Cytokines and inflammation

Enteroviral meningitis accounts for 85%–90% of serous meningitis cases in children. In 40%–70% of cases, it is accompanied by delayed neurological sequale, necessitating the development of methods for early outcome prediction.

This review aimed to formally analyze current data on the mechanisms of neuroinvasion and neuroinflammation in enteroviral infections that underlie enterovirus neurovirulence. The article comprehensively evaluates existing and promising approaches to predicting adverse neurological outcomes of enteroviral meningitis in children, focusing on the search for biomarkers and the development of risk stratification algorithms.

We reviewed current scientific publications on the pathogenesis of enteroviral infections, which address their neurotropism, neuroinvasion routes, and intrathecal inflammation. We systematized data on prognostic methods, including instrumental and laboratory studies of cerebrospinal fluid and blood serum, as well as complex mathematical models. Particular attention was paid to assessing the potential of the chemiluminescence for evaluating neutrophil function and metabolic activity.

The analysis revealed complex, complementary mechanisms of enterovirus neuroinvasion that underlie neuroinflammation and determine the risk of long-term sequelae. Current prognostic approaches were found to be highly heterogeneous; however, the most accurate risk stratification was provided by comprehensive models that integrate clinical, anamnestic, instrumental, and laboratory data. Chemiluminescence was identified as a promising approach for evaluating the neutrophil function, especially in cerebrospinal fluid, given their key role in the Trojan horse mechanism of neuroinvasion and in the modulation of neuroinflammation in enteroviral meningitis. Respiratory burst parameters (activation rate, peak intensity, total volume of reactive oxygen species, and activation index) may potentially serve as early biomarkers of the intrathecal inflammation severity, phagocytic reserve depletion, and complication risk.

The development and validation of algorithms for predicting adverse outcomes of enteroviral meningitis in children remains a priority. Such algorithms should comprize a combination of the most informative parameters, including promising indicators of the neutrophil function and metabolic activity in cerebrospinal fluid assessed by chemiluminescence. Implementation of such algorithms will optimize clinical monitoring and rehabilitation strategies to minimize the severity of neurological deficits.

BACKGROUND: The World Health Organization estimates that seasonal influenza causes 3 to 5 million severe cases requiring hospitalization each year, resulting in 290,000 to 650,000 deaths. Recombinant antibodies represent one of the most advanced and promising treatment options for the effective management of influenza.

AIM: This study aimed to evaluate characteristics, specificity, and virus-neutralizing activity of the IgA1 and IgG1 isotypes of the recombinant FM08 antibody, which targets the influenza hemagglutinin stem domain.

METHODS: Expression plasmids were obtained using molecular genetic techniques. The transient expression technique was used to accumulate experimental samples of the IgA1 and IgG1 isotypes of the FM08 antibody in a serum-free HEK293 cell culture. The biological activities were compared using electrophoretic separation, enzyme-linked immunosorbent assay, and microneutralization reaction. The study also used influenza A strains, including the H1N1pdm, H2N2, H3N2, and H5N1 subtypes, as well as influenza B strains from both genetic lines.

RESULTS: The resulting genetic constructs accumulate recombinant FM08 antibodies of the IgA1 and IgG1 isotypes in eukaryotic cell cultures. The binding patterns of two FM08 antibody isotypes were virtually identical. Starting at a concentration of 16 ng/μL, both isotypes interacted with strains from both influenza A virus phylogenetic groups, except for the 1934 H1N1 strain. The IgA1 and IgG1 FM08 isotypes neutralized the influenza A/California/07/2009 (H1N1pdm09) virus with IC₅₀ of 1–4 μg/mL and the influenza A/Cambodia/E0826360/2020 (H3N2) virus with IC₅₀ of 20 μg/mL.

CONCLUSION: In vitro studies of the biological activity of the experimental FM08 antibody samples of the IgA1 and IgG1 isotypes revealed their high potential as antiviral agents.

BACKGROUND: It has been shown that the novel coronavirus infection (COVID-19), in addition to pulmonary involvement, is frequently accompanied by psychoneurological symptoms. However, rehabilitation of patients after COVID-19, as well as after other viral infections, remains a substantial challenge in clinical practice.

AIM: To analyze the effects of mushroom β-glucans on the mental and physical status of patients with moderate COVID-19 during the acute phase and early post-COVID period.

METHODS: The study included 60 patients (22 men and 38 women aged 26–74 years) with COVID-19 confirmed by polymerase chain reaction and chest computed tomography. Patients were randomized into two groups of 30 individuals each. The control group received standard treatment according to national clinical guidelines (version 11, May 7, 2021) in combination with placebo. In the intervention group, standard therapy was supplemented with mushroom β-glucans (dietary supplement Glucaferon®). The patients’ psychoemotional and physical status was assessed using validated questionnaires: anxiety (GAD-7), depression (PHQ-9), general health status and working capacity (EQ-VAS), and fatigue (VAFS) during 10 days of hospitalization and for 28 days after discharge.

RESULTS: During the first days of hospitalization, symptoms of depression and anxiety predominated over fatigue severity. After discharge, patients reported a gradual increase in fatigue, whereas anxiety and depressive symptoms demonstrated an opposite trend. Comparative analysis showed that patients receiving Glucaferon® experienced faster recovery of psychoemotional status compared with the placebo group. Daily administration of the supplement was associated with an approximately 1.5-fold reduction in fatigue severity by the end of the follow-up period.

CONCLUSION: Mushroom β-glucans may be considered a promising class of agents potentially capable of reducing chronic neuroinflammation and psychoneurological complications associated with COVID-19, as well as preventing neurodegenerative processes. However, further studies are required to confirm these findings.