A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm.

Evaluating the effect of convalescent plasma (CP) on some cytokine storm indices in severe COVID-19 patients. Totally, 62 patients were randomly assigned into two groups for this clinical trial. Patients in the intervention group received one unit (500 mL) plasma on the admission day plus standard drugs while the controls merely received standard treatments. Eventually, primary and secondary outcomes were evaluated. In the CP group, compared with controls, the mean levels of lymphocytes and IL-10 significantly increased while the levels of IL-6, TNF-α, and IFN-γ decreased (p < 0.05). The length of in-hospital stay, and mortality rate did not significantly reduce in the CP group compared with controls (p > 0.05) while WHO severity scores remarkably improved (p = 0.01), despite the higher frequency of underlying diseases among the CP group (66.7%) vs. controls (33.3%). Although CP has a remarkable immunomodulatory and antiviral potential to improve the cytokine storm and disease severity in COVID-19 patients, it did not considerably affect the mortality rate.

The Rh blood group system and its role in alloimmunization rate among sickle cell disease and sickle thalassemia patients in Iran.

INTRODUCTION: The alloimmunization following blood transfusion can be life-threatening. The Rh alloantibodies are one of the most common causes contributing to alloimmunization. This study aimed to evaluate the rate and causes of alloimmunization and to determine the Rh phenotypes and genotypes among sickle cell disease (SCD) and sickle thalassemia (Sß). MATERIALS AND METHODS: Our study included 104 SCD and Sß patients referring to Baghaei 2 Hospital of Ahvaz in 2019 using a non-random simple sampling method. The blood samples were collected for Rh phenotypes, alloantibody screening and identification, and molecular tests. The SSP-PCR and RFLP methods with the Pst 1 enzyme were used. RESULTS: The alloimmunization rate was 9.6% and 13.2% based on immunohematological tests and medical records, respectively. The main alloantibodies (90%) were anti-Rh, and 40% of the patients had multiple alloantibodies. A significant correlation was found between gender and alloimmunization. The phenotypes of DCce (37.5%), DCcEe (24%), Dce (20.2%), and dce (5.8%) and genotypes of R1r (25%), R1R2 (20.2%), R1R1 (18.3%), and R1R0 (10.6%) were the most prevalent. The R1R2 was a frequent genotype in Sß. CONCLUSION: R0r' and R1R0 genotypes were limited to our population in Iran. Due to the differences in RH genotypes between our population and others, the blood transfusion from other ethnicities increased our total alloimmunization rate.

[Informatori biologici per ischemia miocardica silente: approccio diagnostico e prognostico.] / Biological whistleblowers for silent myocardial ischemia: diagnostic and prognostic approach.

Riassunto. L'ischemia miocardica silente (SMI) è un aspetto dello spettro della cardiopatia ischemica che varia dalla malattia coronarica asintomatica all'angina grave. Considerando il progressivo aumento della prevalenza di SMI e l'inaffidabilità di test diagnostici comuni, l'identificazione di biomarcatori SMI benefici è molto critica per una diagnosi rapida e un trattamento efficace della malattia. La presente revisione ha lo scopo di analizzare l'efficienza clinica di biomarcatori ben applicati e nuovi per la diagnosi e la previsione dei risultati dei pazienti con SMI. Questi biomarcatori includono cTnT, cTnI, hs-cTnT, hs-cTnI, hsCRP, NT-proBNP, sST2, GDF-15, Lp-PLA2, recettori della superficie cellulare, citochine antinfiammatorie, OPG, leptina, colesterolo totale, HDL, LDL, lipoproteine (a), omocisteina, albuminuria, microalbuminuria e miRNA circolanti. Nel database PubMed sono stati cercati rapporti scientifici (articoli originali) usando i termini "biomarcatori", "ischemia miocardica silenziosa", "biomarcatori cardiaci", "infiammatori", "marcatori", "stress ossidativo". Una migliore comprensione di vari biomarcatori SMI fornisce una migliore comprensione della sua varia patofisiologia e aspetto asintomatico, nonché dell'uso clinico di routine di questi biomarcatori.

Expression of CD markers' in immune thrombocytopenic purpura: prognostic approaches.

Immune Thrombocytopenic Purpura (ITP) is a common autoimmune bleeding disorder characterized by a reduction in peripheral blood platelet counts. In this disease, autoantibodies (Auto-Abs) are produced against platelet GPIIb/GPIIIa by B cells, which require interaction with T cells. In this review, the importance of B and T lymphocytes in ITP prognosis has been studied. Relevant literature was identified by a PubMed search (1990-2016) of English-language papers using the terms B and T lymphocyte, platelet, CD markers and immune thrombocytopenic purpura. T and B lymphocytes are the main immune cells in the body. Defective function causes disrupted balance of different subgroups of lymphocytes, and abnormal expression of surface markers of these cells results in self-tolerance dysfunction, as well as induction of Auto-Abs against platelet glycoproteins (PG). Given the role of B and T cells in production of autoantibodies against PG, it can be stated that the detection of changes in CD markers' expression in these cells can be a good approach for assessing prognosis in ITP patients.

Thalidomide is more efficient than sodium butyrate in enhancing GATA-1 and EKLF gene expression in erythroid progenitors derived from HSCs with ß-globin gene mutation.

BACKGROUND: Efficient induction of fetal hemoglobin (HbF) is considered as an effective therapeutic approach in beta thalassemia. HbF inducer agents can induce the expression of γ-globin gene and produce high levels of HbF via different epigenetic and molecular mechanisms. Thalidomide and sodium butyrate are known as HbF inducer drugs. MATERIAL AND METHODS: CD133(+) stem cells were isolated from umbilical cord blood of a newborn with minor ß-thalassemia in order to evaluate the effects of these two drugs on the in vitro expression of GATA-1 and EKLF genes as erythroid transcription factors. CD133(+) stem cells were expanded and differentiated into erythroid lineage and then treated with thalidomide and sodium butyrate and finally analyzed by quantitative real-time PCR. Statistical analysis was performed using student's t-test by SPSS software. RESULTS: Thalidomide and sodium butyrate increased GATA-1 and EKLF gene expression, compared to the non-treated control (P<0.05). CONCLUSION: Thalidomide was more efficient than sodium butyrate in augmenting expression of GATA-1 and EKLF genes. It seems that GATA-1 and EKLF have crucial roles in the efficient induction of HbF by thalidomide.