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Int Immunopharmacol . A possible pathogenic correlation between neutrophil elastase (NE) enzyme and inflammation in the pathogenesis of coronavirus

tetano

Editor, Senior Moderator
Int Immunopharmacol


. 2021 Sep 14;100:108137.
doi: 10.1016/j.intimp.2021.108137. Online ahead of print.
A possible pathogenic correlation between neutrophil elastase (NE) enzyme and inflammation in the pathogenesis of coronavirus disease 2019 (COVID-19)


Sajad Karampoor[SUP] 1 [/SUP], Khashayar Hesamizadeh[SUP] 2 [/SUP], Faezeh Maleki[SUP] 3 [/SUP], Mohammad Farahmand[SUP] 4 [/SUP], Hamid Zahednasab[SUP] 5 [/SUP], Rasoul Mirzaei[SUP] 6 [/SUP], Helene Banoun[SUP] 7 [/SUP], Farhad Zamani[SUP] 8 [/SUP], Marzieh Hajibaba[SUP] 8 [/SUP], Alireza Tabibzadeh[SUP] 9 [/SUP], Behnaz Bouzari[SUP] 10 [/SUP], Mohammad-Navid Bastani[SUP] 9 [/SUP], Azadeh Laali[SUP] 11 [/SUP], Hossein Keyvani[SUP] 12 [/SUP]



Affiliations
Free PMC article

Abstract

A growing body of evidence indicates that neutrophil elastase (NE) is involved in the pathogenesis of respiratory infectious diseases, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to analyze the dynamic changes in serum levels of NE associated with inflammation, disease activity, and mortality rate in patients with COVID-19. We measured the serum concentrations of NE, C-Reactive protein (CRP), interleukin (IL)- 4, IL-6, IL-8, IL-10, and vitamin D levels in 83 ICU and 69 non-ICU patients compared with 82 healthy subjects (HS) in three-time points (T1-T3). Serum levels of NE, IL-6, IL-8, and CRP in ICU and non-ICU patients were significantly higher than HS (P < 0.001) in three-time points. Also, serum levels of NE, IL-6, IL-8, and CRP in ICU patients were significantly higher than in non-ICU patients (P < 0.05). On the day of admission (T1), the levels of NE, CRP, IL-6, IL-8 were gradually decreased from T1 to T3. At the same time, IL-4 and IL-10 were gradually increased from T1 to T2 and then reduced to T3. Further analyses demonstrated that the levels of NE, IL-6, and IL-8 in deceased patients were significantly higher than in recovered patients (P < 0.05). The ROC curve analysis demonstrated that markers, including NE, IL-6, and IL-8, were valuable indicators in evaluating the activity of COVID-19. Overall, our results signify the critical role of NE in the pathogenesis of COVID-19, and also, further support that NE has a potential therapeutic target for the attenuation of COVID-19 severity.

Keywords: COVID-19; Disease activity; Inflammation; Neutrophil elastase; SARS-CoV-2.
 
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