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Systemic Immune Inflammatory Disease: New Updates

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 15124

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Special Issue Editor

Dr. Alessandro Perrella

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Guest Editor

VII Department of Infectious Disease and Immunology, AORN Ospedali dei Colli, Naples, Italy
Interests: immunological defects; infectious diseases; chronic inflammatory immunological diseases; big analytic data & eHealth
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Inflammation is the immune system's response to harmful endogenous or exogenous stimuli, such as pathogens, damaged cells, toxic compounds, or irradiation. All process and mechanisms related to inflammation have the main purpose to remove injurious stimuli and to initiate the healing process. Therefore, inflammation is a defense mechanism that is vital to health when homeostasis is granted. Therefore, usually, during acute inflammatory responses, cellular and molecular events and interactions efficiently minimize impending injury or infection. This mitigation process contributes to the restoration of tissue homeostasis and the resolution of the acute inflammation. However, uncontrolled acute inflammation may become an acute or chronic issue for the organisms, contributing to a variety of illnesses and possible evolving chronic inflammatory diseases. COVID-19 has shown how unregulated inflammation may be harmful determining exitus, particularly when present with other disorders.

This Special Issue of Journal Clinical Medicine would focus attention on those aspects of inflammation mechanisms and inflammatory states disease related that represents an issue in clinical practice. Therefore, inflammatory-state SARS-CoV-2-related, uncontrolled, acute inflammation responses during or after viral infection or sepsis, inflammation state, post-solid organ transplant, as well as treatment aiming to regulate this response would represent an optima target of this Special Issue.

Currently, incredible improvements were made in this medical research field, and we think that worldwide experiences could be a very interesting point of discussion for scientific community

Dr. Alessandro Perrella
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

infectious diseases
inflammation
acute inflammatory responses
inflammatory states disease

Published Papers (9 papers)

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Research

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7 pages, 519 KiB

Open AccessArticle

Exploring the Risk Factors for Poor Survival in Lupus Pericarditis Patients: A Retrospective Cohort Study

by Yen-Fu Chen, Meng-Ru Hsieh, Che-Tzu Chang, Ping-Han Tsai and Yao-Fan Fang

J. Clin. Med. 2022, 11(18), 5473; https://doi.org/10.3390/jcm11185473 - 17 Sep 2022

Cited by 1 | Viewed by 1475

Abstract

Patients with systemic lupus erythematosus (SLE) have a higher risk of pericarditis, which could be fatal. The goal of this study was to identify the prognostic factors for mortality in patients with lupus pericarditis. Patients with lupus pericarditis treated at Chang Gung Memorial Hospital were included in this observational cohort study. This study conducted univariate and multivariate COX regression, as well as Kaplan–Meier survival curve analysis, to investigate mortality risk in SLE patients. The average age at admission was 40.78 ± 15.92 years. A total of 113 (16.4%) of the 689 patients had lupus pericarditis. Patients with lupus pericarditis exhibited older age, shorter follow-up, higher disease activities, and higher incidence rates of comorbidities than patients without pericarditis. Cox regression adjusted analysis indicated that lupus pericarditis (hazard ratio = 1.963, 95% CI = 1.315, 2.963, p = 0.001), old age at admission (HR = 1.053, 95% CI = 1.040, 1.065, p < 0.001), high SLEDAI score (HR = 1.079, 95% CI = 1.043, 1.116, p < 0.001), and end-stage kidney disease (ESKD) (HR = 2.533, 95% CI = 1.620, 3.961, p < 0.001) were all linked to increased mortality. Moreover, the Kaplan–Meier survival curve analysis revealed that patients with pericarditis compared to those without pericarditis had a higher mortality rate (log-rank test, p < 0.001). A high proportion of SLE patients have manifestations of lupus pericarditis. Moreover, patients with lupus pericarditis have a greater risk of mortality even if they have no pericardial tamponade. Therefore, these patients need prompt diagnosis and treatment. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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7 pages, 1197 KiB

Open AccessArticle

Differential Regulation of CD45 Expression on Granulocytes, Lymphocytes, and Monocytes in COVID-19

by Muhammad G. T. Ahmed, Andreas Limmer, Christoph Sucker, Khaled Mohamed Fares, Sahar Abdel-Baky Mohamed, Ahmed H. Othman, Marc Moritz Berger, Thorsten Brenner and Matthias Hartmann

J. Clin. Med. 2022, 11(14), 4219; https://doi.org/10.3390/jcm11144219 - 20 Jul 2022

Cited by 5 | Viewed by 1827

Abstract

CD45 is a transmembrane glycoprotein and protein tyrosine phosphatase expressed on the surface of all nucleated hematopoietic cells. While there is increasing evidence demonstrating the involvement of CD45 in immune system regulation, no information on CD45 expression in inflammation and sepsis is currently available. Therefore, we determined the CD45 surface expression on granulocytes, lymphocytes, and monocytes in patients with COVID-19 and healthy volunteers in both absence and presence of lipopolysaccharide (LPS). Following approval by the local ethics committee, whole blood samples were obtained from patients with COVID-19 infection on day 1 of hospital admission and healthy volunteers. Samples were incubated in absence and presence of LPS and CD45 was measured in granulocytes, lymphocytes, and monocytes using flow cytometry. In comparison with healthy individuals, COVID-19 patients showed an increased CD45 expression on the surface of granulocytes (+35%, p < 0.02) and lymphocytes (+39%, p < 0.0001), but a reduced CD45 expression on monocytes (−35%, p < 0.0001). LPS incubation of whole blood from healthy individuals increased the CD45 expression on granulocytes (+430%, p < 0.0001), lymphocytes (+32%, p = 0.0012), and monocytes (+36%, p = 0.0005), respectively. LPS incubation of whole blood samples from COVID-19 patients increased the CD45 expression on granulocytes and monocytes, and decreased the CD45 expression on lymphocytes. In conclusion, CD45 expression on leucocytes is altered: (1) in COVID-19 patients, and (2) in in vitro endotoxemia in a complex cell-specific way, thus representing a new immunoregulatory mechanism. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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10 pages, 285 KiB

Open AccessArticle

Aseptic Abscess Syndrome: Clinical Characteristics, Associated Diseases, and up to 30 Years’ Evolution Data on a 71-Patient Series

by Ludovic Trefond, Camille Frances, Nathalie Costedoat-Chalumeau, Jean-Charles Piette, Julien Haroche, Laurent Sailler, Souad Assaad, Jean-François Viallard, Patrick Jego, Arnaud Hot, Jerome Connault, Jean-Marc Galempoix, Elisabeth Aslangul, Nicolas Limal, Fabrice Bonnet, Stanislas Faguer, Olivier Chosidow, Christophe Deligny, François Lifermann, Alexandre Thibault Jacques Maria, Bruno Pereira, Olivier Aumaitre, Marc André and on behalf of the French Study Group on Aseptic Abscesses Show full author list Hide full author list

J. Clin. Med. 2022, 11(13), 3669; https://doi.org/10.3390/jcm11133669 - 25 Jun 2022

Cited by 10 | Viewed by 2593

Abstract

Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; 95% CI [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35–3.40]; p = 0.001 and HR 1.78; 95% CI [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

10 pages, 993 KiB

Open AccessArticle

Prediction of SARS-CoV-2-Related Lung Inflammation Spreading by V:ERITAS (Vanvitelli Early Recognition of Inflamed Thoracic Areas Spreading)

by Ciro Romano, Domenico Cozzolino, Giovanna Cuomo, Marianna Abitabile, Caterina Carusone, Francesca Cinone, Francesco Nappo, Riccardo Nevola, Ausilia Sellitto, Annamaria Auricchio, Francesca Cardella, Giovanni Del Sorbo, Eva Lieto, Gennaro Galizia, Luigi Elio Adinolfi, Aldo Marrone and Luca Rinaldi

J. Clin. Med. 2022, 11(9), 2434; https://doi.org/10.3390/jcm11092434 - 26 Apr 2022

Cited by 3 | Viewed by 1844

Abstract

Background Coronavirus disease 2019 (COVID-19) can be complicated by interstitial pneumonia, possibly leading to severe acute respiratory failure and death. Because of variable evolution ranging from asymptomatic cases to the need for invasive ventilation, COVID-19 outcomes cannot be precisely predicted on admission. The aim of this study was to provide a simple tool able to predict the outcome of COVID-19 pneumonia on admission to a low-intensity ward in order to better plan management strategies for these patients. Methods The clinical records of 123 eligible patients were reviewed. The following variables were analyzed on admission: chest computed tomography severity score (CTSS), PaO₂/FiO₂ ratio, lactate dehydrogenase (LDH), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio, C-reactive protein (CRP), fibrinogen, D-dimer, aspartate aminotransferase (AST), alanine aminotransferase, alkaline phosphatase, and albumin. The main outcome was the intensity of respiratory support (RS). To simplify the statistical analysis, patients were split into two main groups: those requiring no or low/moderate oxygen support (group 1); and those needing subintensive/intensive RS up to mechanical ventilation (group 2). Results The RS intensity was significantly associated with higher CTSS and NLR scores; lower PaO₂/FiO₂ ratios; and higher serum levels of LDH, CRP, D-dimer, and AST. After multivariate logistic regression and ROC curve analysis, CTSS and LDH were shown to be the best predictors of respiratory function worsening. Conclusions Two easy-to-obtain parameters (CTSS and LDH) were able to reliably predict a worse evolution of COVID-19 pneumonia with values of >7 and >328 U/L, respectively. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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8 pages, 516 KiB

Open AccessBrief Report

Sepsis Outcome after Major Abdominal Surgery Does Not Seem to Be Improved by the Use of Pentameric Immunoglobulin IgM: A Single-Center Retrospective Analysis

by Alessandro Perrella, Luca Rinaldi, Ilaria Guarino, Francesca Futura Bernardi, Maurizio Castriconi, Carmine Antropoli, Pia Clara Pafundi, Pierpaolo Di Micco, Marina Sarno, Nicolina Capoluongo, Giuseppina Minei, Marco Perrella, Antonio Frangiosa and Annalisa Capuano

J. Clin. Med. 2023, 12(21), 6887; https://doi.org/10.3390/jcm12216887 - 31 Oct 2023

Viewed by 825

Abstract

Background: Sepsis still represents a major public health issue worldwide, and the immune system plays a main role during infections; therefore, its activity is mandatory to resolve this clinical condition. In this report, we aimed to retrospectively verify in a real-life setting the possible usefulness of pentameric IgM plus antibiotics in recovering patients with sepsis after major abdominal surgery. Materials/methods: We reviewed, from January 2013 until December 2019, all adult patients admitted to the ICU for sepsis or septic shock (2) after major abdominal surgery. Among these patients, were identified those that, according to legal indication and licenses in Italy, were treated with pentameric IgM plus antibiotics (Group A) or with antibiotics alone (Group B). The following parameters were evaluated: blood gas analysis, lactate, CRP, procalcitonin, endotoxin activity, liver and renal function, coagulation and blood cell count at different time points (every 48 h for at least 7 days). Differences between groups were analyzed using Fisher’s exact test or a chi-square test for categorical variables. A Mann–Whitney U test or Kruskal–Wallis test were instead been performed to compare continuous variables. Univariate and multivariate analysis were also performed. Results: Over a period of 30 months, 24 patients were enrolled in Group A and 20 patients in Group B. In those subjects, no statistical differences were found in terms of bacterial or fungal infection isolates, when detected in a blood culture test, or according to inflammatory index, a score, lactate levels and mortality rate. A 48 h response was statistically more frequent in Group B than in Group A, while no differences were found in other clinical and laboratory evaluations. Conclusions: Based on our results, the use of pentameric IgM does not seem to give any clinical advantages in preventing sepsis after major abdominal surgery. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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8 pages, 1585 KiB

Open AccessCase Report

Case Report: Spontaneous Left Inferior Epigastric Artery Injury in a COVID-19 Female Patient Undergoing Anticoagulation Therapy

by Hristo Abrashev, Julian Ananiev and Ekaterina Georgieva

J. Clin. Med. 2023, 12(5), 1842; https://doi.org/10.3390/jcm12051842 - 25 Feb 2023

Viewed by 1410

Abstract

Since the beginning of the pandemic, a recommendation was made for the use of anticoagulants in high-risk hospitalized patients. This therapeutic approach has positive and negative effects regarding the outcome of the disease. Anticoagulant therapy prevents thromboembolic events, but it can also lead to spontaneous hematoma formation, or be accompanied by massive active bleeding. We present a 63-year-old COVID-19-positive female patient with a massive retroperitoneal hematoma and spontaneous left inferior epigastric artery injury. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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8 pages, 668 KiB

Open AccessCase Report

Treatment of Severe Swallowing Dysfunction in Systemic Sclerosis with IVIG: Role of Antimuscarinic Antibodies

by Fabian A. Mendoza, Anthony DiMarino, Sidney Cohen, Christopher Adkins, Shady Abdelbaki, Satish Rattan, Christopher Cao, Susie Denuna-Rivera and Sergio A. Jimenez

J. Clin. Med. 2022, 11(22), 6665; https://doi.org/10.3390/jcm11226665 - 10 Nov 2022

Cited by 3 | Viewed by 1945

Abstract

Oropharyngeal and esophageal dysmotility can cause serious clinical complications such as aspiration pneumonia, cachexia, and sarcopenia, with a resulting increase in mortality and disability. The current standard of care for the treatment of SSc-associated swallowing dysfunction is mainly supportive, although severe cases are usually refractory to conventional management. Recent studies have shown that the abnormal production of functional autoantibodies such as anti-cholinergic muscarinic receptor III antibodies may participate in the pathogenesis of SSc-associated gastrointestinal dysmotility and may provide a novel target for therapeutic intervention. We describe two patients with severe and rapid onset of SSc-associated severe swallowing dysfunction and esophageal dysmotility who had failed standard of care therapy, requiring complete enteral and parenteral nutrition. Both patients were positive for the presence of circulating antimuscarinic III receptor antibodies. They were treated with IVIG at a dose of 2 g/Kg/month divided in two consecutive days, for six months. Following IVIG therapy, both patients markedly improved their symptoms as shown by a reduction in their UCLA2.0 score, and achieved an improvement of esophageal motility documented radiologically. Both patients resumed oral feeding and had their feeding tubes removed within the treatment period. None of the patients developed severe adverse events attributable to IVIG, except for low-grade fever during IVIG infusion in one of the cases. These results provide support for the role of functional autoantibodies in the development of SSc-associated gastrointestinal dysfunction. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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5 pages, 2712 KiB

Open AccessCase Report

Massive Thrombosis of Mitral Bioprosthesis Due to SARS-CoV-2 Infection

by Mariateresa Librera, Stefania Paolillo, Guido Carlomagno, Gianluca Santise, Antonio Mariniello, Saverio Nardella, Carlo Briguori and Daniele Maselli

J. Clin. Med. 2022, 11(18), 5277; https://doi.org/10.3390/jcm11185277 - 7 Sep 2022

Cited by 1 | Viewed by 1082

Abstract

Thromboembolic events have been reported as frequent and fearsome complications in patients affected by SARS-CoV-2 infection. Patients undergoing cardiac valve replacement exhibit an increased risk of valve thrombosis, even with prosthetic biological valves, and especially in the first period after surgery. The management of these patients is challenging and requires prompt interventions. We report the case of a young woman infected by SARS-CoV-2 three months after double cardiac valve replacement that developed a massive prosthetic biological valve thrombosis despite optimal anticoagulant therapy. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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9 pages, 1748 KiB

Open AccessCase Report

Fatal Acute Heart Failure in the Course of Macrophage Activation Syndrome: Case Report and Literature Review

by Jakub Kuna, Grzegorz Chmielewski, Marcin Gruchała, Jolanta Szade, Mateusz Mikiewicz, Przemysław Ręcki and Magdalena Krajewska-Włodarczyk

J. Clin. Med. 2022, 11(14), 4208; https://doi.org/10.3390/jcm11144208 - 20 Jul 2022

Cited by 1 | Viewed by 1247

Abstract

Macrophage activation syndrome is a severe and potentially fatal condition in rheumatology. It can involve many different organs and systems, including the cardiovascular system, but heart failure due to its course is a relatively rare occurrence. In the following paper, we present a case of a young woman with newly diagnosed systemic lupus erythematosus who, in the span of two months, developed macrophage activation syndrome and acute heart failure, which caused her death. We analyze potential causes that may have led to that outcome, and present a brief review of the current literature concerning different macrophage groups in the heart and their potential involvement in the development of heart failure. Full article

(This article belongs to the Special Issue Systemic Immune Inflammatory Disease: New Updates)

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