1. Coagulation factor V is a T-cell inhibitor expressed by leukocytes in COVID-19
- Author
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Wang, J, Kotagiri, P, Lyons, PA, Al-Lamki, RS, Mescia, F, Bergamaschi, L, Turner, L, Morgan, MD, Calero-Nieto, FJ, Bach, K, Mende, N, Wilson, NK, Watts, ER, Maxwell, PH, Chinnery, PF, Kingston, N, Papadia, S, Stirrups, KE, Walker, N, Gupta, RK, Menon, DK, Allinson, K, Aitken, SJ, Toshner, M, Weekes, MP, Nathan, JA, Walmsley, SR, Ouwehand, WH, Kasanicki, M, Gottgens, B, Marioni, JC, Smith, KGC, Pober, JS, Bradley, JR, Wang, J, Kotagiri, P, Lyons, PA, Al-Lamki, RS, Mescia, F, Bergamaschi, L, Turner, L, Morgan, MD, Calero-Nieto, FJ, Bach, K, Mende, N, Wilson, NK, Watts, ER, Maxwell, PH, Chinnery, PF, Kingston, N, Papadia, S, Stirrups, KE, Walker, N, Gupta, RK, Menon, DK, Allinson, K, Aitken, SJ, Toshner, M, Weekes, MP, Nathan, JA, Walmsley, SR, Ouwehand, WH, Kasanicki, M, Gottgens, B, Marioni, JC, Smith, KGC, Pober, JS, and Bradley, JR
- Abstract
Clotting Factor V (FV) is primarily synthesized in the liver and when cleaved by thrombin forms pro-coagulant Factor Va (FVa). Using whole blood RNAseq and scRNAseq of peripheral blood mononuclear cells, we find that FV mRNA is expressed in leukocytes, and identify neutrophils, monocytes, and T regulatory cells as sources of increased FV in hospitalized patients with COVID-19. Proteomic analysis confirms increased FV in circulating neutrophils in severe COVID-19, and immunofluorescence microscopy identifies FV in lung-infiltrating leukocytes in COVID-19 lung disease. Increased leukocyte FV expression in severe disease correlates with T-cell lymphopenia. Both plasma-derived and a cleavage resistant recombinant FV, but not thrombin cleaved FVa, suppress T-cell proliferation in vitro. Anticoagulants that reduce FV conversion to FVa, including heparin, may have the unintended consequence of suppressing the adaptive immune system.
- Published
- 2022