The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on "Profibrotic Cytokine" IL-1 β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study

Karina Karina; Louis Martin Christoffel; Rita Novariani; Imam Rosadi; Iis Rosliana; Siti Rosidah; Siti Sobariah; Novy Fatkhurohman; Nurlaela Puspitaningrum; Yuli Hertati; Irsyah Afini; Difky Ernanda; Tias Widyastuti; A D Sulaeha; Alfida Zakiyah; Noor Aini; Grady Krisandi; Hubert Andrew

doi:10.1155/2021/9427978

The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on "Profibrotic Cytokine" IL-1 β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study

Scientifica (Cairo). 2021 Jul 8:2021:9427978. doi: 10.1155/2021/9427978. eCollection 2021.

Authors

Karina Karina^{1

2

3

4}, Louis Martin Christoffel⁵, Rita Novariani⁵, Imam Rosadi^{2

6}, Iis Rosliana², Siti Rosidah⁵, Siti Sobariah², Novy Fatkhurohman⁵, Nurlaela Puspitaningrum⁵, Yuli Hertati⁵, Irsyah Afini², Difky Ernanda², Tias Widyastuti², A D Sulaeha¹, Alfida Zakiyah², Noor Aini², Grady Krisandi^{2

7}, Hubert Andrew^{2

7}

Affiliations

¹ Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia.
² HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia.
³ Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia.
⁴ Pusat Kajian Stem Cell, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia.
⁵ Koja Regional Public Hospital, Jl. Deli No. 4, Jakarta, Indonesia.
⁶ Department of Biology, Faculty of Mathematics and Natural Sciences, Mulawarman University, Samarinda, Indonesia.
⁷ Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, Indonesia.

Abstract

Introduction: Elevated concentration of proinflammatory cytokines followed by hyperinflammation is one of the hallmarks of severe and critical COVID-19. In the short term, this may result in ARDS and lung injury; subsequently, this may cause pulmonary fibrosis-a disease with poor prognosis-in the long run. Among the cytokines, interleukin-1β (IL-1β) is one of the most overexpressed in COVID-19. We speculate that administration of intravenous activated autologous platelet-rich plasma (aaPRP), which contains interleukin-1 receptor antagonist (IL-1RA), would lower IL-1β levels and benefit the severe and critical COVID-19 patients.

Methods: After acquiring ethical clearance, we recruited 12 adult COVID-19 patients of both sexes from the Koja Regional Hospital (Jakarta, Indonesia) ICU. After selection, seven patients were included and divided into two groups, severe and critical. In addition to three doses of aaPRP, both groups received the same treatment of antiviral, steroid, and antibiotics. Quantification of plasma IL-1β levels was performed by beads multiplex assay a day before the first aaPRP administration and a day after the second and third aaPRP administration. PaO₂/FiO₂ ratio and lung injury scores were evaluated a day before and a day after each aaPRP administration.

Results: Severe and critical patients' initial plasma IL-1β concentration was 4.71 pg/mL and 3.095 pg/mL, respectively. After 2 treatments with aaPRP, severe patients' plasma IL-1β concentration decreased 12.48 pg/mL, while critical patients' plasma IL-1β concentration increased to 18.77 pg/mL. Furthermore, after 3 aaPRP treatments, significant amelioration of patients' PaO₂/FiO₂ ratio from 71.33 mmHg at baseline to 144.97 mmHg was observed (p < 0.05). However, no significant improvement in lung injury score was observed in severe and critical groups. All severe patients and one critical patient recovered.

Conclusion: The use of aaPRP may prevent pulmonary fibrosis in severe COVID-19 patients through the reduction of patients' plasma IL-1β concentration and the amelioration of PaO₂/FiO₂ ratio.