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Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS
Background. Glucocorticoids (GCs) have been shown to reduce mortality and the need for invasive mechanical ventilation (IMV) in SARS-CoV-2-induced acute respiratory distress syndrome (ARDS). It has been suggested that serum cytokines levels are markers of disease severity in ARDS, although there is...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180983/ https://www.ncbi.nlm.nih.gov/pubmed/35683340 http://dx.doi.org/10.3390/jcm11112951 |
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author | Salton, Francesco Confalonieri, Paola Campisciano, Giuseppina Cifaldi, Rossella Rizzardi, Clara Generali, Daniele Pozzan, Riccardo Tavano, Stefano Bozzi, Chiara Lapadula, Giulia Meduri, Gianfranco Umberto Confalonieri, Marco Comar, Manola Lerda, Selene Ruaro, Barbara |
author_facet | Salton, Francesco Confalonieri, Paola Campisciano, Giuseppina Cifaldi, Rossella Rizzardi, Clara Generali, Daniele Pozzan, Riccardo Tavano, Stefano Bozzi, Chiara Lapadula, Giulia Meduri, Gianfranco Umberto Confalonieri, Marco Comar, Manola Lerda, Selene Ruaro, Barbara |
author_sort | Salton, Francesco |
collection | PubMed |
description | Background. Glucocorticoids (GCs) have been shown to reduce mortality and the need for invasive mechanical ventilation (IMV) in SARS-CoV-2-induced acute respiratory distress syndrome (ARDS). It has been suggested that serum cytokines levels are markers of disease severity in ARDS, although there is only limited evidence of a relationship between the longitudinal cytokine profile and clinical outcomes in patients with SARS-CoV-2-induced ARDS treated with GC. Methods. We conducted a single-center observational study to investigate serial plasma cytokine levels in 17 patients supported with non-invasive ventilation (NIV) in order to compare the response in five patients who progressed to IMV versus 12 patients who continued with NIV alone. All patients received methylprednisolone 80 mg/day continuous infusion until clinical improvement. Results. The study groups were comparable at baseline. All patients survived. Although IL-6 was higher in the NIV group at baseline, several cytokines were significantly higher in the IMV group on day 7 (IL-6, IL-8, IL-9, G-CSF, IP-10, MCP-1, MIP-1α) and 14 (IL-6, IL-8, IL-17, G-CSF, MIP-1α, RANTES). No significant differences were observed between groups on day 28. Conclusions. Patients in the IMV group had higher inflammation levels at intubation than the NIV group, which may indicate a higher resistance to glucocorticoids. Higher GC doses or a longer treatment duration in these patients might have allowed for a better control of inflammation and a better outcome. Further studies are required to define the prognostic value of cytokine patterns, in terms of both GC treatment tailoring and timely initiation of IMV. |
format | Online Article Text |
id | pubmed-9180983 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91809832022-06-10 Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS Salton, Francesco Confalonieri, Paola Campisciano, Giuseppina Cifaldi, Rossella Rizzardi, Clara Generali, Daniele Pozzan, Riccardo Tavano, Stefano Bozzi, Chiara Lapadula, Giulia Meduri, Gianfranco Umberto Confalonieri, Marco Comar, Manola Lerda, Selene Ruaro, Barbara J Clin Med Article Background. Glucocorticoids (GCs) have been shown to reduce mortality and the need for invasive mechanical ventilation (IMV) in SARS-CoV-2-induced acute respiratory distress syndrome (ARDS). It has been suggested that serum cytokines levels are markers of disease severity in ARDS, although there is only limited evidence of a relationship between the longitudinal cytokine profile and clinical outcomes in patients with SARS-CoV-2-induced ARDS treated with GC. Methods. We conducted a single-center observational study to investigate serial plasma cytokine levels in 17 patients supported with non-invasive ventilation (NIV) in order to compare the response in five patients who progressed to IMV versus 12 patients who continued with NIV alone. All patients received methylprednisolone 80 mg/day continuous infusion until clinical improvement. Results. The study groups were comparable at baseline. All patients survived. Although IL-6 was higher in the NIV group at baseline, several cytokines were significantly higher in the IMV group on day 7 (IL-6, IL-8, IL-9, G-CSF, IP-10, MCP-1, MIP-1α) and 14 (IL-6, IL-8, IL-17, G-CSF, MIP-1α, RANTES). No significant differences were observed between groups on day 28. Conclusions. Patients in the IMV group had higher inflammation levels at intubation than the NIV group, which may indicate a higher resistance to glucocorticoids. Higher GC doses or a longer treatment duration in these patients might have allowed for a better control of inflammation and a better outcome. Further studies are required to define the prognostic value of cytokine patterns, in terms of both GC treatment tailoring and timely initiation of IMV. MDPI 2022-05-24 /pmc/articles/PMC9180983/ /pubmed/35683340 http://dx.doi.org/10.3390/jcm11112951 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Salton, Francesco Confalonieri, Paola Campisciano, Giuseppina Cifaldi, Rossella Rizzardi, Clara Generali, Daniele Pozzan, Riccardo Tavano, Stefano Bozzi, Chiara Lapadula, Giulia Meduri, Gianfranco Umberto Confalonieri, Marco Comar, Manola Lerda, Selene Ruaro, Barbara Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title | Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title_full | Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title_fullStr | Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title_full_unstemmed | Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title_short | Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS |
title_sort | cytokine profiles as potential prognostic and therapeutic markers in sars-cov-2-induced ards |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180983/ https://www.ncbi.nlm.nih.gov/pubmed/35683340 http://dx.doi.org/10.3390/jcm11112951 |
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