Coagulation factor V is a T-cell inhibitor expressed by leukocytes in COVID-19.


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Article
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Authors
Kotagiri, Prasanti 
Al-Lamki, Rafia 
Mescia, Federica 
Abstract

Clotting Factor V (FV) is primarily synthesized in the liver and when cleaved by thrombin forms pro-coagulant Factor Va (FVa). Using whole blood RNAseq and scRNAseq of peripheral blood mononuclear cells, we find that FV mRNA is expressed in leukocytes, and identify neutrophils, monocytes, and T regulatory cells as sources of increased FV in hospitalized patients with COVID-19. Proteomic analysis confirms increased FV in circulating neutrophils in severe COVID-19, and immunofluorescence microscopy identifies FV in lung-infiltrating leukocytes in COVID-19 lung disease. Increased leukocyte FV expression in severe disease correlates with T-cell lymphopenia. Both plasma-derived and a cleavage resistant recombinant FV, but not thrombin cleaved FVa, suppress T-cell proliferation in vitro. Anticoagulants that reduce FV conversion to FVa, including heparin, may have the unintended consequence of suppressing the adaptive immune system.

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Journal Title
iScience
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Journal ISSN
2589-0042
2589-0042
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Publisher
Elsevier BV
Sponsorship
National Institute for Health Research (NIHRDH-IS-BRC-1215-20014)