1. Indoleamine 2,3-dioxygenase (IDO)-1 and IDO-2 activity and severe course of COVID-19
- Author
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René Lutter, Dorien Wouters, A H Koos Zwinderman, Markus Hollmann, Esther J. Nossent, Jorinde Raasveld, Bram Goorhuis, Syun-Ru Yeh, Kim C. E. Sigaloff, Michiel A. van Agtmael, Lieuwe D. J. Bos, Martin P. Grobusch, Michèle van Vugt, Anissa Tsonas, Leo Heunks, Marije K. Bomers, Michela Botta, Frederique Paulus, Joppe W. Hovius, Menno D. de Jong, Suzanne Geerlings, Zachary Geeraerts, Carolien Volleman, Jaap Schuurmans, Jeannine Nellen, Dan A.I. Piña-Fuentes, Edgar Peters, Frédéric M. Vaz, Vanessa Harris, Heder de Vries, Patrick Thoral, Jörg Hamann, Anne Geke Algera, Romein W.G. Dujardin, Laura Hagens, Femke A.P. Schrauwen, Lucas Fleuren, Bennedikt Preckel, Paul Elbers, Rutger Koning, Jan M. Prins, Tom Reijnders, Marry Smit, Alex Cloherty, Justin de Brabander, Harm Jan Bogaard, Eva Roos, Alexander P.J. Vlaar, Armand Girbes, Matthijs C. Brouwer, Cornelis S. Stijnis, Tom van der Poll, Brent Appelman, Theo Geijtenbeek, Diane Bax, Florianne Hafkamp, Anissa M. Tsonas, Michiel Schinkel, Charlotte E. Teunissen, Robert Hemke, Annemiek Dijkhuis, Frank van Baarle, Alex Schuurmans, Paul van der Valk, Buis T P David, Lonneke A. Vught, Marc van der Valk, Peter Bonta, Janneke Horn, Bernadette Schurink, Maurits C.F.J. de Rotte, Sanne de Bruin, Esther Bulle, Endry H.T. Lim, Denise Veelo, Lihui Guo, Marcus J. Schultz, Marleen A. Slim, Sabine M. Hermans, Martijn Beudel, Marianna Bugiani, JanWillem Duitman, Lonneke A. van Vught, W. Joost Wiersinga, Godelieve J. de Bree, Niels van Mourik, Mirjam Dijkstra, Dave A. Dongelmans, Osoul Chouchane, Diederik van de Beek, Willemke Stilma, Pathology, Pulmonary medicine, Amsterdam Neuroscience - Neuroinfection & -inflammation, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Amsterdam Neuroscience - Complex Trait Genetics, Internal medicine, AII - Infectious diseases, Intensive care medicine, Neurology, ACS - Pulmonary hypertension & thrombosis, Laboratory Medicine, Amsterdam Cardiovascular Sciences, ACS - Diabetes & metabolism, Radiology and nuclear medicine, Anesthesiology, Medical Microbiology and Infection Prevention, AMS - Rehabilitation & Development, VU University medical center, Amsterdam Neuroscience - Neurodegeneration, Amsterdam Reproduction & Development (AR&D), Graduate School, Pulmonology, Intensive Care Medicine, ACS - Microcirculation, Vascular Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Laboratory Genetic Metabolic Diseases, Experimental Immunology, APH - Personalized Medicine, Center of Experimental and Molecular Medicine, ANS - Neurodegeneration, Laboratory for General Clinical Chemistry, Genetic Metabolic Diseases, APH - Quality of Care, Infectious diseases, APH - Global Health, Global Health, APH - Health Behaviors & Chronic Diseases, AII - Amsterdam institute for Infection and Immunity, Radiology and Nuclear Medicine, AMS - Sports, AMS - Musculoskeletal Health, APH - Methodology, ACS - Heart failure & arrhythmias, ANS - Neuroinfection & -inflammation, Nursing, APH - Digital Health, and APH - Aging & Later Life
- Subjects
Adult ,Programmed cell death ,Cell ,3-Hydroxyanthranilic Acid ,Apoptosis ,Severity of Illness Index ,Pathology and Forensic Medicine ,chemistry.chemical_compound ,Medicine ,Humans ,Indoleamine-Pyrrole 2,3,-Dioxygenase ,Prospective Studies ,Receptor ,Indoleamine 2,3-dioxygenase ,Lung ,Kynurenine ,Aged ,business.industry ,Myocardium ,Tryptophan ,Brain ,COVID-19 ,Middle Aged ,Quinolinic Acid ,medicine.anatomical_structure ,chemistry ,Immunology ,Autopsy ,business ,Quinolinic acid ,Hormone - Abstract
COVID-19 is a pandemic with high morbidity and mortality. In an autopsy cohort of COVID-19 patients, we found extensive accumulation of the tryptophan degradation products 3-hydroxy-anthranilic acid and quinolinic acid in the lungs, heart, and brain. This was not related to the expression of the tryptophan-catabolizing indoleamine 2,3-dioxygenase (IDO)-1, but rather to that of its isoform IDO-2, which otherwise is expressed rarely. Bioavailability of tryptophan is an absolute requirement for proper cell functioning and synthesis of hormones, whereas its degradation products can cause cell death. Markers of apoptosis and severe cellular stress were associated with IDO-2 expression in large areas of lung and heart tissue, whereas affected areas in brain were more restricted. Analyses of tissue, cerebrospinal fluid, and sequential plasma samples indicate early initiation of the kynurenine/aryl-hydrocarbon receptor/IDO-2 axis as a positive feedback loop, potentially leading to severe COVID-19 pathology. © 2021 The Authors. The Journal of Pathology published by John WileySons, Ltd on behalf of The Pathological Society of Great Britain and Ireland.
- Published
- 2021
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