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10.1136/thoraxjnl-2020-216256

http://scihub22266oqcxt.onion/10.1136/thoraxjnl-2020-216256
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suck abstract from ncbi


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pmid33846275      Thorax 2021 ; 76 (10): 1010-1019
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  • Distinct cellular immune profiles in the airways and blood of critically ill patients with COVID-19 #MMPMID33846275
  • Saris A; Reijnders TDY; Nossent EJ; Schuurman AR; Verhoeff J; Asten SV; Bontkes H; Blok S; Duitman J; Bogaard HJ; Heunks L; Lutter R; van der Poll T; Garcia Vallejo JJ
  • Thorax 2021[Oct]; 76 (10): 1010-1019 PMID33846275show ga
  • BACKGROUND: Knowledge of the pathophysiology of COVID-19 is almost exclusively derived from studies that examined the immune response in blood. We here aimed to analyse the pulmonary immune response during severe COVID-19 and to compare this with blood responses. METHODS: This was an observational study in patients with COVID-19 admitted to the intensive care unit (ICU). Mononuclear cells were purified from bronchoalveolar lavage fluid (BALF) and blood, and analysed by spectral flow cytometry; inflammatory mediators were measured in BALF and plasma. FINDINGS: Paired blood and BALF samples were obtained from 17 patients, four of whom died in the ICU. Macrophages and T cells were the most abundant cells in BALF, with a high percentage of T cells expressing the ydelta T cell receptor. In the lungs, both CD4 and CD8 T cells were predominantly effector memory cells (87.3% and 83.8%, respectively), and these cells expressed higher levels of the exhaustion marker programmad death-1 than in peripheral blood. Prolonged ICU stay (>14 days) was associated with a reduced proportion of activated T cells in peripheral blood and even more so in BALF. T cell activation in blood, but not in BALF, was higher in fatal COVID-19 cases. Increased levels of inflammatory mediators were more pronounced in BALF than in plasma. INTERPRETATION: The bronchoalveolar immune response in COVID-19 has a unique local profile that strongly differs from the immune profile in peripheral blood. Fully elucidating COVID-19 pathophysiology will require investigation of the pulmonary immune response.
  • |Aged[MESH]
  • |Bronchoalveolar Lavage Fluid/chemistry/cytology[MESH]
  • |COVID-19/blood/*immunology/pathology[MESH]
  • |Critical Care[MESH]
  • |Critical Illness[MESH]
  • |Female[MESH]
  • |Flow Cytometry[MESH]
  • |Humans[MESH]
  • |Immunity, Cellular/*physiology[MESH]
  • |Inflammation Mediators/*metabolism[MESH]
  • |Macrophages/physiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]


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