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Costa VV, Resende F, Melo EM, Teixeira MM. Resolution pharmacology and the treatment of infectious diseases. Br J Pharmacol 2024; 181:917-937. [PMID: 38355144 DOI: 10.1111/bph.16323] [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: 06/28/2023] [Revised: 12/06/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Inflammation is elicited by the host in response to microbes, and is believed to be essential for protection against infection. However, we have previously hypothesized that excessive or misplaced inflammation may be a major contributor to tissue dysfunction and death associated with viral and bacterial infections. The resolutive phase of inflammation is a necessary condition to achieve homeostasis after acute inflammation. It is possible that targeting inflammation resolution may be beneficial for the host during infection. In this review, we summarize the evidence demonstrating the expression, roles and effects of the best described pro-resolving molecules in the context of bacterial and viral infections. Pro-resolving molecules play a pivotal role in modulating a spectrum of pathways associated with tissue inflammation and damage during both viral and bacterial infections. These molecules offer a blend of anti-inflammatory, pro-resolving and sometimes anti-infective benefits, all the while circumventing the undesired and immune-suppressive unwanted effects associated with glucocorticoids. Whether these beneficial effects will translate into benefits to patients clearly deserve further investigation.
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Affiliation(s)
- Vivian Vasconcelos Costa
- Centro de Pesquisa e Desenvolvimento de Fármacos, Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Filipe Resende
- Centro de Pesquisa e Desenvolvimento de Fármacos, Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eliza Mathias Melo
- Centro de Pesquisa e Desenvolvimento de Fármacos, Department of Biochemistry and Immunology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mauro Martins Teixeira
- Centro de Pesquisa e Desenvolvimento de Fármacos, Department of Biochemistry and Immunology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Zhang YD, He TW, Chen YR, Xiong BD, Zhe Z, Liu P, Tang BQ. A Model for Predicting the Duration of Viral Shedding in Patients Who Had Been Hospitalized with Mild COVID-19: A Single-Center Retrospective Study. Infect Drug Resist 2023; 16:5799-5813. [PMID: 37692465 PMCID: PMC10492566 DOI: 10.2147/idr.s421938] [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: 05/18/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023] Open
Abstract
Background Clinical decision-making is enhanced by the development of a mathematical model for prognosis prediction. Screening criteria associated with viral shedding time and developing a prediction model facilitate clinical decision-making and are, thus, of great medical value. Methods This study comprised 631 patients who were hospitalized with mild COVID-19 from a single center and 30 independent variables included. The data set was randomly divided into the training set (80%) and the validation set (20%). The outcome variable included viral shedding time and whether the viral shedding time >14 days, LASSO was used to screen the influencing factors. Results There were 321 males and 310 females among the 631 cases, with an average age of 62.1 years; the median viral shedding time was 12 days, and 68.8% of patients experienced viral shedding within 14 days, with fever (50.9%) and cough (44.2%) being the most common clinical manifestations. Using LASSO with viral shedding time as the outcome variable, the model with lambda as 0.1592 (λ = 0.1592) and 13 variables (eg the time from diagnosis to admission, constipation, cough, hs-CRP, IL-8, IL-1β, etc.) was more accurate. Factors were screened by LASSO and multivariable logistic regression with whether the viral shedding time >14 days as the outcome variable, five variables, including the time from diagnosis to admission, CD4 cell count, Ct value of ORF1ab, constipation, and IL-8, were included, and a nomogram was drawn; after model validation, the consistency index was 0.888, the AUC was 0.847, the sensitivity was 0.744, and the specificity was 0.830. Conclusion A clinical model developed after LASSO regression was used to identify the factors that influence the viral shedding time. The predicted performance of the model was good, and it was useful for the allocation of medical resources.
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Affiliation(s)
- Ya-Da Zhang
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Tai-Wen He
- Department of Ophthalmology, Shanghai Public Health Clinical Center, Shanghai, 201500, People’s Republic of China
| | - Yi-Ren Chen
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Bi-Dan Xiong
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Zhe Zhe
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Ping Liu
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, 201500, People’s Republic of China
| | - Bin-Qing Tang
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
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Saheb Sharif-Askari N, Soares NC, Mohamed HA, Saheb Sharif-Askari F, Alsayed HAH, Al-Hroub H, Salameh L, Osman RS, Mahboub B, Hamid Q, Semreen MH, Halwani R. Saliva metabolomic profile of COVID-19 patients associates with disease severity. Metabolomics 2022; 18:81. [PMID: 36271948 PMCID: PMC9589589 DOI: 10.1007/s11306-022-01936-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/27/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is strongly linked to dysregulation of various molecular, cellular, and physiological processes that change abundance of different biomolecules including metabolites that may be ultimately used as biomarkers for disease progression and severity. It is important at early stage to readily distinguish those patients that are likely to progress to moderate and severe stages. OBJECTIVES This study aimed to investigate the utility of saliva and plasma metabolomic profiles as a potential parameter for risk stratifying COVID-19 patients. METHOD LC-MS/MS-based untargeted metabolomics were used to profile the changes in saliva and plasma metabolomic profiles of COVID-19 patients with different severities. RESULTS Saliva and plasma metabolites were screened in 62 COVID-19 patients and 18 non-infected controls. The COVID-19 group included 16 severe, 15 moderate, 16 mild, and 15 asymptomatic cases. Thirty-six differential metabolites were detected in COVID-19 versus control comparisons. SARS-CoV-2 induced metabolic derangement differed with infection severity. The metabolic changes were identified in saliva and plasma, however, saliva showed higher intensity of metabolic changes. Levels of saliva metabolites such as sphingosine and kynurenine were significantly different between COVID-19 infected and non-infected individuals; while linoleic acid and Alpha-ketoisovaleric acid were specifically increased in severe compared to non-severe patients. As expected, the two prognostic biomarkers of C-reactive protein and D-dimer were negatively correlated with sphingosine and 5-Aminolevulinic acid, and positively correlated with L-Tryptophan and L-Kynurenine. CONCLUSION Saliva disease-specific and severity-specific metabolite could be employed as potential COVID-19 diagnostic and prognostic biomarkers.
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Affiliation(s)
- Narjes Saheb Sharif-Askari
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
| | - Nelson Cruz Soares
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
- grid.412789.10000 0004 4686 5317Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Hajer A. Mohamed
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
- grid.412789.10000 0004 4686 5317Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Fatemeh Saheb Sharif-Askari
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
| | | | - Hamza Al-Hroub
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
| | - Laila Salameh
- grid.414167.10000 0004 1757 0894Rashid Hospital, Dubai Health Authority, Dubai, UAE
- grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Rufaida Satti Osman
- grid.414167.10000 0004 1757 0894Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - Bassam Mahboub
- grid.414167.10000 0004 1757 0894Rashid Hospital, Dubai Health Authority, Dubai, UAE
- grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Qutayba Hamid
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
- grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, UAE
- grid.14709.3b0000 0004 1936 8649Meakins-Christie Laboratories, McGill University, Montreal, QC Canada
| | - Mohammad H. Semreen
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
- grid.412789.10000 0004 4686 5317College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Rabih Halwani
- grid.412789.10000 0004 4686 5317Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, UAE
- grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, UAE
- grid.56302.320000 0004 1773 5396Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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Ogletree ML, Chander Chiang K, Kulshrestha R, Agarwal A, Agarwal A, Gupta A. Treatment of COVID-19 Pneumonia and Acute Respiratory Distress With Ramatroban, a Thromboxane A2 and Prostaglandin D2 Receptor Antagonist: A Four-Patient Case Series Report. Front Pharmacol 2022; 13:904020. [PMID: 35935851 PMCID: PMC9355466 DOI: 10.3389/fphar.2022.904020] [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: 03/25/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Hypoxemia in COVID-19 pneumonia is associated with hospitalization, mechanical ventilation, and mortality. COVID-19 patients exhibit marked increases in fatty acid levels and inflammatory lipid mediators, predominantly arachidonic acid metabolites, notably thromboxane B2 >> prostaglandin E2 > prostaglandin D2. Thromboxane A2 increases pulmonary capillary pressure and microvascular permeability, leading to pulmonary edema, and causes bronchoconstriction contributing to ventilation/perfusion mismatch. Prostaglandin D2-stimulated IL-13 production is associated with respiratory failure, possibly due to hyaluronan accumulation in the lungs. Ramatroban is an orally bioavailable, dual thromboxane A2/TP and prostaglandin D2/DP2 receptor antagonist used in Japan for allergic rhinitis. Four consecutive outpatients with COVID-19 pneumonia treated with ramatroban exhibited rapid relief of dyspnea and hypoxemia within 12–36 h and complete resolution over 5 days, thereby avoiding hospitalization. Therefore, ramatroban as an antivasospastic, broncho-relaxant, antithrombotic, and immunomodulatory agent merits study in randomized clinical trials that might offer hope for a cost-effective pandemic treatment.
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Affiliation(s)
- Martin L. Ogletree
- Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, United States
- *Correspondence: Martin L. Ogletree, ; Ajay Gupta,
| | | | | | - Aditya Agarwal
- Charak Foundation of India, Indore, India
- EyeSight Eye Hospital and Retina Centre, Indore, India
| | - Ashutosh Agarwal
- Charak Foundation of India, Indore, India
- EyeSight Eye Hospital and Retina Centre, Indore, India
| | - Ajay Gupta
- Charak Foundation, Orange, CA, United States
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Irvine, CA, United States
- *Correspondence: Martin L. Ogletree, ; Ajay Gupta,
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Costa BTD, Araújo GRL, da Silva Júnior RT, Santos LKDS, Lima de Souza Gonçalves V, Lima DBA, Cuzzuol BR, Santos Apolonio J, de Carvalho LS, Marques HS, Silva CS, Barcelos IDS, Oliveira MV, Freire de Melo F. Effects of nutrients on immunomodulation in patients with severe COVID-19: Current knowledge. World J Crit Care Med 2022; 11:201-218. [PMID: 36051942 PMCID: PMC9305681 DOI: 10.5492/wjccm.v11.i4.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/24/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
Recent research has demonstrated that critically ill patients with coronavirus disease 2019 (COVID-19) show significant immune system dysregulation. Due to that, some nutrients that influence immunomodulation have been suggested as a form of treatment against the infection. This review collected the information on the impact of vitamins on the prognosis of COVID-19, with the intention of facilitating treatment and prevention of the disease risk status in patients. The collected information was obtained using the PubMed electronic database by searching for articles that relate COVID-19 and the mechanisms/effects of the nutrients: Proteins, glucose, lipids, vitamin B12, vitamin D, calcium, iron, copper, zinc, and magnesium, including prospective, retrospective, and support articles. The findings reveal an optimal response related mainly to omega-3, eicosapentaenoic acid, docosahexaenoic acid, calcium, and iron that might represent benefits in the treatment of critically ill patients. However, nutrient supplementation should be done with caution due to the limited availability of randomized controlled studies.
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Affiliation(s)
- Bruna Teixeira da Costa
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Glauber Rocha Lima Araújo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Luana Kauany de Sá Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Daniel Bastos Alves Lima
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Beatriz Rocha Cuzzuol
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Jonathan Santos Apolonio
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Lorena Sousa de Carvalho
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Hanna Santos Marques
- Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45083-900, Bahia, Brazil
| | - Camilo Santana Silva
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Isadora de Souza Barcelos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Márcio Vasconcelos Oliveira
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
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