An excessive immune response known as cytokine storm is the hallmark of severe COVID-19. The cause of this cytokine rampage is yet not known. Based on recent epidemiological evidence, we hypothesized that CD80/86 signaling is essential for this hyperinflammation, and that blocking this proinflammatory axis could be an effective therapeutic approach to protect against severe COVID-19. Here we provide exploratory evidence that abatacept, a drug that blocks CD80/86 co-stimulation, produces changes at the systemic level that are highly antagonistic of the proinflammatory processes elicited by COVID-19. Using RNA-seq from blood samples from a longitudinal cohort of n = 38 rheumatic patients treated with abatacept, we determined the immunological processes that are significantly regulated by this treatment. We then analyzed available blood RNA-seq from two COVID19 patient cohorts, a very early cohort from the epicenter of the pandemic in China (n = 3 COVID-19 cases and n = 3 controls), and a recent and larger cohort from the USA (n = 49 severe and n = 51 mild COVD-19 patients). We found a highly significant antagonism between SARS-CoV-2 infection and COVID-19 severity with the systemic response to abatacept. Analysis of previous single-cell RNA-seq data from bronchoalveolar lavage fluid from mild and severe COVID-19 patients and controls, reinforce the implication of the CD80/86 proinflammatory axis. Our functional results further support abatacept as a candidate therapeutic approach to prevent severe COVID-19.
【저자키워드】 Inflammatory diseases, viral infection, Target identification, 【초록키워드】 COVID-19, Treatment, Cytokine storm, COVID19, pandemic, severe COVID-19, SARS-COV-2 infection, COVID-19 severity, cytokine, drug, China, proinflammatory, Cohort, RNA-Seq, Bronchoalveolar lavage fluid, hyperinflammation, single-cell RNA-seq, Mild, epidemiological, USA, exploratory, change, Blood, Stimulation, Signaling, Evidence, Therapeutic approach, Support, Blood samples, COVID-19 case, epicenter, blood sample, hallmark, systemic level, CD80, patient cohorts, abatacept, excessive immune response, block, Prevent, immunological, controls, effective, PROTECT, analyzed, significantly, functional, regulated, elicited, antagonistic, COVD-19 patients, patients treated, severe COVID-19 patient, 【제목키워드】 proinflammatory, therapeutic strategy, targeting, Prevent,