Identification of a protein expression signature distinguishing early from organising diffuse alveolar damage in COVID-19 patients

Helen Ashwin, Luke Milross, Julie Wilson, Joaquim Majo, Jimmy Tsz Hang Lee, Grant Calder, Bethany Hunter, Sally James, Dimitris Lagos, Nathalie Signoret, Andrew Filby, Omer Ali Bayraktar, Andrew J Fisher, Paul M Kaye

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Diffuse alveolar damage (DAD) is the histological expression of acute respiratory distress syndrome and characterises lung pathology due to infection with SARS-CoV-2, and other respiratory pathogens of clinical significance. DAD reflects a time-dependent immunopathological process, progressing from an early/exudative stage through to an organising/fibrotic stage, yet within an individual these different stages of DAD may coexist. Understanding the progression of DAD is central to the development of new therapeutics to limit progressive lung damage. Here, we applied highly multiplexed spatial protein profiling to autopsy lung tissues derived from 27 patients who died from COVID-19 and identified a protein signature (ARG1, CD127, GZMB, IDO1, Ki67, phospho-PRAS40 (T246) and VISTA) that distinguishes early DAD from late DAD with good predictive accuracy. These proteins warrant further investigation as potential regulators of DAD progression.

Original languageEnglish
Number of pages5
JournalJournal of clinical pathology
Early online date9 Mar 2023
Publication statusE-pub ahead of print - 9 Mar 2023

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