ArticleAllergy2021
Elastase and exacerbation of neutrophil innate immunity are involved in multi-visceral manifestations of COVID-19.
Article in Allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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Who cites it
47 citing papers in PubMed, 86 citations in OpenAlex.
- Differences in concentration of neuron-specific enolase (NSE), neutrophil elastase (NE), and calcium-binding protein S100B in viral diseases: a pilot study focused on normoglycemic COVID-19 patients.Frontiers in molecular biosciences · 2026Article
- Assessment of Patients With Beta-Lactams Positive Provocation Tests by Biomarkers of IgG-Related Neutrophil Activation.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2025Article
- Urine Neutrophil Elastase: A Novel Predictor of ICU Admission for Patients with COVID-19 Infection.Journal of inflammation research · 2025Article
- Previous COVID-19 infection significantly reduces elastase levels in newly diagnosed pulmonary tuberculosis patients.Frontiers in immunology · 2025Article
- Understanding the long-term interplay of SARS-CoV-2 immune and inflammatory responses with proteases in COVID-19 recovery: a longitudinal study.Frontiers in immunology · 2025Article
- Enzymatic, structural, and biophysical characterization of a single-domain antibody (VHH) selectively and tightly inhibiting neutrophil elastase and exhibiting favorable developability properties.Protein science : a publication of the Protein Society · 2024Article
- Neutrophil Elastase, Neuron-Specific Enolase, and S100B Protein as Potential Markers of Long-Term Complications Caused by COVID-19 in Patients with Type 2 Diabetes Mellitus (T2DM) and Advanced Stage of Diabetic Nephropathy (NfT2DM)-Observational Studies.International journal of molecular sciences · 2024Observational
- Biomarkers of tissue remodelling are elevated in serum of COVID-19 patients who develop interstitial lung disease - an exploratory biomarker study.BMC pulmonary medicine · 2024Article
- ELANE rs17223045C/T and rs3761007G/A variants: Protective factors against COVID-19.Biomolecules & biomedicine · 2024Article
- COVID-19 PBMCs are doubly harmful, through LDN-mediated lung epithelial damage and monocytic impaired responsiveness to liveFrontiers in immunology · 2024Article
- An early warning indicator of mortality risk in patients with COVID-19: the neutrophil extracellular traps/neutrophilic segmented granulocyte ratio.Frontiers in immunology · 2024Article
- Could the Oxidation of α1-Antitrypsin Prevent the Binding of Human Neutrophil Elastase in COVID-19 Patients?International journal of molecular sciences · 2023Article
- Neutrophils in COVID-19: recent insights and advances.Virology journal · 2023Review
- Using system biology and bioinformatics to identify the influences of COVID-19 co-infection with influenza virus on COPD.Functional & integrative genomics · 2023Article
- Innate and Adaptive Immunity during SARS-CoV-2 Infection: Biomolecular Cellular Markers and Mechanisms.Vaccines · 2023Review
- Monocytic HLA-DR Expression in Immune Responses of Acute Pancreatitis and COVID-19.International journal of molecular sciences · 2023Review
- Hyperactive immature state and differential CXCR2 expression of neutrophils in severe COVID-19.Life science alliance · 2023Article
- Role and Therapeutic Targeting Strategies of Neutrophil Extracellular Traps in Inflammation.International journal of nanomedicine · 2023Review
- Characterization of young and aged ferrets as animal models for SARS-CoV-2 infection with focus on neutrophil extracellular traps.Frontiers in immunology · 2023Article
- Saline nasal irrigation and gargling in COVID-19: a multidisciplinary review of effects on viral load, mucosal dynamics, and patient outcomes.Frontiers in public health · 2023Review
Corrections and comments
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMany arguments suggest that neutrophils could play a prominent role in COVID-19. However, the role of key components of neutrophil innate immunity in severe forms of COVID-19 has deserved insufficient attention. We aimed to evaluate the involvement of neutrophil elastase, histone-DNA, and DNases in systemic and multi-organ manifestations of COVID-19.
methodsWe performed a multicenter study of markers of neutrophil innate immunity in 155 cases consecutively recruited in a screening center, local hospitals, and two regional university hospitals. The cases were evaluated according to clinical and biological markers of severity and multi-organ manifestations and compared to 35 healthy controls.
resultsBlood neutrophil elastase, histone-DNA, myeloperoxidase-DNA, and free dsDNA were dramatically increased, and DNase activity was decreased by 10-fold, compared with controls. Neutrophil elastase and histone-DNA were associated with intensive care admission, body temperature, lung damage, and markers of cardiovascular outcomes, renal failure, and increased interleukin-6 (IL-6), IL-8, and CXCR2. Neutrophil elastase was an independent predictor of the computed tomography score of COVID-19 lung damage and the number of affected organs, in multivariate analyses. The increased blood concentrations of NE and neutrophil extracellular traps were related to exacerbation of neutrophil stimulation through IL-8 and CXCR2 increased concentrations and increased serum DAMPs, and to impaired degradation of NETs as a consequence of the dramatic decrease in blood DNase activity.
conclusionOur results point out the key role of neutrophil innate immunity exacerbation in COVID-19. Neutrophil elastase and DNase could be potential biomarkers and therapeutic targets of severe systemic manifestations of COVID-19.
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