SARS-CoV-2 Infection in Unvaccinated High Risk Pregnant Women in the Bronx, NY is Associated with Placental Abnormalities, Shorter Gestation and Lower Apgar Scores

Preprint

2022 Sep 06

Reznik, S;Vuguin, P;Khoury, R;Loudig, O;Balakrashnian, R;Fineberg, S;Hughes, F;Harigopal, M;Charron, M;
| DOI: 10.20944/preprints202209.0063.v1

. Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Fifty-five SARS-CoV-2 positive and 61 negative third trimester patients were randomly selected from Montefiore Medical Center (MMC), Bronx, NY. In addition, two positive cases from Yale New Haven Hospital, CT were included as controls. All 55 placentas delivered by SARS-CoV-2 positive mothers were uninfected by the virus, based on immunohistochemistry, in-situ hybridization, and qPCR analysis. However, placental villous infarcts, mild preeclampsia, shortened gestational periods and lower Apgar scores were observed in the infected cases. These findings suggest that even without entering the placenta, SARS-CoV-2 can affect various systemic pathways culminating in altered placental development and function, which may adversely affect the fetus, especially in a high-risk patient population such as ours. These results underline the importance of vaccination among pregnant women, particularly in low resource areas.

The differential immune response in mild versus fatal SARS-CoV2 infection

Annals of diagnostic pathology

2022 Sep 02

Suster, D;Tili, E;Nuovo, GJ;
PMID: 36113259 | DOI: 10.1016/j.anndiagpath.2022.152032

This study compared the immune response in mild versus fatal SARS-CoV2 infection. Forty nasopharyngeal swabs with either productive mild infection (n = 20) or negative for SARS-CoV2 (n = 20) were tested along with ten lung sections from people who died of COVID-19 which contained abundant SARS-CoV2 and ten controls. There was a 25-fold increase in the CD3+T cell numbers in the viral positive nasopharyngeal swabs compared to the controls (p < 0.001) and no change in the CD3+T cell count in the fatal COVID-19 lungs versus the controls. CD11b + and CD206+ macrophage counts were significantly higher in the mild versus fatal disease (p = 0.002). In situ analysis for SARS-CoV2 RNA found ten COVID-19 lung sections that had no/rare detectable virus and also lacked the microangiopathy typical of the viral positive sections. These viral negative lung tissues when compared to the viral positive lung samples showed a highly significant increase in CD3+ and CD8 T cells (p < 0.001), equivalent numbers of CD163+ cells, and significantly less PDL1, CD11b and CD206+ cells (p = 0.002). It is concluded that mild SARS-CoV2 infection is marked by a much stronger CD3/CD8 T cell, CD11b, and CD206 macrophage response than the fatal lung disease where viral RNA is abundant.

Antemortem vs Postmortem Histopathologic and Ultrastructural Findings in Paired Transbronchial Biopsy Specimens and Lung Autopsy Samples From Three Patients With Confirmed SARS-CoV-2

American journal of clinical pathology

2021 Aug 31

Gagiannis, D;Umathum, VG;Bloch, W;Rother, C;Stahl, M;Witte, HM;Djudjaj, S;Boor, P;Steinestel, K;
PMID: 34463314 | DOI: 10.1093/ajcp/aqab087

Respiratory failure is the major cause of death in coronavirus disease 2019 (COVID-19). Autopsy-based reports describe diffuse alveolar damage (DAD), organizing pneumonia, and fibrotic change, but data on early pathologic changes and during progression of the disease are rare.We prospectively enrolled three patients with COVID-19 and performed full clinical evaluation, including high-resolution computed tomography. We took transbronchial biopsy (TBB) specimens at different time points and autopsy tissue samples for histopathologic and ultrastructural evaluation after the patients' death.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed by reverse transcription polymerase chain reaction and/or fluorescence in situ hybridization in all TBBs. Lung histology showed reactive pneumocytes and capillary congestion in one patient who died shortly after hospital admission with detectable virus in one of two lung autopsy samples. SARS-CoV-2 was detected in two of two autopsy samples from another patient with a fulminant course and very short latency between biopsy and autopsy, showing widespread organizing DAD. In a third patient with a prolonged course, autopsy samples showed extensive fibrosis without detectable virus.We report the course of COVID-19 in paired biopsy specimens and autopsies, illustrating vascular, organizing, and fibrotic patterns of COVID-19-induced lung injury. Our results suggest an early spread of SARS-CoV-2 from the upper airways to the lung periphery with diminishing viral load during disease.

SARS-CoV-2 infection in the mouse olfactory system

Cell discovery

2021 Jul 06

Ye, Q;Zhou, J;He, Q;Li, RT;Yang, G;Zhang, Y;Wu, SJ;Chen, Q;Shi, JH;Zhang, RR;Zhu, HM;Qiu, HY;Zhang, T;Deng, YQ;Li, XF;Liu, JF;Xu, P;Yang, X;Qin, CF;
PMID: 34230457 | DOI: 10.1038/s41421-021-00290-1

SARS-CoV-2 infection causes a wide spectrum of clinical manifestations in humans, and olfactory dysfunction is one of the most predictive and common symptoms in COVID-19 patients. However, the underlying mechanism by which SARS-CoV-2 infection leads to olfactory disorders remains elusive. Herein, we demonstrate that intranasal inoculation with SARS-CoV-2 induces robust viral replication in the olfactory epithelium (OE), not the olfactory bulb (OB), resulting in transient olfactory dysfunction in humanized ACE2 (hACE2) mice. The sustentacular cells and Bowman's gland cells in the OE were identified as the major target cells of SARS-CoV-2 before invasion into olfactory sensory neurons (OSNs). Remarkably, SARS-CoV-2 infection triggers massive cell death and immune cell infiltration and directly impairs the uniformity of the OE structure. Combined transcriptomic and quantitative proteomic analyses revealed the induction of antiviral and inflammatory responses, as well as the downregulation of olfactory receptor (OR) genes in the OE from the infected animals. Overall, our mouse model recapitulates olfactory dysfunction in COVID-19 patients and provides critical clues for understanding the physiological basis for extrapulmonary manifestations of COVID-19.

Monocyte-derived IL-6 programs microglia to rebuild damaged brain vasculature

Nature immunology

2023 Jul 01

Choi, BR;Johnson, KR;Maric, D;McGavern, DB;
PMID: 37248420 | DOI: 10.1038/s41590-023-01521-1

Cerebrovascular injury (CVI) is a common pathology caused by infections, injury, stroke, neurodegeneration and autoimmune disease. Rapid resolution of a CVI requires a coordinated innate immune response. In the present study, we sought mechanistic insights into how central nervous system-infiltrating monocytes program resident microglia to mediate angiogenesis and cerebrovascular repair after an intracerebral hemorrhage. In the penumbrae of human stroke brain lesions, we identified a subpopulation of microglia that express vascular endothelial growth factor A. These cells, termed 'repair-associated microglia' (RAMs), were also observed in a rodent model of CVI and coexpressed interleukin (IL)-6Ra. Cerebrovascular repair did not occur in IL-6 knockouts or in mice lacking microglial IL-6Ra expression and single-cell transcriptomic analyses revealed faulty RAM programming in the absence of IL-6 signaling. Infiltrating CCR2+ monocytes were the primary source of IL-6 after a CVI and were required to endow microglia with proliferative and proangiogenic properties. Faulty RAM programming in the absence of IL-6 or inflammatory monocytes resulted in poor cerebrovascular repair, neuronal destruction and sustained neurological deficits that were all restored via exogenous IL-6 administration. These data provide a molecular and cellular basis for how monocytes instruct microglia to repair damaged brain vasculature and promote functional recovery after injury.

Infection of lung megakaryocytes and platelets by SARS-CoV-2 anticipate fatal COVID-19

Cellular and molecular life sciences : CMLS

2022 Jun 16

Zhu, A;Real, F;Capron, C;Rosenberg, AR;Silvin, A;Dunsmore, G;Zhu, J;Cottoignies-Callamarte, A;Massé, JM;Moine, P;Bessis, S;Godement, M;Geri, G;Chiche, JD;Valdebenito, S;Belouzard, S;Dubuisson, J;Lorin de la Grandmaison, G;Chevret, S;Ginhoux, F;Eugenin, EA;Annane, D;Bordé, EC;Bomsel, M;
PMID: 35708858 | DOI: 10.1007/s00018-022-04318-x

SARS-CoV-2, although not being a circulatory virus, spread from the respiratory tract resulting in multiorgan failures and thrombotic complications, the hallmarks of fatal COVID-19. A convergent contributor could be platelets that beyond hemostatic functions can carry infectious viruses. Here, we profiled 52 patients with severe COVID-19 and demonstrated that circulating platelets of 19 out 20 non-survivor patients contain SARS-CoV-2 in robust correlation with fatal outcome. Platelets containing SARS-CoV-2 might originate from bone marrow and lung megakaryocytes (MKs), the platelet precursors, which were found infected by SARS-CoV-2 in COVID-19 autopsies. Accordingly, MKs undergoing shortened differentiation and expressing anti-viral IFITM1 and IFITM3 RNA as a sign of viral sensing were enriched in the circulation of deadly COVID-19. Infected MKs reach the lung concomitant with a specific MK-related cytokine storm rich in VEGF, PDGF and inflammatory molecules, anticipating fatal outcome. Lung macrophages capture SARS-CoV-2-containing platelets in vivo. The virus contained by platelets is infectious as capture of platelets carrying SARS-CoV-2 propagates infection to macrophages in vitro, in a process blocked by an anti-GPIIbIIIa drug. Altogether, platelets containing infectious SARS-CoV-2 alter COVID-19 pathogenesis and provide a powerful fatality marker. Clinical targeting of platelets might prevent viral spread, thrombus formation and exacerbated inflammation at once and increase survival in COVID-19.

The severity of SARS-CoV-2 infection in K18-hACE2 mice is attenuated by a novel steroid-derivative in a gender-specific manner

British journal of pharmacology

2023 May 31

Gupte, SA;Bakshi, CS;Blackham, E;Duhamel, GE;Jordan, A;Salgame, P;D'silva, M;Khan, MY;Nadler, J;Gupte, R;
PMID: 37259182 | DOI: 10.1111/bph.16155

COVID-19 infections caused by SARS-CoV-2 disseminate through human-to-human transmission can evoke severe inflammation. Treatments to reduce the SARS-CoV-2-associated inflammation are needed and are the focus of much research. In this study, we investigated the effect of N-Ethyl-N'-[(3β,5α)-17-oxoandrostan-3-yl] urea (NEOU), a novel 17α-ketosteroid derivative, on the severity of COVID-19 infections.Studies were conducted in SARS-CoV-2-infected K18-hACE2 mice.SARS-CoV-2-infected K18-hACE2 mice developed severe inflammatory crises and immune responses along with up-regulation of genes in associated signaling pathways in male more than female mice. Notably, SARS-CoV-2 infection down-regulated genes encoding drug metabolizing cytochrome P450 enzymes in male but not female mice. Treatment with NEOU (1 mg/kg/day) 24 or 72 h post-viral infection alleviated lung injury by decreasing expression of genes encoding inflammatory cytokines and chemokines while increasing expression of genes encoding immunoglobins. In situ hybridization using RNA scope probes and immunohistochemical assays revealed that NEOU increased resident CD169+ immunoregulatory macrophages and IBA-1 immunoreactive macrophage-dendritic cells within alveolar spaces in the lungs of infected mice. Consequentially, NEOU reduced morbidity more prominently in male than female mice. However, NEOU increased median survival time and accelerated recovery from infection by 6 days in both males and females.These findings demonstrate that SARS-CoV-2 exhibits gender bias by differentially regulating genes encoding inflammatory cytokines, immunogenic factors, and drug-metabolizing enzymes, in male versus female mice. Most importantly, we identified a novel 17α-ketosteroid that reduces the severity of COVID-19 infection and could be beneficial for reducing impact of COVID-19.This article is protected by

MicroRNA-9 promotion of interleukin-6 expression by inhibiting monocyte chemoattractant protein-induced protein 1 expression in interleukin-1β-stimulated human chondrocytes.

Arthritis Rheumatol. 2015 Apr 27.

Makki MS, Haseeb A, Haqqi TM.
PMID: 25917063 | DOI: 10.1002/art.39173

Abstract OBJECTIVE: Enhanced IL-6 expression plays an important role in the pathogenesis of osteoarthritis (OA). MCPIP1 is a novel post-transcriptional regulator of IL-6 expression and is targeted by miR-9. We investigated the MCPIP1 expression in OA cartilage and explored whether targeting of MCPIP1 by miR-9 contributes to enhanced IL-6 expression in OA. METHODS: Gene and protein expression in IL-1β-stimulated human OA chondrocytes/cartilage was determined by TaqMan assays and immunoblotting respectively. MCPIP1 and IL-6 mRNA expression at single cell level was analyzed using RNAScopeTM . MCPIP1 protein interaction with IL-6 mRNA was investigated using RNA immunoprecipitation (RIP). Transient transfections were used for siRNA mediated knockdown and overexpression of MCPIP1, its RNAse defective mutant, miR-9 or antagomir. Role of signaling pathways was evaluated using small molecule inhibitors. Binding of miR-9 with the "seed sequence" in the 3'UTR of MCPIP1 mRNA was investigated using a luciferase reporter assay. RESULTS: MCPIP1 mRNA expression was low but expression of miR-9 and IL-6 was high in the damaged OA cartilage. In IL-1β-stimulated OA chondrocytes expression of miR-9 and MCPIP1 was mutually exclusive and increase in miR-9 expression level correlated with reduced MCPIP1 expression and enhanced IL-6 expression. MCPIP1 protein directly binds with IL-6 mRNA and over-expression of wild type MCPIP1 destabilized the IL-6 mRNA. MCPIP1 expression was altered by overexpression or inhibition of miR-9. Transfection with miR-9 mimics inhibited the reporter activity and mutation of the "seed sequence" abolished the repression of reporter activity. CONCLUSIONS: These studies implicate miR-9-mediated suppression of MCPIP1 in OA pathogenesis via upregulation of IL-6 expression in IL-1β-stimulated human OA chondrocytes. This article is protected by copyright. All rights reserved.

Bacterial Prostatitis Enhances 2-amino-1-methyl-6-phenylimidazo[4,5-β]pyridine (PhIP)-Induced Cancer at Multiple Sites.

Cancer Prev Res (Phila). 2015 May 19.

Sfanos KS, Canene-Adams K, Hempel H, Yu SH, Simons B, Schaeffer A, Schaeffer E, Nelson WG, De Marzo AM.
PMID: 10.1016/j.jpurol.2015.04.018

Dietary carcinogens, such as 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), and chronic inflammation have each been implicated as etiological agents in prostate cancer. We hypothesized that bacterial prostatitis would accelerate PhIP-induced pre-invasive lesions in the rat prostate. Male Fischer 344 rats were assigned into 4 groups: Control (untreated), PhIP (200 ppm in the diet for 20 weeks), E. coli (prostatic inoculation in week 10), or PhIP+E. coli. Study animals were monitored for a total of 52 weeks and were euthanized as necessary based on strict criteria for health status and tumor burden. Animals treated with E. coli initially developed acute and chronic inflammation in all lobes of the prostate, whereas inflammation was observed predominantly in the ventral lobe at time of death. PhIP+E. coli-treated animals exhibited a marked decrease in survival compared to PhIP-alone treated animals as a result of an increase in the number of invasive cancers that developed at multiple sites including the skin, small intestine, and Zymbal's gland. Despite their earlier mortality, PhIP+E. coli-treated animals developed an increased average number of precancerous lesions within the prostate compared to PhIP-treated animals, with a significantly increased Ki-67 index. Multiplexed serum cytokine analysis indicated an increase in the level of circulating IL-6 and IL-12 in PhIP+E. coli-treated animals. Elevated serum IL-6 levels correlated with the development of precancerous lesions within the prostate. These results suggest that bacterial infections and dietary carcinogens - two conceivably preventable cancer risk factors - may synergistically promote tumorigenesis.

Characterization and antiviral susceptibility of SARS-CoV-2 Omicron/BA.2

Research square

2022 Feb 24

Kawaoka, Y;Uraki, R;Kiso, M;Iida, S;Imai, M;Takashita, E;Kuroda, M;Halfmann, P;Loeber, S;Maemura, T;Yamayoshi, S;Fujisaki, S;Wang, Z;Ito, M;Ujie, M;Iwatsuki-Horimoto, K;Furusawa, Y;Wright, R;Chong, Z;Ozono, S;Yasuhara, A;Ueki, H;Sakai, Y;Li, R;Liu, Y;Larson, D;Koga, M;Tsutsumi, T;Adachi, E;Saito, M;Yamamoto, S;Matsubara, S;Hagihara, M;Mitamura, K;Sato, T;Hojo, M;Hattori, SI;Maeda, K;Okuda, M;Murakami, J;Duong, C;Godbole, S;Douek, D;Watanabe, S;Ohmagari, N;Yotsuyanagi, H;Diamond, M;Hasegawa, H;Mitsuya, H;Suzuki, T;
PMID: 35233565 | DOI: 10.21203/rs.3.rs-1375091/v1

The recent emergence of SARS-CoV-2 Omicron variants possessing large numbers of mutations has raised concerns of decreased effectiveness of current vaccines, therapeutic monoclonal antibodies, and antiviral drugs for COVID-19 against these variants1,2. While the original Omicron lineage, BA.1, has become dominant in many countries, BA.2 has been detected in at least 67 countries and has become dominant in the Philippines, India, and Denmark. Here, we evaluated the replicative ability and pathogenicity of an authentic infectious BA.2 isolate in immunocompetent and human ACE2 (hACE2)-expressing mice and hamsters. In contrast to recent data with chimeric, recombinant SARS-CoV-2 strains expressing the spike proteins of BA.1 and BA.2 on an ancestral WK-521 backbone3, we observed similar infectivity and pathogenicity in mice and hamsters between BA.2 and BA.1, and less pathogenicity compared to early SARS-CoV-2 strains. We also observed a marked and significant reduction in the neutralizing activity of plasma from COVID-19 convalescent individuals and vaccine recipients against BA.2 compared to ancestral and Delta variant strains. In addition, we found that some therapeutic monoclonal antibodies (REGN10987/REGN10933, COV2-2196/COV2-2130, and S309) and antiviral drugs (molnupiravir, nirmatrelvir, and S-217622) can restrict viral infection in the respiratory organs of hamsters infected with BA.2. These findings suggest that the replication and pathogenicity of BA.2 is comparable to that of BA.1 in rodents and that several therapeutic monoclonal antibodies and antiviral compounds are effective against Omicron/BA.2 variants.

MVA vector expression of SARS-CoV-2 spike protein and protection of adult Syrian hamsters against SARS-CoV-2 challenge

NPJ vaccines

2021 Dec 03

Meseda, CA;Stauft, CB;Selvaraj, P;Lien, CZ;Pedro, C;Nuñez, IA;Woerner, AM;Wang, TT;Weir, JP;
PMID: 34862398 | DOI: 10.1038/s41541-021-00410-8

Numerous vaccine candidates against SARS-CoV-2, the causative agent of the COVID-19 pandemic, are under development. The majority of vaccine candidates to date are designed to induce immune responses against the viral spike (S) protein, although different forms of S antigen have been incorporated. To evaluate the yield and immunogenicity of different forms of S, we constructed modified vaccinia virus Ankara (MVA) vectors expressing full-length S (MVA-S), the RBD, and soluble S ectodomain and tested their immunogenicity in dose-ranging studies in mice. All three MVA vectors induced spike-specific immunoglobulin G after one subcutaneous immunization and serum titers were boosted following a second immunization. The MVA-S and MVA-ssM elicited the strongest neutralizing antibody responses. In assessing protective efficacy, MVA-S-immunized adult Syrian hamsters were challenged with SARS-CoV-2 (USA/WA1/2020). MVA-S-vaccinated hamsters exhibited less severe manifestations of atypical pneumocyte hyperplasia, hemorrhage, vasculitis, and especially consolidation, compared to control animals. They also displayed significant reductions in gross pathology scores and weight loss, and a moderate reduction in virus shedding was observed post challenge in nasal washes. There was evidence of reduced viral replication by in situ hybridization, although the reduction in viral RNA levels in lungs and nasal turbinates did not reach significance. Taken together, the data indicate that immunization with two doses of an MVA vector expressing SARS-CoV-2 S provides protection against a stringent SARS-CoV-2 challenge of adult Syrian hamsters, reaffirm the utility of this animal model for evaluating candidate SARS-CoV-2 vaccines, and demonstrate the value of an MVA platform in facilitating vaccine development against SARS-CoV-2.

Pro-inflammatory cytokine responses in extra-respiratory tissues during severe influenza

Short KR, Veeris R, Leijten LM, van den Brand JM, Jong VL, Stittelaar K, Osterhaus ADME, Andeweg A, van Riel D.

2017 Jun 16

Short KR, Veeris R, Leijten LM, van den Brand JM, Jong VL, Stittelaar K, Osterhaus ADME, Andeweg A, van Riel D.
PMID: - | DOI: 10.1093/infdis/jix281

Severe influenza is often associated with disease manifestations outside the respiratory tract. Whilst pro-inflammatory cytokines can be detected in the lungs and blood of infected patients, the role of extra-respiratory organs in the production of pro-inflammatory cytokines is unknown. Here, we show that both pandemic H1N1 and highly pathogenic H5N1 virus induce expression of TNFα, IL-6 and IL-8 in the respiratory tract and central nervous system. In addition, H5N1 virus induced cytokines in the heart, pancreas, spleen, liver and jejunum. Together, these data suggest that extra-respiratory tissues contribute to systemic cytokine responses which may increase the severity of influenza.

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	Description
sense Example: Hs-LAG3-sense	Standard probes for RNA detection are in antisense. Sense probe is reverse complent to the corresponding antisense probe.
Intron# Example: Mm-Htt-intron2	Probe targets the indicated intron in the target gene, commonly used for pre-mRNA detection
Pool/Pan Example: Hs-CD3-pool (Hs-CD3D, Hs-CD3E, Hs-CD3G)	A mixture of multiple probe sets targeting multiple genes or transcripts
No-XSp Example: Hs-PDGFB-No-XMm	Does not cross detect with the species (Sp)
XSp Example: Rn-Pde9a-XMm	designed to cross detect with the species (Sp)
O# Example: Mm-Islr-O1	Alternative design targeting different regions of the same transcript or isoforms
CDS Example: Hs-SLC31A-CDS	Probe targets the protein-coding sequence only
EnEm	Probe targets exons n and m
En-Em	Probe targets region from exon n to exon m
Retired Nomenclature
tvn Example: Hs-LEPR-tv1	Designed to target transcript variant n
ORF Example: Hs-ACVRL1-ORF	Probe targets open reading frame
UTR Example: Hs-HTT-UTR-C3	Probe targets the untranslated region (non-protein-coding region) only
5UTR Example: Hs-GNRHR-5UTR	Probe targets the 5' untranslated region only
3UTR Example: Rn-Npy1r-3UTR	Probe targets the 3' untranslated region only
Pan Example: Pool	A mixture of multiple probe sets targeting multiple genes or transcripts

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