Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

PubMed Disclaimer

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.
See this image and copyright information in PMC

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