S100A8/A9 drives the formation of procoagulant platelets through GPIbα.

S100A8/A9, also known as "calprotectin" or "MRP8/14," is an alarmin primarily secreted by activated myeloid cells with antimicrobial, proinflammatory, and prothrombotic properties. Increased plasma levels of S100A8/A9 in thrombo-inflammatory diseases are associated with thrombotic complications. We assessed the presence of S100A8/A9 in the plasma and lung autopsies from patients with COVID-19 and investigated the molecular mechanism by which S100A8/A9 affects platelet function and thrombosis. S100A8/A9 plasma levels were increased in patients with COVID-19 and sustained high levels during hospitalization correlated with poor outcomes. Heterodimeric S100A8/A9 was mainly detected in neutrophils and deposited on the vessel wall in COVID-19 lung autopsies. Immobilization of S100A8/A9 with collagen accelerated the formation of a fibrin-rich network after perfusion of recalcified blood at venous shear. In vitro, platelets adhered and partially spread on S100A8/A9, leading to the formation of distinct populations of either P-selectin or phosphatidylserine (PS)-positive platelets. By using washed platelets, soluble S100A8/A9 induced PS exposure but failed to induce platelet aggregation, despite GPIIb/IIIa activation and alpha-granule secretion. We identified GPIbα as the receptor for S100A8/A9 on platelets inducing the formation of procoagulant platelets with a supporting role for CD36. The effect of S100A8/A9 on platelets was abolished by recombinant GPIbα ectodomain, platelets from a patient with Bernard-Soulier syndrome with GPIb-IX-V deficiency, and platelets from mice deficient in the extracellular domain of GPIbα. We identified the S100A8/A9-GPIbα axis as a novel targetable prothrombotic pathway inducing procoagulant platelets and fibrin formation, in particular in diseases associated with high levels of S100A8/A9, such as COVID-19.

The roles of integrins in function of human neutrophils after their migration through endothelium into interstitial matrix.

We investigated the changes in neutrophil phenotype and function after transendothelial migration, and the roles played by integrin receptors in their behaviour. Neutrophils were tracked microscopically as they migrated through endothelial cells into collagen gels, and were retrieved at desired times. When endothelial cells were treated with increasing doses of tumour necrosis factor-α, neutrophils not only migrated in greater number, but also to a greater depth in the gel. Apoptosis was barely detectable in neutrophils retrieved after 24h, and many remained viable and motile at 48h. Neutrophils retrieved after 1h had increased oxidative capacity and at 24h had similar capacity as freshly-isolated neutrophils. However, by then they had impaired ability to phagocytose bacteria. Compared to fresh neutrophils, total mRNA was halved by 24h, but while ß2-integrin expression decreased, ß1- and ß3-integrin increased along with ICAM-1. Studies of integrin blockade indicated that while ß2-integrins were needed to cross the endothelial barrier, no integrins were required for migration within the gel. ß2-integrins also contributed to phagocytosis, but their binding was not required for prolonged survival. These results demonstrate a model for integrated analysis of neutrophil migration and function, and describe development of effector functions and the roles of integrins in human neutrophils for the first time.