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Predictors of mortality in patients with COVID-19 by flow cytometry 流式细胞术预测COVID-19患者死亡率
Pub Date : 2023-02-11 DOI: 10.1016/j.clicom.2023.02.003
Marco Bonilla Izquierdo , Ana María Navas Romo , Aurora Gema Sicilia Zafra , Juan de Dios López-González Garrido

Despite the great impact of severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2), we still lack techniques that allow us to anticipate the natural history of the disease in order to avoid or shorten the clinical period of the disease. The values of nine cytokines were measured in COVID-19+ patients admitted to the Hospital Universitario Reina Sofía (HURS) using flow cytometry. The cytokines measured are IL-1ß, IL-6, MCP-1, IP-10, IL-10, IL-8, IL-12, IFN-γ and TNF-α. Given the absence of previous studies on cytokine values in healthy patients using the flow cytometry technique, and the low availability of resources in the first waves of COVID-19, a control group was lacking, all resources were employed for monitoring sick patients. However, this study has revealed a greater increase in two specific cytokines, which are also found to be higher than the rest in healthy patients: MCP-1 and IP-10, which are mainly responsible for cytokine storm and post-disease thrombosis.

尽管冠状病毒2型(严重急性呼吸系统综合征冠状病毒2型)引起的严重急性呼吸综合征具有巨大影响,但我们仍然缺乏能够预测疾病自然史的技术,以避免或缩短疾病的临床周期。使用流式细胞术测量了入住Reina Sofía大学医院(HURS)的新冠肺炎+患者的9种细胞因子值。测量的细胞因子为IL-1ß、IL-6、MCP-1、IP-10、IL-10、IL-8、IL-12、IFN-γ和TNF-α。鉴于之前没有使用流式细胞术技术对健康患者的细胞因子值进行研究,并且在第一波新冠肺炎中资源的可用性较低,因此缺乏对照组,所有资源都用于监测患病患者。然而,这项研究揭示了两种特定细胞因子的增加幅度更大,这两种细胞因子在健康患者中也高于其他细胞因子:MCP-1和IP-10,它们主要负责细胞因子风暴和疾病后血栓形成。
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引用次数: 0
Protective role of human beta-defensin-2 and cathelicidin in high risk close household contacts of pulmonary tuberculosis 人β-防御素-2和组织蛋白酶对肺结核高危家庭密切接触者的保护作用
Pub Date : 2023-02-10 DOI: 10.1016/j.clicom.2023.02.006
Sudhasini Panda , Shah Faisal , Diravya M Seelan , Manisha Dagar , Lokesh Mandlecha , Vidushi Varshney , Mridul Sharma , Kalpana Luthra , Neeraj Kumar Gupta , Archana Singh

Host-defense peptides (HDPs) such as human beta-defensin-2 (hBD-2) and cathelicidin (LL37) are essential components of innate immune response against tuberculosis (TB) infection, which could also be assessed for diagnostic potential in spectrum of TB infection. We assessed mRNA and circulating levels of HDPs in pulmonary TB (PTB) patients and their household contacts (HHCs). hBD-2 and LL37 were found to be significantly higher in both PTB and HHCs suggestive of bacterial exposure which was further corroborated by higher levels of HDPs in mantoux positive HHCs (latent TB). Higher levels of HDPs in HHCs may suggest protective host response against infection as indicated by inverse relation of LL37 with disease severity in PTB. Both peptides demonstrated high levels of sensitivity and specificity, although hBD-2 proved to be a better HDP for distinguishing LTBI from active TB at a cutoff of 3904 pg/ml. However, follow-up studies are required to validate these findings.

宿主防御肽(HDPs),如人β-防御素-2(hBD-2)和组织蛋白酶(LL37),是抵抗结核病(TB)感染的先天免疫反应的重要组成部分,也可以评估其在结核病感染谱中的诊断潜力。我们评估了肺结核(PTB)患者及其家庭接触者(HHC)中HDPs的mRNA和循环水平。发现hBD-2和LL37在PTB和HHCs中均显著升高,提示细菌暴露,mantoux阳性HHCs(潜伏性TB)中较高水平的HDPs进一步证实了这一点。HHCs中较高水平的HDPs可能表明宿主对感染的保护性反应,如LL37与PTB疾病严重程度的反比关系所示。尽管hBD-2在3904 pg/ml的临界值下被证明是区分LTBI和活动性TB的更好的HDP,但这两种肽都表现出高水平的敏感性和特异性。然而,需要进行后续研究来验证这些发现。
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引用次数: 0
Is Interleukin-6 blockade a viable strategy to prevent progression of acute respiratory distress syndrome in non-COVID viral pneumonia? 白细胞介素-6阻断是预防非covid病毒肺炎急性呼吸窘迫综合征进展的可行策略吗?
Pub Date : 2023-02-10 DOI: 10.1016/j.clicom.2023.02.004
Rana Prathap Padappayil , Siva Naga S. Yarrarapu , Raghu Tiperneni , Boning Li
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引用次数: 0
GROWTH HORMONE, IMMUNOSENESCENCE AND VACCINATION FAILURE IN THE ELDERLY 老年人的生长激素、免疫衰老和疫苗接种失败
Pub Date : 2023-02-10 DOI: 10.1016/j.clicom.2023.02.005
José E Belizário, Miguel Garay-Malpartida

In the aging population, the longitudinal decrease in the secretion of steroidal and polypeptides growth hormones is directly associated with accumulation of senescent cells in tissues and organs. The cellular hypo-replicative senescence state is caused by metabolic stress and persistent DNA damage, which lead to the activation of the p16INK4a cell-cycle inhibitor, retinoblastoma and p53 pathways. Aging increases the susceptibility to physical frailty, sarcopenia, diabetes, atherosclerosis, infectious disease and cancer in the older adults. As a consequence of immunosenescence and reduced immunoreactivity of the innate and adaptive systems, seniors have a weak response to vaccination. The high doses of vaccines have been recommended to boost growth and activation of memory T and B cells in non-responsive older individuals, but it is not sufficient for long-term protection. The treatment with recombinant human growth hormone has been shown to regenerate thymus and increase the repertoire of naive T cells CD4+ and CD8+ T cell and B cell subsets in people with age-related diseases, chronic viral infection and immunodeficiencies. This review presents an update on senescence biology and their clinical immunological manifestations in the elderly. We describe possible immune mechanisms by which personalized recombinant growth hormone therapy could act to prolong the effectiveness of the vaccines recommended to older adults.

在老龄化人群中,甾体和多肽生长激素分泌的纵向减少与衰老细胞在组织和器官中的积累直接相关。细胞低复制衰老状态是由代谢应激和持续的DNA损伤引起的,这些损伤导致p16INK4a细胞周期抑制剂、视网膜母细胞瘤和p53通路的激活。衰老增加了老年人身体虚弱、少肌症、糖尿病、动脉粥样硬化、传染病和癌症的易感性。由于先天和适应性系统的免疫衰老和免疫反应性降低,老年人对疫苗接种的反应较弱。高剂量的疫苗被推荐用于促进无反应老年人记忆T和B细胞的生长和激活,但不足以提供长期保护。在患有年龄相关疾病、慢性病毒感染和免疫缺陷的人群中,用重组人生长激素治疗已被证明可以再生胸腺并增加原始T细胞CD4+和CD8+T细胞及B细胞亚群。本文综述了老年人衰老生物学及其临床免疫学表现的最新进展。我们描述了可能的免疫机制,通过这种机制,个性化重组生长激素治疗可以延长推荐给老年人的疫苗的有效性。
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引用次数: 2
Analysis of humoral and cellular immunity after SARS-CoV-2 vaccination in patients with multiple sclerosis treated with immunomodulatory drugs 免疫调节药物治疗多发性硬化症患者接种SARS-CoV-2疫苗后体液免疫和细胞免疫分析
Pub Date : 2023-02-04 DOI: 10.1016/j.clicom.2023.02.001
Virginia Meca-Lallana , Laura Esparcia-Pinedo , Clara Aguirre , Carolina Díaz-Pérez , Ainhoa Gutierrez-Cobos , Mónica Sobrado , Estefanía Carabajal , Beatriz del Río , Noelia Ropero , Ramón Villagrasa , José Vivancos , Francisco Sanchez-Madrid , Arantzazu Alfranca

We analyzed immune response to SARS-CoV-2 vaccination by measuring specific IgG titers and T-cell reactivity to different SARS-CoV-2 peptides in multiple sclerosis patients taking different disease-modifying treatments. Of the 88 patients included, 72 developed any kind of immune response after vaccination. Although DMTs such as fingolimod and anti-CD20+ treatments prevented patients from developing a robust humoral response to the vaccine, most of them were still able to develop a cellular response, which could be crucial for long-term immunity. It is probably advisable that all MS patients take additional/booster doses to increase their humoral and/or cellular immune response to SARS-CoV-2.

我们通过测量接受不同疾病改良治疗的多发性硬化症患者对不同严重急性呼吸系统综合征冠状病毒2型肽的特异性IgG滴度和T细胞反应性,分析了对严重急性呼吸综合征冠状病毒二型疫苗接种的免疫反应。在包括在内的88名患者中,72人在接种疫苗后出现任何类型的免疫反应。尽管芬戈莫德和抗CD20+治疗等DMT阻止了患者对疫苗产生强大的体液反应,但他们中的大多数人仍然能够产生细胞反应,这可能对长期免疫至关重要。建议所有MS患者服用额外/加强剂量,以增加他们对严重急性呼吸系统综合征冠状病毒2型的体液和/或细胞免疫反应。
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引用次数: 1
Partial recovery of SARS-CoV-2 immunity after booster vaccination in renal transplant recipients 肾移植受者加强接种后SARS-CoV-2免疫的部分恢复
Pub Date : 2022-12-11 DOI: 10.1016/j.clicom.2022.12.001
J.M. Urra , P. Castro , N. Jiménez , E. Moral , C. Vozmediano

The pandemic caused by the SARS-CoV-2 coronavirus has been especially detrimental to patients with end-stage renal disease. History with other vaccines suggests that patients with renal disease may not respond adequately to the SARS-CoV-2 vaccine. The aim of this study is to evaluate the immunity to SARS-CoV-2 mRNA vaccines in renal patients. Post SARS-CoV-2 vaccination first, and after the booster dose, antibodies and cellular immunity were studied in patients on hemodialysis (N = 20), peritoneal dialysis (N = 10) and renal transplantation (N = 10). After the two doses of vaccine, there was an effective immunity in dialysis patients, with 100% seroconversion and 87% detection of cellular immunity (85% in hemodialysis and 90% in peritoneal dialysis). In contrast, in renal transplant recipients there was only 50% seroconversion and cellular immunity was detected in 30% of patients. After the booster dose, all dialysis patients achieved a cellular and antibody immunity, whereas in transplant patients, despite improvement, 20% did not produce antibodies and in 37.5% cellular immunity could not be detected. The mRNA vaccine plus booster performs excellently in dialysis patients, whereas in kidney transplant recipients, despite the booster, complete immunization is not achieved.

严重急性呼吸系统综合征冠状病毒2型引起的疫情对终末期肾病患者尤其有害。其他疫苗的历史表明,肾病患者可能对严重急性呼吸系统综合征冠状病毒2型疫苗反应不足。本研究的目的是评估肾脏患者对严重急性呼吸系统综合征冠状病毒2型信使核糖核酸疫苗的免疫力。首先接种严重急性呼吸系统综合征冠状病毒2型疫苗后和加强剂接种后,对血液透析(N=20)、腹膜透析(N=10)和肾移植(N=10 10)患者的抗体和细胞免疫进行了研究。接种两剂疫苗后,透析患者具有有效的免疫力,血清转化率为100%,细胞免疫检测率为87%(血液透析为85%,腹膜透析为90%)。相比之下,肾移植受者只有50%的血清转化率,30%的患者检测到细胞免疫。在加强剂量后,所有透析患者都实现了细胞和抗体免疫,而在移植患者中,尽管有所改善,但20%的患者没有产生抗体,37.5%的患者无法检测到细胞免疫。信使核糖核酸疫苗加加强针在透析患者中表现出色,而在肾移植受者中,尽管有加强针,但尚未实现完全免疫。
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引用次数: 1
Endogenous antibody response to SARS-CoV-2 in patients who received monoclonal antibodies against COVID-19: A systematic review 接受COVID-19单克隆抗体的患者对SARS-CoV-2的内源性抗体反应:一项系统综述
Pub Date : 2022-12-01 DOI: 10.1016/j.clicom.2022.08.003
Andrea Lombardi , Cecilia Azzarà , Giulia Renisi , Giulia Viero , Andrea Gori , Alessandra Bandera

Passive immunization with mAbs has been employed in COVID-19. We performed a systematic review of the literature assessing the endogenous humoral immune response against SARS-CoV-2 in patients treated with mAbs. Administration of mAbs in seronegative patients led to a reduction in both antibody titres and neutralizing activity against the virus.

单克隆抗体被动免疫已应用于COVID-19。我们进行了一项系统的文献综述,评估了单克隆抗体治疗患者对SARS-CoV-2的内源性体液免疫反应。在血清阴性患者中使用单克隆抗体导致抗体滴度和对病毒的中和活性降低。
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引用次数: 1
Differential peripheral blood mononuclear cell reactivity against SARS-CoV-2 proteins in naïve and previously infected subjects following COVID-19 vaccination naïve和先前感染的受试者接种COVID-19疫苗后外周血单个核细胞对SARS-CoV-2蛋白的反应性差异
Pub Date : 2022-12-01 DOI: 10.1016/j.clicom.2022.11.004
Elizabete Cristina Iseke Bispo , Amandda Évelin Silva-Carvalho , Marielly Reis Resende Sousa , Francisco de Assis Rocha Neves , Juliana Lott Carvalho , Enrique Roberto Arganaraz , Felipe Saldanha-Araujo

The decline in vaccine efficacy and the risk of reinfection by SARS-CoV-2 make new studies important to better characterize the immune response against the virus and its components. Here, we investigated the pattern of activation of T-cells and the expression of inflammatory factors by PBMCs obtained from naïve and previously infected subjects following COVID-19 vaccination, after PBMCs stimulation with S1, RBD, and N-RBD SARS-CoV-2 proteins. PBMCs showed low levels of ACE2 and TMPRSS2 transcripts, which were not modulated by the exposure of these cells to SARS-CoV-2 proteins. Compared to S1 and RBD, N-RBD stimulation showed a greater ability to stimulate T-cell reactivity, according to CD25 and CD69 markers. Interestingly, T-cell reactivity was more pronounced in vaccinated subjects with prior SARS-CoV-2 infection than in vaccinated donors who never had been diagnosed with COVID-19. Finally, N-RBD stimulation promoted greater expression of IL-6 and IFN-γ in PBMCs, which reinforces the greater immunogenic potential of this protein in the vaccinated subjects. These data suggest that PBMCs from previously infected and vaccinated subjects are more reactive than those derived from just vaccinated donors. Moreover, the N-RBD together viral proteins showed a greater stimulatory capacity than S1 and RBD viral proteins.

疫苗效力的下降和SARS-CoV-2再感染的风险使得新的研究对更好地表征针对该病毒及其成分的免疫反应具有重要意义。在这里,我们研究了在接种COVID-19疫苗后,在PBMCs受到S1、RBD和N-RBD SARS-CoV-2蛋白刺激后,从naïve和先前感染的受试者中获得的PBMCs激活t细胞和炎症因子表达的模式。pbmc显示出低水平的ACE2和TMPRSS2转录本,这些转录本不受这些细胞暴露于SARS-CoV-2蛋白的调节。根据CD25和CD69标记,与S1和RBD相比,N-RBD刺激显示出更大的刺激t细胞反应性的能力。有趣的是,在先前感染过SARS-CoV-2的接种疫苗的受试者中,t细胞反应性比从未被诊断为COVID-19的接种疫苗的捐赠者更明显。最后,N-RBD刺激促进了pbmc中IL-6和IFN-γ的表达,这加强了该蛋白在接种受试者中更大的免疫原性潜力。这些数据表明,来自先前感染和接种过疫苗的受试者的pbmc比来自刚刚接种过疫苗的供者的pbmc更具反应性。此外,N-RBD组合病毒蛋白比S1和RBD组合病毒蛋白表现出更强的刺激能力。
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引用次数: 2
Evaluation of the performance of a lateral flow device for quantitative detection of anti-SARS-CoV-2 IgG 抗sars - cov -2 IgG水平流式定量检测装置的性能评价
Pub Date : 2022-12-01 DOI: 10.1016/j.clicom.2022.09.001
J.S. Moore , L.J. Robertson , R. Price , G. Curry , J. Farnan , A. Black , M.A. Nesbit , J.A. McLaughlin , T. Moore

Introduction: The AbC-19™ lateral flow immunoassay (LFIA) performance was evaluated on plasma samples from a SARS-CoV-2 vaccination cohort, WHO international standards for anti-SARS-CoV-2 IgG (human), individuals ≥2 weeks from infection of RT-PCR confirmed SARS-CoV-2 genetic variants, as well as microorganism serology.

Methods: Pre-vaccination to three weeks post-booster samples were collected from a cohort of 111 patients (including clinically extremely vulnerable patients) from Northern Ireland. All patients received Oxford-AstraZeneca COVID-19 vaccination for the first and second dose, and Pfizer-BioNTech for the third (first booster). WHO international standards, 15 samples from 2 variants of concern (Delta and Omicron) and cross-reactivity with plasma samples from other microorganism infections were also assessed on AbC-19™.

Results: All 80 (100%) participants sampled post-booster had high positive IgG responses, compared to 38/95 (40%) participants at 6 months post-first vaccination. WHO standard results correlated with information from corresponding biological data sheets, and antibodies to all genetic variants were detected by LFIA. No cross-reactivity was found with exception of one (of five) Dengue virus samples.

Conclusion: These findings suggest BNT162b2 booster vaccination enhanced humoral immunity to SARS-CoV-2 from pre-booster levels, and that this antibody response was detectable by the LFIA. In combination with cross-reactivity, standards and genetic variant results would suggest LFIA may be a cost-effective measure to assess SARS-CoV-2 antibody status.

本研究对来自SARS-CoV-2疫苗接种队列、WHO抗SARS-CoV-2 IgG(人)国际标准、感染RT-PCR确认的SARS-CoV-2遗传变异≥2周的个体以及微生物血清学的血浆样本进行了AbC-19™横向流动免疫测定(LFIA)性能评估。方法:从北爱尔兰111例患者(包括临床极度易感患者)中收集疫苗接种前至加强后三周的样本。所有患者均接种了第一剂和第二剂牛津-阿斯利康COVID-19疫苗,第三剂为辉瑞- biontech疫苗(第一次加强剂)。还用AbC-19™评估了世卫组织国际标准、来自两种关注变体(Delta和Omicron)的15份样本以及与其他微生物感染血浆样本的交叉反应性。结果:与首次接种疫苗6个月后38/95(40%)的参与者相比,所有80名(100%)接种强化疫苗后的参与者都有高阳性IgG反应。世卫组织标准结果与相应生物数据表的信息相关,LFIA检测到所有遗传变异的抗体。除五份登革热病毒样本中的一份外,未发现交叉反应性。结论:上述结果提示BNT162b2加强疫苗接种可增强对SARS-CoV-2的体液免疫,且这种抗体应答可通过LFIA检测到。结合交叉反应性、标准和遗传变异结果,LFIA可能是评估SARS-CoV-2抗体状态的一种具有成本效益的措施。
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引用次数: 0
Appraising SARS-CoV-2 infections after full mRNA COVID-19 vaccination in patients with systemic lupus erythematosus (SLE) 系统性红斑狼疮(SLE)患者全mRNA COVID-19疫苗接种后SARS-CoV-2感染的评价
Pub Date : 2022-12-01 DOI: 10.1016/j.clicom.2022.03.002
Anderson Anuforo , Michael Sandhu , Jianghong Yu , Andras Perl

The 2019 Coronavirus disease (COVID-19) vaccine is a major weapon in the fight against the severe acute respiratory syndrome brought about by coronavirus 2 (SARS-CoV-2). The vaccine significantly reduces the risk and severity of infection by SARS-CoV-2. Patients with systemic lupus erythematosus (SLE) need protection from vaccine-preventable diseases including COVID-19. SLE patients have higher rates of severe infections due to immunosuppressive therapies and multiple immunologic defects – both of which are capable of blunting the immune responses after vaccination. In the management of COVID-19, recommendations have been developed to guide adjustments and/or continuation of immunosuppressive therapies for an effective immune response following vaccination with mRNA-based or viral vector-delivered vaccines. Monoclonal antibodies have also become available since December 2021. Here we present three cases of SLE patients who contracted COVID-19 after vaccination. One was managed in ambulatory settings and two required inpatient hospital admission.

2019冠状病毒病(COVID-19)疫苗是抗击冠状病毒2型(SARS-CoV-2)引起的严重急性呼吸系统综合征(SARS-CoV-2)的主要武器。该疫苗可显著降低感染SARS-CoV-2的风险和严重程度。系统性红斑狼疮(SLE)患者需要预防疫苗可预防的疾病,包括COVID-19。由于免疫抑制疗法和多种免疫缺陷,SLE患者的严重感染发生率更高,这两者都能够减弱接种疫苗后的免疫反应。在COVID-19的管理中,已经制定了建议,以指导在接种基于mrna或病毒载体递送的疫苗后调整和/或继续使用免疫抑制疗法,以实现有效的免疫反应。自2021年12月起,单克隆抗体也已上市。在这里,我们报告了三例接种疫苗后感染COVID-19的SLE患者。1例在门诊环境中进行管理,2例需要住院治疗。
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引用次数: 2
期刊
Clinical Immunology Communications
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