Case Report: Interferon-γ Restores Monocytic Human Leukocyte Antigen Receptor (mHLA-DR) in Severe COVID-19 With Acquired Immunosuppression Syndrome

Frontiers in Immunology

Clemens Grimm¹  Sebastian Uwe Schnitzler¹  Martin Sebastian Winkler¹  Onnen Moerer¹  Steffen Dickel¹  Katharina Amschler²  Bjoern Tampe³  Julie Schanz⁴  Didier Payen⁵ 

[1] Department of Anesthesiology and Intensive Care Medicine, University Medical, Center Goettingen, Goettingen, Germany;Department of Dermatology, University Medical Center Goettingen, Goettingen, Germany;Department of Nephrology and Rheumatology, University Medical Center, Goettingen, Goettingen, Germany;Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Goettingen, Goettingen, Germany;Universite Paris 7 Cite Sorbonne, UMR INSERM 1160, Paris, France;

关键词: SARS-CoV-2;    COVID-19;    monocytic human leukocyte antigen receptor;    interferon-y;    intensive care;    acute respiratory distress syndrome;   

DOI  :  10.3389/fimmu.2021.645124

来源: DOAJ

【 摘 要 】

BackgroundThe major histocompatibility complex (MHC) class II characterized by monocytes CD14+ expression of human leukocyte antigen receptors (HLA-DR), is essential for the synapse between innate and adaptive immune response in infectious disease. Its reduced expression is associated with a high risk of secondary infections in septic patients and can be safely corrected by Interferon-y (IFNy) injection. Coronavirus disease (COVID-19) induces an alteration of Interferon (IFN) genes expression potentially responsible for the observed low HLA-DR expression in circulating monocytes (mHLA-DR).MethodsWe report a case of one-time INFy injection (100 mcg s.c.) in a superinfected 61-year-old man with COVID-19–associated acute respiratory distress syndrome (ARDS), with monitoring of mHLA-DR expression and clinical tolerance.ObservationsLow mHLA-DR pretreatment expression (26.7%) was observed. IFNy therapy leading to a rapid increase in mHLA-DR expression (83.1%).ConclusionsSevere ARDS in a COVID-19 patient has a deep reduction in mHLA-DR expression concomitantly with secondary infections. The unique IFNy injection was safe and led to a sharp increase in the expression of mHLA-DR. Based on immune and infection monitoring, more cases of severe COVID-19 patients with low mHLA-DR should be treated by IFNy to test the clinical effectiveness.

【 授权许可】

Unknown