Literature DB >> 34373855

A Master Autoantigen-ome Links Alternative Splicing, Female Predilection, and COVID-19 to Autoimmune Diseases.

Julia Y Wang1, Michael W Roehrl1, Victor B Roehrl1, Michael H Roehrl2.   

Abstract

Chronic and debilitating autoimmune sequelae pose a grave concern for the post-COVID-19 pandemic era. Based on our discovery that the glycosaminoglycan dermatan sulfate (DS) displays peculiar affinity to apoptotic cells and autoantigens (autoAgs) and that DS-autoAg complexes cooperatively stimulate autoreactive B1 cell responses, we compiled a database of 751 candidate autoAgs from six human cell types. At least 657 of these have been found to be affected by SARS-CoV-2 infection based on currently available multi-omic COVID data, and at least 400 are confirmed targets of autoantibodies in a wide array of autoimmune diseases and cancer. The autoantigen-ome is significantly associated with various processes in viral infections, such as translation, protein processing, and vesicle transport. Interestingly, the coding genes of autoAgs predominantly contain multiple exons with many possible alternative splicing variants, short transcripts, and short UTR lengths. These observations and the finding that numerous autoAgs involved in RNA-splicing showed altered expression in viral infections suggest that viruses exploit alternative splicing to reprogram host cell machinery to ensure viral replication and survival. While each cell type gives rise to a unique pool of autoAgs, 39 common autoAgs associated with cell stress and apoptosis were identified from all six cell types, with several being known markers of systemic autoimmune diseases. In particular, the common autoAg UBA1 that catalyzes the first step in ubiquitination is encoded by an X-chromosome escape gene. Given its essential function in apoptotic cell clearance and that X-inactivation escape tends to increase with aging, UBA1 dysfunction can therefore predispose aging women to autoimmune disorders. In summary, we propose a model of how viral infections lead to extensive molecular alterations and host cell death, autoimmune responses facilitated by autoAg-DS complexes, and ultimately autoimmune diseases. Overall, this master autoantigen-ome provides a molecular guide for investigating the myriad of autoimmune sequalae to COVID-19 and clues to the rare but reported adverse effects of the currently available COVID vaccines.

Entities:  

Year:  2021        PMID: 34373855      PMCID: PMC8351778          DOI: 10.1101/2021.07.30.454526

Source DB:  PubMed          Journal:  bioRxiv


Introduction

Autoimmune disorders are an important feature of the disease manifestations of COVID-19 and long-COVID syndromes. Based on the insights we gained from numerous COVID-related autoantigens (autoAgs) and their associated cellular process and pathways [1-5], we propose a model to explain how viral infections in general and SARS-CoV-2 in particular can lead to a wide array of autoimmune diseases (Figure 1). We illustrate how viral infections lead to extensive molecular alterations in the host cell, host cell death and tissue injury, autoimmune reactions, and the eventual development of autoimmune diseases.
Fig. 1.

A model on how viral infections lead to autoimmune diseases. Viral infections induce extensive host molecular changes, cell death, and tissue damage. AutoAgs shed from apototic cells form affinity complexes with DS that is overexpressed in the wound area. Cooperative binding of DS-autoAg complexes to autoBCRs activate autoreactive B1 cells. Once internalized via autoBCR, DS engages Ig-processing complexes in the ER and GTF2I in the nucleus to facilitate Ig production. Activated B1 cells secrete autoantibodies and may also present autoAgs to autoreactive T cells, which then leads to autoimmune diseases.

During infections, opportunistic viruses have to hijack the host cell machinery in order to transcribe and translate the viral genes, synthesize viral proteins with correct polypeptide folding and post-translational modifications, and assemble viral particles. At the same time, viruses have to manipulate the host’s immune defense to avoid elimination. This intricate host-virus symbiosis is accomplished by extensive alterations of host molecules and reprogramming of host molecular networks. The infected host cells undergo extreme stress and ultimately die, which releases altered molecules (i.e., potential autoAgs) that the immune system may recognize as non-self. In response, the host also synthesizes a cascade of molecules such as dermatan sulfate (DS) to facilitate wound healing and dead cell clearance. We have discovered previously that DS possesses peculiar affinity for apoptotic cells and their released autoAgs [6-9]. DS, a major component of the extracellular matrix and connective tissue, is increasingly expressed during tissue injury and accumulates in wound areas [1, 10]. Because of their affinity, DS and autoAgs form macromolecular complexes which cooperatively activate autoreactive B1 cells. AutoAg-DS complexes may activate B1 cells via a dual binding mode, i.e., with autoAg binding to the variable region of the B1 cell’s autoBCR and DS binding to the heavy chain of the autoBCR. Upon entering B1 cells, DS may regulate immunoglobulin (Ig) production by engaging the Ig-processing complex in the endoplasmic reticulum and the transcription factor GTF2I necessary for Ig gene expression [8, 9]. AutoAg-DS affinity therefore defines a unifying biochemical and immunological property of autoAgs: any self-molecule possessing DS-affinity has a high propensity to become autoantigenic, and this has led to the identification of numerous autoAgs [7, 11–13]. To gain a better understanding of autoimmune sequelae due to COVID-19, we present a master autoantigen atlas of over 750 potential autoAgs identified from six human cell types [1, 2, 4, 5, 7, 11]. These autoAgs show significant correlation with pathways and processes that are crucial in viral infection and mRNA vaccine action, reveal common autoAgs associated with apoptosis and cell stress which may serve as markers for systemic autoimmune diseases, and provide a detailed molecular map for understanding and for investigating diverse autoimmune sequalae of COVID-19 and potential rare side-effects to viral vector- and mRNA-based vaccines. For the first time, we reveal intriguing features of autoAgs and their coding genes. Furthermore, we discuss how UBA1 (or UBE1, ubiquitin-like modifier-activating enzyme 1), an autoAg found overexpressed in SARS-CoV-2 infection, may predispose aging females to autoimmune disorders.

Results and Discussion

The master autoantigen-ome

To understand the diversity of autoimmune diseases, we were curious to know how many autoAgs possibly exist. A total of 751 potential autoAgs were identified (Table 1) when we combined all DS-affinity autoAgs profiled from six human cell lines, namely, HFL1 fetal lung fibroblasts, HEp2 fibroblasts, A549 lung epithelial cells, HS-Sultan and Wil2-NS B-lymphoblasts, and Jurkat T-lymphoblasts. Extensive literature searches confirmed that at least 400 of these proteins (53.3%) have been reported as targets of autoantibodies in a wide variety of autoimmune diseases and cancer (see autoAg confirmation references in Table 1). The majority of unconfirmed or putative autoAgs are isoforms of or structurally similar to reported autoAgs and are yet-to-confirmed autoAgs. For example, 56 ribosomal proteins were identified by DS-affinity, but only 22 are thus far confirmed autoAgs; but given their structural similarity and shared epitopes, it is likely that most if not all of the 56 ribosomal proteins are likely true autoAgs awaiting further confirmation.
Table 1.

Autoantigens identified by DS-affinity and their alterations in SARS-CoV-2 infection

PGeneProteinCell lineSARS-Cov-2 infectionDS affinityRef.
HFL1HS-SultanWil2A549JurkatHEp-2udinteract.hilow
5A2MAlpha-2-macroglobulin++d+[1]
6AARSAlanine-tRNA ligase, AARS1++ud+[2]
15ACLYATP-citrate synthase++ud+[3]
4ACTA1Actin, alpha skeletal muscle+ud+[4]
10ACTA2Actin, aortic smooth muscle++++ud++[5]
8ACTBActin, cytoplasmic 1++++ud++[6]
7ACTBL2Beta-actin-like protein++++ud++[6]
2ACTBL3Putative beta-actin-like protein 3, kappa actin, POTEKP++u+
6ACTC1Actin, alpha cardiac muscle+ud++[7]
4ACTG1Actin, cytoplasmic 2++ud++[8]
28 ACTN1 Alpha-actinin-1 + + + + + + u d + [9]
22ACTN4Alpha-actinin-4+++++ud+[5]
2ACTR2Actin-related protein 2+ud+[10]
2ACTR3Actin-related protein 3+u+[11]
2ADSS2Adenylosuccinate synthetase isozyme 2, ADSS+u+
3AFPAlpha-fetoprotein+++d+[12]
2AGRNAgrin+uNsp6Nsp13Orf8Orf10+[13]
15AHCYAdenosylhomocysteinase, SAHH++d+[14]
5AHNAKNeuroblast differentiation-associated protein+ud+[15]
4AHSA1Activator of 90 kDa heat shock protein ATPase homolog 1+d+
2AHSGAlpha-2-HS-glycoprotein, FETUA+d+[16]
5AKR1B1Aldo-keto reductase family 1 member B1+udOrf3+[17]
10ALBAlbumin++ud++[18]
5ALDH18A1Delta-1-pyrroline-5-carboxylate synthetase++d+
23ALDH1A1Retinal dehydrogenase 1+ud+[19]
5ALDH2Aldehyde dehydrogenase, mitochondrial+udENsp5Nsp12Nsp16+[20]
5ALDH3A1Aldehyde dehydrogenase 3, ALDH3+ud+
9ALDOAFructose-bisphosphate aldolase A++ud+[21]
4ALDOCFructose-bisphosphate aldolase C+ud+[22]
3ALPPAlkaline phosphatase, placental type precursor++[23]
10 ANP32A Acidic leucine-rich nuclear phosphoprotein 32 member A + + + + + + u d + +
13 ANP32B ANP 32 family member B + + + + + + d N + + [24]
3ANP32CANP 32 family member C, PP32R1+++++
4ANP32EANP 32 family member E+++udOrf9c++
4ANXA2Annexin A2++ud++[25]
13ANXA2P2Putative annexin A2-like protein, ANX2L2, LPC2B++ud+[26]
10ANXA3Annexin A3+ud+[25]
5ANXA4Annexin IV+ud+[27]
15ANXA5Annexin A5+++udOrf3+[28]
33ANXA6Annexin VI+++++ud+[29]
2AP1B1AP-1 complex subunit beta-1++
8AP3B1AP-3 complex subunit beta-1++uE+
2AP3B2AP-3 complex subunit beta-2+++[30]
8AP3D1AP-3 complex subunit delta-1++ud+
4APEHAcylamino-acid-releasing enzyme++
4APEX1DNA-(apurinic or apyrimidinic site) lyase++ud+[31]
2API5Apoptosis inhibitor 5++d+
3APOA1Apolipoprotein A-I+d+[32]
2APODApolipoprotein D+ud+
8ARF1ADP-ribosylation factor++Nsp6+
2ARHGAP1Rho-GTPase-activating protein 1+uOrf3aOrf3bOrf6Orf7aOrf7bOrf8Orf9cS+
6ARHGDIARho GDP-dissociation inhibitor 1++ud+
8ARHGDIBRho GDP-dissociation inhibitor 2+d+[33]
3ARPC2Actin-related protein 2/3 complex subunit 2+d+
7ASMTLN-Acetylserotonin O-methyltransferase-like protein++
2ASNSGlutamine-dependent asparagine synthetase+u+
4ASPHAspartyl/asparaginyl beta-hydroxylase+udOrf9c+
14ATICBifunctional purine biosynthesis protein, PURH++++[34]
2ATP2A2Sarcoplasmic/ER calcium ATPase 2+uNsp4+[35]
13ATP5F1BATP synthase subunit beta, mitochondrial, ATP5B+++++udNsp6Orf9b++[36]
3ATXN10Ataxin-10, Spinocerebellar ataxia type 10 protein+ud+
3BASP1Brain acid soluble protein 1 (Neuronal axonal membrane protein NAP22)+udMOrf3aOrf7bS+
3BCAT1Branched chain amino acid aminotransferase+u+
2BCCIPBRCA2 and CDKN1A-interacting protein++
2BGNBiglycan++[37]
3BRIX1Ribosome biogenesis protein BRX1 homolog++
2BSGBasigin, CD147+d+[38]
3BTF3Transcription factor BTF3, NACB+ud+
2BZW1Basic leucine zipper and W2 domain-containing protein 1+u+
3BZW2Basic leucine zipper and W2 domain-containing protein 2+++M+
7 C1QBP Complement C1q-binding protein + + + + + + d + + [39]
7CALD1Caldesmon+d+[40]
8CALM1Calmodulin-1++++ud+[41]
5CALM2Calmodulin-2+d+
2CALM3Calmodulin-3++u+[42]
19 CALR Calreticulin + + + + + + u d + [43]
2CALUCalumenin+udEMNsp6Nsp7Orf3aOrf3bOrf6Orf7aOrf7bOrf9cS+[44]
15CAND1Cullin-associated NEDD8-dissociated protein 1++++
7CANXCalnexin+++udNsp4Orf8+[45]
9CAP1Adenylyl cyclase-associated protein 1+++udOrf3+
7CAPN1Calpain-1 catalytic subunit++++
5CAPN2Calpain-2 catalytic subunit++udNsp16+[41]
3CAPNS1Calpain small subunit 1++
3CAPRIN1Caprin-1+++d+
3CAPZA1F-actin-capping protein subunit alpha-1+++d++[46]
3CAPZBF-actin-capping protein subunit beta+++d+[47]
8CAVIN1Caveolae-associated protein 1, PTRF+udNS+[48]
3CBX1Chromobox protein homolog 1++u+[49]
3CBX3Chromobox protein homolog 3+ud+
3CCDC6Coiled-coil domain-containing protein 6+ud+[50]
12CCT2T-complex protein 1 subunit beta++++dNsp12Orf8Orf9bOrf10+[51]
12CCT3T-complex protein 1 subunit gamma+++uOrf8Orf10+[52]
6CCT4T-complex protein 1 subunit delta+++u+[52]
10CCT5T-complex protein 1 subunit epsilon+++udNsp1Nsp12Orf8Orf10+[51]
7CCT6AT-complex protein 1 subunit zeta+++udNsp1Nsp12Orf10+[51]
9CCT7T-complex protein 1 subunit eta+++Orf10+[51]
20CCT8T-complex protein 1 subunit theta+++++udNsp1Nsp12Nsp14Nsp15+[52]
4CD248Endosialin+d+
7CDC37Hsp90 co-chaperone Cdc37++++udNsp16+
3CDK11ACyclin-dependent kinase 11A, CDC2L2+u+
3CEBPZCCAAT/enhancer-binding protein zeta+u+
2CFL1Cofilin-1, CFL+ud+[53]
4CKAP4Cytoskeleton-associated protein 4, P63+udNsp2Orf7b+[54]
8CKBCreatine kinase B-typeud+[55]
7CLIC1Chloride intracellular channel protein 1++++udNsp16+[56]
2CLIC4Chloride intracellular channel protein 4+ud+
51CLTCClathrin heavy chain 1++++ud++[57]
4CLTCL1Clathrin heavy chain 2++++++
4CLUHClustered mitochondria protein homolog (mRNA-binding)+dNsp7Nsp16+
2CMPK1UMP-CMP kinase+d+
3CNDP2Cytosolic non-specific dipeptidase+uOrf3Orf10+
3CNPY2Protein canopy homolog+++dOrf3a+
13COL12A1Collagen type XII alpha-1 chain+ud+
45COL1A1Collagen type I alpha-1 chain+ud+[58]
37COL1A2Collagen type I alpha-2 chain+d+[59]
2COL2A1Collagen type II alpha-1 chain+u+[60]
12COL3A1Collagen type III alpha-1 chain++[61]
3COL5A1Collagen type V alpha 1+u+[62]
6COL6A1Collagen type VI alpha-1 chain+dOrf8+[63]
4COL6A2Collagen type VI alpha-2 chain+d+
29COL6A3Collagen type VI alpha-3 chain+d+
2COPACoatomer subunit alpha++ud+[64]
2COPB1Coatomer subunit beta+dNsp7+[65]
5COPB2Coatomer subunit beta’++u+[66]
2COPDCoatomer subunit delta, ARCN1+dOrf3bOrf6+
2COPG1Coatomer subunit gamma-1+EMNsp4Nsp6Orf3bOrf6Orf7aOrf7b+[39]
2COPZ1Coatomer subunit zeta-1++d+
12CORO1ACoronin-1A+u+[67]
3CORO1CCoronin-1C++
3CPNE1Copine-1++
4CPNE3Copine-3++ud+
4CRKProto-oncogene c-Crk+udNsp12Nsp14Nsp15+
5CRTAPCartilage-associated protein, P3H5+d+
3CSCitrate synthase, mitochondrial+udE+[3]
4CSKTyrosine-protein kinase CSK+d+[68]
3CSNK2A1Casein kinase 2, alpha 1++
4CSPG4Chondroitin sulfate proteoglycan 4+dOrf7bS+[69]
4CTCFLHigh mobility group box 1 pseudogene 1, HMGB1P1, HMGB1L1++[136]
2CTR9RNA polymerase-associated protein CTR9 homolog+udOrf9c+
3CTSBCathepsin B, APP secretase+udMNsp12+
2CTSDCathepsin D+ud+[70]
2CUTAProtein CutA+ud+
6DAP328S ribosomal protein S29, mitochondrial, MRPS29++
6DARSAspartate-tRNA ligase, DARS1++[71]
2DBN1Drebrin 1+ud+[72]
4DCAF1DDB1- and CUL4-associated factor 1, VPRBP+ud+
3DCKDeoxycytidine kinase+u+
3DCNDecorin+d+[73]
2DCTN1Dynactin subunit 1, 150 KDa Dynein-associated protein+d+[74]
5DCTN2Dynactin subunit 2++Orf6+
3DCTPP1dCTP pyrophosphatase 1+dOrf9b+
28DDB1DNA damage-binding protein 1+++++ud++[57]
3DDX17ATP-dependent RNA helicase DDX17+ud+[53]
7DDX18ATP-dependent RNA helicase DDX18+u+
5DDX21Nucleolar RNA helicase 2++udN+[75]
4DDX27ATP-dependent RNA helicase DDX27+u+
3DDX30ATP-dependent RNA helicase DHX30+d+
7DDX39AATP-dependent RNA helicase DDX39A++++ud+[39]
5DDX39BSpliceosome RNA helicase BAT1++++d+
4DDX5ATP-dependent RNA helicase, p68++ud++[76]
16DDX9ATP-dependent RNA helicase A, DHX9+++++++[77]
2DEKProtein DEK+ud+[53]
12DHX15Pre-mRNA-splicing factor ATP-dependent RNA helicase++++d++
4DHX36ATP-dependent RNA helicase DHX36+u+
5DIABLOSecond mitochondria-derived activator of caspase+++udNsp6Nsp15+
4DKC1H/ACA ribonucleoprotein complex subunit B++ud+
4DLDDihydrolipoyl dehydrogenase, mitochondrial++[79]
2DLSTDihydrolipoyllysine-residue succinyltransferase component of 2-oxoglutarate dehydrogenase complex+d+[80]
2DNAJB11DnaJ (Hsp40) homolog subfamily B member 11+u+[81]
2DNAJC8DnaJ homolog subfamily C member 8+u+
4DNPH12’-deoxynucleoside 5’-phosphate N-hydrolase 1+u+
6DPP3Dipeptidyl-peptidase 3+++d+
3DPYSL2Dihydropyrimidinase-related protein+ud+[82]
3DRG1Developmentally-regulated GTP-binding protein+d+
5DUTDeoxyuridine 5’-triphosphate nucleotidohydrolase, mitochondrial+ud+
5DYNC1H1Dynein cytoplasmic 1 heavy chain 1++
3DYNC1I2Dynein cytoplasmic 1 intermediate chain 2+++
3EBP2Probable rRNA-processing protein, EBNA1BP2++
4ECH1Delta(3,5)-delta(2,4)-dienoyl-CoA isomerase, mitochondrial+ud+[83]
2EEF1A1Elongation factor 1-alph 1+++ud+[84]
4EEF1A2Elongation factor 1-alpha 2+++uOrf3+[85]
2EEF1B2Elongation factor 1-beta 2++++d+
5EEF1DElongation factor 1-delta+++d+[86]
10EEF1GElongation factor 1-gamma+++++ud+
17EEF2Elongation factor 2++++ud++[87]
16EFTUD2116 kDa U5 snRNP component, SNRP116+++++d++[88]
4EHD2EH domain-containing protein 2+ud+
3EIF2AEukaryotic translation initiation factor 2 subunit 1, EIF2S1+++++[89]
10EIF3AEukaryotic translation initiation factor 3 subunit A+++udNsp1++[90]
9EIF3BEukaryotic translation initiation factor 3 subunit B+++udNsp1++[39]
2EIF3CEukaryotic translation initiation factor 3 subunit C++dNsp1+[91]
3EIF3CLEukaryotic translation initiation factor 3 subunit C-like protein++d+
5EIF3EEukaryotic translation initiation factor 3 subunit E++++udNsp1++[92]
4EIF3FEukaryotic translation initiation factor 3 subunit F++udNsp1++[93]
2EIF3GEukaryotic translation initiation factor 3 subunit G+Nsp1+[93]
2EIF3IEukaryotic translation initiation factor 3 subunit I+dNsp1+[91]
10EIF3LEIF3, subunit E interacting protein++++dNsp1++[39]
19EIF4A1Eukaryotic initiation factor 4A-1, DDX2A++++ud+
8EIF4A3Eukaryotic initiation factor 4A-III, DDX48+++++[94]
4EIF4G1Eukaryotic translation initiation factor 4 gamma 1++ud+[93]
2EIF4G2Eukaryotic translation initiation factor 4 gamma 2+dNsp1+[93]
2EIF5Eukaryotic translation initiation factor 5+ud+[95]
5EIF5AEukaryotic translation initiation factor 5A-1+++ud+[95]
2EIF5A2Eukaryotic translation initiation factor 5A-2+++d+[95]
2EIF5BEukaryotic translation initiation factor 5b (eif-5b) (translation initiation factor if-2)+u+
3EIF6Eukaryotic translation initiation factor 6+++u+
4ELAVL1ELAV-like protein++d+[96]
2ELOBTranscription elongation factor B, TCEB2+udNsp16Orf10+
2EMG1Ribosomal RNA small subunit methyltransferase NEP1+ud+
12ENO1Alpha-enolase++++ud+[97]
7ENO2Gamma-enolase++ud+[98]
2ENOPH1Enolase-phosphatase E1+u+
6EPHX1Epoxide hydrolase+d+[99]
4ERO1AEndoplasmic oxidoreductin-1-like protein, ERO1L++dOrf3a+
6ERP44Endoplasmic reticulum resident protein ERp44+Orf8+[101]
4ESYT1Extended synaptotagmin-1, FAM62A++EMNsp3Nsp4Nsp6Orf3aOrf6Orf7aOrf7bOrf8Orf9cS+[102]
4ETF1Eukaryotic peptide chain release factor subunit 1+u+
2EWSR1EWS RNA-binding protein+ud+
14EZREzrin++udS+[103]
2FAF1FAS-associated factor 1+u+
3FARSBPhenylalanine-tRNA ligase beta subunit++[104]
19FASNFatty acid synthase++++ud+[105]
3FBLN1Fibulin 1+ud+[106]
2FDPSFarnesyl pyrophosphate synthetase like-4 protein+d+
2FEN1Flap endonuclease 1+ud+
2FERMT3Fermitin family homolog 3+u+
8FKBP10FK506-binding protein 10+Orf8+
11FKBP4Peptidyl-prolyl cis-trans isomerase FKBP4, FKBP-52++Nsp12+[107]
2FKBP5Peptidyl-prolyl cis-trans isomerase FKBP5 (FK506-binding protein)+u+
4FKBP9FK506-binding protein 9+d+
43FLNAFilamin-A+++ud++[108]
25FLNBFilamin-B+++u+[57]
24FLNCFilamin-C++ud++[109]
23FN1Fibronectin+ud+[110]
3FSTL1Follistatin-related protein+ud+[111]
2FTH1Ferritin heavy chain++ud+[111]
2FUBP1Far upstream element-binding protein 1+ud+[112]
10G6PDGlucose-6-phosphate 1-dehydrogenase+++ud++[44]
15GANABNeutral alpha-glucosidase AB+++dOrf6Orf8Orf9c+[113]
6GAPDHGlyceraldehyde-3-phosphate dehydrogenase++++udOrf8++[114]
2GAR1H/ACA ribonucleoprotein complex subunit 1+++
4GARSGlycine-tRNA ligase, GARS1+u+[115]
2GARTTrifunctional purine biosynthetic protein adenosine-3+dNsp15+
2GBE11,4-alpha-glucan-branching enzyme++u+
4GCLCGlutamate-cysteine ligase catalytic subunit+Orf3+
8GDI1Rab GDP dissociation inhibitor alpha+++ud+[116]
10GDI2Rab GDP dissociation inhibitor beta+++udNsp12Orf9b+[117]
2GGCTGamma-glutamylcyclotransferase, cytochrome c-releasing factor 21+u+
3GLO1Lactoylglutathione lyase++dOrf3+[118]
3GLRX3Glutaredoxin 3, Thioredoxin-like 2++d+[119]
10GLUD1Glutamate dehydrogenase 1, mitochondrial++[120]
2GMFBGlia maturation factor, beta++u+
2GPALPP1Lipopolysaccharide-specific response protein 7++
5GPC1Glypican-1++d+
2GPIGlucose-6-phosphate isomerase+udENsp6Orf3Orf3bOrf6+[121]
4GRWD1Glutamate-rich WD repeat-containing protein 1++
16GSNGelsolin+ud+[16]
3GSPT1Eukaryotic peptide chain release factor GTP-binding subunit ERF3A++
3GSSGlutathione synthetase+d+
6GSTP1Glutathione S-transferase+ud+[122]
4GTF2IGeneral transcription factor II-I++ud+[25]
3H1-1Histone H1.1, H1F1, HIST1H1A, H1FNT++ud++[123]
2H1F0Histone H1.0, H1FV, H1-0+udNsp3Nsp8Orf3bOrf10+
3H2AFVHistone H2A.V, H2AZ2++++ud++[127]
11H2AFYCore histone macro-H2A.1, MACROH2A1++u+[128]
4H2AFY2Cor2 histone macro-H2A.2, MACROH2A2+++u+[128]
4HADHATrifunctional enzyme subunit alpha, mitochondrial++
3HARSHistidyl-tRNA synthetase, cytoplasmic++++[41]
5HDGFHepatoma-derived growth factor, HMG1L2+++++ud+[134]
2HDLBPVigilin, High density lipoprotein binding protein+udNNsp2+
4HEATR1HEAT repeat-containing protein 1+ud+
2HEBP2Heme-binding protein 2+u+
5HEXBBeta-hexosaminidase subunit beta+d+
6HIST1H1BHistone H1.5, H1F5, H1-5+++++ud++[124]
6 HIST1H1C Histone H1.2, H1F2, H1-2 + + + + + + u d Nsp8 + + [124]
4HIST1H2A AHistone H2A type 1-A, H2AFR, H2AC1+++++[125]
2HIST1H2ABHistone H2A type 1-B/E, H2AFM, H2AC4+d+[126]
5HIST1H2BAHistone H2B type 1-A, H2BC1++++[123]
5HIST1H2BBHistone H2B type 1-B, H2BFF, H2BC3+++[131]
2HIST1H2BLHistone H2B type 1-L, H2BFC, H2BC13+++ud+[129]
12HIST2H2BEHistone H2B type 2-E, H2BC21++++ud+[130]
5HIST2H3AHistone H3.2, H3C15++++ud++[132]
4HIST3H3Histone H3.1t, H3FT, H3-4++++[123]
14 HIST4H4 Histone H4, H4C1 + + + + + + u d + + [133]
10HMGB1High mobility group protein 1+++d+[135]
3HMGCS1Hydroxymethylglutaryl-CoA synthase, cytoplasmic+++ud+
2HMGN1Non-histone chromosomal protein HMG14+u+
4HNRNPA1Heterogeneous nuclear ribonucleoprotein A1+++++ud+[137]
8HNRNPA2 B1hnRNP A2/B1+++++ud+[138]
2HNRNPA3hnRNP A3+++ud+[139]
2HNRNPABhnRNP A/B+d+[139]
3HNRNPChnRNP C1/C2++++ud++[140]
7 HNRNPCL1 hnRNP C-like 1 + + + + + + + + [141]
5HNRNPDhnRNP D, AUF1++++[142]
3HNRNPDLhnRNP D-like++ud+[143]
5HNRNPFhnRNP F+++d++[144]
2HNRNPH1hnRNP H1++++ud+
2HNRNPH3hnRNP H3+ud+[145]
9HNRNPKhnRNP K+++++u+[146]
3HNRNPMhnRNP M+ud+
6 HNRNPQ hnRNP Q, SYNCRIP + + + + + + d +
7HNRNPRhnRNP R+++++ud+[147]
5 HNRNPU hnRNP U (scaffold attachment factor A) + + + + + + u d + + [148]
6HNRNPUL1hnRNP U-like protein 1++ud+
4HNRNPUL 2hnRNP U-like protein 2+ud+
6HPRT1Hypoxanthine-guanine phosphoribosyltransferase++
2HSP70BPutative heat shock 70 kDa protein, HSPA7+ud+
38 HSP90AA1 Heat shock protein 90-alpha + + + + + + u d + + [149]
6HSP90AA2Heat shock protein 90-alpha A2++++u++[150]
16 HSP90AB1 Heat shock protein HSP 90-beta + + + + + + u d Nsp12 + [151]
31 HSP90B1 Endoplasmin, GRP94 + + + + + + u d Orf3a Orf9c + + [152]
7HSPA1AHeat shock 70 kDa protein 1A++udNOrf9b+
4HSPA1LHeat shock 70 kDa protein 1-like, HSP70T+++[153]
2HSPA2Heat shock 70 kda protein 2+uNsp3+
14HSPA4Heat shock 70 kDa protein 4++++ud+[154]
35 HSPA5 Endoplasmic reticulum chaperone BiP, GRP78 + + + + + + u d E M Nsp2 Nsp4 Nsp6 Orf3a Orf7a Orf7b S + [155]
27HSPA8Heat shock cognate 71 kDa protein+++++udNsp2Nsp12+[156]
25HSPA9Stress-70 protein, mitochondrial (GRP75)+++++udN+[156]
7HSPB1Heat shock protein beta-1+ud+[157]
2HSPBP1Hsp70-binding protein 1+udS+
30HSPD160 kDa heat shock protein, mitochondrial++++ud+[158]
3HSPG2Basement membrane heparan sulfate proteoglycan++ud+[159]
13HSPH1Heat shock protein 105 kDa+++u+[160]
4HTATSF1HIV Tat-specific factor 1++d+
7HYOU1Hypoxia up-regulated protein+++uNsp4Orf3aOrf8+[161]
4IDEInsulin-degrading enzyme++Nsp4Nsp12Nsp14Nsp15Nsp16Orf3b+
2IDH3AIsocitrate dehydrogenase [NAD] subunit alpha, mitochondrial++
2IGBP1Immunoglobulin-binding protein 1+ud+
2IL18Interleukin-18+ud+[162]
7ILF2Interleukin enhancer-binding factor 2++++u++[163]
6ILF3Interleukin enhancer-binding factor 3++u+[163]
2IMPDH2Inosine-5’-monophosphate dehydrogenase 2 (imp dehydrogenase 2) (impdh-ii)+dNsp14+
7IPO5Importin-5, KPNB3, RANBP5++++[164]
3IPO7Importin-7, RANBP7+Nsp6Orf9c+[165]
13IQGAP1Ras GTPase-activating-like protein IQGAP1++++u++[166]
2IRGQImmunity-related GTPase family Q protein+ud+
4ITGB1Integrin beta-1++udNsp4Of3bOrf6Orf8Orf9c+[167]
2IWS1Protein IWS1 homolog+ud+
4KARSLysyl-tRNA synthetase+++Nsp7++[100]
3KHSRPFar upstream element-binding protein 2 (KH-type splicing regulatory protein), FUBP2+ud+[53]
2KPNA2Importin subunit alpha-1+dOrf6+
2KPNA3Importin subunit alpha-4++++
11 KPNB1 Importin subunit beta-1 + + + + + + + + [164]
2KRR1KRR1 small subunit processome component homolog, HIV-1 Rev-binding protein+d+[168]
10KTN1Kinectin+uOrf6+[169]
2KYNUKynureninase+uOrf3+
7LAMB1Laminin subunit beta-1+d+[170]
5LAMC1Laminin subunit gamma-1+ud+[171]
2LAMP2Lysosome-associated membrane glycoprotein 2+ud+[172]
2LARSLeucyl-tRNA synthetase, cytoplasmic++[100]
8LDHAL-lactate dehydrogenase A chain+++udNsp12+[173]
10LDHBL-lactate dehydrogenase B chain+++udNsp12Nsp7+[174]
2LEO1RNA polymerase-associated protein LEO1+u+
5LGALS1Galectin-1+ud+[175]
23LMNAPrelamin-A/C+++udNsp13Orf3bOrf8Orf10+[176]
8LMNB1Lamin-B1+++ud++[177]
7LMNB2Lamin-B2++ud+[178]
16LRPPRCLeucine-rich PPR motif-containing protein+++++d+[179]
2LSM2U6 snRNA-associated Sm-like protein LSm2+u+
2LSM6U6 snRNA-associated Sm-like protein LSm6+u+
2LSM8U6 snRNA-associated Sm-like protein LSm8++
2MAGOHBProtein mago nashi homolog+ud+
3MANBABeta-mannosidase+d+
3MAP1BMicrotubule-associated protein 1B++ud++[180]
6MAPRE1Microtubule-associated protein RP/EB family member+++Orf3+
2MARCKSMyristoylated alanine-rich c-kinase substrate (marcks) (protein kinase c substrate, 80 kda protein, light chain) (pkcsl)+udMNsp4Nsp6Orf3aOrf3bOrf7bS+
2MARSMethionine-tRNA ligase, MARS1+d+[39]
9MCM2DNA replication licensing factor MCM2++++d+[181]
7MCM3DNA replication licensing factor MCM3++++ud+[39]
5MCM4DNA replication licensing factor MCM4+++ud+[181]
3MCM5DNA replication licensing factor MCM5++ud+[181]
9MCM6DNA replication licensing factor MCM6++++ud+[39]
2MDH1Malate dehydrogenase, cytoplasmic+dEOrf3+
3MDH2Malate dehydrogenase, mitochondrial+ud+[25]
2ME2NAD-dependent malic enzyme, mitochondrial+udNsp15+
10MOV10Putative helicase, Moloney leukemia virus 10 protein++udEMNNsp3Nsp4Nsp6Orf3aOrf7aOrf7bOrf8Orf9cS+
5MRPL139S ribosomal protein L1, mitochondrial++
3MRPL1339S ribosomal protein L13, mitochondrial+d+
2MRPL1539S ribosomal protein L15, mitochondrial+ud+
2MRPL1739S ribosomal protein L17, mitochondrial+d+
2MRPL1839S ribosomal protein L18, mitochondrial+d+
4MRPL1939S ribosomal protein L19, mitochondrial+dOrf8+
2MRPL239S ribosomal protein L2, mitochondrial+dNsp6+
2MRPL2339S ribosomal protein L23, mitochondrial+d+
5MRPL3739S ribosomal protein L37, mitochondrial+ud+
5MRPL3839S ribosomal protein L38, mitochondrial+d+
2MRPL3939S ribosomal protein L39, mitochondrial++d++
3MRPL4539S ribosomal protein L45, mitochondrial+d+
2MRPL4939S ribosomal protein L49, mitochondrial+d+
4MRPS2228S ribosomal protein S22, mitochondrial++
4MRPS2328S ribosomal protein S23, mitochondrial++
6MRPS2728S ribosomal protein S27, mitochondrial+Nsp8+
2MRPS2828S ribosomal protein S28, mitochondrial, MRPS35++
2MRPS3028S ribosomal protein S30, mitochondrial+d+
2MRPS3428S ribosomal protein S34, mitochondrial+d+
3MRPS928S ribosomal protein S9, mitochondrial++
6MSNMoesin+++uNsp6Orf3S+[182]
21MVPMajor vault protein++ud+[183]
4MXRA5Matrix-remodeling-associated protein 5+d+[183]
16MYBBP1AMyb-binding protein 1A+++ud++
2MYG1UPF0160 protein MYG1, mitochondrial, C12orf10+++
2MYH10Myosin-10+udNsp9+[184]
43MYH9Myosin-9++++ud++[184]
3MYL6Myosin light chain 6++u+[185]
4MYLKMyosin light chain kinase, smooth muscle+ud+
3MYO1CUnconventional myosin-Ic, MYO1E++ud+[186]
4MZB1Marginal zone B- and B1-cell-specifc protein (Proapoptotic caspase adapter protein, plasma cell-induced resident protein)+u+
3NAA15N-alpha-acetyltransferase 15, NatA auxiliary subunit (NMDA receptor-regulated protein, NARG1)+d+
2NAA25N-alpha-acetyltransferase 25, NatB auxiliary subunit (TPR repeat-containing protein C12orf30)++
4NACANascent polypeptide associated complex subunit alpha++++ud+[187]
7NAP1L1Nucleosome assembly protein 1-like 1++++ud++
7NAP1L4Nucleosome assembly protein 1-like 4+++ud++
5NARSAsparagine-tRNA ligase, cytoplasmic, NARS1+d+[188]
6NASPNuclear autoantigenic sperm protein++++ud+[189]
23 NCL Nucleolin + + + + + + u d + + [190]
2NESNestin+ud+
2NEU1Sialidase-1+udOrf8+[191]
3NEXNNexilin F-actin binding protein+ud+
2NFU1HIRA interacting protein 5++
8NME1Nucleoside diphosphate kinase A, RMRP+++ud+[192]
3NME2Nucleoside diphosphate kinase 2, NM23+ud+[193]
2NMT1Glycylpeptide N-tetradecanoyltransferase 1++[194]
2NMT2Glycylpeptide N-tetradecanoyltransferase 2+d+
2NOC2LNucleolar complex protein 2 homolog+d+
7NOLC1Nucleolar phosphoprotein p130 (nucleolar and coiled-body phosphoprotein 1)+ud+
9NOP2Probable 28S rRNA (cytosine(4447)-C(5)-methyltransferase+u+
15NPEPPSPuromycin-sensitive aminopeptidase, metalloproteinase MP100++++
7 NPM1 Nucleophosmin (nucleolar phosphoprotein, numatrin) + + + + + + u d Orf9c + + [195]
2NRCAMNeuronal cell adhesion molecule+ud+[196]
3NSFL1CNSFL1 cofactor p47+u+
8NUDCNuclear distribution C, Dynein complex regulator+++dNsp12+
4NUDT21Cleavage and polyadenylation specificity factor 5+++d+
2NUDT3Diphosphoinositol polyphosphate phosphohydrolase++
4NUDT5Nudix hydrolase 5++++d+
3NUMA1Nuclear mitotic apparatus protein 1+ud+[197]
2OLA1Obg-like ATPase 1+u+
2OTUB1Ubiquitin thioesterase protein OTUB1++
5P3H1Basement membrane chondroitin sulfate proteoglycan+u+
2P3H3Prolyl 3-hydroxylase 3, LEPREL2+d+
2P3H4ER protein SC65, nucleolar autoantigen No55+M+[198]
2P4HA2Prolyl 4-hydroxylase subunit alpha-2+d+
18 P4HB Protein disulfide-isomerase + + + + + + u d Nsp7 Orf3b + [199]
14PA2G4Proliferation-associated protein 2G4++ud+
22PABPC1Poly(A)-binding protein 1+++dN+[200]
9PABPC3Poly(A)-binding protein 3+++d++
16PABPC4Poly(A)-binding protein 4, APP1++++dN++[201]
4PAF1RNA polymerase II-associated factor 1 homolog+d+
2PAFAH1B2Platelet-activating factor acetylhydrolase IB subunit beta++ud+
3PAFAH1B3Platelet-activating factor acetylhydrolase IB subunit gamma++uNsp12Nsp5Orf3b+
6PAICSMultifunctional protein ADE2+d+
2PARP1Poly [ADP-ribose] polymerase 1+ud+
3PARVAAlpha-parvin+u+
8 PCNA Proliferating cell nuclear antigen + + + + + + u d + [202]
2PDCD10Programmed cell death protein 10++
21PDIA3Protein disulfide-isomerase A3+++udMOrf3aOrf3bOrf8Orf9c+[203]
34 PDIA4 Protein disulfide-isomerase A4 + + + + + + u d Nsp16 Nsp7 Orf3b + [204]
10 PDIA6 Protein disulfide-isomerase A6 + + + + + + u d + [205]
6PELP1Proline-, glutamic acid-, leucine-rich protein 1+d+
2PES1Pescadillo homolog+d+
7PFASFormylglycinamide ribonucleotide amidotransferase++Nsp7Nsp12Nsp15Nsp16+
3PFDN2Prefoldin subunit 2++uNsp12Nsp15Orf10+[206]
4PFDN3Prefoldin subunit 3, von hippel-lindau-binding protein 1, VBP1++++dNsp12Nsp15+
2PFKPATP-dependent 6-phofructokinase, platelet type+udOrf7a+[207]
9PFN1Profilin-1+++ud+[208]
2PFN2Profilin-2+u+[181]
4PGAM1Phosphoglycerate mutase 1+ud+[209]
4PGAM2Phosphoglycerate mutase 2+++
9PGD6-phosphogluconate dehydrogenase, decarboxylating+ud+
3PGLS6-phosphogluconolactonase+u+
3PHGDHD-3-phosphoglycerate dehydrogenase+ud+[210]
2PLA2G4ACytosolic phospholipase a2++
10PLCG21-phosphatidylinositol-4,5-bisphosphate phosphodiesterase gamma-2+u+
2PLD3Phospholipase D3, 5’–3’ exonuclease PLD3+udNsp2Nsp3Nsp5Orf6Orf7bOrf8Orf10+
91PLECPlectin-1, PLEC1++ud++[211]
5PLOD1Procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1+d+
5PLOD3Multifunctional procollagen lysine hydroxylase and glycosyltransferase LH3++
2PLS1Plastin-1+d+
30PLS2Plastin-2, LCP1+++++ud+[212]
6PLS3Plastin-3++ud+
2PMPCBMitochondrial-processing peptidase subunit beta+dM+
2POP1Ribonucleases P/MRP protein subunit POP1+u+[213]
3PORNADPH--cytochrome P450 reductase+udNsp2Orf6+
8PPA1Inorganic pyrophosphatase++uOrf3+[214]
3PPATAmidophosphoribosyltransferase+d+
10PPIBPeptidyl-prolyl cis-trans isomerase+++udOrf8+[215]
3PPM1GProtein phosphatase 1G (PPM1C)++Orf9b+
2PPP1R7Protein phosphatase 1 regulatory subunit 7 (subunit 22)++u+
7PPP2R1ASerine/threonine-protein phosphatase 2A 65 kDa regulatory subunit A alpha isoform+++d+
6PRDX1Peroxiredoxin-1++ud+[216]
5PRDX3Thioredoxin-dependent peroxide reductase+++ud+[217]
3PRDX4Peroxiredoxin-4++udOrf3a+[218]
2PRKAR2AProtein kinase CAMP-dependent type II regulatory alpha+uNsp1Orf9b+[48]
2PRKCDBPProtein kinase C delta-binding protein++
11PRKCSHProtein kinase C substrate 80K-H+++++dNsp6Orf3Orf3aS+
17PRKDCDNA-dependent protein kinase catalytic subunit (DNA-PKcs)++++udMNsp4++[219]
5 PRMT1 Protein arginine N-methyltransferase 1 (Histone-arginine N-methyltransferase) + + + + + + d + [220]
24PRPF8Pre-mRNA-processing-splicing factor 8 (U5 snRNP-specific protein 220 kDa)+++ud++[57]
2PRPSAP2Phosphoribosyl pyrophosphate synthetase-associated protein 2+u+
2PSAPProactivator polypeptide, Prosaposin+ud+
6PSAT1Phosphoserine aminotransferase 1+udOrf3Orf7a+
3PSMA1Proteasome subunit alpha type-1+++dOrf3b+[25]
2PSMA2Proteasome subunit alpha type-2+++d+
6PSMA3Proteasome subunit alpha type-3, C8+++udNsp2Nsp4Nsp7Nsp10Nsp12+[221]
5PSMA4Proteasome subunit alpha type-4, C9++u+[25]
5PSMA5Proteasome subunit alpha type-5+++++uOrf3b+[222]
8PSMA6Proteasome subunit alpha type-6++udOrf3b+
6PSMA7Proteasome subunit alpha type-7+++++ud+[223]
3PSMA8Proteasome subunit alpha type 7-like+++[223]
5PSMB1Proteasome subunit beta type-1+++[224]
3PSMB3Proteasome subunit beta type-3+++dOrf3b+[221]
7PSMB4Proteasome subunit beta type-4++++Orf3b+[25]
3PSMB6Proteasome subunit beta type-6+++dOrf3b+
5PSMB7Proteasome subunit beta type-7+++d+[221]
3PSMB8Proteasome subunit beta type-8+ud+
4PSMB9Proteasome subunit beta type-9+ud+
2PSMC126s Proteasome regulatory subunit 4+dOrf6+
2PSMC326S protease regulatory subunit 6A+dOrf6+
5PSMD126S proteasome non-ATPase regulatory subunit 1+++uNsp7Orf6Orf8++
9PSMD11Proteasome 26S non-ATPase regulatory subunit 11++u+
3PSMD1226S proteasome non-ATPase regulatory subunit 12++d++
3PSMD13Proteasome 26S non-ATPase subunit 13++d+[225]
2PSMD1426S proteasome non-ATPase regulatory subunit 14++
8PSMD326S proteasome non-ATPase regulatory subunit 3+d+
9PSMD626S proteasome non-ATPase regulatory subunit 6+++++
2PSMD726S proteasome non-ATPase regulatory subunit 7+u+
11PSME1Proteasome activator complex subunit 1+uNsp15+
8PSME2Proteasome activator complex subunit 2+u+
4PSME3Proteasome activator complex subunit 3+++dNsp16+[226]
2PSPHPhosphoserine phosphatase++
6PTBP1Polypyrimidine tract-binding protein, hnRNP I++ud+[227]
2PTBP3Polypyrimidine tract-binding protein, ROD1++ud+[227]
16PTCD3Pentatricopeptide repeat-containing protein 3, mitochondrial, MRPS39+++
2PTGES3Prostaglandin E synthase 3 (telomerase-binding protein p23) (hsp90 co-chaperone) (progesterone rec)+++d+
4PTMAProthymosin alpha+++ud+[228]
2PTPN6Tyrosine-protein phosphatase non-receptor type 6+ud+
2PUF60Poly(U)-binding-splicing factor PUF60+u+[229]
18PUM1Pumilio homolog 1+d+
3PURATranscriptional activator protein Pur-alpha+ud+
2PUS1tRNA pseudouridine synthase A++
2PZPPregnancy zone protein, alpha-2macroglobulin like+d+[230]
4QARSBifunctional glutamate/proline-tRNA ligase, EPRS, EPRS1+++u++[100]
3RAB1ARas-related protein Rab-1A++dNsp7Orf3Orf7b+
5RAB7ARas-related protein Rab-7a++udNsp7Orf3Orf7b+
3RAD23AUV excision repair protein RAD23 homolog A++d+[231]
5RAD23BUV excision repair protein RAD23 homolog B+udOrf3aOrf3bOrf7aOrf9c+[231]
6RALYRNA binding protein, autoantigen p542++udOrf9c+[232]
3RANBP1Ran-specific GTPase-activating protein+ud+
2RANBP6Ran-binding protein 6+dOrf7a+
2RANGAP1Ran GTPase-activating protein 1++d+[165]
3RARSArginyl-tRNA synthetase, cytoplasmic, RARS1+u+[39]
5RBBP4Chromosome assembly factor 1 subunit C++d+[233]
3RBBP7Histone-binding protein rbbp7++ud+
2RBM3Putative RNA-binding protein 3+udOrf8+
3RBM8ARNA-binding protein 8A+u+
2RBMXL2RNA-binding motif protein X-linked-like-2++
2RCN3Reticulocalbin-3++
8RDXRadixin++++udNsp13+[234]
2RMI2RecQ-mediated genome instability protein 2++
3RNPEPArginine aminopeptidase, APB+Orf3+
2RNPS1RNA-binding protein with serine-rich domain 1+ud+
4RO52E3 ubiquitin-protein ligase TRIM21 (Ro/SS-A), TRIM21+ud+
4RO6060 kDa SS-A/Ro ribonucleoprotein++u+[235]
2RPA3Replication protein A 14 kda subunit++[236]
3RPF2Ribosome production factor 2 homolog, BXDC1+++
2RPL10A60S ribosomal protein L10a+++
2RPL1160S ribosomal protein L11+++u+
4RPL1260S ribosomal protein L12+++ud+[237]
2RPL1560S ribosomal protein L15++++d+
3RPL1860S ribosomal protein L18+++d+
2RPL2260S ribosomal protein L22++++d+[93]
2RPL23ARibosomal protein L23a+u+
2RPL26L160S ribosomal protein L26-like 1, RPL26P1++Orf9b+
3RPL360s ribosomal protein L3 (hiv-1 tar rna-binding protein b)+ud+
2RPL3160S ribosomal protein L31+ud+
2RPL35A60S ribosomal protein L35a+ud+[238]
2RPL460S ribosomal protein L4+ud+
17RPL560S ribosomal protein L5+++++d++[239]
11RPL660S ribosomal protein L6+++++ud+[181]
9RPL760S ribosomal protein L7, RPL7P32+++++ud+[93]
4RPL7A60S ribosomal protein L7A++ud+[238]
2RPL860S ribosomal protein L8++ud+[165]
8RPLP060S acidic ribosomal protein P0+++++ud+[240]
2RPLP160S acidic ribosomal protein P1+ud+[241]
4RPLP260S acidic ribosomal protein P2++++ud++[241]
2RPS15A40s ribosomal protein S15a+++u+
3RPS1840S ribosomal protein S18++udNsp13Orf8Orf10+[165]
3RPS1940S ribosomal protein S19+dOrf9c+[238]
3RPS240S ribosomal protein S2+++ud+[39]
2RPS2540S ribosomal protein S25++udOrf8++[93]
3RPS27AUbiquitin-40S ribosomal protein S27a, UBA80, UBCEP1++udNsp4S+[93]
6RPS340S ribosomal protein S3++++udOrf8++[242]
3RPS3A40S ribosomal protein S3a++++udOrf8++
3RPS4X40S ribosomal protein S4, X isoform++dOrf8+[25]
3RPS640S ribosomal protein S6++udNsp6+[238]
3RPS740S ribosomal protein S7+++ud+[93]
2RPS840S ribosomal protein S8++ud+
8RPS940S ribosomal protein S9++++d+[238]
5RPSA40S ribosomal protein SA++ud+[243]
13RRBP1Ribosome-binding protein 1++udOrf8++
11RRP12RRP12-like protein+u+
4RRP9U3 small nucleolar RNA-interacting protein 2++udN+[244]
4RRS1Ribosome biogenesis regulatory protein homolog+u+
5RSL1D1Ribosomal L1 domain-containing protein 1+ud+
6RUVBL1RuvB-like 1, tata box-binding protein-interacting protein+++Nsp1Nsp7Nsp12Orf9b++[245]
5RUVBL2RuvB-like 2+dNsp1Nsp7Nsp12Orf9b+[246]
2SARSSerine-tRNA ligase, cytoplasmic, SARS1+uNsp15+
4SEPHS1Selenide, water dikinase+d+[247]
2SEPT11Septin-11+d+[25]
2SEPT2Septin-2, NEDD5, DIFF6++ud+[248]
3SEPT7Septin-7+d+[249]
5SERPINB1Leukocyte elastase inhibitor+u+
4SERPINB6Serpin B6, peptidase inhibitor 6++
8SERPINB9Serpin B9+ud+
2SERPINC1Antithrombin-III++u+
3SERPINE1Plasminogen activator inhibitor 1+udOrf8+[250]
4SERPINH1Serpin H1, HSP47+d+[251]
6 SET SET nuclear proto-oncogene (Inhibitor of granzyme A-activated DNase, HLA-DR-associated protein II) + + + + + + u d + + [252]
2SF3A1Splicing factor 3 subunit 1 (spliceosome-associated protein 114) (sap 114) (sf3a120)+u+
14SF3B1Splicing factor 3B subunit 1++ud+[253]
13 SF3B3 Splicing factor 3B subunit 3, SAP130 + + + + + + u + + [253]
8SFN14-3-3 protein sigma, Stratifin++ud+[254]
3SFPQSplicing factor, proline- and glutamine-rich++ud+[255]
3SGTASmall glutamine-rich tetratricopeptide repeat-containing protein alpha+udM+
3SH3BGRL3SH3 domain-binding glutamic acid-rich-like protein 3+d+
2SHMT1Serine hydroxymethyltransferase, cytosolic+d+
9SHMT2Serine hydroxymethyltransferase, mitochondrial+d+
2SKP1S-phase kinase-associated protein 1+ud+
2SLC1A5Neutral amino acid transporter B, Simian type D retrovirus receptor, Baboon M7 virus receptor+udOrf3S+
2SLC2A1HepG2 glucose transporter, GLUT1+dNsp8+[256]
17SLC3A24F2 cell-surface antigen heavy chain, CD98++udOrf3bOrf9c+
2SLIRPSRA stem-loop-interacting RNA-binding protein, mitochondrial+ud+
4SMSSpermine synthase+udOrf3+
9SND1Staphylococcal nuclease domain-containing protein 1+++ud+
15SNRNP200U5 small nuclear ribonucleoprotein 200 kDa helicase++d+[257]
3SNRNP70U1 small nuclear ribonucleoprotein 70 kDa+++ud+[258]
3SNRPAU1 small nuclear ribonucleoprotein A+++u+[259]
8SNRPA1U2 small nuclear ribonucleoprotein A’++++[260]
3SNRPBSnRNP-associated proteins B and B’+++ud+[261]
2SNRPD1Small nuclear ribonucleoprotein Sm D1+++u++[262]
4SNRPD2Small nuclear ribonucleoprotein Sm D2+++++d++[263]
2SNRPD3Small nuclear ribonucleoprotein Sm D3+++d++[262]
2SNRPESmall nuclear ribonucleoprotein E+++d++[264]
2SNRPGSmall nuclear ribonucleoprotein G, PBSCG++[264]
2SOD1Superoxide dismutase [Cu-Zn]+ud+[265]
46SPTAN1Spectrin alpha chain, brain (spectrin, non-erythroid alpha chain)+++++ud++[266]
29SPTBN1Spectrin beta chain, brain+++ud+[267]
3SRMSpermidine synthase+d+
3SRP14Signal recognition particle 14 kDa protein+udNsp13Orf8+
2SRP68Signal recognition particle 68 kda protein+NNsp2+
2SRP72Signal recognition particle 72 kDa protein+dNsp8+[268]
2SRP9Signal recognition particle 9 kda protein+ud+
2SRRTArsenite-resistance protein 2+d+
5SRSF1Serine/argine-rich splicing factor 1++++ud++[269]
2SRSF11Arginine/serine-rich splicing factor 11, SRSF11+ud+
3SRSF2Arginine/serine-rich splicing factor 2, SFRS2+++ud+[65]
2SRSF3Serine/arginine-rich splicing factor 3, SFRS3++[270]
4SRSF4Splicing factor, arginine/serine-rich 4 (srp75)++
2SRSF5Serine/arginine-rich splicing factor 5, SRP40++ud+[271]
2SRSF6Splicing factor, arginine/serine-rich 6+ud+
3SRSF7Serine /arginine-rich splicing factor 7, SRSF7++++u++[271]
2SRSF8Serine/arginine-rich splicing factor 8++d+
11 SSB Lupus la protein (sjoegren syndrome type b antigen) (La/SSB) + + + + + + u d + + [41]
9SSBP1Single-stranded DNA-binding protein, mitochondrial+++N+
8SSRP1Fact complex subunit ssrp1 (facilitates chromatin transcription complex subunit ssrp1) (factp80) (chromatin- specific transcription elongation factor 80 kda)+++ud+[272]
6ST13Hsc70-interacting protein (hip) (suppression of tumorigenicity protein 13) (putative tumor suppressor st13) (protein fam10a1) (progesterone receptor-associate)+++++uNsp12Orf3bOrf6Orf8Orf10+[273]
3STIP1Stress-induced-phosphoprotein 1+udENsp12Orf3aOrf8+[14]
2STRBPSpermatid perinuclear RNA-binding protein+Nsp15+
4SUB1Activated RNA polymerase II transcriptional coactivator p15 (PC4, RPO2TC1)+++ud++
2SUGT1Protein SGT1 homolog (Suppressor of G2 allele of SKP1 homolog)+uNsp12Nsp15+
2SUMO1Small ubiquitin-related modifier+d+[274]
9SUPT16HFACT complex subunit SPT16+++d+
2SUPT5HTranscription elongation factor SPT5++
2SWAP70Switch-associated protein 70+dNsp2+
11TALDO1Transaldolase++ud+[275]
3TBCATubulin-specific chaperone A+Nsp11+
3TCL1AT-cell leukemia/lymphoma protein 1A+ud+
7TCP1T-complex protein 1 subunit alpha (tcp-1-alpha) (cct-alpha)+++dOrf10+[51]
4TEX10Testis-expressed protein 10++
3TFGTRK-fused gene protein+++
4TGM2Protein-glutamine gamma-glutamyltransferase 2+ud+[276]
9THBS1Thrombospondin-1+ud+[277]
29TLN1Talin-1++++ud+[278]
4TLN2Talin-2+u+
6TNCTenascin C+d+[279]
5TNPO1Transportin-1, KPNB2++
3TOP1DNA topoisomerase 1 (Scl 70)++++u+[280]
5TP53I3Quinone oxidoreductase+ud+
3TPD52L2Tumor protein D54+udNsp4Orf6+
2TPI1Triosephosphate isomerase+dNsp15+[53]
16 TPM1 Tropomyosin 1 alpha chain + + + + + + u d Nsp9 + [281]
17TPM2Tropomyosin beta chain++++ud+[25]
6 TPM3 Tropomyosin alpha-3 chain + + + + + + u d + [282]
20 TPM4 Tropomyosin alpha-4 chain + + + + + + u d + [283]
2TPP1Tripeptidyl-peptidase 1+ud+
4TPP2Tripeptidyl-peptidase 2++
4TPRNucleoprotein TPR+ud+[284]
4TPT1Tumor protein, translationally-controlled+ud+
3TSNTranslin+d+
3TTLL12Tubulin-tyrosine ligase-like protein 12++d+[285]
2TTLL3Tubulin monoglycylase TTLL3+u+
4 TUBA1C Tubulin alpha-1C, tubulin alpha-6 + + + + + + u d + + [286]
10TUBA3CTubulin alpha-3C chain, TUBA2++++
12TUBA4ATubulin alpha-4A chain, TUBA1+++ud++[287]
7TUBBTubulin beta chain, TUBB5++++ud++[288]
4TUBB1Tubulin beta-1 chain+++++[289]
2TUBB4ATubulin beta-4A chain, TUBB4, TUBB5+ud+[290]
12TUBB4BTubulin beta-4B chain, TUBB2C++++ud++[289]
2TXNThioredoxin+ud+[291]
2TXNDC17Thioredoxin domain-containing protein 17++ud+
4TXNDC5Thioredoxin domain-containing protein 5++ud+
2TXNL1Thioredoxin-like protein 1 (32 kda thioredoxin-related protein)+u+
15TXNRD1Thioredoxin reductase 1, cytoplasmic+++ud+[291]
2U2AF2Splicing factor U2AF 65 kDa subunit+d+{Imai, 1993 #256}
15 UBA1 Ubiquitin-like modifier-activating enzyme 1 + + + + + + u d + [292]
2UBA2Ubiquitin-like 1-activating enzyme e1b (sumo-1-activating enzyme subunit 2) (anthracycline-associated resistance arx)+dNsp7+
2UBA6Ubiquitin-like modifier-activating enzyme 6+Nsp7+
2UBE2KUbiquitin-conjugating enzyme E2 K++
2UBLE1AUbiquitin-like 1-activating enzyme e1a (SUMO-1-activating enzyme subunit 1), SAE1++ud+[274]
2UBTFNucleolar transcription factor 1, autoantigen NOR-90+d+[293]
2UCHL1Ubiquitin carboxyl-terminal hydrolase isozyme L1++udNsp7Orf3+[294]
5UGDHUDP-glucose 6-dehydrogenase+ud+
6UGGT1UDP-glucose:glycoprotein glucosyltransferase 1, UGCGL1+dOrf3aOrf7a+
18UPF1Regulator of nonsense transcripts 1++dN+
3USP5Ubiquitin carboxyl-terminal hydrolase 5 (ubiquitin thioesterase 5) (ubiquitin-specific-processing protease 5) (deubiquitinating enzyme 5) (isopeptidase T)+++ud+
2USP7Ubiquitin carboxyl-terminal hydrolase (Herpes virus associated)+uEMNsp4Orf7aOrf7b+
2USP9XUbiquitin specific protease 9, X chromosome+ud+
3VARS1Valine-tRNA ligase++
4VASNVasorin+ud+
4VAT1Synaptic vesicle membrane protein VAT-1 homolog+udOrf3bOrf6+
27VCLVinculin++udNsp14+[295]
18 VCP Transitional endoplasmic reticulum ATPase (Valosin-containing protein) (ER) + + + + + + u d + [296]
17 VIM Vimentin + + + + + + u d + + [297]
2VPS35Vacuolar protein sorting 35+ud+[298]
6WARSTryptophanyl-tRNA synthetase, cytoplasmic++ud+[299]
5WDR18WD repeat-containing protein 18+dNsp15+
2XPNPEP1Xaa-Pro aminopeptidase 1++d+
4XPO1Exportin-1+Nsp4Orf7a+
10XPO2Exportin-2, CAS, CSE1L+d+
5XPOTExportin-T (trna exportin) (exportin(trna))++uOrf7a+
32 XRCC5 ATP-dependent DNA helicase 2 subunit 2, Ku80 + + + + + + d + + [300]
30 XRCC6 ATP-dependent DNA helicase 2 subunit 1, Ku70 + + + + + + u d + + [300]
6YARSTyrosine-tRNA ligase, cytoplasmic, YARS1+ud+[301]
3YBX1Y-box-binding protein 1++ud+[302]
6YBX3Y-box-binding protein 3++++ud+[303]
12 YWHAB 14-3-3 protein beta/alpha + + + + + + u d +
15 YWHAE 14-3-3 protein epsilon + + + + + + u d + [254]
6 YWHAG 14-3-3 protein gamma + + + + + + u d + [254]
5YWHAH14-3-3 protein eta+++++d+[304]
7YWHAQ14-3-3 protein theta + + + + + + u d + [243]
7 YWHAZ 14-3-3 protein zeta/delta + + + + + + u d + [305]
2ZPR1Zinc finger protein ZPR1+ud+[306]

Columns from left to right: P (the largest number of peptides identified for a protein by mass spectrometry for all cell lines), gene symbol, protein name, cell lines (HFL1 fetal lung fibroblast, HS-Sultan B lymphoblast, Wil2-NS B-lymphoblast, A549 lung epithelial cell, Jurkat T-lymphoblast, HEp-2 fibroblast), SARS-Cov-2 infection (up-regulated, down-regulated, interactome of specific viral protein), dermatan sulfate (DS) affinity (high affinity: eluted from DS-affinity resins with 1.0 M NaCl; low affinity: eluted with 0.4–0.6 M NaCl), Ref. (representive paper reporting autoantibodies specific for the autoAg protein). Highlighted in red: common (shared) autoAgs found in all 6 cell lines.

The master autoantigen-ome contains clusters of protein families, including 56 ribosomal proteins, 27 proteasome subunits, 19 heterogeneous ribonucleoproteins, 17 splicing factors, 17 ATP-dependent RNA helicase subunits, 16 eukaryotic translation initiation factors, 16 histones, 16 aminoacyl-tRNA synthases, 12 heat shock proteins, 9 elongation factors, 9 small nuclear ribonucleoproteins, 8 T-complex protein 1 subunits, and 7 14-3-3 proteins. In addition, there are multiple isoforms of numerous proteins, such as actin, tropomyosin, myosin, collagen, tubulin, and annexin. The 751 confirmed and putative autoAgs are highly connected and have significantly more interactions than what would be expected for a random set of proteins of similar size drawn from the genome (exhibiting 6,936 interactions vs. 3,596 expected with the highest confidence level cutoff; enrichment p value <1.0e-16) as per protein-protein interaction analysis in STRING [14] (Fig. 2). The 400 confirmed autoAgs also form a similar, strong interacting network (exhibiting 2,758 interactions vs. 1,269 expected; enrichment p value <10e-16) (Fig. 3). The tight connections within the autoAg network suggest that these proteins are biologically connected, and given that they are all identified by DS-affinity, the autoAg protein networks offer a glimpse of the biological roles and functions of DS that await further investigation.
Fig. 2.

The master autoAg-ome of 751 DS-affinity proteins identified from 6 cell types forms a highly interacting connected network. Lines represent protein-protein interactions with the highest confidence cutoff. Colored proteins are associated with translation (104 proteins, red), RNA processing (120 proteins, pink), protein folding (53 proteins, blue), vesicle-mediated transport (141 proteins, green), chromosome organization (76 proteins, yellow), regulation of cell death (110 proteins, dark purple), and apoptosis (46 proteins, brown).

Fig. 3.

Protein interaction network of the 400 confirmed autoAgs. Lines represent protein-protein interactions with highest confidence. Colored proteins are associated with translation (57 proteins, red), RNA processing (65 proteins, pink), vesicle-mediated transport (89 proteins, green), response to stress (125 proteins, blue), regulation of cell death (74 proteins, amber), and apoptosis (28 proteins, brown).

The 751-protein master autoantigen-ome is significantly associated with many biological processes and pathways, most notably translation, RNA processing, RNA splicing, protein folding, vesicle-mediated transport, chromosome organization, regulation of cell death, and apoptosis (Figs. 2 and 4). The 400 confirmed autoAgs are similarly significantly associated with the same processes and pathways (Fig. 3). In addition, these proteins are associated with numerous other processes, e.g., mRNA metabolic process, peptide metabolic process, establishment of localization in the cell, intracellular transport, interspecies interaction between organisms, viral process (infection and virulence), symbiotic process, and response to stress (Figs. 2–4). Hierarchical clustering [15] of the top 50 enriched Gene Ontology Biological Processes reveals RNA processing, particularly RNA splicing, to be the most noticeable (Fig. 4).
Fig. 4.

Hierarchical clustering of the top 50 GO Biological Processes associated with the master autoantigen-ome of 751 DS-affinity autoAgs. Bigger blue dots indicate more significant p values.

The COVID-19 autoantigen-ome

To find out how many autoAgs in the autoantigen-ome are potentially affected by SARS-CoV-2 infection, we looked for them in currently available multi-omic COVID data compiled by Coronascape [16-37]. Remarkably, 657 (87.5%) proteins of the 751-member master autoantigen-ome are found to be affected in SARS-CoV-2 infection (Table 1 and Supplemental Table 1). Among them, 109 proteins were found up-regulated only, 176 were found down-regulated only, and 343 were found both up- and down-regulated at protein and/or RNA levels in virally infected cells or COVID-19 patients (Table 1 and Fig. 6). In addition, 191 potential autoAgs were found in the interactomes of different SARS-CoV-2 viral component proteins, meaning that they may directly or indirectly interact with the virus.
Fig. 6.

COVID-affected autoAgs that are found up-regulated only, down-regulated only, or interacting with SARS-Cov-2 proteins. Note the significant enrichment of proteins associated with translation, RNA processing and splicing, and other processes.

The 657-member COVID autoantigen-ome is also a highly interacting protein network (Fig. 5). Not surprisingly, these proteins are significantly associated with processes that are crucial in viral infection, e.g., RNA processing, mRNA metabolic process, regulation of mRNA stability, translation, peptide biosynthetic process, protein folding, intracellular transport, vesicle-mediated transport, regulated exocytosis, symbiont process, and interspecies interaction between organisms, response to stress, regulation of cell death, and apoptosis (Fig. 5). We also analyzed the 109 up-only and the 176 down-only protein networks separately. Both networks are significantly associated with translation, RNA processing and splicing, and the proteasome, which further illustrates that these processes are perturbed by the viral infection (Fig. 6).
Fig. 5.

The COVID autoantigen-ome of 657 autoAg candidates. Lines represent protein-protein interactions with highest confident level. Colored proteins are associated with translation (87 proteins, red), RNA processing (103 proteins, blue), protein folding (51 proteins, pink), symbiont process (78 proteins, yellow), vesicle-mediated transport (125 proteins, green), and response to stress (161 proteins, brown).

Translation is an essential step in viral replication and mRNA vaccine action. DS-affinity identified 19 eukaryotic translation initiation factors, with 15 thus far being confirmed autoAgs (Table 1). In particular, 8 of the 13 subunits of the human eIF3 complex were found in the interactome of the NSP1 protein of SARS-CoV-2, and all 8 are known autoAgs (Table 1). eIF3 is essential for the most forms of cap-dependent and cap-independent translation initiation and stimulates nearly all steps of translation initiation, as well as other phases of translation such as recycling. eIF3 functions in a number of prominent human pathogens, e.g., HIV and HCV; and the present finding indicates that eIF3 also functions in SARS-CoV-2 infection. Among the 657 COVID-affected DS-affinity proteins, 369 (56%) are thus far confirmed autoAgs, accounting for 92% of the 400 confirmed autoAgs of the master autoantigen-ome. This vast number of perturbed autoAgs demonstrates that COVID-19 could lead to a wide variety of autoimmune diseases. For example, 42 autoAgs are associated with the myelin sheath and many are associated with other components of the nervous system, as we have described previously, which may help explain a myriad of neurological symptoms caused by COVID-19 [1]. As another example, 11 autoAgs are related to stress fibers (contractile actin filament bundles consisting of short actin filaments with alternating polarity) and 25 proteins are associated with myofibrils (contractile elements of skeletal and cardiac muscle), which may explain various muscular and cardiomuscular sequelae of COVID-19. A few autoAgs also interact with multiple viral proteins of SARS-CoV-2, suggesting that they play important roles in COVID-19 and merit further investigation. For example, ESYT1 and MOV10 interact with 12 viral proteins, CALU interacts with 11, HSPA5 interacts with 9, COPG1 and ARHGAP1 interact with 8, PLD3 and MARCKS interact with 7, and IDE interacts with 6 viral proteins (Table 1). PLD3 (a phospholipase) influences the processing of amyloid-beta precursor protein and is associated with spinocerebellar ataxia and Alzheimer’s disease. IDE (insulin-degrading enzyme) degrades intracellular insulin and is associated with diabetes.

AutoAg coding gene characteristics and alternative splicing

To further understand the autoantigen-ome, we mapped the coding genes for 751 proteins of the master autoantigen-ome, and they are distributed over all chromosomes (Fig. 7). Since these include both confirmed and putative autoAgs, one may argue that some of the putative autoAgs may not be true and the gene characteristics may not be meaningful. Therefore, we also mapped the genes for the 400 confirmed autoAgs, and they are similarly distributed over all chromosomes (Fig. 7). For both confirmed and putative autoAgs, coding gene prevalence is significantly higher on chromosomes 11, 12, 17, and 19, lower on chromosome 18, and almost absent on chromosome Y (Fig. 7). Various cluster loci are noticeable, e.g., on chromosomes 1, 11, 12, 17, and 19.
Fig. 7.

Distribution of autoAg coding genes by chromosomes. Left: 751 confirmed and putative autoAgs. Right: 400 confirmed autoAgs only.

Intriguingly, autoAg coding genes contain significantly larger numbers of exons than expected, with the majority containing at least 4 exons (Fig. 8). The number of transcript isoforms per coding gene is also significantly skewed towards higher numbers, and those with ≥6 isoforms are particularly dominant. Furthermore, the lengths of coding sequence, transcript, and 3’ and 5’-UTR of autoAg coding genes are skewed towards shorter sizes relative to the distribution of all coding genes (Fig. 8). We also examined the coding genes of the 400 confirmed autoAgs, and they show similar dominance in higher number ofexons and -isoforms, shorter transcripts, and shorter 3’-UTR lengths (Fig. 8).
Fig. 8.

Characteristics of the autoAg coding genes compared with the rest in the genome. Differences are evaluated with Chi-squred and Student’s t-tests. (A) 751 confirmed and putative autoAgs. (B) 400 confirmed autoAgs.

The predominance of multiple exons and transcript variants suggests a role for RNA processing and alternative splicing in the origination of autoAgs. For genes with multiple exons, alternative splicing can yield a range of unique protein isoforms by varying the exon composition. Curiously, numerous components of the splicing machinery are well-known nuclear autoAgs. In fact, this study identified 120 potential autoAgs associated with RNA processing and 70 potential autoAgs associated with RNA splicing (Table 1 and Figs. 2–3). The majority of these have been found to be affected by SARS-CoV-2 infection (Figs. 5–6). During splicing, a group of snRNPs (small nuclear ribonucleoproteins) bind to the intron of a newly formed pre-mRNA and splice it to result in a mature mRNA. Ten snRNP autoAgs are identified by DS-affinity, 8 of which have been found to be affected by SARS-CoV-2 infection (Table 1). During splicing, snRNAs undergo conformational rearrangements that are catalyzed by the DEAH/DEAD box superfamily of RNA helicases. 11 such helicases are identified by DS-affinity, and 10 have been found to be affected by the viral infection (Table 1). Serine/arginine-rich splicing factors, such as SRSF1 (also known as alternative splicing factor 1), are sequence-specific splicing factors involved in pre-mRNA splicing. 9 SRSF proteins are identified by DS-affinity, with 7 found to be affected by the viral infection. Seven additional splicing factors are identified by DS-affinity (e.g., poly(U)-binding splicing factor PUF60), with all found to be affected by SARS-CoV-2 infection. Heterogeneous nuclear ribonucleoproteins (hnRNPs) play various roles in gene transcription and post-transcriptional modification of pre-mRNA, e.g., binding pre-mRNAs to render splice sites more or less accessible to the spliceosome and suppressing RNA splicing at a particular exon. 19 hnRNP proteins are identified by DS-affinity, with 17 found affected by SARS-CoV-2 infection. The large number of autoAgs of the RNA splicing machinery and their involvement in SARS-CoV-2 infection provide support to the notion that viral infections exploit alternative splicing. It is logical to speculate that viruses hijack the splicing machinery to force the host to synthesize virus-beneficial protein isoforms and thereby reprogram the host cellular protein network so that the virus can survive and replicate. It is also plausible that protein isoforms from virus-induced alternative splicing are recognizable by our immune system as unusual and non-self and hence may trigger an (auto)immune response. Various studies have reported alternative splicing among autoAgs. For example, an informatics analysis of 45 autoAgs showed that alternative splicing occurred in 100% of the transcripts, which was significantly higher than the ~42% rate observed in a randomly selected set of 9,554 gene transcripts. Furthermore, 80% of the transcripts underwent non-canonical alternative splicing, which was significantly higher than the <1% rate in randomly selected human gene transcripts [38]. As another example, Ro52/SSA is one of the autoAg targets strongly associated with the autoimmune responses in mothers whose children have manifestations of neonatal lupus. The gene for full-length Ro52 spans 10 kb of DNA and contains 7 exons, and an alternatively spliced transcript encoding a novel autoAg expressed in the fetal and adult heart has been identified [39]. In a patient with primary Sjörgren syndrome, an alternative mRNA variant of the nuclear autoAg La/SSB was found to result from a promoter switch and alternative splicing [40].

Common autoAgs associated with cell stress and apoptosis

We have consistently found that DS binds apoptotic cells regardless of cell type [6, 8]. To figure out which molecules are involved in this affinity, we searched for DS-affinity proteins shared in all 6 human cell lines of this study and found 39 autoAg candidates (Fig. 9). These include 9 ER chaperone complex proteins, 5 14-3-3 proteins, 3 hnRNPs, and 3 tropomyosin proteins. All are known autoAgs except for ANP32A and YWHAB (14-3-3 alpha/beta). Given that ANP32A’s paralog ANP32B and 5 other 14-3-3 isoforms are known autoAgs, it is likely they are also true autoAgs. Remarkably, several classical ANA (antinuclear antibody) autoAgs that define systemic autoimmune diseases are among the autoAgs found in the DS-affinity proteomes of all 6 human cell lines, including histone H1 and H4, SSB (lupus La), XRCC5/Ku80, XRCC6/Ku70, and PCNA. Because these autoAgs are commonly found in apoptotic cells, it is not surprising that autoimmune responses targeting these autoAgs tend to be systemic; in other words, they all are potential markers of systemic autoimmune diseases.
Fig. 9.

Common autoAgs identified from all six cell types examined in this study. Colored are proteins associated with viral infection (13 proteins, red), regulation of apoptotic process (17 proteins, amber), response to stress (22 proteins, blue), and apoptosis (8 proteins, brown).

Based on GO Biological Process and Reactome Pathway analysis, 22 of the common autoAgs are associated with cellular responses to stress, 17 are associated with regulation of apoptotic processes, and 8 are markers of apoptosis (Fig. 9). Moreover, these common autoAgs are involved in chromosome organization (ANP32A, ANP32B, H1–2, H4, KPNB1, NPM1, PCNA, SET, XRCC5, XRCC6), cytoskeleton organization (ACTN1, CALR, TPM1, TPM3, TPM4, TUBA1C, VIM), and mitochondrial membrane organization (YWHAB, YWHAE, YWHAG, YWHAQ, YWHAZ). These findings reveal that apoptosis is accompanied by reorganization of the nucleus, mitochondria, and cytoskeleton. Furthermore, 37 of the 39 common autoAgs were altered in SARS-CoV-2 infection. Based on GO Biological Process analysis, 13 of these proteins are involved in viral processing, namely, KPNB1, C1QBP, HSP90AB1, NPM1, SYNCRIP, SET, SSB, XRCC5, XRCC6, VCP, VIM, YWHAB, and YWHAE. These findings further support our model of linking viral infection to autoimmunity, with viral infections leading to host cell stress, cell death, autoimmune reactions, and eventually autoimmune diseases (Fig. 1).

UBA1, X-inactivation escape, and female predilection of autoimmunity

Among the above common autoAgs, UBA1 (or UBE1, ubiquitin-like modifier-activating enzyme 1) plays an essential role in dead cell clearance. UBA1 catalyzes the first step in ubiquitination – the “kiss of death” – that marks cellular proteins for degradation. It has long been speculated that dysregulation of apoptotic pathways and dysfunctional clearance of dead cells are among the main causes of autoimmunity, which is in line with our findings [6, 8]. Apoptosis also directly contributes to the maintenance of lymphocyte homeostasis and the deletion of autoreactive cells. Therefore, dysfunction of UBA1 could result in deficient clearance of apoptotic cells and aberrant autoimmunity. Recently, UBA1 somatic mutations have been linked to a severe adult-onset autoinflammatory disease termed VEXAS syndrome [41]. A somatic mutation affecting methionine-41 in UBA1 results in a loss of the canonical cytoplasmic isoform of UBA1 and in the expression of a novel catalytically impaired isoform. Additionally, mutant peripheral blood cells show decreased ubiquitination and activated innate immune pathways. Strikingly, UBA1 protein expression is found up-regulated at different time points of SARS-CoV-2 infection, whereas two deubiquitinating enzymes, USP9X and USP5, are down-regulated [33] (Supplemental Table 1). Furthermore, among the 657 proteins of the COVID autoantigen-ome, 178 have been found to be affected by ubiquitination (Fig. 10). They are most significantly associated with RNA metabolism and cellular response to stress. In addition, ubiquitination affects proteins involved in signaling by Rho GTPase, RNA splicing, translation, protein folding, nonsense-mediated decay, DNA damage stress-induced senescence, and the cytoskeleton. These findings underline the extensive involvement of ubiquitination in viral infection.
Fig. 10.

Top: Potential autoAgs affected by ubiquitination in SARS-Cov-2 infection (lines represent protein-protein interactions with the highest confidence). Colored are proteins associated with translation (32 proteins, red), RNA splicing (25 proteins, pink), regulation of cell death (40 proteins, dark purple), chromosome organization (26 proteins, yellow), response to stress (50 proteins, green), cytoskeleton (45 proteins, aqua), and apoptosis (11 proteins, blue). Bottom: Top 20 enriched processes and pathways associated with the ubiquitinated autoAgs.

UBA1 is coded by the UBA1 gene located on the X chromosome with no homolog on the Y chromosome, and more importantly, UBA1 can escape X-chromosome inactivation. UBA1 appears to be protected against chromosome-wide transcriptional silencing by a chromatin boundary flanked by histone H3 modifications and CpG hypomethylation [42]. In human female fibroblasts, UBA1 mRNA is detected from both the active and inactive X chromosomes, and UBA1 is expressed in a large panel of somatic cell hybrids retaining inactive X chromosomes [43]. In human endothelial cells from dizygotic twins, UBA1 and a few other X-chromosome encoded proteins are expressed at higher levels in female cells [44]. UBA1 expression is estimated to be ~ 60% from X-active alleles, 30% biallelic, and 10% from X-inactive alleles [45]. X-linked genes, particularly escape genes, contribute to sex differences. In women, about 15% of X-linked genes are bi-allelically expressed, and expression from the inactive X allele varies from a few percent to near equal to that of the active allele [46]. X-inactivation and escape may enhance phenotypic differences between females and males and may also enhance variability within females due to mosaicism from cells with the X-maternal or X-paternal inactivated and to a variable degree of escape from X-inactivation [46]. Aging, which is associated with telomere shortening, can relax X-inactivation and force global transcriptome alterations [47], which may lead to gene escape and altered expression of UBA1. Therefore, dysfunction of UBA1 due to X-inactivation escape may predispose women, particularly aging women, to increasing dysfunctional regulation of apoptosis and aberrant autoimmunity.

Considerations for vaccine design based on Spike-protein via viral vectors or mRNAs

To understand the various rare but reported side effects from the currently available viral vector- and mRNA-encoded S-protein COVID vaccines, we searched for autoAgs that may interact with the spike protein of SARS-CoV-2 and found 15 autoAg candidates (Table 2). Of these, CALU, ESYT1, MOV10, and MARCKS may also interact with many other SARS-CoV-2 proteins as discussed earlier. Curiously, at least 2 of these are associated with blood clotting problems, and 5 are implicated in neurological disorders (Table 2). For example, CALU (calumenin) is a calcium-binding protein and is expressed in high levels in the heart, placenta, and skeletal muscle. CALU is associated with pharmacodynamics and response to elevated platelet cytosolic Ca2+, platelet degranulation, and Coumarin/Warfarin resistance. Warfarin is an anticoagulant (blood thinner) drug used to treat blood clots such as deep vein thrombosis and pulmonary embolism and to prevent stroke in people with heart problems such as atrial fibrillation, valvular heart disease or in people with artificial heart valves.
Table 2.

Diseases associated with potential SARS-CoV-2 spike protein-interacting autoAgs*

CALU Warfarin (anti-coagulants for blot clotting) resistance disease
ESYT1 Stormorken syndrome (mild bleeding tendency due to platelet dysfunction, thrombocytopenia, anemia, asplenia, etc.)
MOV10 Viral infection, autism spectrum disorder
MARCKS Spinocerebellar ataxia 14, barbiturate dependence
HSPBP1 Autosomal recessive spinocerebellar ataxia 16, Sjögren-Larsson syndrome
PRS27A Machado-Joseph disease (spinocerebellar ataxia type III), spherocytosis type 5
EZR Autosomal recessive non-syndromic intellectual disability, neurofibromatosis type II
HSPA5Mucormycosis (fungal infection), Wolfram syndrome 1 (diabetes mellitus)
ARHGAP1Noma, Lowe oculocerebrorenal syndrome (affects eyes, central nervous system and kidneys)
MSNX-linked moesin-associated immunodeficiency, verrucous carcinoma
CSPG4Acral lentiginous melanoma, melanoma
SLC1A5Hartnup disorder, placental choriocarcinoma
PRKCSHPolycystic liver disease
CAVIN1Lipodystrophy, congenital generalized lipodystrophy
BASP1Distal X-linked spinal muscular atrophy, Wilms tumor 1

Disease associations were obtained from the GeneCards database.

Although largely speculative at present, these potential S-protein-interacting autoAgs may provide partial explanations for the rare hematological, neurological, and muscular side effects reported for the currently available COVID vaccines (Table 2). Although it is known that S proteins are synthesized intracellularly following vaccination with mRNAs or viral vectors, many of the precise molecular steps remain unknown. In particular, how do these newly synthesized S proteins fold and are they glycosylated differently depending on the cell type that rakes up the mRNA or the viral vector? How does the newly synthesized S protein interact with other host cell components before being processed (or degraded) and presented to immune cells? For example, could the nascent S proteins interact with CALU or ESYT1 to cause blood clotting problems, could S protein interaction with HSPA5 contributes to fungal infection outbreaks as seen in India? These and many other questions await further investigation. This is of interest because mRNA and vector-based vaccines make use of a variety of cell types in vivo to produce the immunogen, whereas recombinant protein-based vaccines introduce the ex vivo prepared immunogen directly to the immune system. In addition, this study identified a large number of autoAg candidates that are crucial for vector-based or mRNA vaccine action, including translation, RNA processing and metabolism, vesicles and vesicle-mediated transport, and protein processing and transport (Figs. 2–6). For example, the master autoantigen-ome contains 56 ribosomal proteins, 16 eukaryotic translation initiation factors, 16 aminoacyl-tRNA synthases/ligases, and 6 translation elongation factors, all of which are essential actors in translating mRNAs into proteins. There are also many autoAgs related to protein folding and post-translational protein modification, although it is not clear whether the S proteins are folded and post-translationally modified before being processed and presented to immune cells in the currently used mRNA or vector vaccines for COVID-19. These potential autoAgs may confer clues to understanding the observed rare adverse events and should help guide the future development of even safer vaccines.

Conclusion

In this report, we compiled a master autoantigen-ome of 751 potential autoAgs, 657 of which are affected in SARS-CoV-2 infection, and 400 of which are confirmed autoAgs in a wide variety of autoimmune diseases and cancer. Our proposed model (Fig. 1) provides a plausible explanation for how a cascade of molecular changes associated with viral infection leads to cell stress, apoptosis, and subsequent autoimmune responses. The large number of autoAg candidates associated with SARS-CoV-2 infection provides a mechanistic rationale for the close monitoring of autoimmune diseases that may follow the COVID-19 pandemic. In addition, the coding gene characteristics of autoAgs described in this study provide further insights into the genetic origination of autoAgs. The significance of ubiquitination in apoptotic cell clearance and protein turnover and the X-linked escape expression of UBA1 might explain, in part, the predisposition of aging women to autoimmune diseases.

Materials and Methods

DS-affinity autoAg identification

Potential autoAgs were identified by DS-affinity from protein extracts from six human cell lines as previously described, including HFL1 fetal lung fibroblasts [1], A549 lung epithelial cells [2], HS-Sultan B-lymphoblasts [4], Wil2-NS B-lymphoblasts [7], Jurkat T-lymphoblasts [5], and HEp-2 fibroblasts [11].

Autoantigen literature text mining

Each DS-affinity protein was verified as to whether it is a target of autoantibodies by an extensive literature search on PubMed. Search keywords included the MeSH keyword “autoantibodies”, the protein name or its gene symbol, or alternative names and symbols. Only proteins for which specific autoantibodies are reported in PubMed-listed journal articles were considered “confirmed” or “known” autoAgs in this study.

COVID data comparison

DS-affinity proteins were compared with currently available COVID-19 multi-omic data compiled in the Coronascape database (as of 05/27/2021) [16-37]. These data have been obtained with proteomics, phosphoproteomics, interactome and ubiquitome studies, and RNA-seq techniques. Up- and/or down-regulated proteins or genes were identified by comparing cells infected vs. uninfected by SARS-CoV-2 or COVID-19 patients vs. healthy controls. Similarity searches were conducted to identify DS-affinity proteins that are similar to those found up- and/or down-regulated in the viral infection at any omic level.

Protein network analysis

Protein-protein interactions were analyzed with STRING [14]. Interactions include both direct physical interaction and indirect functional associations, which are derived from genomic context predictions, high-throughput lab experiments, co-expression, automated text mining, and previous knowledge in databases. Each interaction is annotated with a confidence score between 0 (lowest) and 1 (highest), indicating the likelihood of an interaction to be true. Enrichment of pathways and processes were analyzed with Metascape [16], which utilize various ontological sources such as KEGG Pathway, GO Biological Process, Reactome Gene Sets, and Canonical Pathways. All genes in the genome were used as the enrichment background. Terms with a p value <0.01, a minimum count of 3, and an enrichment factor (ratio between the observed counts and the counts expected by chance) >1.5 were grouped into clusters based on their membership similarities. The most statistically significant term within a cluster was chosen to represent the cluster.

Gene characteristic analysis

Gene characteristics were analyzed with ShinyGO [15]. ShinyGO is based on a large annotation database derived from Ensembl and STRING-db. The characteristics of the genes for the groups of autoAgs in this study were compared with the rest in the genome. Chi-squared and Student’s t-tests were run to see if the autoAg genes had special characteristics when compared with all other genes in the human genome.
  343 in total

1.  Immunological characterization of heterochromatin protein p25beta autoantibodies and relationship with centromere autoantibodies and pulmonary fibrosis in systemic scleroderma.

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Journal:  J Mol Med (Berl)       Date:  1998-01       Impact factor: 4.599

2.  Tryptophanyl-tRNA synthetase as a human autoantigen.

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Journal:  Immunol Lett       Date:  1995-12       Impact factor: 3.685

3.  Specific interaction between human kinetochore protein CENP-C and a nucleolar transcriptional regulator.

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Journal:  J Biol Chem       Date:  1996-08-02       Impact factor: 5.157

4.  Autoantibody response to microsomal epoxide hydrolase in hepatitis C and A.

Authors:  Toshitaka Akatsuka; Nobuharu Kobayashi; Takashi Ishikawa; Takafumi Saito; Michiko Shindo; Masayoshi Yamauchi; Kazutaka Kurokohchi; Hitoshi Miyazawa; Hongying Duan; Toshiyuki Matsunaga; Tsugikazu Komoda; Christophe Morisseau; Bruce D Hammock
Journal:  J Autoimmun       Date:  2007-02-12       Impact factor: 7.094

5.  Protein disulfide isomerase A3-specific Th1 effector cells infiltrate colon cancer tissue of patients with circulating anti-protein disulfide isomerase A3 autoantibodies.

Authors:  Cristiana Caorsi; Elena Niccolai; Michela Capello; Rosario Vallone; Michelle S Chattaragada; Brunilda Alushi; Anna Castiglione; Gianni Ciccone; Alessandro Mautino; Paola Cassoni; Lucia De Monte; Sheila M Álvarez-Fernández; Amedeo Amedei; Massimo Alessio; Francesco Novelli
Journal:  Transl Res       Date:  2015-12-23       Impact factor: 7.012

6.  Cell nonhomologous end joining capacity controls SAF-A phosphorylation by DNA-PK in response to DNA double-strand breaks inducers.

Authors:  Sébastien Britton; Carine Froment; Philippe Frit; Bernard Monsarrat; Bernard Salles; Patrick Calsou
Journal:  Cell Cycle       Date:  2009-11-09       Impact factor: 4.534

7.  Antibody that recognizes conformations of calmodulin in the serum from patient with chronic active hepatitis.

Authors:  Y Ikeda; G Toda; N Hashimoto; T Maruyama; H Oka
Journal:  Biochem Biophys Res Commun       Date:  1987-04-14       Impact factor: 3.575

8.  Autoimmunity to Vimentin Is Associated with Outcomes of Patients with Idiopathic Pulmonary Fibrosis.

Authors:  Fu Jun Li; Ranu Surolia; Huashi Li; Zheng Wang; Tejaswini Kulkarni; Gang Liu; Joao A de Andrade; Daniel J Kass; Victor J Thannickal; Steven R Duncan; Veena B Antony
Journal:  J Immunol       Date:  2017-07-28       Impact factor: 5.426

9.  Identification of a novel autoantigen eukaryotic initiation factor 3 associated with polymyositis.

Authors:  Zoe Betteridge; Hector Chinoy; Jiri Vencovsky; John Winer; Kiran Putchakayala; Pauline Ho; Ingrid Lundberg; Katalin Danko; Robert Cooper; Neil McHugh
Journal:  Rheumatology (Oxford)       Date:  2020-05-01       Impact factor: 7.580

10.  Serological Proteome Analysis (SERPA) as a tool for the identification of new candidate autoantigens in type 1 diabetes.

Authors:  Ornella Massa; Massimo Alessio; Lucia Russo; Giovanni Nardo; Valentina Bonetto; Federico Bertuzzi; Alessandra Paladini; Dario Iafusco; Patrizia Patera; Giorgio Federici; Tarcisio Not; Claudio Tiberti; Riccardo Bonfanti; Fabrizio Barbetti
Journal:  J Proteomics       Date:  2013-03-14       Impact factor: 4.044

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