iScience (Mar 2022)

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

  • Jun Wang,
  • Prasanti Kotagiri,
  • Paul A. Lyons,
  • Rafia S. Al-Lamki,
  • Federica Mescia,
  • Laura Bergamaschi,
  • Lorinda Turner,
  • Michael D. Morgan,
  • Fernando J. Calero-Nieto,
  • Karsten Bach,
  • Nicole Mende,
  • Nicola K. Wilson,
  • Emily R. Watts,
  • Patrick H. Maxwell,
  • Patrick F. Chinnery,
  • Nathalie Kingston,
  • Sofia Papadia,
  • Kathleen E. Stirrups,
  • Neil Walker,
  • Ravindra K. Gupta,
  • David K. Menon,
  • Kieren Allinson,
  • Sarah J. Aitken,
  • Mark Toshner,
  • Michael P. Weekes,
  • James A. Nathan,
  • Sarah R. Walmsley,
  • Willem H. Ouwehand,
  • Mary Kasanicki,
  • Berthold Göttgens,
  • John C. Marioni,
  • Kenneth G.C. Smith,
  • Jordan S. Pober,
  • John R. Bradley

Journal volume & issue
Vol. 25, no. 3
p. 103971

Abstract

Read online

Summary: 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.

Keywords