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Donlan AN, Sutherland TE, Marie C, Preissner S, Bradley BT, Carpenter RM, Sturek JM, Ma JZ, Moreau GB, Donowitz JR, Buck GA, Serrano MG, Burgess SL, Abhyankar MM, Mura C, Bourne PE, Preissner R, Young MK, Lyons GR, Loomba JJ, Ratcliffe SJ, Poulter MD, Mathers AJ, Day A, Mann BJ, Allen JE, Petri WA. IL-13 is a driver of COVID-19 severity. medRxiv 2021:2020.06.18.20134353. [PMID: 33688686 PMCID: PMC7941663 DOI: 10.1101/2020.06.18.20134353] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Immune dysregulation is characteristic of the more severe stages of SARS-CoV-2 infection. Understanding the mechanisms by which the immune system contributes to COVID-19 severity may open new avenues to treatment. Here we report that elevated interleukin-13 (IL-13) was associated with the need for mechanical ventilation in two independent patient cohorts. In addition, patients who acquired COVID-19 while prescribed Dupilumab had less severe disease. In SARS-CoV-2 infected mice, IL-13 neutralization reduced death and disease severity without affecting viral load, demonstrating an immunopathogenic role for this cytokine. Following anti-IL-13 treatment in infected mice, in the lung, hyaluronan synthase 1 (Has1) was the most downregulated gene and hyaluronan accumulation was decreased. Blockade of the hyaluronan receptor, CD44, reduced mortality in infected mice, supporting the importance of hyaluronan as a pathogenic mediator, and indicating a new role for IL-13 in lung disease. Understanding the role of IL-13 and hyaluronan has important implications for therapy of COVID-19 and potentially other pulmonary diseases.
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Affiliation(s)
- Alexandra N. Donlan
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Tara E. Sutherland
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, United Kingdom
| | - Chelsea Marie
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Saskia Preissner
- Department Oral and Maxillofacial Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ben T. Bradley
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle WA 98109 USA
| | - Rebecca M. Carpenter
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Jeffrey M. Sturek
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Jennie Z. Ma
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - G. Brett Moreau
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Jeffrey R. Donowitz
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
- Division of Pediatric Infectious Diseases, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond VA 23298 USA
| | - Gregory A. Buck
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond VA 23298 USA
| | - Myrna G. Serrano
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond VA 23298 USA
| | - Stacey L. Burgess
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Mayuresh M. Abhyankar
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Cameron Mura
- School of Data Science and Department of Biomedical Engineering University of Virginia, Charlottesville, VA 22904
| | - Philip E. Bourne
- School of Data Science and Department of Biomedical Engineering University of Virginia, Charlottesville, VA 22904
| | - Robert Preissner
- Science-IT and Institute of Physiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstrasse 12, 10115 Berlin, Germany
| | - Mary K. Young
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Genevieve R. Lyons
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Johanna J. Loomba
- Integrated Translational Health Research Institute (iTHRIV), University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Sarah J Ratcliffe
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Melinda D. Poulter
- Department of Pathology University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Amy J. Mathers
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
- Department of Pathology University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Anthony Day
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, United Kingdom
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PT, United Kingdom
| | - Barbara J. Mann
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
| | - Judith E. Allen
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, United Kingdom
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PT, United Kingdom
| | - William A. Petri
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville VA 22908 USA
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville VA 22908 USA
- Department of Pathology University of Virginia School of Medicine, Charlottesville VA 22908 USA
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