Uso del péptido CIGB-258 en un paciente pediátrico con neumonía grave por SARS-CoV-2 / Use of CIGB-258 peptide in a pediatric patient with severe pneumonia due to SARS-CoV-2

Introducción: La presentación clínica de la enfermedad provocada por el SARS-CoV-2 es heterogénea. Los pacientes pueden ser asintomáticos o tener una enfermedad leve de las vías respiratorias superiores o desarrollar una neumonía grave que puede progresar al síndrome de dificultad respiratoria aguda y provocar la muerte. La fisiopatología de las formas graves de la enfermedad se caracteriza por una marcada hiperinflamación. Las terapias que modulan la respuesta inmunitaria pueden ser cruciales para tratar y prevenir este estado. El péptido CIGB-258, marca comercial Jusvinza, es una opción terapéutica para este propósito, por sus propiedades inmunomoduladoras. Objetivo: Describir la evolución clínica de un paciente pediátrico con neumonía grave por SARS-CoV-2, tratado con el péptido CIGB-258 Presentación del caso: Adolescente de 12 años con epilepsia refractaria, parálisis cerebral infantil y antecedentes epidemiológicos de contacto con paciente positivo a test confirmatorio de reacción en cadena de la polimerasa con transcriptasa inversa para SARS-CoV-2 que ocho días después del contacto, muestra evidencias clínicas, radiográficas y de laboratorio de neumonía grave por COVID-19. Dentro del protocolo terapéutico, recibió tratamiento con el péptido inmunomodulador CIGB-258, con una evolución favorable y egreso hospitalario. Conclusiones: El uso del péptido CIGB-258 en el tratamiento de la neumonía grave por COVID-19 en pediatría, podría contribuir a evitar la progresión hacia las etapas críticas de la enfermedad(AU)

Introduction: The clinical presentation of the disease caused by SARS-CoV-2 is heterogeneous. Patients may be asymptomatic or have mild upper respiratory tract disease, or develop severe pneumonia that can progress to acute respiratory distress syndrome and lead to death. The pathophysiology of severe forms of the disease is characterized by a marked hyperinflammation. Therapies that modulate the immune response can be crucial in treating and preventing this state. The CIGB-258 peptide, brand name Jusvinza, is a therapeutic option for this purpose, due to its immunomodulatory properties. Objective: Describe the clinical evolution of a pediatric patient with severe pneumonia due to SARS-CoV-2, and treated with the CIGB-258 peptide. Case Presentation: A 12-year-old adolescent with refractory epilepsy, infantile cerebral palsy, and an epidemiological history of contact with a patient positive to PCR confirmatory test for SARS-CoV-2 who, eight days after contact, shows clinical, radiographic, and laboratory evidence of severe pneumonia due to COVID-19. Within the therapeutic protocol, he received treatment with CIGB-258 immunomodulatory peptide, with a favorable evolution and hospital discharge. Conclusions: The use of CIGB-258 peptide in the treatment of severe pneumonia due to COVID-19 in pediatrics could contribute to prevent progression to the critical stages of the disease(AU)

Potential applications of PLGA film-implants in modulating in vitro drugs release.

In this work we evaluate poly(lactic/glycolic) acid (PLGA) film-implants as potential biodegradable devices for controlled release of two different drugs: 5-Fluorouridine (5-FUR), a conventional low molecular weight water-soluble compound and SPf66 malaria vaccine, a therapeutic synthetic polypeptide. Three types of devices were prepared by solvent-casting techniques alone or combined with compression method: simple monolithic discs (SMD), multilayer discs with a central monolithic layer (MLDM), and multilayer discs with a central drug-reservoir (MLDR). For the highly water-soluble drug, 5-FUR, in vitro release from SMD showed an initial burst (24% in 2 h) followed by prolonged release over 20 days. In contrast, from a MLDM (two drug-free PLGA discs were added to the SMD) showed an initial lag-time of 12 days followed by a very fast second release phase. Finally, when the load of this system was increased from 3 to 9%, an extended release over 20 days with a low burst effect was obtained. For SPf66, the central reservoir containing the synthetic polypeptide MLDR reduces the possibility of degradation due to peptide contact with polymer solution. When four layers were added, 10 days sustained-release was obtained without any burst effect. With six layers a moderate pulse was obtained, 18-22 days from the beginning of the release. The results show the suitability of the proposed devices to control release and avoid the burst effect with highly water-soluble drugs; as well as modulate in vitro peptide release.

Characterization of antimalarial SPf66 peptide using MALDI-TOF MS, CD and SEC.

SPf66 is the first chemically synthesized peptide to elicit a partial protective immune response against malaria. Size-exclusion chromatography (SEC) with multi-angle laser light-scattering (MALLS) detection and hydrogen/deuterium (H/D) exchange monitored by (matrix-assisted laser desorption/ionization) MALDI-TOF (time-of-flight) mass spectrometry (MS) were used to assess the conformation and stability in aqueous solution after storage at different temperatures. Moreover, the feasible conformational changes of this peptide were also measured by circular dichroism (CD)-spectroscopy. The absolute molecular weight of SPf66 monomer and dimer species were 4765 and 8960Da using SEC with MALLS detection, and 4643 and 9490Da by MALDI-TOF MS, the discrepancy being between both methods lower than 5.7%, a value quite close to those found in other proteins. The results from H/D exchange monitored by MALDI-TOF MS and CD-spectroscopy show that the SPf66 monomer lacks ordered structure, whereas the SPf66 dimer species presents segments of secondary structure as a determined by CD measurements.