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Increased Plasma Heparanase Activity in COVID-19 Patients #MMPMID33123154
Buijsers B; Yanginlar C; de Nooijer A; Grondman I; Maciej-Hulme ML; Jonkman I; Janssen NAF; Rother N; de Graaf M; Pickkers P; Kox M; Joosten LAB; Nijenhuis T; Netea MG; Hilbrands L; van de Veerdonk FL; Duivenvoorden R; de Mast Q; van der Vlag J
Front Immunol 2020[]; 11 (ä): 575047 PMID33123154show ga
Reports suggest a role of endothelial dysfunction and loss of endothelial barrier function in COVID-19. It is well established that the endothelial glycocalyx-degrading enzyme heparanase contributes to vascular leakage and inflammation. Low molecular weight heparins (LMWH) serve as an inhibitor of heparanase. We hypothesize that heparanase contributes to the pathogenesis of COVID-19, and that heparanase may be inhibited by LMWH. To test this hypothesis, heparanase activity and heparan sulfate levels were measured in plasma of healthy controls (n = 10) and COVID-19 patients (n = 48). Plasma heparanase activity and heparan sulfate levels were significantly elevated in COVID-19 patients. Heparanase activity was associated with disease severity including the need for intensive care, lactate dehydrogenase levels, and creatinine levels. Use of prophylactic LMWH in non-ICU patients was associated with a reduced heparanase activity. Since there is no other clinically applied heparanase inhibitor currently available, therapeutic treatment of COVID-19 patients with low molecular weight heparins should be explored.