Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19
BackgroundImmunological disturbances (anti-type I IFN auto-antibody production, cytokine storm, lymphopenia, T-cell hyperactivation and exhaustion) are responsible for disease exacerbation during severe COVID-19 infections.MethodsIn this study, we set up a prospective, randomised clinical trial (Cli...
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2025-01-01
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| author | Aurelie Guironnet-Paquet Aurelie Guironnet-Paquet Hind Hamzeh-Cognasse Frederic Berard Fabrice Cognasse Fabrice Cognasse Jean Christophe Richard Hodane Yonis Mehdi Mezidi Olivier Desebbe Bertrand Delannoy Sophie Demeret Clemence Marois Clemence Marois Clemence Marois Samir Saheb Quoc Viet Le Mathieu Schoeffler Paul Simon Pugliesi Sophie Debord Paul Bastard Paul Bastard Paul Bastard Paul Bastard Aurélie Cobat Aurélie Cobat Aurélie Cobat Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Rémi Pescarmona Sébastien Viel Jean François Nicolas Jean François Nicolas Audrey Nosbaum Audrey Nosbaum Marc Vocanson Olivier Hequet Olivier Hequet |
| author_facet | Aurelie Guironnet-Paquet Aurelie Guironnet-Paquet Hind Hamzeh-Cognasse Frederic Berard Fabrice Cognasse Fabrice Cognasse Jean Christophe Richard Hodane Yonis Mehdi Mezidi Olivier Desebbe Bertrand Delannoy Sophie Demeret Clemence Marois Clemence Marois Clemence Marois Samir Saheb Quoc Viet Le Mathieu Schoeffler Paul Simon Pugliesi Sophie Debord Paul Bastard Paul Bastard Paul Bastard Paul Bastard Aurélie Cobat Aurélie Cobat Aurélie Cobat Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Rémi Pescarmona Sébastien Viel Jean François Nicolas Jean François Nicolas Audrey Nosbaum Audrey Nosbaum Marc Vocanson Olivier Hequet Olivier Hequet |
| author_sort | Aurelie Guironnet-Paquet |
| collection | DOAJ |
| description | BackgroundImmunological disturbances (anti-type I IFN auto-antibody production, cytokine storm, lymphopenia, T-cell hyperactivation and exhaustion) are responsible for disease exacerbation during severe COVID-19 infections.MethodsIn this study, we set up a prospective, randomised clinical trial (ClinicalTrials.gov ID: NCT04751643) and performed therapeutic plasma exchange (TPE) in severe COVID-19 patients in order to decrease excess cytokines and auto-antibodies and to assess whether adding TPE to the standard treatment (ST, including corticosteroids plus high-flow rate oxygen) could help restore immune parameters and limit the progression of acute respiratory distress syndrome (ARDS).ResultsAs expected, performing TPE decreased the amount of anti-type I IFN auto-antibodies and improved the elimination or limited the production of certain inflammatory mediators (IL-18, IL-7, CCL2, CCL3, etc.) circulating in the blood of COVID-19 patients, compared to ST controls. Interestingly, while TPE did not influence changes in ARDS parameters throughout the protocol, it proved more effective than ST in reversing lymphopenia, preventing T-cell hyperactivation and reducing T-cell exhaustion, notably in a fraction of TPE patients who had an early favourable respiratory outcome. TPE also restored appropriate numbers of CD4+ and CD8+ T–cell memory populations and increased the number of circulating virus-specific T cells in these patients.ConclusionOur results therefore indicate that the addition of TPE sessions to the standard treatment accelerates immune cell recovery and contributes to the development of appropriate antiviral T-cell responses in some patients with severe COVID-19 disease. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-f8bec48c7b6c4b0e82171710c5c573482025-01-17T06:51:08ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14926721492672Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19Aurelie Guironnet-Paquet0Aurelie Guironnet-Paquet1Hind Hamzeh-Cognasse2Frederic Berard3Fabrice Cognasse4Fabrice Cognasse5Jean Christophe Richard6Hodane Yonis7Mehdi Mezidi8Olivier Desebbe9Bertrand Delannoy10Sophie Demeret11Clemence Marois12Clemence Marois13Clemence Marois14Samir Saheb15Quoc Viet Le16Mathieu Schoeffler17Paul Simon Pugliesi18Sophie Debord19Paul Bastard20Paul Bastard21Paul Bastard22Paul Bastard23Aurélie Cobat24Aurélie Cobat25Aurélie Cobat26Jean Laurent Casanova27Jean Laurent Casanova28Jean Laurent Casanova29Jean Laurent Casanova30Jean Laurent Casanova31Rémi Pescarmona32Sébastien Viel33Jean François Nicolas34Jean François Nicolas35Audrey Nosbaum36Audrey Nosbaum37Marc Vocanson38Olivier Hequet39Olivier Hequet40Apheresis Unit, Etablissement Français du Sang Auvergne-Rhône-Alpes, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre Bénite, FranceInternational Center for Infectiology Research (CIRI), Université de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM), U1111, Lyon, FranceUniversity of Jean Monnet, Mines Saint-Étienne, Institut National de la Santé et de la Recherche Médicale (INSERM), U 1059 SAINBIOSE, Saint-Étienne, FranceClinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre-Bénite, FranceUniversity of Jean Monnet, Mines Saint-Étienne, Institut National de la Santé et de la Recherche Médicale (INSERM), U 1059 SAINBIOSE, Saint-Étienne, FranceScientific Department, Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, FranceIntensive Care Unit, Centre Hospitalier Croix–Rousse, Hospices Civils de Lyon (HCL), Lyon, FranceIntensive Care Unit, Centre Hospitalier Croix–Rousse, Hospices Civils de Lyon (HCL), Lyon, FranceIntensive Care Unit, Centre Hospitalier Croix–Rousse, Hospices Civils de Lyon (HCL), Lyon, FranceDepartment of Anesthesiology and Perioperative Medicine, Sauvegarde Clinic, Ramsay Santé, Lyon, FranceDepartment of Anesthesiology and Perioperative Medicine, Sauvegarde Clinic, Ramsay Santé, Lyon, FranceNeuro-Intensive Care Unit, Assistance Publique des Hopitaux de Paris (AP-HP), Hôpital de la Pitié-Salpêtrière, Paris, FranceNeuro-Intensive Care Unit, Assistance Publique des Hopitaux de Paris (AP-HP), Hôpital de la Pitié-Salpêtrière, Paris, FranceSorbonne Université, Institut du Cerveau, Paris Brain Institute, Institut du Cerveau et de la Moelle (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Assistance Publique des Hopitaux de Paris (AP-HP), Hôpital de la Pitié-Salpêtrière, Departement Médico-Universitaire (DMU) Neurosciences 6, Paris, France0Groupe de Recherche Clinique en REanimation et Soins Intensifs du Patient en Insuffisance Respiratoire aiguE (GRC-RESPIRE), Sorbonne Université, Paris, France1Hemobiotherapy Unit, Assistance Publique des Hopitaux de Paris (AP-HP), Hôpital de la Pitié-Salpêtrière, Paris, France2Intensive Care Unit, Medipôle Lyon Villeurbanne, Villeurbanne, France3Department of Anesthesiology and Intensive Care Unit, Centre Hospitalier de Montélimar, Montélimar, France4Intensive Care Unit, Centre Hospitalier William Morey, Chalon sur Saône, France5Department of Anesthesiology and Intensive Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon (HCL), Lyon, France6Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) U1163, Necker Hospital for Sick Children, Paris, France7Paris Cité University, Imagine Institute, Paris, France8St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States9Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique des Hopitaux de Paris (AP-HP), Paris, France6Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) U1163, Necker Hospital for Sick Children, Paris, France7Paris Cité University, Imagine Institute, Paris, France8St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States6Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) U1163, Necker Hospital for Sick Children, Paris, France7Paris Cité University, Imagine Institute, Paris, France8St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States9Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique des Hopitaux de Paris (AP-HP), Paris, France0Howards Hugues Medical Institute, New York, NY, United States1Immun Monitorage Laboratory, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre-Bénite, France2Plateforme de Biothérapies et de production de Médicaments de Thérapie Innovante (MTI), Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), Lyon, FranceInternational Center for Infectiology Research (CIRI), Université de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM), U1111, Lyon, FranceClinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre-Bénite, FranceInternational Center for Infectiology Research (CIRI), Université de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM), U1111, Lyon, FranceClinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre-Bénite, FranceInternational Center for Infectiology Research (CIRI), Université de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM), U1111, Lyon, FranceApheresis Unit, Etablissement Français du Sang Auvergne-Rhône-Alpes, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Pierre Bénite, FranceInternational Center for Infectiology Research (CIRI), Université de Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM), U1111, Lyon, FranceBackgroundImmunological disturbances (anti-type I IFN auto-antibody production, cytokine storm, lymphopenia, T-cell hyperactivation and exhaustion) are responsible for disease exacerbation during severe COVID-19 infections.MethodsIn this study, we set up a prospective, randomised clinical trial (ClinicalTrials.gov ID: NCT04751643) and performed therapeutic plasma exchange (TPE) in severe COVID-19 patients in order to decrease excess cytokines and auto-antibodies and to assess whether adding TPE to the standard treatment (ST, including corticosteroids plus high-flow rate oxygen) could help restore immune parameters and limit the progression of acute respiratory distress syndrome (ARDS).ResultsAs expected, performing TPE decreased the amount of anti-type I IFN auto-antibodies and improved the elimination or limited the production of certain inflammatory mediators (IL-18, IL-7, CCL2, CCL3, etc.) circulating in the blood of COVID-19 patients, compared to ST controls. Interestingly, while TPE did not influence changes in ARDS parameters throughout the protocol, it proved more effective than ST in reversing lymphopenia, preventing T-cell hyperactivation and reducing T-cell exhaustion, notably in a fraction of TPE patients who had an early favourable respiratory outcome. TPE also restored appropriate numbers of CD4+ and CD8+ T–cell memory populations and increased the number of circulating virus-specific T cells in these patients.ConclusionOur results therefore indicate that the addition of TPE sessions to the standard treatment accelerates immune cell recovery and contributes to the development of appropriate antiviral T-cell responses in some patients with severe COVID-19 disease.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1492672/fullCOVID-19therapeutic plasma exchangeimmune responseanti-type I IFN autoantibodiescytokine stormadaptive immunity |
| spellingShingle | Aurelie Guironnet-Paquet Aurelie Guironnet-Paquet Hind Hamzeh-Cognasse Frederic Berard Fabrice Cognasse Fabrice Cognasse Jean Christophe Richard Hodane Yonis Mehdi Mezidi Olivier Desebbe Bertrand Delannoy Sophie Demeret Clemence Marois Clemence Marois Clemence Marois Samir Saheb Quoc Viet Le Mathieu Schoeffler Paul Simon Pugliesi Sophie Debord Paul Bastard Paul Bastard Paul Bastard Paul Bastard Aurélie Cobat Aurélie Cobat Aurélie Cobat Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Jean Laurent Casanova Rémi Pescarmona Sébastien Viel Jean François Nicolas Jean François Nicolas Audrey Nosbaum Audrey Nosbaum Marc Vocanson Olivier Hequet Olivier Hequet Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 Frontiers in Immunology COVID-19 therapeutic plasma exchange immune response anti-type I IFN autoantibodies cytokine storm adaptive immunity |
| title | Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 |
| title_full | Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 |
| title_fullStr | Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 |
| title_full_unstemmed | Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 |
| title_short | Therapeutic plasma exchange accelerates immune cell recovery in severe COVID-19 |
| title_sort | therapeutic plasma exchange accelerates immune cell recovery in severe covid 19 |
| topic | COVID-19 therapeutic plasma exchange immune response anti-type I IFN autoantibodies cytokine storm adaptive immunity |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1492672/full |
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