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Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients
We herein characterize the immunopathological features of two Italian COVID-19 patients who underwent bilateral lung transplantation (bLTx). Removed lungs underwent histopathological evaluation. Gene expression profiling (GEP) for immune-related signatures was performed on lung specimens and SARS-Co...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999589/ https://www.ncbi.nlm.nih.gov/pubmed/33801959 http://dx.doi.org/10.3390/cells10030611 |
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author | Croci, Giorgio A. Vaira, Valentina Trabattoni, Daria Biasin, Mara Valenti, Luca Baselli, Guido Barberis, Massimo Guerini Rocco, Elena Gregato, Giuliana Scandroglio, Mara Fominskiy, Evgeny Palleschi, Alessandro Rosso, Lorenzo Nosotti, Mario Clerici, Mario Ferrero, Stefano |
author_facet | Croci, Giorgio A. Vaira, Valentina Trabattoni, Daria Biasin, Mara Valenti, Luca Baselli, Guido Barberis, Massimo Guerini Rocco, Elena Gregato, Giuliana Scandroglio, Mara Fominskiy, Evgeny Palleschi, Alessandro Rosso, Lorenzo Nosotti, Mario Clerici, Mario Ferrero, Stefano |
author_sort | Croci, Giorgio A. |
collection | PubMed |
description | We herein characterize the immunopathological features of two Italian COVID-19 patients who underwent bilateral lung transplantation (bLTx). Removed lungs underwent histopathological evaluation. Gene expression profiling (GEP) for immune-related signatures was performed on lung specimens and SARS-CoV-2-stimulated peripheral blood mononuclear cells (PBMCs). Cytokine levels were measured on lungs, bronchoalveolar lavage fluids and in culture supernatants. Pathological assessment showed extensive lung damage with the pattern of proliferative to fibrotic phases, with diffuse alveolar damage mimicking usual interstitial pneumonia (UIP). Lungs’ GEP revealed overexpression of pathogen recognition receptors, effector cytokines and chemokines, immune activation receptors and of the inflammasome components. Multiplex cytokine analysis confirmed a proinflammatory state, with high levels of monocyte/macrophage chemotactic and activating factors and of IL-6 and TNF-α. A similar profile was observed in SARS-CoV-2-stimulated PBMCs collected 7 days after transplant. The pattern of tissue damage observed in the lungs suggests that this may represent the output of protracted disease, resembling a diffuse UIP-like picture. The molecular immune profiling supports the paradigm of a persistent proinflammatory state and sustained humoral immunity, conditions that are maintained despite the iatrogenic immunosuppression. |
format | Online Article Text |
id | pubmed-7999589 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79995892021-03-28 Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients Croci, Giorgio A. Vaira, Valentina Trabattoni, Daria Biasin, Mara Valenti, Luca Baselli, Guido Barberis, Massimo Guerini Rocco, Elena Gregato, Giuliana Scandroglio, Mara Fominskiy, Evgeny Palleschi, Alessandro Rosso, Lorenzo Nosotti, Mario Clerici, Mario Ferrero, Stefano Cells Article We herein characterize the immunopathological features of two Italian COVID-19 patients who underwent bilateral lung transplantation (bLTx). Removed lungs underwent histopathological evaluation. Gene expression profiling (GEP) for immune-related signatures was performed on lung specimens and SARS-CoV-2-stimulated peripheral blood mononuclear cells (PBMCs). Cytokine levels were measured on lungs, bronchoalveolar lavage fluids and in culture supernatants. Pathological assessment showed extensive lung damage with the pattern of proliferative to fibrotic phases, with diffuse alveolar damage mimicking usual interstitial pneumonia (UIP). Lungs’ GEP revealed overexpression of pathogen recognition receptors, effector cytokines and chemokines, immune activation receptors and of the inflammasome components. Multiplex cytokine analysis confirmed a proinflammatory state, with high levels of monocyte/macrophage chemotactic and activating factors and of IL-6 and TNF-α. A similar profile was observed in SARS-CoV-2-stimulated PBMCs collected 7 days after transplant. The pattern of tissue damage observed in the lungs suggests that this may represent the output of protracted disease, resembling a diffuse UIP-like picture. The molecular immune profiling supports the paradigm of a persistent proinflammatory state and sustained humoral immunity, conditions that are maintained despite the iatrogenic immunosuppression. MDPI 2021-03-10 /pmc/articles/PMC7999589/ /pubmed/33801959 http://dx.doi.org/10.3390/cells10030611 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ). |
spellingShingle | Article Croci, Giorgio A. Vaira, Valentina Trabattoni, Daria Biasin, Mara Valenti, Luca Baselli, Guido Barberis, Massimo Guerini Rocco, Elena Gregato, Giuliana Scandroglio, Mara Fominskiy, Evgeny Palleschi, Alessandro Rosso, Lorenzo Nosotti, Mario Clerici, Mario Ferrero, Stefano Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title | Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title_full | Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title_fullStr | Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title_full_unstemmed | Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title_short | Emergency Lung Transplantation after COVID-19: Immunopathological Insights on Two Affected Patients |
title_sort | emergency lung transplantation after covid-19: immunopathological insights on two affected patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999589/ https://www.ncbi.nlm.nih.gov/pubmed/33801959 http://dx.doi.org/10.3390/cells10030611 |
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