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Case Report: A Peculiar Case of Inflammatory Colitis After SARS-CoV-2 Infection.

Mariangela Rutigliani1, Matteo Bozzo2, Andrea Barberis3

  • 1Department of Laboratory and Service - Histological and Anatomical Pathology Unit, Ente Ospedaliero (E.O.) Galliera Hospital, Genova, Italy.

Frontiers in Immunology
|February 28, 2022
PubMed
Summary

Severe COVID-19 can trigger inflammatory colitis by altering immune checkpoints. This study links SARS-CoV-2 infection to a breakdown in PD-1/PD-L1 interaction, potentially causing fatal autoinflammatory responses.

Keywords:
COVID-19PD-1/PD-L1 axisSARS-CoV-2cytotoxic immune cellsnecrotizing ulcerative colitis

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Area of Science:

  • Immunology
  • Gastroenterology
  • Virology

Background:

  • SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection is known to cause immunological alterations.
  • Investigating immune checkpoints like PD-1 (Programmed cell death protein 1) and PD-L1 (Programmed death-ligand 1) may elucidate mechanisms of self-tolerance breakdown.

Observation:

  • SARS-CoV-2 viral RNA and nucleocapsid protein were detected in colon tissue of a patient with fatal inflammatory colitis.
  • PD-1 and PD-L1 expression was observed in inflamed, non-ulcerated mucosal areas but was undetectable in ulcerated regions.

Findings:

  • Compared to healthy tissue, inflamed colon tissue showed altered expression of PD-1 and PD-L1.
  • The PD-1/PD-L1 axis interaction was disrupted in the context of SARS-CoV-2-induced colitis.

Implications:

  • The findings suggest a potential link between SARS-CoV-2 infection and aberrant autoinflammatory responses.
  • Breakdown of the PD-1/PD-L1 interaction may contribute to severe outcomes, including early mortality, in SARS-CoV-2 patients.