Immunothrombosis in COVID-19: Implications of Neutrophil Extracellular Traps

Biomolecules - Tập 11 Số 5 - Trang 694
Brandon Bautista-Becerril1,2, Rebeca Campi-Caballero3,2, Samuel Sevilla-Fuentes4, Laura M. Hernández-Regino5, Alejandro Hanono6, Al Flores-Bustamante7, Julieta González-Flores2, Carlos García-Ávila5, Arnoldo Aquino‐Gálvez8, Manuel Castillejos‐López9, Armida Juárez-Cisneros1, Ángel Camarena1
1Laboratorio HLA, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico
2Programa MEDICI, Carrera Médico Cirujano, FES Iztacala, Universidad Nacional Autónoma de México, Mexico City 54090, Mexico
3Laboratorio de Neuropsicofarmacología, Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
4Departamento de Infectología, Hospital General de México Eduardo Liceaga, Mexico City 06720, Mexico
5Escuela Nacional de Ciencias Biológicas, Programa de Posgrado, Instituto Politécnico Nacional, Mexico City 11340, Mexico
6Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Mexico City 52786, Mexico
7Laboratorio de Farmacología, Instituto Nacional de Pediatría, Mexico City 04530, Mexico
8Laboratorio de Biología Molecular, Departamento de Fibrosis Pulmonar, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico
9Departamento de Epidemiología Hospitalaria e Infectología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico

Tóm tắt

SARS-CoV-2 is a member of the family of coronaviruses associated with severe outbreaks of respiratory diseases in recent decades and is the causative agent of the COVID-19 pandemic. The recognition by and activation of the innate immune response recruits neutrophils, which, through their different mechanisms of action, form extracellular neutrophil traps, playing a role in infection control and trapping viral, bacterial, and fungal etiological agents. However, in patients with COVID-19, activation at the vascular level, combined with other cells and inflammatory mediators, leads to thrombotic events and disseminated intravascular coagulation, thus leading to a series of clinical manifestations in cerebrovascular, cardiac, pulmonary, and kidney disease while promoting severe disease and mortality. Previous studies of hospitalized patients with COVID-19 have shown that elevated levels of markers specific for NETs, such as free DNA, MPO, and H3Cit, are strongly associated with the total neutrophil count; with acute phase reactants that include CRP, D-dimer, lactate dehydrogenase, and interleukin secretion; and with an increased risk of severe COVID-19. This study analyzed the interactions between NETs and the activation pathways involved in immunothrombotic processes in patients with COVID-19.

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