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Parepalli A, Sarode R, Kumar S, Nelakuditi M, Kumar MJ. Antiphospholipid Syndrome and Catastrophic Antiphospholipid Syndrome: A Comprehensive Review of Pathogenesis, Clinical Features, and Management Strategies. Cureus 2024; 16:e66555. [PMID: 39252716 PMCID: PMC11381965 DOI: 10.7759/cureus.66555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 08/09/2024] [Indexed: 09/11/2024] Open
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPLs) that predispose individuals to thrombotic events and pregnancy-related complications. APS can occur as a primary condition or in association with other autoimmune diseases, most commonly systemic lupus erythematosus (SLE). Catastrophic APS (CAPS) is a rare, severe variant of APS, marked by rapid-onset, widespread thrombosis leading to multi-organ failure, often triggered by infections, surgical procedures, or cessation of anticoagulation therapy. Both APS and CAPS present significant clinical challenges due to their potential for severe morbidity and mortality. This comprehensive review aims to provide a detailed overview of the pathogenesis, clinical features, diagnostic criteria, and management strategies for APS and CAPS. The review highlights the immunological mechanisms underlying APS, including the role of aPLs, complement system activation, and endothelial cell dysfunction in developing thrombosis. It also outlines the clinical manifestations of APS, such as venous and arterial thrombosis, pregnancy morbidity, and neurological symptoms, along with the diagnostic criteria based on clinical and laboratory findings. The review delves into its pathogenesis, clinical presentation, and diagnostic challenges in the context of CAPS, emphasizing the need for immediate and intensive therapy to manage this life-threatening condition. Current management strategies for APS, including anticoagulant therapy, immunomodulatory treatments, and specific interventions for pregnancy-related complications, are discussed. The review highlights the importance of a multidisciplinary approach for CAPS, combining anticoagulation, high-dose corticosteroids, plasma exchange, and intravenous immunoglobulin. The review also addresses the prognosis and long-term outcomes for patients with APS and CAPS, underlining the necessity for ongoing monitoring and follow-up to prevent recurrent thrombotic events and manage chronic complications. Finally, future directions in research are explored, focusing on emerging therapies, biomarkers for early diagnosis, and the need for clinical trials to advance the understanding and treatment of these complex syndromes. By enhancing the understanding of APS and CAPS, this review aims to improve diagnosis, treatment, and patient care, ultimately leading to better health outcomes for those affected by these conditions.
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Affiliation(s)
- Avinash Parepalli
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajesh Sarode
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manikanta Nelakuditi
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - M Jayanth Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Aljuhani O, Korayem GB, Altebainawi AF, AlMohammady D, Alfahed A, Altebainawi EF, Aldhaeefi M, Badreldin HA, Vishwakarma R, Almutairi FE, Alenazi AA, Alsulaiman T, Alqahtani RA, Al Dhahri F, Aldardeer N, Alenazi AO, Al Harbi S, Kensara R, Alalawi M, Al Sulaiman K. Dexamethasone versus methylprednisolone for multiple organ dysfunction in COVID-19 critically ill patients: a multicenter propensity score matching study. BMC Infect Dis 2024; 24:189. [PMID: 38350878 PMCID: PMC10863167 DOI: 10.1186/s12879-024-09056-y] [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: 04/22/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Dexamethasone usually recommended for patients with severe coronavirus disease 2019 (COVID-19) to reduce short-term mortality. However, it is uncertain if another corticosteroid, such as methylprednisolone, may be utilized to obtain better clinical outcome. This study assessed dexamethasone's clinical and safety outcomes compared to methylprednisolone. METHODS A multicenter, retrospective cohort study was conducted between March 01, 2020, and July 31, 2021. It included adult COVID-19 patients who were initiated on either dexamethasone or methylprednisolone therapy within 24 h of intensive care unit (ICU) admission. The primary outcome was the progression of multiple organ dysfunction score (MODS) on day three of ICU admission. Propensity score (PS) matching was used (1:3 ratio) based on the patient's age and MODS within 24 h of ICU admission. RESULTS After Propensity Score (PS) matching, 264 patients were included; 198 received dexamethasone, while 66 patients received methylprednisolone within 24 h of ICU admission. In regression analysis, patients who received methylprednisolone had a higher MODS on day three of ICU admission than those who received dexamethasone (beta coefficient: 0.17 (95% CI 0.02, 0.32), P = 0.03). Moreover, hospital-acquired infection was higher in the methylprednisolone group (OR 2.17, 95% CI 1.01, 4.66; p = 0.04). On the other hand, the 30-day and the in-hospital mortality were not statistically significant different between the two groups. CONCLUSION Dexamethasone showed a lower MODS on day three of ICU admission compared to methylprednisolone, with no statistically significant difference in mortality.
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Affiliation(s)
- Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghazwa B Korayem
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ali F Altebainawi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Daniah AlMohammady
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amjaad Alfahed
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Elaf F Altebainawi
- Department of Medicine, King Khalid Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Mohammed Aldhaeefi
- Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC, 20059, USA
| | - Hisham A Badreldin
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ramesh Vishwakarma
- Norwich clinical trial unit, Norwich medical school, University of east Anglia, Norwich, UK
| | - Faisal E Almutairi
- Clinical Pharmacy Department, Pharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abeer A Alenazi
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Thamer Alsulaiman
- Family Medicine Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Rahaf Ali Alqahtani
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Fahad Al Dhahri
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Namareq Aldardeer
- Pharmaceutical Care Services, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed O Alenazi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Dammam, Saudi Arabia
| | - Shmeylan Al Harbi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Raed Kensara
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mai Alalawi
- Pharmaceutical Care Services, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Khalid Al Sulaiman
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
- King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, PO Box 22490, Riyadh, 11426, Saudi Arabia.
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Walczak J, Iwaszkiewicz-Grześ D, Cholewiński G. Approaches Towards Better Immunosuppressive Agents. Curr Top Med Chem 2024; 24:1230-1263. [PMID: 38561615 DOI: 10.2174/0115680266292661240322072908] [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: 11/13/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
Several classes of compounds are applied in clinics due to their immunosuppressive properties in transplantology and the treatment of autoimmune diseases. Derivatives of mycophenolic acid, corticosteroids and chemotherapeutics bearing heterocyclic moieties like methotrexate, azathioprine, mizoribine, and ruxolitinib are active substances with investigated mechanisms of action. However, improved synthetic approaches of known drugs and novel derivatives are still being reported to attempt better accessibility and therapeutic properties. In this review article, we present the synthesis of the designed chemical structures based on recent literature reports concerning novel compounds as promising immunosuppressive drugs. Moreover, some of the discussed derivers revealed also other types of activities with prospective medicinal potential.
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Affiliation(s)
- Juliusz Walczak
- Department of Organic Chemistry, Faculty of Chemistry, Gdańsk University of Technology, G. Narutowicza 11/12, 80-233, Gdańsk, Poland
| | - Dorota Iwaszkiewicz-Grześ
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdansk, ul. Dębinki 7, 80-210, Gdańsk, Poland
| | - Grzegorz Cholewiński
- Department of Organic Chemistry, Faculty of Chemistry, Gdańsk University of Technology, G. Narutowicza 11/12, 80-233, Gdańsk, Poland
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Mahmoudian MH, Azari A, Jahantigh A, Sarkhosh M, Yousefi M, Razavinasab SA, Afsharizadeh M, Mohammadi Shahraji F, Pour Pasandi A, Zeidabadi A, Ilaghinezhad Bardsiri T, Ghasemian M. Statistical modeling and optimization of dexamethasone adsorption from aqueous solution by Fe3O4@NH2-MIL88B nanorods: Isotherm, Kinetics, and Thermodynamic. ENVIRONMENTAL RESEARCH 2023; 236:116773. [PMID: 37543125 DOI: 10.1016/j.envres.2023.116773] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/16/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
The presence of pharmaceutical compounds in the environment poses a significant threat to human and aquatic animal health. Dexamethasone (DEX), a synthetic steroid hormone with endocrine-disrupting effects, is one such compound that needs to be effectively removed before discharging into the environment. This research presents a novel approach utilizing magnetically recyclable Fe3O4@NH2-MIL88B NRs as an efficient adsorbent for the treatment of DEX from aqueous solutions. The synthesized adsorbent was characterized by X-ray diffraction (XRD), scanning microscopy (SEM), transmission electron microscopy (TEM), vibrating sample magnetometer (VSM), diffuse reflectance spectra (DRS), and Fourier transform infrared spectroscopy (FTIR). Response surface methodology based on central composite design (RSM-CCD) was employed to optimize DEX removal efficiency by determining the optimal conditions, including pH, adsorbent dose, time, and DEX concentration. Under the optimized conditions (pH: 5.53, adsorbent dose: 0.185 g/L, time: 16.068 min, and DEX concentration: 33.491 mg/L), Fe3O4@NH2-MIL88B NRs revealed remarkable DEX adsorption efficiency of 91 ± 1.34% and adsorption capacity of 180.01 mg/g. The Langmuir isotherm and pseudo-second-order kinetic model were found to fit well with the experimental data, indicating a monolayer and chemical adsorption process. Thermodynamic analysis revealed that the adsorption process was spontaneous and endothermic. The study also investigated the inhibitory effect of background ions on DEX removal by Fe3O4@NH2-MIL88B NRs. Magnesium exhibited superior competitive ability with dexamethasone to occupy the active sites of the adsorbent compared to other background ions. The reuse of the adsorbent over ten consecutive cycles resulted in a 39.46% decrease in removal efficiency. The Fe3O4@NH2-MIL88B NRs are surrounded by abundant amounts of functional groups and π-electrons bands that can play a key role in the adsorption and separation of DEX from aqueous environments. The promising results obtained under real conditions highlight the potential of Fe3O4@NH2-MIL88B NRs as a practical and efficient adsorbent for the removal of DEX and other similar corticosteroids from aqueous solutions.
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Affiliation(s)
- Mohammad Hassan Mahmoudian
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Ali Azari
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Sirjan School of Medical Sciences, Sirjan, Iran.
| | - Anis Jahantigh
- Department of Environmental Health Engineering, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Maryam Sarkhosh
- Department of Environmental Health Engineering, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmood Yousefi
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Fatemeh Mohammadi Shahraji
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | | | | | | | - Mohammad Ghasemian
- Tehran Sewerage Company, Operation Manager of West Tehran Wastewater Treatment Plant, Tehran, Iran
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Yalci A, Doğan E, Kapici MA, Demirkıran BÇ, Filiz M, Artuk C. What we learned from steroid therapy in the COVID-19 pandemic. Niger J Clin Pract 2023; 26:1348-1353. [PMID: 37794549 DOI: 10.4103/njcp.njcp_110_23] [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] [Indexed: 10/06/2023]
Abstract
Background The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic named coronavirus disease 2019 (COVID-19) that has become the greatest worldwide public health threat. Although different treatment recommendations are offered for COVID-19 infection, steroid treatment remains important. Aim We aimed to demonstrate the effect of pulse steroid therapy (PST) on inflammatory markers and patient outcomes in moderate/severe COVID-19 pneumonia. Materials and Methods We retrospectively analyzed the patients 18 years and older hospitalized in our hospital's COVID-19 clinics between April 1, 2020, to June 30, 2020, and July 1, 2021, to November 30, 2021. Patients in the moderate/severe COVID-19 pneumonia category, according to the World Health Organization COVID-19 guidelines, were included in the study. The demographic characteristics of the patients, treatments, inflammatory markers, and patient outcomes (need for intensive care, length of hospital stay, high-flow nasal oxygen (HFNO) requirement, mechanical ventilation (MV), and mortality rates) were recorded and analyzed. Results Patients who received PST had more advanced age (P < 0.01), more comorbidities (P < 0.001), and more HFNO need (P < 001) compared with the patients who did not receive PST. There was no statistically significant difference between clinical outcomes: the need for intensive care, length of hospital stay, need for MV, and mortality rates (P = 0.54, P = 0.3, P = 0.14, and P = 0.09, respectively). When we evaluated the unvaccinated patients, there was a statistically significant difference in the MV need and mortality rates between those who received PST and those who did not (P = 0.017, P = 0.014, respectively). Conclusion It was observed that PST provided similar mortality, ICU, and MV requirements in patients with older age and comorbidities. Lower MV requirements and mortality were observed in the unvaccinated group receiving PST compared with the unvaccinated group not receiving steroids. PST is still promising in COVID-19 infection, and more studies are needed for standard doses and applications.
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Affiliation(s)
- A Yalci
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
| | - E Doğan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
| | - M A Kapici
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
| | - B Ç Demirkıran
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
| | - M Filiz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
| | - C Artuk
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Gülhane Educational and Research Hospital, Ankara, Turkey
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Al Sulaiman K, Aljuhani O, Korayem GB, Altebainawi A, Alharbi R, Assadoon M, Vishwakarma R, Ismail NH, Alshehri AA, Al Mutairi FE, AlFaifi M, Alharthi AF, Alenazi AA, Alalawi M, Al Zumai O, Al Haji H, Al Dughaish ST, Alawaji AS, Alhaidal HA, Al Ghamdi G. Evaluation of the use of methylprednisolone and dexamethasone in asthma critically ill patients with COVID-19: a multicenter cohort study. BMC Pulm Med 2023; 23:315. [PMID: 37641042 PMCID: PMC10463591 DOI: 10.1186/s12890-023-02603-4] [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: 05/13/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Previous studies have shown mortality benefits with corticosteroids in Coronavirus disease-19 (COVID-19). However, there is inconsistency regarding the use of methylprednisolone over dexamethasone in COVID-19, and this has not been extensively evaluated in patients with a history of asthma. This study aims to investigate and compare the effectiveness and safety of methylprednisolone and dexamethasone in critically ill patients with asthma and COVID-19. METHODS The primary endpoint was the in-hospital mortality. Other endpoints include 30-day mortality, respiratory failure requiring mechanical ventilation (MV), acute kidney injury (AKI), acute liver injury, length of stay (LOS), ventilator-free days (VFDs), and hospital-acquired infections. Propensity score (PS) matching, and regression analyses were used. RESULTS A total of one hundred-five patients were included. Thirty patients received methylprednisolone, whereas seventy-five patients received dexamethasone. After PS matching (1:1 ratio), patients who received methylprednisolone had higher but insignificant in-hospital mortality in both crude and logistic regression analysis, [(35.0% vs. 18.2%, P = 0.22) and (OR 2.31; CI: 0.56 - 9.59; P = 0.25), respectively]. There were no statistically significant differences in the 30-day mortality, respiratory failure requiring MV, AKI, acute liver injury, ICU LOS, hospital LOS, and hospital-acquired infections. CONCLUSIONS Methylprednisolone in COVID-19 patients with asthma may lead to increased in-hospital mortality and shorter VFDs compared to dexamethasone; however, it failed to reach statistical significance. Therefore, it is necessary to interpret these data cautiously, and further large-scale randomized clinical trials are needed to establish more conclusive evidence and support these conclusions.
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Affiliation(s)
- Khalid Al Sulaiman
- Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center (KAIMRC), KSAU-HS, PO Box 22490, Riyadh, 11426, Saudi Arabia.
- Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia.
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghazwa B Korayem
- Department of Pharmacy Practice, Princess Nourah bint Abdulrahman University, Riyadh, P.O.Box 84428, 11671, Saudi Arabia
| | - Ali Altebainawi
- Pharmaceutical Care Services, King Khalid Hospital, Hail, Saudi Arabia
| | - Reham Alharbi
- College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Maha Assadoon
- Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia
| | | | - Nadia H Ismail
- King Fahad Hospital of the University, AL-Khobar, Saudi Arabia
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Asma A Alshehri
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faisal E Al Mutairi
- Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia
| | - Mashael AlFaifi
- Pharmaceutical Services Administration, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Abeer A Alenazi
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mai Alalawi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Omar Al Zumai
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Respiratory Department Services, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Hussain Al Haji
- King Abdullah International Medical Research Center (KAIMRC), KSAU-HS, PO Box 22490, Riyadh, 11426, Saudi Arabia
- Respiratory Department Services, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Sarah T Al Dughaish
- Pharmaceutical Care Department, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Abdulrahman S Alawaji
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Haifa A Alhaidal
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), KSAU-HS, PO Box 22490, Riyadh, 11426, Saudi Arabia
| | - Ghassan Al Ghamdi
- King Abdullah International Medical Research Center (KAIMRC), KSAU-HS, PO Box 22490, Riyadh, 11426, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Hsu CH, Po-Liang Chen A, Chen HP, Chan YJ. Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia - a propensity-matched case control study. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:757-765. [PMID: 36990896 DOI: 10.1016/j.jmii.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVES To assess the outcomes of corticosteroid treatment in critically ill patients with respiratory virus-related community-acquired pneumonia (CAP). MATERIALS/METHODS Adult patients who were admitted to the intensive care unit and had a polymerase chain reaction-confirmed diagnosis of respiratory virus-related CAP were included. Patients with and without corticosteroid treatment during the hospital course were retrospectively compared using a propensity score-matched case-control analysis. RESULTS From January 2018 to December 2020, 194 adult patients were enrolled with 1:1 matching. The 14-day and 28-day mortality rates did not differ significantly between patients treated with and without corticosteroids (14-day mortality: 7% versus 14%, P = 0.11; 28-day mortality: 15% versus 20%, P = 0.35). However, multivariate analysis by using a Cox regression model revealed that corticosteroid treatment was an independent factor predicting decreased mortality (adjusted odds ratio, 0.46; 95% confidence interval, 0.22-0.97, P = 0.04). Subgroup analysis revealed lower 14-day and 28-day mortality rates in patients younger than 70 years treated with corticosteroids than in those not treated with corticosteroids (14-day mortality: 6% versus 23%; P = 0.01 and 28-day mortality: 12% versus 27%; P = 0.04). CONCLUSIONS Non-elderly patients with severe respiratory virus-related CAP are more likely to benefit from corticosteroid treatment than elderly patients.
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Affiliation(s)
- Ching-Hao Hsu
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Andrew Po-Liang Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Pai Chen
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yu-Jiun Chan
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Infection Control, Taipei Veterans General Hospital, Taipei, Taiwan
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Arraut J, Thomas J, Oakley C, Schmicker T, Aggarwal VK, Schwarzkopf R, Rozell JC. Effects of Dexamethasone on Postoperative Glycemic Control in Diabetic Patients Following Primary Total Joint Arthroplasty: A Retrospective Cohort Study. J Arthroplasty 2023:S0883-5403(23)00348-0. [PMID: 37040822 DOI: 10.1016/j.arth.2023.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION Concerns regarding the effects of dexamethasone on diabetics' glucose control have stymied its use following total joint arthroplasty (TJA). This study aimed to evaluate the effects of two intravenous (IV) perioperative doses of dexamethasone on glucose levels, pain scores, and inpatient opioid consumption following TJA in diabetic patients. METHODS A retrospective review of 523 diabetic patients who underwent primary elective THA and 953 diabetic patients who underwent primary elective TKA between May 6, 2020 and December 17, 2021. Patients who received one dose (1D) of perioperative dexamethasone 10 mg IV were compared to patients who received two doses (2D). Primary outcomes included postoperative glucose levels, opioid consumption as morphine milligram equivalences (MMEs), postoperative pain as Verbal Rating Scale (VRS) pain scores, and postoperative complications. RESULTS The 2D TKA cohort had significantly greater average and maximum blood glucose levels from 24 to 60 hours compared to the 1D TKA cohort. The 2D THA cohort had significantly greater average blood glucose levels at 24 to 36 hours compared to the 1D THA cohort. However, the 2D TKA group had significantly reduced opioid consumption from 24 to 72 hours and reduced total consumption compared to the 1D TKA group. VRS pain scores did not differ between cohorts for both TKA and THA at any interval. CONCLUSION Administration of a second perioperative dose of dexamethasone was associated with increased postoperative blood glucose levels. However, the observed effect on glucose control may not outweigh the clinical benefits of a second perioperative dose of glucocorticoids.
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Affiliation(s)
- Jerry Arraut
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Jeremiah Thomas
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Christian Oakley
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Thomas Schmicker
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Vinay K Aggarwal
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
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9
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Kit Y, Starykovych M, Manko N, Orfin A, Alexanyan T, Bozhko L, Turchyna T, Kit O, Krishnankutty R, Anand A, Sibirny A, Souchelnytskyi S, Stoika R. Elevation of truncated (48 kDa) form of unconventional myosin 1C in blood serum correlates with severe Covid-19. J Immunol Methods 2023; 514:113437. [PMID: 36736950 PMCID: PMC9889275 DOI: 10.1016/j.jim.2023.113437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/25/2022] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
In Covid-19 and autoimmune patients, there are several similarities revealed in the immune responses (Liu et al., 2021; Woodruff et al., 2020). Earlier, we firstly detected a truncated (48 kDa) form of the unconventional Myosin 1C (48/Myo1C) in a fraction of proteins soluble in 10% 2,2,2-trichloroacetic acid (TCA). These proteins were obtained from blood serum of patients with autoimmune diseases, such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis (Kit et al., 2018). Here, we demonstrated that content of 48/Myo1C was also elevated in blood serum of the severe Covid-19 patients. Whereas in blood of 28 clinically healthy human individuals regularly tested for Covid-19 infection, the amount of this protein was undetectable or very low, in blood of 16 of 28 patients hospitalized with severe course of this disease, its amount was significantly increased. Dexamethasone, steroid hormone which is widely used for treatment of severe Covid-19 patients, induced time-dependent elevation of the 48/Myo1C in blood of such patients. The 48/Myo1C dose-dependently suppressed the viability of anti-CD3-activated lymphocytes of human peripheral blood. Recently, we used affinity chromatography on the magnetic poly(glycidyl-methacrylate) (mag-PGMA-NH2) microparticles functionalized with Myo1C and MALDI-TOF mass spectrometry with molecular modeling in silico in order to identify potential molecular partners of the 48/Myo1C. It was found that 48/Myo1C might bind to component 3 of the complement system and the anti-thrombin-III (Starykovych et al., 2021). Thus, the mechanisms of the pathogenic action of truncated form of Myo1C in severe COVID-19 patients may involve a suppression of the immune cells, as well as modulation of complement and coagulation cascades.
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Affiliation(s)
- Yuriy Kit
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov st., 14/16, Lviv 79005, Ukraine
| | - Marina Starykovych
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov st., 14/16, Lviv 79005, Ukraine
| | - Nazar Manko
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov st., 14/16, Lviv 79005, Ukraine
| | - Andrii Orfin
- Municipal Non-commercial Enterprise of Lviv Regional Council "Lviv Regional Infection Clinical Hospital", Pekarska St., 54, 79010, Lviv, Ukraine
| | - Tamila Alexanyan
- Municipal Non-commercial Enterprise of Lviv Regional Council "Lviv Regional Infection Clinical Hospital", Pekarska St., 54, 79010, Lviv, Ukraine
| | - Lydmyla Bozhko
- Lviv Regional Phthysio-pulmonology Clinical Medical and Diagnostic Center, Zelena st., 477, 79035, Lviv, Ukraine
| | - Tetiana Turchyna
- Lviv Regional Phthysio-pulmonology Clinical Medical and Diagnostic Center, Zelena st., 477, 79035, Lviv, Ukraine
| | - Oleg Kit
- Interregional Academy of Personnel Management, Frometivska st., 2, Kyiv 01001, Ukraine
| | - Roopesh Krishnankutty
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 2713, Qatar; University of Edinburgh, Edinburgh EH4 2XU, the, UK
| | - Anjana Anand
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 2713, Qatar
| | - Andrey Sibirny
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov st., 14/16, Lviv 79005, Ukraine
| | | | - Rostyslav Stoika
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov st., 14/16, Lviv 79005, Ukraine.
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10
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Mezine F, Guerin CL, Philippe A, Gendron N, Soret L, Sanchez O, Mirault T, Diehl JL, Chocron R, Boulanger CM, Smadja DM. Increased Circulating CD62E + Endothelial Extracellular Vesicles Predict Severity and in- Hospital Mortality of COVID-19 Patients. Stem Cell Rev Rep 2023; 19:114-119. [PMID: 35982357 PMCID: PMC9387889 DOI: 10.1007/s12015-022-10446-5] [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] [Accepted: 08/10/2022] [Indexed: 01/29/2023]
Abstract
COVID-19 and infectious diseases have been included in strategic development goals (SDG) of United Nations (UN). Severe form of COVID-19 has been described as an endothelial disease. In order to better evaluate Covid-19 endotheliopathy, we characterized several subsets of circulating endothelial extracellular vesicles (EVs) at hospital admission among a cohort of 60 patients whose severity of COVID-19 was classified at the time of inclusion. Degree of COVID-19 severity was determined upon inclusion and categorized as moderate to severe in 40 patients and critical in 20 patients. We measured citrated plasma EVs expressing endothelial membrane markers. Endothelial EVs were defined as harboring VE-cadherin (CD144+), PECAM-1 (CD31 + CD41-) or E-selectin (CD62E+). An increase in CD62E + EV levels on admission to the hospital was significantly associated with critical disease. Moreover, Kaplan-Meier survival curves for CD62E + EV level showed that level ≥ 88,053 EVs/μL at admission was a significant predictor of in hospital mortality (p = 0.004). Moreover, CD62E + EV level ≥ 88,053 EV/μL was significantly associated with higher in-hospital mortality (OR 6.98, 95% CI 2.1-26.4, p = 0.002) in a univariate logistic regression model, while after adjustment to BMI CD62E + EV level ≥ 88,053 EV/μL was always significantly associated with higher in-hospital mortality (OR 5.1, 95% CI 1.4-20.0, p = 0.01). The present findings highlight the potential interest of detecting EVs expressing E-selectin (CD62) to discriminate Covid-19 patients at the time of hospital admission and identify individuals with higher risk of fatal outcome.
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Affiliation(s)
- Fariza Mezine
- Université Paris Cité, INSERM, PARCC, F-75015 Paris, France
| | - Coralie L. Guerin
- Cytometry core, Institut Curie, F-75005 Paris, France ,Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France
| | - Aurélien Philippe
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Hematology department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Nicolas Gendron
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Hematology department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Lou Soret
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Hematology department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Olivier Sanchez
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Respiratory disease department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Tristan Mirault
- Université Paris Cité, INSERM, PARCC, F-75015 Paris, France ,Vascular medicine department, AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Jean-Luc Diehl
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Intensive care medicine department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | - Richard Chocron
- Université Paris Cité, INSERM, PARCC, F-75015 Paris, France ,Emergency department, AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
| | | | - David M. Smadja
- Université Paris Cité, INSERM, Innovative Therapies in Haemostasis, F-75006 Paris, France ,Hematology department and Biosurgical research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, F-75015 Paris, France
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11
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Nandi S, Nayak BS, Khede MK, Saxena AK. Repurposing of Chemotherapeutics to Combat COVID-19. Curr Top Med Chem 2022; 22:2660-2694. [PMID: 36453483 DOI: 10.2174/1568026623666221130142517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/16/2022] [Accepted: 10/06/2022] [Indexed: 12/05/2022]
Abstract
Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a novel strain of SARS coronavirus. The COVID-19 disease caused by this virus was declared a pandemic by the World Health Organization (WHO). SARS-CoV-2 mainly spreads through droplets sprayed by coughs or sneezes of the infected to a healthy person within the vicinity of 6 feet. It also spreads through asymptomatic carriers and has negative impact on the global economy, security and lives of people since 2019. Numerous lives have been lost to this viral infection; hence there is an emergency to build up a potent measure to combat SARS-CoV-2. In view of the non-availability of any drugs or vaccines at the time of its eruption, the existing antivirals, antibacterials, antimalarials, mucolytic agents and antipyretic paracetamol were used to treat the COVID-19 patients. Still there are no specific small molecule chemotherapeutics available to combat COVID-19 except for a few vaccines approved for emergency use only. Thus, the repurposing of chemotherapeutics with the potential to treat COVID-19 infected people is being used. The antiviral activity for COVID-19 and biochemical mechanisms of the repurposed drugs are being explored by the biological assay screening and structure-based in silico docking simulations. The present study describes the various US-FDA approved chemotherapeutics repositioned to combat COVID-19 along with their screening for biological activity, pharmacokinetic and pharmacodynamic evaluation.
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Affiliation(s)
- Sisir Nandi
- Department of Pharmaceutical Chemistry, Global Institute of Pharmaceutical Education and Research, Affiliated to Uttarakhand Technical University, Kashipur, 244713, India
| | - Bhabani Shankar Nayak
- Department of Pharmaceutics, Institute of Pharmacy and Technology, Salipur, Affiliated to Biju Patnaik University of Technology, Odisha, 754202, India
| | - Mayank Kumar Khede
- Department of Pharmaceutics, Institute of Pharmacy and Technology, Salipur, Affiliated to Biju Patnaik University of Technology, Odisha, 754202, India
| | - Anil Kumar Saxena
- Department of Pharmaceutical Chemistry, Global Institute of Pharmaceutical Education and Research, Affiliated to Uttarakhand Technical University, Kashipur, 244713, India
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12
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Kawamata T, Tanino Y, Nikaido T, Minemura H, Sato Y, Togawa R, Watanabe N, Yamada R, Sato R, Onuma T, Tomita H, Saito M, Rikimaru M, Suzuki Y, Tsukada Y, Nakamura K, Kanemitsu K, Iseki K, Shibata Y. Clinical effect of early administration of tocilizumab following the initiation of corticosteroid therapy for patients with COVID-19. J Infect Chemother 2022; 28:1639-1644. [PMID: 36057415 PMCID: PMC9428329 DOI: 10.1016/j.jiac.2022.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first broke out in Wuhan in December 2019, and has since caused a global pandemic. The efficacy of several drugs has been evaluated, and it is now evident that tocilizumab has a beneficial effect, especially combined with corticosteroids, in patients with Coronavirus Disease 2019 (COVID-19). However, the optimal timing of tocilizumab administration has not yet been established. The goal of the present study was to determine the optimal timing of tocilizumab administration after starting corticosteroid therapy in patients with COVID-19. METHODS We retrospectively analyzed the clinical characteristics of patients who were hospitalized for COVID-19 and treated with tocilizumab and corticosteroids in our hospital. The patients were divided into concurrent and sequential groups. The concurrent group received tocilizumab ≤24 h after corticosteroids, and the sequential group received tocilizumab >24 h after corticosteroid administration. RESULTS The baseline clinical characteristics of tocilizumab administration were similar between the two groups. White blood cell counts were significantly lower and C-reactive protein levels were significantly higher in the concurrent group than the sequential group. In the concurrent group, tocilizumab administration led to a significant decrease in maximum body temperature. In addition, there were significantly more oxygen-free days in the concurrent group than in the sequential group. However, survival rate was not significantly different between the concurrent and the sequential groups. CONCLUSIONS In the combination therapy with tocilizumab and corticosteroids, early administration of tocilizumab after starting corticosteroid treatment is effective when treating COVID-19.
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Affiliation(s)
| | | | | | | | - Yuki Sato
- Department of Pulmonary Medicine, Japan.
| | | | | | | | - Riko Sato
- Department of Pulmonary Medicine, Japan.
| | | | | | | | | | | | | | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan.
| | - Keiji Kanemitsu
- Department of Infection Control, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan.
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Japan.
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13
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Shao L, Pelayo A, Shi R, Ma J, Liu H, Cai Y, Prochazkova M, Somerville RP, Panch SR, Shah NN, Stroncek DF, Jin P. Identification of genomic determinants contributing to cytokine release in immunotherapies and human diseases. J Transl Med 2022; 20:338. [PMID: 35902861 PMCID: PMC9331024 DOI: 10.1186/s12967-022-03531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cytokine release syndrome (CRS) is a strong immune system response that can occur as a result of the reaction of a cellular immunotherapy with malignant cells. While the frequency and management of CRS in CAR T-cell therapy has been well documented, there is emerging interest in pre-emptive treatment to reduce CRS severity and improve overall outcomes. Accordingly, identification of genomic determinants that contribute to cytokine release may lead to the development of targeted therapies to prevent or abrogate the severity of CRS. METHODS Forty three clinical CD22 CAR T-cell products were collected for RNA extraction. 100 ng of mRNA was used for Nanostring assay analysis which is based on the nCounter platform. Several public datasets were used for validation purposes. RESULTS We found the expression of the PFKFB4 gene and glycolytic pathway activity were upregulated in CD22 CAR T-cells given to patients who developed CRS compared to those who did not experience CRS. Moreover, these results were further validated in cohorts with COVID-19, influenza infections and autoimmune diseases, and in tumor tissues. The findings were similar, except that glycolytic pathway activity was not increased in patients with influenza infections and systemic lupus erythematosus (SLE). CONCLUSION Our data strongly suggests that PFKFB4 acts as a driving factor in mediating cytokine release in vivo by regulating glycolytic activity. Our results suggest that it would beneficial to develop drugs targeting PFKFB4 and the glycolytic pathway for the treatment of CRS.
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Affiliation(s)
- Lipei Shao
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Alejandra Pelayo
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Rongye Shi
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Jinxia Ma
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Hui Liu
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Yihua Cai
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Michaela Prochazkova
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Robert P Somerville
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Sandhya R Panch
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA
| | - Nirali N Shah
- Pediatric Oncology Branch, Center for Cancer Research, NIH NCI, Bethesda, MD, 20892, USA
| | - David F Stroncek
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA.
| | - Ping Jin
- Department of Transfusion Medicine, Center for Cellular Engineering, NIH Clinical Center, Bethesda, MD, 20892, USA.
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14
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Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients Treated with Standard Dose of Dexamethasone or High Dose of Methylprednisolone. Biomedicines 2022; 10:biomedicines10071548. [PMID: 35884852 PMCID: PMC9312892 DOI: 10.3390/biomedicines10071548] [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: 06/02/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
The hyperinflammatory phase represents the main cause for the clinical worsening of acute respiratory distress syndrome (ARDS) in Coronavirus disease 2019 (COVID-19), leading to the hypothesis that steroid therapy could be a mainstream treatment in COVID-19 patients. This is an observational study including all consecutive patients admitted to two Italian University Hospitals for COVID-19 from March 2020 to December 2021. The aim of this study was to describe clinical characteristics and outcome parameters of hospitalized COVID-19 patients treated with dexamethasone 6 mg once daily (standard-dose group) or methylprednisolone 40 mg twice daily (high-dose group). The primary outcome was the impact of these different steroid treatments on 30-day mortality. During the study period, 990 patients were evaluated: 695 (70.2%) receiving standard dosage of dexamethasone and 295 (29.8%) receiving a high dose of methylprednisolone. Cox regression analysis showed that chronic obstructive pulmonary disease (HR 1.98, CI95% 1.34−9.81, p = 0.002), chronic kidney disease (HR 5.21, CI95% 1.48−22.23, p = 0.001), oncologic disease (HR 2.81, CI95% 1.45−19.8, p = 0.005) and high-flow nasal cannula, continuous positive airway pressure or non-invasive ventilation oxygen therapy (HR 61.1, CI95% 5.12−511.1, p < 0.001) were independently associated with 30-day mortality; conversely, high-dose steroid therapy was associated with survival (HR 0.42, CI95% 0.38−0.86, p = 0.002) at 30 days. Kaplan−Meier curves for 30-day survival displayed a statistically significant better survival rate in patients treated with high-dose steroid therapy (p = 0.018). The results of this study highlighted that the use of high-dose methylprednisolone, compared to dexamethasone 6 mg once daily, in hospitalized patients with COVID-19 may be associated with a significant reduction in mortality.
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15
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Cooreman A, Caufriez A, Tabernilla A, Van Campenhout R, Leroy K, Kadam P, Sanz Serrano J, dos Santos Rodrigues B, Annaert P, Vinken M. Effects of Drugs Formerly Proposed for COVID-19 Treatment on Connexin43 Hemichannels. Int J Mol Sci 2022; 23:5018. [PMID: 35563409 PMCID: PMC9103705 DOI: 10.3390/ijms23095018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023] Open
Abstract
Connexin43 (Cx43) hemichannels form a pathway for cellular communication between the cell and its extracellular environment. Under pathological conditions, Cx43 hemichannels release adenosine triphosphate (ATP), which triggers inflammation. Over the past two years, azithromycin, chloroquine, dexamethasone, favipiravir, hydroxychloroquine, lopinavir, remdesivir, ribavirin, and ritonavir have been proposed as drugs for the treatment of the coronavirus disease 2019 (COVID-19), which is associated with prominent systemic inflammation. The current study aimed to investigate if Cx43 hemichannels, being key players in inflammation, could be affected by these drugs which were formerly designated as COVID-19 drugs. For this purpose, Cx43-transduced cells were exposed to these drugs. The effects on Cx43 hemichannel activity were assessed by measuring extracellular ATP release, while the effects at the transcriptional and translational levels were monitored by means of real-time quantitative reverse transcriptase polymerase chain reaction analysis and immunoblot analysis, respectively. Exposure to lopinavir and ritonavir combined (4:1 ratio), as well as to remdesivir, reduced Cx43 mRNA levels. None of the tested drugs affected Cx43 protein expression.
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Affiliation(s)
- Axelle Cooreman
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Anne Caufriez
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Andrés Tabernilla
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Raf Van Campenhout
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Kaat Leroy
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Prashant Kadam
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Julen Sanz Serrano
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Bruna dos Santos Rodrigues
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
| | - Pieter Annaert
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium;
| | - Mathieu Vinken
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.C.); (A.C.); (A.T.); (R.V.C.); (K.L.); (P.K.); (J.S.S.); (B.d.S.R.)
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16
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Fuloria S, Mehta J, Chandel A, Sekar M, Rani NNIM, Begum MY, Subramaniyan V, Chidambaram K, Thangavelu L, Nordin R, Wu YS, Sathasivam KV, Lum PT, Meenakshi DU, Kumarasamy V, Azad AK, Fuloria NK. A Comprehensive Review on the Therapeutic Potential of Curcuma longa Linn. in Relation to its Major Active Constituent Curcumin. Front Pharmacol 2022; 13:820806. [PMID: 35401176 PMCID: PMC8990857 DOI: 10.3389/fphar.2022.820806] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/27/2022] [Indexed: 12/16/2022] Open
Abstract
Curcuma longa Linn. (C. longa), popularly known as turmeric, belongs to the Zingiberaceae family and has a long historical background of having healing properties against many diseases. In Unani and Ayurveda medicine, C. longa has been used for liver obstruction and jaundice, and has been applied externally for ulcers and inflammation. Additionally, it is employed in several other ailments such as cough, cold, dental issues, indigestion, skin infections, blood purification, asthma, piles, bronchitis, tumor, wounds, and hepatic disorders, and is used as an antiseptic. Curcumin, a major constituent of C. longa, is well known for its therapeutic potential in numerous disorders. However, there is a lack of literature on the therapeutic potential of C. longa in contrast to curcumin. Hence, the present review aimed to provide in-depth information by highlighting knowledge gaps in traditional and scientific evidence about C. longa in relation to curcumin. The relationship to one another in terms of biological action includes their antioxidant, anti-inflammatory, neuroprotective, anticancer, hepatoprotective, cardioprotective, immunomodulatory, antifertility, antimicrobial, antiallergic, antidermatophytic, and antidepressant properties. Furthermore, in-depth discussion of C. longa on its taxonomic categorization, traditional uses, botanical description, phytochemical ingredients, pharmacology, toxicity, and safety aspects in relation to its major compound curcumin is needed to explore the trends and perspectives for future research. Considering all of the promising evidence to date, there is still a lack of supportive evidence especially from clinical trials on the adjunct use of C. longa and curcumin. This prompts further preclinical and clinical investigations on curcumin.
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Affiliation(s)
| | - Jyoti Mehta
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Aditi Chandel
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, Malaysia
| | - Nur Najihah Izzati Mat Rani
- Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, Malaysia
| | - M. Yasmin Begum
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | | | - Kumarappan Chidambaram
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Rusli Nordin
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Selangor, Malaysia
| | - Yuan Seng Wu
- Department of Biological Sciences and Centre for Virus and Vaccine Research, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | | | - Pei Teng Lum
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, Malaysia
| | | | - Vinoth Kumarasamy
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Selangor, Malaysia
- Department of Preclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Perak, Malaysia
| | | | - Neeraj Kumar Fuloria
- Faculty of Pharmacy, AIMST University, Kedah, Malaysia
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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