies) or genetic defects that affect their expression tend to develop particularly severe forms of disease. The findings also help to explain why older individuals are more susceptible to the more severe forms of COVID-19.
The results of the study, which were published in two papers appearing today in the prestigious journal Science Immunology, may also have important implications for the clinical management of the disease.
The University of Milan-Bicocca, in partnership with Monza Local Health Authority, made a substantial contribution to these important results with the project "STORM, Observational study on the natural history of patients hospitalised for SARS-COV-2", an electronic archive of clinical, diagnostic and therapeutic data regarding COVID-19 patients hospitalised at San Gerardo Hospital in Monza, coordinated by Paolo Bonfanti, Professor of Infectious Diseases of Milan-Bicocca University and implemented by the Bicocca Clinical Research Office (BiCRO). For the research published in "Science Immunology", a particularly fundamental contribution was made by the collection of residual biological material from patient swabs and samples, coordinated by Andrea Biondi, Professor of Paediatrics at Milan-Bicocca University.
"These studies are the continuation of an international research project that began in the early months of the pandemic,” explain Paolo Bonfanti and Andrea Biondi, “in order to study the causes underlying the extreme multiformity of the disease, which can present with a spectrum ranging from asymptomatic infection to rapid death. Research has long focused on the genetic causes of this diversity and in particular on the role of certain proteins produced by immune system cells, such as interferons, which affect the favourable response to COVID-19."
In studies published in Science Immunology, autoantibodies that neutralise type I interferons increase in prevalence over the age of 60 and are responsible for approximately 20% of all fatal cases of COVID-19. The very important finding of the research is that the presence of autoantibodies precedes the onset of COVID-19.
"These results,” conclude Bonfanti and Biondi, “could have very important therapeutic implications: first of all, the search for anti-interferon antibodies could become a screening test given the discrete frequency of these autoantibodies in the general population as age progresses. Secondly, patients with autoantibodies against type I interferon should be given priority when it comes to vaccination against COVID-19. And finally, in the case of SARS-CoV-2 infection, unvaccinated individuals in whom the presence of these autoantibodies is detected should be hospitalised for proper clinical management. Early treatment with monoclonal antibodies could be administered in these patients before symptoms of COVID-19 pneumonia appear."