Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.
J Biomed Sci. 2022 Nov 10;29(1):94. doi: 10.1186/s12929-022-00880-5.
Among various complications of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), renal complications, namely COVID-19-associated kidney injuries, are related to the mortality of COVID-19.
In this retrospective cross-sectional study, we measured the sphingolipids and glycerophospholipids, which have been shown to possess potent biological properties, using liquid chromatography-mass spectrometry in 272 urine samples collected longitudinally from 91 COVID-19 subjects and 95 control subjects without infectious diseases, to elucidate the pathogenesis of COVID-19-associated kidney injuries.
The urinary levels of C18:0, C18:1, C22:0, and C24:0 ceramides, sphingosine, dihydrosphingosine, phosphatidylcholine, lysophosphatidylcholine, lysophosphatidic acid, and phosphatidylglycerol decreased, while those of phosphatidylserine, lysophosphatidylserine, phosphatidylethanolamine, and lysophosphatidylethanolamine increased in patients with mild COVID-19, especially during the early phase (day 1-3), suggesting that these modulations might reflect the direct effects of infection with SARS-CoV-2. Generally, the urinary levels of sphingomyelin, ceramides, sphingosine, dihydrosphingosine, dihydrosphingosine L-phosphate, phosphatidylcholine, lysophosphatidic acid, phosphatidylserine, lysophosphatidylserine, phosphatidylethanolamine, lysophosphatidylethanolamine, phosphatidylglycerol, lysophosphatidylglycerol, phosphatidylinositol, and lysophosphatidylinositol increased, especially in patients with severe COVID-19 during the later phase, suggesting that their modulations might result from kidney injuries accompanying severe COVID-19.
Considering the biological properties of sphingolipids and glycerophospholipids, an understanding of their urinary modulations in COVID-19 will help us to understand the mechanisms causing COVID-19-associated kidney injuries as well as general acute kidney injuries and may prompt researchers to develop laboratory tests for predicting maximum severity and/or novel reagents to suppress the renal complications of COVID-19.
由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）的各种并发症中，肾脏并发症，即 COVID-19 相关的肾损伤，与 COVID-19 的死亡率有关。
在这项回顾性的横断面研究中，我们使用液相色谱-质谱法测量了 272 份尿液样本中的鞘脂和甘油磷脂，这些样本是从 91 名 COVID-19 患者和 95 名无传染病的对照患者中纵向收集的，以阐明 COVID-19 相关肾损伤的发病机制。
轻度 COVID-19 患者（尤其是早期[第 1-3 天]）的尿中 C18:0、C18:1、C22:0 和 C24:0 神经酰胺、神经鞘氨醇、二氢神经鞘氨醇、磷脂酰胆碱、溶血磷脂酰胆碱、溶血磷脂酸和磷脂酰甘油水平降低，而丝氨酸磷脂、溶血丝氨酸磷脂、磷脂乙醇胺和溶血磷脂乙醇胺水平升高，提示这些变化可能反映了 SARS-CoV-2 感染的直接作用。一般来说，尿中鞘磷脂、神经酰胺、神经鞘氨醇、二氢神经鞘氨醇、二氢神经鞘氨醇 L-磷酸、磷脂酰胆碱、溶血磷脂酸、丝氨酸磷脂、溶血丝氨酸磷脂、磷脂乙醇胺、溶血磷脂乙醇胺、磷脂酰甘油、溶血磷脂酰甘油、磷脂酰肌醇和溶血磷脂酰肌醇水平升高，尤其是在重度 COVID-19 患者的后期，提示这些变化可能是由重度 COVID-19 伴发的肾损伤所致。
考虑到鞘脂和甘油磷脂的生物学特性，了解它们在 COVID-19 中的尿调节情况，有助于我们了解导致 COVID-19 相关肾损伤以及一般急性肾损伤的机制，并可能促使研究人员开发用于预测最大严重程度和/或新型试剂以抑制 COVID-19 肾脏并发症的实验室检测。
