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Torres-Ruiz J, Absalón-Aguilar A, Nuñez-Aguirre M, Pérez-Fragoso A, Carrillo-Vázquez DA, Maravillas-Montero JL, Mejía-Domínguez NR, Llorente L, Alcalá-Carmona B, Lira-Luna J, Núñez-Álvarez C, Juárez-Vega G, Meza-Sánchez D, Hernández-Gilsoul T, Tapia-Rodríguez M, Gómez-Martín D. Neutrophil Extracellular Traps Contribute to COVID-19 Hyperinflammation and Humoral Autoimmunity. Cells 2021; 10:cells10102545. [PMID: 34685525 PMCID: PMC8533917 DOI: 10.3390/cells10102545] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) is related to enhanced production of NETs, and autoimmune/autoinflammatory phenomena. We evaluated the proportion of low-density granulocytes (LDG) by flow cytometry, and their capacity to produce NETs was compared with that of conventional neutrophils. NETs and their protein cargo were quantified by confocal microscopy and ELISA. Antinuclear antibodies (ANA), anti-neutrophil cytoplasmic antibodies (ANCA) and the degradation capacity of NETs were addressed in serum. MILLIPLEX assay was used to assess the cytokine levels in macrophages’ supernatant and serum. We found a higher proportion of LDG in severe and critical COVID-19 which correlated with severity and inflammatory markers. Severe/critical COVID-19 patients had higher plasmatic NE, LL-37 and HMGB1-DNA complexes, whilst ISG-15-DNA complexes were lower in severe patients. Sera from severe/critical COVID-19 patients had lower degradation capacity of NETs, which was reverted after adding hrDNase. Anti-NET antibodies were found in COVID-19, which correlated with ANA and ANCA positivity. NET stimuli enhanced the secretion of cytokines in macrophages. This study unveils the role of COVID-19 NETs as inducers of pro-inflammatory and autoimmune responses. The deficient degradation capacity of NETs may contribute to the accumulation of these structures and anti-NET antibodies are related to the presence of autoantibodies.
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Affiliation(s)
- Jiram Torres-Ruiz
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
- Emergency Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico;
| | - Abdiel Absalón-Aguilar
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Miroslava Nuñez-Aguirre
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Alfredo Pérez-Fragoso
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Daniel Alberto Carrillo-Vázquez
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico;
| | - José Luis Maravillas-Montero
- Red de Apoyo a la Investigacion, Coordinacion de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (J.L.M.-M.); (N.R.M.-D.); (G.J.-V.); (D.M.-S.)
| | - Nancy R. Mejía-Domínguez
- Red de Apoyo a la Investigacion, Coordinacion de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (J.L.M.-M.); (N.R.M.-D.); (G.J.-V.); (D.M.-S.)
| | - Luis Llorente
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Beatriz Alcalá-Carmona
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Jaquelin Lira-Luna
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Carlos Núñez-Álvarez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
| | - Guillermo Juárez-Vega
- Red de Apoyo a la Investigacion, Coordinacion de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (J.L.M.-M.); (N.R.M.-D.); (G.J.-V.); (D.M.-S.)
| | - David Meza-Sánchez
- Red de Apoyo a la Investigacion, Coordinacion de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (J.L.M.-M.); (N.R.M.-D.); (G.J.-V.); (D.M.-S.)
| | - Thierry Hernández-Gilsoul
- Emergency Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico;
| | - Miguel Tapia-Rodríguez
- Microscopy Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - Diana Gómez-Martín
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (J.T.-R.); (A.A.-A.); (M.N.-A.); (A.P.-F.); (L.L.); (B.A.-C.); (J.L.-L.); (C.N.-Á.)
- Red de Apoyo a la Investigacion, Coordinacion de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (J.L.M.-M.); (N.R.M.-D.); (G.J.-V.); (D.M.-S.)
- Correspondence:
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