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Identification of biomarkers for COVID-19 associated secondary hemophagocytic lymphohistiocytosis.
- Source :
-
BioRxiv : the preprint server for biology [bioRxiv] 2024 Aug 15. Date of Electronic Publication: 2024 Aug 15. - Publication Year :
- 2024
-
Abstract
- Objectives: We aimed to define and validate novel biomarkers that could identify individuals with COVID-19 associated secondary hemophagocytic lymphohistiocytosis (sHLH) and to test whether fatalities due to COVID-19 in the presence of sHLH were associated with specific defects in the immune system.<br />Design: In two cohorts of adult patients presenting with COVID-19 in 2020 and 2021, clinical lab values and serum proteomics were assessed. Subjects identified as having sHLH were compared to those with COVID-19 without sHLH. Eight deceased patients defined as COVID-sHLH underwent genomic sequencing in order to identify variants in immune-related genes.<br />Setting: Two tertiary care hospitals in Seattle, Washington (Virginia Mason Medical Center and Harborview Medical Center).<br />Patients: 186 patients with COVID-19.<br />Interventions: None.<br />Measurements and Main Results: Nine percent of enrolled COVID-19 subjects met our defined criteria for sHLH. Using broad serum proteomic approaches (O-link and SomaScan), we identified three biomarkers for COVID-19 associated sHLH (soluble PD-L1, TNF-R1, and IL-18BP), supporting a role for proteins previously associated with other forms of sHLH (IL-18BP and sTNF-R1). We also identified novel biomarkers and pathways of COVID-sHLH, including sPD-L1 and the syntaxin pathway. We detected variants in several genes involved in immune responses in individuals with COVID-sHLH, including in DOCK8 and in TMPRSS15 , suggesting that genetic alterations in immune-related genes may contribute to hyperinflammation and fatal outcomes in COVID-19.<br />Conclusions: Biomarkers of COVID-19 associated sHLH, such as soluble PD-L1, and pathways, such as the syntaxin pathway, and variants in immune genes in these individuals, suggest critical roles for the immune response in driving sHLH in the context of COVID-19.
Details
- Language :
- English
- ISSN :
- 2692-8205
- Database :
- MEDLINE
- Journal :
- BioRxiv : the preprint server for biology
- Publication Type :
- Academic Journal
- Accession number :
- 39185173
- Full Text :
- https://doi.org/10.1101/2024.08.13.607855