1
|
Noppert GA, Clarke P, Stebbins RC, Duchowny KA, Melendez R, Rollings K, Aiello AE. The embodiment of the neighborhood socioeconomic environment in the architecture of the immune system. PNAS NEXUS 2024; 3:pgae253. [PMID: 39006475 PMCID: PMC11244187 DOI: 10.1093/pnasnexus/pgae253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/31/2024] [Indexed: 07/16/2024]
Abstract
There is growing recognition of the importance of immune health for understanding the origins of ageing-related disease and decline. Numerous studies have demonstrated consistent associations between the social determinants of health and immunosenescence (i.e. ageing of the immune system). Yet few studies have interrogated the relationship between neighborhood socioeconomic status (nSES) and biologically specific measures of immunosenescence. We used data from the US Health and Retirement Study to measure immunosenescence linked with neighborhood socioeconomic data from the National Neighborhood Data Archive to examine associations between indicators of nSES and immunosenescence. We found associations between both the ratio of terminally differentiated effector memory to naïve (EMRA:Naïve) CD4+ T cells and cytomegalovirus (CMV) immunoglobulin G (IgG) levels and nSES. For the CD4+ EMRA:Naïve ratio, each 1% increase in the neighborhood disadvantage index was associated with a 0.005 standard deviation higher value of the EMRA:Naïve ratio (95% CI: 0.0003, 0.01) indicating that living in a neighborhood that is 10% higher in disadvantage is associated with a 0.05 higher standardized value of the CD4+ EMRA:Naïve ratio. The results were fully attenuated when adjusting for both individual-level SES and race/ethnicity. For CMV IgG antibodies, a 1% increase in neighborhood disadvantage was associated a 0.03 standard deviation higher value of CMV IgG antibodies (β = 0.03; 95% CI: 0.002, 0.03) indicating that living in a neighborhood that is 10% higher in disadvantage is associated with a 0.3 higher standardized value of CMV. This association was attenuated though still statistically significant when controlling for individual-level SES and race/ethnicity. The findings from this study provide compelling initial evidence that large, nonspecific social exposures, such as neighborhood socioeconomic conditions, can become embodied in cellular processes of immune ageing.
Collapse
Affiliation(s)
- Grace A Noppert
- Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Philippa Clarke
- Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Rebecca C Stebbins
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University Irving Medical Center, 722 W. 168th St., New York, NY 10032, USA
| | - Kate A Duchowny
- Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Robert Melendez
- Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Kimberly Rollings
- Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Allison E Aiello
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University Irving Medical Center, 722 W. 168th St., New York, NY 10032, USA
| |
Collapse
|
2
|
Noppert GA, Stebbins RC, Dowd JB, Aiello AE. Socioeconomic and race/ethnic differences in immunosenescence: Evidence from the Health and Retirement Study. Brain Behav Immun 2023; 107:361-368. [PMID: 36347419 PMCID: PMC9636606 DOI: 10.1016/j.bbi.2022.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/20/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the urgent need to understand variation in immunosenescence at the population-level. Thus far, population patterns of immunosenescence have not well described. METHODS We characterized measures of immunosenescence from the 2016 Venous Blood Study from the nationally representative U.S Health and Retirement Study (HRS) of individuals ages 50 years and older. RESULTS Median values of the CD8+:CD4+, EMRA:Naïve CD4+ and EMRA:Naïve CD8+ ratios were higher among older participants and were lower in those with additional educational attainment. Generally, minoritized race and ethnic groups had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95 % CI: 0.35, 0.39) compared to 0.30 in non-Hispanic Whites (95 % CI: 0.29, 0.31). Non-Hispanic Blacks had the highest median value of the EMRA:Naïve CD4+ ratio (0.08; 95 % CI: 0.07, 0.09) compared to non-Hispanic Whites (0.03; 95 % CI: 0.028, 0.033). In regression analyses, race/ethnicity and education were associated with large differences in the immune ratio measures after adjustment for age and sex. CONCLUSIONS Lower educational attainment and minoritized racial ethnic status were associated with higher levels of immunosenescence. This population variation may have important implications for both risk of age-related disease and vulnerability to emerging pathogens (e.g., SARS-CoV-2).
Collapse
Affiliation(s)
- Grace A Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Rebecca C Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute for Psychiatry, Psychology, and Neuroscience; King's College London, London, UK.
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology, University of Oxford, UK
| | - Allison E Aiello
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
| |
Collapse
|
3
|
Noppert GA, Stebbins RC, Dowd JB, Aiello AE. Sociodemographic Differences in Population-Level Immunosenescence in Older Age. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.03.05.22271952. [PMID: 35291293 PMCID: PMC8923107 DOI: 10.1101/2022.03.05.22271952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background The COVID-19 pandemic has highlighted the urgent need to understand variation in immunosenescence at the population-level. Thus far, population patterns of immunosenescence are not well described. Methods We characterized measures of immunosenescence from newly released venous blood data from the nationally representative U.S Health and Retirement Study (HRS) of individuals ages 56 years and older. Findings Median values of the CD8+:CD4+, EMRA:Nave CD4+ and EMRA:Nave CD8+ ratios were higher among older participants and were lower in those with additional educational attainment. Generally, minoritized race and ethnic groups had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95% CI: 0.35, 0.39) compared to 0.30 in Whites (95% CI: 0.29, 0.31). Blacks had the highest median value of the EMRA:Nave CD4+ ratio (0.08; 95% CI: 0.07, 0.09) compared to Whites (0.03; 95% CI: 0.028, 0.033). In regression analyses, race/ethnicity and education were associated with large differences in the immune ratio measures after adjustment for age and sex. For example, each additional level of education was associated with roughly an additional decade of immunological age, and the racial/ethnic differences were associated with two to four decades of additional immunological age. Interpretation Our study provides novel insights into population variation in immunosenescence. This has implications for both risk of age-related disease and vulnerability to novel pathogens (e.g., SARS-CoV-2). Funding This study was partially funded by the U.S. National Institutes of Health, National Institute on Aging R00AG062749. AEA and GAN acknowledge support from the National Institutes of Health, National Institute on Aging R01AG075719. JBD acknowledges support from the Leverhulme Trust (Centre Grant) and the European Research Council grant ERC-2021-CoG-101002587. Research in context Evidence before this study: Alterations in immunity with chronological aging have been consistently demonstrated across human populations. Some of the hallmark changes in adaptive immunity associated with aging, termed immunosenescence, include a decrease in nave T-cells, an increase in terminal effector memory cells, and an inverted CD8:CD4 T cell ratio. Several studies have shown that social and psychosocial exposures can alter aspects of immunity and lead to increased susceptibility to infectious diseases.Add value of this study: While chronological age is known to impact immunosenescence, there are no studies examining whether social and demographic factors independently impact immunosenescence. This is important because immunosenescence has been associated with greater susceptibility to disease and lower immune response to vaccination. Identifying social and demographic variability in immunosenescence could help inform risk and surveillance efforts for preventing disease in older age. To our knowledge, we present one of the first large-scale population-based investigations of the social and demographic patterns of immunosenescence among individuals ages 50 and older living in the US. We found differences in the measures of immunosenescence by age, sex, race/ethnicity, and education, though the magnitude of these differences varied across immune measures and sociodemographic subgroup. Those occupying more disadvantaged societal positions (i.e., minoritized race and ethnic groups and individuals with lower educational attainment) experience greater levels of immunosenescence compared to those in less disadvantaged positions. Of note, the magnitude of effect of sociodemographic factors was larger than chronological age for many of the associations.Implications for practice or policy and future research: The COVID-19 pandemic has highlighted the need to better understand variation in adaptive and innate immunity at the population-level. While chronological age has traditionally been thought of as the primary driver of immunological aging, the magnitude of differences we observed by sociodemographic factors suggests an important role for the social environment in the aging human immune system.
Collapse
Affiliation(s)
- Grace A Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, MI USA
| | - Rebecca C Stebbins
- Social, Genetic, & Developmental Psychiatry Centre; Institute for Psychiatry, Psychology, and Neuroscience; King's College London, London, UK
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology, University of Oxford
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
| |
Collapse
|
4
|
Lebedeva A, Fitzgerald W, Molodtsov I, Shpektor A, Vasilieva E, Margolis L. Differential clusterization of soluble and extracellular vesicle-associated cytokines in myocardial infarction. Sci Rep 2020; 10:21114. [PMID: 33273611 PMCID: PMC7713058 DOI: 10.1038/s41598-020-78004-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
A proinflammatory dysregulation of cytokine release is associated with various diseases, in particular with those of infectious etiology, as well as with cardiovascular diseases (CVD). We showed earlier that cytokines are released in two forms, soluble and in association with extracellular vesicles (EVs). Here, we investigated the patterns of expression and clustering of soluble and EV-associated cytokines in patients with ST-elevation myocardial infarction (STEMI). We collected plasma samples from 48 volunteers without CVD and 62 patients with STEMI, separated soluble and EV fractions, and analyzed them for 33 cytokines using a multiplexed bead-based assay. We identified soluble and EV-associated cytokines that are upregulated in STEMI and form correlative clusters. Several clustered soluble cytokines were expressed almost exclusively in patients with STEMI. EV-associated cytokines were largely not affected by STEMI, except for pro-inflammatory cytokines IL-6, IL-18, and MIG, as well as anti-inflammatory IL-2 that were upregulated in a correlated fashion. Our results demonstrated that soluble cytokines in patients with STEMI are upregulated in a coordinated fashion in contrast to the mainly unaffected system of EV-associated cytokines. Identification of cytokine clusters affected differently by STEMI now permits investigation of their differential contributions to this pathology.
Collapse
Affiliation(s)
- Anna Lebedeva
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, 11/6 Yauzskaya Street, Moscow, Russia, 119027.,Department of Internal Medicine and Cardiology, Charité University of Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Wendy Fitzgerald
- Section On Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ivan Molodtsov
- N.F. Gamaleya Federal National Research Centre for Epidemiology and Microbiology, 18 Gamaleya Street, Moscow, Russia, 123098
| | - Alexander Shpektor
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, 11/6 Yauzskaya Street, Moscow, Russia, 119027
| | - Elena Vasilieva
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, 11/6 Yauzskaya Street, Moscow, Russia, 119027.
| | - Leonid Margolis
- Section On Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA
| |
Collapse
|
5
|
Lebedeva A, Maryukhnich E, Grivel JC, Vasilieva E, Margolis L, Shpektor A. Productive Cytomegalovirus Infection Is Associated With Impaired Endothelial Function in ST-Elevation Myocardial Infarction. Am J Med 2020; 133:133-142. [PMID: 31295440 PMCID: PMC6940528 DOI: 10.1016/j.amjmed.2019.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/01/2019] [Accepted: 06/03/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND An association between productive cytomegalovirus infection and atherosclerosis was shown recently in several trials, including a previous study of ours. However, the mechanism involved in this association is still under investigation. Here, we addressed the interaction between productive cytomegalovirus infection and endothelial function in patients with ST-elevation myocardial infarction (STEMI). METHODS We analyzed the presence of cytomegaloviral DNA in plasma and endothelial function in 33 patients with STEMI and 33 volunteers without cardiovascular diseases, using real-time polymerase chain reaction (PCR) and a noninvasive test of flow-mediated dilation. RESULTS Both the frequency of presence and the load of cytomegaloviral DNA were higher in plasma of patients with STEMI than those in controls. This difference was independent of other cardiovascular risk factors (7.38 [1.36-40.07]; P = 0.02). The results of the flow-mediated dilation test were lower in patients in STEMI than in controls (5.0% [2.65%-3.09%] vs 12. %5 [7.5%-15.15%]; P = 0.004) and correlated negatively with the cytomegaloviral DNA load (Spearman R = -0.407; P = 0.019) independently of other cardiovascular risk factors. CONCLUSIONS Productive cytomegalovirus infection in patients with STEMI correlated negatively with endothelial function independently of other cardiovascular risk factors. The impact of cytomegalovirus on endothelial function may explain the role of cytomegalovirus in cardiovascular prognosis.
Collapse
Affiliation(s)
- Anna Lebedeva
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Elena Maryukhnich
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | | | - Elena Vasilieva
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Leonid Margolis
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md.
| | - Alexander Shpektor
- Laboratory of Atherothrombosis, Moscow State University of Medicine and Dentistry, Moscow, Russia
| |
Collapse
|
6
|
Liu H, Chen X, Hu X, Niu H, Tian R, Wang H, Pang H, Jiang L, Qiu B, Chen X, Zhang Y, Ma Y, Tang S, Li H, Feng S, Zhang S, Zhang C. Alterations in the gut microbiome and metabolism with coronary artery disease severity. MICROBIOME 2019; 7:68. [PMID: 31027508 PMCID: PMC6486680 DOI: 10.1186/s40168-019-0683-9] [Citation(s) in RCA: 178] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/09/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is associated with gut microbiota alterations in different populations. Gut microbe-derived metabolites have been proposed as markers of major adverse cardiac events. However, the relationship between the gut microbiome and the different stages of CAD pathophysiology remains to be established by a systematic study. RESULTS Based on multi-omic analyses (sequencing of the V3-V4 regions of the 16S rRNA gene and metabolomics) of 161 CAD patients and 40 healthy controls, we found that the composition of both the gut microbiota and metabolites changed significantly with CAD severity. We identified 29 metabolite modules that were separately classified as being positively or negatively correlated with CAD phenotypes, and the bacterial co-abundance group (CAG) with characteristic changes at different stages of CAD was represented by Roseburia, Klebsiella, Clostridium IV and Ruminococcaceae. The result revealed that certain bacteria might affect atherosclerosis by modulating the metabolic pathways of the host, such as taurine, sphingolipid and ceramide, and benzene metabolism. Moreover, a disease classifier based on differential levels of microbes and metabolites was constructed to discriminate cases from controls and was even able to distinguish stable coronary artery disease from acute coronary syndrome accurately. CONCLUSION Overall, the composition and functions of the gut microbial community differed from healthy controls to diverse coronary artery disease subtypes. Our study identified the relationships between the features of the gut microbiota and circulating metabolites, providing a new direction for future studies aiming to understand the host-gut microbiota interplay in atherosclerotic pathogenesis.
Collapse
Affiliation(s)
- Honghong Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xi Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaomin Hu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Haitao Niu
- Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing, China
| | - Ran Tian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Wang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Haiyu Pang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lingjuan Jiang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Bintao Qiu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xiuting Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yiyangzi Ma
- Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing, China
| | - Si Tang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Hanyu Li
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Siqin Feng
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chenhong Zhang
- State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Joint International Research Laboratory of Metabolic & Developmental Science, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
7
|
Lebedeva AM, Shpektor AV, Vasilieva EY, Margolis LB. Cytomegalovirus Infection in Cardiovascular Diseases. BIOCHEMISTRY (MOSCOW) 2019; 83:1437-1447. [PMID: 30878019 DOI: 10.1134/s0006297918120027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Atherosclerosis underlies the development of many cardiovascular diseases that continue to hold a leading place among the causes of death in developed countries. The role of activated immune cells in atherosclerosis progression has been convincingly demonstrated, but the mechanism of their action remains poorly investigated. Since atherosclerosis is associated with chronic inflammatory response, involvement of viral and bacterial infections in atherogenesis has been examined. A special place among the infectious agents is held by human herpesviruses as the most common persistent viruses in human population coupled to chronic inflammation during atherosclerosis. We found that activation of cytomegalovirus (CMV, human herpesvirus 5) infection is associated with the emergence of acute coronary syndrome, which is in a good agreement with the data on productive CMV infection published elsewhere. In this review, we discuss the data obtained by us and other researchers regarding the role of cytomegalovirus infection and related potential mechanisms resulting in the expansion of atherosclerotic plaques during ischemic heart disease and stroke, including virus transfer to immune and endothelial cells via extracellular vesicles. In particular, the data presented in the review demonstrate that virus spreading in the vascular wall triggers immune system activation in atherosclerotic plaques and causes endothelial dysfunction. Moreover, productive CMV infection in patients with acute myocardial infarction correlates with the extent of endothelial dysfunction. The mechanisms described by us and other researchers may explain the role of CMV infection in atherosclerosis and development of ischemic heart disease.
Collapse
Affiliation(s)
- A M Lebedeva
- Department of Cardiology and Laboratory of Atherothrombosis, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, Moscow, 127473, Russia.
| | - A V Shpektor
- Department of Cardiology and Laboratory of Atherothrombosis, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, Moscow, 127473, Russia
| | - E Yu Vasilieva
- Department of Cardiology and Laboratory of Atherothrombosis, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, Moscow, 127473, Russia
| | - L B Margolis
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
| |
Collapse
|
8
|
Feng Q, Hui J, Tang N, Liu YM, Zhong H, Li Z, Wang LM, Qu YY, Deng FM, He F. Unexpected role of the human cytomegalovirus contribute to essential hypertension in the Kazakh Chinese population of Xinjiang. Biosci Rep 2018; 38:BSR20171522. [PMID: 29752343 PMCID: PMC6019381 DOI: 10.1042/bsr20171522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/29/2018] [Accepted: 05/10/2018] [Indexed: 02/06/2023] Open
Abstract
Human cytomegalovirus (HCMV) infection, chronic inflammation and oxidative stress, the renin-angiotensin system (RAS), endothelial function, and DNA methylation play roles in the pathogenesis of essential hypertension (EH); however, the mechanism by which HCMV predisposes patients to hypertension remain unclear. Our group previously demonstrated an association between EH and HCMV infection in Kazakh Chinese. Here, we investigated the relationship between HCMV infection and other clinicopathological features in 720 Kazakh individuals with or without hypertension (n=360 each; age: 18-80). Multiple linear and logistic regression analyses were used to determine the associations between HCMV infection, clinical characteristics, and EH. Notably, patients with EH, particularly those with HCMV infection, exhibited a marked increase in tumor necrosis factor-α (TNF-α) and 8-hydroxy-2-deoxyguanosine (8-OHDG) levels, but a decrease in endothelial nitric oxide synthase (eNOS) and renin levels. Similarly, elevated TNF-α and 8-OHDG levels were independent predictors of increased HCMV antibody titers, whereas eNOS and renin were negatively correlated with the latter. Moreover, serum angiotensin-converting enzyme (sACE, ACE) methylation was increased, whereas 11-β hydroxysteroid dehydrogenase 2 (HSD11β2; HSD3B2) methylation was decreased in patients with EH who were also infected with HCMV. A positive correlation between HSD3B2 methylation and HCMV IgG titer and blood pressure was additionally observed, whereas angiotensin-converting enzyme (ACE) methylation was inversely correlated with blood pressure. Collectively, these data indicate that HCMV may contribute to EH development in the Kazakh Chinese by increasing TNF-α and 8-OHDG levels, suppressing eNOS and renin, and manipulating HSD3B2 and ACE methylation.
Collapse
Affiliation(s)
- Qian Feng
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - Jing Hui
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - Na Tang
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - Yong-Min Liu
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - Hua Zhong
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - Zhen Li
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| | - La-Mei Wang
- Centre of Medical Functional Experiments, Medical College of Shihezi University, Shihezi, China
| | - Yuan-Yuan Qu
- Department of Respiration Medicine, The First Affiliated Hospital of Medical College of Shihezi University, Shihezi, Xijiang, China
| | - Feng-Mei Deng
- Department of Pathophysiology, Chengdu Medical College, Sichuan, China
| | - Fang He
- Department of Pathophysiology/Key Laboratory of Education Ministry of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, China
| |
Collapse
|
9
|
Ligand-selective small molecule modulators of the constitutively active vGPCR US28. Eur J Med Chem 2018; 155:244-254. [PMID: 29886326 DOI: 10.1016/j.ejmech.2018.05.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023]
Abstract
US28 is a broad-spectrum constitutively active G protein-coupled receptor encoded by the human cytomegalovirus (HCMV). It binds and scavenges multiple CC-chemokines as well as CX3CL1 (fractalkine) by constitutive receptor endocytosis to escape immune surveillance. We herein report the design and characterization of a novel library of US28-acting commercially available ligands based on the molecular descriptors of two previously reported US28-acting structures. Among these, we identify compounds capable of selectively recognizing CCL2-and CCL4-, but not CX3CL1-induced receptor conformations. Moreover, we find a direct correlation between the binding properties of small molecule ligands to CCL-induced conformations at the wild-type receptor and functional activity at the C-terminal truncated US28Δ300. As US28Δ300 is devoid of arrestin-recruitment and endocytosis, this highlights the potential usefulness of this construct in future drug discovery efforts aimed at specific US28 conformations. The new scaffolds identified herein represent valuable starting points for the generation of novel anti-HCMV therapies targeting the virus-encoded chemokine receptor US28 in a conformational-selective manner.
Collapse
|
10
|
Aguilera V, Di Maira T, Conde I, Fornés-Ferrer V, Vinaixa C, Pallarés C, Carvalho-Gomes A, Cubells A, García M, Rubín Á, Benlloch S, Gonzalez-Dieguez L, Molina JM, Puchades L, López-Labrador FX, Prieto M, Berenguer M. Cytomegalovirus reactivation in liver transplant recipients due to hepatitis C cirrhosis is associated with higher cardiovascular risk - an observational, retrospective study. Transpl Int 2018; 31:649-657. [PMID: 29493818 DOI: 10.1111/tri.13145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/16/2017] [Accepted: 02/23/2018] [Indexed: 12/19/2022]
Abstract
The association between cytomegalovirus (CMV) reactivation and cardiovascular risk has been reported in solid organ transplant populations; however, it has yet to be assessed in liver transplantation (LT). We aim to evaluate whether CMV reactivation is associated with cardiovascular events (CVE) in HCV-LT patients. LT patients (2010 and 2014) due to HCV cirrhosis were included. Clinically significant CMV (CS-CMV) was defined as viral load (VL) >5000 copies/ml, need of therapy or CMV disease. Baseline variables and endpoint measures (CVE, survival, severe recurrent hepatitis C, de novo tumors, and diabetes) were collected. One hundred and forty patients were included. At LT, a history of AHT was present in 23%, diabetes 22%, tobacco use 45%, obesity 20%, and renal impairment (eGFR < 60 ml/min) in 26.5%. CS-CMV reactivation occurred in 25% of patients. Twenty-six patients (18.5%) developed a CVE. Cox regression analysis revealed two factors significantly associated with CVE: Pre-LT DM [HR = 4.6 95% CI (1.6, 13), P = 0.004] and CS-CMV [HR = 4.7 95% CI (1.8, 12.5), P = 0.002]. CS-CMV was not independently associated with the remaining endpoints except for survival (P = 0.03). In our series, CS-CMV reactivation was associated with a greater risk of developing CVE, thus confirming data from other solid organ transplant populations and emphasizing the need for adequate CMV control.
Collapse
Affiliation(s)
- Victoria Aguilera
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | - Tommaso Di Maira
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - Isabel Conde
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,Laboratorio de Hepatología y Trasplante Hepático, Instituto de Investigación La Fe, Valencia, Spain
| | | | - Carmen Vinaixa
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | - Carmen Pallarés
- CIBERehd, Instituto de Salud Carlos III, Valencia, Spain.,Laboratorio de Hepatología y Trasplante Hepático, Instituto de Investigación La Fe, Valencia, Spain
| | - Angela Carvalho-Gomes
- CIBERehd, Instituto de Salud Carlos III, Valencia, Spain.,Laboratorio de Hepatología y Trasplante Hepático, Instituto de Investigación La Fe, Valencia, Spain
| | - Almudena Cubells
- Laboratorio de Hepatología y Trasplante Hepático, Instituto de Investigación La Fe, Valencia, Spain
| | - María García
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | - Ángel Rubín
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | - Salvador Benlloch
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | | | - Jose Miguel Molina
- Microbiology Department, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - Lorena Puchades
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - F Xavier López-Labrador
- Fundación para el fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain.,Centro de Investigación Biomédica en Epidemiología y Salud Pública (CIBER ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Martin Prieto
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain
| | - Marina Berenguer
- Liver Transplantation and Hepatology Unit, Hospital Universitari i Politécnic La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Valencia, Spain.,Department of Medicine, Universitat de Valencia, Valencia, Spain
| |
Collapse
|
11
|
Priyanka S, Kaarthikeyan G, Nadathur JD, Mohanraj A, Kavarthapu A. Detection of cytomegalovirus, Epstein-Barr virus, and Torque Teno virus in subgingival and atheromatous plaques of cardiac patients with chronic periodontitis. J Indian Soc Periodontol 2017; 21:456-460. [PMID: 29551863 PMCID: PMC5846241 DOI: 10.4103/jisp.jisp_205_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Periodontitis and atherosclerosis represent a chronic inflammatory process. The incidence of periodontitis in cardiac patients with atherosclerosis is a well-established fact. The role of viruses in the etiopathogenesis of both has been proposed. AIM The aim of the study was to evaluate the prevalence of Torque Teno virus (TTV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) in cardiac patients with atherosclerosis and coexisting chronic periodontitis (CP). MATERIALS AND METHODS Thirty patients (17 males and 13 females) with atherosclerotic plaques and coexisting periodontitis were recruited for this cross-sectional study. Viral DNA was extracted from the subgingival and atheromatous plaque. The presence of CMV, EBV, and TTV in the plaque samples was identified using polymerase chain reaction. The collected data were statistically analyzed for the prevalence of the viruses and Chi-squared test was performed to find out its association with atheroma and CP. RESULTS The prevalence of CMV, EBV, and TTV in atheromatous plaque was 63.3%, 56.7%, and 46.7%, respectively, as compared to rates of 80%, 63.3%, and 53.3% in subgingival plaque. Results also indicated no significant association of CMV, EBV, and TTV in both samples (P = 0.08, 0.346, and 0.261, respectively). CONCLUSIONS There was no significant association of CMV, EBV, and TTV between subgingival and atheromatous plaque. The prevalence of CMV, EBV, and TTV was high in atheromatous plaque. TTV was isolated from more than 50% of participants in atheromatous plaque, which is a significant finding.
Collapse
Affiliation(s)
- Sriraman Priyanka
- Department of Periodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
| | | | | | - Anbarasu Mohanraj
- Department of Cardiothorasic Surgery, Madras Medical Mission, Chennai, Tamil Nadu, India
| | - Avinash Kavarthapu
- Department of Periodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
| |
Collapse
|
12
|
Murdock KW, Fagundes CP, Peek MK, Vohra V, Stowe RP. The effect of self-reported health on latent herpesvirus reactivation and inflammation in an ethnically diverse sample. Psychoneuroendocrinology 2016; 72:113-8. [PMID: 27398881 PMCID: PMC5116910 DOI: 10.1016/j.psyneuen.2016.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/17/2016] [Accepted: 06/20/2016] [Indexed: 02/05/2023]
Abstract
Self-rated health (SRH) is a reliable predictor of health outcomes including morbidity and mortality. Immune dysregulation is one hypothesized mechanism underlying the association between SRH and health outcomes. Indeed, poorer SRH is associated with greater inflammation. The association between SRH and reactivation of latent herpesviruses is unknown, representing an important gap in the literature given that reactivation of latent herpesviruses leads to enhanced inflammation. The present study addressed this important gap in the literature by examining associations between SRH, inflammation (i.e., peripheral cytokines in the blood), and reactivation of latent herpesviruses among a sample of 1208 individuals participating in the Texas City Stress and Health Study. Participants completed a self-report measure of SRH and a blood draw. Results indicated that higher SRH was associated with lower reactivation of latent herpesviruses and inflammation. Moreover, reactivation of latent herpesviruses partially mediated the association between SRH and inflammation. Accordingly, findings add to our growing understanding of the association between SRH and immune dysfunction.
Collapse
Affiliation(s)
- Kyle W. Murdock
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Christopher P. Fagundes
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
,Department of Symptoms Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, Texas 77030, USA
,Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, Texas 77030 , USA
| | - M. Kristen Peek
- Department of Preventative Medicine and Community Health, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Vansh Vohra
- Department of Psychology, Rice University, 6500 Main Street, Houston, TX 77005, USA
| | - Raymond P. Stowe
- Microgen Laboratories, 903 Texas Avenue, La Marque, TX 77568, USA
| |
Collapse
|
13
|
Influence of cytomegalovirus infection in the development of cardiac allograft vasculopathy after heart transplantation. J Heart Lung Transplant 2015; 34:1112-9. [DOI: 10.1016/j.healun.2015.03.015] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/16/2015] [Accepted: 03/16/2015] [Indexed: 11/17/2022] Open
|
14
|
Fehr T, Cippà PE, Mueller NJ. Cytomegalovirus post kidney transplantation: prophylaxis versus pre-emptive therapy? Transpl Int 2015; 28:1351-6. [PMID: 26138458 DOI: 10.1111/tri.12629] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/13/2015] [Accepted: 06/18/2015] [Indexed: 01/15/2023]
Abstract
Cytomegalovirus is the most important pathogen causing opportunistic infections in kidney allograft recipients. The occurrence of CMV disease is associated with higher morbidity, higher incidence of other opportunistic infections, allograft loss and death. Therefore, an efficient strategy to prevent CMV disease after kidney transplantation is required. Two options are currently available: pre-emptive therapy based on regular CMV PCR monitoring and generalized antiviral prophylaxis during a defined period. In this review, we describe those two approaches, highlight the distinct advantages and risks of each strategy and summarize the four randomized controlled trials performed in this field so far. Taken this evidence together, pre-emptive therapy and anti-CMV prophylaxis are both equally potent in preventing CMV-associated complications; however, the pre-emptive approach may have distinct advantages in allowing for development of long-term anti-CMV immunity. We propose a risk-adapted use of these approaches based on serostatus, immunosuppressive therapy and availability of resources at a particular transplant centre.
Collapse
Affiliation(s)
- Thomas Fehr
- Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland.,Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Pietro E Cippà
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
15
|
Jeong SJ, Ku NS, Han SH, Choi JY, Kim CO, Song YG, Kim JM. Anti-cytomegalovirus antibody levels are associated with carotid atherosclerosis and inflammatory cytokine production in elderly Koreans. Clin Chim Acta 2015; 445:65-9. [DOI: 10.1016/j.cca.2015.03.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 02/24/2015] [Accepted: 03/02/2015] [Indexed: 01/04/2023]
|
16
|
Fagundes CP, Jaremka LM, Glaser R, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Yee LD, Carson WE, Farrar WB, Malarkey WB, Chen M, Kiecolt-Glaser JK. Attachment anxiety is related to Epstein-Barr virus latency. Brain Behav Immun 2014; 41:232-8. [PMID: 24945717 PMCID: PMC4304069 DOI: 10.1016/j.bbi.2014.04.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 04/03/2014] [Accepted: 04/05/2014] [Indexed: 12/22/2022] Open
Abstract
Attachment theory provides a framework for understanding individual differences in chronic interpersonal stress. Attachment anxiety, a type of relationship insecurity characterized by worry about rejection and abandonment, is a chronic interpersonal stressor. Stress impacts cellular immunity, including herpesvirus reactivation. We investigated whether attachment anxiety was related to the expression of a latent herpesvirus, Epstein-Barr virus (EBV), when individuals were being tested for breast or colon cancer and approximately 1 year later. Participants (N=183) completed a standard attachment questionnaire and provided blood to assess EBV viral capsid antigen (VCA) IgG antibody titers. Individuals with more attachment anxiety had higher EBV VCA IgG antibody titers than those with less attachment anxiety. The strength of the association between attachment anxiety and antibody titers was the same at both assessments. This study is the first to show an association between latent herpesvirus reactivation and attachment anxiety. Because elevated herpesvirus antibody titers reflect poorer cellular immune system control over the latent virus, these data suggest that high attachment anxiety is associated with cellular immune dysregulation.
Collapse
Affiliation(s)
- Christopher P Fagundes
- Department of Health Disparities, University of Texas MD Anderson Cancer Center, United States.
| | - Lisa M Jaremka
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States
| | - Ronald Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States
| | - Catherine M Alfano
- Office of Cancer Survivorship, National Cancer Institute, National Institute of Health, United States
| | - Stephen P Povoski
- Department of Surgery, The Ohio State University College of Medicine, United States
| | - Adele M Lipari
- Department of Radiology, The Ohio State University College of Medicine, United States
| | - Doreen M Agnese
- Department of Surgery, The Ohio State University College of Medicine, United States
| | - Lisa D Yee
- Department of Surgery, The Ohio State University College of Medicine, United States
| | - William E Carson
- Department of Surgery, The Ohio State University College of Medicine, United States; Department of Molecular Virology, Immunology, and Medical Genetics, The Ohio State University College of Medicine, United States
| | - William B Farrar
- Department of Surgery, The Ohio State University College of Medicine, United States
| | - William B Malarkey
- Department of Internal Medicine, The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States; Department of Molecular Virology, Immunology, and Medical Genetics, The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States; The Institute for Behavioral Medicine Research, Comprehensive Cancer Center, and Department of Psychiatry, The Ohio State University College of Medicine, United States
| | - Min Chen
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States
| | - Janice K Kiecolt-Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, United States; The Institute for Behavioral Medicine Research, Comprehensive Cancer Center, and Department of Psychiatry, The Ohio State University College of Medicine, United States
| |
Collapse
|
17
|
Assinger A, Kral JB, Yaiw KC, Schrottmaier WC, Kurzejamska E, Wang Y, Mohammad AA, Religa P, Rahbar A, Schabbauer G, Butler LM, Söderberg-Naucler C. Human cytomegalovirus-platelet interaction triggers toll-like receptor 2-dependent proinflammatory and proangiogenic responses. Arterioscler Thromb Vasc Biol 2014; 34:801-9. [PMID: 24558109 DOI: 10.1161/atvbaha.114.303287] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Human cytomegalovirus (HCMV) is a widespread pathogen that correlates with various clinical complications, including atherosclerosis. HCMV is released into the circulation during primary infection and periodic viral reactivation, allowing virus-platelet interactions. Platelets are important in the onset and development of atherosclerosis, but the consequences of platelet-HCMV interactions are unclear. APPROACH AND RESULTS We studied the effects of HCMV-platelet interactions in blood from healthy donors using the purified clinical HCMV isolate VR1814. We demonstrated that HCMV bound to a Toll-like receptor (TLR) 2-positive platelet subpopulation, which resulted in signal transduction, degranulation, and release of proinflammatory CD40L and interleukin-1β and proangiogenic vascular endothelial-derived growth factor. In mice, murine CMV activated wild-type but not TLR2-deficient platelets. However, supernatant from murine CMV-stimulated wild-type platelets also activated TLR2-deficient platelets, indicating that activated platelets generated soluble mediators that triggered further platelet activation, independent of TLR2 expression. Inhibitor studies, using ADP receptor antagonists and apyrase, revealed that ADP release is important to trigger secondary platelet activation in response to HCMV. HCMV-activated platelets rapidly bound to and activated neutrophils, supporting their adhesion and transmigration through endothelial monolayers. In an in vivo model, murine CMV induced systemic upregulation of platelet-leukocyte aggregates and plasma vascular endothelial-derived growth factor in mice and showed a tendency to enhance neutrophil extravasation in a TLR2-dependent fashion. CONCLUSIONS HCMV is a well-adapted pathogen that does not induce immediate thrombotic events. However, HCMV-platelet interactions lead to proinflammatory and proangiogenic responses, which exacerbate tissue damage and contribute to atherogenesis. Therefore, platelets might contribute to the effects of HCMV in accelerating atherosclerosis.
Collapse
Affiliation(s)
- Alice Assinger
- From the Department of Medicine, Centre for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden (A.A., K.C.Y., E.K., Y.W., A.-A.M., P.R., A.R., L.M.B., C.S.-N.); Institute of Physiology, Centre for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria (A.A., J.B.K., W.C.S., G.S.); Postgraduate School of Molecular Medicine, Department of Internal Medicine and Hypertension, Medical University of Warsaw, Warsaw, Poland (E.K.); and Department of Geriatrics, Qilu Hospital, Shandong University, Jinan, China (Y.W.)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Reischig T. Cytomegalovirus-associated renal allograft rejection: new challenges for antiviral preventive strategies. Expert Rev Anti Infect Ther 2014; 8:903-10. [DOI: 10.1586/eri.10.63] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
19
|
Courivaud C, Bamoulid J, Chalopin JM, Gaiffe E, Tiberghien P, Saas P, Ducloux D. Cytomegalovirus exposure and cardiovascular disease in kidney transplant recipients. J Infect Dis 2013; 207:1569-75. [PMID: 23417659 DOI: 10.1093/infdis/jit064] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Some data suggest that cytomegalovirus (CMV) may be involved in atherogenesis. However, there are few data suggesting that CMV may contribute to posttransplantation atherosclerosis. We studied a cohort of 570 consecutive renal transplant recipients. The impact of CMV on atherosclerotic events was analyzed with respect to other known main cardiovascular risk factors. The mean follow-up duration (± SD) was 87 ± 31 months. A total of 357 patients were considered to be CMV exposed, and 213 were considered to be CMV naive. Cox regression analysis revealed that CMV exposure (hazard ratio [HR], 1.80 [95% confidence interval {CI}, 1.06-3.05]; P = .030) was an independent risk factor for atherosclerotic events. A total of 213 patients remained CMV negative during follow-up, 225 CMV-positive patients had no replication after transplantation, and 132 CMV-positive patients experienced CMV replication after transplantation. Atherosclerotic event rates were 8.5%, 13.3%, and 18.2%, respectively (P = .034). Cox regression analysis revealed that patients with posttransplantation CMV replication had an increased risk of atherosclerotic events (HR, 2.06 [95% CI, 1.03-4.15]; P = .042) and death (HR, 1.76 [95% CI, 1.08-2.89]; P = .024). There was also a trend toward an increased risk of atherosclerotic events in CMV-positive patients without posttransplantation replication (HR, 1.62 [95% CI, .91-3.05]; P = .098). Both pretransplantation CMV exposure and posttransplantation CMV replication contribute to the increased risk of cardiovascular disease in transplant recipients.
Collapse
|
20
|
Binkley PF, Cooke GE, Lesinski A, Taylor M, Chen M, Laskowski B, Waldman WJ, Ariza ME, Williams MV, Knight DA, Glaser R. Evidence for the role of Epstein Barr Virus infections in the pathogenesis of acute coronary events. PLoS One 2013; 8:e54008. [PMID: 23349778 PMCID: PMC3547968 DOI: 10.1371/journal.pone.0054008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 12/06/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The role of viral infections in the pathogenesis of atherosclerosis remains controversial largely due to inconsistent detection of the virus in atherosclerotic lesions. However, viral infections elicit a pro-inflammatory cascade known to be atherogenic and to precipitate acute ischemic events. We have published in vitro data that provide the foundation for a mechanism that reconciles these conflicting observations. To determine the relation between an early viral protein, deoxyuridine triphosphate nucleotidohydrolase (dUTPase), produced following reactivation of Epstein Barr Virus (EBV) to circulating pro-inflammatory cytokines, intercellular adhesion molecule-1 (ICAM-1) and acute coronary events. METHODOLOGY/PRINCIPAL FINDINGS Blood samples were obtained from 299 patients undergoing percutaneous coronary intervention for stable angina (SA), unstable angina (UA), or acute myocardial infarction (AMI). Plasma concentrations of pro-inflammatory cytokines and neutralizing antibody against EBV-encoded dUTPase were compared in the three patient groups. AMI was associated with the highest measures of interleukin-6 (ANOVA p<0.05; 4.6 ± 2.6 pg/mL in patients with AMI vs. 3.2 ± 2.3 pg/mL in SA). ICAM-1 was significantly higher in patients with AMI (ANOVA p<0.05; 304 ± 116 pg/mL in AMI vs. 265 ± 86 pg/mL SA). The highest values of ICAM-1 were found in patients having an AMI and who were antibody positive for dUTPase (ANOVA p=0.008; 369 ± 183 pg/mL in AMI and positive for dUTPase vs. 249 ± 70 pg/mL in SA negative for dUTPase antibody). CONCLUSIONS/SIGNIFICANCE These clinical data support a model, based on in vitro studies, by which EBV may precipitate AMI even under conditions of low viral load through the pro-inflammatory action of the early protein dUTPase that is produced even during incomplete viral replication. They further support the putative role of viral infections in the pathogenesis of atherosclerosis and coronary artery events.
Collapse
Affiliation(s)
- Philip F Binkley
- Division of Cardiovascular Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Tang-Feldman YJ, Lochhead SR, Lochhead GR, Yu C, George M, Villablanca AC, Pomeroy C. Murine cytomegalovirus (MCMV) infection upregulates P38 MAP kinase in aortas of Apo E KO mice: a molecular mechanism for MCMV-induced acceleration of atherosclerosis. J Cardiovasc Transl Res 2012. [PMID: 23192592 DOI: 10.1007/s12265-012-9428-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Multiple studies suggest an association between cytomegalovirus (CMV) infection and atherogenesis; however, the molecular mechanisms by which viral infection might exacerbate atherosclerosis are not well understood. Aortas of MCMV-infected and uninfected Apo E knockout (KO) mice were analyzed for atherosclerotic lesion development and differential gene expression. Lesions in the infected mice were larger and showed more advanced disease compared to the uninfected mice. Sixty percent of the genes in the MAPK pathway were upregulated in the infected mice. p38 and ERK 1/2 MAPK genes were 5.6- and 2.0-fold higher, respectively, in aortas of infected vs. uninfected mice. Levels of VCAM-1, ICAM-1, and MCP-1 were ~2.0-2.6-fold higher in aortas of infected vs. uninfected mice. Inhibition of p38 with SB203580 resulted in lower levels of pro-atherogenic molecules and MCMV viral load in aortas of infected mice. MCMV-induced upregulation of p38 may drive the virus-induced acceleration of atherogenesis observed in our model.
Collapse
|
22
|
Langemeijer EV, Slinger E, de Munnik S, Schreiber A, Maussang D, Vischer H, Verkaar F, Leurs R, Siderius M, Smit MJ. Constitutive β-catenin signaling by the viral chemokine receptor US28. PLoS One 2012; 7:e48935. [PMID: 23145028 PMCID: PMC3493591 DOI: 10.1371/journal.pone.0048935] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 10/02/2012] [Indexed: 01/17/2023] Open
Abstract
Chronic activation of Wnt/ß-catenin signaling is found in a variety of human malignancies including melanoma, colorectal and hepatocellular carcinomas. Interestingly, expression of the HCMV-encoded chemokine receptor US28 in intestinal epithelial cells promotes intestinal neoplasia in transgenic mice, which is associated with increased nuclear accumulation of ß-catenin. In this study we show that this viral receptor constitutively activates ß-catenin and enhances ß-catenin-dependent transcription. Our data illustrate that this viral receptor does not activate ß-catenin via the classical Wnt/Frizzled signaling pathway. Analysis of US28 mediated signaling indicates the involvement of the Rho-Rho kinase (ROCK) pathway in the activation of ß-catenin. Moreover, cells infected with HCMV show significant increases in ß-catenin stabilization and signaling, which is mediated to a large extent by expression of US28. The modulation of the ß-catenin signal transduction pathway by a viral chemokine receptor provides alternative regulation of this pathway, with potential relevance for the development of colon cancer and virus-associated diseases.
Collapse
Affiliation(s)
- Ellen V Langemeijer
- Division of Medicinal Chemistry, Leiden/Amsterdam Center for Drug Research, VU University Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Fagundes CP, Glaser R, Malarkey WB, Kiecolt-Glaser JK. Childhood adversity and herpesvirus latency in breast cancer survivors. Health Psychol 2012; 32:337-44. [PMID: 22746260 DOI: 10.1037/a0028595] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Childhood adversity has been linked to greater emotional and physiological sensitivity to stress. Stress has well-documented effects on cellular immunity, including enhanced herpesvirus reactivation. This study assessed whether childhood adversity was associated with the expression of two latent herpesviruses, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in adults, and whether this association could be detected beyond the psychological distress women experienced in the aftermath of a breast cancer diagnosis and its treatment. METHODS One hundred and eight breast cancer survivors completed questionnaires and provided blood samples to assess EBV virus capsid antigen (VCA) IgG antibody titers and CMV IgG antibody titers. RESULTS Breast cancer survivors who experienced more childhood adversities had higher EBV and CMV antibody titers than those with fewer childhood adversities. Those who experienced more childhood adversities also had more depressive symptoms, less education, and poorer sleep quality than those with fewer childhood adversities. Depressive symptoms, education, sleep quality, age, BMI, cancer stage, comorbidities, and weekly alcohol consumption were not related to EBV or CMV antibody titers. Time since last treatment was negatively associated with EBV and CMV antibody titers. Elevated antibody titers to latent herpesviruses represent poorer cellular immune system control over viral latency; these data suggest that those with more childhood adversities have poorer cellular immune function. CONCLUSIONS These findings add to the emerging literature suggesting that adverse early experiences may make people more vulnerable to immune dysregulation in adulthood. The consequences of early adversity appear to persist across the life span.
Collapse
Affiliation(s)
- Christopher P Fagundes
- Institute for Behavioral Medicine Research, Ohio State University College of Medicine, Columbus, OH 43210, USA.
| | | | | | | |
Collapse
|
24
|
Abele-Ohl S, Leis M, Wollin M, Mahmoudian S, Hoffmann J, Müller R, Heim C, Spriewald BM, Weyand M, Stamminger T, Ensminger SM. Human cytomegalovirus infection leads to elevated levels of transplant arteriosclerosis in a humanized mouse aortic xenograft model. Am J Transplant 2012; 12:1720-9. [PMID: 22429329 DOI: 10.1111/j.1600-6143.2012.04018.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recent findings emphasized an important role of human cytomegalovirus (HCMV) infection in the development of transplant arteriosclerosis. Therefore, the aim of this study was to develop a human peripheral blood lymphocyte (hu-PBL)/Rag-2(-/-) γc(-/-) mouse-xenograft-model to investigate both immunological as well as viral effector mechanisms in the progression of transplant arteriosclerosis. For this, sidebranches from the internal mammary artery were recovered during coronary artery bypass graft surgery, tissue-typed and infected with HCMV. Then, size-matched sidebranches were implanted into the infrarenal aorta of Rag-2(-/-) γc(-/-) mice. The animals were reconstituted with human peripheral blood mononuclear cells (PBMCs) 7 days after transplantation. HCMV-infection was confirmed by Taqman-PCR and immunofluorescence analyses. Arterial grafts were analyzed by histology on day 40 after transplantation. PBMC-reconstituted Rag-2(-/-) γc(-/-) animals showed splenic chimerism levels ranging from 1-16% human cells. After reconstitution, Rag-2(-/-) γc(-/-) mice developed human leukocyte infiltrates in their grafts and vascular lesions that were significantly elevated after infection. Cellular infiltration revealed significantly increased ICAM-1 and PDGF-R-β expression after HCMV-infection of the graft. Arterial grafts from unreconstituted Rag-2(-/-) γc(-/-) recipients showed no vascular lesions. These data demonstrate a causative relationship between HCMV-infection as an isolated risk factor and the development of transplant-arteriosclerosis in a humanized mouse arterial-transplant-model possibly by elevated ICAM-1 and PDGF-R-β expression.
Collapse
Affiliation(s)
- S Abele-Ohl
- Department of Cardiac Surgery, Friedrich-Alexander University, Erlangen-Nürnberg, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
van Ree RM, de Vries APJ, Zelle DM, de Vries LV, Oterdoom LH, Gans ROB, Schouten JP, Lems SPM, van Son WJ, Bakker SJL. Latent cytomegalovirus infection is an independent risk factor for late graft failure in renal transplant recipients. Med Sci Monit 2012; 17:CR609-617. [PMID: 22037739 PMCID: PMC3539501 DOI: 10.12659/msm.882045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Cytomegalovirus (CMV) is a risk factor for rejection and mortality soon after renal transplantation. Little is known about its consequences longer after transplantation. We prospectively investigated whether latent CMV infection is a risk factor for graft failure and mortality long after transplantation. Material/Methods Our study included 606 renal transplant recipients (RTR) with a functioning graft for >1 year. CMV serology was determined using ELISA. RTRs were divided into CMV-seronegative and latent CMV (seropositive + seroconverted). Results We measured CMV IgG at 6.0 [2.6–11.4] years post-transplant. During follow-up (7.0 [6.2–7.5] years), 54 (9%) RTRs experienced graft failure and 137 (23%) RTRs died. Risk for graft failure and mortality was significantly higher in RTRs with latent CMV compared to CMV-seronegative RTRs (HR=3.1, P=0.005 and HR=2.0, P=0.002, respectively). After adjustment for potential confounders, latent CMV infection remained an independent risk factor for graft failure (HR=4.6, P=0.001), but not for mortality (HR=1.4, P=0.2). Conclusions Latent CMV is an independent risk factor for graft failure long after renal transplantation and carries a higher risk for graft failure than for mortality. These findings confirm the notion that latent CMV can be harmful in transplanted kidneys.
Collapse
Affiliation(s)
- Rutger M van Ree
- Renal Transplant Program, University Medical Center Groningen and University of Groningen, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Slopen N, Koenen KC, Kubzansky LD. Childhood adversity and immune and inflammatory biomarkers associated with cardiovascular risk in youth: a systematic review. Brain Behav Immun 2012; 26:239-50. [PMID: 22138616 DOI: 10.1016/j.bbi.2011.11.003] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 10/13/2011] [Accepted: 11/09/2011] [Indexed: 10/15/2022] Open
Abstract
BACKGROUND Research suggests that adverse experiences in childhood affect the development of cardiovascular disease (CVD), and immune and inflammation dysregulation has been postulated to play role. However, it is unclear whether the effects of social adversity on immune-related biomarkers are evident in early life, and if these biomarkers may provide an early risk marker for targeting prevention and intervention. The purpose of this review is to evaluate research on the relationship between adversity and CVD-relevant immune biomarkers in youth, assess the consistency of the findings, and consider what additional research is needed. METHODS PubMed and PsycINFO searches were conducted through September 2011. Studies were selected using criteria related to the childhood exposure, biomarker outcome, age range, and sample selection. Twenty articles were identified, examining associations between childhood adversity and immune biomarkers (assessed during childhood) that are potential risk markers for CVD later in life. RESULTS Although childhood adversity was not consistently related to youth levels of inflammatory and other immune markers relevant to CVD, a trend toward positive findings was observed. No detectable patterns were evident based on measure of adversity, biomarker, study design, or sample size. CONCLUSIONS Overall, our findings suggest this avenue of research is worth continued investigation. We offer recommendations for future research related to (1) study design and sample, (2) definition and measurement of adversity, (3) statistical analysis, and (4) outcomes that will help distinguish whether there are immunologic alterations related to adversity and subsequent CVD risk that can be reliably detected in childhood.
Collapse
Affiliation(s)
- Natalie Slopen
- Center on the Developing Child, Harvard University, Cambridge, MA 02138, United States.
| | | | | |
Collapse
|
27
|
|
28
|
Associations Between Cytomegalovirus Infection and Functional Impairment and Frailty in the BELFRAIL Cohort. J Am Geriatr Soc 2011; 59:2201-8. [DOI: 10.1111/j.1532-5415.2011.03719.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
29
|
Romo N, Fitó M, Gumá M, Sala J, García C, Ramos R, Muntasell A, Masiá R, Bruguera J, Subirana I, Vila J, de Groot E, Elosua R, Marrugat J, López-Botet M. Association of Atherosclerosis With Expression of the LILRB1 Receptor By Human NK and T-Cells Supports the Infectious Burden Hypothesis. Arterioscler Thromb Vasc Biol 2011; 31:2314-21. [DOI: 10.1161/atvbaha.111.233288] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
The contribution of human cytomegalovirus (HCMV) to vascular disease may depend on features of the immune response not reflected by the detection of specific antibodies. Persistent HCMV infection in healthy blood donors has been associated with changes in the distribution of NK cell receptors (NKR). The putative relationship among HCMV infection, NKR distribution, subclinical atherosclerosis, and coronary heart disease was assessed.
Methods and Results—
NKR expression was compared in acute myocardial infarction (AMI) patients (
n
=70) and a population-based control sample (
n
=209). The relationship between NKR expression and carotid intima-media thickness (CIMT) in controls (
n
=149) was also studied. HCMV infection was associated with higher proportions of NKG2C+ and LILRB1+ NK and T-cells. In contrast, only LILRB1+ NK and CD56+ T-cells were found to be increased in AMI patients, independent of age, sex, conventional vascular risk factors, and HCMV seropositivity. Remarkably, LILRB1 expression in NK and T-cells significantly correlated with CIMT in controls.
Conclusion—
The association of overt and subclinical atherosclerotic disease with LILRB1+ NK and T-cells likely reflects a relationship between the immune challenge by infections and cardiovascular disease risk, without attributing a dominant role for HCMV. Our findings may lead to the identification of novel biomarkers of vascular disease.
Collapse
Affiliation(s)
- Neus Romo
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Montserrat Fitó
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Mónica Gumá
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Joan Sala
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Cosme García
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Rafel Ramos
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Aura Muntasell
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Rafel Masiá
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Jordi Bruguera
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Isaac Subirana
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Joan Vila
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Eric de Groot
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Roberto Elosua
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Jaume Marrugat
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| | - Miguel López-Botet
- From the Immunology Unit (N.R., M.G., M.L.-B.), University Pompeu Fabra, Barcelona, Spain; IMIM (Hospital del Mar Research Institute) (M.F., A.M., I.S., J.V., R.E., J.M., M.L.-B.), Barcelona, Spain; Department of Cardiology (J.S., R.M.), Hospital Universitari Josep Trueta, Girona, Spain; Department of Cardiology (C.G., J.B.), Hospital del Mar, Barcelona, Spain; Department of Vascular Medicine (E.G.), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; CIBER Epidemiology and
| |
Collapse
|
30
|
Snydman DR, Limaye AP, Potena L, Zamora MR. Update and review: state-of-the-art management of cytomegalovirus infection and disease following thoracic organ transplantation. Transplant Proc 2011; 43:S1-S17. [PMID: 21482317 DOI: 10.1016/j.transproceed.2011.02.069] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Cytomegalovirus (CMV) is among the most important viral pathogens affecting solid organ recipients. The direct effects of CMV (eg, infection and its sequela; tissue invasive disease) are responsible for significant morbidity and mortality. In addition, CMV is associated with numerous indirect effects, including immunomodulatory effects, acute and chronic rejection, and opportunistic infections. Due to the potentially devastating effects of CMV, transplant surgeons and physicians have been challenged to fully understand this infectious complication and find the best ways to prevent and treat it to ensure optimal patient outcomes. SUMMARY Lung, heart, and heart-lung recipients are at considerably high risk of CMV infection. Both direct and indirect effects of CMV in these populations have potentially lethal consequences. The use of available treatment options depend on the level of risk of each patient population for CMV infection and disease. Those at the highest risk are CMV negative recipients of CMV positive organs (D+/R-), followed by D+/R+, and D-/R+. More than 1 guideline exists delineating prevention and treatment options for CMV, and new guidelines are being developed. It is hoped that new treatment algorithms will provide further guidance to the transplantation community. The first part describes the overall effects of CMV, both direct and indirect; risk factors for CMV infection and disease; methods of diagnosis; and currently available therapies for prevention and treatment. Part 2 similarly addresses antiviral-resistant CMV, summarizing incidence, risk factors, methods of diagnosis, and treatment options. Parts 3 and 4 present cases to illustrate issues surrounding CMV in heart and lung transplantation, respectively. Part 3 discusses the possible mechanisms by which CMV can cause damage to the coronary allograft and potential techniques of avoiding such damage, with emphasis on fostering strong CMV-specific immunity. Part 4 highlights the increased incidence of CMV infection and disease among lung transplant recipients and its detrimental effect on survival. The possible benefits of extended-duration anti-CMV prophylaxis are explored, as are those of combination prophylaxis with valganciclovir and CMVIG. CONCLUSION Through improved utilization of information regarding optimized antiviral therapy for heart and lung transplant recipients to prevent and treat CMV infection and disease and through increased understanding of clinical strategies to assess, treat, and monitor patients at high risk for CMV recurrence and resistance, the health care team will be able to provide the coordinated effort needed to improve patient outcomes.
Collapse
Affiliation(s)
- David R Snydman
- Chief of Division of Geographic Medicine and Infectious Diseases, Hospital Epidemiologist, Tufts Medical Center, Boston, Massachusetts, USA
| | | | | | | |
Collapse
|
31
|
Seropositivity to cytomegalovirus, inflammation, all-cause and cardiovascular disease-related mortality in the United States. PLoS One 2011; 6:e16103. [PMID: 21379581 PMCID: PMC3040745 DOI: 10.1371/journal.pone.0016103] [Citation(s) in RCA: 285] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 12/10/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Studies have suggested that CMV infection may influence cardiovascular disease (CVD) risk and mortality. However, there have been no large-scale examinations of these relationships among demographically diverse populations. The inflammatory marker C-reactive protein (CRP) is also linked with CVD outcomes and mortality and may play an important role in the pathway between CMV and mortality. We utilized a U.S. nationally representative study to examine whether CMV infection is associated with all-cause and CVD-related mortality. We also assessed whether CRP level mediated or modified these relationships. METHODOLOGY/PRINCIPAL FINDINGS Data come from subjects ≥ 25 years of age who were tested for CMV and CRP level and were eligible for mortality follow-up on December 31(st), 2006 (N = 14153) in the National Health and Nutrition Examination Survey (NHANES) III (1988-1994). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and CVD-related mortality by CMV serostatus. After adjusting for multiple confounders, CMV seropositivity remained statistically significantly associated with all-cause mortality (HR 1.19, 95% CI: 1.01, 1.41). The association between CMV and CVD-related mortality did not achieve statistical significance after confounder adjustment. CRP did not mediate these associations. However, CMV seropositive individuals with high CRP levels showed a 30.1% higher risk for all-cause mortality and 29.5% higher risk for CVD-related mortality compared to CMV seropositive individuals with low CRP levels. CONCLUSIONS/SIGNIFICANCE CMV was associated with a significant increased risk for all-cause mortality and CMV seropositive subjects who also had high CRP levels were at substantially higher risk for both for all-cause and CVD-related mortality than subjects with low CRP levels. Future work should target the mechanisms by which CMV infection and low-level inflammation interact to yield significant impact on mortality.
Collapse
|
32
|
Murine cytomegalovirus infection leads to increased levels of transplant arteriosclerosis in a murine aortic allograft model. Transplantation 2010; 90:373-9. [PMID: 20585280 DOI: 10.1097/tp.0b013e3181e8a699] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cytomegalovirus infection after heart transplantation is considered as risk factor for the development of transplant arteriosclerosis. Therefore, the aim of this study was to investigate the effect of murine cytomegalovirus (MCMV) as a single risk factor on transplant arteriosclerosis in an experimental aortic allograft model. METHODS Major histocompatibility complex class I-mismatched aortas of C.B10-H2(b)/LilMcdJ donor were transplanted into BALB/c recipients, which were either mock-infected or infected with MCMV (strain Smith) on day 7 and harvested 37 days after transplantation. In one experimental group animals received a daily dose of everolimus to increase the viral load of recipients. Grafts were analyzed by histology, morphometry, and immunofluorescence. Intragraft cytokine mRNA production was analyzed by real-time polymerase chain reaction (PCR), and persistence of cytomegalovirus infection was confirmed by TaqMan PCR. RESULTS After infection with MCMV, there was significantly more intimal proliferation when compared with uninfected controls (intimal proliferation 83.5%+/-9.6% [MCMV] vs. 43.9%+/-5.1% [MCMV]), indicating that MCMV plays a role in the development of transplant arteriosclerosis. Even after treatment with everolimus, MCMV infection pronounced significantly more intimal proliferation (intimal proliferation 52.5%+/-7.3% [MCMV] vs. 20.2%+/-1.7% [MCMV]). Intragraft mRNA expression showed significantly higher production of CD62E, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 after infection with MCMV. Cellular infiltration revealed significantly more CD4, CD8, and dendritic cells. We could also confirm the presence of MCMV for the duration of the experimental protocol by PCR within the spleen, liver, salivary glands, lung, and the aortic transplant. CONCLUSION These data suggest that MCMV infection plays an important role in the development of transplant arteriosclerosis.
Collapse
|
33
|
Roberts ET, Haan MN, Dowd JB, Aiello AE. Cytomegalovirus antibody levels, inflammation, and mortality among elderly Latinos over 9 years of follow-up. Am J Epidemiol 2010; 172:363-71. [PMID: 20660122 DOI: 10.1093/aje/kwq177] [Citation(s) in RCA: 198] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examined the relation between immune response to cytomegalovirus (CMV) and all-cause and cardiovascular disease (CVD) mortality, and possible mediating mechanisms. Data were derived from the Sacramento Area Latino Study on Aging, a population-based study of older Latinos (aged 60-101 years) in California followed in 1998-2008. CMV immunoglobulin G (IgG), tumor necrosis factor, and interleukin-6 were assayed from baseline blood draws. Data on all-cause and CVD mortality were abstracted from death certificates. Analyses included 1,468 of 1,789 participants. For individuals with CMV IgG antibody titers in the highest quartile compared with lower quartiles, fully adjusted models showed that all-cause mortality was 1.43 times (95% confidence interval: 1.14, 1.79) higher over 9 years. In fully adjusted models, the hazard of CVD mortality was also elevated (hazard ratio = 1.35, 95% confidence interval: 1.01, 1.80). A composite measure of tumor necrosis factor and interleukin-6 mediated a substantial proportion of the association between CMV and all-cause (18.9%, P < 0.001) and CVD (29.0%, P = 0.02) mortality. This study is the first known to show that high CMV IgG antibody levels are significantly related to mortality and that the relation is largely mediated by interleukin-6 and tumor necrosis factor. Further studies investigating methods for reducing IgG antibody response to CMV are warranted.
Collapse
Affiliation(s)
- Eric T Roberts
- Department of Epidemiology, 3659 SPH Tower, 109 Observatory, Ann Arbor, MI 48104-2548, USA
| | | | | | | |
Collapse
|
34
|
Slinger E, Maussang D, Schreiber A, Siderius M, Rahbar A, Fraile-Ramos A, Lira SA, Söderberg-Nauclér C, Smit MJ. HCMV-encoded chemokine receptor US28 mediates proliferative signaling through the IL-6-STAT3 axis. Sci Signal 2010; 3:ra58. [PMID: 20682912 DOI: 10.1126/scisignal.2001180] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
US28 is a viral G protein (heterotrimeric guanosine triphosphate-binding protein)-coupled receptor encoded by the human cytomegalovirus (HCMV). In addition to binding and internalizing chemokines, US28 constitutively activates signaling pathways linked to cell proliferation. Here, we show increased concentrations of vascular endothelial growth factor and interleukin-6 (IL-6) in supernatants of US28-expressing NIH 3T3 cells. Increased IL-6 was associated with increased activation of the signal transducer and activator of transcription 3 (STAT3) through upstream activation of the Janus-activated kinase JAK1. We used conditioned growth medium, IL-6-neutralizing antibodies, an inhibitor of the IL-6 receptor, and short hairpin RNA targeting IL-6 to show that US28 activates the IL-6-JAK1-STAT3 signaling axis through activation of the transcription factor nuclear factor kappaB and the consequent production of IL-6. Treatment of cells with a specific inhibitor of STAT3 inhibited US28-dependent [(3)H]thymidine incorporation and foci formation, suggesting a key role for STAT3 in the US28-mediated proliferative phenotype. US28 also elicited STAT3 activation and IL-6 secretion in HCMV-infected cells. Analyses of tumor specimens from glioblastoma patients demonstrated colocalization of US28 and phosphorylated STAT3 in the vascular niche of these tumors. Moreover, increased phospho-STAT3 abundance correlated with poor patient outcome. We propose that US28 induces proliferation in HCMV-infected tumors by establishing a positive feedback loop through activation of the IL-6-STAT3 signaling axis.
Collapse
Affiliation(s)
- Erik Slinger
- Leiden/Amsterdam Center for Drug Research, Division of Medicinal Chemistry, Faculty of Sciences, VU University Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Revello MG, Gerna G. Human cytomegalovirus tropism for endothelial/epithelial cells: scientific background and clinical implications. Rev Med Virol 2010; 20:136-55. [PMID: 20084641 DOI: 10.1002/rmv.645] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Human cytomegalovirus (HCMV) has been routinely isolated from and propagated in vitro in human embryonic lung fibroblast (HELF) cell cultures, while in vivo it is known to infect predominantly endothelial and epithelial cells. In recent years, genetic determinants of the HCMV tropism for endothelial/epithelial cells were identified in the UL131A/UL130/UL128 locus of HCMV genome of wild-type strains. UL131A-UL128 gene products form a complex with glycoprotein H (gH) and L (gL) resulting in a gH/gL/UL131A-UL128 complex that is required for HCMV entry into endothelial/epithelial cells. In contrast, virus entry into fibroblasts has its genetic determinants in the complex gH/gL/gO (or gH/gL). During primary HCMV infection, the neutralising antibody response measured in endothelial cells (EC) is potent, occurs very early and is directed mostly against combinations of two or three gene products of the UL131A-128 locus. On the contrary, neutralising antibodies measured in fibroblasts appear late, are relatively weak in potency and are directed against gH and gB. The T-cell immune response to UL131A-UL128 gene products remains to be investigated. Recently, a role has been proposed for neutralising antibody in conferring prevention/protection against HCMV infection/disease in pregnant women with primary HCMV infection. However, the level of cooperation between humoral immunity and the well-established T-cell protection remains to be defined.
Collapse
Affiliation(s)
- M Grazia Revello
- Servizio di Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | | |
Collapse
|
36
|
Betjes MGH, de Wit EEA, Weimar W, Litjens NHR. Circulating pro-inflammatory CD4posCD28null T cells are independently associated with cardiovascular disease in ESRD patients. Nephrol Dial Transplant 2010; 25:3640-6. [PMID: 20400452 DOI: 10.1093/ndt/gfq203] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cytomegalovirus seropositivity is associated with an increased risk for cardiovascular disease in end-stage renal disease (ESRD) patients. Circulating pro-inflammatory CD4posCD28null T cells are expanded in cytomegalovirus-seropositive ESRD patients and potentially could mediate atherosclerotic plaque instability and rupture. METHODS In this study, we tested the hypothesis that increased numbers of circulating CD4posCD28null T cells may represent a risk factor for cardiovascular disease in ESRD patients. Prospectively collected data from 240 cytomegalovirus-seropositive stable ESRD patients were analysed. RESULTS Traditional cardiovascular risk factors (age, smoking, hypercholesterolaemia and diabetes mellitus) and the percentage and absolute number of CD4posCD28null T cells were significantly associated with the presence of atherosclerotic disease, after univariate and multivariate statistical analysis. An ~2-3-fold increase in the prevalence of atherosclerotic disease was noted between patients with the highest and lowest number of CD4posCD28null cells. CD8posCD28null T-cell populations were also significantly expanded in cytomegalovirus-seropositive ESRD patients and closely correlated with the number of CD4posCD28null T cells. However, this cell population was not related to an increased prevalence of cardiovascular disease. CONCLUSIONS Cytomegalovirus-seropositive ESRD patients may have substantially increased numbers of circulating pro-inflammatory CD4posCD28null T cells that are independently associated with the presence of atherosclerotic disease. The expansion of these cells may therefore represent a novel non-traditional cardiovascular risk factor for ESRD patients.
Collapse
Affiliation(s)
- Michiel G H Betjes
- Erasmus Medical Center, Department of Internal Medicine, Division of Nephrology, Rotterdam, The Netherlands.
| | | | | | | |
Collapse
|
37
|
Vescovini R, Biasini C, Telera AR, Basaglia M, Stella A, Magalini F, Bucci L, Monti D, Lazzarotto T, Dal Monte P, Pedrazzoni M, Medici MC, Chezzi C, Franceschi C, Fagnoni FF, Sansoni P. Intense antiextracellular adaptive immune response to human cytomegalovirus in very old subjects with impaired health and cognitive and functional status. THE JOURNAL OF IMMUNOLOGY 2010; 184:3242-9. [PMID: 20173031 DOI: 10.4049/jimmunol.0902890] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human aging is characterized by expanded and altered adaptive immune responses to human CMV (HCMV). It is unclear whether this expansion has its origins in age-related homeostatic disturbances or viral reactivation, whether anti-CMV immune surveillance may still be effective, and what are the consequences of this expanded immune response for health and longevity. We conducted an observational cross-sectional study in groups of HCMV-seropositive subjects aged >or=65 y of variable health status to compare the intensity of Ab responses against HCMV with those against EBV and with CD4(+) and CD8(+) T cell proinflammatory effector responses directed to HCMV-derived pp65 and immediate-early protein 1 synthetic peptides. Ab responses to HCMV, but not to EBV, and anti-HCMV CD4(+), but not CD8(+), T cell responses were more intense in elderly subjects aged >or=85 y in poor health and were inversely correlated with markers of functional activity and cognitive function. Therefore, humoral and CD4(+) T cell anti-HCMV responses were specifically intensified in advanced aging associated with comorbidity and cognitive and functional impairments. Such a distinctive pattern of adaptive immunity indicates that immune responses targeting the extracellular phase of HCMV are increased in these elderly subjects and could represent an indirect effect of localized and undetectable HCMV reactivation. This study demonstrates that the oldest subjects in poor health with physical and mental impairment express intense functional immune responses to extracellular HCMV and suggests that they may be at risk for direct pathogenic effects by HCMV reactivation as well as indirect pathogenic effects linked to proinflammatory anti-HCMV effector responses.
Collapse
Affiliation(s)
- Rosanna Vescovini
- Department of Internal Medicine and Biomedical Sciences, University of Parma,Parma, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Reischig T, Němcová J, Vaněček T, Jindra P, Hes O, Bouda M, Treška V. Intragraft cytomegalovirus infection: a randomized trial of valacyclovir prophylaxis versus pre-emptive therapy in renal transplant recipients. Antivir Ther 2010; 15:23-30. [DOI: 10.3851/imp1485] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Potena L, Grigioni F, Magnani G, Lazzarotto T, Musuraca AC, Ortolani P, Coccolo F, Fallani F, Russo A, Branzi A. Prophylaxis versus preemptive anti-cytomegalovirus approach for prevention of allograft vasculopathy in heart transplant recipients. J Heart Lung Transplant 2009; 28:461-7. [PMID: 19416774 DOI: 10.1016/j.healun.2009.02.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 02/11/2009] [Accepted: 02/19/2009] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection may influence the development of cardiac allograft vasculopathy (CAV). Prophylactic or preemptive administration of anti-CMV agents effectively prevents acute CMV manifestations. However, studies comparing allograft-related outcomes between these anti-CMV approaches are lacking. Herein we report a longitudinal observational study comparing CAV development between prophylactic and preemptive approaches. METHODS The 1-year change in maximal intimal thickening (MIT) assessed by intravascular ultrasound at 1 and 12 months after heart transplantation (the major surrogate for late survival) was compared in groups of patients routinely assigned to a preemptive strategy (from November 2004 to October 2005; n = 21) or receiving valganciclovir prophylaxis (from November 2005 to October 2006; n = 19). CMV infection was monitored with pp65 antigenemia. RESULTS The 1-year increase in MIT was significantly lower in patients receiving prophylaxis compared with those managed preemptively (0.15 +/- 0.17 vs 0.31 +/- 0.20 mm; p = 0.01). Prophylaxed recipients presented less frequently with MIT change > or =0.3 mm (p = 0.03) and > or =0.5 mm (p = 0.10) than those managed preemptively. Prophylaxis was also associated with later onset of CMV infection (p = 0.01), lower peak CMV detection (p < 0.01) and reduced incidence of CMV disease/syndrome (p = 0.04). After adjusting for metabolic risk factors and other possible confounders, prophylaxis remained independently associated with lower risk for MIT change > or =0.3 mm (odds ratio = 0.09, 95% confidence interval 0.01 to 0.93; p = 0.04). CONCLUSIONS Universal prophylaxis was associated with delayed onset of CMV infection, lower viral burden, reduced CMV disease/syndrome and less intimal thickening, as compared with a preemptive anti-CMV approach. Randomized studies are required to confirm the potential benefits of prophylaxis vs a preemptive approach in heart transplant recipients.
Collapse
Affiliation(s)
- Luciano Potena
- Cardiovascular Department, Heart Transplant Program, University of Bologna, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Simanek AM, Dowd JB, Aiello AE. Persistent pathogens linking socioeconomic position and cardiovascular disease in the US. Int J Epidemiol 2009; 38:775-87. [PMID: 19109247 PMCID: PMC2689394 DOI: 10.1093/ije/dyn273] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2008] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Numerous studies have documented a strong inverse association between cardiovascular disease and socioeconomic position (SEP). Several infections are associated with both cardiovascular disease and SEP; hence infection may form an important link between SEP and cardiovascular disease. This study examines whether seropositivity to cytomegalovirus (CMV), to herpes simplex virus type-1 (HSV-1), and/or to both pathogens mediates the relationship between SEP and cardiovascular disease history in a nationally representative sample of the United States. METHODS We conducted a cross-sectional study of subjects > or =45 years of age, who were tested for seropositivity to CMV, HSV-1 or both pathogens and assessed for cardiovascular disease history in the National Health and Nutrition Examination Survey III. Cardiovascular disease history was defined as history of stroke, heart attack and/or congestive heart failure and SEP as education level. RESULTS SEP was associated with CMV, HSV-1 and seropositivity to both pathogens. CMV seropositivity was associated with cardiovascular disease history even after adjusting for confounders as well as SEP. The odds of reporting a history of cardiovascular disease for those with less than a high school education compared with those with more than a high school education decreased by 7.7% after adjusting for CMV (Sobel mediation test for CMV, P = 0.0006). In contrast, neither seropositivity to HSV-1 nor to both pathogens was associated with cardiovascular disease history after adjusting for SEP. CONCLUSIONS Persistent pathogens such as CMV infection may explain a portion of the relationship between SEP and cardiovascular disease in the United States. Further studies examining additional pathogens and sociobiological mechanisms are warranted.
Collapse
Affiliation(s)
- Amanda M Simanek
- Center for Social Epidemiology & Population Health School of Public Health-University of Michigan, Ann Arbor, MI 48109-2029, USA
| | | | | |
Collapse
|
41
|
Cheng J, Ke Q, Jin Z, Wang H, Kocher O, Morgan JP, Zhang J, Crumpacker CS. Cytomegalovirus infection causes an increase of arterial blood pressure. PLoS Pathog 2009; 5:e1000427. [PMID: 19436702 PMCID: PMC2673691 DOI: 10.1371/journal.ppat.1000427] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 04/13/2009] [Indexed: 02/05/2023] Open
Abstract
Cytomegalovirus (CMV) infection is a common infection in adults (seropositive 60–99% globally), and is associated with cardiovascular diseases, in line with risk factors such as hypertension and atherosclerosis. Several viral infections are linked to hypertension, including human herpes virus 8 (HHV-8) and HIV-1. The mechanisms of how viral infection contributes to hypertension or increased blood pressure are not defined. In this report, the role of CMV infection as a cause of increased blood pressure and in forming aortic atherosclerotic plaques is examined. Using in vivo mouse model and in vitro molecular biology analyses, we find that CMV infection alone caused a significant increase in arterial blood pressure (ABp) (p<0.01∼0.05), measured by microtip catheter technique. This increase in blood pressure by mouse CMV (MCMV) was independent of atherosclerotic plaque formation in the aorta, defined by histological analyses. MCMV DNA was detected in blood vessel samples of viral infected mice but not in the control mice by nested PCR assay. MCMV significantly increased expression of pro-inflammatory cytokines IL-6, TNF-α, and MCP-1 in mouse serum by enzyme-linked immunosorbent assay (ELISA). Using quantitative real time reverse transcriptase PCR (Q-RT-PCR) and Western blot, we find that CMV stimulated expression of renin in mouse and human cells in an infectious dose-dependent manner. Co-staining and immunofluorescent microscopy analyses showed that MCMV infection stimulated renin expression at a single cell level. Further examination of angiotensin-II (Ang II) in mouse serum and arterial tissues with ELISA showed an increased expression of Ang II by MCMV infection. Consistent with the findings of the mouse trial, human CMV (HCMV) infection of blood vessel endothelial cells (EC) induced renin expression in a non-lytic infection manner. Viral replication kinetics and plaque formation assay showed that an active, CMV persistent infection in EC and expression of viral genes might underpin the molecular mechanism. These results show that CMV infection is a risk factor for increased arterial blood pressure, and is a co-factor in aortic atherosclerosis. Viral persistent infection of EC may underlie the mechanism. Control of CMV infection can be developed to restrict hypertension and atherosclerosis in the cardiovascular system. Cytomegalovirus (CMV) infection is associated with cardiovascular diseases. The exact mechanisms, however, remain to be defined. Using both mouse model and cell culture analyses, we find that CMV infection alone causes an increase in blood pressure. Additionally, CMV infection augments the increased blood pressure induced by a high cholesterol diet. CMV infection alone, however, does not cause atherosclerosis in aortas. CMV infection along with a high cholesterol diet, however, causes the classic atherosclerotic plaque formation in the main artery connected to the heart. Further studies show that CMV infection induces renin and angiotensin II (Ang II) expression in blood and in vessel cells, in a persistent infection manner. An increased expression of renin and Ang II has been known to cause an increase in blood pressure or hypertension in humans. Expression of viral genes and viral persistent infection of blood vessel endothelial cells resulting in an increased expression of inflammatory cytokines, including renin and Ang II, may underpin the molecular mechanism by which CMV infection induces an increase in blood pressure.
Collapse
Affiliation(s)
- Jilin Cheng
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Britt W. Manifestations of human cytomegalovirus infection: proposed mechanisms of acute and chronic disease. Curr Top Microbiol Immunol 2008; 325:417-70. [PMID: 18637519 DOI: 10.1007/978-3-540-77349-8_23] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Infections with human cytomegalovirus (HCMV) are a major cause of morbidity and mortality in humans with acquired or developmental deficits in innate and adaptive immunity. In the normal immunocompetent host, symptoms rarely accompany acute infections, although prolonged virus shedding is frequent. Virus persistence is established in all infected individuals and appears to be maintained by both a chronic productive infections as well as latency with restricted viral gene expression. The contributions of the each of these mechanisms to the persistence of this virus in the individual is unknown but frequent virus shedding into the saliva and genitourinary tract likely accounts for the near universal incidence of infection in most populations in the world. The pathogenesis of disease associated with acute HCMV infection is most readily attributable to lytic virus replication and end organ damage either secondary to virus replication and cell death or from host immunological responses that target virus-infected cells. Antiviral agents limit the severity of disease associated with acute HCMV infections, suggesting a requirement for virus replication in clinical syndromes associated with acute infection. End organ disease secondary to unchecked virus replication can be observed in infants infected in utero, allograft recipients receiving potent immunosuppressive agents, and patients with HIV infections that exhibit a loss of adaptive immune function. In contrast, diseases associated with chronic or persistent infections appear in normal individuals and in the allografts of the transplant recipient. The manifestations of these infections appear related to chronic inflammation, but it is unclear if poorly controlled virus replication is necessary for the different phenotypic expressions of disease that are reported in these patients. Although the relationship between HCMV infection and chronic allograft rejection is well known, the mechanisms that account for the role of this virus in graft loss are not well understood. However, the capacity of this virus to persist in the midst of intense inflammation suggests that its persistence could serve as a trigger for the induction of host-vs-graft responses or alternatively host responses to HCMV could contribute to the inflammatory milieu characteristic of chronic allograft rejection.
Collapse
Affiliation(s)
- W Britt
- Department of Pediatrics, University of Alabama School of Medicine, Childrens Hospital, Harbor Bldg. 104, 1600 7th Ave. South Birmingham, AL 35233, USA.
| |
Collapse
|
43
|
Abstract
The human cytomegalovirus (HCMV) can infect a remarkably broad cell range within its host, including parenchymal cells and connective tissue cells of virtually any organ and various hematopoietic cell types. Epithelial cells, endothelial cells, fibroblasts and smooth muscle cells are the predominant targets for virus replication. The pathogenesis of acute HCMV infections is greatly influenced by this broad target cell range. Infection of epithelial cells presumably contributes to inter-host transmission. Infection of endothelial cells and hematopoietic cells facilitates systemic spread within the host. Infection of ubiquitous cell types such as fibroblasts and smooth muscle cells provides the platform for efficient proliferation of the virus. The tropism for endothelial cells, macrophages and dendritic cells varies greatly among different HCMV strains, mostly dependent on alterations within the UL128-131 gene locus. In line with the classification of the respective proteins as structural components of the viral envelope, interstrain differences concerning the infectivity in endothelial cells and macrophages are regulated on the level of viral entry.
Collapse
|
44
|
Raftery MJ, Winau F, Giese T, Kaufmann SHE, Schaible UE, Schönrich G. Viral danger signals control CD1d de novo synthesis and NKT cell activation. Eur J Immunol 2008; 38:668-79. [PMID: 18253929 DOI: 10.1002/eji.200737233] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The nonpolymorphic CD1 molecules present lipid antigens to T cells. In myeloid DC humans express five different CD1 proteins (CD1a-e; the corresponding CD1 genes are designated CD1A-E). A role for CD1d-restricted NKT cells in the control of virus infections has been delineated from clinical observations, mouse models and viral evasion mechanisms targeting CD1d. How NKT cells are activated by virus infections is unclear. We found that human myeloid DC differentially regulate CD1 antigen presentation in response to viral danger signals. Stimulation with type I IFN, viral TLR ligands or viruses strongly enhanced the number of CD1D transcripts in human myeloid DC but diminished the abundance of CD1A, CD1B and CD1E mRNA. These changes on the transcriptional level were mirrored by altered cellular distribution and increased surface expression of CD1d. As a consequence NKT cells were activated and showed a Th1-like response. Moreover, NKT cell activation in PBMC exposed to viral danger signals was dependent on human plasmacytoid DC which produce large amounts of IFN-alpha. In conclusion, our data indicate that viral danger signals trigger NKT cell activation by enhancing CD1d de novo synthesis through increasing the abundance of CD1D mRNA in human myeloid DC.
Collapse
Affiliation(s)
- Martin J Raftery
- Institute of Virology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | | |
Collapse
|
45
|
Constitutive serum response factor activation by the viral chemokine receptor homologue pUS28 is differentially regulated by Galpha(q/11) and Galpha(16). Cell Signal 2008; 20:1528-37. [PMID: 18534820 DOI: 10.1016/j.cellsig.2008.04.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Accepted: 04/11/2008] [Indexed: 01/30/2023]
Abstract
Expression of the human cytomegalovirus (HCMV)-encoded chemokine receptor homologue pUS28 in mammalian cells results in ligand-dependent and -independent changes in the activity of multiple cellular signal transduction pathways. The ligand-dependent signalling activity of pUS28 has been shown to be predominantly mediated by heterotrimeric G proteins of the G(i/o) and G(12/13) subfamilies. Ligand-independent constitutive activity of pUS28 causing stimulation of inositol phosphate formation has been correlated with the coupling of pUS28 to G proteins of the G(q) family. It is well known that activation of G(q) proteins by cell surface receptors is coupled to activation of the Rho GTPase RhoA. Activated RhoA regulates numerous cellular functions, including the activity of the transcription factor serum response factor (SRF). The marked activation of G(q) proteins by pUS28 in transfected and HCMV-infected cells prompted us to investigate its effect on SRF activity. The results presented herein demonstrate that expression of pUS28 in COS-7 cells caused a vigorous induction of SRF activity. This effect was observed in the absence of chemokines known to interact with pUS28, and was specifically mediated by endogenous G(q) and/or G(11) as well as RhoA and/or a closely related Rho GTPase. The stimulatory effect of pUS28 and Galpha(q/11) was independent of phospholipase C-beta (PLCbeta) activation and was markedly sensitive to inhibition by wild-type, but not by constitutively active Galpha(16), thus identifying Galpha(16) as a modulator of Galpha(q/11) function likely to act by competing with Galpha(q/11) for and thus uncoupling Galpha(q/11) from activation by pUS28.
Collapse
|
46
|
Structure, function and physiological consequences of virally encoded chemokine seven transmembrane receptors. Br J Pharmacol 2008; 153 Suppl 1:S154-66. [PMID: 18204488 DOI: 10.1038/sj.bjp.0707660] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A number of human and animal herpes viruses encode G-protein coupled receptors with seven transmembrane (7TM) segments-most of which are clearly related to human chemokine receptors. It appears, that these receptors are used by the virus for immune evasion, cellular transformation, tissue targeting, and possibly for cell entry. In addition, many virally-encoded chemokine 7TM receptors have been suggested to be causally involved in pathogenic phenotypes like Kaposi sarcoma, atherosclerosis, HIV-infection and tumour development. The role of these receptors during the viral life cycle and in viral pathogenesis is still poorly understood. Here we focus on the current knowledge of structure, function and trafficking patterns of virally encoded chemokine receptors and further address the putative roles of these receptors in virus survival and host -cell and/or -immune system modulation. Finally, we highlight the emerging impact of these receptor on virus-mediated diseases.
Collapse
|
47
|
Abstract
Inflammation underpins the development of atherosclerosis. Initiation and progression of vascular inflammation involves a complex cellular network, with macrophages as major contributors. Activated macrophages produce proinflammatory mediators, bridge innate and adaptive immunity, regulate lipid retention, and participate directly in vascular repair and remodeling. Recent efforts to elucidate molecular mechanisms involved in the regulation of vascular inflammation in atherosclerosis have implicated several families of innate immune recognition receptors in inflammatory activation during the course of this disease. This article reviews our current understanding of innate immune recognition receptors, signaling pathways, and putative ligands implicated in activation of macrophages in the disease. In its final section, we propose a model for the role of macrophages in bridging inflammation and atherosclerosis from the perspective of innate immune recognition and activation.
Collapse
Affiliation(s)
- Zhong-qun Yan
- Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
| | | |
Collapse
|
48
|
Potena L, Valantine HA. Cytomegalovirus-associated allograft rejection in heart transplant patients. Curr Opin Infect Dis 2007; 20:425-31. [PMID: 17609604 DOI: 10.1097/qco.0b013e328259c33b] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Modern antiviral strategies are effective in controlling the clinical syndromes associated with acute cytomegalovirus infection in heart transplant recipients. Despite this effectiveness, subclinical cytomegalovirus infection is a common finding in these patients and its impact on long-term graft outcome is currently underestimated. RECENT FINDINGS Recent studies provide evidence implicating subclinical cytomegalovirus infection in the pathogenesis of allograft rejection and cardiac allograft vasculopathy. In this process, cytomegalovirus interacts with local inflammatory pathways, and systemic immune-regulation mechanisms, which may lead to graft damage, even in the absence of cytomegalovirus replication within the graft. Consequently, in addition to pharmacologic strategies that inhibit viral replication, immune-based therapies that abrogate host immune response may provide an effective tool to prevent the indirect impact of cytomegalovirus on graft function. SUMMARY Current evidence suggests that subclinical cytomegalovirus infection plays an important role in the pathogenesis of long-term graft dysfunction in heart transplant recipients and in other solid organ transplant recipients. Pending the availability of definitive data from randomized trials, we propose that the use of pharmacologic and immune-based approaches, directed at complete suppression of cytomegalovirus infection, represents the best strategy for prevention of cytomegalovirus-induced rejection, cardiac allograft vasculopathy and chronic allograft damage.
Collapse
Affiliation(s)
- Luciano Potena
- Institute of Cardiology, University of Bologna, Bologna, Italy
| | | |
Collapse
|
49
|
Voisard R, Krügers T, Reinhardt B, Vaida B, Baur R, Herter T, Lüske A, Weckermann D, Weingärtner K, Rössler W, Hombach V, Mertens T. HCMV-infection in a human arterial organ culture model: effects on cell proliferation and neointimal hyperplasia. BMC Microbiol 2007; 7:68. [PMID: 17659083 PMCID: PMC1950876 DOI: 10.1186/1471-2180-7-68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 07/20/2007] [Indexed: 12/02/2022] Open
Abstract
Background The impact of infections with the human cytomegalovirus (HCMV) for the development of atherosclerosis and restenosis is still unclear. Both a clear correlation and no correlation at all have been reported in clinical, mostly serological studies. In our study we employed a human non-injury ex vivo organ culture model to investigate the effect of an in vitro permissive HCMV-infection on cell proliferation and neointimal hyperplasia for a period of 56 days. Results During routine-nephrectomies parts of renal arteries from 71 patients were obtained and prepared as human organ cultures. Cell free HCMV infection was performed with the fibroblast adapted HCMV strain AD169, the endotheliotropic strain TB40E, and a clinical isolate (AN 365). After 3, 7, 14, 21, 28, 35, and 56 days in culture staining of HCMV-antigens was carried out and reactive cell proliferation and neointimal thickening were analysed. Successful HCMV-infection was accomplished with all three virus strains studied. During the first 21 days in organ culture no cell proliferation or neointimal hyperplasia was detected. At day 35 and day 56 moderate cell proliferation and neointimal hyperplasia was found both in HCMV-infected segments and mock infected controls. Neointimal hyperplasia in productively HCMV-infected segments was lower than in non infected at day 35 and day 56, but relatively higher after infection with the endotheliotropic TB40E in comparison with the two other strains. Conclusion The data do not support the hypothesis that HCMV-infection triggers restenosis via a stimulatory effect on cell proliferation and neointimal hyperplasia in comparison to non infected controls. Interestingly however, even after lytic infection, a virus strain specific difference was observed.
Collapse
Affiliation(s)
- Rainer Voisard
- Department of Internal Medicine II – Cardiology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Tanja Krügers
- Department of Internal Medicine II – Cardiology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Barbara Reinhardt
- Department of Virology, Institute of Microbiology and Immunology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Bianca Vaida
- Department of Virology, Institute of Microbiology and Immunology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Regine Baur
- Department of Internal Medicine II – Cardiology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Tina Herter
- Department of Internal Medicine II – Cardiology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Anke Lüske
- Department of Virology, Institute of Microbiology and Immunology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Dorothea Weckermann
- Department of Urology, Klinikum Augsburg, Stenglin Straße 2, D-86156 Augsburg, Germany
| | - Karl Weingärtner
- Department of Urology, University of Würzburg, Oberdürrbacher Straße 6, D-97080 Würzburg, Germany
| | - Wolfgang Rössler
- Department of Urology, St. Josef Spital Regensburg, Landshuter Straße 65, D-93053 Regensburg, Germany
| | - Vinzenz Hombach
- Department of Internal Medicine II – Cardiology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| | - Thomas Mertens
- Department of Virology, Institute of Microbiology and Immunology, University of Ulm, Robert-Koch Straße 8, D-89081 Ulm, Germany
| |
Collapse
|
50
|
Halvorsen DS, Karlsen J, Notø ATW, Mathiesen EB, Njølstad I, Gutteberg TJ, Vorland LH, Hansen JB. No detectable Chlamydia pneumoniae and cytomegalovirus DNA in leukocytes in subjects with echolucent and echogenic carotid artery plaques. Int J Cardiol 2007; 117:388-94. [PMID: 17182139 DOI: 10.1016/j.ijcard.2006.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 05/01/2006] [Accepted: 05/18/2006] [Indexed: 11/21/2022]
Abstract
BACKGROUND Controversy exists whether persistent Chlamydia pneumoniae or cytomegalovirus infections cause initiation or progression of atherosclerosis. C. pneumoniae DNA in peripheral blood mononuclear cells (PBMC) has been proposed to be a more reliable marker of cardiovascular risk than are C. pneumoniae antibodies. Reported prevalences of C. pneumoniae DNA among cardiovascular patients vary greatly, indicating methodological limitations. There is an increasing concern that published results may have been biased by extensive use of less specific polymerase chain reaction (PCR) technology. METHODS C. pneumoniae DNA and cytomegalovirus DNA were determined by probe-based real-time PCR technology in PBMCs among subjects with echolucent (n=29) or echogenic (n=28) carotid artery plaques, and in controls without carotid plaques (n=38), all recruited from a population-based study. Samples were examined in multiple repeats with PCR assays targeting two different sequences of the genome for both microorganisms. RESULTS AND CONCLUSION IgG seropositivity was frequent in all three groups, confirming previous exposure, but C. pneumoniae DNA or cytomegalovirus DNA was not detected in a single PBMC sample by means of probe-based, highly sensitive, and specific real-time PCR assays. Our results indicate that persistent C. pneumoniae or CMV infection is not a common phenomenon in subjects with carotid atherosclerosis.
Collapse
Affiliation(s)
- Dag S Halvorsen
- Department of Microbiology, University Hospital of North Norway, N-9038 Tromsø, Norway.
| | | | | | | | | | | | | | | |
Collapse
|