Abstract
Coronavirus disease 2019 (COVID-19), which is a major global concern, is characterized by a progressive disease pattern involving diverse host immune responses. Programmed cell death marker-1(PD-1) expression, a critical checkpoint for T cell exhaustion, can be modulated by interleukin-10, which also mediates apoptotic T cell cytopenia. We aimed to measure the level of PD-1 expression and to investigate its correlation with IL-10 serum levels in modulating T cell effector function, correlating the results with the level of severity of the disease. This study involved 40 patients with COVID-19 and 20 healthy controls. Using flow cytometry, the expression of PD-1 was determined on CD8+ T lymphocytes and CD4+ T lymphocytes. ELISA was used to determine the levels of IL-10 in the serum. We found a remarkable decrease in T cell counts with functionally exhausted surviving T cells in the patient groups, especially in patients with severe disease. PD-1 expression increased significantly in CD4+, CD8+, and total T cells, showing a higher expression in CD8+ T cells. The patient groups had significantly higher serum IL-10 levels than the control group. The ROC analysis demonstrated the predictive role of IL-10 levels in disease severity (65% sensitivity, 80% specificity, and AUC = 0.806). IL-10 serum levels and PD-1 expression in total T cells were positively correlated, suggesting that IL-10 participates in T cell exhaustion.
Highlights
Coronavirus disease 2019 (COVID-19)is considered to be a worldwide pandemic with 2,597,381 deaths and 116,874,912 confirmed COVID-19 cases globally according to the report of the World Health Organization (WHO) dated March 9, 20211,2
All the studied groups were subjected to blood sample collection, and the expression of Programmed Cell Death 1 (PD-1) was measured using flow cytometric analysis, and IL-10 serum levels were measured using enzyme-linked immunosorbent assay (ELISA)
These results were similar to those of Zhang et al.[17], who found that patients with COVID-19 had significantly lower CD4+, CD8+, and total T cell counts, in those suffering from severe disease
Summary
Coronavirus disease 2019 (COVID-19)is considered to be a worldwide pandemic with 2,597,381 deaths and 116,874,912 confirmed COVID-19 cases globally according to the report of the World Health Organization (WHO) dated March 9, 20211,2. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the cause of this pandemic, is a new beta corona virus belonging to the order Nidovirales, with a positive single-stranded RNA3,4. Critical cases rapidly develop acute respiratory distress syndrome, metabolic acidosis, multiorgan failure, coagulation disorders, septic shock, and death[1,5]. This heterogeneous disease pattern of acute SARS-CoV-2 infection presents with differential cytokine patterns that may be directed by variable immunological responses to the virus and investigating these responses is a critical step toward precision medicine in this disease[4]. T cell exhaustion refers to impaired T cell function, occurring throughout infections and malignancies, described as continuously expressed inhibitory receptors and weak effector function, which is distinct from functional effector T cells in terms of transcriptional state[6,7]
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