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Pandey RK, Srivastava A, Mishra RK, Singh PP, Chaubey G. Novel genetic association of the Furin gene polymorphism rs1981458 with COVID-19 severity among Indian populations. Sci Rep 2024; 14:7822. [PMID: 38570613 PMCID: PMC10991378 DOI: 10.1038/s41598-024-54607-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/14/2024] [Indexed: 04/05/2024] Open
Abstract
SARS CoV-2, the causative agent for the ongoing COVID-19 pandemic, it enters the host cell by activating the ACE2 receptor with the help of two proteasesi.e., Furin and TMPRSS2. Therefore, variations in these genes may account for differential susceptibility and severity between populations. Previous studies have shown that the role of ACE2 and TMPRSS2 gene variants in understanding COVID-19 susceptibility among Indian populations. Nevertheless, a knowledge gap exists concerning the COVID-19 susceptibility of Furin gene variants among diverse South Asian ethnic groups. Investigating the role of Furin gene variants and their global phylogeographic structure is essential to comprehensively understanding COVID-19 susceptibility in these populations. We have used 450 samples from diverse Indian states and performed linear regression to analyse the Furin gene variant's with COVID-19 Case Fatality Rate (CFR) that could be epidemiologically associated with disease severity outcomes. Associated genetic variants were further evaluated for their expression and regulatory potential through various Insilco analyses. Additionally, we examined the Furin gene using next-generation sequencing (NGS) data from 393 diverse global samples, with a particular emphasis on South Asia, to investigate its Phylogeographic structure among diverse world populations. We found a significant positive association for the SNP rs1981458 with COVID-19 CFR (p < 0.05) among diverse Indian populations at different timelines of the first and second waves. Further, QTL and other regulatory analyses showed various significant associations for positive regulatory roles of rs1981458 and Furin gene, mainly in Immune cells and virus infection process, highlighting their role in host immunity and viral assembly and processing. The Furin protein-protein interaction suggested that COVID-19 may contribute to Pulmonary arterial hypertension via a typical inflammation mechanism. The phylogeographic architecture of the Furin gene demonstrated a closer genetic affinity of South Asia with West Eurasian populations. Therefore, it is worth proposing that for the Furin gene, the COVID-19 susceptibility of South Asians will be more similar to the West Eurasian population. Our previous studies on the ACE2 and TMPRSS2 genes showed genetic affinity of South Asian with East Eurasians and West Eurasians, respectively. Therefore, with the collective information from these three important genes (ACE2, TMPRSS2 and Furin) we modelled COVID-19 susceptibilityof South Asia in between these two major ancestries with an inclination towards West Eurasia. In conclusion, this study, for the first time, concluded the role of rs1981458 in COVID-19 severity among the Indian population and outlined its regulatory potential.This study also highlights that the genetic structure for COVID-19 susceptibilityof South Asia is distinct, however, inclined to the West Eurasian population. We believe this insight may be utilised as a genetic biomarker to identify vulnerable populations, which might be directly relevant for developing policies and allocating resources more effectively during an epidemic.
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Affiliation(s)
- Rudra Kumar Pandey
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, 221005, India.
| | - Anshika Srivastava
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, 221005, India
| | - Rahul Kumar Mishra
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, 221005, India
| | - Prajjval Pratap Singh
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, 221005, India
| | - Gyaneshwer Chaubey
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, 221005, India.
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Charif F, Dakroub F, Bou Akl I, Kularatne M, Montani D. Pulmonary arterial hypertension and COVID-19: Piecing the puzzle. Respir Med Res 2023; 84:101053. [PMID: 38236767 DOI: 10.1016/j.resmer.2023.101053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/20/2023] [Accepted: 09/30/2023] [Indexed: 01/23/2024]
Abstract
COVID-19 remains a health care concern despite the end of the pandemic. Patients with cardiovascular disease (CVD) are at a higher risk for developing severe COVID-19 complications. Studies investigating the COVID-19 clinical characteristics in pulmonary arterial hypertension (PAH) patients have reported discordant conclusions so far. In this review, we summarize the literature pertaining to the clinical presentation of COVID-19 in patients with PAH. In addition, we discuss common pathological aspects and disease mechanisms between PAH and COVID-19. We present an overview of the different types of PAH-approved therapy and their potential utilization as a treatment in the context of COVID-19. Moreover, we summarize the clinical trials that assessed the safety and efficiency of PAH-approved drugs in COVID-19 patients. Finally, we conclude with proposals for prospective research studies.
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Affiliation(s)
- Fida Charif
- Pulmonology Division, Hopitaux du Léman, Thonon les bains, France.
| | - Fatima Dakroub
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Imad Bou Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | | | - David Montani
- Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis Robinson, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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3
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Hryzhak I, Pryshliak O, Kobryn T, Fedorov S, Boichuk O, Marynchak O, Kvasniuk V, Protsyk A, Miziuk R, Kucher A, Simchych M, Hryzhak L, Kuravkin M. Clinical and echocardiographic findings in patients with COVID-19 across different severity levels. J Med Life 2023; 16:1692-1700. [PMID: 38406777 PMCID: PMC10893567 DOI: 10.25122/jml-2023-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/08/2023] [Indexed: 02/27/2024] Open
Abstract
Cardiovascular pathology can complicate the course of COVID-19. The study aimed to identify echocardiographic abnormalities and key prognostic factors influencing severe and fatal COVID-19 outcomes. This retrospective cohort study included clinical and echocardiogram data from 194 medical records of hospitalized patients with COVID-19: 100 moderate cases, 34 severe cases with favorable outcomes, and 60 severe cases with fatal outcomes. Severe patients with favorable outcomes had greater reductions in left ventricular systolic fraction of left ventricle compared to moderate cases (23.5% vs. 7.0%, respectively, p=0.008) and ejection fraction of left ventricle (14.7% vs. 3.0%, respectively, p=0.013), grade I diastolic dysfunction of the left ventricle (20.6% vs. 8.0%, respectively, p=0.044), and pulmonary hypertension (29.41% vs. 10.0%, respectively, p=0.006). Patients with fatal outcomes had a mean age of 67.1±1.51 years, chronic heart failure functional class II (58.3%), hypertension (50.0%), type 2 diabetes (43.3%), and obesity (33.3%). Compared to severe cases but with favorable outcomes, fatal cases had a greater decrease in left ventricular ejection fraction (36.7% vs. 14.7%, respectively, p=0.024), various types of myocardial dysfunction (51.7% vs. 29.4%, respectively, p=0.037) and a trend towards increased pulmonary hypertension (48.3% vs. 29.4%, respectively, p=0.074). Consequently, chronic heart failure class II, reduced left ventricular ejection fraction, various myocardial dysfunctions, and pulmonary hypertension emerged as key cardiac risk factors for severe disease progression and mortality in patients with COVID-19.
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Affiliation(s)
- Ihor Hryzhak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandra Pryshliak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Taras Kobryn
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Sergiy Fedorov
- Department of Therapy, Family and Emergency Medicines of Postgraduate Education, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandr Boichuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandra Marynchak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Viktoriia Kvasniuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andrii Protsyk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Ruslan Miziuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andrii Kucher
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Marianna Simchych
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Lilia Hryzhak
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Mariia Kuravkin
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
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Wang D, Gomes MT, Mo Y, Prohaska CC, Zhang L, Chelvanambi S, Clauss MA, Zhang D, Machado RF, Gao M, Bai Y. Human Endogenous Retrovirus, SARS-CoV-2, and HIV Promote PAH via Inflammation and Growth Stimulation. Int J Mol Sci 2023; 24:7472. [PMID: 37108634 PMCID: PMC10138839 DOI: 10.3390/ijms24087472] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a pulmonary vascular disease characterized by the progressive elevation of pulmonary arterial pressures. It is becoming increasingly apparent that inflammation contributes to the pathogenesis and progression of PAH. Several viruses are known to cause PAH, such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), human endogenous retrovirus K(HERV-K), and human immunodeficiency virus (HIV), in part due to acute and chronic inflammation. In this review, we discuss the connections between HERV-K, HIV, SARS-CoV-2, and PAH, to stimulate research regarding new therapeutic options and provide new targets for the treatment of the disease.
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Affiliation(s)
- Desheng Wang
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang 110122, China
| | - Marta T. Gomes
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Yanfei Mo
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang 110122, China
| | - Clare C. Prohaska
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Lu Zhang
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang 110122, China
| | - Sarvesh Chelvanambi
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Matthias A. Clauss
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Dongfang Zhang
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang 110122, China
| | - Roberto F. Machado
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Mingqi Gao
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang 110122, China
| | - Yang Bai
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang 110122, China
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
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5
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Thomas C, Chandel A, King CS, Aryal S, Brown AW, Khangoora V, Nyquist A, Singhal A, Fonseca OC, Shlobin O, Nathan SD. Prevalence of pulmonary hypertension in patients with COVID-19 related lung disease listed for lung transplantation: A UNOS registry analysis. Pulm Circ 2023; 13:e12228. [PMID: 37091120 PMCID: PMC10114532 DOI: 10.1002/pul2.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/11/2023] [Accepted: 04/09/2023] [Indexed: 04/25/2023] Open
Abstract
COVID-19 related lung disease (CRLD) has emerged as an indication for lung transplantation (LT) in highly select patients. The prevalence and prognostic implication of coexisting pulmonary hypertension (PH) in patients with CRLD listed for LT is not known. Adult patients in the United Network for Organ Sharing database listed for LT for COVID-19 related acute respiratory distress syndrome or fibrosis through March 2022 were identified. The prevalence and impact of precapillary PH on pre- and posttransplantation survival was determined. Time-to-event analysis was used to compare outcomes between those with and without precapillary PH. We identified 245 patients listed for LT for CRLD who had right heart catheterization data available at the time of registry listing. Median age of the cohort was 54 years (interquartile range [IQR]: 46, 60), 56 (22.9%) were female, and the median lung allocation score was 81.3 (IQR: 53.3, 89.4). The prevalence of precapillary PH at the time of transplant listing was 27.9%. There was no significant difference in pretransplant mortality in patients with and without precapillary PH (sHR: 0.5; 95% confidence interval [CI]: 0.1-1.7, p = 0.261). A total of 187 patients ultimately underwent LT; of those, 60 (31.0%) were identified as having precapillary PH during the waitlist period. Posttransplantation survival was similar between patients with and without pretransplant precapillary PH (hazard ratio: 0.96; 95% CI: 0.2-3.7, p = 0.953). We observed a high rate of concomitant precapillary PH in patients listed for LT for CRLD. Though common, coexisting precapillary PH was not associated with a significant difference in either pre- or post-transplantation outcomes.
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Affiliation(s)
- Christopher Thomas
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Abhimanyu Chandel
- Department of Pulmonary and Critical Care MedicineWalter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Christopher S. King
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Shambhu Aryal
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - A. Whitney Brown
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Vikramjit Khangoora
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Alan Nyquist
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Anju Singhal
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Onix Cantres Fonseca
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Oksana Shlobin
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
| | - Steven D. Nathan
- Inova Heart and Vascular Institute, Advanced Lung Disease and Transplant ProgramInova Fairfax HospitalFalls ChurchVirginiaUSA
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Correale M, Croella F, Leopizzi A, Mazzeo P, Tricarico L, Mallardi A, Fortunato M, Magnesa M, Ceci V, Puteo A, Iacoviello M, Di Biase M, Brunetti ND. The Evolving Phenotypes of Cardiovascular Disease during COVID-19 Pandemic. Cardiovasc Drugs Ther 2023; 37:341-351. [PMID: 34328581 PMCID: PMC8322635 DOI: 10.1007/s10557-021-07217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 pandemic has negatively impacted the management of patients with acute and chronic cardiovascular disease: acute coronary syndrome patients were often not timely reperfused, heart failure patients not adequately followed up and titrated, atrial arrhythmias not efficaciously treated and became chronic. New phenotypes of cardiovascular patients were more and more frequent during COVID-19 pandemic and are expected to be even more frequent in the next future in the new world shaped by the pandemic. We therefore aimed to briefly summarize the main changes in the phenotype of cardiovascular patients in the COVID-19 era, focusing on new clinical challenges and possible therapeutic options.
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Affiliation(s)
| | - Francesca Croella
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Alessandra Leopizzi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Mazzeo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lucia Tricarico
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Adriana Mallardi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Martino Fortunato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Michele Magnesa
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Ceci
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Massimo Iacoviello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Matteo Di Biase
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Nurul Fitri AM, Elim D, Sya'ban Mahfud MA, Fitri Sultan NA, Saputra MD, Afika N, Friandini RA, Natsir Djide NJ, Permana AD. Polymeric hydrogel forming microneedle-mediated transdermal delivery of sildenafil citrate from direct-compressed tablet reservoir for potential improvement of pulmonary hypertension therapy. Int J Pharm 2023; 631:122549. [PMID: 36572265 DOI: 10.1016/j.ijpharm.2022.122549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
Pulmonary hypertension (PH) is a cardiovascular disease affecting patient's life. Sildenafil citrate (SC), the first-line treatment, is present in oral and injectable forms with some drawbacks, primarily poor patient's comfort and low oral bioavailability. To counter these limitations, stratum corneum-penetrating hydrogel-forming microneedles (HFM) was created, making it easier to distribute SC transdermally. HFM was fabricated using polyvinyl alcohol (PVA) and two variations of polyvinyl pyrrolidone's (PVP) concentration as polymers and citric acid (CA) as crosslinking agent. The crosslinking time was also variated. The assessment of swelling, insertion characteristics, and mechanical resistance revealed that it possessed swelling capacities up to 470 % and strong insertion capabilities. This HFM was integrated with a tablet reservoir prepared using several concentrations of sodium starch glycolate (SSG) as super disintegrant. The tablet reservoir's hardness, dissolution rate, XRD, and FTIR profiles were evaluated and the results showed that 4 % of SSG was the option for enhancing SC's solubility. According to ex vivo study, this system released 24.12 ± 0.92 % of SC. For the first time, SC was successfully incorporated into a system of HFM and tablet reservoir and was non-toxic, showing promise in terms of improving PAH therapy's efficacy following comprehensive in vivo studies in the future.
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Affiliation(s)
| | - Diany Elim
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | | | | | | | - Nur Afika
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | | | | | - Andi Dian Permana
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia.
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8
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Pavliuk O, Kolesnyk H. Machine-learning method for analyzing and predicting the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic in the Lviv region. JOURNAL OF RELIABLE INTELLIGENT ENVIRONMENTS 2023; 9:17-26. [PMID: 36065343 PMCID: PMC9434091 DOI: 10.1007/s40860-022-00188-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022]
Abstract
The purpose of this paper is to develop a machine-learning model for analyzing and predicting the number of hospitalizations of children in the Lviv region during the fourth wave of the COVID-19 pandemic. This wave is characterized by dominance of a new strain of the virus-Omicron-that spreads faster than previous ones and often affects children. Their high sociability and a low level of vaccination in Ukraine resulted in a sharp increase in the number of hospitalizations. The complexity of the research is also related to the geolocation of the Lviv region. This article analyzes and predicts the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic for the first time for the Lviv region. Data were obtained from publicly available resources. Public Domain Software-the Python programming language and the Pandas library-was used for software implementation of the machine-learning method: the developed model consists of two components-analysis and prediction. The analysis of the number of hospitalized children was performed using the Pearson correlation coefficient. Short- and medium-term predictions were made with the use of non-iterative SGTM neural-like structures that were taught in supervised mode and tested in online mode. The RMS and maximum ones that were reduced to the range of error values of short-term (up to a week) and medium-term (up to 2 weeks) predictions did not exceed 0.48% and 0.61% and 1.81% and 2.83%, respectively. The developed model can also be used for predicting other COVID-19 parameters.
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Affiliation(s)
- Olena Pavliuk
- grid.10067.300000 0001 1280 1647Department of Automated Control Systems, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
| | - Halyna Kolesnyk
- grid.10067.300000 0001 1280 1647Foreign Languages Department, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
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Farmakis IT, Giannakoulas G. Management of COVID-19 in Patients with Pulmonary Arterial Hypertension. Heart Fail Clin 2023; 19:107-114. [PMID: 36435565 PMCID: PMC9364740 DOI: 10.1016/j.hfc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this review, we discuss the evidence regarding the course and management of COVID-19 in patients with pulmonary arterial hypertension (PAH), the challenges in PAH management during the pandemic and, lastly, the long-term complications of COVID-19 in relation to pulmonary vascular disease. The inherent PAH disease characteristics, as well as age, comorbidities, and the patient's functional status act synergistically to define the prognosis of COVID-19 in patients with PAH. Management of COVID-19 should follow the general guidelines, while PAH-targeted therapies should be continued. The pandemic has caused a shift toward telemedicine in the chronic care of patients with PAH. Whether COVID-19 could predispose to the development of chronic pulmonary hypertension is a subject of future investigation.
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Affiliation(s)
- Ioannis T. Farmakis
- Department of Cardiology, AHEPA University Hospital, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langebeckstr. 1, 55131, Mainz, Germany
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece,Corresponding author. Aristotle University of Thessaloniki, AHEPA Hospital, Cardiology Department, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece
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10
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Oliveira RKF, Nyasulu PS, Iqbal AA, Hamdan Gul M, Ferreira EVM, Leclair JW, Htun ZM, Howard LS, Mocumbi AO, Bryant AJ, Tamuzi JL, Avdeev S, Petrosillo N, Hassan A, Butrous G, de Jesus Perez V. Cardiopulmonary disease as sequelae of long-term COVID-19: Current perspectives and challenges. Front Med (Lausanne) 2022; 9:1041236. [PMID: 36530872 PMCID: PMC9748443 DOI: 10.3389/fmed.2022.1041236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
COVID-19 infection primarily targets the lungs, which in severe cases progresses to cytokine storm, acute respiratory distress syndrome, multiorgan dysfunction, and shock. Survivors are now presenting evidence of cardiopulmonary sequelae such as persistent right ventricular dysfunction, chronic thrombosis, lung fibrosis, and pulmonary hypertension. This review will summarize the current knowledge on long-term cardiopulmonary sequelae of COVID-19 and provide a framework for approaching the diagnosis and management of these entities. We will also identify research priorities to address areas of uncertainty and improve the quality of care provided to these patients.
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Affiliation(s)
- Rudolf K. F. Oliveira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- *Correspondence: Rudolf K. F. Oliveira,
| | - Peter S. Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Adeel Ahmed Iqbal
- National Health System (NHS), Global Clinical Network, London, United Kingdom
| | - Muhammad Hamdan Gul
- Department of Internal Medicine, University of Kentucky, Lexington, KY, United States
| | - Eloara V. M. Ferreira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Zin Mar Htun
- Division of Pulmonary and Critical Care, National Institute of Health, University of Maryland, College Park, College Park, MD, United States
| | - Luke S. Howard
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ana O. Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
- Non-communicable Diseases Division, Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Andrew J. Bryant
- College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jacques L. Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Sergey Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nicola Petrosillo
- Infection Prevention and Control-Infectious Disease Service, Foundation University Hospital Campus Bio-Medico, Rome, Italy
| | - Ahmed Hassan
- Department of Cardiology, Cairo University, Cairo, Egypt
| | - Ghazwan Butrous
- Medway School of Pharmacy, University of Kent at Canterbury, Canterbury, United Kingdom
| | - Vinicio de Jesus Perez
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center, Stanford, CA, United States
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11
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Muacevic A, Adler JR. Comprehensive Review of Pulmonary Hypertension and Treatment Options in the Paediatric Population. Cureus 2022; 14:e30622. [PMID: 36426339 PMCID: PMC9681719 DOI: 10.7759/cureus.30622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/23/2022] [Indexed: 01/25/2023] Open
Abstract
Pulmonary hypertension (PH) is a complex condition that can occur as a result of a wide range of disorders, including left heart disease, lung disease, and chronic pulmonary thromboembolism. Multiple improvements have been made in the diagnosis and treatment of pulmonary arterial hypertension (PAH) including a greater understanding of the involvement of extrapulmonary vascular organ systems, validated point of care, clinical assessment tools, and a focus on the initial exposure of numerous pharmacotherapeutics in the appropriate level of care. To achieve a minimal symptom burden, improve the patient's biochemical, hemodynamic, and functional profile, and reduce adverse impact, early diagnosis of PAH is a key objective today. The preferred method of management for thromboembolic PH, which is chronic, is pulmonary endarterectomy since the majority of affected patients are operable. The timing of pulmonary endarterectomy should never be delayed for medical reasons, and risk stratification can enable us to select patients who have a high chance of success. Patients who are not qualified for endarterectomy should be referred for drug trials. Even though there are more effective ways to guarantee a sufficient, long-lasting septostomy, atrial septostomy is promising but undervalued. The procedure's indications remain the same and need to be taken into account more frequently. Class III or IV patients who are not improving need to be consulted at a transplant centre as soon as possible as they may be candidates for potential recipients of bilateral sequential lung or heart-lung transplants, which is a significant choice for some people. PH is rarely linked to other conditions like connective tissue or thromboembolic disease. It is either idiopathic or linked to congenital heart disease. Infants and children with PH are more frequently recognised in conjunction with a congenital diaphragmatic hernia and developmental lung diseases like bronchopulmonary dysplasia. Although the underlying disease has not yet been treated and advanced structural changes have not yet been reversed, the value of natural life and survival have suggestively increased. Children's haemodynamic and functional outcomes have improved as a result of endothelin receptor antagonists, prostacyclin analogues, and phosphodiesterase type 5 inhibitors, which are examples of targeted pulmonary vasodilator therapies. The health maintenance of paediatric PH is still difficult because treatment decisions are largely based on the findings of adult studies that have been supported by evidence and the clinical expertise of paediatric specialists.
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12
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Integrating epigenetics and metabolomics to advance treatments for pulmonary arterial hypertension. Biochem Pharmacol 2022; 204:115245. [PMID: 36096239 DOI: 10.1016/j.bcp.2022.115245] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a devastating vascular disease with multiple etiologies. Emerging evidence supports a fundamental role for epigenetic machinery and metabolism in the initiation and progression of PAH. Here, we summarize emerging epigenetic mechanisms that have been identified as contributors to PAH evolution, specifically, DNA methylation, histone modifications, and microRNAs. Furthermore, the interplay between epigenetics with metabolism is explored while new crosstalk targets to be investigated in PAH are proposed that highlight multi-omics strategies including integrated epigenomics and metabolomics. Therapeutic opportunities and challenges associated with epigenetics and metabolomics in PAH are examined, highlighting the role that epigenetics and metabolomics have in facilitating early detection, personalized dietary plans, and advanced drug therapy for PAH.
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13
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Molecular Pathways in Pulmonary Arterial Hypertension. Int J Mol Sci 2022; 23:ijms231710001. [PMID: 36077398 PMCID: PMC9456336 DOI: 10.3390/ijms231710001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Pulmonary arterial hypertension is a multifactorial, chronic disease process that leads to pulmonary arterial endothelial dysfunction and smooth muscular hypertrophy, resulting in impaired pliability and hemodynamics of the pulmonary vascular system, and consequent right ventricular dysfunction. Existing treatments target limited pathways with only modest improvement in disease morbidity, and little or no improvement in mortality. Ongoing research has focused on the molecular basis of pulmonary arterial hypertension and is going to be important in the discovery of new treatments and genetic pathways involved. This review focuses on the molecular pathogenesis of pulmonary arterial hypertension.
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14
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Post pandemic research priorities: A consensus statement from the HL-PIVOT. Prog Cardiovasc Dis 2022; 73:2-16. [PMID: 35842068 PMCID: PMC9278010 DOI: 10.1016/j.pcad.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/20/2022]
Abstract
We have been amid unhealthy living and related chronic disease pandemics for several decades. These longstanding crises have troublingly synergized with the coronavirus disease 2019 (COVID-19) pandemic. The need to establish research priorities in response to COVID-19 can be used to address broad health and wellbeing, social and economic impacts for the future is emerging. Accordingly, this paper sets out a series of research priorities that could inform interdisciplinary collaboration between clinical sciences, public health, business, technology, economics, healthcare providers, and the exercise science/sports medicine communities, among others. A five-step methodology was used to generate and evaluate the research priorities with a focus on broad health and well-being impacts. The methodology was deployed by an international and interdisciplinary team from the Healthy Living for Pandemic Event Protection (HL- PIVOT) network. This team were all engaged in responding to the Pandemic either on the 'front-line' and/or in leadership positions ensuring the currency and authenticity of the process. Eight research priorities were identified clustered into two groups: i) Societal & Environmental, and ii) Clinical. Our eight research priorities are presented with insight from previously published research priorities from other groups.
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15
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Christou H, Khalil RA. Mechanisms of pulmonary vascular dysfunction in pulmonary hypertension and implications for novel therapies. Am J Physiol Heart Circ Physiol 2022; 322:H702-H724. [PMID: 35213243 PMCID: PMC8977136 DOI: 10.1152/ajpheart.00021.2022] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022]
Abstract
Pulmonary hypertension (PH) is a serious disease characterized by various degrees of pulmonary vasoconstriction and progressive fibroproliferative remodeling and inflammation of the pulmonary arterioles that lead to increased pulmonary vascular resistance, right ventricular hypertrophy, and failure. Pulmonary vascular tone is regulated by a balance between vasoconstrictor and vasodilator mediators, and a shift in this balance to vasoconstriction is an important component of PH pathology, Therefore, the mainstay of current pharmacological therapies centers on pulmonary vasodilation methodologies that either enhance vasodilator mechanisms such as the NO-cGMP and prostacyclin-cAMP pathways and/or inhibit vasoconstrictor mechanisms such as the endothelin-1, cytosolic Ca2+, and Rho-kinase pathways. However, in addition to the increased vascular tone, many patients have a "fixed" component in their disease that involves altered biology of various cells in the pulmonary vascular wall, excessive pulmonary artery remodeling, and perivascular fibrosis and inflammation. Pulmonary arterial smooth muscle cell (PASMC) phenotypic switch from a contractile to a synthetic and proliferative phenotype is an important factor in pulmonary artery remodeling. Although current vasodilator therapies also have some antiproliferative effects on PASMCs, they are not universally successful in halting PH progression and increasing survival. Mild acidification and other novel approaches that aim to reverse the resident pulmonary vascular pathology and structural remodeling and restore a contractile PASMC phenotype could ameliorate vascular remodeling and enhance the responsiveness of PH to vasodilator therapies.
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Affiliation(s)
- Helen Christou
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raouf A Khalil
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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16
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Hajra A, Safiriyu I, Balasubramanian P, Gupta R, Chowdhury S, Prasad AJ, Kumar A, Kumar D, Khan B, Bilberry RSF, Sarkar A, Malik P, Aronow WS. Recent Advances and Future Prospects of Treatment of Pulmonary Hypertension. Curr Probl Cardiol 2022:101236. [PMID: 35500734 PMCID: PMC9171713 DOI: 10.1016/j.cpcardiol.2022.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/30/2022]
Abstract
Pulmonary hypertension is one of the difficult situations to treat. Complex pathophysiology, association of the multiple comorbidities make clinical scenario challenging. Recently it is being shown that patients who had recovered from coronavirus disease infection, are at risk of developing pulmonary hypertension. Studies on animals have been going on to find out newer treatment options. There are recent advancements in the treatment of pulmonary hypertension. Role of anticoagulation, recombinant fusion proteins, stem cell therapy are emerging as therapeutic options for affected patients. SGLT2 inhibitors have potential to have beneficial effects on pulmonary hypertension. Apart from the medical managements, advanced interventions are also getting popular. In this review article, the authors have discussed pathophysiology, recent advancement of treatments including coronavirus disease patients, and future aspect of managing pulmonary hypertension. We have highlighted treatment options for patients with sleep apnea, interstitial lung disease to discuss the challenges and possible options to manage those patients.
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Affiliation(s)
| | | | | | | | | | | | - Akshay Kumar
- Jinnah Sindh Medical Univeristy Karachi, Karachi, Pakistan
| | - Deepak Kumar
- Jinnah Sindh Medical Univeristy Karachi, Karachi, Pakistan
| | - Baseer Khan
- Jinnah Sindh Medical Univeristy Karachi, Karachi, Pakistan
| | | | | | | | - Wilbert S Aronow
- Westchester Medical Center, New York Medical College, Valhalla, NY
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17
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Raman B, Bluemke DA, Lüscher TF, Neubauer S. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J 2022; 43:1157-1172. [PMID: 35176758 PMCID: PMC8903393 DOI: 10.1093/eurheartj/ehac031] [Citation(s) in RCA: 261] [Impact Index Per Article: 130.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/20/2021] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Emerging as a new epidemic, long COVID or post-acute sequelae of coronavirus disease 2019 (COVID-19), a condition characterized by the persistence of COVID-19 symptoms beyond 3 months, is anticipated to substantially alter the lives of millions of people globally. Cardiopulmonary symptoms including chest pain, shortness of breath, fatigue, and autonomic manifestations such as postural orthostatic tachycardia are common and associated with significant disability, heightened anxiety, and public awareness. A range of cardiovascular (CV) abnormalities has been reported among patients beyond the acute phase and include myocardial inflammation, myocardial infarction, right ventricular dysfunction, and arrhythmias. Pathophysiological mechanisms for delayed complications are still poorly understood, with a dissociation seen between ongoing symptoms and objective measures of cardiopulmonary health. COVID-19 is anticipated to alter the long-term trajectory of many chronic cardiac diseases which are abundant in those at risk of severe disease. In this review, we discuss the definition of long COVID and its epidemiology, with an emphasis on cardiopulmonary symptoms. We further review the pathophysiological mechanisms underlying acute and chronic CV injury, the range of post-acute CV sequelae, and impact of COVID-19 on multiorgan health. We propose a possible model for referral of post-COVID-19 patients to cardiac services and discuss future directions including research priorities and clinical trials that are currently underway to evaluate the efficacy of treatment strategies for long COVID and associated CV sequelae.
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Affiliation(s)
- Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - David A. Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 3252 Clinical Science Center, 600 Highland Ave, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 3252 Clinical Science Center, 600 Highland Ave, Madison, WI 53792, USA
| | - Thomas F. Lüscher
- Royal Brompton & Harefield Hospitals and National Heart and Lung Institute, Imperial College, London, UK
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
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18
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Adrover JM, Carrau L, Daßler-Plenker J, Bram Y, Chandar V, Houghton S, Redmond D, Merrill JR, Shevik M, tenOever BR, Lyons SK, Schwartz RE, Egeblad M. Disulfiram inhibits neutrophil extracellular trap formation protecting rodents from acute lung injury and SARS-CoV-2 infection. JCI Insight 2022; 7:157342. [PMID: 35133984 PMCID: PMC8983145 DOI: 10.1172/jci.insight.157342] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/26/2022] [Indexed: 12/15/2022] Open
Abstract
Severe acute lung injury has few treatment options and a high mortality rate. Upon injury, neutrophils infiltrate the lungs and form neutrophil extracellular traps (NETs), damaging the lungs and driving an exacerbated immune response. Unfortunately, no drug preventing NET formation has completed clinical development. Here, we report that disulfiram — an FDA-approved drug for alcohol use disorder — dramatically reduced NETs, increased survival, improved blood oxygenation, and reduced lung edema in a transfusion-related acute lung injury (TRALI) mouse model. We then tested whether disulfiram could confer protection in the context of SARS-CoV-2 infection, as NETs are elevated in patients with severe COVID-19. In SARS-CoV-2–infected golden hamsters, disulfiram reduced NETs and perivascular fibrosis in the lungs, and it downregulated innate immune and complement/coagulation pathways, suggesting that it could be beneficial for patients with COVID-19. In conclusion, an existing FDA-approved drug can block NET formation and improve disease course in 2 rodent models of lung injury for which treatment options are limited.
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Affiliation(s)
- Jose M Adrover
- Cancer Center, Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
| | - Lucia Carrau
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Juliane Daßler-Plenker
- Cancer Center, Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
| | - Yaron Bram
- Department of Medicine, Weill Cornell Medicine, New York, United States of America
| | - Vasuretha Chandar
- Department of Medicine, Weill Cornell Medicine, New York, United States of America
| | - Sean Houghton
- Division of Regenerative Medicine, Weill Cornell Medicine, New York, United States of America
| | - David Redmond
- Division of Regenerative Medicine, Weill Cornell Medicine, New York, United States of America
| | - Joseph R Merrill
- Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
| | - Margaret Shevik
- Cancer Center, Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
| | - Benjamin R tenOever
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Scott K Lyons
- Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
| | - Robert E Schwartz
- Department of Medicine, Weill Cornell Medical College, New York, United States of America
| | - Mikala Egeblad
- Cold Spring Harbor Laboratory, Cold Spring Harbor, United States of America
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19
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ESENDAĞLI D, YILMAZ A, AKÇAY Ş, ÖZLÜ T. Post-COVID syndrome: pulmonary complications. Turk J Med Sci 2021; 51:3359-3371. [PMID: 34284532 PMCID: PMC8771021 DOI: 10.3906/sag-2106-238] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/20/2021] [Indexed: 11/03/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worlwide and caused a pandemic that is still ongoing. The virus can cause a disease named as COVID-19, which is composed of multi systemic manifestations with a pulmonary system predominance. As the time passes, we are dealing more and more with a wide variety of effects and complications of the disease in survivors as far as with concerns about the clinical outcome and the timeline of symptoms in different patients. Since the lungs are the most involved organs and the post-COVID prolonged and persistent effects are mainly related to the pulmonary system, it is crucial to define and predict the outcome and to determine the individuals that can progress to fibrosis and loss of function of lungs. This review summarizes the current literature regarding the pulmonary complications in post-COVID syndrome and the management of these conditions.
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Affiliation(s)
- Dorina ESENDAĞLI
- Department of Chest Diseases, Faculty of Medicine, Başkent University, AnkaraTurkey
| | - Aydın YILMAZ
- Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Centre, Health Sciences University, AnkaraTukey
| | - Şule AKÇAY
- Department of Chest Diseases, Faculty of Medicine, Başkent University, AnkaraTurkey
| | - Tevfik ÖZLÜ
- Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, TrabzonTurkey
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20
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Rohr JM, Strah H, Berkheim D, Siddique A, Radio SJ, Swanson BJ. Pulmonary Hypertensive Changes Secondary to COVID-19 Pneumonia in a Chronically SARS-CoV-2-Infected Bilateral Lung Explant. Int J Surg Pathol 2021; 30:443-447. [PMID: 34894817 PMCID: PMC9111901 DOI: 10.1177/10668969211064208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
COVID-19, the syndrome caused by the novel coronavirus SARS-CoV-2, has spread
throughout the world, causing the death of at least three million people. For
the over 81 million who have recovered, however, the long-term effects are only
beginning to manifest. We performed a bilateral lung transplant on a 31-year-old
male patient for chronic hypoxic respiratory failure, severe pulmonary
hypertension and radiographically identified pulmonary fibrosis five months
after an acute COVID-19 infection. The explant demonstrated moderate pulmonary
vascular remodeling with intimal thickening and medial hypertrophy throughout,
consistent with pulmonary hypertension. The parenchyma demonstrated an
organizing lung injury in the proliferative phase, with severe fibrosis,
histiocytic proliferation, type II pneumocyte hyperplasia, and alveolar loss
consistent with known COVID-19 pneumonia complications. This report highlights a novel histologic finding in severe, chronic COVID-19.
Although the findings in acute COVID-19 pneumonia have been well-examined at
autopsy, the chronic course of this complex disease is not yet understood. The
case presented herein suggests that COVID-induced pulmonary hypertension may
become more common as more patients survive severe SARS-CoV-2-related pneumonia.
Pulmonologists and pulmonary pathologists should be aware of this possible
association and look for the clinical, radiographic, and histologic criteria in
the appropriate clinical setting.
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Affiliation(s)
- Joseph M Rohr
- Department of Pathology and Microbiology, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Heather Strah
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Omaha, NE , USA
| | - David Berkheim
- Division of Cardiothoracic Surgery, Department of Surgery, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Aleem Siddique
- Division of Cardiothoracic Surgery, Department of Surgery, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Stanley J Radio
- Department of Pathology and Microbiology, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Benjamin J Swanson
- Department of Pathology and Microbiology, 12284University of Nebraska Medical Center, Omaha, NE, USA
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21
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Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: a global perspective. Nat Rev Cardiol 2021; 19:314-331. [PMID: 34873286 PMCID: PMC8647069 DOI: 10.1038/s41569-021-00640-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/13/2022]
Abstract
The lungs are the primary target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with severe hypoxia being the cause of death in the most critical cases. Coronavirus disease 2019 (COVID-19) is extremely heterogeneous in terms of severity, clinical phenotype and, importantly, global distribution. Although the majority of affected patients recover from the acute infection, many continue to suffer from late sequelae affecting various organs, including the lungs. The role of the pulmonary vascular system during the acute and chronic stages of COVID-19 has not been adequately studied. A thorough understanding of the origins and dynamic behaviour of the SARS-CoV-2 virus and the potential causes of heterogeneity in COVID-19 is essential for anticipating and treating the disease, in both the acute and the chronic stages, including the development of chronic pulmonary hypertension. Both COVID-19 and chronic pulmonary hypertension have assumed global dimensions, with potential complex interactions. In this Review, we present an update on the origins and behaviour of the SARS-CoV-2 virus and discuss the potential causes of the heterogeneity of COVID-19. In addition, we summarize the pathobiology of COVID-19, with an emphasis on the role of the pulmonary vasculature, both in the acute stage and in terms of the potential for developing chronic pulmonary hypertension. We hope that the information presented in this Review will help in the development of strategies for the prevention and treatment of the continuing COVID-19 pandemic. In this Review, the authors discuss the potential causes of the heterogeneity of COVID-19 and summarize the pathobiology of the disease, with an emphasis on the role of the pulmonary vasculature in the acute stage and the potential for developing chronic pulmonary hypertension. A thorough understanding of the dynamic behaviour of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential to understanding its heterogeneous effects on the pulmonary vasculature in patients with coronavirus disease 2019 (COVID-19). The severity and clinical phenotype of COVID-19 are influenced by host factors, including socioeconomic factors and genetics. Silent hypoxia is a major and independent cause of lung damage in COVID-19; the use of modern imaging techniques is proving to be very valuable in identifying silent hypoxia. The pulmonary vascular system has a major role in the pathobiology of COVID-19. Both COVID-19 and chronic pulmonary hypertension are global diseases with a complex interaction.
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22
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Tudoran C, Tudoran M, Lazureanu VE, Marinescu AR, Cut TG, Oancea C, Pescariu SA, Pop GN. Factors Influencing the Evolution of Pulmonary Hypertension in Previously Healthy Subjects Recovering from a SARS-CoV-2 Infection. J Clin Med 2021; 10:jcm10225272. [PMID: 34830554 PMCID: PMC8625017 DOI: 10.3390/jcm10225272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 01/10/2023] Open
Abstract
(1) Background: While the COVID-19 pandemic has been persisting for almost 2 years, more and more people are diagnosed with residual complications such as pulmonary hypertension (PH) and right ventricular dysfunction (RVD). This study aims to evaluate the course of PH and borderline PH (BPH) at 3 and 6 months after the acute COVID-19 infection and investigate if there are differences regarding its evolution between the patients from the first three waves of this disease. (2) Methods: We analyzed, by transthoracic echocardiography (TTE), the 3 and 6 months' evolution of the echocardiographically estimated systolic pulmonary artery pressures (esPAP) in 116 patients already diagnosed with PH or BPH due to COVID-19 during the first three subsequent waves of COVID-19. (3) Results: We documented a gradual, statistically significant reduction in esPAP values, but also an improvement of the parameters characterizing RVD after 3 and 6 months (p < 0.001). This evolution was somewhat different between subjects infected with different viral strains and was related to the initial severity of the pulmonary injury and PH (adjusted R2 = 0.722, p < 0.001). (4) Conclusions: PH and RVD alleviate gradually during the recovery after COVID-19, but in some cases, they persist, suggesting the activation of pathophysiological mechanisms responsible for the self-propagation of PH.
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Affiliation(s)
- Cristina Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Cardiology Clinic, County Emergency Hospital “Pius Brinzeu”, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania
| | - Mariana Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Cardiology Clinic, County Emergency Hospital “Pius Brinzeu”, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania
- Correspondence: or ; Tel.: +40-722310302
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (V.E.L.); (A.R.M.); (T.G.C.); (C.O.)
| | - Adelina Raluca Marinescu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (V.E.L.); (A.R.M.); (T.G.C.); (C.O.)
| | - Talida Georgiana Cut
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (V.E.L.); (A.R.M.); (T.G.C.); (C.O.)
| | - Cristian Oancea
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (V.E.L.); (A.R.M.); (T.G.C.); (C.O.)
| | - Silvius Alexandru Pescariu
- Department VI, Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (S.A.P.); (G.N.P.)
| | - Gheorghe Nicusor Pop
- Department VI, Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (S.A.P.); (G.N.P.)
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23
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Affiliation(s)
- Ross Arena
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Il, USA
| | - Mark A Faghy
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Il, USA.,Human Sciences Research Centre, University of Derby, Derby, UK
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24
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Nabeh OA, Matter LM, Khattab MA, Esraa Menshawey. "The possible implication of endothelin in the pathology of COVID-19-induced pulmonary hypertension". Pulm Pharmacol Ther 2021; 71:102082. [PMID: 34601121 PMCID: PMC8483983 DOI: 10.1016/j.pupt.2021.102082] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/21/2022]
Abstract
COVID-19 pandemic has changed the world dramatically since was first reported in Wuhan city, China [1]. Not only as a respiratory illness that could lead to fatal respiratory failure, but also some evidences suggest that it can propagate as a chronic disease associated with a variety of persistent post COVID-19 pathologies that affect patients' life [2,3]. Pulmonary hypertension (PH) is one of the challenging diseases that may develop as a consequence of SARS-COV-2 infection in some COVID-19 survivors [4,5]. The vasopressor, proliferative, proinflammatory, and prothrombotic actions of endothelin [6] may be encountered in the COVID-19-induced PH pathology. And so, endothelin blockers may have an important role to restrict the development of serious PH outcomes with special precautions considering patients with significant hypoxemia.
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Affiliation(s)
- Omnia Azmy Nabeh
- M.Sc/ Assistant Lecturer, Department of Medical Pharmacology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; M.Sc, Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Lamiaa Mohammed Matter
- MD/Lecturer, Department of Medical Pharmacology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Professional Diploma of Family Medicine, Arab Institute for Continuing Professional Development, Arab Medical Union, Egypt.
| | - Mahmoud Ahmed Khattab
- M.Sc/ Assistant Lecturer, Department of Medical Pharmacology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; M.Sc Internal Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Esraa Menshawey
- Medical Student, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
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Cueto-Robledo G, Porres-Aguilar M, Puebla-Aldama D, Barragán-Martínez MDP, Jurado-Hernández MY, García-César M, Rojas MBT, García-Treminio C, Roldan-Valadez E. Severe Pulmonary Hypertension: An Important Sequel After Severe Post-Acute COVID-19 Pneumonia. Curr Probl Cardiol 2021; 47:101004. [PMID: 34601005 PMCID: PMC8482545 DOI: 10.1016/j.cpcardiol.2021.101004] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Guillermo Cueto-Robledo
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico; National Autonomous University of Mexico (UNAM); Mexico City, Mexico.
| | - Mateo Porres-Aguilar
- Department of Medicine; Division of Hospital and Adult Thrombosis Medicine; Texas Tech University Health Sciences Center; El Paso, TX
| | - David Puebla-Aldama
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico
| | - María Del Pilar Barragán-Martínez
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico
| | | | - Marisol García-César
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico
| | - María B Torres Rojas
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico
| | - Carlos García-Treminio
- Department of Cardiopulmonary Emergencies and Pulmonary Vascular Disorders Clinic; General Hospital of Mexico "Dr. Eduardo Liceaga"; Mexico City; Mexico
| | - Ernesto Roldan-Valadez
- Directorate of Clinical Research; Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico; Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University); Moscow, Russia
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26
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Bai Y, Lockett AD, Gomes MT, Stearman RS, Machado RF. Sphingosine Kinase 1 Regulates the Pulmonary Vascular Immune Response. Cell Biochem Biophys 2021; 79:517-529. [PMID: 34133010 PMCID: PMC8206894 DOI: 10.1007/s12013-021-01006-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 12/13/2022]
Abstract
The aberrant proliferation of pulmonary artery smooth muscle (PASMCs) cells is a defining characteristic of pulmonary arterial hypertension (PAH) and leads to increased vascular resistance, elevated pulmonary pressure, and right heart failure. The sphingosine kinase 1 (SPHK1)/sphingosine-1 phosphate/sphingosine-1 phosphate receptor 2 pathway promotes vascular remodeling and induces PAH. The aim of this study was to identify genes and cellular processes that are modulated by over-expression of SPHK1 in human PASMCs (hPASMCs). RNA was purified and submitted for RNA sequencing to identify differentially expressed genes. Using a corrected p-value threshold of <0.05, there were 294 genes significantly up-regulated while 179 were significantly down-regulated. Predicted effects of these differentially expressed genes were evaluated using the freeware tool Enrichr to assess general gene set over-representation (enrichment) and ingenuity pathway analysis (IPA™) for upstream regulator predictions. We found a strong change in genes that regulated the cellular immune response. IL6, STAT1, and PARP9 were elevated in response to SPHK1 over-expression in hPASMCs. The gene set enrichment mapped to a few immune-modulatory signaling networks, including IFNG. Furthermore, PARP9 and STAT1 protein were elevated in primary hPASMCs isolated from PAH patients. In conclusion, these data suggest a role of Sphk1 regulates pulmonary vascular immune response in PAH.
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Affiliation(s)
- Yang Bai
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China
| | - Angelia D Lockett
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marta T Gomes
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert S Stearman
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Roberto F Machado
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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27
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Cascino TM, Desai AA, Kanthi Y. At a crossroads: coronavirus disease 2019 recovery and the risk of pulmonary vascular disease. Curr Opin Pulm Med 2021; 27:342-349. [PMID: 34127622 PMCID: PMC8373709 DOI: 10.1097/mcp.0000000000000792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW The coronavirus disease 2019 (COVID-19) pandemic has led to almost 3,000,000 deaths across 139 million people infected worldwide. Involvement of the pulmonary vasculature is considered a major driving force for morbidity and mortality. We set out to summarize current knowledge on the acute manifestations of pulmonary vascular disease (PVD) resulting from COVID-19 and prioritize long-term complications that may result in pulmonary hypertension (PH). RECENT FINDINGS Acute COVID-19 infection can result in widespread involvement of the pulmonary vasculature, myocardial injury, evidence of persistent lung disease, and venous thromboembolism. Post COVID-19 survivors frequently report ongoing symptoms and may be at risk for the spectrum of PH, including group 1 pulmonary arterial hypertension, group 2 PH due to left heart disease, group 3 PH due to lung disease and/or hypoxia, and group 4 chronic thromboembolic PH. SUMMARY The impact of COVID-19 on the pulmonary vasculature is central to determining disease severity. Although the long-term PVD manifestations of COVID-19 are currently uncertain, optimizing the care of risk factors for PH and monitoring for the development of PVD will be critical to reducing long-term morbidity and improving the health of survivors.
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Affiliation(s)
- Thomas M Cascino
- Frankel Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Ankit A Desai
- Department of Medicine, Indiana University, Indianapolis, Indiana
| | - Yogendra Kanthi
- Frankel Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
- Laboratory of Vascular Thrombosis and Inflammation, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
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28
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Stevens RP, Paudel SS, Johnson SC, Stevens T, Lee JY. Endothelial metabolism in pulmonary vascular homeostasis and acute respiratory distress syndrome. Am J Physiol Lung Cell Mol Physiol 2021; 321:L358-L376. [PMID: 34159794 PMCID: PMC8384476 DOI: 10.1152/ajplung.00131.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 12/27/2022] Open
Abstract
Capillary endothelial cells possess a specialized metabolism necessary to adapt to the unique alveolar-capillary environment. Here, we highlight how endothelial metabolism preserves the integrity of the pulmonary circulation by controlling vascular permeability, defending against oxidative stress, facilitating rapid migration and angiogenesis in response to injury, and regulating the epigenetic landscape of endothelial cells. Recent reports on single-cell RNA-sequencing reveal subpopulations of pulmonary capillary endothelial cells with distinctive reparative capacities, which potentially offer new insight into their metabolic signature. Lastly, we discuss broad implications of pulmonary vascular metabolism on acute respiratory distress syndrome, touching on emerging findings of endotheliitis in coronavirus disease 2019 (COVID-19) lungs.
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Affiliation(s)
- Reece P Stevens
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama
- Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, Alabama
| | - Sunita S Paudel
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama
- Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, Alabama
| | - Santina C Johnson
- Department of Pharmacology, College of Medicine, University of South Alabama, Mobile, Alabama
- Department of Biomolecular Engineering, College of Medicine, University of South Alabama, Mobile, Alabama
| | - Troy Stevens
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama
- Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, Alabama
| | - Ji Young Lee
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama
- Department of Internal Medicine, College of Medicine, University of South Alabama, Mobile, Alabama
- Division of Pulmonary and Critical Care Medicine, College of Medicine, University of South Alabama, Mobile, Alabama
- Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, Alabama
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29
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Clauss M, Chelvanambi S, Cook C, ElMergawy R, Dhillon N. Viral Bad News Sent by EVAIL. Viruses 2021; 13:v13061168. [PMID: 34207152 PMCID: PMC8234235 DOI: 10.3390/v13061168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 01/08/2023] Open
Abstract
This article reviews the current knowledge on how viruses may utilize Extracellular Vesicle Assisted Inflammatory Load (EVAIL) to exert pathologic activities. Viruses are classically considered to exert their pathologic actions through acute or chronic infection followed by the host response. This host response causes the release of cytokines leading to vascular endothelial cell dysfunction and cardiovascular complications. However, viruses may employ an alternative pathway to soluble cytokine-induced pathologies-by initiating the release of extracellular vesicles (EVs), including exosomes. The best-understood example of this alternative pathway is human immunodeficiency virus (HIV)-elicited EVs and their propensity to harm vascular endothelial cells. Specifically, an HIV-encoded accessory protein called the "negative factor" (Nef) was demonstrated in EVs from the body fluids of HIV patients on successful combined antiretroviral therapy (ART); it was also demonstrated to be sufficient in inducing endothelial and cardiovascular dysfunction. This review will highlight HIV-Nef as an example of how HIV can produce EVs loaded with proinflammatory cargo to disseminate cardiovascular pathologies. It will further discuss whether EV production can explain SARS-CoV-2-mediated pulmonary and cardiovascular pathologies.
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Affiliation(s)
- Matthias Clauss
- IU School of Medicine, Pulmonary, Critical Care, Sleep and Occupational Medicine, Indianapolis, IN 46202, USA;
- Correspondence: or
| | - Sarvesh Chelvanambi
- Brigham and Women’s Hospital, Department of Medicine, Boston, MA 02115, USA;
| | - Christine Cook
- Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.C.); (N.D.)
| | - Rabab ElMergawy
- IU School of Medicine, Pulmonary, Critical Care, Sleep and Occupational Medicine, Indianapolis, IN 46202, USA;
| | - Navneet Dhillon
- Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.C.); (N.D.)
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