Clinical Immunology: Diseases Control and Prevention

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Clinical Immunology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 3353

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New York Medical Research Scientist, New York Medical College, New York, NY, USA
Interests: metabolic syndrome; high blood pressure and abnormal cholesterol levels; diabetes and insulin resistance; cardiovascular diseases; kidney damage and fibrosis; nano-medicine and toxicology
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Special Issue Information

Dear Colleagues,

Clinical immunology provides the recent and core information required to understand diseases with an immunological basis, which covers the underlying pathophysiology, the signs and symptoms of disease, the investigations required, and guidance for the management of patients. With the exploration of clinical studies in the control and prevention of general diseases through immunology research, the application of practical immunological techniques and methods and will further introduce new and emerging research.

Recent discoveries from basic and clinical research in the field of clinical immunology have led to significant progress, including a better understanding of the natural histories of diseases, risk predictors, and treatment options and strategies. This knowledge developed from a mechanistic approach focusing on disease symptoms and complex immunological pathways as well. However, the complexity of the immune system has led to some intrinsic obstacles with clinical research, particularly in relation to targeting the right genes, identifying the appropriate patient populations, and accessing internal tissues for testing. Therefore, the scope and aim of this Special Issue is to cover recent studies on medicines and immunological therapies in clinical research, and to deliver a comprehensive concept and examples in daily life.

Dr. Shailendra Pratap Singh
Guest Editor

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Keywords

  • metabolic syndrome
  • clinical infections
  • immunology therapeutics

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Published Papers (1 paper)

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Research

18 pages, 2365 KiB  
Article
Patients with SARS-CoV-2-Induced Viral Sepsis Simultaneously Show Immune Activation, Impaired Immune Function and a Procoagulatory Disease State
by Andreas Limmer, Andrea Engler, Simone Kattner, Jonas Gregorius, Kevin Thomas Pattberg, Rebecca Schulz, Jansje Schwab, Johannes Roth, Thomas Vogl, Adalbert Krawczyk, Oliver Witzke, Gennadiy Zelinskyy, Ulf Dittmer, Thorsten Brenner and Marc Moritz Berger
Vaccines 2023, 11(2), 435; https://doi.org/10.3390/vaccines11020435 - 13 Feb 2023
Cited by 5 | Viewed by 2911
Abstract
Background: It is widely accepted that SARS-CoV-2 causes a dysregulation of immune and coagulation processes. In severely affected patients, viral sepsis may result in life endangering multiple organ dysfunction. Furthermore, most therapies for COVID-19 patients target either the immune system or coagulation processes. [...] Read more.
Background: It is widely accepted that SARS-CoV-2 causes a dysregulation of immune and coagulation processes. In severely affected patients, viral sepsis may result in life endangering multiple organ dysfunction. Furthermore, most therapies for COVID-19 patients target either the immune system or coagulation processes. As the exact mechanism causing SARS-CoV-2-induced morbidity and mortality was unknown, we started an in-depth analysis of immunologic and coagulation processes. Methods: 127 COVID-19 patients were treated at the University Hospital Essen, Germany, between May 2020 and February 2022. Patients were divided according to their maximum COVID-19 WHO ordinal severity score (WHO 0–10) into hospitalized patients with a non-severe course of disease (WHO 4–5, n = 52) and those with a severe course of disease (WHO 6–10, n = 75). Non-infected individuals served as healthy controls (WHO 0, n = 42). Blood was analyzed with respect to cell numbers, clotting factors, as well as pro- and anti-inflammatory mediators in plasma. As functional parameters, phagocytosis and inflammatory responses to LPS and antigen-specific stimulation were determined in monocytes, granulocytes, and T cells using flow cytometry. Findings: In the present study, immune and coagulation systems were analyzed simultaneously. Interestingly, many severe COVID-19 patients showed an upregulation of pro-inflammatory mediators and at the same time clear signs of immunosuppression. Furthermore, severe COVID-19 patients not only exhibited a disturbed immune system, but in addition showed a pronounced pro-coagulation phenotype with impaired fibrinolysis. Therefore, our study adds another puzzle piece to the already complex picture of COVID-19 pathology implying that therapies in COVID-19 must be individualized. Conclusion: Despite years of research, COVID-19 has not been understood completely and still no therapies exist, fitting all requirements and phases of COVID-19 disease. This observation is highly reminiscent to sepsis. Research in sepsis has been going on for decades, while the disease is still not completely understood and therapies fitting all patients are lacking as well. In both septic and COVID-19 patients, immune activation can be accompanied by immune paralysis, complicating therapeutic intervention. Accordingly, therapies that lower immune activation may cause detrimental effects in patients, who are immune paralyzed by viral infections or sepsis. We therefore suggest individualizing therapies and to broaden the spectrum of immunological parameters analyzed before therapy. Only if the immune status of a patient is understood, can a therapeutic intervention be successful. Full article
(This article belongs to the Special Issue Clinical Immunology: Diseases Control and Prevention)
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