Can Beta-2-Adrenergic Pathway Be a New Target to Combat SARS-CoV-2 Hyperinflammatory Syndrome?—Lessons Learned From Cancer

SARS-CoV-2 infection is a new threat to global public health in the 21st century (2020), which has now rapidly spread around the globe causing severe pneumonia often linked to Acute Respiratory Distress Syndrome (ARDS) and hyperinflammatory syndrome. SARS-CoV-2 is highly contagious through saliva droplets. The structural analysis suggests that the virus enters human cells through the ligation of the spike protein to angiotensin-converting enzyme 2 (ACE2). The progression of Covid-19 has been divided into three main stages: stage I—viral response, stage II—pulmonary phase, and stage III—hyperinflammation phase. Once the patients enter stage III, it will likely need ventilation and it becomes difficult to manage. Thus, it will be of paramount importance to find therapies to prevent or slow down the progression of the disease toward stage III. The key event leading to hyperinflammation seems to be the activation of Th-17 immunity response and Cytokine storm. B2-adrenergic receptors (B2ARs) are expressed on airways and on all the immune cells such as macrophages, dendritic cells, B and T lymphocytes. Blocking (B2AR) has been proven, also in clinical settings, to reduce Th-17 response and negatively modulate inflammatory cytokines including IL-6 while increasing IFNγ. Non-selective beta-blockers are currently used to treat several diseases and have been proven to reduce stress-induced inflammation and reduce anxiety. For these reasons, we speculate that targeting B2AR in the early phase of Covid-19 might be beneficial to prevent hyperinflammation

Cardiac and Vascular Microenvironment: Biological and Clinical Implications in Cardiology

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Prevalence of interstitial pneumonia suggestive of COVID-19 at 18F-FDG PET/CT in oncological asymptomatic patients in a high prevalence country during pandemic period: a national multi-centric retrospective study

Purpose: To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([18F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus. Methods: This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January\u2013February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET. Results: Overall, [18F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1). Conclusions: A significant increase of interstitial pneumonia incidentally detected with [18F]FDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management

Trastuzumab and target-therapy side effects: Is still valid to differentiate anthracycline Type I from Type II cardiomyopathies?

The improvement in cancer therapy and the increasing number of long term survivors unearth the issue of cardiovascular side effects of anticancer treatments. As a paradox in cancer survivors, delayed cardiotoxicity has emerged as a significant problem. Two categories of cardiotoxic side effects of antineoplastic drugs have been previously proposed: Type I cardiotoxicity, defined as permanent cardiotoxicity, is usually caused by anthracyclines; Type II cardiotoxicity, considered as reversible cardiotoxicity, has been mainly related to monoclonal antibodies. The cardiotoxicity of antibodies has been associated to trastuzumab, a humanized anti-ErbB2 monoclonal antibody currently in clinical use for the therapy of breast carcinomas, which induces cardiac dysfunction when used in monotherapy, or in combination with anthracyclines. Furthermore, recent retrospective studies have shown an increased incidence of heart failure and/or cardiomyopathy in patients treated with trastuzumab, that can persist many years after the conclusion of the therapy, thus suggesting that the side toxic effects are not always reversible as it was initially proposed. On the other hand, early detection and prompt therapy of anthracycline associated cardiotoxicity can lead to substantial recovery of cardiac function. On the basis of these observations, we propose to find a new different classification for cardiotoxic side effects of drugs used in cancer therapy

Importance of the macrofauna for the feeding of young fish species from infralittoral of Arrozal - Cananeia lagoon estuarine region (25º02'S-47º56'W): Brazil

The aim of this study was to establish the importance of the macrofauna as food for young fish species that inhabit the infralittoral adjacent to the lower marsh. The sampling site is located at Arrozal, Cananéia lagoon estuarine region (25º02'S and 47º56'W) and the collectings were realized monthly, during a year. The results suggest that the studied area could be considered as a nursery ground for young fish species. The local macrofauna is composed mainly by several groups of crustaceans and has a marked temporal variation. Mysids were dominant in Spring, copepods in Summer, mysids and bivalves were co-dominants in the Autumn and amphipods in Winter. Mysids, copepods, ostracods, tan aids and other epifaunal crustaceans were more consumed than other items. According to the trophic habits, the twelve fish species could be divided into three groups: the first and the third as mysids and copepods eaters respectively, and the second group with a balanced diet reflecting more than the other groups the seasonal variation of the macrofauna collected by the dredge. Benthonic and benthopelagic organisms were considered the major food source, being consumed by 75% of the analysed fish species, in Cananéia infralittoral.<br>O objetivo do presente trabalho foi avaliar a importância da macrofauna do infralitoral, adjacente a marisma do Arrozal, região de Cananéia, na dieta alimentar de doze espécies de peixes jovens. De acordo com os resultados obtidos, a região pode ser considerada um berçário para muitas espécies de peixes. A macrofauna local é composta principalmente de crustáceos e apresenta uma acentuada variação temporal. Misidáceos foram dominantes na primavera, copépodes no verão, misidáceos e bivalves foram co-dominantes no outono e anfípodes no inverno. Misidáceos, copépodes, ostrácodes, tanaidáceos e outros crustáceos epifaunais foram mais consumidos pelos peixes macropredadores que outros itens. Os peixes capturados foram divididos em três grupos, de acordo com os hábitos tróficos: comedores de misidáceos, comedores de copépodes e "generalistas" que refletiu a variação sazonal da macrofauna. Setenta e cinco por cento das espécies de peixes predadores alimentaram-se de organismos bentônicos e bentopelágicos e vinte e cinco por cento de organismos pelágicos. Assim, no infralitoral de Cananéia - Arrozal os organismos bentônicos e bentopelágicos constituem a principal fonte alimentar de peixes jovens