Deciphering the balance of IL-6/IL-10 cytokines in severe to critical COVID-19 patients.

The severity of COVID-19 is largely determined by the inflammatory response, a "Cytokine storm," that involves both pro- and anti-inflammatory cytokines. In the current study we investigated the balance of pro- and anti-inflammatory status as represented by the levels of IL-6/IL-10 in severe to critical COVID-19 patients. 66 confirmed COVID-19 patients admitted to the ICU were categorized into groups according to the mortality and respiratory failure. Data were collected retrospectively in ICU, including a peripheral immune cells and infection-related biomarker CRP. The measurements of cytokine levels were performed by Immulite analyzer for IL-6 and ELISA sandwich for IL-10. In addition, longitudinal measurement of IL-6 was performed during 5 days post admission. Longitudinal assays showed that IL-6 was sustained at a medium level within 5 days post admission in severe cases who survived or not requiring mechanical ventilation, whereas it was sustained at high levels throughout the disease course in either deceased cases or who developed respiratory failure. The ratio of IL-6/lymphocytes was positively correlated with the risk of mortality, while IL-10/lymphocytes ratio could predict respiratory failure in ICU. IL-6/IL-10 profiling revealed that deceased patients have different magnitudes of both IL-6 and IL-10 cytokine release. Notably, excessive levels of IL-6 concomitant with high levels of IL-10 were more common in diseased COVID-19 patients. Taking into account the IL-6/IL-10 profiling may help clinicians to identify the right time of anti-inflammation treatment and select patients who will respond to anti-cytokine therapies and maintain an adequate inflammatory response for SARS-CoV-2 clearance.

Immunotoxicological and biochemical effects of aflatoxins in rats prevented by Tunisian montmorillonite with reference to HSCAS.

BACKGROUND AND AIM: Previously we reported that hydrated sodium calcium aluminosilicate (HSCAS) and Tunisian Montmorillonite (TM) had an ability to sorb aflatoxins with a high affinity. Addition of these compounds to feedstuffs contaminated with aflatoxins has shown protective effects against the development of aflatoxicosis in farm and laboratory animals. The objective of the current study was to compare the efficiency of HSCAS and the TM in respect to the protection against immunotoxicological effects of aflatoxins in rats. MATERIALS AND METHODS: Animals fed an aflatoxin-contaminated diet (2.5 mg/kg diet) showed a significant decrease in all hematological parameters, cholesterol, triglycerides, cholinesterase, total protein, albumin, zinc and copper concentrations. RESULTS: Such feeding significantly increased createnine, bilirubin, urea nitrogen, alkaline phosphatase and transaminases concentrations. The immunological results showed a significant decrease in lymphocytes of the total white blood cells, immunoglobulin profile (Ig G and Ig A), T-cells sub-types (CD3(+), CD4(+) and CD8(+)), NK and pro-inflammatory cytokines (TNFalpha and IL-1beta) typical of aflatoxicosis. Both HSCAS and TM at the level of 5 g/kg contaminated diet resulted in a significant improvement in all immunological parameters-in lymphocyte, immunoglobulin profile, T-cells sub-types and pro-inflammatory cytokines as well as the mineral status and the biochemical parameters. CONCLUSIONS: The deleterious effects of aflatoxin could be overcome or, at least, diminished by the addition of sorbents. Moreover, both tested sorbents by themselves had no toxic effects and bind aflatoxin with high affinity.