Immune Response Gaps Linked to SARS-CoV-2 Infection: Cellular Exhaustion, Senescence, or Both?

The COVID-19 pandemic, promoted by the SARS-CoV-2 respiratory virus, has resulted in widespread global morbidity and mortality. The immune response against this pathogen has shown a thin line between protective effects and pathological reactions resulting from the massive release of cytokines and poor viral clearance. The latter is possibly caused by exhaustion, senescence, or both of TCD8+ cells and reduced activity of natural killer (NK) cells. The imbalance between innate and adaptive responses during the early stages of infection caused by SARS-CoV-2 contributes to the ineffective control of viral spread. The present study evaluated the tissue immunoexpression of the tissue biomarkers (Arginase-1, CCR4, CD3, CD4, CD8, CD20, CD57, CD68, CD138, IL-4, INF-α, INF-γ, iNOS, PD-1, Perforin and Sphingosine-1) to understand the cellular immune response triggered in patients who died of COVID-19. We evaluated twenty-four paraffin-embedded lung tissue samples from patients who died of COVID-19 (COVID-19 group) and compared them with ten lung tissue samples from patients who died of H1N1pdm09 (H1N1 group) with the immunohistochemical markers mentioned above. In addition, polymorphisms in the Perforin gene were genotyped through Real-Time PCR. Significantly increased tissue immunoexpression of Arginase, CD4, CD68, CD138, Perforin, Sphingosine-1, and IL-4 markers were observed in the COVID-19 group. A significantly lower immunoexpression of CD8 and CD57 was also found in this group. It is suggested that patients who died from COVID-19 had a poor cellular response concerning viral clearance and adaptive response going through tissue repair.

COVID-19 Outcome Relates With Circulating BDNF, According to Patient Adiposity and Age.

Background and Aims: We evaluated adipose tissue-derived hormones, body composition, serum metabolic profile, levels of brain-derived neurotrophic factor (BDNF), and the association of these parameters with the clinical outcome in patients with COVID-19. We sought to examine whether obesity, sex, and age influence the adipose tissue endocrine response to the disease. Methods: This prospective study investigated 145 hospitalized patients with COVID-19. Patients were categorized based on their body mass index (BMI), sex and age, and were also classified regarding their outcome after hospitalization as: (a) Non-ICU: patients hospitalized who did not receive intensive care; (b) ICU-survivor: patients admitted to the intensive care unit and discharged; (c) ICU-death: patients who died. Blood samples were collected by the hospital staff between the first and third day of hospitalization. Serum leptin, adiponectin and BDNF concentrations, triglycerides, total cholesterol and cholesterol fractions were performed following the manufacturer's guidelines. Results: We demonstrate that BDNF levels predict intensive care (IC) need (p < 0.01). This association was found to be stronger in patients >60y (p = 0.026). Neither leptin nor adiponectin concentration was associated with IC requirement or with patient's outcome, while the BDNF/adiponectin ratio was closely associated with worsened outcomes (p < 0.01). BDNF concentration was similar between sexes, however tended to be lower in male patients (p = 0.023). In older patients, BDNF concentration was lower than that of younger patients (p = 0.020). These age and sex-specific differences should be considered when employing these potential markers for prognosis assessment. While appetite and body composition regulating hormones secreted by the white adipose tissue are not reliable predictors of disease severity, the ratio BDNF/adiponectin was indicative of patient status. Conclusion: Thus, we propose that serum BDNF content and BDNF/adiponectin ratio may serve as tools predicting worsened prognosis in COVID-19, especially for male patients.

Quantificação da angiogênese induzida por tumor em membrana corioalantóica de embrião de galinha / Quantification of tumor-induced angiogenesis on chicken embryo chorioallantoic membrane

Angiogênese é um processo de surgimento de novos microvasos provenientes de vasos sanguíneos já existentes. O desenvolvimento tumoral e o processo de metástase são dependentes de angiogênese, pois o tumor em crescimento necessita de uma rede capilar que forneça nutrientes e oxigênio. A membrana corioalantóica de embrião de galinha (CAM) é um modelo experimental in vivo que oferece muitas vantagens, como a alta vascularização natural e alta taxa de reprodução, além de ser um modelo simples e de baixo custo. A CAM é composta por proteínas de matriz extracelular, que mimetizam o ambiente fisiológico de células cancerosas. A etapa de contagem do número total de vasos permite a determinação dos efeitos dos estímulos pró ou anti angiogênicos, portanto a padronização de um método eficaz é necessário. O presente estudo teve como objetivo geral avaliar o potencial angiogênico de células de uma linhagem de adenocarcinoma de cólon humano (HT29) e propor um método para quantificação da angiogênese induzida por células tumorais na CAM. Os embriões foram mantidos em sistema ex ovo. No oitavo dia, foram adicionados sobre a CAM, implantes de colágeno contendo células tumorais em diferentes concentrações. No décimo primeiro dia foi feito o registro fotográfico utilizando microscópio estereoscópico e foram determinados quatro scores para a quantificação e caracterização dos vasos, considerando-se se seccionavam o implante e também seu grau de ramificação. A contagem dos vasos, feita em uma área específica ao redor do implante, foi realizada após edição das imagens pelo programa Image Pro Plus. Os resultados mostraram aumento significativo do número de vasos que não seccionavam o implante para aqueles contendo 3 x 104 e 6 x 104 células. Pode-se concluir que a metodologia de contagem dos vasos, utilizando registros fotográficos e edições de imagens, é eficaz. Demonstrou-se que as células HT29 induzem a uma alteração no padrão de crescimento de novos vasos quando depositada sobre a CAM em implantes de colágeno e podem ser utilizadas como modelo experimental para se investigar o efeito de diferentes compostos sobre a angiogênese induzida por tumor.

Angiogenesis is a process of sprouting of new microvessels from existing blood vessels. The tumoral development and the metastasis process are angiogenesis dependent, because the growing tumor needs a capillaries network that provides nutrients and oxygen. The chicken chorioallantoic membrane (CAM) is an experimental in vivo model which offer many advantages, such as the high natural vascularization and high reproducibility, besides the simplicity and low cost. The CAM contains extracellular matrix proteins, which mimics the physiological cancer cell environment. The counting of the total number of vessels allows a determination of pro- and anti-angiogenic effects of different stimulus, therefore patterning an effective method is necessary. The general goal of the present study was to evaluate the angiogenic potential of a human colon adenocarcinoma cell line (HT29) and propose a method to quantify angiogenesis induced by cancer cells on the CAM. Embryos were cultivated in an ex ovo system. At the eighth day, collagen implants containing cancer cells in different concentrations were added on the top of CAM. At the eleventh day, the photographic records were made by using stereoscope microscope and were determined four scores for vessels quantification and characterization. Vessels counting were done in a specific area around the implant, and edition of the captured images were done using Image Pro Plus software. Our results showed a significant increase in vessels that do not section the implant. It was demonstrated that HT29 cells induce a change in the pattern of growth of new blood vessels when placed on CAM into collagen implants and can be used as an experimental model for investigating the effect of different compounds on tumor-induced angiogenesis.