Anti-cardiolipin IgG autoantibodies associate with circulating extracellular DNA in severe COVID-19

Daniel Bertin (1) , Alexandre Brodovitch (1) , Alexandre Lopez (2) , Robin Arcani (3) , Grace Thomas (3) , Abdou Beziane (1) , Samuel Weber (1) , Benjamin Babacci (1) , Xavier Heim (1, 3) , Louise Rey (1) , Marc Leone (2) , Jean Louis Mege (4, 1) , Nathalie Bardin (3, 1)

1 TIMONE - Hôpital de la Timone [CHU - APHM]
2 Hôpital Nord [CHU - APHM]
3 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
4 MEPHI - Microbes évolution phylogénie et infections

Whereas the detection of antiphospholipid autoantibodies (aPL) in COVID-19 is of increasing interest, their role is still unclear. We analyzed a large aPL panel in 157 patients with COVID-19 according to the disease severity. We also investigated a potential association between aPL and extracellular DNA (exDNA, n = 85) or circulating markers of neutrophil extracellular traps (NET) such as citrullinated histones H3 (CitH3, n = 49). A total of 157 sera of patients infected by SARS-CoV-2 were collected. A large aPL panel including lupus anticoagulant, anti-cardiolipin and anti-beta-2 glycoprotein I (IgG, IgM and IgA), anti-phosphatidylethanolamine IgA, anti-prothrombin (IgG and IgM) was retrospectively analyzed according to the disease severity. We found a total aPL prevalence of 54.8% with almost half of the cases having aCL IgG. Within an extended panel of aPL, only aCL IgG were associated with COVID-19 severity. Additionally, severe patients displayed higher CitH3 levels than mild patients. Interestingly, we highlighted a significant association between the levels of aCL IgG and exDNA only in aCL positive patients with severe disease. In conclusion, we showed a significant link between aPL, namely aCL IgG, and circulating exDNA in patients with severe form of COVID-19, that could exacerbate the thrombo-inflammatory state related to disease severity.

Mots clés: Biomarkers; Diseases; Immunology; Pathogenesis; Risk factors

Domaines: Sciences du Vivant [q-bio]

Daniel Bertin, Alexandre Brodovitch, Alexandre Lopez, Robin Arcani, Grace Thomas, et al.. Anti-cardiolipin IgG autoantibodies associate with circulating extracellular DNA in severe COVID-19. Scientific Reports, 2022, 12 (1), pp.12523. ⟨10.1038/s41598-022-15969-y⟩. ⟨hal-03792013⟩