Back

CD4+ T cell lymphopenia and dysfunction in severe COVID-19 disease is autocrine TNF-α/TNFRI-dependent

Popescu, I.; Snyder, M. E.; Iasella, C. J.; Hannan, S. J.; Koshy, R.; Burke, R.; Das, A.; Brown, M. J.; Lyons, E. J.; Lieber, S. C.; Chen, X.; Sembrat, J. C.; An, X.; Linstrum, K.; Kitsios, G.; Konstantinidis, I.; Saul, M.; Kass, D. J.; Alder, J. K.; Chen, B. B.; Lendermon, E. A.; Kilaru, S.; Johnson, B.; Morrell, M. R.; Pilewski, J. M.; Kiss, J. E.; Wells, A. H.; Morris, A.; McVerry, B. J.; McMahon, D. K.; Triulzi, D. J.; Chen, K.; Sanchez, P. G.; McDyer, J. F.

2021-06-03 immunology
10.1101/2021.06.02.446831 bioRxiv
Show abstract

Lymphopenia is common in severe COVID-19 disease, yet the mechanisms are poorly understood. In 148 patients with severe COVID-19, we found lymphopenia was associated with worse survival. CD4+ lymphopenia predominated, with lower CD4+/CD8+ ratios in severe COVID-19 compared to recovered, mild disease (p<0.0001). In severe disease, immunodominant CD4+ T cell responses to Spike-1(S1) produced increased in vitro TNF-, but impaired proliferation and increased susceptibility to activation-induced cell death (AICD). CD4+TNF-+ T cell responses inversely correlated with absolute CD4+ counts from severe COVID-19 patients (n=76; R=-0.744, P<0.0001). TNF- blockade including infliximab or anti-TNFRI antibodies strikingly rescued S1-specific CD4+ proliferation and abrogated S1-AICD in severe COVID-19 patients (P<0.001). Single-cell RNAseq demonstrated downregulation of Type-1 cytokines and NF{kappa}B signaling in S1-stimulated CD4+ cells with infliximab treatment. Lung CD4+ T cells in severe COVID-19 were reduced and produced higher TNF- versus PBMC. Together, our findings show COVID-19-associated CD4+ lymphopenia and dysfunction is autocrine TNF-/TNFRI-dependent and therapies targeting TNF- may be beneficial in severe COVID-19. One Sentence SummaryAutocrine TNF-/TNFRI regulates CD4+ T cell lymphopenia and dysfunction in severe COVID-19 disease.

Matching journals

The top 7 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.