Nature and Dimensions of Systemic Hyperinflammation and its Attenuation by Convalescent Plasma in Severe COVID-19
Nature and Dimensions of Systemic Hyperinflammation and its Attenuation by Convalescent Plasma in Severe COVID-19
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DOI：
10.1093/infdis/jiab010
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发表时间：
2021-07-13
影响因子：
6.4
通讯作者：
Ganguly, Dipyaman
中科院分区：
文献类型：
--
作者：
Bandopadhyay, Purbita;D'Rozario, Ranit;Ganguly, Dipyaman
背景。引起2019冠状病毒病（COVID-19）的严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）已导致大量发病率和死亡率。虽然大多数患者症状轻微，但一些患者进展为严重的急性呼吸窘迫综合征（ARDS）和相关的全身性炎症。首先，为了表征这种高炎症状态下的关键细胞因子及其动态，我们评估了进展为ARDS的患者与轻度疾病患者相比48组细胞因子的丰度和相关表达。然后，在一项正在进行的恢复期血浆治疗（CPT）的随机对照试验中，我们分析了CPT对全身细胞因子动力学的快速影响与患者缺氧水平的相关性。我们发现CPT具有独立于其中和抗体含量的抗炎作用。中和抗体，以及循环白细胞介素-6和干扰素- γ诱导蛋白10的减少，促成了CPT反应中缺氧的显著快速减少。
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has led to significant morbidity and mortality. While most suffer from mild symptoms, some patients progress to severe disease with acute respiratory distress syndrome (ARDS) and associated systemic hyperinflammation.Methods. First, to characterize key cytokines and their dynamics in this hyperinflammatory condition, we assessed abundance and correlative expression of a panel of 48 cytokines in patients progressing to ARDS as compared to patients with mild disease. Then, in an ongoing randomized controlled trial of convalescent plasma therapy (CPT), we analyzed rapid effects of CPT on the systemic cytokine dynamics as a correlate for the level of hypoxia experienced by the patients.Results. We identified an anti-inflammatory role of CPT independent of its neutralizing antibody content.Conclusions. Neutralizing antibodies, as well as reductions in circulating interleukin-6 and interferon-gamma-inducible protein 10, contributed to marked rapid reductions in hypoxia in response to CPT.