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Multi-omics Characterization of Neutrophil Extracellular Trap Formation in Severe and Mild COVID-19 Infections

Bramer, L.; Hontz, R.; Eisfeld, A.; Sims, A.; Kim, Y.-M.; Stratton, K.; Nicora, C.; Gritsenko, M.; Schepmoes, A.; Akasaka, O.; Koga, M.; Tsutsumi, T.; Nakamura, M.; Nakachi, I.; Baba, R.; Tateno, H.; Suzuki, S.; Nakajima, H.; Kato, H.; Ishida, K.; Ishii, M.; Uwamino, Y.; Mitamura, K.; Paurus, V.; Nakayasu, E.; Attah, I.; Letizia, A. G.; Waters, K.; Metz, T.; Corson, K.; Kawaoka, Y.; Gerbasi, V. R.

2022-04-28 infectious diseases
10.1101/2022.04.26.22274196 medRxiv
Show abstract

The detailed mechanisms of COVID-19 infection pathology remain poorly understood. To improve our understanding of SARS-CoV-2 pathology, we performed a multi-omics analysis of an immunologically naive SARS-CoV-2 clinical cohort from the plasma of uninfected controls, mild, and severe infections. A comparison of healthy controls and patient samples showed activation of neutrophil degranulation pathways and formation of neutrophil extracellular trap (NET) complexes that were activated in a subset of the mild infections and more prevalent in severe infections (containing multiple NET proteins in individual patient samples). As a potential mechanism to suppress NET formation, multiple redox enzymes were elevated in the mild and severe symptom population. Analysis of metabolites from the same cohort showed a 24- and 60-fold elevation in plasma L-cystine, the oxidized form of cysteine, which is a substrate of the powerful antioxidant glutathione, in mild and severe patients, respectively. Unique to patients with mild infections, the carnosine dipeptidase modifying enzyme (CNDP1) was up-regulated. The strong protein and metabolite oxidation signatures suggest multiple compensatory pathways working to suppress oxidation and NET formation in SARS-CoV-2 infections.

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