tetano
Editor, Senior Moderator
J Clin Med
. 2021 Dec 9;10(24):5765.
doi: 10.3390/jcm10245765.
Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia
Pierachille Santus[SUP] 1 2 [/SUP], Dejan Radovanovic[SUP] 2 [/SUP], Micaela Garziano[SUP] 1 3 [/SUP], Stefano Pini[SUP] 1 2 [/SUP], Giuseppe Croce[SUP] 1 2 [/SUP], Giuseppe Fuccia[SUP] 1 2 [/SUP], Debora Spitaleri[SUP] 1 2 [/SUP], Mara Biasin[SUP] 1 [/SUP], Mario Clerici[SUP] 3 4 [/SUP], Daria Trabattoni[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The effects of immunomodulators in patients with Coronavirus Disease 2019 (COVID-19) pneumonia are still unknown. We investigated the cellular inflammatory and molecular changes in response to standard-of-care + pidotimod (PDT) and explored the possible association with blood biomarkers of disease severity.
Methods: Clinical characteristics and outcomes, neutrophil-to-lymphocyte ratio (NLR), plasma and cell supernatant chemokines, and gene expression patterns after SARS-CoV-2 and influenza (FLU) virus in vitro stimulation were assessed in 16 patients with mild-moderate COVID-19 pneumonia, treated with standard of care and PDT 800 mg twice daily (PDT group), and measured at admission, 7 (T1), and 12 (T2) days after therapy initiation. Clinical outcomes and NLR were compared with age-matched historical controls not exposed to PDT.
Results: Hospital stay, in-hospital mortality, and intubation rate did not differ between groups. At T1, NLR was 2.9 (1.7-4.6) in the PDT group and 5.5 (3.4-7.1) in controls (p = 0.037). In the PDT group, eotaxin and IL-4 plasma concentrations progressively increased (p < 0.05). Upon SARS-CoV-2 and FLU-specific stimulation, IFN-γ was upregulated (p < 0.05), while at genetic transcription level, Pathogen Recognition Receptors (TRLs) were upregulated, especially in FLU-stimulated conditions.
Conclusions: Immunomodulation exerted by PDT and systemic corticosteroids may foster a restoration in the innate response to the viral infection. These results should be confirmed in larger RCTs.
Keywords: COVID-19; cytokine; immune response; immunomodulation; pidotimod; respiratory failure; toll like receptor; viral pneumonia.
. 2021 Dec 9;10(24):5765.
doi: 10.3390/jcm10245765.
Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia
Pierachille Santus[SUP] 1 2 [/SUP], Dejan Radovanovic[SUP] 2 [/SUP], Micaela Garziano[SUP] 1 3 [/SUP], Stefano Pini[SUP] 1 2 [/SUP], Giuseppe Croce[SUP] 1 2 [/SUP], Giuseppe Fuccia[SUP] 1 2 [/SUP], Debora Spitaleri[SUP] 1 2 [/SUP], Mara Biasin[SUP] 1 [/SUP], Mario Clerici[SUP] 3 4 [/SUP], Daria Trabattoni[SUP] 1 [/SUP]
Affiliations
- PMID: 34945060
- DOI: 10.3390/jcm10245765
Abstract
Background: The effects of immunomodulators in patients with Coronavirus Disease 2019 (COVID-19) pneumonia are still unknown. We investigated the cellular inflammatory and molecular changes in response to standard-of-care + pidotimod (PDT) and explored the possible association with blood biomarkers of disease severity.
Methods: Clinical characteristics and outcomes, neutrophil-to-lymphocyte ratio (NLR), plasma and cell supernatant chemokines, and gene expression patterns after SARS-CoV-2 and influenza (FLU) virus in vitro stimulation were assessed in 16 patients with mild-moderate COVID-19 pneumonia, treated with standard of care and PDT 800 mg twice daily (PDT group), and measured at admission, 7 (T1), and 12 (T2) days after therapy initiation. Clinical outcomes and NLR were compared with age-matched historical controls not exposed to PDT.
Results: Hospital stay, in-hospital mortality, and intubation rate did not differ between groups. At T1, NLR was 2.9 (1.7-4.6) in the PDT group and 5.5 (3.4-7.1) in controls (p = 0.037). In the PDT group, eotaxin and IL-4 plasma concentrations progressively increased (p < 0.05). Upon SARS-CoV-2 and FLU-specific stimulation, IFN-γ was upregulated (p < 0.05), while at genetic transcription level, Pathogen Recognition Receptors (TRLs) were upregulated, especially in FLU-stimulated conditions.
Conclusions: Immunomodulation exerted by PDT and systemic corticosteroids may foster a restoration in the innate response to the viral infection. These results should be confirmed in larger RCTs.
Keywords: COVID-19; cytokine; immune response; immunomodulation; pidotimod; respiratory failure; toll like receptor; viral pneumonia.