SARS-CoV-2 Triggers Complement Activation Through Interactions with Heparan Sulfate

Overview

Journal Clin Transl Immunology

Specialty Allergy & Immunology

Date 2022 Aug 24

PMID 35999893

Authors

Martin W Lo

Alberto A Amarilla

John D Lee

Eduardo A Albornoz

Naphak Modhiran

Richard J Clark

Vito Ferro

Mohit Chhabra

Alexander A Khromykh

Daniel Watterson

Trent M Woodruff

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine whether SARS-CoV-2 can trigger complement activation, the pathways that are involved and the functional significance of the resultant effect.

Methods: SARS-CoV-2 was inoculated into a human lepirudin-anticoagulated whole blood model, which contains a full repertoire of complement factors and leukocytes that express complement receptors. Complement activation was determined by measuring C5a production with an ELISA, and pretreatment with specific inhibitors was used to identify the pathways involved. The functional significance of this was then assessed by measuring markers of C5a signalling including leukocyte C5aR1 internalisation and CD11b upregulation with flow cytometry.

Results: SARS-CoV-2 inoculation in this whole blood model caused progressive C5a production over 24 h, which was significantly reduced by inhibitors for factor B, C3, C5 and heparan sulfate. However, this phenomenon could not be replicated in cell-free plasma, highlighting the requirement for cell surface interactions with heparan sulfate. Functional analysis of this phenomenon revealed that C5aR1 signalling and CD11b upregulation in granulocytes and monocytes was delayed and only occurred after 24 h.

Conclusion: SARS-CoV-2 is a noncanonical alternative pathway activator that progressively triggers complement activation through interactions with heparan sulfate.

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