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Complement activation induces excessive T cell cytotoxicity in severe COVID-19 #MMPMID35032429
Georg P; Astaburuaga-Garcia R; Bonaguro L; Brumhard S; Michalick L; Lippert LJ; Kostevc T; Gabel C; Schneider M; Streitz M; Demichev V; Gemund I; Barone M; Tober-Lau P; Helbig ET; Hillus D; Petrov L; Stein J; Dey HP; Paclik D; Iwert C; Mulleder M; Aulakh SK; Djudjaj S; Bulow RD; Mei HE; Schulz AR; Thiel A; Hippenstiel S; Saliba AE; Eils R; Lehmann I; Mall MA; Stricker S; Rohmel J; Corman VM; Beule D; Wyler E; Landthaler M; Obermayer B; von Stillfried S; Boor P; Demir M; Wesselmann H; Suttorp N; Uhrig A; Muller-Redetzky H; Nattermann J; Kuebler WM; Meisel C; Ralser M; Schultze JL; Aschenbrenner AC; Thibeault C; Kurth F; Sander LE; Bluthgen N; Sawitzki B
Cell 2022[Feb]; 185 (3): 493-512.e25 PMID35032429show ga
Severe COVID-19 is linked to both dysfunctional immune response and unrestrained immunopathology, and it remains unclear whether T cells contribute to disease pathology. Here, we combined single-cell transcriptomics and single-cell proteomics with mechanistic studies to assess pathogenic T cell functions and inducing signals. We identified highly activated CD16(+) T cells with increased cytotoxic functions in severe COVID-19. CD16 expression enabled immune-complex-mediated, T cell receptor-independent degranulation and cytotoxicity not found in other diseases. CD16(+) T cells from COVID-19 patients promoted microvascular endothelial cell injury and release of neutrophil and monocyte chemoattractants. CD16(+) T cell clones persisted beyond acute disease maintaining their cytotoxic phenotype. Increased generation of C3a in severe COVID-19 induced activated CD16(+) cytotoxic T cells. Proportions of activated CD16(+) T cells and plasma levels of complement proteins upstream of C3a were associated with fatal outcome of COVID-19, supporting a pathological role of exacerbated cytotoxicity and complement activation in COVID-19.