32 research outputs found

    Whole-genome sequencing reveals host factors underlying critical COVID-19

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    Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

    A model of solute transport through stratum corneum using solute capture and release

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    A one-dimensional model of solute transport through the stratum corneum is presented. Solute is assumed to diffuse through lipid bi-layers surrounding impermeable corneocytes. Transverse diffusion (perpendicular to the skin surface) through lipids separating adjacent corneocytes, is modeled in the usual way. Longitudinal diffusion (parallel to the skin surface) through lipids between corneocyte layers, is modeled as temporary trapping of solute, with subsequent release in the transverse direction. This leads to a linear equation for one-dimensional transport in the transverse direction. The model involves an arbitrary function whose precise form is uncertain. For a specific choice of this function, closed form expressions for the Laplace transform of solute out-flux at the inner boundary, and for the time lag are obtained in the case that a constant solute concentration is maintained at the outer skin surface, with the inner boundary of the stratum corneum kept at zero concentration, and with the stratum corneum initially free of solute
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