Multi-omics of NET formation and correlations with CNDP1, PSPB, and L-cystine levels in severe and mild COVID-19 infections

Lisa M. Bramer, Robert D. Hontz, Amie J. Eisfeld, Amy C. Sims, Young Mo Kim, Kelly G. Stratton, Carrie D. Nicora, Marina A. Gritsenko, Athena A. Schepmoes, Osamu Akasaka, Michiko Koga, Takeya Tsutsumi, Morio Nakamura, Ichiro Nakachi, Rie Baba, Hiroki Tateno, Shoji Suzuki, Hideaki Nakajima, Hideaki Kato, Kazunari IshidaMakoto Ishii, Yoshifumi Uwamino, Keiko Mitamura, Vanessa L. Paurus, Ernesto S. Nakayasu, Isaac K. Attah, Andrew G. Letizia, Katrina M. Waters, Thomas O. Metz, Karen Corson, Yoshihiro Kawaoka, Vincent R. Gerbasi, Hiroshi Yotsuyanagi, Kiyoko Iwatsuki-Horimoto

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


The detailed mechanisms of COVID-19 infection pathology remain poorly understood. To improve our understanding of SARS-CoV-2 pathology, we performed a multi-omics and correlative analysis of an immunologically naïve SARS-CoV-2 clinical cohort from blood plasma of uninfected controls, mild, and severe infections. Consistent with previous observations, severe patient populations showed an elevation of pulmonary surfactant levels. Intriguingly, mild patients showed a statistically significant elevation in the carnosine dipeptidase modifying enzyme (CNDP1). Mild and severe patient populations showed a strong elevation in the metabolite L-cystine (oxidized form of the amino acid cysteine) and enzymes with roles in glutathione metabolism. Neutrophil extracellular traps (NETs) were observed in both mild and severe populations, and NET formation was higher in severe vs. mild samples. Our correlative analysis suggests a potential protective role for CNDP1 in suppressing PSPB release from the pulmonary space whereas NET formation correlates with increased PSPB levels and disease severity. In our discussion we put forward a possible model where NET formation drives pulmonary occlusions and CNDP1 promotes antioxidation, pleiotropic immune responses, and vasodilation by accelerating histamine synthesis.

Original languageEnglish
Article numbere13795
Issue number3
Publication statusPublished - 2023 Mar


  • CNDP1
  • COVID-19
  • Carnosinase
  • Carnosine
  • Cystine
  • Glutathione
  • NETs
  • Neutrophils
  • ROS
  • SARS-CoV-2

ASJC Scopus subject areas

  • General


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