Immunothrombosis and its underlying biological mechanisms.

The evolutionary conserved link between coagulation and innate immunity is a biological process characterized by the thrombosis formation stimulus of immune cells and specific thrombosis-related molecules. In physiological settings, the relationship between the immune system and thrombosis facilitates the recognition of pathogens and damaged cells and inhibits pathogen proliferation. However, when deregulated, the interplay between hemostasis and innate immunity becomes a pathological process named immunothrombosis, which is at the basis of several infectious and inflammation-related thrombotic disorders, including coronavirus disease 2019 (COVID-19). In advanced stages, alterations in both coagulation and immune cell function due to extreme inflammation lead to an increase in blood coagulability, with high rates of thrombosis and mortality. Therefore, understanding underlying mechanisms in immunothrombosis has become decisive for the development of more efficient therapies to treat and prevent thrombosis in COVID-19 and in other thrombotic disorders. In this review, we outline the existing knowledge on the molecular and cellular processes involved in immunothrombosis, focusing on the role of neutrophil extracellular traps (NETs), platelets and the coagulation pathway. We also describe how the deregulation of hemostasis is associated with pathological conditions and can significantly aggravate a patient's condition, using COVID-19 as a clinical model.

Brief multidimensional measure of spirituality/religiousness, self-esteem, quality of life, and epilepsy.

INTRODUCTION: The relationships between religiousness/spirituality (RS), self-esteem, and quality of life (QoL) in adult people with epilepsy (PWEs) have not been studied in detail. METHODS: This cross-sectional study assessed RS using the brief multidimensional measure of religiousness/spirituality (BMMRS) scores of 86 PWEs. These scores were compared to 58 individuals in the control group (CG). Among the PWEs, the BMMRS data were related with the QOLIE-31 and the Rosenberg self-esteem scale (RSES) scores and clinical variables. RESULTS: Among the PWEs, 48 individuals had temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and other epilepsies in 38 cases. Higher "daily spiritual experiences," "overall self-ranking as a religious/spiritual person," and lower perception of "religious/spiritual coping" were observed in the TLE-HS group when compared to the CG. Among the PWEs, there was lower "religious/spiritual coping" and higher "overall self-ranking as a religious/spiritual person" in the TLE-HS group. There was a significant difference in the BMMRS dimensions according to the type and frequency of seizures and the number of antiseizure drugs taken. There was a low correlation between the BMMRS, the QOLIE-31, and the RSES. In the network analysis with the Fruchterman-Reingold algorithm, there was no correlation between self-esteem and RS. In the TLE-HS group, there was a correlation between the "forgiveness" dimension of the BMMRS and some dimensions of the QOLIE-31. CONCLUSION: There was a greater RS in the TLE-HS group when compared to the CG. Regarding the two epilepsy groups, there was a higher "overall self-ranking as a religious/spiritual person" and lower "religious/spiritual coping" in the TLE-HS. The clinical variables and demographic data are related to different BMMRS dimensions according to the type of epilepsy. In the TLE-HS group, a higher RS is related to a better QoL. RS is not related to self-esteem.