tetano
Editor, Senior Moderator
Histopathology
. 2024 Jan 22.
doi: 10.1111/his.15143. Online ahead of print. Increase in venous thromboembolism in SARS-CoV-2 infected lung tissue: proteome analysis of lung parenchyma, isolated endothelium, and thrombi
Boaz V Lopuhaä[SUP] 1 [/SUP], Coşkun Guzel[SUP] 2 [/SUP], Anabel van der Lee[SUP] 3 [/SUP], Thierry P P van den Bosch[SUP] 1 [/SUP], Folkert J van Kemenade[SUP] 1 [/SUP], Menno V Huisman[SUP] 4 [/SUP], Marieke J H A Kruip[SUP] 5 [/SUP], Theo M Luider[SUP] 2 [/SUP], Jan H von der Thüsen[SUP] 1 [/SUP]
Affiliations
Aims: COVID-19 pneumonia is characterized by an increased rate of deep venous thrombosis and pulmonary embolism. To better understand the pathophysiology behind thrombosis in COVID-19, we performed proteomics analysis on SARS-CoV-2 infected lung tissue.
Methods: Liquid chromatography mass spectrometry was performed on SARS-CoV-2 infected postmortem lung tissue samples. Five protein profiling analyses were performed: whole slide lung parenchyma analysis, followed by analysis of isolated thrombi and endothelium, both stratified by disease (COVID-19 versus influenza) and thrombus morphology (embolism versus in situ). Influenza autopsy cases with pulmonary thrombi were used as controls.
Results: Compared to influenza controls, both analyses of COVID-19 whole-tissue and isolated endothelium showed upregulation of proteins and pathways related to liver metabolism including urea cycle activation, with arginase being among the top upregulated proteins in COVID-19 lung tissue. Analysis of isolated COVID-19 thrombi showed significant downregulation of pathways related to platelet activation compared to influenza thrombi. Analysis of isolated thrombi based on histomorphology shows that in situ thrombi have significant upregulation of coronavirus pathogenesis proteins.
Conclusions: The decrease in platelet activation pathways in severe COVID-19 thrombi suggests a relative increase in venous thromboembolism, as thrombi from venous origin tend to contain fewer platelets than arterial thrombi. Based on histomorphology, in situ thrombi show upregulation of various proteins related to SARS-CoV-2 pathogenesis compared to thromboemboli, which may indicate increased in situ pulmonary thrombosis in COVID-19. Therefore, this study supports the increase of venous thromboembolism without undercutting the involvement of in situ thrombosis in severe COVID-19.
Keywords: COVID-19; in situ thrombosis; proteomics; thromboembolism; thrombosis.
. 2024 Jan 22.
doi: 10.1111/his.15143. Online ahead of print. Increase in venous thromboembolism in SARS-CoV-2 infected lung tissue: proteome analysis of lung parenchyma, isolated endothelium, and thrombi
Boaz V Lopuhaä[SUP] 1 [/SUP], Coşkun Guzel[SUP] 2 [/SUP], Anabel van der Lee[SUP] 3 [/SUP], Thierry P P van den Bosch[SUP] 1 [/SUP], Folkert J van Kemenade[SUP] 1 [/SUP], Menno V Huisman[SUP] 4 [/SUP], Marieke J H A Kruip[SUP] 5 [/SUP], Theo M Luider[SUP] 2 [/SUP], Jan H von der Thüsen[SUP] 1 [/SUP]
Affiliations
- PMID: 38253958
- DOI: 10.1111/his.15143
Aims: COVID-19 pneumonia is characterized by an increased rate of deep venous thrombosis and pulmonary embolism. To better understand the pathophysiology behind thrombosis in COVID-19, we performed proteomics analysis on SARS-CoV-2 infected lung tissue.
Methods: Liquid chromatography mass spectrometry was performed on SARS-CoV-2 infected postmortem lung tissue samples. Five protein profiling analyses were performed: whole slide lung parenchyma analysis, followed by analysis of isolated thrombi and endothelium, both stratified by disease (COVID-19 versus influenza) and thrombus morphology (embolism versus in situ). Influenza autopsy cases with pulmonary thrombi were used as controls.
Results: Compared to influenza controls, both analyses of COVID-19 whole-tissue and isolated endothelium showed upregulation of proteins and pathways related to liver metabolism including urea cycle activation, with arginase being among the top upregulated proteins in COVID-19 lung tissue. Analysis of isolated COVID-19 thrombi showed significant downregulation of pathways related to platelet activation compared to influenza thrombi. Analysis of isolated thrombi based on histomorphology shows that in situ thrombi have significant upregulation of coronavirus pathogenesis proteins.
Conclusions: The decrease in platelet activation pathways in severe COVID-19 thrombi suggests a relative increase in venous thromboembolism, as thrombi from venous origin tend to contain fewer platelets than arterial thrombi. Based on histomorphology, in situ thrombi show upregulation of various proteins related to SARS-CoV-2 pathogenesis compared to thromboemboli, which may indicate increased in situ pulmonary thrombosis in COVID-19. Therefore, this study supports the increase of venous thromboembolism without undercutting the involvement of in situ thrombosis in severe COVID-19.
Keywords: COVID-19; in situ thrombosis; proteomics; thromboembolism; thrombosis.
