NETs, infections, and antimicrobials: a complex interplay

In response to a range of stimuli, neutrophils produce web-like structures known as neutrophil extracellular traps (NETs). The benefits of NETs in pathogen control are commonly offset by excessive release as part of a pro-inflammatory response, as shown in several disorders. The discovery of potential drugs that regulate NET release has helped to enhance our understanding of the role of NETs in immunological protection, inflammatory diseases, and autoimmune disorders. Emerging evidence has indicated that antimicrobials play an immunomodulatory role by influencing the levels of circulating NETs. Herein, we address NETosis in several disorders and detail the mechanisms of NET-mediated damage in infections. We also aim to evaluate recent evidence on the effects of antimicrobials on NET levels. Relevant keywords were searched in PubMed. Studies were evaluated for their relevance, and a narrative review was written accordingly. Several antibiotics, including beta-lactams and cephalosporins, alter NET formation and degradation in a protective manner, resulting in minimal host organ damage. Additionally, some studies have highlighted the immunomodulatory effects of antivirals and antifungals on NET. Further studies are needed to fully understand the clinical implications of NET-antimicrobial interactions and their underlying mechanisms.

Public health in Global South: effect of environmental pollutant PM2.5 on the incidence and mortality of SARS-CoV-2 in Karachi, Lahore, and Islamabad

OBJECTIVE

Environmental pollution has undoubtedly been established as a planetary, intergenerational, and existential threat to global human health and safety. Environmental pollution is adversely affecting the world, mainly the countries where human health is not a priority aspect, and this has been exacerbated due to the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and pandemic is known as "COVID pandemic". This study investigates the association of environmental pollutants, particulate matter (PM2.5), with SARS-CoV-2 daily cases and deaths in Karachi, Lahore, and Islamabad, Pakistan, presenting the perspectives from the Global South.

MATERIALS AND METHODS

The day-to-day PM2.5 levels were recorded from the metrological website, Real-Time Air Quality Index-AQI. The corresponding data on the COVID cases and deaths in Karachi, Lahore, and Islamabad were obtained from August 1, 2020, to September 30, 2021, from the Health Ministry and National Command Operations Centre Pakistan.

RESULTS

The mean values for PM2.5 in Karachi were 110.4±46.2; in Lahore 174.0±83.2; and in Islamabad 107.1±40.0. The COVID-19 mean daily cases in Karachi were 538.9±446.6; Lahore 398.3±403.1; and Islamabad 212.2±187.6; and mean daily deaths in Karachi were 9.2±8.3; Lahore 9.3±9.7; and Islamabad 1.8±1.8. The results further depicted that the SARS-CoV-2 cases were 2.86 times higher in Karachi and 1.4 times higher in Lahore than in Islamabad. Similarly, the SARS-CoV-2 deaths were 3.6 and 2.8 times higher in Karachi and Lahore, respectively, compared to Islamabad.

CONCLUSIONS

The findings claim that cases and deaths augmented significantly along with PM2.5 levels. These empirical estimates demonstrate an association between PM2.5 and SARS-CoV-2 daily cases and deaths in the cities of the Global South. These findings can contribute to policy-making decisions about addressing air pollutants and climate concerns in developing countries and create an urgency to develop a strategy for minimizing environmental pollution. This study can also steer the actions needed to address the environmental problems in developing countries to improve public health and safety.