Targeting of the CD80/86 proinflammatory axis as a therapeutic strategy to prevent severe COVID-19

Sci Rep. 2021 Jun 1;11(1):11462. doi: 10.1038/s41598-021-90797-0.

Abstract

An excessive immune response known as cytokine storm is the hallmark of severe COVID-19. The cause of this cytokine rampage is yet not known. Based on recent epidemiological evidence, we hypothesized that CD80/86 signaling is essential for this hyperinflammation, and that blocking this proinflammatory axis could be an effective therapeutic approach to protect against severe COVID-19. Here we provide exploratory evidence that abatacept, a drug that blocks CD80/86 co-stimulation, produces changes at the systemic level that are highly antagonistic of the proinflammatory processes elicited by COVID-19. Using RNA-seq from blood samples from a longitudinal cohort of n = 38 rheumatic patients treated with abatacept, we determined the immunological processes that are significantly regulated by this treatment. We then analyzed available blood RNA-seq from two COVID19 patient cohorts, a very early cohort from the epicenter of the pandemic in China (n = 3 COVID-19 cases and n = 3 controls), and a recent and larger cohort from the USA (n = 49 severe and n = 51 mild COVD-19 patients). We found a highly significant antagonism between SARS-CoV-2 infection and COVID-19 severity with the systemic response to abatacept. Analysis of previous single-cell RNA-seq data from bronchoalveolar lavage fluid from mild and severe COVID-19 patients and controls, reinforce the implication of the CD80/86 proinflammatory axis. Our functional results further support abatacept as a candidate therapeutic approach to prevent severe COVID-19.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abatacept / pharmacology*
  • Abatacept / therapeutic use
  • Aged
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology
  • B7-1 Antigen / metabolism
  • B7-2 Antigen / metabolism
  • Bronchoalveolar Lavage Fluid / cytology
  • COVID-19 / blood
  • COVID-19 / complications
  • COVID-19 / immunology
  • COVID-19 Drug Treatment*
  • China
  • Cytokine Release Syndrome / immunology
  • Cytokine Release Syndrome / prevention & control*
  • Cytokine Release Syndrome / virology
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacology*
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • RNA-Seq
  • SARS-CoV-2 / immunology*
  • Severity of Illness Index
  • Signal Transduction / drug effects*
  • Signal Transduction / immunology
  • Single-Cell Analysis
  • Spain
  • United States
  • Up-Regulation / drug effects
  • Up-Regulation / immunology

Substances

  • B7-1 Antigen
  • B7-2 Antigen
  • CD80 protein, human
  • CD86 protein, human
  • Immunosuppressive Agents
  • Abatacept