Possible Involvement of Human epididymis secretory Protein 4 (HE4) in Innate Immunity of the Oral Cavity and Respiratory Tract in COVID-19 Patients: Its Correlation with Interleukin 6 (IL-6) Procalcitonin (PCT), Presepsin (PSP), C Reactive Protein (C
Roberto Lovero*1, Annalisa Schirinzi 1, Rosa Genco1, Maria Carmela Petrelli1, Vito Masellis1, Lucia Varraso1, Renato Contino1, Francesca Di Serio 1, Lorenzo Lo Muzio 2, Maria Eleonora Bizzoca 2, Pietro Pozzessere3, Luigi Santacroce4 Angela P. Cazzolla 2
1. AOU Policlinico Consorziale di Bari—Ospedale Giovanni XXIII, Clinical Pathology Unit, Italy
2. Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Italy
3. AOU Policlinico Consorziale di Bari—Ospedale Giovanni XXIII, Emergency Medicine and Surgery Unit, Italy
4. Ionian Department (DJSGEM), Microbiology and Virology Lab, University of Study Bari, Italy
Citation: Lovero R, Schirinzi A, Genco R, Petrlli MC, Masellis V et al (2020) Possible Involvement of Human epididymis secretory Protein 4 (HE4) in Innate Immunity of the Oral Cavity and Respiratory Tract in COVID-19 Patients: Its Correlation with Interleukin 6 (IL-6) Procalcitonin (PCT), Presepsin (PSP), C Reactive Protein (CRP), D-Dimer their role and Predictive Values. SciTech Central COVID-19
Received: November 18, 2020 Accepted: November 23, 2020 Published: November 23, 2020
Abstract
An emerging issue in SARS-CoV-2 pathogenesis is its interaction with the host immune system, particularly with the innate immune system. A significant role in natural immunity of the lung, nasal and oral cavities is played by HE4, a serum inflammatory biomarker with antimicrobial/antiviral and anti-inflammatory activity.
The aim of this study was to correlate the blood levels of CRP, IL-6, PSP, PCT, D-Dimer, predictor factors for the clinical evolution of COVID-19 patients, with He4 to evaluate the role of HE4 in innate immunity of oral cavity and respiratory tract.
Material and methods: 86 patients (58 men aged 67.6±12.4, 28 women aged 65.7±15.4) admitted to the COVID hospital of the Policlinic-University Bari underwent venous samplings at admission and during hospital stay. For each patient, six measurements relating to considered parameters were performed. IL-6 (v.n.0–7 pg/mL) and PCT (v.n.0.0–0.05 ng/mL) assay was performed using Cobas e801(Roche Instrumentation); He4 (v.n.0–70 pmol/L) using ARCHITECT(Abbott Instrumentation); Presepsin (v.n.20–200 pg/mL) using PATHFAST®(Mitsubishi Instrumentation) all of them with chemiluminescence assay, CRP (v.n.0–3 mg/L) nephelometric assay using Siemens Dimension Vista 1500(SIEMENS, instrumentation), D-dimer (v.n.<500 μg/L FEU) assay with turbidimetric assay using Siemens CS 5100(SIEMENS, Instrumentation). All analyses were performed using MedCalc program and p-value threshold of 5% was adopted for all the tests used.
Results: Correlations between He4 and IL-6 levels (r=0.797), He4 and PSP (r=0.621), He4 and PCT (r=0.447), He4 and D-Dimer (r=0.367), He4 and RCP (r =0.327) have been found. ROC curves analysis showed excellent accuracy for He4 (AUC=0.92), IL-6 (AUC=0.91), very good accuracy for PSP (AUC=0.81), good accuracy for PCT (AUC=0.701) D-Dimer (AUC=0.721), sufficient accuracy for RCP (AUC=0.616).
Conclusion: The correlation between He4, IL6 and PSP, the excellent accuracy of He4 and IL6 show the possible involvement of He4 in innate immunity of the oral cavity and respiratory tract. Besides He4 together with IL6 might be used as innovative biomarkers to monitor clinical evolution of COVID-19 because He4 could indicate a multi-organ involvement.
