International immunopharmacology
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Int. Immunopharmacol. · Jan 2021
Clinical characteristics and antibiotics treatment in suspected bacterial infection patients with COVID-19.
Coronavirus disease 2019 (COVID-19) pandemic has brought challenges to health and social care systems. However, the empirical use of antibiotics is still confusing. Presently, a total of 1123 patients with COVID-19 admitted to Renmin Hospital of Wuhan University was included in this retrospective cohort study. ⋯ Moreover, penicillin and meropenem treatments were associated with increased mortality of the patients with no evidence of bacterial infection. In conclusion, patients with suspected bacterial infection were more likely to have negative clinical outcomes than those without bacterial infection. Empirical use of antibiotics may not have the expected benefits.
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Int. Immunopharmacol. · Jan 2021
Randomized Controlled TrialEvaluating the effects of Intravenous Immunoglobulin (IVIg) on the management of severe COVID-19 cases: A randomized controlled trial.
The newly discovered coronavirus has turned into coronavirus disease 2019 (COVID-19) pandemic and it rages at an unprecedented rate. Considering the findings of previous studies on the use of Intravenous Immunoglobulin (IVIg) for treating severe H1N1 infection and the satisfying results for reducing viral load and mortality, this study aimed to investigate the potential usefulness of IVIg for the management of severe cases. ⋯ Our findings did not support the use of IVIg in combination with hydroxychloroquine and lopinavir/ritonavir in treatment of severe COVID-19 cases.
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Int. Immunopharmacol. · Jan 2021
ReviewThe deregulated immune reaction and cytokines release storm (CRS) in COVID-19 disease.
COVID-19 caused by the SARS-CoV-2 virus, accompanies an unprecedented spike in cytokines levels termed cytokines release syndrome (CRS), in critically ill patients. Clinicians claim that the surge demonstrates a deregulated immune defence in host, as infected cell expression analysis depicts a delay in type-I (interferon-I) and type-III IFNs expression, along with a limited Interferon-Stimulated Gene (ISG) response, which later resume and culminates in elicitation of several cytokines including- IL-6, IL-8, IL-12, TNFα, IL-17, MCP-1, IP-10 and IL-10 etc. Although cytokines are messenger molecules of the immune system, but their increased concentration results in inflammation, infiltration of macrophages, neutrophils and lung injury in patients. ⋯ In pathogenesis analysis, it emerges that a timely forceful type-I IFN production (18-24hrs post infection) promotes innate and acquired immune responses, while a delay in IFNs production (3-4 days post infection) actually renders both innate and acquired responses ineffective in fighting infection. Further, underlying conditions including hypertension, obesity, cardio-vascular disease etc may increase the chances of putting people in risk groups, which end up having critical form of infection. This review summarizes the events starting from viral entry, its struggle with the immune system and failure of host immunological parameters to obliterate the infections, which finally culminate into massive release of CRS and inflammation in gravely ill patients.
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Int. Immunopharmacol. · Jan 2021
Persistence of SARS-CoV-2-specific antibodies in COVID-19 patients.
To better understand humoral immunity following SARS-CoV-2 infection, 114 hospitalised COVID-19 patients with antibody monitored over 8 weeks from symptom onset were retrospectively investigated. A total of 445 serum samples were assessed via chemiluminescence immunoassay. Positive rate of virus-specific IgM reached up to over 80% from the second week to the eighth week after symptom onset, then declined quickly to below 30% in the twelfth week. ⋯ As compared with the non-severe group, serum IgM level from week 3 to week 8 was significantly higher among the patients with severe clinical symptoms (P = 0.012) but not IgG (P = 0.053). Serum IgM level from week 3 to week 8 was correlated with positive virus RNA test (r = 0.201, P = 0.044), albumin level (r = -0.295, P = 0.003), lactic dehydrogenase (LDH) level (r = 0.292, P = 0.003), alkaline phosphatase (ALP) level (r = 0.254, P = 0.010), C-reactive protein (CRP) level (r = 0.281, P = 0.004) during the same course, while serum IgG level was correlated with age (r = 0.207, P = 0.038). This presented results provide insight into duration of SARS-CoV-2 antibodies and interaction between the virus and host systems.
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Int. Immunopharmacol. · Dec 2020
ReviewToll-like receptors in sepsis-associated cytokine storm and their endogenous negative regulators as future immunomodulatory targets.
Cytokine storm generates during various systemic acute infections, including sepsis and current pandemic called COVID-19 (severe) causing devastating inflammatory conditions, which include multi-organ failure or multi-organ dysfunction syndrome (MODS) and death of the patient. Toll-like receptors (TLRs) are one of the major pattern recognition receptors (PRRs) expressed by immune cells as well as non-immune cells, including neurons, which play a crucial role in generating cytokine storm. They recognize microbial-associated molecular patterns (MAMPs, expressed by pathogens) and damage or death-associate molecular patterns (DAMPs; released and/expressed by damaged/killed host cells). ⋯ This state-of-the-art review describes the importance of TLR signaling in the onset of the sepsis-associated cytokine storm and discusses various host-derived endogenous negative regulators of TLR signaling pathways. The subject is very important as there is a vast array of genes and processes implicated in these negative feedback mechanisms. These molecules and mechanisms can be targeted for developing novel therapeutic drugs for cytokine storm-associated diseases, including sepsis, severe COVID-19, and other inflammatory diseases, where TLR-signaling plays a significant role.