학술논문
Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19.
Document Type
Article
Author
Zguro, Kristina; Baldassarri, Margherita; Fava, Francesca; Beligni, Giada; Daga, Sergio; Leoncini, Roberto; Galasso, Lucrezia; Cirianni, Michele; Rusconi, Stefano; Siano, Matteo; Francisci, Daniela; Schiaroli, Elisabetta; Luchi, Sauro; Morelli, Giovanna; Martinelli, Enrico; Girardis, Massimo; Busani, Stefano; Parisi, Saverio Giuseppe; Panese, Sandro; Piscopo, Carmelo
Source
Subject
*THROMBOTIC thrombocytopenic purpura
*COVID-19
*BLOOD platelet aggregation
*RECESSIVE genes
*DRUG accessibility
*GENETIC variation
*CELL aggregation
*
*
*
*
*
*
Language
ISSN
1999-4915
Abstract
Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF–platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage. [ABSTRACT FROM AUTHOR]