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Front Immunol . Differential immunoregulation by human surfactant protein A variants determines severity of SARS-CoV-2-induced lung disease

tetano

Editor, Senior Moderator
Front Immunol


. 2025 Apr 2:16:1462278.
doi: 10.3389/fimmu.2025.1462278. eCollection 2025. Differential immunoregulation by human surfactant protein A variants determines severity of SARS-CoV-2-induced lung disease

Ikechukwu B Jacob[SUP] 1 2 [/SUP], Akinkunmi O Lawal[SUP] 1 2 [/SUP], Salma S Mahmoud[SUP] 1 [/SUP], Emerson M Kopsack[SUP] 1 [/SUP], Erin S Reynolds[SUP] 2 [/SUP], Qinghe Meng[SUP] 1 [/SUP], Hongkuan Fan[SUP] 3 [/SUP], Paul T Massa[SUP] 2 4 [/SUP], Saravanan Thangamani[SUP] 2 [/SUP], Hongpeng Jia[SUP] 5 [/SUP], Guirong Wang[SUP] 1 2 [/SUP]



Affiliations
Abstract

Introduction: COVID-19 remains a significant threat to public health globally. Infection in some susceptible individuals causes life-threatening acute lung injury (ALI/ARDS) and/or death. Human surfactant protein A (SP-A) is a C-type lectin expressed in the lung and other mucosal tissues, and it plays a critical role in host defense against various pathogens. The human SP-A genes (SFTPA1 and SFTPA2) are highly polymorphic and comprise several common genetic variants, i.e., SP-A1 (variants 6A[SUP]2[/SUP], 6A[SUP]4[/SUP]) and SP-A2 (variants 1A[SUP]0[/SUP], 1A[SUP]3[/SUP]). Here, we elucidated the differential antiviral and immunoregulatory roles of SP-A variants in response to SARS-CoV-2 infection in vivo.
Methods: Six genetically-modified mouse lines, expressing both hACE2 (SARS-CoV-2 receptor) and individual SP-A variants: (hACE2/6A[SUP]2[/SUP] (6A[SUP]2[/SUP]), hACE2/6A[SUP]4[/SUP] (6A[SUP]4[/SUP]), hACE2/1A[SUP]0[/SUP] (1A[SUP]0[/SUP]), and hACE2/1A[SUP]3[/SUP] (1A[SUP]3[/SUP]), one SP-A knockout (hACE2/SP-A KO (KO) and one hACE2/mouse SP-A (K18) mice, were challenged intranasally with 10[SUP]3[/SUP] PFU SARS-CoV-2 or MEM medium (Sham).
Results: Infected KO and 1A[SUP]0[/SUP] mice had more weight loss and mortality compared to other mouse lines. Relative to other infected mouse lines, a more severe ALI was observed in KO, 1A[SUP]0[/SUP], and 6A[SUP]2[/SUP] mice. Reduced viral titers were generally observed in the lungs of infected SP-A mice relative to KO mice. Transcriptomic analysis revealed an upregulation in genes that play central roles in immune responses such as MyD88, Stat3, IL-18, and Jak2 in the lungs of KO and 1A[SUP]0[/SUP] mice. However, Mapk1 was significantly downregulated in 6A[SUP]2[/SUP] versus 1A[SUP]0[/SUP] mice. Analysis of biological pathways identified those involved in lung host defense and innate immunity, including pathogen-induced cytokine, NOD1/2, and Trem1 signaling pathways. Consistent with the transcriptomic data, levels of cytokines and chemokines such as G-CSF, IL-6, and IL-1β were comparatively higher in the lungs and sera of KO and 1A[SUP]0[/SUP] mice with the highest mortality rate. Furthermore, we observed the complexity of COVID-19, such as the difference between lung and systemic immune response to viral infection and of viral load and mortality among SP-A variants in this model.
Conclusion: These findings demonstrate that human SP-A variants differentially modulate SARS-CoV-2-induced lung injury and disease severity by differentially inhibiting viral infectivity and regulating immune-related gene expressions.

Keywords: SARS-CoV-2 infection; humanized transgenic mice; innate immunity; signaling pathway; surfactant protein A; susceptibility.

 
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