Th1/Th2/Th17/TREG and TLRs Activation/KIR for COVID 19 Prediction of Outcome (Resistir)

Asociacion para el Estudio de las Enfermedades Infecciosas

Status: Completed

Conditions: Cytokine Release Syndrome; Disease, Viral; TLRs

Treatments: Diagnostic Test: KIR phenotype evaluation; Diagnostic Test: Cellular response; Diagnostic Test: Cytokines measurement; Diagnostic Test: TLRs activation measurement

Study type: Observational

Funder types: Other; NETWORK

Identifiers

NCT04403061

EC128/20

Details and patient eligibility

About

To ascertain globally the changes in the cytokines involved and TLRs/KIR activation in patients admitted to the hospital with a COVID-19 diagnosis, and the changes after initiation of the different therapies

Full description

COVID-19 is a disease with an initial viral phase followed, usually at the 7th day, of an inflammatory state (cytokine storm) leading to respiratory distress, ICU admission and risk of death. Thus, several biological agents, antagonists of the different cytokines (IL-6, IL-1) have been used for patients with severe disease. However, there are no data about the cytokine changes, at admission and after therapy, and its predictive value, a fundamental knowledge to establish the best therapeutic strategy.

The first line of immune defense is the interaction of the virus with innate immunity cell members. The toll like receptors (TLRs) family is a group of pattern recognition receptors that include many different molecules (21-23). These bindings can activate dendritic cells, monocytes, macrophages. There is an important RNA and DNA connection, activation of TLRs, the production of type I interferons, and the development of some autoimmune diseases. TLR7 and TLR8 specifically recognize simple-chain RNA of viruses and are expressed in endosomal membranes. TLR8 is expressed in regulatory cells (Treg) and its activation results in inhibition of its regulatory functions. Natural killer cells (NK) respond to alterations of class I HLA molecules present in infected cells (24-26). An increase in class I HLA expression could lead to an increase in NK activation by increasing its ability to produce IFN-gamma. Therefore, the reasons for KIR binding are often variable between individuals and between populations.

Enrollment: 106 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with a diagnosis of COVID-19 (PCR confirmed)

Exclusion criteria

• No informed consent
• Presence of chronic therapy with immunomodulators, corticoids or antineoplastic agents.