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What causes such different reactions to the attack of the SarS-CoV-2 virus? Why do some people get seriously ill and others less? Faced with complex and unstable clinical pictures, is it possible to predict the level of severity of the disease? A study based on two independent case series, performed respectively by one Irccs Humanitas working group led by Professor Alberto Mantovani which includes researchers and doctors on the front line against Covid 19, and from group of doctors and researchers of the Asst Papa Giovanni XXIII, led by Professor Alessandro Rambaldi, identified an indicator of the severity of the disease in patients with Covid 19: the Ptx3 molecule. Il lavoro «Expression of macrophages and prognostic significance of long PTX3 pentraxin in Covid-19», just published in Nature Immunology, involved 96 patients in Humanitas and 54 in Pope John XXIII. In addition, thanks to access to bioinformatic data and analysis supported by Artificial Intelligence, it examined data from patients residing in Israel and the US The researchers investigated the mechanisms of innate immunity in circulating blood and lungs.
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“The analysis brought to light the role of a gene discovered by my group years ago, Ptx3: a molecule involved in immunity and inflammation. – explains Professor Alberto Mantovani, Scientific Director of Humanitas and Emeritus Professor of the Humanitas University -. In patients with Covid-19, this molecule is present at high levels. in the circulating blood, in the lungs, in the cells of the first line of defense (macrophages) and in the cells that line the inner surface of the blood vessels (the vascular endothelium). Important information since patients with Covid-19 have very strong inflammation (macrophage activation syndrome) that leads to thrombosis of the pulmonary microcirculation at the endothelial cell level. Following, we verified that Ptx3 could be a severity marker, thanks to reagents and a test developed by Humanitas researchers “. The two independent case studies, that of Milan and that of Bergamo, confirm that the measurement of Ptx3 is, to date, the most important prognostic factor associated with the worsening of patients’ conditions.
“These dates – explains Professor Alessandro Rambaldi, Director of the Hematology Unit and the Department of Oncology and Hematology at the Papa Giovanni XXIII Hospital in Bergamo – confirm the centrality of endothelial damage in the pathogenesis of the most serious manifestations observed in patients with Covid. Circulating Ptx3 levels, measured in the blood, will help guide the assessment of the response of these patients to treatments. The validation of the results obtained in two independent cohorts of patients highlights the robustness and reproducibility of this observation and the importance of being able to use properly stored biological material at the time of admission of these patients “. The next step will be to transfer the discovery from the research desk to the patient’s bed. “The study, which needs further verification and confirmation, could be an important tool to guide physicians in defining therapies for each patient. – continues prof. Mantovani –. At Humanitas we are putting the test at the service of doctors who work with Covid patients thanks to the collaboration of the Hospital’s Clinical Analysis Laboratory led by Dr. María Teresa Sandri. We hope it will help doctors quickly assess the severity of the disease and treat the sick even better. “.
Starting from a high-tech approach, the study defines a simple test (in fact, a blood test is sufficient to assess the Ptx3 level), low-cost and potentially shared by everyone. The study shows that the advancement of knowledge is made thanks to the collection of biological samples and personal and health data of the population, essential for an effective investigation on Covid-19, according to internationally consolidated standard operating procedures.»- concludes Professor Rambaldi.
Last Updated: Thursday, November 19, 2020, 08:03 AM
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