Lerma L Angelica, Chaudhary Anu, Bryan Andrew, Morishima Chihiro, Wener Mark H, Fink Susan L
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
J Transl Autoimmun. 2020;3:100073. doi: 10.1016/j.jtauto.2020.100073. Epub 2020 Nov 27.
Immunopathology may play a significant role in the pathogenesis of Coronavirus-Induced Disease-19 (COVID-19). Immune-mediated tissue damage could result from development of rapid autoimmune responses, characterized by production of self-reactive autoantibodies. In this study, we tested specimens from acutely ill patients hospitalized with COVID-19 for autoantibodies against nuclear, vasculitis-associated, and phospholipid antigens. Detectable autoantibodies were present in 30% of the patients in our cohort, with the majority of reactive specimens demonstrating antibodies to nuclear antigens. However, antinuclear antibodies were only weakly reactive and directed to single antigens, as is often seen during acute infection. We identified strongly reactive antibodies to nuclear antigens only in patients with a prior history of autoimmune disease. In our cohort, the prevalence of antiphospholipid antibodies was low, and we did not detect any vasculitis-associated autoantibodies. We found similar levels of inflammatory markers and total immunoglobulin levels in autoantibody positive versus negative patients, but anti-SARS-CoV-2 antibody levels were increased in autoantibody positive patients. Together, our results suggest that acute COVID-19 is not associated with a high prevalence of clinically significant autoantibody responses of the type usually associated with autoimmune rheumatic disease.
免疫病理学可能在冠状病毒诱导的疾病-19（COVID-19）发病机制中发挥重要作用。免疫介导的组织损伤可能源于快速自身免疫反应的发展，其特征是产生自身反应性自身抗体。在本研究中，我们检测了因COVID-19住院的急性病患者的标本，以寻找针对核抗原、血管炎相关抗原和磷脂抗原的自身抗体。在我们队列中的30%患者中存在可检测到的自身抗体，大多数反应性标本显示出针对核抗原的抗体。然而，抗核抗体仅呈弱反应性且针对单一抗原，这在急性感染期间很常见。我们仅在有自身免疫疾病既往史的患者中发现了针对核抗原的强反应性抗体。在我们的队列中，抗磷脂抗体的患病率较低，并且我们未检测到任何血管炎相关的自身抗体。我们发现自身抗体阳性和阴性患者的炎症标志物水平和总免疫球蛋白水平相似，但自身抗体阳性患者的抗SARS-CoV-2抗体水平有所升高。总之，我们的结果表明，急性COVID-19与通常与自身免疫性风湿病相关的具有临床意义的自身抗体反应的高患病率无关。
