Although much remains unclear with respect to the pathogenesis of COVID-19, the possibilities that cytokine storm and altered coagulation contribute to adverse disease pathogenesis have emerged. Both the cytokine output and promotion of coagulation may be mediated by activated monocytes. Monocytes, for instance, are the central leukocyte in blood to express tissue factor (F3) and initiate coagulation and this activity promotes comorbidity in Ebola and HIV infections. One cytokine that seems most notably elevated in plasma of COVID patients is IL-6. In keeping with the potential importance of IL-6 in cytokine storm, our preliminary data reveal that blood monocytes, of all subsets, are a major source of IL-6 in COVID leukocytes and that their production of IL-6 positively correlates with adverse disease progression. Surprisingly, though monocytes produce cytokines, other features of canonical activation were not present in monocyte subsets of COVID patients. Particularly, induction of functional tissue factor in IL-6-producing monocytes was minimal to absent. This was in striking contrast to control monocytes from healthy subjects treated ex vivo with LPS or resiquimod. Given the clinical concern that coagulation may be altered in COVID-19 and contribute to pathogenesis of adverse disease and given the very robust expression of IL-6, we were especially surprised that tissue factor was not induced. Overall, it appears that the stimulus for activation of monocytes in COVID-19 patients is distinct from canonical responses that also induce tissue factor in cytokine-producing cells, or perhaps a subset of monocytes able to activate the tissue factor pathway is missing or in extracted COVID-19 PBMCs. The overarching aim of this work is to define, using a robust longitudinal dataset, whether proinflammatory activation of monocyte subsets in blood associates with disease severity and to define the core characteristics of such activation. We will also carry out exploratory analyses in search of signals that lead to such activation. A key resource for our proposal is access to a bank of frozen PBMC, serum, plasma and whole blood in which longitudinal blood draws are being collected on 300 COVID-19 patients of differing disease severity admitted to Barnes Jewish Hospital. This bank has been established by the Institutional Clinical and Translational Research program at Washington University School of Medicine. Resources from this bank will be coupled with a stock of frozen PBMCs from >50 control participants in our laboratory and PBMCs from HIV subjects, where the state of monocyte activation will be compared with that of monocytes derived from COVID patients.

Public Health Relevance

This study addresses the role of monocyte subsets in producing cytokines in symptomatic COVID-19 patients. We will generate a longitudinal dataset to track the dynamics of cytokine-producing monocytes versus other leukocytes in relation to disease severity, while simultaneously attempting to understand a unique pattern of activation observed in COVID-19 patients compared with that observed upon canonical activation in response to TLR ligands or other viral diseases like HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
3R37AI049653-20S2
Application #
10158696
Study Section
Program Officer
Peyman, John A
Project Start
2020-06-19
Project End
2020-11-30
Budget Start
2020-06-19
Budget End
2020-11-30
Support Year
20
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Washington University
Department
Pathology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Czepielewski, Rafael S; Randolph, Gwendalyn J (2018) Lymph nodes go with the flow. J Exp Med 215:2699-2701
Williams, Jesse W; Martel, Catherine; Potteaux, Stephane et al. (2018) Limited Macrophage Positional Dynamics in Progressing or Regressing Murine Atherosclerotic Plaques-Brief Report. Arterioscler Thromb Vasc Biol 38:1702-1710
Huang, Li-Hao; Zinselmeyer, Bernd H; Chang, Chih-Hao et al. (2018) Interleukin-17 Drives Interstitial Entrapment of Tissue Lipoproteins in Experimental Psoriasis. Cell Metab :
Williams, Jesse W; Giannarelli, Chiara; Rahman, Adeeb et al. (2018) Macrophage Biology, Classification, and Phenotype in Cardiovascular Disease: JACC Macrophage in CVD Series (Part 1). J Am Coll Cardiol 72:2166-2180
Williams, Jesse W; Elvington, Andrew; Ivanov, Stoyan et al. (2017) Thermoneutrality but Not UCP1 Deficiency Suppresses Monocyte Mobilization Into Blood. Circ Res 121:662-676
Lee, Sanghyun; Wilen, Craig B; Orvedahl, Anthony et al. (2017) Norovirus Cell Tropism Is Determined by Combinatorial Action of a Viral Non-structural Protein and Host Cytokine. Cell Host Microbe 22:449-459.e4
Randolph, Gwendalyn J; Ivanov, Stoyan; Zinselmeyer, Bernd H et al. (2017) The Lymphatic System: Integral Roles in Immunity. Annu Rev Immunol 35:31-52
Williams, Jesse W; Randolph, Gwendalyn J; Zinselmeyer, Bernd H (2017) A Polecat's View of Patrolling Monocytes. Circ Res 120:1699-1701
Ivanov, Stoyan; Scallan, Joshua P; Kim, Ki-Wook et al. (2016) CCR7 and IRF4-dependent dendritic cells regulate lymphatic collecting vessel permeability. J Clin Invest 126:1581-91
Lu, Qun; Yokoyama, Christine C; Williams, Jesse W et al. (2016) Homeostatic Control of Innate Lung Inflammation by Vici Syndrome Gene Epg5 and Additional Autophagy Genes Promotes Influenza Pathogenesis. Cell Host Microbe 19:102-13

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