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. 2021 Sep 9;58(3):2100377.
doi: 10.1183/13993003.00377-2021. Print 2021 Sep.

Between inflammation and thrombosis: endothelial cells in COVID-19

Anna Birnhuber  1   2 , Elisabeth Fließer  1   2 , Gregor Gorkiewicz  3 , Martin Zacharias  3 , Benjamin Seeliger  4 , Sascha David  5 , Tobias Welte  4 , Julius Schmidt  6 , Horst Olschewski  7 , Malgorzata Wygrecka  8   2 , Grazyna Kwapiszewska  1   9   2
Affiliations

Between inflammation and thrombosis: endothelial cells in COVID-19

Anna Birnhuber et al. Eur Respir J. .

Abstract

Elevated levels of several endothelial markers, including CD31, VEGFR-2, ICAM-1, VCAM-1, E-selectin, P-selectin and vWF, in lung tissue and circulation support an important role of the pulmonary endothelium in local and systemic COVID-19 pathology https://bit.ly/3eQObIR

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Conflict of interest statement

Conflict of interest: A. Birnhuber has nothing to disclose. Conflict of interest: E. Fliesser has nothing to disclose. Conflict of interest: G. Gorkiewicz has nothing to disclose. Conflict of interest: M. Zacharias has nothing to disclose. Conflict of interest: B. Seeliger has nothing to disclose. Conflict of interest: S. David reports grants from German Research Foundation and Cytosorbents, outside the submitted work. Conflict of interest: T. Welte reports grants from German Ministry of Research and Education, during the conduct of the study; personal fees from Roche, Novartis, GSK, AstraZeneca and Boehringer, outside the submitted work. Conflict of interest: J. Schmidt has nothing to disclose. Conflict of interest: H. Olschewski reports personal fees for advisory board work and non-financial support from Bayer and Novartis, grants grants, personal fees for advisory board work and non-financial support from Actelion, grants and personal fees for advisory board work and symposium support from MSD, personal fees for adjudication and non-financial support from Pfizer, grants from Inventiva and Algorithm Sciences, personal fees for advisory board work, lectures and travel, and non-financial support from Boehringer, personal fees for advisory board work from Chiesi, Menarini, AstraZeneca and GSK, personal fees for lectures from MedUpdate, outside the submitted work; and is Co-Director of Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria. Conflict of interest: M. Wygrecka has nothing to disclose. Conflict of interest: G. Kwapiszewska has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
a) Patient characteristics of coronavirus disease 2019 (COVID-19) and control lung autopsy samples. Median (range) values are shown. b) Patient characteristics and clinical parameters of the COVID-19 cohort used to assess plasma levels of endothelial cell and inflammatory markers. Median (range) values are shown. c) Quantitative real-time PCR analysis of important endothelial markers in COVID-19 (n=19) and control (n=11) lung tissue homogenates. Heatmap representation of relative expression changes. z-scores are shown. d) Immunofluorescence staining of von Willebrand factor (vWF) (red) and inflammatory marker CD45 (green) in control and COVID-19 lung tissue. White arrowheads highlight inflammatory cells. White asterisks indicate auto-fluorescent extracellular matrix. Scale bar: 50 µm. Circulating levels of e) endothelial markers intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, E-selectin, CD31, P-selectin and vWF, and f) inflammatory mediators interleukin (IL)-6, monocyte-chemoattractant protein (MCP)-1, IL-8 and tumour necrosis factor (TNF)-α in the plasma of COVID-19 patients (n=21) and healthy controls (n=22). g) Correlation matrix of clinical parameters and ICAM-1, VCAM-1, E-selectin, CD31, P-selectin, vWF, IL-6, IL-8 and MCP-1 circulating levels in COVID-19 patients. Dot size and colour correspond to the correlation coefficient, circled dots indicate significance using a threshold of p<0.05. h) Selected correlations as calculated in (d). *: p<0.05; **: p<0.01; ***: p<0.001; ****: p<0.0001. KDR/VEGFR2: vascular endothelial growth factor receptor 2; CD31/PECAM1: platelet and endothelial cell adhesion molecule 1; SELP: P-selectin; CRP: C-reactive protein; PCT: procalcitonin; PTT: partial thromboplastin time; BMI: body mass index; SOFA: sequential organ failure assessment score.
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References

    1. Huang C, Wang Y, Li X, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506. doi:10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed
    1. Ackermann M, Verleden SE, Kuehnel M, et al. . Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med 2020; 383: 120–128. doi:10.1056/NEJMoa2015432 - DOI - PMC - PubMed
    1. Michalick L, Weidenfeld S, Grimmer B, et al. . Plasma mediators in patients with severe COVID-19 cause lung endothelial barrier failure. Eur Respir J 2020; 57: 2002384. doi:10.1183/13993003.02384-2020 - DOI - PMC - PubMed
    1. Stahl K, Gronski PA, Kiyan Y, et al. . Injury to the endothelial glycocalyx in critically ill patients with COVID-19. Am J Respir Crit Care Med 2020; 202: 1178–1181. doi:10.1164/rccm.202007-2676LE - DOI - PMC - PubMed
    1. Varga Z, Flammer AJ, Steiger P, et al. . Endothelial cell infection and endotheliitis in COVID-19. Lancet 2020; 395: 1417–1418. doi:10.1016/S0140-6736(20)30937-5 - DOI - PMC - PubMed