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接受恢复期血浆治疗的COVID-19患者细胞因子、SARS-CoV-2特异性IgG和中和抗体水平的动态变化

Dynamics of Cytokine, SARS-CoV-2-Specific IgG, and Neutralizing Antibody Levels in COVID-19 Patients Treated with Convalescent Plasma.

作者信息

Pratedrat Pornpitra, Intharasongkroh Duangnapa, Chansaenroj Jira, Vichaiwattana Preeyaporn, Srimuan Donchida, Thatsanatorn Thaksaporn, Klinfueng Sirapa, Nilyanimit Pornjarim, Chirathaworn Chintana, Kupatawintu Pawinee, Chaiwanichsiri Dootchai, Wanlapakorn Nasamon, Poovorawan Yong

机构信息

Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

Department of Basic Medical Science, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand.

出版信息

Diseases. 2023 Aug 30;11(3):112. doi: 10.3390/diseases11030112.

Abstract

Coronavirus disease 2019 (COVID-19) is a contagious illness worldwide. While guidelines for the treatment of COVID-19 have been established, the understanding of the relationship among neutralizing antibodies, cytokines, and the combined use of antiviral medications, steroid drugs, and convalescent plasma therapy remains limited. Here, we investigated the connection between the immunological response and the efficacy of convalescent plasma therapy in COVID-19 patients with moderate-to-severe pneumonia. The study included a retrospective analysis of 49 patients aged 35 to 57. We conducted clinical assessments to determine antibody levels, biochemical markers, and cytokine levels. Among the patients, 48 (98%) were discharged, while one died. We observed significantly higher levels of anti-nucleocapsid, anti-spike, and neutralizing antibodies on days 3, 7, and 14 after the transfusion compared to before treatment. Serum CRP and D-dimer levels varied significantly across these four time points. Moreover, convalescent plasma therapy demonstrated an immunoregulatory effect on cytokine parameters, with significant differences in IFN-β, IL-6, IL-10, and IFN-α levels observed at different sampling times. Evaluating the cytokine signature, along with standard clinical and laboratory parameters, may help to identify the onset of a cytokine storm in COVID-19 patients and determine the appropriate indication for anti-cytokine treatment.

摘要

2019冠状病毒病(COVID-19)是一种全球性的传染性疾病。虽然已经制定了COVID-19的治疗指南,但对于中和抗体、细胞因子以及抗病毒药物、类固醇药物和康复期血浆疗法联合使用之间的关系,人们的了解仍然有限。在此,我们研究了中度至重度肺炎COVID-19患者的免疫反应与康复期血浆疗法疗效之间的联系。该研究包括对49名年龄在35至57岁之间的患者进行回顾性分析。我们进行了临床评估以确定抗体水平、生化标志物和细胞因子水平。在这些患者中,48人(98%)出院,1人死亡。我们观察到,与治疗前相比,输血后第3天、第7天和第14天的抗核衣壳、抗刺突和中和抗体水平显著更高。血清CRP和D-二聚体水平在这四个时间点上有显著差异。此外,康复期血浆疗法对细胞因子参数具有免疫调节作用,在不同采样时间观察到IFN-β、IL-6、IL-10和IFN-α水平存在显著差异。评估细胞因子特征以及标准的临床和实验室参数,可能有助于识别COVID-19患者细胞因子风暴的发作,并确定抗细胞因子治疗的适当适应症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0be/10527804/457ad69692dc/diseases-11-00112-g001.jpg

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