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Perrotta F, D'Agnano V, Mariniello DF, Castaldo G, Vitale M, Cazzola M, Bianco A, Scialò F. Potential role of SIRT-1 and SIRT-3 as biomarkers for the diagnosis and prognosis of idiopathic pulmonary fibrosis. Respir Res 2024; 25:189. [PMID: 38678247 DOI: 10.1186/s12931-024-02796-0] [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: 03/08/2024] [Accepted: 03/30/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a debilitating and progressive lung disease of unknown aetiology, characterized by the relentless deposition of fibrotic tissue. Biomarkers may play a pivotal role as indicators of disease presence, progression, and treatment response. Sirtuins, a family of enzymes with ADP ribosyltransferase or deacetylase activity, have been implicated in several diseases, including pulmonary fibrosis. METHODS A cross-sectional, prospective, observational single-center study was conducted to investigate the potential role of serum SIRTs levels as biomarkers in patients with IPF. Demographic, clinical, and functional data and serological samples were collected from 34 patients with IPF followed at the Interstital Lung and Rare Diseases Outpatient Clinic of the Vanvitelli Pneumology Clinic, Monaldi Hospital, Naples, Italy and from 19 age-matched controls. RESULTS Serum SIRT-1 levels were significantly reduced in IPF patients compared to controls (median IPF 667 [435-858] pg/mL versus controls 925 [794-1173] pg/mL; p < 0.001 ). In contrast, serum SIRT-3 levels were significantly increased in IPF patients compared to controls (median IPF 338 [230-500] pg/mL versus controls 154 [99.8-246] pg/mL; p < 0.001). There were no statistically significant differences in serum SIRT-6 and SIRT-7 levels between IPF and controls. In addition, we found a significant positive correlation between SIRT-1 and lung function parameters such as FEV1% (ϱ=0.417;p = 0.016), FVC% (ϱ=0.449;p = 0.009) and DLCO% (ϱ=0.393;p = 0.024), while a significant negative correlation was demonstrated between SIR-1 and GAP score, demonstrating a significant reduction in SIRT-1 in advanced Gender-Age-Physiology (GAP) stages 2-3 compared to GAP stage 1 (p = 0.008). CONCLUSIONS This prospective, cross-sectional study showed that SIRT-1 was associated with lung function and IPF severity and that both SIRT-1 and SIRT-3 could be considered as potential biomarkers of IPF, whereas SIRT-6 and SIRT-7 were not associated with IPF.
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Affiliation(s)
- Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania 'L. Vanvitelli', Naples, Italy.
- U.O.C. Clinica Pneumologica L. Vanvitelli, A.O. dei Colli, Monaldi Hospital, Naples, Italy.
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania 'L. Vanvitelli', Naples, Italy
- U.O.C. Clinica Pneumologica L. Vanvitelli, A.O. dei Colli, Monaldi Hospital, Naples, Italy
| | - Domenica Francesca Mariniello
- Department of Translational Medical Sciences, University of Campania 'L. Vanvitelli', Naples, Italy
- U.O.C. Clinica Pneumologica L. Vanvitelli, A.O. dei Colli, Monaldi Hospital, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Maria Vitale
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania 'L. Vanvitelli', Naples, Italy
- U.O.C. Clinica Pneumologica L. Vanvitelli, A.O. dei Colli, Monaldi Hospital, Naples, Italy
| | - Filippo Scialò
- Department of Translational Medical Sciences, University of Campania 'L. Vanvitelli', Naples, Italy
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Naples, Italy
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Scialò F, Vitale M, D'Agnano V, Mariniello DF, Perrotta F, Castaldo A, Campbell SFM, Pastore L, Cazzola M, Bianco A. Lung Microbiome as a Treatable Trait in Chronic Respiratory Disorders. Lung 2023; 201:455-466. [PMID: 37752217 DOI: 10.1007/s00408-023-00645-3] [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: 06/01/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
Once thought to be a sterile environment, it is now established that lungs are populated by various microorganisms that participate in maintaining lung function and play an important role in shaping lung immune surveillance. Although our comprehension of the molecular and metabolic interactions between microbes and lung cells is still in its infancy, any event causing a persistent qualitative or quantitative variation in the composition of lung microbiome, termed "dysbiosis", has been virtually associated with many respiratory diseases. A deep understanding of the composition and function of the "healthy" lung microbiota and how dysbiosis can cause or participate in disease progression will be pivotal in finding specific therapies aimed at preventing diseases and restoring lung function. Here, we review lung microbiome dysbiosis in different lung pathologies and the mechanisms by which these bacteria can cause or contribute to the severity of the disease. Furthermore, we describe how different respiratory disorders can be caused by the same pathogen, and that the real pathogenetic mechanism is not only dependent by the presence and amount of the main pathogen but can be shaped by the interaction it can build with other bacteria, fungi, and viruses present in the lung. Understanding the nature of this bacteria crosstalk could further our understanding of each respiratory disease leading to the development of new therapeutic strategies.
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Affiliation(s)
- Filippo Scialò
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy
- CEINGE-Biotecnologie Avanzate-Franco Salvatore, Naples, Italy
| | - Maria Vitale
- CEINGE-Biotecnologie Avanzate-Franco Salvatore, Naples, Italy
| | - Vito D'Agnano
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Fabio Perrotta
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alice Castaldo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Susan F M Campbell
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucio Pastore
- CEINGE-Biotecnologie Avanzate-Franco Salvatore, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Mario Cazzola
- Dipartimento di Medicina Sperimentale, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Bianco
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy.
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3
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Medusa PM, Gilli M, Notizia L, Pagliaro R, Carro N, Moriello A, D'Agnano V, Bianco A, Perrotta F, Vitiello F. Complete response to pembrolizumab as a single agent in a patient with stage III NSCLC with high PD-L1 expression: a case report. Monaldi Arch Chest Dis 2022; 93. [PMID: 36426899 DOI: 10.4081/monaldi.2022.2440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) accounts for 75-80% of all lung cancer cases. Stage III NSCLC represents a highly heterogenous stage characterized by different disease presentations and a wide range of treatment options. For patients with good performance status and unresectable-stage III NSCLC with programmed death-ligands 1 (PD-L1) tumor proportion score (TPS) ≥1%, durvalumab consolidation immunotherapy after a platinum-based chemo-radiotherapy is strongly recommended. However, age, poor performance status, underlying comorbidities may represent contraindications for chemotherapy to be used in a subgroup of patients. Herein, we report a case of an 80-year-old male affected by a stage IIIB lung adenocarcinoma with overexpression of PD-L1 (TPS 90%) treated with pembrolizumab, an immune checkpoint inhibitor targeting PD-1/PD-L1 pathways, which shows a complete resolution of lung lesion after four cycles of treatment. Although randomized controlled trials are required, this case report may suggest the potential role of pembrolizumab for chemotherapy unsuitable patients with overexpressing PD-L1 unresectable-stage III NSCLC.
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Affiliation(s)
- Paola Maria Medusa
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Marina Gilli
- Unit of Pulmonary Oncology, University of Campania "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Luca Notizia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Raffaella Pagliaro
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Nicola Carro
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Alessandro Moriello
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Fabiana Vitiello
- Unit of Pulmonary Oncology, University of Campania "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
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Komici K, Bencivenga L, Navani N, D'Agnano V, Guerra G, Bianco A, Rengo G, Perrotta F. Frailty in Patients With Lung Cancer: A Systematic Review and Meta-Analysis. Chest 2022; 162:485-497. [PMID: 35217002 DOI: 10.1016/j.chest.2022.02.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 08/29/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Previous studies regarding the prevalence of frailty in patients with lung cancer and mortality in frail patients with lung cancer are inconsistent and require clarification. RESEARCH QUESTION What is the prevalence and impact of frailty in patients with lung cancer? STUDY DESIGN AND METHODS This systematic review and meta-analysis used a combination of free-text terms and medical subject headings terms, according to the database requirements in MEDLINE/PubMed, Scopus, and Cochrane Library from inception until November 15, 2020. RESULTS A total of 2,571 articles were identified, and 16 articles involving 4,183 patients were included for study. The prevalence of frailty in lung cancer was 45% (95% CI, 28-61; I2 = 99.5%; P < .0001). In patients with lung cancer, frailty was associated with an increased hazard ratio for mortality (hazard ratio, 3.01; 95% CI, 1.77-5.10; P < .001). INTERPRETATION The prevalence of frailty in lung cancer is 45%, which has a significant negative impact on survival of patients with lung cancer. These results highlight the importance of measuring frailty, which provides important prognostic information, and may provide opportunities for interventions to improve outcomes in patients with lung cancer.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Leonardo Bencivenga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II," Naples, Italy; Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Toulouse, France
| | - Neal Navani
- Division of Medicine, Lungs for Living Research Centre, UCL Respiratory, University College London, London, England; Department of Thoracic Medicine, University College London Hospital, London, England
| | - Vito D'Agnano
- Department of Translational Medicine, University of Campania "L. Vanvitelli," Naples, Italy
| | - Germano Guerra
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Andrea Bianco
- Department of Translational Medicine, University of Campania "L. Vanvitelli," Naples, Italy
| | - Giuseppe Rengo
- Istituti Clinici Scientifici ICS Maugeri-S.p.A.-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Scientifico di Telese Terme, Telese, Italy; Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Fabio Perrotta
- U.O.C. Pneumology A.O.R.N. Sant'Anna e San Sebastiano, Caserta, Italy
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Parrella R, Marra A, Scarano F, Manzillo E, Esposito V, Punzi R, Fragranza F, D'Agnano V, Cazzola M, Bianco A. [Corticosteroids and delayed conversion of SARS-CoV-2 RNA nasopharyngeal swabs in hospitalized patients with COVID 19 pneumonia]. Arch Bronconeumol 2021; 58:55-58. [PMID: 34866749 PMCID: PMC8627005 DOI: 10.1016/j.arbres.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Roberto Parrella
- UOC Malattie Infettive ad Indirizzo Respiratorio, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Alberto Marra
- Dipartimento Malattie Infettive e Urgenze Infettivologiche, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Francesco Scarano
- UOC Malattie Infettive ad Indirizzo Respiratorio, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Elio Manzillo
- UOC Malattie Infettive e dell'Immigrazione, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Vincenzo Esposito
- UOC Malattie Infettive e Medicina di Genere, Cotugno Hospital AORN Ospedali dei Colli, Napoli, Italy
| | - Rodolfo Punzi
- UOC Malattie Infettive ad Indirizzo Epato-Oncologico e dei Trapianti, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Fiorentino Fragranza
- UOC Anestesia, Rianimazione e Terapia Intensiva, Cotugno Hospital, AORN Ospedali dei Colli, Napoli, Italy
| | - Vito D'Agnano
- Dipartimento di Scienze Mediche Traslazionali, University of Campania "L. Vanvitelli", Napoli, Italy
| | - Mario Cazzola
- Dipartimento di Medicina Sperimentale, University of Rome "Tor Vergata", Roma, Italy
| | - Andrea Bianco
- Dipartimento di Scienze Mediche Traslazionali, University of Campania "L. Vanvitelli", Napoli, Italy
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6
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Bianco A, D'Agnano V, Matera MG, Della Gravara L, Perrotta F, Rocco D. Immune checkpoint inhibitors: a new landscape for extensive stage small cell lung cancer treatment. Expert Rev Respir Med 2021; 15:1415-1425. [PMID: 34374626 DOI: 10.1080/17476348.2021.1964362] [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: 10/20/2022]
Abstract
Introduction: Landscape of Extensive Stage (ES)-SCLC treatment has been unchanged over the years. Chemotherapy, mostly based on cisplatin and etoposide, remained the standard-of-care for patients with ES-SCLC for almost 40 years. Recently, immune check points inhibitors have emerged marking a turning point for ES-SCLC treatmentAreas covered: Aim of the paper is to discuss ICIs impact on ES-SCLC treatment algorithms, review current clinical trials, and explore future perspectives.Expert opinion: A growing body of evidence supports ICI-containing regimens as a new mainstay of ES-SCLC treatment. Whether subgroups of SCLC patients may have greater survival benefits from ICIs treatment needs to be better defined. Understanding the impact of tumor microenvironment and identifying reliable predictive and/or prognostic biomarkers will be fundamental to move toward a personalized treatment approach leading to improved survival.
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Affiliation(s)
- Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,Department of Pneumology and Oncology- A.o Dei Colli - Monaldi Hospital, Napoli, Italy
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,Department of Pneumology and Oncology- A.o Dei Colli - Monaldi Hospital, Napoli, Italy
| | - Maria Gabriella Matera
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Luigi Della Gravara
- Department of Pneumology and Oncology- A.o Dei Colli - Monaldi Hospital, Napoli, Italy
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Danilo Rocco
- Department of Pneumology and Oncology- A.o Dei Colli - Monaldi Hospital, Napoli, Italy
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Perrotta F, Corbi G, Mazzeo G, Boccia M, Aronne L, D'Agnano V, Komici K, Mazzarella G, Parrella R, Bianco A. COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging Clin Exp Res 2020; 32:1599-1608. [PMID: 32557332 PMCID: PMC7298699 DOI: 10.1007/s40520-020-01631-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [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] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/06/2020] [Indexed: 02/06/2023]
Abstract
The elderly may represent a specific cluster of high-risk patients for developing COVID-19 with rapidly progressive clinical deterioration. Indeed, in older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening respiratory failure and multisystemic involvement. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and polypharmacotherapy. Our review examines the pathogenesis and clinical implications of ageing in COVID-19 patients; finally, we discuss the evidence and controversies in the management in the long-stay residential care homes and aspects of end-of-life care for elderly patients with COVID-19.
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Affiliation(s)
- Fabio Perrotta
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy.
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy
- Italian Society of Gerontology and Geriatrics (SIGG), Florence, Italy
| | - Grazia Mazzeo
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
- COVID-19 Unit, Infectious Disease Department, University of Campania "L. Vanvitelli", 80131, Naples, Italy
| | - Matilde Boccia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Luigi Aronne
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Klara Komici
- Department of Medicine and Health Sciences, "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy
- Italian Society of Gerontology and Geriatrics (SIGG), Florence, Italy
| | - Gennaro Mazzarella
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
| | - Roberto Parrella
- COVID Unit D, Department of Infectious Diseases, Cotugno Hospital, A.O.R.N. dei Colli, Naples, Italy
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"/Hosp. Monaldi, 80131, Naples, Italy
- COVID-19 Unit, Infectious Disease Department, University of Campania "L. Vanvitelli", 80131, Naples, Italy
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8
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Boccia M, Aronne L, Celia B, Mazzeo G, Ceparano M, D'Agnano V, Parrella R, Valente T, Bianco A, Perrotta F. COVID-19 and coagulative axis: review of emerging aspects in a novel disease. Monaldi Arch Chest Dis 2020; 90. [PMID: 32425013 DOI: 10.4081/monaldi.2020.1300] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
Latest evidences from literature suggest that SARS-CoV-2 disease 2019 (COVID-19) is commonly complicated with coagulopathy and that disseminated intravascular coagulation is present in the majority of deceased patients. Particularly, conventional coagulation parameters appear to be significantly altered in patients with poor prognosis. A wide-ranging cross- talk between coagulative haemostasis and inflammation, as well as the activation of coagulation cascade during viral infections, are well established. Another important evidence which may explain coagulation disorders in COVID-19 is the increase of thrombus formation under conditions of hypoxia. Despite the exact pathophysiological mechanism of coronavirus-induced thromboembolism needs to be further investigated, this finding suggests that it is good practice to assess the risk of thrombosis in COVID-19 patients to improvethe clinical management in terms of anticoagulation therapy. Anticoagulants, mainly low-molecular-weight heparin (LMWH), should be tailored in patients meeting sepsis induced coagulopathy (SIC) criteria or with markedly elevated D-dimer. In this context, further studies are needed to optimise the decision making in therapeutic approach.
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Affiliation(s)
- Matilde Boccia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Luigi Aronne
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Benito Celia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Grazia Mazzeo
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Maria Ceparano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Roberto Parrella
- Department of Infectious Diseases, COVID Unit D, Cotugno Hospital, A.O.R.N. dei Colli, Naples.
| | - Tullio Valente
- Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples.
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples.
| | - Fabio Perrotta
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso.
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9
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Nigro E, Perrotta F, Polito R, D'Agnano V, Scialò F, Bianco A, Daniele A. Metabolic Perturbations and Severe COVID-19 Disease: Implication of Molecular Pathways. Int J Endocrinol 2020; 2020:8896536. [PMID: 33312199 PMCID: PMC7703458 DOI: 10.1155/2020/8896536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/04/2020] [Accepted: 11/17/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease (COVID-19) is caused by SARS-CoV-2 virus, which can result in serious respiratory illnesses such as pneumonia leading to respiratory failure. It was first reported in Wuhan, Hubei, China, in December 2019 and rapidly spread globally, becoming a pandemic in March 2020. Among comorbidities observed in SARS-CoV-2 positive patients, hypertension (68.3%) and type 2-diabetes (30.1%) are the most frequent conditions. Although symptoms are highly heterogeneous (ranging from absence of symptoms to severe acute respiratory failure), patients with metabolic-associated diseases often experience worse COVID-19 outcomes. This review investigates the association between metabolic disorders and COVID-19 severity, exploring the molecular mechanisms potentially underlying this relationship and those that are responsible for more severe COVID-19 outcomes. In addition, the role of the main biological processes that may connect metabolic alterations to SARS-CoV-2 infection such as hyperglycemia, immune system deregulation, ACE-2 receptor modulation, and inflammatory response is described. The impact of metabolic disorders on the prognosis of COVID-19 has major implications in public health especially for countries affected by a high incidence of metabolic diseases.
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Affiliation(s)
- Ersilia Nigro
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, Università Degli Studi Della Campania “Luigi Vanvitelli”, Via G. Vivaldi 42, Caserta 81100, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, Napoli 80145, Italy
| | - Fabio Perrotta
- Dipartimento di Medicina e Scienze Della Salute “V. Tiberio”, Università Del Molise, Campobasso 86100, Italy
| | - Rita Polito
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, Napoli 80145, Italy
| | - Vito D'Agnano
- Dipartimento di Scienze Mediche Traslazionali e Chirurgiche, Università Della Campania “L. Vanvitelli”, Napoli 80131, Italy
| | - Filippo Scialò
- Dipartimento di Scienze Mediche Traslazionali e Chirurgiche, Università Della Campania “L. Vanvitelli”, Napoli 80131, Italy
| | - Andrea Bianco
- Dipartimento di Scienze Mediche Traslazionali e Chirurgiche, Università Della Campania “L. Vanvitelli”, Napoli 80131, Italy
| | - Aurora Daniele
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, Università Degli Studi Della Campania “Luigi Vanvitelli”, Via G. Vivaldi 42, Caserta 81100, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, Napoli 80145, Italy
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