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Al-Saigh NN, Harb AA, Abdalla S. Receptors Involved in COVID-19-Related Anosmia: An Update on the Pathophysiology and the Mechanistic Aspects. Int J Mol Sci 2024; 25:8527. [PMID: 39126095 PMCID: PMC11313362 DOI: 10.3390/ijms25158527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Olfactory perception is an important physiological function for human well-being and health. Loss of olfaction, or anosmia, caused by viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has received considerable attention, especially in persistent cases that take a long time to recover. This review discusses the integration of different components of the olfactory epithelium to serve as a structural and functional unit and explores how they are affected during viral infections, leading to the development of olfactory dysfunction. The review mainly focused on the role of receptors mediating the disruption of olfactory signal transduction pathways such as angiotensin converting enzyme 2 (ACE2), transmembrane protease serine type 2 (TMPRSS2), neuropilin 1 (NRP1), basigin (CD147), olfactory, transient receptor potential vanilloid 1 (TRPV1), purinergic, and interferon gamma receptors. Furthermore, the compromised function of the epithelial sodium channel (ENaC) induced by SARS-CoV-2 infection and its contribution to olfactory dysfunction are also discussed. Collectively, this review provides fundamental information about the many types of receptors that may modulate olfaction and participate in olfactory dysfunction. It will help to understand the underlying pathophysiology of virus-induced anosmia, which may help in finding and designing effective therapies targeting molecules involved in viral invasion and olfaction. To the best of our knowledge, this is the only review that covered all the receptors potentially involved in, or mediating, the disruption of olfactory signal transduction pathways during COVID-19 infection. This wide and complex spectrum of receptors that mediates the pathophysiology of olfactory dysfunction reflects the many ways in which anosmia can be therapeutically managed.
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Affiliation(s)
- Noor N. Al-Saigh
- Department of Basic Medical Sciences, Faculty of Medicine, Ibn Sina University for Medical Sciences, Amman 16197, Jordan;
| | - Amani A. Harb
- Department of Basic Sciences, Faculty of Arts and Sciences, Al-Ahliyya Amman University, Amman 19111, Jordan;
| | - Shtaywy Abdalla
- Department of Biological Sciences, School of Science, The University of Jordan, Amman 11942, Jordan
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2
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Chacko B, Chaudhry D, Peter JV, Khilnani GC, Saxena P, Sehgal IS, Ahuja K, Rodrigues C, Modi M, Jaiswal A, Jasiel GJ, Sahasrabudhe S, Bose P, Ahuja A, Suprapaneni V, Prajapat B, Manesh A, Chawla R, Guleria R. ISCCM Position Statement on the Approach to and Management of Critically Ill Patients with Tuberculosis. Indian J Crit Care Med 2024; 28:S67-S91. [PMID: 39234233 PMCID: PMC11369919 DOI: 10.5005/jp-journals-10071-24783] [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: 07/02/2024] [Accepted: 07/24/2024] [Indexed: 09/06/2024] Open
Abstract
Tuberculosis (TB) is an important cause of morbidity and mortality globally. About 3-4% of hospitalized TB patients require admission to the intensive care unit (ICU); the mortality in these patients is around 50-60%. There is limited literature on the evaluation and management of patients with TB who required ICU admission. The Indian Society of Critical Care Medicine (ISCCM) constituted a working group to develop a position paper that provides recommendations on the various aspects of TB in the ICU setting based on available evidence. Seven domains were identified including the categorization of TB in the critically ill, diagnostic workup, drug therapy, TB in the immunocompromised host, organ support, infection control, and post-TB sequelae. Forty-one questions pertaining to these domains were identified and evidence-based position statements were generated, where available, keeping in focus the critical care aspects. Where evidence was not available, the recommendations were based on consensus. This position paper guides the approach to and management of critically ill patients with TB. How to cite this article Chacko B, Chaudhry D, Peter JV, Khilnani G, Saxena P, Sehgal IS, et al. isccm Position Statement on the Approach to and Management of Critically Ill Patients with Tuberculosis. Indian J Crit Care Med 2024;28(S2):S67-S91.
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Affiliation(s)
- Binila Chacko
- Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dhruva Chaudhry
- Department of Pulmonary and Critical Care Medicine, Pt BDS Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - John V Peter
- Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gopi C Khilnani
- Department of Pulmonary, Critical Care and Sleep Medicine, PSRI Hospital, New Delhi, India
| | - Prashant Saxena
- Department of Pulmonary, Critical Care and Sleep Medicine, Fortis Hospital, Vasant Kung, New Delhi, India
| | - Inderpaul S Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Kunal Ahuja
- Department of Pulmonary, Critical Care and Sleep Medicine, PSRI Hospital, New Delhi, India
| | - Camilla Rodrigues
- Department of Lab Medicine, Hinduja Hospital, Mumbai, Maharashtra, India
| | - Manish Modi
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Anand Jaiswal
- Deparment of Respiratory Diseases, Medanta Medicity, Gurugram, Haryana, India
| | - G Joel Jasiel
- Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shrikant Sahasrabudhe
- Department of Critical Care Medicine and Pulmonology, KIMS Manavata Hospital, Nashik, Maharashtra, India
| | - Prithviraj Bose
- Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aman Ahuja
- Department of Pulmonary and Critical Care Medicine, PGIMS, Rohtak, Haryana, India
| | - Vineela Suprapaneni
- Department of Pulmonary and Critical Care Medicine, PGIMS, Rohtak, Haryana, India
| | - Brijesh Prajapat
- Department of Pulmonary and Critical Care Medicine, Yashoda Group of Hospitals, Ghaziabad, Uttar Pradesh, India
| | - Abi Manesh
- Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rajesh Chawla
- Department of Respiratory Medicine, Critical Care and Sleep Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - Randeep Guleria
- Institute of Internal Medicine and Respiratory and Sleep Medicine, Medanta Medical School, Gurugram, Haryana, India
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3
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Song J, Kim S, Park Y. A Retrospective Study of Factors Contributing to the Performance of an Interferon-Gamma Release Assay Blood Test for Tuberculosis Infection. Clin Chem 2024; 70:551-561. [PMID: 38299916 DOI: 10.1093/clinchem/hvad220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/16/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Tuberculosis (TB) remains a significant global health concern. Accurate detection of latent TB infection is crucial for effective control and prevention. We aimed to assess the performance of an interferon-gamma release assay blood test (QuantiFERON-TB Gold Plus [QFT-Plus]) in various clinical contexts and identify conditions that affect its results. METHODS We conducted a retrospective analysis of 31 000 QFT-Plus samples collected from 26 000 subjects at a tertiary hospital in South Korea over a 4-year period and compared the rates of positivity and indeterminate results across diverse clinical situations. We also analysed the contribution of the QuantiFERON TB2 tube to the test's sensitivity and determined optimal cutoff values for 3 hematologic parameters to distinguish false-negative results. These cutoff values were validated in a separate cohort of subjects with microbiologically confirmed subclinical TB. RESULTS Rates of QFT-Plus positivity and indeterminate results were disparate across diagnoses. The TB2 tube increased QFT-Plus sensitivity by 4.1% (95% CI, 1.1%-7.0%) in patients with subclinical TB. Absolute lymphocyte count ≤1.19 × 109/L, absolute neutrophil count ≥5.88 × 109/L, and neutrophil-to-lymphocyte ratio ≥4.33 were effective criteria to discriminate false-negative QFT-Plus results. Application of the hematologic criteria, individually or combined with mitogen response <10 IU/mL, substantially improved performance in the main study cohort and the validation cohort. CONCLUSIONS These findings highlight the influence of clinical context and patient hematologic profiles on QFT-Plus results. To minimise neglected latent TB infections due to false-negative QFT-Plus results, serial retesting is advisable in patients with severe lymphopenia or neutrophilia, particularly when the mitogen response is <10 IU/mL.
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Affiliation(s)
- Junhyup Song
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Sinyoung Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Younhee Park
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Peng W, Deng R, Wu S, Zhao J, Fu J, Zhang Y, Chen W, Wang W. Increased rates of indeterminate results in QuantiFERON-TB gold in-tube during the COVID-19 epidemic in Hunan province, China. Diagn Microbiol Infect Dis 2024; 108:116131. [PMID: 37976555 DOI: 10.1016/j.diagmicrobio.2023.116131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Increased rates of indeterminate QuantiFERON-TB Gold In-Tube (QFT-GIT) results have been reported since the COVID-19 epidemic in Hunan Province, China. The indeterminate result (ITR) rate of QFT increased from an average of 5.2% to 12.4%, paralleling the first COVID-19 pandemic wave in the region. QFT-GIT results of 243 hospitalized patients with COVID-19 from January 2022 to April 2023 at Xiangya Hospital of Central South University were analyzed. Of the 243 patients, 71 (29.2%) had ITRs due to reduced interferon-gamma production in the positive control. Multiple factors are associated with ITRs, such as disease severity, respiratory failure incidence, immunosuppressant use, and prognosis. Additionally, interferon-gamma (Mitogen-Nil) levels differed significantly depending upon disease severity, prognosis, immunosuppressant use, sepsis symptoms, respiratory failure, or hyperlipidemia. An abnormal increase in the ITR rate in the QFT was observed after the COVID-19 pandemic, and an optimal machine learning predictive model for indeterminate QFT results was established.
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Affiliation(s)
- Wanchan Peng
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Rihui Deng
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Siyu Wu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Juan Zhao
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Jinfang Fu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Yunli Zhang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Wei Chen
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China
| | - Wei Wang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China.
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Masiá M, de la Rica A, Fernández-González M, García JA, Padilla S, García-Abellán J, Botella Á, Mascarell P, Gutiérrez F. Integrating SARS-CoV-2-specific interferon-γ release assay testing in the evaluation of patients hospitalized with COVID-19. Microbiol Spectr 2023; 11:e0241923. [PMID: 37855635 PMCID: PMC10715100 DOI: 10.1128/spectrum.02419-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE The cellular immune response is essential in the protection against severe disease in patients with established SARS-CoV-2 infection. The novelty of this study lies in the evaluation of the overall performance of a standardized assay to measure cellular immune response, the SARS-CoV-2-specific interferon-γ release assay (IGRA), in hospitalized patients with severe COVID-19. The SARS-CoV-2 IGRA was shown to accurately classify patients based on disease severity and prognosis, and the study revealed that test performance was not affected by the SARS-CoV-2 variant or control tube results. We identified an assay cut-off point with a high negative predictive value against mortality. The SARS-CoV-2 IGRA in patients hospitalized for COVID-19 may be a useful tool to assess cellular immunity and adopt targeted therapeutic and preventive measures.
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Affiliation(s)
- Mar Masiá
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Alba de la Rica
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- Microbiology Service, Hospital General Universitario de Elche, Alicant, Spain
| | - Marta Fernández-González
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - José Alberto García
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Padilla
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Javier García-Abellán
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Ángela Botella
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
| | - Paula Mascarell
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
| | - Félix Gutiérrez
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicant, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante, Spain
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6
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Ben Tekaya A, Jerbi A, Ben Sassi M, Mokaddem S, Mahmoud I, Dziri C, Abdelmoula L. Prevalence of indeterminate tuberculosis interferon-gamma release assays in COVID-19 patients: Systematic review and meta-analysis. Health Sci Rep 2023; 6:e1695. [PMID: 38130328 PMCID: PMC10733599 DOI: 10.1002/hsr2.1695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims The reliability of interferon-gamma-release-assays (IGRAs) for tuberculosis (TB) testing in coronavirus disease 2019 (COVID-19) patients is unknown. This study aimed to systematically review the prevalence of indeterminate TB-IGRA following SARS-CoV-2 infection or vaccination and to review associated factors. Methods This systematic literature review was guided according to the PRISMA guidelines by searching PubMed, Scopus, Web of Science, Clinicalkey, and Cochrane Library. Studies reporting results of TB-IGRA tests (QuantiFERON [QFT]-TB, T-SPOT.TB) in COVID-19 patients or vaccines were included. The random effects model was used to assess the prevalence of indeterminate IGRA results. Heterogeneity was evaluated using the Τ 2 and 95% predictive interval. Results Of the 273 citations screened, 12 articles were included in the final analysis including a total of 2107 patients. The overall pooled effect size proportion of indeterminate QFT-TB results, estimated in eight studies using the QFT-TB Plus assay, was 0.26 (95% CI: 0.205-0.324, Τ 2 = 0.158). The mean true effect size was 0.26 (95% predictive interval: [0.110-0.500]). A subgroup analysis was not undertaken due to the small number of studies. Indeterminate QFT-TB rates were associated with COVID-19 severity, steroid treatment, inflammation-related parameters, neutrophilia, and lymphopenia. Conclusion Indeterminate QFT-TB results in COVID-19 patients occur in almost one-quarter of tests performed. Further studies are needed to assess associated factors.
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Affiliation(s)
- Aicha Ben Tekaya
- Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Ameni Jerbi
- Immunology Department, Habib Bourguiba Hospital, Faculty of Medicine of SfaxUniversity of SfaxSfaxTunisia
| | - Mouna Ben Sassi
- Department of Clinical Pharmacology, National Center of Pharmacovigilance, Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Salma Mokaddem
- Physiology Department, Faculty of Medicine of TunisUniversity of Tunis el ManarTunisTunisia
| | - Ines Mahmoud
- Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Chedli Dziri
- Honoris Medical Simulation Center, Faculty of Medicine of TunisUniversity of Tunis el ManarTunisTunisia
| | - Leila Abdelmoula
- Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
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Fernández-González M, Agulló V, García JA, Padilla S, García-Abellán J, de la Rica A, Mascarell P, Masiá M, Gutiérrez F. T-Cell Immunity Against Severe Acute Respiratory Syndrome Coronavirus 2 Measured by an Interferon-γ Release Assay Is Strongly Associated With Patient Outcomes in Vaccinated Persons Hospitalized With Delta or Omicron Variants. J Infect Dis 2023; 228:1240-1252. [PMID: 37418551 DOI: 10.1093/infdis/jiad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/08/2023] [Accepted: 07/06/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND We measured T-cell and antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vaccinated patients hospitalized for coronavirus disease 2019 (COVID-19) and explored their potential value to predict outcomes. METHODS This was a prospective, longitudinal study including vaccinated patients hospitalized with Delta and Omicron SARS-CoV-2 variants. TrimericS-IgG antibodies and SARS-CoV-2 T-cell response were measured using a specific quantitative interferon-γ release assay (IGRA). Primary outcome was all-cause 28-day mortality or need for intensive care unit (ICU) admission. Cox models were used to assess associations with outcomes. RESULTS Of 181 individuals, 158 (87.3%) had detectable SARS-CoV-2 antibodies, 92 (50.8%) showed SARS-CoV-2-specific T-cell responses, and 87 (48.1%) had both responses. Patients who died within 28 days or were admitted to ICU were less likely to have both unspecific and specific T-cell responses in IGRA. In adjusted analyses (adjusted hazard ratio [95% confidence interval]), for the entire cohort, having both T-cell and antibody responses at admission (0.16 [.05-.58]) and Omicron variant (0.38 [.17-.87]) reduced the hazard of 28-day mortality or ICU admission, whereas higher Charlson comorbidity index score (1.27 [1.07-1.51]) and lower oxygen saturation to fraction of inspired oxygen ratio (2.36 [1.51-3.67]) increased the risk. CONCLUSIONS Preexisting immunity against SARS-CoV-2 is strongly associated with patient outcomes in vaccinated individuals requiring hospital admission for COVID-19. Persons showing both T-cell and antibody responses have the lowest risk of severe outcomes.
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Affiliation(s)
- Marta Fernández-González
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - Vanesa Agulló
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - José Alberto García
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - Sergio Padilla
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante
| | - Javier García-Abellán
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante
| | - Alba de la Rica
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Microbiology Service, Hospital General Universitario de Elche, Elche, Spain
| | - Paula Mascarell
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
| | - Mar Masiá
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante
| | - Félix Gutiérrez
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
- Clinical Medicine Department, Universidad Miguel Hernández, San Juan de Alicante
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Bonacini M, Ferrigno I, Rossi A, Facciolongo N, Massari M, Corsini R, Galli V, Zerbini A, Salvarani C, Croci S. Comparable cytokine release ex-vivo by whole blood from COVID-19 patients with and without non-invasive ventilation. Immunobiology 2023; 228:152755. [PMID: 38570901 DOI: 10.1016/j.imbio.2023.152755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/21/2023] [Accepted: 10/15/2023] [Indexed: 04/05/2024]
Abstract
T cells are key players in the resolution of the infection by SARS-CoV-2. A delay in their activation can lead to severe COVID-19. The present work aimed to identify differences in cytokine release by T cells ex-vivo between COVID-19 patients in the acute phase, showing diverse disease severity. Concentrations of IFNγ, Granzyme B, IL-6, IL-10, IL-17A, IL-18, IP-10, MCP-1, and TNFα were evaluated after stimulation ex-vivo of whole blood samples with peptides from SARS-CoV-2 spike protein and a mitogen as well as without stimulation. Samples derived from hospitalized COVID-19 patients and SARS-CoV-2 vaccinated controls (CTR). Patients were classified on disease severity considering the necessity of non-invasive ventilation (NIV). Samples from patients requiring NIV revealed a similar release of cytokines compared with patients without NIV. COVID-19 patients showed higher spontaneous production of IFNγ and IP-10, lower production of MCP-1 after SARS-CoV-2 peptide stimulation and lower production of IFNγ, IL-10, IL-17A, Granzyme B, IP-10 after mitogenic stimulus compared with CTR. In conclusion, differences in T cell responses evaluated ex-vivo by a whole blood-based cytokine release assay do not appear to explain the need for non-invasive ventilation in COVID-19 patients.
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Affiliation(s)
- Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy
| | - Ilaria Ferrigno
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Rossi
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Massari
- Infectious Disease Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Romina Corsini
- Infectious Disease Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Veronica Galli
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy
| | - Alessandro Zerbini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Surgery, Medicine Dentistry and Morphological Sciences with Interest in Transplant, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
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9
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Booysen P, Wilkinson KA, Sheerin D, Waters R, Coussens AK, Wilkinson RJ. Immune interaction between SARS-CoV-2 and Mycobacterium tuberculosis. Front Immunol 2023; 14:1254206. [PMID: 37841282 PMCID: PMC10569495 DOI: 10.3389/fimmu.2023.1254206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
SARS-CoV-2 and Mycobacterium tuberculosis (Mtb) are major infectious causes of death, with meta-analyses and population-based studies finding increased mortality in co-infected patients simultaneously diagnosed with COVID-19 and tuberculosis (TB). There is a need to understand the immune interaction between SARS-CoV-2 and Mtb which impacts poor outcomes for those co-infected. We performed a PubMed and preprint search using keywords [SARS-CoV-2] AND [tuberculosis] AND [Immune response], including publications after January 2020, excluding reviews or opinions. Abstracts were evaluated by authors for inclusion of data specifically investigating the innate and/or acquired immune responses to SARS-CoV-2 and Mtb in humans and animal models, immunopathological responses in co-infection and both trials and investigations of potential protection against SARS-CoV-2 by Bacille Calmette Guérin (BCG). Of the 248 articles identified, 39 were included. Incidence of co-infection is discussed, considering in areas with a high burden of TB, where reported co-infection is likely underestimated. We evaluated evidence of the clinical association between COVID-19 and TB, discuss differences and similarities in immune responses in humans and in murine studies, and the implications of co-infection. SARS-CoV-2 and Mtb have both been shown to modulate immune responses, particularly of monocytes, macrophages, neutrophils, and T cells. Co-infection may result in impaired immunity to SARS-CoV-2, with an exacerbated inflammatory response, while T cell responses to Mtb may be modulated by SARS-CoV-2. Furthermore, there has been no proven potential COVID-19 clinical benefit of BCG despite numerous large-scale clinical trials.
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Affiliation(s)
- Petro Booysen
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Katalin A. Wilkinson
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Tuberculosis Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Dylan Sheerin
- Infectious Diseases and Immune Defence Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Robyn Waters
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna K. Coussens
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Infectious Diseases and Immune Defence Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Robert J. Wilkinson
- Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Tuberculosis Laboratory, The Francis Crick Institute, London, United Kingdom
- Department of Infectious Diseases, Imperial College, London, United Kingdom
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10
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Shaw JA, Malherbe ST, Walzl G, du Plessis N. Suppressive myeloid cells in SARS-CoV-2 and Mycobacterium tuberculosis co-infection. Front Immunol 2023; 14:1222911. [PMID: 37545508 PMCID: PMC10399583 DOI: 10.3389/fimmu.2023.1222911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Epidemiologic data show that both current and previous tuberculosis (TB) increase the risk of in-hospital mortality from coronavirus disease-2019 (COVID-19), and there is a similar trend for poor outcomes from Mycobacterium tuberculosis (Mtb) infection after recent SARS-CoV-2. A shared dysregulation of immunity explains the dual risk posed by co-infection, but the specific mechanisms are being explored. While initial attention focused on T cell immunity, more comprehensive analyses revealed a dysfunctional innate immune response in COVID-19, characterized by reduced numbers of dendritic cells, NK cells and a redistribution of mononuclear phagocytes towards intermediate myeloid subsets. During hyper- or chronic inflammatory processes, activation signals from molecules such as growth factors and alarmins lead to the expansion of an immature population of myeloid cells called myeloid-deprived suppressor cells (MDSC). These cells enter a state of pathological activation, lose their ability to rapidly clear pathogens, and instead become broadly immunosuppressive. MDSC are enriched in the peripheral blood of patients with severe COVID-19; associated with mortality; and with higher levels of inflammatory cytokines. In TB, MDSC have been implicated in loss of control of Mtb in the granuloma and ineffective innate and T cell immunity to the pathogen. Considering that innate immune sensing serves as first line of both anti-bacterial and anti-viral defence mechanisms, we propose MDSC as a crucial mechanism for the adverse clinical trajectories of TB-COVID-19 coinfection.
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11
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Jung YJ, Park JE, Park JW, Lee KS, Chung WY, Park JH, Sheen SS, You S, Sun JS, Park KJ, Kim YJ, Park KJ. Enhancing the interferon-γ release assay through omission of nil and mitogen values. Respir Res 2023; 24:179. [PMID: 37420251 DOI: 10.1186/s12931-023-02485-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023] Open
Abstract
PURPOSE To address the limited utility of the interferon (IFN)-γ release assay (IGRA) caused by its variability and inconsistency. METHODS This retrospective cohort study was based on data obtained between 2011 and 2019. QuantiFERON-TB Gold-In-Tube was used to measure IFN-γ levels in nil, tuberculosis (TB) antigen, and mitogen tubes. RESULTS Of 9,378 cases, 431 had active TB. The non-TB group comprised 1,513 IGRA-positive, 7,202 IGRA-negative, and 232 IGRA-indeterminate cases. Nil-tube IFN-γ levels were significantly higher in the active TB group (median = 0.18 IU/mL; interquartile range: 0.09-0.45 IU/mL) than in the IGRA-positive non-TB (0.11 IU/mL; 0.06-0.23 IU/mL) and IGRA-negative non-TB (0.09 IU/mL; 0.05-0.15 IU/mL) groups (P < 0.0001). From receiver operating characteristic analysis, TB antigen tube IFN-γ levels had higher diagnostic utility for active TB than TB antigen minus nil values. In a logistic regression analysis, active TB was the main driver of higher nil values. In the active TB group, after reclassifying the results based on a TB antigen tube IFN-γ level of 0.48 IU/mL, 14/36 cases with negative results and 15/19 cases with indeterminate results became positive, while 1/376 cases with positive results became negative. Overall, the sensitivity for detecting active TB improved from 87.2 to 93.7%. CONCLUSION The results of our comprehensive assessment can aid in IGRA interpretation. Since nil values are governed by TB infection rather than reflecting background noise, TB antigen tube IFN-γ levels should be used without subtracting nil values. Despite indeterminate results, TB antigen tube IFN-γ levels can be informative.
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Affiliation(s)
- Yun Jung Jung
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Ji Eun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Ji Won Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Keu Sung Lee
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Wou Young Chung
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Joo Hun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea
| | - Seulgi You
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea
| | - Joo Sung Sun
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea
| | - Kyung Joo Park
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea
| | - Youn Jung Kim
- Department of Health and Medical Information, Ajou University Hospital, Suwon, South Korea
| | - Kwang Joo Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, Gyeonggi-do, South Korea.
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12
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Calabrese F, Lunardi F, Baldasso E, Pezzuto F, Kilitci A, Olteanu GE, Del Vecchio C, Fortarezza F, Boscolo A, Schiavon M, Vedovelli L, Cattelan A, Gregori D, Rea F, Navalesi P. Comprehensive bronchoalveolar lavage characterization in COVID-19 associated acute respiratory distress syndrome patients: a prospective cohort study. Respir Res 2023; 24:152. [PMID: 37296478 DOI: 10.1186/s12931-023-02464-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
COVID-19-related acute respiratory distress syndrome (CARDS) is associated with high mortality rates. We still have limited knowledge of the complex alterations developing in the lung microenvironment. The goal of the present study was to comprehensively analyze the cellular components, inflammatory signature, and respiratory pathogens in bronchoalveolar lavage (BAL) of CARDS patients (16) in comparison to those of other invasively mechanically ventilated patients (24). In CARDS patients, BAL analysis revealed: SARS-CoV-2 infection frequently associated with other respiratory pathogens, significantly higher neutrophil granulocyte percentage, remarkably low interferon-gamma expression, and high levels of interleukins (IL)-1β and IL-9. The most important predictive variables for worse outcomes were age, IL-18 expression, and BAL neutrophilia. To the best of our knowledge, this is the first study that was able to identify, through a comprehensive analysis of BAL, several aspects relevant to the complex pathophysiology of CARDS.
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Affiliation(s)
- Fiorella Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy.
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy.
| | - Francesca Lunardi
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy
| | - Elisa Baldasso
- Department of Medicine, University of Padova Medical School, Padova, Italy
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- Pathological Anatomy Unit, Padova University Hospital, Padova, Italy
| | - Asuman Kilitci
- Department of Medical Pathology, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Gheorghe-Emilian Olteanu
- Department of Infectious Diseases, Discipline of Pulmonology, Center for Research and Innovation in Personalized Medicine of Respiratory Diseases, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Center of Expertise for Rare Lung Diseases, Clinical Hospital of Infectious Diseases and Pneumophisiology "Dr. Victor Babes", Timisoara, Romania
| | - Claudia Del Vecchio
- Department of Medicine, University of Padova Medical School, Padova, Italy
- Microbiology and Virology Unit, Padova University Hospital, Padova, Italy
| | | | - Annalisa Boscolo
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- Department of Medicine, University of Padova Medical School, Padova, Italy
- Institute of Anaesthesia and Intensive Care, Padova University Hospital, Padova, Italy
| | - Marco Schiavon
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- Thoracic Surgery Unit, Padova University Hospital, Padova, Italy
| | - Luca Vedovelli
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
| | - Annamaria Cattelan
- Infectious Diseases Unit, Department of Medicine, Padova University Hospital, Padova, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
| | - Federico Rea
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- Thoracic Surgery Unit, Padova University Hospital, Padova, Italy
| | - Paolo Navalesi
- Department of Medicine, University of Padova Medical School, Padova, Italy
- Institute of Anaesthesia and Intensive Care, Padova University Hospital, Padova, Italy
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13
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De Rose DU, Pace PG, Ceccherini-Silberstein F, Dotta A, Andreoni M, Sarmati L, Iannetta M. T Lymphocyte Subset Counts and Interferon-Gamma Production in Adults and Children with COVID-19: A Narrative Review. J Pers Med 2023; 13:jpm13050755. [PMID: 37240926 DOI: 10.3390/jpm13050755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Adults and children exhibit a broad range of clinical outcomes from SARS-CoV-2 infection, with minimal to mild symptoms, especially in the pediatric age. However, some children present with a severe hyperinflammatory post-infectious complication named multisystem inflammatory syndrome in children (MIS-C), mainly affecting previously healthy subjects. Understanding these differences is still an ongoing challenge, that can lead to new therapeutic strategies and avoid unfavorable outcomes. In this review, we discuss the different roles of T lymphocyte subsets and interferon-γ (IFN-γ) in the immune responses of adults and children. Lymphopenia can influence these responses and represent a good predictor for the outcome, as reported by most authors. The increased IFN-γ response exhibited by children could be the starting point for the activation of a broad response that leads to MIS-C, with a significantly higher risk than in adults, although a single IFN signature has not been identified. Multicenter studies with large cohorts in both age groups are still needed to study SARS-CoV-2 pathogenesis with new tools and to understand how is possible to better modulate immune responses.
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Affiliation(s)
- Domenico Umberto De Rose
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, 00165 Rome, Italy
- PhD Course in Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Pier Giorgio Pace
- Infectious Disease Unit, Department of System Medicine, "Tor Vergata" University and Hospital, 00133 Rome, Italy
| | | | - Andrea Dotta
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, 00165 Rome, Italy
| | - Massimo Andreoni
- Infectious Disease Unit, Department of System Medicine, "Tor Vergata" University and Hospital, 00133 Rome, Italy
| | - Loredana Sarmati
- Infectious Disease Unit, Department of System Medicine, "Tor Vergata" University and Hospital, 00133 Rome, Italy
| | - Marco Iannetta
- Infectious Disease Unit, Department of System Medicine, "Tor Vergata" University and Hospital, 00133 Rome, Italy
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14
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Santos AP, Werneck GL, Dalvi APR, Dos Santos CC, Tierno PFGMM, Condelo HS, Macedo B, de Medeiros Leung JA, de Souza Nogueira J, Malvão L, Galliez R, Aguiar R, Stefan R, Knackfuss SM, da Silva EC, Castineiras TMPP, de Andrade Medronho R, E Silva JRL, Alves RLR, de Moraes Sobrino Porto LC, Rodrigues LS, Kritski AL, de Queiroz Mello FC. The effect of BCG vaccination on infection and antibody levels against SARS-CoV-2-The results of ProBCG: a multicenter randomized clinical trial in Brazil. Int J Infect Dis 2023; 130:8-16. [PMID: 36841502 PMCID: PMC9972589 DOI: 10.1016/j.ijid.2023.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVES Evatuate if Bacillus Calmette-Guérin (BCG) vaccine could be used as a tool against SARS-CoV-2 based on the concept of trained immunity. METHODS A multicenter, double-blinded, randomized clinical trial recruited health care workers (HCWs) in Brazil. The incidence rates of COVID-19, clinical manifestations, absenteeism, and adverse events among HCWs receiving BCG vaccine (Moreau or Moscow strains) or placebo were compared. BCG vaccine-mediated immune response before and after implementing specific vaccines for COVID-19 (CoronaVac or COVISHIELD) was analyzed. Cox proportional hazard and linear mixed effect modeling were used. RESULTS A total of 264 volunteers were included for analysis (BCG = 134 and placebo = 130). The placebo group presented a COVID-19 cumulative incidence of 0.75% vs 0.52% of BCG. The Moreau strain also presented a higher incidence rate (1.60% × 0.22%). BCG did not show a protective hazard ratio against COVID-19. In addition, the log (immunoglobulin G) level against SARS-CoV-2 presented a higher increase in the BCG group, whether or not participants had COVID-19, but also without statistical significance. CONCLUSION Our results suggest that BCG has a tendency of protection against SARS-CoV-2 and higher immunoglobulin G levels than placebo. The clinical trial was registered at https://clinicaltrials.gov/ (NCT04659941).
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Affiliation(s)
- Ana Paula Santos
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ana Paula Razal Dalvi
- Collective Health Studies Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Hanna Silva Condelo
- Histocompatibility Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Macedo
- Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Janaina Aparecida de Medeiros Leung
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ludmila Malvão
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Galliez
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberta Aguiar
- Thorax Diseases Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto Stefan
- Medical Sciences School, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elisangela Costa da Silva
- Molecular Micobacteriology Laboratory, Medical School and Hospital Complex HUCFF-IDT - Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Afrânio Lineu Kritski
- Molecular Micobacteriology Laboratory, Medical School and Hospital Complex HUCFF-IDT - Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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15
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Santana H, González Y, Dorta D, Blanco R, Viltres Y, González J, Espinosa LA, Leyva A, Bello I. Stability-indicative and conformation-specific enzyme linked immunosorbent assay for analysis of recombinant human gamma interferon. J Pharm Biomed Anal 2023; 222:115070. [DOI: 10.1016/j.jpba.2022.115070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/06/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022]
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16
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Alessio G, Imeneo A, Di Lorenzo A, Rossi B, Sorace C, Compagno M, Coppola L, Campogiani L, Crea AMA, Malagnino V, Buccisano F, Andreoni M, Sarmati L, Iannetta M. Longitudinal Evaluation of the QuantiFERON-TB Gold Plus Assay in Hospitalized COVID-19 Patients with a First Indeterminate Result: Resolution of Inflammation and Restoration of T-Lymphocyte Counts and Interferon-Gamma Production. Microbiol Spectr 2022; 10:e0185822. [PMID: 36098523 PMCID: PMC9602342 DOI: 10.1128/spectrum.01858-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Grazia Alessio
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Benedetta Rossi
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Chiara Sorace
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Mirko Compagno
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Luigi Coppola
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Laura Campogiani
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Francesco Buccisano
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Marco Iannetta
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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17
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Assessing T-Cell Immunity in Kidney Transplant Recipients with Absent Antibody Production after a 3rd Dose of the mRNA-1273 Vaccine. Int J Mol Sci 2022; 23:ijms232012333. [PMID: 36293190 PMCID: PMC9604095 DOI: 10.3390/ijms232012333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/30/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
The vulnerable population of kidney transplant recipients (KTRs) are low responders to COVID-19 vaccines, so specific immune surveillance is needed. The interferon-gamma (IFN-γ) release assay (IGRA) is effective in assessing T cell-mediated immunity. We assessed SARS-CoV-2-directed T cell responses in KTRs with absent antibody production after a third dose of the mRNA-1273 vaccine, using two different IGRAs. A cohort of 57 KTRs, who were actively followed up, received a third dose of the mRNA-1273 vaccine. After the evaluation of humoral immunity to SARS-CoV-2, 14 seronegative patients were tested with two commercial IGRAs (SD Biosensor and Euroimmun). Out of 14 patients, one and three samples were positive by IGRAs with Euroimmun and SD Biosensor, respectively. The overall agreement between the two assays was 85.7% (κ = 0.444). In addition, multivariate linear regression analysis showed no statistically significant association between the IFN-γ concentration, and the independent variables analyzed (age, gender, years since transplant, total lymphocytes cells/mcl, CD3+ cells/mcl, CD3+ CD4+ cells/mcl, CD3+ CD8+ cells/mcl, CD19+ cells/mcl, CD3-CD16+CD56+ cells/mcl) (p > 0.01). In a vulnerable setting, assessing cellular immune response to complement the humoral response may be advantageous. Since the two commercial IGRAs showed a good agreement on negative samples, the three discordant samples highlight the need for further investigations.
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18
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Urrutia-Pereira M, Chong-Neto HJ, Annesi Maesano I, Ansotegui IJ, Caraballo L, Cecchi L, Galán C, López JF, Aguttes MM, Peden D, Pomés A, Zakzuk J, Rosário Filho NA, D'Amato G. Environmental contributions to the interactions of COVID-19 and asthma: A secondary publication and update. World Allergy Organ J 2022; 15:100686. [PMID: 35966894 PMCID: PMC9359502 DOI: 10.1016/j.waojou.2022.100686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 11/01/2022] Open
Abstract
An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started in Wuhan, Hubei Province, China and quickly spread around the world. Current evidence is contradictory on the association of asthma with COVID-19 and associated severe outcomes. Type 2 inflammation may reduce the risk for severe COVID-19. Whether asthma diagnosis may be a risk factor for severe COVID-19, especially for those with severe disease or non-allergic phenotypes, deserves further attention and clarification. In addition, COVID-19 does not appear to provoke asthma exacerbations, and asthma therapeutics should be continued for patients with exposure to COVID-19. Changes in the intensity of pollinization, an earlier start and extension of the pollinating season, and the increase in production and allergenicity of pollen are known direct effects that air pollution has on physical, chemical, and biological properties of the pollen grains. They are influenced and triggered by meteorological variables that could partially explain the effect on COVID-19. SARS-CoV-2 is capable of persisting in the environment and can be transported by bioaerosols which can further influence its transmission rate and seasonality. The COVID-19 pandemic has changed the behavior of adults and children globally. A general trend during the pandemic has been human isolation indoors due to school lockdowns and loss of job or implementation of virtual work at home. A consequence of this behavior change would presumably be changes in indoor allergen exposures and reduction of inhaled outdoor allergens. Therefore, lockdowns during the pandemic might have improved some specific allergies, while worsening others, depending on the housing conditions.
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Affiliation(s)
| | - Herberto Jose Chong-Neto
- Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba, PR, Brazil
| | - Isabella Annesi Maesano
- French NIH (INSERM), and EPAR Department, IPLESP, INSERM and Sorbonne University, Paris, France
| | | | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
- SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Carmen Galán
- Department of Botany, Ecology and Plant Physiology, International Campus of Excellence on Agrifood (ceiA3), University of Córdoba, Córdoba, Spain
| | - Juan Felipe López
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | | | - David Peden
- UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Anna Pomés
- Basic Research, Indoor Biotechnologies, Inc, Charlottesville, VA, United States
| | - Josefina Zakzuk
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | | | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases, High Specialty Hospital A. Cardarelli, School of Specialization in Respiratory Diseases, Federico II University, Naples, Italy
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Cortes MP, Schultz CS, Isha S, Sinclair JE, Bhakta S, Kunze KL, Johnson PW, Cowart JB, Carter RE, Franco PM, Sanghavi DK, Roy A. The Pitfalls of Mining for QuantiFERON Gold in Severely Ill COVID-19 Patients. MAYO CLINIC PROCEEDINGS: INNOVATIONS, QUALITY & OUTCOMES 2022; 6:409-419. [PMID: 35818352 PMCID: PMC9259470 DOI: 10.1016/j.mayocpiqo.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Abstract
Objective To assess the proportion of indeterminate QFT-Plus results in patients admitted with severe COVID-19 pneumonia and to evaluate the factors associated with indeterminate QFT-Plus results. Study design Retrospective cohort study. Material & Methods Data of COVID-19 admissions at Mayo Clinic Florida were extracted between October 13, 2020 and September 20, 2021, and from a pre-pandemic cohort between October 13, 2018 and September 20, 2019. Secondary analysis of the COVID-19 cohort was performed using gradient boosting modeling to generate variable importance and SHAP plots. Results Our findings demonstrated more indeterminate QFT-Plus test results among hospitalized patients with severe COVID-19 infection compared to non-COVID patients (139 of 495, 28.1%). Factors associated with indeterminate QFT-Plus tests included elevated C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), and interleukin-6 (IL 6), as well as low leukocytes, lymphocytes, and platelets. Conclusions Patients with severe COVID-19 had a higher likelihood of indeterminate QFT-Plus results which were associated with elevated inflammatory markers consistent with severe infection. IGRA screening tests are likely confounded by COVID-19 infection itself, limiting the screening ability for LTBI reactivation. Indeterminate QFT-Plus results may also require follow-up QFT-Plus testing, after patient recovery from COVID-19, increasing cost and complexity of medical decision making and management. Additional risk assessments may be needed in this patient population for LTBI screening in severe COVID-19 infected patients.
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Key Words
- AUC, Area under the curve
- CDC, Centers for Disease Control and Prevention
- CKD, Chronic kidney disease
- COVID-19, Coronavirus disease 2019
- CRP, C-reactive protein
- GBM, Gradient boosting machine
- IFN, Interferon
- IFN-γ, Interferon gamma release assay
- IL-6, Interleukin-6
- IRGAs, Interferon-gamma release assays
- LDH, Lactate dehydrogenase
- LTBI, Latent tuberculosis infection
- QFT-Plus, QuantiFERON-TB Gold Plus
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Affiliation(s)
- Melissa P Cortes
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Carrie S Schultz
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Shahin Isha
- Department of Critical Care, Mayo Clinic, Jacksonville, FL, USA
| | | | - Shivang Bhakta
- Department of Critical Care, Mayo Clinic, Jacksonville, FL, USA
| | - Katie L Kunze
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ, USA
| | - Patrick W Johnson
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer B Cowart
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Rickey E Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Pablo Moreno Franco
- Department of Critical Care, Mayo Clinic, Jacksonville, FL, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA.,Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
| | | | - Archana Roy
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
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20
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Martínez L, Malaina I, Salcines-Cuevas D, Terán-Navarro H, Zeoli A, Alonso S, M De la Fuente I, Gonzalez-Lopez E, Ocejo-Vinyals JG, Gozalo-Margüello M, Calvo-Montes J, Alvarez-Dominguez C. First computational design using lambda-superstrings and in vivo validation of SARS-CoV-2 vaccine. Sci Rep 2022; 12:6410. [PMID: 35440789 PMCID: PMC9016385 DOI: 10.1038/s41598-022-09615-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/07/2022] [Indexed: 12/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the greatest threat to global health at the present time, and considerable public and private effort is being devoted to fighting this recently emerged disease. Despite the undoubted advances in the development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, uncertainty remains about their future efficacy and the duration of the immunity induced. It is therefore prudent to continue designing and testing vaccines against this pathogen. In this article we computationally designed two candidate vaccines, one monopeptide and one multipeptide, using a technique involving optimizing lambda-superstrings, which was introduced and developed by our research group. We tested the monopeptide vaccine, thus establishing a proof of concept for the validity of the technique. We synthesized a peptide of 22 amino acids in length, corresponding to one of the candidate vaccines, and prepared a dendritic cell (DC) vaccine vector loaded with the 22 amino acids SARS-CoV-2 peptide (positions 50-71) contained in the NTD domain (DC-CoVPSA) of the Spike protein. Next, we tested the immunogenicity, the type of immune response elicited, and the cytokine profile induced by the vaccine, using a non-related bacterial peptide as negative control. Our results indicated that the CoVPSA peptide of the Spike protein elicits noticeable immunogenicity in vivo using a DC vaccine vector and remarkable cellular and humoral immune responses. This DC vaccine vector loaded with the NTD peptide of the Spike protein elicited a predominant Th1-Th17 cytokine profile, indicative of an effective anti-viral response. Finally, we performed a proof of concept experiment in humans that included the following groups: asymptomatic non-active COVID-19 patients, vaccinated volunteers, and control donors that tested negative for SARS-CoV-2. The positive control was the current receptor binding domain epitope of COVID-19 RNA-vaccines. We successfully developed a vaccine candidate technique involving optimizing lambda-superstrings and provided proof of concept in human subjects. We conclude that it is a valid method to decipher the best epitopes of the Spike protein of SARS-CoV-2 to prepare peptide-based vaccines for different vector platforms, including DC vaccines.
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Affiliation(s)
- Luis Martínez
- Department of Mathematics, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain. .,BCAM, Basque Center for Applied Mathematics, 48009, Bilbao, Spain.
| | - Iker Malaina
- Department of Mathematics, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain.,BioCruces Health Research Institute, Cruces University Hospital, 48903, Barakaldo, Spain
| | | | - Héctor Terán-Navarro
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), 39011, Santander, Spain
| | - Andrea Zeoli
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), 39011, Santander, Spain
| | - Santos Alonso
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain.,María Goyri Building. Animal Biotechnology Center, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain
| | - Ildefonso M De la Fuente
- Department of Mathematics, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain.,Department of Nutrition, CEBAS-CSIC Institute, Espinardo University Campus, 30100, Murcia, Spain
| | - Elena Gonzalez-Lopez
- Servicio de Inmunología, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - J Gonzalo Ocejo-Vinyals
- Servicio de Inmunología, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Mónica Gozalo-Margüello
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Jorge Calvo-Montes
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), 39011, Santander, Spain.,Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain.,CIBER Enfermedades Infecciosas, ISCIII, Madrid, Spain
| | - Carmen Alvarez-Dominguez
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), 39011, Santander, Spain. .,Universidad Internacional de La Rioja, 26006, Logroño, Spain.
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21
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Pettengill MA. Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus. CLINICAL MICROBIOLOGY NEWSLETTER 2022; 44:73-80. [PMID: 35529099 PMCID: PMC9053308 DOI: 10.1016/j.clinmicnews.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Matthew A Pettengill
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
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22
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Renaudineau Y, Abravanel F, Izopet J, Bost C, Treiner E, Congy N, Blancher A. Novel T cell interferon gamma release assay (IGRA) using spike recombinant protein for COVID19 vaccine response and Nucleocapsid for SARS-Cov2 response. Clin Immunol 2022; 237:108979. [PMID: 35301104 PMCID: PMC8920083 DOI: 10.1016/j.clim.2022.108979] [Citation(s) in RCA: 6] [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: 10/31/2021] [Revised: 02/08/2022] [Accepted: 03/08/2022] [Indexed: 01/04/2023]
Abstract
We explored the performance of a whole blood interferon gamma release assay (IGRA) based on the stimulation of SARS-Cov2-specific T cells by purified recombinant proteins. Twenty volunteers vaccinated with BNT162b2 were selected first for T cell response evaluation using an in-house IGRA, a commercial IGRA, and ELISpot showing a S2 > S1 poly-epitopic response. Next, 64 vaccinated and 103 non-vaccinated individuals were tested for humoral and T cell response (IGRA-Spike/-nucleocapsid recombinant proteins). Following the second vaccine injection, humoral (100%) and IGRA-Spike T cell (95.3%) responses took place irrespective of sex, age, and vaccine type. The humoral response declined first, followed by IGRA-Spike T cell response after the second vaccine injection. Altogether, this study confirms the utility of the IGRA-Spike/-nucleocapsid assay to complement serology in COVID19 vaccinated individuals and those who have recovered from SARS-Cov2.
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Affiliation(s)
- Yves Renaudineau
- Immunology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France; INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France.
| | - Florence Abravanel
- INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France; Virology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France.
| | - Jacques Izopet
- INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France; Virology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France.
| | - Chloé Bost
- Immunology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France; INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France.
| | - Emmanuel Treiner
- Immunology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France; INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France.
| | - Nicolas Congy
- Immunology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France.
| | - Antoine Blancher
- Immunology department laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France; INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France.
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23
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Rosas Mejia O, Gloag ES, Li J, Ruane-Foster M, Claeys TA, Farkas D, Wang SH, Farkas L, Xin G, Robinson RT. Mice infected with Mycobacterium tuberculosis are resistant to acute disease caused by secondary infection with SARS-CoV-2. PLoS Pathog 2022; 18:e1010093. [PMID: 35325013 PMCID: PMC8946739 DOI: 10.1371/journal.ppat.1010093] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 12/22/2022] Open
Abstract
Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are the leading causes of death due to infectious disease. Although Mtb and CoV2 both cause serious and sometimes fatal respiratory infections, the effect of Mtb infection and its associated immune response on secondary infection with CoV2 is unknown. To address this question we applied two mouse models of COVID19, using mice which were chronically infected with Mtb. In both model systems, Mtb-infected mice were resistant to the pathological consequences of secondary CoV2 infection, and CoV2 infection did not affect Mtb burdens. Single cell RNA sequencing of coinfected and monoinfected lungs demonstrated the resistance of Mtb-infected mice is associated with expansion of T and B cell subsets upon viral challenge. Collectively, these data demonstrate that Mtb infection conditions the lung environment in a manner that is not conducive to CoV2 survival. Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are distinct organisms which both cause lung disease. We report the surprising observation that Mtb-infected mice are resistant to secondary infection with CoV2, with no impact on Mtb burden and resistance associating with lung T and B cell expansion.
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Affiliation(s)
| | | | | | | | | | - Daniela Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute
| | - Shu-Hua Wang
- Department of Infectious Disease, The Ohio State University, Columbus, Ohio, United States of America
| | - Laszlo Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute
| | - Gang Xin
- Department of Microbial Infection and Immunity
- Pelotonia Institute for Immuno-Oncology
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24
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Indeterminate mycobacterium tuberculosis QuantiFERON post Moderna mRNA Covid-19 vaccination. Indian J Tuberc 2022; 69:369-370. [PMID: 35760490 PMCID: PMC8968178 DOI: 10.1016/j.ijtb.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022]
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25
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Imeneo A, Alessio G, Di Lorenzo A, Campogiani L, Lodi A, Barreca F, Zordan M, Barchi V, Massa B, Tedde S, Crea A, Vitale P, Spalliera I, Compagno M, Coppola L, Dori L, Malagnino V, Teti E, Andreoni M, Sarmati L, Iannetta M. In Patients with Severe COVID-19, the Profound Decrease in the Peripheral Blood T-Cell Subsets Is Correlated with an Increase of QuantiFERON-TB Gold Plus Indeterminate Rates and Reflecting a Reduced Interferon-Gamma Production. Life (Basel) 2022; 12:life12020244. [PMID: 35207531 PMCID: PMC8880410 DOI: 10.3390/life12020244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 12/15/2022] Open
Abstract
Increased rates of indeterminate QuantiFERON-TB Gold Plus Assay (QFT-Plus) were demonstrated in patients hospitalized with Coronavirus Disease (COVID)-19. We aimed to define the prevalence and characteristics of hospitalized COVID-19 patients with indeterminate QFT-Plus. A retrospective study was performed including hospitalized COVID-19 patients, stratified in survivors and non-survivors, non-severe and severe according to the maximal oxygen supply required. Statistical analysis was performed using JASP ver0.14.1 and GraphPad Prism ver8.2.1. A total of 420 patients were included, median age: 65 years, males: 66.4%. The QFT-Plus was indeterminate in 22.1% of patients. Increased rate of indeterminate QFT-Plus was found in non-survivors (p = 0.013) and in severe COVID-19 patients (p < 0.001). Considering the Mitogen-Nil condition of the QFT-Plus, an impaired production of interferon-gamma (IFN-γ) was found in non-survivors (p < 0.001) and in severe COVID-19 patients (p < 0.001). A positive correlation between IFN-γ levels in the Mitogen-Nil condition and the absolute counts of CD3+ (p < 0.001), CD4+ (p < 0.001), and CD8+ (p < 0.001) T-lymphocytes was found. At the multivariable analysis, CD3+ T-cell absolute counts and CD4/CD8 ratio were confirmed as independent predictors of indeterminate results at the QFT-Plus. Our study confirmed the increased rate of indeterminate QFT-Plus in COVID-19 patients, mainly depending on the peripheral blood T-lymphocyte depletion found in the most severe cases.
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Affiliation(s)
- Alessandra Imeneo
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Grazia Alessio
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Andrea Di Lorenzo
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Laura Campogiani
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Alessandra Lodi
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Filippo Barreca
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Marta Zordan
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Virginia Barchi
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Barbara Massa
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Simona Tedde
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Angela Crea
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
| | - Pietro Vitale
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Ilaria Spalliera
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Mirko Compagno
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Luigi Coppola
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Luca Dori
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Vincenzo Malagnino
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Elisabetta Teti
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Massimo Andreoni
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Loredana Sarmati
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
| | - Marco Iannetta
- Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.I.); (G.A.); (A.D.L.); (A.L.); (F.B.); (M.Z.); (V.B.); (B.M.); (S.T.); (A.C.); (V.M.); (M.A.); (L.S.)
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (L.C.); (P.V.); (I.S.); (M.C.); (L.C.); (L.D.); (E.T.)
- Correspondence:
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26
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Gusev E, Sarapultsev A, Solomatina L, Chereshnev V. SARS-CoV-2-Specific Immune Response and the Pathogenesis of COVID-19. Int J Mol Sci 2022; 23:1716. [PMID: 35163638 PMCID: PMC8835786 DOI: 10.3390/ijms23031716] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/13/2022] Open
Abstract
The review aims to consolidate research findings on the molecular mechanisms and virulence and pathogenicity characteristics of coronavirus disease (COVID-19) causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and their relevance to four typical stages in the development of acute viral infection. These four stages are invasion; primary blockade of antiviral innate immunity; engagement of the virus's protection mechanisms against the factors of adaptive immunity; and acute, long-term complications of COVID-19. The invasion stage entails the recognition of the spike protein (S) of SARS-CoV-2 target cell receptors, namely, the main receptor (angiotensin-converting enzyme 2, ACE2), its coreceptors, and potential alternative receptors. The presence of a diverse repertoire of receptors allows SARS-CoV-2 to infect various types of cells, including those not expressing ACE2. During the second stage, the majority of the polyfunctional structural, non-structural, and extra proteins SARS-CoV-2 synthesizes in infected cells are involved in the primary blockage of antiviral innate immunity. A high degree of redundancy and systemic action characterizing these pathogenic factors allows SARS-CoV-2 to overcome antiviral mechanisms at the initial stages of invasion. The third stage includes passive and active protection of the virus from factors of adaptive immunity, overcoming of the barrier function at the focus of inflammation, and generalization of SARS-CoV-2 in the body. The fourth stage is associated with the deployment of variants of acute and long-term complications of COVID-19. SARS-CoV-2's ability to induce autoimmune and autoinflammatory pathways of tissue invasion and development of both immunosuppressive and hyperergic mechanisms of systemic inflammation is critical at this stage of infection.
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Affiliation(s)
- Evgenii Gusev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
| | - Alexey Sarapultsev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
- Russian-Chinese Education and Research Center of System Pathology, South Ural State University, 454080 Chelyabinsk, Russia
| | - Liliya Solomatina
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
| | - Valeriy Chereshnev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
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27
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Palacios-Gutiérrez JJ, Rodríguez-Guardado A, Arias-Guillén M, Alonso-Arias R, Palacios-Penedo S, García-García JM, Balbín M, Pérez-Hernández D, Sandoval-Torrientes M, Torreblanca-Gil A, Melón S, Asensi-Álvarez V, Clain JM, Escalante P. Clinical and epidemiological correlates of low IFN-gamma responses in mitogen tube of QuantiFERON assay in tuberculosis infection screening during the COVID-19 pandemic: A population-based marker of COVID-19 mortality? Arch Bronconeumol 2022; 58:649-659. [PMID: 35185258 PMCID: PMC8842091 DOI: 10.1016/j.arbres.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/16/2022] [Indexed: 11/21/2022]
Abstract
Background The clinical and epidemiological implications of abnormal immune responses in COVID-19 for latent tuberculosis infection (LTBI) screening are unclear. Methods We reviewed QuantiFERON TB Gold Plus (QFT-Plus) results (36,709 patients) from July 2016 until October 2021 in Asturias (Spain). We also studied a cohort of ninety hospitalized patients with suspected/confirmed COVID-19 pneumonia and a group of elderly hospitalized patients with COVID-19 who underwent serial QFT-Plus and immune profiling testing. Results The indeterminate QFT-Plus results rate went from 1.4% (July 2016 to November 2019) to 4.2% during the COVID-19 pandemic. The evolution of the number of cases with low/very low interferon-gamma (IFN-gamma) response in the mitogen tube paralleled the disease activity and number of deaths during the pandemic waves in our region (from March 2020 to October 2021). The percentages of positive QFT-plus patients did not significantly change before and during the pandemic (13.9% vs. 12.2%). Forty-nine patients from the suspected/confirmed COVID-19 pneumonia cohort (54.4%) had low/very low IFN-gamma response to mitogen, 22 of them (24.4%) had severe and critical pneumonia. None received immunosuppressants prior to testing. Abnormal radiological findings (P = 0.01) but not COVID-19 severity was associated with low mitogen response. Immune profiling showed a reduction of CD8 + T cells and a direct correlation between the number of EMRA CD8 + T-cells and IFN-gamma response to mitogen (P = 0.03). Conclusion Low IFN-gamma responses in mitogen tube of QFT-Plus often occur in COVID-19 pneumonia, which is associated with a low number of an effector CD8 + T-cell subset and does not seem to affect LTBI screening; however, this abnormality seems to parallel the dynamics of COVID-19 at the population level and its mortality.
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Shier KL. Elevated Rates of Indeterminate Results on QuantiFERON-TB Gold Plus in COVID-19 Patients. J Clin Microbiol 2021; 59:e0141421. [PMID: 34346720 PMCID: PMC8451408 DOI: 10.1128/jcm.01414-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Interferon gamma release assays are used to screen various patient populations for latent tuberculosis infection. In this issue of the Journal of Clinical Microbiology, J. D. Ward, C. Cornaby, and J. L. Schmitz (J Clin Microbiol 59:e00811-21, 2021, https://doi.org/10.1128/JCM.00811-21) investigated an increased indeterminate rate in the QuantiFERON-TB Gold Plus assay among COVID-19 patients that was independent of immunosuppressive agents and lymphopenia. In their study, COVID-19 patients with indeterminate QuantiFERON-TB Gold Plus results trended toward decreased survival as well as increased serum interleukin-6 (IL-6) and IL-10 levels, although the differences were not statistically significant. They suggest that this pattern of cytokine expression supports an impairment of Th1, specifically interferon gamma production, in critically ill COVID-19 patients, as indicated by indeterminate QuantiFERON-TB Gold Plus results. Clinicians should be aware of the increased rate of indeterminate QuantiFERON-TB Gold Plus results in critically ill COVID-19 patients.
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Affiliation(s)
- Kileen L. Shier
- Quest Diagnostics Nichols Institute, Chantilly, Virginia, USA
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Lippi G, Henry BM, Plebani M. Optimizing effectiveness of COVID-19 vaccination: will laboratory stewardship play a role? Clin Chem Lab Med 2021; 59:1885-1888. [PMID: 34496165 DOI: 10.1515/cclm-2021-0972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giuseppe Lippi
- Department of Neuroscience, Biomedicine and Movement, Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Brandon M Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
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