Background: Besides the well-accepted role in lipid metabolism, high-density lipoprotein (HDL) also seems to participate in host immune response against infectious diseases. Objective: We used a quantitative proteomic approach to test the hypothesis that alterations in HDL proteome associate with severity of Coronavirus disease 2019 (COVID-19). Methods: Based on clinical criteria, subjects (n=41) diagnosed with COVID-19 were divided into two groups: a group of subjects presenting mild symptoms and a second group displaying severe symptoms and requiring hospitalization. Using a proteomic approach, we quantified the levels of 29 proteins in HDL particles derived from these subjects. Results: We showed that the levels of serum amyloid A 1 and 2 (SAA1 and SAA2, respectively), pulmonary surfactant-associated protein B (SFTPB), apolipoprotein F (APOF), and inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) were increased by more than 50% in hospitalized patients, independently of sex, HDL-C or triglycerides when comparing with subjects presenting only mild symptoms. Altered HDL proteins were able to classify COVID-19 subjects according to the severity of the disease (error rate 4.9%). Moreover, apolipoprotein M (APOM) in HDL was inversely associated with odds of death due to COVID-19 complications (odds ratio [OR] per 1-SD increase in APOM was 0.27, with 95% confidence interval [CI] of 0.07 to 0.72, P=0.007). Conclusion: Our results point to a profound inflammatory remodeling of HDL proteome tracking with severity of COVID-19 infection. They also raise the possibility that HDL particles could play an important role in infectious diseases.
Bibliografisk noteFunding Information:
This work was supported by awards from Funda??o de Amparo ? Pesquisa do Estado de S?o Paulo (FAPESP, grants # 2013/07937-8, 2015/26722-8, 2016/00696-3, 2017/07725-1, 2018/18257-1, 2018/15549-1, 2019/25702-4, 2020/04923-0), from Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq grant # 402683/2016-1), and from Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES). D.R.S.J., A.R.M.S., and L.R.R. are recipients of FAPESP fellowships.