1
|
Jesus FR, Moraes ACS, da Silva ILN, Passos FC, Salles C, Neves MCLC, Baccan GC. Analysis of Endocrine and Inflammatory Markers in Preserved Ratio Impaired Spirometry. Med Sci (Basel) 2024; 12:18. [PMID: 38651412 PMCID: PMC11036252 DOI: 10.3390/medsci12020018] [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: 02/18/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a disease of the lungs characterized by chronic airflow obstruction. Individuals with preserved ratio impaired spirometry (PRISm) may be at risk for developing COPD. This study aimed to characterize PRISm and COPD patients in terms of their immune response and endocrine profile to identify differences extending beyond lung function. The participants performed the clinical assessment, pulmonary function test, and blood collection to determine serum hormone levels and concentrations of cytokine. Differences were observed in the nutritional status, lung function, and comorbidity. There were no differences in IL-6, IL-8, IL-10, IL-12, and TNF levels between PRISm and COPD groups. Both PRISm and COPD patients have lower dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) levels than controls. Correlation analysis of PRISm and COPD patients revealed positive correlations between serum levels of DHEA-S and DHEA, with forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), which negatively correlated with IL-8 levels. The results indicated that despite differences in lung function parameters, the PRISm and COPD groups exhibited similarities in endocrine profile alterations. This study represents the first attempt to link endocrine with immune markers and lung function in individuals with PRISm.
Collapse
Affiliation(s)
- Fabíola Ramos Jesus
- Maternidade Climério de Oliveira (MCO/EBSERH), Universidade Federal da Bahia, Salvador 40055-150, Bahia, Brazil;
| | - Anna Clara Santiago Moraes
- Departamento de Bioquímica e Biofísica, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40110-110, Bahia, Brazil
| | - Ingrid Lorena Neves da Silva
- Departamento de Bioquímica e Biofísica, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40110-110, Bahia, Brazil
| | - Fabine Correia Passos
- Departamento de Bioquímica e Biofísica, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40110-110, Bahia, Brazil
| | - Cristina Salles
- Unidade do Sistema Respiratório, Ambulatório Professor Francisco Magalhães Neto-Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40110-200, Bahia, Brazil
| | - Margarida Célia Lima Costa Neves
- Unidade do Sistema Respiratório, Ambulatório Professor Francisco Magalhães Neto-Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador 40110-200, Bahia, Brazil
| | - Gyselle Chrystina Baccan
- Departamento de Bioquímica e Biofísica, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador 40110-110, Bahia, Brazil
| |
Collapse
|
2
|
Abelman RA, Fitzpatrick J, Byanova KL, Zawedde J, Sanyu I, Byanyima P, Musisi E, Hsieh J, Zhang M, Branchini J, Sessolo A, Hunt PW, Lalitha R, Davis JL, Crothers K, Worodria W, Huang L. Sex and HIV Differences in Preserved Ratio Impaired Spirometry (PRISm) Among Ugandans Postpneumonia. Open Forum Infect Dis 2024; 11:ofae033. [PMID: 38456193 PMCID: PMC10919919 DOI: 10.1093/ofid/ofae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/18/2024] [Indexed: 03/09/2024] Open
Abstract
Background Preserved ratio impaired spirometry (PRISm), defined as a normal ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (≥0.70) with low FEV1 (<80% predicted), has been associated with increased mortality in the general population. Female sex has been associated with increased odds of PRISm in people without HIV. People with HIV (PWH) are at increased risk for lung function abnormalities, but whether HIV modifies the effect of sex on PRISm development is largely unknown. Methods Adults with and without HIV underwent baseline followed by serial spirometry after completing therapy for pneumonia, predominantly tuberculosis (TB), in Kampala, Uganda. Using generalized estimating equations adjusted for age, body mass index, smoking, biomass fuel exposure, HIV, and TB status, we compared individuals with PRISm with those with normal spirometry. These models were stratified by HIV status. Results Of 339 baseline participants, 153 (45%) were women; 129 (38%) had HIV, of whom 53% were women. Overall, 105/339 participants (31%) had PRISm at baseline. HIV was associated with lower odds of PRISm (adjusted odds ratio [aOR], 0.38; 95% CI, 0.21-0.68; P = .001). Female sex trended toward increased odds of PRISm among all participants (aOR, 1.65; 95% CI, 0.99-2.75; P = .052). The association between female sex and PRISm tended to be stronger among PWH (aOR, 3.16; 95% CI, 1.14-8.76; P = .03) than among those without HIV (aOR, 1.34; 95% CI, 0.73-2.45; P = .34); this study was underpowered to detect an HIV-sex interaction of this magnitude (P = .30). Conclusions Among Ugandan adults who recovered from pneumonia, female sex was associated with increased odds and HIV with decreased odds of PRISm, suggesting independent sex and HIV effects on PRISm pathogenesis.
Collapse
Affiliation(s)
- Rebecca A Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica Fitzpatrick
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Katerina L Byanova
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Ingvar Sanyu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Emmanuel Musisi
- Division of Infection and Global Health, School of Medicine, University of St. Andrews, St. Andrews, UK
| | - Jenny Hsieh
- Department of Anesthesia and Critical Care, University of California San Francisco, San Francisco, California, USA
| | - Michelle Zhang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jake Branchini
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Abdul Sessolo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Peter W Hunt
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rejani Lalitha
- Division of Pulmonary Medicine, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda
| | - J Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Veterans Affairs (VA) Puget Sound Health Care System and University of Washington, Seattle, Washington, USA
| | - William Worodria
- Division of Pulmonary Medicine, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda
- Division of Pulmonary Medicine, Department of Medicine, Mulago Hospital and Complex, Kampala, Uganda
| | - Laurence Huang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
3
|
Peña-Valencia K, Riaño W, Herrera-Diaz M, López L, Marín D, Gonzalez S, Agudelo-García O, Rodríguez-Sabogal IA, Vélez L, Rueda ZV, Keynan Y. Markers of Inflammation, Tissue Damage, and Fibrosis in Individuals Diagnosed with Human Immunodeficiency Virus and Pneumonia: A Cohort Study. Pathogens 2024; 13:84. [PMID: 38251391 PMCID: PMC10820350 DOI: 10.3390/pathogens13010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
Previous studies have noted that persons living with human immunodeficiency virus (HIV) experience persistent lung dysfunction after an episode of community-acquired pneumonia (CAP), although the underlying mechanisms remain unclear. We hypothesized that inflammation during pneumonia triggers increased tissue damage and accelerated pulmonary fibrosis, resulting in a gradual loss of lung function. We carried out a prospective cohort study of people diagnosed with CAP and/or HIV between 2016 and 2018 in three clinical institutions in Medellín, Colombia. Clinical data, blood samples, and pulmonary function tests (PFTs) were collected at baseline. Forty-one patients were included, divided into two groups: HIV and CAP (n = 17) and HIV alone (n = 24). We compared the concentrations of 17 molecules and PFT values between the groups. Patients with HIV and pneumonia presented elevated levels of cytokines and chemokines (IL-6, IL-8, IL-18, IL-1RA, IL-10, IP-10, MCP-1, and MIP-1β) compared to those with only HIV. A marked pulmonary dysfunction was evidenced by significant reductions in FEF25, FEF25-75, and FEV1. The correlation between these immune mediators and lung function parameters supports the connection between pneumonia-associated inflammation and end organ lung dysfunction. A low CD4 cell count (<200 cells/μL) predicted inflammation and lung dysfunction. These results underscore the need for targeted clinical approaches to mitigate the adverse impacts of CAP on lung function in this population.
Collapse
Affiliation(s)
- Katherine Peña-Valencia
- Escuela de Microbiología, Universidad de Antioquia, Medellin 050010, Colombia;
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050010, Colombia; (W.R.); (L.L.); (D.M.); (Z.V.R.)
- Grupo Bacterias & Cáncer, School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia;
| | - Will Riaño
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050010, Colombia; (W.R.); (L.L.); (D.M.); (Z.V.R.)
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia;
| | - Mariana Herrera-Diaz
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada; (M.H.-D.); (S.G.)
| | - Lucelly López
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050010, Colombia; (W.R.); (L.L.); (D.M.); (Z.V.R.)
- School of Medicine, Universidad Pontificia Bolivariana, Medellin 050010, Colombia
| | - Diana Marín
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050010, Colombia; (W.R.); (L.L.); (D.M.); (Z.V.R.)
- School of Medicine, Universidad Pontificia Bolivariana, Medellin 050010, Colombia
| | - Sandra Gonzalez
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada; (M.H.-D.); (S.G.)
- JC Wilt Infectious Diseases Research Center, Winnipeg, MB R3E 3L5, Canada
| | - Olga Agudelo-García
- Grupo Bacterias & Cáncer, School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia;
| | - Iván Arturo Rodríguez-Sabogal
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia;
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia;
| | - Lázaro Vélez
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia;
| | - Zulma Vanessa Rueda
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050010, Colombia; (W.R.); (L.L.); (D.M.); (Z.V.R.)
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada; (M.H.-D.); (S.G.)
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada; (M.H.-D.); (S.G.)
- Grupo Investigador de Problemas en Enfermedades Infecciosas-GRIPE, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| |
Collapse
|
4
|
Abelman RA, Fitzpatrick J, Zawedde J, Sanyu I, Byanyima P, Kaswabuli S, Musisi E, Hsieh J, Gardner K, Zhang M, Byanova KL, Sessolo A, Hunt PW, Lalitha R, Davis JL, Crothers K, Worodria W, Huang L. Sex modifies the risk of HIV-associated obstructive lung disease in Ugandans postpneumonia. AIDS 2023; 37:1683-1692. [PMID: 37352494 PMCID: PMC10527596 DOI: 10.1097/qad.0000000000003626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
OBJECTIVES Spirometric abnormalities are frequent, and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD. DESIGN AND METHODS To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a postbronchodilator forced expiratory volume in the first second to forced vital capacity (FEV 1 /FVC) ratio less than 0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, BMI, smoking status, and TB status. RESULTS Among 348 participants, 147 (42%) were women and 135 (39%) were HIV-positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease ( P = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11-12.0; P = 0.04) increased odds of having OLD compared with men with HIV. Women without HIV did not have increased odds of having OLD compared with men without HIV. CONCLUSION HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.
Collapse
Affiliation(s)
- Rebecca A Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica Fitzpatrick
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Ingvar Sanyu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Emmanuel Musisi
- Division of Infection and Global Health, School of Medicine, University of St. Andrews, St. Andrews, United Kingdom
| | - Jenny Hsieh
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
| | - Kendall Gardner
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Michelle Zhang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Abdul Sessolo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Peter W Hunt
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rejani Lalitha
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Veterans Affairs (VA) Puget Sound Healthcare System and University of Washington, Seattle, Washington, USA
| | - William Worodria
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Division of Pulmonary Medicine, Department of Medicine, Mulago Hospital and Complex, Kampala, Uganda
| | - Laurence Huang
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
| |
Collapse
|