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10.1182/blood.2020007008

http://scihub22266oqcxt.onion/10.1182/blood.2020007008
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suck abstract from ncbi


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pmid32597954      Blood 2020 ; 136 (10): 1169-1179
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  • Neutrophil extracellular traps contribute to immunothrombosis in COVID-19 acute respiratory distress syndrome #MMPMID32597954
  • Middleton EA; He XY; Denorme F; Campbell RA; Ng D; Salvatore SP; Mostyka M; Baxter-Stoltzfus A; Borczuk AC; Loda M; Cody MJ; Manne BK; Portier I; Harris ES; Petrey AC; Beswick EJ; Caulin AF; Iovino A; Abegglen LM; Weyrich AS; Rondina MT; Egeblad M; Schiffman JD; Yost CC
  • Blood 2020[Sep]; 136 (10): 1169-1179 PMID32597954show ga
  • COVID-19 affects millions of patients worldwide, with clinical presentation ranging from isolated thrombosis to acute respiratory distress syndrome (ARDS) requiring ventilator support. Neutrophil extracellular traps (NETs) originate from decondensed chromatin released to immobilize pathogens, and they can trigger immunothrombosis. We studied the connection between NETs and COVID-19 severity and progression. We conducted a prospective cohort study of COVID-19 patients (n = 33) and age- and sex-matched controls (n = 17). We measured plasma myeloperoxidase (MPO)-DNA complexes (NETs), platelet factor 4, RANTES, and selected cytokines. Three COVID-19 lung autopsies were examined for NETs and platelet involvement. We assessed NET formation ex vivo in COVID-19 neutrophils and in healthy neutrophils incubated with COVID-19 plasma. We also tested the ability of neonatal NET-inhibitory factor (nNIF) to block NET formation induced by COVID-19 plasma. Plasma MPO-DNA complexes increased in COVID-19, with intubation (P < .0001) and death (P < .0005) as outcome. Illness severity correlated directly with plasma MPO-DNA complexes (P = .0360), whereas Pao2/fraction of inspired oxygen correlated inversely (P = .0340). Soluble and cellular factors triggering NETs were significantly increased in COVID-19, and pulmonary autopsies confirmed NET-containing microthrombi with neutrophil-platelet infiltration. Finally, COVID-19 neutrophils ex vivo displayed excessive NETs at baseline, and COVID-19 plasma triggered NET formation, which was blocked by nNIF. Thus, NETs triggering immunothrombosis may, in part, explain the prothrombotic clinical presentations in COVID-19, and NETs may represent targets for therapeutic intervention.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Betacoronavirus/immunology[MESH]
  • |Blood Platelets/immunology/pathology[MESH]
  • |Blood Proteins/immunology[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*complications/immunology/pathology[MESH]
  • |Extracellular Traps/*immunology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Neutrophil Infiltration[MESH]
  • |Neutrophils/*immunology/pathology[MESH]
  • |Pandemics[MESH]
  • |Peroxidase/immunology[MESH]
  • |Pneumonia, Viral/*complications/immunology/pathology[MESH]
  • |Prospective Studies[MESH]
  • |SARS-CoV-2[MESH]


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