The significance of surface neutrophilic MPO expression level in NETosis and NETosis-associated coagulopathies in covid-19 infected patients

Elham Jamali; Mojdeh Abbasi; Akbar Hashemi Tayer; Ali Arabi Monfared; Parisa Tandel; Gholamhossein Tamaddon; Ehsan Sarraf Kazerooni; Shahrokh Rakhshandehroo; Reza Ranjbaran

doi:10.1016/j.bcmd.2022.102676

The significance of surface neutrophilic MPO expression level in NETosis and NETosis-associated coagulopathies in covid-19 infected patients

Blood Cells Mol Dis. 2022 May 29:96:102676. doi: 10.1016/j.bcmd.2022.102676. Online ahead of print.

Authors

Elham Jamali¹, Mojdeh Abbasi², Akbar Hashemi Tayer³, Ali Arabi Monfared⁴, Parisa Tandel⁴, Gholamhossein Tamaddon⁴, Ehsan Sarraf Kazerooni⁴, Shahrokh Rakhshandehroo⁵, Reza Ranjbaran⁶

Affiliations

¹ Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Peyvand Pathobiology and Genetic Lab, Shiraz, Iran.
² Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. Electronic address: mojab49@liu.se.
³ Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
⁴ Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ Peyvand Pathobiology and Genetic Lab, Shiraz, Iran.
⁶ Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: r_ranjbaran@sums.ac.ir.

Abstract

Introduction: Inflammatory response-induced coagulopathy is a common complication associated with severe form of covid-19 infection. Evidences suggest that neutrophil extracellular traps (NETs) play a significant role in triggering the immunothrombosis in this condition. We aimed to evaluate the diagnostic value of surface neutrophilic myeloperoxidase (MPO) as NETosis biomarker for predicting the risk of covid-19-associated coagulopathies.

Methods: Covid-19 infection was assessed by real-time-PCR and plasma d-dimer levels were measured by ELFA. Based on the covid-19 infection and d-dimer level outcomes, patients were categorized into four groups. Any alteration in the serum level of IL-6, H3Cit and neutrophilic surface MPO were analyzed by CLIA, ELISA, and flow cytometry, respectively.

Results: H3Cit variations and different d-dimer values confirmed the association between NETosis and coagulopathies. Findings showed that the expression of neutrophilic MPO reduced in cases with NETosis, which was correlated with increased levels of H3Cit. ANC/MPO ratio was signified as a valuable marker to discriminate the covid-19 and non covid-19-associated coagulopathies and could be considered as a prognostic factor due to its noteworthy correlation with serum IL-6 concentration.

Conclusion: Declined levels of surface neutrophilic MPO in NETosis correlate with covid-19-associated coagulopathies and increased IL-6 levels, as a potential biomarker of covid-19 disease severity.

Keywords: Coagulopathies; NETosis; Surface myeloperoxidase.