Dysregulated TFEB-autophagy-lysosome pathway links acute COVID-19 immunopathology to Long COVID sequelae.

Dysregulated TFEB-autophagy-lysosome pathway links acute COVID-19 immunopathology to Long COVID sequelae.

Publication date: Sep 29, 2025

SARS-CoV-2 disrupts cellular homeostasis, including the autophagy-lysosome pathway (ALP), a critical component of innate immunity and viral clearance. By subverting autophagy, SARS-CoV-2 proteins such as ORF3a, ORF7a, and NSP6 inhibit autophagosome-lysosome (APG-L) fusion, generating “incomplete autophagy” that permits viral persistence and drives hyperinflammation. Transcription factor EB (TFEB), a master regulator of lysosomal biogenesis and autophagy, has emerged as a central player in the host response to coronavirus infection. TFEB orchestrates the expression of genes required for lysosomal function and autophagic flux while also shaping immune processes, including cytokine production, interferon-stimulated gene expression, and inflammasome clearance. This mini review synthesizes current knowledge on the TFEB-ALP axis in COVID-19 pathogenesis, highlighting its influence on acute immunopathology and its potential contribution to post-acute sequelae (Long COVID). Restoring TFEB activity and autophagic flux may counteract SARS-CoV-2 evasion strategies and restrain aberrant inflammatory responses. Harnessing the TFEB-autophagy pathway as a host-directed therapeutic strategy could help rebalance immune homeostasis, limit tissue damage during acute infection, and mitigate persistent inflammatory sequelae in Long COVID.

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Concepts Keywords
Homeostasis Animals
Immunopathology Autophagy
Long autophagy-lysosome pathway (ALP)
Lysosomal COVID-19
Viral COVID-19
host-directed therapy
Humans
Immunity, Innate
Long COVID
lysosomal organelle
Lysosomes
SARS-CoV-2
SARS-CoV-2
Signal Transduction
TFEB protein, human

Semantics

Type Source Name
pathway REACTOME Autophagy
pathway KEGG Lysosome
disease MESH COVID-19
disease MESH Long COVID
disease MESH ALP
disease MESH coronavirus infection
disease MESH infection
pathway REACTOME Reproduction
disease MESH Severe Acute Respiratory Syndrome
pathway KEGG Viral replication
drug DRUGBANK Rasagiline
drug DRUGBANK Huperzine B
pathway REACTOME Metabolism
drug DRUGBANK Sirolimus
pathway REACTOME Translation
drug DRUGBANK Calcium
drug DRUGBANK Coenzyme M
disease MESH inflammation
pathway REACTOME Immune System
disease MESH microphthalmia
drug DRUGBANK L-Leucine
disease MESH ALPs
disease MESH malnutrition
pathway REACTOME Inflammasomes
disease MESH psoriasis
disease MESH HOPS
disease MESH syndrome
disease MESH CRS
disease MESH cytokine storm
disease MESH virus infection
disease MESH fatigue
disease MESH cognitive dysfunction
disease MESH mitochondrial dysfunction
pathway REACTOME Mitophagy
drug DRUGBANK ATP
drug DRUGBANK Oxygen
disease MESH neuroinflammation
drug DRUGBANK Trihexyphenidyl
drug DRUGBANK Profenamine
disease MESH PTEN
disease MESH acute disease
drug DRUGBANK Chloroquine
drug DRUGBANK Hydroxychloroquine
drug DRUGBANK Isoxaflutole
disease MESH pneumonia
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH Death
drug DRUGBANK Carboxyamidotriazole
disease MESH Dis
disease MESH autoimmune diseases
disease MESH lysosomal storage diseases
disease MESH PKD
disease MESH lymphopenia
disease MESH Clinical progression
disease MESH Cancer
disease MESH acute lung injury
disease MESH thromboinflammation
disease MESH non communicable diseases
disease MESH Infectious Diseases
drug DRUGBANK Azithromycin
pathway REACTOME Signal Transduction

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