T cell apoptosis characterizes severe Covid-19 disease

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André, Sonia | Picard, Morgane | Cezar, Renaud | Roux-Dalvai, Florence | Alleaume-Butaux, Aurélie | Soundaramourty, Calaiselvy | Cruz, André Santa | Mendes-Frias, Ana | Gotti, Clarisse | Leclercq, Mickaël | Nicolas, Alexandre | Tauzin, Alexandra | Carvalho, Alexandre | Capela, Carlos | Pedrosa, Jorge | Castro, António Gil | Kundura, Lucy | Loubet, Paul | Sotto, Albert | Muller, Laurent | Lefrant, Jean-Yves | Roger, Claire | Claret, Pierre-Géraud | Duvnjak, Sandra | Tran, Tu-Anh | Racine, Gina | Zghidi-Abouzid, Ouafa | Nioche, Pierre | Silvestre, Ricardo | Droit, Arnaud | Mammano, Fabrizio | Corbeau, Pierre | Estaquier, Jérôme

Edité par CCSD ; Nature Publishing Group -

International audience. Severe SARS-CoV-2 infections are characterized by lymphopenia, but the mechanisms involved are still elusive. Based on our knowledge of HIV pathophysiology, we hypothesized that SARS-CoV-2 infection-mediated lymphopenia could also be related to T cell apoptosis. By comparing intensive care unit (ICU) and non-ICU COVID-19 patients with age-matched healthy donors, we found a strong positive correlation between plasma levels of soluble FasL (sFasL) and T cell surface expression of Fas/CD95 with the propensity of T cells to die and CD4 T cell counts. Plasma levels of sFasL and T cell death are correlated with CXCL10 which is part of the signature of 4 biomarkers of disease severity (ROC, 0.98). We also found that members of the Bcl-2 family had modulated in the T cells of COVID-19 patients. More importantly, we demonstrated that the pan-caspase inhibitor, Q-VD, prevents T cell death by apoptosis and enhances Th1 transcripts. Altogether, our results are compatible with a model in which T-cell apoptosis accounts for T lymphopenia in individuals with severe COVID-19. Therefore, a strategy aimed at blocking caspase activation could be beneficial for preventing immunodeficiency in COVID-19 patients.

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