Manuscript Detail

Authors: Saris, Anno et al
Abstract: BACKGROUND: Knowledge of the pathophysiology of COVID-19 is almost exclusively derived from studies that examined the immune response in blood. We here aimed to analyse the pulmonary immune response during severe COVID-19 and to compare this with blood responses. METHODS: This was an observational study in patients with COVID-19 admitted to the intensive care unit (ICU). Mononuclear cells were purified from bronchoalveolar lavage fluid (BALF) and blood, and analysed by spectral flow cytometry; inflammatory mediators were measured in BALF and plasma. FINDINGS: Paired blood and BALF samples were obtained from 17 patients, four of whom died in the ICU. Macrophages and T cells were the most abundant cells in BALF, with a high percentage of T cells expressing the ƴδ T cell receptor. In the lungs, both CD4 and CD8 T cells were predominantly effector memory cells (87·3% and 83·8%, respectively), and these cells expressed higher levels of the exhaustion marker programmad death-1 than in peripheral blood. Prolonged ICU stay (>14 days) was associated with a reduced proportion of activated T cells in peripheral blood and even more so in BALF. T cell activation in blood, but not in BALF, was higher in fatal COVID-19 cases. Increased levels of inflammatory mediators were more pronounced in BALF than in plasma. INTERPRETATION: The bronchoalveolar immune response in COVID-19 has a unique local profile that strongly differs from the immune profile in peripheral blood. Fully elucidating COVID-19 pathophysiology will require investigation of the pulmonary immune response.
Journal: Thorax
Curator: Hancock Lab
Reviewer: Aris Floratos
Author-provided data: ?

paper: Saris, A., Reijnders, T. D., Nossent, E. J., Schuurman, A. R., Verhoeff, J., van A. S., Bontkes, H., Blok, S., Duitman, J., Bogaard, H., Heunks, L., Lutter, R., van d. P. T. and Garcia V. J. J. (2021). Distinct cellular immune profiles in the airways and blood of critically ill patients with COVID-19. Thorax
contributor: Anno Saris
contributor_organization: Center for Experimental and Molecular Medicine


    • description: Immunophenotyping of bronchoalveolar lavage and blood mononuclear cells of COVID-19 patients admitted to the ICU using a 32-color spectral flow cytometry panel. In addition, 45-panel Luminex (R&D) and 10-panel coagulation CBA (biolegend) was performed on BALF and plasma. In parralel PBMCs from healthy controls were measured.
    • exact_source: Figure 1-3 & S2-S4 and table 1
    • tissue: Mononuclear cells from bronchoalveolar lavage and paired blood
    • immune_exposure: COVID-19 and possibly subsequent superinfection
    • cohort: 33-79yr ICU admitted COVID-19 patients
    • comparison: Bronchoalveolar lavage vs blood in COVID-19.
    • repository_id: data avaialble upon request, not (yet) publically
    • platform:
    • response_components:
    • response_behavior: variable