The evolutionary landscape of host immunity genes involved in respiratory and other immune-related diseases, and the identification of TLR2 variation associated with severe COVID-19.

Publication date: May 29, 2026

Given its high mortality and broad societal impact, the COVID-19 pandemic is arguably one of the most consequential public health crises of the twenty-first century. Although previous studies have identified several genes associated with COVID-19 susceptibility, relatively little is known about the genes contributing to severe COVID-19, including their evolutionary histories. In the current study, we analyzed IL-4, TLR2, CCL2, and SLC11A1-immunity genes that have previously been implicated in severe COVID-19 and other immune-related diseases-in globally diverse populations from the 1000 Genomes Project. We also tested for associations between genetic variation at these genes and clinical COVID-19 phenotypes in nearly 4000 laboratory-confirmed COVID-19-positive individuals across two datasets from the GEN-COVID Multicenter Study in Italy. Based on our analyses, we identified striking signatures of positive selection within and around all four genes, including extensive haplotype structure, elevated population differentiation, and significant selection coefficients consistent with both ancient and more recent adaptive events. Notably, many of these signals were population-specific, highlighting the role of local selection in shaping immune gene diversity. Several selected alleles were also present in Neanderthal and/or Denisovan genomes, reflecting both shared ancestral polymorphism and archaic introgression within these genes. Functional predictions based on in silico analyses further revealed that a subset of selected alleles maps to transcription factor binding sites and is predicted to influence binding affinity. In addition, our genotype-phenotype analyses uncovered coding variants in TLR2 that were correlated with COVID-19 severity and a related comorbidity, with estimated effect sizes ranging from moderate to large. Interestingly, these significantly associated alleles occur at rare or low frequency in western European and East Asian populations but are absent in populations of African and South Asian descent, indicative of a relatively recent origin. Overall, our study provides new insights into the evolution of biologically relevant immunity genes in modern human populations and identifies genetic variation that may contribute to differences in risk for severe COVID-19.

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Concepts Keywords
Genomes Antagonistic pleiotropy
Italy Archaic introgression
Neanderthal Genetic association
Pandemic Population-specific selection
Slc11a1 Selection coefficient
Severe COVID-19

Semantics

Type Source Name
disease MESH COVID-19
drug DRUGBANK Binetrakin
pathway REACTOME Reproduction
disease MESH included
disease MESH severe acute respiratory syndrome
disease MESH infection
disease MESH inflammation
disease MESH cytokine storm
disease MESH genetic susceptibility
disease MESH psoriasis
disease MESH osteoarthritis
disease MESH pulmonary tuberculosis
disease MESH syndrome
disease MESH influenza
disease MESH pneumonia
disease MESH PBS
disease MESH cancer
disease MESH heart failure
disease MESH asthma
pathway KEGG Asthma
disease MESH hypertension
disease MESH infarction
disease MESH stroke
drug DRUGBANK Oxygen
disease MESH death
drug DRUGBANK Angiotensin II
drug DRUGBANK L-Arginine
drug DRUGBANK Cefadroxil
disease MESH CHS
disease MESH Hepatitis
disease MESH IBS
drug DRUGBANK Natural alpha interferon
drug DRUGBANK Morpholinylmercaptobenzothiazole
disease MESH Mbs
drug DRUGBANK Pidolic Acid
disease MESH PCA
disease MESH Tuberculosis
pathway KEGG Tuberculosis
drug DRUGBANK Serine
drug DRUGBANK Nonoxynol-9
drug DRUGBANK Zinc
drug DRUGBANK Cinacalcet
disease MESH AIDS
drug DRUGBANK MCC
drug DRUGBANK Trifluoro-thiamin phosphate
pathway REACTOME Release
disease MESH PPR
disease MESH Polygenic Risk Score
disease MESH Dis
disease MESH MGS
disease MESH Coronavirus infection
disease MESH Park
disease MESH TSC
disease MESH Respiratory Failure
disease MESH critical illness
disease MESH thromboinflammation
disease MESH SMS
disease MESH AHC
pathway REACTOME Eicosanoids
disease MESH Allergy
drug DRUGBANK Carboxyamidotriazole
disease MESH lung injury
drug DRUGBANK Adenosine 5′-phosphosulfate
drug DRUGBANK Dimethyl sulfone
disease MESH infectious diseases
disease MESH rheumatic diseases
disease MESH respiratory infections
drug DRUGBANK Risedronate
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH STAR
drug DRUGBANK L-Aspartic Acid
disease MESH uveitis
disease MESH Waardenburg syndrome
disease MESH Hirschsprung disease
disease MESH fibrosis
disease MESH Escherichia coli infection
drug DRUGBANK Megestrol acetate
drug DRUGBANK Nitric Oxide
disease MESH Shock
disease MESH viral infections
disease MESH myelodysplastic syndrome
disease MESH Leukemia
disease MESH nervous system disorders
disease MESH Roca
disease MESH respiratory diseases
drug DRUGBANK Hyaluronic acid

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