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Kuypers FA, Rostad CA, Anderson EJ, Chahroudi A, Jaggi P, Wrammert J, Mantus G, Basu R, Harris F, Hanberry B, Camacho-Gonzalez A, Manoranjithan S, Vos M, Brown LA, Morris CR. Secretory phospholipase A2 in SARS-CoV-2 infection and multisystem inflammatory syndrome in children (MIS-C). Exp Biol Med (Maywood) 2021; 246:2543-2552. [PMID: 34255566 PMCID: PMC8649422 DOI: 10.1177/15353702211028560] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Secretory phospholipase 2 (sPLA2) acts as a mediator between proximal and distal events of the inflammatory cascade. Its role in SARS-CoV-2 infection is unknown, but could contribute to COVID-19 inflammasome activation and cellular damage. We present the first report of plasma sPLA2 levels in adults and children with COVID-19 compared with controls. Currently asymptomatic adults with a history of recent COVID-19 infection (≥4 weeks before) identified by SARS-CoV-2 IgG antibodies had sPLA2 levels similar to those who were seronegative (9 ± 6 vs.17 ± 28 ng/mL, P = 0.26). In contrast, children hospitalized with severe COVID-19 had significantly elevated sPLA2 compared with those with mild or asymptomatic SARS-CoV-2 infection (269 ± 137 vs. 2 ± 3 ng/mL, P = 0.01). Among children hospitalized with multisystem inflammatory syndrome in children (MIS-C), all had severe disease requiring pediatric intensive care unit (PICU) admission. sPLA2 levels were significantly higher in those with acute illness <10 days versus convalescent disease ≥10 days (540 ± 510 vs. 2 ± 1, P = 0.04). Thus, sPLA2 levels correlated with COVID-19 severity and acute MIS-C in children, implicating a role in inflammasome activation and disease pathogenesis. sPLA2 may be a useful biomarker to stratify risk and guide patient management for children with acute COVID-19 and MIS-C. Therapeutic compounds targeting sPLA2 and inflammasome activation warrant consideration.
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Affiliation(s)
- Frans A Kuypers
- Division of Hematology, Department of Pediatrics, University of California, San Francisco, CA 94609, USA
| | - Christina A Rostad
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Evan J Anderson
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA.,Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Ann Chahroudi
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Preeti Jaggi
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Jens Wrammert
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Grace Mantus
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Rajit Basu
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Frank Harris
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Bradley Hanberry
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Andres Camacho-Gonzalez
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | | | - Miriam Vos
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Clinical and Translational Research, Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Lou Ann Brown
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Claudia R Morris
- Department of Pediatrics1371, School of Medicine, Emory University, Atlanta, GA 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.,Center for Clinical and Translational Research, Children's Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
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Teoh NC, Ajamieh H, Wong HJ, Croft K, Mori T, Allison AC, Farrell GC. Microparticles mediate hepatic ischemia-reperfusion injury and are the targets of Diannexin (ASP8597). PLoS One 2014; 9:e104376. [PMID: 25222287 PMCID: PMC4164362 DOI: 10.1371/journal.pone.0104376] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/30/2014] [Indexed: 11/24/2022] Open
Abstract
Background & Aims Ischemia–reperfusion injury (IRI) can cause hepatic failure after liver surgery or transplantation. IRI causes oxidative stress, which injures sinusoidal endothelial cells (SECs), leading to recruitment and activation of Kupffer cells, platelets and microcirculatory impairment. We investigated whether injured SECs and other cell types release microparticles during post-ischemic reperfusion, and whether such microparticles have pro-inflammatory, platelet-activating and pro-injurious effects that could contribute to IRI pathogenesis. Methods C57BL6 mice underwent 60 min of partial hepatic ischemia followed by 15 min–24 hrs of reperfusion. We collected blood and liver samples, isolated circulating microparticles, and determined protein and lipid content. To establish mechanism for microparticle production, we subjected murine primary hepatocytes to hypoxia-reoxygenation. Because microparticles express everted phosphatidylserine residues that are the target of annexin V, we analyzed the effects of an annexin V-homodimer (Diannexin or ASP8597) on post-ischemia microparticle production and function. Results Microparticles were detected in the circulation 15–30 min after post-ischemic reperfusion, and contained markers of SECs, platelets, natural killer T cells, and CD8+ cells; 4 hrs later, they contained markers of macrophages. Microparticles contained F2-isoprostanes, indicating oxidative damage to membrane lipids. Injection of mice with TNF-α increased microparticle formation, whereas Diannexin substantially reduced microparticle release and prevented IRI. Hypoxia-re-oxygenation generated microparticles from primary hepatocytes by processes that involved oxidative stress. Exposing cultured hepatocytes to preparations of microparticles isolated from the circulation during IRI caused injury involving mitochondrial membrane permeability transition. Microparticles also activated platelets and induced neutrophil migration in vitro. The inflammatory properties of microparticles involved activation of NF-κB and JNK, increased expression of E-selectin, P-selectin, ICAM-1 and VCAM-1. All these processes were blocked by coating microparticles with Diannexin. Conclusions Following hepatic IRI, microparticles circulate and can be taken up by hepatocytes, where they activate signaling pathways that mediate inflammation and hepatocyte injury. Diannexin prevents microparticle formation and subsequent inflammation.
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Affiliation(s)
- Narci C. Teoh
- Australian National University Medical School at The Canberra Hospital, Canberra, ACT, Australia
| | - Hussam Ajamieh
- Australian National University Medical School at The Canberra Hospital, Canberra, ACT, Australia
| | - Heng Jian Wong
- Australian National University Medical School at The Canberra Hospital, Canberra, ACT, Australia
| | - Kevin Croft
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Trevor Mori
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | - Geoffrey C. Farrell
- Australian National University Medical School at The Canberra Hospital, Canberra, ACT, Australia
- * E-mail:
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