Endothelial cell activation, Weibel-Palade body secretion, and enhanced angiogenesis in severe COVID-19

Ellie Karampini1, Helen Fogarty1, Stephanie Elliott1

  • 1Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

Insights

Severe COVID-19 activates endothelial cells (ECs), increasing Weibel-Palade body proteins like von Willebrand factor (VWF) and angiopoietin-2 (Angpt-2). This EC activation promotes angiogenesis and correlates with disease severity.

Area of Science:

  • Vascular Biology
  • Infectious Diseases
  • Immunology

Background:

  • Severe COVID-19 is linked to endothelial cell (EC) activation, contributing to immunothrombosis and microvascular occlusion.
  • The precise mechanisms by which SARS-CoV-2 induces EC activation and damage are not fully understood.

Purpose of the Study:

  • To investigate EC activation in COVID-19 patients.
  • To determine the role of Weibel-Palade body proteins in COVID-19 pathogenesis.

Main Methods:

  • Recruited 39 patients with confirmed COVID-19.
  • Measured Weibel-Palade body biomarkers (von Willebrand factor [VWF], angiopoietin-2 [Angpt-2], osteoprotegerin) and soluble thrombomodulin (sTM).
  • Assessed EC activation and angiogenesis with and without COVID-19 plasma incubation.

Main Results:

  • Patients with acute COVID-19 showed elevated plasma VWF, Angpt-2, osteoprotegerin, and sTM.
  • Increased sTM and Weibel-Palade biomarkers correlated with COVID-19 severity.
  • COVID-19 plasma incubation enhanced EC VWF secretion, Angpt-2 expression, and angiogenesis.

Conclusions:

  • Acute SARS-CoV-2 infection causes multifactorial EC activation and thrombomodulin loss.
  • Increased Angpt-2 expression promotes a proangiogenic state in COVID-19.
  • These findings elucidate mechanisms of EC dysfunction in severe COVID-19.
Abstract

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