Background: HELLP syndrome is one of the disorders characterized by hemolysis, increased liver enzymes and decreased platelet count. So far, many molecular pathways and genes have been identified in relation to the pathogenesis of this syndrome; however, the main cause of the incidence and progression of the disease has not been identified. Using the biological system approach is a way to target patients by identifying genes and molecular pathways. In this study, we investigated genes and important molecular factors in the pathogenesis of HELLP syndrome. Material and Methods: In this study, the microarray dataset was downloaded from Gene Expression Omnibus (GEO) database and analyzed using the GEO2R online tool for identifying differentially expressed genes (DEGs). Enrichment analysis of DEGs was evaluated using the Enrichr database. Then, protein-protein interaction (PPI) networks were constructed via the STRING database; they were visualized by Cytoscape. Then the STRING database was used to construct PPI networks. The hub genes were recognized using the cytoHubba. Ultimately, the interaction of the miRNA-hub genes and drug-hub genes were also evaluated. Result: After analysis, it was found that some genes with the highest degree of connectivity are involved in the pathogenesis of HELLP syndrome, which are known as the hub genes. These genes are as follows: KIT, JAK2, LEP, EP300, HIST1H4L, HIST1H4F, HIST1H4H, MMP9, THBS2, and ADAMTS3. Has-miR-34a-5p was also most associated with hub genes. Conclusion: Finally, it can be said, that the identification of genes and molecular pathways in HELLP syndrome can be helpful in identifying the pathogenesis pathways of the disease, and designing therapeutic targets.

Background: Coronavirus disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China. Different treatments have been used to fight against the virus; however, one of the most effective and accessible is convalescent plasma therapy (CPT). Objectives: The present study investigated the effect of CPT on improving the clinical conditions of COVID-19 patients. Methods: This study was conducted on 440 individuals, including 220 COVID-19-recovered individuals as plasma donors and 220 plasma recipients, in Shiraz, Fars province, Iran, from May 2020 to February 2021 using random sampling. After complete recovery from COVID-19, patients were recalled for apheresis and plasma isolation for convalescent plasma (CP) preparation; they were referred to the blood donation centers of Shiraz. According to the hospital request, compatible and related plasma was sent for COVID-19-hospitalized patients. At the same time, hospitals were asked to send the clinical condition documents of the patients based on the medical records and the outcomes after CPT. The Iranian Blood Transfusion Organization evaluated the results. Results: The median antibody titer was 1300. Titers higher and lower than 1300 were considered high and low, respectively. Blood group O had 54 times higher antibody titers above 1300 than other blood groups (odds ratio (OR) = 54, confidence interval (CI): 19.5 - 205.3, P < 0.001). Additionally, most deceased cases received plasma with antibody titers less than 1300 (OR = 0.08, CI: 0.009 - 0.36, P < 0.001). Nevertheless, most discharged patients received plasma with antibody titers higher than 1300 (OR = 1.5, CI: 1.06 - 2.3, P = 0.01). Moreover, when donors’ antibody titer was higher than 1300, the chance of survival increased by 50%. In addition, the results of this study showed higher mortality in patients whose volume of received plasma was less than 387 mL (OR = 0.3, CI: 0.10 - 0.91, P = 0.018). However, patients who received more than 387 mL CP were more likely to discharge (OR = 5.7, CI: 3.7 - 8.8, P < 0.001). Conclusions: Using blood group O plasma with a minimum volume of 387 mL can be very effective in improving the clinical symptoms of patients with COVID-19 and increasing the chances of survival for these patients.

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