Classical monocytes-low expressing HLA-DR is associated with higher mortality rate in SARS-CoV-2+ young patients with severe pneumonia.

Aims: This study aimed to investigate whether monocyte dysregulation and hyperinflammation serve as predictive markers for mortality in young patients with SARS-CoV-2 severe pneumonia. Methods: A prospective cohort study was conducted in a tertiary-level public University Hospital in Colombia. Forty young adults (18-50 years of age) with severe pneumonia and SARS-CoV-2 infection confirmed by qPCR, were enrroled. Serum cytokines and the monocyte phenotype profile, including PDL1/HLA-DR expression, were determined during the first 24 h of hospitalization. Routine laboratory parameters were measured throughout patient follow-up until either death or hospital discharge. We also included a cohort of twenty-five healthy control subjects. Key findings: Elevated levels of IL-10, IL-8, and IL-6 cytokines emerged as robust predictors of mortality in young adults with severe pneumonia due to SARS-CoV-2 infected. A descriptive analysis revealed a cumulative mortality rate of 30 % in unvaccinated and ICU-admitted patients. Patients who died had significantly lower expression of HLA-DR on their classical monocytes subsets (CD14+CD16-) than survivors and healthy controls. Lower expression of HLA-DR was associated with greater clinical severity (APACHE≥12) and bacterial coinfection (relative risk 2.5 95%CI [1.18-5.74]). Notably, the expression of HLA-DR in 27.5 % of CD14+/CD16- monocytes was associated with a significantly lower probability of survival. Significance: The early reduction in HLA-DR expression within classical monocytes emerged as an independent predictor of mortality, irrespective of comorbidities. Together with PD-L1 expression and cytokine alterations, these findings support the notion that monocyte immunosuppression plays a fundamental role in the pathogenesis and mortality of young patients infected with SARS-CoV-2. These findings hold significant implications for risk assessment and therapeutic strategies in managing critically ill young adults with SARS-CoV-2 infection.

Imbalance between the circulating endothelium-derived apoptotic microparticles and the endothelial colony-forming units of progenitor cells in patients undergoing diagnostic coronary angiography.

PURPOSE: The involvement of the circulating endothelium-derived microparticles (EMPs) and the endothelial progenitor cells (EPCs) has been shown in the pathogenesis of coronary artery disease (CAD). The current study aimed to explore whether the Friesinger index is associated with the levels of the apoptotic CD144+/CD31+/annexin V+ â€‹EMPs and the number of endothelial colony-forming units of progenitor cells in patients undergoing coronary angiography. PATIENTS AND METHODS: Fifty-seven patients with a median age of 62 years (range: 48-84 years) were enrolled. Quantification of the apoptotic CD144+/CD31+/annexin V+ EMPs was performed by flow cytometry. The number of endothelial colony-forming units defined by CFU-Hill was assessed by cell culture. RESULTS: There was a positive correlation between the Friesinger index and the circulating levels of the apoptotic CD144+/CD31+/annexin V+ EMPs (rho=0.817, p<0.001), whereas a negative correlation was found with the number of CFU-Hill (rho â€‹= â€‹- 0.649, p<0.001). Multivariable logistic analysis showed that the risk of having moderate/severe CAD was five times greater among male patients (OR:5.32; 95% CI: 1.19 - 16.33; p=0.038) and almost one and a half times higher among those with a higher level of apoptotic CD144+/CD31+/annexin V+ EMPs (OR:1.74; 95% CI: 1.23 - 2.28; p=0.001). Finally, the circulating levels of apoptotic EMPs labelled for CD144+/CD31+/annexin V+ presented a good discrimination of moderate/severe CAD, with an AUC of 0.85 (95% CI â€‹= â€‹0.74 - 0.96; p< 0.001). CONCLUSIONS: Moderate or severe CAD is associated with increased levels of apoptotic EMPs and reduced EPC colony-forming capacity, increasing the occurrence of endothelial injuries.

Hydroethanolic stem bark extracts of Stryphnodendron adstringens impair M1 macrophages and promote M2 polarization.

ETHNOPHARMACOLOGICAL RELEVANCE: Stryphnodendron adstringens has been used by indigenous Brazilian people to treat wound, infections, inflammation and other conditions. AIM OF THE STUDY: This study aims to investigate the effect of S. adstringens on macrophage polarization. METHODS: To prepare the hydroethanolic extract of Stryphnodendron adstringens (HESA), fresh bark was exposed to maceration, filtered and subsequently lyophilized. The extract HESA were analyzed by LC-DAD-MS to identify their constituents. Bone marrow cells were obtained from male C57BL/6 mice. Then, the cells were polarized into M1 or M2 subsets in the presence or absence of HESA. The membrane expression of TLR2, CD206, CCR7, class II MHC, and CD86, the intracellular expression of iNOS and IL-6 and the supernatant expression of IL-6 were determined by flow cytometry. RESULTS: By LC-DAD-MS, twenty-four compounds could be detected from HESA and proanthocyanidins, flavan-3-ols, and chromones were identified. NO and iNOS were reduced in the HESA-treated cells. There was a reduction in IL6 in HESA-treated cells. The membrane expression of TLR2, CD206, CCR7, CD86, and class II MHC was reduced in HESA-treated cells. The densities of CD206 and IL-10 were found to be significantly increased in HESA-treated cells. CONCLUSION: This work is the first to demonstrate that S. adstringens can modulate the functional polarization of macrophages into the M2 profile and suppress costimulatory molecules in M1 macrophages. These results corroborate with the ethnopharmacology use of S. adstringens, contributing to its pharmacological validation in wound treatment and expanding the knowledge about immunoregulatory action of this specie.