Case report: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 with severe myocardial dysfunction. Is there any hope in immunotherapy?

Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) develops in a small percentage of children after COVID-19, however, it might cause severe myocardial dysfunction. The pathogenesis of this disease includes systemic hyper-inflammation with cytokine storm. This case report concerns a 12-year-old boy with PIMS-TS who presented severe respiratory and circulatory failure with increased inflammatory markers and significant reduction of left ventricle ejaculatory fraction (LVEF) from 65% to 35%. The recommended therapy with the use of vasopressors, corticosteroids, intravenous immunoglobulins and mechanical ventilation was introduced and his condition gradually improved. However, after few days, aggravation of cardiac symptoms occurred again and among other treatment, the therapy with the use of anakinra - the human interleukin 1 receptor antagonist protein was introduced. This case highlights a satisfactory regression of cardiac disturbances and generally favorable outcome of the treatment in patients with PIMS-TS with the use of immunomodulatory therapy

Does the Composition of Gut Microbiota Affect Hypertension? Molecular Mechanisms Involved in Increasing Blood Pressure

Arterial hypertension is a chronic disease which is very prevalent contemporarily. The aim of this review was to investigate the impact of gut microbiota on the development and potential treatment of hypertension, taking into consideration underlying molecular mechanisms. The bacteria present in the intestines have the ability to secrete different metabolites, which might play a significant role in the regulation of blood pressure. The most important include short-chain fatty acids (SCFAs), vasoactive hormones, trimethylamine (TMA) and trimethylamine N-oxide (TMAO) and uremic toxins, such as indoxyl sulfate (IS) and p-cresyl sulfate (PCS). Their action in regulating blood pressure is mainly based on their pro- or anti-inflammatory function. The use of specifically formulated probiotics to modify the composition of gut microbiota might be a beneficial way of supportive treatment of hypertension; however, further research on this topic is needed to choose the species of bacteria that could induce the hypotensive pattern