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Increased Plasma Heparanase Activity in COVID-19 Patients.

Frontiers in immunology

Authors: Baranca Buijsers, Cansu Yanginlar, Aline de Nooijer, Inge Grondman, Marissa L Maciej-Hulme, Inge Jonkman, Nico A F Janssen, Nils Rother, Mark de Graaf, Peter Pickkers, Matthijs Kox, Leo A B Joosten, Tom Nijenhuis, Mihai G Netea, Luuk Hilbrands, Frank L van de Veerdonk, Raphaël Duivenvoorden, Quirijn de Mast, Johan van der Vlag

Reports suggest a role of endothelial dysfunction and loss of endothelial barrier function in COVID-19. It is well established that the endothelial glycocalyx-degrading enzyme heparanase contributes to vascular leakage and inflammation. Low molecular weight heparins (LMWH) serve as an inhibitor of heparanase. We hypothesize that heparanase contributes to the pathogenesis of COVID-19, and that heparanase may be inhibited by LMWH. To test this hypothesis, heparanase activity and heparan sulfate levels were measured in plasma of healthy controls (n = 10) and COVID-19 patients (n = 48). Plasma heparanase activity and heparan sulfate levels were significantly elevated in COVID-19 patients. Heparanase activity was associated with disease severity including the need for intensive care, lactate dehydrogenase levels, and creatinine levels. Use of prophylactic LMWH in non-ICU patients was associated with a reduced heparanase activity. Since there is no other clinically applied heparanase inhibitor currently available, therapeutic treatment of COVID-19 patients with low molecular weight heparins should be explored.

Copyright © 2020 Buijsers, Yanginlar, de Nooijer, Grondman, Maciej-Hulme, Jonkman, Janssen, Rother, de Graaf, Pickkers, Kox, Joosten, Nijenhuis, Netea, Hilbrands, van de Veerdonk, Duivenvoorden, de Mast and van der Vlag.

PMID: 33123154

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