Role of microbiota-derived corisin in coagulation activation during SARS-CoV-2 infection

Tatsuki Tsuruga, Hajime Fujimoto, Taro Yasuma, Corina N. D'Alessandro-Gabazza, Masaaki Toda, Toshiyuki Ito, Atsushi Tomaru, Haruko Saiki, Tomohito Okano, Manal A.B. Alhawsawi, Atsuro Takeshita, Kota Nishihama, Reoto Takei, Yasuhiro Kondoh, Isaac Cann, Esteban C. Gabazza, Tetsu Kobayashi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Coagulopathy is a major cause of morbidity and mortality in COVID-19 patients. Hypercoagulability in COVID-19 results in deep vein thrombosis, thromboembolic complications, and diffuse intravascular coagulation. Microbiome dysbiosis influences the clinical course of COVID-19. However, the role of dysbiosis in COVID-19-associated coagulopathy is not fully understood. Objectives: The present study tested the hypothesis that the microbiota-derived proapoptotic corisin is involved in the coagulation system activation during SARS-CoV-2 infection. Methods: This cross-sectional study included 47 consecutive patients who consulted for symptoms of COVID-19. A mouse acute lung injury model was used to recapitulate the clinical findings. A549 alveolar epithelial, THP-1, and human umbilical vein endothelial cells were used to evaluate procoagulant and anticoagulant activity of corisin. Results: COVID-19 patients showed significantly high circulating levels of corisin, thrombin-antithrombin complex, D-dimer, tumor necrosis factor-α, and monocyte-chemoattractant protein-1 with reduced levels of free protein S compared with healthy subjects. The levels of thrombin-antithrombin complex, D-dimer, and corisin were significantly correlated. A monoclonal anticorisin-neutralizing antibody significantly inhibited the inflammatory response and coagulation system activation in a SARS-CoV-2 spike protein-associated acute lung injury mouse model, and the levels of corisin and thrombin-antithrombin complex were significantly correlated. In an in vitro experiment, corisin increased the tissue factor activity and decreased the anticoagulant activity of thrombomodulin in epithelial, endothelial, and monocytic cells. Conclusion: The microbiota-derived corisin is significantly increased and correlated with activation of the coagulation system during SARS-CoV-2 infection, and corisin may directly increase the procoagulant activity in epithelial, endothelial, and monocytic cells.

Original languageEnglish (US)
Pages (from-to)1919-1935
Number of pages17
JournalJournal of Thrombosis and Haemostasis
Volume22
Issue number7
DOIs
StatePublished - Jul 2024

Keywords

  • COVID-19
  • apoptosis
  • coagulation
  • corisin
  • inflammation
  • microbiota

ASJC Scopus subject areas

  • Hematology

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