Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Allergology, Campus Benjamin Franklin, Berlin, Germany.
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
Eur J Immunol. 2023 Oct;53(10):e2350433. doi: 10.1002/eji.202350433. Epub 2023 Jul 12.
For targeted intervention in coronavirus disease 2019 (COVID-19), there is a high medical need for biomarkers that predict disease progression and severity in the first days after symptom onset. This study assessed the utility of early transforming growth factor β (TGF-β) serum levels in COVID-19 patients to predict disease severity, fatality, and response to dexamethasone therapy. Patients with severe COVID-19 had significantly higher TGF-β levels (416 pg/mL) as compared to patients with mild (165 pg/mL, p < 0.0001) or moderate COVID-19 (241 pg/mL; p < 0.0001). Receiver operating characteristics area under the curve values were 0.92 (95% confidence interval [CI] 0.85-0.99, cut-off: 255 pg/mL) for mild versus severe COVID-19, and 0.83 (95% CI 0.65-1.0, cut-off: 202 pg/mL) for moderate versus severe COVID-19. Patients who died of severe COVID-19 had significantly higher TGF-β levels (453 pg/mL) as compared to convalescent patients (344 pg/mL), and TGF-β levels predicted fatality (area under the curve: 0.75, 95% CI 0.53-0.96). TGF-β was significantly reduced in severely ill patients treated with dexamethasone (301 pg/mL) as compared to untreated patients (416 pg/mL; p < 0.05). Early TGF-β serum levels in COVID-19 patients predict, with high accuracy, disease severity, and fatality. In addition, TGF-β serves as a specific biomarker to assess response to dexamethasone treatment.
为了对 2019 年冠状病毒病（COVID-19）进行靶向干预，非常需要生物标志物来预测症状出现后最初几天的疾病进展和严重程度。本研究评估了 COVID-19 患者早期转化生长因子β（TGF-β）血清水平预测疾病严重程度、死亡率和对地塞米松治疗反应的效用。严重 COVID-19 患者的 TGF-β 水平（416 pg/mL）明显高于轻度（165 pg/mL，p < 0.0001）或中度 COVID-19 患者（241 pg/mL；p < 0.0001）。轻度与严重 COVID-19 患者之间的受试者工作特征曲线下面积值为 0.92（95%置信区间[CI] 0.85-0.99，截断值：255 pg/mL），中度与严重 COVID-19 患者之间为 0.83（95% CI 0.65-1.0，截断值：202 pg/mL）。死于严重 COVID-19 的患者的 TGF-β 水平（453 pg/mL）明显高于恢复期患者（344 pg/mL），TGF-β 水平可预测死亡率（曲线下面积：0.75，95% CI 0.53-0.96）。与未接受治疗的患者（416 pg/mL）相比，接受地塞米松治疗的重症患者（301 pg/mL）的 TGF-β 水平显著降低（p < 0.05）。COVID-19 患者的早期 TGF-β 血清水平可准确预测疾病严重程度和死亡率。此外，TGF-β 可作为评估地塞米松治疗反应的特异性生物标志物。
