Assessment of plasma Catestatin in COVID-19 reveals a hitherto unknown inflammatory activity with impact on morbidity-mortality.

Introduction: Neuroendocrine cells release Catestatin (CST) from Chromogranin A (CgA) to regulate stress responses. As regards COVID-19 patients (COVID+) requiring oxygen supply, to date nobody has studied CST as a potential mediator in the regulation of immunity. Patients & Methods: Admission plasma CST and CgA - its precursor - concentrations were measured (ELISA test) in 73 COVID+ and 27 controls. Relationships with demographics, comorbidities, disease severity and outcomes were analysed (Mann-Whitney, Spearman correlation tests, ROC curves). Results: Among COVID+, 49 required ICU-admission (COVID+ICU+) and 24 standard hospitalization (COVID+ICU-). Controls were either healthy staff (COVID-ICU-, n=11) or COVID-ICU+ patients (n=16). Median plasma CST were higher in COVID+ than in controls (1.6 [1.02; 3.79] vs 0.87 [0.59; 2.21] ng/mL, p<0.03), with no difference between COVID+ and COVID-ICU+. There was no difference between groups in either CgA or CST/CgA ratios, but these parameters were lower in healthy controls (p<0.01). CST did not correlate with either hypoxia- or usual inflammation-related parameters. In-hospital mortality was similar whether COVID+ or not, but COVID+ had longer oxygen support and more complications (p<0.03). CST concentrations and the CST/CgA ratio were associated with in-hospital mortality (p<0.01) in COVID+, whereas CgA was not. CgA correlated with care-related infections (p<0.001). Conclusion: Respiratory COVID patients release significant amounts of CST in the plasma making this protein widely available for the neural regulation of immunity. If confirmed prospectively, plasma CST will reliably help in predicting in-hospital mortality, whereas CgA will facilitate the detection of patients prone to care-related infections.

Optimization of the Elasticity and Adhesion of Catechol- or Dopamine-Loaded Gelatin Gels under Oxidative Conditions.

The synthesis of surgical adhesives is based on the need to design glues that give rise to strong and fast bonds without cytotoxic side effects. A recent trend in surgical adhesives is to use gel-forming polymers modified with catechol groups, which can undergo oxidative crosslinking reactions and are strongly adhesive to all kinds on surfaces in wet conditions. We previously showed that blending gelatin with catechol can yield strong adhesion when the catechol is oxidized by a strong oxidant. Our previous work was limited to the study of the variation in the sodium periodate concentration. In this article, for an in-depth approach to the interactions between the components of the gels, the influence of the gelatin, the sodium periodate and dopamine/(pyro)catechol concentration on the storage (G') and loss (G″) moduli of the gels, as well as their adhesion on steel, have been studied by shear rheometry. The hydrogels were characterized by infrared and UV-Vis spectroscopy and the size of their pores visualized by digital microscopy and SEM after freeze drying but without further additives. In terms of adhesion between two stainless steel plates, the optimum was obtained for a concentration of 10% w/v in gelatin, 10 mM in sodium periodate, and 20 mM in phenolic compounds. Below these values, it is likely that crosslinking has not been maximized and that the oxidizing environment is weakening the gelatin. Above these values, the loss in adhesiveness may result from the disruption of the alpha helixes due to the large number of phenolic compounds as well as the maintenance of an oxidizing environment. Overall, this investigation shows the possibility to design strongly adhesive hydrogels to metal surfaces by blending gelatin with polyphenols in oxidative conditions.

A Pilot Study on Continuous Infusion of 4% Albumin in Critically Ill Patients: Impact on Nosocomial Infection via a Reduction Mechanism for Oxidized Substrates.

Care-related infections affect up to 11% of ICU patients. Running therapeutic albumin is sometimes associated to less infection: whether a specific method of its infusion is of any interest to modulate innate defense is unknown. Our objectives were: 1) to test whether the method for albumin infusion is important to prevent care-related infections and 2) to analyze in vitro the antioxidative role of albumin on host defense proteins during shock (using vasostatin-I as an example). DESIGN: In a prospective, randomized, open-label trial, shock patients were allocated to receive either continuously 4% albumin or intermittently 20% albumin, as long as they were infused with norepinephrine. A translational study including in vivo and in vitro analyses of albumin-vasostatin-I interactions is reported. SETTING: A tertiary ICU caring for 1,000 patients per year. PATIENTS: Fifty shock patients with serum albumin less than 20 g/L. INTERVENTIONS: In vivo colonization and nosocomial infections were recorded and time-dependent changes in serum albumin, chromogranin A, and vasostatin-I concentrations as well. In vitro, we studied biochemical albumin-vasostatin-I relationship using biochemical methods. MEASUREMENTS AND MAIN RESULTS: Over 18 days, we recorded a decrease in colonization (four vs 12 episodes; p = 0.035) and nosocomial infection frequency (two vs 13 episodes; p = 0.002) in patients infused continuously 4% albumin versus controls. In vitro, albumin interacts with the disulfide loop vasostatin-I (residues 17-40) and continuous 4% albumin infusion restores its oxidative status required for antimicrobial activity. CONCLUSIONS: Continuous 4% albumin is effective in reducing care-related infections in shock patients by increasing the availability of antimicrobial vasostatin-I. This might guide future care of shock patients.

Polyelectrolyte multilayer films built from poly(L-lysine) and a two-component anionic polysaccharide blend.

The buildup of polyelectrolyte multilayer films made from poly(L-lysine) (PLL) as a polycation and from a blend of two anionic polysaccharides, namely, beta-1,3 glycan sulfate (GlyS) and alginate (Alg), was investigated as a function of the mass fraction, x, of GlyS in the blend, at a constant total weight concentration in polyanions. We find that the film thickness, after the deposition of a given number of layer pairs, reaches a minimum for x values lower than 0.1 (the position of this minimum could not be more precisely localized) and that the film thickness at intermediate values of x is the same as that of films built at the same concentration of GlyS in the absence of Alg (pure GlyS solution). Infrared spectroscopy in the attenuated total reflection mode shows that the weight fraction of GlyS in the multilayer films is much higher than its weight fraction, x, in the blend used to build the film. This preferential incorporation of GlyS over Alg is related to preferential interactions of GlyS as compared to Alg with PLL in solution, as measured by means of isothermal titration calorimetry. We also demonstrate that GlyS is able to displace Alg almost quantitatively from (PLL/Alg)n films but that in contrast Alg is not able to exchange GlyS from (PLL/GlyS)n films. These results, which combine adsorption from blended polyanion solutions, exchange of one polyanion already present in the film by the other in solution, and thermodynamic measurements, suggest that sulfated polymers are able to interact with polycations preferentially over polymers carrying carboxylated charged groups. These results give a first structural basis to the mechanism of preferential incorporation of a given polyanion with respect to another.

Relationship between the growth regime of polyelectrolyte multilayers and the polyanion/polycation complexation enthalpy.

The alternate deposition of polyanions and polycations leads to the formation of films called polyelectrolyte multilayer films (PEMs). Two types of growth processes are reported in the literature, leading to films that grow either linearly or exponentially with the number of deposition steps. In this article we try to establish a correlation between the nature of the growth process and the heat of complexation between the polyanions and the polycations constituting the PEM film. Isothermal titration microcalorimetry experiments performed on several polyanion/polycation systems seem to indicate that an endothermic complexation process is characteristic of an exponential film growth, whereas a strongly exothermic process corresponds to a linear growth regime. Finally, weakly exothermic processes seem to be associated with weakly exponentially growing films. These results thus show that exponentially growing processes are mainly driven by entropy. This explains why the exponential growth processes are more sensitive to temperature than the linear growing processes. This temperature sensitivity is shown on the poly-L-glutamic acid/poly(allylamine) system which grows either linearly or exponentially depending on the ionic strength of the polyelectrolyte solutions.