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Khan MS, Talha KM, Maqsood MH, Rymer JA, Borlaug BA, Docherty KF, Pandey A, Kahles F, Cikes M, Lam CS, Ducharme A, Voors AA, Hernandez AF, Lincoff AM, Petrie MC, Ridker PM, Fudim M. Interleukin-6 and Cardiovascular Events in Healthy Adults: MESA. JACC. ADVANCES 2024; 3:101063. [PMID: 39077632 PMCID: PMC11284704 DOI: 10.1016/j.jacadv.2024.101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 07/31/2024]
Abstract
Background Elevated interleukin (IL)-6 levels have been linked to adverse outcomes in patients with and without baseline cardiovascular disease (CVD). Objectives The purpose of this study was to examine the association between circulating IL-6 levels and CVD events without baseline CVD across racial and ethnic groups. Methods We conducted an observational analysis utilizing the MESA (Multi-Ethnic Study of Atherosclerosis), a multicenter, prospective community-based study of CVD at baseline from four racial and ethnic groups. IL-6 levels were measured at the time of enrollment (visit 1) and were divided into 3 terciles. Patient baseline characteristics and outcomes, including all-cause mortality, CV mortality, heart failure, and non-CV mortality, were included. Cox proportional hazard regression models were used to assess associations between IL-6 levels and study outcomes with IL-6 tercile 1 as reference. Results Of 6,622 individuals, over half were women (53%) with a median age of 62 (IQR: 53-70) years. Racial and ethnic composition was non-Hispanic White (39%) followed by African American (27%), Hispanic (22%), and Chinese American (12%). Compared to tercile 1, participants with IL-6 tercile 3 had a higher adjusted risk of and all-cause mortality (HR: 1.98 [95% CI: 1.67-2.36]), CV mortality (HR: 1.55 [95% CI: 1.05-2.30]), non-CV mortality (HR: 2.05 [95% CI: 1.65-2.56]), and heart failure (HR: 1.48 [95% CI: 0.99-2.19]). When tested as a continuous variable, higher levels of IL-6 were associated with an increased risk of all individual outcomes. Compared to non-Hispanic White participants, the unadjusted and adjusted risk of all outcomes across all races and ethnicities was similar across all IL-6 terciles. Conclusions High levels of circulating IL-6 are associated with worse CV outcomes and increased all-cause mortality consistently across all racial and ethnic groups.
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Affiliation(s)
- Muhammad Shahzeb Khan
- Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Khawaja M. Talha
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Muhammad Haisum Maqsood
- Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA
| | - Jennifer A. Rymer
- Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Barry A. Borlaug
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Kieran F. Docherty
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Florian Kahles
- Department of Internal Medicine I-Cardiology, University Hospital Aachen, Aachen, Germany
| | - Maja Cikes
- University of Zagreb School of Medicine, University Hospital Centre, Zagreb, Croatia
| | | | - Anique Ducharme
- Institut de Cardiologie, de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Adrian A. Voors
- Department of Cardiology, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands
| | - Adrian F. Hernandez
- Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - A. Michael Lincoff
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mark C. Petrie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul M. Ridker
- Center for Cardiovascular Disease Prevention, Division of Preventive Medicine and the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Marat Fudim
- Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Lugtenburg A, Zuidersma M, Rius Ottenheim N, Rhebergen D, Oude Voshaar RC. Age-related subtypes of late life depression and mortality: A prospective clinical cohort study. Int J Geriatr Psychiatry 2024; 39:e6064. [PMID: 38342779 DOI: 10.1002/gps.6064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/27/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Late Life Depression (LLD) is associated with increased mortality rates, but it remains unclear which depressed patients are at increased risk. This study examined the mortality risk of previously identified subgroups of depressed older patients based on age-related clinical features (the presence of physical and cognitive frailty). METHODS A six-year follow-up of a clinical cohort study including 375 depressed older patients and 132 non-depressed persons (NESDO). Depressed patients were diagnosed with the Composite International Diagnostic Interview (CIDI) according to DSM-IV criteria and classified by latent profile analysis on depressive symptom severity, cognitive domains and physical frailty. We estimated the hazard rate of mortality for the four depressed subgroups compared to non-depressed persons by applying Cox-regression analyses. Models were adjusted for age, sex and education as confounders and for explanatory variables per pathway in separate models: somatic burden, lifestyle characteristics, vascular burden or inflammation markers. RESULTS A total of 61/375 (16.3%) depressed patients and 8/132 (6.1%) non-depressed persons died during the 6-year follow-up. Two of the four subgroups (n = 186/375 (50%) of the depressed sample) had a higher hazard rate (HR) for mortality compared to non-depressed participants, that is, frail-depressed patients (HR = 5.25, [95%-CI: 2.13-13.0]) and pure mild depressed patients (HR = 3.32 [95%-CI: 1.46-7.58]) adjusted for confounders. Adding possible underlying pathways did not explain these associations. CONCLUSIONS Age-related features (the presence of physical and cognitive frailty) contribute to the increased mortality risk in late-life depression. Future studies in depressed older patients should study the additional value of a clinical geriatric assessment and integrated treatment aimed to at reduce frailty and ameliorate their mortality risk.
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Affiliation(s)
- Astrid Lugtenburg
- Department Old Age Psychiatry, GGZ Drenthe Mental Health Institute, Assen, The Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands
| | | | - Didi Rhebergen
- Department of Psychiatry, Amsterdam UMC-Location VU University Medical Center & GGZ Centraal Specialized Mental Health Care, Amersfoort, The Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands
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Hua T, Chu Y, Wang M, Zhang Y, Shi W, Huang Q, Zhang L, Yang M. Protective effect of canagliflozin on post-resuscitation myocardial function in a rat model of cardiac arrest. Intensive Care Med Exp 2023; 11:78. [PMID: 37966667 PMCID: PMC10651816 DOI: 10.1186/s40635-023-00562-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Currently, most patients with cardiac arrest (CA) show reversible myocardial dysfunction, hemodynamic instability, systemic inflammation and other pathophysiological state in early stage of resuscitation, some patients may eventually progress to multiple organ failure. There is evidence that heart failure is the terminal stage in the development of various cardiovascular diseases. Although the cardio-protective effect of canagliflozin (CANA) has been confirmed in large clinical studies and recommended in domestic and international heart failure-related guidelines, the effectiveness of CANA after resuscitation remains unclear. In this study, we constructed a modified CA/CPR rat model to investigate whether CANA administered on post-resuscitation improves myocardial function. METHODS Twenty-fourth healthy male Sprague-Dawley rats were randomized into four groups: (1) Sham + placebo group, (2) Sham + CANA group, (3) CPR + placebo group, and (4) CPR + CANA group. Ventricular fibrillation was induced by transcutaneous electrical stimulation on epicardium. After 6 min untreated ventricular fibrillation, chest compressions was initiated. The rats were received an injection of placebo or canagliflozin (3 ug/kg) randomly 15 min after restore of spontaneous circulation (ROSC). Electrocardiogram (ECG) and blood pressure were continuously detected in each group throughout the experiment. The rats were killed 6 h after ROSC to collected the arterial serum and myocardial tissue. Myocardial injury was estimated with concentrations of inflammatory factors, oxidative stress indexes and, apoptosis index, myocardial injury markers, echocardiography and myocardial pathological slices. RESULTS After resuscitation, mean arterial pressure (MAP) were significantly increased after cardiopulmonary resuscitation in CANA group rats when compared with placebo group. Heart rate, body lactate returned and left ventricular ejection fraction (LVEF) to normal levels in a shorter time and the myocardial injury was obviously attenuated in CPR + CANA group. Inflammatory factors (IL-6, TNF-α) and oxidative stress indexes (MAD, SOD, CAT) were dramatically decreased with the administration of CANA. The expression of apoptosis index (BAX, caspase-3) were higher in CPR + placebo group and the expression of anti-apoptosis index (Bcl-2) was lower (P < 0.05). CONCLUSIONS The administration of CANA effectively reduces myocardial ischaemia/reperfusion (I/R) injury after cardiac arrest and cardiopulmonary resuscitation (CPR), and the underlying mechanism may be related to anti-inflammation, oxidative stress and apoptosis.
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Affiliation(s)
- Tianfeng Hua
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Yuqian Chu
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Minjie Wang
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Yijun Zhang
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Wei Shi
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Qihui Huang
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Liangliang Zhang
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China
| | - Min Yang
- The Second Department of Critical Care Medicine and The Laboratory of Cardiopulmonary Resuscitation and Critical Care, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui Province, China.
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5
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Sutin AR, Stephan Y, Luchetti M, Terracciano A. Purpose in life and markers of immunity and inflammation: Testing pathways of episodic memory. J Psychosom Res 2023; 174:111487. [PMID: 37696089 PMCID: PMC10591954 DOI: 10.1016/j.jpsychores.2023.111487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE This prospective cohort study examines whether purpose in life is associated with markers of immunity and inflammation and tests these markers as mediators between purpose and episodic memory. METHODS Participants from the Venous Blood Study of the Health and Retirement Study reported on their purpose in life, had their blood assayed for markers of immunity and inflammation, and were administered an episodic memory task (N = 8999). Regression analyses tested the association between purpose and each marker. Prospective mediation analyses (N = 6092) tested whether these markers measured in 2016 were mediators between purpose measured in 2012/2014 and episodic memory measured in 2018. RESULTS Higher purpose in life was associated with lower neutrophil counts (β = -0.08, p < .001), lower ratio of neutrophils/lymphocytes (β = -0.05, p < .001), and lower systemic immune inflammation index (β = -0.04, p < .001); purpose was unrelated to monocyte, platelet, and lymphocyte counts or the ratio of platelets/lymphocytes (all ns). Purpose was associated negatively with c-reactive protein (β = -0.07, p < .001), Interleukin-6 (β = -0.08, p < .001), Interleukin-10 (β = -0.07, p < .001), Interleukin-1ra (β = -0.08, p < .001), and soluble Tumor Necrosis Factor Receptor 1 (sTNFR1; β = -0.10, p < .001); purpose was unrelated to Transforming Growth Factor beta 1. These associations were largely not moderated by age, sex, race, ethnicity, and education. Lower neutrophils, Interleukin-6, and sTNFR1 were associated prospectively with better episodic memory and mediated the association between purpose and episodic memory. CONCLUSION Purpose in life is associated with markers of immunity and inflammation, some of which are one mechanism in the pathway between purpose and healthier episodic memory.
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Napiórkowska-Baran K, Schmidt O, Szymczak B, Lubański J, Doligalska A, Bartuzi Z. Molecular Linkage between Immune System Disorders and Atherosclerosis. Curr Issues Mol Biol 2023; 45:8780-8815. [PMID: 37998729 PMCID: PMC10670175 DOI: 10.3390/cimb45110552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
A strong relationship exists between immune dysfunction and cardiovascular disease. Immune dysregulation can promote the development of cardiovascular diseases as well as exacerbate their course. The disorders may occur due to the presence of primary immune defects (currently known as inborn errors of immunity) and the more common secondary immune deficiencies. Secondary immune deficiencies can be caused by certain chronic conditions (such as diabetes, chronic kidney disease, obesity, autoimmune diseases, or cancer), nutritional deficiencies (including both lack of nutrients and bioactive non-nutrient compounds), and medical treatments and addictive substances. This article unravels the molecular linkage between the aforementioned immune system disorders and atherosclerosis.
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Affiliation(s)
- Katarzyna Napiórkowska-Baran
- Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland;
| | - Oskar Schmidt
- Student Research Club of Clinical Immunology, Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland; (O.S.); (B.S.); (J.L.); (A.D.)
| | - Bartłomiej Szymczak
- Student Research Club of Clinical Immunology, Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland; (O.S.); (B.S.); (J.L.); (A.D.)
| | - Jakub Lubański
- Student Research Club of Clinical Immunology, Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland; (O.S.); (B.S.); (J.L.); (A.D.)
| | - Agata Doligalska
- Student Research Club of Clinical Immunology, Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland; (O.S.); (B.S.); (J.L.); (A.D.)
| | - Zbigniew Bartuzi
- Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, 85-067 Bydgoszcz, Poland;
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Gupta L, Thomas J, Ravichandran R, Singh M, Nag A, Panjiyar BK. Inflammation in Cardiovascular Disease: A Comprehensive Review of Biomarkers and Therapeutic Targets. Cureus 2023; 15:e45483. [PMID: 37859889 PMCID: PMC10584272 DOI: 10.7759/cureus.45483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Cardiovascular disorders (CVDs) represent a global challenge and are regarded as one of the leading causes of mortality. The role of inflammation as a risk factor in these disorders has been studied, with the accelerated atherosclerotic process being a crucial factor in the pathogenesis. Several inflammatory biomarkers such as C-reactive protein (CRP), Interleukins (ILs), Tumor Necrosis Factor-alpha (TNF-α), and others have been identified that play a role in the atherosclerotic process, thus linking systemic inflammatory conditions with CVDs, including acute myocardial infarction (AMI), chronic heart failure (CHF), venous thromboembolism (VTE) and others. These markers could be used to predict the risk of CVDs. Understanding the precise mechanisms can lead to therapeutic strategies targeted at pro-inflammatory processes. We aim to provide an overview of the existing literature on the role of inflammation in various cardiovascular disorders and identify different inflammatory biomarkers and therapeutic targets in this comprehensive literature review. We reviewed 190 references published between 2013 and August 3, 2023, in well-reputed journals and analyzed eight selected papers in-depth. We describe the pathophysiologic pathways that lead to atherosclerosis and other cardiovascular pathologies. Several inflammatory cytokines encompassing various groups were identified to be causing endothelial dysfunction, leading to an increased risk for CVDs. Polymorphisms in the genes for different cytokines also led to different levels of susceptibility to CVDs. Nevertheless, future research detailing the inflammatory pathways and their link with CVDs would lead to better outcomes for patients with preexisting and new onset of CVDs as well as chronic inflammatory disorders.
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Affiliation(s)
- Lovish Gupta
- Internal Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Jingle Thomas
- Internal Medicine, Al-Ameen Medical College, Vijayapura, IND
| | | | - Mansi Singh
- Department of Medicine, O. O. Bogomolets National Medical University, Kyiv, UKR
| | - Aiswarya Nag
- Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Binay K Panjiyar
- Global Clinical Scholars Research Training (GCSRT) and Postgraduate Medical Education (PGME), Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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8
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Mao Q, Deng M, Zhao J, Zhou D, Chen M, Liu Q, Xu S, Zhao X. Low serum Klotho reflects senile inflammation in middle-aged and elderly patients with coronary atherosclerosis. Cytokine 2023; 167:156213. [PMID: 37121091 DOI: 10.1016/j.cyto.2023.156213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Anti-aging protein Klotho has been reported to be associated with atherosclerosis, which was considered as a chronic inflammatory disease. However, the relationship between Klotho and senile inflammation remained unclear. The present study aims to ascertain the correlation of Klotho with inflammation in middle-aged and elderly coronary atherosclerotic disease (CAD). METHODS A total of 302 patients with CAD were included in this study. Coronary atherosclerosis was confirmed and quantified for all patients by coronary angiography. Serum Klotho was detected by enzyme linked immunosorbent assay. Serum concentrations of IL-6 and IL-8 were quantified by chemiluminescence assay. T-lymphocyte subsets were measured using flow cytometry. RESULTS Multivariate linear regression analysis showed that serum Klotho was an independent predictor for circulating monocytes (standard β = -0.321, P < 0.001) and CD4+/CD8+ ratio (standard β = -0.522, P < 0.001). After adjustment, serum Klotho was still independently associated with IL-6 (standard β = -0.395, P < 0.001) and IL-8 (standard β = -0.296, P < 0.001). Moreover, circulating monocytes, CD4+ and CD8+ lymphocytes were correlated with increased serum concentrations of IL-6 and IL-8, independent of CRP (P < 0.05). In receiver operating characteristic curve analysis, CD4+/CD8+ ratio (AUC = 0.863, P < 0.001), IL-6 (AUC = 0.893, P < 0.001) and IL-8 (AUC = 0.884, P < 0.001) presented the excellent predictive performance for significant CAD. CONCLUSIONS Decreased concentrations in serum Klotho reflect senile inflammation, which is related to the severity of CAD in middle-aged and elderly patients.
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Affiliation(s)
- Qi Mao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Mengyang Deng
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Jianhua Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Denglu Zhou
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Man Chen
- Department of Clinical Laboratory, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Qingsong Liu
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
| | - Shangcheng Xu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China; Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China.
| | - Xiaohui Zhao
- Department of Cardiology, Institute of Cardiovascular Research, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
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Grasmann J, Almenräder F, Voracek M, Tran US. Only Small Effects of Mindfulness-Based Interventions on Biomarker Levels of Inflammation and Stress: A Preregistered Systematic Review and Two Three-Level Meta-Analyses. Int J Mol Sci 2023; 24:ijms24054445. [PMID: 36901875 PMCID: PMC10003032 DOI: 10.3390/ijms24054445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
Mindfulness-based interventions (MBIs) have a positive effect on biomarkers of inflammation and stress in patients with psychiatric disorders and physical illnesses. Regarding subclinical populations, results are less clear. The present meta-analysis addressed the effects of MBIs on biomarkers in psychiatric populations and among healthy, stressed, and at-risk populations. All available biomarker data were investigated with a comprehensive approach, using two three-level meta-analyses. Pre-post changes in biomarker levels within treatment groups (k = 40 studies, total N = 1441) and treatment effects compared to control group effects, using only RCT data (k = 32, total N = 2880), were of similar magnitude, Hedges g = -0.15 (95% CI = [-0.23, -0.06], p < 0.001) and g = -0.11 (95% CI = [-0.23, 0.001], p = 0.053). Effects increased in magnitude when including available follow-up data but did not differ between type of sample, MBI, biomarker, and control group or duration of the MBI. This suggests that MBIs may ameliorate biomarker levels in both psychiatric and subclinical populations to a small extent. However, low study quality and evidence of publication bias may have impacted on the results. More large and preregistered studies are still needed in this field of research.
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Dimosiari A, Patoulias D, Kitas GD, Dimitroulas T. Do Interleukin-1 and Interleukin-6 Antagonists Hold Any Place in the Treatment of Atherosclerotic Cardiovascular Disease and Related Co-Morbidities? An Overview of Available Clinical Evidence. J Clin Med 2023; 12:jcm12041302. [PMID: 36835838 PMCID: PMC9962740 DOI: 10.3390/jcm12041302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Cardiovascular disease (CVD) constitutes a real pandemic of the 21st century. According to data from the Centers for Disease Control and Prevention, one person dies every 34 min due to some form of CVD in the United States. Apart from the extremely high morbidity and mortality accompanying CVD, the economic burden seems to be unbearable even for developed countries in the Western World. The role of inflammation in the development and progression of CVD appears to be crucial, while, various inflammatory pathways, such as the Nod-like receptor protein 3 (NLRP3) inflammasome-interleukin (IL)-1/IL-6 pathway of the innate immunity, have attracted scientific interest during the last decade, as a potential treatment target in primary and/or secondary prevention of CVD. Whereas there is a significant amount of evidence, stemming mainly from observational studies, concerning the cardiovascular safety of IL-1 and IL-6 antagonists in patients with rheumatic diseases, evidence from relevant randomized controlled trials (RCTs) is rather scarce and conflicting, especially for patients without underlying rheumatic disease. In this review, we summarize and critically present the currently available evidence, both from RCTs and observational studies, concerning the place that IL-1 and IL-6 antagonists may hold in the treatment of CVD.
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Affiliation(s)
- Athina Dimosiari
- Second Department of Internal Medicine, European Interbalkan Medical Center, 57001 Thessaloniki, Greece
| | - Dimitrios Patoulias
- Second Department of Internal Medicine, European Interbalkan Medical Center, 57001 Thessaloniki, Greece
- Outpatient Department of Cardiometabolic Medicine, Second Department of Cardiology, General Hospital Hippokration, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Correspondence:
| | - George D. Kitas
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK
| | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine, General Hospital Hippokration, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
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Inflammageing and Cardiovascular System: Focus on Cardiokines and Cardiac-Specific Biomarkers. Int J Mol Sci 2023; 24:ijms24010844. [PMID: 36614282 PMCID: PMC9820990 DOI: 10.3390/ijms24010844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
The term "inflammageing" was introduced in 2000, with the aim of describing the chronic inflammatory state typical of elderly individuals, which is characterized by a combination of elevated levels of inflammatory biomarkers, a high burden of comorbidities, an elevated risk of disability, frailty, and premature death. Inflammageing is a hallmark of various cardiovascular diseases, including atherosclerosis, hypertension, and rapid progression to heart failure. The great experimental and clinical evidence accumulated in recent years has clearly demonstrated that early detection and counteraction of inflammageing is a promising strategy not only to prevent cardiovascular disease, but also to slow down the progressive decline of health that occurs with ageing. It is conceivable that beneficial effects of counteracting inflammageing should be most effective if implemented in the early stages, when the compensatory capacity of the organism is not completely exhausted. Early interventions and treatments require early diagnosis using reliable and cost-effective biomarkers. Indeed, recent clinical studies have demonstrated that cardiac-specific biomarkers (i.e., cardiac natriuretic peptides and cardiac troponins) are able to identify, even in the general population, the individuals at highest risk of progression to heart failure. However, further clinical studies are needed to better understand the usefulness and cost/benefit ratio of cardiac-specific biomarkers as potential targets in preventive and therapeutic strategies for early detection and counteraction of inflammageing mechanisms and in this way slowing the progressive decline of health that occurs with ageing.
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12
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Yanai H, Adachi H, Hakoshima M, Katsuyama H. Atherogenic Lipoproteins for the Statin Residual Cardiovascular Disease Risk. Int J Mol Sci 2022; 23:ijms232113499. [PMID: 36362288 PMCID: PMC9657259 DOI: 10.3390/ijms232113499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Randomized controlled trials (RCTs) show that decreases in low-density lipoprotein cholesterol (LDL-C) by the use of statins cause a significant reduction in the development of cardiovascular disease (CVD). However, one of our previous studies showed that, among eight RCTs that investigated the effect of statins vs. a placebo on CVD development, 56–79% of patients had residual CVD risk after the trials. In three RCTs that investigated the effect of a high dose vs. a usual dose of statins on CVD development, 78–87% of patients in the high-dose statin arms still had residual CVD risk. The risk of CVD development remains even when statins are used to strongly reduce LDL-C, and this type of risk is now regarded as statin residual CVD risk. Our study shows that elevated triglyceride (TG) levels, reduced high-density lipoprotein cholesterol (HDL-C), and the existence of obesity/insulin resistance and diabetes may be important metabolic factors that determine statin residual CVD risk. Here, we discuss atherogenic lipoproteins that were not investigated in such RCTs, such as lipoprotein (a) (Lp(a)), remnant lipoproteins, malondialdehyde-modified LDL (MDA-LDL), and small-dense LDL (Sd-LDL). Lp(a) is under strong genetic control by apolipoprotein (a), which is an LPA gene locus. Variations in the LPA gene account for 91% of the variability in the plasma concentration of Lp(a). A meta-analysis showed that genetic variations at the LPA locus are associated with CVD events during statin therapy, independent of the extent of LDL lowering, providing support for exploring strategies targeting circulating concentrations of Lp(a) to reduce CVD events in patients receiving statins. Remnant lipoproteins and small-dense LDL are highly associated with high TG levels, low HDL-C, and obesity/insulin resistance. MDA-LDL is a representative form of oxidized LDL and plays important roles in the formation and development of the primary lesions of atherosclerosis. MDA-LDL levels were higher in CVD patients and diabetic patients than in the control subjects. Furthermore, we demonstrated the atherogenic properties of such lipoproteins and their association with CVD as well as therapeutic approaches.
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Affiliation(s)
- Hidekatsu Yanai
- Correspondence: ; Tel.: +81-473-72-3501; Fax: +81-473-72-1858
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13
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Repurposing SGLT-2 Inhibitors to Target Aging: Available Evidence and Molecular Mechanisms. Int J Mol Sci 2022; 23:ijms232012325. [PMID: 36293181 PMCID: PMC9604287 DOI: 10.3390/ijms232012325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
Caloric restriction promotes longevity in multiple animal models. Compounds modulating nutrient-sensing pathways have been suggested to reproduce part of the beneficial effect of caloric restriction on aging. However, none of the commonly studied caloric restriction mimetics actually produce a decrease in calories. Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) are a class of drugs which lower glucose by promoting its elimination through urine, thus inducing a net loss of calories. This effect promotes a metabolic shift at the systemic level, fostering ketones and fatty acids utilization as glucose-alternative substrates, and is accompanied by a modulation of major nutrient-sensing pathways held to drive aging, e.g., mTOR and the inflammasome, overall resembling major features of caloric restriction. In addition, preliminary experimental data suggest that SGLT-2i might also have intrinsic activities independent of their systemic effects, such as the inhibition of cellular senescence. Consistently, evidence from both preclinical and clinical studies have also suggested a marked ability of SGLT-2i to ameliorate low-grade inflammation in humans, a relevant driver of aging commonly referred to as inflammaging. Considering also the amount of data from clinical trials, observational studies, and meta-analyses suggesting a tangible effect on age-related outcomes, such as cardiovascular diseases, heart failure, kidney disease, and all-cause mortality also in patients without diabetes, here we propose a framework where at least part of the benefit provided by SGLT-2i is mediated by their ability to blunt the drivers of aging. To support this postulate, we synthesize available data relative to the effect of this class on: 1- animal models of healthspan and lifespan; 2- selected molecular pillars of aging in preclinical models; 3- biomarkers of aging and especially inflammaging in humans; and 4- COVID-19-related outcomes. The burden of evidence might prompt the design of studies testing the potential employment of this class as anti-aging drugs.
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Kucuk B, Baltaci Ozen S, Kocabeyoglu GM, Mutlu NM, Cakir E, Ozkocak Turan I. NUTRIC Score Is Not Superior to mNUTRIC Score in Prediction of Mortality of COVID-19 Patients. Int J Clin Pract 2022; 2022:1864776. [PMID: 35685514 PMCID: PMC9159233 DOI: 10.1155/2022/1864776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/21/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The NUTRIC (nutrition risk in the critically ill) score and the modified NUTRIC score are two scoring systems that show the nutritional risk status and severity of acute disease of patients. The only difference between them is the examination of interleukin-6 (IL-6) level. The aim of this study was to investigate whether or not the NUTRIC score is superior to the mNUTRIC score in the prediction of mortality of patients with COVID-19 followed up in the Intensive Care Unit (ICU). Material and Method. This retrospective study included 322 patients followed up in ICU with a diagnosis of COVID-19. A record was made of demographic data, laboratory values, clinical results, and mortality status. All the data of the patients were compared between high and low variations of the NUTRIC score and the mNUTRIC score. RESULTS A high NUTRIC score was determined in 62 patients and a high mNUTRIC score in 86 patients. The need for invasive mechanical ventilation, the use of vasopressors in ICU, the development of acute kidney injury, and mortality rates were statistically significantly higher in the patients with high NUTRIC and high mNUTRIC scores than in those with low scores (p = 0.0001 for all). The AUC values were 0.791 for high NUTRIC score and 0.786 for high mNUTRIC score (p = 0.0001 for both). No statistically significant difference was determined between the two scoring systems. CONCLUSION Although the NUTRIC score was seen to be superior to the mNUTRIC score, no statistically significant difference was determined. Therefore, when IL-6 cannot be examined, the mNUTRIC score can be considered safe and effective for the prediction of mortality in COVID-19 patients.
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Affiliation(s)
- Berkay Kucuk
- Department of Critical Care, Hatay Education and Research Hospital, Hatay, Turkey
| | - Sevil Baltaci Ozen
- Department of Critical Care, Yenimahalle Education and Research Hospital, Ankara, Turkey
| | | | | | - Esra Cakir
- Department of Critical Care, Ankara City Hospital, Ankara, Turkey
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15
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Kunutsor SK, Jae SY, Kurl S, Kauhanen J, Laukkanen JA. Inflammation, sauna bathing, and all-cause mortality in middle-aged and older Finnish men: a cohort study. Eur J Epidemiol 2022; 37:1225-1231. [PMID: 36255556 PMCID: PMC9792415 DOI: 10.1007/s10654-022-00926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/26/2022] [Indexed: 12/30/2022]
Abstract
Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42-61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13-1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12-1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81-1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.
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Affiliation(s)
- Setor K. Kunutsor
- grid.410421.20000 0004 0380 7336National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB UK ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Gwendolen Road, Leicester, LE5 4WP UK
| | - Sae Young Jae
- grid.267134.50000 0000 8597 6969Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea ,grid.267134.50000 0000 8597 6969Department of Sport Science, University of Seoul, Seoul, South Korea ,grid.267134.50000 0000 8597 6969Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A. Laukkanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland ,grid.460356.20000 0004 0449 0385Department of Medicine, Central Finland Health Care District, Hospital District, Jyvaskyla, Finland
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Chen MA, LeRoy AS, Majd M, Chen JY, Brown RL, Christian LM, Fagundes CP. Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan. Front Psychol 2021; 12:788351. [PMID: 34899540 PMCID: PMC8662704 DOI: 10.3389/fpsyg.2021.788351] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/04/2021] [Indexed: 12/17/2022] Open
Abstract
Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at a greater risk for morbidity and premature mortality than those not exposed to childhood adversity. Several mechanisms likely contribute to the relationship between childhood adversity and health across the lifespan (e.g., health behaviors, cardiovascular reactivity). In this paper, we review a large body of research within the field of psychoneuroimmunology, demonstrating the relationship between early life stress and alterations of the immune system. We first review the literature demonstrating that childhood adversity is associated with immune dysregulation across different indices, including proinflammatory cytokine production (and its impact on telomere length), illness and infection susceptibility, latent herpesvirus reactivation, and immune response to a tumor. We then summarize the growing literature on how childhood adversity may alter epigenetic processes. Finally, we propose future directions related to this work that have basic and applied implications.
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Affiliation(s)
- Michelle A Chen
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Angie S LeRoy
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Jonathan Y Chen
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ryan L Brown
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Lisa M Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX, United States.,Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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17
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Scarale MG, Antonucci A, Cardellini M, Copetti M, Salvemini L, Menghini R, Mazza T, Casagrande V, Ferrazza G, Lamacchia O, De Cosmo S, Di Paola R, Federici M, Trischitta V, Menzaghi C. A Serum Resistin and Multicytokine Inflammatory Pathway Is Linked With and Helps Predict All-cause Death in Diabetes. J Clin Endocrinol Metab 2021; 106:e4350-e4359. [PMID: 34192323 DOI: 10.1210/clinem/dgab472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Type 2 diabetes (T2D) shows a high mortality rate, partly mediated by atherosclerotic plaque instability. Discovering novel biomarkers may help identify high-risk patients who would benefit from more aggressive and specific managements. We recently described a serum resistin and multicytokine inflammatory pathway (REMAP), including resistin, interleukin (IL)-1β, IL-6, IL-8, and TNF-α, that is associated with cardiovascular disease. OBJECTIVE We investigated whether REMAP is associated with and improves the prediction of mortality in T2D. METHODS A REMAP score was investigated in 3 cohorts comprising 1528 patients with T2D (409 incident deaths) and in 59 patients who underwent carotid endarterectomy (CEA; 24 deaths). Plaques were classified as unstable/stable according to the modified American Heart Association atherosclerosis classification. RESULTS REMAP was associated with all-cause mortality in each cohort and in all 1528 individuals (fully adjusted hazard ratio [HR] for 1 SD increase = 1.34, P < .001). In CEA patients, REMAP was associated with mortality (HR = 1.64, P = .04) and a modest change was observed when plaque stability was taken into account (HR = 1.58; P = .07). REMAP improved discrimination and reclassification measures of both Estimation of Mortality Risk in Type 2 Diabetic Patients and Risk Equations for Complications of Type 2 Diabetes, well-established prediction models of mortality in T2D (P < .05-< .001). CONCLUSION REMAP is independently associated with and improves predict all-cause mortality in T2D; it can therefore be used to identify high-risk individuals to be targeted with more aggressive management. Whether REMAP can also identify patients who are more responsive to IL-6 and IL-1β monoclonal antibodies that reduce cardiovascular burden and total mortality is an intriguing possibility to be tested.
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Affiliation(s)
- Maria Giovanna Scarale
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
| | - Alessandra Antonucci
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
| | - Marina Cardellini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
- Center for Atherosclerosis, Department of Medical Sciences, Policlinico Tor Vergata University, Rome 00133, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Fondazione IRCCS "Casa Sollievo della Sofferenza," San Giovanni Rotondo 71013, Italy
| | - Lucia Salvemini
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
| | - Rossella Menghini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, IRCCS "Casa Sollievo della Sofferenza," San Giovanni Rotondo 71013, Italy
| | - Viviana Casagrande
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Gianluigi Ferrazza
- Center for Atherosclerosis, Department of Medical Sciences, Policlinico Tor Vergata University, Rome 00133, Italy
| | - Olga Lamacchia
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, Foggia 71100, Italy
| | - Salvatore De Cosmo
- Department of Clinical Sciences, Fondazione IRCCS "Casa Sollievo Della Sofferenza," San Giovanni Rotondo 71013, Italy
| | - Rosa Di Paola
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
- Center for Atherosclerosis, Department of Medical Sciences, Policlinico Tor Vergata University, Rome 00133, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
- Department of Experimental Medicine, "Sapienza" University, Rome 00185, Italy
| | - Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS "Casa Sollievo della Sofferenza," 71013 San Giovanni Rotondo, Italy
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Association of statin use in older people primary prevention group with risk of cardiovascular events and mortality: a systematic review and meta-analysis of observational studies. BMC Med 2021; 19:139. [PMID: 34154589 PMCID: PMC8218529 DOI: 10.1186/s12916-021-02009-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Current evidence from randomized controlled trials on statins for primary prevention of cardiovascular disease (CVD) in older people, especially those aged > 75 years, is still lacking. We conducted a systematic review and meta-analysis of observational studies to extend the current evidence about the association of statin use in older people primary prevention group with risk of CVD and mortality. METHODS PubMed, Scopus, and Embase were searched from inception until March 18, 2021. We included observational studies (cohort or nested case-control) that compared statin use vs non-use for primary prevention of CVD in older people aged ≥ 65 years; provided that each of them reported the risk estimate on at least one of the following primary outcomes: all cause-mortality, CVD death, myocardial infarction (MI), and stroke. Risk estimates of each relevant outcome were pooled as a hazard ratio (HR) with a 95% confidence interval (CI) using the random-effects meta-analysis model. The quality of the evidence was rated using the GRADE approach. RESULTS Ten observational studies (9 cohorts and one case-control study; n = 815,667) fulfilled our criteria. The overall combined estimate suggested that statin therapy was associated with a significantly lower risk of all-cause mortality (HR: 0.86 [95% CI 0.79 to 0.93]), CVD death (HR: 0.80 [95% CI 0.78 to 0.81]), and stroke (HR: 0.85 [95% CI 0.76 to 0.94]) and a non-significant association with risk of MI (HR 0.74 [95% CI 0.53 to 1.02]). The beneficial association of statins with the risk of all-cause mortality remained significant even at higher ages (> 75 years old; HR 0.88 [95% CI 0.81 to 0.96]) and in both men (HR: 0.75 [95% CI: 0.74 to 0.76]) and women (HR 0.85 [95% CI 0.72 to 0.99]). However, this association with the risk of all-cause mortality remained significant only in those with diabetes mellitus (DM) (HR 0.82 [95% CI 0.68 to 0.98]) but not in those without DM. The level of evidence of all the primary outcomes was rated as "very low." CONCLUSIONS Statin therapy in older people (aged ≥ 65 years) without CVD was associated with a 14%, 20%, and 15% lower risk of all-cause mortality, CVD death, and stroke, respectively. The beneficial association with the risk of all-cause mortality remained significant even at higher ages (> 75 years old), in both men and women, and in individuals with DM, but not in those without DM. These observational findings support the need for trials to test the benefits of statins in those above 75 years of age.
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Rizza S, Morabito P, De Meo L, Farcomeni A, Testorio G, Cardellini M, Ballanti M, Davato F, Pecchioli C, Di Cola G, Mavilio M, Federici M. IL-6 Levels Influence 3-Month All-Cause Mortality in Frail Hospitalized Older Patients. Aging Dis 2021; 12:353-359. [PMID: 33815869 PMCID: PMC7990358 DOI: 10.14336/ad.2020.0713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/13/2020] [Indexed: 01/15/2023] Open
Abstract
The multidimensional prognostic index (MPI) is a sensitive and specific prognosis estimation tool that accurately predicts all-cause mortality in frail older patients. It has been validated to assess the risk of 1-month to 2-year mortality in frail older patients during hospitalization and after hospital discharge. However, whether the MPI is a valid prognostic tool for follow-up periods of different lengths remains to be validated. To this end, we followed up 80 hospitalized patients (female=37, male 43) at least 75 years of age (mean age=82.6±4.4, range=75-94 years) to assess the 3-month all-cause mortality (mean follow-up=61.0 ± 31.7 months [range 4-90 days]). Accordingly, patients were subdivided into low (MPI-1, score 0-0.33), moderate (MPI-2, score 0.34-0.66) and high (MPI-3, score 0.67-1) mortality risk classes. Moreover, baseline biochemical, inflammatory and metabolic parameters, as well as anamnestic and clinical characteristics, were obtained. Although the MPI-3 score was significantly associated with 3-month all-cause mortality in univariate analysis (HR=5.79, 95%CI=1.77-18.92, p=0.004), a multivariate model indicated that only low albumin (HR=0.33, 95%CI=0.16-0.68, p=0.003) and high IL6 (HR=1.01, 95%CI=1.00-1.02, p=0.010) levels were significantly associated with 3-month all-cause mortality. In conclusion, we suggest that measurement of IL6 as well as albumin, rather than the MPI score, may help in providing tailored therapeutic interventions to decrease short term mortality in older hospitalized individuals.
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Affiliation(s)
- Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pasquale Morabito
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Livia De Meo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alessio Farcomeni
- Department of Economics and Finance, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Testorio
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marina Cardellini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Ballanti
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Davato
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Pecchioli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Di Cola
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Mavilio
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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20
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Simone S, Chieti A, Pontrelli P, Rascio F, Castellano G, Stallone G, Infante B, Gesualdo L, Grandaliano G, Pertosa G. On-line hemodiafiltration modulates atherosclerosis signaling in peripheral lymphomonocytes of hemodialysis patients. J Nephrol 2021; 34:1989-1997. [PMID: 33761122 PMCID: PMC8610953 DOI: 10.1007/s40620-020-00958-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/27/2020] [Indexed: 11/18/2022]
Abstract
Background Hemodialysis patients present a dramatic increase in cardiovascular morbidity/mortality. Circulating immune cells, activated by both uremic milieu and dialysis, play a key role in the pathogenesis of dialysis-related vascular disease. The aim of our study was to identify, through a high-throughput approach, differences in gene expression profiles in the peripheral blood mononuclear cells (PBMCs) of patients treated with on-line hemodiafiltration and bicarbonate hemodialysis. Methods The transcriptomic profile was investigated in PBMCs isolated from eight patients on on-line hemodiafiltration and eight patients on bicarbonate hemodialysis by microarray analysis. The results were evaluated by statistical and functional pathway analysis and validated by real time PCR (qPCR) in an independent cohort of patients (on-line hemodiafiltration N = 20, bicarbonate hemodialysis n = 20). Results Eight hundred and forty-seven genes were differentially expressed in patients treated with on-line hemodiafiltration and bicarbonate hemodialysis. Thirty-seven functional gene networks were identified and atherosclerosis signaling was the top canonical pathway regulated by on-line hemodiafiltration. Among the genes of this pathway, on-line hemodiafiltration was associated with a reduced expression of Platelet-derived growth factor A chain (PDGF A), Clusterin, Monoamine Oxidase A, Interleukin-6 (IL-6) and Vascular Endothelial Growth
Factor C (VEGF-)C and with an increase of Apolipoprotein E. qPCR confirmed the microarray results. Platelet derived growth factor AA (PDGF-AA), IL-6 and VEGF-C serum levels were significantly lower in the on-line hemodiafiltration group. Finally, 10 patients previously on bicarbonate hemodialysis were switched to on-line hemodiafiltration and PBMCs were harvested after 6 months. The qPCR results from this perspective group confirmed the modulation of atherosclerotic genes observed in the cross-sectional analysis. Conclusions Our data suggest that type of dialysis (on-line hemodiafiltration versus bicarbonate hemodialysis) may modulate the expression of several genes involved in the pathogenesis of atherosclerotic disease.
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Affiliation(s)
- Simona Simone
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Piazza G. Cesare 11, 70122, Bari, Italy.
| | - Annarita Chieti
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Piazza G. Cesare 11, 70122, Bari, Italy
| | - Paola Pontrelli
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Piazza G. Cesare 11, 70122, Bari, Italy
| | - Federica Rascio
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe Castellano
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giovanni Stallone
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Barbara Infante
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Piazza G. Cesare 11, 70122, Bari, Italy
| | - Giuseppe Grandaliano
- Nephrology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Pertosa
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Piazza G. Cesare 11, 70122, Bari, Italy
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21
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Marcelli D, Basile C. Has time come to replace the residual acetate with citrate in the dialysis fluid? J Nephrol 2021; 35:87-90. [PMID: 33661506 DOI: 10.1007/s40620-021-00991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Affiliation(s)
| | - Carlo Basile
- Division of Nephrology, Clinical Research Branch, Miulli General Hospital, Acquaviva delle Fonti, Italy. .,Associazione Nefrologica Gabriella Sebastio, Martina Franca, Italy.
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22
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O'Súilleabháin PS, Turiano NA, Gerstorf D, Luchetti M, Gallagher S, Sesker AA, Terracciano A, Sutin AR. Personality pathways to mortality: Interleukin-6 links conscientiousness to mortality risk. Brain Behav Immun 2021; 93:238-244. [PMID: 33571630 PMCID: PMC7979517 DOI: 10.1016/j.bbi.2021.01.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 01/29/2023] Open
Abstract
Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35-86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.
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Affiliation(s)
- Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | | | - Denis Gerstorf
- Department of Psychology, Humboldt University Berlin, Germany
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
| | - Stephen Gallagher
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Amanda A Sesker
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University, Tallahassee, United States
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
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23
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Pizzarelli F, Cantaluppi V, Panichi V, Toccafondi A, Ferro G, Farruggio S, Grossini E, Dattolo PC, Miniello V, Migliori M, Grimaldi C, Casani A, Borzumati M, Cusinato S, Capitanini A, Quercia A, Filiberti O, Dani L. Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study "Hephaestus". J Nephrol 2021; 34:1701-1710. [PMID: 33559851 DOI: 10.1007/s40620-020-00943-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Studies addressing the anti-inflammatory properties of citrate dialysate enrolled patients in both hemodialysis (HD) and hemodiafiltration (HDF), the latter not adjusted for adequate convective exchange. This is a potential source of confounding in that HDF itself has anti-inflammatory effects regardless of the buffer, and optimal clinical outcomes are related to the amount of convection. METHODS To distinguish the merits of the buffer from those of convection, we performed a 6-month, prospective, randomized, crossover AB-BA study. Comparisons were made during the 3-month study period of on-line HDF with standard dialysate containing three mmol of acetic acid (OL-HDFst) and the 3-month of OL-HDF with dialysate containing one mmol of citric acid (OL-HDFcit). Primary outcome measure of the study was interleukin-6 (IL-6). Klotho, high sensitivity C-reactive protein (hsCRP), fetuin and routine biochemical parameters were also analyzed. RESULTS We analyzed 47 patients (mean age 64 years, range 27-84 years) enrolled in 10 participating Nephrology Units. Convective volumes were around 25 L/session with 90 percent of sessions > 20 L and ß2-microglobulin reduction rate 76% in both HDFs. Baseline median IL-6 values in OL-HDFst were 5.6 pg/ml (25:75 interquartile range IQR 2.9:10.6) and in OL-HDFcit 6.6 pg/ml (IQR 3.4:11.4 pg/ml). The difference was not statistically significant (p 0.88). IL-6 values were lower during OL-HDFcit than during OL-HDFst, both when analyzed as the median difference of overall IL-6 values (p 0.02) and as the median of pairwise differences between the baseline and the 3-month time points (p 0.03). The overall hsCRP values too, were lower during OL-HDFcit than during OL-HDFst (p 0.01). Klotho levels showed a time effect (p 0.02) and the increase was significant only during OL-HDFcit (p 0.01). CONCLUSIONS Citrate buffer modulated IL-6, hsCRP and Klotho levels during high volume OL-HDF. These results are not attributable to differences in the dialysis technology that was applied and may suggest a potential biological effect of citrate on CKD-associated inflammatory state. ClinicalTrials.gov identifier NCT02863016.
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Affiliation(s)
- Francesco Pizzarelli
- Nephrology and Dialysis Unit, SM Annunziata Hospital, ASL Toscana Centro, via dell'Antella, 50012, Firenze, Italy.
| | - Vincenzo Cantaluppi
- Nephrology and Kidney Transplantation Unit, Department of Translational Medicine, University of Piemonte Orientale (UPO), Novara, Italy
| | - Vincenzo Panichi
- Nephrology and Dialysis Unit, Versilia Hospital, ASL Nord-Ovest, Lido Di Camaiore, Italy
| | - Alessandro Toccafondi
- Nephrology and Dialysis Unit, SM Annunziata Hospital, ASL Toscana Centro, via dell'Antella, 50012, Firenze, Italy
| | - Giuseppe Ferro
- Nephrology and Dialysis Unit, SM Annunziata Hospital, ASL Toscana Centro, via dell'Antella, 50012, Firenze, Italy
| | - Serena Farruggio
- Nephrology and Kidney Transplantation Unit, Department of Translational Medicine, University of Piemonte Orientale (UPO), Novara, Italy
| | - Elena Grossini
- Lab Physiology, Department Translational Medicine, University of Piemonte Orientale (UPO), Novara, Italy
| | - Pietro Claudio Dattolo
- Nephrology and Dialysis Unit, SM Annunziata Hospital, ASL Toscana Centro, via dell'Antella, 50012, Firenze, Italy
| | | | - Massimiliano Migliori
- Nephrology and Dialysis Unit, Versilia Hospital, ASL Nord-Ovest, Lido Di Camaiore, Italy
| | - Cristina Grimaldi
- Nephrology and Dialysis Unit, NSGD Hospital, ASL Toscana Centro, Firenze, Italy
| | - Aldo Casani
- Nephrology and Dialysis Unit, ASL Nord-Ovest, Massa Carrara, Italy
| | - Maurizio Borzumati
- Nephrology and Dialysis Unit, ASL VCO, Verbania, Verbano Cusio Ossola, Italy
| | - Stefano Cusinato
- Nephrology and Dialysis Unit, Borgomanero Hospital, ASL NO Novara, Borgomanero, Italy
| | | | | | | | - Lucia Dani
- Nephrology and Dialysis Unit, ASL Toscana Centro, Empoli, Italy
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Kallen V, Tahir M, Bedard A, Bongers B, van Riel N, van Meeteren N. Aging and Allostasis: Using Bayesian Network Analytics to Explore and Evaluate Allostatic Markers in the Context of Aging. Diagnostics (Basel) 2021; 11:diagnostics11020157. [PMID: 33494482 PMCID: PMC7912325 DOI: 10.3390/diagnostics11020157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 12/30/2022] Open
Abstract
Allostatic load reflects the cumulative strain on organic functions that may gradually evolve into overt disease. Our aim was to evaluate the allostatic parameters in the context of aging, and identify the parameters that may be suitable for an allostatic load index for elderly people (>60 years). From previously published studies, 11 allostatic (bio)markers could be identified that sustain sufficient variability with aging to capture meaningful changes in health status. Based on reported statistics (prevalence of a biomarker and its associated outcome, and/or an odds/risk ratio relating these two), seven of these could be adopted in a Bayesian Belief Network (BBN), providing the probability of “disturbed” allostasis in any given elder. Additional statistical analyses showed that changes in IL-6 and BMI contributed the most to a “disturbed” allostasis, indicating their prognostic potential in relation to deteriorating health in otherwise generally healthy elderly. In this way, and despite the natural decline in variance that irrevocably alters the prognostic relevance of most allostatic (bio)markers with aging, it appeared possible to outline an allostatic load index specifically for the elderly. The allostatic parameters here identified might consequently be considered a useful basis for future quantitative modelling in the context of (healthy) aging.
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Affiliation(s)
- Victor Kallen
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Correspondence:
| | - Muhammad Tahir
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
| | - Andrew Bedard
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
| | - Bart Bongers
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism/Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Natal van Riel
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5300 Eindhoven, The Netherlands
| | - Nico van Meeteren
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Health~Holland, Top Sector Life Sciences and Health, Wilhelmina van Pruisenweg 104, 2595 AN The Hague, The Netherlands
- Erasmus Medical Center, Department of Anesthesiology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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25
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Masala G, Bendinelli B, Della Bella C, Assedi M, Tapinassi S, Ermini I, Occhini D, Castaldo M, Saieva C, Caini S, D'Elios MM, Palli D. Inflammatory marker changes in a 24-month dietary and physical activity randomised intervention trial in postmenopausal women. Sci Rep 2020; 10:21845. [PMID: 33318523 PMCID: PMC7736293 DOI: 10.1038/s41598-020-78796-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/19/2020] [Indexed: 12/22/2022] Open
Abstract
Chronic low-grade inflammation plays a role in the pathogenesis of several chronic diseases including cancer. Physical activity (PA) and diet have been supposed to modulate inflammatory markers. We evaluated the effects of a 24-month dietary and/or PA intervention on plasma levels of pro-inflammatory cytokines, a secondary analysis in the DAMA factorial trial. The 234 study participants (healthy postmenopausal women with high breast density, 50-69 years, non smokers, no hormone therapy) were randomised to four arms: (1) isocaloric dietary intervention mainly based on plant-foods; (2) moderate-intensity PA intervention with at least 1 h/week of supervised strenuous activity; (3) both interventions; (4) general recommendations on healthy dietary and PA patterns. Interleukins (IL)-1α, -1β, -6, tumor necrosis factor-α and C-reactive protein were measured at baseline and at the end of the intervention. Intention-to-treat-analyses were carried out using Tobit regression. Although all cytokines tended to increase over time, after 24 months women in the PA intervention (arms 2 + 3) showed lower levels of IL-1α (exp(β) = 0.66; p = 0.04) and IL-6 (exp(β) = 0.70; p = 0.01) in comparison with women in the control group (arms 1 + 4). No effects of the dietary intervention emerged. In healthy postmenopausal women with high breast density a moderate-intensity PA appears to slow the age-related increase of pro-inflammatory cytokines.
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Affiliation(s)
- G Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy.
| | - B Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - C Della Bella
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - M Assedi
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - S Tapinassi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - I Ermini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - D Occhini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - M Castaldo
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - C Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - M M D'Elios
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - D Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
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Silva BSDA, Lira FSD, de Freitas MC, Uzeloto JS, Dos Santos VR, Freire APCF, Bertolini GN, Gobbo LA. Traditional and elastic resistance training enhances functionality and lipid profile in the elderly. Exp Gerontol 2020; 135:110921. [PMID: 32151736 DOI: 10.1016/j.exger.2020.110921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Bruna Spolador de Alencar Silva
- Skeletal Muscle Assessment Laboratory, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil.
| | - Fábio Santos de Lira
- Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Marcelo Conrado de Freitas
- Skeletal Muscle Assessment Laboratory, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Juliana Souza Uzeloto
- Postgraduate Program in Physical Therapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Vanessa Ribeiro Dos Santos
- Skeletal Muscle Assessment Laboratory, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Ana Paula Coelho Figueira Freire
- Postgraduate Program in Physical Therapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Giovana Navarro Bertolini
- Skeletal Muscle Assessment Laboratory, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Luís Alberto Gobbo
- Skeletal Muscle Assessment Laboratory, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil; Postgraduate Program in Physical Therapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil.
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27
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Schliep KC. Invited Commentary: Women's Reproductive Life Spans and Subsequent Inflammatory Profiles-How to Best Measure Reproductive Life Span and the Need for Baseline Assessments. Am J Epidemiol 2020; 189:674-676. [PMID: 31845720 DOI: 10.1093/aje/kwz266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022] Open
Abstract
Inflammatory processes are known to drive the pathogenesis of several chronic diseases, including cardiovascular disease and Alzheimer disease, as well as all-cause mortality. Emerging research indicates that women who have a longer reproductive life span-roughly determined as the period from menarche to menopause or lifetime number of ovulatory cycles after accounting for anovulatory time spans-are at lower risk for these inflammation-related chronic diseases. The paradox is that ovulation is known to induce acute inflammation. Given the limited research assessing the relationship between reproductive life span and later inflammatory profiles, Huang et al. (Am J Epidemiol. 2020;189(7):660-670) set out to investigate this relationship within 2 of the most robust longitudinal cohort studies of women, the Nurses' Health studies. They found that after adjustment for other inflammation-related factors, including adiposity, exercise, and diet, lifetime ovulatory years was associated with lower C-reactive protein levels in both premenopausal and postmenopausal women. Huang et al. call attention to several challenges in research on women's reproductive life spans, including how to appropriately capture lifetime ovulatory cycles and the need for repeated measurements of inflammatory biomarkers across the life course if we wish to understand pathogenic processes linking reproductive factors to subsequent chronic disease.
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Khaltourina D, Matveyev Y, Alekseev A, Cortese F, Ioviţă A. Aging Fits the Disease Criteria of the International Classification of Diseases. Mech Ageing Dev 2020; 189:111230. [PMID: 32251691 DOI: 10.1016/j.mad.2020.111230] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 12/24/2022]
Abstract
The disease criteria used by the World Health Organization (WHO) were applied to human biological aging in order to assess whether aging can be classified as a disease. These criteria were developed for the 11th revision of the International Classification of Diseases (ICD) and included disease diagnostics, mechanisms, course and outcomes, known interventions, and linkage to genetic and environmental factors. RESULTS: Biological aging can be diagnosed with frailty indices, functional, blood-based biomarkers. A number of major causal mechanisms of human aging involved in various organs have been described, such as inflammation, replicative cellular senescence, immune senescence, proteostasis failures, mitochondrial dysfunctions, fibrotic propensity, hormonal aging, body composition changes, etc. We identified a number of clinically proven interventions, as well as genetic and environmental factors of aging. Therefore, aging fits the ICD-11 criteria and can be considered a disease. Our proposal was submitted to the ICD-11 Joint Task force, and this led to the inclusion of the extension code for "Ageing-related" (XT9T) into the "Causality" section of the ICD-11. This might lead to greater focus on biological aging in global health policy and might provide for more opportunities for the new therapy developers.
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Affiliation(s)
- Daria Khaltourina
- Department of Risk Factor Prevention, Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Dobrolyubova St. 11, Moscow, 127254, Russia; International Longevity Alliance, 19 avenue Jean Jaurès, Sceaux, 92330, France.
| | - Yuri Matveyev
- Research Lab, Moscow Regional Research and Clinical Institute, Schepkina St. 61/2 k.1, Moscow, 129110, Russia
| | - Aleksey Alekseev
- Faculty of Physics, Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow, 119991, Russia
| | - Franco Cortese
- Biogerontology Research Foundation, Apt 2354 Chynoweth House, Trevissome Park, Truro, London, TR4 8UN, UK
| | - Anca Ioviţă
- International Longevity Alliance, 19 avenue Jean Jaurès, Sceaux, 92330, France
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Leavitt C, Zakai NA, Auer P, Cushman M, Lange EM, Levitan EB, Olson N, Thornton TA, Tracy RP, Wilson JG, Lange LA, Reiner AP, Raffield LM. Interferon gamma-induced protein 10 (IP-10) and cardiovascular disease in African Americans. PLoS One 2020; 15:e0231013. [PMID: 32240245 PMCID: PMC7117698 DOI: 10.1371/journal.pone.0231013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/15/2020] [Indexed: 12/25/2022] Open
Abstract
Biomarkers of chronic inflammation (such as C-reactive protein) have long been associated with cardiovascular disease and mortality; however, biomarkers involved in antiviral cytokine induction and adaptive immune system activation remain largely unexamined. We hypothesized the cytokine interferon gamma inducible protein 10 (IP-10) would be associated with clinical and subclinical cardiovascular disease and all-cause mortality in African Americans. We assessed these associations in the Jackson Heart Study (JHS) cohort and the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. There was a modest association of IP-10 with higher odds of left ventricular hypertrophy (OR = 1.20 (95% confidence interval (CI) 1.03, 1.41) per standard deviation (SD) higher natural log-transformed IP-10 in JHS). We did not observe associations with ankle brachial index, intima-media thickness, or arterial calcification. Each SD higher increment of ln-transformed IP-10 concentration was associated with incident heart failure (hazard ratio (HR) 1.26; 95% CI 1.11, 1.42, p = 4x10-4) in JHS, and with overall mortality in both JHS (HR 1.12 per SD, 95% CI 1.03, 1.21, p = 7.5x10-3) and REGARDS (HR 1.31 per SD, 95% CI 1.10, 1.55, p = 2.0 x 10-3), adjusting for cardiovascular risk factors and C-reactive protein. However, we found no association between IP-10 and stroke or coronary heart disease. These results suggest a role of IP-10 in heart failure and mortality risk independent of C-reactive protein. Further research is needed to investigate how the body's response to chronic viral infection may mediate heart failure and overall mortality risk in African Americans.
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Affiliation(s)
- Colton Leavitt
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Neil A. Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Paul Auer
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Ethan M. Lange
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Emily B. Levitan
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, United States of America
| | - Nels Olson
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Timothy A. Thornton
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Russell P. Tracy
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Leslie A. Lange
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Alex P. Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States of America
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30
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Fiuza-Luces C, Santos-Lozano A, Joyner M, Carrera-Bastos P, Picazo O, Zugaza JL, Izquierdo M, Ruilope LM, Lucia A. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol 2019; 15:731-743. [PMID: 30115967 DOI: 10.1038/s41569-018-0065-1] [Citation(s) in RCA: 418] [Impact Index Per Article: 83.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite strong scientific evidence supporting the benefits of regular exercise for the prevention and management of cardiovascular disease (CVD), physical inactivity is highly prevalent worldwide. In addition to merely changing well-known risk factors for systemic CVD, regular exercise can also improve cardiovascular health through non-traditional mechanisms. Understanding the pathways through which exercise influences different physiological systems is important and might yield new therapeutic strategies to target pathophysiological mechanisms in CVD. This Review includes a critical discussion of how regular exercise can have antiatherogenic effects in the vasculature, improve autonomic balance (thereby reducing the risk of malignant arrhythmias), and induce cardioprotection against ischaemia-reperfusion injury, independent of effects on traditional CVD risk factors. This Review also describes how exercise promotes a healthy anti-inflammatory milieu (largely through the release of muscle-derived myokines), stimulates myocardial regeneration, and ameliorates age-related loss of muscle mass and strength, a frequently overlooked non-traditional CVD risk factor. Finally, we discuss how the benefits of exercise might also occur via promotion of a healthy gut microbiota. We argue, therefore, that a holistic view of all body systems is necessary and useful when analysing the role of exercise in cardiovascular health.
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Affiliation(s)
- Carmen Fiuza-Luces
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain. .,CIBER de Enfermedades Raras (CIBERER), Madrid, Spain.
| | - Alejandro Santos-Lozano
- i+HeALTH Research Group, Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain.,Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Michael Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Pedro Carrera-Bastos
- Centre for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.,NutriScience - Education and Consulting, Lisbon, Portugal
| | - Oscar Picazo
- NutriScience - Education and Consulting, Lisbon, Portugal
| | - José L Zugaza
- Achucarro - Basque Center for Neuroscience, Bilbao, Spain.,Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, Leioa, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER of Frailty and Healthy Aging (CIBERFES), Navarrabiomed, Pamplona, Spain
| | - Luis M Ruilope
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
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Community-Acquired Pneumonia Patients at Risk for Early and Long-term Cardiovascular Events Are Identified by Cardiac Biomarkers. Chest 2019; 156:1080-1091. [PMID: 31381883 DOI: 10.1016/j.chest.2019.06.040] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/07/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Community-acquired pneumonia (CAP) increases the risk of cardiovascular complications during and following the episode. The goal of this study was to determine the usefulness of cardiovascular and inflammatory biomarkers for assessing the risk of early (within 30 days) or long-term (1-year follow-up) cardiovascular events. METHODS A total of 730 hospitalized patients with CAP were prospectively followed up during 1 year. Cardiovascular (proadrenomedullin [proADM], pro-B-type natriuretic peptide (proBNP), proendothelin-1, and troponin T) and inflammatory (interleukin 6 [IL-6], C-reactive protein, and procalcitonin) biomarkers were measured on day 1, at day 4/5, and at day 30. RESULTS Ninety-two patients developed an early event, and 67 developed a long-term event. Significantly higher initial levels of proADM, proendothelin-1, troponin, proBNP, and IL-6 were recorded in patients who developed cardiovascular events. Despite a decrease at day 4/5, levels remained steady until day 30 in those who developed late events. Biomarkers (days 1 and 30) independently predicted cardiovascular events adjusted for age, previous cardiac disease, Pao2/Fio2 < 250 mm Hg, and sepsis: ORs (95% CIs), proendothelin-1, 2.25 (1.34-3.79); proADM, 2.53 (1.53-4.20); proBNP, 2.67 (1.59-4.49); and troponin T, 2.70 (1.62-4.49) for early events. For late events, the ORs (95% CIs) were: proendothelin-1, 3.13 (1.41-7.80); proADM, 2.29 (1.01-5.19); and proBNP, 2.34 (1.01-5.56). Addition of IL-6 levels at day 30 to proendothelin-1 or proADM increased the ORs to 3.53 and 2.80, respectively. CONCLUSIONS Cardiac biomarkers are useful for identifying patients with CAP at high risk for early and long-term cardiovascular events. They may aid personalized treatment optimization and for designing future interventional studies to reduce cardiovascular risk.
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Okada E, Shirakawa T, Shivappa N, Wakai K, Suzuki K, Date C, Iso H, Hébert JR, Tamakoshi A. Dietary Inflammatory Index Is Associated with Risk of All-Cause and Cardiovascular Disease Mortality but Not with Cancer Mortality in Middle-Aged and Older Japanese Adults. J Nutr 2019; 149:1451-1459. [PMID: 31100121 DOI: 10.1093/jn/nxz085] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/05/2018] [Accepted: 04/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Dietary Inflammatory Index (DII) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers. Several studies have shown an association between DII score and mortality, but there are limited prospective studies in Asian populations. OBJECTIVES The aim of this study was to investigate the association between DII score and risk of all-cause, total cardiovascular disease (CVD), stroke, coronary heart disease (CHD), total cancer, digestive cancer, and noncancer/non-CVD mortality in the Japanese population. METHODS A total of 58,782 Japanese participants aged 40-79 y who were enrolled in the Japan Collaborative Cohort Study during 1988-1990 were included in the analysis. DII scores were calculated based on a food-frequency questionnaire. HRs and 95% CIs for mortality according to DII quintiles were estimated using Cox proportional hazards models. RESULTS During the median follow-up period of 19.3 y, a total of 11,693 participants died. The multivariable HR for all-cause mortality for the highest compared with the lowest DII quintiles was 1.13 (95% CI: 1.05, 1.21). For CVD mortality, the highest multivariable HRs were 1.30 (95% CI: 1.13, 1.49), 1.29 (95% CI: 1.05, 1.59), and 1.30 (95% CI: 0.96, 1.76) for total CVD, stroke, and CHD, respectively. No significant associations were observed between DII and risk of total cancer, digestive cancer, and noncancer/non-CVD mortality. CONCLUSION Our findings suggest that a higher DII was associated with an increased risk of all-cause and CVD mortality among Japanese adults.
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Affiliation(s)
- Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Toru Shirakawa
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Koji Suzuki
- Department of Public Health, Fujita Health University School of Health Sciences, Aichi, Japan
| | - Chigusa Date
- Department of Food Science and Nutrition, School of Human Science and Environment, University of Hyogo, Hyogo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
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The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study. J Immunol Res 2019; 2019:3128231. [PMID: 30915369 PMCID: PMC6402210 DOI: 10.1155/2019/3128231] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/29/2018] [Indexed: 12/11/2022] Open
Abstract
Background Olfactory dysfunction might unveil the association between ageing and frailty, as it is associated with declining cognitive function, depression, reduced physical performance, reduced dietary intake, and mortality; all these conditions are characterized by increased levels of inflammatory parameters. The present study is aimed at evaluating the association between olfactory dysfunction, frailty, and mortality and whether such association might be mediated by inflammation. Methods We analysed data of 1035 participants aged 65+ enrolled in the “InCHIANTI” study. Olfactory function was tested by the recognition of the smells of coffee, mint, and air. Olfactory dysfunction was defined as lack of recognition of at least two smells. Considering the items “shrinking,” “exhaustion,” “sedentariness,” “slowness,” and “weakness” included in the Fried definition, frailty was defined as the presence of at least three criteria, prefrailty of one or two, and robustness of none. Serum interleukin-6 (IL-6) was measured in duplicate by high-sensitivity enzyme-linked immunosorbent assays. Logistic regression was adopted to assess the association of frailty with olfactory function, as well as with the increasing number of olfactory deficits. Cox regression was used to test the association between olfactory dysfunction and 9-year survival. Results Olfactory dysfunction was associated with frailty, after adjusting (OR 1.94, 95% CI = 1.07-3.51; P = .028); analysis of the interaction term indicated that the association varied according to interleukin-6 levels (P for interaction = .005). Increasing levels of olfactory dysfunction were associated with increasing probability of being frail. Also, olfactory dysfunction was associated with reduced survival (HR 1.52, 95% CI = 1.16-1.98; P = .002); this association varied according to the presence of frailty (P for interaction = .017) and prefrailty status (P for interaction = .046), as well as increased interleukin-6 levels (P for interaction = .011). Conclusions Impairment of olfactory function might represent a marker of frailty, prefrailty, and consequently reduced survival in an advanced age. Inflammation might represent the possible link between these conditions.
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O'Toole MS, Bovbjerg DH, Renna ME, Lekander M, Mennin DS, Zachariae R. Effects of psychological interventions on systemic levels of inflammatory biomarkers in humans: A systematic review and meta-analysis. Brain Behav Immun 2018; 74:68-78. [PMID: 29630988 DOI: 10.1016/j.bbi.2018.04.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/27/2018] [Accepted: 04/04/2018] [Indexed: 12/12/2022] Open
Abstract
The purpose of the present investigation was to systematically review randomized controlled trials examining the effects of psychological interventions on inflammatory biomarkers in adult populations and to quantitatively analyze those effects by meta-analysis. Two researchers independently searched key electronic databases, selected eligible publications, extracted data, and evaluated methodological quality. Nineteen randomized controlled trials examining a total of 1510 participants were included. The overall combined effect size from pre to post psychological intervention on pro-inflammatory biomarker levels was statistically significant, showing an attenuating effect, although of a small magnitude (s' g = 0.15, p = .008, CI [0.04-0.26]). However, this effect was not maintained into the follow-up period (g < -0.01, p = .964, CI [-0.19-0.18]). Looking at the individual biomarkers assessed across studies, only C-reactive protein (CRP) was found to significantly decrease following psychological intervention. A number of moderation analyses were conducted, none of which reached statistical significance. However, the numerically largest - and significant - within-group effect size was obtained for the group of studies that had preselected participants based on elevated psychological distress (g = 0.29, p = .047). In conclusion, psychological interventions appear efficacious in reducing pro-inflammatory biomarker levels. Future studies are recommended to carefully select individuals based on inflammatory (e.g., the presence of low-grade inflammation) and/or psychological (e.g., psychological distress) criteria.
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Affiliation(s)
- M S O'Toole
- Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.
| | - D H Bovbjerg
- Biobehavioral Oncology Program, Hillman Cancer Center; Departments of: Psychiatry, Psychology, Behavioral & Community Health Sciences, and Health & Community Systems, University of Pittsburgh, Pittsburgh, PA, USA
| | - M E Renna
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - M Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Stress Research Institute, Stockholm University, Sweden
| | - D S Mennin
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - R Zachariae
- Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark
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DiNicolantonio JJ, McCarty MF. Is interleukin-6 the link between low LDL cholesterol and increased non-cardiovascular mortality in the elderly? Open Heart 2018; 5:e000789. [PMID: 29682295 PMCID: PMC5905839 DOI: 10.1136/openhrt-2018-000789] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/20/2022] Open
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