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Network Analysis for Uncovering the Relationship between Host Response and Clinical Factors to Virus Pathogen: Lessons from SARS-CoV-2. Viruses 2022; 14:v14112422. [PMID: 36366522 PMCID: PMC9697085 DOI: 10.3390/v14112422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Analysing complex datasets while maintaining the interpretability and explainability of outcomes for clinicians and patients is challenging, not only in viral infections. These datasets often include a variety of heterogeneous clinical, demographic, laboratory, and personal data, and it is not a single factor but a combination of multiple factors that contribute to patient characterisation and host response. Therefore, multivariate approaches are needed to analyse these complex patient datasets, which are impossible to analyse with univariate comparisons (e.g., one immune cell subset versus one clinical factor). Using a SARS-CoV-2 infection as an example, we employed a patient similarity network (PSN) approach to assess the relationship between host immune factors and the clinical course of infection and performed visualisation and data interpretation. A PSN analysis of ~85 immunological (cellular and humoral) and ~70 clinical factors in 250 recruited patients with coronavirus disease (COVID-19) who were sampled four to eight weeks after a PCR-confirmed SARS-CoV-2 infection identified a minimal immune signature, as well as clinical and laboratory factors strongly associated with disease severity. Our study demonstrates the benefits of implementing multivariate network approaches to identify relevant factors and visualise their relationships in a SARS-CoV-2 infection, but the model is generally applicable to any complex dataset.
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Romano A, Cerchione C, Conticello C, Filetti S, Bulla A, Chiarenza A, Del Fabro V, Leotta S, Markovic U, Motta G, Parisi M, Stagno F, Palumbo GA, Di Raimondo F. Reduced Absolute Count of Monocytes in Patients Carrying Hematological Neoplasms and SARS-CoV2 Infection. Cancers (Basel) 2022; 14:cancers14051173. [PMID: 35267478 PMCID: PMC8909066 DOI: 10.3390/cancers14051173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary In hematological neoplasms associated with COVID-19, immunological dysfunction, including reduced count of non-classical monocytes, has been suggested as a primary driver of morbidity and mortality. In this work, we investigated the contribution of absolute monocyte count to clinical outcome of COVID-19 in 120 patients affected by hematological neoplasms that tested positive to SARS-CoV-2. We found that there was no statistical difference in 30-day mortality, rate of hospitalization for intensive cure and viral clearance at 14 days between fully vaccinated and unvaccinated patients. Increased 30-day mortality was associated with presence of active/progressing disease and absolute monocyte count lower than 400 cells/uL. Reduced absolute counts of monocytes should be used as an alert of increased risk of severe/critical forms of COVID-19 in patients with hematological malignancies, even when the full vaccination cycle has been completed. Abstract Background: Clinical course of COVID-19 depends on several patient-specific risk factors, including immune function, that is largely compromised in cancer patients. Methods: We prospectively evaluated 120 adult consecutive patients (including 34 cases of COVID-19 breakthrough after two full doses of BNT162b2 vaccine) with underlying hematological malignancies and a SARS-CoV-2 infection, in terms of patient’s clinical outcome. Results: Among fully vaccinated patients the achievement of viral clearance by day 14 was more frequent than in unvaccinated patients. Increased 30-day mortality was associated with presence of active/progressing disease and absolute monocyte count lower than 400 cells/uL. Results of multivariable analysis in unvaccinated patients showed that the pre-infection absolute count of monocytes less or equal to 400 cells/mmc, active or progressive disease of the underlying hematological malignancy, the COVID-19 severity identified by hospitalization requirement and lack of viral clearance at 14 days were independent predictors of 1-year overall survival. Conclusions: Taken together, our results indicate that absolute monocyte count determined one month before any documented SARS-CoV-2 infection could identify patients affected by hematological neoplasms with increased risk of inferior overall survival.
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Affiliation(s)
- Alessandra Romano
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Claudio Cerchione
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori [M1] (IRST) IRCCS, 47014 Meldola (FC), Italy
- Correspondence:
| | - Concetta Conticello
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Sabina Filetti
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Anna Bulla
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Annalisa Chiarenza
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Vittorio Del Fabro
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Salvatore Leotta
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Uros Markovic
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Oncohematology and BMT Unit, Mediterranean Institute of Oncology, 95125 Viagrande, Italy
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98122 Messina, Italy
| | - Giovanna Motta
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Marina Parisi
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Fabio Stagno
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
| | - Giuseppe Alberto Palumbo
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Ingrassia Department, University of Catania, 95100 Catania, Italy
| | - Francesco Di Raimondo
- Division of Hematology, AOU “Policlinico G. Rodolico-San Marco”, 95100 Catania, Italy; (A.R.); (C.C.); (S.F.); (A.B.); (A.C.); (V.D.F.); (S.L.); (U.M.); (G.M.); (M.P.); (F.S.); (G.A.P.); (F.D.R.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
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Manukyan G, Mikulkova Z, Turcsanyi P, Savara J, Trajerová M, Kubova Z, Papajik T, Kriegova E. Towards a Better Characterisation of Leukemic Cells in Chronic Lymphocytic Leukaemia: Cell-Size Heterogeneity Reflects Their Activation Status and Migratory Abilities. Cancers (Basel) 2021; 13:cancers13194922. [PMID: 34638404 PMCID: PMC8508598 DOI: 10.3390/cancers13194922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Chronic lymphocytic leukaemia (CLL) is a heterogeneous chronic disease characterised by the clonal expansion of mature CD19+CD23+CD5+ B-cells in blood, bone marrow and lymphoid tissue. Despite the CLL tumour cell population showing considerable heterogeneity in cell size, the functional characteristics of leukemic cells that differ in size have not been explored. The results of our study demonstrate that differences in CLL cell size reflect their activation state, polarisation and migratory capacity, with large CLL cells being more activated, polarised and motile than the small CLL cells present in the CLL cell pool. Our data provide evidence of the importance of cell-size heterogeneity within the CLL cell pool and the dynamics of cell-size changes for disease pathogenesis. Abstract Chronic lymphocytic leukaemia (CLL) is a genetically, morphologically and phenotypically heterogeneous chronic disease with clinical variability between patients. Whether the significant heterogeneity of cell size within the CLL population contributes to the heterogeneous features of this disease has not been investigated. The present study aimed to characterise the phenotypic and functional properties of two subpopulations of typical CLL cells that differ in cell size: small (s-CLL) and large (l-CLL) CLL cells delineated by forward scatter cytometry. The s-CLL cells were characterised by the CD5lowCXCR4hi phenotype, while the l-CLL cells were characterised by the CD5hiCXCR4dim phenotype and indicated a higher expression of CXCR3, CD20, CD38 and HLA-DR. The l-CLL cells displayed higher migration activity towards CXCL12, a tendency towards a higher proliferation rate and an increased capacity to produce IgM in the presence of CpG compared with s-CLL cells. When stimulated with CpG and CXCL12, l-CLL cells were characterised by a higher polarisation phenotype and motility than s-CLL cells. Our study revealed that the differences in CLL cell size reflected their activation status, polarisation and migratory abilities. Our data provide evidence of the importance of cell-size heterogeneity within a CLL pool and the dynamics of cell-size changes for disease pathogenesis, thus deserving further investigation.
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Affiliation(s)
- Gayane Manukyan
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Laboratory of Molecular and Cellular Immunology, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia
| | - Zuzana Mikulkova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
| | - Peter Turcsanyi
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Jakub Savara
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 70800 Ostrava, Czech Republic
| | - Markéta Trajerová
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
| | - Zuzana Kubova
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Tomas Papajik
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Correspondence:
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