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Steardo L, Steardo L, Scuderi C. Astrocytes and the Psychiatric Sequelae of COVID-19: What We Learned from the Pandemic. Neurochem Res 2023; 48:1015-1025. [PMID: 35922744 PMCID: PMC9362636 DOI: 10.1007/s11064-022-03709-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 11/05/2022]
Abstract
COVID-19, initially regarded as specific lung disease, exhibits an extremely broad spectrum of symptoms. Extrapulmonary manifestations of the disease also include important neuropsychiatric symptoms with atypical characteristics. Are these disturbances linked to stress accompanying every systemic infection, or are due to specific neurobiological changes associated with COVID-19? Evidence accumulated so far indicates that the pathophysiology of COVID-19 is characterized by systemic inflammation, hypoxia resulting from respiratory failure, and neuroinflammation (either due to viral neurotropism or in response to cytokine storm), all affecting the brain. It is reasonable to hypothesize that all these events may initiate or worsen psychiatric and cognitive disorders. Damage to the brain triggers a specific type of reactive response mounted by neuroglia cells, in particular by astrocytes which are the homeostatic cell par excellence. Astrocytes undergo complex morphological, biochemical, and functional remodeling aimed at mobilizing the regenerative potential of the central nervous system. If the brain is not directly damaged, resolution of systemic pathology usually results in restoration of the physiological homeostatic status of neuroglial cells. The completeness and dynamics of this process in pathological conditions remain largely unknown. In a subset of patients, glial cells could fail to recover after infection thus promoting the onset and progression of COVID-19-related neuropsychiatric diseases. There is evidence from post-mortem examinations of the brains of COVID-19 patients of alterations in both astrocytes and microglia. In conclusion, COVID-19 activates a huge reactive response of glial cells, that physiologically act as the main controller of the inflammatory, protective and regenerative events. However, in some patients the restoration of glial physiological state does not occur, thus compromising glial function and ultimately resulting in homeostatic failure underlying a set of specific neuropsychiatric symptoms related to COVID-19.
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Affiliation(s)
- Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luca Steardo
- Department of Physiology and Pharmacology "Vittorio Erspamer", SAPIENZA University of Rome, Rome, Italy
- Università Giustino Fortunato, Benevento, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology "Vittorio Erspamer", SAPIENZA University of Rome, Rome, Italy.
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Utrero-Rico A, González-Cuadrado C, Chivite-Lacaba M, Cabrera-Marante O, Laguna-Goya R, Almendro-Vazquez P, Díaz-Pedroche C, Ruiz-Ruigómez M, Lalueza A, Folgueira MD, Vázquez E, Quintas A, Berges-Buxeda MJ, Martín-Rodriguez M, Dopazo A, Serrano-Hernández A, Aguado JM, Paz-Artal E. Alterations in Circulating Monocytes Predict COVID-19 Severity and Include Chromatin Modifications Still Detectable Six Months after Recovery. Biomedicines 2021; 9:1253. [PMID: 34572439 PMCID: PMC8471575 DOI: 10.3390/biomedicines9091253] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
An early analysis of circulating monocytes may be critical for predicting COVID-19 course and its sequelae. In 131 untreated, acute COVID-19 patients at emergency room arrival, monocytes showed decreased surface molecule expression, including low HLA-DR, in association with an inflammatory cytokine status and limited anti-SARS-CoV-2-specific T cell response. Most of these alterations had normalized in post-COVID-19 patients 6 months after discharge. Acute COVID-19 monocytes transcriptome showed upregulation of anti-inflammatory tissue repair genes such as BCL6, AREG and IL-10 and increased accessibility of chromatin. Some of these transcriptomic and epigenetic features still remained in post-COVID-19 monocytes. Importantly, a poorer expression of surface molecules and low IRF1 gene transcription in circulating monocytes at admission defined a COVID-19 patient group with impaired SARS-CoV-2-specific T cell response and increased risk of requiring intensive care or dying. An early analysis of monocytes may be useful for COVID-19 patient stratification and for designing innate immunity-focused therapies.
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Affiliation(s)
- Alberto Utrero-Rico
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Cecilia González-Cuadrado
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Marta Chivite-Lacaba
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Oscar Cabrera-Marante
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Rocío Laguna-Goya
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Patricia Almendro-Vazquez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Carmen Díaz-Pedroche
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - María Ruiz-Ruigómez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Antonio Lalueza
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - María Dolores Folgueira
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Microbiology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Enrique Vázquez
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Ana Quintas
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Marcos J. Berges-Buxeda
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Moisés Martín-Rodriguez
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
| | - Ana Dopazo
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain; (E.V.); (A.Q.); (A.D.)
| | - Antonio Serrano-Hernández
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - José María Aguado
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Estela Paz-Artal
- Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain; (C.G.-C.); (M.C.-L.); (O.C.-M.); (R.L.-G.); (P.A.-V.); (C.D.-P.); (M.R.-R.); (A.L.); (M.D.F.); (M.J.B.-B.); (M.M.-R.); (A.S.-H.); (J.M.A.); (E.P.-A.)
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
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Chilunda V, Martinez-Aguado P, Xia LC, Cheney L, Murphy A, Veksler V, Ruiz V, Calderon TM, Berman JW. Transcriptional Changes in CD16+ Monocytes May Contribute to the Pathogenesis of COVID-19. Front Immunol 2021; 12:665773. [PMID: 34108966 PMCID: PMC8181441 DOI: 10.3389/fimmu.2021.665773] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/06/2021] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic has caused more than three million deaths globally. The severity of the disease is characterized, in part, by a dysregulated immune response. CD16+ monocytes are innate immune cells involved in inflammatory responses to viral infections, and tissue repair, among other functions. We characterized the transcriptional changes in CD16+ monocytes from PBMC of people with COVID-19, and from healthy individuals using publicly available single cell RNA sequencing data. CD16+ monocytes from people with COVID-19 compared to those from healthy individuals expressed transcriptional changes indicative of increased cell activation, and induction of a migratory phenotype. We also analyzed COVID-19 cases based on severity of the disease and found that mild cases were characterized by upregulation of interferon response and MHC class II related genes, whereas the severe cases had dysregulated expression of mitochondrial and antigen presentation genes, and upregulated inflammatory, cell movement, and apoptotic gene signatures. These results suggest that CD16+ monocytes in people with COVID-19 contribute to a dysregulated host response characterized by decreased antigen presentation, and an elevated inflammatory response with increased monocytic infiltration into tissues. Our results show that there are transcriptomic changes in CD16+ monocytes that may impact the functions of these cells, contributing to the pathogenesis and severity of COVID-19.
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Affiliation(s)
- Vanessa Chilunda
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Pablo Martinez-Aguado
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Li C. Xia
- Department of Epidemiology and Public Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Laura Cheney
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States,Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States
| | - Aniella Murphy
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Veronica Veksler
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Vanessa Ruiz
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Tina M. Calderon
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joan W. Berman
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States,Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, United States,*Correspondence: Joan W. Berman,
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