Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Respir Investig. 2022 Nov;60(6):750-761. doi: 10.1016/j.resinv.2022.06.007. Epub 2022 Jul 12.
The role of programmed cell death, especially pyroptosis and apoptosis, in unfavorable immune responses in COVID-19 remains to be elucidated.
We conducted a cross-sectional analysis to investigate the association between the serum gasdermin D (GSDMD) levels, a pyroptotic marker, and caspase-cleaved cytokeratin 18 fragment (M30), an apoptotic marker, and the clinical status and abnormal chest computed tomography (CT) findings in patients with COVID-19.
In this study, 46 patients diagnosed with COVID-19 were divided into the following three groups according to the disease severity: mild to moderate group (n = 10), severe group (n = 14), and critical group (n = 22). The serum GSDMD levels were higher in the critical group than in the mild to moderate group (P = 0.016). In contrast, serum M30 levels were lower in the critical group than in the severe group (P = 0.048). Patients who required mechanical ventilation or died had higher serum GSDMD levels than those who did not (P = 0.007). Area of consolidation only and of ground glass opacity plus consolidation positively correlated with serum GSDMD levels (r = 0.56, P < 0.001 and r = 0.53, P < 0.001, respectively).
Higher serum GSDMD levels are associated with critical respiratory status and the consolidation area on chest CT in patients with COVID-19, suggesting that excessive activation of pyroptosis may affect the clinical manifestations in patients with COVID-19.
程序性细胞死亡，尤其是细胞焦亡和细胞凋亡，在 COVID-19 中的不利免疫反应中的作用仍需阐明。
我们进行了一项横断面分析，以研究 COVID-19 患者血清中细胞焦亡标志物 Gasdermin D（GSDMD）和细胞凋亡标志物 caspase 切割细胞角蛋白 18 片段（M30）水平与临床状况和异常胸部计算机断层扫描（CT）表现之间的关系。
本研究中，根据疾病严重程度将 46 例 COVID-19 患者分为三组：轻度至中度组（n=10）、重度组（n=14）和危重组（n=22）。危重组的血清 GSDMD 水平高于轻度至中度组（P=0.016）。相反，危重组的血清 M30 水平低于重度组（P=0.048）。需要机械通气或死亡的患者的血清 GSDMD 水平高于未需要机械通气或死亡的患者（P=0.007）。单纯实变区和磨玻璃影合并实变区与血清 GSDMD 水平呈正相关（r=0.56，P<0.001 和 r=0.53，P<0.001）。
COVID-19 患者血清中较高的 GSDMD 水平与严重的呼吸状态和胸部 CT 的实变区有关，提示细胞焦亡的过度激活可能影响 COVID-19 患者的临床表现。
