A. Caraffa’s research while affiliated with Università di Camerino and other places

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Publications (158)


Pain control and functional recovery as therapeutic goals in patients with chronic musculoskeletal pain: two experiences with tapentadol hydrochloride
  • Article

April 2024

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6 Reads

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G Ancillai

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A Caraffa

Objective: This study aimed to evaluate pain control, functioning, and quality of life (QoL) recovery in patients with chronic low back pain (cLBP) or post-traumatic osteoarthritis (OA) pain in the ankle/foot area, treated with tapentadol prolonged release and unresponsive to other treatments. Patients and methods: Two observational retrospective studies were conducted using clinical practice datasets of patients with chronic pain in cLBP and OA foot/ankle at different time points (total follow-up=60-90 days). The studies assessed pain intensity by the Numerical Rating Scale (NRS) pain scale (patients were classified as responder in case of ≥30% pain reduction), QoL by the 5-level EQ-5D (EQ-5D-5L) questionnaire, patient satisfaction by the 7-point Patients' Global Impression of Change (PGIC) scale; cLBP health status by the Roland Morris Disability Questionnaire (RMDQ); foot and ankle functional status by European Foot and Ankle Society (EFAS) score; and treatment-related AEs. Results: For the cLBP setting, 37 patients were enrolled, of which 86.50% were classified as responders (n=32; CI: 75.5% ÷ 97.5%). For the foot/ankle OA pain setting, 21 patients were enrolled. Pain assessment at final follow-up was available only for 11 patients, of which 72.73% (n=8; CI: 39.0% ÷ 94.0%) were classified as responders. Statistically significant improvements were seen in the RMDQ, EQ-5D-5L, and PGIC scores in cLBP. Improvements in the EFAS, EQ-5D-5L, and PGIC scores were seen in OA as well. The incidence of treatment-related adverse reactions was low in both studies. Conclusions: In the study population, tapentadol prolonged release was effective and well tolerated in treating cLBP and post-traumatic foot/ankle OA chronic pain when used in a multimodal manner. The reduction in pain was accompanied by clinically relevant improvements in patients' functionality and QoL.


Mast cell virus infection and inflammatory cytokines

July 2021

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12 Reads

Journal of Biological Regulators and Homeostatic Agents

P. Conti

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G. Ronconi

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A. Caraffa

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[...]

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Mast cells (MCs) are hematopoietic cells developed from bone marrow progenitors in response to the ligand stem cell factor, a trans-membrane tyrosine kinase kit receptor. MCs are located virtually in all vascularized tissues and in proximity to neurons and play a decisive role in both innate and adaptive immune responses. Their activation is involved in oxidative stress correlated with infection and inflammation. Pro-inflammatory cytokines are secreted by MCs after physiologic and psychological stress due to virus infection, including SARS-CoV-2. MCs, along with macrophages and pulmonary alveolar epithelial cells, are the main targets attacked by the coronavirus. COVID-19 induced by SARS-CoV-2 causes inflammatory stress which activates MCs to secrete corticotrophin-releasing hormone (CRH), SP, IL-6, TNF, and IL-1. Toll-like receptor (TLR) virus activation in MCs leads to pro-inflammatory cytokine generation without degranulation, an effect that can be inhibited by IL-10, IL-4, IL-1Ra and IL-37. TLR has the ability to recognize extracellular PAMPs by causing the transcription of NLRP, pro-IL-1, and other pro-inflammatory cytokines. The multi-protein complex, comprising pro-caspase-1, activates caspase-1 which in turn activates pro-IL-1 that is transformed into highly inflammatory mature IL-1. In COVID-19, viral RNA is specifically recognized by TLR, followed by recruiting the signal transfer proteins MyD88, IRAK, IKK and TRAF6 which can activate the NF-κB, resulting in transcription of the pro-inflammatory cytokines IL-1 and TNF, responsible for the “cytokine storm” phenomenon. Meanwhile, a new variant of the coronavirus-19 called C.1.2. has been discovered in the United States in the past few days, the effects of which are unknown, and it is therefore of great concern. Researchers are now testing it on immune cells to see if they react and are comparing it to a delta variant. Thus, from the existing data in biomedical literature, we can conclude that the suppression of pro-inflammatory cytokines in viral infections (including COVID-19) mediated by MCs represents a promising therapy not only in this field of medicine, but also in autoimmune, allergic, and cardiovascular disorders, as well as tumor inflammation where MCs play a key role.


Anaphylaxis is a rare reaction in COVID-19 vaccination

June 2021

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34 Reads

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9 Citations

Journal of Biological Regulators and Homeostatic Agents

Anaphylaxis is a severe multisystem reaction that occurs rapidly after the introduction of an antigen that would otherwise be a harmless substance. It is characterized by airway and respiratory problems, cardiovascular collapse, mucosal inflammation, and other complications, all severe symptoms that can cause death. IgE-dependent anaphylaxis involves mast cells (MCs) which are the main sources of biologically active mediators that contribute to the pathological and lethal phenomena that can occur in anaphylaxis. Antibody-mediated anaphylaxis can follow multiple pathways such as that mediated by MCs carrying the FcεRI receptor, which can be activated by very small amounts of antigen including a vaccine antigen and trigger an anaphylactic reaction. In addition, anaphylaxis can also be provoked by high concentrations of IgG antibodies that bind to the FcγR receptor present on basophils, neutrophils, macrophages and MCs. For this reason, the IgG concentration should be kept under control in vaccinations. Activation of MCs is a major cause of anaphylaxis, which requires immediate treatment with epinephrine to arrest severe lethal symptoms. MCs are activated through the antigen binding and cross-linking of IgE with release of mediators such as histamine, proteases, prostaglandins, leukotrienes and inflammatory cytokines. The release of these compounds causes nausea, vomiting, hives, wheezing, flushing, tachycardia, hypotension, laryngeal edema, and cardiovascular collapse. mRNA and viral vector vaccines have been cleared by the United States, Food and Drug Administration (FDA), generating hope of prevention and cure for COVID-19 around the world. Scientists advise against giving the vaccine to individuals who have had a previous history of anaphylaxis. The US Centers for Disease Control and Prevention (CDC) advises people with a previous history of any immediate allergic reaction to remain under observation for approximately 30 minutes after COVID-19 vaccination. To date, vaccines that prevent SARS-CoV-2 infection have not raised major concerns of severe allergic reactions, although, in some cases, pain and redness at the injection site and fever have occurred after administration of the vaccine. These reactions occur in the first 24-48 hours after vaccination. It has been reported that probable forms of anaphylaxis could also occur, especially in women approximately 40 years of age. But after tens of millions of vaccinations, only a few patients had this severe reaction with a low incidence. Anaphylactic and severe allergic reactions can also occur to any component of the vaccine including polysorbates and polyethylene glycol. To date, there is no precise information on allergic reactions to COVID-19 vaccines. Individuals with MCs and complement with higher activation than others may be at greater allergic risk. Moreover, the reactions called anaphylactoids, are those not mediated by IgE because they do not involve this antibody and can also occur in COVID-19 vaccination. These not-IgE-mediated reactions occur through direct activation of MCs and complement with tryptase production, but to a lesser extent than IgE-mediated anaphylaxis. However, at the moment it is not known exactly which component of the vaccine causes the allergic reaction and which vaccine causes the most side effects, including anaphylaxis. Thus, individuals who have a known allergy to any component of the vaccine should not be vaccinated. However, should an anaphylactic reaction occur, this requires immediate treatment with epinephrine to arrest severe lethal symptoms. In conclusion, the purpose of this editorial is to encourage the population to be vaccinated in order to extinguish this global pandemic that is afflicting the world population, and to reassure individuals that anaphylactic reactions do not occur with a higher incidence than other vaccinations.


168 Interprosthetic Fractures of The Femur: A Literature Review

May 2021

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27 Reads

BJS (British Journal of Surgery)

Increasing age expectations and number of joint replacement procedures have made interprosthetic femoral fractures (IFF) a progressively more common diagnosis and a challenge for surgeons. A gold standard and universally accepted classifications and guidelines do not exist yet. Customized structured electronic searches performed in PubMed database. Relevant key terms: IFF, classification interprosthetic fracture, peri-implant femoral fracture, biomechanics interprosthetic femur fracture, radiographic femur fracture, risk factor IFF. 42 articles finally included (up to 2019). High morbidity and mortality linked to IFF. Standardised classifications, management guidelines and surgical approaches are not available yet. Periprosthetic classification systems are still utilized even if not entirely appropriate. High rate of failure is related to thinner cortical bone, larger medullary canals and variable stresses depending on the distance among implants. High complication rates in all studies. Stress risers and implant stability based on fracture patterns and stress forces. Several surgical options with no uniformity. Less invasive surgical procedures are associated to reduction of metalwork failure rate, better preservation of vascularization and better functional-clinical outcomes. Lack of specific classification systems and management guidelines. Several surgical options are available with no uniformity of results. Attention to stress risers and preservation of bone stock and vascularization are key aspects for better results.


163 Audit cycle on the formal introduction of a standardised orthopaedic trauma patients’ admission pro-forma: the first Italian experience

May 2021

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5 Reads

BJS (British Journal of Surgery)

An internationally recognised issue of general district hospitals is the accuracy and completeness of the admission documentation, particularly in a trauma setting. We built and formally introduced a Hospital Trust Wide admission pro-forma for orthopaedic trauma patients. An Audit looking into the quality and completeness of the admission documentation for orthopaedic trauma patients was carried out at a single Hospital Trust in December 2017. This was followed by a second round Audit with formal implementation of our new clerking pro-forma. Compliance was 94% overall. The documentation was incomplete in 7% of the cases. Delays of patients’ treatment caused by lack of documentation or written plan/instructions was recorded in only 3% of the cases. Satisfaction questionnaire: excellent 55%, good 42%, fair 7%, poor 1%. The pro-forma provides all relevant information needed to fully assess orthopaedic trauma patients and plan the appropriate management. His utilisation facilitates completeness of documentation with a standardised approach. This is a unique work on the introduction of a standardised clerking pro-forma for the admission of orthopaedic trauma patients with excellent results in terms of compliance and improvement of patients’ care. Our study seems to be a quality improvement intervention with potentials of becoming a milestone for further improvements.


169 Literature Review on Efficacy of Manual Therapy in The Conservative Treatment of Adolescent Idiopathic Scoliosis (AIS)

May 2021

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14 Reads

BJS (British Journal of Surgery)

AIS is a common condition whose conservative options usually involve physical therapy. Manual therapy can be part of an adequate conservative strategy due to his ability to improve range of motion and decrease muscle tone and pain. However, his indications and efficacy remain controversial. What is the current evidence on indications and efficacy of manual therapy in the treatment of AIS? Customized structured electronic searches: PubMed, Cochrane. Key terms: AIS manual therapy, AIS manipulative therapy, AIS mobilization exercises. 17 works included. 5 case reports, 3 case series, 2 group-control studies, 3 narrative reviews, 4 systematic reviews. Complications:0. Reviews suggested that manual therapy is a promising option if in adjunct to physical therapy exercises. Prevention of curve progression and better spine flexibility are often achieved. It remains unclear whether this should be attributed to physical therapy, manual therapy, or combination of both. Lacks in methodology leave room for uncertainty. Only few papers analyse the indications and efficacy of manual therapy in treatment of AIS. The current evidence suggest that manual therapy is a promising beneficial treatment strategy for AIS with conservative indications, especially if in conjunction with physical therapy. This is further supported by absence of reported complications. Further research with better methodology is needed.


Monoclonal antibody therapy in COVID-19 induced by SARS-CoV-2

April 2021

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27 Reads

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19 Citations

Journal of Biological Regulators and Homeostatic Agents

Acute severe respiratory syndrome coronavirus-2 (SARS-CoV-2) infection causes coronavirus disease-2019 (COVID-19) which is associated with inflammation, thrombosis edema, hemorrhage, intra-alveolar fibrin deposition, and vascular and pulmonary damage. In COVID-19, the coronavirus activates macrophages by inducing the generation of pro-inflammatory cytokines [interleukin (IL)-1, IL-6, IL-18 and TNF] that can damage endothelial cells, activate platelets and neutrophils to produce thromboxane A2 (TxA2), and mediate thrombus generation. In severe cases, all these phenomena can lead to patient death. The binding of SARS-CoV-2 to the Toll Like Receptor (TLR) results in the release of pro-IL-1β that is cleaved by caspase-1, followed by the production of active mature IL-1β which is the most important cytokine in causing fever and inflammation. Its activation in COVID-19 can cause a "cytokine storm" with serious biological and clinical consequences. Blockade of IL-1 with inhibitory and anti-inflammatory cytokines represents a new therapeutic strategy also for COVID-19. Recently, very rare allergic reactions to vaccines have been reported, with phenomena of pulmonary thrombosis. These side effects have raised substantial concern in the population. Highly allergic subjects should therefore be vaccinated under strict medical supervision. COVID-19 has accelerated vaccine therapy but also the use of drugs and monoclonal antibodies (mABs) which have been used in COVID-19 therapy. They are primarily adopted to treat high-risk mild-to-moderate non-hospitalized patients, and it has been noted that the administration of two mABs gave better results. mABs, other than polyclonal plasma antibodies from infected subjects with SARS-CoV-2, are produced in the laboratory and are intended to fight SARS-CoV-2. They bind specifically to the antigenic determinant of the spike protein, inhibiting the pathogenicity of the virus. The most suitable individuals for mAB therapy are people at particular risk, such as the elderly and those with serious chronic diseases including diabetics, hypertension and obesity, including subjects suffering from cardiovascular diseases. These antibodies have a well-predetermined target, they bind mainly to the protein S (formed by the S1A, B, C and D subtypes), located on the viral surface, and to the S2 protein that acts as a fuser between the virus and the cell membrane. Since mABs are derived from a single splenic immune cell, they are identical and form a cell clone which can neutralize SARS-CoV-2 by binding to the epitope of the virus. However, this COVID-19 therapy may cause several side effects such as mild pain, bleeding, bruising of the skin, soreness, swelling, thrombotic-type episodes, arterial hypertension, changes in heart activity, slowed bone marrow activity, impaired renal function, diarrhea, fatigue, nausea, vomiting, allergic reaction, fever, and possible subsequent infection may occur at the site of injection. In conclusion, the studies promoting mAB therapy in COVID-19 are very promising but the results are not yet definitive and more investigations are needed to certify both their good neutralizing effects of SARS-CoV-2, and to eliminate, or at least mitigate, the harmful side effects.


The British variant of the new coronavirus-19 (Sars-Cov-2) should not create a vaccine problem
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  • Full-text available

December 2020

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1,351 Reads

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134 Citations

Journal of Biological Regulators and Homeostatic Agents

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious virus that infects humans and a number of animal species causing coronavirus disease-19 (COVID-19), a respiratory distress syndrome which has provoked a global pandemic and a serious health crisis in most countries across our planet. COVID-19 inflammation is mediated by IL-1, a disease that can cause symptoms such as fever, cough, lung inflammation, thrombosis, stroke, renal failure and headache, to name a few. Strategies that inhibit IL-1 are certainly helpful in COVID-19 and can represent one of the therapeutic options. However, until now, COVID-19 therapy has been scarce and, in many cases, ineffective, since there are no specific drugs other than the vaccine that can solve this serious health problem. Messenger RNA (mRNA) vaccines which are the newest approach, are already available and will certainly meet the many expectations that the population is waiting for. mRNA vaccines, coated with protected soft fatty lipids, use genetic mRNA (plus various inactive excipients) to make a piece of the coronavirus spike protein, which will instruct the immune system to produce specific antibodies. The soft fatty lipids allow the entry of mRNA into cells where it is absorbed into the cytoplasm and initiates the synthesis of the spike protein. In addition, vaccination also activates T cells that help the immune system respond to further exposure to the coronavirus. mRNA induces the synthesis of antigens of SARS-CoV-2 virus which stimulate the antibody response of the vaccinated person with the production of neutralizing antibodies. The new variant of the coronavirus-19 has been detected in the UK where, at the moment, the London government has imposed a lockdown with restrictions on international movements. The virus variant had already infected 1/4 of the total cases and in December 2020, it reached 2/3 of those infected in the UK. It has been noted that the spreading rate of the British variant could be greater than 70% of cases compared to the normal SARS-CoV-2 virus, with an R index growth of 0.4. Recent studies suggest that coronavirus-19 variation occurs at the level N501Y of the spike protein and involves 23 separate mutations on the spike, 17 of which are linked to the virus proteins, thus giving specific characteristics to the virus. In general, coronaviruses undergo many mutations that are often not decisive for their biological behavior and does not significantly alter the structure and the components of the virus. This phenomenon also occurs in SARS-CoV-2. It is highly probable that the variants recently described in the UK will not hinder vaccine-induced immunity. In fact, the variant will not break the vaccine although it may have some chance of making it a little less effective. Therefore, it is pertinent to think that the vaccine will work against the SARS-CoV-2 variant as well. In today's pandemic, the D614G mutation of the amino acid of corronavirus-19, which emerged in Europe in February 2020 is the most frequent form and causes high viral growth. The previously infrequent D614G mutation is now globally dominant. This variant, which is being tested by many international laboratories, is rapidly spreading across the countries and a series of vaccinated subjects are testing to see if their antibodies can neutralize the new variant of SARS-CoV-2. This variant has a very high viral growth and is less detectable with the RT-PCR technique in the laboratory. It has been reported that the British variant that increases viral load does not cause more severe effects in the respiratory tract and lung disease, therefore, it is certain that the variant is growing rapidly and must be kept under control; for this reason, laboratory data is expected impatiently. The study on the many variants that coronavirus-19 presents is very interesting and complete and clearer data on this topic will be ready in the near future. In addition, it is still unclear whether the different variants discovered in many countries, including Africa, share the same spike protein mutation and therefore, this is another study to elaborate on. In order to be certain and to not have unexpected surprises, we need to reduce the spread and the transmission speed of viral variants that could appear around the world, creating new pandemics. For this reason, the scientific community is on the alert since laboratory tests on serum antibodies from COVID-19 survivors have been reported to be less effective in attacking the variant. In light of the above, the scientific community must be on the alert as larger variants of the spike protein could escape vaccine-induced antibodies, which for now are of great help to the community and can save millions of lives. Deepening the study of spike protein mutations will help to better understand how to combat coronavirus-19 and its variants.

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Coronavirus-19 (SARS-CoV-2) induces acute severe lung inflammation via IL-1 causing cytokine storm in COVID-19: a promising inhibitory strategy

October 2020

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602 Reads

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104 Citations

Journal of Biological Regulators and Homeostatic Agents

SARS-Cov-2 infection causes local and systemic inflammation mediated by pro-inflammatory cytokines and COX-2 eicosanoid products with metabolic dysfunction and tissue damage that can lead to patient death. These effects are primarily induced by IL-1 cytokines, which are involved in the elevation of hepatic acute phase proteins and fever. IL-1 has a broad spectrum of biological activities and participates in both innate and acquired immunity. In infections, IL-1 induces gene expression and synthesis of several cytokines/chemokines in both macrophages and mast cells (MCs). The activation of MCs triggers the secretion of mediators stored in the granules, and the de novo synthesis of pro-inflammatory cytokines. In microorganism infections, the release of IL-1 macrophage acts on adhesion molecules and endothelial cells leading to hypotension and septic shock syndrome. IL-1 activated by SARS-CoV-2 stimulates the secretion of TNF, IL-6 and other cytokines, a pro-inflammatory complex that can lead to cytokine storm and be deleterious in both lung and systemically. In SARS-CoV-2 septic shock, severe metabolic cellular abnormalities occur which can lead to death. Here, we report that SARS-CoV-2 induces IL-1 in macrophages and MCs causing the induction of gene expression and activation of other pro-inflammatory cytokines. Since IL-1 is toxic, its production from ubiquitous MCs and macrophages activated by SARS-CoV-2 can also provokes both gastrointestinal and brain disorders. Furthermore, in these immune cells, IL-1 also elevates nitric oxide, and the release of inflammatory arachidonic acid products such as prostaglndins and thromboxane A2. All together these effects can generate cytokine storm and be the primary cause of severe inflammation with respiratory distress and death. Although, IL-1 administered in low doses may be protective; when it is produced in high doses in infectious diseases can be detrimental, therefore, IL-1 blockade has been studied in many human diseases including sepsis, resulting that blocking it is absolutely necessary. This definitely nurtures hope for a new effective therapeutic treatment. Recently, two interesting anti-IL-1 cytokines have been widely described: IL-37 and IL-1Ra. IL-37, by blocking IL-1, has been observed to have anti-inflammatory action in rodents in vivo and in transfected cells. It has been reported that IL-37 is a very powerful protein which inhibits inflammation and its inhibition can be a valid therapeutic strategy. IL-37 is a natural suppressor of inflammation that is generated through a caspase-1 that cleaves pro-IL-37 into mature IL-37 which translocates to the nucleus and inhibits the transcription of pro-inflammatory genes; while IL-1Ra inhibits inflammation by binding IL-1 to its IL-1R (receptor). We firmly believe that blocking IL-1 with an anti-inflammatory cytokine such as IL-37 and/or IL-1Ra is an effective valid therapy in a wide spectrum of inflammatory disorders including SARS-CoV-2-induced COVID-19. Here, we propose for the first time that IL-37, by blocking IL-1, may have an important role in the therapy of COVID-19.


Fig. 1. Activation of mast cell by SARS-CoV-2 causes an early release of histamine and late release of IL-1 which activate macrophage. Histamine potentiates the production of IL-1 which causes cytokine storm and lung inflammation in COVID-19.
Mast cells activated by SARS-CoV-2 release histamine which increases IL-1 levels causing cytokine storm and inflammatory reaction in COVID-19

September 2020

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1,795 Reads

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112 Citations

Journal of Biological Regulators and Homeostatic Agents

SARS-CoV-2 virus is an infectious agent commonly found in certain mammalian animal species and today also in humans. SARS-CoV-2, can cause a pandemic infection with severe acute lung injury respiratory distress syndrome in patients with COVID-19, that can lead to patient death across all ages. The pathology associated with pandemic infection is linked to an over-response of immune cells, including virus-activated macrophages and mast cells (MCs). The local inflammatory response in the lung that occurs after exposure to SARS-CoV-2 is due to a complex network of activated inflammatory innate immune cells and structural lung cells such as bronchial epithelial cells, endothelial cells and fibroblasts. Bronchial epithelial cells and fibroblasts activated by SARS-CoV-2 can result in the up-regulation of pro-inflammatory cytokines and induction of MC differentiation. In addition, endothelial cells which control leukocyte traffic through the expression of adhesion molecules are also able to amplify leukocyte activation by generating interleukin (IL)-1, IL-6 and CXC chemokines. In this pathologic environment, the activation of mast cells (MCs) causes the release of histamine, proteases, cytokines, chemokines and arachidonic acid compounds, such as prostaglandin D2 and leukotrienes, all of which are involved in the inflammatory network. Histamine is stored endogenously within the secretory granules of MCs and is released into the vessels after cell stimulation. Histamine is involved in the expression of chemokine IL-8 and cytokine IL-6, an effect that can be inhibited by histamine receptor antagonists. IL-1 is a pleiotropic cytokine that is mainly active in inflammation and immunity. Alveolar macrophages activated by SARS-CoV-2 through the TLR produce IL-1 which stimulates MCs to produce IL-6. IL-1 in combination with IL-6 leads to excessive inflammation which can be lethal. In an interesting study published several years ago (by E. Vannier et al., 1993), it was found that histamine as well as IL-1 are implicated in the pathogenesis of pulmonary inflammatory reaction, after micorganism immune cell activation. IL-1 in combination with histamine can cause a strong increase of IL-1 levels and, consequently, a higher degree of inflammation. However, it has been reported that histamine alone has no effect on IL-1 production. Furthermore, histamine enhances IL-1-induced IL-6 gene expression and protein synthesis via H2 receptors in peripheral monocytes. Therefore, since MCs are large producers of histamine in inflammatory reactions, this vasoactive amine, by increasing the production of IL-1, can amplify the inflammatory process in the lung infected with SARS-CoV-2. Here, we have proposed for the first time an emerging role for histamine released by MCs which in combination with IL-1 can cause an increase in lung inflammation induced by the viral infection SARS-CoV-2.


Citations (85)


... Although, many vaccines have been licensed for the use against SARS-CoV-2 virus, still there is a need for safe and effective vaccines especially for elderly populations. Currently used anti-COVID-19 vaccines exhibit sometimes allergic reactions, which may be attributed to the high levels of generated IgG antibodies that interact with the Fcg receptors present on the surface of some immune cells (26,27). It is of great importance that vaccines elicit an immune response capable of neutralizing the circulating variants of concern and possible new strains so as to induce immune memory cells and actively prevent the development of disease. ...

Reference:

The Influence of Adjuvant Type on the Immunogenicity of RBD/N Cocktail Antigens as a Vaccine Candidate against SARS-CoV-2 Virus
Anaphylaxis is a rare reaction in COVID-19 vaccination
  • Citing Article
  • June 2021

Journal of Biological Regulators and Homeostatic Agents

... This positive profile in AECA autoantibodies raises intriguing questions about the interplay between SARS-CoV-2 infection and the immune response. Activation of macrophages by coronavirus, inducing the generation of pro-inflammatory cytokines (interleukin (IL)-1, IL-6, IL-18, and TNF) that can damage endothelial cells and activate platelets and neutrophils, has been reported in several studies [39]. Specifically, cytokine storms, result from the dysregulation of endothelial cells, characterized by abnormal coagulation and vascular leakage [40]. ...

Monoclonal antibody therapy in COVID-19 induced by SARS-CoV-2
  • Citing Article
  • April 2021

Journal of Biological Regulators and Homeostatic Agents

... Cases of cerebral venous thrombosis and other unusual thrombotic events have occurred following vaccination with the Vaxzevria vaccine [31,32,54,[77][78][79][80][81]. This has led to widespread age restrictions in many countries worldwide, including the complete cessation of the use of the Vaxzevria vaccine. ...

The British variant of the new coronavirus-19 (Sars-Cov-2) should not create a vaccine problem

Journal of Biological Regulators and Homeostatic Agents

... The high production of pro-inflammatory cytokines in SARS-CoV-2-infected patients is a major contributor to the disease's severity, particularly in severe cases where acute respiratory distress syndrome (ARDS) can progress to pulmonary fibrosis [5,23]. Given the emergence of viral variants and the serious post-infection complications, there is an urgent need for therapeutic agents that can broadly target the molecular mechanisms involved in SARS-CoV-2 pathology. ...

Coronavirus-19 (SARS-CoV-2) induces acute severe lung inflammation via IL-1 causing cytokine storm in COVID-19: a promising inhibitory strategy

Journal of Biological Regulators and Homeostatic Agents

... In response, macrophages release excessive levels of IL-1 and IL-6, which play a key role in the cytokine storm. 197 Interestingly, famotidine (an H2R antagonist) was reported to lower the risk of clinical deterioration in COVID-19 patients. 198 Further in vitro studies reported that SARS-CoV-2-infected Caco2 cells pretreated with famotidine had notably reduced levels of CCL2 expression, 199 which acts as a crucial cytokine in the severity and COVID-19-related mortality. ...

Mast cells activated by SARS-CoV-2 release histamine which increases IL-1 levels causing cytokine storm and inflammatory reaction in COVID-19

Journal of Biological Regulators and Homeostatic Agents

... The activation of purinergic receptors by ATP can trigger several responses, including releasing pro-inflammatory cytokines. We showed an increase in mRNA of IL-1β and TNF-α, two important inflammatory markers that are involved in the purinergic signaling pathway and SARS-CoV-2 infection in the lung [75,76]. These cytokines are produced mainly by activated macrophages and are central in mediating the inflammatory-purinergic response [77]. ...

IL-1 induces throboxane-A2 (TxA2) in COVID-19 causing inflammation and micro-thrombi: inhibitory effect of the IL-1 receptor antagonist (IL-1Ra)

Journal of Biological Regulators and Homeostatic Agents

... The global pandemic has resulted in more than 700 million cases and 7 million deaths worldwide [1]. The clinical manifestations of COVID-19 disease are characterized by high levels of inflammation mediated by proinflammatory cytokines [2][3][4]. This condition can last six months or more, leading to a condition known as long COVID-19 [5,6]. ...

SARS-CoV-2, which induces COVID-19, causes kawasaki-like disease in children: role of pro-inflammatory and anti-inflammatory cytokines

Journal of Biological Regulators and Homeostatic Agents

... [1] Rapid viral infections around the world have led to a sharp rise in the number of afflicted persons and the deaths that follow. [2] The pandemic disease's widespread outbreak has been associated with a large number of fatalities and hospitalisations. [3] To control the spread of the disease, most of the population has been put under lockdown with restricted movements. ...

How to reduce the likelihood of coronavirus-19 (CoV-19 or SARS-CoV-2) infection and lung inflammation mediated by IL-1

Journal of Biological Regulators and Homeostatic Agents

... It was reported by Huang et al. that in coronavirus infection increased level of IP-10, IFN-γ, IL-1ß, and MCP-1 and greater concentration of TNF-α, G-CSF, MCP-1A, and MCP-1 were found in those patients needing cure at ICU than those who are not treated at the ICU [41]. Also, it was reported by Conti P et al. that the pro-inflammatory cytokines such as IL-6 and (IL)-1β are associated with lung fibrosis development in COVID-19 [42]. And the suppression of these pro-inflammatory cytokines might have a significant therapeutic effect. ...

Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by COVID-19: anti-inflammatory strategies

Journal of Biological Regulators and Homeostatic Agents

... Simple decompression, anterior transposition of the ulnar nerve (subcutaneous, intramuscular, submuscular), and medial epicondylectomy are known surgical options for the cubital tunnel syndrome [21,22] and this study demonstrated favorable outcomes of submuscular anterior transposition of the ulnar nerve using a musculofascial lengthening technique that uses only a portion of the flexor-pronator mass. Significant improvement occurred in both subjective patient-reported outcomes and objectively measured functions. ...

Neurolysis versus anterior transposition of the ulnar nerve in cubital tunnel syndrome: a 12 years single secondary specialist centre experience
  • Citing Article
  • February 2020

MUSCULOSKELETAL SURGERY