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Nguyen S, Godon J, de Barros JPP, Masson D, Piroth L, Blot M. Pneumococcal meningitis and endotoxemia: A cross-sectional clinical study. PLoS One 2025; 20:e0324153. [PMID: 40397876 DOI: 10.1371/journal.pone.0324153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 04/21/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Lipopolysaccharide (LPS) is a major virulence factor during both meningococcal and Haemophilus influenzae meningitis. Pneumococcus does not produce LPS but could be responsible for bacterial digestive translocation as a consequence of sepsis. We addressed this question in the context of pneumococcal meningitis. METHODS A cross-sectional study on 24 patients with pneumococcal meningitis (20 (83%) admitted in intensive care unit, 4 (17%) with septic shock) and 34 prospectively-enrolled healthy volunteers. Interleukin 6 and C-reactive proteins plasma concentrations were measured as markers of systemic inflammation. Endotoxemia was measured using mass spectrometry (LC-MS/MS) for detection of molecules bound to the lipid A, namely 3-OH fatty acids. RESULTS Meningitis patients had significantly higher levels of plasma C-reactive protein (237 (74-373) vs. 2 (2-2) mg/l, p < 0.001 and interleukin 6 (43 (13-128) vs. 4.6 (4.6-16.6) pg/ml; p < 0.001) than healthy volunteers. However, we observed no significant difference in plasma lipopolysaccharide concentrations between patients and healthy volunteers (674 (554-896) vs. 668 (623-777) pmol/ml; p = 0.546). CONCLUSIONS Our results suggest that LPS is not a key determinant of the excessive inflammation associated with severe forms of pneumococcal meningitis.
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Affiliation(s)
- Sylvie Nguyen
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Jeanne Godon
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
| | | | - David Masson
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Lionel Piroth
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne, CIC, Module Épidémiologie Clinique, Dijon, France and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Mathieu Blot
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne, CIC, Module Épidémiologie Clinique, Dijon, France and LabEx LipSTIC, University of Burgundy, Dijon, France
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Li F, Tian X, Wang L, Wu LP, Liu X, Peng HY. Role of plasma suPAR, sTNFR1, and sTNFR2 levels in risk stratification and outcome prediction of complicated acute kidney injury in elderly patients with coronavirus disease 2019. Exp Gerontol 2024; 198:112634. [PMID: 39561952 DOI: 10.1016/j.exger.2024.112634] [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: 08/29/2024] [Revised: 11/12/2024] [Accepted: 11/13/2024] [Indexed: 11/21/2024]
Abstract
OBJECTIVE The aim of this study is to investigate the early prognostic efficacy of plasma soluble urokinase-type plasminogen activator receptor (suPAR), soluble tumor necrosis factor receptor 1 (sTNFR1), and soluble tumor necrosis factor receptor 2 (sTNFR2) in complicated acute kidney injury (AKI) in patients with coronavirus disease 2019 (COVID-19), and to analyze the relevant factors contributing to complicated AKI in these patients. METHODS Patients with COVID-19 hospitalized at the Affiliated Baiyun Hospital of Guizhou Medical University from March 2022 to March 2024 were selected as study participants. A total of 589 patients met the inclusion and exclusion criteria, 68 patients complicated with AKI were classified as AKI group, and the remaining 521 cases were divided into proportion sampling method and randomly selected 200 samples, which were classified as non-AKI group. Additionally, 50 healthy controls were enrolled as the control group. Logistic regression analysis was conducted to identify the relevant factors associated with complicated AKI in patients with COVID-19. Receiver operating characteristic (ROC) curves were plotted to evaluate the prognostic efficacy of plasma suPAR, sTNFR1, and sTNFR2 indicators for complicated AKI in patients with COVID-19. RESULTS Among the patients with COVID-19 in the AKI group, 43 were males (63.20 %), with a median age of 79.00 (interquartile range: 75.00, 83.00) years, while the non-AKI group comprised 83 males (41.50 %), with a median age of 73.00 (interquartile range: 60.00, 80.75) years. Comparison of the sex and age between the two groups indicated that males and elderly patients had increased risks of complicated AKI (P < 0.05). Plasma levels of suPAR, sTNFR1, and sTNFR2 in the AKI group were significantly higher than those in the non-AKI group (P < 0.05). Logistic regression analysis indicated that suPAR and sTNFR2 were independent factors influencing complicated AKI in patients with COVID-19 (P < 0.05). The ROC curve for a single indicator showed that suPAR had the highest prognostic efficacy for complicated AKI, with an area under the curve (AUC) of 0.813, a sensitivity of 79.4 %, and a specificity of 74.0 %. The combined use of suPAR and sTNFR2 for risk assessment yielded the highest AUC of 0.838, with a sensitivity of 66.2 % and a specificity of 87.5 %. The combined risk assessment using all three indicators (suPAR, sTNFR1, and sTNFR2) had an AUC of 0.837, with a sensitivity of 64.7 % and a specificity of 89.0 %. CONCLUSION Elderly patients had increased risks of complicated AKI. Indicators such as suPAR, sTNFR1, and sTNFR2 can assist in assessing the risk in patients with COVID-19 complicated AKI, with suPAR demonstrating the highest prognostic efficacy as a single indicator. The combined detection of suPAR, sTNFR1, and sTNFR2 offers greater prognostic value than using any single indicator.
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Affiliation(s)
- Fang Li
- Demartment of Nerhrology, The Affiliated Hospital of Guizhou Medical University, Guizhou 550004, China
| | - Xue Tian
- Demartment of Nerhrology, The Affiliated Hospital of Guizhou Medical University, Guizhou 550004, China
| | - Lu Wang
- Department of Nephrology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Ling-Pei Wu
- Department of Nephrology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Xiao Liu
- Department of Nephrology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Hong-Ying Peng
- Department of Nephrology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550004, China.
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Mascle O, Dupuis C, Brailova M, Bonnet B, Mirand A, De Beauchene RC, Philipponnet C, Adda M, Calvet L, Cassagnes L, Henquell C, Sapin V, Evrard B, Souweine B. Clustering based on renal and inflammatory admission parameters in critically ill patients admitted to the ICU. PLoS One 2024; 19:e0307938. [PMID: 39485788 PMCID: PMC11530013 DOI: 10.1371/journal.pone.0307938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/15/2024] [Indexed: 11/03/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has been associated with significant variability in acute kidney injury (AKI) incidence, leading to concerns regarding patient heterogeneity. The study's primary objective was a cluster analysis, to identify homogeneous subgroups of patients (clusters) using baseline characteristics, including inflammatory biomarkers. The secondary objectives were the comparisons of MAKE-90 and mortality between the different clusters at three months. METHODS This retrospective single-center study was conducted in the Medical Intensive Care Unit of the University Hospital of Clermont-Ferrand, France. Baseline data, clinical and biological characteristics on ICU admission, and outcomes at day 90 were recorded. The primary outcome was the risk of major adverse kidney events at 90 days (MAKE-90). Clusters were determined using hierarchical clustering on principal components approach based on admission characteristics, biomarkers and serum values of immune dysfunction and kidney function. RESULTS It included consecutive adult patients admitted between March 20, 2020 and February 28, 2021 for severe COVID-19. A total of 149 patients were included in the study. Three clusters were identified of which two were fully described (cluster 3 comprising 2 patients). Cluster 1 comprised 122 patients with fewer organ dysfunctions, moderate immune dysfunction, and was associated with reduced mortality and a lower incidence of MAKE-90. Cluster 2 comprised 25 patients with greater disease severity, immune dysfunction, higher levels of suPAR and L-FABP/U Creat, and greater organ support requirement, incidence of AKI, day-90 mortality and MAKE-90. CONCLUSIONS This study identified two clusters of severe COVID-19 patients with distinct biological characteristics and renal event risks. Such clusters may help facilitate the identification of targeted populations for future clinical trials. Also, it may help to understand the significant variability in AKI incidence observed in COVID-19 patients.
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Affiliation(s)
- Olivier Mascle
- CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France
| | - Claire Dupuis
- CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France
- Unité de Nutrition Humaine, INRAe, CRNH Auvergne, Université Clermont Auvergne, Clermont Ferrand, France
| | - Marina Brailova
- CHU de Clermont-Ferrand, Service de Biochimie Médicale, Clermont-Ferrand, France
| | - Benjamin Bonnet
- CHU de Clermont-Ferrand, Service d’Immunologie, Clermont-Ferrand, France
- Laboratoire d’Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Audrey Mirand
- CHU de Clermont-Ferrand, 3IHP, Service de Virologie, Clermont-Ferrand, France
- UMR CNRS 6023 LMGE, Université Clermont Auvergne, Clermont-Ferrand, France
| | | | | | - Mireille Adda
- CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France
| | - Laure Calvet
- CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France
| | - Lucie Cassagnes
- CHU de Clermont-Ferrand, Service de Radiologie, Clermont-Ferrand, France
| | - Cécile Henquell
- CHU de Clermont-Ferrand, 3IHP, Service de Virologie, Clermont-Ferrand, France
- UMR CNRS 6023 LMGE, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Vincent Sapin
- CHU de Clermont-Ferrand, Service de Biochimie Médicale, Clermont-Ferrand, France
| | - Bertrand Evrard
- CHU de Clermont-Ferrand, Service d’Immunologie, Clermont-Ferrand, France
- Laboratoire d’Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bertrand Souweine
- CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France
- UMR CNRS 6023 LMGE, Université Clermont Auvergne, Clermont-Ferrand, France
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Godon J, Charles PE, Nguyen S, de Barros JPP, Choubley H, Jacquier M, Tetu J, Quenot JP, Luu M, Binquet C, Masson D, Piroth L, Blot M. Pneumococcal pneumonia and endotoxemia: An experimental and clinical reappraisal. Eur J Clin Invest 2024; 54:e14077. [PMID: 37642230 DOI: 10.1111/eci.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/20/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Circulating endotoxins could result from bacterial digestive translocation during sepsis, thus contributing to uncontrolled systemic inflammation, leading in turn to organ dysfunction. We addressed this issue in the setting of severe pneumococcal pneumonia. METHODS Endotoxemia was measured in a clinically relevant rabbit model of ventilated pneumococcal pneumonia and in 110 patients with bacteraemic pneumonia, using a patented mass spectrometry (LC-MS/MS) method for detection of 3-OH fatty acids (C10, C12, C14, C16 and C18), which are molecules bound to the lipid A motif of LPS. RESULTS Whereas higher levels of systemic inflammation and organ dysfunctions were found, there was no significant difference in lipopolysaccharide concentrations when infected rabbits were compared to non-infected ones, or when patients were compared to healthy volunteers. CONCLUSIONS Seemingly, endotoxins do not drive the overwhelming inflammation associated with severe forms of pneumococcal pneumonia.
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Affiliation(s)
- Jeanne Godon
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
| | - Pierre-Emmanuel Charles
- Department of Intensive Care, Dijon-Bourgogne University Hospital, Dijon, France
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Sylvie Nguyen
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | | | | | - Marine Jacquier
- Department of Intensive Care, Dijon-Bourgogne University Hospital, Dijon, France
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Jennifer Tetu
- Laboratory of bacteriology, Dijon-Bourgogne University Hospital, Dijon, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Dijon-Bourgogne University Hospital, Dijon, France
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne CIC 1432 Module Épidémiologie Clinique, Dijon France and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Maxime Luu
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne CIC 1432 Module Plurithématique, Dijon, University of Burgundy, Dijon, France
| | - Christine Binquet
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne CIC 1432 Module Épidémiologie Clinique, Dijon France and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - David Masson
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Lionel Piroth
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne CIC 1432 Module Épidémiologie Clinique, Dijon France and LabEx LipSTIC, University of Burgundy, Dijon, France
| | - Mathieu Blot
- Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France
- Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- CHU Dijon-Bourgogne, INSERM, Université de Bourgogne CIC 1432 Module Épidémiologie Clinique, Dijon France and LabEx LipSTIC, University of Burgundy, Dijon, France
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Shivram H, Hackney JA, Rosenberger CM, Teterina A, Qamra A, Onabajo O, McBride J, Cai F, Bao M, Tsai L, Regev A, Rosas IO, Bauer RN. Transcriptomic and proteomic assessment of tocilizumab response in a randomized controlled trial of patients hospitalized with COVID-19. iScience 2023; 26:107597. [PMID: 37664617 PMCID: PMC10470387 DOI: 10.1016/j.isci.2023.107597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/16/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023] Open
Abstract
High interleukin (IL)-6 levels are associated with greater COVID-19 severity. IL-6 receptor blockade by tocilizumab (anti-IL6R; Actemra) is used globally for the treatment of severe COVID-19, yet a molecular understanding of the therapeutic benefit remains unclear. We characterized the immune profile and identified cellular and molecular pathways modified by tocilizumab in peripheral blood samples from patients enrolled in the COVACTA study, a phase 3, randomized, double-blind, placebo-controlled trial of the efficacy and safety of tocilizumab in hospitalized patients with severe COVID-19. We identified markers of inflammation, lymphopenia, myeloid dysregulation, and organ injury that predict disease severity and clinical outcomes. Proteomic analysis confirmed a pharmacodynamic effect for tocilizumab and identified novel pharmacodynamic biomarkers. Transcriptomic analysis revealed that tocilizumab treatment leads to faster resolution of lymphopenia and myeloid dysregulation associated with severe COVID-19, indicating greater anti-inflammatory activity relative to placebo and potentially leading to faster recovery in patients hospitalized with COVID-19.
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Affiliation(s)
| | | | | | | | - Aditi Qamra
- Hoffmann-La Roche Ltd, Mississauga, ON L5N 5M8, Canada
| | | | | | - Fang Cai
- Genentech, South San Francisco, CA 94080, USA
| | - Min Bao
- Genentech, South San Francisco, CA 94080, USA
| | - Larry Tsai
- Genentech, South San Francisco, CA 94080, USA
| | - Aviv Regev
- Genentech, South San Francisco, CA 94080, USA
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Intestinal Fatty Acid Binding Protein (I-FABP) as a Prognostic Marker in Critically Ill COVID-19 Patients. Pathogens 2022; 11:pathogens11121526. [PMID: 36558860 PMCID: PMC9784725 DOI: 10.3390/pathogens11121526] [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: 10/25/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Gastrointestinal symptoms are common in critically ill COVID-19 patients. There is currently no generally recognized method of assessing gastrointestinal injury in unconscious or sedated intensive care unit (ICU) patients. I-FABP (intestinal fatty acid binding protein) and citrulline have previously been studied as potential biomarkers of enterocyte damage in various gastrointestinal tract diseases, and changes in the levels of these markers may reflect intestinal wall damage in COVID-19. Patients with critical COVID-19, with diagnosed sepsis, or septic shock requiring ICU treatment were included in the study. Blood samples for citrulline and I-FABP were taken daily from day 1 to 5. I-FABP levels were significantly higher in patients who eventually died from COVID-19 than in survivors, and the optimal I-FABP cut-off point for predicting 28-day mortality was 668.57 pg/mL (sensitivity 0.739, specificity 0.765). Plasma levels of I-FABP, but not citrulline, were associated with significantly higher mortality and appeared to be a predictor of poor outcome in multivariate logistic regression analysis. In conclusion, I-FABP seems to be an effective prognostic marker in critically ill COVID-19 patients. Assessing mortality risk based on intestinal markers may be helpful in making clinical decisions regarding the management of intestinal injury, imaging diagnostics, and potential surgical interventions.
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Su L, Zhang J, Peng Z. The role of kidney injury biomarkers in COVID-19. Ren Fail 2022; 44:1280-1288. [PMID: 35930243 PMCID: PMC9359166 DOI: 10.1080/0886022x.2022.2107544] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease-2019 (COVID-19) outbreak has been declared a global pandemic. COVID-19-associated acute kidney injury (COVID-19 AKI) is related to a high mortality rate and serves as an independent risk factor for hospital death in patients with COVID-19. Early diagnosis would allow for earlier intervention and potentially improve patient outcomes. The goal of early identification of AKI has been the primary impetus for AKI biomarker research, and several kidney injury biomarkers have been demonstrated to be beneficial in predicting COVID-19 AKI as well as disease progression in COVID-19. Furthermore, such data provide valuable insights into the molecular mechanisms underlying this complex and unique disease and serve as a molecular phenotyping tool that could be utilized to direct clinical intervention. This review focuses on a number of kidney injury biomarkers, such as CysC, NAGAL, KIM-1, L-FABP, IL-18, suPAR, and [TIMP-2] • [IGFBP7], which have been widely studied in common clinical settings, such as sepsis, cardiac surgery, and contrast-induced AKI. We explore the role of kidney injury biomarkers in COVID-19 and discuss what remains to be learned.
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Affiliation(s)
- Lianjiu Su
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jiahao Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhiyong Peng
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Critical Care Medicine, Center of Critical Care Nephrology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Assante G, Tourna A, Carpani R, Ferrari F, Prati D, Peyvandi F, Blasi F, Bandera A, Le Guennec A, Chokshi S, Patel VC, Cox IJ, Valenti L, Youngson NA. Reduced circulating FABP2 in patients with moderate to severe COVID-19 may indicate enterocyte functional change rather than cell death. Sci Rep 2022; 12:18792. [PMID: 36335131 PMCID: PMC9637119 DOI: 10.1038/s41598-022-23282-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022] Open
Abstract
The gut is of importance in the pathology of COVID-19 both as a route of infection, and gut dysfunction influencing the severity of disease. Systemic changes caused by SARS-CoV-2 gut infection include alterations in circulating levels of metabolites, nutrients and microbial products which alter immune and inflammatory responses. Circulating plasma markers for gut inflammation and damage such as zonulin, lipopolysaccharide and β-glycan increase in plasma along with severity of disease. However, Intestinal Fatty Acid Binding Protein / Fatty Acid Binding Protein 2 (I-FABP/FABP2), a widely used biomarker for gut cell death, has paradoxically been shown to be reduced in moderate to severe COVID-19. We also found this pattern in a pilot cohort of mild (n = 18) and moderately severe (n = 19) COVID-19 patients in Milan from March to June 2020. These patients were part of the first phase of COVID-19 in Europe and were therefore all unvaccinated. After exclusion of outliers, patients with more severe vs milder disease showed reduced FABP2 levels (median [IQR]) (124 [368] vs. 274 [558] pg/mL, P < 0.01). A reduction in NMR measured plasma relative lipid-CH3 levels approached significance (median [IQR]) (0.081 [0.011] vs. 0.073 [0.024], P = 0.06). Changes in circulating lipid levels are another feature commonly observed in severe COVID-19 and a weak positive correlation was observed in the more severe group between reduced FABP2 and reduced relative lipid-CH3 and lipid-CH2 levels. FABP2 is a key regulator of enterocyte lipid import, a process which is inhibited by gut SARS-CoV-2 infection. We propose that the reduced circulating FABP2 in moderate to severe COVID-19 is a marker of infected enterocyte functional change rather than gut damage, which could also contribute to the development of hypolipidemia in patients with more severe disease.
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Affiliation(s)
- G Assante
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College, London, UK
| | - A Tourna
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College, London, UK
| | - R Carpani
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - F Ferrari
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - D Prati
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - F Peyvandi
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy
| | - F Blasi
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy
| | - A Bandera
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy
| | - A Le Guennec
- Randall Centre for Cell & Molecular Biophysics, King's College, London, UK
| | - S Chokshi
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College, London, UK
| | - V C Patel
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College, London, UK
- Institute of Liver Studies, King's College Hospital, London, UK
| | - I J Cox
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK.
- Faculty of Life Sciences & Medicine, King's College, London, UK.
| | - L Valenti
- Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy.
| | - N A Youngson
- The Roger Williams Institute of Hepatology, Foundation for Liver Research, London, UK.
- Faculty of Life Sciences & Medicine, King's College, London, UK.
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Nowowiejska J, Baran A, Flisiak I. Fatty Acid-Binding Proteins in Psoriasis-A Review. Metabolites 2022; 12:metabo12090833. [PMID: 36144237 PMCID: PMC9500650 DOI: 10.3390/metabo12090833] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is one of the most common skin diseases in dermatological practice. It affects about 1–3% of the general population and is associated with different comorbidities, especially metabolic syndrome. Fatty-acid-binding proteins (FABPs) are a family of cytosolic proteins which are an important link in lipid metabolism and transport; moreover, they have different tissue specificity and properties. So far, ten FABPs have been discovered and seven have been investigated in psoriasis. In this review, we discuss the nature of all FABPs and their role in psoriasis. FABPs have different organ and tissue expression, and hence various functions, and may be markers of different disorders. Considering the concentration of a few of them tends to be elevated in psoriasis, it confirms the current perception of psoriasis as a multiorgan disorder associated with plenty of comorbidities. Some FABPs may be also further investigated as biomarkers of psoriasis organ complications. FABP-1 and FABP-5 may become potential markers of metabolic complications and inflammation in psoriasis. FABP-7 could perhaps be further investigated as an indicator of the neurodegenerative processes in psoriatic patients.
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O'Moráin N, Stack R, Doherty J, Tosetto M, Garcia Leon A, Mallon P, Doherty G. Faecal calprotectin as a potential biomarker of disease severity in SARS-CoV-2 infection. J Infect 2022; 85:436-480. [PMID: 35768051 PMCID: PMC9233623 DOI: 10.1016/j.jinf.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/05/2022]
Affiliation(s)
- N O'Moráin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland.
| | - R Stack
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
| | - J Doherty
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
| | - M Tosetto
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - A Garcia Leon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, 4, Ireland
| | - P Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, 4, Ireland; Department of Infectious Disease, St. Vincent's University Hospital, Dublin, 4, Ireland
| | - G Doherty
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
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11
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Josyabhatla R, Kamdar AA, Armbrister SA, Daniel R, Boukas K, Smith KG, Van Arsdall MR, Kakarala K, Flores AR, Wanger A, Liu Y, Rhoads JM. Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis. Front Pediatr 2021; 9:748368. [PMID: 34778138 PMCID: PMC8588082 DOI: 10.3389/fped.2021.748368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022] Open
Abstract
Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2-4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., lymphopenia, markedly elevated acute phase reactants, and hypoalbuminemia). We also show serologic evidence that the pathophysiological mechanism of SARS-CoV-2 related diarrhea may differ from other causes of dehydrating vomiting and diarrhea, with no serologic evidence of villus cell injury.
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Affiliation(s)
- Rohit Josyabhatla
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Children's Memorial Hermann Hospital, Houston, TX, United States
| | - Ankur A. Kamdar
- Children's Memorial Hermann Hospital, Houston, TX, United States
- Division of Rheumatology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Shabba A. Armbrister
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Rhea Daniel
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Children's Memorial Hermann Hospital, Houston, TX, United States
| | - Konstantinos Boukas
- Children's Memorial Hermann Hospital, Houston, TX, United States
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Keely G. Smith
- Children's Memorial Hermann Hospital, Houston, TX, United States
- Division of Pediatric Hospital Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Melissa R. Van Arsdall
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Children's Memorial Hermann Hospital, Houston, TX, United States
| | - Kokila Kakarala
- Children's Memorial Hermann Hospital, Houston, TX, United States
- Division of Pediatric Hospital Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Anthony R. Flores
- Children's Memorial Hermann Hospital, Houston, TX, United States
- Division of Infectious Disease, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Audrey Wanger
- Department of Pathology and Laboratory Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Yuying Liu
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jon Marc Rhoads
- Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
- Children's Memorial Hermann Hospital, Houston, TX, United States
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12
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Rodríguez de la Concepción ML, Ainsua-Enrich E, Reynaga E, Ávila-Nieto C, Santos JR, Roure S, Mateu L, Paredes R, Puig J, Jimenez JM, Izquierdo-Useros N, Clotet B, Pedro-Botet ML, Carrillo J. High-dose intravenous immunoglobulins might modulate inflammation in COVID-19 patients. Life Sci Alliance 2021; 4:e202001009. [PMID: 34321327 PMCID: PMC8321664 DOI: 10.26508/lsa.202001009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 01/08/2023] Open
Abstract
The use of high-dose of intravenous immunoglobulins (IVIGs) as immunomodulators for the treatment of COVID-19-affected individuals has shown promising results. IVIG reduced inflammation in these patients, who progressively restored respiratory function. However, little is known about how they may modulate immune responses in COVID-19 individuals. Here, we have analyzed the levels of 41 inflammatory biomarkers in plasma samples obtained at day 0 (pretreatment initiation), 3, 7, and 14 from five hospitalized COVID-19 patients treated with a 5-d course of 400 mg/kg/d of IVIG. The plasmatic levels of several cytokines (Tumor Necrosis Factor, IL-10, IL-5, and IL-7), chemokines (macrophage inflammatory protein-1α), growth/tissue repairing factors (hepatic growth factor), complement activation (C5a), and intestinal damage such as Fatty acid-binding protein 2 and LPS-binding protein showed a progressive decreasing trend during the next 2 wk after treatment initiation. This trend was not observed in IVIG-untreated COVID-19 patients. Thus, the administration of high-dose IVIG to hospitalized COVID-19 patients may improve their clinical evolution by modulating their hyperinflammatory and immunosuppressive status.
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Affiliation(s)
| | - Erola Ainsua-Enrich
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
| | - Esteban Reynaga
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Carlos Ávila-Nieto
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
| | - Jose Ramón Santos
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Silvia Roure
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Lourdes Mateu
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola Del Vallès, Spain
- CIBERes: Centro de investigaciones en Red de Enfermedades Respiratorias Del Instituto Carlos III, Madrid, Spain
| | - Roger Paredes
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Jordi Puig
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Juan Manuel Jimenez
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
| | - Nuria Izquierdo-Useros
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
- Chair in Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine. University of Vic–Central University of Catalonia (UVic–UCC), Vic, Spain
- Universitat Autonoma de Barcelona, Cerdanyola Del Vallès, Spain
- CIBERes: Centro de investigaciones en Red de Enfermedades Respiratorias Del Instituto Carlos III, Madrid, Spain
| | - María Luisa Pedro-Botet
- Infectious Diseases Department, Fight Against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Badalona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola Del Vallès, Spain
- CIBERes: Centro de investigaciones en Red de Enfermedades Respiratorias Del Instituto Carlos III, Madrid, Spain
| | - Jorge Carrillo
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Spain
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