|
1
|
Abarca YA, Chadalavada B, Ceron JR, Sai BA, Bhatia A, Espinoza I, Rao NL, Khan R, Ansar R, Morani Z. A Comprehensive Review of the Manifestation of Cardiovascular Diseases in HIV Patients. Cureus 2025; 17:e77509. [PMID: 39958097 PMCID: PMC11828753 DOI: 10.7759/cureus.77509] [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] [Accepted: 01/15/2025] [Indexed: 02/18/2025] Open
Abstract
The increasing lifespan of people living with HIV (PLWH) due to advancements in antiretroviral therapy (ART) has shifted mortality patterns from AIDS-related to non-AIDS-related causes, notably cardiovascular diseases (CVDs). This review investigates how HIV and ART contribute to vascular endothelial dysfunction, myocardial fibrosis, and hypercoagulation, which significantly exacerbate cardiovascular risk. Mechanistic insights include chronic inflammation and immune dysregulation due to persistent HIV infection and ART-specific effects such as protease inhibitors causing dyslipidemia and zidovudine inducing mitochondrial toxicity leading to cardiomyopathy. ART, while lifesaving, has been implicated in promoting subclinical atherosclerosis and increasing the risk of acute myocardial infarction, further highlighting the need for tailored approaches. The manuscript addresses pressing obstacles, including disparities in healthcare access and the lack of standardized cardiovascular screening guidelines specific to PLWH. It emphasizes the integration of advanced imaging techniques and emerging biomarkers, such as coronary artery calcium scoring and soluble ST2, to detect early subclinical cardiovascular abnormalities. The review also identifies challenges in ART selection to balance virologic control and cardiovascular safety. What sets this review apart is its holistic and detailed approach to the intersection of HIV and cardiovascular health. It not only elucidates complex pathophysiological mechanisms but also offers actionable insights into how current clinical guidelines fall short. This manuscript underscores the urgency of implementing proactive cardiovascular screening protocols tailored for PLWH and refining ART regimens to mitigate CVD risks. By addressing these gaps, this work aims to expand our understanding of HIV-related cardiovascular manifestations and provide a foundation for targeted interventions, thereby improving long-term health outcomes for PLWH. This comprehensive perspective is poised to transform clinical practice by fostering greater awareness among physicians and encouraging the development of more effective strategies for managing cardiovascular risks in the HIV population.
Collapse
Affiliation(s)
- Yozahandy A Abarca
- Internal Medicine, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, MEX
| | | | - Jose R Ceron
- Medicine, Universidad Popular Autonóma del Estado de Puebla (UPAEP), Puebla, MEX
| | - Boddu Abhinav Sai
- Medicine, Kamineni Academy of Medical Sciences and Research Centre (KAMSRC), Hyderabad, IND
| | - Aarzoo Bhatia
- Infectious Diseases, North Manchester General Hospital, Manchester, GBR
| | - Itzel Espinoza
- Medicine, Universidad Autónoma de Guadalajara, Guadalajara, MEX
| | - Nidhi L Rao
- Internal Medicine, K.A.P. Viswanatham Government Medical College, Tiruchirappalli, IND
| | - Razaan Khan
- Medicine, Dow International Medical College, Karachi, PAK
| | - Rimsha Ansar
- Medicine, Continental Medical College, Lahore, PAK
| | - Zoya Morani
- Medicine, Washington University of Health and Science, San Pedro, BLZ
| |
Collapse
|
|
2
|
Martín-Reyes F, Bernal M, Rodríguez-Díaz C, Rodríguez-de los Reyes D, Ho-Plagaro A, Rodríguez-Pacheco F, Camacho-Martel L, Camargo-Camero R, Rodríguez-González FJ, Alcain-Martínez G, Martín-Masot R, Navas-López VM, Villanueva-Paz M, Lucena MI, García-Fuentes E, López-Gómez C. Mitochondrial Stress Links Environmental Triggers with Pro-Inflammatory Signaling in Crohn's Disease. Antioxidants (Basel) 2023; 12:2105. [PMID: 38136224 PMCID: PMC10741078 DOI: 10.3390/antiox12122105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Inflammatory Bowel Diseases (IBD) are a group of chronic, inflammatory disorders of the gut. The incidence and activity of IBD are determined by both genetic and environmental factors. Among these factors, polymorphisms in genes related to autophagy and the consumption of non-steroidal anti-inflammatory drugs (NSAIDs) have been consistently associated with IBD. We show that NSAIDs induce mitochondrial stress and mitophagy in intestinal epithelial cells. In an altered mitophagy context simulating that observed in IBD patients, NSAID-induced mitochondrial stress leads to the release of mitochondrial components, which act as Danger Associated Molecular Patterns with pro-inflammatory potential. Furthermore, colonic organoids from Crohn's disease patients and healthy donors show activation of the mitochondrial Unfolded Protein Response (UPRmt) upon treatment with ibuprofen. Finally, colon biopsies from Crohn's disease patients in remission or with low-to-moderate activity also show expression of genes involved in UPRmt, while patients with severe activity show no increase compared to healthy donors. Our results suggest the involvement of mitochondria in the mechanisms triggering inflammation in IBD after NSAID use. Moreover, our results highlight the clinical relevance of mitochondrial stress and activation of the UPRmt pathway in the pathophysiology of Crohn's disease.
Collapse
Affiliation(s)
- Flores Martín-Reyes
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Manuel Bernal
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Departamento de Biología Molecular y Bioquímica, Facultad de Ciencias, Universidad de Málaga, 29010 Malaga, Spain
| | - Cristina Rodríguez-Díaz
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Damaris Rodríguez-de los Reyes
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Ailec Ho-Plagaro
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Francisca Rodríguez-Pacheco
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Laura Camacho-Martel
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Raquel Camargo-Camero
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Francisco J. Rodríguez-González
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Guillermo Alcain-Martínez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Rafael Martín-Masot
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Sección de Gastroenterología y Nutrición Infantil, Unidad de Gestión Clínica de Pediatría, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Víctor M. Navas-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Sección de Gastroenterología y Nutrición Infantil, Unidad de Gestión Clínica de Pediatría, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Marina Villanueva-Paz
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- Servicio de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, 29010 Malaga, Spain
| | - María Isabel Lucena
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Servicio de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, 29010 Malaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, 28220 Madrid, Spain
- UICEC IBIMA, Plataforma SCReN (Spanish Clinical Research Network), Servicio de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, 29010 Malaga, Spain
| | - Eduardo García-Fuentes
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Carlos López-Gómez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (F.M.-R.); (M.B.); (C.R.-D.); (D.R.-d.l.R.); (A.H.-P.); (F.R.-P.); (L.C.-M.); (R.C.-C.); (G.A.-M.); (R.M.-M.); (V.M.N.-L.); (M.V.-P.); (M.I.L.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| |
Collapse
|
|
3
|
Brunetti G, Barile B, Nicchia GP, Onorati F, Luciani GB, Galeone A. The ST2/IL-33 Pathway in Adult and Paediatric Heart Disease and Transplantation. Biomedicines 2023; 11:1676. [PMID: 37371771 DOI: 10.3390/biomedicines11061676] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
ST2 is a member of interleukin 1 receptor family with soluble sST2 and transmembrane ST2L isoforms. The ligand of ST2 is IL-33, which determines the activation of numerous intracytoplasmic mediators following the binding with ST2L and IL-1RAcP, leading to nuclear signal and cardiovascular effect. Differently, sST2 is released in the blood and works as a decoy receptor, binding IL-33 and blocking IL-33/ST2L interaction. sST2 is mainly involved in maintaining homeostasis and/or alterations of different tissues, as counterbalance/activation of IL-33/ST2L axis is typically involved in the development of fibrosis, tissue damage, inflammation and remodeling. sST2 has been described in different clinical reports as a fundamental prognostic marker in patients with cardiovascular disease, as well as marker for the treatment monitoring of patients with heart failure; however, further studies are needed to better elucidate its role. In this review we reported the current knowledge about its role in coronary artery disease, heart failure, heart transplantation, heart valve disease, pulmonary arterial hypertension, and cardiovascular interventions.
Collapse
Affiliation(s)
- Giacomina Brunetti
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Barbara Barile
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Grazia Paola Nicchia
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Francesco Onorati
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy
| | - Giovanni Battista Luciani
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy
| | - Antonella Galeone
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy
| |
Collapse
|