Circulating Reelin promotes inflammation and modulates disease activity in acute and long COVID-19 cases

Laurent Calvier, Aleksandra Drelich, Jason Hsu, Chien Te Tseng, Yair Mina, Avindra Nath, Maria Z. Kounnas, Joachim Herz

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Thromboembolic complications and excessive inflammation are frequent in severe COVID-19, potentially leading to long COVID. In non-COVID studies, we and others demonstrated that circulating Reelin promotes leukocyte infiltration and thrombosis. Thus, we hypothesized that Reelin participates in endothelial dysfunction and hyperinflammation during COVID-19. We showed that Reelin was increased in COVID-19 patients and correlated with the disease activity. In the severe COVID-19 group, we observed a hyperinflammatory state, as judged by increased concentration of cytokines (IL-1α, IL-4, IL-6, IL-10 and IL-17A), chemokines (IP-10 and MIP-1β), and adhesion markers (E-selectin and ICAM-1). Reelin level was correlated with IL-1α, IL-4, IP-10, MIP-1β, and ICAM-1, suggesting a specific role for Reelin in COVID-19 progression. Furthermore, Reelin and all of the inflammatory markers aforementioned returned to normal in a long COVID cohort, showing that the hyperinflammatory state was resolved. Finally, we tested Reelin inhibition with the anti-Reelin antibody CR-50 in hACE2 transgenic mice infected with SARS-CoV-2. CR-50 prophylactic treatment decreased mortality and disease severity in this model. These results demonstrate a direct proinflammatory function for Reelin in COVID-19 and identify it as a drug target. This work opens translational clinical applications in severe SARS-CoV-2 infection and beyond in auto-inflammatory diseases.

Original languageEnglish (US)
Article number1185748
Pages (from-to)1185748
JournalFrontiers in immunology
StatePublished - Jun 25 2023


  • COVID-19
  • Reelin
  • adhesion markers
  • cytokine storm
  • endothelial dysfunction
  • inflammation
  • leukocyte
  • long COVID

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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