{"doi":"10.1172/jci.insight.156104","title":"Marked elevations in lung and plasma ceramide in COVID-19 linked to microvascular injury","abstract":"The pathogenesis of the marked pulmonary microvasculature injury, a distinguishing feature of COVID-19 acute respiratory distress syndrome (COVID-ARDS), remains unclear. Implicated in the pathophysiology of diverse diseases characterized by endothelial damage, including ARDS and ischemic cardiovascular disease, ceramide and in particular palmitoyl ceramide (C16:0-ceramide) may be involved in the microvascular injury in COVID-19. Using deidentified plasma and lung samples from COVID-19 patients, ceramide profiling by mass spectrometry was performed. Compared with healthy individuals, a specific 3-fold C16:0-ceramide elevation in COVID-19 patient plasma was identified. Compared with age-matched controls, autopsied lungs of individuals succumbing to COVID-ARDS displayed a massive 9-fold C16:0-ceramide elevation and exhibited a previously unrecognized microvascular ceramide-staining pattern and markedly enhanced apoptosis. In COVID-19 plasma and lungs, the C16-ceramide/C24-ceramide ratios were increased and reversed, respectively, consistent with increased risk of vascular injury. Indeed, exposure of primary human lung microvascular endothelial cell monolayers to C16:0-ceramide-rich plasma lipid extracts from COVID-19, but not healthy, individuals led to a significant decrease in endothelial barrier function. This effect was phenocopied by spiking healthy plasma lipid extracts with synthetic C16:0-ceramide and was inhibited by treatment with ceramide-neutralizing monoclonal antibody or single-chain variable fragment. These results indicate that C16:0-ceramide may be implicated in the vascular injury associated with COVID-19.","journal":"JCI Insight","year":2023,"id":334599,"datarank":0.4636563680037475,"base_score":3.091042453358316,"endowment":3.091042453358316,"self_citation_contribution":0.4636563680037475,"citation_network_contribution":0.0,"self_endowment_contribution":0.4636563680037475,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9487,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":87227,"name":"Elisabet Pujadas","orcid":"0000-0003-4795-7945","position":1,"is_corresponding":false},{"id":1063376,"name":"Aditya Ganju","orcid":"0000-0003-1258-0105","position":2,"is_corresponding":false},{"id":639178,"name":"Karina A. Serban","orcid":"0000-0002-9372-3034","position":3,"is_corresponding":false},{"id":1064058,"name":"Alexander Borowiec","orcid":null,"position":4,"is_corresponding":false},{"id":1064059,"name":"Beatrice Babbs","orcid":null,"position":5,"is_corresponding":false},{"id":403056,"name":"Irina Bronova","orcid":"0000-0003-0867-2496","position":6,"is_corresponding":false},{"id":753424,"name":"N.W. Egersdorf","orcid":"0009-0005-4471-3963","position":7,"is_corresponding":false},{"id":883287,"name":"Patrick S. Hume","orcid":"0000-0002-5861-7375","position":8,"is_corresponding":false},{"id":752161,"name":"Khushboo Goel","orcid":"0000-0002-2212-4317","position":9,"is_corresponding":false},{"id":44871,"name":"William J. Janssen","orcid":"0000-0002-6397-3454","position":10,"is_corresponding":false},{"id":251021,"name":"Evgeny Berdyshev","orcid":"0000-0002-1376-0098","position":11,"is_corresponding":false},{"id":13006,"name":"Carlos Cordon‐Cardo","orcid":"0000-0003-0858-5624","position":12,"is_corresponding":false},{"id":353754,"name":"Richard Kolesnick","orcid":"0000-0002-4914-2945","position":13,"is_corresponding":false},{"id":353842,"name":"Irina Petrache","orcid":"0000-0003-1094-2600","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:09:53.742667Z","pmid":"37212278","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}