Abstract

Human leukocyte antigen (HLA) is a group of molecules involved in inflammatory and infective responses. We evaluated blood sHLA-E and sHLA-G levels in hospitalized COVID-19 patients with respiratory failure and their relationship with clinical evolution, changes in endothelial activation biomarker profile, and neutrophil adhesion. sHLA-E, sHLA-G, and endothelial activation biomarkers were quantified by ELISA assay in plasma samples. Neutrophil adhesion to endothelium was assessed in the presence/absence of patients’ plasma samples. At admission, plasma levels of sHLA-G and sHLA-E were significantly higher in COVID-19 patients with respiratory failure compared to controls. COVID-19 clinical improvement was associated with increased sHLA-G plasma levels. In COVID-19, but not in control patients, an inverse correlation was found between serum sICAM-1 and E-selectin levels and plasma sHLA-G values. The in vitro analysis of activated endothelial cells confirmed the ability of HLA-G molecules to control sICAM-1 and sE-selectin expression via CD160 interaction and FGF2 induction and consequently neutrophil adhesion. We suggest a potential role for sHLA-G in improving COVID-19 patients’ clinical condition related to the control of neutrophil adhesion to activated endothelium.

Highlights

  • We report here for the first time the increased levels of sHLA-G and sHLA-E in plasma samples from hospitalized COVID-19 patients with respiratory failure

  • We have demonstrated that sHLA-G and sHLA-E levels were higher in plasma samples from COVID-19 patients than in hospitalized control patients with respiratory failure at the time of admission and healthy controls

  • The evaluation of the genetic background did not show any differences in the three groups in terms of allelic frequencies. sHLA-G was increased in patients with improved clinical outcomes, suggesting that the increased concentration of sHLA-G in plasma samples may be related to inflammation and might reflect a peculiar feature of COVID-19 evolution

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Summary

Introduction

Human leukocyte antigen (HLA)-E and HLA-G belong to ‘non-classical’ HLA-class. Ib molecules, which includes -F and -H [1,2]. HLA-class Ia molecules (HLA-A, -B, and -C), HLA-Ib molecules display a low degree of polymorphism and different immunoregulatory properties [3]. Several results supported a correlation between HLA-E and HLA-G expression in physiological and pathological conditions [4,5]. HLA-G molecules interact with immune inhibitory receptors (ILT2, ILT4, KIR2DL4), modulating the functions of NK (Natural Killer) cells, T cells, B cells, and [6,7]

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