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Sales LP, Souza LVB, Fernandes AL, Murai IH, Santos MD, Vendramini MBG, Oliveira RM, Figueiredo CP, Caparbo VF, Gualano B, Pereira RMR. Effect of vitamin D 3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19. Clinics (Sao Paulo) 2024; 79:100474. [PMID: 39208655 PMCID: PMC11399608 DOI: 10.1016/j.clinsp.2024.100474] [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: 08/15/2023] [Revised: 06/05/2024] [Accepted: 07/21/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE To investigate the effect of a single oral dose of 200,000 IU of vitamin D3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19. METHODS This is a post-hoc, exploratory analysis from a double-blind, placebo-controlled, randomized clinical trial performed in two centers in Sao Paulo, Brazil. Hospitalized patients with COVID-19 were randomly assigned to receive either vitamin D3 (n = 97) or placebo (n = 97). In this post-hoc analysis, the endpoints were titers and frequency of anti-β2-Glycoprotein-I (aβ2-GP) and Anticardiolipin (aCL) antibodies [Immunoglobulin G, M and A (IgG, IgM and IgA)]. RESULTS Overall mean (SD) age was 55.3 (13.9) years, Body Mass Index (BMI) was 32.2 (7.1 kg/m2), and 106 participants (54.6 %) were male. There was a significant group by time interaction (p = 0.046) for frequency of aCL IgG, with increased values from baseline to discharge in the placebo group [n (%), from 13 (13.4) to 25 (25.8)] compared to the vitamin D3 [from 25 (25.8) to 29 (29.9)]. However, the frequency of aCL IgG did not change between the groups on discharge. No significant differences between vitamin D3 and placebo groups were found for any other autoantibodies. CONCLUSION These findings do not support the use of a single oral dose of 200,000 IU of vitamin D3 to modulate autoantibodies in hospitalized patients with moderate to severe COVID-19.
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Affiliation(s)
- Lucas P Sales
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Lucas V B Souza
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Alan L Fernandes
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Igor H Murai
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Mayara D Santos
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Margarete B G Vendramini
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | | | - Camille P Figueiredo
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Valéria F Caparbo
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Bruno Gualano
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
| | - Rosa M R Pereira
- Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
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Chen T, Ma W, Wang X, Ye Q, Hou X, Wang Y, Jiang C, Meng X, Sun Y, Cai J. Insights of immune cell heterogeneity, tumor-initiated subtype transformation, drug resistance, treatment and detecting technologies in glioma microenvironment. J Adv Res 2024:S2090-1232(24)00315-1. [PMID: 39097088 DOI: 10.1016/j.jare.2024.07.033] [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: 04/07/2024] [Revised: 06/30/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND With the gradual understanding of glioma development and the immune microenvironment, many immune cells have been discovered. Despite the growing comprehension of immune cell functions and the clinical application of immunotherapy, the precise roles and characteristics of immune cell subtypes, how glioma induces subtype transformation of immune cells and its impact on glioma progression have yet to be understood. AIM OF THE REVIEW In this review, we comprehensively center on the four major immune cells within the glioma microenvironment, particularly neutrophils, macrophages, lymphocytes, myeloid-derived suppressor cells (MDSCs), and other significant immune cells. We discuss (1) immune cell subtype markers, (2) glioma-induced immune cell subtype transformation, (3) the mechanisms of each subtype influencing chemotherapy resistance, (4) therapies targeting immune cells, and (5) immune cell-associated single-cell sequencing. Eventually, we identified the characteristics of immune cell subtypes in glioma, comprehensively summarized the exact mechanism of glioma-induced immune cell subtype transformation, and concluded the progress of single-cell sequencing in exploring immune cell subtypes in glioma. KEY SCIENTIFIC CONCEPTS OF REVIEW In conclusion, we have analyzed the mechanism of chemotherapy resistance detailly, and have discovered prospective immunotherapy targets, excavating the potential of novel immunotherapies approach that synergistically combines radiotherapy, chemotherapy, and surgery, thereby paving the way for improved immunotherapeutic strategies against glioma and enhanced patient outcomes.
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Affiliation(s)
- Tongzheng Chen
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenbin Ma
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xin Wang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qile Ye
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xintong Hou
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yiwei Wang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chuanlu Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Six Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiangqi Meng
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Ying Sun
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Jinquan Cai
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Zhang MN, Yuan YL, Ao SH. Advances in the study of myeloid-derived suppressor cells in infectious lung diseases. Front Immunol 2023; 14:1125737. [PMID: 37063919 PMCID: PMC10090681 DOI: 10.3389/fimmu.2023.1125737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature cells capable of inhibiting T-cell responses. MDSCs have a crucial role in the regulation of the immune response of the body to pathogens, especially in inflammatory response and pathogenesis during anti-infection. Pathogens such as bacteria and viruses use MDSCs as their infectious targets, and even some pathogens may exploit the inhibitory activity of MDSCs to enhance pathogen persistence and chronic infection of the host. Recent researches have revealed the pathogenic significance of MDSCs in pathogens such as bacteria and viruses, despite the fact that the majority of studies on MDSCs have focused on tumor immune evasion. With the increased prevalence of viral respiratory infections, the resurgence of classical tuberculosis, and the advent of medication resistance in common bacterial pneumonia, research on MDSCs in these illnesses is intensifying. The purpose of this work is to provide new avenues for treatment approaches to pulmonary infectious disorders by outlining the mechanism of action of MDSCs as a biomarker and therapeutic target in pulmonary infectious diseases.
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Affiliation(s)
- Meng-Nan Zhang
- College of Integrated Chinese and Western Medicine and the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Yu-Lai Yuan
- The Department of Respirology of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Su-Hua Ao
- The Department of Respirology of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China
- *Correspondence: Su-Hua Ao,
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Rajasegaran T, How CW, Saud A, Ali A, Lim JCW. Targeting Inflammation in Non-Small Cell Lung Cancer through Drug Repurposing. Pharmaceuticals (Basel) 2023; 16:ph16030451. [PMID: 36986550 PMCID: PMC10051080 DOI: 10.3390/ph16030451] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Lung cancer is the most common cause of cancer-related deaths. Lung cancers can be classified as small-cell (SCLC) or non-small cell (NSCLC). About 84% of all lung cancers are NSCLC and about 16% are SCLC. For the past few years, there have been a lot of new advances in the management of NSCLC in terms of screening, diagnosis and treatment. Unfortunately, most of the NSCLCs are resistant to current treatments and eventually progress to advanced stages. In this perspective, we discuss some of the drugs that can be repurposed to specifically target the inflammatory pathway of NSCLC utilizing its well-defined inflammatory tumor microenvironment. Continuous inflammatory conditions are responsible to induce DNA damage and enhance cell division rate in lung tissues. There are existing anti-inflammatory drugs which were found suitable for repurposing in non-small cell lung carcinoma (NSCLC) treatment and drug modification for delivery via inhalation. Repurposing anti-inflammatory drugs and their delivery through the airway is a promising strategy to treat NSCLC. In this review, suitable drug candidates that can be repurposed to treat inflammation-mediated NSCLC will be comprehensively discussed together with their administration via inhalation from physico-chemical and nanocarrier perspectives.
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Affiliation(s)
- Thiviyadarshini Rajasegaran
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Chee Wun How
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia
| | - Anoosha Saud
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Azhar Ali
- Cancer Science Institute Singapore, National University of Singapore, Singapore 117599, Singapore
| | - Jonathan Chee Woei Lim
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Correspondence:
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Senkevich OA, Chernobrovkina MA, Kovalsky YG. Vitamin D Supplementation of 7–8 Years Old Children from Different Geographical Areas (48–52° North Latitude): Cross Sectional Study. CURRENT PEDIATRICS 2022. [DOI: 10.15690/vsp.v21i6.2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background. The prevalence of vitamin D deficiency in children by their geographic latitude of residence requires follow-up study. This is crucial for implementation of preventive measures that can reduce the risk of developing pathological conditions associated with vitamin D deficiency.Objective. The aim of the study is to study the vitamin D supplementation of 7–8 years old children living in different geographical latitudes of one subject of Russian Federation.Methods. The study included relatively healthy children living in three geographical areas (northern — 52°, central — 50°, southern — 48°) of one region (Khabarovsk Krai). Vitamin D supplementation was evaluated by 25(OH)D serum concentration via enzyme-linked immunosorbent assay. Vitamin D insufficiency was diagnosed at 25(OH)D concentration of 21–30 ng/ml, deficiency — 10–20 ng/ml, severe deficiency — < 10 ng/ml; optimal 25(OH)D concentration was considered as 30–100 ng/ml.Results. The increase in prevalence of vitamin D deficiency and insufficiency has been revealed with gradual increase from southern (57%) to central (73%) and northern (83%) geographic areas in 7–8 years old children living in the same region. The prevalence of vitamin D deficiency and insufficiency (25(OH)D ≤ 30 ng/mL) among children living in the northern geographic area was greater by 3.8-fold (95% confidence interval 1.2–12.7) then among peers living in the southern areas.Conclusion. One factor affecting 25(OH)D serum concentration in children of this region is the insolation level determined by the geographical latitude of residence. The 4°N difference is significant in determining vitamin D status in residents of relatively high latitudes. Further studies of factors associated with 25(OH)D concentration in children living in different latitudes are required (insolation level, number of sunny days per year, food and household characteristics in families).
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Lu L, Zheng J, Liu B, Wu H, Huang J, Wu L, Li D. The m7G Modification Level and Immune Infiltration Characteristics in Patients with COVID-19. J Multidiscip Healthc 2022; 15:2461-2472. [PMID: 36320552 PMCID: PMC9618243 DOI: 10.2147/jmdh.s385050] [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: 08/04/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose The 7-methylguanosine (m7G)-related genes were used to identify the clinical severity and prognosis of patients with coronavirus disease 2019 (COVID-19) and to identify possible therapeutic targets. Patients and Methods The GSE157103 dataset provides the transcriptional spectrum and clinical information required to analyze the expression of m7G-related genes and the disease subtypes. R language was applied for immune infiltration analysis, functional enrichment analysis, and nomogram model construction. Results Most m7G-related genes were up-regulated in COVID-19 and were closely related to immune cell infiltration. Disease subtypes were grouped using a clustering algorithm. It was found that the m7G-cluster B was associated with higher immune infiltration, lower mechanical ventilation, lower intensive care unit (ICU) status, higher ventilator-free days, and lower m7G scores. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differentially expressed genes (DEGs) between m7G-cluster A and B were enriched in viral infection and immune-related aspects, including COVID-19 infection; Th17, Th1, and Th2 cell differentiation, and human T-cell leukemia virus 1 infection. Finally, through machine learning, six disease characteristic genes, NUDT4B, IFIT5, LARP1, EIF4E, LSM1, and NUDT4, were screened and used to develop a nomogram model to estimate disease risk. Conclusion The expression of most m7G genes was higher in COVID-19 patients compared with that in non-COVID-19 patients. The m7G-cluster B showed higher immune infiltration and milder symptoms. The predictive nomogram based on the six m7G genes can be used to accurately assess risk.
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Affiliation(s)
- Lingling Lu
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China
| | - Jiaolong Zheng
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China,Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, Fuzhou, People’s Republic of China
| | - Bang Liu
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China
| | - Haicong Wu
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China,Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, Fuzhou, People’s Republic of China
| | - Jiaofeng Huang
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China
| | - Liqing Wu
- Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, Fuzhou, People’s Republic of China
| | - Dongliang Li
- Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital, Fuzhou, People’s Republic of China,Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, Fuzhou, People’s Republic of China,Correspondence: Dongliang Li, Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital of the People’s Liberation Army Joint Logistics Support Force, No. 156 Xierhuan Road, Fuzhou, Fujian, 350025, People’s Republic of China, Tel/Fax +86 591 22859128, Email
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The function of myeloid-derived suppressor cells in COVID-19 lymphopenia. Int Immunopharmacol 2022; 112:109277. [PMID: 36206651 PMCID: PMC9513342 DOI: 10.1016/j.intimp.2022.109277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/02/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has caused a global pandemic and presents a significant danger to public health. Lymphopenia is considered to be the defining characteristic of severe COVID-19, especially in elderly people. Lymphopenia has been suggested as a pivotal factor in disease severity. To minimize mortality in COVID-19 patients, it is essential to have a deeper understanding of the processes behind lymphocytopenia. Recently, myeloid-derived suppressor cells (MDSCs) have been confirmed as a key mediator of lymphopenia. MDSCs are characterized by their powerful capacity to suppress T cells and eventually contribute to the course of illness. Targeting these cells may improve the disease prognosis. In this article, we analyze the available research on MDSCs in lymphopenia and discuss their immunopathologic changes and prospective therapeutic targets in patients with COVID-19 lymphocytopenia.
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Smaha J, Kužma M, Jackuliak P, Nachtmann S, Max F, Tibenská E, Binkley N, Payer J. Serum 25-hydroxyvitamin D Concentration Significantly Decreases in Patients with COVID-19 Pneumonia during the First 48 Hours after Hospital Admission. Nutrients 2022; 14:2362. [PMID: 35745092 PMCID: PMC9228147 DOI: 10.3390/nu14122362] [Citation(s) in RCA: 1] [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: 05/18/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 12/12/2022] Open
Abstract
It is unclear how ongoing inflammation in Coronavirus Disease 2019 (COVID-19) affects 25-hydroxyvitamin D (25[OH]D) concentration. The objective of our study was to examine serum 25(OH)D levels during COVID-19 pneumonia. Patients were admitted between 1 November and 31 December 2021. Blood samples were taken on admission (day 0) and every 24 h for the subsequent four days (day 1−4). On admission, 59% of patients were 25(OH)D sufficient (>30 ng/mL), and 41% had 25(OH)D inadequacy (<30 ng/mL). A significant fall in mean 25(OH)D concentration from admission to day 2 (first 48 h) was observed (30.7 ng/mL vs. 26.4 ng/mL; p < 0.0001). No subsequent significant change in 25(OH)D concentration was observed between day 2 and 3 (26.4 ng/mL vs. 25.9 ng/mL; p = 0.230) and day 3 and day 4 (25.8 ng/mL vs. 25.9 ng/mL; p = 0.703). The absolute 25(OH)D change between hospital admission and day 4 was 16% (4.8 ng/mL; p < 0.0001). On day 4, the number of patients with 25(OH)D inadequacy increased by 18% (p = 0.018). Therefore, serum 25(OH)D concentration after hospital admission in acutely ill COVID-19 patients should be interpreted with caution. Whether low 25(OH)D in COVID-19 reflects tissue level vitamin D deficiency or represents only a laboratory phenomenon remains to be elucidated in further prospective trials of vitamin D supplementation.
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Affiliation(s)
- Juraj Smaha
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
| | - Martin Kužma
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
| | - Peter Jackuliak
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
| | - Samuel Nachtmann
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
| | - Filip Max
- Department of Pharmacology and Toxicology, Comenius University Faculty of Pharmacy, Odbojarov 10, 832 32 Bratislava, Slovakia;
| | - Elena Tibenská
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
- Medirex, a.s., Galvaniho 17/C, 820 16 Bratislava, Slovakia
| | - Neil Binkley
- Department of Medicine, Geriatrics Faculty, Medical Sciences Center, University of Wisconsin, 1300 University Ave, Madison, WI 53706-1510, USA;
| | - Juraj Payer
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia; (M.K.); (P.J.); (S.N.); (E.T.); (J.P.)
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Abstract
PURPOSE OF REVIEW To review the mechanisms by which vitamin D and its metabolites regulate the immune system to facilitate the ability of the body to prevent and/or treat SARS-CoV2 and other respiratory infections and encourage further research into the role that vitamin D supplementation plays in preventing/treating such infections. RECENT FINDINGS Vitamin D deficiency is associated with an increased risk of SARS-CoV2 and other respiratory infections. Clinical trials in general demonstrate that correction of vitamin D deficiency reduces the risk of hospitalization, ICU admission, and death from SARS-CoV2 infection. The airway epithelium and alveolar macrophages express the enzyme, CYP27B1, that produces the active metabolite of vitamin D, 1,25(OH)2D, and the vitamin D receptor, VDR. Vitamin D and its metabolites promote the innate immune response, which provides the first line of defense against viral and bacterial infections while restricting the adaptive immune response, which if unchecked promotes the inflammatory response leading to the acute respiratory distress syndrome and death. The rationale for treating vitamin D deficiency to reduce the risk of SARS-CoV2 infection and supplementing patients with vitamin D early in the course of SARS-CoV2 infection rests primarily on the ability of vitamin D metabolites to promote an effective immune response to the infection.
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Affiliation(s)
- Daniel D Bikle
- Veterans Affairs Medical Center, University of California San Francisco, 1700 Owens St, San Francisco, CA, 94158, USA.
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Role of T Regulatory Cells and Myeloid-Derived Suppressor Cells in COVID-19. J Immunol Res 2022; 2022:5545319. [PMID: 35497875 PMCID: PMC9042623 DOI: 10.1155/2022/5545319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/13/2022] [Accepted: 03/28/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been raised as a pandemic disease since December 2019. Immunosuppressive cells including T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSCs) are key players in immunological tolerance and immunoregulation; however, they contribute to the pathogenesis of different diseases including infections. Tregs have been shown to impair the protective role of CD8+ T lymphocytes against viral infections. In COVID-19 patients, most studies reported reduction, while few other studies found elevation in Treg levels. Moreover, Tregs have a dual role, depending on the different stages of COVID-19 disease. At early stages of COVID-19, Tregs have a critical role in decreasing antiviral immune responses, and consequently reducing the viral clearance. On the other side, during late stages, Tregs reduce inflammation-induced organ damage. Therefore, inhibition of Tregs in early stages and their expansion in late stages have potentials to improve clinical outcomes. In viral infections, MDSC levels are highly increased, and they have the potential to suppress T cell proliferation and reduce viral clearance. Some subsets of MDSCs are expanded in the blood of COVID-19 patients; however, there is a controversy whether this expansion has pathogenic or protective effects in COVID-19 patients. In conclusion, further studies are required to investigate the role and function of immunosuppressive cells and their potentials as prognostic biomarkers and therapeutic targets in COVID-19 patients.
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Abstract
Covid-19 has to date infected a confirmed 275 million people with 5.4 million, now dead, with the count rising every day. Although the virus, SARS-CoV2, causing Covid-19 infects many cells in the body, its infection of the upper and lower respiratory tract (upper airway epithelia and pulmonary alveolar pneumocytes and macrophages) causing what is now called a cytokine storm in the lungs is the major cause of morbidity and mortality. This results from a dysregulation of the innate immune system with an outpouring of proinflammatory cytokines and chemokines leading to abnormal activation of the adaptive immune pathway. Airway epithelia constitutively expresses CYP27B1, the enzyme producing the active vitamin D metabolite, 1,25(OH)2D, and the vitamin D receptor (VDR) for which 1,25(OH)2D is the ligand. Pulmonary alveolar macrophages, on the other hand, are induced to express both CYP27B1 and VDR by various pathogens including viruses and cytokines released from infected epithelia and other immune cells. Although not demonstrated for corona viruses like SARS-CoV2, for other viruses and other respiratory pathogens activation of innate immunity leading to increased local 1,25(OH)2D production has been shown to enhance viral neutralization and clearance while modulating the subsequent proinflammatory response. Whether such will be the case for SARS-CoV2 remains to be seen, but is currently being proposed and investigated. This mini review will discuss some of the mechanisms by which vitamin D may help reduce morbidity and mortality in this devastating pandemic.
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Affiliation(s)
- Daniel D Bikle
- Veterans Affairs Medical Center and University of California San Francisco, 4150 Clement Street (111N), San Francisco, CA, 94121, USA.
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Albergamo A, Apprato G, Silvagno F. The Role of Vitamin D in Supporting Health in the COVID-19 Era. Int J Mol Sci 2022; 23:3621. [PMID: 35408981 PMCID: PMC8998275 DOI: 10.3390/ijms23073621] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
The genomic activity of vitamin D is associated with metabolic effects, and the hormone has a strong impact on several physiological functions and, therefore, on health. Among its renowned functions, vitamin D is an immunomodulator and a molecule with an anti-inflammatory effect, and, recently, it has been much studied in relation to its response against viral infections, especially against COVID-19. This review aims to take stock of the correlation studies between vitamin D deficiency and increased risks of severe COVID-19 disease and, similarly, between vitamin D deficiency and acute respiratory distress syndrome. Based on this evidence, supplementation with vitamin D has been tested in clinical trials, and the results are discussed. Finally, this study includes a biochemical analysis on the effects of vitamin D in the body's defense mechanisms against viral infection. In particular, the antioxidant and anti-inflammatory functions are considered in relation to energy metabolism, and the potential, beneficial effect of vitamin D in COVID-19 is described, with discussion of its influence on different biochemical pathways. The proposed, broader view of vitamin D activity could support a better-integrated approach in supplementation strategies against severe COVID-19, which could be valuable in a near future of living with an infection becoming endemic.
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Affiliation(s)
- Alice Albergamo
- Department of Oncology, University of Torino, 10126 Torino, Italy
| | - Giulia Apprato
- Department of Oncology, University of Torino, 10126 Torino, Italy
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Fernandes AL, Murai IH, Reis BZ, Sales LP, Santos MD, Pinto AJ, Goessler KF, Duran CSC, Silva CBR, Franco AS, Macedo MB, Dalmolin HHH, Baggio J, Balbi GGM, Antonangelo L, Caparbo VF, Gualano B, Pereira RMR. Effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in patients with moderate to severe COVID-19. Am J Clin Nutr 2022; 115:790-798. [PMID: 35020796 PMCID: PMC8807215 DOI: 10.1093/ajcn/nqab426] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/27/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The modulating effect of vitamin D on cytokine concentrations in severe coronavirus disease 2019 (COVID-19) remains unknown. OBJECTIVES We aimed to investigate the effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. METHODS This is a post hoc, ancillary, and exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients with moderate to severe COVID-19 were recruited from 2 hospitals in São Paulo, Brazil. Of 240 randomly assigned patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200,000 IU vitamin D3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, which has been published in our previous study. The prespecified secondary outcomes were serum concentrations of IL-1β, IL-6, IL-10, TNF-α, and 25-hydroxyvitamin D. The post hoc exploratory secondary outcomes were IL-4, IL-12p70, IL-17A, IFN-γ, granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-8, IFN-inducible protein-10 (IP-10), macrophage inflammatory protein-1β (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and leukocyte count. Generalized estimating equations for repeated measures, with Bonferroni's adjustment, were used for testing all outcomes. RESULTS The study included 200 patients with a mean ± SD age of 55.5 ± 14.3 y and BMI of 32.2 ± 7.1 kg/m2, of which 109 (54.5%) were male. GM-CSF concentrations showed a significant group-by-time interaction effect (P = 0.04), although the between-group difference at postintervention after Bonferroni's adjustment was not significant. No significant effects were observed for the other outcomes. CONCLUSIONS The findings do not support the use of a single dose of 200,000 IU vitamin D3, compared with placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19.This trial was registered at clinicaltrials.gov as NCT04449718.
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Affiliation(s)
- Alan L Fernandes
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Igor H Murai
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruna Z Reis
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lucas P Sales
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mayara D Santos
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ana J Pinto
- Applied Physiology & Nutrition Research Group, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Karla F Goessler
- Applied Physiology & Nutrition Research Group, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Camila SC Duran
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carla BR Silva
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - André S Franco
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marina B Macedo
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil,Address correspondence to RMRP (E-mail: )
| | - Henrique HH Dalmolin
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Janaina Baggio
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Guilherme GM Balbi
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Leila Antonangelo
- Clinical Pathology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Valeria F Caparbo
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil,Food Research Center, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rosa MR Pereira
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Athanassiou L, Mavragani CP, Koutsilieris M. The Immunomodulatory Properties of Vitamin D. Mediterr J Rheumatol 2022; 33:7-13. [PMID: 35611096 PMCID: PMC9092099 DOI: 10.31138/mjr.33.1.7] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 11/17/2022] Open
Abstract
Since its discovery, vitamin D was shown to have both immunostimulatory and immunomodulatory effects on the immune system. A growing body of evidence so far linked vitamin D deficiency with the development and severity of several systemic and organ specific autoimmune/inflammatory diseases, such as systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis. In the present report, the multiple and diverse effects of vitamin D on the immune system are reviewed.
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Affiliation(s)
- Lambros Athanassiou
- Department of Physiology, Medical School, University of Athens, Athens, Greece
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15
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Romano A, Cerchione C, Conticello C, Filetti S, Bulla A, Chiarenza A, Del Fabro V, Leotta S, Markovic U, Motta G, Parisi M, Stagno F, Palumbo GA, Di Raimondo F. Reduced Absolute Count of Monocytes in Patients Carrying Hematological Neoplasms and SARS-CoV2 Infection. Cancers (Basel) 2022; 14:cancers14051173. [PMID: 35267478 PMCID: PMC8909066 DOI: 10.3390/cancers14051173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary In hematological neoplasms associated with COVID-19, immunological dysfunction, including reduced count of non-classical monocytes, has been suggested as a primary driver of morbidity and mortality. In this work, we investigated the contribution of absolute monocyte count to clinical outcome of COVID-19 in 120 patients affected by hematological neoplasms that tested positive to SARS-CoV-2. We found that there was no statistical difference in 30-day mortality, rate of hospitalization for intensive cure and viral clearance at 14 days between fully vaccinated and unvaccinated patients. Increased 30-day mortality was associated with presence of active/progressing disease and absolute monocyte count lower than 400 cells/uL. Reduced absolute counts of monocytes should be used as an alert of increased risk of severe/critical forms of COVID-19 in patients with hematological malignancies, even when the full vaccination cycle has been completed. Abstract Background: Clinical course of COVID-19 depends on several patient-specific risk factors, including immune function, that is largely compromised in cancer patients. Methods: We prospectively evaluated 120 adult consecutive patients (including 34 cases of COVID-19 breakthrough after two full doses of BNT162b2 vaccine) with underlying hematological malignancies and a SARS-CoV-2 infection, in terms of patient’s clinical outcome. Results: Among fully vaccinated patients the achievement of viral clearance by day 14 was more frequent than in unvaccinated patients. Increased 30-day mortality was associated with presence of active/progressing disease and absolute monocyte count lower than 400 cells/uL. Results of multivariable analysis in unvaccinated patients showed that the pre-infection absolute count of monocytes less or equal to 400 cells/mmc, active or progressive disease of the underlying hematological malignancy, the COVID-19 severity identified by hospitalization requirement and lack of viral clearance at 14 days were independent predictors of 1-year overall survival. Conclusions: Taken together, our results indicate that absolute monocyte count determined one month before any documented SARS-CoV-2 infection could identify patients affected by hematological neoplasms with increased risk of inferior overall survival.
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Affiliation(s)
- Alessandra Romano
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Claudio Cerchione
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori [M1] (IRST) IRCCS, 47014 Meldola (FC), Italy
- Correspondence:
| | - Concetta Conticello
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Sabina Filetti
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Anna Bulla
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Annalisa Chiarenza
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Vittorio Del Fabro
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Salvatore Leotta
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Uros Markovic
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Oncohematology and BMT Unit, Mediterranean Institute of Oncology, 95125 Viagrande, Italy
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98122 Messina, Italy
| | - Giovanna Motta
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Marina Parisi
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Fabio Stagno
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Giuseppe Alberto Palumbo
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Ingrassia Department, University of Catania, 95100 Catania, Italy
| | - Francesco Di Raimondo
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
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16
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Luo X, Wu F, Wang C, Wen C. Analysis of Development Trends of the Research Hotspots of Vitamin D in Children. Front Pediatr 2022; 10:899844. [PMID: 35601441 PMCID: PMC9120835 DOI: 10.3389/fped.2022.899844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Using multivariate statistics and social network analysis techniques, we present a realistic and intuitive visualization of the research hotspots and development trends of vitamin D in children. METHODS The Medical Subject Headings (MeSH) term "vitamin D" was used to search all the publications (the study subjects were 0-18 years old) included in PubMed by time period. The subject terms for each development stage were extracted, the high-frequency subject terms were extracted using the Bibliographic Items Co-occurrence Matrix Builder (BICOMB), and a core subject term co-occurrence matrix was established. The Netdraw function of Ucinet 6.0 software was used to complete the social network drawing of the core subject term co-occurrence matrix to form a co-word network diagram composed of core subject terms. RESULTS Prior to 1979, there were 890 papers with 1,899 core subject terms; from 2010 to 2020, there were 3,773 papers with 12,682 core subject terms. Before 1979, the research direction of vitamin D in children focused on vitamin D in the classical regulation of calcium and phosphorus metabolism. From 1980 to 1989, studies focused on vitamin D metabolites and therapeutic drugs such as "calcitriol" and "calcifediol." From 1990 to 1999, studies focused on "calcitriol" and its association with "psoriasis," "chronic renal failure," and "dermatological drugs." From 2000 to 2009, studies focused on "vitamin D" and "vitamin D deficiency." From 2010 to 2020, studies focused on "vitamin D3" and its association with "vitamins," "bone mineral density protectants," "asthma," "obesity," "pregnancy complications" and "fetal blood." CONCLUSION Since 2010, the research direction of vitamin D in children has been growing rapidly, and the overall development trend is good. Studies extend from the study of the skeletal effect of vitamin D to the study of its extraskeletal effect and the investigation of mechanisms of its association with related diseases.
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Affiliation(s)
- Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Feifeng Wu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Wang
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chuan Wen
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
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Afzal M, Kazmi I, Al-Abbasi FA, Alshehri S, Ghoneim MM, Imam SS, Nadeem MS, Al-Zahrani MH, Alzarea SI, Alquraini A. Current Overview on Therapeutic Potential of Vitamin D in Inflammatory Lung Diseases. Biomedicines 2021; 9:1843. [PMID: 34944659 PMCID: PMC8698997 DOI: 10.3390/biomedicines9121843] [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: 10/23/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Inflammatory lung disorders (ILDs) are one of the world's major reasons for fatalities and sickness, impacting millions of individuals of all ages and constituting a severe and pervasive health hazard. Asthma, lung cancer, bronchiectasis, pulmonary fibrosis acute respiratory distress syndrome, and COPD all include inflammation as a significant component. Microbe invasions, as well as the damage and even death of host cells, can cause and sustain inflammation. To counteract the negative consequences of irritants, the airways are equipped with cellular and host defense immunological systems that block the cellular entrance of these irritants or eliminate them from airway regions by triggering the immune system. Failure to activate the host defense system will trigger chronic inflammatory cataracts, leading to permanent lung damage. This damage makes the lungs more susceptible to various respiratory diseases. There are certain restrictions of the available therapy for lung illnesses. Vitamins are nutritional molecules that are required for optimal health but are not produced by the human body. Cholecalciferol (Vitamin D) is classified as a vitamin, although it is a hormone. Vitamin D is thought to perform a function in bone and calcium homeostasis. Recent research has found that vitamin D can perform a variety of cellular processes, including cellular proliferation; differentiation; wound repair; healing; and regulatory systems, such as the immune response, immunological, and inflammation. The actions of vitamin D on inflammatory cells are dissected in this review, as well as their clinical significance in respiratory illnesses.
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Affiliation(s)
- Muhammad Afzal
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 72341, Saudi Arabia; (M.A.); (S.I.A.)
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Fahad A. Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Syed Sarim Imam
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Maryam Hassan Al-Zahrani
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Sami I. Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 72341, Saudi Arabia; (M.A.); (S.I.A.)
| | - Ali Alquraini
- Department of Pharmaceutical Chemistry, Faculty of Clinical Pharmacy, Al Baha University, Al Baha 65779, Saudi Arabia;
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18
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Verma S, Chaturvedi V, Ganguly NK, Mittal SA. Vitamin D deficiency: concern for rheumatoid arthritis and COVID-19? Mol Cell Biochem 2021; 476:4351-4362. [PMID: 34453644 PMCID: PMC8401347 DOI: 10.1007/s11010-021-04245-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022]
Abstract
Vitamin D is an immunomodulatory hormone with an established role in calcium and phosphate metabolism and skeletal mineralization. Evidence showing its immunological benefits by regulating essential components of the innate and adaptive immune system is prevalent. Vitamin D deficiency is reported worldwide and is thereby found to be associated with various immune-related diseases. Rheumatoid Arthritis and COVID-19 are two such diseases, sharing a similar hyperinflammatory response. Various studies have found an association of lower Vitamin D levels to be associated with both these diseases. However, contrasting data is also reported. We review here the available scientific data on risk factor association and supplementation benefits of Vitamin D in Rheumatoid Arthritis and COVID-19, intending to critically evaluate the literature.
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Affiliation(s)
- Sneha Verma
- Department of Research, Sir Ganga Ram Hospital, New Delhi, India
| | - Ved Chaturvedi
- Department of Rheumatology & Clinical Immunology, Sir Ganga Ram Hospital, New Delhi, India
| | - N K Ganguly
- Department of Research, Sir Ganga Ram Hospital, New Delhi, India
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Koushki K, Salemi M, Miri SM, Arjeini Y, Keshavarz M, Ghaemi A. Role of myeloid-derived suppressor cells in viral respiratory infections; Hints for discovering therapeutic targets for COVID-19. Biomed Pharmacother 2021; 144:112346. [PMID: 34678727 PMCID: PMC8516725 DOI: 10.1016/j.biopha.2021.112346] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 02/06/2023] Open
Abstract
The expansion of myeloid-derived suppressor cells (MDSCs), known as heterogeneous population of immature myeloid cells, is enhanced during several pathological conditions such as inflammatory or viral respiratory infections. It seems that the way MDSCs behave in infection depends on the type and the virulence mechanisms of the invader pathogen, the disease stage, and the infection-related pathology. Increasing evidence showing that in correlation with the severity of the disease, MDSCs are accumulated in COVID-19 patients, in particular in those at severe stages of the disease or ICU patients, contributing to pathogenesis of SARS-CoV2 infection. Based on the involved subsets, MDSCs delay the clearance of the virus through inhibiting T-cell proliferation and responses by employing various mechanisms such as inducing the secretion of anti-inflammatory cytokines, inducible nitric oxide synthase (iNOS)-mediated hampering of IFN-γ production, or forcing arginine shortage. While the immunosuppressive characteristic of MDSCs may help to preserve the tissue homeostasis and prevent hyperinflammation at early stages of the infection, hampering of efficient immune responses proved to exert significant pathogenic effects on severe forms of COVID-19, suggesting the targeting of MDSCs as a potential intervention to reactivate T-cell immunity and thereby prevent the infection from developing into severe stages of the disease. This review tried to compile evidence on the roles of different subsets of MDSCs during viral respiratory infections, which is far from being totally understood, and introduce the promising potential of MDSCs for developing novel diagnostic and therapeutic approaches, especially against COVID-19 disease.
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Affiliation(s)
- Khadijeh Koushki
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Salemi
- Department of Medical Virology, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyed Mohammad Miri
- Department of Influenza and Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Yaser Arjeini
- Department of Research and Development, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Mohsen Keshavarz
- Department of Medical Virology, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Amir Ghaemi
- Department of Influenza and Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran.
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Mazess RB, Bischoff‐Ferrari HA, Dawson‐Hughes B. Vitamin D: Bolus Is Bogus-A Narrative Review. JBMR Plus 2021; 5:e10567. [PMID: 34950828 PMCID: PMC8674779 DOI: 10.1002/jbm4.10567] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
In this review we summarize the impact of bolus versus daily dosing of vitamin D on 25(OH)D and 1,25(OH)2D levels, as well as on key countervailing factors that block vitamin D functions at the cellular level. Further, we discuss the role of bolus versus daily dosing of vitamin D for several health outcomes, including respiratory infections and coronavirus disease 2019 (COVID-19), rickets, falls and fractures, any cancer, and cancer-related mortality. This discussion appears timely because bolus doses continue to be tested for various disease outcomes despite a growing amount of evidence suggesting lack of efficacy or even detrimental effects of bolus dosing of vitamin D for outcomes where daily dosing at modest levels was effective in the vitamin D deficient. As a result, these discordant results may bias health recommendations for vitamin D if the recommendations are based on meta-analyses combining both daily and bolus dosing trials. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
| | - Heike A. Bischoff‐Ferrari
- Department of Aging Medicine and Aging ResearchUniversity of ZurichZurichSwitzerland
- City Hospital ZurichUniversity Clinic for Aging MedicineZurichSwitzerland
| | - Bess Dawson‐Hughes
- Jean Mayer US Department of Agriculture (USDA) Human Nutrition Research Center on AgingTufts UniversityBostonMAUSA
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Barhoumi T, Alghanem B, Shaibah H, Mansour FA, Alamri HS, Akiel MA, Alroqi F, Boudjelal M. SARS-CoV-2 Coronavirus Spike Protein-Induced Apoptosis, Inflammatory, and Oxidative Stress Responses in THP-1-Like-Macrophages: Potential Role of Angiotensin-Converting Enzyme Inhibitor (Perindopril). Front Immunol 2021; 12:728896. [PMID: 34616396 PMCID: PMC8488399 DOI: 10.3389/fimmu.2021.728896] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/30/2021] [Indexed: 12/21/2022] Open
Abstract
A purified spike (S) glycoprotein of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) coronavirus was used to study its effects on THP-1 macrophages, peripheral blood mononuclear cells (PBMCs), and HUVEC cells. The S protein mediates the entry of SARS-CoV-2 into cells through binding to the angiotensin-converting enzyme 2 (ACE2) receptors. We measured the viability, intracellular cytokine release, oxidative stress, proinflammatory markers, and THP-1-like macrophage polarization. We observed an increase in apoptosis, ROS generation, MCP-1, and intracellular calcium expression in the THP-1 macrophages. Stimulation with the S protein polarizes the THP-1 macrophages towards proinflammatory futures with an increase in the TNFα and MHC-II M1-like phenotype markers. Treating the cells with an ACE inhibitor, perindopril, at 100 µM reduced apoptosis, ROS, and MHC-II expression induced by S protein. We analyzed the sensitivity of the HUVEC cells after the exposure to a conditioned media (CM) of THP-1 macrophages stimulated with the S protein. The CM induced endothelial cell apoptosis and MCP-1 expression. Treatment with perindopril reduced these effects. However, the direct stimulation of the HUVEC cells with the S protein, slightly increased HIF1α and MCP-1 expression, which was significantly increased by the ACE inhibitor treatment. The S protein stimulation induced ROS generation and changed the mitogenic responses of the PBMCs through the upregulation of TNFα and interleukin (IL)-17 cytokine expression. These effects were reduced by the perindopril (100 µM) treatment. Proteomic analysis of the S protein stimulated THP-1 macrophages with or without perindopril (100 µM) exposed more than 400 differentially regulated proteins. Our results provide a mechanistic analysis suggesting that the blood and vascular components could be activated directly through S protein systemically present in the circulation and that the activation of the local renin angiotensin system may be partially involved in this process. Graphical Suggested pathways that might be involved at least in part in S protein inducing activation of inflammatory markers (red narrow) and angiotensin-converting enzyme inhibitor (ACEi) modulation of this process (green narrow).
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Affiliation(s)
- Tlili Barhoumi
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bandar Alghanem
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hayat Shaibah
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fatmah A Mansour
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hassan S Alamri
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Maaged A Akiel
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Human and Molecular Genetics, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Fayhan Alroqi
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdulaziz Medical City, King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia
| | - Mohammad Boudjelal
- Medical Research Core Facility and Platforms (MRCFP), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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22
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Yang Y, Li N, Wang TM, Di L. Natural Products with Activity against Lung Cancer: A Review Focusing on the Tumor Microenvironment. Int J Mol Sci 2021; 22:ijms221910827. [PMID: 34639167 PMCID: PMC8509218 DOI: 10.3390/ijms221910827] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Lung cancer is one of the most prevalent malignancies worldwide. Despite the undeniable progress in lung cancer research made over the past decade, it is still the leading cause of cancer-related deaths and continues to challenge scientists and researchers engaged in searching for therapeutics and drugs. The tumor microenvironment (TME) is recognized as one of the major hallmarks of epithelial cancers, including the majority of lung cancers, and is associated with tumorigenesis, progression, invasion, and metastasis. Targeting of the TME has received increasing attention in recent years. Natural products have historically made substantial contributions to pharmacotherapy, especially for cancer. In this review, we emphasize the role of the TME and summarize the experimental proof demonstrating the antitumor effects and underlying mechanisms of natural products that target the TME. We also review the effects of natural products used in combination with anticancer agents. Moreover, we highlight nanotechnology and other materials used to enhance the effects of natural products. Overall, our hope is that this review of these natural products will encourage more thoughts and ideas on therapeutic development to benefit lung cancer patients.
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Affiliation(s)
| | - Ning Li
- Correspondence: (N.L.); (L.D.); Tel.: +86-551-6516-1115 (N.L.)
| | | | - Lei Di
- Correspondence: (N.L.); (L.D.); Tel.: +86-551-6516-1115 (N.L.)
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23
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Briceno Noriega D, Savelkoul HFJ. Vitamin D and Allergy Susceptibility during Gestation and Early Life. Nutrients 2021; 13:1015. [PMID: 33801051 PMCID: PMC8003945 DOI: 10.3390/nu13031015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023] Open
Abstract
Worldwide, the prevalence of allergies in young children, but also vitamin D deficiency during pregnancy and in newborns is rising. Vitamin D modulates the development and activity of the immune system and a low vitamin D status during pregnancy and in early life might be associated with an increased risk to develop an allergy during early childhood. This review studies the effects of vitamin D during gestation and early life, on allergy susceptibility in infants. The bioactive form of vitamin D, 1,25(OH)2D, inhibits maturation and results in immature dendritic cells that cause a decreased differentiation of naive T cells into effector T cells. Nevertheless, the development of regulatory T cells and the production of interleukin-10 was increased. Consequently, a more tolerogenic immune response developed against antigens. Secondly, binding of 1,25(OH)2D to epithelial cells induces the expression of tight junction proteins resulting in enhanced epithelial barrier function. Thirdly, 1,25(OH)2D increased the expression of anti-microbial peptides by epithelial cells that also promoted the defense mechanism against pathogens, by preventing an invasive penetration of pathogens. Immune intervention by vitamin D supplementation can mitigate the disease burden from asthma and allergy. In conclusion, our review indicates that a sufficient vitamin D status during gestation and early life can lower the susceptibility to develop an allergy in infants although there remains a need for more causal evidence.
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Affiliation(s)
| | - Huub F. J. Savelkoul
- Cell Biology and Immunology Group, Wageningen University & Research, 6708 WD Wageningen, The Netherlands;
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24
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Anderson G, Carbone A, Mazzoccoli G. Tryptophan Metabolites and Aryl Hydrocarbon Receptor in Severe Acute Respiratory Syndrome, Coronavirus-2 (SARS-CoV-2) Pathophysiology. Int J Mol Sci 2021; 22:ijms22041597. [PMID: 33562472 PMCID: PMC7915649 DOI: 10.3390/ijms22041597] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
The metabolism of tryptophan is intimately associated with the differential regulation of diverse physiological processes, including in the regulation of responses to severe acute respiratory syndrome, coronavirus-2 (SARS-CoV-2) infection that underpins the COVID-19 pandemic. Two important products of tryptophan metabolism, viz kynurenine and interleukin (IL)4-inducible1 (IL41)-driven indole 3 pyruvate (I3P), activate the aryl hydrocarbon receptor (AhR), thereby altering the nature of immune responses to SARS-CoV-2 infection. AhR activation dysregulates the initial pro-inflammatory cytokines production driven by neutrophils, macrophages, and mast cells, whilst AhR activation suppresses the endogenous antiviral responses of natural killer cells and CD8+ T cells. Such immune responses become further dysregulated by the increased and prolonged pro-inflammatory cytokine suppression of pineal melatonin production coupled to increased gut dysbiosis and gut permeability. The suppression of pineal melatonin and gut microbiome-derived butyrate, coupled to an increase in circulating lipopolysaccharide (LPS) further dysregulates the immune response. The AhR mediates its effects via alterations in the regulation of mitochondrial function in immune cells. The increased risk of severe/fatal SARS-CoV-2 infection by high risk conditions, such as elderly age, obesity, and diabetes are mediated by these conditions having expression levels of melatonin, AhR, butyrate, and LPS that are closer to those driven by SARS-CoV-2 infection. This has a number of future research and treatment implications, including the utilization of melatonin and nutraceuticals that inhibit the AhR, including the polyphenols, epigallocatechin gallate (EGCG), and resveratrol.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SW1V 1PX, UK
| | - Annalucia Carbone
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy
| | - Gianluigi Mazzoccoli
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy
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