Gut microbiota in COVID-19 treatment

A novel coronavirus (severe acute respiratory syndrome coronavirus [SARS-CoV-2]), has been causing a COVID-19 pandemic of acute respiratory syndrome in humans since December 2019. It appears to be similar in structure to the virus that caused the SARS-CoV outbreak of 18 years ago. However, in addition to the respiratory disorders, the COVID-19 patients might suffer extra-pulmonary disorders, including gut dysfunction or liver dysfunction complications, which show as gut-lung crosstalk. Fecal specimens should be considered as a source of detection of SARS-CoV-2 as one of the routine diagnostic tests in order to guide hospital\u27s liberation and release of quarantine of patients

Immune-related adverse kidney events by immune checkpoint inhibitors; a narrative review on current studies

Chemotherapy-associated renal injury is considered one of the major concerns among nephrological and oncological practice. The use of novel anti-neoplastic therapies that target carcinomas has helped in the detection of this form of renal injury. Immune checkpoint inhibitors (ICPIs) are a group of monoclonal antibodies targeting inhibitory receptors that exist on tumor cells and T cells. ICPIs are able to suppress tumors that might have escaped from the immune surveillance. Meanwhile, although ICPIs have shown promising efficacy in cancer treatment, their immune-related side effects limit their widespread use in cancer therapy schedules. One of the major side effects limiting ICPIs' usage is nephrotoxicity. Glomerular disease, acute interstitial nephritis (AIN), and acute tubular necrosis (ATN) are considered different infusion-related adverse events. Infiltration of eosinophils, T lymphocytes, and plasma cells, as well as interstitial inflammation and edema, leading to acute tubulointerstitial nephritis (ATIN). It is conceivable that the rupture of self-tolerance by ICPIs induces an autoimmune reaction against some specific self-antigens in the organs including kidneys. The exact nature of the antigen is unclear; however, it is possible that it is found in the renal tubular cells, as indicated by a greater frequency of ATIN in kidney biopsies. The current review paper discusses the relationship between ICPIs therapy and kidney disorders or more specifically, their possible role in renal damage along with renal toxicity profile in the setting of ICPIs treatment

Efficacy and side effects of Sputnik V, Sinopharm and AstraZeneca vaccines to stop COVID-19; a review and discussion

We believe that vaccination is just a way to eliminate or strongly stop the COVID-19. In this regard, there are several vaccines with different efficacy and side effects. It is urgently required to have some efficient vaccines for the prevention and control of SARS-CoV-2. In this review, international databases were considered for searching relevant articles from 1 January 2020 to 1 May 2021. Keywords were COVID-19, novel coronavirus, 2019-nCoV, coronavirus disease 2019, vaccine, Sputnik V, Gamaleya, Gam-COVID-Vac, Sinopharm, BBIBP-CorV, AstraZeneca, Vaxzevria, Oxford, ChAdOx1 nCoV-19 and AZD1222. Three Sputnik V, Sinopharm and AstraZeneca vaccines are useful to gain herd immunity. Enough intervals (at least three weeks/21 days) must be considered for sufficient neutralizing antibody titers. What is important is that the vaccination should be accelerated with each of the aforementioned three vaccines to achieve herd immunity in a shorter period of time because all three vaccines provide 100% prevention of severe COVID-19

COVID-19 and renal involvement; evolving role of thromboinflammation, vascular and glomerular disease in the pathogenesis

Coronavirus disease 2019 (COVID-19), the currently prevailing pandemic that has besieged the whole world, is caused by a novel coronavirus, named as, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, there was a focus on respiratory disease, which was and is the most predominant presentation. However, with increasing spread of the infection and consequent increasing knowledge and experience about the disease, it has become apparent that the virus has wide-ranging effects on other organs and systems, including heart, blood, kidney and gastrointestinal tract. A variety of mechanisms are involved in viral damage of these organs. Blood vessels, particularly the microvasculature, and blood clotting systems are also frequently targeted by the virus, especially in severe cases. This review narrates the available evidence on the mechanisms underlying hypercoagulability and thrombotic tendency in COVID-19 disease

Systemic lupus erythematosus following SARS-CoV-2 vaccination; a review of literature

From March 2020, the coronavirus disease 2019 (COVID-19) pandemic challenged public health and healthcare systems worldwide. Viral infection is one of the environmental factors that has been associated with the development, relapse, or exacerbation of systemic lupus erythematosus (SLE). SLE patients are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of immune system dysfunction related to their disease as well as immunosuppression medications. So far, the most effective way to reduce SARS-CoV-2 infection-induced hospitalization and death is vaccination. On the other hand, SLE patients present distinct challenges related to the safety and effectiveness of SARS-CoV-2 vaccination. We have reviewed some reports on the onset or flare of SLE post-COVID-19 vaccination. Of note, the mRNA COVID-19 vaccines are associated with increased SLE disease activity, more frequently than the other types of COVID-19 vaccines

Antioxidants and cisplatin nephrotoxicity; an updated review on current knowledge

Cisplatin is a first-line antitumor drug which is applied in the therapeutic field of numerous kinds of cancers. The main dose-dependent adverse effect of cisplatin is nephrotoxicity in approximately one-third of patients, who received this drug during their treatment. Oxidative stress is one of the most significant mechanisms in cisplatin nephrotoxicity. Cisplatin-induced oxidative stress stimulates apoptosis, inflammation, mitochondrial damage within cells, and endoplasmic reticulum (ER) stress. The administration of an antioxidant in this context could be a suitable approach for preventing of cisplatin nephrotoxicity. Antioxidants are categorized into four classes: dietary antioxidants, free radical scavengers, thiol-containing compounds, and iron chelators

Gut microbiota in COVID-19 treatment

A novel coronavirus (severe acute respiratory syndrome coronavirus [SARS-CoV-2]), has been causing a COVID-19 pandemic of acute respiratory syndrome in humans since December 2019. It appears to be similar in structure to the virus that caused the SARS-CoV outbreak of 18 years ago. However, in addition to the respiratory disorders, the COVID-19 patients might suffer extra-pulmonary disorders, including gut dysfunction or liver dysfunction complications, which show as gut–lung crosstalk. Fecal specimens should be considered as a source of detection of SARS-CoV-2 as one of the routine diagnostic tests in order to guide hospital’s liberation and release of quarantine of patients

Risk stratification and long-term kidney survival in IgA nephropathy with particular emphasis on Oxford classification; A narrative review

Introduction: IgA nephropathy (IgAN) is one of the most common forms of glomerulonephritis worldwide. It leads to end-stage renal disease (ESRD) in many patients. At the time of diagnosis, risk stratification is of paramount importance in planning proper management in individual cases. Several studies have been conducted to determine the utility of various demographic, clinical, laboratory, and pathological features on renal biopsy to stratify the risk of disease progression and predict the likely outcome. This review summarizes the emerging data on demographic, clinical, laboratory, and histological prognosis along with risk factors associated with renal outcomes in patients with IgAN. Methods: For this review, we searched DOAJ (Directory of Open Access Journals), PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar, using keywords including; "IgA nephropathy," "IgA nephritis," "IgAN," "Berger’s disease," "Berger’s syndrome," "chronic glomerulonephritis, "prognostic factors," "risk factors," "risk stratification," "renal survival," "ESRD," "MEST classification," "MEST-C classification" and "Oxford Classification." To identify other relevant studies, we manually scanned the bibliographic lists of the identified studies and reviewed articles from January 2009 through December 2020. All relevant articles were carefully reviewed, and relevant information was extracted for this narrative review. Results: A total of 152 articles were retrieved from the above literature database searches. The abstracts were carefully reviewed to identify 35 articles containing information on prognostic factors and long-term renal survival in IgAN patients. Relevant information was collected and summarized for this review. The main focus was on using demographic, clinical, and laboratory features, especially serial changes in these parameters during follow-up, for this purpose. Recently a standardized, evidence-based formulation has been devised to evaluate and categorize pathological features on renal biopsy to augment and refine the risk stratification and prognostic value of traditional risk factors; it is popularly known as the Oxford classification of IgAN. There have been numerous validation studies in various ethnic groups that have proven its clinical utility. Conclusion: In conclusion, the clinicians should also take into account the pathologic variables according to the revised Oxford classification in addition to demographic, clinical, and laboratory parameters for early and reliable risk stratification and prognostication in individual patients at the time of diagnosis in IgAN for optimal management and ultimate improvement in long-term outcomes