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Profound Treg perturbations correlate with COVID-19 severity #MMPMID34433692
Galvan-Pena S; Leon J; Chowdhary K; Michelson DA; Vijaykumar B; Yang L; Magnuson AM; Chen F; Manickas-Hill Z; Piechocka-Trocha A; Worrall DP; Hall KE; Ghebremichael M; Walker BD; Li JZ; Yu XG; Mathis D; Benoist C
Proc Natl Acad Sci U S A 2021[Sep]; 118 (37): ä PMID34433692show ga
The hallmark of severe COVID-19 is an uncontrolled inflammatory response, resulting from poorly understood immunological dysfunction. We hypothesized that perturbations in FoxP3(+) T regulatory cells (Treg), key enforcers of immune homeostasis, contribute to COVID-19 pathology. Cytometric and transcriptomic profiling revealed a distinct Treg phenotype in severe COVID-19 patients, with an increase in Treg proportions and intracellular levels of the lineage-defining transcription factor FoxP3, correlating with poor outcomes. These Tregs showed a distinct transcriptional signature, with overexpression of several suppressive effectors, but also proinflammatory molecules like interleukin (IL)-32, and a striking similarity to tumor-infiltrating Tregs that suppress antitumor responses. Most marked during acute severe disease, these traits persisted somewhat in convalescent patients. A screen for candidate agents revealed that IL-6 and IL-18 may individually contribute different facets of these COVID-19-linked perturbations. These results suggest that Tregs may play nefarious roles in COVID-19, by suppressing antiviral T cell responses during the severe phase of the disease, and by a direct proinflammatory role.