Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India.
Department of Paediatric Neurology, Sarvee Integra Private Limited, Chennai, India.
Front Immunol. 2022 Jun 27;13:870632. doi: 10.3389/fimmu.2022.870632. eCollection 2022.
Sepsis is a life-threatening condition caused by an abnormal immune response induced by infection with no approved or specific therapeutic options. We present our perspectives for the therapeutic management of sepsis through a four-way approach: (1) infection control through immune enhancement; (2) immune suppression during the initial hyper-inflammatory phase; (3) balanced immune-modulation to counter the later immune-paralysis phase; and (4) advantageous effects on metabolic and coagulation parameters throughout. COVID-19 is a virus-triggered, accelerated sepsis-like reaction that is associated with the rapid progress of an inflammatory cascade involving a cytokine storm and multiorgan failure. Here, we discuss the potential of the biological response modifiers, β-glucans (BRMGs), in the management of sepsis based on their beneficial effects on inflammatory-immune events in COVID-19 clinical studies. In COVID-19 patients, apart from metabolic regulation, BRMGs, derived from a black yeast, strain AFO-202, have been reported to stimulate immune responses. BRMGs, produced by another strain (N-163) of , have been implicated in the beneficial regulation of inflammatory markers and immunity, namely IL-6, C-reactive protein (CRP), D-Dimer, ferritin, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), leucocyte-to-C-reactive protein ratio (LeCR), and leukocyte-to-IL-6 ratio (LeIR). Agents such as these β-glucans, which are safe as they have been widely consumed by humans for decades, have potential as adjuncts for the prevention and management of sepsis as they exert their beneficial effects across the spectrum of processes and factors involved in sepsis pathology, including, but not limited to, metabolism, infection, inflammation, immune modulation, immune enhancement, and gut microbiota.
脓毒症是一种危及生命的病症,由感染引起的异常免疫反应导致,目前尚无批准的或特定的治疗方法。我们提出了通过四步方法治疗脓毒症的观点:(1)通过免疫增强控制感染;(2)在初始过度炎症阶段进行免疫抑制;(3)平衡免疫调节以对抗后期免疫麻痹阶段;(4)在整个过程中对代谢和凝血参数产生有利影响。COVID-19 是一种由病毒引发的、加速的类似脓毒症的反应,与涉及细胞因子风暴和多器官衰竭的炎症级联的快速进展有关。在这里,我们根据 β-葡聚糖(BRMGs)在 COVID-19 临床研究中对炎症-免疫事件的有益影响,讨论了其在脓毒症管理中的潜在应用。在 COVID-19 患者中,除了代谢调节外,BRMGs,源自一种黑酵母,菌株 AFO-202,已被报道能刺激免疫反应。另一种菌株(N-163)产生的 BRMGs 被认为能调节有益的炎症标志物和免疫,即白细胞介素-6(IL-6)、C 反应蛋白(CRP)、D-二聚体、铁蛋白、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与 CRP 比值(LCR)、白细胞与 CRP 比值(LeCR)和白细胞与 IL-6 比值(LeIR)。这些 β-葡聚糖等安全的药物,由于几十年来已被人类广泛食用,具有作为脓毒症预防和治疗辅助药物的潜力,因为它们对脓毒症病理涉及的各种过程和因素发挥有益作用,包括但不限于代谢、感染、炎症、免疫调节、免疫增强和肠道微生物群。