Antibodies Against Angiotensin II Receptor Type 1 and Endothelin A Receptor Are Associated With an Unfavorable COVID19 Disease Course

Jelle Miedema*, Marco Schreurs, Simone van der Sar – van der Brugge, Marthe Paats, Sara Baart, Marleen Bakker, Rogier Hoek, Willem Arnout Dik, Henrik Endeman, Vincent Van Der Velden, Adriaan van Gammeren, Antonius Ermens, Joachim G. Aerts, Jan Von Der Thüsen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Scopus)
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Abstract

Background: Lung histopathology demonstrates vasculopathy in a subset of deceased COVID19 patients, which resembles histopathology observed in antibody-mediated lung transplant rejection. Autoantibodies against angiotensin II type 1 receptor (AT1R) and Endothelin receptor Type A (ETAR) have been demonstrated in antibody-mediated rejection and may also be associated with severe COVID19 infection. Objective To assess AT1R and ETAR auto-antibodies in COVID19 patients and controls, and explore their association with disease course. Methods: 65 hospitalized patients with COVID19 infection were included. Clinical and laboratory findings were retrospectively assessed. Patients with unfavorable disease course, admitted at the intensive care unit and/or deceased during hospital admission (n=33) were compared to admitted COVID19 patients with favorable disease course (n=32). The presence of antinuclear antibodies (ANA) and auto-antibodies against AT1R or ETAR in peripheral blood were compared between COVID19 with unfavorable and favorable disease course and age matched controls (n=20). Results: The presence of ANA was not significantly different between COVID19 patients with unfavorable (n=7/33; 21%) and favorable disease course (n=6/32; 19%) (p= 0.804) and controls (n=3/20; 15%). Auto-antibodies against AT1R were significantly increased in unfavorable disease course (median 14.59 U/mL, IQR 11.28 – 19.89) compared to favorable disease course (median 10.67 U/mL, IQR 8.55 – 13.0, p< 0.01). ETAR antibody titers were also significantly increased in unfavorable disease course (median 7.21, IQR 5.0 – 10.45) as compared to favorable disease course (median 4.0, IQR 3.0 – 6.0, p <0.05). Conclusion: Auto-antibodies against AT1R and ETAR are significantly increased in COVID19 patients with an unfavorable disease course.

Original languageEnglish
Article number684142
JournalFrontiers in Immunology
Volume12
DOIs
Publication statusPublished - 13 May 2021

Bibliographical note

Funding Information:
We would like to thank Anton W. Langerak, Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands, for his valuable contribution to this research.

Publisher Copyright:
© Copyright © 2021 Miedema, Schreurs, van der Sar – van der Brugge, Paats, Baart, Bakker, Hoek, Dik, Endeman, Van Der Velden, van Gammeren, Ermens, Aerts and Thüsen.

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