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Bellanti F, Kasperczyk S, Kasperczyk A, Dobrakowski M, Pacilli G, Vurchio G, Maddalena A, Quiete S, Lo Buglio A, Capurso C, Serviddio G, Vendemiale G. Alteration of circulating redox balance in coronavirus disease-19-induced acute respiratory distress syndrome. J Intensive Care 2023; 11:30. [PMID: 37408073 DOI: 10.1186/s40560-023-00679-y] [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] [Received: 04/17/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Mechanisms underpinning ARDS induced by COVID-19 are mostly immune-mediated, but need to be completely clarified. This study aimed to investigate redox balance in COVID-19 patients with ARDS, trying to recognize possible differences from typical ARDS related to the pathophysiology of severe disease. METHODS Patients affected by ARDS and positive for the SARS-CoV-2 virus (N = 40, COVID-19) were compared to ARDS patients negative to the molecular test (N = 42, No COVID-19). Circulating markers of redox balance were measured in serum and erythrocytes, and related to markers of inflammation and coagulability. RESULTS No differences in serum markers of oxidative damage were found between both groups, but a reduction in total antioxidant status and serum ceruloplasmin level was observed in COVID-19 rather than No COVID-19 patients. Redox balance alterations were described in erythrocytes from COVID-19 with respect to No COVID-19 group, characterized by increased lipofuscin and malondialdehyde concentration, and reduced glutathione S-transferase and glutathione reductase activity. These markers were associated with circulating indexes of respiratory disease severity (Horowitz index and alveolar-to-arterial oxygen gradient), inflammation (interleukin-6 and interleukin-10), and hypercoagulability (D-dimer) in COVID-19 patients with ARDS. CONCLUSIONS ARDS caused by COVID-19 is sustained by impairment of redox balance, particularly in erythrocytes. This alteration is associated with the pro-inflammatory and pro-coagulant status which characterizes severe COVID-19.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy.
| | - Sławomir Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Michał Dobrakowski
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Gabriella Pacilli
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Giuseppina Vurchio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Alessandro Maddalena
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Stefano Quiete
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Cristiano Capurso
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
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Pawelzik SC, Arnardottir H, Sarajlic P, Mahdi A, Vigor C, Zurita J, Zhou B, Kolmert J, Galano JM, Religa D, Durand T, Wheelock CE, Bäck M. Decreased oxidative stress and altered urinary oxylipidome by intravenous omega-3 fatty acid emulsion in a randomized controlled trial of older subjects hospitalized for COVID-19. Free Radic Biol Med 2023; 194:308-315. [PMID: 36509313 PMCID: PMC9733960 DOI: 10.1016/j.freeradbiomed.2022.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Proinflammatory bioactive lipid mediators and oxidative stress are increased in coronavirus disease 2019 (COVID-19). The randomized controlled single-blind trial COVID-Omega-F showed that intravenous omega-3 polyunsaturated fatty acids (n-3 PUFA) shifted the plasma lipid signature of COVID-19 towards increased proresolving precursor levels and decreased leukotoxin diols, associated with a beneficial immunodulatory response. The present study aimed to determine the effects of n-3 PUFA on the urinary oxylipidome and oxidative stress in COVID-19. From the COVID-Omega-F trial, 20 patients hospitalized for COVID-19 had available serial urinary samples collected at baseline, after 24-48 h, and after completing 5 days treatment with one daily intravenous infusion (2 mL/kg) of either placebo (NaCl; n = 10) or a lipid emulsion containing 10 g of n-3 PUFA per 100 mL (n = 10). Urinary eicosanoids and isoprostanes were analyzed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Erythrocytes obtained at the different time-points from n = 10 patients (n = 5 placebo and n = 5 n-3 PUFA) were used for determination of reactive oxygen species. Intravenous n-3 PUFA emulsion administration altered eicosanoid metabolites towards decreased levels for mediators of inflammation and thrombosis, and increased levels of the endothelial function mediator prostacyclin. Furthermore, non-enzymatic metabolism was skewed towards n-3 PUFA-derived metabolites with potential anti-inflammatory and pro-resolving effects. The oxidative stress marker 15-F2t-isoprostane was significantly lower in patients receiving n-3 PUFA treatment, who also exhibited significantly decreased erythrocyte oxidative stress compared with placebo-treated patients. These findings point to additional beneficial effects of intravenous n-3 PUFA emulsion treatment through a beneficial oxylipin profile and decreased oxidative stress in COVID-19.
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Affiliation(s)
- Sven-Christian Pawelzik
- Department of Medicine, Karolinska Institutet, Theme Heart, Vessels, and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Hildur Arnardottir
- Department of Medicine, Karolinska Institutet, Theme Heart, Vessels, and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Philip Sarajlic
- Department of Medicine, Karolinska Institutet, Theme Heart, Vessels, and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Ali Mahdi
- Department of Medicine, Karolinska Institutet, Theme Heart, Vessels, and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Claire Vigor
- Institut des Biomolécules Max Mousseron, IBMM, UMR 5247, Université de Montpellier, CNRS, ENSCM, Pôle Recherche Chimie Balard, 34293, Cedex 5, Montpellier, France
| | - Javier Zurita
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bingqing Zhou
- Institut des Biomolécules Max Mousseron, IBMM, UMR 5247, Université de Montpellier, CNRS, ENSCM, Pôle Recherche Chimie Balard, 34293, Cedex 5, Montpellier, France
| | - Johan Kolmert
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron, IBMM, UMR 5247, Université de Montpellier, CNRS, ENSCM, Pôle Recherche Chimie Balard, 34293, Cedex 5, Montpellier, France
| | - Dorota Religa
- Department of Neurobiology, Karolinska Institutet and Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron, IBMM, UMR 5247, Université de Montpellier, CNRS, ENSCM, Pôle Recherche Chimie Balard, 34293, Cedex 5, Montpellier, France
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Bäck
- Department of Medicine, Karolinska Institutet, Theme Heart, Vessels, and Neuro, Karolinska University Hospital, Stockholm, Sweden.
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