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Volume: 44 Issue: 1

  • Open Access
  • Original Article

A cross sectional study to assess the elevation in glucose regulated protein 78 levels in severe acute respiratory syndrome Coronavirus 2 infected patients and its correlation with metabolic conditions, severity, complications


Deepthi D’Souza1, Roopa Bhandary2, Reshma Kiran3, Pavithra K.2, Sushith3 

1A J Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, 575 004, Karnataka, India 

2Department of Microbiology, 3Department of Biochemistry, A J Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore 575 004, Karnataka, India 


 Corresponding author: Pavithra K. Email: [email protected] 

Year: 2024, Page: 136-139, Doi: https://doi.org/10.51248/.v44i1.4122

Received: Dec. 11, 2023 Accepted: Feb. 16, 2024 Published: May 1, 2024


Introduction and Aim: COVID-19 pandemic has posed an exceptional challenge worldwide. Research encompassing newer diagnostic tests, targeted therapy has become the need of the hour. The objective of this work is to evaluate the levels of Glucose regulated protein 78 (GRP78) an Endoplasmic Reticulum stress (ERS) protein in severe acute respiratory syndrome coronavirus -2 (SARS -CoV-2) infected patients. 

Materials and Methods: We carried out a cross-sectional investigation at the hospital, with three distinct groups: SARS-CoV-2-positive patients with metabolic syndrome (Group A), SARS-CoV-2-positive patients without metabolic abnormalities (Group B), and healthy volunteers (Group C). Enzyme linked immunosorbent assay (ELISA) method was used to estimate the serum levels of GRP78. 

Results: Our results showed that serum GRP78 levels were elevated in patients with SARS-CoV-2 infections. Furthermore, it could be demonstrated that Group A had considerably higher serum GRP78 levels than Groups B and C suggesting an elevated GRP78 levels in COVID-19 patients with metabolic syndrome These findings highlight the clinical importance of GRP78 in COVID-19 and its utility as a marker for severity of the illness. 

Conclusion: This work compares the trend of serum GRP78 levels in SARS-CoV-2 patients with and without metabolic conditions as compared to the control group. This finding encourages more research on GRP78 to aid the development of targeted therapeutic and prophylactic interventions to combat COVID-19 infection 

Keywords: Glucose regulated protein 78; SARS-CoV-2; metabolic syndrome



1. Jawetz, Melnick & Adelberg’s Medical Microbiology, NewYork: McGraw Hill Medical, 2010.Print. 

2. Shang, J., Ye, G., Shi, K., Wan, Y., Luo, C., Aihara, H., et al., Structural basis of receptor recognition by SARS-CoV-2. Nature. 2020; 581:7807. 

3. Ibrahim, I. M., Abdelmalek, D. H., Elshahat, M. E., Elfiky, A. A. COVID-19 spike-host cell receptor GRP78 binding site prediction. Journal of Infection. 2020; 80(5): 554-562. 

4. Elfiky, A. A. SARS-CoV-2 Spike-heat shock protein A5 (GRP78) recognition may be related to the immersed human coronaviruses. Frontiers in Pharmacology. 2020; 11: 577467. 

5. Ibrahim, I. M., Abdelmalek, D. H., Elfiky, A. A. GRP78: A cell’s response to stress. Life Sciences. 2019; 226: 156-163. 

6. Triantafilou, K., Fradelizi, D., Wilson, K., Triantafilou, M. GRP78, a coreceptor for Coxsackievirus A9, interacts with major histocompatibility complex class I molecules which mediate virus internalization. Journal of Virology.2002;76: 633-643. 

7. Reyes-del Valle, J., Chávez-Salinas, S., Medina, F., del Angel, R. M. Heat shock protein 90 and heat shock protein 70 are components of dengue virus receptor complex in human cells. Journal of Virology, 2005;79:4557-4567. 

8. Chan, C.P., Siu, K.L., Chin, K.T., Yuen, K.Y., Zheng, B., Jin, D.Y. Modulation of the unfolded protein response by the severe acute respiratory syndrome coronavirus spike protein. Journal of Virology.2006; 80(18):9279-9287. 

9. Vig, S., Buitinga, M., Rondas, D., Crèvecoeur, I., van Zandvoort, M., Waelkens, E., et al., Cytokine-induced translocation of GRP78 to the plasma membrane triggers a pro-apoptotic feedback loop in pancreatic beta cells. Cell Death and Disease.2019; 10(4): 309. 

10. Liu, M., Spellberg, B., Phan, Q. T., Fu, Y., Fu, Y., Lee, A. S., et al., The endothelial cell receptor GRP78 is required for mucormycosis pathogenesis in diabetic mice. Journal of Clinical Investigation.2010;120(6):1914-1924. 

11. Back, S. H., Kaufman, R. J. Endoplasmic reticulum stress and type 2 diabetes. Annual Review of Biochemistry. 2012; 81:767-793. 

12. Chu, H., Chan, C.M., Zhang, X., Wang, Y., Yuan, S., Zhou, J., et al., Middle East respiratory syndrome coronavirus and bat coronavirus HKU9 both can utilize GRP78 for attachment onto host cells. Journal of Biological Chemistry. 2018; 293(30):11709-11726. 

13. Sabirli, R., Koseler, A., Goren, T., Turkcuer, I., Kurt, O. High GRP78 levels in Covid-19 infection: A case-control study. Life Sciences. 2021. https://doi.org/10.1016/j.lfs.2020. 118781 14. Ulm, J. W., Nelson, S. F. COVID‐19 drug repurposing: Summary: statistics on current clinical trials and promising untested candidates. Transboundary and Emerging Diseases. 2021; 68(2): 313-317. 

15. Sabirli, R., Koseler, A., Mansur, N., Zeytunluoglu, A., Sabirli, G. T., Turkcuer, I., et al., Predictive Value of endoplasmic reticulum stress markers in low ejection fractional heart failure. In Vivo.2019; 33(5):1581-1592. 

16. Ardic, S., Yilmaz, S., Demir, S., Dogramaci, S., Altuntas, G., Imamoglu, M., et al., Endoplasmic reticulum stress markers are of no value in predicting cardiopulmonary resuscitation success and survival in out of hospital cardiac arrest: A nested case-control study. Turkish Journal of Emergency Medicine. 2019;19(2): 58-63. 

17. Cirrik, S., ÇetinkoL, Y., Altunçekiç Yildirim, A., Çalgin, M. K., Noyan, T. Circulating glucose-regulated protein 78 levels in patients with chronic hepatitis B infection. Viral Hepatitis Journal. 2018; 24(3): 85-89. 

18. Ibrahim, I. M., Abdelmalek, D. H., Elshahat, M.E., Elfiky, A.A. COVID-19 spike-host cell receptor GRP78 binding site prediction. Journal of Infection. 2020;80:54-62. 

19. Köseler, A., Sabirli, R., Gören, T., Türkçüer, B., Kurt, Z. Endoplasmic reticulum stress markers in SARS-COV-2 infection and pneumonia: Case-control study. In Vivo.2020; 34(3 suppl):1645–1650. 

20. Palmeira, A., Sousa, E., Köseler, A., Sabirli, R., Gören, T., Türkçüer, İ., et al., Preliminary virtual screening studies to identify GRP78 inhibitors which may interfere with SARS-CoV-2 infection. Pharmaceuticals.2020;13(6):32. 

21. Elfiky, A. A., Baghdady, A. M., Ali, S. A., Ahmed, M. I. GRP78 targeting: Hitting two birds with a stone. Life Sciences.2020. https://doi.org/10.1016/j.lfs.2020.118317. 

22. Elfiky, A. A., Ibrahim, I. M., Ismail, A. M., Elshemey, W. M. A possible role for GRP78 in cross vaccination against COVID-19. Journal of Infection. 2020; https://doi. org/10.1016/ j.jinf.2020.09.004. 

Cite this article

Deepthi D’Souza, Roopa Bhandary, Reshma Kiran, Pavithra K. Sushith. A cross sectional study to assess the elevation in glucose regulated protein 78 levels in severe acute respiratory syndrome Coronavirus 2 infected patients and its correlation with metabolic conditions, severity, complications.  Biomedicine: 2024; 44(1): 136-139