151
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Xiao Y, Lidsky PV, Shirogane Y, Aviner R, Wu CT, Li W, Zheng W, Talbot D, Catching A, Doitsh G, Su W, Gekko CE, Nayak A, Ernst JD, Brodsky L, Brodsky E, Rousseau E, Capponi S, Bianco S, Nakamura R, Jackson PK, Frydman J, Andino R. A defective viral genome strategy elicits broad protective immunity against respiratory viruses. Cell 2021; 184:6037-6051.e14. [PMID: 34852237 PMCID: PMC8598942 DOI: 10.1016/j.cell.2021.11.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/18/2022]
Abstract
RNA viruses generate defective viral genomes (DVGs) that can interfere with replication of the parental wild-type virus. To examine their therapeutic potential, we created a DVG by deleting the capsid-coding region of poliovirus. Strikingly, intraperitoneal or intranasal administration of this genome, which we termed eTIP1, elicits an antiviral response, inhibits replication, and protects mice from several RNA viruses, including enteroviruses, influenza, and SARS-CoV-2. While eTIP1 replication following intranasal administration is limited to the nasal cavity, its antiviral action extends non-cell-autonomously to the lungs. eTIP1 broad-spectrum antiviral effects are mediated by both local and distal type I interferon responses. Importantly, while a single eTIP1 dose protects animals from SARS-CoV-2 infection, it also stimulates production of SARS-CoV-2 neutralizing antibodies that afford long-lasting protection from SARS-CoV-2 reinfection. Thus, eTIP1 is a safe and effective broad-spectrum antiviral generating short- and long-term protection against SARS-CoV-2 and other respiratory infections in animal models.
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Affiliation(s)
- Yinghong Xiao
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Peter V Lidsky
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Yuta Shirogane
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Virology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Ranen Aviner
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Biology and Genetics, Stanford University, Stanford, CA 94305, USA
| | - Chien-Ting Wu
- Baxter Laboratory for Stem Cell Biology, Department of Microbiology & Immunology, Stanford University, Stanford, CA 94305, USA
| | - Weiyi Li
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Weihao Zheng
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94110, USA
| | - Dale Talbot
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA; Aleph Therapeutics, Inc., Stanford, CA 94305, USA
| | - Adam Catching
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Gilad Doitsh
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Weiheng Su
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA; School of Life Sciences, Jilin University, Changchun, China
| | - Colby E Gekko
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Arabinda Nayak
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Biology and Genetics, Stanford University, Stanford, CA 94305, USA
| | - Joel D Ernst
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94110, USA
| | - Leonid Brodsky
- Tauber Bioinformatics Research Center and Department of Evolutionary & Environmental Biology, University of Haifa, Mount Carmel, Haifa 31905, Israel
| | | | - Elsa Rousseau
- Functional Genomics and Cellular Engineering, AI and Cognitive Software, IBM Almaden Research Center, San Jose, CA 95120, USA
| | - Sara Capponi
- Functional Genomics and Cellular Engineering, AI and Cognitive Software, IBM Almaden Research Center, San Jose, CA 95120, USA
| | - Simone Bianco
- Functional Genomics and Cellular Engineering, AI and Cognitive Software, IBM Almaden Research Center, San Jose, CA 95120, USA
| | | | - Peter K Jackson
- Baxter Laboratory for Stem Cell Biology, Department of Microbiology & Immunology, Stanford University, Stanford, CA 94305, USA
| | - Judith Frydman
- Department of Biology and Genetics, Stanford University, Stanford, CA 94305, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA.
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152
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Senent Y, Inogés S, López-Díaz de Cerio A, Blanco A, Campo A, Carmona-Torre F, Sunsundegui P, González-Martín A, Ajona D, Okrój M, Prósper F, Pio R, Yuste JR, Tavira B. Persistence of High Levels of Serum Complement C5a in Severe COVID-19 Cases After Hospital Discharge. Front Immunol 2021; 12:767376. [PMID: 34868021 PMCID: PMC8636747 DOI: 10.3389/fimmu.2021.767376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/29/2021] [Indexed: 01/08/2023] Open
Abstract
Evidence supports a role of complement anaphylatoxin C5a in the pathophysiology of COVID-19. However, information about the evolution and impact of C5a levels after hospital discharge is lacking. We analyzed the association between circulating C5a levels and the clinical evolution of hospitalized patients infected with SARS-CoV-2. Serum C5a levels were determined in 32 hospitalized and 17 non-hospitalized patients from Clinica Universidad de Navarra. One hundred and eighty eight serial samples were collected during the hospitalization stay and up to three months during the follow-up. Median C5a levels were 27.71 ng/ml (25th to 75th percentile: 19.35-34.96) for samples collected during hospitalization, versus 16.76 ng/ml (12.90-25.08) for samples collected during the follow-up (p<0.001). There was a negative correlation between serum C5a levels and the number of days from symptom onset (p<0.001). C5a levels also correlated with a previously validated clinical risk score (p<0.001), and was associated with the severity of the disease (p<0.001). An overall reduction of C5a levels was observed after hospital discharge. However, elevated C5a levels persisted in those patients with high COVID-19 severity (i.e. those with a longest stay in the hospital), even after months from hospital discharge (p=0.020). Moreover, high C5a levels appeared to be associated with the presence of long-term respiratory symptoms (p=0.004). In conclusion, serum C5a levels remain high in severe cases of COVID-19, and are associated with the presence of respiratory symptoms after hospital discharge. These results may suggest a role for C5a in the long-term effects of COVID-19 infection.
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Affiliation(s)
- Yaiza Senent
- Program in Solid Tumors, Translational Oncology Group, Cima-University of Navarra, Pamplona, Spain.,Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain.,Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain
| | - Susana Inogés
- Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Immunology and Immunotherapy, Clinica Universidad de Navarra, Pamplona, Spain.,Area of Cell Therapy and Department of Hematology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Ascensión López-Díaz de Cerio
- Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Immunology and Immunotherapy, Clinica Universidad de Navarra, Pamplona, Spain.,Area of Cell Therapy and Department of Hematology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Andres Blanco
- Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - Arantxa Campo
- Pulmonary Department, Clinica Universidad de Navarra, Pamplona, Spain
| | - Francisco Carmona-Torre
- Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain.,Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
| | - Patricia Sunsundegui
- Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - Antonio González-Martín
- Program in Solid Tumors, Translational Oncology Group, Cima-University of Navarra, Pamplona, Spain.,Department of Oncology, Clinica Universidad de Navarra, Madrid, Spain
| | - Daniel Ajona
- Program in Solid Tumors, Translational Oncology Group, Cima-University of Navarra, Pamplona, Spain.,Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain.,Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Program in Respiratory Tract Tumors, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Marcin Okrój
- Department of Cell Biology and Immunology, Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, Gdańsk, Poland
| | - Felipe Prósper
- Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Immunology and Immunotherapy, Clinica Universidad de Navarra, Pamplona, Spain.,Program in Respiratory Tract Tumors, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Program of Regenerative Medicine, Cima-University of Navarra, Pamplona, Spain
| | - Ruben Pio
- Program in Solid Tumors, Translational Oncology Group, Cima-University of Navarra, Pamplona, Spain.,Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain.,Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Program in Respiratory Tract Tumors, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - José Ramón Yuste
- Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain.,Division of Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
| | - Beatriz Tavira
- Program in Solid Tumors, Translational Oncology Group, Cima-University of Navarra, Pamplona, Spain.,Respiratory Tract Cancer Group, Navarra Institute for Health Research (IdISNA), Pamplona, Spain.,Department of Pathology, Anatomy and Physiology, School of Medicine, University of Navarra, Pamplona, Spain
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153
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Chavda VP, Pandya R, Apostolopoulos V. DNA vaccines for SARS-CoV-2: toward third-generation vaccination era. Expert Rev Vaccines 2021; 20:1549-1560. [PMID: 34582298 PMCID: PMC8567274 DOI: 10.1080/14760584.2021.1987223] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022]
Abstract
Introduction: Coronavirus outbreak 2019 (COVID-19) has affected all the corners of the globe and created chaos to human life. In order to put some control on the pandemic, vaccines are urgently required that are safe, cost effective, easy to produce, and most importantly induce appropriate immune responses and protection against viral infection. DNA vaccines possess all these features and are promising candidates for providing protection against SARS-CoV-2.Area covered: Current understanding and advances in DNA vaccines toward COVID-19, especially those under various stages of clinical trials.Expert opinion: Through DNA vaccines, host cells are momentarily transformed into factories that produce proteins of the SARS-CoV-2. The host immune system detects these proteins to develop antibodies that neutralize and prevent the infection. This vaccine platform has additional benefits compared to traditional vaccination strategies like strong cellular immune response, higher safety margin, a simple production process as per cGMP norms, lack of any infectious agent, and a robust platform for large-scale production.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad, Gujarat, India
| | - Radhika Pandya
- Department of Pharmaceutics and Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad, Gujarat, India
| | - Vasso Apostolopoulos
- Department of Immunology, Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
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154
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Rangchaikul P, Venketaraman V. SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations. Infect Dis Rep 2021; 13:993-1008. [PMID: 34940401 PMCID: PMC8700906 DOI: 10.3390/idr13040091] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 12/15/2022] Open
Abstract
As of September 2021, there has been a total of 123,633 confirmed cases of pregnant women with SARS-CoV-2 infection in the US according to the CDC, with maternal death being 2.85 times more likely, pre-eclampsia 1.33 times more likely, preterm birth 1.47 times more likely, still birth 2.84 times more likely, and NICU admission 4.89 times more likely when compared to pregnant women without COVID-19 infection. In our literature review, we have identified eight key changes in the immunological functioning of the pregnant body that may predispose the pregnant patient to both a greater susceptibility to SARS-CoV-2, as well as a more severe disease course. Factors that may impede immune clearance of SARS-CoV-2 include decreased levels of natural killer (NK) cells, Th1 CD4+ T cells, plasmacytoid dendritic cells (pDC), a decreased phagocytic index of neutrophil granulocytes and monocytes, as well as the immunomodulatory properties of progesterone, which is elevated in pregnancy. Factors that may exacerbate SARS-CoV-2 morbidity through hyperinflammatory states include increases in the complement system, which are linked to greater lung injury, as well as increases in TLR-1 and TLR-7, which are known to bind to the virus, leading to increased proinflammatory cytokines such as IL-6 and TNF-α, which are already elevated in normal pregnant physiology. Other considerations include an increase in angiotensin converting enzyme 2 (ACE2) in the maternal circulation, leading to increased viral binding on the host cell, as well as increased IL-6 and decreased regulatory T cells in pre-eclampsia. We also focus on how the Delta variant has had a concerning impact on SARS-CoV-2 cases in pregnancy, with an increased case volume and proportion of ICU admissions among the infected expecting mothers. We propose that the effects of the Delta variant are due to a combination of (1) the Delta variant itself being more transmissible, contagious, and efficient at infecting host cells, (2) initial evidence pointing to the Delta variant causing a significantly greater viral load that accumulates more rapidly in the respiratory system, (3) the pregnancy state being more susceptible to SARS-CoV-2 infection, as discussed in-depth, and (4) the lower rates of vaccination in pregnant women compared to the general population. In the face of continually evolving strains and the relatively low awareness of COVID-19 vaccination for pregnant women, it is imperative that we continue to push for global vaccine equity.
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Affiliation(s)
| | - Vishwanath Venketaraman
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA;
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155
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Jorge RG, Marta SM, Vanesa GH, Luis ML, Fernando RL, Silvia CA, Natacha PF, Borja GT, Alberto C, Patricia CL, Ignacio PCJ, Ignacio GL. Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients. J Clin Med 2021; 10:5478. [PMID: 34884180 PMCID: PMC8658110 DOI: 10.3390/jcm10235478] [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: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Risk stratification of COVID-19 patients is fundamental to improving prognosis and selecting the right treatment. We hypothesized that a combination of lung ultrasound (LUZ-score), biomarkers (sST2), and clinical models (PANDEMYC score) could be useful to improve risk stratification. METHODS This was a prospective cohort study designed to analyze the prognostic value of lung ultrasound, sST2, and PANDEMYC score in COVID-19 patients. The primary endpoint was in-hospital death and/or admission to the intensive care unit. The total length of hospital stay, increase of oxygen flow, or escalated medical treatment during the first 72 h were secondary endpoints. RESULTS a total of 144 patients were included; the mean age was 57.5 ± 12.78 years. The median PANDEMYC score was 243 (52), the median LUZ-score was 21 (10), and the median sST2 was 53.1 ng/mL (30.9). Soluble ST2 showed the best predictive capacity for the primary endpoint (AUC = 0.764 (0.658-0.871); p = 0.001), towards the PANDEMYC score (AUC = 0.762 (0.655-0.870); p = 0.001) and LUZ-score (AUC = 0.749 (0.596-0.901); p = 0.002). Taken together, these three tools significantly improved the risk capacity (AUC = 0.840 (0.727-0.953); p ≤ 0.001). CONCLUSIONS The PANDEMYC score, lung ultrasound, and sST2 concentrations upon admission for COVID-19 are independent predictors of intra-hospital death and/or the need for admission to the ICU for mechanical ventilation. The combination of these predictive tools improves the predictive power compared to each one separately. The use of decision trees, based on multivariate models, could be useful in clinical practice.
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Affiliation(s)
- Rubio-Gracia Jorge
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
| | - Sánchez-Marteles Marta
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
| | - Garcés-Horna Vanesa
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
| | - Martínez-Lostao Luis
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Immunology Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain
- Center for Biomedical Research of Aragon, 50009 Zaragoza, Spain
| | - Ruiz-Laiglesia Fernando
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
| | - Crespo-Aznarez Silvia
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
| | - Peña-Fresneda Natacha
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Center for Biomedical Research of Aragon, 50009 Zaragoza, Spain
| | - Gracia-Tello Borja
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Immunology Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain
| | - Cebollada Alberto
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Biocomputation Unit, Center for Biomedical Research of Aragon, 50009 Zaragoza, Spain
| | - Carrera-Lasfuentes Patricia
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), 28005 Madrid, Spain
| | - Pérez-Calvo Juan Ignacio
- Internal Medicine Department, Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain; (S.-M.M.); (G.-H.V.); (R.-L.F.); (C.-A.S.); (G.-T.B.); (P.-C.J.I.)
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Center for Biomedical Research of Aragon, 50009 Zaragoza, Spain
- School Medicine, Zaragoza University, 50009 Zaragoza, Spain
| | - Giménez-López Ignacio
- Aragon Health Research Institute, 50009 Zaragoza, Spain; (M.-L.L.); (P.-F.N.); (C.A.); (C.-L.P.); (G.-L.I.)
- Center for Biomedical Research of Aragon, 50009 Zaragoza, Spain
- School Medicine, Zaragoza University, 50009 Zaragoza, Spain
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156
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Sanchez BG, Gasalla JM, Sánchez-Chapado M, Bort A, Diaz-Laviada I. Increase in Ischemia-Modified Albumin and Pregnancy-Associated Plasma Protein-A in COVID-19 Patients. J Clin Med 2021; 10:jcm10235474. [PMID: 34884175 PMCID: PMC8658290 DOI: 10.3390/jcm10235474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
This study was undertaken due to the urgent need to explore reliable biomarkers for early SARS-CoV-2 infection. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers IL-6, TNF-α, N-terminal pro-B natriuretic peptide, cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and pregnancy-associated plasma protein-A (PAPP-A) in 84 patients with COVID-19.Patients were divided into three groups according to their RT-qPCR and IgG values: acute infection (n = 35), early infection (n = 25) or control subjects (n = 24). Levels of biomarkers were analyzed in patient serum samples using commercially available ELISA kits. Results showed a significant increase in IMA and PAPP-A levels in the early infected patients. Moreover, multivariate analysis and receiver operating characteristic (ROC) curve showed that IMA and PAPP-A had excellent discrimination value for the early stage of COVID-19. For IMA, the area under the ROC curve (AUC) had a value of 0.94 (95% confidence interval (CI): 0.881–0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in the control subjects (AUC = 0.801 (95% CI: 0.673–0.929)). The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2-infected patients to 93%. These results suggest that the increased levels of PAPP-A and IMA shed light on underlying mechanisms of COVID-19 physiopathology and might be used as efficient biomarkers with high sensitivity and specificity for the early stage of COVID-19. Importantly, when monitoring pregnancy and cardiovascular diseases using PAPP-A or IMA levels, a SARS-CoV-2 infection should be discarded for proper interpretation of the results.
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Affiliation(s)
- Belén G. Sanchez
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
| | - Jose M. Gasalla
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Clinical Biochemistry Service, Principe de Asturias Hospital, 28805 Alcalá de Henares, Spain
| | - Manuel Sánchez-Chapado
- Department of Urology, Principe de Asturias Hospital, 28805 Alcalá de Henares, Spain;
- Department of Surgery, Medical and Social Sciences, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain
| | - Alicia Bort
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Correspondence: (A.B.); (I.D.-L.)
| | - Inés Diaz-Laviada
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Chemical Research Institute “Andrés M. del Río” (IQAR), Alcalá University, 28871 Alcalá de Henares, Spain
- Correspondence: (A.B.); (I.D.-L.)
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157
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Salvotti F, Poiatti F, Bressa S, Montani G, Nardin M, Rizzoni D. Platypnoea-Orthodeoxia Syndrome in COVID-19. Eur J Case Rep Intern Med 2021; 8:002849. [PMID: 34790629 DOI: 10.12890/2021_002849] [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: 08/25/2021] [Accepted: 10/05/2021] [Indexed: 11/05/2022] Open
Abstract
Platypnoea-orthodeoxia syndrome (POS) is a rare disorder and its pathophysiology has puzzled clinicians for years. Few cases of POS are described in COVID-19 patients in the literature, with a high variability of conditions related to the syndrome. In this article, we report the case of a patient admitted to our hospital for SARS-CoV-2 interstitial pneumonia, who developed POS during the hospitalization. LEARNING POINTS Platypnoea-orthodeoxia syndrome (POS) is a possible and rare condition associated with SARS-CoV-2 pneumonia.A prompt diagnosis of POS is important in order to start careful and adequate oxygen supplementation.Clinical data on COVID-19 evolution in patients with POS and possible therapeutic and rehabilitative strategies are not available in the literature.
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Affiliation(s)
- Francesca Salvotti
- Third Medicine Division, Department of Medicine, ASST Spedali Civili di Brescia, Brescia, Italy.,Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
| | - Francesco Poiatti
- Third Medicine Division, Department of Medicine, ASST Spedali Civili di Brescia, Brescia, Italy.,Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
| | - Stefano Bressa
- Third Medicine Division, Department of Medicine, ASST Spedali Civili di Brescia, Brescia, Italy.,Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Montani
- Third Medicine Division, Department of Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Matteo Nardin
- Third Medicine Division, Department of Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Damiano Rizzoni
- Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.,Division of Medicine, A.S.S.T. Spedali Civili di Brescia, Montichiari, Italy
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Loke XY, Imran SAM, Tye GJ, Wan Kamarul Zaman WS, Nordin F. Immunomodulation and Regenerative Capacity of MSCs for Long-COVID. Int J Mol Sci 2021; 22:ijms222212421. [PMID: 34830303 PMCID: PMC8625432 DOI: 10.3390/ijms222212421] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/26/2022] Open
Abstract
The rapid mutation of the SARS-CoV-2 virus is now a major concern with no effective drugs and treatments. The severity of the disease is linked to the induction of a cytokine storm that promotes extensive inflammation in the lung, leading to many acute lung injuries, pulmonary edema, and eventually death. Mesenchymal stem cells (MSCs) might prove to be a treatment option as they have immunomodulation and regenerative properties. Clinical trials utilizing MSCs in treating acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) have provided a basis in treating post-COVID-19 patients. In this review, we discussed the effects of MSCs as an immunomodulator to reduce the severity and death in patients with COVID-19, including the usage of MSCs as an alternative regenerative therapy in post-COVID-19 patients. This review also includes the current clinical trials in utilizing MSCs and their potential future utilization for long-COVID treatments.
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Affiliation(s)
- Xin Ya Loke
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (X.Y.L.); (S.A.M.I.)
| | - Siti A. M. Imran
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (X.Y.L.); (S.A.M.I.)
| | - Gee Jun Tye
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor 11800, Malaysia;
| | - Wan Safwani Wan Kamarul Zaman
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
- Centre for Innovation in Medical Engineering (CIME), Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Fazlina Nordin
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (X.Y.L.); (S.A.M.I.)
- Correspondence: ; Tel.: +60-38921-5555
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159
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Phenylalanine and COVID-19: Tracking disease severity markers. Int Immunopharmacol 2021; 101:108313. [PMID: 34741868 PMCID: PMC8559801 DOI: 10.1016/j.intimp.2021.108313] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 12/13/2022]
Abstract
Background Although there are several severity
predictors for COVID-19, none are specific. Serum levels of phenylalanine
were recently associated with increased inflammation, higher SOFA scores,
ICU admission, and mortality rates among non-COVID-19 patients. Here, we
investigated the relationship between phenylalanine and inflammatory
markers in adults with COVID-19. Methods We assessed adults with COVID-19 at
hospital admission for clinical and laboratory data. Nuclear magnetic
resonance spectroscopy measured serum levels of phenylalanine and other
amino acids of its metabolomic pathway. Flow Cytometry measured serum
levels of IL-2, IL-4, IL-6, Il-10, TNF-α, and IFN-γ. Linear regression
models adjusted for potential confounders assessed the relationship
between serum levels of phenylalanine and inflammatory
cytokines. Results Phenylalanine and tyrosine were
significantly lower in mild disease as compared to moderate and severe
groups. Linear regression models showed that phenylalanine is
independently and positively associated with disease severity regardless
of the cytokine analyzed and after adjustment for potential confounders.
In addition, mild cases showed consistently lower serum phenylalanine
levels within the first ten days from disease onset to hospital
admission. Conclusions Phenylalanine is a marker of disease
severity. This association is independent of the time between the onset
of symptoms and the magnitude of the inflammatory state.
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160
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Ahmed AA, Ad'hiah AH. Interleukin-37 gene polymorphism and susceptibility to coronavirus disease 19 among Iraqi patients. Meta Gene 2021; 31:100989. [PMID: 34729360 PMCID: PMC8553418 DOI: 10.1016/j.mgene.2021.100989] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease 19 (COVID-19) is a highly contagious respiratory viral infection. Dysregulated immune response is an important feature of disease, and cytokines are among the most important mediators of dysregulated immunity. Interleukin-37 (IL-37) is one such cytokine and studies have indicated its role in pathogenesis of COVID-19. However, IL37 gene polymorphisms have not been identified in patients with COVID-19. Therefore, this case-control study (100 patients and 100 controls) was performed to understand the role six single nucleotide polymorphisms of IL37 gene (SNPs: rs3811042, rs3811043, rs2466449, rs3811045, rs3811046 and rs3811047) in susceptibility to COVID-19 among cases with severe disease. These polymorphisms were identified by Sanger DNA sequencing. Results revealed that TG genotype of rs3811046 showed a significantly increased frequency in patients compared to controls (61.0 vs. 38.0%; odds ratio [OR] = 2.55; 95% confidence interval [CI] = 1.45–4.50; probability [p] = 0.002; corrected p [pc] = 0.01). GA genotype of rs3811047 also showed an increased frequency in patients but the pc-value was not significant (39.0 vs. 24.0%; OR = 2.02; 95% CI = 1.10–3.71; p = 0.033; pc = 0.165). Haplotype analysis revealed a significantly increased frequency of the haplotype G-C-A-T-T-A (in the order: rs3811042, rs3811043, rs2466449, rs3811045, rs3811046 and rs3811047) in COVID-19 patients compared to controls (0.055 vs. 0.006; OR = 10.23; 95% CI = 1.53–68.14; p = 0.003; pc = 0.03). In conclusion, the study indicated that two variants of IL37 gene (rs3811046 and rs3811047) may be associated with susceptibility to COVID-19 among Iraqi population.
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Affiliation(s)
- Aeshah A Ahmed
- Biotechnology Department, College of Science, University of Baghdad, Baghdad, Iraq
| | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
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161
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Teixeira AL, Krause TM, Ghosh L, Shahani L, Machado-Vieira R, Lane SD, Boerwinkle E, Soares JC. Analysis of COVID-19 Infection and Mortality Among Patients With Psychiatric Disorders, 2020. JAMA Netw Open 2021; 4:e2134969. [PMID: 34812848 PMCID: PMC8611476 DOI: 10.1001/jamanetworkopen.2021.34969] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPORTANCE People with major psychiatric disorders are more likely to have comorbidities associated with worse outcomes of COVID-19. This fact alone could determine greater vulnerability of people with major psychiatric disorders to COVID-19. OBJECTIVE To assess the odds of testing positive for and mortality from COVID-19 among and between patients with schizophrenia, mood disorders, anxiety disorders and a reference group in a large national database. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used an electronic health record data set aggregated from many national sources in the United States and licensed from Optum with current and historical data on patients tested for COVID-19 in 2020. Three psychiatric cohorts (patients with schizophrenia, mood disorders, or anxiety disorders) were compared with a reference group with no major psychiatric conditions. Statistical analysis was performed from March to April 2021. EXPOSURE The exposures observed include lab-confirmed positivity for COVID-19 and mortality. MAIN OUTCOMES AND MEASURES The odds of testing positive for COVID-19 in 2020 and the odds of death from COVID-19 were measured. RESULTS The population studied included 2 535 098 unique persons, 3350 with schizophrenia, 26 610 with mood disorders, and 18 550 with anxiety disorders. The mean (SD) age was 44 (23) years; 233 519 were non-Hispanic African American, 1 583 440 were non-Hispanic Caucasian; and 1 580 703 (62%) were female. The schizophrenia cohort (positivity rate: 9.86%; adjusted OR, 0.90 [95% CI, 0.84-0.97]) and the mood disorder cohort (positivity rate: 9.86%; adjusted OR, 0.93 [95% CI, 0.87-0.99]) had a significantly lower rate of positivity than the anxiety disorder cohort (positivity rate: 11.17%; adjusted OR, 1.05 [95% CI, 0.98-1.12) which was closer to the reference group (11.91%). After fully adjusting for demographic factors and comorbid conditions, patients with schizophrenia were nearly 4 times more likely to die from the disease than the reference group (OR, 3.74; 95% CI, 2.66-5.24). The mood disorders COVID-19 cohort had a 2.76 times greater odds of mortality than the reference group (OR, 2.76; 95% CI, 2.00-3.81), and the anxiety disorders cohort had a 2.39 times greater odds of mortality than the reference group (OR, 2.39; 95% CI, 1.68-3.27). CONCLUSIONS AND RELEVANCE By examining a large database while controlling for multiple confounding factors such as age, race and ethnicity, and comorbid medical conditions, the present study found that patients with schizophrenia had much increased odds of mortality by COVID-19.
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Affiliation(s)
- Antonio L. Teixeira
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston
| | - Trudy Millard Krause
- School of Public Health, The University of Texas Health Science Center at Houston, Houston
| | - Lopita Ghosh
- School of Public Health, The University of Texas Health Science Center at Houston, Houston
| | - Lokesh Shahani
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston
| | - Rodrigo Machado-Vieira
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston
| | - Scott D. Lane
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston
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162
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Al-Kuraishy HM, Al-Gareeb AI, Qusti S, Alshammari EM, Atanu FO, Batiha GES. Arginine vasopressin and pathophysiology of COVID-19: An innovative perspective. Biomed Pharmacother 2021; 143:112193. [PMID: 34543987 PMCID: PMC8440235 DOI: 10.1016/j.biopha.2021.112193] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 12/25/2022] Open
Abstract
In Covid-19, systemic disturbances may progress due to development of cytokine storm and dysregulation of and plasma osmolarility due to high release of pro-inflammatory cytokines and neuro-hormonal disorders. Arginine vasopressin (AVP) which is involve in the regulation of body osmotic system, body water content, blood pressure and plasma volume, that are highly disturbed in Covid-19 and linked with poor clinical outcomes. Therefore, this present study aimed to find the potential association between AVP serum level and inflammatory disorders in Covid-19. It has been observed by different recent studies that physiological response due to fever, pain, hypovolemia, dehydration, and psychological stress is characterized by activation release of AVP to counter-balance high blood viscosity in Covid-19 patients. In addition, activated immune cells mainly T and B lymphocytes and released pro-inflammatory cytokines stimulate discharge of stored AVP from immune cells, which in a vicious cycle trigger release of pro-inflammatory cytokines. Vasopressin receptor antagonists have antiviral and anti-inflammatory effects that may inhibit AVP-induced hyponatremia and release of pro-inflammatory cytokines in Covid-19. In conclusion, release of AVP from hypothalamus is augmented in Covid-19 due to stress, high pro-inflammatory cytokines, high circulating AngII and inhibition of GABAergic neurons. In turn, high AVP level leads to induction of hyponatremia, inflammatory disorders, and development of complications in Covid-19 by activation of NF-κB and NLRP3 inflammasome with release of pro-inflammatory cytokines. Therefore, AVP antagonists might be novel potential therapeutic modality in treating Covid-19 through mitigation of AVP-mediated inflammatory disorders and hyponatremia.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq.
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq.
| | - Safaa Qusti
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Eida M Alshammari
- Department of Chemistry, College of Sciences, University of Ha'il, Ha'il, Saudi Arabia.
| | - Francis O Atanu
- Department of Biochemistry, Faculty of Natural Sciences, Kogi State University, P.M.B. 1008 Anyigba, Nigeria.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, AlBeheira, Egypt.
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163
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Molecular Insights on the Possible Role of Annexin A2 in COVID-19 Pathogenesis and Post-Infection Complications. Int J Mol Sci 2021; 22:ijms222011028. [PMID: 34681689 PMCID: PMC8538098 DOI: 10.3390/ijms222011028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has infected >235 million people and killed over 4.8 million individuals worldwide. Although vaccines have been developed for prophylactic management, there are no clinically proven antivirals to treat the viral infection. Continuous efforts are being made all over the world to develop effective drugs but these are being delayed by periodic outbreak of mutated SARS-CoV-2 and a lack of knowledge of molecular mechanisms underlying viral pathogenesis and post-infection complications. In this regard, the involvement of Annexin A2 (AnxA2), a lipid-raft related phospholipid-binding protein, in SARS-CoV-2 attachment, internalization, and replication has been discussed. In addition to the evidence from published literature, we have performed in silico docking of viral spike glycoprotein and RNA-dependent RNA polymerase with human AnxA2 to find the molecular interactions. Overall, this review provides the molecular insights into a potential role of AnxA2 in the SARS-CoV-2 pathogenesis and post-infection complications, especially thrombosis, cytokine storm, and insulin resistance.
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164
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Ahmed AA, Ad'hiah AH. Interleukin-37 is down-regulated in serum of patients with severe coronavirus disease 2019 (COVID-19). Cytokine 2021; 148:155702. [PMID: 34534925 PMCID: PMC8439667 DOI: 10.1016/j.cyto.2021.155702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
Pro-inflammatory and anti-inflammatory cytokines are indicated to play a prominent role in mediating the immunopathogenesis of coronavirus disease 19 (COVID-19). Interleukin (IL-37) is one of the anti-inflammatory cytokines that has been proposed to be involved in disease progression but the data are not overwhelming. Therefore, a case-control study was performed to analyze IL-37 levels in serum of 100 patients with severe COVID-19 and 100 blood donors (control group). Median age was significantly higher in COVID-19 cases than in controls. Stratification by gender, body mass index and ABO and Rh blood group systems showed no significant differences between patients and controls. Chronic diseases (cardiovascular and diabetes) were observed in 57.0% of patients. Serum levels of IL-37 and vitamin D were significantly decreased in patients compared to controls. The low level of IL-37 was more pronounced in males, overweight/obese cases, blood group B or AB cases, Rh-positive cases, and cases with no chronic disease. Low producers of IL-37 were more likely to develop COVID-19 (odds ratio = 2.66; 95% confidence interval = 1.51–4.70; corrected probability = 0.015). Receiver operating characteristic curve analysis demonstrated that a low serum level of IL-37 was a good predictor of COVID-19. Spearman's rank correlation analysis showed that IL-37 and vitamin D were significantly correlated. In conclusion, IL-37 was down-regulated in serum of patients with severe COVID-19 compared to controls. This down-regulation may be associated with an increased risk of disease. Gender, body mass index, blood groups and chronic disease status may also affect IL-37 levels.
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Affiliation(s)
- Aeshah A Ahmed
- Biotechnology Department, College of Science, University of Baghdad, Baghdad, Iraq
| | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq.
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165
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Iglesias JI, Vassallo AV, Sullivan JB, Elbaga Y, Patel VV, Patel N, Ayad L, Benson P, Pittiglio M, Gobran E, Clark A, Khan W, Damalas K, Mohan R, Singh SP. Retrospective analysis of anti-inflammatory therapies during the first wave of COVID-19 at a community hospital. World J Crit Care Med 2021; 10:244-259. [PMID: 34616660 PMCID: PMC8462025 DOI: 10.5492/wjccm.v10.i5.244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/23/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Our understanding of the severe acute respiratory syndrome coronavirus 2 has evolved since the first reported cases in December 2019, and a greater emphasis has been placed on the hyper-inflammatory response in severely ill patients. The purpose of this study was to determine risk factors for mortality and the impact of anti-inflammatory therapies on survival.
AIM To determine the impact of various therapies on outcomes in severe coronavirus disease 2019 patients with a focus on anti-inflammatory and immune-modulating agents.
METHODS A retrospective analysis was conducted on 261 patients admitted or transferred to the intensive care unit in two community hospitals between March 12, 2020 and June 17, 2020. Totally 167 patients received glucocorticoid (GC) therapy. Seventy-three patients received GC alone, 94 received GC and tocilizumab, 28 received tocilizumab monotherapy, and 66 received no anti-inflammatory therapy.
RESULTS Patient survival was associated with GC use, either alone or with tocilizumab, and decreased vasopressor requirements. Delayed administration of GC was found to decrease the survival benefit of GC therapy. No difference in survival was found with varying anticoagulant doses, convalescent plasma, tocilizumab monotherapy; prone ventilation, hydroxychloroquine, azithromycin, or intravenous ascorbic acid use.
CONCLUSION This analysis demonstrated the survival benefit associated with anti-inflammatory therapy of GC, with or without tocilizumab, with the combination providing the most benefit. More studies are needed to assess the optimal timing of anti-inflammatory therapy initiation.
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Affiliation(s)
- Jose I Iglesias
- Department of Critical Care, Community Medical Center, Toms River, NJ 08757, United States
- Department of Nephrology, Community Medical Center, Toms River, NJ 08757, United States
- Department of Nephrology, Jersey Shore University Medical Center, Hackensack Meridian School of Medicine at Seton Hall, Neptune, NJ 07753, United States
| | - Andrew V Vassallo
- Department of Pharmacy, Community Medical Center, Toms River, NJ 08757, United States
| | - Jesse B Sullivan
- Fairleigh Dickinson University School of Pharmacy & Health Sciences, Fairleigh Dickinson University, Florham Park, NJ 07932, United States
| | - Yasmine Elbaga
- Department of Pharmancy, Monmouth Medical Center Southern Campus, Lakewood, NJ 08701, United States
| | - Vishal V Patel
- Department of Pharmacy, Community Medical Center, Toms River, NJ 08757, United States
| | - Nikunjkumar Patel
- Department of Medicine, Community Medical Center, Toms River, NJ 08757, United States
| | - Lydia Ayad
- Department of Medicine, Community Medical Center, Toms River, NJ 08757, United States
| | - Payam Benson
- Department of Medicine, Community Medical Center, Toms River, NJ 08757, United States
| | - Marina Pittiglio
- Department of Pharmacy, Community Medical Center, Toms River, NJ 08757, United States
| | - Emad Gobran
- Department of Medicine, Community Medical Center, Toms River, NJ 08757, United States
| | - Alexander Clark
- Department of Pharmancy, Monmouth Medical Center Southern Campus, Lakewood, NJ 08701, United States
| | - Wajahat Khan
- Department of Critical Care, Community Medical Center, Toms River, NJ 08757, United States
| | - Kaliope Damalas
- Department of Pharmacy, Community Medical Center, Toms River, NJ 08757, United States
| | - Rajesh Mohan
- Department of Cardiology, Monmouth Medical Center Southern Campus, Lakewood, NJ 08701, United States
| | - Satyendra P Singh
- Department of Medicine, Monmouth Medical Center Southern Campus, Lakewood, NJ 08701, United States
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166
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Karnina R, Arif SK, Hatta M, Bukhari A. Molecular mechanisms of lidocaine. Ann Med Surg (Lond) 2021; 69:102733. [PMID: 34457261 PMCID: PMC8379473 DOI: 10.1016/j.amsu.2021.102733] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 02/08/2023] Open
Abstract
Lidocaine is an amide-class local anesthetic used clinically to inhibit pain sensations. Systemic administration of lidocaine has antinociceptive, antiarrhythmic, anti-inflammatory, and antithrombotic effects. Lidocaine exerts these effects under both acute and chronic pain conditions and acute respiratory distress syndrome through mechanisms that can be independent of its primary mechanism of action, sodium channel inhibition. Here we review the pathophysiological underpinnings of lidocaine's role as an anti-nociceptive, anti-inflammatory mediated by toll-like receptor (TLR) and nuclear factor kappa-β (NF-kβ) signalling pathways and downstream cytokine effectors high mobility group box 1 (HMGB1) and tumour necrosis factor-α (TNF-α).
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Affiliation(s)
- Resiana Karnina
- Doctoral Program of Biomedical Sciences, Faculty of Medicine, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia
- Faculty of Medicine, Muhammadiyah University of Jakarta, Banten, Indonesia
| | - Syafri Kamsul Arif
- Department of Anesthesiology, Faculty of Medicine, Hasanuddin University, Sulawesi Selatan, Indonesia
| | - Mochammad Hatta
- Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia
| | - Agussalim Bukhari
- Department of Nutritional Sciences, Faculty of Medicine, Hasanuddin University, Sulawesi Selatan, Indonesia
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167
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Wang Z, Zhang J, Zhan J, Gao H. Screening out anti-inflammatory or anti-viral targets in Xuanfei Baidu Tang through a new technique of reverse finding target. Bioorg Chem 2021; 116:105274. [PMID: 34455301 PMCID: PMC8373853 DOI: 10.1016/j.bioorg.2021.105274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 01/25/2023]
Abstract
Traditional Chinese herbal compound prescription in Xuanfei Baidu Tang (XBT) has obvious effects in the treatment of COVID-19. However, its effective compounds and targets for the treatment of COVID-19 remain unclear. Computer-Aided Drug Design is used to virtually screen out the anti-inflammatory or anti-viral compounds in XBT, and predict the potential targets by Discovery Studio 2020. Then, we searched for COVID-19 targets using Genecards databases and Protein Data Bank (PDB) databases and compared them to identify targets that were common to both. Finally, the target we screened out is: TP53 (Tumor Protein P53). This article also shows that XBT in the treatment of COVID-19 works in a multi-link and overall synergistic manner. Our results will help to design the new drugs for COVID-19.
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Affiliation(s)
- Zixuan Wang
- School of Life Science, Ludong University, Yantai, Shandong 264025, China
| | - Jumei Zhang
- School of Life Science, Ludong University, Yantai, Shandong 264025, China
| | - Jiuyu Zhan
- School of Life Science, Ludong University, Yantai, Shandong 264025, China
| | - Hongwei Gao
- School of Life Science, Ludong University, Yantai, Shandong 264025, China.
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168
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Macedo-Ojeda G, Muñoz-Valle JF, Yokogawa-Teraoka P, Machado-Sulbarán AC, Loza-Rojas MG, García-Arredondo AC, Tejeda-Constantini R, Vega-Magaña AN, González-Estevez G, García-Chagollán M, Zepeda-Nuño JS, Hernández-Bello J. COVID-19 Screening by Anti-SARS-CoV-2 Antibody Seropositivity: Clinical and Epidemiological Characteristics, Comorbidities, and Food Intake Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178995. [PMID: 34501583 PMCID: PMC8431502 DOI: 10.3390/ijerph18178995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 12/16/2022]
Abstract
Developing countries have reported lower molecular diagnostic testing levels due to a lack of resources. Therefore, antibody tests represent an alternative to detect exposure to SARS-CoV-2 and analyze possible risk factors. We aimed to describe and compare the clinical-epidemiological characteristics and the quality of food intake in Mexican individuals with a positive or negative test to antibodies against SARS-CoV-2. We carried out antibody tests and applied a survey to 1799 individuals; 42% were positive, and diabetes was more prevalent in these cases (p < 0.01). No differences were identified in the blood type nor influenza vaccination between groups. Coughing, respiratory distress, muscle pain, joint pain, and anosmia were the most prevalent symptoms among seropositive cases (p < 0.0001). Food intake quality was similar in both groups, except for the most consumed type of fat (p = 0.006). In conclusion, this study supports the association of diabetes as a principal risk factor for SARS-CoV-2 infection in the Mexican population. The results do not support previous associations between blood group or influenza vaccination as protective factors against SARS-CoV-2 infection. However, frequent consumption of polyunsaturated fats is highlighted as a new possible associated factor with COVID-19, which more studies should corroborate as with all novel findings.
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Affiliation(s)
- Gabriela Macedo-Ojeda
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
- Department of Public Health, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico
| | - José Francisco Muñoz-Valle
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
| | - Patricia Yokogawa-Teraoka
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
- Department of Social Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico
| | - Andrea Carolina Machado-Sulbarán
- Institute for Research in Childhood and Adolescent Cancer (INICIA), University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico;
| | - María Guadalupe Loza-Rojas
- Department of Applied Clinical Nursing, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (M.G.L.-R.); (A.C.G.-A.)
| | - Atziri Citlally García-Arredondo
- Department of Applied Clinical Nursing, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (M.G.L.-R.); (A.C.G.-A.)
| | - Rafael Tejeda-Constantini
- Institutional System of Safety, Health and Environment (SISSMA), University of Guadalajara, Guadalajara 44100, Mexico;
| | - Alejandra Natali Vega-Magaña
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
- Emerging and Reemerging Diseases Diagnostic Laboratory (LaDEER), University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico
| | - Guillermo González-Estevez
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
- Department of Social Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico
| | - Mariel García-Chagollán
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- Emerging and Reemerging Diseases Diagnostic Laboratory (LaDEER), University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico
| | - José Sergio Zepeda-Nuño
- Department of Microbiology and Pathology, Pathology Laboratory, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico;
| | - Jorge Hernández-Bello
- Institute of Research in Biomedical Sciences, University Center for Health Sciences (CUCS), University of Guadalajara, Guadalajara 44100, Mexico; (G.M.-O.); (J.F.M.-V.); (A.N.V.-M.); (G.G.-E.); (M.G.-C.)
- COVID-19 Health Situation Room, University of Guadalajara, Guadalajara 44100, Mexico;
- Correspondence:
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[Research progress in coagulation dysfunction and its relationship with cytokine storm syndrome in patients with severe/critical COVID-19]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:700-704. [PMID: 34547883 PMCID: PMC8501276 DOI: 10.3760/cma.j.issn.0253-2727.2021.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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170
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Heindl LM, Borderie VM. Plague rampant: two sides of the coin. Br J Ophthalmol 2021; 105:891-892. [PMID: 34045223 DOI: 10.1136/bjophthalmol-2021-319687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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171
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Iliadi V, Konstantinidou I, Aftzoglou K, Iliadis S, Konstantinidis TG, Tsigalou C. The Emerging Role of Neutrophils in the Pathogenesis of Thrombosis in COVID-19. Int J Mol Sci 2021; 22:5368. [PMID: 34065210 PMCID: PMC8161034 DOI: 10.3390/ijms22105368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022] Open
Abstract
Previous studies have shown that COVID-19 leads to thrombotic complications, which have been associated with high morbidity and mortality rates. Neutrophils are the largest population of white blood cells and play a pivotal role in innate immunity. During an infection, neutrophils migrate from circulation to the infection site, contributing to killing pathogens. This mechanism is regulated by chemokines such as IL-8. Moreover, it was shown that neutrophils play an important role in thromboinflammation. Through a diverse repertoire of mechanisms, neutrophils, apart from directly killing pathogens, are able to activate the formation of thrombi. In COVID-19 patients, neutrophil activation promotes neutrophil extracellular trap (NET) formation, platelet aggregation, and cell damage. Furthermore, neutrophils participate in the pathogenesis of endothelitis. Overall, this review summarizes recent progress in research on the pathogenesis of COVID-19, highlighting the role of the prothrombotic action of neutrophils in NET formation.
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Affiliation(s)
- Valeria Iliadi
- Medical School, Izhevsk State Medical Academy, Kommunarov Street 281, 426034 Izhevsk, Russia; (V.I.); (S.I.)
| | | | | | - Sergios Iliadis
- Medical School, Izhevsk State Medical Academy, Kommunarov Street 281, 426034 Izhevsk, Russia; (V.I.); (S.I.)
| | - Theocharis G. Konstantinidis
- Blood Transfusion Center, University General Hospital of Alexandroupolis Dragana Campus, 68100 Alexandroupolis, Greece
| | - Christina Tsigalou
- Laboratory of Microbiology, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece;
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172
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Harrell CR, Popovska Jovicic B, Djonov V, Volarevic V. Molecular Mechanisms Responsible for Mesenchymal Stem Cell-Based Treatment of Viral Diseases. Pathogens 2021; 10:pathogens10040409. [PMID: 33915728 PMCID: PMC8066286 DOI: 10.3390/pathogens10040409] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/16/2021] [Accepted: 03/26/2021] [Indexed: 12/29/2022] Open
Abstract
Mesenchymal stem cells (MSCs) are adult, immunomodulatory stem cells which reside in almost all postnatal tissues. Viral antigens and damage-associated molecular patterns released from injured and infected cells activate MSCs, which elicit strong antiviral immune response. MSC-sourced interferons and inflammatory cytokines modulate the cytotoxicity of NK cells and CTLs, enhance the antigen-presentation properties of DCs and macrophages, regulate cytokine synthesis in CD4+ T helper cells and promote antibody production in B cells. After the elimination of viral pathogens, MSCs produce immunoregulatory cytokines and trophic factors, prevent the over-activation of immune cells and promote tissue repair and regeneration. In this review article, we summarize the current knowledge on the molecular mechanisms that are responsible for the MSC-dependent elimination of virus-infected cells, and we emphasize the therapeutic potential of MSCs and their secretomes in the treatment of viral diseases.
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Affiliation(s)
- Carl Randall Harrell
- Regenerative Processing Plant, LLC, 34176 US Highway 19 N Palm Harbor, Palm Harbor, FL 34684, USA;
| | - Biljana Popovska Jovicic
- Department of Infectious Diseases, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia
- Correspondence: (B.P.J.); (V.V.); Tel./Fax: +381-34306800 (V.V.)
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, 2 Baltzerstrasse, 3012 Bern, Switzerland;
| | - Vladislav Volarevic
- Department for Microbiology and Immunology, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia
- Correspondence: (B.P.J.); (V.V.); Tel./Fax: +381-34306800 (V.V.)
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173
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Pojero F, Candore G, Caruso C, Di Bona D, Groneberg DA, Ligotti ME, Accardi G, Aiello A. The Role of Immunogenetics in COVID-19. Int J Mol Sci 2021; 22:2636. [PMID: 33807915 PMCID: PMC7961811 DOI: 10.3390/ijms22052636] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is induced by SARS-CoV-2 and may arise as a variety of clinical manifestations, ranging from an asymptomatic condition to a life-threatening disease associated with cytokine storm, multiorgan and respiratory failure. The molecular mechanism behind such variability is still under investigation. Several pieces of experimental evidence suggest that genetic variants influencing the onset, maintenance and resolution of the immune response may be fundamental in predicting the evolution of the disease. The identification of genetic variants behind immune system reactivity and function in COVID-19 may help in the elaboration of personalized therapeutic strategies. In the frenetic look for universally shared treatment plans, those genetic variants that are common to other diseases/models may also help in addressing future research in terms of drug repurposing. In this paper, we discuss the most recent updates about the role of immunogenetics in determining the susceptibility to and the history of SARS-CoV-2 infection. We propose a narrative review of available data, speculating about lessons that we have learnt from other viral infections and immunosenescence, and discussing what kind of aspects of research should be deepened in order to improve our knowledge of how host genetic variability impacts the outcome for COVID-19 patients.
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Affiliation(s)
- Fanny Pojero
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
| | - Giuseppina Candore
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
| | - Calogero Caruso
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
| | - Danilo Di Bona
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - David A. Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany;
| | - Mattia E. Ligotti
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
| | - Giulia Accardi
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
| | - Anna Aiello
- Laboratory of Immunopathology and Immunosenescence, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90134 Palermo, Italy; (F.P.); (G.C.); (M.E.L.); (G.A.)
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