Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill
Severe forms of coronavirus 2019 (COVID-19) disease are caused by an exaggerated systemic inflammatory response and subsequent inflammation-related coagulopathy. Anti-inflammatory treatment with low dose dexamethasone has been shown to reduce mortality in COVID-19 patients requiring oxygen therapy....
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | International Journal of Molecular Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1422-0067/24/8/7278 |
| _version_ | 1797605069207633920 |
|---|---|
| author | Mélanie Dechamps Julien De Poortere Marie Octave Audrey Ginion Valentine Robaux Laurence Pirotton Julie Bodart Damien Gruson Marie-Astrid Van Dievoet Jonathan Douxfils Hélène Haguet Laure Morimont Marc Derive Lucie Jolly Luc Bertrand Pierre-François Laterre Sandrine Horman Christophe Beauloye |
| author_facet | Mélanie Dechamps Julien De Poortere Marie Octave Audrey Ginion Valentine Robaux Laurence Pirotton Julie Bodart Damien Gruson Marie-Astrid Van Dievoet Jonathan Douxfils Hélène Haguet Laure Morimont Marc Derive Lucie Jolly Luc Bertrand Pierre-François Laterre Sandrine Horman Christophe Beauloye |
| author_sort | Mélanie Dechamps |
| collection | DOAJ |
| description | Severe forms of coronavirus 2019 (COVID-19) disease are caused by an exaggerated systemic inflammatory response and subsequent inflammation-related coagulopathy. Anti-inflammatory treatment with low dose dexamethasone has been shown to reduce mortality in COVID-19 patients requiring oxygen therapy. However, the mechanisms of action of corticosteroids have not been extensively studied in critically ill patients in the context of COVID-19. Plasma biomarkers of inflammatory and immune responses, endothelial and platelet activation, neutrophil extracellular trap formation, and coagulopathy were compared between patients treated or not by systemic dexamethasone for severe forms of COVID-19. Dexamethasone treatment significantly reduced the inflammatory and lymphoid immune response in critical COVID-19 patients but had little effect on the myeloid immune response and no effect on endothelial activation, platelet activation, neutrophil extracellular trap formation, and coagulopathy. The benefits of low dose dexamethasone on outcome in critical COVID-19 can be partially explained by a modulation of the inflammatory response but not by reduction of coagulopathy. Future studies should explore the impact of combining dexamethasone with other immunomodulatory or anticoagulant drugs in severe COVID-19. |
| first_indexed | 2024-03-11T04:55:56Z |
| format | Article |
| id | doaj.art-3e695b6fd56a41e4b9aa7d27c06bfd84 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T04:55:56Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-3e695b6fd56a41e4b9aa7d27c06bfd842023-11-17T19:38:00ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-04-01248727810.3390/ijms24087278Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically IllMélanie Dechamps0Julien De Poortere1Marie Octave2Audrey Ginion3Valentine Robaux4Laurence Pirotton5Julie Bodart6Damien Gruson7Marie-Astrid Van Dievoet8Jonathan Douxfils9Hélène Haguet10Laure Morimont11Marc Derive12Lucie Jolly13Luc Bertrand14Pierre-François Laterre15Sandrine Horman16Christophe Beauloye17Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumDepartment of Clinical Biology, Cliniques Universitaires Saint-Luc, 1200 Brussels, BelgiumDepartment of Clinical Biology, Cliniques Universitaires Saint-Luc, 1200 Brussels, BelgiumDepartment of Pharmacy, Namur Research Institute for Life Sciences (Narilis), 5000 Namur, BelgiumDepartment of Pharmacy, Namur Research Institute for Life Sciences (Narilis), 5000 Namur, BelgiumDepartment of Pharmacy, Namur Research Institute for Life Sciences (Narilis), 5000 Namur, BelgiumInotrem s.a., 54500 Vandoeuvre-les-Nancy, FranceInotrem s.a., 54500 Vandoeuvre-les-Nancy, FrancePôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumDepartment of Intensive Care, Centre Hospitalier Regional Mons-Hainaut, 7000 Mons, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumPôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, BelgiumSevere forms of coronavirus 2019 (COVID-19) disease are caused by an exaggerated systemic inflammatory response and subsequent inflammation-related coagulopathy. Anti-inflammatory treatment with low dose dexamethasone has been shown to reduce mortality in COVID-19 patients requiring oxygen therapy. However, the mechanisms of action of corticosteroids have not been extensively studied in critically ill patients in the context of COVID-19. Plasma biomarkers of inflammatory and immune responses, endothelial and platelet activation, neutrophil extracellular trap formation, and coagulopathy were compared between patients treated or not by systemic dexamethasone for severe forms of COVID-19. Dexamethasone treatment significantly reduced the inflammatory and lymphoid immune response in critical COVID-19 patients but had little effect on the myeloid immune response and no effect on endothelial activation, platelet activation, neutrophil extracellular trap formation, and coagulopathy. The benefits of low dose dexamethasone on outcome in critical COVID-19 can be partially explained by a modulation of the inflammatory response but not by reduction of coagulopathy. Future studies should explore the impact of combining dexamethasone with other immunomodulatory or anticoagulant drugs in severe COVID-19.https://www.mdpi.com/1422-0067/24/8/7278COVID-19low dose dexamethasoneinflammationcoagulopathycytokine storm |
| spellingShingle | Mélanie Dechamps Julien De Poortere Marie Octave Audrey Ginion Valentine Robaux Laurence Pirotton Julie Bodart Damien Gruson Marie-Astrid Van Dievoet Jonathan Douxfils Hélène Haguet Laure Morimont Marc Derive Lucie Jolly Luc Bertrand Pierre-François Laterre Sandrine Horman Christophe Beauloye Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill International Journal of Molecular Sciences COVID-19 low dose dexamethasone inflammation coagulopathy cytokine storm |
| title | Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill |
| title_full | Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill |
| title_fullStr | Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill |
| title_full_unstemmed | Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill |
| title_short | Dexamethasone Modulates the Cytokine Response but Not COVID-19-Induced Coagulopathy in Critically Ill |
| title_sort | dexamethasone modulates the cytokine response but not covid 19 induced coagulopathy in critically ill |
| topic | COVID-19 low dose dexamethasone inflammation coagulopathy cytokine storm |
| url | https://www.mdpi.com/1422-0067/24/8/7278 |
| work_keys_str_mv | AT melaniedechamps dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT juliendepoortere dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT marieoctave dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT audreyginion dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT valentinerobaux dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT laurencepirotton dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT juliebodart dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT damiengruson dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT marieastridvandievoet dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT jonathandouxfils dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT helenehaguet dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT lauremorimont dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT marcderive dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT luciejolly dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT lucbertrand dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT pierrefrancoislaterre dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT sandrinehorman dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill AT christophebeauloye dexamethasonemodulatesthecytokineresponsebutnotcovid19inducedcoagulopathyincriticallyill |