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Joshi G, Das A, Verma G, Guchhait P. Viral infection and host immune response in diabetes. IUBMB Life 2024; 76:242-266. [PMID: 38063433 DOI: 10.1002/iub.2794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/05/2023] [Indexed: 04/24/2024]
Abstract
Diabetes, a chronic metabolic disorder disrupting blood sugar regulation, has emerged as a prominent silent pandemic. Uncontrolled diabetes predisposes an individual to develop fatal complications like cardiovascular disorders, kidney damage, and neuropathies and aggravates the severity of treatable infections. Escalating cases of Type 1 and Type 2 diabetes correlate with a global upswing in diabetes-linked mortality. As a growing global concern with limited preventive interventions, diabetes necessitates extensive research to mitigate its healthcare burden and assist ailing patients. An altered immune system exacerbated by chronic hyperinflammation heightens the susceptibility of diabetic individuals to microbial infections, including notable viruses like SARS-CoV-2, dengue, and influenza. Given such a scenario, we scrutinized the literature and compiled molecular pathways and signaling cascades related to immune compartments in diabetics that escalate the severity associated with the above-mentioned viral infections in them as compared to healthy individuals. The pathogenesis of these viral infections that trigger diabetes compromises both innate and adaptive immune functions and pre-existing diabetes also leads to heightened disease severity. Lastly, this review succinctly outlines available treatments for diabetics, which may hold promise as preventive or supportive measures to effectively combat these viral infections in the former.
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Affiliation(s)
- Garima Joshi
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
| | - Anushka Das
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
| | - Garima Verma
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
| | - Prasenjit Guchhait
- Regional Centre for Biotechnology, National Capital Region Biotech Science Cluster, Faridabad, India
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2
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Chen Z, Yuan Y, Hu Q, Zhu A, Chen F, Li S, Guan X, Lv C, Tang T, He Y, Cheng J, Zheng J, Hu X, Zhao J, Zhao J, Sun J. SARS-CoV-2 immunity in animal models. Cell Mol Immunol 2024; 21:119-133. [PMID: 38238440 PMCID: PMC10806257 DOI: 10.1038/s41423-023-01122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
The COVID-19 pandemic, which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a worldwide health crisis due to its transmissibility. SARS-CoV-2 infection results in severe respiratory illness and can lead to significant complications in affected individuals. These complications encompass symptoms such as coughing, respiratory distress, fever, infectious shock, acute respiratory distress syndrome (ARDS), and even multiple-organ failure. Animal models serve as crucial tools for investigating pathogenic mechanisms, immune responses, immune escape mechanisms, antiviral drug development, and vaccines against SARS-CoV-2. Currently, various animal models for SARS-CoV-2 infection, such as nonhuman primates (NHPs), ferrets, hamsters, and many different mouse models, have been developed. Each model possesses distinctive features and applications. In this review, we elucidate the immune response elicited by SARS-CoV-2 infection in patients and provide an overview of the characteristics of various animal models mainly used for SARS-CoV-2 infection, as well as the corresponding immune responses and applications of these models. A comparative analysis of transcriptomic alterations in the lungs from different animal models revealed that the K18-hACE2 and mouse-adapted virus mouse models exhibited the highest similarity with the deceased COVID-19 patients. Finally, we highlighted the current gaps in related research between animal model studies and clinical investigations, underscoring lingering scientific questions that demand further clarification.
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Affiliation(s)
- Zhao Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Yaochang Yuan
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Qingtao Hu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
- GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, 510000, China
| | - Airu Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Fenghua Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Shu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Xin Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Chao Lv
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Tian Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Yiyun He
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jinling Cheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jie Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Xiaoyu Hu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China
| | - Jingxian Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China.
- Guangzhou National Laboratory, Guangzhou, Guangdong, 510005, China.
| | - Jincun Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China.
- Guangzhou National Laboratory, Guangzhou, Guangdong, 510005, China.
- Shanghai Institute for Advanced Immunochemical Studies, School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, the Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, 518005, China.
| | - Jing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, National Centre for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, China.
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3
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Julla JB, Girard D, Diedisheim M, Saulnier PJ, Tran Vuong B, Blériot C, Carcarino E, De Keizer J, Orliaguet L, Nemazanyy I, Potier C, Khider K, Tonui DC, Ejlalmanesh T, Ballaire R, Mambu Mambueni H, Germain S, Gaborit B, Vidal-Trécan T, Riveline JP, Garchon HJ, Fenaille F, Lemoine S, Carlier A, Castelli F, Potier L, Masson D, Roussel R, Vandiedonck C, Hadjadj S, Alzaid F, Gautier JF, Venteclef N. Blood Monocyte Phenotype Is A Marker of Cardiovascular Risk in Type 2 Diabetes. Circ Res 2024; 134:189-202. [PMID: 38152893 DOI: 10.1161/circresaha.123.322757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Diabetes is a major risk factor for atherosclerotic cardiovascular diseases with a 2-fold higher risk of cardiovascular events in people with diabetes compared with those without. Circulating monocytes are inflammatory effector cells involved in both type 2 diabetes (T2D) and atherogenesis. METHODS We investigated the relationship between circulating monocytes and cardiovascular risk progression in people with T2D, using phenotypic, transcriptomic, and metabolomic analyses. cardiovascular risk progression was estimated with coronary artery calcium score in a cohort of 672 people with T2D. RESULTS Coronary artery calcium score was positively correlated with blood monocyte count and frequency of the classical monocyte subtype. Unsupervised k-means clustering based on monocyte subtype profiles revealed 3 main endotypes of people with T2D at varying risk of cardiovascular events. These observations were confirmed in a validation cohort of 279 T2D participants. The predictive association between monocyte count and major adverse cardiovascular events was validated through an independent prospective cohort of 757 patients with T2D. Integration of monocyte transcriptome analyses and plasma metabolomes showed a disruption of mitochondrial pathways (tricarboxylic acid cycle, oxidative phosphorylation pathway) that underlined a proatherogenic phenotype. CONCLUSIONS In this study, we provide evidence that frequency and monocyte phenotypic profile are closely linked to cardiovascular risk in patients with T2D. The assessment of monocyte frequency and count is a valuable predictive marker for risk of cardiovascular events in patients with T2D. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT04353869.
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Affiliation(s)
- Jean-Baptiste Julla
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology, Endocrinology and Nutrition Department, Lariboisière Hospital, Fédération de Diabétologie, France (J.-B.J., T.V.-T., J.-P.R., J.-F.G.)
| | - Diane Girard
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Marc Diedisheim
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Clinique Saint Gatien Alliance (NCT+), Saint-Cyr-sur-Loire, France (M.D.)
| | - Pierre-Jean Saulnier
- Poitiers Université, CHU Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Poitiers, France (P.-J.S.)
| | - Bao Tran Vuong
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Camille Blériot
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Elena Carcarino
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Joe De Keizer
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France (J.D.K., S.H.)
| | - Lucie Orliaguet
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Ivan Nemazanyy
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Charline Potier
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Kennan Khider
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Dorothy Chepngenoh Tonui
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Tina Ejlalmanesh
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Raphaelle Ballaire
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Hendrick Mambu Mambueni
- Genomics platform UFR Simone Veil 1173; U, University of Versailles Paris-Saclay; Inserm UMR 1173 (H.M.M., H.-J.G.)
| | - Stéphane Germain
- Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS, INSERM, Université PSL, Paris, France (S.G.)
| | - Bénédicte Gaborit
- C2VN, INRAE, INSERM, Aix Marseille University, Marseille, France (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, AP-HM, Marseille, France (B.G.)
| | - Tiphaine Vidal-Trécan
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology, Endocrinology and Nutrition Department, Lariboisière Hospital, Fédération de Diabétologie, France (J.-B.J., T.V.-T., J.-P.R., J.-F.G.)
| | - Jean-Pierre Riveline
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology, Endocrinology and Nutrition Department, Lariboisière Hospital, Fédération de Diabétologie, France (J.-B.J., T.V.-T., J.-P.R., J.-F.G.)
| | - Henri-Jean Garchon
- Genomics platform UFR Simone Veil 1173; U, University of Versailles Paris-Saclay; Inserm UMR 1173 (H.M.M., H.-J.G.)
| | - François Fenaille
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (MTS), MetaboHUB, France (F.F., F.C.)
| | - Sophie Lemoine
- Genomics core facility, Institut de Biologie de l'ENS (IBENS), Département de biologie, École Normale Supérieure, CNRS, INSERM, Université PSL, Paris, France (S.L.)
| | - Aurélie Carlier
- Diabetology and Endocrinology Department, Bichat Hospital, Fédération de Diabétologie, France (L.P., A.C., R.R.)
| | - Florence Castelli
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (MTS), MetaboHUB, France (F.F., F.C.)
| | - Louis Potier
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology and Endocrinology Department, Bichat Hospital, Fédération de Diabétologie, France (L.P., A.C., R.R.)
| | - David Masson
- INSERM, LNC UMR1231, Dijon, France (D.M.)
- University of Bourgogne and Franche-Comté, LNC UMR1231, Dijon, France (D.M.)
- FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France (D.M.)
- Plateau Automatisé de Biochimie, Dijon University Hospital, France (D.M.)
| | - Ronan Roussel
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology and Endocrinology Department, Bichat Hospital, Fédération de Diabétologie, France (L.P., A.C., R.R.)
| | - Claire Vandiedonck
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
| | - Samy Hadjadj
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France (J.D.K., S.H.)
| | - Fawaz Alzaid
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Dasman Diabetes Institute, Kuwait (F.A.)
| | - Jean-François Gautier
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetology, Endocrinology and Nutrition Department, Lariboisière Hospital, Fédération de Diabétologie, France (J.-B.J., T.V.-T., J.-P.R., J.-F.G.)
| | - Nicolas Venteclef
- INSERM, Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., I.N., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Cordeliers Research Centre, INSERM, IMMEDIAB Laboratory, Sorbonne Université (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
- Diabetes Institute (J.-B.J., D.G., M.D., B.T.V., C.B., E.C., L.O., C.P., K.K., D.C.T., T.E., R.B., T.V.-T., J.-P.R., L.P., R.R., C.V., F.A., J.-F.G., N.V.), Université Paris Cité, France
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4
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Kosari M, Khorvash F, Sayyah MK, Ansari Chaharsoughi M, Najafi A, Momen-Heravi M, Karimian M, Akbari H, Noureddini M, Salami M, Ghaderi A, Amini Mahabadi J, Khamechi SP, Yeganeh S, Banafshe HR. The influence of propolis plus Hyoscyamus niger L. against COVID-19: A phase II, multicenter, placebo-controlled, randomized trial. Phytother Res 2024; 38:400-410. [PMID: 37992760 DOI: 10.1002/ptr.8047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 11/24/2023]
Abstract
The incubation period of COVID-19 symptoms, along with the proliferation and high transmission rate of the SARS-CoV-2 virus, is the cause of an uncontrolled epidemic worldwide. Vaccination is the front line of prevention, and antiinflammatory and antiviral drugs are the treatment of this disease. In addition, some herbal therapy approaches can be a good way to deal with this disease. The aim of this study was to evaluate the effect of propolis syrup with Hyoscyamus niger L. extract in hospitalized patients with COVID-19 with acute disease conditions in a double-blinded approach. The study was performed on 140 patients with COVID-19 in a double-blind, randomized, and multicentral approach. The main inclusion criterion was the presence of a severe type of COVID-19 disease. The duration of treatment with syrup was 6 days and 30 CC per day in the form of three meals. On Days 0, 2, 4, and 6, arterial blood oxygen levels, C-reactive protein (CRP), erythrocyte sedimentation rate, and white blood cell, as well as the patient's clinical symptoms such as fever and chills, cough and shortness of breath, chest pain, and other symptoms, were recorded and analyzed. Propolis syrup with H. niger L. significantly reduces cough from the second day, relieving shortness of breath on the fourth day, and significantly reduces CRP, weakness, and lethargy, as well as significantly increased arterial blood oxygen pressure on the sixth day compared to the placebo group (p < 0.05). The results in patients are such that in the most severe conditions of the disease 80% < SpO2 (oxygen saturation), the healing process of the syrup on reducing CRP and increasing arterial blood oxygen pressure from the fourth day is significantly different compared with the placebo group (p < 0.05). The use of syrup is associated with a reduction of 3.6 days in the hospitalization period compared with the placebo group. Propolis syrup with H. niger L. has effectiveness in the viral and inflammatory phases on clinical symptoms and blood parameters and arterial blood oxygen levels of patients with COVID-19. Also, it reduces referrals to the intensive care unit and mortality in hospitalized patients with COVID-19. So, this syrup promises to be an effective treatment in the great challenge of COVID-19.
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Affiliation(s)
- Morteza Kosari
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farzin Khorvash
- Department of Infectious Disease, Medical School, Isfahan University of Medical Science, Isfahan, Iran
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Kazem Sayyah
- Department of Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Ansari Chaharsoughi
- Department of Infectious Diseases, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Najafi
- Department of Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Momen-Heravi
- Department of Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Hossein Akbari
- Social Determinants of Health Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehdi Noureddini
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahmoud Salami
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Ghaderi
- Department of Addiction Studies, School of Medical, Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Javad Amini Mahabadi
- Anatomical Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Sarem Fertility and Infertility Research Center, Sarem Women's Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Sarem Cell Research Center, Sarem Women's Hospital, Tehran, Iran
| | - Seyed Peyman Khamechi
- Department of Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Yeganeh
- Department of Mathematical Sciences, Isfahan University of Technology, Isfahan, Iran
| | - Hamid Reza Banafshe
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
- Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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5
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Doğan HO, Budak M, Doğan K, Zararsız GE, Yerlitaş Sİ, Bolat S, Şenol O, Büyüktuna SA, Pınarbaşı E, Sarıismailoğlu R, Yavuz H. DYSREGULATED LEUKOTRIENE METABOLISM IN COVID-19 PATIENTS. Jpn J Infect Dis 2023:JJID.2023.211. [PMID: 38171849 DOI: 10.7883/yoken.jjid.2023.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The aim of this study was to examine leukotriene metabolism in COVID-19. A total of 180 people were included in the study. Of these, 60 were healthy controls, 60 were patients who needed intensive care unit (ICU), and 60 were patients who did not need intensive care (non-ICU). Serum levels of 5-lipoxygenase (5-LO), 5-LO activating protein (ALOX5AP) and cysteinyl leukotriene (CYSLT) were measured and mRNA expressions of 5-LO, ALOX5AP and cysteinyl leukotriene receptor 1 (CYSLTR1) were investigated. As compared to the control group, both non-ICU and ICU groups had lower levels of 5-LO and mRNA expression. ICU patients had lower levels of 5-LO and mRNA expression compared with non-ICU patients. The expression of CYSLTR1 mRNA was higher in patients compared to healthy controls. CYSLTR1 mRNA expression was found to be higher in ICU group than in non-ICU group. CYSLT levels were higher in the control group compared to both non-ICU and ICU patients. Due to the higher expressions of CYSLTR1 in patients than control group, selective leukotriene receptor blockers can be used as a treatment option. CYSLTR1 expressions were also higher in ICU group than non-ICU group. Thus, CYSLTR1 mRNA expression could be a promising biomarker of COVID-19 severity.
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Affiliation(s)
- Halef Okan Doğan
- Department of Biochemistry, School of Medicine, Sivas Cumhuriyet University, Turkey
| | - Mahir Budak
- Department of Molecular Biology and Genetics, Faculty of Science, Sivas Cumhuriyet University, Turkey
| | - Kübra Doğan
- Department of Biochemistry, Sivas Numune Hospital, Turkey
| | - Gözde Ertürk Zararsız
- Department of Biostatistics, School of Medicine, Erciyes University, Turkey
- Drug Application and Research Center (ERFARMA), Erciyes University, Turkey
| | - Serra İlayda Yerlitaş
- Department of Biostatistics, School of Medicine, Erciyes University, Turkey
- Drug Application and Research Center (ERFARMA), Erciyes University, Turkey
| | - Serkan Bolat
- Department of Biochemistry, School of Medicine, Sivas Cumhuriyet University, Turkey
| | - Onur Şenol
- Department of Analytical Chemistry, Faculty of Pharmacy, Atatürk University, Turkey
| | - Seyit Ali Büyüktuna
- Department of Infectious Diseases and Clinic Microbiology, School of Medicine, Sivas Cumhuriyet University, Turkey
| | - Ergun Pınarbaşı
- Department of Medical Biology, School of Medicine, Sivas Cumhuriyet University, Turkey
| | | | - Hayrettin Yavuz
- Division of Pediatric Nephrology, Department of Pediatrics, University of Virginia, USA
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Ferguson M, Vel J, Phan V, Ali R, Mabe L, Cherner A, Doan T, Manakatt B, Jose M, Powell AR, McKinney K, Serag H, Sallam HS. Coronavirus Disease 2019, Diabetes, and Inflammation: A Systemic Review. Metab Syndr Relat Disord 2023; 21:177-187. [PMID: 37130311 DOI: 10.1089/met.2022.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
People with cardiometabolic diseases [namely type 2 diabetes (T2D), obesity, or metabolic syndrome] are more susceptible to coronavirus disease 2019 (COVID-19) infection and endure more severe illness and poorer outcomes. Hyperinflammation has been suggested as a common pathway for both diseases. To examine the role of inflammatory biomarkers shared between COVID-19 and cardiometabolic diseases, we reviewed and evaluated published data using PubMed, SCOPUS, and World Health Organization COVID-19 databases for English articles from December 2019 to February 2022. Of 248 identified articles, 50 were selected and included. We found that people with diabetes or obesity have (i) increased risk of COVID-19 infection; (ii) increased risk of hospitalization (those with diabetes have a higher risk of intensive care unit admissions) and death; and (iii) heightened inflammatory and stress responses (hyperinflammation) to COVID-19, which worsen their prognosis. In addition, COVID-19-infected patients have a higher risk of developing T2D, especially if they have other comorbidities. Treatments controlling blood glucose levels and or ameliorating the inflammatory response may be valuable for improving clinical outcomes in these patient populations. In conclusion, it is critical for health care providers to clinically evaluate hyperinflammatory states to drive clinical decisions for COVID-19 patients.
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Affiliation(s)
- Monique Ferguson
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jaysonn Vel
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Vincent Phan
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Roshaneh Ali
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Lainie Mabe
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Annie Cherner
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Thao Doan
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Bushra Manakatt
- School of Nursing, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mini Jose
- School of Nursing, University of Texas Medical Branch, Galveston, Texas, USA
| | - Audrey Ross Powell
- University of Texas Medical Branch Alumni, Galveston, Texas, USA
- Madrigal Pharmaceuticals, Conshohocken, Pennsylvania, USA
| | - Kevin McKinney
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Hani Serag
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Hanaa S Sallam
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Physiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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7
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Abstract
PURPOSE Patients with type 2 diabetes (T2D) have demonstrated a higher risk for developing more severe cases of COVID-19, but the complex genetic mechanism between them is still unknown. The aim of the present study was to untangle this relationship using genetically based approaches. METHODS By leveraging large-scale genome-wide association study (GWAS) summary statistics of T2D and COVID-19 severity, linkage disequilibrium score regression and Mendelian randomization (MR) analyses were utilized to quantify the genetic correlations and causal relationships between the two traits. Gene-based association and enrichment analysis were further applied to identify putative functional pathways shared between T2D and COVID-19 severity. RESULTS Significant, moderate genetic correlations were detected between T2D and COVID-19 hospitalization (rg = 0.156, SE = 0.057, p = 0.005) or severe disease (rg = 0.155, SE = 0.057, p = 0.006). MR analysis did not support evidence for a causal effect of T2D on COVID-19 hospitalization (OR 1.030, 95% CI 0.979, 1.084, p = 0.259) or severe disease (OR 0.999, 95% CI 0.934, 1.069, p = 0.982). Genes having pgene < 0.05 for both T2D and COVID-19 severe were significantly enriched for biological pathways, such as response to type I interferon, glutathione derivative metabolic process and glutathione derivative biosynthetic process. CONCLUSIONS Our findings further confirm the comorbidity of T2D and COVID-19 severity, but a non-causal impact of T2D on severe COVID-19. Shared genetically modulated molecular mechanisms underlying the co-occurrence of the two disorders are crucial for identifying therapeutic targets.
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Affiliation(s)
- J Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - L-J Qiu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- Medical Insurance Office, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - K-J Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - G-M Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China
| | - H-F Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
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8
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Abstract
The influence of comorbidities on COVID-19 outcomes has been recognized since the earliest days of the pandemic. But establishing causality and determining underlying mechanisms and clinical implications has been challenging-owing to the multitude of confounding factors and patient variability. Several distinct pathological mechanisms, not active in every patient, determine health outcomes in the three different phases of COVID-19-from the initial viral replication phase to inflammatory lung injury and post-acute sequelae. Specific comorbidities (and overall multimorbidity) can either exacerbate these pathological mechanisms or reduce the patient's tolerance to organ injury. In this Review, we consider the impact of specific comorbidities, and overall multimorbidity, on the three mechanistically distinct phases of COVID-19, and we discuss the utility of host genetics as a route to causal inference by eliminating many sources of confounding. Continued research into the mechanisms of disease-state interactions will be crucial to inform stratification of therapeutic approaches and improve outcomes for patients.
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Affiliation(s)
- Clark D Russell
- Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Nazir I Lone
- Usher Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK.
- Intensive Care Unit, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK.
| | - J Kenneth Baillie
- Intensive Care Unit, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK.
- Baillie Gifford Pandemic Science Hub, Centre for Inflammation Research, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK.
- Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK.
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9
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Ning D, Garg K, Mayer B, Schick B, Bracht H, Barth E, Weiss M, Li C, Schneider J, Schneider EM. Monocyte subtype expression patterns in septic patients with diabetes are distinct from patterns observed in obese patients. Front Med (Lausanne) 2023; 9:1026298. [PMID: 36687421 PMCID: PMC9849690 DOI: 10.3389/fmed.2022.1026298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Background Sepsis causes a high rate of mortality and long-term morbidity, associated with an imbalance of innate immunity against infections and inflammation. Obesity and diabetes increase the risk for disease severity. Monocyte dysfunction plays a major role and justify further investigations. Objective To investigate the distribution and inflammatory phenotypes in circulating monocyte subsets in patients manifesting with sepsis including septic shock with and without obesity and diabetes. Methods A total of 235 blood samples were tested from critically ill adult patients registered at the intensive care unit (ICU). The cohorts were divided into non-diabetic groups with or without obesity and diabetic groups with or without obesity, suffering from sepsis or septic shock. We determined frequencies of total monocytes and of monocyte subsets in the circulation and density expression levels of functional markers, including CD14, CD16, HLA-DR, CD33, CD163, CD206, and arginase-1 by flow cytometric analysis. Results When progressing to septic shock in non-diabetic and diabetic patients, the percentages of total monocytes among the leukocyte population and of CD33+ and CD14+ monocytes among the monocyte population were consistently down-regulated compared to non-sepsis in non-diabetic and diabetic patients, respectively. Non-diabetic sepsis patients further presented with decreased CD33 and up-regulated CD163 expression density, which was absent in diabetic patients. We subsequently addressed obesity-related changes of monocytes in non-diabetic and diabetic septic patients. Obese septic patients with diabetes were unique in displaying increased monocytic CD16 and CD163 expression. However, obese septic patients without diabetes solely presented with lower amounts of non-classical monocytes. Body mass index (BMI) dependent changes were restricted to diabetic septic patients, with a significantly higher diminution of the classical monocyte subset and concomitantly increased CD16 expression densities. Conclusion Distribution and phenotypes of monocyte subsets were differentially modulated in critically ill patients with and without metabolic disease when progressing to sepsis or septic shock. Only diabetic septic patients displayed decline of classical monocytes and increase of CD16 expression densities. Therefore, diabetes but not obesity appears to promote the inflammatory phenotype of circulating monocytes in critically ill patients.
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Affiliation(s)
- Dan Ning
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Kunal Garg
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Benjamin Mayer
- Faculty of Medicine, Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Benedikt Schick
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Hendrik Bracht
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Eberhard Barth
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Manfred Weiss
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Chen Li
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - Julian Schneider
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany
| | - E. Marion Schneider
- Clinic for Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany,*Correspondence: E. Marion Schneider,
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10
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Ranjbar M, Rahimi A, Baghernejadan Z, Ghorbani A, Khorramdelazad H. Role of CCL2/CCR2 axis in the pathogenesis of COVID-19 and possible Treatments: All options on the Table. Int Immunopharmacol 2022; 113:109325. [PMID: 36252475 PMCID: PMC9561120 DOI: 10.1016/j.intimp.2022.109325] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 07/28/2022] [Revised: 10/05/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is cause of the novel coronavirus disease (COVID-19). In the last two years, SARS-CoV-2 has infected millions of people worldwide with different waves, resulting in the death of many individuals. The evidence disclosed that the host immune responses to SARS-CoV-2 play a pivotal role in COVID-19 pathogenesis and clinical manifestations. In addition to inducing antiviral immune responses, SARS-CoV-2 can also cause dysregulated inflammatory responses characterized by the noticeable release of proinflammatory mediators in COVID-19 patients. Among these proinflammatory mediators, chemokines are considered a subset of cytokines that participate in the chemotaxis process to recruit immune and non-immune cells to the site of inflammation and infection. Researchers have demonstrated that monocyte chemoattractant protein-1 (MCP-1/CCL2) and its receptor (CCR2) are involved in the recruitment of monocytes and infiltration of these cells into the lungs of patients suffering from COVID-19. Moreover, elevated levels of CCL2 have been reported in the bronchoalveolar lavage fluid (BALF) obtained from patients with severe COVID-19, initiating cytokine storm and promoting CD163+ myeloid cells infiltration in the airways and further alveolar damage. Therefore, CCL2/CCR axis plays a key role in the immunopathogenesis of COVID-19 and targeted therapy of involved molecules in this axis can be a potential therapeutic approach for these patients. This review discusses the biology of the CCL2/CCR2 axis as well as the role of this axis in COVID-19 immunopathogenesis, along with therapeutic options aimed at inhibiting CCL2/CCR2 and modulating dysregulated inflammatory responses in patients with severe SARS-CoV-2 infection.
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Affiliation(s)
- Mitra Ranjbar
- Department of Infectious Disease, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Rahimi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Baghernejadan
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Atousa Ghorbani
- Department of Biology, East Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Hossein Khorramdelazad
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,Corresponding author at: Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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11
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Audu CO, Melvin WJ, Joshi AD, Wolf SJ, Moon JY, Davis FM, Barrett EC, Mangum KD, Deng H, Xing X, Wasikowski R, Tsoi LC, Sharma SB, Bauer TM, Shadiow J, Corriere MA, Obi AT, Kunkel SL, Levi B, Moore BB, Gudjonsson JE, Smith AM, Gallagher KA. Macrophage-specific inhibition of the histone demethylase JMJD3 decreases STING and pathologic inflammation in diabetic wound repair. Cell Mol Immunol 2022; 19:1251-1262. [PMID: 36127466 PMCID: PMC9622909 DOI: 10.1038/s41423-022-00919-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/09/2022] [Indexed: 02/01/2023] Open
Abstract
Macrophage plasticity is critical for normal tissue repair following injury. In pathologic states such as diabetes, macrophage plasticity is impaired, and macrophages remain in a persistent proinflammatory state; however, the reasons for this are unknown. Here, using single-cell RNA sequencing of human diabetic wounds, we identified increased JMJD3 in diabetic wound macrophages, resulting in increased inflammatory gene expression. Mechanistically, we report that in wound healing, JMJD3 directs early macrophage-mediated inflammation via JAK1,3/STAT3 signaling. However, in the diabetic state, we found that IL-6, a cytokine increased in diabetic wound tissue at later time points post-injury, regulates JMJD3 expression in diabetic wound macrophages via the JAK1,3/STAT3 pathway and that this late increase in JMJD3 induces NFκB-mediated inflammatory gene transcription in wound macrophages via an H3K27me3 mechanism. Interestingly, RNA sequencing of wound macrophages isolated from mice with JMJD3-deficient myeloid cells (Jmjd3f/fLyz2Cre+) identified that the STING gene (Tmem173) is regulated by JMJD3 in wound macrophages. STING limits inflammatory cytokine production by wound macrophages during healing. However, in diabetic mice, its role changes to limit wound repair and enhance inflammation. This finding is important since STING is associated with chronic inflammation, and we found STING to be elevated in human and murine diabetic wound macrophages at late time points. Finally, we demonstrate that macrophage-specific, nanoparticle inhibition of JMJD3 in diabetic wounds significantly improves diabetic wound repair by decreasing inflammatory cytokines and STING. Taken together, this work highlights the central role of JMJD3 in tissue repair and identifies cell-specific targeting as a viable therapeutic strategy for nonhealing diabetic wounds.
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Affiliation(s)
- Christopher O Audu
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - William J Melvin
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Amrita D Joshi
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Sonya J Wolf
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Jadie Y Moon
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Frank M Davis
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Emily C Barrett
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Kevin D Mangum
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Hongping Deng
- Department of Bioengineering, University of Illinois, Urbana-Champaign, Champaign, IL, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Rachel Wasikowski
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Sriganesh B Sharma
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Tyler M Bauer
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
| | - James Shadiow
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Matthew A Corriere
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Andrea T Obi
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Steven L Kunkel
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin Levi
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bethany B Moore
- Department of Surgery, Section of General Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Andrew M Smith
- Department of Bioengineering, University of Illinois, Urbana-Champaign, Champaign, IL, USA
| | - Katherine A Gallagher
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA.
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA.
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12
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Zini G, d'Onofrio G. Coronavirus disease 2019 (COVID-19): Focus on peripheral blood cell morphology. Br J Haematol 2022; 200:404-419. [PMID: 36203344 PMCID: PMC9874661 DOI: 10.1111/bjh.18489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/22/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 02/07/2023]
Abstract
Numerous studies have shown peculiar morphological anomalies in COVID-19 patients' smears. We searched all the peer-reviewed scientific publications that explicitly reference the cytomorphological alterations on peripheral blood smears of patients with COVID-19. We extracted data from sixty-five publications (case reports, patient group studies, reviews, and erythrocyte morphology studies). The results show that frequent alterations concern the morphology of lymphocytes (large lymphocytes with weakly basophilic cytoplasm, plasmacytoid lymphocytes, large granular lymphocytes). Neutrophils display abnormal nuclei and cytoplasm in a distinctive cytomorphological picture. Besides a left shift in maturation, granulations can be increased (toxic type) or decreased with areas of basophilia. Nuclei are often hyposegmented (pseudo-Pelger-Huёt anomaly). Apoptotic or pycnotic cells are not uncommon. Monocytes typically have a large cytoplasm loaded with heterogeneous and coalescing vacuoles. Platelets show large and giant shapes. The presence of erythrocyte fragments and schistocytes is especially evident in the forms of COVID-19 that are associated with thrombotic microangiopathies. Such atypia of blood cells reflects the generalized activation in severe COVID-19, which has been demonstrated with immunophenotypic, molecular, genetic, and functional methods. Neutrophils, in particular, are involved in the pathophysiology of hyperinflammation with cytokine storm, which characterizes the most unfavorable evolution.
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Affiliation(s)
- Gina Zini
- HaematologyCatholic University of Sacred HeartRomeItaly,Fondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
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13
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Aznaourova M, Schmerer N, Janga H, Zhang Z, Pauck K, Bushe J, Volkers SM, Wendisch D, Georg P, Ntini E, Aillaud M, Gündisch M, Mack E, Skevaki C, Keller C, Bauer C, Bertrams W, Marsico A, Nist A, Stiewe T, Gruber AD, Ruppert C, Li Y, Garn H, Sander LE, Schmeck B, Schulte LN. Single-cell RNA sequencing uncovers the nuclear decoy lincRNA PIRAT as a regulator of systemic monocyte immunity during COVID-19. Proc Natl Acad Sci U S A 2022; 119:e2120680119. [PMID: 35998224 DOI: 10.1073/pnas.2120680119] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
SARS-CoV-2–infected patients often display characteristic changes in the production of immune mediators that trigger life-threatening courses of COVID-19. The underlying molecular mechanisms are not yet fully understood. Here, we used single-cell RNA sequencing to investigate the involvement of the emerging class of long regulatory RNA in COVID-19. Our data reveal that a previously unknown regulatory RNA in the nucleus of immune cells is altered after SARS-CoV-2 infection. The degradation of this RNA removes a natural brake on the production of critical immune mediators that can promote the development of severe COVID-19. We believe that therapeutic intervention in this nuclear RNA circuit could counteract the overproduction of disease-causing immune mediators and protect against severe COVID-19. The systemic immune response to viral infection is shaped by master transcription factors, such as NF-κB, STAT1, or PU.1. Although long noncoding RNAs (lncRNAs) have been suggested as important regulators of transcription factor activity, their contributions to the systemic immunopathologies observed during SARS-CoV-2 infection have remained unknown. Here, we employed a targeted single-cell RNA sequencing approach to reveal lncRNAs differentially expressed in blood leukocytes during severe COVID-19. Our results uncover the lncRNA PIRAT (PU.1-induced regulator of alarmin transcription) as a major PU.1 feedback-regulator in monocytes, governing the production of the alarmins S100A8/A9, key drivers of COVID-19 pathogenesis. Knockout and transgene expression, combined with chromatin-occupancy profiling, characterized PIRAT as a nuclear decoy RNA, keeping PU.1 from binding to alarmin promoters and promoting its binding to pseudogenes in naïve monocytes. NF-κB–dependent PIRAT down-regulation during COVID-19 consequently releases a transcriptional brake, fueling alarmin production. Alarmin expression is additionally enhanced by the up-regulation of the lncRNA LUCAT1, which promotes NF-κB–dependent gene expression at the expense of targets of the JAK-STAT pathway. Our results suggest a major role of nuclear noncoding RNA networks in systemic antiviral responses to SARS-CoV-2 in humans.
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14
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Cariou B, Wargny M, Boureau AS, Smati S, Tramunt B, Desailloud R, Lebeault M, Amadou C, Ancelle D, Balkau B, Bordier L, Borot S, Bourgeon M, Bourron O, Cosson E, Eisinger M, Gonfroy-Leymarie C, Julla JB, Marchand L, Meyer L, Seret-Bégué D, Simon D, Sultan A, Thivolet C, Vambergue A, Vatier C, Winiszewski P, Saulnier PJ, Bauduceau B, Gourdy P, Hadjadj S. Impact of diabetes on COVID-19 prognosis beyond comorbidity burden: the CORONADO initiative. Diabetologia 2022; 65:1436-1449. [PMID: 35701673 PMCID: PMC9197674 DOI: 10.1007/s00125-022-05734-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/06/2022] [Indexed: 12/11/2022]
Abstract
AIMS/HYPOTHESIS Diabetes has been recognised as a pejorative prognostic factor in coronavirus disease 2019 (COVID-19). Since diabetes is typically a disease of advanced age, it remains unclear whether diabetes remains a COVID-19 risk factor beyond advanced age and associated comorbidities. We designed a cohort study that considered age and comorbidities to address this question. METHODS The Coronavirus SARS-CoV-2 and Diabetes Outcomes (CORONADO) initiative is a French, multicentric, cohort study of individuals with (exposed) and without diabetes (non-exposed) admitted to hospital with COVID-19, with a 1:1 matching on sex, age (±5 years), centre and admission date (10 March 2020 to 10 April 2020). Comorbidity burden was assessed by calculating the updated Charlson comorbidity index (uCCi). A predefined composite primary endpoint combining death and/or invasive mechanical ventilation (IMV), as well as these two components separately, was assessed within 7 and 28 days following hospital admission. We performed multivariable analyses to compare clinical outcomes between patients with and without diabetes. RESULTS A total of 2210 pairs of participants (diabetes/no-diabetes) were matched on age (mean±SD 69.4±13.2/69.5±13.2 years) and sex (36.3% women). The uCCi was higher in individuals with diabetes. In unadjusted analysis, the primary composite endpoint occurred more frequently in the diabetes group by day 7 (29.0% vs 21.6% in the no-diabetes group; HR 1.43 [95% CI 1.19, 1.72], p<0.001). After multiple adjustments for age, BMI, uCCi, clinical (time between onset of COVID-19 symptoms and dyspnoea) and biological variables (eGFR, aspartate aminotransferase, white cell count, platelet count, C-reactive protein) on admission to hospital, diabetes remained associated with a higher risk of primary composite endpoint within 7 days (adjusted HR 1.42 [95% CI 1.17, 1.72], p<0.001) and 28 days (adjusted HR 1.30 [95% CI 1.09, 1.55], p=0.003), compared with individuals without diabetes. Using the same adjustment model, diabetes was associated with the risk of IMV, but not with risk of death, within 28 days of admission to hospital. CONCLUSIONS/INTERPRETATION Our results demonstrate that diabetes status was associated with a deleterious COVID-19 prognosis irrespective of age and comorbidity status. TRIAL REGISTRATION ClinicalTrials.gov NCT04324736.
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Grants
- the Fondation Francophone de Recherche sur le Diabète (FFRD), supported by Novo Nordisk, Merck Sharpe Dome (MSD), Abbott, AstraZeneca, Lilly and FFD (Fédération Française des Diabétiques) – CORONADO initiative emergency grant
- The CORONADO control leg of the study was supported by a grant from the French Ministry of Health
- Société Francophone du Diabète (SFD) – CORONADO initiative emergency grant
- Fonds de dotation du CHU de Nantes (CORONADO project: Sanofi, Air Liquid Healthcare, Novo Nordisk, NHC, Allergan, Lifescan)
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Affiliation(s)
- Bertrand Cariou
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France.
| | - Matthieu Wargny
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
- CHU Nantes, Inserm CIC 1413, Pôle Hospitalo-Universitaire 11 : Santé Publique, Clinique des données, Nantes, France
| | - Anne-Sophie Boureau
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
- CHU Nantes, Pôle de Gérontologie Clinique, Nantes, France
| | - Sarra Smati
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
| | - Blandine Tramunt
- Service de Diabétologie, Maladies Métaboliques & Nutrition, CHU Toulouse, Institut des Maladies Métaboliques & Cardiovasculaires, UMR1297 Inserm/UT3, Université de Toulouse, Toulouse, France
| | - Rachel Desailloud
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PériTox UMR_I 01, University of Picardie Jules Verne, Amiens, France
| | - Maylis Lebeault
- Département de Diabétologie, Centre Hospitalier Universitaire, Angers, France
| | - Coralie Amadou
- Département de Diabétologie, Centre Hospitalier Sud Francilien, Corbeil Essonne, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
| | - Deborah Ancelle
- Service endocrinologie-diabétologie-nutrition, CH Le Havre, Montivilliers, France
| | - Beverley Balkau
- Épidémiologie Clinique, Centre de Recherche en Épidémiologie et Santé des Populations, Inserm U1018, Université Paris-Saclay, USVQ, Université Paris-Sud, Villejuif, France
| | - Lyse Bordier
- Service d'endocrinologie et maladies métaboliques, H.I.A Bégin, Saint-Mandé, France
| | - Sophie Borot
- Department of Endocrinology, Diabetology and Nutrition, Besançon University Hospital, Besançon, France
| | - Muriel Bourgeon
- Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Paris-Saclay University, Antoine Béclère Hospital, Clamart, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Olivier Bourron
- Assistance Publique Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié-Salpêtrière - Charles-Foix; Inserm, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06; Institute of Cardiometabolism and Nutrition ICAN, Sorbonne Université, Paris, France
| | - Emmanuel Cosson
- Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology, Diabetology and Nutrition, CRNH-IdF, CINFO, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm / U11125 INRAE / CNAM / Paris13 University, Nutritional Epidemiological Research Unit, Bobigny, France
| | - Martin Eisinger
- Hôpital de la Conception, Service d'Endocrinologie, Maladies Métaboliques et Nutrition, Marseille, France
- Inserm, INRAE, C2VN, Aix Marseille Univ, Marseille, France
| | | | - Jean-Baptiste Julla
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | | | - Laurent Meyer
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Dominique Seret-Bégué
- Unité de Diabétologie, Endocrinologie et Nutrition, Centre Hospitalier de Gonesse, Gonesse, France
| | | | - Ariane Sultan
- Department of Endocrinology-Diabetology-Nutrition, CHU Montpellier, University of Montpellier, Montpellier, France
- PhyMedExp, CHU Montpellier, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Charles Thivolet
- Centre du Diabète DIAB-eCARE, Hospices Civils de Lyon et Laboratoire CarMeN, Inserm, INRA, INSA, Université Claude Bernard Lyon 1, Lyon, France
- Société Francophone du Diabète (SFD), Paris, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology, Metabolism and Nutrition Lille University Hospital, Lille, France
- European Genomic Institute of Diabetes, University School of Medicine, Lille, France
| | - Camille Vatier
- Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Department of Endocrinology, Paris, France
- Inserm UMRS 938, Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Patrice Winiszewski
- Service d'Endocrinologie, Diabétologie et Nutrition, Hôpital Nord Franche-Comté, Trévenans, France
| | - Pierre-Jean Saulnier
- Clinical Investigation Centre CIC1402, University of Poitiers, Inserm, CHU Poitiers, Poitiers, France
| | - Bernard Bauduceau
- Service d'endocrinologie et maladies métaboliques, H.I.A Bégin, Saint-Mandé, France
- Fondation Francophone pour la Recherche sur le Diabète (FFRD), Paris, France
| | - Pierre Gourdy
- Service de Diabétologie, Maladies Métaboliques & Nutrition, CHU Toulouse, Institut des Maladies Métaboliques & Cardiovasculaires, UMR1297 Inserm/UT3, Université de Toulouse, Toulouse, France
| | - Samy Hadjadj
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
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Alipour M, Javeshghani D, Roustazadeh A. Gene expression pattern in severely progressing covid-19 patients is related to diabetes mellitus type 1: A functional annotation analysis. Human Gene 2022; 33:201039. [PMID: 37520164 PMCID: PMC9217787 DOI: 10.1016/j.humgen.2022.201039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aims The aim of this study was to extract the signaling mediators or biological pathways that link covid-19 to other diseases such as type 1 diabetes mellitus (T1DM). Methods Microarray data of covid-19 (GSE164805) was extracted from Gene Expression Omnibus (GEO) and analyses were performed by R package and GEO2R. Functional enrichment analysis was done to extract enriched molecular pathways (MP), biological process (BP) and molecular function (MF). Then commonly up- and down-regulated genes in covid-19 and T1DM were extracted by comparing deferentially expressed genes (DEGs) of GSE164805 and GSE9006. Results Down-regulated DEGs in the severely progressing covid-19 patients (SPCP) had a link to T1DM. Major histocompatibility system (MHC) class II, gamma interferon (IFNγ), and IL-1B were enriched in extracted pathway that leads to T1DM. In addition, comparing extracted DEGs from GSE164805 and GSE9006 indicated that MTUS1, EGR1 and EGR3 are the genes that are up-regulated in both SPCP and T1DM. Conclusion The findings of this study indicate that coincidence of SARS-COV-2 infection and T1DM may increase the severity of both diseases. Although covid-19 reduced the T cell mediated immune response, but increased mediators of T-cell signaling pathway such as IL-1 in both diseases. This could potentiate the inflammation response and worsens the severity of covid-19 cytokine storm or increase the resistance to insulin.
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16
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Ulloque-Badaracco JR, Alarcon-Braga EA, Hernandez-Bustamante EA, Al-Kassab-Córdova A, Mosquera-Rojas MD, Ulloque-Badaracco RR, Huayta-Cortez MA, Maita-Arauco SH, Herrera-Añazco P, Benites-Zapata VA. Fibrinogen-to-Albumin Ratio and Blood Urea Nitrogen-to-Albumin Ratio in COVID-19 Patients: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7. [PMID: 36006242 DOI: 10.3390/tropicalmed7080150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 01/08/2023] Open
Abstract
Fibrinogen-to-albumin ratio (FAR) and blood urea nitrogen-to-albumin ratio (BAR) are inflammatory biomarkers that have been associated with clinical outcomes of multiple diseases. The objective of this study is to evaluate the association of these biomarkers with the severity and mortality of COVID-19 patients. A systematic search was performed in five databases. Observational studies that reported the association between FAR and BAR values with the severity and mortality of COVID-19 patients were included. Random-effects models were used for meta-analyses, and effects were expressed as Odds Ratio (OR) and their 95% confidence intervals (CI). Publication bias was assessed using the Begg test, while the quality assessment was assessed using the Newcastle Ottawa Scale. A total of 21 studies (n = 7949) were included. High FAR values were associated with a higher risk of severity (OR: 2.41; 95% CI 1.41−4.12; p < 0.001) and mortality (OR: 2.05; 95% CI 1.66−2.54; p < 0.001). High BAR values were associated with higher risk of mortality (OR: 4.63; 95% CI 2.11−10.15; p < 0.001). However, no statistically significant association was found between BAR values and the risk of severity (OR: 1.16; 95% CI 0.83−1.63; p = 0.38). High FAR and BAR values were associated with poor clinical outcomes.
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17
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Al-Sayyar A, Hulme KD, Thibaut R, Bayry J, Sheedy FJ, Short KR, Alzaid F. Respiratory Tract Infections in Diabetes - Lessons From Tuberculosis and Influenza to Guide Understanding of COVID-19 Severity. Front Endocrinol (Lausanne) 2022; 13:919223. [PMID: 35957811 PMCID: PMC9363013 DOI: 10.3389/fendo.2022.919223] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Patients with type-2 diabetes (T2D) are more likely to develop severe respiratory tract infections. Such susceptibility has gained increasing attention since the global spread of Coronavirus Disease 2019 (COVID-19) in early 2020. The earliest reports marked T2D as an important risk-factor for severe forms of disease and mortality across all adult age groups. Several mechanisms have been proposed for this increased susceptibility, including pre-existing immune dysfunction, a lack of metabolic flexibility due to insulin resistance, inadequate dietary quality or adverse interactions with antidiabetic treatments or common comorbidities. Some mechanisms that predispose patients with T2D to severe COVID-19 may indeed be shared with other previously characterized respiratory tract infections. Accordingly, in this review, we give an overview of response to Influenza A virus and to Mycobacterium tuberculosis (Mtb) infections. Similar risk factors and mechanisms are discussed between the two conditions and in the case of COVID-19. Lastly, we address emerging approaches to address research needs in infection and metabolic disease, and perspectives with regards to deployment or repositioning of metabolically active therapeutics.
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Affiliation(s)
| | - Katina D. Hulme
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Ronan Thibaut
- Institut Necker Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1151/CNRS UMRS8253, Immunity and Metabolism of Diabetes (IMMEDIAB), Université de Paris Cité, Paris, France
| | - Jagadeesh Bayry
- Department of Biological Sciences & Engineering, Indian Institute of Technology Palakkad, Palakkad, India
| | | | - Kirsty R. Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD, Australia
| | - Fawaz Alzaid
- Dasman Diabetes Institute, Dasman, Kuwait
- Institut Necker Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1151/CNRS UMRS8253, Immunity and Metabolism of Diabetes (IMMEDIAB), Université de Paris Cité, Paris, France
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18
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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19
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Muskiet FAJ, Carrera-bastos P, Pruimboom L, Lucia A, Furman D. Obesity and Leptin Resistance in the Regulation of the Type I Interferon Early Response and the Increased Risk for Severe COVID-19. Nutrients 2022; 14:1388. [PMID: 35406000 PMCID: PMC9002648 DOI: 10.3390/nu14071388] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity, and obesity-associated conditions such as hypertension, chronic kidney disease, type 2 diabetes, and cardiovascular disease, are important risk factors for severe Coronavirus disease-2019 (COVID-19). The common denominator is metaflammation, a portmanteau of metabolism and inflammation, which is characterized by chronically elevated levels of leptin and pro-inflammatory cytokines. These induce the “Suppressor Of Cytokine Signaling 1 and 3” (SOCS1/3), which deactivates the leptin receptor and also other SOCS1/3 sensitive cytokine receptors in immune cells, impairing the type I and III interferon early responses. By also upregulating SOCS1/3, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 adds a significant boost to this. The ensuing consequence is a delayed but over-reactive immune response, characterized by high-grade inflammation (e.g., cytokine storm), endothelial damage, and hypercoagulation, thus leading to severe COVID-19. Superimposing an acute disturbance, such as a SARS-CoV-2 infection, on metaflammation severely tests resilience. In the long run, metaflammation causes the “typical western” conditions associated with metabolic syndrome. Severe COVID-19 and other serious infectious diseases can be added to the list of its short-term consequences. Therefore, preventive measures should include not only vaccination and the well-established actions intended to avoid infection, but also dietary and lifestyle interventions aimed at improving body composition and preventing or reversing metaflammation.
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20
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Palaiodimos L, Ali R, Teo HO, Parthasarathy S, Karamanis D, Chamorro-Pareja N, Kokkinidis DG, Kaur S, Kladas M, Sperling J, Chang M, Hupart K, Cha-Fong C, Srinivasan S, Kishore P, Davis N, Faillace RT. Obesity, Inflammation, and Mortality in COVID-19: An Observational Study from the Public Health Care System of New York City. J Clin Med 2022; 11:jcm11030622. [PMID: 35160073 PMCID: PMC8836690 DOI: 10.3390/jcm11030622] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/15/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 01/08/2023] Open
Abstract
Severe obesity increases the risk for negative outcomes in patients with coronavirus disease 2019 (COVID-19). Our objectives were to investigate the effect of BMI on in-hospital outcomes in our New York City Health and Hospitals’ ethnically diverse population, further explore this effect by age, sex, race/ethnicity, and timing of admission, and, given the relationship between COVID-19 and hyperinflammation, assess the concentrations of markers of systemic inflammation in different BMI groups. A retrospective study was conducted in hospitalized patients with COVID-19 in the public health care system of New York City from 1 March 2020 to 31 October 2020. A total of 8833 patients were included in this analysis (women: 3593, median age: 62 years). The median body mass index (BMI) was 27.9 kg/m2. Both overweight and obesity were independently associated with in-hospital death. The association of overweight and obesity with death appeared to be stronger in men, younger patients, and individuals of Hispanic ethnicity. We did not observe higher concentrations of inflammatory markers in patients with obesity as compared to those without obesity. In conclusion, overweight and obesity were independently associated with in-hospital death. Obesity was not associated with higher concentrations of inflammatory markers.
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Affiliation(s)
- Leonidas Palaiodimos
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: (L.P.); (S.P.)
| | - Ryad Ali
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Hugo O. Teo
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Sahana Parthasarathy
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: (L.P.); (S.P.)
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Natalia Chamorro-Pareja
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Damianos G. Kokkinidis
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Sharanjit Kaur
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Michail Kladas
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jeremy Sperling
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Michael Chang
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Kenneth Hupart
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
| | - Colin Cha-Fong
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Shankar Srinivasan
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA; (R.A.); (D.K.); (S.S.)
| | - Preeti Kishore
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nichola Davis
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Robert T. Faillace
- NYC Health + Hospitals, New York, NY 10461, USA; (H.O.T.); (N.C.-P.); (D.G.K.); (S.K.); (M.K.); (J.S.); (M.C.); (K.H.); (C.C.-F.); (P.K.); (N.D.); (R.T.F.)
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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21
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Marfella R, D'Onofrio N, Sardu C, Scisciola L, Maggi P, Coppola N, Romano C, Messina V, Turriziani F, Siniscalchi M, Maniscalco M, Boccalatte M, Napolitano G, Salemme L, Marfella LV, Basile E, Montemurro MV, Papa C, Frascaria F, Papa A, Russo F, Tirino V, Papaccio G, Galdiero M, Sasso FC, Barbieri M, Rizzo MR, Balestrieri ML, Angelillo IF, Napoli C, Paolisso G. Does poor glycaemic control affect the immunogenicity of the COVID-19 vaccination in patients with type 2 diabetes: The CAVEAT study. Diabetes Obes Metab 2022; 24:160-165. [PMID: 34494705 PMCID: PMC8653151 DOI: 10.1111/dom.14547] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Raffaele Marfella
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
- Mediterranea CardiocentroNaples
| | - Nunzia D'Onofrio
- Department of Precision MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Celestino Sardu
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Lucia Scisciola
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Paolo Maggi
- Department of Infectious DiseasesSant'Anna HospitalCasertaItaly
| | - Nicola Coppola
- Department of Mental and Physical Health and Preventive MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Ciro Romano
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | | | - Fabrizio Turriziani
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Mario Siniscalchi
- Rehabilitation Cardiology UnitAORN “A. Cardarelli ”of NaplesNaplesItaly
| | - Mauro Maniscalco
- Rehabilitation Pneumology UnitICS Maugeri‐IRCCS of TeleseTelese TermeItaly
| | - Marco Boccalatte
- Cardiology‐UTIC‐Hemodynamic Unit“S.M. delle Grazie” Pozzuoli, ASL Napoli 2 NordPozzuoliItaly
| | - Giovanni Napolitano
- Cardiology‐UTIC Unit“San Giuliano” Hospital of Giugliano in Campania, ASL Napoli2 NordGiugliano in CampaniaItaly
| | - Luigi Salemme
- Hemodynamics Laboratory Unit“Montevergine” Clinic of Mercogliano (AV)MercoglianoItaly
| | | | | | | | | | | | | | | | - Virginia Tirino
- Department of Experimental MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Gianpaolo Papaccio
- Department of Experimental MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Marilena Galdiero
- Department of Experimental MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | | | | | - Claudio Napoli
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”Naples
- Mediterranea CardiocentroNaples
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22
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Gallo CG, Fiorino S, Posabella G, Antonacci D, Tropeano A, Pausini E, Pausini C, Guarniero T, Hong W, Giampieri E, Corazza I, Federico L, de Biase D, Zippi M, Zancanaro M. COVID-19, what could sepsis, severe acute pancreatitis, gender differences, and aging teach us? Cytokine 2021; 148:155628. [PMID: 34411989 PMCID: PMC8343368 DOI: 10.1016/j.cyto.2021.155628] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a potentially life-threatening disease, defined as Coronavirus Disease 19 (COVID-19). The most common signs and symptoms of this pathological condition include cough, fever, shortness of breath, and sudden onset of anosmia, ageusia, or dysgeusia. The course of COVID-19 is mild or moderate in more than 80% of cases, but it is severe or critical in about 14% and 5% of infected subjects respectively, with a significant risk of mortality. SARS-CoV-2 related infection is characterized by some pathogenetic events, resembling those detectable in other pathological conditions, such as sepsis and severe acute pancreatitis. All these syndromes are characterized by some similar features, including the coexistence of an exuberant inflammatory- as well as an anti-inflammatory-response with immune depression. Based on current knowledge concerning the onset and the development of acute pancreatitis and sepsis, we have considered these syndromes as a very interesting paradigm for improving our understanding of pathogenetic events detectable in patients with COVID-19. The aim of our review is: 1)to examine the pathogenetic mechanisms acting during the emergence of inflammatory and anti-inflammatory processes in human pathology; 2)to examine inflammatory and anti-inflammatory events in sepsis, acute pancreatitis, and SARS-CoV-2 infection and clinical manifestations detectable in patients suffering from these syndromes also according to the age and gender of these individuals; as well as to analyze the possible common and different features among these pathological conditions; 3)to obtain insights into our knowledge concerning COVID-19 pathogenesis. This approach may improve the management of patients suffering from this disease and it may suggest more effective diagnostic approaches and schedules of therapy, depending on the different phases and/or on the severity of SARS-CoV-2 infection.
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Affiliation(s)
- Claudio G Gallo
- Emilian Physiolaser Therapy Center, Castel S. Pietro Terme, Bologna, Italy.
| | - Sirio Fiorino
- Internal Medicine Unit, Budrio Hospital Azienda USL, Bologna, Italy
| | | | - Donato Antonacci
- Medical Science Department, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo (FG), Italy
| | | | | | | | | | - Wandong Hong
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang, The People's Republic of China
| | - Enrico Giampieri
- Experimental, Diagnostic and Specialty Medicine Department, University of Bologna, Bologna, Italy
| | - Ivan Corazza
- Experimental, Diagnostic and Specialty Medicine Department, University of Bologna, Bologna, Italy
| | - Lari Federico
- Internal Medicine Unit, Budrio Hospital Azienda USL, Bologna, Italy
| | - Dario de Biase
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Maddalena Zippi
- Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy
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23
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Figueroa-Pizano MD, Campa-Mada AC, Carvajal-Millan E, Martinez-Robinson KG, Chu AR. The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review. AIMS Public Health 2021; 8:720-742. [PMID: 34786431 PMCID: PMC8568590 DOI: 10.3934/publichealth.2021057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023] Open
Abstract
Diabetes mellitus (DM) has a high incidence of comorbidities among patients with severe coronavirus disease 2019 (COVID-19). The elevated prevalence of DM in the world population makes it a significant risk factor because diabetic individuals appear to be prone to clinical complications and have increased mortality rates. Here, we review the possible underlying mechanisms involved in DM that led to worse outcomes in COVID-19. The impacts of hyperglycemia side effects, secondary comorbidities, weakened innate and adaptive immunity, chronic inflammation, and poor nutritional status, commonly present in DM, are discussed. The role of the SARS-CoV-2 receptor and its polymorphic variations on higher binding affinity to facilitate viral uptake in people with DM were also considered. Clinical differences between individuals with type 1 DM and type 2 DM affected by COVID-19 and the potential diabetogenic effect of SARS-CoV-2 infection were addressed.
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Affiliation(s)
- María D Figueroa-Pizano
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Alma C Campa-Mada
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Elizabeth Carvajal-Millan
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Karla G Martinez-Robinson
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Agustin Rascon Chu
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
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24
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Sabri S, Bourron O, Phan F, Nguyen LS. Interactions between diabetes and COVID-19: A narrative review. World J Diabetes 2021; 12:1674-1692. [PMID: 34754370 PMCID: PMC8554367 DOI: 10.4239/wjd.v12.i10.1674] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes, whether due to pancreatic beta cells insufficiency or peripheral resistance to insulin, has been suggested as a risk factor of developing severe acute respiratory disease coronavirus-2 (SARS-CoV-2) infections. Indeed, diabetes has been associated with a higher risk of infections and higher risk of developing severe forms of coronavirus disease 2019 (COVID-19) related pneumonia. Diabetic patients often present associated comorbidities such as obesity, hypertension and cardiovascular diseases, and complications of diabetes, including chronic kidney disease, vasculopathy and relative immune dysfunction, all of which make them more susceptible to infectious complications. Moreover, they often present low-grade inflammation with increased circulating interleukin levels, endothelial susceptibility to inflammation and dysfunction, and finally, hyperglycemia, which increases this risk. Additionally, corticosteroids, which count among the few medications which showed benefit on survival and mechanical ventilation requirement in COVID-19 pneumonia in large randomized controlled trials, are associated to new onsets of diabetes, and metabolic disorders in patients with previous history of diabetes. Finally, SARS-CoV-2 via the alternate effects of the renin-angiotensin system, mediated by the angiotensin-converting-enzyme 2, was also associated with insulin resistance in key tissues involved in glucose homeostasis, such as liver, skeletal muscles, and adipose tissue; and also, with impaired insulin secretion by pancreatic β-cells. In this work, we reviewed all elements which may help understand how diabetes affects patients with COVID-19, how treatments affect outcomes in patients with COVID-19, how they may cause new onsets of diabetes, and finally review how SARS-CoV-2 may inherently be a risk factor of developing diabetes, through immune-mediated diabetogenic mechanisms.
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Affiliation(s)
- Sophia Sabri
- Intensive Care Medicine, CMC Ambroise Paré, Neuilly-Sur-Seine 92200, France
| | - Olivier Bourron
- Sorbonne Université Médecine; Assistance publique Hôpitaux de Paris (APHP), Service de Diabétologie, Hôpital Pitié-Salpêtrière; INSERM UMRS_1138, Centre de recherche des Cordeliers; Institute of CArdiometabolisme and Nutrition (ICAN), Paris 75013, France
| | - Franck Phan
- Sorbonne Université Médecine; Assistance publique Hôpitaux de Paris (APHP), Service de Diabétologie, Hôpital Pitié-Salpêtrière; INSERM UMRS_1138, Centre de recherche des Cordeliers; Institute of CArdiometabolisme and Nutrition (ICAN), Paris 75013, France
| | - Lee S Nguyen
- Research and Innovation, RICAP, CMC Ambroise Paré, Neuilly-Sur-Seine 92200, France
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25
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Klonoff DC, Messler J, Valk T, Jagannathan R, Pasquel FJ, Umpierrez GE. Clinical Trials of COVID-19 Therapies Should Account for Diabetes and Hyperglycemia. J Diabetes Sci Technol 2021; 15:1181-1187. [PMID: 34159841 PMCID: PMC8442178 DOI: 10.1177/19322968211013369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Complications of Coronavirus Disease 2019 (COVID-19) occur with increased frequency in people admitted to the hospital with diabetes or hyperglycemia. The increased risk for COVID-19 infections in the presence of these metabolic conditions is in part due to overlapping pathophysiologic features of COVID-19, diabetes, and glucose control. Various antiviral treatments are being tested in COVID-19 patients. We believe that in these trials, it will be useful to evaluate treatment effect differences in patients stratified according to whether they have diabetes or hyperglycemia. In this way, it will be possible to better facilitate development of antiviral treatments that are most specifically beneficial for the large subset of COVID-19 patients who have diabetes or hyperglycemia.
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Affiliation(s)
- David C. Klonoff
- Mills-Peninsula Medical Center, San
Mateo, CA, USA
- David C. Klonoff, M.D., FACP, FRCP (Edin),
Fellow AIMBE, Medical Director, Diabetes Research Institute, Mills-Peninsula
Medical Center, 100 South San Mateo Drive, Room 5147, San Mateo, CA 94401, USA.
| | | | - Timothy Valk
- Admetsys Corporation, Research
Division, Winter Park, FL, USA
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26
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Lasbleiz A, Gaborit B, Soghomonian A, Bartoli A, Ancel P, Jacquier A, Dutour A. COVID-19 and Obesity: Role of Ectopic Visceral and Epicardial Adipose Tissues in Myocardial Injury. Front Endocrinol (Lausanne) 2021; 12:726967. [PMID: 34484128 PMCID: PMC8415546 DOI: 10.3389/fendo.2021.726967] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
In March 2020, the WHO declared coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a global pandemic. Obesity was soon identified as a risk factor for poor prognosis, with an increased risk of intensive care admissions and mechanical ventilation, but also of adverse cardiovascular events. Obesity is associated with adipose tissue, chronic low-grade inflammation, and immune dysregulation with hypertrophy and hyperplasia of adipocytes and overexpression of pro-inflammatory cytokines. However, to implement appropriate therapeutic strategies, exact mechanisms must be clarified. The role of white visceral adipose tissue, increased in individuals with obesity, seems important, as a viral reservoir for SARS-CoV-2 via angiotensin-converting enzyme 2 (ACE2) receptors. After infection of host cells, the activation of pro-inflammatory cytokines creates a setting conducive to the "cytokine storm" and macrophage activation syndrome associated with progression to acute respiratory distress syndrome. In obesity, systemic viral spread, entry, and prolonged viral shedding in already inflamed adipose tissue may spur immune responses and subsequent amplification of a cytokine cascade, causing worse outcomes. More precisely, visceral adipose tissue, more than subcutaneous fat, could predict intensive care admission; and lower density of epicardial adipose tissue (EAT) could be associated with worse outcome. EAT, an ectopic adipose tissue that surrounds the myocardium, could fuel COVID-19-induced cardiac injury and myocarditis, and extensive pneumopathy, by strong expression of inflammatory mediators that could diffuse paracrinally through the vascular wall. The purpose of this review is to ascertain what mechanisms may be involved in unfavorable prognosis among COVID-19 patients with obesity, especially cardiovascular events, emphasizing the harmful role of excess ectopic adipose tissue, particularly EAT.
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Affiliation(s)
- Adèle Lasbleiz
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Bénédicte Gaborit
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Astrid Soghomonian
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Axel Bartoli
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Medical Imaging, Hôpital Universitaire Timone APHM, Marseille, France
| | - Patricia Ancel
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Alexis Jacquier
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Medical Imaging, Hôpital Universitaire Timone APHM, Marseille, France
| | - Anne Dutour
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
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27
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Koufakis T, Dimitriadis G, Metallidis S, Zebekakis P, Kotsa K. The role of autoimmunity in the pathophysiology of type 2 diabetes: Looking at the other side of the moon. Obes Rev 2021; 22:e13231. [PMID: 33682984 DOI: 10.1111/obr.13231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022]
Abstract
Efforts to unravel the pathophysiological mechanisms of type 2 diabetes (T2D) have been traditionally trapped into a metabolic perspective. However, T2D is a phenotypically and pathophysiologically heterogenous disorder, and the need for a tailored approach in its management is becoming increasingly evident. There is emerging evidence that irregular immune responses contribute to the development of hyperglycemia in T2D and, inversely, that insulin resistance is a component of the pathogenesis of autoimmune diabetes. Nevertheless, it has not yet been fully elucidated to what extent the presence of conventional autoimmune markers, such as autoantibodies, in subjects with T2D might affect the natural history of the disease and particularly each response to various treatments. The challenge for future research in the field is the discovery of novel genetic, molecular, or phenotypical indicators that would enable the characterization of specific subpopulations of people with T2D who would benefit most from the addition of immunomodulatory therapies to standard glucose-lowering treatment. This narrative review aims to discuss the plausible mechanisms through which the immune system might be implicated in the development of metabolic disturbances in T2D and obesity and explore a potential role of immunotherapy in the future management of the disorder and its complications.
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Affiliation(s)
- Theocharis Koufakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - George Dimitriadis
- Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Symeon Metallidis
- Infectious Diseases Division, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Pantelis Zebekakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.,Infectious Diseases Division, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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28
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Kaminska H, Szarpak L, Kosior D, Wieczorek W, Szarpak A, Al-Jeabory M, Gawel W, Gasecka A, Jaguszewski MJ, Jarosz-Chobot P. Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis. Acta Diabetol 2021; 58:1101-1110. [PMID: 33778910 PMCID: PMC8005367 DOI: 10.1007/s00592-021-01701-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/03/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) has spread worldwide since the beginning of 2020, placing the heavy burden on the health systems all over the world. The population that particularly has been affected by the pandemic is the group of patients suffering from diabetes mellitus. Having taken the public health in considerations, we have decided to perform a systematic review and meta-analysis of diabetes mellitus on in-hospital mortality in patients with COVID-19. METHODS A systematic literature review (MEDLINE, EMBASE, Web of Science, Scopus, Cochrane) including all published clinical trials or observational studies published till December 10, 2020, was performed using following terms "diabetes mellitus" OR "diabetes" OR "DM" AND "survival" OR "mortality" AND "SARS-CoV-2" OR "COVID-19". RESULTS Nineteen studies were included out of the 7327 initially identified studies. Mortality of DM patients vs non-DM patients was 21.3 versus 6.1%, respectively (OR = 2.39; 95%CI: 1.65, 3.64; P < 0.001), while severe disease in DM and non-DM group varied and amounted to 34.8% versus 22.8% (OR = 1.43; 95%CI: 0.82, 2.50; P = 0.20). In the DM group, the complications were observed far more often when compared with non-DM group, both in acute respiratory distress (31.4 vs. 17.2%; OR = 2.38; 95%CI:1.80, 3.13; P < 0.001), acute cardiac injury (22.0% vs. 12.8%; OR = 2.59; 95%CI: 1.81, 3.73; P < 0.001), and acute kidney injury (19.1 vs. 10.2%; OR = 1.97; 95%CI: 1.36, 2.85; P < 0.001). CONCLUSIONS Based on the findings, we shall conclude that diabetes is an independent risk factor of the severity of COVID-19 in-hospital settings; therefore, patients with diabetes shall aim to reduce the exposure to the potential infection of COVID-19.
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Affiliation(s)
- Halla Kaminska
- Department of Pediatrics and Children's Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Silesia, Poland
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Bialystok Oncology Center, Ogrodowa 12 str., 15-027, Bialystok, Poland.
- Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Dariusz Kosior
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
- Department of Cardiology and Hypertension With Electrophysiological Lab, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Wojciech Wieczorek
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Wladyslaw Gawel
- Department of Surgery, The Silesian Hospital in Opava, Opava, Czech Republic
| | - Aleksandra Gasecka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- 1St Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Przemyslawa Jarosz-Chobot
- Department of Pediatrics and Children's Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Silesia, Poland
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29
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Delgado-Enciso I, Paz-Garcia J, Barajas-Saucedo CE, Mokay-Ramírez KA, Meza-Robles C, Lopez-Flores R, Delgado-Machuca M, Murillo-Zamora E, Toscano-Velazquez JA, Delgado-Enciso J, Melnikov V, Walle-Guillen M, Galvan-Salazar HR, Delgado-Enciso OG, Cabrera-Licona A, Danielewicz-Mata EJ, Mandujano-Diaz PJ, Guzman-Esquivel J, Montes-Galindo DA, Perez-Martinez H, Jimenez-Villegaz JM, Hernandez-Rangel AE, Montes-Diaz P, Rodriguez-Sanchez IP, Martinez-Fierro ML, Garza-Veloz I, Tiburcio-Jimenez D, Zaizar-Fregoso SA, Gonzalez-Alcaraz F, Gutierrez-Gutierrez L, Diaz-Lopez L, Ramirez-Flores M, Guzman-Solorzano HP, Gaytan-Sandoval G, Martinez-Perez CR, Espinoza-Gómez F, Rojas-Larios F, Hirsch-Meillon MJ, Baltazar-Rodriguez LM, Barrios-Navarro E, Oviedo-Rodriguez V, Mendoza-Hernandez MA, Prieto-Diaz-Chavez E, Paz-Michel BA. Safety and efficacy of a COVID-19 treatment with nebulized and/or intravenous neutral electrolyzed saline combined with usual medical care vs. usual medical care alone: A randomized, open-label, controlled trial. Exp Ther Med 2021; 22:915. [PMID: 34306189 PMCID: PMC8281484 DOI: 10.3892/etm.2021.10347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/04/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is currently the major public health problem worldwide. Neutral electrolyzed saline solution that contains reactive chlorine and oxygen species may be an effective therapeutic. In the present study, the treatment efficacy of intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care vs. usual medical care alone was evaluated in ambulatory patients with COVID-19. A prospective, 2-arm, parallel-group, randomized, open-label, multi-center, phase I-II clinical trial including 214 patients was performed. The following two outcomes were evaluated during the 20-day follow-up: i) The number of patients with disease progression; and ii) the patient acceptable symptom state. Serial severe acute respiratory syndrome coronavirus 2 naso/oro-pharyngeal detection by reverse transcription-quantitative (RT-q) PCR was performed in certain patients of the experimental group. Biochemical and hematologic parameters, as well as adverse effects, were also evaluated in the experimental group. The experimental treatment decreased the risk of hospitalization by 89% [adjusted relative risk (RR)=0.11, 95% confidence interval (CI): 0.03-0.37, P<0.001] and the risk of death by 96% (adjusted RR=0.04, 95% CI: 0.01-0.42, P=0.007) and also resulted in an 18-fold higher probability of achieving an acceptable symptom state on day 5 (adjusted RR=18.14, 95% CI: 7.29-45.09, P<0.001), compared with usual medical care alone. Overall, neutral electrolyzed saline solution was better than usual medical care alone. Of the patients analyzed, >50% were negative for the virus as detected by RT-qPCR in naso/oro-pharyngeal samples on day 4, with only a small number of positive patients on day 6. Clinical improvement correlated with a decrease in C-reactive protein, aberrant monocytes and increased lymphocytes and platelets. Cortisol and testosterone levels were also evaluated and a decrease in cortisol levels and an increase in the testosterone-cortisol ratio were observed on days 2 and 4. The experimental treatment produced no serious adverse effects. In conclusion, neutral electrolyzed saline solution markedly reduced the symptomatology and risk of progression in ambulatory patients with COVID-19. The present clinical trial was registered in the Cuban public registry of clinical trials (RPCEC) database (May 5, 2020; no. TX-COVID19: RPCEC00000309).
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Affiliation(s)
- Ivan Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Juan Paz-Garcia
- Department of Internal Medicine and Surgery, Union Hospital Center, Villa de Álvarez, Colima 28970, México
| | - Carlos E Barajas-Saucedo
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Karen A Mokay-Ramírez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Carmen Meza-Robles
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Rodrigo Lopez-Flores
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Marina Delgado-Machuca
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Efren Murillo-Zamora
- Department of Research, General Hospital of Zone No. 1 and Family Medicine Unit No. 19 IMSS, Villa de Alvarez, Colima 28984, México
| | - Jose A Toscano-Velazquez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | - Valery Melnikov
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Mireya Walle-Guillen
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Hector R Galvan-Salazar
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Osiris G Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | | | | | - Pablo J Mandujano-Diaz
- COVID-19 Respiratory Care Clinic INSABI Poliforum, Tuxtla Gutierrez, Chiapas 29040, México
| | - José Guzman-Esquivel
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | - Daniel A Montes-Galindo
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Henry Perez-Martinez
- COVID-19 Respiratory Care Clinic INSABI Poliforum, Tuxtla Gutierrez, Chiapas 29040, México
| | | | | | | | - Iram P Rodriguez-Sanchez
- Laboratory of Molecular and Structural Physiology, School of Biological Sciences, Universidad Autónoma de Nuevo León, San Nicolas de los Garza, Nuevo León 66455, México
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, México
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, México
| | - Daniel Tiburcio-Jimenez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Sergio A Zaizar-Fregoso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | | | | | - Luciano Diaz-Lopez
- COVID-19 Respiratory Care Clinic INSABI Poliforum, Tuxtla Gutierrez, Chiapas 29040, México
| | - Mario Ramirez-Flores
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | | | - Gustavo Gaytan-Sandoval
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Carlos R Martinez-Perez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Francisco Espinoza-Gómez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Fabián Rojas-Larios
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Michael J Hirsch-Meillon
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Luz M Baltazar-Rodriguez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Enrique Barrios-Navarro
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Vladimir Oviedo-Rodriguez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | | | | | - Brenda A Paz-Michel
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México.,Department of Research, Esteripharma S.A. de C.V., Ciudad de México 03100, México
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30
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Peña KB, Riu F, Gumà J, Guilarte C, Pique B, Hernandez A, Àvila A, Parra S, Castro A, Rovira C, Cueto P, Vallverdu I, Parada D. Study of the Plasma and Buffy Coat in Patients with SARS-CoV-2 Infection-A Preliminary Report. Pathogens 2021; 10:805. [PMID: 34201967 DOI: 10.3390/pathogens10070805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
The pandemic caused by the SARS-CoV-2 infection affects many aspects of public health knowledge, science, and practice around the world. Several studies have shown that SARS-CoV-2 RNA in plasma seems to be associated with a worse prognosis of COVID-19. In the present study, we investigated plasma and buffy RNA in patients with COVID-19 to determine its prognostic value. A prospective study was carried out in patients hospitalized for COVID-19, in which RNA was analyzed in plasma and the buffy coat. Morphological and immunohistochemical studies were used to detect the presence of SARS-CoV-2 in the buffy coat. In COVID-19 patients, the obtained RNA concentration in plasma was 448.3 ± 31.30 ng/mL. Of all the patients with positive plasma tests for SARS-CoV-2, 46.15% died from COVID-19. In four cases, tests revealed that SARS-CoV-2 was present in the buffy coat. Abnormal morphology of monocytes, lymphocytes and neutrophils was found. An immunohistochemical study showed positivity in mononuclear cells and platelets. Our results suggest that SARS-CoV-2 is present in the plasma. This facilitates viral dissemination and migration to specific organs, where SARS-CoV-2 infects target cells by binding to their receptors. In our study, the presence of plasma SARS-CoV-2 RNA was correlated with worse prognoses.
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31
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Paolini A, Borella R, De Biasi S, Neroni A, Mattioli M, Lo Tartaro D, Simonini C, Franceschini L, Cicco G, Piparo AM, Cossarizza A, Gibellini L. Cell Death in Coronavirus Infections: Uncovering Its Role during COVID-19. Cells 2021; 10:1585. [PMID: 34201847 DOI: 10.3390/cells10071585] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 02/07/2023] Open
Abstract
Cell death mechanisms are crucial to maintain an appropriate environment for the functionality of healthy cells. However, during viral infections, dysregulation of these processes can be present and can participate in the pathogenetic mechanisms of the disease. In this review, we describe some features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and some immunopathogenic mechanisms characterizing the present coronavirus disease (COVID-19). Lymphopenia and monocytopenia are important contributors to COVID-19 immunopathogenesis. The fine mechanisms underlying these phenomena are still unknown, and several hypotheses have been raised, some of which assign a role to cell death as far as the reduction of specific types of immune cells is concerned. Thus, we discuss three major pathways such as apoptosis, necroptosis, and pyroptosis, and suggest that all of them likely occur simultaneously in COVID-19 patients. We describe that SARS-CoV-2 can have both a direct and an indirect role in inducing cell death. Indeed, on the one hand, cell death can be caused by the virus entry into cells, on the other, the excessive concentration of cytokines and chemokines, a process that is known as a COVID-19-related cytokine storm, exerts deleterious effects on circulating immune cells. However, the overall knowledge of these mechanisms is still scarce and further studies are needed to delineate new therapeutic strategies.
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32
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Li Y, Mateu E. Interaction of Type 1 Porcine Reproductive and Respiratory Syndrome Virus With In Vitro Derived Conventional Dendritic Cells. Front Immunol 2021; 12:674185. [PMID: 34177915 PMCID: PMC8221110 DOI: 10.3389/fimmu.2021.674185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/28/2021] [Accepted: 05/12/2021] [Indexed: 12/22/2022] Open
Abstract
The present study delineates the interaction of a typical PRRSV1.1 isolate 3267 (moderate virulence) with in vitro derived pig conventional dendritic cells, cDC1, cDC2, and a CD14+ population (designated as CD14+ DCs). cDC1 and cDC2 were not susceptible to 3267 infection, but a fraction of CD14+ DCs were infected. After exposure to the virus, all three DC types remained immature as determined by no increase of maturation molecules (MHC-I, MHC-II, CD80/86, CCR7), no release of cytokines, no modification of antigen presentation abilities, and no alteration of endocytic/phagocytic capabilities. However, when infected MARC-145 cells were used as a source of viral antigens, cDC2 and CD14+ DCs showed a significant increase in the expression of maturation molecules and substantial release of cytokines, notably IL-12/IL-23p40 (by both DC types) and IL-10 (by CD14+ DCs). To address the impact of PRRSV1 3267 on TLR3- and TLR7-mediated activation, cDC1, cDC2, and CD14+ DCs were inoculated by the virus (live or UV-inactivated) for 6 h prior to or simultaneously with the addition of poly I:C (TLR3 ligand) or gardiquimod (TLR7 ligand; not used for cDC1). Compared with using TLR ligand alone, combination with the virus did not result in any alteration to the maturation markers on all DC types but changed the cytokine response to either TLR3 or TLR7 ligand. Pre-exposure of cDC2 or CD14+ DCs to the live virus resulted in an increased production of IFN-α upon poly I:C stimulation, while pre-exposure to UV-inactivated virus tended to enhance the release of IL-10 upon gardiquimod stimulation. Simultaneous addition of the live virus and the TLR ligand either had no effect (mainly in cDC2) or impaired most of the cytokine release after gardiquimod stimulation (in CD14+ DCs). When used as antigen presenting cells, cDC2 pre-inoculated by the live virus before addition of gardiquimod impaired the proliferation of CD4–CD8– T cells. In the case of CD14+ DCs, pre-exposure to the live virus or simultaneously added with TLR3 or TLR7 ligand largely decreased the proliferation of CD4–CD8+ and CD4–CD8+ T-cell subsets. For cDC1, no significant changes were observed in cytokine responses or T-cell proliferation after poly I:C stimulation. Of note, cDC1 had a short life during in vitro culturing, for which the results obtained might be biased. Overall, exposure to PRRSV1 did not induce maturation of cDC1, cDC2, or CD14+ DCs, but modified TLR3 and TLR7-associated responses (except for cDC1), which may affect the development of adaptive immunity during PRRSV1 infection. Moreover, the sensing of infected cells was different from that of the free virus.
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Affiliation(s)
- Yanli Li
- Departament de Sanitat i Anatomia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Enric Mateu
- Departament de Sanitat i Anatomia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Bellaterra, Spain
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Abstract
The increased prevalence of obesity, diabetes, and cardiovascular risk factors in people hospitalized with severe COVID-19 illness has engendered considerable interest in the metabolic aspects of SARS-CoV-2-induced pathophysiology. Here, I update concepts informing how metabolic disorders and their co-morbidities modify the susceptibility to, natural history, and potential treatment of SARS-CoV-2 infection, with a focus on human biology. New data informing genetic predisposition, epidemiology, immune responses, disease severity, and therapy of COVID-19 in people with obesity and diabetes are highlighted. The emerging relationships of metabolic disorders to viral-induced immune responses and viral persistence, and the putative importance of adipose and islet ACE2 expression, glycemic control, cholesterol metabolism, and glucose- and lipid-lowering drugs is reviewed, with attention to controversies and unresolved questions. Rapid progress in these areas informs our growing understanding of SARS-CoV-2 infection in people with diabetes and obesity, while refining the therapeutic strategies and research priorities in this vulnerable population.
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Affiliation(s)
- Daniel J Drucker
- Department of Medicine, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON M5G 1X5, Canada.
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Dhar SK, Sachdeva K, Das M. Inflammation and hypercoagulopathy are predominant risk factors of severity in COVID-19 patients with diabetes mellitus: Summary of a meta-analysis. Diabetes Metab Syndr 2021; 15:639-641. [PMID: 33676871 PMCID: PMC7903900 DOI: 10.1016/j.dsx.2021.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Sujan K Dhar
- Beyond Antibody, InCite Lab, MSMF, 8th Floor MSMC, Bommasandra, Bangalore, India
| | - Kartik Sachdeva
- Mazumdar Shaw Medical Foundation, 8th Floor MSMC, Bommasandra, Bangalore, India
| | - Manjula Das
- Mazumdar Shaw Medical Foundation, 8th Floor MSMC, Bommasandra, Bangalore, India.
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Zhu A, Chen Z, Wang Y, Zeng Q, Sun J, Zhuang Z, Li F, Zhao J, Zhao J, Zhong N. Immune responses to SARS-CoV-2 infection in Humans and ACE2 humanized mice. Fundamental Research 2021; 1:124-30. [DOI: 10.1016/j.fmre.2021.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a major public health threat worldwide. Insight into protective and pathogenic aspects of SARS-CoV-2 immune responses is critical to work out effective therapeutics and develop vaccines for controlling the disease. Here, we review the present literature describing the innate and adaptive immune responses including innate immune cells, cytokine responses, antibody responses and T cell responses against SARS-CoV-2 in human infection, as well as in AEC2-humanized mouse infection. We also summarize the now known and unknown about the role of the SARS-CoV-2 immune responses. By better understanding the mechanisms that drive the immune responses, we can tailor treatment strategies at specific disease stages and improve our response to this worldwide public health threat.
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Vasse M, Zuber B, Goubeau L, Ballester MC, Roumier M, Delcominette F, Habarou F, Jolly E, Ackermann F, Cerf C, Farfour E, Pascreau T. A low level of CD16 pos monocytes in SARS-CoV-2 infected patients is a marker of severity. Clin Chem Lab Med 2021; 59:1315-1322. [PMID: 33606928 DOI: 10.1515/cclm-2020-1801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/08/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Severe forms of coronavirus disease 2019 (COVID-19) are characterized by an excessive production of inflammatory cytokines. Activated monocytes secrete high levels of cytokines. Human monocytes are divided into three major populations: conventional (CD14posCD16neg), non-classical (CD14dimCD16pos), and intermediate (CD14posCD16pos) monocytes. The aim of this study was to analyze whether the distribution of conventional (CD16neg) and CD16pos monocytes is different in patients with COVID-19 and whether the variations could be predictive of the outcome of the disease. METHODS We performed a prospective study on 390 consecutive patients referred to the Emergency Unit, with a proven diagnosis of SARS-CoV 2 infection by RT-PCR. Using the CytoDiff™ reagent, an automated routine leukocyte differential, we quantified CD16neg and CD16pos monocytes. RESULTS In the entire population, median CD16neg and CD16pos monocyte levels (0.398 and 0.054×109/L, respectively) were in the normal range [(0.3-0.7×109/L) and (0.015-0.065×109/L), respectively], but the 35 patients in the intensive care unit (ICU) had a significantly (p<0.001) lower CD16pos monocyte count (0.018 × 109/L) in comparison to the 70 patients who were discharged (0.064 × 109/L) or were hospitalized in conventional units (0.058 × 109/L). By ROC curve analysis, the ratio [absolute neutrophil count/CD16pos monocyte count] was highly discriminant to identify patients requiring ICU hospitalization: with a cut-off 193.1, the sensitivity and the specificity were 74.3 and 81.8%, respectively (area under the curve=0.817). CONCLUSIONS Quantification of CD16pos monocytes and the ratio [absolute neutrophil count/CD16pos monocyte count] could constitute a marker of the severity of disease in COVID-19 patients.
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Affiliation(s)
- Marc Vasse
- Biology Department, Foch Hospital, Suresnes, France
- UMRS-1176, Le Kremlin-Bicêtre, France
| | | | | | | | | | | | | | - Emilie Jolly
- Biology Department, Foch Hospital, Suresnes, France
| | - Felix Ackermann
- Internal Medicine Department, Foch Hospital, Suresnes, France
| | - Charles Cerf
- Intensive Care Unit, Foch Hospital, Suresnes, France
| | - Eric Farfour
- Biology Department, Foch Hospital, Suresnes, France
| | - Tiffany Pascreau
- Biology Department, Foch Hospital, Suresnes, France
- UMRS-1176, Le Kremlin-Bicêtre, France
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Sultan A, Halimi S. Relation entre diabète de type 2 et la COVID-19 : les dernières données. Médecine des Maladies Métaboliques 2021. [PMCID: PMC7733688 DOI: 10.1016/j.mmm.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Très rapidement après le début de la pandémie de la maladie à coronavirus 2019 (COVID-19), le diabète a été identifié comme facteur associé aux formes graves, et facteur pronostique. Depuis, de nombreuses études se sont intéressées à cette relation et ont pu préciser un certain nombre d’éléments : impact des comorbidités associées au diabète, phénotype des sujets diabétiques à risque de formes graves, impact de l’équilibre glycémique, impact de la COVID-19 sur le risque de diabète. Il persiste cependant un certain nombre de questions ou d’hypothèses, concernant notamment l’influence de traitements antidiabétiques sur le pronostic ou les mécanismes physiopathologiques impliqués dans les formes graves associées au diabète. Une mise à jour de l’ensemble de ces points est présentée dans cet article, mais les données de la littérature évoluent très vite…
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Najm A, Alunno A, Mariette X, Terrier B, De Marco G, Emmel J, Mason L, McGonagle DG, Machado PM. Pathophysiology of acute respiratory syndrome coronavirus 2 infection: a systematic literature review to inform EULAR points to consider. RMD Open 2021; 7:e001549. [PMID: 33574116 PMCID: PMC7880117 DOI: 10.1136/rmdopen-2020-001549] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic is a global health problem. Beside the specific pathogenic effect of SARS-CoV-2, incompletely understood deleterious and aberrant host immune responses play critical roles in severe disease. Our objective was to summarise the available information on the pathophysiology of COVID-19. METHODS Two reviewers independently identified eligible studies according to the following PICO framework: P (population): patients with SARS-CoV-2 infection; I (intervention): any intervention/no intervention; C (comparator): any comparator; O (outcome) any clinical or serological outcome including but not limited to immune cell phenotype and function and serum cytokine concentration. RESULTS Of the 55 496 records yielded, 84 articles were eligible for inclusion according to question-specific research criteria. Proinflammatory cytokine expression, including interleukin-6 (IL-6), was increased, especially in severe COVID-19, although not as high as other states with severe systemic inflammation. The myeloid and lymphoid compartments were differentially affected by SARS-CoV-2 infection depending on disease phenotype. Failure to maintain high interferon (IFN) levels was characteristic of severe forms of COVID-19 and could be related to loss-of-function mutations in the IFN pathway and/or the presence of anti-IFN antibodies. Antibody response to SARS-CoV-2 infection showed a high variability across individuals and disease spectrum. Multiparametric algorithms showed variable diagnostic performances in predicting survival, hospitalisation, disease progression or severity, and mortality. CONCLUSIONS SARS-CoV-2 infection affects both humoral and cellular immunity depending on both disease severity and individual parameters. This systematic literature review informed the EULAR 'points to consider' on COVID-19 pathophysiology and immunomodulatory therapies.
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Affiliation(s)
- Aurélie Najm
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alessia Alunno
- Department of Medicine, Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Xavier Mariette
- INSERM U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris-Sud University, Paris-Saclay University, Le Kremlin-Bicêtre, France
- Department of Rheumatology, AP-HP, Paris-Sud University Hospitals, Le Kremlin Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Benjamin Terrier
- University of Paris, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France
- INSERM U970, PARCC, Paris, Île-de-France, France
| | - Gabriele De Marco
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, West Yorkshire, UK
- Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - Jenny Emmel
- Medical Education, Library & Evidence Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Laura Mason
- Medical Education, Library & Evidence Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Dennis G McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, West Yorkshire, UK
- Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Pedro M Machado
- Centre for Rheumatology, National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC), University College London Hospitals (UCLH) NHS Foundation Trus, London, UK
- Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK
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Ishikawa G, Argenti G, Fadel CB. Non-specific blood tests as proxies for COVID-19 hospitalisation: are there plausible associations after excluding noisy predictors? Epidemiol Infect 2021; 149:e23. [PMID: 33427157 PMCID: PMC7844186 DOI: 10.1017/s0950268821000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 01/08/2023] Open
Abstract
This study applied causal criteria in directed acyclic graphs for handling covariates in associations for prognosis of severe coronavirus disease 2019 (COVID-19) cases. To identify non-specific blood tests and risk factors as predictors of hospitalisation due to COVID-19, one has to exclude noisy predictors by comparing the concordance statistics (area under the curve - AUC) for positive and negative cases of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Predictors with significant AUC at negative stratum should be either controlled for their confounders or eliminated (when confounders are unavailable). Models were classified according to the difference of AUC between strata. The framework was applied to an open database with 5644 patients from Hospital Israelita Albert Einstein in Brazil with SARS-CoV-2 reverse transcription - polymerase chain reaction (RT-PCR) exam. C-reactive protein (CRP) was a noisy predictor: hospitalisation could have happened due to causes other than COVID-19 even when SARS-CoV-2 RT-PCR is positive and CRP is reactive, as most cases are asymptomatic to mild. Candidates of characteristic response from moderate-to-severe inflammation of COVID-19 were: combinations of eosinophils, monocytes and neutrophils, with age as risk factor; and creatinine, as risk factor, sharpens the odds ratio of the model with monocytes, neutrophils and age.
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Affiliation(s)
- G. Ishikawa
- Professor and researcher, Universidade Tecnologica Federal do Parana (UTFPR), Ponta Grossa, Brazil
| | - G. Argenti
- Researcher, Postgraduate Programme in Health Sciences, Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa, Brazil
| | - C. B. Fadel
- Professor and researcher, Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa, Brazil
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Alzaid F, Julla J, Diedisheim M, Potier C, Potier L, Velho G, Gaborit B, Manivet P, Germain S, Vidal‐Trecan T, Roussel R, Riveline J, Dalmas E, Venteclef N, Gautier J. Monocytopenia, monocyte morphological anomalies and hyperinflammation characterise severe COVID-19 in type 2 diabetes. EMBO Mol Med 2020; 12:e13038. [PMID: 32816392 PMCID: PMC7461002 DOI: 10.15252/emmm.202013038] [Citation(s) in RCA: 40] [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: 06/30/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
Early in the COVID-19 pandemic, type 2 diabetes (T2D) was marked as a risk factor for severe disease and mortality. Inflammation is central to the aetiology of both conditions where variations in immune responses can mitigate or aggravate disease course. Identifying at-risk groups based on immunoinflammatory signatures is valuable in directing personalised care and developing potential targets for precision therapy. This observational study characterised immunophenotypic variation associated with COVID-19 severity in T2D. Broad-spectrum immunophenotyping quantified 15 leucocyte populations in peripheral circulation from a cohort of 45 hospitalised COVID-19 patients with and without T2D. Lymphocytopenia and specific loss of cytotoxic CD8+ lymphocytes were associated with severe COVID-19 and requirement for intensive care in both non-diabetic and T2D patients. A morphological anomaly of increased monocyte size and monocytopenia restricted to classical CD14Hi CD16- monocytes was specifically associated with severe COVID-19 in patients with T2D requiring intensive care. Increased expression of inflammatory markers reminiscent of the type 1 interferon pathway (IL6, IL8, CCL2, INFB1) underlaid the immunophenotype associated with T2D. These immunophenotypic and hyperinflammatory changes may contribute to increased voracity of COVID-19 in T2D. These findings allow precise identification of T2D patients with severe COVID-19 as well as provide evidence that the type 1 interferon pathway may be an actionable therapeutic target for future studies.
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Affiliation(s)
- Fawaz Alzaid
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
| | - Jean‐Baptiste Julla
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of DiabetesClinical Investigation Centre (CIC‐9504)Lariboisière HospitalAssistance Publique – Hôpitaux de ParisParisFrance
| | - Marc Diedisheim
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of DiabetologyCochin HospitalAssistance Publique Hôpitaux de ParisUniversité de ParisParisFrance
| | - Charline Potier
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
| | - Louis Potier
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of Diabetology, Endocrinology and NutritionBichat HospitalAssistance Publique ‐ Hôpitaux de ParisParisFrance
| | - Gilberto Velho
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
| | | | - Philippe Manivet
- Endocrinology, Metabolic Diseases and Nutrition DepartmentAssistance Publique Hôpitaux de MarseilleMarseilleFrance
- Centre de Ressources Biologique “biobank Lariboisière”BB‐0033-00064APHPNordUniversité de ParisParis DiderotHôpital LariboisièreParisFrance
| | - Stéphane Germain
- Center for Interdisciplinary Research in Biology (CIRB)College de France – Centre National de la Recherche Scientifique (CNRS)Institut National de la Santé et de la Recherche Médicale (INSERM)Paris Sciences et Lettres (PSL) Research UniversityParisFrance
| | - Tiphaine Vidal‐Trecan
- Department of DiabetesClinical Investigation Centre (CIC‐9504)Lariboisière HospitalAssistance Publique – Hôpitaux de ParisParisFrance
| | - Ronan Roussel
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of Diabetology, Endocrinology and NutritionBichat HospitalAssistance Publique ‐ Hôpitaux de ParisParisFrance
| | - Jean‐Pierre Riveline
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of DiabetesClinical Investigation Centre (CIC‐9504)Lariboisière HospitalAssistance Publique – Hôpitaux de ParisParisFrance
| | - Elise Dalmas
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
| | - Nicolas Venteclef
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
| | - Jean‐François Gautier
- Cordeliers Research CentreINSERMIMMEDIAB LaboratorySorbonne UniversitéUniversité de ParisParisFrance
- Department of DiabetesClinical Investigation Centre (CIC‐9504)Lariboisière HospitalAssistance Publique – Hôpitaux de ParisParisFrance
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Delgado-Enciso I, Paz-Garcia J, Barajas-Saucedo CE, Mokay-Ramírez KA, Meza-Robles C, Lopez-Flores R, Delgado-Machuca M, Murillo-Zamora E, Toscano-Velazquez JA, Delgado-Enciso J, Melnikov V, Walle-Guillen M, Galvan-Salazar HR, Delgado-Enciso OG, Cabrera-Licona A, Guzman-Esqu J, Montes-Galindo DA, Hernandez-Rangel AE, Montes-Diaz P, Rodriguez-Sanchez IP, Martinez-Fierro ML, Garza-Veloz I, Tiburcio-Jimenez D, Zaizar-Fregoso SA, Ramirez-Flores M, Gaytan-Sandoval G, Martinez-Perez CR, Espinoza-Gómez F, Rojas-Larios F, Hirsch-Meillon MJ, Barrios-Navarro E, Oviedo-Rodriguez V, Rodriguez LMB, Paz-Michel BA. Patient-Reported Health Outcomes After Treatment of COVID-19 with Nebulized and/or Intravenous Neutral Electrolyzed Saline Combined with Usual Medical Care Versus Usual Medical care alone: A Randomized, Open-Label, Controlled Trial. Res Sq 2020. [PMID: 32935090 PMCID: PMC7491578 DOI: 10.21203/rs.3.rs-68403/v1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Coronavirus disease (COVID-19) is currently the main public health problem worldwide. The administration of neutral electrolyzed saline, a solution that contains reactive species of chlorine and oxygen (ROS), may be an effective therapeutic alternative due to its immunomodulating characteristics, in systemic inflammation control, as well as in immune response improvement, promoting control of the viral infection. The present study evaluated the efficacy of treatment with intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care versus usual medical care alone, in ambulatory patients with COVID-19. Methods: A prospective, 2-arm, parallel group, randomized, open-label, phase I-II clinical trial included 39 patients in the control group (usual medical care alone) and 45 patients in the experimental group (usual medical care + intravenous and/or nebulized electrolyzed saline, with dose escalation). Two aspects were evaluated during the twenty-day follow-up: i) the number of patients with disease progression (hospitalization or death); and ii) the Patient Acceptable Symptom State (PASS), a single-question outcome that determines patient well-being thresholds for pain and function. Biochemical and hematologic parameters, as well as adverse effects, were evaluated in the experimental group. Results: The experimental treatment decreased the risk for hospitalization by 92% (adjusted RR=0.08, 95% CI: 0.01–0.50, P=0.007), with a 43-fold increase in the probability of achieving an acceptable symptom state on day 5 (adjusted RR= 42.96, 95% CI: 9.22–200.0, P<0.001). Intravenous + nebulized administration was better than nebulized administration alone, but nebulized administration was better than usual medical care alone. Clinical improvement correlated with a decrease in C-reactive protein, and aberrant monocytes and an increase of lymphocytes, and platelets. Cortisol and testosterone levels were also evaluated, observing a decrease in cortisol levels and an increment of testosterone-cortisol ratio, on days 2 and 4. Conclusions: The experimental treatment produced no serious adverse effects. In conclusion, intravenous and/or nebulized neutral electrolyzed saline importantly reduced the symptomatology and risk of progression (hospitalization and death), in ambulatory patients with COVID-19. Trial registration: Cuban Public Registry of Clinical Trials (RPCEC) Database RPCEC00000309. Registered: 05. May 2020. https://rpcec.sld.cu/en/trials/RPCEC00000309-En
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