[HTML][HTML] Autoantibodies stabilize neutrophil extracellular traps in COVID-19

Y Zuo, S Yalavarthi, SA Navaz, CK Hoy, A Harbaugh… - JCI insight, 2021 - ncbi.nlm.nih.gov
Y Zuo, S Yalavarthi, SA Navaz, CK Hoy, A Harbaugh, K Gockman, M Zuo, JA Madison, H Shi…
JCI insight, 2021ncbi.nlm.nih.gov
The release of neutrophil extracellular traps (NETs) by hyperactive neutrophils is recognized
to play an important role in the thromboinflammatory milieu inherent to severe presentations
of COVID-19. At the same time, a variety of functional autoantibodies have been observed in
individuals with severe COVID-19, where they likely contribute to immunopathology. Here,
we aimed to determine the extent to which autoantibodies might target NETs in COVID-19
and, if detected, to elucidate their potential functions and clinical associations. We measured …
Abstract
The release of neutrophil extracellular traps (NETs) by hyperactive neutrophils is recognized to play an important role in the thromboinflammatory milieu inherent to severe presentations of COVID-19. At the same time, a variety of functional autoantibodies have been observed in individuals with severe COVID-19, where they likely contribute to immunopathology. Here, we aimed to determine the extent to which autoantibodies might target NETs in COVID-19 and, if detected, to elucidate their potential functions and clinical associations. We measured anti-NET antibodies in 328 individuals hospitalized with COVID-19 alongside 48 healthy controls. We found high anti-NET activity in the IgG and IgM fractions of 27% and 60% of patients, respectively. There was a strong correlation between anti–NET IgG and anti–NET IgM. Both anti–NET IgG and anti–NET IgM tracked with high levels of circulating NETs, impaired oxygenation efficiency, and high circulating D-dimer. Furthermore, patients who required mechanical ventilation had a greater burden of anti-NET antibodies than did those not requiring oxygen supplementation. Levels of anti–NET IgG (and, to a lesser extent, anti–NET IgM) demonstrated an inverse correlation with the efficiency of NET degradation by COVID-19 sera. Furthermore, purified IgG from COVID-19 sera with high levels of anti-NET antibodies impaired the ability of healthy control serum to degrade NETs. In summary, many individuals hospitalized with COVID-19 have anti-NET antibodies, which likely impair NET clearance and may potentiate SARS-CoV-2–mediated thromboinflammation.
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