The Role of TLR-2 in Lethal COVID-19 Disease Involving Medullary and Resident Lung Megakaryocyte Up-Regulation in the Microthrombosis Mechanism

TLR-2 在致命的 COVID-19 疾病中的作用,涉及髓质和常驻肺巨核细胞在微血栓形成机制中的上调

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作者:Giuseppe Pannone, Maria Carmela Pedicillo, Ilenia Sara De Stefano, Francesco Angelillis, Raffaele Barile, Chiara Pannone, Giuliana Villani, Francesco Miele, Maurizio Municinò, Andrea Ronchi, Gaetano Serviddio, Federica Zito Marino, Renato Franco, Tommaso Colangelo, Rosanna Zamparese

Conclusions

Microthrombosis in deadly COVID-19+ lung disease is associated with an increase in the number of CD61+ platelets and megakaryocytes in the pulmonary interstitium, as well as their functional activation; this phenomenon is associated with increased expression of innate immunity TLR2+ cells, which binds the SARS-CoV-2 E protein, and significantly with the persistence of the Spike-S1 viral sequence.

Methods

The aim of this study was to study the expression of platelet glycoprotein IIIa (CD61), playing a critical role in platelet aggregation, together with TRL-2 as a marker of innate immune activation.

Results

A total of 25 patients were investigated, with the majority (24/25, 96%) having co-morbidities and dying from a fatal form of SARS-CoV-2(+) infection (COVID-19+), with 13 men and 12 females ranging in age from 45 to 80 years. When compared to a control group of SARS-CoV-2 (-) negative lungs (COVID-19-), TLR-2 expression was up-regulated in a subset of patients with deadly COVID-19 fatal lung illness. The proportion of Spike-1 (+) patients found by PCR and ISH correlates to the proportion of Spike-S1-positive cases as detected by digital pathology examination. Furthermore, CD61 expression was considerably higher in the lungs of deceased patients. In

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