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Shin JJ, Fan W, Par-Young J, Piecychna M, Leng L, Israni-Winger K, Qing H, Gu J, Zhao H, Schulz WL, Unlu S, Kuster J, Young G, Liu J, Ko AI, Baeza Garcia A, Sauler M, Wisnewski AV, Young L, Orduña A, Wang A, Klementina O, Garcia AB, Hegyi P, Armstrong ME, Mitchell P, Ordiz DB, Garami A, Kang I, Bucala R. MIF is a common genetic determinant of COVID-19 symptomatic infection and severity. QJM 2023; 116:205-212. [PMID: 36222594 PMCID: PMC9620729 DOI: 10.1093/qjmed/hcac234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Genetic predisposition to coronavirus disease 2019 (COVID-19) may contribute to its morbidity and mortality. Because cytokines play an important role in multiple phases of infection, we examined whether commonly occurring, functional polymorphisms in macrophage migration inhibitory factor (MIF) are associated with COVID-19 infection or disease severity. AIM To determine associations of common functional polymorphisms in MIF with symptomatic COVID-19 or its severity. METHODS This retrospective case-control study utilized 1171 patients with COVID-19 from three tertiary medical centers in the USA, Hungary and Spain, together with a group of 637 pre-pandemic, healthy control subjects. Functional MIF promoter alleles (-794 CATT5-8,rs5844572), serum MIF and soluble MIF receptor levels, and available clinical characteristics were measured and correlated with COVID-19 diagnosis and hospitalization. Experimental mice genetically engineered to express human high- or low-expression MIF alleles were studied for response to coronavirus infection. RESULTS In patients with COVID-19, there was a lower frequency of the high-expression MIF CATT7 allele when compared to healthy controls [11% vs. 19%, odds ratio (OR) 0.54 [0.41-0.72], P < 0.0001]. Among inpatients with COVID-19 (n = 805), there was a higher frequency of the MIF CATT7 allele compared to outpatients (n = 187) (12% vs. 5%, OR 2.87 [1.42-5.78], P = 0.002). Inpatients presented with higher serum MIF levels when compared to outpatients or uninfected healthy controls (87 ng/ml vs. 35 ng/ml vs. 29 ng/ml, P < 0.001, respectively). Among inpatients, circulating MIF concentrations correlated with admission ferritin (r = 0.19, P = 0.01) and maximum CRP (r = 0.16, P = 0.03) levels. Mice with a human high-expression MIF allele showed more severe disease than those with a low-expression MIF allele. CONCLUSIONS In this multinational retrospective study of 1171 subjects with COVID-19, the commonly occurring -794 CATT7MIF allele is associated with reduced susceptibility to symptomatic SARS-CoV-2 infection but increased disease progression as assessed by hospitalization. These findings affirm the importance of the high-expression CATT7MIF allele, which occurs in 19% of the population, in different stages of COVID-19 infection.
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Affiliation(s)
- Junghee J Shin
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | - Wei Fan
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | | | - Marta Piecychna
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | - Lin Leng
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | | | - Hua Qing
- Department of Medicine, Department of Immunobiology, New Haven, CT, USA
| | - Jianlei Gu
- Department of Pathology, New Haven, CT, USA
| | | | - Wade L Schulz
- Department of Medicine, Department of Immunobiology, New Haven, CT, USA
| | - Serhan Unlu
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | - John Kuster
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | | | - Jian Liu
- Department of Pathology, New Haven, CT, USA
| | | | | | - Maor Sauler
- Pulmonary, Critical Care, and Sleep Medicine, New Haven, CT, USA
| | | | | | - Antonio Orduña
- Microbiology Service. Hospital Clínico Universtario. Valladolid. Spain
| | - Andrew Wang
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
- Department of Medicine, Department of Immunobiology, New Haven, CT, USA
| | - Ocskay Klementina
- Universidad de Valladolid, Valladolid, Spain; University of Pécs, Pécs, Hungary. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest Hungary
| | - Antonio Blesa Garcia
- Mucosal Immunology Lab. Unidad de Excelencia Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC. Valladolid. Spain
| | - Peter Hegyi
- Universidad de Valladolid, Valladolid, Spain; University of Pécs, Pécs, Hungary. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | | | - David Bernardo Ordiz
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Centro de Investigaciones Biomédicas en Red de Enfermedades infecciosas (CIBERinfec). Madrid. Spain
| | - András Garami
- Universidad de Valladolid, Valladolid, Spain; University of Pécs, Pécs, Hungary. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Insoo Kang
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
| | - Richard Bucala
- Sections of Rheumatology, Allergy and Immunology, New Haven, CT, USA
- Department of Pathology, New Haven, CT, USA
- Yale Schools of Medicine and Public Health, New Haven, CT, USA
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