Background Coronavirus disease 2019 (COVID-19) is a new health problem discovered in 2019 thus requires biomarkers that can detect early tissue damage. Soluble Receptor for Advanced Glycation End-Products (sRAGE) is a biomarker that can be used to identify early lung damage. Objective Analyzing the association of serum sRAGE with COVID-19 severity. Methods This study employed a cross-sectional design with a consecutive sampling method. It was conducted from May 2020–October 2021. The number of participants in this study was 145 participants which were divided into 2 groups (non-severe = 47 and severe = 98). Association of sRAGE serum with COVID-19 severity was analyzed using the chi-square test, Fisher's exact test, independence t-test, Mann Withney test, and Spearman's rank test with p -value <0.05. Results The results of blood analysis showed several blood components such as leukocytes (9896.51 ± 4949.64/μL; z = 2.431; p = 0.015), lymphocytes (13.55 ± 8.48%; z = 2.256; p = 0.024), neutrophils (78.91 ± 10.50%; z = 2.464; p = 0.014), procalcitonin (0.92 ± 3.22 ng/mL; z = 3.323; p = 0.001), CRP (8.59 ± 7.62 mg/L; z = 2.114; p = 0.034), D-dimer (4360.29 ± 7797.81 ng/mL; z = 2.186; p = 0.029), and fibrinogen (474.58 ± 168.90 mg/dL; t = 0.383; p = 0.703). There was a significant difference in serum sRAGE values in the non-severe group (0.78 [0.63–1.00] ng/mL) and severe group (1.47 [0.97–2.25] ng/mL; r = 7.154; p < 0.001). There was a significant association between serum sRAGE and COVID-19 severity ( r = 0.598; p < 0.001). The cut-off value for serum sRAGE between the severe and non-severe groups was 0.985 ng/mL. This study obtained sensitivity of 73.5%, specificity of 74.5% OR 8.077 and AUC 0.868 95% CI. Conclusion There is a significant association between serum sRAGE and COVID-19 severity and there is also a significant difference in serum sRAGE in the two groups.
Background: Coronavirus disease-19 (COVID-19) can, in severe cases, lead to cytokine-release syndrome owing to an excessive immune response. The release of different cytokines aggravates disease severity. IL-1β is a pro-inflammatory cytokine, while IL-10 is an anti-inflammatory cytokine, and both are involved in the human immune response to infection. This study aimed to determine whether serum levels of IL-1β and IL-10 and the ratio of the two over time in patients with COVID-19 could facilitate early identification of disease severity. Methods: An analytical, observational time-series design was employed. Fifty participants were enrolled between May and October 2020 and were divided into two groups-non-severe (n = 20), and severe (n = 30). IL-1β and IL-10 were analyzed using BD cytometric bead array sets. Association of the IL-1β:IL-10 ratio with COVID-19 severity was analyzed using a Mann-Whitney test and Fisher's exact test. Optimal cut-off values to predict disease severity were determined by Youden's index. Results: In non-severe and severe groups, the median serum levels of IL-1β decreased on day 3 (1.72 ng/mL and 2.10 ng/mL, respectively), then increased on day 6 (2.05 ng/mL and 3.31 ng/mL, respectively). However, the median of IL-10 increased on day 3 (1.88 ng/mL and 2.30 ng/mL, respectively) and day 6 (2.02 ng/mL and 2.39 ng/mL, respectively). There was no significant association between the IL-1β:IL-10 ratio and COVID-19 severity at any time-point (p>0.05). The cutoff value of serum IL-10 between the two groups on days 0, 3, and 6 was 1.09 pg/mL (sensitivity: 66.6%; PPV: 71.4%), 2.11 pg/mL (sensitivity: 67.7%; PPV: 50.0%), and 2.08 pg/mL (sensitivity: 78.6%; PPV: 70.9%), respectively. Conclusion:The IL-1β:IL-10 ratio was not correlated to COVID-19 severity. However, owing to its high sensitivity, IL-10 may be a potential biomarker for disease severity in severe COVID-19.
Leprosy, a chronic infection caused by M. leprae, has a complex transmission problem that makes eradication programs difficult. New cases and ongoing transmission of leprosy in endemic areas make individuals living in endemic environments vulnerable to leprosy. This can be caused by the dysregulation of immune system in individuals living in leprosy-endemic areas. Although the number of male leprosy patients is higher, female leprosy patients have more impact on the family health status due to close contact with family members, roles in the household, and parenting. This could cause the increased number of children leprosy patients. We investigated the dysregulation of immune system by comparing IL-17 and FOXP3+ levels occurring in maternal and child leprosy patients in endemic and nonendemic areas. The results of the study found a statistically significant difference in IL-17 levels between the MB leprosy patient group and the control group ( p = 0.048 ), where higher levels of IL-17 are observed in the control group. A significant difference also was found in FOXP3+ levels between the group of healthy children living in endemic and those living in nonendemic areas ( p = 0.047 ), where higher FOXP3+ is observed in the healthy children living in endemic areas group.
Background: COVID-19 pandemic causes severe acute respiratory syndrome and requires rapid action. The development of effective safe vaccines become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein which can neutralize the virus, preventing the virus from binding with ACE 2 receptors. Objective: Evaluating and to know if there any differences of kinetics antibody levels from recipient’s anti-IgG S-RBD and NAb with complete second dose CoronaVac Vaccine, to determine the antibody response in preventing SARS-CoV-2. Method: A prospective-cohort study using observational analytics was conducted from January-April 2021 at Dr. Soetomo Hospital, Surabaya. A total of 50 subjects are healthcare workers who received two doses of CoronaVac. The IgG S-RBD and NAb levels were measured on Maglumi 800 device (SNIBE, China). Differences in IgG S-RBD and NAb levels before vaccination and after second dose CoronaVac vaccination on 14th day, on 28th day, ware tested using Friedman and Wilcoxon tests. Result: Mean values of IgG S-RBD and NAb have fluctuated. There was a significant difference between IgG S-RBD and NAb levels on day-0 (0.090 vs 18.630; p < 0.001) and day-28 (141.266 vs 116.640; p = 0.037). The median value showed the IgG S-RBD level on day-28 was much better than NAb value (141,266 v 116,640). Conclusion: CoronaVac will form persistent antibodies. Despite antibody development, the acquired humoral immunity decreased at 28 days after full CoronaVac immunization. Kinetics of antibody NAb decreased more rapidly than IgG S-RBD.
The aim of the research is to analyze the differences in the subset of T lymphocytes and NK cells at various degrees of disease severity in order to be used in stratification of patients’ management and to predict outcomes for optimal treatment. The study sample of 123 patients with confirmed COVID-19 was classified based on the degree of severity: 50 patients with mild severity, 34 patients with moderate severity and 39 patients with severe to critical severity who were subjected to complete blood count and T lymphocyte subsets (CD3, CD4, CD8) and NK cells with Flowcytometry. There were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.000), CD8 (p=0.000), and NK cells (p=0.000) in the three groups. In the severe to critical group there was a decrease in lymphocytes accompanied by decrease of the number of CD3, CD4, CD8 and NK cells as well as an increase in WBC and neutrophils. Based on the outcome, there were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.001), CD8 (p=0.000), and NK cells (p=0.001) between the Discharged and death groups. The decrease in the number of CD3, CD4, CD8 and NK cells indicates a relationship between changes in lymphocyte subsets and the pathogenesis of SARS-CoV-2, namely immune system disorders such as SARS infection. Increased of WBC with a decrease in CD3, CD4, CD8 and NK cell counts are associated with poor patient outcome. A significant decrease in the number of CD3, CD4, CD8 and NK cells in COVID-19 patients with severe to critical and moderate symptoms compared to mild groups and associated with poor patient clinical outcome.
BackgroundThis study aimed to analyze the relationship between glial fibrillary acidic protein (GFAP), glial-derived neurotrophic factor (GDNF), and fatty acid-binding protein-2 (FABP-2) in preterm infants on the incidence of NEC.MethodsPreterm infants with a birth weight <1,500 g and gestational age <34 weeks were included in this study. Biomarker examination was performed using the umbilical vein blood at birth (first sample). Biomarker examination was repeated if the infant developed symptoms of NEC using peripheral vein blood (second sample). Infants were observed for 14 days. If NEC did not exist, a biomarker examination was performed at 14 days.ResultsThis study included 30 preterm infants, nine infants experienced NEC. The values of GFAP, GDNF, and FABP-2 (median and range) in the group with NEC were higher than those in the group without NEC in both the first samples {GFAP [1.40 (0.20–6.50) vs. 0.30 (0.10–1.30) P = 0.014], GDNF [2.84 (1.05–14.11) vs. 1.56 (1.07–3.48) P = 0.050], and FABP-2 [621.70 (278.40–2,207.00) vs. 294.20 (211.40–597.50) P = 0.002]} and second samples {GFAP [2.40 (0.30–3.10) vs. 0.30 (0.10–0.60) P = 0.003], GDNF [2.99 (0.56–10.30) vs. 1.46 (0.85–2.24) P = 0.019], and FABP-2 [646.8 (179.20–1,571.00) vs. 314.90 (184.70–521.60) P = 0.040]}. In infants with NEC, the median values of GFAP [2.40 (0.30–3.10) vs. 1.40 (0.20–6.50) P = 0.767], GDNF [2.99 (0.56–10.30) vs. 2.84 (1.05–14.11) P = 0.859], and FABP-2 [646.80 (179.20–1,571.00) vs. 621.70 (278.40–2,207.00) P = 0.953] in the second sample were higher than those in the first sample. Logistic regression demonstrated that GFAP at birth (Odds Ratio [OR] = 15.629, 95% Confidence Interval [CI] = 1.697–143.906, P = 0.015) and FABP-2 levels at birth (OR = 1.008, 95% CI = 1.001–1.015, P = 0.033) were significantly associated with an increased risk of NEC.ConclusionIncreased GFAP, GDNF, and FABP-2 at birth are associated with NEC occurrence within two weeks of birth. These findings suggest that early-onset NEC is associated with intestinal injury that occurs during the perinatal or even prenatal period.
Introduction: Convalescent plasma therapy (CPT) is an alternative therapy for managing COVID-19, but its use is still controversial. Objective: Analyzing the effectiveness of CPT in modulating immune responses based on SARS-COV-2 anti-spike protein receptorbinding domain (s-RBD) IgG, inflammatory cytokines (IL-6 and IL-4), and mortality in severe-critical COVID-19 patients. Methods: This study was an observational analytical with a prospective cohort design. The number of participants was 39 patients from June to December 2020. The participants received CPT and was tested for blood analysis such as IL-4, IL-6 and s-RBD IgG. The data were taken a day before CPT, 1st day, 2nd day, and 7th day after CPT. The analysis included Friedman, Pearson correlation, and Mann-Whitney test which is significant if p <0.05. Results:The value of participant's s-RBD IgG before CPT was 91.49 (0.43-3074.73) AU/mL and the 7th day post-CPT, s-RBD IgG value of 1169.79 (6.48-5577.91) AU/mL (p <0.001). The IL-4 value before CPT was 1.78 (0.85-5.21) ng/mL and the 7th day post-CPT, IL-4 value of 1.97 (0.87-120.30) ng/mL (p = 0.401). The condition was also found in IL-6 value, in which the IL-4 value participant before CPT was 109.61 (0.73-4701.63) ng/mL and the 7th day post-CPT, IL-6 value of 1.97 (0.87-120.30) ng/mL (p = 0.401). No significant correlation found between increased s-RBD IgG level with increased IL-4 and decreased IL-6 before and after CPT in severe-critical COVID-19 patients (p >0.05). No significant correlation was also found between increased s-RBD IgG levels, IL-4 too, and decreased IL-6 after CPT therapy between deceased and alive patients, both in 1st, 2nd, and 7th days (p >0.05). Conclusion:No correlation between the increase in s-RBD IgG levels and changes in IL-4 and IL-6 levels. Changes in s-RBD IgG, IL-4, and IL-6 levels are not associated with mortality in severe-critical COVID-19 degree post CPT recipients.
Various strategies for dealing with COVID-19 have been carried out since the WHO declared COVID-19 as an international health emergency. One of the preventive strategies is the development of vaccines. Various vaccines have been developed worldwide. As of April 13, 2021, there were 184 vaccine candidates in the pre-clinical phase and 16 vaccine candidates currently in phase III clinical trials using several platforms, such as inactivated viruses, vector viruses, and protein subunits, and mRNA. Clinical trials of the SARS-CoV-2 vaccine include a screening test consisting of thorough physical examination and laboratory tests. The safety of clinical trials is evaluated based on laboratory test results referring to the standard toxicity grading scale. Immunogenicity assessment at the stage of clinical trials of vaccines includes assessment of humoral and cellular immunogenicity. The humoral immunogenicity test measures the ability of antibodies to neutralize the virus with the live virus neutralization test, Pseudo Virus Neutralization Test (pVNT), and Surrogate Virus Neutralization Test (sVNT) method. The cellular immunogenicity response aims to assess the immune response that leads to the Th1-cell phenotype. The COVID-19 vaccine under development is expected to trigger a helper 1 (Th1) cell response. Th1-producing Interferon-g (IFNg) is formed during acute viral infection, and Th1-type immune response correlates with milder disease. This is one of the considerations in vaccination. Th1-cell phenotype as part of cellular immunogenicity can be evaluated with ELISPOT, interferon-gamma release assay, and flow cytometry using blood samples that have been cultured with the administration of specific SARS-CoV-2 peptides. This literature review aims to study various immunogenicity assessments in the laboratory for clinical trials of COVID-19 vaccines.
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