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Ferritin and procalcitonin in COVID-19 associated acute kidney injury – gender disparities, but similar outcomes. REV ROMANA MED LAB 2023. [DOI: 10.2478/rrlm-2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Abstract
Background: Acute kidney injury is a severe complication of COVID-19. Both COVID-19 and related acute kidney injury are reported in the literature to be more prevalent and more severe in males.
Methods: We performed a retrospective analysis of the COVID-19 associated acute kidney injury cases in order to search for differences between genders regarding patients’ and renal outcome.
Results: 250 patients with acute kidney injury were included in the study: 93 women (37.20%), 157 men (62.80%). There were no differences between sexes regarding age. Diabetes mellitus was significantly more present in women. Peak ferritin and procalcitonin levels were significantly higher in men, but other severity markers for COVID-19 did not differ between genders. There were no differences between sexes regarding history of chronic kidney disease, timing of acute kidney injury, need for dialysis or recovery of renal function. ICU admission and in-hospital mortality were similar between men and women.
Conclusions: In our study, COVID-19 related-AKI was more prevalent in men than in women, but the patients’ and renal outcome were similar. Significantly higher ferritin and procalcitonin serum levels registered in male patients when compared to women may have additional explanations beside more severe SARS-CoV-2 infection in males.
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Martínez-García JJ, López-Acosta JR, Arce-Cabrera D, León-Sicairos N, Hernández-Parra AC, Cuen-Diaz HM, Zatarain-Lopez R, Canizalez-Roman A. Case report: Multisystem inflammatory syndrome in children associated with COVID-19, macrophage activation syndrome, and incomplete Kawasaki disease. Front Pediatr 2023; 11:1167828. [PMID: 37138560 PMCID: PMC10149839 DOI: 10.3389/fped.2023.1167828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C), is a severe complication of coronavirus disease 2019 (COVID-19), characterized by persistent fever, systemic inflammatory response, and organ failure. MIS-C with a history of COVID-19 may share clinical features with other well-defined syndromes such as macrophage activation syndrome, Kawasaki disease, hemophagocytic syndrome and toxic shock syndrome. Case 1 An 11-year-old male with a history of hypothyroidism and precocious puberty with positive antibody test for COVID-19 was admitted for fever, poor general condition, severe respiratory distress, refractory shock, and multiple organ failure. His laboratory examination showed elevated inflammatory parameters, and bone marrow aspirate showed hemophagocytosis. Case 2 A 13-year-old male with a history of attention deficit hyperactivity disorder and cognitive delay presented clinical manifestations of Kawasaki disease, fever, conjunctival congestion, exanthema, and hyperemia in oral mucosa, tongue, and genitals, with refractory shock and multiple organ failure. Reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies for COVID-19 were negative, inflammation parameters were elevated, and bone marrow aspirate showed hemophagocytosis. Patients required intensive care with invasive mechanical ventilation, vasopressor support, intravenous gamma globulin, systemic corticosteroids, low molecular weight heparin, antibiotics, and monoclonal antibodies and, patient 2 required renal replacement therapy. Conclusions Multisystemic inflammatory syndrome in children can have atypical manifestations, and identifying them early is very important for the timely treatment and prognosis of patients.
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Affiliation(s)
- Jesús Javier Martínez-García
- Pediatric Intensive Care Unit, Pediatric Hospital of Sinaloa, Culiacan, Mexico
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
| | | | | | - Nidia León-Sicairos
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
- Research Department, Pediatric Hospital of Sinaloa, Culiacan, Mexico
| | | | | | | | - Adrian Canizalez-Roman
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
- Research Department, The Women’s Hospital, Secretariat of Health, Culiacan, Mexico
- Correspondence: Adrian Canizalez Roman
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El-Medany A, Kandoole V, Lonsdale N, Doolub G, Felekos I. In-stent Thrombosis and COVID-19 Infection: Current Insights on the Mechanistic Relationship. Curr Cardiol Rev 2023; 19:e120522204669. [PMID: 35549872 PMCID: PMC10201881 DOI: 10.2174/1573403x18666220512142019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 02/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been demonstrated as a major risk factor in inducing coronary stent thrombosis due to its propensity to create a pro-thrombotic state. This review explores the mechanisms that may contribute to the increased thrombosis risk seen in COVID-19. Furthermore, we discuss the patient and haematological factors that predispose to an increased risk of stent thrombosis, as well as the role of certain antiplatelet and anticoagulation therapies, including ticagrelor and enoxaparin, that may reduce the likelihood and severity of in-stent thrombosis, in SARS-CoV-2 infection. To counter the proinflammatory and pro-thrombotic state shown in COVID-19, anti-thrombotic therapy in the future may be optimised using point-of-care platelet inhibition testing and inflammation-modifying therapies. Large-scale randomised trials with long-term follow-up are increasingly necessary to assess the intersection of COVID-19 and stent optimisation as well as the reduction of stent thrombosis after drug-eluting stent (DES) implantation.
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Affiliation(s)
- Ahmed El-Medany
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Vanessa Kandoole
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Nicholas Lonsdale
- Weston General Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Gemina Doolub
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Ioannis Felekos
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
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Zhao L, Liu H, Wang Y, Wang S, Xun D, Wang Y, Cheng Y, Zhang B. Multimodal Identification by Transcriptomics and Multiscale Bioassays of Active Components in Xuanfeibaidu Formula to Suppress Macrophage-Mediated Immune Response. ENGINEERING (BEIJING, CHINA) 2023; 20:63-76. [PMID: 34815890 PMCID: PMC8601788 DOI: 10.1016/j.eng.2021.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 05/22/2023]
Abstract
Xuanfeibaidu Formula (XFBD) is a Chinese medicine used in the clinical treatment of coronavirus disease 2019 (COVID-19) patients. Although XFBD has exhibited significant therapeutic efficacy in clinical practice, its underlying pharmacological mechanism remains unclear. Here, we combine a comprehensive research approach that includes network pharmacology, transcriptomics, and bioassays in multiple model systems to investigate the pharmacological mechanism of XFBD and its bioactive substances. High-resolution mass spectrometry was combined with molecular networking to profile the major active substances in XFBD. A total of 104 compounds were identified or tentatively characterized, including flavonoids, terpenes, carboxylic acids, and other types of constituents. Based on the chemical composition of XFBD, a network pharmacology-based analysis identified inflammation-related pathways as primary targets. Thus, we examined the anti-inflammation activity of XFBD in a lipopolysaccharide-induced acute inflammation mice model. XFBD significantly alleviated pulmonary inflammation and decreased the level of serum proinflammatory cytokines. Transcriptomic profiling suggested that genes related to macrophage function were differently expressed after XFBD treatment. Consequently, the effects of XFBD on macrophage activation and mobilization were investigated in a macrophage cell line and a zebrafish wounding model. XFBD exerts strong inhibitory effects on both macrophage activation and migration. Moreover, through multimodal screening, we further identified the major components and compounds from the different herbs of XFBD that mediate its anti-inflammation function. Active components from XFBD, including Polygoni cuspidati Rhizoma, Phragmitis Rhizoma, and Citri grandis Exocarpium rubrum, were then found to strongly downregulate macrophage activation, and polydatin, isoliquiritin, and acteoside were identified as active compounds. Components of Artemisiae annuae Herba and Ephedrae Herba were found to substantially inhibit endogenous macrophage migration, while the presence of ephedrine, atractylenolide I, and kaempferol was attributed to these effects. In summary, our study explores the pharmacological mechanism and effective components of XFBD in inflammation regulation via multimodal approaches, and thereby provides a biological illustration of the clinical efficacy of XFBD.
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Affiliation(s)
- Lu Zhao
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Hao Liu
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yingchao Wang
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Shufang Wang
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Dejin Xun
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yi Wang
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yiyu Cheng
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Boli Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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Therapeutic Potential of the Purinergic System in Major Depressive Disorder Associated with COVID-19. Cell Mol Neurobiol 2023; 43:621-637. [PMID: 35348977 PMCID: PMC8960668 DOI: 10.1007/s10571-022-01215-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/18/2022] [Indexed: 12/23/2022]
Abstract
Neuroinflammation is closely related to the development of depression, since the latter is caused, among other factors, by inflammatory processes, mainly related to the activation of microglia and expression of specific genes, which occurs during the neuroinflammatory process. Thus, COVID-19 is an important risk factor for the development of depression, since in addition to generating the feeling of stress, which also increases the activity of the immune system, it is also the cause of pathological processes and physiological ones that lead to the development of neuroinflammation, microglial activation, gene expression dysfunction and decreased concentration of available serotonin. That said, drugs are being used to combat COVID-19 to reduce the oxidative stress presented in the disease. Thus, tramadol and fluoxetine are highlighted as drugs used, however, although they present some positive results, such as the reduction of pro-inflammatory cytokines, they are also associated with negative effects such as dependence, pulmonary, cardiac and brain impairment. From this, the purinergic system is highlighted in the literature as a possible therapeutic target. This is because its mechanisms are related to the regulation of microglia, astrocytes and the physiology of important neurotransmitters and hormones. Added to this, there is a modulation of inflammatory activity, especially with regard to the P2X7 receptors of this system. The latter is an important target for the treatment of depression and COVID-19, since positive results were obtained through the genetic exclusion of this receptor and the use of selective antagonists.
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Planas R, Felber M, Vavassori S, Pachlopnik Schmid J. The hyperinflammatory spectrum: from defects in cytotoxicity to cytokine control. Front Immunol 2023; 14:1163316. [PMID: 37187762 PMCID: PMC10175623 DOI: 10.3389/fimmu.2023.1163316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Cytotoxic lymphocytes kill target cells through polarized release of the content of cytotoxic granules towards the target cell. The importance of this cytotoxic pathway in immune regulation is evidenced by the severe and often fatal condition, known as hemophagocytic lymphohistiocytosis (HLH) that occurs in mice and humans with inborn errors of lymphocyte cytotoxic function. The clinical and preclinical data indicate that the damage seen in severe, virally triggered HLH is due to an overwhelming immune system reaction and not the direct effects of the virus per se. The main HLH-disease mechanism, which links impaired cytotoxicity to excessive release of pro-inflammatory cytokines is a prolongation of the synapse time between the cytotoxic effector cell and the target cell, which prompts the former to secrete larger amounts of cytokines (including interferon gamma) that activate macrophages. We and others have identified novel genetic HLH spectrum disorders. In the present update, we position these newly reported molecular causes, including CD48-haploinsufficiency and ZNFX1-deficiency, within the pathogenic pathways that lead to HLH. These genetic defects have consequences on the cellular level on a gradient model ranging from impaired lymphocyte cytotoxicity to intrinsic activation of macrophages and virally infected cells. Altogether, it is clear that target cells and macrophages may play an independent role and are not passive bystanders in the pathogenesis of HLH. Understanding these processes which lead to immune dysregulation may pave the way to novel ideas for medical intervention in HLH and virally triggered hypercytokinemia.
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Affiliation(s)
- Raquel Planas
- Division of Immunology, University Children’s Hospital Zurich, Zurich, Switzerland
- Department of Cell Biology, Physiology and Immunology, University of Barcelona, Barcelona, Spain
| | - Matthias Felber
- Division of Immunology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Stefano Vavassori
- Division of Immunology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Jana Pachlopnik Schmid
- Division of Immunology, University Children’s Hospital Zurich, Zurich, Switzerland
- Pediatric Immunology, University of Zurich, Zurich, Switzerland
- *Correspondence: Jana Pachlopnik Schmid,
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Kulinich G, Kuzmenko O, Sorochan P. Features of hematological and immune disorders in the combined treatment of breast cancer patients with the risk of development of late radiation damage. УКРАЇНСЬКИЙ РАДІОЛОГІЧНИЙ ТА ОНКОЛОГІЧНИЙ ЖУРНАЛ 2022. [DOI: 10.46879/ukroj.4.2022.39-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. Breast cancer (BC) is one of the most common forms of malignant neoplasms among the female population of Ukraine. The widespread use of radiation therapy in the treatment of BC, along with the improvement of treatment efficiency, inevitably leads to an increase in the probability of early and/or late radiation injuries (LRI), which puts before scientists the task of a detailed study of this problem and the search for ways to prevent the development of LRI.The body’s reaction to the development of a malignant neoplasm and to antitumor treatment is largely determined by the state of homeostatic mechanisms, in the regulation of which one of the key roles is played by the immune system. Recently, special attention has been focused on the role of immune inflammatory responses in the pathogenesis of LRI in cancer patients. All of the above determines the urgency of finding a differential approach to immunocorrective therapy as a prevention of the development of LRI. Рurpose – to determine the characteristics of changes in hematological indicators and the subpopulation composition of lymphocytes during immunocorrective therapy as a prevention of the development of LRI in patients with BC. Materials and Methods. 55 patients with BC were examined. The patients were divided into groups: the comparison group (n=13) – patients with BC with the risk of developing LRI who were given standard therapy, the main group (n=15) – patients with BC with the risk of developing LRI who were given immunocorrective therapy against the background of standard treatment. The control group (n=27) consisted of patients with BC without the risk of developing LRI. The groups were comparable in terms of age and disease stage. Results. Immunocorrective therapy increased the number of erythrocytes, hemoglobin level, CD19+-, CD3+CD8+-lymphocytes, NK-cells, CRP, IL-6, IL-2 and TNF-α in patients of the main group. In patients of the comparison group, after treatment, lower levels of erythrocytes, hemoglobin, lymphocytes, the relative number of CD8+-T-lymphocytes, CD19+-B-lymphocytes and higher levels of the relative number of eosinophils, monocytes, neutrophils, cytokine levels, and CRP were found in comparison with the indicators of patients, who underwent immunocorrective treatment. In patients with BC of the main group, immunocorrection reduces systemic changes that can contribute to the development of late radiation damage and recurrence of the oncological process. The inclusion of immunocorrective therapy with the use of melatonin had a positive effect on the hematological and immune indicators of patients. Conclusions. Immunocorrective therapy in patients at risk of developing LRI optimized immune and hematological parameters: it contributed to an increase in the number of erythrocytes by 1.25 times, hemoglobin level by 1.6 times, CD19+- (1.5 times), CD3+CD8+-lymphocytes (1.1 times), and a decrease in NK cells (1.77 times), CRP by 2.19 times, IL-6 by 1.8 times, IL-2 by 2.13 times, and TNF-α by 3 times, 22 times. It was found that in patients with BC with the possibility of developing LRIwithout immunotherapy, lower levels of erythrocytes (by 1.15 times), hemoglobin (by 1.13 times), lymphocytes (by 1.3 times), and the relative number of CD8+ were observed after treatment - T lymphocytes (1.4 times), CD19+ B lymphocytes (6.5 times) and higher levels of relative numbers of eosinophils, monocytes, neutrophils, cytokine levels (1.5 times) and CRP (2.1 times) in comparison with the indicators of patients who underwent immunocorrective treatment. The appointment of immunocorrective therapy with melatonin in a daily dose of 9 mg during radiation treatment for patients with BC with the risk of developing LRI led to the normalization of hematoimmune indicators, a significant decrease in the systemic inflammatory reaction.
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Fan Z, Kernan KF, Sriram A, Benos PV, Canna SW, Carcillo JA, Kim S, Park HJ. Deep neural networks with knockoff features identify nonlinear causal relations and estimate effect sizes in complex biological systems. Gigascience 2022; 12:giad044. [PMID: 37395630 PMCID: PMC10316696 DOI: 10.1093/gigascience/giad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/31/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Learning the causal structure helps identify risk factors, disease mechanisms, and candidate therapeutics for complex diseases. However, although complex biological systems are characterized by nonlinear associations, existing bioinformatic methods of causal inference cannot identify the nonlinear relationships and estimate their effect size. RESULTS To overcome these limitations, we developed the first computational method that explicitly learns nonlinear causal relations and estimates the effect size using a deep neural network approach coupled with the knockoff framework, named causal directed acyclic graphs using deep learning variable selection (DAG-deepVASE). Using simulation data of diverse scenarios and identifying known and novel causal relations in molecular and clinical data of various diseases, we demonstrated that DAG-deepVASE consistently outperforms existing methods in identifying true and known causal relations. In the analyses, we also illustrate how identifying nonlinear causal relations and estimating their effect size help understand the complex disease pathobiology, which is not possible using other methods. CONCLUSIONS With these advantages, the application of DAG-deepVASE can help identify driver genes and therapeutic agents in biomedical studies and clinical trials.
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Affiliation(s)
- Zhenjiang Fan
- Department of Computer Science, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kate F Kernan
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA 15260,USA
| | - Aditya Sriram
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Panayiotis V Benos
- Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA
| | - Scott W Canna
- Pediatric Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Joseph A Carcillo
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA 15260,USA
| | - Soyeon Kim
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Hyun Jung Park
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Chen Q, Zhang Q, Wang X. Connective tissue disease with macrophage activation syndrome: A case report. Medicine (Baltimore) 2022; 101:e32426. [PMID: 36595872 PMCID: PMC9794242 DOI: 10.1097/md.0000000000032426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
RATIONALE Macrophage activation syndrome (MAS), or secondary hemophagocytic lymphocytosis (sHLH), is a rare systemic inflammatory response syndrome that is fatal. Adult patients lack clear criteria for diagnosis and treatment, primarily derived from guidelines and protocols for treating family hemophagocytic lymphocytosis and systemic juvenile idiopathic arthritis (sJIA)-related MAS in children or from retrospective case reports. As a subtype of sHLH, MAS has a clinical presentation like sHLH, but treatment varies. Herein, we report the case of a 40-year-old female with MAS caused by a connective tissue disease. PATIENT CONCERNS The patient presented to the Rheumatology and Immunology Clinic with recurrent fever and rash, and MAS was confirmed after a series of examinations. The patient had no significant effect after treatment with JAK inhibitors, but after the use of the IL-6 inhibitor tocilizumab, the fever and rash were significantly reduced, and laboratory indicators returned to normal levels. DIAGNOSIS Considering the patient's condition and laboratory test results, we judged that the patient had connective tissue disease with MAS. INTERVENTIONS We gave sequential treatment of tocilizumab. OUTCOMES ALL indicators are mostly back to normal when the patient was monitored at the outpatient clinic. LESSONS MAS/HLH lacks clear criteria for diagnosis or treatment in adult patients and is extremely difficult to distinguish from bacterial sepsis or other systemic inflammatory response syndromes. Consequently, early diagnosis and treatment are indispensable for enhancing patient survival.
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Affiliation(s)
- Qu Chen
- Department of Rheumatology, Binzhou Medical University Hospital, Binzhou, China
| | - Qiushuang Zhang
- Department of Rheumatology, Binzhou Medical University Hospital, Binzhou, China
| | - Xuebin Wang
- Department of Rheumatology, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Xuebin Wang, Department of Rheumatology, Binzhou Medical University Hospital, Binzhou, Shandong Province, China (e-mail: )
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Wei D, Qi J, Wang Y, Li L, Yang G, He X, Zhang Z. NR4A2 may be a potential diagnostic biomarker for myocardial infarction: A comprehensive bioinformatics analysis and experimental validation. Front Immunol 2022; 13:1061800. [PMID: 36618351 PMCID: PMC9815548 DOI: 10.3389/fimmu.2022.1061800] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Myocardial infarction is a well-established severe consequence of coronary artery disease. However, the lack of effective early biomarkers accounts for the lag time before clinical diagnosis of myocardial infarction. The present study aimed to predict critical genes for the diagnosis of MI by immune infiltration analysis and establish a nomogram. Methods Gene microarray data were downloaded from Gene Expression Omnibus (GEO). Differential expression analysis, single-cell sequencing, and disease ontology (DO) enrichment analysis were performed to determine the distribution of Differentially Expressed Genes (DEGs) in cell subpopulations and their correlation with MI. Next, the level of infiltration of 16 immune cells and immune functions and their hub genes were analyzed using a Single-sample Gene Set Enrichment Analysis (ssGSEA). In addition, the accuracy of critical markers for the diagnosis of MI was subsequently assessed using receiver operating characteristic curves (ROC). One datasets were used to test the accuracy of the model. Finally, the genes with the most diagnostic value for MI were screened and experimentally validated. Results 335 DEGs were identified in GSE66360, including 280 upregulated and 55 downregulated genes. Single-cell sequencing results demonstrated that DEGs were mainly distributed in endothelial cells. DO enrichment analysis suggested that DEGs were highly correlated with MI. In the MI population, macrophages, neutrophils, CCR, and Parainflammation were significantly upregulated compared to the average population. NR4A2 was identified as the gene with the most significant diagnostic value in the immune scoring and diagnostic model. 191 possible drugs for the treatment of myocardial infarction were identified by drug prediction analysis. Finally, our results were validated by Real-time Quantitativepolymerase chain reaction and Western Blot of animal samples. Conclusion Our comprehensive in silico analysis revealed that NR4A2 has huge prospects for application in diagnosing patients with MI.
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Affiliation(s)
- Dongsheng Wei
- Graduate Academy, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Jiajie Qi
- Graduate Academy, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Yuxuan Wang
- Graduate Academy, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Luzhen Li
- Graduate Academy, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Guanlin Yang
- Key Laboratory of Ministry of Education for Traditional Chinese Medicine Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Xinyong He
- College of Medical Laboratory, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Zhe Zhang
- Key Laboratory of Ministry of Education for Traditional Chinese Medicine Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China,*Correspondence: Zhe Zhang,
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He YF, Jiang ZG, Wu N, Bian N, Ren JL. Correlation between COVID-19 and hepatitis B: A systematic review. World J Gastroenterol 2022; 28:6599-6618. [PMID: 36569273 PMCID: PMC9782843 DOI: 10.3748/wjg.v28.i46.6599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND There is growing evidence that patients with coronavirus disease 2019 (COVID-19) frequently present with liver impairment. Hepatitis B virus (HBV) remains a major public health threat in current society. Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HBV can cause liver damage, and current findings on whether HBV infection increases disease severity in COVID-19 patients are inconsistent, and whether SARS-CoV-2 infection accelerates hepatitis B progression or leads to a worse prognosis in hepatitis B patients has not been adequately elucidated.
AIM To explore the complex relationship between COVID-19 and hepatitis B in order to inform the research and management of patients co-infected with SARS-CoV-2 and HBV.
METHODS An experienced information specialist searched the literature in the following online databases: PubMed, China National Knowledge Infrastructure, Google Scholar, Scopus, Wiley, Web of Science, Cochrane, and ScienceDirect. The literature published from December 2019 to September 1, 2022 was included in the search. We also searched medRxiv and bioRxiv for gray literature and manually scanned references of included articles. Articles reporting studies conducted in humans discussing hepatitis B and COVID-19 were included. We excluded duplicate publications. News reports, reports, and other gray literature were included if they contained quantifiable evidence (case reports, findings, and qualitative analysis). Some topics that included HBV or COVID-19 samples but did not have quantitative evidence were excluded from the review.
RESULTS A total of 57 studies were eligible and included in this review. They were from 11 countries, of which 33 (57.9%) were from China. Forty-two of the 57 studies reported abnormalities in liver enzymes, three mainly reported abnormalities in blood parameters, four indicated no significant liver function alterations, and another eight studies did not provide data on changes in liver function. Fifty-seven studies were retrospective and the total number of co-infections was 1932, the largest sample size was 7723, and the largest number of co-infections was 353. Most of the studies suggested an interaction between hepatitis B and COVID-19, while 12 studies clearly indicated no interaction between hepatitis B and COVID-19. Six of the 57 studies clearly reported HBV activation. Six studies were related to liver transplant patients.
CONCLUSION There is some association between COVID-19 and hepatitis B. Future high-quality randomized trials are needed to further elucidate the interaction between COVID-19 and hepatitis B.
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Affiliation(s)
- Yan-Fei He
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Zhi-Gang Jiang
- Department of Statistics, Zunyi Medical University, Guizhou 563006, Guizhou Province, China
| | - Ni Wu
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Ning Bian
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Jun-Lin Ren
- Department of Infection Control, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
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Elghannam MT, Hassanien MH, Ameen YA, ELattar GM, ELRay AA, Turky EA, ELTalkawy MD. COVID-19 and liver diseases. EGYPTIAN LIVER JOURNAL 2022; 12:43. [PMID: 35880136 PMCID: PMC9301896 DOI: 10.1186/s43066-022-00202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus causes an outbreak of viral pneumonia that spread throughout the world. Liver injury is becoming more widely recognized as a component of the clinical picture of COVID-19 infection. Hepatitis with serum ALT elevation has been reported in up to half of patients. Patients with CLD were at a higher risk of decompensation with liver failure, hospitalization, and mortality. The percentage of acute liver injury (ALI) varied from 5 to 28%. COVID-19 hinders HCV elimination by 2030. It is recommended to continue treatment of chronic HCV and chronic HBV if already receiving treatment. Consider using antiviral therapy to prevent viral flare-ups in patients with occult or resolved HBV and COVID-19 who are receiving immunosuppressive agents. Patients with AIH do not have an increased risk of adverse outcomes even in high-risk areas. There is an association between MAFLD and disease progression. Patients with any type of cancer are at a higher risk of infection and are more likely to develop more severe clinical outcomes. Most societies advise against immunosuppressant modifications in patients with mild COVID-19, whereas in rare cases such as severe lymphopenia, worsening pneumonia, or bacterial or fungal superinfection, reduction or discontinuation of antiproliferative agents and lymphocyte-depleting therapies has been suggested.
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113
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Tang S, Yang C, Li S, Ding Y, Zhu D, Ying S, Sun C, Shi Y, Qiao J, Fang H. Genetic and pharmacological targeting of GSDMD ameliorates systemic inflammation in macrophage activation syndrome. J Autoimmun 2022; 133:102929. [PMID: 36326513 DOI: 10.1016/j.jaut.2022.102929] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
Macrophage activation syndrome (MAS), a potentially life-threatening complication of autoimmune/autoinflammatory diseases, is characterized by the excessive expansion and activation of macrophages and cytotoxic T lymphocytes in multiple organs. Most commonly, MAS occurs in patients with systemic juvenile idiopathic arthritis and in its adult equivalent, adult-onset Still's disease (AOSD). Gasdermin D (GSDMD) is a critical pore-forming effector protein that mediates pro-inflammatory cytokine secretion via releasing its N terminal fragments to form transmembrane pores. GSDMD has been implicated in various inflammatory diseases, however, its role in MAS remains elusive. Here, we unveiled that the serum levels of GSDMD-N were elevated in patients with AOSD compared to heathy controls. In addition, the emergence of MAS features in AOSD patients resulted in further elevation. The serum levels of GSDMD were positively correlated with ferritin and interleukin-18 (IL-18). Repeated toll-like receptor 9 stimulation with unmethylated cytosine-phosphate-guanine (CpG) induced MAS symptoms in wild-type mice, including body weight loss, pancytopenia and hepatosplenomegaly. Genetic deletion and pharmacological inhibition of GSDMD ameliorated MAS symptoms in mice with the concomitant reduction of splenic and hepatic macrophage infiltration and IL-18 production. Consistent with these in vivo results, bone marrow-derived macrophages obtained from GSDMD-/- mice or treated with GSDMD inhibitor disulfiram exhibited attenuated IL-18 expression after CpG stimulation. Collectively, our findings identified GSDMD as a novel marker for MAS complication and a promising target for MAS treatment.
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Affiliation(s)
- Shunli Tang
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Dermatology, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Changyi Yang
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sheng Li
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuwei Ding
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingxian Zhu
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuni Ying
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chuanyin Sun
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Shi
- Department of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Jianjun Qiao
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Hong Fang
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Athale J, Busch LM, O'Grady NP. Cytokine Release Syndrome and Sepsis: Analogous Clinical Syndromes with Distinct Causes and Challenges in Management. Infect Dis Clin North Am 2022; 36:735-748. [PMID: 36328633 PMCID: PMC9641544 DOI: 10.1016/j.idc.2022.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Both cytokine release syndrome (CRS) and sepsis are clinical syndromes rather than distinct diseases and share considerable overlap. It can often be challenging to distinguish between the two, but it is important given the availability of targeted treatment options. In addition, several other clinical syndromes overlap with CRS and sepsis, further making it difficult to differentiate them. This has particularly been highlighted in the recent coronavirus disease-2019 pandemic. As we start to understand the differences in the inflammatory markers and presentations in these syndromes, hopefully we will be able to enhance treatment and improve outcomes.
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Affiliation(s)
- Janhavi Athale
- Department of Critical Care Medicine, Division of Hematology and Oncology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
| | - Lindsay M Busch
- Department of Medicine, Emory University Hospital, 550 Peachtree Street Northeast, Atlanta, GA 30308, USA
| | - Naomi P O'Grady
- Internal Medicine Services, National Institutes of Health, Room 2-2734, Bethesda, MD 20892-1662, USA.
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Huang Z, You X, Chen L, Du Y, Brodeur K, Jee H, Wang Q, Linder G, Darbousset R, Cunin P, Chang MH, Wactor A, Wauford BM, Todd MJC, Wei K, Li Y, Levescot A, Iwakura Y, Pascual V, Baldwin NE, Quartier P, Li T, Gianatasio MT, Hasserjian RP, Henderson LA, Sykes DB, Mellins ED, Canna SW, Charles JF, Nigrovic PA, Lee PY. mTORC1 links pathology in experimental models of Still's disease and macrophage activation syndrome. Nat Commun 2022; 13:6915. [PMID: 36443301 PMCID: PMC9705324 DOI: 10.1038/s41467-022-34480-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 10/26/2022] [Indexed: 11/29/2022] Open
Abstract
Still's disease is a severe inflammatory syndrome characterized by fever, skin rash and arthritis affecting children and adults. Patients with Still's disease may also develop macrophage activation syndrome, a potentially fatal complication of immune dysregulation resulting in cytokine storm. Here we show that mTORC1 (mechanistic target of rapamycin complex 1) underpins the pathology of Still's disease and macrophage activation syndrome. Single-cell RNA sequencing in a murine model of Still's disease shows preferential activation of mTORC1 in monocytes; both mTOR inhibition and monocyte depletion attenuate disease severity. Transcriptomic data from patients with Still's disease suggest decreased expression of the mTORC1 inhibitors TSC1/TSC2 and an mTORC1 gene signature that strongly correlates with disease activity and treatment response. Unrestricted activation of mTORC1 by Tsc2 deletion in mice is sufficient to trigger a Still's disease-like syndrome, including both inflammatory arthritis and macrophage activation syndrome with hemophagocytosis, a cellular manifestation that is reproduced in human monocytes by CRISPR/Cas-mediated deletion of TSC2. Consistent with this observation, hemophagocytic histiocytes from patients with macrophage activation syndrome display prominent mTORC1 activity. Our study suggests a mechanistic link of mTORC1 to inflammation that connects the pathogenesis of Still's disease and macrophage activation syndrome.
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Affiliation(s)
- Zhengping Huang
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA ,grid.38142.3c000000041936754XDivision of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA ,grid.413405.70000 0004 1808 0686Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiaomeng You
- grid.38142.3c000000041936754XDepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Liang Chen
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Yan Du
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA ,grid.412465.0Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Kailey Brodeur
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Hyuk Jee
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Qiang Wang
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Grace Linder
- grid.239552.a0000 0001 0680 8770Blood Bank and Transfusion Medicine Division, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Roxane Darbousset
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Pierre Cunin
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Margaret H. Chang
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Alexandra Wactor
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Brian M. Wauford
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Marc J. C. Todd
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Kevin Wei
- grid.38142.3c000000041936754XDivision of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Ying Li
- grid.38142.3c000000041936754XDivision of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Anais Levescot
- grid.462336.6Université Paris Cité, Institut Imagine, INSERM UMR1163, Laboratory Intestinal Immunity, Paris, France
| | - Yoichiro Iwakura
- grid.143643.70000 0001 0660 6861Centre for Animal Disease Models, Research Institute for Biomedical Sciences, Tokyo University of Science, Chiba, Japan
| | - Virginia Pascual
- grid.5386.8000000041936877XDepartment of Pediatrics and Drukier Institute for Children’s Health, Weill Cornell Medicine, New York, NY USA
| | - Nicole E. Baldwin
- grid.486749.00000 0004 4685 2620Baylor Scott & White Research Institute, Dallas, TX USA
| | - Pierre Quartier
- grid.5842.b0000 0001 2171 2558Pediatric Immunology, Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital, Assistance Publique-Hopitaux de Paris, Universite de Paris, Paris, France
| | - Tianwang Li
- grid.413405.70000 0004 1808 0686Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Maria T. Gianatasio
- grid.416636.00000 0004 0460 4960Mass General Brigham Healthcare Center - Salem Hospital, Salem, MA USA
| | - Robert P. Hasserjian
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Lauren A. Henderson
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - David B. Sykes
- grid.32224.350000 0004 0386 9924Center for Regenerative Medicine, Massachusetts General Hospital, Boston, USA
| | - Elizabeth D. Mellins
- grid.168010.e0000000419368956Department of Pediatrics, Program in Immunology, Stanford University, Stanford, CA USA
| | - Scott W. Canna
- grid.239552.a0000 0001 0680 8770Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Julia F. Charles
- grid.38142.3c000000041936754XDivision of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Peter A. Nigrovic
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA ,grid.38142.3c000000041936754XDivision of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Pui Y. Lee
- grid.38142.3c000000041936754XDivision of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
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Dupont T, Darmon M, Mariotte E, Lemiale V, Fadlallah J, Mirouse A, Zafrani L, Azoulay E, Valade S. Etoposide treatment in secondary hemophagocytic syndrome: impact on healthcare-associated infections and survival. Ann Intensive Care 2022; 12:101. [DOI: 10.1186/s13613-022-01075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/15/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Etoposide remains the cornerstone of symptomatic management of critically ill patients with secondary hemophagocytic syndrome (sHS). Risk of healthcare-associated infections (HAIs) in this setting with etoposide has never been assessed. We sought to evaluate the association between etoposide administration, HAIs occurrence and survival in critically ill adult patients with sHS. In this retrospective single-center study conducted in a university hospital ICU between January 2007 and March 2020, all consecutive patients with sHS were included. HAIs were defined as any microbiologically documented infection throughout ICU stay. Competing risk survival analysis was performed to determine factors associated with HAIs. Propensity score-based overlap weighting was performed to adjust for factors associated with etoposide use.
Results
168 patients with a median age of 49 [38, 59] were included. Forty-three (25.6%) patients presented with at least 1 microbiologically documented HAI throughout ICU stay. After adjustment, cumulative incidence of HAI was higher in patients receiving etoposide (p = 0.007), while survival was unaffected by etoposide status (p = 0.824). By multivariable analysis, etoposide treatment was associated with a higher incidence of HAIs (sHR 3.75 [1.05, 6.67]), whereas no association with survival (sHR 0.53 [0.20, 1.98]) was found. Other factors associated with increased mortality after adjustment included age, immunodepression, male sex, SOFA score > 13, and occurrence of HAI.
Conclusions
In patients with sHS, etoposide treatment is independently associated with increased occurrence of HAIs, whereas no association with survival was found. Intensivists should be aware of increased infectious risk, to promptly detect and treat infections in this specific setting. Studies to assess benefits from prophylactic anti-infectious agents in this setting are warranted and the lack of benefit of etoposide on survival needs to be interpreted cautiously.
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117
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Lee H, Krishnan M, Kim M, Yoon YK, Kim Y. Rhamnetin, a Natural Flavonoid, Ameliorates Organ Damage in a Mouse Model of Carbapenem-Resistant Acinetobacter baumannii-Induced Sepsis. Int J Mol Sci 2022; 23:12895. [PMID: 36361685 PMCID: PMC9656386 DOI: 10.3390/ijms232112895] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 11/15/2023] Open
Abstract
In sepsis, the persistence of uncontrolled inflammatory response of infected host cells eventually leads to severe lung and organ failure and, ultimately, death. Carbapenem-resistant Acinetobacter baumannii (CRAB), causative bacteria of sepsis and lung failure in acute cases, belongs to a group of critical pathogens that cannot be eradicated using the currently available antibiotics. This underlines the necessity of developing new modes of therapeutics that can control sepsis at the initial stages. In this study, we investigated the anti-inflammatory activities in vitro and in vivo and the antiseptic effects of rhamnetin, a naturally occurring flavonoid. We found that among its isoforms, the potency of rhamnetin was less explored but rhamnetin possessed superior anti-inflammatory activity with least cytotoxicity. Rhamnetin showed significant anti-inflammatory effects in lipopolysaccharide-, CRAB-, and Escherichia coli (E. coli)-stimulated mouse macrophages by inhibiting the release of interleukin-6 and nitric oxide. In a mouse model of sepsis infected with clinically isolated CRAB or E. coli, rhamnetin significantly reduced the bacterial burden in the organs. In addition, normalized pro-inflammatory cytokine levels in lung lysates and histological analysis of lung tissue indicated alleviation of lung damage. This study implies that a potent natural product such as rhamnetin could be a future therapeutic for treating carbapenem-resistant gram-negative sepsis.
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Affiliation(s)
- Hyeju Lee
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Manigandan Krishnan
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Minju Kim
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Korea University, Seoul 02841, Korea
| | - Yangmee Kim
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea
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118
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Macovei LA, Burlui A, Bratoiu I, Rezus C, Cardoneanu A, Richter P, Szalontay A, Rezus E. Adult-Onset Still's Disease-A Complex Disease, a Challenging Treatment. Int J Mol Sci 2022; 23:12810. [PMID: 36361602 PMCID: PMC9655522 DOI: 10.3390/ijms232112810] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder with an unknown cause characterized by high-spiking fever, lymphadenopathy, hepatosplenomegaly, hyperferritinemia, and leukocytosis. The clinical course can be divided into three significant patterns, each with a different prognosis: Self-limited or monophasic, intermittent or polycyclic systemic, and chronic articular. Two criteria sets have been validated. The Yamaguchi criteria are the most generally used, although the Fautrel criteria offer the benefit of adding ferritin and glycosylated ferritin values. AOSD's pathogenesis is not yet completely understood. Chemokines and pro-inflammatory cytokines, including interferon (IFN)-γ, tumor necrosis factor α (TNFα), interleukin (IL)-1, IL-6, IL-8, and IL-18, play a crucial role in the progression of illness, resulting in the development of innovative targeted therapeutics. There are no treatment guidelines for AOSD due to its rarity, absence of controlled research, and lack of a standard definition for remission and therapy objectives. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CS), and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are used in AOSD treatment. Biological therapy, including IL-1, IL-6, IL-18, and IL-17 inhibitors, as well as TNFα or Janus-kinases (JAKs) inhibitors, is administered to patients who do not react to CS and csDMARDs or achieve an inadequate response.
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Affiliation(s)
- Luana Andreea Macovei
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Alexandra Burlui
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ioana Bratoiu
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ciprian Rezus
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- III Internal Medicine Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Anca Cardoneanu
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Patricia Richter
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andreea Szalontay
- Department of Psychiatry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Institute of Psychiatry “Socola”, 700282 Iasi, Romania
| | - Elena Rezus
- Department of Rheumatology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
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Sequí-Sabater JM, Beretta L. Defining the Role of Monocytes in Sjögren's Syndrome. Int J Mol Sci 2022; 23:ijms232112765. [PMID: 36361554 PMCID: PMC9654893 DOI: 10.3390/ijms232112765] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
Sjögren's syndrome is one of the most prevalent autoimmune diseases after rheumatoid arthritis, with a preference for middle age, and is characterised by exocrine glandular involvement leading to xerostomia and xerophthalmia. It can have systemic implications with vascular, neurological, renal, and pulmonary involvement, and in some cases, it may evolve to non-Hodgkin's lymphoma. For a long time, B- and T-lymphocytes have been the focus of research and have been considered key players in Sjögren's syndrome pathogenesis and evolution. With the development of new technologies, including omics, more insights have been found on the different signalling pathways that lead to inflammation and activation of the immune system. New evidence indicates that a third actor linking innate and adaptive immunity plays a leading role in the Sjögren's syndrome play: the monocyte. This review summarises the recent insights from transcriptomic, proteomic, and epigenetic studies that help us to understand more about the Sjögren's syndrome pathophysiology and redefine the involvement of monocytes in this disease.
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Affiliation(s)
- Jose Miguel Sequí-Sabater
- Rheumatology Department, Reina Sofía University Hospital, Menéndez Pidal Ave., 14005 Córdoba, Spain
- Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), University of Córdoba, Menéndez Pidal Ave., 14005 Córdoba, Spain
| | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, Francesco Sforza St. 35, 20122 Milan, Italy
- Correspondence:
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120
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Ailioaie LM, Ailioaie C, Litscher G. Biomarkers in Systemic Juvenile Idiopathic Arthritis, Macrophage Activation Syndrome and Their Importance in COVID Era. Int J Mol Sci 2022; 23:12757. [PMID: 36361547 PMCID: PMC9655921 DOI: 10.3390/ijms232112757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 08/30/2023] Open
Abstract
Systemic juvenile idiopathic arthritis (sJIA) and its complication, macrophage activation syndrome (sJIA-MAS), are rare but sometimes very serious or even critical diseases of childhood that can occasionally be characterized by nonspecific clinical signs and symptoms at onset-such as non-remitting high fever, headache, rash, or arthralgia-and are biologically accompanied by an increase in acute-phase reactants. For a correct positive diagnosis, it is necessary to rule out bacterial or viral infections, neoplasia, and other immune-mediated inflammatory diseases. Delays in diagnosis will result in late initiation of targeted therapy. A set of biomarkers is useful to distinguish sJIA or sJIA-MAS from similar clinical entities, especially when arthritis is absent. Biomarkers should be accessible to many patients, with convenient production and acquisition prices for pediatric medical laboratories, as well as being easy to determine, having high sensitivity and specificity, and correlating with pathophysiological disease pathways. The aim of this review was to identify the newest and most powerful biomarkers and their synergistic interaction for easy and accurate recognition of sJIA and sJIA-MAS, so as to immediately guide clinicians in correct diagnosis and in predicting disease outcomes, the response to treatment, and the risk of relapses. Biomarkers constitute an exciting field of research, especially due to the heterogeneous nature of cytokine storm syndromes (CSSs) in the COVID era. They must be selected with utmost care-a fact supported by the increasingly improved genetic and pathophysiological comprehension of sJIA, but also of CSS-so that new classification systems may soon be developed to define homogeneous groups of patients, although each with a distinct disease.
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Affiliation(s)
- Laura Marinela Ailioaie
- Department of Medical Physics, Alexandru Ioan Cuza University, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Constantin Ailioaie
- Department of Medical Physics, Alexandru Ioan Cuza University, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Gerhard Litscher
- Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Research Unit for Complementary and Integrative Laser Medicine, Traditional Chinese Medicine (TCM) Research Center Graz, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 39, 8036 Graz, Austria
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121
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Diagnosing Hemophagocytic Lymphohistiocytosis with Machine Learning: A Proof of Concept. J Clin Med 2022; 11:jcm11206219. [PMID: 36294539 PMCID: PMC9605669 DOI: 10.3390/jcm11206219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome characterized by uncontrolled activation of immune cells and mediators. Two diagnostic tools are widely used in clinical practice: the HLH-2004 criteria and the Hscore. Despite their good diagnostic performance, these scores were constructed after a selection of variables based on expert consensus. We propose here a machine learning approach to build a classification model for HLH in a cohort of patients selected by glycosylated ferritin dosage in our tertiary center in Lyon, France. On a dataset of 207 adult patients with 26 variables, our model showed good overall diagnostic performances with a sensitivity of 71.4% and high specificity, and positive and negative predictive values which were 100%, 100%, and 96.9%, respectively. Although generalization is difficult on a selected population, this is the first study to date to provide a machine-learning model for HLH detection. Further studies will be required to improve the machine learning model performances with a large number of HLH cases and with appropriate controls.
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Al-Hakim A, Mistry A, Savic S. Improving Diagnosis and Clinical Management of Acquired Systemic Autoinflammatory Diseases. J Inflamm Res 2022; 15:5739-5755. [PMID: 36238769 PMCID: PMC9553278 DOI: 10.2147/jir.s343261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
Systemic autoinflammatory diseases (SAID) are conditions caused by dysregulation or disturbance of the innate immune system, with neutrophils and macrophages the main effector cells. Although there are now more than 40 distinct, genetically defined SAIDs, the genetic/molecular diagnosis remains unknown for a significant proportion of patients with the disease onset in adulthood. This review focuses on new developments related to acquired/late onset SAID, including phenocopies of monogenic disorders, Schnitzler's syndrome, Adult onset Still's disease, VEXAS syndrome, and autoinflammatory complications associated with myelodysplastic syndrome.
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Affiliation(s)
- Adam Al-Hakim
- Department of Clinical Immunology and Allergy, St James’s University Hospital, Leeds, UK
| | - Anoop Mistry
- Department of Clinical Immunology and Allergy, St James’s University Hospital, Leeds, UK
| | - Sinisa Savic
- Department of Clinical Immunology and Allergy, St James’s University Hospital, Leeds, UK,Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK,Correspondence: Sinisa Savic, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Clinical Science Building, St James’s University Hospital, Leeds, LS9 7TF, UK, Tel +441132065567, Email
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123
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Schulert GS. The Big Bad Wolf: Macrophage Activation Syndrome in Childhood-Onset Systemic Lupus Erythematosus. J Rheumatol 2022; 49:1082-1084. [PMID: 36271722 DOI: 10.3899/jrheum.220780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Grant S Schulert
- G.S. Schulert, MD, PhD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
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Muacevic A, Adler JR. Possible Macrophage Activation Syndrome Caused by Endoscopic Retrograde Cholangiopancreatography for Bacteremia Due to Chronic Cholelithiasis. Cureus 2022; 14:e30932. [PMID: 36465726 PMCID: PMC9711020 DOI: 10.7759/cureus.30932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 12/13/2022] Open
Abstract
Hypoglycemia is caused by various clinical diseases. Among older patients, occult bacteremia may cause critical illness-related corticosteroid insufficiency (CIRCI), triggering hypoglycemia. Additionally, older patients have various chronic medical and homeostatic conditions. Interventions may be needed when chronic conditions cause clinical diseases and CIRCI. Herein, we report a case of possible macrophage activation syndrome (MAS) caused by endoscopic retrograde cholangiopancreatography for bacteremia due to chronic cholelithiasis in an 85-year-old man. Interventions for chronic conditions could impinge on homeostasis in older patients, causing acute conditions such as MAS. Among older frail patients with chronic conditions, interventions for chronic conditions should be discussed, including the triggering of other acute conditions, such as MAS.
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Bris PN, Gauchez P, Devillier R, Galicier L, Collignon A, Piana G, Poizat F, Faucher M, Hospital MA, Vey N, Gonzalez F, Servan L, Chow-Chine L, Sannini A, Mokart D, Saillard C, Bisbal M. Hepatic haemophagocytosis in haematology patients with hepatic dysfunction: prognostic impact and contribution of liver biopsy combined with the haemophagocytic syndrome diagnostic score (HScore). Br J Haematol 2022; 199:106-116. [PMID: 35968907 DOI: 10.1111/bjh.18382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023]
Abstract
Hepatic dysfunction (HD) is common in patients with haematological malignancies. Hepatic haemophagocytosis (HH) was detected in >50% of liver biopsies taken when HD remained unresolved after standard examination. We aimed to explore the contribution of liver biopsy in patients with both haematological malignancies and HD, describe the population of patients with HH, assess the prognostic impact of HH, and investigate haemophagocytic syndrome diagnostic score (HScore) utility in patients with HH. Between 2016 and 2019, 116 consecutive liver biopsies (76 transjugular, 40 percutaneous) were taken in 110 patients with haematological malignancy and HD (hyperbilirubinaemia, elevated transaminases, and/or cholestasis) and without a clear diagnosis. Liver biopsies were safe and diagnostically efficient. Predominant diagnoses included: HH (56%), graft-versus-host disease (55%), associated infections (24%), sinusoidal obstruction syndrome (15%), and tumoral infiltration (8%). Of patients, 35% were critically ill and 74% were allogeneic haematopoietic stem cell transplantation recipients, while 1-year overall survival (OS) was 35% with HH versus 58% without HH (p = 0.026). The 1-year OS was 24% with a HScore of ≥169 versus 50% with a HScore of <169 (p = 0.019). Liver biopsies are feasible in and contribute significantly to haematology patients with HD. HH occurred frequently and was associated with a poor prognosis. Combined with liver biopsy, the HScore may be helpful in refining haemophagocytic syndrome diagnosis.
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Affiliation(s)
- Pierre-Nicolas Bris
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Philippe Gauchez
- Pathology Department, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, France
| | | | | | - Aude Collignon
- Hematology Department, Institut Paoli Calmettes, Marseille, France
| | - Gilles Piana
- Imagery Department, Institut Paoli Calmettes, Marseille, France
| | - Flora Poizat
- Pathology Department, Institut Paoli Calmettes, Marseille, France
| | - Marion Faucher
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | | | - Norbert Vey
- Hematology Department, Institut Paoli Calmettes, Marseille, France.,Aix-Marseille University, Marseille, France
| | - Frederic Gonzalez
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Luca Servan
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Laurent Chow-Chine
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Antoine Sannini
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Djamel Mokart
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
| | - Colombe Saillard
- Hematology Department, Institut Paoli Calmettes, Marseille, France
| | - Magali Bisbal
- Anaesthesia and Critical Care Department, Intensive Care Unit, Institut Paoli Calmettes, Marseille, France
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Guiraud V, Verney C, Tetelboum N, Argy N, Debus J, Herbel S, Thy M, Ricard JD, Roux D, Zucman N. Life-threatening hemophagocytic syndrome triggered by disseminated toxoplasmosis in a young patient with previously unknown AIDS. Rev Med Interne 2022; 43:622-625. [PMID: 36089427 DOI: 10.1016/j.revmed.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 10/14/2022]
Abstract
Hemophagocytic syndrome is a rare life-threatening disorder that can be triggered by various conditions such as HIV infection and opportunistic agents. We report a case of disseminated toxoplasmosis complicated with severe hemophagocytic syndrome and revealing an unknown acquired immunodeficiency syndrome. The patient presented with multiple organ failure in intensive care unit. Once diagnosed, he benefitted from etoposide infusion, administration of specific anti-toxoplasmosis treatments and secondary antiretroviral therapy. He was alive at intensive care unit discharge and returned home with little sequalae. This case illustrates both the importance of rapid investigations of hemophagocytic syndrome etiologies in HIV positive patients and the necessity to prompt etoposide and specific treatments in order to improve potentially dramatic outcomes.
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Affiliation(s)
- V Guiraud
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France
| | - C Verney
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France
| | - N Tetelboum
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU DREAM, department of radiology, 92700 Colombes, France
| | - N Argy
- Université de Paris, AP-HP, Hôpital Bichat-Claude Bernard, DMU BIOGEM, Laboratoire de Parasitologie-Mycologie, 75018 Paris, France; Université de Paris, UMR 261 MERIT, IRD, faculté de pharmacie, 75006 Paris, France
| | - J Debus
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU BIOGEM, hématologie biologique et transfusion, 92700 Colombes, France
| | - S Herbel
- Université de Paris, AP-HP, hôpital Bichat-Claude Bernard, DMU INVICTUS, service de maladies infectieuses et tropicales, 75018 Paris, France
| | - M Thy
- Université de Paris, AP-HP, hôpital Bichat-Claude Bernard, DMU INVICTUS, service de maladies infectieuses et tropicales, 75018 Paris, France
| | - J D Ricard
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France; Université de Paris, UMR 1137 IAME, Inserm, 75018 Paris, France
| | - D Roux
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France; Université de Paris, institut Necker-Enfants Malades, Inserm U1151, CNRS UMR 8253, 75015 Paris, France
| | - N Zucman
- Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France.
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127
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Kim JY, Kim M, Park JK, Lee EB, Park JW, Hong J. Limited efficacy of tocilizumab in adult patients with secondary hemophagocytic lymphohistiocytosis: a retrospective cohort study. Orphanet J Rare Dis 2022; 17:363. [PMID: 36131317 PMCID: PMC9490693 DOI: 10.1186/s13023-022-02516-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Interleukin (IL)-6 is one of the key cytokines in the pathogenesis of secondary hemophagocytic lymphohistiocytosis (sHLH); however, the efficacy and safety of tocilizumab (TCZ), a monoclonal IL-6 receptor antibody, in patients with sHLH is uncertain.
Methods/Results This study included 64 adult patients who were diagnosed with sHLH based on the HLH-2004 criteria. Patients were classified into two groups based on treatment regimen at baseline: tocilizumab (TCZ group, n = 8) versus other treatments (control group), including HLH-2004 protocol (n = 35), chemotherapy (n = 7), glucocorticoid alone (n = 8), and with other immunosuppressants (n = 6). Primary outcome was overall 8-week survival. Baseline characteristics between the two groups were comparable. At day 56, one patient (12.5%) in the TCZ group and twenty-eight patients (51.9%) in the control group survived. Univariable and multivariable Cox proportional hazard analysis showed that TCZ significantly increased the risk of death (adjusted hazard ratio 5.55; 95% CI 2.13–14.49). The complete or partial response rate at day 14 was 44.6% in the control group, and nil in the TCZ group. In contrast, infectious complications occurred more frequently in the TCZ group than in the control group (14.3% vs. 50.0%). Conclusion Our results suggest that tocilizumab has limited efficacy in treating adult patients with sHLH and could increase the risk of infectious complications compared to the conventional treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02516-1.
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Affiliation(s)
- Ju Yeon Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Miso Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Eun Bong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Jun Won Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
| | - Junshik Hong
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
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128
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He L, Yao S, Zhang R, Liu M, Hua Z, Zou H, Wang Z, Wang Y. Macrophage activation syndrome in adults: Characteristics, outcomes, and therapeutic effectiveness of etoposide-based regimen. Front Immunol 2022; 13:955523. [PMID: 36189240 PMCID: PMC9520258 DOI: 10.3389/fimmu.2022.955523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To describe the clinical characteristics and outcomes of adult macrophage activation syndrome (MAS) patients and to provide experience for the treatment. Methods Adult patients with MAS admitted to Beijing Friendship Hospital from December 2014 to September 2021 were enrolled in this study. Clinical data of patients were collected and analyzed. Results A total of 118 adult MAS patients entered this study. MAS was the first manifestation in 43 (36.4%) patients, while 75 (63.6%) developed MAS after the diagnosis of autoimmune disease (AID) with a median diagnostic interval of 2 (0.5–359) months. Eighty-two patients were initially treated with glucocorticoid-based regimen; the overall response (OR) rate at the 2-week posttreatment was 37.8%. Forty-five patients switched to etoposide-based regimen, and the OR rate was 84.4%. Thirty-six patients were initially treated with etoposide-based regimen, and the OR rate at the 2-week posttreatment was 80.6%. Serum IL-18 (P = 0.021), IFN-γ (P = 0.013), IP-10 (P = 0.001), IL-10 (P = 0.041), IL-1RA (P < 0.001), and TNF-α (P = 0.020) levels of patients were significantly decreased in the remission phase than in the active phase. Levels of SDF-1α (P = 0.018) and IL-7 (P = 0.022) were higher in refractory patients, while the GRO-α level had a strong tendency toward statistical significance (P = 0.050). The probability of overall survival (OS) at 3, 6, and 36 months after HLH diagnosis were 89.8%, 89.0%, and 87.9%, retrospectively. The active MAS status at the 2-week post initial treatment [P = 0.009, HR = 15.281, 95% CI, (0.1.972, 118.430)] and baseline neutrophil count (Neu) <1.5 × 109/l [P = 0.017, HR = 3.678, 95% CI, (1.267, 10.672)] were negative prognostic factors. Conclusion MAS typically occurs within 2 months after the onset of autoimmune disease in adults. SDF-1α, IL-7, and GRO-α could be used to predict refractory MAS. The etoposide-based regimen is effective and tolerable for adult MAS.
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Affiliation(s)
- Lingbo He
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuyan Yao
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruoxi Zhang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Menghan Liu
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhengjie Hua
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heshan Zou
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhao Wang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yini Wang
- Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of General Practice, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Yini Wang,
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Gleeson TA, Nordling E, Kaiser C, Lawrence CB, Brough D, Green JP, Allan SM. Looking into the IL-1 of the storm: are inflammasomes the link between immunothrombosis and hyperinflammation in cytokine storm syndromes? DISCOVERY IMMUNOLOGY 2022; 1:kyac005. [PMID: 38566906 PMCID: PMC10917224 DOI: 10.1093/discim/kyac005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/17/2022] [Accepted: 09/13/2022] [Indexed: 04/04/2024]
Abstract
Inflammasomes and the interleukin (IL)-1 family of cytokines are key mediators of both inflammation and immunothrombosis. Inflammasomes are responsible for the release of the pro-inflammatory cytokines IL-1β and IL-18, as well as releasing tissue factor (TF), a pivotal initiator of the extrinsic coagulation cascade. Uncontrolled production of inflammatory cytokines results in what is known as a "cytokine storm" leading to hyperinflammatory disease. Cytokine storms can complicate a variety of diseases and results in hypercytokinemia, coagulopathies, tissue damage, multiorgan failure, and death. Patients presenting with cytokine storm syndromes have a high mortality rate, driven in part by disseminated intravascular coagulation (DIC). While our knowledge on the factors propagating cytokine storms is increasing, how cytokine storm influences DIC remains unknown, and therefore treatments for diseases, where these aspects are a key feature are limited, with most targeting specific cytokines. Currently, no therapies target the immunothrombosis aspect of hyperinflammatory syndromes. Here we discuss how targeting the inflammasome and pyroptosis may be a novel therapeutic strategy for the treatment of hyperinflammation and its associated pathologies.
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Affiliation(s)
- Tara A Gleeson
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance NHS Group, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Erik Nordling
- Swedish Orphan Biovitrum AB, Stockholm 112 76, Sweden
| | | | - Catherine B Lawrence
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance NHS Group, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - David Brough
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance NHS Group, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Jack P Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance NHS Group, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Stuart M Allan
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance NHS Group, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
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130
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Selezneva A, Gibb AJ, Willis D. The contribution of ion channels to shaping macrophage behaviour. Front Pharmacol 2022; 13:970234. [PMID: 36160429 PMCID: PMC9490177 DOI: 10.3389/fphar.2022.970234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/15/2022] [Indexed: 11/25/2022] Open
Abstract
The expanding roles of macrophages in physiological and pathophysiological mechanisms now include normal tissue homeostasis, tissue repair and regeneration, including neuronal tissue; initiation, progression, and resolution of the inflammatory response and a diverse array of anti-microbial activities. Two hallmarks of macrophage activity which appear to be fundamental to their diverse cellular functionalities are cellular plasticity and phenotypic heterogeneity. Macrophage plasticity allows these cells to take on a broad spectrum of differing cellular phenotypes in response to local and possibly previous encountered environmental signals. Cellular plasticity also contributes to tissue- and stimulus-dependent macrophage heterogeneity, which manifests itself as different macrophage phenotypes being found at different tissue locations and/or after different cell stimuli. Together, plasticity and heterogeneity align macrophage phenotypes to their required local cellular functions and prevent inappropriate activation of the cell, which could lead to pathology. To execute the appropriate function, which must be regulated at the qualitative, quantitative, spatial and temporal levels, macrophages constantly monitor intracellular and extracellular parameters to initiate and control the appropriate cell signaling cascades. The sensors and signaling mechanisms which control macrophages are the focus of a considerable amount of research. Ion channels regulate the flow of ions between cellular membranes and are critical to cell signaling mechanisms in a variety of cellular functions. It is therefore surprising that the role of ion channels in the macrophage biology has been relatively overlooked. In this review we provide a summary of ion channel research in macrophages. We begin by giving a narrative-based explanation of the membrane potential and its importance in cell biology. We then report on research implicating different ion channel families in macrophage functions. Finally, we highlight some areas of ion channel research in macrophages which need to be addressed, future possible developments in this field and therapeutic potential.
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131
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Clift SJ, Martí-Garcia B, Lawrence JA, Mitchell EP, Fehrsen J, Martínez J, Williams JH, Steyl JCA. Theileriosis in naturally infected roan antelope ( Hippotragus equinus). Vet Pathol 2022; 59:1031-1046. [PMID: 36052867 DOI: 10.1177/03009858221120011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cases of Theileria-associated mortality are rarely reported in African wild artiodactyls. Descriptions of lesions are limited, particularly in endangered hippotraginids. Here, we analyzed retrospectively the gross and histologic findings in 55 roan antelope (Hippotragus equinus) with fatal natural theileriosis. The most frequently recorded gross findings in 40 cases were widespread petechiae and ecchymoses (72.5%), probable anemia (67.5%), icterus (60%), splenomegaly (60%), hepatomegaly (52.5%), and pulmonary edema (50%). Histologic lesions in 34 cases were characterized by multi-organ infiltrates of parasitized and nonparasitized mononuclear leukocytes (MLs), and fewer multinucleate giant cells (MNGCs). Liver, lung, kidney, adrenal gland, and heart were most consistently infiltrated, followed by spleen and lymph nodes. Leukocytes were phenotyped in lung, liver, kidney, and heart specimens from 16 cases, using immunohistochemistry to detect CD20, CD3, myeloid/histiocyte antigen (MAC387), IBA-1, and CD204 surface receptors. A roan polyclonal anti-Theileria sp. (sable) antibody was applied to the same tissues to identify intraleukocytic parasite antigens. Similar proportions of intravascular and extravascular IBA-1-, CD204-, and MAC387-reactive putative monocyte-macrophages and fewer CD3-positive putative T-lymphocytes were identified in all organs, especially the lungs in infected roan. CD20-positive putative B-lymphocytes were significantly scarcer than in uninfected controls. Intraleukocytic Theileria parasites labeled consistently in affected tissues. Some parasitized and nonparasitized MLs and the MNGCs failed to label with selected leukocyte markers. Fatal theileriosis in roans may largely be the result of multi-organ monocyte-macrophage activation with associated tissue injury and overwhelming systemic inflammation. The identity of the parasitized leukocytes and characteristics of the lymphohistiocytic response require further clarification in roans.
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Affiliation(s)
| | | | | | | | - Jeanni Fehrsen
- University of Pretoria, Onderstepoort, South Africa.,ARC-Onderstepoort Veterinary Research, Onderstepoort, South Africa
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Riley ED, Kizer JR, Tien PC, Vittinghoff E, Lynch KL, Wu AHB, Coffin PO, Beck-Engeser G, Braun C, Hunt PW. Multiple substance use, inflammation and cardiac stretch in women living with HIV. Drug Alcohol Depend 2022; 238:109564. [PMID: 35872529 PMCID: PMC9924802 DOI: 10.1016/j.drugalcdep.2022.109564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/10/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) and heart failure (HF) are disproportionately high in people living with HIV and differ by sex. Few CVD-related studies focus on drug use, yet it is common in low-income women living with HIV (WLWH) and increases cardiac dysfunction. SETTING We recruited unsheltered and unstably housed WLWH from San Francisco community venues to participate in a six-month cohort study investigating linkages between drug use, inflammation, and cardiac dysfunction. METHODS Adjusting for CVD risk factors, co-infections, medications, and menopause, we examined the effects of toxicology-confirmed drug use and inflammation (C-reactive protein, sCD14, sCD163 and sTNFR2) on levels of NT-proBNP, a biomarker of cardiac stretch and HF. RESULTS Among 74 WLWH, the median age was 53 years and 45 % were Black. At baseline, 72 % of participants had hypertension. Substances used included tobacco (65 %), cannabis (53 %), cocaine (49 %), methamphetamine (31 %), alcohol (28 %), and opioids (20 %). Factors significantly associated with NT-proBNP included cannabis use (Adjusted Relative Effect [ARE]: -39.6 %) and sTNFR2 (ARE: 65.5 %). Adjusting for heart failure and restricting analyses to virally suppressed persons did not diminish effects appreciably. Cannabis use was not significantly associated with sTNFR2 and did not change the association between sTNFR2 and NT-proBNP. CONCLUSIONS Among polysubstance-using WLWH, NT-proBNP levels signaling cardiac stretch were positively associated with sTNFR2, but 40 % lower in people who used cannabis. Whether results suggest that cardiovascular pathways associated with cannabis use mitigate cardiac stress and dysfunction independent of inflammation in WLWH who use multiple substances merits further investigation.
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Affiliation(s)
- Elise D Riley
- University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA.
| | - Jorge R Kizer
- San Francisco VA Health Care System, Division of Cardiology, San Francisco, CA, USA; University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Phyllis C Tien
- University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA
| | - Eric Vittinghoff
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Kara L Lynch
- University of California, San Francisco, School of Medicine, Department of Laboratory Medicine, San Francisco, CA, USA
| | - Alan H B Wu
- University of California, San Francisco, School of Medicine, Department of Laboratory Medicine, San Francisco, CA, USA
| | - Phillip O Coffin
- University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA; San Francisco Department of Public Health, San Francisco, CA, USA
| | - Gabriele Beck-Engeser
- University of California, San Francisco, School of Medicine, Department of Experimental Medicine, San Francisco, CA, USA
| | - Carl Braun
- University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA
| | - Peter W Hunt
- University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA; University of California, San Francisco, School of Medicine, Department of Experimental Medicine, San Francisco, CA, USA
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Deng H, Li Xu, Ju J, Mo X, Ge G, Zhu X. Multifunctional nanoprobes for macrophage imaging. Biomaterials 2022; 290:121824. [DOI: 10.1016/j.biomaterials.2022.121824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/28/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022]
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Cron RQ. Biologic disease-modifying antirheumatic drugs to treat multisystem inflammatory syndrome in children. Curr Opin Rheumatol 2022; 34:274-279. [PMID: 35791863 DOI: 10.1097/bor.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection primarily affecting children. MIS-C shares features with Kawasaki disease (KD) and cytokine storm syndrome (CSS) frequently requiring intensive care support. Although intravenous immunoglobulin (IVIg) and glucocorticoids (GCs) are effective therapeutics for most, refractory MIS-C is treated with various biologic disease-modifying antirheumatic drugs (bDMARDs). Understanding the clinical features, inflammatory cytokines, and genetic associations provides rationale for bDMARD in treating severe MIS-C. RECENT FINDINGS Children with MIS-C have clinical KD features and often present in hypovolemic and cardiogenic shock requiring volume repletion (gastrointestinaI losses) and cardiac pressor support (epinephrine). Investigation of MIS-C serum reveals elevated pro-inflammatory cytokines [interleukin (IL)-1, IL-6, IL-18, interferon gamma (IFNγ), tumor necrosis factor (TNF)], but to a lesser extent than other established CSS. Gene sequencing of MIS-C children identifies heterozygous mutations in CSS associated genes. Treatment of refractory (IVIg and GC) MIS-C with bDMARDs to IL-1, IL-6, and TNF is efficacious for survival as well as resolving cardiac and coronary artery inflammation. SUMMARY MIS-C is a postinfectious complication of SARS-CoV-2 resembling KD and CSS, both genetically and by pro-inflammatory cytokines. MIS-C that is refractory to IVIg and GC is routinely responsive to bDMARDs targeting IL-1, IL-6, and TNF.
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Affiliation(s)
- Randy Q Cron
- Division of Pediatric Rheumatology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
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Peng K, Deng N, Meng Y, He Q, Meng H, Luo T, Wei Y, Kang Y, Zhou X, Shen F. Alpha-Momorcharin Inhibits Proinflammatory Cytokine Expression by M1 Macrophages but Not Anti-Inflammatory Cytokine Expression by M2 Macrophages. J Inflamm Res 2022; 15:4853-4872. [PMID: 36042868 PMCID: PMC9420447 DOI: 10.2147/jir.s372306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Alpha-momorcharin (α-MMC) is a natural medicine derived from bitter melon and has been found to exert immunomodulatory effects. Our previous study indicated that α-MMC can regulate cytokine release from monocytes, but it remains unknown about its regulatory effect on different types of cytokines, such as inflammatory cytokines or anti-inflammatory cytokines. Methods LPS-induced M1-type macrophages model and IL-4-induced M2-type macrophages model were established, and the expression of proinflammatory cytokines and anti-inflammatory cytokines were assessed by ELISA after α-MMC was administered. Then, a LPS-induced acute pneumonia mouse model was established, the proinflammatory cytokines levels and inflammatory lesions in lung tissues were examined by ELISA or H&E staining. Furthermore, omics screening analysis and Western blotting verification were performed on TLR4 and JAK1-STAT6 signalling pathway-related proteins to elucidate the regulatory mechanism of α-MMC in those M1 macrophages and M2 macrophages. Results At a noncytotoxic dose of 0.3 μg/mL, α-MMC significantly inhibited the LPS-induced expression of inflammatory cytokines, such as TNF-α, IL-1β, IL-6, IL-8, MIP-1α and MCP-1, by M1 macrophages in a time-dependent manner, but α-MMC did not inhibit the IL-4-induced synthesis of anti-inflammatory cytokines, such as IL-10, IL-1RA, EGF, VEGF, TGF-β and CCL22, by M2 macrophages. Moreover, α-MMC also inhibited inflammatory cytokine expression in an LPS-induced acute pneumonia mouse model and alleviated inflammation in lung tissues. Furthermore, omics screening and Western blotting analysis confirmed that α-MMC inhibited TAK1/p-TAK1 and subsequently blocked the downstream MAPK and NF-κB pathways, thus inhibiting the LPS-induced inflammatory cytokine expression. Conclusion Our results reveal that α-MMC inhibits proinflammatory cytokine expression by M1 macrophages but not anti-inflammatory cytokine expression by M2 macrophages. The efficacy of α-MMC in selectively inhibiting proinflammatory cytokine expression renders it particularly suitable for the treatment of severe inflammation and autoimmune diseases characterized by cytokine storms.
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Affiliation(s)
- Kejun Peng
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Nianhua Deng
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Yao Meng
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Qianchuan He
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Hao Meng
- PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University School of Life Sciences, Beijing, People's Republic of China
| | - Ting Luo
- Wuhan Corebiolab Co., Ltd, Wuhan, People's Republic of China
| | - Yanru Wei
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Yue Kang
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Xiaodong Zhou
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
| | - Fubing Shen
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, People's Republic of China
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Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and COVID-19: The Clinical Course and Prognosis of 15 Patients From a Tertiary Care Center. J Clin Rheumatol 2022; 28:300-304. [PMID: 35612560 PMCID: PMC9422241 DOI: 10.1097/rhu.0000000000001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate incidence rates, prognoses, and disease-related factors associated with poor outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) who had coronavirus disease (COVID-19). METHODS Patients with AAV were questioned for a history of COVID-19 in the outpatient setting. Cumulative clinical findings and treatment history were obtained from the patients' medical records. The clinical, laboratory, and imaging findings of inpatients with COVID-19 were recorded. The data of patients who developed symptomatic COVID-19 and/or died of the disease were used for comparison. RESULTS Eighty-nine patients (47.2% female; mean age, 56 ± 12.5 years) were included. The diagnosis was granulomatosis with polyangiitis in 56 patients (62.9%) and microscopic polyangiitis in 33 (37.1%). Sixty-one (68.2%) and 21 patients (23.6%) had renal and peripheral nerve involvement, respectively. Ten patients had a history of diffuse alveolar hemorrhage. Fifteen patients (16.9%) had COVID-19, including 9 (60%) with severe pneumonia. Twelve patients (85.7%) were hospitalized, 6 (42.9%) were admitted to the intensive care unit, and 5 (35.7%) died. All deceased patients had hypogammaglobulinemia (IgG levels <700 mg/dL) during hospital admission. Symptomatic COVID-19 was associated with higher disease activity, glucocorticoid and rituximab treatments, and glomerular filtration rate <30 mL/min. A history of peripheral nerve involvement, higher organ damage scores, and hypogammaglobulinemia was associated with mortality. CONCLUSIONS The prognosis was poor in our patients with AAV who had COVID-19, especially those with severe multisystem involvement. Hypogammaglobulinemia was associated with mortality. Serum IgG level monitoring in patients with AAV would be beneficial during the COVID-19 pandemic.
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Sun C, Han Y, Zhang R, Liu S, Wang J, Zhang Y, Chen X, Jiang C, Wang J, Fan X, Wang J. Regulated necrosis in COVID-19: A double-edged sword. Front Immunol 2022; 13:917141. [PMID: 36090995 PMCID: PMC9452688 DOI: 10.3389/fimmu.2022.917141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
COVID-19 caused by SARS-CoV-2 can cause various systemic diseases such as acute pneumonia with cytokine storm. Constituted of necroptosis, pyroptosis, and ferroptosis, regulated necrosis constitutes the cell death patterns under the low apoptosis condition commonly observed in COVID-19. Regulated necrosis is involved in the release of cytokines like TNF-α, IL-1 β, and IL-6 and cell contents such as alarmins, PAMPs, and DAMPs, leading to more severe inflammation. Uncontrolled regulated necrosis may explain the poor prognosis and cytokine storm observed in COVID-19. In this review, the pathophysiology and mechanism of regulated necrosis with the double-edged sword effect in COVID-19 are thoroughly discussed in detail. Furthermore, this review also focuses on the biomarkers and potential therapeutic targets of the regulated necrosis pathway in COVID-19, providing practical guidance to judge the severity, prognosis, and clinical treatment of COVID-19 and guiding the development of clinical anti-SARS-CoV-2 drugs.
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Affiliation(s)
- Chen Sun
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunze Han
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruoyu Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Simon Liu
- Medical Genomics Unit, National Human Genome Research Institute, Bethesda, MD, United States
| | - Jing Wang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuqing Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuemei Chen
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Chao Jiang
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junmin Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
| | - Xiaochong Fan
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
| | - Jian Wang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
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Zhao H, Song S, Ma J, Yan Z, Xie H, Feng Y, Che S. CD47 as a promising therapeutic target in oncology. Front Immunol 2022; 13:757480. [PMID: 36081498 PMCID: PMC9446754 DOI: 10.3389/fimmu.2022.757480] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
CD47 is ubiquitously expressed on the surface of cells and plays a critical role in self-recognition. By interacting with SIRPα, TSP-1 and integrins, CD47 modulates cellular phagocytosis by macrophages, determines life span of individual erythrocytes, regulates activation of immune cells, and manipulates synaptic pruning during neuronal development. As such, CD47 has recently be regarded as one of novel innate checkpoint receptor targets for cancer immunotherapy. In this review, we will discuss increasing awareness about the diverse functions of CD47 and its role in immune system homeostasis. Then, we will discuss its potential therapeutic roles against cancer and outlines, the possible future research directions of CD47- based therapeutics against cancer.
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Affiliation(s)
- Hai Zhao
- Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shuangshuang Song
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Junwei Ma
- Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhiyong Yan
- Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hongwei Xie
- Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Feng
- Department of Emergency, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shusheng Che
- Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Shusheng Che,
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Wolf A, Khimani F, Yoon B, Gerhart C, Endsley D, Ray AK, Yango AF, Flynn SD, Lip GYH, Gonzalez SA, Sathyamoorthy M. The mechanistic basis linking cytokine storm to thrombosis in COVID-19. THROMBOSIS UPDATE 2022; 8:100110. [PMID: 38620974 PMCID: PMC9116969 DOI: 10.1016/j.tru.2022.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/26/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
It is now well established that infection with SARS-CoV-2 resulting in COVID-19 disease includes a severely symptomatic subset of patients in whom an aggressive and/or dysregulated host immune response leads to cytokine storm syndrome (CSS) that may be further complicated by thrombotic events, contributing to the severe morbidity and mortality observed in COVID-19. This review provides a brief overview of cytokine storm in COVID-19, and then presents a mechanistic discussion of how cytokine storm affects integrated pathways in thrombosis involving the endothelium, platelets, the coagulation cascade, eicosanoids, auto-antibody mediated thrombosis, and the fibrinolytic system.
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Affiliation(s)
- Adam Wolf
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- TCU School of Medicine, Fort Worth, TX, United States
| | - Faria Khimani
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- TCU School of Medicine, Fort Worth, TX, United States
| | - Braian Yoon
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- TCU School of Medicine, Fort Worth, TX, United States
| | - Coltin Gerhart
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- TCU School of Medicine, Fort Worth, TX, United States
| | - Dakota Endsley
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- TCU School of Medicine, Fort Worth, TX, United States
| | - Anish K Ray
- Cook Children's Medical Center, Fort Worth, TX, United States
- Department of Pediatrics, TCU School of Medicine, Fort Worth, TX, United States
| | - Angelito F Yango
- Department of Medicine, TCU School of Medicine, Fort Worth, TX, United States
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center, Fort Worth, TX, USA
| | | | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg, Denmark
| | - Stevan A Gonzalez
- Department of Medicine, TCU School of Medicine, Fort Worth, TX, United States
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center, Fort Worth, TX, USA
| | - Mohanakrishnan Sathyamoorthy
- Sathyamoorthy Laboratory, TCU School of Medicine, Fort Worth, TX, United States
- Department of Medicine, TCU School of Medicine, Fort Worth, TX, United States
- Consultants in Cardiovascular Medicine and Science - Fort Worth, PLLC, Fort Worth, TX, United States
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Sun C, Zhao H, Han Y, Wang Y, Sun X. The Role of Inflammasomes in COVID-19: Potential Therapeutic Targets. J Interferon Cytokine Res 2022; 42:406-420. [PMID: 35984324 DOI: 10.1089/jir.2022.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The coronavirus 2019 disease (COVID-19) pandemic has caused massive morbidity and mortality worldwide. In severe cases, it is mainly associated with acute pneumonia, cytokine storm, and multi-organ dysfunction. Inflammasomes play a primary role in various pathological processes such as infection, injury, and cancer. However, their role in COVID-19-related complications has not been explored. In addition, the role of underlying medical conditions on COVID-19 disease severity remains unclear. Therefore, this review expounds on the mechanisms of inflammasomes following COVID-19 infection and provides recent evidence on the potential double-edged sword effect of inflammasomes during COVID-19 pathogenesis. The assembly and activation of inflammasomes are critical for inducing effective antiviral immune responses and disease resolution. However, uncontrolled activation of inflammasomes causes excessive production of proinflammatory cytokines (cytokine storm), increased risk of acute respiratory distress syndrome, and death. Therefore, discoveries in the role of the inflammasome in mediating organ injury are key to identifying therapeutic targets and treatment modifications to prevent or reduce COVID-19-related complications.
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Affiliation(s)
- Chen Sun
- Department of Clinical Medicine, School of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Hangyuan Zhao
- Department of Clinical Medicine, School of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yunze Han
- Department of Clinical Medicine, School of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yiqing Wang
- Department of Clinical Medicine, School of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Xiao Sun
- Department of Basic Medical Research Center, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China.,State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou, China
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Zanchettin AC, Barbosa LV, Dutra AA, Prá DMM, Pereira MRC, Stocco RB, Martins APC, Vaz de Paula CB, Nagashima S, de Noronha L, Machado-Souza C. Role of Genetic Polymorphism Present in Macrophage Activation Syndrome Pathway in Post Mortem Biopsies of Patients with COVID-19. Viruses 2022; 14:v14081699. [PMID: 36016321 PMCID: PMC9415703 DOI: 10.3390/v14081699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
COVID-19 is a viral disease associated with an intense inflammatory response. Macrophage Activation Syndrome (MAS), the complication present in secondary hemophagocytic lymphohistiocytosis (sHLH), shares many clinical aspects observed in COVID-19 patients, and investigating the cytolytic function of the responsible cells for the first line of the immune response is important. Formalin-fixed paraffin-embedded lung tissue samples obtained by post mortem necropsy were accessed for three groups (COVID-19, H1N1, and CONTROL). Polymorphisms in MAS cytolytic pathway (PRF1; STX11; STXBP2; UNC13D and GZMB) were selected and genotyping by TaqMan® assays (Thermo Fisher Scientific, MA, USA) using Real-Time PCR (Applied Biosystems, MA USA). Moreover, immunohistochemistry staining was performed with a monoclonal antibody against perforin, CD8+ and CD57+ proteins. Histopathological analysis showed high perforin tissue expression in the COVID-19 group; CD8+ was high in the H1N1 group and CD57+ in the CONTROL group. An association could be observed in two genes related to the cytolytic pathway (PRF1 rs885822 G/A and STXBP2 rs2303115 G/A). Furthermore, PRF1 rs350947132 was associated with increased immune tissue expression for perforin in the COVID-19 group. The genotype approach could help identify patients that are more susceptible, and for this reason, our results showed that perforin and SNPs in the PRF1 gene can be involved in this critical pathway in the context of COVID-19.
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Affiliation(s)
- Aline Cristina Zanchettin
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba 80230-020, Paraná, Brazil; (A.C.Z.); (L.V.B.)
- Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632, Curitiba 80250-200, Paraná, Brazil
| | - Leonardo Vinicius Barbosa
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba 80230-020, Paraná, Brazil; (A.C.Z.); (L.V.B.)
- Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632, Curitiba 80250-200, Paraná, Brazil
| | - Anderson Azevedo Dutra
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Daniele Margarita Marani Prá
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Marcos Roberto Curcio Pereira
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Rebecca Benicio Stocco
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Ana Paula Camargo Martins
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Caroline Busatta Vaz de Paula
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Seigo Nagashima
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Lucia de Noronha
- School of Medicine, Pontifícia Universidade Católica do Paraná, R. Imaculada Conceição, 1155, Curitiba 80215-901, Paraná, Brazil; (A.A.D.); (D.M.M.P.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (S.N.); (L.d.N.)
| | - Cleber Machado-Souza
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba 80230-020, Paraná, Brazil; (A.C.Z.); (L.V.B.)
- Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632, Curitiba 80250-200, Paraná, Brazil
- Correspondence:
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Hu B, Gao J, Shi J, Zhang F, Shi C, Wen P, Wang Z, Guo W, Zhang S. Necroptosis throws novel insights on patient classification and treatment strategies for hepatocellular carcinoma. Front Immunol 2022; 13:970117. [PMID: 35967375 PMCID: PMC9363630 DOI: 10.3389/fimmu.2022.970117] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionNecroptosis is a novel pattern of immunogenic cell death and has triggered an emerging wave in antitumor therapy. More evidence has suggested the potential associations between necroptosis and intra-tumoral heterogeneity. Currently, the underlying role of necroptosis remains elusive in hepatocellular carcinoma (HCC) at antitumor immunity and inter-tumoral heterogeneity.MethodsThis study enrolled a total of 728 HCC patients and 139 immunotherapy patients from eight public datasets. The consensus clustering approach was employed to depict tumor heterogeneity of cancer necroptosis. Subsequently, our study further decoded the heterogeneous clinical outcomes, genomic landscape, biological behaviors, and immune characteristics in necroptosis subtypes. For each patient, providing curative clinical recommendations and developing potential therapeutic drugs were used to promote precise medicine.ResultsWith the use of the weighted gene coexpression network analysis (WGCNA) algorithm, necroptosis-associated long non-coding RNAs (lncRNAs) (NALRs) were identified in HCC. Based on the NALR expression, two heterogeneous subtypes were decoded with distinct clinical outcomes. Compared to patients in C1, patients in C2 harbored superior pathological stage and presented more unfavorable overall survival and recurrence-free survival. Then, the robustness and reproducibility of necroptosis subtypes were further validated via the nearest template prediction (NTP) approach and classical immune phenotypes. Through comprehensive explorations, C1 was characterized by enriched immune-inflammatory and abundant immune infiltration, while C2 possessed elevated proliferative and metabolic activities and highly genomic instability. Moreover, our results indicated that C1 was more prone to obtain desirable benefits from immunotherapy. For patients in C2, numerous underlying therapeutic agents were developed, which might produce significant efficacy.ConclusionThis study identified two necroptosis subtypes with distinct characteristics, decoding the tumor heterogeneity. For an individualized patient, our work tailored corresponding treatment strategies to improve clinical management.
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Affiliation(s)
- Bowen Hu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Jie Gao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Jihua Shi
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Feng Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Chengcheng Shi
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peihao Wen
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Zhihui Wang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Wenzhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
| | - Shuijun Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Research Centre for Organ Transplantation, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Diagnosis & Treatment League for Hepatopathy, Zhengzhou, China
- The First Affiliated Hospital of Zhengzhou University, Henan Engineering & Research Center for Diagnosis and Treatment of Hepatobiliary and Pancreatic Surgical Diseases, Zhengzhou, China
- *Correspondence: Shuijun Zhang,
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Xing J, Jia Z, Li Y, Han Y. Construction of immunotherapy-related prognostic gene signature and small molecule drug prediction for cutaneous melanoma. Front Oncol 2022; 12:939385. [PMID: 35957907 PMCID: PMC9358033 DOI: 10.3389/fonc.2022.939385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Cutaneous melanoma (CM), a kind of skin cancer with a high rate of advanced mortality, exhibits a wide variety of driver and transmitter gene alterations in the immunological tumor microenvironment (TME) associated with tumor cell survival and proliferation. Methods We analyzed the immunological infiltration of TME cells in normal and malignant tissues using 469 CM and 556 normal skin samples. We used a single sample gene set enrichment assay (ssGSEA) to quantify the relative abundance of 28 cells, then used the LASSO COX regression model to develop a riskScore prognostic model, followed by a small molecule drug screening and molecular docking validation, which was then validated using qRT-PCR and IHC. Results We developed a prognosis model around seven essential protective genes for the first time, dramatically elevated in tumor tissues, as did immune cell infiltration. Multivariate Cox regression results indicated that riskScore is an independent and robust prognostic indicator, and its predictive value in immunotherapy was verified. Additionally, we identified Gabapentin as a possible small molecule therapeutic for CM. Conclusions A riskScore model was developed in this work to analyze patient prognosis, TME cell infiltration features, and treatment responsiveness. The development of this model not only aids in predicting patient response to immunotherapy but also has significant implications for the development of novel immunotherapeutic agents and the promotion of tailored treatment regimens.
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Affiliation(s)
- Jiahua Xing
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Ziqi Jia
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Li
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yan Han, ; Yan Li,
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yan Han, ; Yan Li,
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144
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Fatal Acute Heart Failure in the Course of Macrophage Activation Syndrome: Case Report and Literature Review. J Clin Med 2022; 11:jcm11144208. [PMID: 35887970 PMCID: PMC9324855 DOI: 10.3390/jcm11144208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/16/2022] [Accepted: 07/17/2022] [Indexed: 01/27/2023] Open
Abstract
Macrophage activation syndrome is a severe and potentially fatal condition in rheumatology. It can involve many different organs and systems, including the cardiovascular system, but heart failure due to its course is a relatively rare occurrence. In the following paper, we present a case of a young woman with newly diagnosed systemic lupus erythematosus who, in the span of two months, developed macrophage activation syndrome and acute heart failure, which caused her death. We analyze potential causes that may have led to that outcome, and present a brief review of the current literature concerning different macrophage groups in the heart and their potential involvement in the development of heart failure.
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145
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Park SY, Hisham Y, Shin HM, Yeom SC, Kim S. Interleukin-18 Binding Protein in Immune Regulation and Autoimmune Diseases. Biomedicines 2022; 10:biomedicines10071750. [PMID: 35885055 PMCID: PMC9313042 DOI: 10.3390/biomedicines10071750] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 12/28/2022] Open
Abstract
Natural soluble antagonist and decoy receptor on the surface of the cell membrane are evolving as crucial immune system regulators as these molecules are capable of recognizing, binding, and neutralizing (so-called inhibitors) their targeted ligands. Eventually, these soluble antagonists and decoy receptors terminate signaling by prohibiting ligands from connecting to their receptors on the surface of cell membrane. Interleukin-18 binding protein (IL-18BP) participates in regulating both Th1 and Th2 cytokines. IL-18BP is a soluble neutralizing protein belonging to the immunoglobulin (Ig) superfamily as it harbors a single Ig domain. The Ig domain is essential for its binding to the IL-18 ligand and holds partial homology to the IL-1 receptor 2 (IL-1R2) known as a decoy receptor of IL-1α and IL-1β. IL-18BP was defined as a unique soluble IL-18BP that is distinct from IL-18Rα and IL-18Rβ chain. IL-18BP is encoded by a separated gene, contains 8 exons, and is located at chr.11 q13.4 within the human genome. In this review, we address the difference in the biological activity of IL-18BP isoforms, in the immunity balancing Th1 and Th2 immune response, its critical role in autoimmune diseases, as well as current clinical trials of recombinant IL-18BP (rIL-18BP) or equivalent.
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Affiliation(s)
- Seung Yong Park
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea;
| | - Yasmin Hisham
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea;
| | - Hyun Mu Shin
- System Immunology, Wide River Institute of Immunology, Collage of Medicine, Seoul National University, Hongcheon-gun 25159, Korea;
| | - Su Cheong Yeom
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang 25354, Korea;
| | - Soohyun Kim
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea;
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea;
- Correspondence: ; Tel.: +82-2-457-0868
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146
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Lebedeva A, Molodtsov I, Anisimova A, Berestovskaya A, Dukhin O, Elizarova A, Fitzgerald W, Fomina D, Glebova K, Ivanova O, Kalinskaya A, Lebedeva A, Lysenko M, Maryukhnich E, Misyurina E, Protsenko D, Rosin A, Sapozhnikova O, Sokorev D, Shpektor A, Vorobyeva D, Vasilieva E, Margolis L. Comprehensive Cytokine Profiling of Patients with COVID-19 Receiving Tocilizumab Therapy. Int J Mol Sci 2022; 23:ijms23147937. [PMID: 35887283 PMCID: PMC9316906 DOI: 10.3390/ijms23147937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by immune activation in response to viral spread, in severe cases leading to the development of cytokine storm syndrome (CSS) and increased mortality. Despite its importance in prognosis, the pathophysiological mechanisms of CSS in COVID-19 remain to be defined. Towards this goal, we analyzed cytokine profiles and their interrelation in regard to anti-cytokine treatment with tocilizumab in 98 hospitalized patients with COVID-19. We performed a multiplex measurement of 41 circulating cytokines in the plasma of patients on admission and 3–5 days after, during the follow-up. Then we analyzed the patient groups separated in two ways: according to the clusterization of their blood cytokines and based on the administration of tocilizumab therapy. Patients with and without CSS formed distinct clusters according to their cytokine concentration changes. However, the tocilizumab therapy, administered based on the standard clinical and laboratory criteria, did not fully correspond to those clusters of CSS. Furthermore, among all cytokines, IL-6, IL-1RA, IL-10, and G-CSF demonstrated the most prominent differences between patients with and without clinical endpoints, while only IL-1RA was prognostically significant in both groups of patients with and without tocilizumab therapy, decreasing in the former and increasing in the latter during the follow-up period. Thus, CSS in COVID-19, characterized by a correlated release of multiple cytokines, does not fully correspond to the standard parameters of disease severity. Analysis of the cytokine signature, including the IL-1RA level in addition to standard clinical and laboratory parameters may be useful to define the onset of a cytokine storm in COVID-19 as well as the indications for anti-cytokine therapy.
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Affiliation(s)
- Anna Lebedeva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Correspondence: (A.L.); (E.V.)
| | - Ivan Molodtsov
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Alexandra Anisimova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Anastasia Berestovskaya
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Oleg Dukhin
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Antonina Elizarova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 29B Lincoln Dr., Bethesda, MD 20892, USA; (W.F.); (L.M.)
| | - Darya Fomina
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Kseniya Glebova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Oxana Ivanova
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Anna Kalinskaya
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Department of Cardiology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia
| | - Anastasia Lebedeva
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Maryana Lysenko
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Elena Maryukhnich
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Elena Misyurina
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Denis Protsenko
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Alexander Rosin
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Olga Sapozhnikova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Denis Sokorev
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Alexander Shpektor
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Department of Cardiology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia
| | - Daria Vorobyeva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Elena Vasilieva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Correspondence: (A.L.); (E.V.)
| | - Leonid Margolis
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 29B Lincoln Dr., Bethesda, MD 20892, USA; (W.F.); (L.M.)
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Qin A, Sun J, Gao C, Li C. Bibliometrics analysis on the research status and trends of adult-onset Still’s disease: 1921-2021. Front Immunol 2022; 13:950641. [PMID: 35924251 PMCID: PMC9339616 DOI: 10.3389/fimmu.2022.950641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of this research is to discuss the research status, hotspots, frontiers and development trends in the field of adult-onset Still’s disease (AOSD) based on bibliometrics and visual analysis by CiteSpace software. Methods The relevant research articles on AOSD from 1921 to 2021 were retrieved from the Scopus database. CiteSpace software was used to form a visual knowledge map and conduct analysis for the countries/regions, journals, authors, keywords, clusters, research hotspots and frontiers of the included articles. Results There were 2,373 articles included, and the number of articles published during 1921-2021 is increasing. The country with the highest number of articles published was Japan (355, 14.96%), followed by the United States (329, 13.86%) and France (215, 9.06%). The author with the highest number of publications is Ansell, Barbara M. (30, 1.26%), and the author with the highest co-citation frequency is Yamaguchi, Masaya (703). Clinical Rheumatology is the journal with the highest publication frequency. The top five cluster groups were “joint”, “differential diagnosis”, “prednisolone”, “methotrexate” and “macrophage activation syndrome”. The diagnosis, treatment and pathogenesis of AOSD form the main research fields, and prognosis and complications are the research hotspots and trends. Conclusions The global research field in AOSD has expanded in the past 100 years. The complications and new pathogenesis of AOSD are hotspots in this field and need further study in the future.
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Affiliation(s)
- Aining Qin
- School of Nursing, Peking University, Beijing, China
| | - Jing Sun
- Department of Community Nursing, School of Nursing, Peking University, Beijing, China
- *Correspondence: Jing Sun,
| | - Chao Gao
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Chunying Li
- Information and Reference Department, Peking University Health Science Library, Beijing, China
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148
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Exploring the Immunomodulatory Aspect of Mesenchymal Stem Cells for Treatment of Severe Coronavirus Disease 19. Cells 2022; 11:cells11142175. [PMID: 35883618 PMCID: PMC9322532 DOI: 10.3390/cells11142175] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/06/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an enveloped, positive sense, single stranded RNA (+ssRNA) virus, belonging to the genus Betacoronavirus and family Coronaviridae. It is primarily transmitted from infected persons to healthy ones through inhalation of virus-laden respiratory droplets. After an average incubation period of 2–14 days, the majority of infected individuals remain asymptomatic and/or mildly symptomatic, whereas the remaining individuals manifest a myriad of clinical symptoms, including fever, sore throat, dry cough, fatigue, chest pain, and breathlessness. SARS-CoV-2 exploits the angiotensin converting enzyme 2 (ACE-2) receptor for cellular invasion, and lungs are amongst the most adversely affected organs in the body. Thereupon, immune responses are elicited, which may devolve into a cytokine storm characterized by enhanced secretion of multitude of inflammatory cytokines/chemokines and growth factors, such as interleukin (IL)-2, IL-6, IL-7, IL-8, IL-9, tumor necrosis factor alpha (TNF-α), granulocyte colony-stimulating factor (GCSF), basic fibroblast growth factor 2 (bFGF2), monocyte chemotactic protein-1 (MCP1), interferon-inducible protein 10 (IP10), macrophage inflammatory protein 1A (MIP1A), platelet-derived growth factor subunit B (PDGFB), and vascular endothelial factor (VEGF)-A. The systemic persistence of inflammatory molecules causes widespread histological injury, leading to functional deterioration of the infected organ(s). Although multiple treatment modalities with varying effectiveness are being employed, nevertheless, there is no curative COVID-19 therapy available to date. In this regard, one plausible supportive therapeutic modality may involve administration of mesenchymal stem cells (MSCs) and/or MSC-derived bioactive factors-based secretome to critically ill COVID-19 patients with the intention of accomplishing better clinical outcome owing to their empirically established beneficial effects. MSCs are well established adult stem cells (ASCs) with respect to their immunomodulatory, anti-inflammatory, anti-oxidative, anti-apoptotic, pro-angiogenic, and pro-regenerative properties. The immunomodulatory capabilities of MSCs are not constitutive but rather are highly dependent on a holistic niche. Following intravenous infusion, MSCs are known to undergo considerable histological trapping in the lungs and, therefore, become well positioned to directly engage with lung infiltrating immune cells, and thereby mitigate excessive inflammation and reverse/regenerate damaged alveolar epithelial cells and associated tissue post SARS-CoV-2 infection. Considering the myriad of abovementioned biologically beneficial properties and emerging translational insights, MSCs may be used as potential supportive therapy to counteract cytokine storms and reduce disease severity, thereby facilitating speedy recovery and health restoration.
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149
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Zhang HQ, Yang SW, Fu YC, Chen MC, Yang CH, Yang MH, Liu XD, He QN, Jiang H, Zhao MY. Cytokine storm and targeted therapy in hemophagocytic lymphohistiocytosis. Immunol Res 2022; 70:566-577. [PMID: 35819695 DOI: 10.1007/s12026-022-09285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/03/2022] [Indexed: 11/05/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening systemic hyperinflammatory syndrome. The central pathogenesis is an explosive cytokine storm characterized by a significant increase in proinflammatory cytokines, including IL-1β, IL-6, IL-18, IFN-γ, and TNF-α. Meanwhile, negative regulatory factors, such as IL-10 and TGF-β, are also related to the production of HLH. Exploring the specific mechanism of cytokine storms could provide ideas regarding targeted therapy, which could be helpful for early treatment to reduce the mortality of HLH. Although some research has focused on the advantages of targeted therapies, there is still a lack of a comprehensive discourse. This article attempts to summarize the mechanisms of action of various cytokines and provide a therapeutic overview of the current targeted therapies for HLH.
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Affiliation(s)
- Han-Qi Zhang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.,Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
| | - Si-Wei Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.,Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
| | - Yi-Cheng Fu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Ming-Cong Chen
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Cheng-Hao Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.,Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
| | - Ming-Hua Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Xiao-Dan Liu
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China
| | - Qing-Nan He
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
| | - Hua Jiang
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China.
| | - Ming-Yi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
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Qiao J, Cui L. Multi-Omics Techniques Make it Possible to Analyze Sepsis-Associated Acute Kidney Injury Comprehensively. Front Immunol 2022; 13:905601. [PMID: 35874763 PMCID: PMC9300837 DOI: 10.3389/fimmu.2022.905601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/10/2022] [Indexed: 12/29/2022] Open
Abstract
Sepsis-associated acute kidney injury (SA-AKI) is a common complication in critically ill patients with high morbidity and mortality. SA-AKI varies considerably in disease presentation, progression, and response to treatment, highlighting the heterogeneity of the underlying biological mechanisms. In this review, we briefly describe the pathophysiology of SA-AKI, biomarkers, reference databases, and available omics techniques. Advances in omics technology allow for comprehensive analysis of SA-AKI, and the integration of multiple omics provides an opportunity to understand the information flow behind the disease. These approaches will drive a shift in current paradigms for the prevention, diagnosis, and staging and provide the renal community with significant advances in precision medicine in SA-AKI analysis.
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Affiliation(s)
- Jiao Qiao
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
- Core Unit of National Clinical Research Center for Laboratory Medicine, Peking University Third Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
- Core Unit of National Clinical Research Center for Laboratory Medicine, Peking University Third Hospital, Beijing, China
- *Correspondence: Liyan Cui,
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