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Zhang P, Wang S, Wu JZ, Song Q. Clinical and prognostic significance of perioperative change in red cell distribution width in patients with esophageal squamous cell carcinoma. BMC Cancer 2023; 23:319. [PMID: 37024853 PMCID: PMC10080779 DOI: 10.1186/s12885-023-10804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Numerous studies have reported the prognostic significance of the red cell distribution width (RDW) in patients with esophageal squamous cell carcinoma (ESCC), but the relationship between the perioperative change in RDW (delta RDW) and survival in patients with ESCC after surgery has not been evaluated. METHODS A total of 594 patients with newly diagnosed ESCC after surgery were enrolled in the study. Delta RDW (delta RDW = Postoperative RDW-Preoperative RDW) was counted based on data within one week before surgery and two weeks after surgery. To investigate the relationship between delta RDW and overall survival (OS), the median delta RDW was chosen as the cut-off value. RESULTS 99 (16.7%) patients had pathological stage 1a-1b, 202 (34.0%) patients had pathological stage 2a-2b, and 293 (49.3%) patients had pathological stage 3a-3c.There were 179 (30.1%) patients who had vessel invasive, and 415 (69.9%) patients without vessel invasive. There were 216 (36.4%) patients with nerve infiltration, and 378 (63.6%) without nerve infiltration. In univariate analysis, five parameters including delta RDW(≥ 0.44 vs.<0.44) (P = 0.039, HR = 1.337, 95% CI = 1.014-1.762) significantly correlated with worse OS. Multivariate analysis revealed that delta RDW(≥ 0.44 vs.<0.44) was an independent prognostic marker for OS (P = 0.033, HR = 1.356, 95% CI = 1.025-1.793). Kaplan-Meier curves showed that delta RDW ≥ 0.44 was significantly associated with worse OS (P = 0.039). Subgroup analysis suggested that delta RDW ≥ 0.44 indicated worse survival in patients with ESCC exclusively in these subtypes such as female patients, age > 60 patients, patients with lymph node metastasis, and patients with vessel invasive. CONCLUSIONS Perioperative change in red cell distribution width predicts worse survival in patients with ESCC after surgery.
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Affiliation(s)
- Peng Zhang
- Department of Radiology Physics, Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Sheng Wang
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Jun-Zhou Wu
- Cancer Research Institute, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Qian Song
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
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Molecular Mechanism Exploration of Autologous Blood Transfusion with RBC Surface Membrane Protein pMHC/aCD28 Combined with CD8+T Cells to Promote the Proliferation of CD8+T Cells to Inhibit the Malignant Transformation of Liver Cancer. JOURNAL OF ONCOLOGY 2022; 2022:6102672. [PMID: 36213824 PMCID: PMC9534649 DOI: 10.1155/2022/6102672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022]
Abstract
Autologous blood transfusion is an important blood protection measure. Red blood cells have a certain degree of immunogenicity and their surface membrane proteins CD28 and MHC can participate in the immune response and interact with CD8+ T cells. We build a cell model with a transwell system. The binding characteristics of RBCs and CD8+ T cells were observed with a fluorescent confocal microscope. The content of the inflammatory factor TNF-α and IFN-γ produced was analyzed by ELISA. The proliferation characteristics of CD8+ T cells were analyzed by CFSE staining, and the content of CD3+CD8+ T cells was analyzed by flow cytometry. Cell migration and invasion experiments were used to analyze the malignant metastasis ability of liver cancer cells. The expression of vimentin, E-cadherin, and β-catenin was analyzed by Western blot. We establish a liver cancer model in rats and group them for autologous blood transfusion. The content of CD3+CD8+T cells in the blood of each group of rats was analyzed by flow cytometry. Western blot was used to analyze the expression of vimentin, E-cadherin, and β-catenin in the liver tissues of rats in each group. The red blood cells in the autologous reinfusion blood and CD8+ T cells have an obvious combination. The degree of combination of the two is related to the expression of CD28 and MHC. If CD28 and MHC are expressed at the same time, the combination of the two cells will be high, the proliferation of CD8+ T cells will increase, and the expression of inflammatory factors will also increase, while the expression of the three proteins that are positively correlated with the activity of cancer cells will decrease. If only one of CD28 and MHC is normally expressed, the result is contrary to the situation where both membrane proteins are normally expressed. Our project has proved that autologous infusion of red blood cell surface membrane proteins CD28 and MHC combined with CD8+ T cells can promote the proliferation of CD8+ T cells to inhibit the malignant transformation of liver cancer.
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Fang Y, Doyle MF, Alosco ML, Mez J, Satizabal CL, Qiu WQ, Lunetta KL, Murabito JM. Cross-Sectional Association Between Blood Cell Phenotypes, Cognitive Function, and Brain Imaging Measures in the Community-Based Framingham Heart Study. J Alzheimers Dis 2022; 87:1291-1305. [PMID: 35431244 PMCID: PMC9969805 DOI: 10.3233/jad-215533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Peripheral inflammation is associated with increased risk for dementia. Neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV), are easily measured circulating blood cell phenotypes reflecting chronic peripheral inflammation, but their association with dementia status is unclear. OBJECTIVE We sought to investigate the cross-sectional association of these inflammatory measures with neuropsychological (NP) test performance, and brain magnetic resonance imaging (MRI) measures in the Framingham Heart Study (FHS) Offspring, Third-generation, and Omni cohorts. METHODS We identified FHS participants who attended an exam that included a complete blood cell count (CBC) and underwent NP testing (n = 3,396) or brain MRI (n = 2,770) within five years of blood draw. We investigated the association between NLR, RDW, and MPV and NP test performance and structural MRI-derived volumetric measurements using linear mixed effect models accounting for family relationships and adjusting for potential confounders. RESULTS Participants were on average 60 years old, 53% female, and about 80% attended some college. Higher NLR was significantly associated with poorer performance on visual memory, and visuospatial abilities, as well as with larger white matter hyperintensity volume. We also observed associations for higher RDW with poorer executive function and smaller total cerebral brain volume. CONCLUSION Chronic peripheral inflammation as measured by NLR and RDW was associated with worse cognitive function, reduced brain volume, and greater microvascular disease in FHS participants. If confirmed in other samples, CBC may provide informative and cost-effective biomarkers of abnormal brain aging in the community.
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Affiliation(s)
- Yuan Fang
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Margaret F. Doyle
- University of Vermont, Larner College of Medicine, Department of Pathology and Laboratory Medicine, Burlington, VT
| | - Michael L. Alosco
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Neurology, Boston, MA, USA
| | - Jesse Mez
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Neurology, Boston, MA, USA.,Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA, USA
| | - Claudia L. Satizabal
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA.,University of Texas Health Science Center at San Antonio, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, USA
| | - Wei Qiao Qiu
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA.,Boston University School of Medicine, Department of Pharmacology & Experimental Therapeutics, Boston, MA, USA
| | - Kathryn L. Lunetta
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA, USA.,Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine, Boston, MA, USA
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Owoicho O, Tapela K, Olwal CO, Djomkam Zune AL, Nganyewo NN, Quaye O. Red blood cell distribution width as a prognostic biomarker for viral infections: prospects and challenges. Biomark Med 2021; 16:41-50. [PMID: 34784758 PMCID: PMC8597662 DOI: 10.2217/bmm-2021-0364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Viral diseases remain a significant global health threat, and therefore prioritization of limited healthcare resources is required to effectively manage dangerous viral disease outbreaks. In a pandemic of a newly emerged virus that is yet to be well understood, a noninvasive host-derived prognostic biomarker is invaluable for risk prediction. Red blood cell distribution width (RDW), an index of red blood cell size disorder (anisocytosis), is a potential predictive biomarker for severity of many diseases. In view of the need to prioritize resources during response to outbreaks, this review highlights the prospects and challenges of RDW as a prognostic biomarker for viral infections, with a focus on hepatitis and COVID-19, and provides an outlook to improve the prognostic performance of RDW for risk prediction in viral diseases.
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Affiliation(s)
- Oloche Owoicho
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana.,Department of Biological Sciences, Benue State University, Makurdi, Nigeria
| | - Kesego Tapela
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana.,West African Network of Infectious Diseases ACEs (WANIDA), French National Research Institute for Sustainable Development, Marseille, France
| | - Charles O Olwal
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana
| | - Alexandra L Djomkam Zune
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana
| | - Nora N Nganyewo
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana.,Medical Research Council Unit, The Gambia, at London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Osbourne Quaye
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic & Applied Sciences, University of Ghana, Accra, Ghana
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Hornick A, Tashtish N, Osnard M, Shah B, Bradigan A, Albar Z, Tomalka J, Dalton J, Sharma A, Sekaly RP, Hejal R, Simon DI, Zidar DA, Al-Kindi SG. Anisocytosis is Associated With Short-Term Mortality in COVID-19 and May Reflect Proinflammatory Signature in Uninfected Ambulatory Adults. Pathog Immun 2020; 5:312-326. [PMID: 33089037 PMCID: PMC7556412 DOI: 10.20411/pai.v5i1.391] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/14/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Red cell distribution width (RDW), a measure of anisocytosis, is observed in chronic inflammation and is a prognostic marker in critically ill patients without COVID-19, but data in COVID-19 are limited. METHODS Between March 12 and April 19, 2020, 282 individuals with confirmed COVID-19 and RDW available within 7 days prior to COVID-19 confirmation were evaluated. Individuals were grouped by quartiles of RDW. Association between quartiles of RDW and mortality was assessed using the Kaplan-Meier method and statistical significance was assessed using the log-rank test. The association between RDW and all-cause mortality was further assessed using a Cox proportional hazards model. Plasma cytokine levels in uninfected ambulatory adults without cardiovascular disease (n=38) were measured and bivariate Spearman correlations and principle components analysis were used to identify relationships between cytokine concentrations with RDW. RESULTS After adjusting for age, sex, race, cardiovascular disease, and hemoglobin, there was an association between RDW and mortality (Quartile 4 vs Quartile 1: HR 4.04 [1.08-15.07]), with each 1% increment in RDW associated with a 39% increased rate of mortality (HR 1.39 [1.21-1.59]). Remote RDW was also associated with mortality after COVID-19 infection. Among uninfected ambulatory adults without cardiovascular disease, RDW was associated with elevated pro-inflammatory cytokines (TNF-α, IL8, IL6, IL1b), but not regulatory cytokines (TGFb). CONCLUSIONS Anisocytosis predicts short-term mortality in COVID-19 patients, often predates viral exposure, and may be related to a pro-inflammatory phenotype. Additional study of whether the RDW can assist in the early identification of pending cytokine storm is warranted.
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Affiliation(s)
- Andrew Hornick
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center
| | - Nour Tashtish
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center
| | - Michael Osnard
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center
| | - Binita Shah
- New York VA Harbor Healthcare System and New York University School of Medicine, New York, NY
| | - Allison Bradigan
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH
| | | | | | - Jarrod Dalton
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | | | - Rana Hejal
- Case Western Reserve University, Cleveland, OH.,Department of Pulmonary and Critical Care, University Hospitals, Cleveland, OH
| | - Daniel I Simon
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center.,Case Western Reserve University, Cleveland, OH
| | - David A Zidar
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center.,Case Western Reserve University, Cleveland, OH.,Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - Sadeer G Al-Kindi
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center.,Case Western Reserve University, Cleveland, OH
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Liu F, Cai ZB, Huang JS, Yu WY, Niu HY, Zhang Y, Sui DM, Wang F, Xue LZ, Xu AF. Positive SARS-CoV-2 RNA recurs repeatedly in a case recovered from COVID-19: dynamic results from 108 days of follow-up. Pathog Dis 2020; 78:5863936. [PMID: 32592396 PMCID: PMC7337794 DOI: 10.1093/femspd/ftaa031] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/26/2020] [Indexed: 12/18/2022] Open
Abstract
The evidence of long-term clinical dynamic on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA re-positive case are less. We performed a 108 days follow-up on dynamic clinical presentations in a case, who hospitalized three times due to the positive recurrence of SARS-CoV-2 RNA after discharge, to understand the prognosis of the 2019-Coronavirus disease (COVID-19). In this case, positive SARS-CoV-2 recurred even after apparent recovery (normal CT imaging, no clinical symptoms, negative SARS-CoV-2 on stool sample and negative serum IgM test) from COVID-19, viral shedding duration lasted for 65 days, the time from symptom onset to disappearance was up to 95 days. Erythrocyte-associated indicators, liver function and serum lipid metabolism presented abnormal throughout during the observation period. Awareness of atypical presentations such as this one is important to prompt the improvement of the management of COVID-19.
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Affiliation(s)
- Fang Liu
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Zhao-Bin Cai
- Department of Infectious Disease, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Jin-Song Huang
- Department of Infectious Disease, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Wen-Yan Yu
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Hai-Ying Niu
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Yan Zhang
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Dong-Ming Sui
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Fei Wang
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Li-Zhi Xue
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
| | - Ai-Fang Xu
- Medical Laboratory, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, China
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7
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Poveda E, Tabernilla A, Fitzgerald W, Salgado-Barreira Á, Grandal M, Pérez A, Mariño A, Álvarez H, Valcarce N, González-García J, Bernardino JI, Gutierrez F, Fujioka H, Crespo M, Ruiz-Mateos E, Margolis L, Lederman MM, Freeman ML. Massive release of CD9+ microvesicles in HIV infection, regardless of virologic control. J Infect Dis 2020; 225:1040-1049. [PMID: 32603406 PMCID: PMC8922002 DOI: 10.1093/infdis/jiaa375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background The role of extracellular vesicles (EVs) in human immunodeficiency virus (HIV) pathogenesis is unknown. We examine the cellular origin of plasma microvesicles (MVs), a type of ectocytosis-derived EV, the presence of mitochondria in MVs, and their relationship to circulating cell-free mitochondrial deoxyribonucleic acid (ccf-mtDNA) in HIV-infected patients and controls. Methods Five participant groups were defined: 30 antiretroviral therapy (ART)-naive; 30 ART-treated with nondetectable viremia; 30 elite controllers; 30 viremic controllers; and 30 HIV-uninfected controls. Microvesicles were quantified and characterized from plasma samples by flow cytometry. MitoTrackerDeepRed identified MVs containing mitochondria and ccf-mtDNA was quantified by real-time polymerase chain reaction. Results Microvesicle numbers were expanded at least 10-fold in all HIV-infected groups compared with controls. More than 79% were platelet-derived MVs. Proportions of MVs containing mitochondria (22.3% vs 41.6%) and MV mitochondrial density (706 vs 1346) were significantly lower among HIV-infected subjects than controls, lowest levels for those on ART. Microvesicle numbers correlated with ccf-mtDNA levels that were higher among HIV-infected patients. Conclusions A massive release of platelet-derived MVs occurs during HIV infection. Some MVs contain mitochondria, but their proportion and mitochondrial densities were lower in HIV infection than in controls. Platelet-derived MVs may be biomarkers of platelet activation, possibly reflecting pathogenesis even in absence of HIV replication.
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Affiliation(s)
- Eva Poveda
- Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Andrés Tabernilla
- Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Wendy Fitzgerald
- Section of Intercellular Interactions, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Ángel Salgado-Barreira
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Marta Grandal
- Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Alexandre Pérez
- Infectious Diseases Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, IIS Galicia Sur, SERGAS-UVigo, Spain
| | - Ana Mariño
- Infectious Diseases Unit, University Hospital Ferrol, Spain
| | | | | | | | | | - Félix Gutierrez
- Infectious Diseases Unit, Hospital General de Elche and Miguel Hernández University, Alicante, Spain
| | - Hisashi Fujioka
- Cryo-Electron Microscopy Core, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Manuel Crespo
- Infectious Diseases Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, IIS Galicia Sur, SERGAS-UVigo, Spain
| | - Ezequiel Ruiz-Mateos
- Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, CSIC, University of Seville, Spain
| | - Leonid Margolis
- Section of Intercellular Interactions, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Michael M Lederman
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael L Freeman
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Exploratory examination of inflammation state, immune response and blood cell composition in a human obese cohort to identify potential markers predicting cancer risk. PLoS One 2020; 15:e0228633. [PMID: 32027700 PMCID: PMC7004330 DOI: 10.1371/journal.pone.0228633] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 01/21/2020] [Indexed: 01/12/2023] Open
Abstract
Obesity has reached epidemic proportions and is often accompanied by elevated levels of pro-inflammatory cytokines that promote many chronic diseases, including cancer. However, not all obese people develop these diseases and it would be very helpful to identify those at high risk early on so that preventative measures can be instituted. We performed an extensive evaluation of the effects of obesity on inflammatory markers, on innate and adaptive immune responses, and on blood cell composition to identify markers that might be useful in distinguishing those at elevated risk of cancer. Plasma samples from 42 volunteers with a BMI>35 had significantly higher CRP, PGE2, IL-1RA, IL-6 and IL-17 levels than 34 volunteers with normal BMIs. Of the cytokines and chemokines tested, only IL-17 was significantly higher in men with a BMI>35 than women with a BMI>35. As well, only IL-17 was significantly higher in those with a BMI>35 that had type 2 diabetes versus those without type 2 diabetes. Whole blood samples from participants with a BMI>35, when challenged with E. coli, produced significantly higher levels of IL-1RA while HSV-1 challenge resulted in significantly elevated IL-1RA and VEGF, and a non-significant increase in G-CSF and IL-8 levels. T cell activation of PBMCs, via anti-CD3 plus anti-CD28, resulted in significantly higher IFNγ production from volunteers with a BMI>35. In terms of blood cells, red blood cell distribution width (RDW), monocytes, granulocytes, CD4+T cells and Tregs were all significantly higher while, natural killer (NK) and CD8+ T cells were all significantly lower in the BMI>35 cohort, suggesting that obesity may reduce the ability to kill nascent tumor cells. Importantly, however, there was considerable person-to-person variation amongst participants with a BMI>35, with some volunteers showing markedly different values from controls and others showing normal levels of many parameters measured. These person-to-person variations may prove useful in identifying those at high risk of developing cancer.
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9
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Dissanayake O, Merriman RC, Alnajar S, Hunter A, Burns F, Miller RF. Incidence and significance of an elevated red blood cell distribution width among hospitalised HIV-infected adult patients. Int J STD AIDS 2019; 30:915-918. [PMID: 31159710 DOI: 10.1177/0956462419851903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We audited the records of unselected hospitalised HIV-positive adults admitted to a University-affiliated inner London hospital to identify the frequency of elevated red blood cell distribution width (RDW), and potential associations with specific diagnoses, and with outcome. Of 259 patients audited, 188 (73%) were men. Patients’ median age was 47 years (interquartile range = 41–54). An elevated RDW was seen in 50 patients (19%); 200 (77%) had an elevated C-reactive protein (CRP), and 77 (30%) had a low haemoglobin. Only five patients had an elevated RDW without an elevated CRP and/or low haemoglobin. An elevated RDW was associated with a wide range of infectious, inflammatory, and malignant conditions similar to observed associations reported in the general non-HIV infected adult population. Additionally an elevated RDW occurred both in patients with well-controlled HIV infection and in receipt of antiretroviral therapy, as well as in those with newly diagnosed and poorly-controlled infection. Five (10%) of 50 patients with an elevated RDW needed intensive care unit (ICU) admission and two (4%) died. Two (0.95%) of 209 patients with a normal RDW needed ICU admission and four (1.9%) died. The findings of this audit are limited by the relatively small number of patients and the single site nature of the audit.
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Affiliation(s)
| | | | - Sara Alnajar
- 1 HIV Services, Royal Free London NHS Foundation Trust, London, UK
| | - Alan Hunter
- 1 HIV Services, Royal Free London NHS Foundation Trust, London, UK
| | - Fiona Burns
- 1 HIV Services, Royal Free London NHS Foundation Trust, London, UK.,2 Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK
| | - Robert F Miller
- 1 HIV Services, Royal Free London NHS Foundation Trust, London, UK.,2 Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,3 Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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