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Baena Carstens L, Campos D’amico R, Fernandes de Moura K, Morais de Castro E, Centenaro F, Silva Barbosa G, Vieira Cavalcante da Silva G, Brenny I, Honório D’Agostini JC, Hlatchuk EC, Pissette de Lima S, Camargo Martins AP, De Castro Deus M, Konzen Klein C, Kubaski Benevides AP, Nagashima S, Machado-Souza C, Pinho RA, Pellegrino Baena C, de Noronha L. Lung Inflammasome Activation in SARS-CoV-2 Post-Mortem Biopsies. Int J Mol Sci 2022; 23:ijms232113033. [PMID: 36361818 PMCID: PMC9659061 DOI: 10.3390/ijms232113033] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
The inflammasome complex is a key part of chronic diseases and acute infections, being responsible for cytokine release and cell death mechanism regulation. The SARS-CoV-2 infection is characterized by a dysregulated cytokine release. In this context, the inflammasome complex analysis within SARS-CoV-2 infection may prove beneficial to understand the disease’s mechanisms. Post-mortem minimally invasive autopsies were performed in patients who died from COVID-19 (n = 24), and lung samples were compared to a patient control group (n = 11) and an Influenza A virus H1N1 subtype group from the 2009 pandemics (n = 10). Histological analysis was performed using hematoxylin-eosin staining. Immunohistochemical (IHC) staining was performed using monoclonal antibodies against targets: ACE2, TLR4, NF-κB, NLRP-3 (or NALP), IL-1β, IL-18, ASC, CASP1, CASP9, GSDMD, NOX4, TNF-α. Data obtained from digital analysis underwent appropriate statistical tests. IHC analysis showed biomarkers that indicate inflammasome activation (ACE2; NF-κB; NOX4; ASC) were significantly increased in the COVID-19 group (p < 0.05 for all) and biomarkers that indicate cell pyroptosis and inflammasome derived cytokines such as IL-18 (p < 0.005) and CASP1 were greatly increased (p < 0.0001) even when compared to the H1N1 group. We propose that the SARS-CoV-2 pathogenesis is connected to the inflammasome complex activation. Further studies are still warranted to elucidate the pathophysiology of the disease.
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Affiliation(s)
- Lucas Baena Carstens
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Raissa Campos D’amico
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Hospital Marcelino Champagnat, Av. Presidente Affonso Camargo, 1399-Cristo Rei, Curitiba 80050-370, PR, Brazil
| | - Karen Fernandes de Moura
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Hospital Marcelino Champagnat, Av. Presidente Affonso Camargo, 1399-Cristo Rei, Curitiba 80050-370, PR, Brazil
| | - Eduardo Morais de Castro
- Postgraduate in Biotechnology Applied in Health of Children and Adolescent, Faculdades Pequeno Príncipe (FPP), Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), R. Silva Jardim, 1632-Água Verde, Curitiba 80230-020, PR, Brazil
| | - Flávia Centenaro
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Giovanna Silva Barbosa
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Guilherme Vieira Cavalcante da Silva
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Isadora Brenny
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Júlio César Honório D’Agostini
- Departmnet of Medical Pathology, Universidade Federal do Paraná (UFPR), Rua General Carneiro, 181-Alto da Glória, Curitiba 80215-901, PR, Brazil
| | - Elisa Carolina Hlatchuk
- Departmnet of Medical Pathology, Universidade Federal do Paraná (UFPR), Rua General Carneiro, 181-Alto da Glória, Curitiba 80215-901, PR, Brazil
| | - Sabrina Pissette de Lima
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Ana Paula Camargo Martins
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Marina De Castro Deus
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Carolline Konzen Klein
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Ana Paula Kubaski Benevides
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Seigo Nagashima
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Correspondence: (S.N.); (L.d.N.); Tel.: +55-(41)-99942-7191 (S.N.); Tel.: +55-(41)-999994769 (L.d.N.)
| | - Cleber Machado-Souza
- Postgraduate in Biotechnology Applied in Health of Children and Adolescent, Faculdades Pequeno Príncipe (FPP), Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), R. Silva Jardim, 1632-Água Verde, Curitiba 80230-020, PR, Brazil
| | - Ricardo A Pinho
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
| | - Cristina Pellegrino Baena
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Hospital Marcelino Champagnat, Av. Presidente Affonso Camargo, 1399-Cristo Rei, Curitiba 80050-370, PR, Brazil
| | - Lúcia de Noronha
- Laboratory of Experimental Pathology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Postgraduate Program of Health Sciences, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), R. Imaculada Conceição, 1155-Prado Velho, Curitiba 80215-901, PR, Brazil
- Correspondence: (S.N.); (L.d.N.); Tel.: +55-(41)-99942-7191 (S.N.); Tel.: +55-(41)-999994769 (L.d.N.)
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2
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Rarani FZ, Rashidi B, Jafari Najaf Abadi MH, Hamblin MR, Reza Hashemian SM, Mirzaei H. Cytokines and microRNAs in SARS-CoV-2: What do we know? MOLECULAR THERAPY. NUCLEIC ACIDS 2022; 29:219-242. [PMID: 35782361 PMCID: PMC9233348 DOI: 10.1016/j.omtn.2022.06.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic constitutes a global health emergency. Currently, there are no completely effective therapeutic medications for the management of this outbreak. The cytokine storm is a hyperinflammatory medical condition due to excessive and uncontrolled release of pro-inflammatory cytokines in patients suffering from severe COVID-19, leading to the development of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) and even mortality. Understanding the pathophysiology of COVID-19 can be helpful for the treatment of patients. Evidence suggests that the levels of tumor necrosis factor alpha (TNF-α) and interleukin (IL)-1 and IL-6 are dramatically different between mild and severe patients, so they may be important contributors to the cytokine storm. Several serum markers can be predictors for the cytokine storm. This review discusses the cytokines involved in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, focusing on interferons (IFNs) and ILs, and whether they can be used in COVID-19 treatment. Moreover, we highlight several microRNAs that are involved in these cytokines and their role in the cytokine storm caused by COVID-19.
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Affiliation(s)
- Fahimeh Zamani Rarani
- Department of Anatomical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahman Rashidi
- Department of Anatomical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa
| | - Seyed Mohammad Reza Hashemian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mirzaei
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, IR, Iran
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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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Wu ML, Liu FL, Sun J, Li X, Qin JR, Yan QH, Jin X, Chen XW, Zheng YT, Zhao JC, Wang JH. Combinational benefit of antihistamines and remdesivir for reducing SARS-CoV-2 replication and alleviating inflammation-induced lung injury in mice. Zool Res 2022; 43:457-468. [PMID: 35503561 PMCID: PMC9113965 DOI: 10.24272/j.issn.2095-8137.2021.469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection, the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits. We recently demonstrated that mast cells (MCs) are an essential mediator of SARS-CoV-2-initiated hyperinflammation. We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury. In this study, we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo, and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice. Specifically, SARS-CoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury, while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption; predictably, the combination of antiviral drug remdesivir with the antihistamine loratadine, a histamine receptor 1 (HR1) antagonist, dampened viral replication and inflammation, thereby greatly reducing lung injury. Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.
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Affiliation(s)
- Meng-Li Wu
- College of Life Science, Henan Normal University, Xinxiang, Henan 453007, China
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Feng-Liang Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650223, China
| | - Jing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Xin Li
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Jian-Ru Qin
- College of Life Science, Henan Normal University, Xinxiang, Henan 453007, China
| | - Qi-Hong Yan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Xia Jin
- College of Life Science, Henan Normal University, Xinxiang, Henan 453007, China
| | - Xin-Wen Chen
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Yong-Tang Zheng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650223, China. E-mail:
| | - Jin-Cun Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China. E-mail:
| | - Jian-Hua Wang
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
- University of Chinese Academy of Sciences, Beijing 100049, China. E-mail:
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5
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Gibellini L, De Biasi S, Meschiari M, Gozzi L, Paolini A, Borella R, Mattioli M, Lo Tartaro D, Fidanza L, Neroni A, Busani S, Girardis M, Guaraldi G, Mussini C, Cozzi-Lepri A, Cossarizza A. Plasma Cytokine Atlas Reveals the Importance of TH2 Polarization and Interferons in Predicting COVID-19 Severity and Survival. Front Immunol 2022; 13:842150. [PMID: 35386702 PMCID: PMC8979161 DOI: 10.3389/fimmu.2022.842150] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/21/2022] [Indexed: 12/11/2022] Open
Abstract
Although it is now widely accepted that host inflammatory response contributes to COVID-19 immunopathogenesis, the pathways and mechanisms driving disease severity and clinical outcome remain poorly understood. In the effort to identify key soluble mediators that characterize life-threatening COVID-19, we quantified 62 cytokines, chemokines and other factors involved in inflammation and immunity in plasma samples, collected at hospital admission, from 80 hospitalized patients with severe COVID-19 disease who were stratified on the basis of clinical outcome (mechanical ventilation or death by day 28). Our data confirm that age, as well as neutrophilia, lymphocytopenia, procalcitonin, D-dimer and lactate dehydrogenase are strongly associated with the risk of fatal COVID-19. In addition, we found that cytokines related to TH2 regulations (IL-4, IL-13, IL-33), cell metabolism (lep, lep-R) and interferons (IFNα, IFNβ, IFNγ) were also predictive of life-threatening COVID-19.
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Affiliation(s)
- Lara Gibellini
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Sara De Biasi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Marianna Meschiari
- Infectious Diseases Clinics, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Licia Gozzi
- Infectious Diseases Clinics, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Annamaria Paolini
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Rebecca Borella
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Marco Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Domenico Lo Tartaro
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Lucia Fidanza
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Anita Neroni
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - Stefano Busani
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Girardis
- Department of Anesthesia and Intensive Care, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Guaraldi
- Infectious Diseases Clinics, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Mussini
- Infectious Diseases Clinics, Azienda Ospedaliera-Universitaria (AOU) Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, London, United Kingdom
| | - Andrea Cossarizza
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine, Modena, Italy.,National Institute for Cardiovascular Research, Bologna, Italy
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6
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Nagashima S, Dutra AA, Arantes MP, Zeni RC, Klein CK, de Oliveira FC, Piper GW, Brenny ID, Pereira MRC, Stocco RB, Martins APC, de Castro EM, Vaz de Paula CB, Amaral ANM, Machado-Souza C, Baena CP, Noronha L. COVID-19 and Lung Mast Cells: The Kallikrein-Kinin Activation Pathway. Int J Mol Sci 2022; 23:1714. [PMID: 35163636 PMCID: PMC8836064 DOI: 10.3390/ijms23031714] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023] Open
Abstract
Mast cells (MCs) have relevant participation in inflammatory and vascular hyperpermeability events, responsible for the action of the kallikrein-kinin system (KKS), that affect patients inflicted by the severe form of COVID-19. Given a higher number of activated MCs present in COVID-19 patients and their association with vascular hyperpermeability events, we investigated the factors that lead to the activation and degranulation of these cells and their harmful effects on the alveolar septum environment provided by the action of its mediators. Therefore, the pyroptotic processes throughout caspase-1 (CASP-1) and alarmin interleukin-33 (IL-33) secretion were investigated, along with the immunoexpression of angiotensin-converting enzyme 2 (ACE2), bradykinin receptor B1 (B1R) and bradykinin receptor B2 (B2R) on post-mortem lung samples from 24 patients affected by COVID-19. The results were compared to 10 patients affected by H1N1pdm09 and 11 control patients. As a result of the inflammatory processes induced by SARS-CoV-2, the activation by immunoglobulin E (IgE) and degranulation of tryptase, as well as Toluidine Blue metachromatic (TB)-stained MCs of the interstitial and perivascular regions of the same groups were also counted. An increased immunoexpression of the tissue biomarkers CASP-1, IL-33, ACE2, B1R and B2R was observed in the alveolar septum of the COVID-19 patients, associated with a higher density of IgE+ MCs, tryptase+ MCs and TB-stained MCs, in addition to the presence of intra-alveolar edema. These findings suggest the direct correlation of MCs with vascular hyperpermeability, edema and diffuse alveolar damage (DAD) events that affect patients with a severe form of this disease. The role of KKS activation in events involving the exacerbated increase in vascular permeability and its direct link with the conditions that precede intra-alveolar edema, and the consequent DAD, is evidenced. Therapy with drugs that inhibit the activation/degranulation of MCs can prevent the worsening of the prognosis and provide a better outcome for the patient.
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Affiliation(s)
- Seigo Nagashima
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Anderson Azevedo Dutra
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Mayara Pezzini Arantes
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Rafaela Chiuco Zeni
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Carolline Konzen Klein
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Flávia Centenaro de Oliveira
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Giulia Werner Piper
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Isadora Drews Brenny
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Marcos Roberto Curcio Pereira
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Rebecca Benicio Stocco
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Ana Paula Camargo Martins
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Eduardo Morais de Castro
- Postgraduate Program in Biotechnology Applied in Health of Children and Adolescent, Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Curitiba 80250-060, Brazil; (E.M.d.C.); (C.M.-S.)
| | - Caroline Busatta Vaz de Paula
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Andréa Novaes Moreno Amaral
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
| | - Cleber Machado-Souza
- Postgraduate Program in Biotechnology Applied in Health of Children and Adolescent, Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Curitiba 80250-060, Brazil; (E.M.d.C.); (C.M.-S.)
| | - Cristina Pellegrino Baena
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
- Marcelino Champagnat Hospital, Curitiba 80020-110, Brazil
| | - Lucia Noronha
- Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba 80910-215, Brazil; (A.A.D.); (M.P.A.); (R.C.Z.); (C.K.K.); (F.C.d.O.); (G.W.P.); (I.D.B.); (M.R.C.P.); (R.B.S.); (A.P.C.M.); (C.B.V.d.P.); (A.N.M.A.); (C.P.B.)
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Budnevsky AV, Avdeev SN, Kosanovic D, Shishkina VV, Filin AA, Esaulenko DI, Ovsyannikov ES, Samoylenko TV, Redkin AN, Suvorova OA, Perveeva IM. Role of mast cells in the pathogenesis of severe lung damage in COVID-19 patients. Respir Res 2022; 23:371. [PMID: 36544127 PMCID: PMC9769495 DOI: 10.1186/s12931-022-02284-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is still insufficient knowledge with regard to the potential involvement of mast cells (MCs) and their mediators in the pathology of coronavirus disease-2019 (COVID-19). Therefore, our study aimed to investigate the role of MCs, their activation and protease profiles in the pathogenesis of early and late lung damage in COVID-19 patients. METHODS Formalin-fixed and paraffin embedded lung specimens from 30 patients who died from COVID-19 and 9 controls were used for histological detection of MCs and their proteases (tryptase, chymase) followed by morphometric quantification. RESULTS Our results demonstrated increased numbers of MCs at early stage and further augmentation of MCs number during the late stage of alveolar damage in COVID-19 patients, as compared to the control group. Importantly, the percentage of degranulated (activated) MCs was higher during both stages of alveolar lesions in comparison to the controls. While there was no prominent alteration in the profile of tryptase-positive MCs, our data revealed a significant elevation in the number of chymase-positive MCs in the lungs of COVID-19 patients, compared to the controls. CONCLUSIONS MCs are characterized by dysregulated accumulation and increased activation in the lungs of patients suffering from COVID-19. However, future profound studies are needed for precise analysis of the role of these immune cells in the context of novel coronavirus disease.
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Affiliation(s)
- Andrey V. Budnevsky
- grid.445088.50000 0004 0620 3837Department of Faculty Therapy, Burdenko Voronezh State Medical University, 10 Studencheskaya Str., Voronezh, Russia 394036
| | - Sergey N. Avdeev
- grid.448878.f0000 0001 2288 8774Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, 119991 Moscow, Russia
| | - Djuro Kosanovic
- grid.448878.f0000 0001 2288 8774Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, 119991 Moscow, Russia
| | - Victoria V. Shishkina
- grid.445088.50000 0004 0620 3837Scientific Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, Moskovsky Prospect, 185, Voronezh, Russia 394036
| | - Andrey A. Filin
- Budgetary Health Care Institution of the Voronezh Region “Voronezh Regional Pathoanatomical Bureau”, Moskovsky Prospect, 151, Voronezh, Russia 394036
| | - Dmitry I. Esaulenko
- grid.445088.50000 0004 0620 3837Scientific Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, Moskovsky Prospect, 185, Voronezh, Russia 394036
| | - Evgeniy S. Ovsyannikov
- grid.445088.50000 0004 0620 3837Department of Faculty Therapy, Burdenko Voronezh State Medical University, 10 Studencheskaya Str., Voronezh, Russia 394036
| | - Tatiana V. Samoylenko
- grid.445088.50000 0004 0620 3837Scientific Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, Moskovsky Prospect, 185, Voronezh, Russia 394036
| | - Alexander N. Redkin
- grid.445088.50000 0004 0620 3837Scientific Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, Moskovsky Prospect, 185, Voronezh, Russia 394036
| | - Olga A. Suvorova
- grid.448878.f0000 0001 2288 8774Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, 119991 Moscow, Russia
| | - Inna M. Perveeva
- Department of Pulmonology, Voronezh Regional Clinical Hospital, № 1, Moskovsky Prospect, 151, Voronezh, Russia 394036
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8
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Wu ML, Liu FL, Sun J, Li X, He XY, Zheng HY, Zhou YH, Yan Q, Chen L, Yu GY, Chang J, Jin X, Zhao J, Chen XW, Zheng YT, Wang JH. SARS-CoV-2-triggered mast cell rapid degranulation induces alveolar epithelial inflammation and lung injury. Signal Transduct Target Ther 2021; 6:428. [PMID: 34921131 PMCID: PMC8677926 DOI: 10.1038/s41392-021-00849-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/15/2021] [Accepted: 12/02/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection-induced hyper-inflammation links to the acute lung injury and COVID-19 severity. Identifying the primary mediators that initiate the uncontrolled hypercytokinemia is essential for treatments. Mast cells (MCs) are strategically located at the mucosa and beneficially or detrimentally regulate immune inflammations. In this study, we showed that SARS-CoV-2-triggered MC degranulation initiated alveolar epithelial inflammation and lung injury. SARS-CoV-2 challenge induced MC degranulation in ACE-2 humanized mice and rhesus macaques, and a rapid MC degranulation could be recapitulated with Spike-RBD binding to ACE2 in cells; MC degranulation altered various signaling pathways in alveolar epithelial cells, particularly, the induction of pro-inflammatory factors and consequential disruption of tight junctions. Importantly, the administration of clinical MC stabilizers for blocking degranulation dampened SARS-CoV-2-induced production of pro-inflammatory factors and prevented lung injury. These findings uncover a novel mechanism for SARS-CoV-2 initiating lung inflammation, and suggest an off-label use of MC stabilizer as immunomodulators for COVID-19 treatments.
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Affiliation(s)
- Meng-Li Wu
- College of Life Science, Henan Normal University, Xinxiang, 453007, China
| | - Feng-Liang Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
| | - Jing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Xin Li
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Xiao-Yan He
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
- Bioland Laboratory, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510005, China
| | - Hong-Yi Zheng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
| | - Yan-Heng Zhou
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Qihong Yan
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Ling Chen
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Guo-Ying Yu
- College of Life Science, Henan Normal University, Xinxiang, 453007, China
| | - Junbiao Chang
- College of Life Science, Henan Normal University, Xinxiang, 453007, China
| | - Xia Jin
- Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, 201508, China
| | - Jincun Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Xin-Wen Chen
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China.
- Bioland Laboratory, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510005, China.
| | - Yong-Tang Zheng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China.
- Bioland Laboratory, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510005, China.
| | - Jian-Hua Wang
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China.
- University of Chinese Academy of Sciences, Beijing, 100039, China.
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9
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Du J, Wei L, Li G, Hua M, Sun Y, Wang D, Han K, Yan Y, Song C, Song R, Zhang H, Han J, Liu J, Kong Y. Persistent High Percentage of HLA-DR +CD38 high CD8 + T Cells Associated With Immune Disorder and Disease Severity of COVID-19. Front Immunol 2021; 12:735125. [PMID: 34567001 PMCID: PMC8458852 DOI: 10.3389/fimmu.2021.735125] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background The global outbreak of coronavirus disease 2019 (COVID-19) has turned into a worldwide public health crisis and caused more than 100,000,000 severe cases. Progressive lymphopenia, especially in T cells, was a prominent clinical feature of severe COVID-19. Activated HLA-DR+CD38+ CD8+ T cells were enriched over a prolonged period from the lymphopenia patients who died from Ebola and influenza infection and in severe patients infected with SARS-CoV-2. However, the CD38+HLA-DR+ CD8+ T population was reported to play contradictory roles in SARS-CoV-2 infection. Methods A total of 42 COVID-19 patients, including 32 mild or moderate and 10 severe or critical cases, who received care at Beijing Ditan Hospital were recruited into this retrospective study. Blood samples were first collected within 3 days of the hospital admission and once every 3-7 days during hospitalization. The longitudinal flow cytometric data were examined during hospitalization. Moreover, we evaluated serum levels of 45 cytokines/chemokines/growth factors and 14 soluble checkpoints using Luminex multiplex assay longitudinally. Results We revealed that the HLA-DR+CD38+ CD8+ T population was heterogeneous, and could be divided into two subsets with distinct characteristics: HLA-DR+CD38dim and HLA-DR+CD38hi. We observed a persistent accumulation of HLA-DR+CD38hi CD8+ T cells in severe COVID-19 patients. These HLA-DR+CD38hi CD8+ T cells were in a state of overactivation and consequent dysregulation manifested by expression of multiple inhibitory and stimulatory checkpoints, higher apoptotic sensitivity, impaired killing potential, and more exhausted transcriptional regulation compared to HLA-DR+CD38dim CD8+ T cells. Moreover, the clinical and laboratory data supported that only HLA-DR+CD38hi CD8+ T cells were associated with systemic inflammation, tissue injury, and immune disorders of severe COVID-19 patients. Conclusions Our findings indicated that HLA-DR+CD38hi CD8+ T cells were correlated with disease severity of COVID-19 rather than HLA-DR+CD38dim population.
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Affiliation(s)
- Juan Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lirong Wei
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Guoli Li
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Mingxi Hua
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yao Sun
- Intensive Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Di Wang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Kai Han
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yonghong Yan
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chuan Song
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Rui Song
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Henghui Zhang
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Junyan Han
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jingyuan Liu
- Intensive Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yaxian Kong
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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10
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Chirumbolo S, Valdenassi L, Simonetti V, Bertossi D, Ricevuti G, Franzini M, Pandolfi S. Insights on the mechanisms of action of ozone in the medical therapy against COVID-19. Int Immunopharmacol 2021; 96:107777. [PMID: 34020394 PMCID: PMC8112288 DOI: 10.1016/j.intimp.2021.107777] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023]
Abstract
An increasing amount of reports in the literature is showing that medical ozone (O3) is used, with encouraging results, in treating COVID-19 patients, optimizing pain and symptoms relief, respiratory parameters, inflammatory and coagulation markers and the overall health status, so reducing significantly how much time patients underwent hospitalization and intensive care. To date, aside from mechanisms taking into account the ability of O3 to activate a rapid oxidative stress response, by up-regulating antioxidant and scavenging enzymes, no sound hypothesis was addressed to attempt a synopsis of how O3 should act on COVID-19. The knowledge on how O3 works on inflammation and thrombosis mechanisms is of the utmost importance to make physicians endowed with new guns against SARS-CoV2 pandemic. This review tries to address this issue, so to expand the debate in the scientific community.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Luigi Valdenassi
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Vincenzo Simonetti
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Dario Bertossi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology Unit of Maxillo-Facial Surgery University of Verona, Verona, Italy
| | | | - Marianno Franzini
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Sergio Pandolfi
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy; Villa Mafalda Clinics via Monte delle Gioie, Rome, Italy
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11
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Sessa F, Salerno M, Pomara C. Autopsy Tool in Unknown Diseases: The Experience with Coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2). MEDICINA (KAUNAS, LITHUANIA) 2021; 57:309. [PMID: 33806100 PMCID: PMC8064502 DOI: 10.3390/medicina57040309] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
In the last two decades, three unknown pathogens have caused outbreaks, generating severe global health concerns. In 2003, after nucleic acid genotyping, a new virus was named severe acute respiratory syndrome coronavirus (SARS-CoV). After nine years, another coronavirus emerged in the middle east and was named MERS-CoV (Middle East Respiratory Syndrome-Coronavirus). Finally, in December 2019, a new unknown coronavirus was isolated from a cluster of patients and was named SARS-CoV-2 (COVID-19, coronavirus disease 2019). This review aims to propose a complete overview of autopsy in the three coronaviruses over the past two decades, showing its pivotal role in the management of unknown diseases. A total of 116 studies fulfilled the inclusion criteria: 14 studies were collected concerning SARS-CoV (87 autopsy reports, from Asian and American countries), 2 studies for MERS-CoV (2 autopsy reports, from Middle-East Asian countries), and 100 studies on SARS-CoV-2 (930 autopsy reports). Analyzing the data obtained on COVID-19, based on the country criterion, a large number of post-mortem investigation were performed in European countries (580 reports), followed by American countries (251 reports). It is interesting to note that no data were found from the Oceanic countries, maybe because of the minor involvement of the outbreak. In all cases, autopsy provided much information about each unknown coronavirus. Despite advanced technologies in the diagnostic fields, to date, autopsy remains the gold standard method to understand the biological features and the pathogenesis of unknown infections, especially when awareness of a pathogen is restricted and the impact on the healthcare system is substantial. The knowledge gained through this technique may positively influence therapeutic strategies, ultimately reducing mortality.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, Institute of Legal Medicine, University of Foggia, 71122 Foggia, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Institute of Legal Medicine, University of Catania, 95121 Catania, Italy;
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Institute of Legal Medicine, University of Catania, 95121 Catania, Italy;
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