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 Nov:100:108137.
doi: 10.1016/j.intimp.2021.108137. Epub 2021 Sep 14.

A possible pathogenic correlation between neutrophil elastase (NE) enzyme and inflammation in the pathogenesis of coronavirus disease 2019 (COVID-19)

Sajad Karampoor  1 , Khashayar Hesamizadeh  2 , Faezeh Maleki  3 , Mohammad Farahmand  4 , Hamid Zahednasab  5 , Rasoul Mirzaei  6 , Helene Banoun  7 , Farhad Zamani  8 , Marzieh Hajibaba  8 , Alireza Tabibzadeh  9 , Behnaz Bouzari  10 , Mohammad-Navid Bastani  9 , Azadeh Laali  11 , Hossein Keyvani  12
Affiliations

A possible pathogenic correlation between neutrophil elastase (NE) enzyme and inflammation in the pathogenesis of coronavirus disease 2019 (COVID-19)

Sajad Karampoor et al. Int Immunopharmacol. 2021 Nov.

Abstract

A growing body of evidence indicates that neutrophil elastase (NE) is involved in the pathogenesis of respiratory infectious diseases, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to analyze the dynamic changes in serum levels of NE associated with inflammation, disease activity, and mortality rate in patients with COVID-19. We measured the serum concentrations of NE, C-Reactive protein (CRP), interleukin (IL)- 4, IL-6, IL-8, IL-10, and vitamin D levels in 83 ICU and 69 non-ICU patients compared with 82 healthy subjects (HS) in three-time points (T1-T3). Serum levels of NE, IL-6, IL-8, and CRP in ICU and non-ICU patients were significantly higher than HS (P < 0.001) in three-time points. Also, serum levels of NE, IL-6, IL-8, and CRP in ICU patients were significantly higher than in non-ICU patients (P < 0.05). On the day of admission (T1), the levels of NE, CRP, IL-6, IL-8 were gradually decreased from T1 to T3. At the same time, IL-4 and IL-10 were gradually increased from T1 to T2 and then reduced to T3. Further analyses demonstrated that the levels of NE, IL-6, and IL-8 in deceased patients were significantly higher than in recovered patients (P < 0.05). The ROC curve analysis demonstrated that markers, including NE, IL-6, and IL-8, were valuable indicators in evaluating the activity of COVID-19. Overall, our results signify the critical role of NE in the pathogenesis of COVID-19, and also, further support that NE has a potential therapeutic target for the attenuation of COVID-19 severity.

Keywords: COVID-19; Disease activity; Inflammation; Neutrophil elastase; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The laboratory finding and dynamic changes in CRP levels, IL-4, IL-6, IL-8, IL-10, and vitamin D in ICU and non-ICU patients.
Fig. 2
Fig. 2
The correlation between NE, IL-6, CRP, and vitamin D with CT value.
Fig. 3
Fig. 3
The matrix correlation between NE and pro/anti-inflammatory markers.
Fig. 4
Fig. 4
ROC curve analysis between, A: Healthy people vs. ICU patients, B: Healthy people vs. Non-ICU patients, and C: Non-ICU patients vs. ICU patients. AUC: Area under the curve.
See this image and copyright information in PMC

References

    1. Goodarzi P., Mahdavi F., Mirzaei R., Hasanvand H., Sholeh M., Zamani F., Sohrabi M., Tabibzadeh A., Jeda A.S., Niya M.H.K., Coronavirus disease Coronavirus disease 2019 (COVID-19): Immunological approaches and emerging pharmacologic treatments. Int Immunopharmacol. 2020 - PMC - PubMed
    1. Sanders J.M., Monogue M.L., Jodlowski T.Z., Cutrell J.B. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. Jama. 2020;323(18):1824–1836. - PubMed
    1. Keyvani H., Zahednasab H., Sholeh M., Mirzaei R., Esghaei M., Karampoor S. Gender Preponderance Might be Associated with the Severity of COVID-19 Infection. J Clin Cell Immunol. 2020;11:598.
    1. Mirzaei R., Mohammadzadeh R., Mahdavi F., Badrzadeh F., Kazemi S., Ebrahimi M., Soltani F., Kazemi S., Jeda A.S., Darvishmotevalli M. Overview of the current promising approaches for the development of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Int Immunopharmacol. 2020;106928 - PMC - PubMed
    1. Li H., Liu S.-M., Yu X.-H., Tang S.-L., Tang C.-K. Coronavirus disease 2019 (COVID-19): current status and future perspectives. International journal of antimicrobial agents. 2020;55(5) - PMC - PubMed