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Article ; Online: Cytokine storm–based mechanisms for extrapulmonary manifestations of SARS-CoV-2 infection

Maria Del Nogal Avila / Ranjan Das / Joubert Kharlyngdoh / Eduardo Molina-Jijon / Hector Donoro Blazquez / Stéphanie Gambut / Michael Crowley / David K. Crossman / Rasheed A. Gbadegesin / Sunveer S. Chugh / Sunjeet S. Chugh / Carmen Avila-Casado / Camille Macé / Lionel C. Clement / Sumant S. Chugh

JCI Insight, Vol 8, Iss

2023  Volume 10

Abstract: Viral illnesses like SARS-CoV-2 have pathologic effects on nonrespiratory organs in the absence of direct viral infection. We injected mice with cocktails of rodent equivalents of human cytokine storms resulting from SARS-CoV-2/COVID-19 or rhinovirus ... ...

Abstract Viral illnesses like SARS-CoV-2 have pathologic effects on nonrespiratory organs in the absence of direct viral infection. We injected mice with cocktails of rodent equivalents of human cytokine storms resulting from SARS-CoV-2/COVID-19 or rhinovirus common cold infection. At low doses, COVID-19 cocktails induced glomerular injury and albuminuria in zinc fingers and homeoboxes 2 (Zhx2) hypomorph and Zhx2+/+ mice to mimic COVID-19–related proteinuria. Common Cold cocktail induced albuminuria selectively in Zhx2 hypomorph mice to model relapse of minimal change disease, which improved after depletion of TNF-α, soluble IL-4Rα, or IL-6. The Zhx2 hypomorph state increased cell membrane to nuclear migration of podocyte ZHX proteins in vivo (both cocktails) and lowered phosphorylated STAT6 activation (COVID-19 cocktail) in vitro. At higher doses, COVID-19 cocktails induced acute heart injury, myocarditis, pericarditis, acute liver injury, acute kidney injury, and high mortality in Zhx2+/+ mice, whereas Zhx2 hypomorph mice were relatively protected, due in part to early, asynchronous activation of STAT5 and STAT6 pathways in these organs. Dual depletion of cytokine combinations of TNF-α with IL-2, IL-13, or IL-4 in Zhx2+/+ mice reduced multiorgan injury and eliminated mortality. Using genome sequencing and CRISPR/Cas9, an insertion upstream of ZHX2 was identified as a cause of the human ZHX2 hypomorph state.
Keywords Nephrology ; Medicine ; R
Language English
Publishing date 2023-05-01T00:00:00Z
Publisher American Society for Clinical investigation
Document type Article ; Online
Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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