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Torres G, Constantinou D, Gradidge P, Patel D, Patricios J. Exercise is the Most Important Medicine for COVID-19. Curr Sports Med Rep 2023; 22:284-289. [PMID: 37549214 DOI: 10.1249/jsr.0000000000001092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
ABSTRACT COVID-19 infection and long COVID affect multiple organ systems, including the respiratory, cardiovascular, renal, digestive, neuroendocrine, musculoskeletal systems, and sensory organs. Exerkines, released during exercise, have a potent crosstalk effect between multiple body systems. This review describes the evidence of how exerkines can mitigate the effects of COVID-19 in each organ system that the virus affects. The evidence presented in the review suggests that exercise should be considered a first-line strategy in the prevention and treatment of COVID-19 infection and long COVID disease.
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Affiliation(s)
- Georgia Torres
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Demitri Constantinou
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippe Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Deepak Patel
- Division of Sports & Exercise Medicine, Department of Family Medicine & Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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2
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Maiese K. Cellular Metabolism: A Fundamental Component of Degeneration in the Nervous System. Biomolecules 2023; 13:816. [PMID: 37238686 PMCID: PMC10216724 DOI: 10.3390/biom13050816] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
It is estimated that, at minimum, 500 million individuals suffer from cellular metabolic dysfunction, such as diabetes mellitus (DM), throughout the world. Even more concerning is the knowledge that metabolic disease is intimately tied to neurodegenerative disorders, affecting both the central and peripheral nervous systems as well as leading to dementia, the seventh leading cause of death. New and innovative therapeutic strategies that address cellular metabolism, apoptosis, autophagy, and pyroptosis, the mechanistic target of rapamycin (mTOR), AMP activated protein kinase (AMPK), growth factor signaling with erythropoietin (EPO), and risk factors such as the apolipoprotein E (APOE-ε4) gene and coronavirus disease 2019 (COVID-19) can offer valuable insights for the clinical care and treatment of neurodegenerative disorders impacted by cellular metabolic disease. Critical insight into and modulation of these complex pathways are required since mTOR signaling pathways, such as AMPK activation, can improve memory retention in Alzheimer's disease (AD) and DM, promote healthy aging, facilitate clearance of β-amyloid (Aß) and tau in the brain, and control inflammation, but also may lead to cognitive loss and long-COVID syndrome through mechanisms that can include oxidative stress, mitochondrial dysfunction, cytokine release, and APOE-ε4 if pathways such as autophagy and other mechanisms of programmed cell death are left unchecked.
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Affiliation(s)
- Kenneth Maiese
- Cellular and Molecular Signaling, New York, NY 10022, USA
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3
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Assessment of the Interferon-Lambda-3 Polymorphism in the Antibody Response to COVID-19 in Older Adults Seropositive for CMV. Vaccines (Basel) 2023; 11:vaccines11020480. [PMID: 36851357 PMCID: PMC9963200 DOI: 10.3390/vaccines11020480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Here, we investigated the impact of IFN-lambda-3 polymorphism on specific IgG responses for COVID-19 in older adults seropositive for CMV. METHODS Blood samples of 25 older adults of both sexes were obtained at three different times: during a micro-outbreak (MO) of SARS-CoV-2 in 2020; eight months after (CURE); and 30 days after the administration of the second dose of ChadOx-1 vaccine (VAC). The specific IgG for both SARS-CoV-2 and CMV antigens, neutralizing antibodies against SARS-CoV-2, and also the polymorphism profile for IFN-lambda-3 (rs12979860 C > T) were assessed. RESULTS Higher levels of specific IgG for SARS-CoV-2 antigens were found in the MO and VAC than in the CURE time-point. Volunteers with specific neutralizing antibodies against SARS-CoV-2 showed better specific IgG responses for SARS-CoV-2 and lower specific IgG levels for CMV than volunteers without specific neutralizing antibodies. Significant negative correlations between the specific IgG levels for SARS-CoV-2 and CMV were found at the MO time-point, as well as in the group of individuals homozygous for allele 1 (C/C) in the MO time-point and heterozygotes (C/T) in the CURE time-point. CONCLUSION Our results suggested that both CMV seropositivity and the homozygosis for allele 1 (C/C) in IFN-lambda-3 gene can negatively impact the antibody response to COVID-19 infection and vaccination in older adults.
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Silva BR, Monteiro FR, Cezário K, do Amaral JB, Paixão V, Almeida EB, dos Santos CAF, Amirato GR, Oliveira DBL, Durigon EL, Aguiar AS, Vieira RP, dos Santos JDMB, Furtado GE, França CN, Shio MT, Bachi ALL. Older Adults Who Maintained a Regular Physical Exercise Routine before the Pandemic Show Better Immune Response to Vaccination for COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1939. [PMID: 36767315 PMCID: PMC9915291 DOI: 10.3390/ijerph20031939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/23/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In this study, we aimed to investigate the specific-antibody response to the COVID-19 vaccination and the immunophenotyping of T cells in older adults who were engaged or not in an exercise training program before the pandemic. METHODS Ninety-three aged individuals (aged between 60 and 85 years) were separated into 3 groups: practitioners of physical exercise vaccinated with CoronaVac (PE-Co, n = 46), or vaccinated with ChadOx-1 (PE-Ch, n = 23), and non-practitioners vaccinated with ChadOx-1 (NPE-Ch, n = 24). Blood samples were collected before (pre) and 30 days after vaccination with the second vaccine dose. RESULTS Higher IgG levels and immunogenicity were found in the PE-Ch and NPE-Ch groups, whereas increased IgA levels were found only in the PE-Ch group post-vaccination. The PE-Co group showed a positive correlation between the IgA and IgG values, and lower IgG levels post-vaccination were associated with age. Significant alterations in the percentage of naive (CD28+CD57-), double-positive (CD28+CD57+), and senescent (CD28-CD57+) CD4+ T and CD8+ T cells were found post-vaccination, particularly in the PE-Ch group. CONCLUSIONS The volunteers vaccinated with the ChadOx-1 presented not only a better antibody response but also a significant modulation in the percentage of T cell profiles, mainly in the previously exercised group.
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Affiliation(s)
- Brenda Rodrigues Silva
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | | | - Kizzy Cezário
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - Jônatas Bussador do Amaral
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Vitória Paixão
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Ewin Barbosa Almeida
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Carlos André Freitas dos Santos
- Discipline of Geriatrics and Gerontology, Department of Medicine, Paulista School of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo 04020-050, Brazil
- Postgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, Brazil
| | - Gislene Rocha Amirato
- Mane Garrincha Sports Education Center, Sports Department of the Municipality of Sao Paulo (SEME), São Paulo 04039-034, Brazil
| | - Danielle Bruna Leal Oliveira
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science, University of São Paulo, São Paulo 05508-060, Brazil
| | - Edison Luiz Durigon
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science, University of São Paulo, São Paulo 05508-060, Brazil
- Scientific Platform Pasteur, University of São Paulo, São Paulo 05508-060, Brazil
| | - Andressa Simões Aguiar
- Scientific Platform Pasteur, University of São Paulo, São Paulo 05508-060, Brazil
- Infection Control Service, São Luiz Gonzaga Hospital of Santa Casa de Misericordia of São Paulo, São Paulo 02276-140, Brazil
| | - Rodolfo P. Vieira
- Post-graduate Program in Human Movement and Rehabilitation and in Pharmaceutical Sciences, Universidade Evangélica de Goiás (Unievangelica), Av Universitária km 3,5, Anápolis-Go 75083-515, Brazil
| | | | - Guilherme Eustáquio Furtado
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços—S. Martinho do Bispo, 3045-093 Coimbra, Portugal
| | - Carolina Nunes França
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - Marina Tiemi Shio
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - André Luis Lacerda Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
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Alharbi AS. Immune fitness and lifestyle habits of Saudi medical students: a cross sectional study. PeerJ 2023; 11:e14363. [PMID: 36627921 PMCID: PMC9826612 DOI: 10.7717/peerj.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/18/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Immune function reaches an optimum level in young adults. However, young adults are more likely to adopt potentially harmful habits that may pose a risk to their long-term health and immune fitness, and which eventually may put a substantial burden on the healthcare system. This study aimed to assess the status of medical students' immune fitness, using the immune status questionnaire (ISQ) and exploring the association with the commonly adopted lifestyle habits hypothesized to have an impact on immune functions. Methods A descriptive, cross-sectional study was conducted among preclinical students attending the medical school of King Abdulaziz University. An online self-reported questionnaire was used to assess the immune status (ISQ), perceived (momentary) immune fitness, general health, lifestyle habits and students' perception of these lifestyle-associated impacts on immune fitness. Descriptive, Spearman's correlation and stepwise linear regression analyses were performed. Results In a pooled sample of 211 participants, the overall ISQ score was 6.00 ± 5.0 with statistically significant abnormally lower scores in females (ISQ 5.00 ± 5.0, p < 0.001). 49.29% of respondents experienced poor immune fitness as measured by the ISQ (<6). The ISQ score was significantly correlated with fast and fatty food consumption (p = 0.003), daytime sleepiness (p = 0.001), and BMI subgroups (p = 0.028) negatively and positively correlated with adherence to a program of exercise (p = 0.005). A total of 41.23% of participants who reported a normal immune health, rated at ≥6 were graded below 6 on the ISQ score. Only 62.6% of students were able to correctly identify the effects of fast and fatty food consumption on immune fitness. Conclusion Poor immune fitness was common among medical students in KAU and associated significantly with their adopted lifestyle habits. Although, other factors can be significant contributors, biased immune health perception and lack of awareness of these lifestyle-associated impacts on immune fitness and general health may hinder the adoption of healthier habits. Immune biomarkers should be implemented in future work.
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Affiliation(s)
- Azzah S. Alharbi
- Medical Microbiology and Parasitology Department, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia,Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Lino RDS, Silva MSDP, de Jesus DS, de Macedo RC, Lagares LS, dos Santos FNA, de Almeida LAB, Bomfim ES, dos Santos CPC. Molecular aspects of COVID-19 and its relationship with obesity and physical activity: a narrative review. SAO PAULO MED J 2023; 141:78-86. [PMID: 36102458 PMCID: PMC9808989 DOI: 10.1590/1516-3180.2021.1038.r1.06072022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/06/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: "covid-19," "physical activity," and "obesity". The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.
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Affiliation(s)
- Ramon de Souza Lino
- BSc. Physical Education Professional, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Mariana Sousa de Pina Silva
- Undergraduate Student, Research Group on Metabolic Diseases, Physical Exercise, and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Daniel Simões de Jesus
- PhD. Assistant Professor, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Rodrigo Colares de Macedo
- Undergraduate Student, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Laura Souza Lagares
- BSc. Physical Education Professional, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Felipe Nunes Almeida dos Santos
- BSc. Physical Education Professional, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Luiz Alberto Bastos de Almeida
- MSc. Assistant Professor, Laboratory of Physical Activity, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana (BA), Brazil
| | - Eric Simas Bomfim
- BSc. Physical Education Professional, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
| | - Clarcson Plácido Conceição dos Santos
- PhD. Assistant Professor, Research Group on Metabolic Diseases, Physical Exercise and Health Technologies, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador (BA), Brazil
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Ayenigbara IO. Diabetes Prevention and Measures to Ensuring a Healthy Lifestyle during COVID-19 Pandemic and after. Korean J Fam Med 2023; 44:11-20. [PMID: 36709956 PMCID: PMC9887446 DOI: 10.4082/kjfm.21.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/03/2022] [Indexed: 01/20/2023] Open
Abstract
The incidence of diabetes mellitus (DM) is increasing exponentially globally, with 90% of the confirmed cases being type 2 DM. The global incidence of DM is expected to increase by 48% during 2017-2045. The coronavirus disease 2019 (COVID-19) pandemic continues to have a massive impact on human health, causing sudden lifestyle changes through quarantine measures, such as lockdown, social distancing, various curfews, and isolation at home. This in turn might increase the risk of developing numerous chronic diseases, such as DM, obesity, and cardiovascular diseases, which increase the severity of COVID-19. To this end, we performed a comprehensive review to determine viable measures for the prevention of DM and its subsequent upsurge globally. Additionally, we have determined strategies that should be adopted globally to ensure a healthy lifestyle during the COVID-19 pandemic and later.
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Affiliation(s)
- Israel Oluwasegun Ayenigbara
- School and Community Health Promotion Unit, Department of Health Education, University of Ibadan, Ibadan, Nigeria,Corresponding Author: Israel Oluwasegun Ayenigbara https://orcid.org/0000-0002-0085-5493 Tel: +234-8139177538, Fax: +234-8098103043, E-mail:
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Maiese K. The Metabolic Basis for Nervous System Dysfunction in Alzheimer's Disease, Parkinson's Disease, and Huntington's Disease. Curr Neurovasc Res 2023; 20:314-333. [PMID: 37488757 PMCID: PMC10528135 DOI: 10.2174/1567202620666230721122957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023]
Abstract
Disorders of metabolism affect multiple systems throughout the body but may have the greatest impact on both central and peripheral nervous systems. Currently available treatments and behavior changes for disorders that include diabetes mellitus (DM) and nervous system diseases are limited and cannot reverse the disease burden. Greater access to healthcare and a longer lifespan have led to an increased prevalence of metabolic and neurodegenerative disorders. In light of these challenges, innovative studies into the underlying disease pathways offer new treatment perspectives for Alzheimer's Disease, Parkinson's Disease, and Huntington's Disease. Metabolic disorders are intimately tied to neurodegenerative diseases and can lead to debilitating outcomes, such as multi-nervous system disease, susceptibility to viral pathogens, and long-term cognitive disability. Novel strategies that can robustly address metabolic disease and neurodegenerative disorders involve a careful consideration of cellular metabolism, programmed cell death pathways, the mechanistic target of rapamycin (mTOR) and its associated pathways of mTOR Complex 1 (mTORC1), mTOR Complex 2 (mTORC2), AMP-activated protein kinase (AMPK), growth factor signaling, and underlying risk factors such as the apolipoprotein E (APOE-ε4) gene. Yet, these complex pathways necessitate comprehensive understanding to achieve clinical outcomes that target disease susceptibility, onset, and progression.
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Affiliation(s)
- Kenneth Maiese
- Cellular and Molecular Signaling, New York, New York 10022
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9
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Clemente-Suárez VJ, Bustamante-Sanchez Á, Tornero-Aguilera JF, Ruisoto P, Mielgo-Ayuso J. Inflammation in COVID-19 and the Effects of Non-Pharmacological Interventions during the Pandemic: A Review. Int J Mol Sci 2022; 23:ijms232415584. [PMID: 36555231 PMCID: PMC9779440 DOI: 10.3390/ijms232415584] [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: 10/26/2022] [Revised: 11/25/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic that hit the health systems worldwide hard, causing a collapse of healthcare systems. One of the main problems of this new virus is the high inflammatory response it provokes, which is the cause of much of the symptoms. Different pharmacological approaches tried to stop the advance of the pandemic, but it seems that only vaccines are the solution. In this line, different nonpharmacological approaches have been made in order to improve symptomatology, contagion, and spread of COVID-19, the principal factors being the physical activity, nutrition, physiotherapy, psychology, and life patterns. The SARS-CoV-2 virus produces a disproportionate inflammatory response in the organism of the guest and causes complications in this that can end the life of the patient. It has been possible to see how different nonpharmacological interventions based on physical activity, nutritional, psychological, and physical therapy, and lifestyle changes can be functional tools to treat this inflammation. Thus, in the present review, we aim to provide an overview of the role of inflammation in COVID-19 and the nonpharmacological interventions related to it.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
- Correspondence:
| | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
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Gomide EBG, Mazzonetto LF, Cordeiro JFC, Cordeiro DC, Oliveira ADS, Fioco EM, Venturini ACR, Abdalla PP, Da Silva LSL, Tasinafo Júnior MF, De Andrade D, Bohn L, Machado DRL, Dos Santos AP. Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14908. [PMID: 36429628 PMCID: PMC9690567 DOI: 10.3390/ijerph192214908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.
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Affiliation(s)
- Euripedes Barsanulfo Gonçalves Gomide
- Claretiano-University Center, São Paulo 14300-900, Brazil
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Lisa Fernanda Mazzonetto
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | | | | | - Alcivandro de Sousa Oliveira
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | | | - Ana Claudia Rossini Venturini
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Pedro Pugliesi Abdalla
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Leonardo Santos Lopes Da Silva
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Márcio Fernando Tasinafo Júnior
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Denise De Andrade
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
| | - Lucimere Bohn
- Faculty of Psychology, Education and Sport, University Lusófona of Porto, 4000-098 Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Education and Communication, Algarve University, 8005-139 Faro, Portugal
| | - André Pereira Dos Santos
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
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11
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Gomide EBG, Abdalla PP, Pisa MF, Schneider G, Vieira LG, Mazzonetto LF, de Sousa Oliveira A, Sebastião E, Dos Santos AP. The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review. JSAMS PLUS 2022; 1:100007. [PMID: 36415823 PMCID: PMC9672901 DOI: 10.1016/j.jsampl.2022.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/22/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022]
Abstract
Objective This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19. Design Systematic review. Methods The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies. Results After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary. Conclusions Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19. Study registration Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.
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Affiliation(s)
- Euripedes Barsanulfo Gonçalves Gomide
- Claretiano - University Center, São Paulo, Brazil
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Pedro Pugliesi Abdalla
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- School of Sports (FADEUP), University of Porto, Portugal
| | - Marcel Frezza Pisa
- Claretiano - University Center, São Paulo, Brazil
- Ribeirão Preto College of Medicine, University of São Paulo, Brazil
| | | | | | - Lisa Fernanda Mazzonetto
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
| | - Alcivandro de Sousa Oliveira
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
| | - Emerson Sebastião
- Health and Exercise Research Group. Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, United States
| | - André Pereira Dos Santos
- Ribeirão Preto College of Nursing, University of São Paulo, Brazil
- Study and Research Group in Anthropometry, Training and Sport, Ribeirão Preto. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
- Ribeirão Preto School of Physical Education and Sport, University of São Paulo, Brazil
- Human Exposome and Infectious Diseases Network (HEID), Brazil
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12
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Kjertakov M. Commentary: Moderate exercise may prevent the development of severe forms of COVID-19, whereas high-intensity exercise may result in the opposite. Front Physiol 2022; 13:902739. [PMID: 36072850 PMCID: PMC9441653 DOI: 10.3389/fphys.2022.902739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/29/2022] [Indexed: 11/23/2022] Open
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13
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Zhao T, Chu Z, Ma J, Ouyang L. Immunomodulation Effect of Biomaterials on Bone Formation. J Funct Biomater 2022; 13:jfb13030103. [PMID: 35893471 PMCID: PMC9394331 DOI: 10.3390/jfb13030103] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 02/06/2023] Open
Abstract
Traditional bone replacement materials have been developed with the goal of directing the osteogenesis of osteoblastic cell lines toward differentiation and therefore achieving biomaterial-mediated osteogenesis, but the osteogenic effect has been disappointing. With advances in bone biology, it has been revealed that the local immune microenvironment has an important role in regulating the bone formation process. According to the bone immunology hypothesis, the immune system and the skeletal system are inextricably linked, with many cytokines and regulatory factors in common, and immune cells play an essential role in bone-related physiopathological processes. This review combines advances in bone immunology with biomaterial immunomodulatory properties to provide an overview of biomaterials-mediated immune responses to regulate bone regeneration, as well as methods to assess the bone immunomodulatory properties of bone biomaterials and how these strategies can be used for future bone tissue engineering applications.
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Affiliation(s)
- Tong Zhao
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China; (T.Z.); (Z.C.)
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Zhuangzhuang Chu
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China; (T.Z.); (Z.C.)
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Jun Ma
- Department of General Practitioners, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
- Correspondence: (L.O.); (J.M.); Tel.: +86-21-52039999 (L.O.); +86-21-52039999 (J.M.)
| | - Liping Ouyang
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China; (T.Z.); (Z.C.)
- Correspondence: (L.O.); (J.M.); Tel.: +86-21-52039999 (L.O.); +86-21-52039999 (J.M.)
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14
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Ceïde ME, Eguchi D, Ayers EI, Lounsbury DW, Verghese J. Mediation Analyses of the Role of Apathy on Motoric Cognitive Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127376. [PMID: 35742625 PMCID: PMC9224534 DOI: 10.3390/ijerph19127376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Recent literature indicates that apathy is associated with poor cognitive and functional outcomes in older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome. However, the underlying biological pathway is unknown. The objectives of this study were to (1) examine the cross-sectional associations between inflammatory cytokines (Interleukin 6 (IL-6) and C-Reactive Protein (CRP)) and apathy and (2) explore the direct and indirect relationships of apathy and motoric cognitive outcomes as it relates to important cognitive risk factors. N = 347 older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging Study (CCMA). Linear and logic regression models showed that IL-6, but not CRP was significantly associated with apathy adjusted for age, gender, and years of education (β = 0.037, 95% CI: 0.002-0.072, p = 0.04). Apathy was associated with a slower gait velocity (β = -14.45, 95% CI: -24.89-4.01, p = 0.01). Mediation analyses demonstrated that IL-6 modestly mediates the relationship between apathy and gait velocity, while apathy mediated the relationships between dysphoria and multimorbidity and gait velocity. Overall, our findings indicate that apathy may be an early predictor of motoric cognitive decline. Inflammation plays a modest role, but the underlying biology of apathy warrants further investigation.
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Affiliation(s)
- Mirnova E. Ceïde
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
- Department of Psychiatry and Behavioral Sciences and Medicine, Montefiore Medical Center, Bronx, NY 10467, USA
- Correspondence: ; Tel.: +1-347-920-0112; Fax: +1-718-430-3829
| | - Daniel Eguchi
- Medical Program, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Emmeline I. Ayers
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
| | - David W. Lounsbury
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (E.I.A.); (J.V.)
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15
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Salivary Proteome, Inflammatory, and NETosis Biomarkers in Older Adult Practitioners and Nonpractitioners of Physical Exercise. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3725056. [PMID: 35502212 PMCID: PMC9056209 DOI: 10.1155/2022/3725056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022]
Abstract
Since aging has been associated with increased production of inflammatory biomarkers, the ability to monitor older adults repeatedly is highly desirable, and saliva is an interesting biofluid for the search of biomarkers, as it is easily accessible in a noninvasive manner. However, given the incipient knowledge of salivary biomarkers in aging and its relationship to physical exercise, the present study is aimed at evaluating the protein expression and the levels of inflammatory and NETosis biomarkers in the saliva of practitioners (PE) and nonpractitioners (NPE) of physical exercise older adults. Six (6) practitioner and 4 nonpractitioner older adults were enrolled in this study. Unstimulated whole saliva was collected for analysis of the proteome by label-free mass spectrometry, as well as of the inflammatory status by evaluation of C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and cytokines (TNF-α, interleukin- (IL-) 1β, and IL-8), while NETosis was assessed by myeloperoxidase (MPO) and neutrophil elastase. Regarding oral health, the decayed, missing, and filled teeth (DMF-T) index, bleeding on probing, suppuration, and probing depth measurement (mm) were evaluated. In addition, functional capacity was investigated using the General Physical Fitness Index (GPFI). In relation to the proteome analysis, 93 and 143 proteins were found exclusively in the PE and NPE groups, respectively; 224 proteins were common to both groups. Among these proteins, 10 proteins showed statistical difference (
) between the groups: alpha-2-macroglobulin, component 3 of the complement, serotransferrin, and protein soluble in brain acid 1 were less expressed, while lactotransferrin, alpha-amylase 1, S100-A8, S100-A9, lactoperoxidase, and galectin-3 binding protein were more expressed in the PE group. No differences between groups were observed in the analysis of inflammatory and NETosis biomarkers. This study shows the potential utility of saliva for detecting protein biomarkers in a noninvasive biological sample of the elderly population.
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16
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Azócar-Gallardo J, Ojeda-Aravena A, Carrizo Largo J, Hernández-Mosqueira C. Can the immunological system of the upper respiratory tract, improved by physical exercise, act as a first immunological barrier against SARS-CoV-2? Expert Rev Anti Infect Ther 2022; 20:981-986. [PMID: 35412405 DOI: 10.1080/14787210.2022.2065983] [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: 11/04/2022]
Abstract
INTRODUCTION The main route of transmission of SARS-CoV-2 is the upper respiratory tract via cell membranes, including angiotensin-converting enzyme 2 (ACE2) and transmembrane host-associated serine protease transmembrane serine protease 2 (TMPRSS2). Both enzymes present in the nasal epithelium are the first direct point of contact for SARS-CoV-2. In this sense, the mucosal immune mechanisms of the upper respiratory tract, including immunoglobulin A (IgA), could be enhanced by physical exercise and be the first defense mechanism against the transmission and infection of SARS-CoV-2. AREAS COVERED The authors reviewed recent biomedical literature available in databases related to the effects of exercise and training modalities on IgA concentration levels in the upper respiratory tract in different populations. EXPERT OPINION : According to the biomedical literature reviewed, physical exercise can decrease or improve the level of IgA concentrations. However, it is important to take into account factors such as training load, recovery during the exercise session and between training, as well as the exercise modality. Furthermore, the characteristics of the target population should be taken into account to maximize the adaptive immune response to adequately strengthen the upper respiratory tract and potentially be a barrier against SARS-CoV-2 infection.
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Affiliation(s)
- Jairo Azócar-Gallardo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Puerto Montt, Chile.,IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2581967, Chile
| | - Alex Ojeda-Aravena
- Department of Physical Activity Sciences, Universidad de Los Lagos, Puerto Montt, Chile.,IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2581967, Chile
| | - Jorge Carrizo Largo
- Instituto de Investigación Multidisciplinario en Ciencia y Tecnología, Universidad de La Serena, Chile.,Carrera de Kinesiología. Facultad de Ciencias. Universidad de la Serena, Chile
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Molanouri Shamsi M, Vahed A, Hekmatikar AA, Suzuki K. Combined Effects of Exercise Training and Nutritional Supplementation in Cancer Patients in the Context of the COVID-19: A Perspective Study. Front Nutr 2022; 9:847215. [PMID: 35356739 PMCID: PMC8959344 DOI: 10.3389/fnut.2022.847215] [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: 01/01/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
The 2019 coronavirus (COVID-19) epidemic, has caused unprecedented global social and economic impacts and many deaths. Many risk factors have been identified in the progression of COVID-19 to severe and critical stages, and it is shown that the coronavirus appears more severely in people with cancer. Pro-inflammatory status and weakened immune system due to cancer-related treatments can be determinants in the immune system’s response to the coronavirus in these patients. Higher physical activity levels are associated with lower hospitalization rates and mortality in COVID-19. Also, regular exercise training can improve immune system responses, modulate inflammatory responses, and improve psychological parameters in cancer patients. The interactive effects of nutritional supplements on immune responses and anti-inflammatory status have been shown in some studies. The purpose of this perspective article was to investigate the interaction between dietary supplementation and regular physical exercise in controlling risk factors associated with coronavirus in cancer patients. In addition to appropriate dietary habits, some nutritional supplements, especially vitamin D, have been shown to improve the immune system’s response against COVID-19 and cancer. Using lifestyle strategies such as regular physical activity and intake of functional compounds as supplements can be effective in treatment outcomes, quality of life, and overall survival in cancer patients. We proposed that combining dietary supplements and exercise training in cancer patients can boost immune responses against COVID-19 and probably improve vaccine responses. Angiotensin (ANG)-(1-7) Mas receptor axis can probably activate following exercise training and vitamin D combination. And can prevent pulmonary injury, hematological alterations, and hyperinflammatory state in COVID-19.
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Affiliation(s)
- Mahdieh Molanouri Shamsi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
- *Correspondence: Mahdieh Molanouri Shamsi,
| | - Alieh Vahed
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
- Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - AmirHossin Ahmadi Hekmatikar
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
- Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Katsuhiko Suzuki
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- Katsuhiko Suzuki,
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18
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Felismino ES, Santos JMB, Rossi M, Santos CAF, Durigon EL, Oliveira DBL, Thomazelli LM, Monteiro FR, Sperandio A, Apostólico JS, França CN, Amaral JB, Amirato GR, Vieira RP, Vaisberg M, Bachi ALL. Better Response to Influenza Virus Vaccination in Physically Trained Older Adults Is Associated With Reductions of Cytomegalovirus-Specific Immunoglobulins as Well as Improvements in the Inflammatory and CD8 + T-Cell Profiles. Front Immunol 2021; 12:713763. [PMID: 34712226 PMCID: PMC8546344 DOI: 10.3389/fimmu.2021.713763] [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: 05/24/2021] [Accepted: 09/21/2021] [Indexed: 12/26/2022] Open
Abstract
Chronic cytomegalovirus (CMV) infection is a trigger factor for the development of immunosenescence and negatively impacts the immune response to influenza virus vaccination (IVV) in older adults. However, the role of physical exercise training in this context is unknown. Thus, the aim of this study was to investigate whether the regular practice of combined exercise training can improve the specific antibody response to IVV in CMV-seropositive older adults. Eighty older adults were distributed into two groups—non-practitioners (NP, n = 31, age = 74.06 ± 6.4 years) and practitioners of combined exercise training (CET, n = 49, age = 71.7 ± 5.8 years)—for at least 12 months. Both volunteer groups were submitted to IVV and blood samples were collected before (pre) and 30 days after (post) the vaccination. Concerning the specific antibody response to IVV, higher serum levels of specific immunoglobulin A (IgA) were found in the CET group post- than pre-vaccination (p < 0.01), whereas higher levels of specific immunoglobulin M (IgM) were observed both in the NP (p < 0.05) and CET (p < 0.001) groups post-vaccination as compared to the pre-vaccination values. Serum levels of specific immunoglobulin G (IgG) for IVV and CMV, as well as interleukin 6 (IL-6) and IL-10, were similar between the time points evaluated. However, the IL-10/IL-6 ratio post-vaccination was higher (p < 0.05) in the CET group than that before vaccination. Negative correlations were observed between the specific IgG levels for IVV and CMV only in the CET group, both pre- and post-vaccination. In addition, negative correlations were found between IL-10 and specific IgG for CMV in all volunteer groups pre- and post-vaccination, whereas a positive correlation between IL-10 and specific-IgG for IVV pre- and post-vaccination was observed in the CET group. In addition, with the hemagglutination inhibition (HAI) assay, it was found that 32.2% of the NP group and 32.6% of the CET group were responders to IVV and displayed reductions in the CMV serostatus (p < 0.05 and p < 0.001, respectively) and increases in naive and effector CD8+ T cells post-vaccination (p < 0.01). However, only the responders from the CET group showed significant reductions in the ratio of effector to naive CD8+ T cells (p < 0.05) and increased IL-10 levels post-vaccination (p < 0.001). In summary, this study demonstrates that the improvement in the response to IVV in CMV-seropositive older adults was related to an anti-inflammatory status and enhancement of naive CD8+ T cells, particularly associated with regular practice of CET.
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Affiliation(s)
- Eduardo S Felismino
- Post-Graduation Program in Health Science, University of Santo Amaro, São Paulo, Brazil
| | - Juliana M B Santos
- Post-Graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of São Paulo, Santos, Brazil
| | - Marcelo Rossi
- Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil
| | - Carlos A F Santos
- Department of Medicine, Geriatry, Paulista School of Medicine (EPM), São Paulo, Brazil
| | - Edison L Durigon
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science of University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur-University of São Paulo, São Paulo, Brazil
| | - Danielle B L Oliveira
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science of University of São Paulo, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Luciano M Thomazelli
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science of University of São Paulo, São Paulo, Brazil
| | - Fernanda R Monteiro
- Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil.,Method Faculty of São Paulo, São Paulo, Brazil
| | | | - Juliana S Apostólico
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Carolina N França
- Post-Graduation Program in Health Science, University of Santo Amaro, São Paulo, Brazil
| | - Jonatas B Amaral
- Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil
| | - Gislene R Amirato
- Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil
| | - Rodolfo P Vieira
- Post-Graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of São Paulo, Santos, Brazil.,Post-Graduation Program in Bioengineering, Universidade Brasil, São Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
| | - Mauro Vaisberg
- Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil
| | - André L L Bachi
- Post-Graduation Program in Health Science, University of Santo Amaro, São Paulo, Brazil.,Ear, Nose and Throat (ENT) Lab, Department of Otorhinolaryngology, Federal University of São Paulo, São Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
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Costache AD, Costache II, Miftode RȘ, Stafie CS, Leon-Constantin MM, Roca M, Drugescu A, Popa DM, Mitu O, Mitu I, Miftode LI, Iliescu D, Honceriu C, Mitu F. Beyond the Finish Line: The Impact and Dynamics of Biomarkers in Physical Exercise-A Narrative Review. J Clin Med 2021; 10:jcm10214978. [PMID: 34768497 PMCID: PMC8584497 DOI: 10.3390/jcm10214978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
The research of biomarkers continues to emerge as a developing academic field which is attracting substantial interest. The study of biomarkers proves to be useful in developing and implementing new screening methods for a wide variety of diseases including in the sports area, whether for leisure activities or professional sports. Novel research has brought into question the immune system and the limitations it may impose on sports practicing. As the well-being of athletes is a priority, the state of their immune function offers valuable information regarding their health status and their ability to continue training. The assessment of various biomarkers may contribute to a more accurate risk stratification and subsequent prevention of some invalidating or even fatal pathologies such as the sudden cardiac death. Therefore, we have reviewed several studies that included sports-related pathology or specific morphofunctional alterations for which some immune biomarkers may represent an expression of the underlying mechanism. These include the defensins, immunoglobulin A (IgA), interleukin-6 (IL-6), the tumoral necrosis factor α (TNF-α), and the white blood cells (WBC) count. Similarly, also of significant interest are various endocrine biomarkers, such as cortisol and testosterone, as well as anabolic or catabolic markers, respectively. Literature data highlight that these values are greatly influenced not only by the duration, but also by the intensity of the physical exercise; moderate training sessions actually enhance the immune function of the body, while a significant increase in both duration and intensity of sports activity acts as a deleterious factor. Therefore, in this paper we aim to highlight the importance of biomarkers’ evaluation in connection with sports activities and a subsequent more adequate approach towards personalized training regimens.
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Affiliation(s)
- Alexandru-Dan Costache
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
| | - Irina-Iuliana Costache
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (I.-I.C.); (D.-M.P.); (O.M.); (D.I.)
| | - Radu-Ștefan Miftode
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
- Correspondence:
| | - Celina-Silvia Stafie
- Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania;
| | - Maria-Magdalena Leon-Constantin
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
| | - Mihai Roca
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
| | - Andrei Drugescu
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
| | - Delia-Melania Popa
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (I.-I.C.); (D.-M.P.); (O.M.); (D.I.)
| | - Ovidiu Mitu
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (I.-I.C.); (D.-M.P.); (O.M.); (D.I.)
| | - Ivona Mitu
- Department of Morpho-Functional Sciences II, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania;
| | - Larisa-Ionela Miftode
- Department of Infectious Diseases (Internal Medicine II), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania;
| | - Dan Iliescu
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (I.-I.C.); (D.-M.P.); (O.M.); (D.I.)
| | - Cezar Honceriu
- Faculty of Physical Education and Sports, “Alexandru Ioan Cuza” University, 700115 Iasi, Romania;
| | - Florin Mitu
- Department of Cardiovascular Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (M.-M.L.-C.); (M.R.); (A.D.); (F.M.)
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Barros MPD, Bachi ALL, Santos JDMBD, Lambertucci RH, Ishihara R, Polotow TG, Caldo-Silva A, Valente PA, Hogervorst E, Furtado GE. The poorly conducted orchestra of steroid hormones, oxidative stress and inflammation in frailty needs a maestro: Regular physical exercise. Exp Gerontol 2021; 155:111562. [PMID: 34560197 DOI: 10.1016/j.exger.2021.111562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/25/2022]
Abstract
This review outlines the various factors associated with unhealthy aging which includes becoming frail and dependent. With many people not engaging in recommended exercise, facilitators and barriers to engage with exercise must be investigated to promote exercise uptake and adherence over the lifespan for different demographics, including the old, less affluent, women, and those with different cultural-ethnic backgrounds. Governmental and locally funded public health messages and environmental facilitation (gyms, parks etc.) can play an important role. Studies have shown that exercise can act as a conductor to balance oxidative stress, immune and endocrine functions together to promote healthy aging and reduce the risk for age-related morbidities, such as cardiovascular disease and atherosclerosis, and promote cognition and mood over the lifespan. Like a classic symphony orchestra, consisting of four groups of related musical instruments - the woodwinds, brass, percussion, and strings - the aging process should also perform in harmony, with compassion, avoiding the aggrandizement of any of its individual parts during the presentation. This review discusses the wide variety of molecular, cellular and endocrine mechanisms (focusing on the steroid balance) underlying this process and their interrelationships.
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Affiliation(s)
- Marcelo Paes de Barros
- Institute of Physical Activity Sciences and Sports (ICAFE), MSc/PhD Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, 01506-000 São Paulo, Brazil.
| | - André Luís Lacerda Bachi
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04025-002, Brazil; Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | | | | | - Rafael Ishihara
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos 11015-020, SP, Brazil
| | - Tatiana Geraldo Polotow
- Institute of Physical Activity Sciences and Sports (ICAFE), MSc/PhD Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, 01506-000 São Paulo, Brazil
| | - Adriana Caldo-Silva
- University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019) at Faculty of Sport Science and Physical Education, (FCDEF-UC), Portugal
| | - Pedro Afonso Valente
- University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019) at Faculty of Sport Science and Physical Education, (FCDEF-UC), Portugal
| | - Eef Hogervorst
- Applied Cognitive Research National Centre for Sports and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Guilherme Eustáquio Furtado
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal; Institute Polytechnic of Maia, Porto, Portugal; University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019) at Faculty of Sport Science and Physical Education, (FCDEF-UC), Portugal.
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21
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Yuan Q, Huang HY, Chen XL, Chen RH, Zhang Y, Pan XB, Chen JN, Liu N, Du H. Does pre-existent physical inactivity have a role in the severity of COVID-19? Ther Adv Respir Dis 2021; 15:17534666211025221. [PMID: 34148444 PMCID: PMC8221695 DOI: 10.1177/17534666211025221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background and Aims: Physical inactivity is considered an important lifestyle factor for overweight and cardiovascular disease. We aimed to investigate the association between pre-existent physical inactivity and the risk of severe coronavirus disease 2019 (COVID-19). Methods: We included 164 (61.8 ± 13.6 years) patients with COVID-19 who were admitted between 15 February and 14 March 2020 in this retrospective study. We evaluated the association between pre-existent physical inactivity and severe COVID-19 using a logistic regression model. Results: Of 164 eligible patients with COVID-19, 103 (62.8%) were reported to be physically inactive. Univariable logistic regression analysis showed that physical inactivity was associated with an increased risk of severe COVID-19 [unadjusted odds ratio (OR) 6.53, 95% confidence interval (CI) 1.88–22.62]. In the multivariable regression analysis, physical inactivity remained significantly associated with an increased risk of severe COVID-19 (adjusted OR 4.12, 95% CI 1.12–15.14) after adjustment for age, sex, stroke, and overweight. Conclusion: Our data showed that pre-existent physical inactivity was associated with an increased risk of experiencing severe COVID-19. Our findings indicate that people should be encouraged to keep physically active to be at a lower risk of experiencing a severe illness when COVID-19 infection seems unpredicted. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Qilin Yuan
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China, and Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Hua-Yao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiao-Ling Chen
- Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rong-Hua Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China, and Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiao-Bin Pan
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Jun-Nian Chen
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Nan Liu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China, and.,Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Houwei Du
- Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 35000, China
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22
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Evaluation of the impact of the COVID-19 lockdown on the quality of life of patients monitored for cancer who practice an adapted physical activity: rugby for health. J Cancer Res Clin Oncol 2021; 148:425-439. [PMID: 33821320 PMCID: PMC8021215 DOI: 10.1007/s00432-021-03621-7] [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: 11/16/2020] [Accepted: 03/29/2021] [Indexed: 11/19/2022]
Abstract
Purpose The benefits of regular physical exercise on the tolerability of cancer treatments, quality of life and survival rates post-diagnosis have been demonstrated but all supervised physical activities have been interrupted due to the global health crisis and the need for lockdown to halt the spread of SARS-CoV-2. To reintroduce activities post-lockdown, we wanted to assess the impact of the COVID-19 lockdown on the quality of life and the psychological status of patients who practice an adapted physical activity such as rugby for health. Methods The evaluation was conducted in two phases: an initial self-questionnaire comprised of 42 questions sent to all participants to assess the impact of lockdown and a second assessment phase in the presence of the participants. We assessed anthropometric data, functional fitness parameters, quality of life and the psychosocial status of the subjects. The data were compared to pre-lockdown data as part of a standardised follow-up procedure for patients enrolled in the programme. Results 105/120 (87.5%) individuals responded to the rapid post-lockdown survey analysis. In 20% of the cases, the patients reported anxiety, pain, a decline in fitness and a significant impact on the tolerability of cancer treatments. Twenty-seven patients agreed to participate in the individual analysis. Following lockdown, there was a significant decrease in the intensity of physical activity (p = 8.223e–05). No post-lockdown changes were noted in the assessments that focus on the quality of life and the level of psychological distress. Conversely, there was a significant correlation between the total of high energy expended during lockdown and the quality of life (p = 0.03; rho = 0.2248) and the level of psychological distress post-lockdown (p = 0.05; rho = − 0.3772). Conclusion Lockdown and reduced physical activity, particularly leisure activities, did not impact the overall health of the patients. However, there was a significant correlation with the level of physical activity since the higher the level of physical activity, the better the quality of life and the lower the level of psychological distress. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-021-03621-7.
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23
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Paixão V, Almeida EB, Amaral JB, Roseira T, Monteiro FR, Foster R, Sperandio A, Rossi M, Amirato GR, Santos CAF, Pires RS, Leal FB, Durigon EL, Oliveira DBL, Vieira RP, Vaisberg M, Santos JMB, Bachi ALL. Elderly Subjects Supplemented with L-Glutamine Shows an Improvement of Mucosal Immunity in the Upper Airways in Response to Influenza Virus Vaccination. Vaccines (Basel) 2021; 9:vaccines9020107. [PMID: 33572639 PMCID: PMC7911866 DOI: 10.3390/vaccines9020107] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although glutamine is able to improve the immune response, its action in the upper airway immunity against the influenza virus vaccine remains unclear. Therefore, we aimed to evaluate the L-glutamine supplementation effect on the mucosal immune/inflammatory response of elderly subjects vaccinated against the influenza virus. METHODS Saliva sampling from 83 physically active elderly volunteers were collected pre- and 30 days after influenza virus vaccination and supplementation with L-glutamine (Gln, n = 42) or placebo (PL, n = 41). RESULTS Gln group showed higher salivary levels of interleukin (IL)-17, total secretory immunoglobulin A (SIgA), and specific-SIgA post-vaccination than values found pre-vaccination and in the PL group post-vaccination. Whereas higher salivary levels of IL-6 and IL-10 were observed post-vaccination in the Gln group, IL-37 levels were lower post-vaccination in both groups than the values pre-vaccination. Tumor necrosis factor (TNF)-α levels were unchanged. Positive correlations between IL-6 and IL-10 were found in all volunteer groups pre- and post-vaccination and also between IL-17 and IL-6 or IL-10 in the Gln group post-vaccination. A negative correlation between IL-37 and IL-10 was found pre- and post-vaccination in the PL group. CONCLUSION Gln supplementation was able to modulate salivary cytokine profile and increase SIgA levels, both total and specific to the influenza virus vaccine, in physically active elderly subjects.
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Affiliation(s)
- Vitória Paixão
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Ewin B. Almeida
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Jonatas B. Amaral
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Tamaris Roseira
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | - Fernanda R. Monteiro
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | - Roberta Foster
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | | | - Marcelo Rossi
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Gislene R. Amirato
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Carlos A. F. Santos
- Department of Medicine, Geriatry, Paulista School of Medicine (EPM), São Paulo 04023-062, Brazil;
| | - Renier S. Pires
- Post-Graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo 04743-030, Brazil;
| | - Fabyano B. Leal
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
| | - Edison L. Durigon
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
- Scientific Platform Pasteur, University of São Paulo (USP), São Paulo 05508-060, Brazil
| | - Danielle B. L. Oliveira
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Rodolfo P. Vieira
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São Paulo 12245-520, Brazil;
- Post-Graduation Program in Bioengineering and Biomedical Engineering, Universidade Brasil, São Paulo 15600-000, Brazil
- Post-Graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos 11015-020, Brazil
| | - Mauro Vaisberg
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Juliana M. B. Santos
- Post-Graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos 11015-020, Brazil
- Correspondence:
| | - André L. L. Bachi
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Post-Graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo 04743-030, Brazil;
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São Paulo 12245-520, Brazil;
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