Immune Profiling of SARS-CoV-2; What We Know and What We Don't Know

Coronavirus disease 2019 (COVID-19), described as World War 3, is the current worldwide health challenge and nearly all countries have so far faced this disaster. There is still no cure because of the complicated pathogenesis, however, there are several studies on track investigating different aspects of the immune response to the virus. In this review, we will provide an overview of recent investigations that have analyzed immune cells in patients with COVID-19. We will then discuss the differences in immune profiles between healthy controls and various clinical presentations, including asymptomatic, mild, moderate, and severe cases.

IL-27, a pleiotropic cytokine for fine-tuning the immune response in cancer

Interleukin (IL)-27, a member of the IL-6/IL-12 family, has an important role in modulating inflammation in partnership with innate and adaptive immune cells. IL-27 binding to IL-27R starts downstream signaling based on the target cells. It can instigate inflammation by inducing CD4⁺ T cell proliferation, Th1 polarization, cytotoxic T cell activation, generation of the natural killer cell, and macrophage and dendritic cell activation. However, by inducing programmed cell death and suppression of effector cells, IL-27 can suppress inflammation and return the immune response to hemostasis. Altogether, IL-27 displays multifaceted dual functions, which may result in either pro- or anti-inflammatory effects. Recent investigations indicated the antitumor activity of IL-27 via inducing Th1, and CTL responses and generating NK cells. On the other hand, IL-27 also can promote tumor cells' proliferation, survival, and angiogenesis. In the present review, we'll discuss recent advances concerning the role of IL-27 in inflammatory diseases such as infections, autoimmune diseases with a focus on cancer.

CD4+CD25-FoxP3+ T cells: a distinct subset or a heterogeneous population?

In addition to generating effective immunity against infectious agents, the immune system helps to fight against different noninfectious human diseases while maintaining the balance between self and non-self discrimination. The breakdown of tolerance in autoimmune diseases or sustainable tolerance in an abnormal microenvironment such as chronic inflammation may initiate the process of malignancy. Immune system regulation is controlled by a complex, dynamic network of cells and mediators. Understanding the cellular and molecular basis of immune regulation provides better insight into the mechanisms governing the immune pathology of diseases. Among several cellular subsets and mediators with regulatory roles, a subpopulation of CD4⁺ T cells was recently reported to be positive for FoxP3 and negative for CD25, with a suggested range of functional activities in both cancer and autoimmune diseases. This CD4 subset was first reported in 2006 and thought to have a role in the pathogenesis of cancer. However, the spectrum of roles played by this T cell subset is broad, and no consensus has been reached regarding its immunological functions. In this review, we focused on the possible origin of CD4⁺CD25^‒FoxP3⁺ T cells and their function in cancer and autoimmune diseases.

IL-18 in Blood Serum of Hepatitis C Patients Might be of Predictive Value for Individual Outcomes

OBJECTIVE

Pro- inflammatory cytokines including Interleukin (IL)-18 have been shown to be involved in the clearance of Hepatitis C virus (HCV) infection. However, changes in the balance of pro- and anti-inflammatory cytokines production during the immune response, can elicit a variety of liver damages. Therefore, it is of interest to study IL-18 serum levels in hepatitis patients and its correlation with HCV infection.

METHODS

Twenty-nine newly diagnosed HCV+ patients with no history of antiviral therapy, and 17 healthy controls, were enrolled in our study. Biochemical markers of liver disease were evaluated by biochemistry assay kits. Serum concentrations of IL-18 were determined with the ELISA method before and after treatment with pangenotypic direct-acting antivirals (DAAs) treatment.

RESULTS

Our results showed statistically significant difference in serum levels of IL-18 in HCV+ patients (692.261 ± 48.76) compared to healthy controls (520.00 ± 44.73) (P=0.021). However, there was no significant difference in IL-18 serum levels between the treated group compared to untreated patients (P=0.74). No significant correlations were detected between the level of IL-18 and liver enzyme levels.

CONCLUSION

According to our study, IL-18 might be a disease marker associated with HCV infection; however, this conclusion requires further investigation.

The Significance of Biobanking in the Sustainability of Biomedical Research: A Review

Biobank, defined as a functional unit for facilitating and improving research by storing biospecimen and their accompanying data, is a key resource for advancement in life science. The history of biobanking goes back to the time of archiving pathology samples. Nowadays, biobanks have considerably improved and are classified into two categories: diseased-oriented and population-based biobanks. UK biobank as a population-based biobank with about half a million samples, Biobank Graz as one of the largest biobanks in terms of sample size, and The International Agency for Research on Cancer biobank as a specialized the World Health Organization cancer agency are few examples of successful biobanks worldwide. The present review provides a history of biobanking, and after presenting different biobanks, we discuss in detail the challenges in the field of biobanking and its future, as well. In the end, ICR biobank, as the first cancer biobank in Iran established in 1998, is thoroughly described.

Fourth year medical students' reflective writing on "death of Ivan Ilych: a qualitative study

INTRODUCTION

Medical students should be familiar with the end of life ethical issues and its considerations. For teaching end of life care to medical students, literature is a source of excellent narratives of patients with experiences of terminally ill condition in their journey through suffering and one of the most favourite bioethics literature readings has been the death of Ivan Ilych by Tolstoy. We used this novel to show medical students end of life events and suffering and asked them to write a reflective essay on it. We aimed to find what students think about terminally ill patients and their journey to death.

METHODS

In an inductive qualitative content analysis model, 350 essays, collected by homogenous sampling, were analyzed. The fourth year medical students were provided with the Death of Ivan Ilych novel to read. They were asked to write a reflection essay based on the reflective stages defined by Sandars. These essays served as the unit of analysis, each being read several times and a coding model was formed according to main topics. The related concepts in each unit were named as themes and each theme was abstracted to a code and the related codes were compared and developed as categories.

RESULTS

Qualitative content analysis of 350 essays of fourth year medical students revealed three major categories in students' reflection on reading Death of Ivan Ilych as an end of life human body. These included: 1) Emotional experience, 2) Empathy and effective communication, 3) Spirituality and dignity. Analysis of essays showed that this reflection activity may help medical students have a deeper idea of the end of life situation and feelings.

CONCLUSION

This project suggests that literature can be used as an example to introduce new ethical concepts to less experienced medical trainees. The students acquired the concept of the story and reflected the major aspects of the suffering of a human being in their essays. Having used and evaluated the effect of literature on facilitating ethical insight in the teaching end of life care, we strongly recommend this method and specially the novella, Death of Ivan Ilych.

Der(22) syndrome and velo-cardio-facial syndrome/DiGeorge syndrome share a 1.5-Mb region of overlap on chromosome 22q11

Derivative 22 (der[22]) syndrome is a rare disorder associated with multiple congenital anomalies, including profound mental retardation, preauricular skin tags or pits, and conotruncal heart defects. It can occur in offspring of carriers of the constitutional t(11;22)(q23;q11) translocation, owing to a 3:1 meiotic malsegregation event resulting in partial trisomy of chromosomes 11 and 22. The trisomic region on chromosome 22 overlaps the region hemizygously deleted in another congenital anomaly disorder, velo-cardio-facial syndrome/DiGeorge syndrome (VCFS/DGS). Most patients with VCFS/DGS have a similar 3-Mb deletion, whereas some have a nested distal deletion endpoint resulting in a 1.5-Mb deletion, and a few rare patients have unique deletions. To define the interval on 22q11 containing the t(11;22) breakpoint, haplotype analysis and FISH mapping were performed for five patients with der(22) syndrome. Analysis of all the patients was consistent with 3:1 meiotic malsegregation in the t(11;22) carrier parent. FISH-mapping studies showed that the t(11;22) breakpoint occurred in the same interval as the 1.5-Mb distal deletion breakpoint for VCFS. The deletion breakpoint of one VCFS patient with an unbalanced t(18;22) translocation also occurred in the same region. Hamster-human somatic hybrid cell lines from a patient with der(22) syndrome and a patient with VCFS showed that the breakpoints occurred in an interval containing low-copy repeats, distal to RANBP1 and proximal to ZNF74. The presence of low-copy repetitive sequences may confer susceptibility to chromosome rearrangements. A 1.5-Mb region of overlap on 22q11 in both syndromes suggests the presence of dosage-dependent genes in this interval.

A unique carboxy-terminus truncation mutant of the retinoic acid receptor alpha gene associated with a variant marker chromosome in a retinoic acid resistant HL-60 subline

In order to contribute to the study of the molecular basis of leukemic cellular resistance to the induction of differentiation by all-trans retinoic acid (RA) we have generated and analyzed a mutant, RA-resistant HL-60 cell line. Molecular analysis of the retinoic acid receptor alpha (RARalpha) cDNA disclosed, in one of the two alleles, a novel mutation consisting of a 7-base deletion in the ligand binding domain that includes part of a FokI restriction endonuclease site previously described. As a consequence of this deletion and translational frame-shift, a stop signal is created that truncates the protein at codon 421, disrupting an essential functional component of the receptor. Transducing an epitope tagged RARalpha into the mutant is sufficient to inhibit clonal growth in the presence of RA. Standard cytogenetic analysis, fluorescent in situ hybridization (FISH) and comparative genomic hybridization (CGH) analysis revealed the presence of two RARalpha loci, and showed a composite karyotype with additional abnormalities with respect to the parental line, including a chromosome 8 insertion in a chromosome previously known as marker three.

The FHIT gene is alternatively spliced in normal kidney and renal cell carcinoma

FHIT (Fragile Histidine Triad), a putative tumor suppressor gene, was cloned from fetal brain and colon cDNA libraries. Portions of this gene are deleted in esophageal, colon, lung and breast tumors, but this gene has not been found altered in sporadic renal cell carcinomas. We report here an alternatively spliced form of this gene cloned from a kidney cDNA library. This cDNA is 1189 bp in length, and contains an additional 94 bp exon, designated exon 2a (E2a). This novel sequence is located between exon 2 and exon 3 of the FHIT gene's untranslated region and exon 2a is present in all normal kidney tissues and cell lines. Analyses performed on sporadic renal cell carcinoma (RCC) tissues and cell lines, show consistent loss of exon 8 of the FHIT cDNA in almost 60% of the cases. Interestingly, in a familial, as well as, in a metastatic RCC, derived from a patient with the sporadic form, exon 2a and exon 3 are also deleted. Northern analyses with the exon 2a of the familial and the metastatic RCC demonstrates concurrent loss of expression of a 4.4 kb transcript with the loss of the E2a sequence, suggesting that exon 2a of the FHIT gene may play an important role in the oncogenesis of renal cell carcinoma.