Serrano-Gonzalo Irene, Menéndez-Jandula Bárbara, Franco-García Esther, Arévalo-Vargas Isidro, Lahoz-Gil Calos, Latre Paz, Roca-Esteve Sonia, Köhler Ralf, López de Frutos Laura, Giraldo Pilar
Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain.
Grupo de Investigación Mecanismos de Enfermedad Crónica e Investigación Traslacional (MECIT), Zaragoza, Spain.
Front Immunol. 2025 Feb 24;16:1507167. doi: 10.3389/fimmu.2025.1507167. eCollection 2025.
SARS-CoV-2 infection activates macrophages and induces the release of neutrophil extracellular traps (NETs). Excess NETs is linked to inflammatory and thrombotic complications observed in COVID-19.
To explore the impact of NETs and macrophage activation on SARS-CoV-2-infected patients who developed complications.
We included 30 patients from the first (March 2020) and 30 from the second wave (July 2021), collecting two plasma samples at diagnosis and seven days later. Data on demographics, comorbidities, and basic analytical data were compiled. NETs markers (myeloperoxidase (MPO), neutrophil elastase (NE), p-selectin (P-SEL) and S100A8/S100A9 heterodimer (MRP)) and macrophage activation markers (Chitotriosidase activity (ChT), CCL18/PARC and YKL-40) were measured.
The first wave had higher incidences of post-COVID syndrome, ICU admissions, and mortality. Patients of each wave showed elevated blood cells, liver enzymes, and coagulation markers at the time of diagnosis, with fibrinogen and D-Dimer differing between waves. NET and macrophage markers, NE, MPO, MRP, DNAse, ChT, and CCL18 were elevated, while P-SEL, cfDNA, and YKL-40 were decreased if compared to controls. A decrease in NE and DNAse is a link to lower levels of these two markers in complications versus without complications.
This study emonstrates alterations in NETs and macrophage activation markers in COVID-19 patients, indicating an imbalance in inflammatory response regulation.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可激活巨噬细胞并诱导中性粒细胞胞外陷阱（NETs）的释放。过量的NETs与冠状病毒病（COVID-19）中观察到的炎症和血栓形成并发症有关。
探讨NETs和巨噬细胞激活对出现并发症的SARS-CoV-2感染患者的影响。
我们纳入了第一波疫情（2020年3月）的30名患者和第二波疫情（2021年7月）的30名患者，在诊断时和7天后采集两份血浆样本。收集了人口统计学、合并症和基本分析数据。检测了NETs标志物（髓过氧化物酶（MPO）、中性粒细胞弹性蛋白酶（NE）、p-选择素（P-SEL）和S100A8/S100A9异二聚体（MRP））和巨噬细胞激活标志物（几丁质酶活性（ChT）、CCL18/PARC和YKL-40）。
第一波疫情中，COVID-19后综合征、入住重症监护病房（ICU）和死亡率的发生率更高。每一波的患者在诊断时血细胞、肝酶和凝血标志物均升高，纤维蛋白原和D-二聚体在不同波次之间存在差异。与对照组相比，NET和巨噬细胞标志物、NE、MPO、MRP、脱氧核糖核酸酶（DNAse）、ChT和CCL18升高，而P-SEL、游离DNA（cfDNA）和YKL-40降低。NE和DNAse的降低与并发症患者中这两种标志物水平低于无并发症患者有关。
本研究证明了COVID-19患者NETs和巨噬细胞激活标志物的改变，表明炎症反应调节失衡。
