RT Journal Article T1 Cellular stress modulates severity of the inflammatory response in lungs via cell surface BiP. A1 Rico-Llanos, Gustavo A1 Porras-Perales, Oscar A1 Escalante, Sandra A1 Vazquez-Calero, Daniel B A1 Valiente, Lucia A1 Castillo, Maria I A1 Perez-Tejeiro, Jose Miguel A1 Baglietto-Vargas, David A1 Becerra, Jose A1 Reguera, Jose Maria A1 Duran, Ivan A1 Csukasi, Fabiana K1 4-PBA K1 COVID-19 K1 TNFa K1 Acute respiratory distress syndrome K1 Binding-immunoglobulinprotein (BiP/GRP78/HSPA5) K1 Cell surface GRP78 (csGRP78) K1 Cellular stress K1 Cytokine storm AB Inflammation is a central pathogenic feature of the acute respiratory distress syndrome (ARDS) in COVID-19. Previous pathologies such as diabetes, autoimmune or cardiovascular diseases become risk factors for the severe hyperinflammatory syndrome. A common feature among these risk factors is the subclinical presence of cellular stress, a finding that has gained attention after the discovery that BiP (GRP78), a master regulator of stress, participates in the SARS-CoV-2 recognition. Here, we show that BiP serum levels are higher in COVID-19 patients who present certain risk factors. Moreover, early during the infection, BiP levels predict severe pneumonia, supporting the use of BiP as a prognosis biomarker. Using a mouse model of pulmonary inflammation, we observed increased levels of cell surface BiP (cs-BiP) in leukocytes during inflammation. This corresponds with a higher number of neutrophiles, which show naturally high levels of cs-BiP, whereas alveolar macrophages show a higher than usual exposure of BiP in their cell surface. The modulation of cellular stress with the use of a clinically approved drug, 4-PBA, resulted in the amelioration of the lung hyperinflammatory response, supporting the anti-stress therapy as a valid therapeutic strategy for patients developing ARDS. Finally, we identified stress-modulated proteins that shed light into the mechanism underlying the cellular stress-inflammation network in lungs. PB Frontiers Researcch Foundation YR 2022 FD 2022-11-18 LK http://hdl.handle.net/10668/20598 UL http://hdl.handle.net/10668/20598 LA en NO Rico-Llanos G, Porras-Perales Ó, Escalante S, Vázquez-Calero DB, Valiente L, Castillo MI, et al. Cellular stress modulates severity of the inflammatory response in lungs via cell surface BiP. Front Immunol. 2022 Nov 18;13:1054962 NO This study was supported by Junta de Andalucía (Consejería de Salud y Familia) through CV20-81404 and PIGE-0178-2020. Universidad de Málaga and IBIMA-Plataforma Bionand funds (Plan propio UMA and IBIMA-TECH); Ministerio de Ciencia, Innovación y Tecnología (PID2020-117255-RB100). FC is supported by PCI2021-122094-2B and JMPT by FPU19/06951. DS RISalud RD Apr 19, 2025