covid and autoantibodies against Angiotensin II Receptor Type 1 and Endothelin A Receptor

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Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms
panelGerdWallukatabBettinaHohbergercKatrinWenzelbJuliaFürstdSarahSchulze-RothebAnneWallukatbAnne-SophieHönickebJohannesMüllerb

https://doi.org/10.1016/j.jtauto.2021.100100Get rights and content


Highlights


Sera from Long-COVID syndrome patients contained functionally active autoantibodies targeting G-protein coupled receptors.

Autoantibodies target β2- and α1-adrenoceptors, angiotensin II AT1-, muscarinic M2-, MAS-, nociceptin- and ETA-receptors.

Included syndromes were of neurological and cardiological origin, or a combination of both.

Such autoantibody patterns have previously been seen in COVID independent neurological deficits and cardiovascular disease.

13 May 2021 | https://doi.org/10.3389/fimmu.2021.684142
Antibodies Against Angiotensin II Receptor Type 1 and Endothelin A Receptor Are Associated With an Unfavorable COVID19 Disease Course
Jelle Miedema
1*,
Marco Schreurs
2,
Simone van der Sar – van der Brugge
3,
Marthe Paats1,
Sara Baart4,
Marleen Bakker1,
Rogier Hoek
1,
Willem Arnout Dik
2,
Henrik Endeman5,
Vincent Van Der Velden
2,
Adriaan van Gammeren6,
Antonius Ermens6,
Joachim G. Aerts
1 and
Jan Von Der Thüsen
7

Background: Lung histopathology demonstrates vasculopathy in a subset of deceased COVID19 patients, which resembles histopathology observed in antibody-mediated lung transplant rejection.

Autoantibodies against angiotensin II type 1 receptor (AT1R) and Endothelin receptor Type A (ETAR) have been demonstrated in antibody-mediated rejection and may also be associated with severe COVID19 infection.

Objective To assess AT1R and ETAR auto-antibodies in COVID19 patients and controls, and explore their association with disease course.

Methods: 65 hospitalized patients with COVID19 infection were included. Clinical and laboratory findings were retrospectively assessed. Patients with unfavorable disease course, admitted at the intensive care unit and/or deceased during hospital admission (n=33) were compared to admitted COVID19 patients with favorable disease course (n=32). The presence of antinuclear antibodies (ANA) and auto-antibodies against AT1R or ETAR in peripheral blood were compared between COVID19 with unfavorable and favorable disease course and age matched controls (n=20).

Results:
The presence of ANA was not significantly different between COVID19 patients with unfavorable (n=7/33; 21%) and favorable disease course (n=6/32; 19%) (p= 0.804) and controls (n=3/20; 15%).

Auto-antibodies against AT1R were significantly increased in unfavorable disease course (median 14.59 U/mL, IQR 11.28 – 19.89) compared to favorable disease course (median 10.67 U/mL, IQR 8.55 – 13.0, p< 0.01).

ETAR antibody titers were also significantly increased in unfavorable disease course (median 7.21, IQR 5.0 – 10.45) as compared to favorable disease course (median 4.0, IQR 3.0 – 6.0, p <0.05).

Conclusion: Auto-antibodies against AT1R and ETAR are significantly increased in COVID19 patients with an unfavorable disease course.