Mechanisms of Immunothrombosis by SARS-CoV-2

Biomolecules. 2021 Oct 20;11(11):1550. doi: 10.3390/biom11111550.

Abstract

SARS-CoV-2 contains certain molecules that are related to the presence of immunothrombosis. Here, we review the pathogen and damage-associated molecular patterns. We also study the imbalance of different molecules participating in immunothrombosis, such as tissue factor, factors of the contact system, histones, and the role of cells, such as endothelial cells, platelets, and neutrophil extracellular traps. Regarding the pathogenetic mechanism, we discuss clinical trials, case-control studies, comparative and translational studies, and observational studies of regulatory or inhibitory molecules, more specifically, extracellular DNA and RNA, histones, sensors for RNA and DNA, as well as heparin and heparinoids. Overall, it appears that a network of cells and molecules identified in this axis is simultaneously but differentially affecting patients at different stages of COVID-19, and this is characterized by endothelial damage, microthrombosis, and inflammation.

Keywords: SARS-CoV-2; damage-associated molecular patterns; extracellular DNA; extracellular RNA; immunothrombosis; pathogen-associated molecular patterns.

Publication types

  • Review

MeSH terms

  • Alarmins*
  • Angiotensin-Converting Enzyme 2 / metabolism
  • Animals
  • Blood Coagulation
  • Blood Platelets / virology
  • COVID-19 / complications
  • COVID-19 / virology*
  • DNA / metabolism
  • Extracellular Traps
  • Heparin / metabolism
  • Histones / metabolism
  • Humans
  • Mice
  • Neuropilin-1 / metabolism
  • RNA / metabolism
  • SARS-CoV-2*
  • Signal Transduction
  • Thrombin / metabolism
  • Thromboinflammation / virology*
  • Thromboplastin / metabolism
  • Thrombosis / complications
  • Thrombosis / virology*

Substances

  • Alarmins
  • Histones
  • NRP1 protein, human
  • Neuropilin-1
  • RNA
  • Heparin
  • DNA
  • Thromboplastin
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2
  • Thrombin