COVID-19 Diagnostics: UVA Researchers Say That Cytokine IL-13 Can Be Used As A Blood Test Biomarker To Determine COVID-19 Severity
: A new research from the University of Virginia (UVA) School of Medicine suggests doctors can examine COVID-19 patients' blood to identify those at greatest risk of severe illness and to pinpoint those most likely to need a ventilator. The main biomarker that should be looked out for is the cytokine IL-13 (Interleukin 13). High levels of IL-13 were associated with worsened COVID-19 outcomes.
This new discovery could lead to new treatments to prevent deadly "cytokine storms" seen in severe cases of COVID-19.
The research findings are published on a preprint server and are pending peer-review. https://www.medrxiv.org/content/10.1101/2020.06.18.20134353v1
The study team from UVA found that the levels of a particular cytokine in the blood upon diagnosis could be used to predict later outcomes. Cytokines are proteins produced by immune cells are responsible for severe overreactions by the immune system, known as cytokine storms, associated with COVID-19 and other serious illnesses.
The study team says the discovery could become part of a scoring system to let doctors flag at-risk COVID-19 patients for closer monitoring and personalized interventions. The finding also identifies cytokines doctors could target as a new treatment approach.
Dr Bill Petri of UVA's Division of Infectious Diseases and International Health told Thailand Medical News, "The immune response that we discovered to predict severe shortness of breath in COVID-19 is known in other pulmonary diseases to cause damage. So this could lead to a novel way to prevent respiratory failure in individuals infected with the new coronavirus, by inhibiting this immune cytokine. We plan to test this in a model of COVID-19 prior to considering a clinical trial."
Typically cytokine storms, in which the immune system spirals out of control, are associated with an established group of cytokines. But the best predictor of COVID-19 outcomes was an "underappreciated" cytokine more associated with allergies, the UVA researchers report. High levels of that cytokine, IL-13, were associated with worsened COVID-19 outcomes regardless of patients' gender, age or other health problems.
The study team also identified two more cytokines associated with severe outcomes, though the duo had less ability to predict the need for a ventilator.
Furthermore the researchers found that levels of two other cytokines were significantly higher in patients with elevated blood sugar. This "pro-inflammatory response," they say, may help explain why diabetes is associated with worse COVID-19 outcomes. In short, the body is primed to respond too strongly to the infection.
Dr Petri said, "This work was led by Dr Allie Donlan, Dr Mary Young and Dr Mayuresh Abhyankar in my lab but it was also a huge team effort by the School of Medicine with the support of iTHRIV and the Global Infectious Diseases Institute."
In order to draw their conclusions, the researchers identified 57 COVID-19 patients treated at UVA who ultimately required a venti
lator. They then tested blood samples taken from the patients within 48 hours of diagnosis or hospital admission. They compared the results with those from patients who did not wind up needing a ventilator.
The study team says additional research is necessary to determine how the cytokines are contributing to COVID-19 outcomes, but they hope the discovery will help doctors improve care for a disease that has now killed more than 125,000 Americans.
Thailand Medical News would also like to note that another previous research by German scientist said that the biomarkers IL-6 and CRP could also be used to determine if COVID-19 patients were in severe stages and needed mechanical ventilation.https://www.jacionline.org/article/S0091-6749(20)30685-0/abstract
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