{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:40:20Z","timestamp":1777711220815,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bulgarian Fund for scientific investigations","award":["KP-06-DK1\/7\/29.03.2021"],"award-info":[{"award-number":["KP-06-DK1\/7\/29.03.2021"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Immunopathol Pharmacol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Cytokine dysregulation has been proposed as one of the main culprits for severe COVID-19 and poor prognosis. We examined the parallel presence of lymphopoietic, proinflammatory, Th1, Th2, regulatory cytokines, and chemokines in the serum of 47 patients with mild, moderate, and severe COVID-19 and evaluated the association between cytokine concentrations and disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multiplex quantitative cytokine analysis ProcartaPlex\u2122 immunoassay was applied, using the Luminex\n                      <jats:sup>TM<\/jats:sup>\n                      200X detection system (Invitrogen).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The concentrations of twelve cytokines: IL-18, IFN-gamma, TNF-alpha; IL-21; IL-1alpha, IL-1beta, IL-6, IL-22; IL-10, IL-1RA; IL-7 and IFN-alpha were consistently elevated in the studied serum samples. All examined chemokines\u2014Eotaxin, GRO-alpha, IL-8, IP-10, MCP-1, MIP-1alpha, MIP-1beta, SDF-1alpha, and RANTES, were detectable in all studied groups, confirming their importance in mediating the adaptive immune response regardless of disease severity. The serum concentrations of six mediators: IL-1beta, IL-6, IL-18, IL-10, IL-8, and IP-10, showed statistically significant differences among the groups with different disease severity. IL-6, IL-1beta, and IL-10 were more significantly elevated in severe cases while milder symptoms were associated with lower levels of IL-8 and IP-10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, the studied chemokines demonstrated an associated production in acute COVID-19 infection. A strong correlation was observed between the Th1 mediators IL-18 and IL-10 and the proinflammatory IL-6 in the severe COVID-19 group. Our results indicated that severe COVID-19 was characterized by a dysregulated cytokine pattern whereby the Th1 immune response is outweighed by the immunoregulatory response, while inhibitory signals cannot balance the hyperinflammatory response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03946320231163681","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T12:10:11Z","timestamp":1678968611000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Patterns of cytokine and chemokine expression in peripheral blood of patients with COVID-19 associated with disease severity"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-9548","authenticated-orcid":false,"given":"Iva","family":"Trifonova","sequence":"first","affiliation":[{"name":"Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8390-9970","authenticated-orcid":false,"given":"Kim","family":"Ngoc","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Nikolova","sequence":"additional","affiliation":[{"name":"Department of Immunology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radoslava","family":"Emilova","sequence":"additional","affiliation":[{"name":"Department of Immunology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4708-6887","authenticated-orcid":false,"given":"Yana","family":"Todorova","sequence":"additional","affiliation":[{"name":"Department of Immunology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodora","family":"Gladnishka","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Christova","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"bibr1-03946320231163681","doi-asserted-by":"publisher","DOI":"10.1111\/sji.12989"},{"key":"bibr2-03946320231163681","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2021.104799"},{"key":"bibr3-03946320231163681","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2020.107225"},{"key":"bibr4-03946320231163681","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2020.05.002"},{"key":"bibr5-03946320231163681","volume-title":"Clinical Management of COVID-19: Living Guideline","author":"WHO","year":"2022"},{"key":"bibr6-03946320231163681","unstructured":"ProcartaPlex Analyst 1.0 Software | Thermo Fisher Scientific."},{"issue":"1","key":"bibr7-03946320231163681","first-page":"97","volume":"26","author":"Chen Y","year":"2020","journal-title":"Molecular medicine (Cambridge, 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