Researchers of the Virgen Macarena Hospital in Seville have discovered in a trial with eighty Covid patients admitted to the ICU a new biomarker that predicts survival. led by doctor José Garnacho Montero, chief of intensive care, and Victor Sanchez-Margalet, medical doctor at the Seville hospital and professor of Biochemistry and Molecular Biology, the researchers set out to monitor patients admitted to the ICU to check whether the myeloid suppressor cells (MDSC), whose number underwent notable alterations with this disease, could serve as markers of severity, mortality or survival.
MDSC cells are immunomodulatory cells that inhibit lymphocyte function and that, although physiologically they play a counterregulatory role to avoid an excess in the immune response, they play an important
role in immune escape from tumors. Dr. Luis de la Cruz, head of the Virgen Macarena Medical Oncology Servicecollaborated with these researchers in the study of these cells in previous work with patients with breast cancer or lymphoma, concluding that these and other tumors “can recruit these immunosuppressive cells to their advantage to avoid the patient’s immune attack.”
Peripheral blood analysis
In the study carried out with Covid patients -says José Garnacho- «we included the patients consecutively between the summer 2020 and winter 2021 (second and third waves), before vaccination against SARS-CoV-2. Of a total of 80 patients, 40 were discharged from the ICU due to improvement and another 40 did not survive.
The investigators analyzed peripheral blood at admission, 7 days, and 14 days for immune cells, including MDSC, and found that all patients at ICU admission thad a similar number of MDSC cells in peripheral blood. “However, during follow-up of patients in the ICU, those who improved and were discharged from the ICU had either no increase in MDSC numbers or decreased numbers, whereas those patients who had a fatal outcome had a prior increase in cells. MDSC in blood”, says Garnacho.
Victor Sanchez-Margalet says that “we confirmed that all the patients on admission to the ICU had a similar number of MDSC cells in peripheral blood. However, during follow-up of patients in the ICU, those who improved and discharged from the ICU, the number of MDSC did not increase or decrease, whereas those patients who had a fatal outcome had a previous increase in MDSC cells in the blood.”
This researcher concludes, in view of these results, published in Frontiers in Immunology, that “MDSC cells, specifically those of the granulocytic type (G-MDSC), may be a good marker of survival in patients with severe COVID-19 admitted to the ICU.”
And adds: “Apart from this, it points to a new therapeutic target for the management of patients with alterations in the immune response due to an increase in these immunosuppressive cells.Therefore, preclinical, in vitro and animal model studies are necessary to try to modulate the differentiation of these MDSC cells».
This finding, if confirmed in subsequent clinical trials, could have repercussions not only in the treatment of patients Severe Covid but also in cancer patients.
“Although we had already found that COVID-19 patients had higher numbers of M-MDSC cells than healthy subjects, we did not we knew whether they could play a pathophysiological role in the development of the disease or if they could serve as markers in the follow-up of patients with COVID-19”, says this professor of Biochemistry and Molecular Biology.
In the article signed in Frontiers in Immunology they appear as authors Carlos Jiménez-Cortegana, Flora Sánchez-Jiménez, Antonio Pérez-Pérez, Nerissa Álvarez, Alberto Sousa, Luisa Cantón-Bulnes, Teresa Vilariño-García, Sandra Fuentes, Salomón Martín, Marta Jiménez, Antonio León-Justel, Luis De La Cruz- Merino, Jose Garnacho-Montero and Victor Sanchez-Margalet.
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