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Increased serum citrullinated histone H3 levels in COVID-19 patients with acute ischemic stroke

Muhammet Duran Bayar1, Aysel Büşra Şişman1, Gizem Koral2

  • 1Department of Neurology, Haseki Research and Training Hospital, Health Sciences University, Istanbul, Turkey.

Ideggyogyaszati Szemle
|July 12, 2022
PubMed

Insights

Neutrophil extracellular trap (NET) formation is elevated in COVID-19 patients experiencing acute ischemic stroke (AIS). While NETosis may increase thrombosis risk, its markers lack prognostic value in these patients.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with an increased prevalence of acute ischemic stroke (AIS).
  • A leading hypothesis suggests that virus-induced hypercoagulation contributes to arterial thrombosis in COVID-19 patients.
  • Neutrophil extracellular trap (NET) formation, or NETosis, is implicated in inflammatory and thrombotic processes.

Purpose of the Study:

  • To investigate the role of NETosis in the pathogenesis of AIS in patients with COVID-19.
  • To assess serum levels of NETosis markers and associated mediators in different patient cohorts.

Main Methods:

  • Serum levels of citrullinated histone H3 (H3Cit), IL-8, and C5a were measured using ELISA.
  • Patients included: 26 COVID-19+ pneumonia with AIS, 32 COVID-19+ pneumonia without AIS, and 24 AIS without COVID-19.
  • Clinical characteristics and inflammatory markers were collected and analyzed.

Main Results:

  • Significantly higher H3Cit levels were observed in COVID-19+ AIS patients compared to controls.
  • IL-8 and C5a levels were comparable across all study groups.
  • COVID-19+ AIS patients exhibited elevated white blood cell, lymphocyte, neutrophil, D-dimer, C-reactive protein, and procalcitonin levels.

Conclusions:

  • Elevated H3Cit levels in COVID-19 related AIS suggest NETosis may contribute to arterial thrombosis susceptibility.
  • H3Cit levels did not correlate with clinical severity or inflammation parameters, limiting their prognostic value.
  • The association between IL-8 and NETosis appears disrupted in AIS patients.
Abstract

Keywords:
COVID-19IL-8NETosiscitrullinated histone H3ischemic stroke

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