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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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