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1.
Basic Res Cardiol ; 115(4): 36, 2020 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-32399655

RESUMEN

There are no definitive therapies for patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Therefore, new therapeutic strategies are needed to improve clinical outcomes, particularly in patients with severe disease. This case series explores the safety and effectiveness of intravenous allogeneic cardiosphere-derived cells (CDCs), formulated as CAP-1002, in critically ill patients with confirmed coronavirus disease 2019 (COVID-19). Adverse reactions to CAP-1002, clinical status on the World Health Organization (WHO) ordinal scale, and changes in pro-inflammatory biomarkers and leukocyte counts were analyzed. All patients (n = 6; age range 19-75 years, 1 female) required ventilatory support (invasive mechanical ventilation, n = 5) with PaO2/FiO2 ranging from 69 to 198. No adverse events related to CAP-1002 administration were observed. Four patients (67%) were weaned from respiratory support and discharged from the hospital. One patient remains mechanically ventilated as of April 28th, 2020; all survive. A contemporaneous control group of critically ill COVID-19 patients (n = 34) at our institution showed 18% overall mortality at a similar stage of hospitalization. Ferritin was elevated in all patients at baseline (range of all patients 605.43-2991.52 ng/ml) and decreased in 5/6 patients (range of all patients 252.89-1029.90 ng/ml). Absolute lymphocyte counts were low in 5/6 patients at baseline (range 0.26-0.82 × 103/µl) but had increased in three of these five patients at last follow-up (range 0.23-1.02 × 103/µl). In this series of six critically ill COVID-19 patients, intravenous infusion of CAP-1002 was well tolerated and associated with resolution of critical illness in 4 patients. This series demonstrates the apparent safety of CAP-1002 in COVID-19. While this initial experience is promising, efficacy will need to be further assessed in a randomized controlled trial.


Asunto(s)
Tratamiento Basado en Trasplante de Células y Tejidos , Ensayos de Uso Compasivo , Infecciones por Coronavirus/terapia , Miocardio/citología , Neumonía Viral/terapia , Células Madre/citología , Anciano , Betacoronavirus , Biomarcadores/sangre , Enfermedad Crítica/terapia , Femenino , Ferritinas/sangre , Humanos , Infusiones Intravenosas , Los Angeles , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Pandemias , Adulto Joven
2.
BMC Infect Dis ; 20(1): 329, 2020 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-32381073

RESUMEN

BACKGROUND: Although people of all ages are susceptible to the novel coronavirus infection, which is presently named "Coronavirus Disease 2019" (COVID-19), there has been relatively few cases reported among children. Therefore, it is necessary to understand the clinical characteristics of COVID-19 in children and the differences from adults. CASE PRESENTATION: We report one pediatric case of COVID-19. A 14-month-old boy was admitted to the hospital with a symptom of fever, and was diagnosed with a mild form of COVID-19. The child's mother and grandmother also tested positive for SARS-CoV-2 RNA. However, the lymphocyte counts were normal. The chest computed tomography (CT) revealed scattered ground glass opacities in the right lower lobe close to the pleura and resorption after the treatment. The patient continued to test positive for SARS-CoV-2 RNA in the nasopharyngeal swabs and stool at 17 days after the disappearance of symptoms. CONCLUSION: The present pediatric case of COVID-19 was acquired through household transmission, and the symptoms were mild. Lymphocyte counts did not significantly decrease. The RNA of SARS-CoV-2 in stool and nasopharyngeal swabs remained positive for an extended period of time after the disappearance of symptoms. This suggests that attention should be given to the potential contagiousness of pediatric COVID-19 cases after clinical recovery.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus , Heces/virología , Fiebre/etiología , Pulmón/diagnóstico por imagen , Nasofaringe/virología , Neumonía Viral/diagnóstico por imagen , Adulto , Betacoronavirus , Técnicas de Laboratorio Clínico , Coronavirus/genética , Coronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/epidemiología , Composición Familiar , Humanos , Lactante , Recuento de Linfocitos , Masculino , Pandemias , Neumonía Viral/epidemiología , Reacción en Cadena de la Polimerasa , Síndrome Respiratorio Agudo Grave/transmisión , Tomografía Computarizada por Rayos X
3.
Front Immunol ; 11: 827, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32425950

RESUMEN

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed great threat to human health. T cells play a critical role in antiviral immunity but their numbers and functional state in COVID-19 patients remain largely unclear. Methods: We retrospectively reviewed the counts of T cells and serum cytokine concentration from data of 522 patients with laboratory-confirmed COVID-19 and 40 healthy controls. In addition, the expression of T cell exhaustion markers were measured in 14 COVID-19 cases. Results: The number of total T cells, CD4+ and CD8+ T cells were dramatically reduced in COVID-19 patients, especially in patients requiring Intensive Care Unit (ICU) care. Counts of total T cells, CD8+ T cells or CD4+ T cells lower than 800, 300, or 400/µL, respectively, were negatively correlated with patient survival. T cell numbers were negatively correlated to serum IL-6, IL-10, and TNF-α concentration, with patients in the disease resolution period showing reduced IL-6, IL-10, and TNF-α concentrations and restored T cell counts. T cells from COVID-19 patients had significantly higher levels of the exhausted marker PD-1. Increasing PD-1 and Tim-3 expression on T cells was seen as patients progressed from prodromal to overtly symptomatic stages. Conclusions: T cell counts are reduced significantly in COVID-19 patients, and the surviving T cells appear functionally exhausted. Non-ICU patients with total T cells counts lower than 800/µL may still require urgent intervention, even in the immediate absence of more severe symptoms due to a high risk for further deterioration in condition.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/inmunología , Neumonía Viral/inmunología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/patología , Citocinas/sangre , Humanos , Recuento de Linfocitos , Pandemias , Neumonía Viral/sangre , Neumonía Viral/patología , Linfocitos T/inmunología
4.
Anticancer Res ; 40(4): 2141-2150, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234907

RESUMEN

BACKGROUND/AIM: Patients with non-luminal breast cancer subtypes with high levels of tumor infiltrating lymphocytes (TILs) have better prognosis than those with luminal subtype. We evaluated the role of TILs according to the subtype. MATERIALS AND METHODS: An immunohistochemical analysis of 139 breast cancer cases was conducted to calculate the FOXP3+/CD8+ T cell ratios and their relationships with TILs and disease-free survival (DFS) were evaluated. RESULTS: FOXP3+/CD8+ T cell ratios were significantly associated with TIL levels only in luminal breast cancers (p=0.0001). Low FOXP3+/CD8+ T cell ratio was significantly associated with longer DFS (p=0.017). All luminal subtype patients with high TIL levels had high FOXP3+/CD8+ T cell ratios compared to only half of non-luminal subtype patients with high TIL levels. CONCLUSION: High FOXP3+/CD8+ T cell ratios in breast cancers may partly explain the worse prognosis of luminal breast cancers, but not that of non-luminal breast cancers with high TIL levels.


Asunto(s)
Neoplasias de la Mama/metabolismo , Linfocitos T CD8-positivos/metabolismo , Factores de Transcripción Forkhead/biosíntesis , Linfocitos Infiltrantes de Tumor/metabolismo , Adulto , Anciano , Neoplasias de la Mama/clasificación , Neoplasias de la Mama/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Antígeno Ki-67/biosíntesis , Recuento de Linfocitos , Persona de Mediana Edad , Pronóstico
5.
Anticancer Res ; 40(4): 2311-2317, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234931

RESUMEN

BACKGROUND/AIM: Elevated neutrophil-lymphocyte ratio (NLR) has been reported to be a poor prognostic factor in patients with colorectal cancer (CRC). However, no studies have focused on the dynamic change of preoperative NLR (pre-NLR) in CRC patients. We investigated the prognostic value of the change in NLR (ΔNLR) in CRC patients before and after surgery. PATIENTS AND METHODS: We retrospectively analyzed the data from 307 patients with stage II or III CRC. We compared the clinicopathological factors, OS, and DFS among the various NLR factors. RESULTS: The 5-year OS rate of the high ΔNLR group was significantly lower than that of the low ΔNLR group (p<0.01). The 5-year DFS rates of the high ΔNLR groups were worse than those in the low ΔNLR groups. In the multivariate analysis, ΔNLR was an independent prognostic factor (p=0.011). CONCLUSION: Decreasing post-NLR was related to better OS and DFS even in high pre-NLR patients with CRC.


Asunto(s)
Neoplasias Colorrectales/cirugía , Recuento de Linfocitos , Linfocitos/patología , Neutrófilos/patología , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/patología , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Periodo Preoperatorio , Pronóstico , Estudios Retrospectivos
6.
Anticancer Res ; 40(4): 2343-2349, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234936

RESUMEN

BACKGROUND/AIM: The host's systemic inflammatory response is thought to affect the progression of cancer and the antitumor effects of chemotherapy. Meta-analyses have reported that the peripheral blood platelet-to-lymphocyte ratio (PLR) is a prognostic indicator of this effect. Therefore, we hypothesized that PLR may differ, depending on sentinel lymph node metastasis (SLNM) in patients diagnosed with cT1N0M0 breast cancer by preoperative imaging. This study investigated the ability of preoperative PLR to predict SLNM in patients diagnosed with cT1N0M0 breast cancer. PATIENTS AND METHODS: This study included 475 patients with cT1N0M0 breast cancer diagnosed by preoperative imaging. Peripheral blood was obtained at diagnosis, i.e., before surgery. PLR was calculated from preoperative blood tests, by dividing the absolute platelet count by the absolute lymphocyte count. RESULTS: The probability of SLNM was significantly higher (p=0.002) in cases where the tumor diameter was larger than 10 mm. The incidence of SLNM was significantly high in the high (preoperative) PLR group (p=0.031). Multivariate analysis revealed that high PLR [compared to low PLR, p=0.021, odds ratio (OR)=1.815, 95% confidence interval (CI)=1.093-3.090] and large tumor size (compared to small tumor size, p=0.001, OR=2.688, 95%CI=1.524-4.997) were independent factors influencing SLNM. CONCLUSION: PLR may act as a predictor of SLNM in cT1N0M0 breast cancer.


Asunto(s)
Plaquetas/patología , Neoplasias de la Mama/cirugía , Linfocitos/patología , Ganglio Linfático Centinela/patología , Adulto , Anciano , Neoplasias de la Mama/sangre , Neoplasias de la Mama/patología , Femenino , Humanos , Metástasis Linfática , Recuento de Linfocitos , Persona de Mediana Edad , Análisis Multivariante , Evaluación de Resultado en la Atención de Salud , Recuento de Plaquetas , Periodo Preoperatorio , Pronóstico
7.
J Infect Dis ; 221(11): 1762-1769, 2020 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-32227123

RESUMEN

BACKGROUND: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19. METHODS: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed. RESULTS: Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy. CONCLUSIONS: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Subgrupos Linfocitarios , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Neumonía/etiología , Neumonía/fisiopatología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , China , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Femenino , Citometría de Flujo , Humanos , Recuento de Linfocitos , Subgrupos Linfocitarios/inmunología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía/diagnóstico , Neumonía/terapia , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Pronóstico , Resultado del Tratamiento
8.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(4): 294-298, 2020 Apr.
Artículo en Chino | MEDLINE | ID: mdl-32312364

RESUMEN

OBJECTIVE: To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: A retrospective analysis was performed for the clinical data of 13 children with SARS-CoV-2 infection who hospitalized in a Changsha hospital. RESULTS: All 13 children had the disease onset due to family aggregation. Of the 13 children, 2 had no symptoms, and the other 11 children had the clinical manifestations of fever, cough, pharyngeal discomfort, abdominal pain, diarrhea, convulsions, or vomiting. As for clinical typing, 7 had mild type, 5 had common type, and 1 had severe type. The median duration of fever was 2 days in 6 children. All 13 children had normal levels of peripheral blood lymphocyte counts, immunoglobulins, CD4, CD8, and interleukin-6. The median time to clearance of SARS-CoV-2 was 13 days in the nasopharyngeal swabs of the 13 children. Three children presented false negatives for RT-PCR of SARS-CoV-2. SARS-CoV-2 RNA remained detectable in stools for 12 days after the nasopharyngeal swab test yielded a negative result. Abnormal CT findings were observed in 6 children. All 13 children were cured and discharged and they were normal at 2 weeks after discharge. CONCLUSIONS: Intra-family contact is the main transmission route of SARS-CoV-2 infection in children, and there is also a possibility of fecal-oral transmission. Mild and common types are the major clinical types in children with SARS-CoV-2 infection, and cytokine storm is not observed. Children with SARS-CoV-2 infection tend to have a good short-term prognosis, and follow-up is needed to observe their long-term prognosis. Multiple nucleic acid tests should be performed for patients with SARS-CoV-2 infection and their close contacts by multiple site sampling.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Dolor Abdominal/etiología , Enfermedades Asintomáticas , Betacoronavirus/patogenicidad , Biomarcadores/análisis , Niño , China , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/transmisión , Tos/etiología , Diarrea/etiología , Heces/virología , Fiebre/etiología , Humanos , Recuento de Linfocitos , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Neumonía Viral/transmisión , ARN Viral/análisis , Estudios Retrospectivos , Convulsiones/etiología , Tomografía Computarizada por Rayos X
9.
Clin Chim Acta ; 505: 136-140, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32112798

RESUMEN

BACKGROUND: This study aimed to assess the role of fibrinogen (Fib) to albumin (ALB) ratio (FAR) in ankylosing spondylitis (AS) and its association with disease activity. METHODS: 135 AS patients and 76 age - and gender - matched healthy controls were collected in this retrospective study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was used to divide the AS patients into remission group (BASDAI < 4) and active group (BASDAI ≥ 4). The association between FAR and BASDAI was evaluated by Spearman correlation. Receiver operating characteristic (ROC) curve was made to determine the area under curve (AUC) value. The prognostic value of FAR in the AS disease activity was tested by multivariate logistical regression analyses. RESULTS: AS patients showed higher FAR levels than the controls (P < 0.001). FAR was also increased in active group of AS patients than those in inactive group (P < 0.001). Spearman analyses showed that FAR was positively related with BASDAI (r = 0.594, P < 0.001) in AS patients. ROC curve analyses revealed that the AUC of FAR was higher than ALB and Fib. In addition, the optimal cutoff value of FAR for AS diagnosis was 78.84, with a specificity of 88.2% and sensitivity of 77.0%. Logistical regression analyses showed that FAR (odds ratio = 13.091, 95% confidence interval: 4.686-36.571, P < 0.001) was a predictor for AS disease activity. CONCLUSIONS: FAR was increased in AS and may act as a novel inflammatory parameter for mirroring disease activity in AS.


Asunto(s)
Albúminas/análisis , Fibrinógeno/análisis , Espondilitis Anquilosante/sangre , Adulto , Área Bajo la Curva , Biomarcadores/sangre , Femenino , Humanos , Recuento de Linfocitos , Masculino , Recuento de Plaquetas , Valor Predictivo de las Pruebas , Pronóstico , Curva ROC , Valores de Referencia , Estudios Retrospectivos
10.
Rev Assoc Med Bras (1992) ; 66(1): 61-66, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130383

RESUMEN

OBJECTIVE: To relate disease-free survival and overall survival with type I and type II ovarian cancer and preoperative laboratory parameters biomarkers. METHODS: A retrospective study was carried out based on the collection of data from medical records of patients with ovarian tumors. Kaplan-Mayer curves were drawn based on the statistical analysis of the data and were compared using the Log-rank test. RESULTS: Disease-free survival in type I ovarian cancer was significantly higher than in type II (p=0.0013), as well as in those with normal levels of CA-125 (p=0.0243) and with a platelet-lymphocyte ratio (PLR) lower than 200 (p=0.0038). The overall survival of patients with type I ovarian cancer was significantly higher than in patients with type II, as well as in patients with normal CA-125 serum levels (p=0.0039) and those with a preoperative fasting glucose of less than 100 mg/dL. CONCLUSION: CA-125 levels may predict greater overall and disease-free survival. PLR < 200 may suggest greater disease-free survival, whereas normal fasting glucose may suggest greater overall survival.


Asunto(s)
Neoplasias Ováricas/sangre , Neoplasias Ováricas/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/sangre , Antígeno Ca-125/sangre , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Recuento de Linfocitos , Persona de Mediana Edad , Neutrófilos , Neoplasias Ováricas/patología , Recuento de Plaquetas , Valor Predictivo de las Pruebas , Periodo Preoperatorio , Valores de Referencia , Estudios Retrospectivos , Adulto Joven
11.
Int Heart J ; 61(2): 373-379, 2020 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-32173694

RESUMEN

We aimed to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), brain natriuretic peptide (BNP), and left ventricular hypertrophy (LVH) in hypertension. METHODS: This study included 386 patients with hypertension. Mann-Whitney U test and multivariate binary logistic regression analysis were used to investigate the relationship between NLR, CRP, BNP, and LVH in patients with hypertension, as well as compare the levels of NLR, CRP, and BNP in the four configurations. Receiver operator characteristic (ROC) curve was used to compare the diagnostic efficacy of NLR, CRP, and BNP on LVH. RESULTS: The NLR and CRP and BNP levels of the LVH group were significantly higher than those of the non-LVH group. In the multivariate logistic regression analysis, NLR as well as age, BMI, and SBP were associated with LVH. In addition, in patients with eccentric and concentric hypertrophy, the NLR and CRP and BNP levels were higher than those of the normal left ventricular geometry and concentric remodeling groups. The cutoff values of NLR, CRP, and BNP obtained by ROC curve were 2.185, 2.205, and 283.45, respectively, for the prediction of LVH. CONCLUSIONS: NLR is independently associated with LVH in patients with hypertension, and this is consistent with the diagnostic efficacy of CRP and BNP, which may be a simple and convenient indicator for judging LVH.


Asunto(s)
Hipertensión/complicaciones , Hipertrofia Ventricular Izquierda/sangre , Anciano , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Femenino , Humanos , Hipertrofia Ventricular Izquierda/etiología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre
12.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(3): 209-214, 2020 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-32164090

RESUMEN

Objective: To investigate the clinical characteristics of medical staff with novel coronavirus pneumonia(NCP). Methods: 30 patients infected with novel coronavirus referred to jianghan university hospital between January 11, 2020 and January 3, 2020 were studied. The data reviewed included those of clinical manifestations, laboratory investigation and Radiographic features. Results: The patients consisted of 10 men and 20 women, including 22 doctors and 8 nurses,aged 21~59 years(mean 35±8 years).They were divided to 26 common type and 4 severe cases, all of whom had close(within 1m) contact with patients infected of novel coronavirus pneumonia. The average contact times were 12 (7,16) and the average cumulative contact time was 2 (1.5,2.7) h.Clinical symptoms of these patients were fever in 23 patients (76.67%) , headache in 16 petients (53.33%) , fatigue or myalgia in 21patients (70%) , nausea, vomiting or diarrhea in 9 petients (30%) , cough in 25 petients (83.33%) , and dyspnea in 14 petients (46.67%) .Routine blood test revealed WBC<4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count<1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. Conclusion: Medical staffs are at higher risk of infection.Infection rates are associated with contact time, the amount of suction virus. Severe patients had BMI increased, heating time prolonged, white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus , Fiebre , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Neumonía Viral , Adulto , Índice de Masa Corporal , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Tos/etiología , Disnea/etiología , Femenino , Fiebre/clasificación , Fiebre/etiología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Recuento de Leucocitos , Hígado/patología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Miocardio/patología , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Estudios Retrospectivos , Factores de Riesgo , Albúmina Sérica , Factores de Tiempo , Adulto Joven
13.
Zhonghua Nei Ke Za Zhi ; 59(3): 200-206, 2020 Mar 01.
Artículo en Chino | MEDLINE | ID: mdl-32146746

RESUMEN

Objective: To investigate the characteristics and prognostic value of peripheral blood T lymphocyte subsets in patients with severe influenza. Methods: This was a single-center cross-sectional study in influenza patients admitted to Peking Union Medical College Hospital from August 2017 to April 2018. Peripheral blood lymphocyte subsets were detected by flow cytometry in both patients and 108 healthy controls. Influenza patients were divided into mild group and severe group. Severe patients were further classified into alive and fatal subgroups. Results: A total of 42 influenza patients were recruited in this study, including 24 severe cases (6 deaths). The remaining 18 cases were mild. The peripheral blood lymphocyte counts and lymphocyte subset counts (B, NK, CD4(+)T, CD8(+)T) in either mild patients[795 (571,1 007), 43 (23,144), 70 (47,135), 330 (256,457), 226 (148,366) cells/µl respectively] or severe patients[661 (474,1 151),92 (52,139), 54 (34,134), 373 (235,555), 180 (105,310) cells/µl respectively] were both significantly lower than those of healthy controls [1 963 (1 603,2 394),179 (119,239), 356 (231,496), 663 (531,824), 481 (341,693) cells/µl respectively]. Meanwhile, the T cells and CD8(+)T counts in fatal patients [370 (260,537) cells/µl and 87 (74,105) cells/µl] were significantly lower than those in severe and alive patients [722 (390,990) cells/µl and 222 (154,404) cells/µl]. CD8(+)HLA-DR/CD8(+)and CD8(+)CD38(+)/CD8(+)T cell activating subgroups in mild cases[(53.7±19.2)% and 74.8% (64.1%,83.7%) respectively] were significantly higher than those in severe cases[(38.5±21.7)% and 53.3% (45.3%,67.2%) respectively].Moreover,CD8(+)HLA-DR/CD8(+)count in severe and alive group was higher than that in fatal group [(46.1±19.1)% vs. (18.2±14.6)%, P<0.01]. Logistic regression analysis showed that CD8(+)T cell count (OR=0.952, 95%CI 0.910-0.997, P=0.035) and CD8(+)HLA-DR/CD8(+)T (OR=0.916, 95%CI 0.850-0.987, P=0.022) were both negatively correlated with mortality.Peripheral blood lymphocyte counts in mild cases rapidly decreased within 1 day after diagnosis, and returned to the basic level one week later. Conclusions: All peripheral blood lymphocyte subsets (T,B,NK) in patients with influenza are significantly reduced. These findings are consistent with the immunological characteristics of respiratory viral infections, in which peripheral lymphocytes (especially T cells) migrate to respiratory tract in the early stage and circulate to the peripheral blood after recovery. The activated CD8(+)T cell counts in peripheral blood are negatively correlated with the severity of disease, which could be considered as a prognostic indicator of severe influenza.


Asunto(s)
Gripe Humana/diagnóstico , Gripe Humana/inmunología , Subgrupos de Linfocitos T/citología , Linfocitos T CD8-positivos/citología , Estudios de Casos y Controles , Estudios Transversales , Citometría de Flujo , Humanos , Recuento de Linfocitos , Pronóstico , Índice de Severidad de la Enfermedad
14.
Nat Commun ; 11(1): 603, 2020 01 30.
Artículo en Inglés | MEDLINE | ID: mdl-32001676

RESUMEN

Immunotherapy targeting T cells is increasingly utilized to treat solid tumors including non-small cell lung cancer (NSCLC). This requires a better understanding of the T cells in the lungs of patients with NSCLC. Here, we report T cell repertoire analysis in a cohort of 236 early-stage NSCLC patients. T cell repertoire attributes are associated with clinicopathologic features, mutational and immune landscape. A considerable proportion of the most prevalent T cells in tumors are also prevalent in the uninvolved tumor-adjacent lungs and appear specific to shared background mutations or viral infections. Patients with higher T cell repertoire homology between the tumor and uninvolved tumor-adjacent lung, suggesting a less tumor-focused T cell response, exhibit inferior survival. These findings indicate that a concise understanding of antigens and T cells in NSCLC is needed to improve therapeutic efficacy and reduce toxicity with immunotherapy, particularly adoptive T cell therapy.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/inmunología , Neoplasias Pulmonares/inmunología , Linfocitos T/inmunología , Adulto , Anciano , Carcinoma de Pulmón de Células no Pequeñas/patología , Células Clonales , Receptores ErbB/genética , Receptores ErbB/metabolismo , Femenino , Humanos , Pulmón/patología , Neoplasias Pulmonares/patología , Activación de Linfocitos/inmunología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Mutación/genética , Análisis de Supervivencia
15.
PLoS One ; 15(2): e0228745, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32023301

RESUMEN

HIV-1 infection is characterized by generalized deregulation of the immune system, resulting in increased chronic immune activation. However, some individuals called HIV controllers (HICs) present spontaneous control of viral replication and have a more preserved immune system. Among HICs, discordant results have been observed regarding immune activation and the frequency of different T cell subsets, including Treg and Th17 cells. We evaluated T cell immune activation, differentiation and regulatory profiles in two groups of HICs-elite controllers (ECs) and viremic controllers (VCs)-and compared them to those of cART-treated individuals (cART) and HIV-1-negative (HIV-neg) individuals. ECs demonstrated similar levels of activated CD4+ and CD8+ T cells in comparison to HIV-neg, while cART and VCs showed elevated T cell activation. CD4+ T cell subset analyses showed differences only for transitional memory T cell frequency between the EC and HIV-neg groups. However, VC individuals showed higher frequencies of terminally differentiated, naïve, and stem cell memory T cells and lower frequencies of transitional memory and central memory T cells compared to the HIV-neg group. Among CD8+ T cell subsets, ECs presented higher frequencies of stem cell memory T cells, while VCs presented higher frequencies of terminally differentiated T cells compared to the HIV-neg group. HICs showed lower frequencies of total Treg cells compared to the HIV-neg and cART groups. ECs also presented higher frequencies of activated and a lower frequency of resting Treg cells than the HIV-neg and cART groups. Furthermore, we observed a high frequency of Th17 cells in ECs and high Th17/Treg ratios in both HIC groups. Our data showed that ECs had low levels of activated T cells and a high frequency of activated Treg and Th17 cells, which could restrict chronic immune activation and be indicative of a preserved mucosal response in these individuals.


Asunto(s)
Infecciones por VIH/inmunología , VIH-1/fisiología , Activación de Linfocitos , Linfocitos T Reguladores/inmunología , Células Th17/inmunología , Adulto , Femenino , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Linfocitos T Reguladores/citología , Células Th17/citología
16.
PLoS One ; 15(2): e0228734, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32040486

RESUMEN

There is no acknowledged reference interval of mesenteric lymph node size in healthy children, and the size criterion for mesenteric lymph node enlargement (MLNE) has long been controversial. This study aimed to explore the reference intervals of mesenteric lymph node size according to lymphocyte counts in asymptomatic children and to develop a more appropriate definition of MLNE. The asymptomatic children included were divided into five age strata: 2 to 3 yr; 3 to 4 yr; 4 to 5 yr; 5 to 6 yr; and 6 to 7 yr. Correlation analyses between lymphocyte counts and the long-axis diameter, short-axis diameter, and average diameter of the largest mesenteric lymph node (LMLN) were performed. A reference interval of the short-axis diameter of LMLN was established according to this correlation analysis in each age group. We also report a reference interval of lymphocyte count in each age group. This study revealed significant correlations between the short-axis diameter of LMLN and lymphocyte count in all age groups, as well as in subdivided boy groups and girl groups. The overall reference interval of the short-axis diameter of LMLN in children was 0.54 cm-1.03 cm, with mean value of 0.75 cm. This study supports the use of the short-axis diameter greater than 8-10 mm as the diagnostic criterion for primary mesenteric lymphadenitis based on the presence of a cluster of three or more mesenteric lymph nodes and in the absence of other abnormalities.


Asunto(s)
Enfermedades Asintomáticas , Ganglios Linfáticos/inmunología , Recuento de Linfocitos/normas , Mesenterio/inmunología , Niño , Preescolar , Femenino , Humanos , Masculino , Linfadenitis Mesentérica/inmunología , Valores de Referencia
17.
PLoS One ; 15(2): e0228617, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045436

RESUMEN

OBJECTIVE: Determine if patient-specific factors modulate absolute lymphocyte count (ALC), neutrophil count (ANC), and/or Neutrophile-lymphocyte ratio (NLR) in Dimethyl Fumarate (DMF) treated patients. METHODS: A retrospective study of patients who initiated DMF between 2013-2018. A multicenter study of two MS clinics: Charlottesville, VA (UVA) and Dallas, TX (DaVA). RESULTS: 103 patients (67-UVA, 36-DaVA) met eligibility. At baseline, the DaVa population was younger (mean±sd: 38.6±9.0 vs 42.2±12.5, p 0.152) and had a higher proportion of males (61% vs. 35%), consistent with a veteran cohort. Pre-treatment, all other laboratory parameters were similar between the two groups. On treatment there was a 30% lowering of mean ALC, with 3% having grade-3 lymphopenia (ALC < 500). Sustained neutropenia occurred in 3.9% of patients and was more common in males. Over 50% of patients had a high NLR at baseline, with a further 44% increase in NLR on-treatment. Age was significantly predictive of lymphopenia, with grade-3 lymphopenia found in 33% of patients ≥ 55 years. Neutropenia was more common in males. Serum BG (sBG) has modest correlation to leukocyte parameters. BMI was not correlated with any leukocyte-related outcomes. CONCLUSIONS: Patient-specific factors, specifically-age, sex, and serum blood glucose, modulate leukocyte response and ratios in DMF treated MS patients. Age appears to be a relevant predictor of lymphopenia and should be a factor in treatment decision making. Neutropenia, independent of lymphopenia, can occur and males may be at increased risk. High sBG may impact leukocyte count and ratios in MS patients and merits further study, particularly in patients with diabetes. NLR is abnormal in MS and increased with DMF-treatment, the clinical implications of this will require further study.


Asunto(s)
Linfopenia/epidemiología , Esclerosis Múltiple/sangre , Neutropenia/epidemiología , Adulto , Factores de Edad , Dimetilfumarato/farmacología , Dimetilfumarato/uso terapéutico , Femenino , Humanos , Inmunosupresores/farmacología , Inmunosupresores/uso terapéutico , Leucocitos/efectos de los fármacos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/tratamiento farmacológico , Modelación Específica para el Paciente , Factores Sexuales
18.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(1): 196-201, 2020 Feb.
Artículo en Chino | MEDLINE | ID: mdl-32027276

RESUMEN

OBJECTIVE: To investigate the distribution of peripheral blood lymphocytes and natural killer (NK) cells, and its influence on the prognosis of patients with myelodysplastic syndromes (MDS). METHODS: The lymphocytes proportion, absolute lymphocyte counts (ALC), NK cell proportion and absolute NK cell counts (ANKC) as well as the related data of 95 MDS patients diagnosed between 2013 and 2017 analyzed retrospectively. The correlation of ALC and ANKC with prognosis was also analyzed. RESULTS: As compared with low ALC patients, MDS patients with ALC≥0.885×109/L had a higher overall response rate (66.7% vs 35.8%) (P<0.01). The ALC of effective patients after treatment significatitly increased in compaison of ALC at diagnosis. Multivariate analysis indicated that patients with ALC≥0.885×109/L had long overall survival (OS) time in comparison with patients with low level (16.4 vs 12.4 months) (P<0.05). The OS time of patients with ANKC≥0.110×109/L was shorter in comparison with patients with low level (10.9 vs 16.3 months) (P<0.01). Otherwise, blast, cytogenetic risks and treatment response were also independent risk factors of MDS (P<0.05). Revised International Prognostic Scoring System (IPSS-R) combined with ANKC could improve predictive accuracy of IPSS-R alone (AUC 0.718 vs 0.674) (P<0.05). CONCLUSION: Lymphocytes and NK cells are important for the prognosis evaluation of MDS patients.


Asunto(s)
Células Asesinas Naturales , Síndromes Mielodisplásicos , Humanos , Recuento de Linfocitos , Pronóstico , Estudios Retrospectivos
19.
Scand J Immunol ; 91(5): e12872, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32048307

RESUMEN

γδ T cells play important roles in the development of rheumatoid arthritis (RA) through their antigen-presenting capacity, release of pro-inflammatory cytokines, immunomodulatory properties, interaction with CD4+ CD25+ Tregs and promotion of antibody production by helping B cells. Although prostaglandin E2 (PGE2) was proved to have the ability to enhance the antigen-presenting function of dendritic cells and IL-17 production of CD4+ αß T cells in RA, the role of PGE2 in γδ T cells from RA disease has not yet been clarified. The goal of this study was to determine the role of PGE2 in γδ T cells in RA. We first demonstrated that the population of γδT17 cells increased in patients with RA compared to healthy controls. Then, IL-17A level in patients with RA was shown to increase compared to healthy controls. After adding PGE2 to γδ T cells from patients with RA, the IL-17A level increased accordingly, and the expression of the costimulatory molecules, CD80 and CD86, on these cells also increased. These results suggest that PEG2 can increase the production of IL-17A and the expression of CD80 and CD86 on γδ T cells in patients with RA. These findings will benefit to explore new therapeutic targets for RA disease.


Asunto(s)
Artritis Reumatoide/etiología , Artritis Reumatoide/metabolismo , Dinoprostona/metabolismo , Regulación de la Expresión Génica , Interleucina-17/biosíntesis , Receptores de Antígenos de Linfocitos T gamma-delta/metabolismo , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/metabolismo , Adulto , Anciano , Artritis Reumatoide/patología , Antígeno B7-1/genética , Antígeno B7-1/metabolismo , Antígeno B7-2/genética , Antígeno B7-2/metabolismo , Biomarcadores , Femenino , Humanos , Inmunofenotipificación , Recuento de Linfocitos , Masculino , Persona de Mediana Edad
20.
Scand J Immunol ; 91(5): e12868, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32052490

RESUMEN

Renal dysfunctions are major predictors of co-morbidities and mortality in HIV-infected individuals. Unconventional T cells have been shown to regulate kidney functions. However, there is dearth of information on the effect of HIV-associated nephropathies on γδ and DN T cells. It is also not clear whether γδ T cell perturbations observed during the early stages of HIV infection occur before immune activation. In this study, we investigated the relationship between creatinine and urea on the number of unconventional T cells in HIV-infected individuals at the early and chronic stages of infection. Persons in the chronic stage of infection were divided into treatment naïve and exposed groups. Treatment exposed individuals were further subdivided into groups with undetectable and detectable HIV-1RNA in their blood. Creatinine and urea levels were significantly higher among persons in the early HIV infection compared with the other groups. Proportions of γδ T, γδ + CD8, γδ + CD16 cells were also significantly reduced in the early stage of HIV infection (P < .01). Markers of immune activation, CD4 + HLA-DR and CD8 + HLA-DR, were also significantly reduced during early HIV infection (P < .01). Taken together, our findings suggest that high levels of renal markers as well as reduced proportions of gamma delta T cells are associated with the early stages of HIV infection. This event likely occurs before systemic immune activation reaches peak levels. This study provides evidence for the need for early HIV infection diagnosis and treatment.


Asunto(s)
Creatinina/sangre , Infecciones por VIH/inmunología , Infecciones por VIH/metabolismo , Receptores de Antígenos de Linfocitos T gamma-delta/metabolismo , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/metabolismo , Urea/sangre , Adulto , Biomarcadores , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/virología , Humanos , Inmunofenotipificación , Enfermedades Renales/etiología , Enfermedades Renales/fisiopatología , Activación de Linfocitos , Recuento de Linfocitos , Masculino , Neutrófilos , Factores de Tiempo , Carga Viral , Adulto Joven
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