Imbalance between alpha-1-antitrypsin and interleukin 6 is associated with in-hospital mortality and thrombosis during COVID-19. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Biochimie Année : 2022

Imbalance between alpha-1-antitrypsin and interleukin 6 is associated with in-hospital mortality and thrombosis during COVID-19.

A. Philippe
  • Fonction : Auteur
M. Puel
  • Fonction : Auteur
M. A. Durey-Dragon
  • Fonction : Auteur
B. Vedie
  • Fonction : Auteur
R. Chocron
  • Fonction : Auteur
C. Hauw-Berlemont
  • Fonction : Auteur
O. Sanchez
  • Fonction : Auteur
T. Mirault
J. L. Diehl
  • Fonction : Auteur
D. M. Smadja
  • Fonction : Auteur
M. A. Loriot
  • Fonction : Auteur

Résumé

Thrombosis is a hallmark of severe COVID-19. Alpha-1-antitrypsin (AAT), an inflammation-inducible serpin with anti-inflammatory, tissue protective and anticoagulant properties may be involved in severe COVID-19 pathophysiology including thrombosis onset. In this study, we examined AAT ability to predict occurrence of thrombosis and in-hospital mortality during COVID-19. To do so, we performed a monocentric cross-sectional study of 137 hospitalized patients with COVID-19 of whom 56 (41%) were critically ill and 33 (22.4%) suffered from thrombosis during hospitalization. We measured AAT and IL-6 plasma levels in all patients and phenotyped AAT in a subset of patients with or without thrombosis paired for age, sex and COVID-19 severity. We observed that AAT levels at admission were higher in both non-survivors and thrombosis patients than in survivors and non-thrombosis patients. AAT: IL-6 ratio was lower in non-survivors and thrombosis patients. In a logistic regression multivariable analysis model adjusted on age, BMI and D-dimer levels, a higher AAT: IL-6 was a protective factor of both in-hospital mortality (Odds ratio, OR: 0.07 95%CI [0.02–0.25], p < 0.001) and thrombosis (OR 0.36 95%CI [0.14–0.82], p = 0.02). AAT phenotyping did not show a higher proportion of AAT abnormal variants in thrombosis patients.Our findings suggest an insufficient production of AAT regarding inflammation intensity during severe COVID-19. AAT appeared as a powerful predictive marker of severity, mortality and thrombosis mirroring the imbalance between harmful inflammation and protective counter-balancing mechanism in COVID-19. Restoring the balance between AAT and inflammation could offer therapeutic opportunities in severe COVID-19.

Dates et versions

hal-04212072 , version 1 (20-09-2023)

Identifiants

Citer

A. Philippe, M. Puel, C. Narjoz, N. Gendron, M. A. Durey-Dragon, et al.. Imbalance between alpha-1-antitrypsin and interleukin 6 is associated with in-hospital mortality and thrombosis during COVID-19.. Biochimie, 2022, Biochimie, 202, pp.206-211. ⟨10.1016/j.biochi.2022.07.012⟩. ⟨hal-04212072⟩
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