High-dose intravenous immunoglobulins might modulate inflammation in COVID-19 patients

高剂量静脉注射免疫球蛋白可能会调节 COVID-19 患者的炎症

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作者:María Luisa Rodríguez de la Concepción, Erola Ainsua-Enrich, Esteban Reynaga, Carlos Ávila-Nieto, Jose Ramón Santos, Silvia Roure, Lourdes Mateu, Roger Paredes, Jordi Puig, Juan Manuel Jimenez, Nuria Izquierdo-Useros, Bonaventura Clotet, María Luisa Pedro-Botet, Jorge Carrillo

Abstract

The use of high-dose of intravenous immunoglobulins (IVIGs) as immunomodulators for the treatment of COVID-19-affected individuals has shown promising results. IVIG reduced inflammation in these patients, who progressively restored respiratory function. However, little is known about how they may modulate immune responses in COVID-19 individuals. Here, we have analyzed the levels of 41 inflammatory biomarkers in plasma samples obtained at day 0 (pretreatment initiation), 3, 7, and 14 from five hospitalized COVID-19 patients treated with a 5-d course of 400 mg/kg/d of IVIG. The plasmatic levels of several cytokines (Tumor Necrosis Factor, IL-10, IL-5, and IL-7), chemokines (macrophage inflammatory protein-1α), growth/tissue repairing factors (hepatic growth factor), complement activation (C5a), and intestinal damage such as Fatty acid-binding protein 2 and LPS-binding protein showed a progressive decreasing trend during the next 2 wk after treatment initiation. This trend was not observed in IVIG-untreated COVID-19 patients. Thus, the administration of high-dose IVIG to hospitalized COVID-19 patients may improve their clinical evolution by modulating their hyperinflammatory and immunosuppressive status.

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