ABSTRACT
Background: Fibrotic hypersensitivity pneumonitis (fHP) is an immune-mediated interstitial lung disease caused by sensitisation to chronic allergen inhalation. This study aimed to determine prognostic indicators of progression and mortality in fHP. Methods: This was a retrospective, multicentre, observational, cross-sectional cohort study of consecutive patients diagnosed with fHP from 1 January 2012 to 31 December 2021. Multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% confidence intervals for predictors of progression and survival. Results: A total of 403 patients were diagnosed with fHP: median (interquartile range) age 66.5 (14.0)â years, 51.9% females and 55.1% never-smokers. The cause of fHP was mainly fungal (39.7%) or avian (41.4%). Lung biopsy was performed in 269 cases (66.7%). In the whole cohort the variables that were related to mortality or lung transplant were older age (HR 1.08; p<0.001), percentage predicted forced vital capacity (HR 0.96; p=0.001), lymphocytosis in bronchoalveolar lavage (BAL) (HR 0.93; p=0.001), presence of acute exacerbation during follow-up (HR 3.04; p=0.001) and GAP (gender, age and lung physiology) index (HR 1.96; p<0.01). In the group of biopsied patients, the presence of fibroblastic foci at biopsy (HR 8.39; p<0.001) stands out in multivariate Cox regression analyses as a highly significant predictor for increased mortality or lung transplant. GAP index (HR 1.26; p=0.009), lymphocytosis in BAL (HR 0.97; p=0.018) and age (HR 1.03; p=0.018) are also predictors of progression. Conclusions: The study identified several prognostic factors for progression and/or survival in fHP. The presence of fibroblastic foci at biopsy was a consistent predictor for increased mortality and the presence of lymphocytosis in BAL was inversely related to mortality.
ABSTRACT
The study of specific T-cell responses against SARS-CoV-2 is important for understanding long-term immunity and infection management. The aim of this study was to assess the dual IFN-γ and IL-2 detection, using a SARS-CoV-2 specific fluorescence ELISPOT, in patients undergoing acute disease, during convalescence, and after vaccination. We also evaluated humoral response and compared with T-cells with the aim of correlating both types of responses, and increase the number of specific response detection. Blood samples were drawn from acute COVID-19 patients and convalescent individuals classified according to disease severity; and from unvaccinated and vaccinated uninfected individuals. IgGs against Spike and nucleocapsid, IgMs against nucleocapsid, and neutralizing antibodies were also analyzed. Our results show that IFN-γ in combination with IL-2 increases response detection in acute and convalescent individuals (p = 0.023). In addition, IFN-γ detection can be a useful biomarker for monitoring severe acute patients, as our results indicate that those individuals with a poor outcome have lower levels of this cytokine. In some cases, the lack of cellular immunity is compensated by antibodies, confirming the role of both types of immune responses in infection, and confirming that their dual detection can increase the number of specific response detections. In summary, IFN-γ/IL-2 dual detection is promising for characterizing and assessing the immunization status, and helping in the patient management.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Interleukin-2 , Immunity, Cellular , Antibodies, Neutralizing , Antibodies, Viral , Immunity, HumoralSubject(s)
Humans , Male , Female , Middle Aged , Aged , Asthma/complications , Respiratory System , TracheobronchomalaciaABSTRACT
The measurement of specific T-cell responses can be a useful tool for COVID-19 diagnostics and clinical management. In this study, we evaluated the IFN-γ T-cell response against the main SARS-CoV-2 antigens (spike, nucleocapsid and membrane) in acute and convalescent individuals classified according to severity, and in vaccinated and unvaccinated controls. IgG against spike and nucleocapsid were also measured. Spike antigen triggered the highest number of T-cell responses. Acute patients showed a low percentage of positive responses when compared to convalescent (71.6% vs. 91.7%, respectively), but increased during hospitalization and with severity. Some convalescent patients showed an IFN-γ T-cell response more than 200 days after diagnosis. Only half of the vaccinated individuals displayed an IFN-γ T-cell response after the second dose. IgG response was found in a higher percentage of individuals compared to IFN-γ T-cell responses, and moderate correlations between both responses were seen. However, in some acute COVID-19 patients specific T-cell response was detected, but not IgG production. We found that the chances of an IFN-γ T-cell response against SARS-CoV-2 is low during acute phase, but may increase over time, and that only half of the vaccinated individuals had an IFN-γ T-cell response after the second dose.
ABSTRACT
La determinación del grupo sanguíneo y el factor Rh son importantes en el campo de la biología, genética y en la práctica médica por su valor clínico en las transfusiones sanguíneas. Por ello, en la presente investigación se tipificó el grupo sanguíneo de la población de Totora y se analizó su prevalencia tanto en hombres como mujeres. Se realizó un estudio descriptivo, de corte transversal; en una población total de 12 961, del cual se obtuvo una muestra de 175 personas, comprendidas entre las edades de 18 a 84 años que dieron su consentimiento; se excluyó al resto de la población que no quiso participar y que no tuvo acceso al estudio. Para la determinación del grupo sanguíneo y factor Rh se utilizaron los reactivos de la marca DIALAB ® importados de Australia, siguiendo el protocolo establecido. El control de calidad del Kit se realizó con sangre ya tipificada, proporcionada por el Banco de Sangre de Cochabamba. Los resultados mostraron un predominio de grupo sanguíneo O con 85 %, seguido del tipo A con 9%, tipo B 6%, no habiendo resultados para el grupo sanguíneo AB; en cuanto al factor Rh las personas con el factor Rh positivo representan el 99% y el factor Rh negativo 1%. El grupo sanguíneo O y el factor Rh positivo es el predominante en ambos sexos.
The blood grouping and Rh factor are important in the field of biology, genetic and medical practice because of its clinical value in blood transfusions.Thus in the present investigation it was typified the blood group of Totora's population and analyzed its prevalence in both men and women. By performing a descriptive, cross-sectional study, in a total population of 12 961, in which it was obtained a sample of 175 people between the ages of 18-84 years old who assented to the study; the rest of the population that declined to participate and had no access to education were excluded. To determine the blood group and Rh factor it was used DIALAB ® brand reagents imported from Australia, following the established protocol.The quality control was performed with blood Kit typified, provided by the Blood Bank of Cochabamba. The results showed a predominance of blood group O with 85%, followed by 9% of type A, type B 6%, not having results for blood group AB, Rh factor regarding people with Rh-positive, representing 99 %, and Rh-negative it was 1%. Blood group O and positive Rh factor is dominant in both sexes.
