@article {Ashwinjcp-2023-208771, author = {Helen Ashwin and Luke Milross and Julie Wilson and Joaquim Majo and Jimmy Tsz Hang Lee and Grant Calder and Bethany Hunter and Sally James and Dimitris Lagos and Nathalie Signoret and Andrew Filby and Omer Ali Bayraktar and Andrew J Fisher and Paul M Kaye}, title = {Identification of a protein expression signature distinguishing early from organising diffuse alveolar damage in COVID-19 patients}, elocation-id = {jcp-2023-208771}, year = {2023}, doi = {10.1136/jcp-2023-208771}, publisher = {BMJ Publishing Group}, abstract = {Diffuse alveolar damage (DAD) is the histological expression of acute respiratory distress syndrome and characterises lung pathology due to infection with SARS-CoV-2, and other respiratory pathogens of clinical significance. DAD reflects a time-dependent immunopathological process, progressing from an early/exudative stage through to an organising/fibrotic stage, yet within an individual these different stages of DAD may coexist. Understanding the progression of DAD is central to the development of new therapeutics to limit progressive lung damage. Here, we applied highly multiplexed spatial protein profiling to autopsy lung tissues derived from 27 patients who died from COVID-19 and identified a protein signature (ARG1, CD127, GZMB, IDO1, Ki67, phospho-PRAS40 (T246) and VISTA) that distinguishes early DAD from late DAD with good predictive accuracy. These proteins warrant further investigation as potential regulators of DAD progression.}, issn = {0021-9746}, URL = {https://jcp.bmj.com/content/early/2023/03/08/jcp-2023-208771}, eprint = {https://jcp.bmj.com/content/early/2023/03/08/jcp-2023-208771.full.pdf}, journal = {Journal of Clinical Pathology} }