101. IgA autoantibodies target pulmonary surfactant in patients with severe COVID-19
- Author
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Pietro Vernazza, Lorenz Risch, Silvio D. Brugger, Omar Ali, Mara Gilardi, Martin Brutsche, Tobias Sinnberg, Lukas Flatz, Marie-Therese Abdou, Ana Velic, Alexandar Tzankov, David Bomze, Hubert Kalbacher, Oltin T Pop, Carl Zinner, Martin Roecken, Philipp Kohler, Matthias S. Matter, Josef M Penninger, Christian R Kahlert, Christa Lichtensteiger, Lukas Kern, Boris Macek, and Werner C. Albrich
- Subjects
Lung ,Coronavirus disease 2019 (COVID-19) ,biology ,business.industry ,Autoantibody ,medicine.disease_cause ,Autoimmunity ,law.invention ,medicine.anatomical_structure ,Pulmonary surfactant ,law ,Immunology ,biology.protein ,Recombinant DNA ,Medicine ,In patient ,Antibody ,business - Abstract
Complications affecting the lung are hallmarks of severe coronavirus disease 2019 (COVID-19). While there is evidence for autoimmunity in severe COVID-19, the exact mechanisms remain unknown. Here, we established a prospective observational cohort to study lung specific autoantibodies (auto-Abs). Incubation of plasma from severe COVID-19 patients with healthy human lung tissue revealed the presence of IgA antibodies binding to surfactant-producing pneumocytes. Enzyme-linked immunosorbent assays (ELISA) and protein pull-downs using porcine surfactant confirmed the presence of auto-Abs binding to surfactant proteins in severe COVID-19 patients. Mass spectrometry and ELISAs with recombinant proteins identified IgA auto-Abs that target human surfactant proteins B and C. In line with these findings, lungs of deceased COVID-19 patients showed reduced pulmonary surfactant. Our data suggest that IgA-driven autoimmunity against surfactant may result in disease progression of COVID-19.
- Published
- 2021
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