近日，德国明斯特大学Gerd Meyer zu Hörste、Mark Stettner等研究人员合作揭示COVID-19患者脑脊液中T细胞衰竭和去分化单核细胞的神经学表现。2020年12月23日，《免疫》杂志在线发表了这项成果。

研究人员表示，COVID-19患者会出现神经系统后遗症，例如头痛、神经炎或脑血管疾病。这些情况（Neuro-COVID）在严重COVID-19患者中更为常见。

为了了解这些神经系统后遗症的病因，研究人员利用单细胞测序并检查了与非炎性和自身免疫性神经系统疾病或病毒性脑炎患者相比，Neuro-COVID患者脑脊液（CSF）的免疫细胞谱。Neuro-COVID患者的CSF表现为去分化单核细胞和耗尽的CD4⁺T细胞扩增。Neuro-COVID CSF白细胞具有丰富的干扰素特征。但是，这没有病毒性脑炎那么明显。细胞库分析显示，与轻度的Neuro-COVID患者相比，严重者的克隆性T细胞扩增广泛、干扰素反应减弱。

总的来说，这些发现记录了Neuro-COVID患者的CSF免疫区室，并提示在这种情况下抗病毒反应受到损害。

附：英文原文

Title: Neurological Manifestations of COVID-19 Feature T Cell Exhaustion and Dedifferentiated Monocytes in Cerebrospinal Fluid

Author: Michael Heming, Xiaolin Li, Saskia Ruber, Anne K. Mausberg, Anna-Lena Brsch, Maike Hartlehnert, Arpita Singhal, I-Na Lu, Michael Fleischer, Fabian Szepanowski, Oliver Witzke, Thorsten Brenner, Ulf Dittmer, Nir Yosef, Christoph Kleinschnitz, Heinz Wiendl, Mark Stettner, Gerd Meyer zu Hrste

Issue&Volume: 2020-12-22

Abstract: Patients suffering from Coronavirus disease 2019 (COVID-19) can develop neurological sequelae, such as headache, neuroinflammatory or cerebrovascular disease. These conditions - here termed Neuro-COVID - are more frequent in patients with severe COVID-19. To understand the etiology of these neurological sequelae, we utilized single-cell sequencing and examined the immune cell profiles from the cerebrospinal fluid (CSF) of Neuro-COVID patients compared to patients with non-inflammatory and autoimmune neurological diseases or with viral encephalitis. The CSF of Neuro-COVID patients exhibited an expansion of dedifferentiated monocytes and of exhausted CD4+ T cells. Neuro-COVID CSF leukocytes featured an enriched interferon signature; however, this was less pronounced than in viral encephalitis. Repertoire analysis revealed broad clonal T cell expansion and curtailed interferon response in severe compared to mild Neuro-COVID patients. Collectively, our findings document the CSF immune compartment in Neuro-COVID patients and suggest compromised antiviral responses in this setting.

DOI: 10.1016/j.immuni.2020.12.011

Source: https://www.cell.com/immunity/fulltext/S1074-7613(20)30539-2