Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Nov 30:11:611337.
doi: 10.3389/fimmu.2020.611337. eCollection 2020.

Mucosal Immunity in COVID-19: A Neglected but Critical Aspect of SARS-CoV-2 Infection

Michael W Russell  1 , Zina Moldoveanu  2 , Pearay L Ogra  3 , Jiri Mestecky  2
Affiliations
Review

Mucosal Immunity in COVID-19: A Neglected but Critical Aspect of SARS-CoV-2 Infection

Michael W Russell et al. Front Immunol. .

Abstract

The mucosal immune system is the largest component of the entire immune system, having evolved to provide protection at the main sites of infectious threat: the mucosae. As SARS-CoV-2 initially infects the upper respiratory tract, its first interactions with the immune system must occur predominantly at the respiratory mucosal surfaces, during both inductive and effector phases of the response. However, almost all studies of the immune response in COVID-19 have focused exclusively on serum antibodies and systemic cell-mediated immunity including innate responses. This article proposes that there is a significant role for mucosal immunity and for secretory as well as circulating IgA antibodies in COVID-19, and that it is important to elucidate this in order to comprehend especially the asymptomatic and mild states of the infection, which appear to account for the majority of cases. Moreover, it is possible that mucosal immunity can be exploited for beneficial diagnostic, therapeutic, or prophylactic purposes.

Keywords: COVID-19; SARS-CoV-2; immune response; immunoglobulin A; mucosal immunity.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Bermejo-Martin JF, Gonzalez-Rivera M, Almansa R, Micheloud D, Dominguez-Gil M, Resino S, et al. SARS-CoV-2 RNA viremia is associated with a sepsis-like host response and critical illness in COVID-19. medRxiv (2020) 2020.08.25.20154252. 10.1101/2020.08.25.20154252 - DOI
    1. Russell MW, Mestecky J, Strober W, Kelsall BL, Lambrecht BN, Cheroutre H. The mucosal immune system: Overview. In: Mestecky J, Strober W, Russell MW, Kelsall BL, Cheroutre H, Lambrecht BN, editors. Mucosal Immunology, 4 Amsterdam: Academic Press/Elsevier; (2015). p. 3–8.
    1. Russell MW. Biological functions of IgA. In: Kaetzel CS, editor. Mucosal Immune Defense: Immunoglobulin A. New York: Springer; (2007). p. 144–72.
    1. Woof JM, Mestecky J. Mucosal immunoglobulins. In: Mestecky J, Strober W, Russell MW, Kelsall BL, Cheroutre H, Lambrecht BN, editors. In: Mucosal Immunology, 4 Amsterdam: Academic Press/Elsevier; (2015). p. 287–324.
    1. Steffen U, Koeleman CA, Sokolova MV, Bang H, Kleyer A, Rech J, et al. IgA subclasses have different effector functions associated with distinct glycosylation profiles. Nat Communs (2020) 11:120. 10.1038/s41467-019-13992-8 - DOI - PMC - PubMed