CCR5 inhibition in critical COVID-19 patients decreases inflammatory cytokines, increases CD8 T-cells, and decreases SARS-CoV2 RNA in plasma by day 14
•Anti-CCR5 humanized monoclonal antibody restored CD8 counts in COVID patients.•Inversely correlated with decreases in plasma viral load (pVL) by day 14.•CCL5/RANTES up 3–5-fold in mild/moderate patients and >100-fold in critical ones.•First report of highly sensitive, quantitative pVL by ddPCR i...
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| Vydané v: | International journal of infectious diseases Ročník 103; s. 25 - 32 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
Canada
Elsevier Ltd
01.02.2021
The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases Elsevier |
| Predmet: | |
| ISSN: | 1201-9712, 1878-3511, 1878-3511 |
| On-line prístup: | Získať plný text |
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| Shrnutí: | •Anti-CCR5 humanized monoclonal antibody restored CD8 counts in COVID patients.•Inversely correlated with decreases in plasma viral load (pVL) by day 14.•CCL5/RANTES up 3–5-fold in mild/moderate patients and >100-fold in critical ones.•First report of highly sensitive, quantitative pVL by ddPCR in COVID patients.•Statistically significant drop in IL-6 by day 14 of treatment.
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a global pandemic. Emerging results indicate a dysregulated immune response. Given the role of CCR5 in immune cell migration and inflammation, we investigated the impact of CCR5 blockade via the CCR5-specific antibody leronlimab on clinical, immunological, and virological parameters in severe COVID-19 patients.
In March 2020, 10 terminally ill, critical COVID-19 patients received two doses of leronlimab via individual emergency use indication. We analyzed changes in clinical presentation, immune cell populations, inflammation, as well as SARS-CoV-2 plasma viremia before and 14 days after treatment.
Over the 14-day study period, six patients survived, two were extubated, and one discharged. We observed complete CCR5 receptor occupancy in all donors by day 7. Compared with the baseline, we observed a concomitant statistically significant reduction in plasma IL-6, restoration of the CD4/CD8 ratio, and resolution of SARS-CoV2 plasma viremia (pVL). Furthermore, the increase in the CD8 percentage was inversely correlated with the reduction in pVL (r = −0.77, p = 0.0013).
Our study design precludes clinical efficacy inferences but the results implicate CCR5 as a therapeutic target for COVID-19 and they form the basis for ongoing randomized clinical trials. |
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| Bibliografia: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Co-senior authors. |
| ISSN: | 1201-9712 1878-3511 1878-3511 |
| DOI: | 10.1016/j.ijid.2020.10.101 |