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Ji X, Ji HL. Metabolic signatures of acute respiratory distress syndrome: COVID versus non-COVID. Am J Physiol Lung Cell Mol Physiol 2024; 326:L596-L603. [PMID: 38469648 DOI: 10.1152/ajplung.00266.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
Acute respiratory distress syndrome (ARDS) is a fatal pulmonary disorder characterized by severe hypoxia and inflammation. ARDS is commonly triggered by systemic and pulmonary infections, with bacteria and viruses. Notable pathogens include Pseudomonas aeruginosa, Streptococcus aureus, Enterobacter species, coronaviruses, influenza viruses, and herpesviruses. COVID-19 ARDS represents the latest etiological phenotype of the disease. The pathogenesis of ARDS caused by bacteria and viruses exhibits variations in host immune responses and lung mesenchymal injury. We postulate that the systemic and pulmonary metabolomics profiles of ARDS induced by COVID-19 pathogens may exhibit distinctions compared with those induced by other infectious agents. This review aims to compare metabolic signatures in blood and lung specimens specifically within the context of ARDS. Both prevalent and phenotype-specific metabolomic signatures, including but not limited to glycolysis, ketone body production, lipid oxidation, and dysregulation of the kynurenine pathways, were thoroughly examined in this review. The distinctions in metabolic signatures between COVID-19 and non-COVID ARDS have the potential to reveal new biomarkers, elucidate pathogenic mechanisms, identify druggable targets, and facilitate differential diagnosis in the future.
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Affiliation(s)
- Xiangming Ji
- Department of Nutrition, Georgia State University, Atlanta, Georgia, United States
| | - Hong-Long Ji
- Burn and Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, Illinois, United States
- Department of Surgery, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, Illinois, United States
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Borras E, McCartney MM, Rojas DE, Hicks TL, Tran NK, Tham T, Juarez MM, Franzi L, Harper RW, Davis CE, Kenyon NJ. Oxylipin concentration shift in exhaled breath condensate (EBC) of SARS-CoV-2 infected patients. J Breath Res 2023; 17:10.1088/1752-7163/acea3d. [PMID: 37489864 PMCID: PMC10446499 DOI: 10.1088/1752-7163/acea3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/25/2023] [Indexed: 07/26/2023]
Abstract
Infection of airway epithelial cells with severe acute respiratory coronavirus 2 (SARS-CoV-2) can lead to severe respiratory tract damage and lung injury with hypoxia. It is challenging to sample the lower airways non-invasively and the capability to identify a highly representative specimen that can be collected in a non-invasive way would provide opportunities to investigate metabolomic consequences of COVID-19 disease. In the present study, we performed a targeted metabolomic approach using liquid chromatography coupled with high resolution chromatography (LC-MS) on exhaled breath condensate (EBC) collected from hospitalized COVID-19 patients (COVID+) and negative controls, both non-hospitalized and hospitalized for other reasons (COVID-). We were able to noninvasively identify and quantify inflammatory oxylipin shifts and dysregulation that may ultimately be used to monitor COVID-19 disease progression or severity and response to therapy. We also expected EBC-based biochemical oxylipin changes associated with COVID-19 host response to infection. The results indicated ten targeted oxylipins showing significative differences between SAR-CoV-2 infected EBC samples and negative control subjects. These compounds were prostaglandins A2 and D2, LXA4, 5-HETE, 12-HETE, 15-HETE, 5-HEPE, 9-HODE, 13-oxoODE and 19(20)-EpDPA, which are associated with specific pathways (i.e. P450, COX, 15-LOX) related to inflammatory and oxidative stress processes. Moreover, all these compounds were up-regulated by COVID+, meaning their concentrations were higher in subjects with SAR-CoV-2 infection. Given that many COVID-19 symptoms are inflammatory in nature, this is interesting insight into the pathophysiology of the disease. Breath monitoring of these and other EBC metabolites presents an interesting opportunity to monitor key indicators of disease progression and severity.
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Affiliation(s)
- Eva Borras
- Mechanical and Aerospace Engineering, One Shields Avenue, University of California, Davis, Davis, California, USA
- UC Davis Lung Center, University of California Davis, CA
- These authors contributed equally: Eva Borras, Mitchell M. McCartney
| | - Mitchell M. McCartney
- Mechanical and Aerospace Engineering, One Shields Avenue, University of California, Davis, Davis, California, USA
- UC Davis Lung Center, University of California Davis, CA
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
- These authors contributed equally: Eva Borras, Mitchell M. McCartney
| | - Dante E. Rojas
- Mechanical and Aerospace Engineering, One Shields Avenue, University of California, Davis, Davis, California, USA
- UC Davis Lung Center, University of California Davis, CA
| | - Tristan L Hicks
- Mechanical and Aerospace Engineering, One Shields Avenue, University of California, Davis, Davis, California, USA
- UC Davis Lung Center, University of California Davis, CA
| | - Nam K Tran
- UC Davis Lung Center, University of California Davis, CA
- Department of Pathology and Laboratory Medicine, UC Davis, Sacramento CA, USA
| | - Tina Tham
- UC Davis Lung Center, University of California Davis, CA
- Department of Internal Medicine, 4150 V Street, Suite 3400, University of California, Davis, Sacramento, CA 95817, USA
| | - Maya M Juarez
- UC Davis Lung Center, University of California Davis, CA
- Department of Internal Medicine, 4150 V Street, Suite 3400, University of California, Davis, Sacramento, CA 95817, USA
| | - Lisa Franzi
- UC Davis Lung Center, University of California Davis, CA
- Department of Internal Medicine, 4150 V Street, Suite 3400, University of California, Davis, Sacramento, CA 95817, USA
| | - Richart W. Harper
- UC Davis Lung Center, University of California Davis, CA
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
- Department of Internal Medicine, 4150 V Street, Suite 3400, University of California, Davis, Sacramento, CA 95817, USA
| | - Cristina E. Davis
- Mechanical and Aerospace Engineering, One Shields Avenue, University of California, Davis, Davis, California, USA
- UC Davis Lung Center, University of California Davis, CA
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
| | - Nicholas J. Kenyon
- UC Davis Lung Center, University of California Davis, CA
- VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
- Department of Pathology and Laboratory Medicine, UC Davis, Sacramento CA, USA
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McCartney MM, Borras E, Rojas DE, Hicks TL, Hamera KL, Tran NK, Tham T, Juarez MM, Lopez E, Kenyon NJ, Davis CE. Predominant SARS-CoV-2 variant impacts accuracy when screening for infection using exhaled breath vapor. COMMUNICATIONS MEDICINE 2022; 2:158. [PMID: 36482179 PMCID: PMC9731983 DOI: 10.1038/s43856-022-00221-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND New technologies with novel and ambitious approaches are being developed to diagnose or screen for SARS-CoV-2, including breath tests. The US FDA approved the first breath test for COVID-19 under emergency use authorization in April 2022. Most breath-based assays measure volatile metabolites exhaled by persons to identify a host response to infection. We hypothesized that the breathprint of COVID-19 fluctuated after Omicron became the primary variant of transmission over the Delta variant. METHODS We collected breath samples from 142 persons with and without a confirmed COVID-19 infection during the Delta and Omicron waves. Breath samples were analyzed by gas chromatography-mass spectrometry. RESULTS Here we show that based on 63 exhaled compounds, a general COVID-19 model had an accuracy of 0.73 ± 0.06, which improved to 0.82 ± 0.12 when modeling only the Delta wave, and 0.84 ± 0.06 for the Omicron wave. The specificity improved for the Delta and Omicron models (0.79 ± 0.21 and 0.74 ± 0.12, respectively) relative to the general model (0.61 ± 0.13). CONCLUSIONS We report that the volatile signature of COVID-19 in breath differs between the Delta-predominant and Omicron-predominant variant waves, and accuracies improve when samples from these waves are modeled separately rather than as one universal approach. Our findings have important implications for groups developing breath-based assays for COVID-19 and other respiratory pathogens, as the host response to infection may significantly differ depending on variants or subtypes.
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Affiliation(s)
- Mitchell M McCartney
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA
- UC Davis Lung Center, Davis, CA, USA
- VA Northern California Health Care System, Mather, CA, USA
| | - Eva Borras
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA
- UC Davis Lung Center, Davis, CA, USA
| | - Dante E Rojas
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA
- UC Davis Lung Center, Davis, CA, USA
| | - Tristan L Hicks
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA
- UC Davis Lung Center, Davis, CA, USA
| | - Katherine L Hamera
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA
- UC Davis Lung Center, Davis, CA, USA
| | - Nam K Tran
- Department of Pathology and Laboratory Medicine, UC Davis, Sacramento, CA, USA
| | - Tina Tham
- Department of Internal Medicine, UC Davis, Sacramento, CA, USA
| | - Maya M Juarez
- Department of Internal Medicine, UC Davis, Sacramento, CA, USA
| | | | - Nicholas J Kenyon
- UC Davis Lung Center, Davis, CA, USA
- VA Northern California Health Care System, Mather, CA, USA
- Department of Internal Medicine, UC Davis, Sacramento, CA, USA
| | - Cristina E Davis
- Mechanical and Aerospace Engineering, UC Davis, Davis, CA, USA.
- UC Davis Lung Center, Davis, CA, USA.
- VA Northern California Health Care System, Mather, CA, USA.
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Li X, Du J, Chen J, Lin F, Wang W, Wei TT, Xu J, Lu QB. Metabolic profile of exhaled breath condensate from the pneumonia patients. Exp Lung Res 2022; 48:149-157. [PMID: 35708062 DOI: 10.1080/01902148.2022.2078019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE OF THE STUDY Exhaled breath condensate (EBC) is increasingly being used for disease diagnosis and environmental exposure assessment as a noninvasive method reducing the risk of exposure. The purpose of this study was to investigate the application of a new sample type of EBC in pneumonia by metabolomics and to explore differential metabolites and potential metabolic pathways. MATERIALS AND METHODS A case-control study was performed at the Peking University Third Hospital from August to December 2020. C-MS/MS analyses were performed on EBC samples using a UHPLC system. RESULTS Totally 22 patients with pneumonia and 24 healthy controls were recruited. Using untargeted metabolomics based on LC-MS/MS analysis, 25 kinds of differential metabolites were found. Through a comprehensive analysis of the pathways in which the differential metabolites were located, the key pathway with the highest correlation with the difference of metabolites was taurine and hypotaurine metabolism. CONCLUSIONS The study implicates that the hypotaurine/taurine metabolic pathway may play a role on the development of pneumonia through metabolism analysis on EBC and the 3-Sulfinoalanine may be used as a biomarker in the diagnosis of pneumonia.
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Affiliation(s)
- Xiaoguang Li
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research, Peking University, Beijing, People's Republic of China
| | - Jing Chen
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China
| | - Fei Lin
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China
| | - Wei Wang
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China
| | - Ting-Ting Wei
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research, Peking University, Beijing, People's Republic of China
| | - Jie Xu
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China.,Global Center for Infectious Disease and Policy Research, Peking University, Beijing, People's Republic of China
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Hu S, Buser E, Arredondo J, Relyea D, Santos Rocha C, Dandekar S. Altered Expression of ACE2 and Co-receptors of SARS-CoV-2 in the Gut Mucosa of the SIV Model of HIV/AIDS. Front Microbiol 2022; 13:879152. [PMID: 35495669 PMCID: PMC9048205 DOI: 10.3389/fmicb.2022.879152] [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: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the cause of the COVID-19 pandemic, is initiated by its binding to the ACE2 receptor and other co-receptors on mucosal epithelial cells. Variable outcomes of the infection and disease severity can be influenced by pre-existing risk factors. Human immunodeficiency virus (HIV), the cause of AIDS, targets the gut mucosal immune system and impairs epithelial barriers and mucosal immunity. We sought to determine the impact and mechanisms of pre-existing HIV infection increasing mucosal vulnerability to SARS-CoV-2 infection and disease. We investigated changes in the expression of ACE2 and other SARS-CoV-2 receptors and related pathways in virally inflamed gut by using the SIV infected rhesus macaque model of HIV/AIDS. Immunohistochemical analysis showed sustained/enhanced ACE2 expression in the gut epithelium of SIV infected animals compared to uninfected controls. Gut mucosal transcriptomic analysis demonstrated enhanced expression of host factors that support SARS-CoV-2 entry, replication, and infection. Metabolomic analysis of gut luminal contents revealed the impact of SIV infection as demonstrated by impaired mitochondrial function and decreased immune response, which render the host more vulnerable to other pathogens. In summary, SIV infection resulted in sustained or increased ACE2 expression in an inflamed and immune-impaired gut mucosal microenvironment. Collectively, these mucosal changes increase the susceptibility to SARS-CoV-2 infection and disease severity and result in ineffective viral clearance. Our study highlights the use of the SIV model of AIDS to fill the knowledge gap of the enteric mechanisms of co-infections as risk factors for poor disease outcomes, generation of new viral variants and immune escape in COVID-19.
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Affiliation(s)
- Shuang Hu
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Elise Buser
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Juan Arredondo
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Dylan Relyea
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Clarissa Santos Rocha
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Satya Dandekar
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA, United States
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