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Liviero F, Scapellato ML, Volpin A, Battistella M, Fabris L, Brischigliaro L, Folino F, Moretto A, Mason P, Pavanello S. Long term follow-up of heart rate variability in healthcare workers with mild COVID-19. Front Neurol 2024; 15:1403551. [PMID: 38827576 PMCID: PMC11141692 DOI: 10.3389/fneur.2024.1403551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/17/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Prior investigations into post-COVID dysautonomia often lacked control groups or compared affected individuals solely to healthy volunteers. In addition, no data on the follow-up of patients with SARS-CoV-2-related autonomic imbalance are available. Methods In this study, we conducted a comprehensive clinical and functional follow-up on healthcare workers (HCWs) with former mild COVID-19 (group 1, n = 67), to delineate the trajectory of post-acute autonomic imbalance, we previously detected in a case-control study. Additionally, we assessed HCWs for which a test before SARS-CoV-2 infection was available (group 2, n = 29), who later contracted SARS-CoV-2, aiming to validate findings from our prior case-control investigation. We evaluated autonomic nervous system heart modulation by means of time and frequency domain heart rate variability analysis (HRV) in HCWs during health surveillance visits. Short-term electrocardiogram (ECG) recordings, were obtained at about 6, 13 months and both at 6 and 13 months from the negative SARS-CoV-2 naso-pharyngeal swab (NPS) for group 1 and at about 1-month from the negative NPS for group 2. HCWs who used drugs, had comorbidities that affected HRV, or were hospitalized with severe COVID-19 were excluded. Results Group 1 was split into three subgroups clinically and functionally followed at, about 6 months (subgroup-A, n = 17), 13 months (subgroup-B, n = 37) and both at 6 and 13 months (subgroup-C, n = 13) from the negative SARS-CoV-2 NPS. In subgroup-A, at 6-month follow-up compared with baseline, the spectral components in the frequency domain HRV parameters, showed an increase in normalized high frequency power (nHF) (t = 2.99, p = 0.009), a decrease in the normalized low frequency power (nLF) (t = 2.98, p = 0.009) and in the LF/HF ratio (t = 3.13, p = 0.006). In subgroup B, the comparison of the spectral components in the frequency domain HRV parameters, at 13-month follow-up compared with baseline, showed an increase in nHF (t = 2.54, p = 0.02); a decrease in nLF (t = 2.62, p = 0.01) and in the LF/HF ratio (t = 4.00, p = 0.0003). In subgroup-C, at both 6 and 13-month follow-ups, the spectral components in the frequency domain HRV parameters were higher than baseline in nHF (t = 2.64, p = 0.02 and (t = 2.13, p = 0.05, respectively); lower in nLF (t = 2.64, p = 0.02 and (t = 2.13, p = 0.05, respectively), and in LF/HF (t = 1.92, p = 0.08 and (t = 2.43, p = 0.03, respectively). A significant proportion of HCWs reported persistent COVID-19 symptoms at both the 6 and 13-month follow-ups, seemingly unrelated to cardiac autonomic balance. In group 2 HCWs, at 1-month follow-up compared with baseline, the spectral components in the frequency domain HRV parameters, showed a decrease in nHF (t = 2.19, p = 0.04); an increase in nLF (t = 2.15, p = 0.04) and in LF/HF (t = 3.49, p = 0.002). Conclusion These results are consistent with epidemiological data suggesting a higher risk of acute cardiovascular complications during the first 30 days after COVID-19. The SARS-CoV-2 associated autonomic imbalance in the post-acute phase after recovery of mild COVID-19 resolved 6 months after the first negative SARS-CoV-2 NPS. However, a significant proportion of HCWs reported long-term COVID-19 symptoms, which dot not seems to be related to cardiac autonomic balance. Future research should certainly further test whether autonomic imbalance has a role in the mechanisms of long-COVID syndrome.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Anna Volpin
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Monica Battistella
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Laura Fabris
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Laura Brischigliaro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Franco Folino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Sofia Pavanello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
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Sahebari M, Salimi J, Shalchian Tabrizi P, Khodabandeh M, Ariaee Nasab N, Salari M. Skin reaction to capsaicin in patients with systemic lupus erythematosus compared to healthy controls. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:140-147. [PMID: 34012530 PMCID: PMC8111804 DOI: 10.22088/cjim.12.2.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The interaction between nervous and immune systems has been under investigation. Transient receptor potential vanilloid type 1(TRPV1) is a ligand gated calcium channel expressed by sensory neurons which mediates neurogenic inflammatory response. Substance p which can be released following exposure to capsaicin is a TRPV1 inducer, shown to have altered concentration and function in mice with systemic lupus erythematosus (SLE). We evaluated skin reaction to capsaicin in newly diagnosed and established SLE patients compared to healthy controls. Methods: Twenty-nine SLE patients (12 newly diagnosed cases under treatment, and 17 established ones, not receiving medications) who referred to rheumatologic disease research center, and 33 healthy subjects of the control group were recruited in this study. A topical solution of capsaicin (0.075%) was applied on the volar forearm during skin test, and time to the tingling sensation, area of induration and area of redness (centimeters2) were recorded after 5, 10, and 20 minutes. Results: The area of redness and area of induration within 15 minutes, time to the tingling sensation (P=0.02), and the overall frequency of tingling sensation (P=0.01) after capsaicin skin test was considerably higher in SLE patients than the healthy controls. Redness, induration and tingling sensation were more frequent but not statistically significant among the established SLE group compared to the newly diagnosed patients. Conclusion: Since skin reaction to capsaicin is more prominent in SLE patients than the healthy individuals, neurogenic inflammation and the role of P substance should be investigated more in ongoing lupus. Capsaicin test can not predict lupus activity.
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Affiliation(s)
- Maryam Sahebari
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Salimi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mina Khodabandeh
- Allergy Research Center,Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nazila Ariaee Nasab
- Allergy Research Center,Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Salari
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Borbély É, Hunyady Á, Pohóczky K, Payrits M, Botz B, Mócsai A, Berger A, Szőke É, Helyes Z. Hemokinin-1 as a Mediator of Arthritis-Related Pain via Direct Activation of Primary Sensory Neurons. Front Pharmacol 2021; 11:594479. [PMID: 33519457 PMCID: PMC7839295 DOI: 10.3389/fphar.2020.594479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/09/2020] [Indexed: 01/17/2023] Open
Abstract
The tachykinin hemokinin-1 (HK-1) is involved in immune cell development and inflammation, but little is known about its function in pain. It acts through the NK1 tachykinin receptor, but several effects are mediated by a yet unidentified target. Therefore, we investigated the role and mechanism of action of HK-1 in arthritis models of distinct mechanisms with special emphasis on pain. Arthritis was induced by i.p. K/BxN serum (passive transfer of inflammatory cytokines, autoantibodies), intra-articular mast cell tryptase or Complete Freund's Adjuvant (CFA, active immunization) in wild type, HK-1- and NK1-deficient mice. Mechanical- and heat hyperalgesia determined by dynamic plantar esthesiometry and increasing temperature hot plate, respectively, swelling measured by plethysmometry or micrometry were significantly reduced in HK-1-deleted, but not NK1-deficient mice in all models. K/BxN serum-induced histopathological changes (day 14) were also decreased, but early myeloperoxidase activity detected by luminescent in vivo imaging increased in HK-1-deleted mice similarly to the CFA model. However, vasodilation and plasma protein extravasation determined by laser Speckle and fluorescent imaging, respectively, were not altered by HK-1 deficiency in any models. HK-1 induced Ca2+-influx in primary sensory neurons, which was also seen in NK1-deficient cells and after pertussis toxin-pretreatment, but not in extracellular Ca2+-free medium. These are the first results showing that HK-1 mediates arthritic pain and cellular, but not vascular inflammatory mechanisms, independently of NK1 activation. HK-1 activates primary sensory neurons presumably via Ca2+ channel-linked receptor. Identifying its target opens new directions to understand joint pain leading to novel therapeutic opportunities.
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Affiliation(s)
- Éva Borbély
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Ágnes Hunyady
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Krisztina Pohóczky
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Department of Pharmacology, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Maja Payrits
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Botz
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary
| | - Attila Mócsai
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Alexandra Berger
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Éva Szőke
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Helyes
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- PharmInVivo Ltd., Pécs, Hungary
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Borbély É, Sándor K, Markovics A, Kemény Á, Pintér E, Szolcsányi J, Quinn JP, McDougall JJ, Helyes Z. Role of capsaicin-sensitive nerves and tachykinins in mast cell tryptase-induced inflammation of murine knees. Inflamm Res 2016; 65:725-36. [PMID: 27251170 DOI: 10.1007/s00011-016-0954-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/10/2016] [Accepted: 05/18/2016] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE, DESIGN Mast cell tryptase (MCT) is elevated in arthritic joints, but its direct effects are not known. Here, we investigated MCT-evoked acute inflammatory and nociceptive mechanisms with behavioural, in vivo imaging and immunological techniques. MATERIAL AND SUBJECTS Neurogenic inflammation involving capsaicin-sensitive afferents, transient receptor potential vanilloid 1 receptor (TRPV1), substance P (SP), neurokinin A (NKA) and their NK1 tachykinin receptor were studied using gene-deleted mice compared to C57Bl/6 wildtypes (n = 5-8/group). TREATMENT MCT was administered intraarticularly or topically (20 μl, 12 μg/ml). Capsaicin-sensitive afferents were defunctionalized with the TRPV1 agonist resiniferatoxin (RTX; 30-70-100 μg/kg s.c. pretreatment). METHODS Knee diameter was measured with a caliper, synovial perfusion with laser Doppler imaging, mechanonociception with aesthesiometry and weight distribution with incapacitance tester over 6 h. Cytokines and neuropeptides were determined with immunoassays. RESULTS MCT induced synovial vasodilatation, oedema, impaired weight distribution and mechanical hyperalgesia, but cytokine or neuropeptide levels were not altered at the 6-h timepoint. Hyperaemia was reduced in RTX-treated and TRPV1-deleted animals, and oedema was absent in NK1-deficient mice. Hyperalgesia was decreased in SP/NKA- and NK1-deficient mice, weight bearing impairment in RTX-pretreated, TRPV1- and NK1-deficient animals. CONCLUSIONS MCT evokes synovial hyperaemia, oedema, hyperalgesia and spontaneous pain. Capsaicin-sensitive afferents and TRPV1 receptors are essential for vasodilatation, while tachykinins mediate oedema and pain.
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Affiliation(s)
- Éva Borbély
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary
| | - Katalin Sándor
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary
| | - Adrienn Markovics
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary
| | - Ágnes Kemény
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary
| | - Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary
| | - János Szolcsányi
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary
| | - John P Quinn
- School of Biomedical Sciences, Liverpool University, Liverpool, UK
| | - Jason J McDougall
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti u. 12, Pecs, 7624, Hungary. .,János Szentágothai Research Centre, Molecular Pharmacology Research Group, Centre for Neuroscience, University of Pécs, Pecs, Hungary. .,MTA-PTE NAP B Chronic Pain Research Group, Pecs, Hungary.
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Patricio ES, Costa R, Figueiredo CP, Gers-Barlag K, Bicca MA, Manjavachi MN, Segat GC, Gentry C, Luiz AP, Fernandes ES, Cunha TM, Bevan S, Calixto JB. Mechanisms Underlying the Scratching Behavior Induced by the Activation of Proteinase-Activated Receptor-4 in Mice. J Invest Dermatol 2015; 135:2484-2491. [DOI: 10.1038/jid.2015.183] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/20/2015] [Accepted: 04/27/2015] [Indexed: 02/08/2023]
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