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Wyse CA, Rudderham LM, Nordon EA, Ince LM, Coogan AN, Lopez LM. Circadian Variation in the Response to Vaccination: A Systematic Review and Evidence Appraisal. J Biol Rhythms 2024; 39:219-236. [PMID: 38459699 PMCID: PMC11141079 DOI: 10.1177/07487304241232447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Molecular timing mechanisms known as circadian clocks drive endogenous 24-h rhythmicity in most physiological functions, including innate and adaptive immunity. Consequently, the response to immune challenge such as vaccination might depend on the time of day of exposure. This study assessed whether the time of day of vaccination (TODV) is associated with the subsequent immune and clinical response by conducting a systematic review of previous studies. The Cochrane Library, PubMed, Google, Medline, and Embase were searched for studies that reported TODV and immune and clinical outcomes, yielding 3114 studies, 23 of which met the inclusion criteria. The global severe acute respiratory syndrome coronavirus 2 vaccination program facilitated investigation of TODV and almost half of the studies included reported data collected during the COVID-19 pandemic. There was considerable heterogeneity in the demography of participants and type of vaccine, and most studies were biased by failure to account for immune status prior to vaccination, self-selection of vaccination time, or confounding factors such as sleep, chronotype, and shiftwork. The optimum TODV was concluded to be afternoon (5 studies), morning (5 studies), morning and afternoon (1 study), midday (1 study), and morning or late afternoon (1 study), with the remaining 10 studies reporting no effect. Further research is required to understand the relationship between TODV and subsequent immune outcome and whether any clinical benefit outweighs the potential effect of this intervention on vaccine uptake.
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Affiliation(s)
- Cathy A. Wyse
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Laura M. Rudderham
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Enya A. Nordon
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Louise M. Ince
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA
| | - Andrew N. Coogan
- Kathleen Lonsdale Institute for Human Health Research and Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Lorna M. Lopez
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
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Martínez-Albert E, Lutz ND, Hübener R, Dimitrov S, Lange T, Born J, Besedovsky L. Sleep promotes T-cell migration towards CCL19 via growth hormone and prolactin signaling in humans. Brain Behav Immun 2024; 118:69-77. [PMID: 38369248 DOI: 10.1016/j.bbi.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Sleep strongly supports the formation of adaptive immunity, e.g., after vaccination. However, the underlying mechanisms remain largely obscure. Here we show in healthy humans that sleep compared to nocturnal wakefulness specifically promotes the migration of various T-cell subsets towards the chemokine CCL19, which is essential for lymph-node homing and, thus, for the initiation and maintenance of adaptive immune responses. Migration towards the inflammatory chemokine CCL5 remained unaffected. Incubating the cells with plasma from sleeping participants likewise increased CCL19-directed migration, an effect that was dependent on growth hormone and prolactin signaling. These findings show that sleep selectively promotes the lymph node homing potential of T cells by increasing hormonal release, and thus reveal a causal mechanism underlying the supporting effect of sleep on adaptive immunity in humans.
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Affiliation(s)
- Estefanía Martínez-Albert
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany
| | - Nicolas D Lutz
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany
| | - Robert Hübener
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Stoyan Dimitrov
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, 23562 Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Luciana Besedovsky
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany.
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3
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Wagenhäuser I, Reusch J, Gabel A, Mees J, Nyawale H, Frey A, Lâm TT, Schubert-Unkmeir A, Dölken L, Kurzai O, Frantz S, Petri N, Krone M, Krone LB. The relationship between mental health, sleep quality and the immunogenicity of COVID-19 vaccinations. J Sleep Res 2024; 33:e13929. [PMID: 37177872 DOI: 10.1111/jsr.13929] [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: 03/02/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
Sleep modulates the immune response, and sleep loss can reduce vaccine immunogenicity; vice versa, immune responses impact sleep. We aimed to investigate the influence of mental health and sleep quality on the immunogenicity of COVID-19 vaccinations and, conversely, of COVID-19 vaccinations on sleep quality. The prospective CoVacSer study monitored mental health, sleep quality and Anti-SARS-CoV-2-Spike IgG titres in a cohort of 1082 healthcare workers from 29 September 2021 to 19 December 2022. Questionnaires and blood samples were collected before, 14 days, and 3 months after the third COVID-19 vaccination, as well as in 154 participants before and 14 days after the fourth COVID-19 vaccination. Healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before the third COVID-19 vaccination. However, this effect was mediated by higher median age and body mass index in this subgroup. Antibody titres following the third and fourth COVID-19 vaccinations ("booster vaccinations") were not significantly different between subgroups with and without psychiatric disorders. Sleep quality did not affect the humoral immunogenicity of the COVID-19 vaccinations. Moreover, the COVID-19 vaccinations did not impact self-reported sleep quality. Our data suggest that in a working population neither mental health nor sleep quality relevantly impact the immunogenicity of COVID-19 vaccinations, and that COVID-19 vaccinations do not cause a sustained deterioration of sleep, suggesting that they are not a precipitating factor for insomnia. The findings from this large-scale real-life cohort study will inform clinical practice regarding the recommendation of COVID-19 booster vaccinations for individuals with mental health and sleep problems.
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Affiliation(s)
- Isabell Wagenhäuser
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Julia Reusch
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Gabel
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - Juliane Mees
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Anna Frey
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Thiên-Trí Lâm
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | | | - Lars Dölken
- Institute for Virology and Immunobiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Oliver Kurzai
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knoell-Institute, Jena, Germany
| | - Stefan Frantz
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Nils Petri
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Manuel Krone
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Lukas B Krone
- Department of Physiology, Anatomy and Genetics, Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
- Department of Neurology, Centre for Experimental Neurology, University of Bern, Bern, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Pandi-Perumal SR, Saravanan KM, Paul S, Namasivayam GP, Chidambaram SB. Waking Up the Sleep Field: An Overview on the Implications of Genetics and Bioinformatics of Sleep. Mol Biotechnol 2024; 66:919-931. [PMID: 38198051 DOI: 10.1007/s12033-023-01009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Sleep genetics is an intriguing, as yet less understood, understudied, emerging area of biological and medical discipline. A generalist may not be aware of the current status of the field given the variety of journals that have published studies on the genetics of sleep and the circadian clock over the years. For researchers venturing into this fascinating area, this review thus includes fundamental features of circadian rhythm and genetic variables impacting sleep-wake cycles. Sleep/wake pathway medication exposure and susceptibility are influenced by genetic variations, and the responsiveness of sleep-related medicines is influenced by several functional polymorphisms. This review highlights the features of the circadian timing system and then a genetic perspective on wakefulness and sleep, as well as the relationship between sleep genetics and sleep disorders. Neurotransmission genes, as well as circadian and sleep/wake receptors, exhibit functional variability. Experiments on animals and humans have shown that these genetic variants impact clock systems, signaling pathways, nature, amount, duration, type, intensity, quality, and quantity of sleep. In this regard, the overview covers research on sleep genetics, the genomic properties of several popular model species used in sleep studies, homologs of mammalian genes, sleep disorders, and related genes. In addition, the study includes a brief discussion of sleep, narcolepsy, and restless legs syndrome from the viewpoint of a model organism. It is suggested that the understanding of genetic clues on sleep function and sleep disorders may, in future, result in an evidence-based, personalized treatment of sleep disorders.
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Affiliation(s)
- Seithikurippu R Pandi-Perumal
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570015, India
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 602105, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Konda Mani Saravanan
- Department of Biotechnology, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, 600073, India
| | - Sayan Paul
- Department of Biochemistry & Molecular Biology, The University of Texas Medical Branch at Galveston, Galveston, TX, 77555, USA
| | - Ganesh Pandian Namasivayam
- Institute for Integrated Cell-Material Sciences (WPI-iCeMS), A210, Kyoto University Institute for Advanced Study, Yoshida Ushinomiya-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Saravana Babu Chidambaram
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570015, India.
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570015, India.
- Special Interest Group - Brain, Behaviour and Cognitive Neurosciences, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India.
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Zeng Y, Guo Z, Wu M, Chen F, Chen L. Circadian rhythm regulates the function of immune cells and participates in the development of tumors. Cell Death Discov 2024; 10:199. [PMID: 38678017 PMCID: PMC11055927 DOI: 10.1038/s41420-024-01960-1] [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: 01/16/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Circadian rhythms are present in almost all cells and play a crucial role in regulating various biological processes. Maintaining a stable circadian rhythm is essential for overall health. Disruption of this rhythm can alter the expression of clock genes and cancer-related genes, and affect many metabolic pathways and factors, thereby affecting the function of the immune system and contributing to the occurrence and progression of tumors. This paper aims to elucidate the regulatory effects of BMAL1, clock and other clock genes on immune cells, and reveal the molecular mechanism of circadian rhythm's involvement in tumor and its microenvironment regulation. A deeper understanding of circadian rhythms has the potential to provide new strategies for the treatment of cancer and other immune-related diseases.
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Affiliation(s)
- Yuen Zeng
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China
| | - Zichan Guo
- Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Mengqi Wu
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China
| | - Fulin Chen
- Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Lihua Chen
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China.
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6
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Tauman R, Henig O, Rosenberg E, Marudi O, Dunietz TM, Grandner MA, Spitzer A, Zeltser D, Mizrahi M, Sprecher E, Ben-Ami R, Goldshmidt H, Goldiner I, Saiag E, Angel Y. Relationship among sleep, work features, and SARS-cov-2 vaccine antibody response in hospital workers. Sleep Med 2024; 116:90-95. [PMID: 38437781 DOI: 10.1016/j.sleep.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
STUDY OBJECTIVES Immunity is influenced by sleep and the circadian rhythm. Healthcare workers are predisposed to both insufficient sleep and circadian disruption. This study aimed to evaluate the relationship between sleep and work characteristics and the antibody response to the mRNA SARS-CoV-2 vaccine BNT162b2. METHODS The authors' prospective cohort study ("COVI3") evaluated the effect of a third (booster) dose of the BNT162b2 vaccine. A subset of participants provided information on anthropometric measures, sleep, stress and work characteristics including shift work and number of work hours per week. Blood samples for anti-S1-RBD IgG antibody levels were obtained 21 weeks following receipt of the third dose of the vaccine. RESULTS In total, 201 healthcare workers (73% women) were included. After adjustment for age, body mass index (BMI), shift work, smoking status, and perceived stress, short sleep duration (<7 h per night) was associated with lower anti-S1-RBD IgG levels (Odds ratio 2.36 [95% confidence interval 1.08-5.13]). Participants who performed shift work had higher odds of lower anti-S1-RBD IgG levels compared to those who did not work in shifts [odds ratio = 2.99 (95% confidence interval 1.40, 6.39)] after accounting for age, short sleep duration, BMI, smoking status and perceived stress. CONCLUSIONS Shift work and self-reported short sleep duration were associated with a lower antibody response following a booster dose of the SARS-CoV-2 vaccine. These findings suggest that the efficacy of vaccination, particularly among healthcare workers, may be augmented by addressing both sleep and circadian alignment.
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Affiliation(s)
- Riva Tauman
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Oryan Henig
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Or Marudi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Talia M Dunietz
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michael A Grandner
- Department of Psychiatry, Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Avishay Spitzer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Departments of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - David Zeltser
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Mizrahi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Research and Development, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hanoch Goldshmidt
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Goldiner
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Esther Saiag
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Information Systems and Operations, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yoel Angel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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7
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Menghini GM, Thurnheer R, Kahlert CR, Kohler P, Grässli F, Stocker R, Battegay M, Vuichard-Gysin D. Impact of shift work and other work-related factors on anti-SARS-CoV-2 spike-protein serum concentrations in healthcare workers after primary mRNA vaccination - a retrospective cohort study. Swiss Med Wkly 2024; 154:3708. [PMID: 38639178 DOI: 10.57187/s.3708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Knowing whether shift work negatively affects the immune system's response to COVID-19 vaccinations could be valuable for planning future vaccination campaigns for healthcare workers. We aimed to determine the impact of working late or night shifts on serum anti-SARS-CoV-2 spike protein immunoglobulin G (anti-S) antibody levels after primary SARS-CoV-2-mRNA vaccination. METHODS To obtain detailed information on shift work, we sent a separate online questionnaire to 1475 eligible healthcare workers who participated in a prospective longitudinal study conducted in 15 healthcare institutions in Switzerland. We asked all vaccinated healthcare workers with available anti-S antibody levels after vaccination to complete a brief online survey on their working schedules within one week before and after primary mRNA vaccination. We used multivariate regression to evaluate the association between work shifts around primary vaccination and anti-S antibody levels. We adjusted for confounders already known to influence vaccine efficacy (e.g. age, sex, immunosuppression, and obesity) and for variables significant at the 0.05 alpha level in the univariate analyses. RESULTS The survey response rate was 43% (n = 638). Ninety-eight responders were excluded due to unknown vaccination dates, different vaccines, or administration of the second dose shortly (within 14 days) after or before serologic follow-up. Of the 540 healthcare workers included in our analysis, 175 (32.4%) had worked at least one late or night shift within seven days before and/or after primary vaccination. In the univariate analyses, working late or night shifts was associated with a nonsignificant -15.1% decrease in serum anti-S antibody levels (p = 0.090). In the multivariate analysis, prior infection (197.2% increase; p <0.001) and immunisation with the mRNA-1273 vaccine (63.7% increase compared to the BNT162b2 vaccine; p <0.001) were the strongest independent factors associated with increased anti-S antibody levels. However, the impact of shift work remained statistically nonsignificant (-13.5%, p = 0.108). CONCLUSION Working late or night shifts shortly before or after mRNA vaccination against COVID-19 does not appear to significantly impact serum anti-S antibody levels. This result merits consideration since it supports flexible vaccination appointments for healthcare workers, including those working late or night shifts.
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Affiliation(s)
- Gianluca Mauro Menghini
- Department of Internal Medicine, Cantonal Hospital Muensterlingen, Muensterlingen, Switzerland
| | - Robert Thurnheer
- Department of Internal Medicine, Cantonal Hospital Muensterlingen, Muensterlingen, Switzerlandh
| | - Christian R Kahlert
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
- Children's Hospital of Eastern Switzerland, Department of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Fabian Grässli
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | | | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Danielle Vuichard-Gysin
- Department of Internal Medicine, Cantonal Hospital Muensterlingen, Muensterlingen, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, Thurgau Hospital Group, Muensterlingen and Frauenfeld, Switzerland
- Swiss National Center for Infection Prevention (Swissnoso), Bern, Switzerland
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Jaiswal SJ, Gadaleta M, Quer G, Radin JM, Waalen J, Ramos E, Pandit J, Owens RL. Objectively measured peri-vaccination sleep does not predict COVID-19 breakthrough infection. Sci Rep 2024; 14:4655. [PMID: 38409137 PMCID: PMC10897487 DOI: 10.1038/s41598-024-53743-4] [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: 04/07/2023] [Accepted: 02/04/2024] [Indexed: 02/28/2024] Open
Abstract
Prior studies have shown that sleep duration peri-vaccination influences an individual's antibody response. However, whether peri-vaccination sleep affects real-world vaccine effectiveness is unknown. Here, we tested whether objectively measured sleep around COVID-19 vaccination affected breakthrough infection rates. DETECT is a study of digitally recruited participants who report COVID-19-related information, including vaccination and illness data. Objective sleep data are also recorded through activity trackers. We compared the impact of sleep duration, sleep efficiency, and frequency of awakenings on reported breakthrough infection after the 2nd vaccination and 1st COVID-19 booster. Logistic regression models were created to examine if sleep metrics predicted COVID-19 breakthrough infection independent of age and gender. Self-reported breakthrough COVID-19 infection following 2nd COVID-19 vaccination and 1st booster. 256 out of 5265 individuals reported a breakthrough infection after the 2nd vaccine, and 581 out of 2583 individuals reported a breakthrough after the 1st booster. There was no difference in sleep duration between those with and without breakthrough infection. Increased awakening frequency was associated with breakthrough infection after the 1st booster with 3.01 ± 0.65 awakenings/hour in the breakthrough group compared to 2.82 ± 0.65 awakenings/hour in those without breakthrough (P < 0.001). Cox proportional hazards modeling showed that age < 60 years (hazard ratio 2.15, P < 0.001) and frequency of awakenings (hazard ratio 1.17, P = 0.019) were associated with breakthrough infection after the 1st booster. Sleep duration was not associated with breakthrough infection after COVID vaccination. While increased awakening frequency during sleep was associated with breakthrough infection beyond traditional risk factors, the clinical implications of this finding are unclear.
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Affiliation(s)
| | | | - Giorgio Quer
- The Scripps Research Institute, La Jolla, CA, USA
| | | | - Jill Waalen
- The Scripps Research Institute, La Jolla, CA, USA
| | - Edward Ramos
- The Scripps Research Institute, La Jolla, CA, USA
| | - Jay Pandit
- The Scripps Research Institute, La Jolla, CA, USA
| | - Robert L Owens
- University of California San Diego School of Medicine, La Jolla, CA, USA
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9
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Punj M, Desai A, Hashash JG, Farraye FA, Castillo PR. COVID-19 breakthrough infections and sleep disorders: A population-based propensity matched analysis. Sleep Med X 2023; 6:100089. [PMID: 37881352 PMCID: PMC10594631 DOI: 10.1016/j.sleepx.2023.100089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/30/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Objectives Examine risks for breakthrough COVID-19 infections in vaccinated patients with selected sleep disorders. Methods Real-time search and analysis using the TriNetX platform to evaluate risk of COVID-19 breakthrough infections (BTI) for patients having ICD-10 diagnoses relating to insomnia, circadian rhythm disorders, and inadequate sleep. The sleep disorder and control cohorts underwent propensity matching including factors for age, gender, race, ethnicity, and multiple co-morbid conditions. Results Of 24,720 patients identified as having a sleep disturbance relating to insomnia, circadian rhythm disorder, or inadequate sleep, 815 (3.2 %) were found to have a developed a BTI. There was a significant increased risk of BTI noted between the sleep disorder and control cohorts (adjusted odds ratio (aOR) of 1.40, 95 % confidence interval (CI) of 1.23-1.58). Subgroup analysis showed an elevated risk for BTI receiving two doses (aOR 1.53, 95 % CI 1.24-1.89) versus three doses (aOR 1.45, 95 % CI 1.24-1.69). Patients with the sleep disturbance were not found to be at an increased risk of hospitalization, intubation, death, or composite outcome of death and intubation. Conclusion The presence of having a diagnosis of insomnia, circadian rhythm disorder, or inadequate sleep was associated with increased risk of COVID-19 breakthrough infection.
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Affiliation(s)
| | - Aakash Desai
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jana G. Hashash
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Francis A. Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Pablo R. Castillo
- Department of Allergy, Pulmonary, and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA
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10
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Quach HQ, Warner ND, Ovsyannikova IG, Covassin N, Poland GA, Somers V, Kennedy RB. Excessive daytime sleepiness is associated with impaired antibody response to influenza vaccination in older male adults. Front Cell Infect Microbiol 2023; 13:1229035. [PMID: 38149010 PMCID: PMC10749933 DOI: 10.3389/fcimb.2023.1229035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Background The reduced effectiveness of standard-dose influenza vaccines in persons ≥65 years of age led to the preferential recommendation to use high-dose (HDFlu) or MF59-adjuvanted (MF59Flu) vaccines for this age group. Sleep is an important modulator of immune responses to vaccines and poor sleep health is common in older adults. However, potential effects of poor sleep health on immune responses to influenza vaccination in older adults remain largely unknown. Methods We conducted a cohort study of 210 healthy participants age ≥65 years, who received either seasonal high-dose (HDFlu) or MF59-adjuvanted (MF59Flu) influenza vaccine. We assessed sleep characteristics in this cohort by standardized questionnaires and measured the antibody titer against influenza A/H3N2 virus in serum of study participants by hemagglutination inhibition assay on the day of immunization and 28 days thereafter. We then assessed the association between sleep characteristics and antibody titers. Results Our results demonstrated that male, but not female, study participants with excessive daytime sleepiness had an impaired influenza A/H3N2-specific antibody response at Day 28 post-vaccination. No other associations were found between antibody titer and other sleep characteristics, including sleep quality and obstructive sleep apnea. Conclusion Our results provide an additional and easily measured variable explaining poor vaccine effectiveness in older adults. Our results support that gaining sufficient sleep is a simple non-vaccine interventional approach to improve influenza immune responses in older adults. Our findings extend the literature on the negative influence of excessive daytime sleepiness on immune responses to influenza vaccination in older male adults.
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Affiliation(s)
- Huy Quang Quach
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| | - Nathaniel D. Warner
- Department of Quantitative Health Services, Mayo Clinic, Rochester, MN, United States
| | | | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| | - Virend K. Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
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11
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Izuhara M, Matsui K, Yoshiike T, Kawamura A, Utsumi T, Nagao K, Tsuru A, Otsuki R, Kitamura S, Kuriyama K. Association between sleep duration and antibody acquisition after mRNA vaccination against SARS-CoV-2. Front Immunol 2023; 14:1242302. [PMID: 38149250 PMCID: PMC10750410 DOI: 10.3389/fimmu.2023.1242302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/16/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Sleep enhances the antibody response to vaccination, but the relationship between sleep and mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully understood. Methods In this prospective observational study, we investigated the influence of sleep habits on immune acquisition induced by mRNA vaccines against SARS-CoV-2 in 48 healthy adults (BNT-162b2, n=34; mRNA-1273, n=14; female, n=30, 62.5%; male, n=18, 37.5%; median age, 39.5 years; interquartile range, 33.0-44.0 years) from June 2021 to January 2022. The study measured sleep duration using actigraphy and sleep diaries, which covered the periods of the initial and booster vaccinations. Results Multivariable linear regression analysis showed that actigraphy-measured objective sleep duration 3 and 7 days after the booster vaccination was independently and significantly correlated with higher antibody titers (B=0.003; 95% confidence interval, 0.000-0.005; Beta=0.337; p=0.02), even after controlling for covariates, including age, sex, the type of vaccine, and reactogenicity to the vaccination. Associations between acquired antibody titer and average objective sleep duration before vaccination, and any period of subjective sleep duration measured by sleep diary were negligible. Discussion Longer objective, but not subjective, sleep duration after booster vaccination enhances antibody response. Hence, encouraging citizens to sleep longer after mRNA vaccination, especially after a booster dose, may increase protection against SARS-CoV-2. Study registration This study is registered at the University Hospital Medical Information Network Center (UMIN: https://www.umin.ac.jp) on July 30, 2021, #UMIN000045009.
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Affiliation(s)
- Muneto Izuhara
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ayumi Tsuru
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Rei Otsuki
- Department of Psychiatry, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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12
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Samama M, Entezami F, Rosa DS, Sartor A, Piscopo RCCP, Andersen ML, Cunha-Filho JS, Jarmy-Di-Bella ZIK. COVID-19: A Challenge to the Safety of Assisted Reproduction. Sleep Med Clin 2023; 18:489-497. [PMID: 38501521 PMCID: PMC10288308 DOI: 10.1016/j.jsmc.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
There is an increased risk of becoming pregnant through fertility treatments using assisted reproductive technology (ART) during the COVID-19 pandemic. The aim of this review is to gather comprehensive data from the existing literature on the potential risks of fertility management during the pandemic period, and outline strategies to mitigate them, with a focus on the hormonal and surgical procedures of ART. A comprehensive search of the scientific literature on COVID-19 in relation to fertility was conducted in the PubMed database using the keywords "coronavirus," "COVID-19," "SARS-CoV-2" and "pregnancy," "fertility," "urogenital system," "vertical transmission," "assisted human reproduction," "controlled ovarian stimulation," "oocyte retrieval," "in vitro fertilization," "hormones," "surgical procedures," "embryos," "oocytes," "sperm," "semen," "ovary," "testis," "ACE-2 receptor," "immunology," "cytokine storm," and "coagulation," from January 2020-July 2022. Published data on pregnancy and COVID-19, and the interaction of the urogenital system and SARS-CoV-2 is reported. The immunologic and prothrombotic profiles of patients with COVID-19, and their increased risks from controlled ovarian stimulation (COS) and ART surgeries, and how these procedures could facilitate COVID-19 and/or contribute to the severity of the disease by enhancing the cytokine storm are summarized. Strategies to prevent complications during COS that could increase the risks of the disease in pre-symptomatic patients are considered. The impact of SARS-CoV-2 on pre-symptomatic infertile patients presents a challenge to find ways to avoid the increased hormonal, immunologic, and prothrombotic risks presented by the use of COS in ART protocols during the COVID-19 outbreak. Safe ART procedures and recommendations are highlighted.
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Affiliation(s)
- Marise Samama
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; GERA Institute of Reproductive Medicine, São Paulo, Brazil.
| | - Frida Entezami
- American Hospital of Paris, IVF Unit, Neuilly-Sur-Seine, France
| | - Daniela S Rosa
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Amanda Sartor
- GERA Institute of Reproductive Medicine, São Paulo, Brazil; Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Monica L Andersen
- Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
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13
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Witte MA, Lloyd RM, McGree M, Kawai Y. Sleep quantity and quality of critically ill children perceived by caregivers and bedside nursing staff: a pilot study. J Clin Sleep Med 2023; 19:2027-2033. [PMID: 37539642 PMCID: PMC10692947 DOI: 10.5664/jcsm.10750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
STUDY OBJECTIVES Sleep is crucial for healing but often impaired in the pediatric intensive care unit due to environmental disruptions. Caregivers and bedside nursing staff are often most aware of these factors and the impact on patient sleep, but studies have not yet compared their perceptions. METHODS Caregivers and bedside nursing staff of pediatric patients staying a second night in the pediatric intensive care unit were asked to complete a survey regarding environmental factors (ie, temperature, light, sound, nursing staff room entries), sleep quality, and sleep quantity (ie, sleep duration, number of naps) of the pediatric patient. Caregivers were asked similar questions about their child's sleep at home. RESULTS The caregivers and nursing staff of 31 pediatric patients participated in this pilot study. There was no significant difference between caregiver and nursing staff ratings of sleep quality, sleep duration, number of naps, room temperature, sound, or light (P > .05 for all). Nursing staff did report significantly more room entries than caregivers (P = .01). Compared to sleep at home, caregivers reported sleep in the hospital to be of lower quality (P = .009) with more frequent room entries (P = .01). CONCLUSIONS Caregivers rate their child's sleep in the pediatric intensive care unit as lower quality than sleep at home. Caregivers and bedside nursing staff largely agree about pediatric patient sleep quality and quantity as well as environmental factors. This agreement may facilitate further research and interventions at improving sleep in the pediatric intensive care unit. CITATION Witte MA, Lloyd RM, McGree M, Kawai Y. Sleep quantity and quality of critically ill children perceived by caregivers and bedside nursing staff: a pilot study. J Clin Sleep Med. 2023;19(12):2027-2033.
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Affiliation(s)
- Micaela A. Witte
- Department of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Robin M. Lloyd
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michaela McGree
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Yu Kawai
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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14
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Joshi A, Sundar IK. Circadian Disruption in Night Shift Work and Its Association with Chronic Pulmonary Diseases. Adv Biol (Weinh) 2023; 7:e2200292. [PMID: 36797209 DOI: 10.1002/adbi.202200292] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/08/2022] [Indexed: 02/18/2023]
Abstract
Globalization and the expansion of essential services over continuous 24 h cycles have necessitated the adaptation of the human workforce to shift-based schedules. Night shift work (NSW) causes a state of desynchrony between the internal circadian machinery and external environmental cues, which can impact inflammatory and metabolic pathways. The discovery of clock genes in the lung has shed light on potential mechanisms of circadian misalignment in chronic pulmonary disease. Here, the current knowledge of circadian clock disruption caused by NSW and its impact on lung inflammation and associated pathophysiology in chronic lung diseases, such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and COVID-19, is reviewed. Furthermore, the limitations of the current understanding of circadian disruption and potential future chronotherapeutic advances are discussed.
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Affiliation(s)
- Amey Joshi
- Department of Internal Medicine, Manipal Hospitals, Bangalore, Karnataka, 560066, India
| | - Isaac Kirubakaran Sundar
- Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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15
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Whittaker AC, De Nys L, Brindle RC, Drayson MT. Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults. Brain Behav Immun Health 2023; 32:100661. [PMID: 37456624 PMCID: PMC10344668 DOI: 10.1016/j.bbih.2023.100661] [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: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.
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Affiliation(s)
| | - Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, UK
| | - Ryan C. Brindle
- Department of Cognitive and Behavioural Science & Neuroscience Program, Washington and Lee University, USA
| | - Mark T. Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, UK
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16
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Coppeta L, Ferrari C, Verno G, Somma G, Trabucco Aurilio M, Di Giampaolo L, Treglia M, Magrini A, Pietroiusti A, Rizza S. Protective Anti-HBs Antibodies and Response to a Booster Dose in Medical Students Vaccinated at Childhood. Vaccines (Basel) 2023; 11:1326. [PMID: 37631894 PMCID: PMC10460060 DOI: 10.3390/vaccines11081326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/28/2023] Open
Abstract
The immune system in humans is regulated by the circadian rhythm. Published studies have reported that the time of vaccination is associated with the immune response to vaccine for some pathogens. Our study aimed to evaluate the association between time of dose administration of challenge HBV vaccine and seroconversion for anti-HBs in medical students vaccinated at birth who were found to be unprotected at pre-training screening. Humoral protection for HBV was assessed in 885 medical students vaccinated during childhood. In total, 359 (41.0%) of them showed anti-HBs titer < 10 UI/mL and received a challenge dose of HBV vaccine followed by post-vaccination screening 30-60 days later. The challenge dose elicited a protective immune response (anti-HBs IgG titer > 10 UI/mL) in 295 (83.8%) individuals. Seroconversion was significantly associated with female gender and time of vaccination after controlling for age group and nationality at logistic regression analysis. Students who received the booster dose in the morning had a higher response rate than those who received the vaccine in the afternoon (OR 1.93; 95% C.I. 1.047-3.56: p < 0.05). This finding suggests that morning administration of the HBV booster may result in a better immune response in susceptible individuals.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
| | - Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Greta Verno
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Luca Di Giampaolo
- Department of Occupational Medicine, University of Chieti “G. D’Annunzio”, 66100 Chieti, Italy;
| | - Michele Treglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Stefano Rizza
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
- Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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17
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Showler L, Ali Abdelhamid Y, Goldin J, Deane AM. Sleep during and following critical illness: A narrative review. World J Crit Care Med 2023; 12:92-115. [PMID: 37397589 PMCID: PMC10308338 DOI: 10.5492/wjccm.v12.i3.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/13/2023] [Accepted: 03/22/2023] [Indexed: 06/08/2023] Open
Abstract
Sleep is a complex process influenced by biological and environmental factors. Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo. Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment. This review will outline the predisposing and precipitating factors for sleep disturbance, categorised into patient, environmental and treatment-related factors. The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed. While polysomnography remains the gold-standard, its use in the critical care setting still presents many barriers. Other methodologies are needed to better understand the pathophysiology, epidemiology and treatment of sleep disturbance in this population. Subjective outcome measures, including the Richards-Campbell Sleep Questionnaire, are still required for trials involving a greater number of patients and provide valuable insight into patients’ experiences of disturbed sleep. Finally, sleep optimisation strategies are reviewed, including intervention bundles, ambient noise and light reduction, quiet time, and the use of ear plugs and eye masks. While drugs to improve sleep are frequently prescribed to patients in the ICU, evidence supporting their effectiveness is lacking.
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Affiliation(s)
- Laurie Showler
- Intensive Care Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
| | - Yasmine Ali Abdelhamid
- Intensive Care Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
| | - Jeremy Goldin
- Sleep and Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
| | - Adam M Deane
- Intensive Care Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
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18
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Quan SF, Weaver MD, Czeisler MÉ, Barger LK, Booker LA, Howard ME, Jackson ML, Lane RI, McDonald CF, Ridgers A, Robbins R, Varma P, Wiley JF, Rajaratnam SMW, Czeisler CA. Insomnia, Poor Sleep Quality and Sleep Duration and Risk for COVID-19 Infection and Hospitalization. Am J Med 2023:S0002-9343(23)00248-6. [PMID: 37075878 PMCID: PMC10108572 DOI: 10.1016/j.amjmed.2023.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Medical comorbidities increase the risk of severe acute COVID-19 illness. Although sleep problems are common after COVID-19 infection, it is unclear whether insomnia, poor sleep quality and extremely long or short sleep increase risk of developing COVID-19 infection or hospitalization. METHODS Cross-sectional survey of a diverse sample of 19,926 U.S. adults RESULTS: COVID-19 infection and hospitalization prevalence rates were 40.1% and 2.9% respectively. Insomnia and poor sleep quality were reported in 19.8% and 40.1% respectively. In logistic regression models adjusted for comorbid medical conditions and sleep duration but excluding participants who reported COVID-19 associated sleep problems, poor sleep quality but not insomnia was associated with COVID-19 infection (aOR: 1.16, 95%CI: 1.07-1.26) and COVID-19 hospitalization (aOR: 1.50, 95% CI: 1.18-1.91). In comparison to habitual sleep duration of 7-8 hours, sleep durations less than 7 hours (aOR: 1.14, 95% CI: 1.06-1.23) and sleep duration of 12 hours (aOR: 1.61, 95% CI: 1.12-2.31) were associated with increased odds of COVID-19 infection. Overall, the relationship between COVID-19 infection and hours of sleep followed a quadratic (U shaped) pattern. No association between sleep duration and COVID-19 hospitalization was observed. CONCLUSION In a general population sample, poor sleep quality and extremes of sleep duration are associated with greater odds of having had a COVID-19 infection; poor sleep quality was associated with an increased requirement of hospitalization for severe COVID-19 illness. These observations suggest that inclusion of healthy sleep practices in public health messaging may reduce the impact of the COVID-19 pandemic.
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Affiliation(s)
- Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA.
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Mark É Czeisler
- Francis Weld Peabody Society, Harvard Medical School, Boston, MA; School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Lauren A Booker
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melinda L Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Rashon I Lane
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Christine F McDonald
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Faculty of Medicine, Monash University, Melbourne, Australia
| | - Anna Ridgers
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Joshua F Wiley
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA
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19
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Liu S, Sun Q, Ren X. Novel strategies for cancer immunotherapy: counter-immunoediting therapy. J Hematol Oncol 2023; 16:38. [PMID: 37055849 PMCID: PMC10099030 DOI: 10.1186/s13045-023-01430-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/15/2023] Open
Abstract
The advent of immunotherapy has made an indelible mark on the field of cancer therapy, especially the application of immune checkpoint inhibitors in clinical practice. Although immunotherapy has proven its efficacy and safety in some tumors, many patients still have innate or acquired resistance to immunotherapy. The emergence of this phenomenon is closely related to the highly heterogeneous immune microenvironment formed by tumor cells after undergoing cancer immunoediting. The process of cancer immunoediting refers to the cooperative interaction between tumor cells and the immune system that involves three phases: elimination, equilibrium, and escape. During these phases, conflicting interactions between the immune system and tumor cells result in the formation of a complex immune microenvironment, which contributes to the acquisition of different levels of immunotherapy resistance in tumor cells. In this review, we summarize the characteristics of different phases of cancer immunoediting and the corresponding therapeutic tools, and we propose normalized therapeutic strategies based on immunophenotyping. The process of cancer immunoediting is retrograded through targeted interventions in different phases of cancer immunoediting, making immunotherapy in the context of precision therapy the most promising therapy to cure cancer.
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Affiliation(s)
- Shaochuan Liu
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China
| | - Qian Sun
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China.
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China.
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China.
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China.
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
| | - Xiubao Ren
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China.
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China.
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China.
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China.
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
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20
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Abstract
Vaccine failure is a multifactorial global public health problem. A new meta-analysis underscores the role of sleep history as a factor involved in antibody responses to vaccination and subsequent protection against disease.
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Affiliation(s)
- Mark R Opp
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80301, USA.
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21
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Spiegel K, Rey AE, Cheylus A, Ayling K, Benedict C, Lange T, Prather AA, Taylor DJ, Irwin MR, Van Cauter E. A meta-analysis of the associations between insufficient sleep duration and antibody response to vaccination. Curr Biol 2023; 33:998-1005.e2. [PMID: 36917932 DOI: 10.1016/j.cub.2023.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/06/2023] [Accepted: 02/03/2023] [Indexed: 03/14/2023]
Abstract
Vaccination is a major strategy to control a viral pandemic. Simple behavioral interventions that might boost vaccine responses have yet to be identified. We conducted meta-analyses to summarize the evidence linking the amount of sleep obtained in the days surrounding vaccination to antibody response in healthy adults. Authors of the included studies provided the information needed to accurately estimate the pooled effect size (ES) and 95% confidence intervals (95% CI) and to examine sex differences.1,2,3,4,5,6,7 The association between self-reported short sleep (<6 h/night) and reduced vaccine response did not reach our pre-defined statistical significant criteria (total n = 504, ages 18-85; overall ES [95% CI] = 0.29 [-0.04, 0.63]). Objectively assessed short sleep was associated with a robust decrease in antibody response (total n = 304, ages 18-60; overall ES [95% CI] = 0.79 [0.40, 1.18]). In men, the pooled ES was large (overall ES [95% CI] = 0.93 [0.54, 1.33]), whereas it did not reach significance in women (overall ES [95% CI] = 0.42 [-0.49, 1.32]). These results provide evidence that insufficient sleep duration substantially decreases the response to anti-viral vaccination and suggests that achieving adequate amount of sleep during the days surrounding vaccination may enhance and prolong the humoral response. Large-scale well-controlled studies are urgently needed to define (1) the window of time around inoculation when optimizing sleep duration is most beneficial, (2) the causes of the sex disparity in the impact of sleep on the response, and (3) the amount of sleep needed to protect the response.
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Affiliation(s)
- Karine Spiegel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, PAM Team, F-69500 Bron, France.
| | - Amandine E Rey
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, FORGETTING Team, F-69500 Bron, France
| | - Anne Cheylus
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, PAM Team, F-69500 Bron, France
| | - Kieran Ayling
- Centre for Academic Primary Care, School of Medicine, Applied Health Research Building, University of Nottingham, Nottingham NG7 2RD, UK
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology (Sleep Science Laboratory), Uppsala University, 751 24 Uppsala, Sweden
| | - Tanja Lange
- Department of Rheumatology & Clinical Immunology, University of Lübeck, 23538 Lübeck, Germany
| | - Aric A Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94118, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Eve Van Cauter
- The Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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22
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Forthun I, Eliassen KER, Emberland KE, Bjorvatn B. The association between self-reported sleep problems, infection, and antibiotic use in patients in general practice. Front Psychiatry 2023; 14:1033034. [PMID: 36937728 PMCID: PMC10017838 DOI: 10.3389/fpsyt.2023.1033034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/30/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives There is emerging evidence that sleep problems and short sleep duration increase the risk of infection. We aimed to assess whether chronic insomnia disorder, chronic sleep problems, sleep duration and circadian preference based on self-report were associated with risk of infections and antibiotic use among patients visiting their general practitioner (GP). Methods We conducted a cross-sectional study of 1,848 unselected patients in Norway visiting their GP during 2020.The patients completed a one-page questionnaire while waiting for the consultation, that included the validated Bergen Insomnia Scale (BIS), questions on self-assessed sleep problem, sleep duration and circadian preference and whether they have had any infections or used antibiotics in the last 3 months. Relative risks (RR) were estimated using modified Poisson regression models. Results The risk of infection was 27% (95% CI RR 1.11-1.46) and 44% higher (95% CI 1.12-1.84) in patients sleeping < 6 h and >9 h, respectively, compared to those sleeping 7-8 h. The risk was also increased in patients with chronic insomnia disorder or a chronic sleep problem. For antibiotic use, the risk was higher for patients sleeping < 6 h, and for those with chronic insomnia disorder or a chronic sleep problem. Conclusions Among patients visiting their GP, short sleep duration, chronic insomnia and chronic sleep problem based on self-report were associated with higher prevalence of infection and antibiotic use. These findings support the notion of a strong association between sleep and infection.
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Affiliation(s)
- Ingeborg Forthun
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Knut Erik Emberland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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23
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Mahon N, Glennon JC. The Bi-directional Relationship Between Sleep and Inflammation in Muscular Dystrophies: A Narrative Review. Neurosci Biobehav Rev 2023; 150:105116. [PMID: 36870583 DOI: 10.1016/j.neubiorev.2023.105116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/31/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Muscular dystrophies vary in presentation and severity, but are associated with profound disability in many people. Although characterised by muscle weakness and wasting, there is also a very high prevalence of sleep problems and disorders which have significant impacts on quality of life in these individuals. There are no curative therapies for muscular dystrophies, with the only options for patients being supportive therapies to aid with symptoms. Therefore, there is an urgent need for new therapeutic targets and a greater understanding of pathogenesis. Inflammation and altered immunity are factors which have prominent roles in some muscular dystrophies and emerging roles in others such as type 1 myotonic dystrophy, signifying a link to pathogenesis. Interestingly, there is also a strong link between inflammation/immunity and sleep. In this review, we will explore this link in the context of muscular dystrophies and how it may influence potential therapeutic targets and interventions.
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Affiliation(s)
- Niamh Mahon
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jeffrey C Glennon
- School of Medicine, University College Dublin, Dublin, Ireland; UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
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24
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Xie EB, Sedov ID, Sanguino H, Freeman M, Kumari J, Tomfohr-Madsen L. Trait mindfulness and sleep: Interactions between observing and nonreactivity in the association with sleep health. Health Psychol Open 2023; 10:20551029221149282. [PMID: 36756172 PMCID: PMC9900671 DOI: 10.1177/20551029221149282] [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] [Indexed: 02/05/2023] Open
Abstract
The current study investigated the associations between trait mindfulness and sleep health and examined the interactions between theoretically related mindfulness subscales. Participants (n = 162, Mage = 19.93) reported trait levels of mindfulness and sleep was assessed using questionnaires and actigraphy. Higher mindfulness scores in awareness, nonreactivity, and nonjudgment were associated with better sleep health. The associations between observing and sleep health were moderated by nonreactivity. Results indicate that observing is associated with better sleep health at higher levels of nonreactivity and worse sleep health at lower levels, helping to explain the often-contradictory findings between observing and health outcomes.
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Affiliation(s)
| | - Ivan D. Sedov
- Department of Psychology,
University
of Calgary, Calgary, AB, Canada
| | - Hangsel Sanguino
- Department of Psychology,
University
of Calgary, Calgary, AB, Canada
| | - Makayla Freeman
- Department of Educational and
Counselling Psychology, and Special Education, University of British Columbia,
Vancouver, BC, Canada
| | - Jeshna Kumari
- Faculty of Nursing,
University of
Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and
Counselling Psychology, and Special Education, University of British Columbia,
Vancouver, BC, Canada ,Lianne Tomfohr-Madsen, Department of
Educational and Counselling Psychology, and Special Education, University of
British Columbia, Vancouver, BC, V6T 1Z4, Canada.
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25
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Persistent short nighttime sleep duration is associated with a greater post-COVID risk in fully mRNA-vaccinated individuals. Transl Psychiatry 2023; 13:32. [PMID: 36726008 PMCID: PMC9890416 DOI: 10.1038/s41398-023-02334-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Short nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously been linked to lower odds of long-lasting COVID-19 symptoms). Post-COVID was defined as experiencing at least one core COVID-19 symptom for at least three months (e.g., shortness of breath). Multivariate logistic regression adjusting for age, sex, BMI, and other factors showed in 9717 respondents (age span 18-99) that two mRNA vaccinations lowered the risk of suffering from post-COVID by about 21% (p < 0.001). When restricting the analysis to double-vaccinated respondents (n = 5918), short and long sleepers exhibited a greater post-COVID risk than normal sleepers (adjusted OR [95%-CI], 1.56 [1.29, 1.88] and 1.87 [1.32, 2.66], respectively). Among respondents with persistent sleep duration patterns during the pandemic compared to before the pandemic, short but not long sleep duration was significantly associated with the post-COVID risk (adjusted OR [95%-CI], 1.59 [1.24, 2.03] and 1.18 [0.70, 1.97], respectively). No significant association between sleep duration and post-COVID symptoms was observed in those reporting positive SARS-CoV-2 test results (n = 538). Our findings suggest that two mRNA vaccinations against SARS-CoV-2 are associated with a lower post-COVID risk. However, this protection may be less pronounced among those sleeping less than 6 h per night. Our findings warrant replication in cohorts with individuals with confirmed SARS-CoV-2 infection.
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26
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Thorkildsen MS, Laugsand LE, Nilsen TIL, Mohus RM, Høvik LH, Rogne T, Solligård E, Damås JK, Gustad LT. Insomnia symptoms and risk of bloodstream infections: prospective data from the prospective population-based Nord-Trøndelag Health Study (HUNT), Norway. J Sleep Res 2023; 32:e13696. [PMID: 36068650 PMCID: PMC10078600 DOI: 10.1111/jsr.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 02/03/2023]
Abstract
Previous research suggests decreased immune function and increased risk of infections in individuals with insomnia. We examined the effect of insomnia symptoms on risk of bloodstream infections (BSIs) and BSI-related mortality in a population-based prospective study. A total of 53,536 participants in the second Norwegian Nord-Trøndelag Health Study (HUNT2) (1995-97) were linked to prospective data on clinically relevant BSIs until 2011. In Cox regression, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for a first-time BSI and for BSI-related mortality (BSI registered ≤30 days prior to death) associated with insomnia symptoms. Compared with participants who reported "no symptoms", participants reporting having "difficulty initiating sleep" (DIS) often/almost every night had a HR for a first-time BSI of 1.14 (95% CI 0.96-1.34). Participants reporting "difficulties maintaining sleep" (DMS) often/almost every night had a HR of 1.19 (95% CI 1.01-1.40), whereas those having a feeling of "non-restorative sleep" once a week or more had a HR of 1.23 (95% CI 1.04-1.46). Participants frequently experiencing all three of the above symptoms had a HR of 1.39 (1.04-1.87), whilst those who had both DIS and DMS had a HR of 1.15 (0.93-1.41) and being troubled by insomnia symptoms to a degree that affected work performance was associated with a HR of 1.41 (95% CI 1.08-1.84). The HRs for BSI-related mortality suggest an increased risk with increasing insomnia symptoms, but the CIs are wide and inconclusive. We found that frequent insomnia symptoms and insomnia symptoms that affected work performance were associated with a weak positive increased risk of BSI.
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Affiliation(s)
- Marianne S Thorkildsen
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lars E Laugsand
- Clinic of Emergency and Prehospital Care, St. Olavs hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway
| | - Tom I L Nilsen
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway.,Department of Public Health and Nursing, NTNU, Trondheim, Norway
| | - Randi M Mohus
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Lise H Høvik
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Tormod Rogne
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Erik Solligård
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Jan K Damås
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Centre of Molecular Inflammation Research, NTNU, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Infectious Diseases, St. Olavs Hospital, Trondheim, Norway
| | - Lise T Gustad
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway.,Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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27
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Ince LM, Barnoud C, Lutes LK, Pick R, Wang C, Sinturel F, Chen CS, de Juan A, Weber J, Holtkamp SJ, Hergenhan SM, Geddes-McAlister J, Ebner S, Fontannaz P, Meyer B, Vono M, Jemelin S, Dibner C, Siegrist CA, Meissner F, Graw F, Scheiermann C. Influence of circadian clocks on adaptive immunity and vaccination responses. Nat Commun 2023; 14:476. [PMID: 36717561 PMCID: PMC9885059 DOI: 10.1038/s41467-023-35979-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/11/2023] [Indexed: 02/01/2023] Open
Abstract
The adaptive immune response is under circadian control, yet, why adaptive immune reactions continue to exhibit circadian changes over long periods of time is unknown. Using a combination of experimental and mathematical modeling approaches, we show here that dendritic cells migrate from the skin to the draining lymph node in a time-of-day-dependent manner, which provides an enhanced likelihood for functional interactions with T cells. Rhythmic expression of TNF in the draining lymph node enhances BMAL1-controlled ICAM-1 expression in high endothelial venules, resulting in lymphocyte infiltration and lymph node expansion. Lymph node cellularity continues to be different for weeks after the initial time-of-day-dependent challenge, which governs the immune response to vaccinations directed against Hepatitis A virus as well as SARS-CoV-2. In this work, we present a mechanistic understanding of the time-of-day dependent development and maintenance of an adaptive immune response, providing a strategy for using time-of-day to optimize vaccination regimes.
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Affiliation(s)
- Louise Madeleine Ince
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Pharmacology & Toxicology, College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Coline Barnoud
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Lydia Kay Lutes
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Robert Pick
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Chen Wang
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Flore Sinturel
- Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Patient Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland
| | - Chien-Sin Chen
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Alba de Juan
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Jasmin Weber
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Stephan J Holtkamp
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Sophia Martina Hergenhan
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Jennifer Geddes-McAlister
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | - Stefan Ebner
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Systems Immunology and Proteomics, Institute of Innate Immunity, Medical Faculty, University of Bonn, Bonn, Germany
| | - Paola Fontannaz
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Vono
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Jemelin
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Charna Dibner
- Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Patient Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Felix Meissner
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Systems Immunology and Proteomics, Institute of Innate Immunity, Medical Faculty, University of Bonn, Bonn, Germany
| | - Frederik Graw
- BioQuant - Center for Quantitative Biology, Heidelberg University, Heidelberg, Germany.,Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Christoph Scheiermann
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland. .,Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany. .,Geneva Centre for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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28
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Shayea AMF, Alotaibi NM, Nadar MS, Alshemali K, Alhadlaq HW. Effect of Physical Activity and Exercise on the Level of COVID-19 Antibodies and Lifestyle-Related Factors among Vaccinated Health Science Center (HSC) Students: A Pilot Randomized Trial. Vaccines (Basel) 2022; 10:vaccines10122171. [PMID: 36560580 PMCID: PMC9788485 DOI: 10.3390/vaccines10122171] [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: 10/21/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
A vaccine is a type of medicine that increases immunity and the number of antibodies (IgM and IgG) when injected into the body, preparing it in case of an actual viral infection. It has been shown in several studies that there is a significant relationship between physical activity and vaccination. Furthermore, it has been documented that physical activity can play a major role in reducing stress. Evidence also shows the existence of a relationship between immunity, vaccine response, and sleep duration. To investigate the effects of physical activity on the level of COVID-19 antibodies and lifestyle-related factors, Health Science Center (HSC) students who had taken the third dose of the vaccine and had no prior infection of the COVID-19 virus were investigated. To serve the purpose of this study, an anti-SARS-CoV-2 test was applied by taking a blood sample from the students. The Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires and the Borg’s 15-point scale were given to the participants to fill out. The study utilized a two-arm randomized control research design in which 40 participants were randomly assigned into one of two groups, either the control group (n = 20) or the treatment group (n = 20). All tests and assessments were performed before and after intervention for both groups. The control group walked less than 5000 steps every day for one month with a 20 min rest during the exercise session, while the treatment group walked more than 12,000 steps every day for the same time and exercise task session. The students’ steps were monitored using an Apple watch. There was a significant decrease in the IgG antibody level in the treatment group compared to the control group (p < 0.001). The IgM antibody level of all groups did not show any significant difference before starting the intervention. However, there was a significant (p < 0.05) decrease in the IgM level of the treatment group after treatment compared to before treatment. Moreover, there was a significant decrease in the treatment group’s stress level and sleep disruption, indicating better sleep quality, compared to the control group (p < 0.035). The levels of IgG and IgM did not improve for the treatment group. However, the treatment group improved their stress level and sleep disruption. Therefore, further rigorous research is needed to investigate vaccine efficacy among more physically active people.
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Affiliation(s)
- Abdulaziz M. F. Shayea
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Department of Molecular Biology, Faculty of Graduate Studies, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence: (N.M.A.); (A.M.F.S.)
| | - Naser M. Alotaibi
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence: (N.M.A.); (A.M.F.S.)
| | - Mohammed Shaban Nadar
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
| | - Kawthar Alshemali
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
| | - Hussah W. Alhadlaq
- Department of Environmental and Occupational Health, College of Public Health, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
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29
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Identifying Modifiable Predictors of COVID-19 Vaccine Side Effects: A Machine Learning Approach. Vaccines (Basel) 2022; 10:vaccines10101747. [PMID: 36298612 PMCID: PMC9608090 DOI: 10.3390/vaccines10101747] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023] Open
Abstract
Side effects of COVID-19 or other vaccinations may affect an individual's safety, ability to work or care for self or others, and/or willingness to be vaccinated. Identifying modifiable factors that influence these side effects may increase the number of people vaccinated. In this observational study, data were from individuals who received an mRNA COVID-19 vaccine between December 2020 and April 2021 and responded to at least one post-vaccination symptoms survey that was sent daily for three days after each vaccination. We excluded those with a COVID-19 diagnosis or positive SARS-CoV2 test within one week after their vaccination because of the overlap of symptoms. We used machine learning techniques to analyze the data after the first vaccination. Data from 50,484 individuals (73% female, 18 to 95 years old) were included in the primary analysis. Demographics, history of an epinephrine autoinjector prescription, allergy history category (e.g., food, vaccine, medication, insect sting, seasonal), prior COVID-19 diagnosis or positive test, and vaccine manufacturer were identified as factors associated with allergic and non-allergic side effects; vaccination time 6:00-10:59 was associated with more non-allergic side effects. Randomized controlled trials should be conducted to quantify the relative effect of modifiable factors, such as time of vaccination.
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Vidal AS, de Campos Reis NF, De Lorenzo BHP, Alvares-Saraiva AM, Xander P, Novaes E Brito RR. Impact of sleep restriction in B-1 cells activation and differentiation. Immunobiology 2022; 227:152280. [PMID: 36179431 DOI: 10.1016/j.imbio.2022.152280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 12/01/2022]
Abstract
B-1 lymphocytes are a subtype of B cells with functional and phenotypic features that differ from conventional B lymphocytes. These cells are mainly located in mice's pleural and peritoneal cavities and express unconventional B cell surface markers. B-1 cells participate in immunity by producing antibodies, cytokines, and chemokines and physically interacting with other immune cells. In addition, B-1 cells can differentiate into mononuclear phagocyte-like cells and phagocytize several pathogens. However, the activation and differentiation of B-1 cells are not entirely understood. It is known that several factors can influence B-1 cells, such as pathogens components and the immune response. This work aimed to evaluate the influence of chronic stress on B-1 cell activation and differentiation into phagocytes. The experimental sleep restriction was used as a stress model since the sleep alteration alters several immune cells' functions. Thus, mice were submitted to sleep restriction for 21 consecutive days, and the activation and differentiation of B-1 cells were analyzed. Our results demonstrated that B-1 cells initiated the differentiation process into mononuclear phagocytes after the period of sleep restriction. In addition, we detected a significant decrease in lymphoid lineage commitment factors (EBF, E2A, Blnk) (*P < 0.05) and an increase in the G-CSFR gene (related to the myeloid lineage commitment factor) (****P < 0.0001), as compared to control mice no submitted to sleep restriction. An increase in the co-stimulatory molecules CD80 and CD86 (**P < 0.01 and *P < 0.05, respectively) and a higher production of nitric oxide (NO) (*P < 0.05) and reactive oxygen species (ROS) (*P < 0.05) were also observed in B-1 cells from mice submitted to sleep restriction. Nevertheless, B-1 cells from sleep-restricted mice showed a significant reduction in the Toll-like receptors (TLR)-2, -6, and -9, and interleukine-10 (IL-10) cytokine expression (***P < 0.001) as compared to control. Sleep-restricted mice intraperitoneally infected withL. amazonensispromastigotes showed a reduction in the average internalized parasites (*P < 0.05) by B-1 cells. These findings suggest that sleep restriction interferes with B-1 lymphocyte activation and differentiation. In addition, b-1 cells assumed a more myeloid profile but with a lower phagocytic capacity in this stress condition.
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Affiliation(s)
- Andrey Sladkevicius Vidal
- Centro Universitário São Camilo, Centro Universitário São Camilo, Av. Nazaré, 1501, São Paulo, Brazil; Programa de Pós-graduação Biologia-Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo campus Diadema, Rua São Nicolau, 210, Diadema, Brazil
| | - Natasha Ferraz de Campos Reis
- Programa de Pós-graduação Biologia-Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo campus Diadema, Rua São Nicolau, 210, Diadema, Brazil; Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo campus Diadema
| | | | - Anuska Marcelino Alvares-Saraiva
- Instituto de Ciências da Saúde, Pós-graduação em Patologia Ambiental e Experimental, Universidade Paulista, Rua Bacelar, 902, São Paulo, Brazil; Pós Graduação Interdisciplinar em Saúde, Universidade Cruzeiro do Sul, Rua Galvão Bueno, 868, São Paulo, Brazil; Laboratório de Fisiopatologia, Instituto Butantan, Av. Vital Brasil, 1500, São Paulo, Brazil
| | - Patricia Xander
- Programa de Pós-graduação Biologia-Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo campus Diadema, Rua São Nicolau, 210, Diadema, Brazil; Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo campus Diadema.
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Faraut B, Cordina-Duverger E, Aristizabal G, Drogou C, Gauriau C, Sauvet F, Lévi F, Léger D, Guénel P. Immune disruptions and night shift work in hospital healthcare professionals: The intricate effects of social jet-lag and sleep debt. Front Immunol 2022; 13:939829. [PMID: 36164341 PMCID: PMC9509137 DOI: 10.3389/fimmu.2022.939829] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/29/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives We aimed to examine the effects of circadian and sleep rhythm disruptions on immune biomarkers among hospital healthcare professionals working night shifts and rotating day shifts. Methods Hospital nurses working either as permanent night shifters (n=95) or as day shifters rotating between morning and afternoon shifts (n=96) kept a daily diary on their sleep and work schedules over a full working week. Blood samples were collected at the beginning and end of the last shift during the week, and participants were categorized into three groups based on work shift: morning shift (39 day shifters sampled at 7:00 and 14:00), afternoon shift (57 day shifters sampled at 14:00 and 21:00), and night shift (95 night shifters sampled at 21:00 and 7:00). Circulating blood counts in immune cells, interleukin-6 and C-reactive protein concentrations as well as total sleep time per 24 hours during work days (TST24w) and free days (TST24f), sleep debt (TST24f - TST24w) and social jet-lag (a behavioral proxy of circadian misalignment) were assessed. Results Compared with day shifters, night shifters had shorter sleep duration (TST24w=5.4 ± 1.4h), greater sleep debt (3.2 ± 1.4 h) and social jet-lag (6.7 ± 2.4 h). Variations of immune biomarkers concentrations were consistent with the expected diurnal variations among day shifters (i.e., low level in the morning, increase during the day, peak value in the evening). By contrast, in night shifters, blood concentrations of total lymphocytes, T-helper cells, cytotoxic T-cells, memory B-cells and interleukin-6 were lower at 21:00, increased during the night, and reached higher values at 7:00. Multivariate analyses ruled out significant impact of TST24w, sleep debt, and social jet-lag on immune biomarkers concentrations among day shifters. In contrast, among night shifters, multivariate analyses indicated a combined effect of total sleep time (TST24w), sleep debt and social jet-lag for total lymphocytes and T-helper cells but only a social jet-lag effect for interleukin-6 and a single total sleep time effect for neutrophil and B-Cells. Conclusions Altogether, our results point to intricate response patterns of immune rhythms to circadian misalignment and sleep debt in night shifters. Specifically, these altered pattern expressions of immune cells may increase vulnerability to infections and reduce vaccination efficiency in night workers.
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Affiliation(s)
- Brice Faraut
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Emilie Cordina-Duverger
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
| | - Guillen Aristizabal
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
| | - Catherine Drogou
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- Institut de Recherche Biomédicale des Armées (IRBA), Unité Fatigue et Vigilance, Brétigny sur Orge, France
| | - Caroline Gauriau
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Fabien Sauvet
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- Institut de Recherche Biomédicale des Armées (IRBA), Unité Fatigue et Vigilance, Brétigny sur Orge, France
| | - Francis Lévi
- UPR “Chronothérapie, Cancers, et Transplantation”, Faculté de Médecine, Université Paris-Saclay, Villejuif, France
- Hepato-Biliary Center, Hôpital Paul Brousse, Villejuif, France
- Cancer Chronotherapy Team, Cancer Research Centre, Division of Biomedical Sciences, Warwick Medical School, Coventry, United Kingdom
| | - Damien Léger
- Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France
| | - Pascal Guénel
- Inserm, CESP (Center for research in Epidemiology and Population Health), Team Exposome and Heredity, University Paris-Saclay, Gustave-Roussy, Villejuif, France
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Kuna K, Szewczyk K, Gabryelska A, Białasiewicz P, Ditmer M, Strzelecki D, Sochal M. Potential Role of Sleep Deficiency in Inducing Immune Dysfunction. Biomedicines 2022; 10:biomedicines10092159. [PMID: 36140260 PMCID: PMC9496201 DOI: 10.3390/biomedicines10092159] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Sleep deficiency and insomnia deteriorate the quality of patients’ lives, yet the exact influence of these factors on the immune system has only begun to gain interest in recent years. Growing evidence shows that insomnia is a risk factor for numerous diseases, including common infections and autoimmune diseases. Levels of inflammatory markers also seem to be abnormal in sleep deficient individuals, which may lead to low-grade inflammation. The interpretation of studies is difficult due to the equivocal term “sleep disturbances,” as well as due to the various criteria used in studies. This narrative review aims to summarize the available knowledge regarding the bidirectional influence of the immune system and sleep disturbances.
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Affiliation(s)
- Kasper Kuna
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Krzysztof Szewczyk
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Marta Ditmer
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-213 Lodz, Poland
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
- Correspondence: ; Tel.: +48-42-678-18-00
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Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
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Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
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Time-of-Day Variation in SARS-CoV-2 RNA Levels during the Second Wave of COVID-19. Viruses 2022; 14:v14081728. [PMID: 36016350 PMCID: PMC9413669 DOI: 10.3390/v14081728] [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: 06/16/2022] [Revised: 07/25/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
Circadian rhythms influence and coordinate an organism's response to its environment and to invading pathogens. We studied the diurnal variation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in nasal/throat swabs collected in late 2020 to spring 2021 in a population immunologically naïve to SARS-CoV-2 and prior to widespread vaccination. SARS-CoV-2 diagnostic PCR data from 1698 participants showed a significantly higher viral load in samples obtained in the afternoon, in males, and in hospitalised patients when linear mixed modelling was applied. This study illustrates the importance of recording sample collection times when measuring viral replication parameters in clinical and research studies.
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Paik JJ, Sparks JA, Kim AHJ. Immunogenicity, breakthrough infection, and underlying disease flare after SARS-CoV-2 vaccination among individuals with systemic autoimmune rheumatic diseases. Curr Opin Pharmacol 2022; 65:102243. [PMID: 35636384 PMCID: PMC9058024 DOI: 10.1016/j.coph.2022.102243] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 12/18/2022]
Abstract
Many patients with systemic autoimmune rheumatic diseases (SARDs) require immunosuppression to reduce disease activity, but this also has important possible detrimental impacts on immune responses following vaccination. The phase III clinical trials for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines did not include those who are immunosuppressed. Fortunately, we now have a clearer idea of how immune responses following SARS-CoV-2 vaccination has for the immunosuppressed, with much of the data being within a year of its introduction. Here, we summarize what is known in this rapidly evolving field about the impact immunosuppression has on humoral immunogenicity including waning immunity and additional doses, breakthrough infection rates and severity, disease flare rates, along with additional considerations and remaining unanswered questions.
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Affiliation(s)
- Julie J Paik
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alfred H J Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
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Arleevskaya M, Takha E, Petrov S, Kazarian G, Renaudineau Y, Brooks W, Larionova R, Korovina M, Valeeva A, Shuralev E, Mukminov M, Kravtsova O, Novikov A. Interplay of Environmental, Individual and Genetic Factors in Rheumatoid Arthritis Provocation. Int J Mol Sci 2022; 23:ijms23158140. [PMID: 35897715 PMCID: PMC9329780 DOI: 10.3390/ijms23158140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023] Open
Abstract
In this review, we explore systemization of knowledge about the triggering effects of non-genetic factors in pathogenic mechanisms that contribute to the development of rheumatoid arthritis (RA). Possible mechanisms involving environmental and individual factors in RA pathogenesis were analyzed, namely, infections, mental stress, sleep deprivation ecology, age, perinatal and gender factors, eating habits, obesity and smoking. The non-genetic factors modulate basic processes in the body with the impact of these factors being non-specific, but these common challenges may be decisive for advancement of the disease in the predisposed body at risk for RA. The provocation of this particular disease is associated with the presence of congenital loci minoris resistentia. The more frequent non-genetic factors form tangles of interdependent relationships and, thereby, several interdependent external factors hit one vulnerable basic process at once, either provoking or reinforcing each other. Understanding the specific mechanisms by which environmental and individual factors impact an individual under RA risk in the preclinical stages can contribute to early disease diagnosis and, if the factor is modifiable, might be useful for the prevention or delay of its development.
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Affiliation(s)
- Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
- Correspondence: ; Tel.: +7-89172-886-679; Fax: +7-843-238-5413
| | - Elena Takha
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Sergey Petrov
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Gevorg Kazarian
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Yves Renaudineau
- Department of Immunology, CHU Toulouse, INSERM U1291, CNRS U5051, University Toulouse IIII, 31000 Toulouse, France;
| | - Wesley Brooks
- Department of Chemistry, University of South Florida, Tampa, FL 33620, USA;
| | - Regina Larionova
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Marina Korovina
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
| | - Anna Valeeva
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Eduard Shuralev
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Malik Mukminov
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Olga Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
| | - Andrey Novikov
- Mathematical Center, Sobolev Instiute of Mathematics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia;
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Irwinda R, Harzif AK, Prameswari N, Hiksas R, Lokeswara AW, Wibowo N. Serum Antibodies SARS-CoV-2 Spike (S) Protein Receptor-Binding Domain in OBGYN Residents and Effectiveness 3 Months after COVID-19 Vaccination. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The health care workers are considered as vulnerable people who had higher infecting dose of SARS-CoV-2 infection compared to other society. Among more than 500 deaths of Indonesians physicians, obstetrics and gynecologist (OBGYN) has become the most specialists who died in this pandemic.
AIM: The objective of our study is to evaluate the antibodies of SARS-CoV-2 in serum OBGYN residents post-vaccination as well as the presence of infection 3 months after the vaccination.
METHODS: A prospective cohort study was conducted in OBGYN residents Universitas Indonesia. Serum antibodies SARS-CoV-2 spike (S) protein receptor-binding domain (RBD) was measured using electrochemiluminescence immunoassay, 21 days after Sinovac vaccination, with basic characteristics being recorded. Within 3 months follow-up, the participants were monthly checked related to post-vaccination infection.
RESULTS: The median antibodies SARS-CoV-2 for all participants were 50.72 (19.09–98.57) U/mL. There were 20 residents (24.1%) who had post-vaccination infection within 3 months and dominated by asymptomatic to mild symptoms. Body mass index (r = –0.221, p = 0.044) and sleep hours (r = –0.225, p = 0.041) were found to be inversely correlated with antibodies SARS-CoV-2 S RBD.
CONCLUSION: Antibodies SARS-CoV-2 S RBD found to be correlated with BMI and sleep hours. The 3-month post-vaccine infection among OBGYN residents was almost similar to Jakarta’s positivity rate and the efficacy rate was higher than expected by National Agency of Drug and Food Control.
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Meyhöfer S, Dembinski K, Schultes B, Born J, Wilms B, Lehnert H, Hallschmid M, Meyhöfer SM. Sleep deprivation prevents counterregulatory adaptation to recurrent hypoglycaemia. Diabetologia 2022; 65:1212-1221. [PMID: 35445819 PMCID: PMC9174142 DOI: 10.1007/s00125-022-05702-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Attenuated counterregulation after recurrent hypoglycaemia is a major complication of diabetes treatment. As there is previous evidence for the relevance of sleep in metabolic control, we assessed the acute contribution of sleep to the counterregulatory adaptation to recurrent hypoglycaemia. METHODS Within a balanced crossover design, 15 healthy, normal-weight male participants aged 18-35 years underwent three hyperinsulinaemic-hypoglycaemic clamps with a glucose nadir of 2.5 mmol/l, under two experimental conditions, sleep and sleep deprivation. Participants were exposed to two hypoglycaemic episodes, followed by a third hypoglycaemic clamp after one night of regular 8 h sleep vs sleep deprivation. The counterregulatory response of relevant hormones (glucagon, growth hormone [GH], ACTH, cortisol, adrenaline [epinephrine] and noradrenaline [norepinephrine]) was measured, and autonomic and neuroglycopenic symptoms were assessed. RESULTS Sleep deprivation compared with sleep dampened the adaptation to recurrent hypoglycaemia for adrenaline (p=0.004), and this pattern also emerged in an overall analysis including adrenaline, GH and glucagon (p=0.064). After regular sleep, the counterregulatory responses of adrenaline (p=0.005), GH (p=0.029) and glucagon (p=0.009) were attenuated during the 3rd clamp compared with the 1st clamp, but were preserved after sleep deprivation (all p>0.225). Neuroglycopenic and autonomic symptoms during the 3rd clamp compared with the 1st clamp were likewise reduced after sleep (p=0.005 and p=0.019, respectively). In sleep deprivation, neuroglycopenic symptoms increased (p=0.014) and autonomic symptoms were unchanged (p=0.859). CONCLUSIONS/INTERPRETATION The counterregulatory adaptation to recurrent hypoglycaemia is compromised by sleep deprivation between hypoglycaemic episodes, indicating that sleep is essential for the formation of a neurometabolic memory, and may be a potential target of interventions to treat hypoglycaemia unawareness syndrome.
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Affiliation(s)
- Svenja Meyhöfer
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany.
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
- Department of Internal Medicine 1, Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany.
| | - Katharina Dembinski
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
| | - Bernd Schultes
- Metabolic Center St Gallen, FriendlyDocs Ltd, St Gallen, Switzerland
| | - Jan Born
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Deparment of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Britta Wilms
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | | | - Manfred Hallschmid
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Deparment of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Sebastian M Meyhöfer
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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Roenneberg T, Foster RG, Klerman EB. The circadian system, sleep, and the health/disease balance: a conceptual review. J Sleep Res 2022; 31:e13621. [PMID: 35670313 PMCID: PMC9352354 DOI: 10.1111/jsr.13621] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
The field of "circadian medicine" is a recent addition to chronobiology and sleep research efforts. It represents a logical step arising from the increasing insights into the circadian system and its interactions with life in urbanised societies; applying these insights to the health/disease balance at home and in the medical practice (outpatient) and clinic (inpatient). Despite its fast expansion and proliferating research efforts, circadian medicine lacks a formal framework to categorise the many observations describing interactions among the circadian system, sleep, and the health/disease balance. A good framework allows us to categorise observations and then assign them to one or more components with hypothesised interactions. Such assignments can lead to experiments that document causal (rather than correlational) relationships and move from describing observations to discovering mechanisms. This review details such a proposed formal framework for circadian medicine and will hopefully trigger discussion among our colleagues, so that the framework can be improved and expanded. As the basis of the framework for circadian medicine, we define "circadian health" and how it links to general health. We then define interactions among the circadian system, sleep, and the health/disease balance and put the framework into the context of the literature with examples from six domains of health/disease balance: fertility, cancer, immune system, mental health, cardiovascular, and metabolism.
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Affiliation(s)
- Till Roenneberg
- Institute of Medical Psychology and Institute for Occupational, Social and Environmental Medicine, Munich, Germany
| | - Russell G Foster
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, New Biochemistry Building, University of Oxford, Oxford, UK
| | - Elizabeth B Klerman
- Department of Neurology, Massachusetts General Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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40
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Xiao K, Gillissie ES, Lui LM, Ceban F, Teopiz KM, Gill H, Cao B, Ho R, Rosenblat JD, McIntyre RS. Immune response to vaccination in adults with mental disorders: A systematic review. J Affect Disord 2022; 304:66-77. [PMID: 35167926 PMCID: PMC8837484 DOI: 10.1016/j.jad.2022.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mental disorders are associated with immune dysregulation as measured by serum levels of biological markers of immunity. Adults with mental disorders have also been reported to have attenuated post vaccine immune response. The COVID-19 pandemic has invited the need to determine whether individuals with mental disorders exhibit differential immune response following the administration of vaccines for other infections. METHODS A systematic search of MEDLINE, Embase, Cochrane, and PsycInfo was conducted from inception to May 2021 investigating vaccine response in persons with mental disorders, as measured by biological markers of immunity (i.e., antibodies, cytokines). RESULTS Thirteen articles were identified which evaluated vaccine efficacy in persons with mental disorders. Individuals with major depressive disorder (MDD) or schizophrenia revealed attenuated immune response to vaccination, or no statistical difference compared to control subjects. Individuals with anorexia nervosa or post-traumatic stress disorder (PTSD) displayed no attenuated post-vaccination antibody level. Individuals with insomnia displayed lower levels of antibodies after vaccination, whereas individuals with obstructive sleep apnea (OSA) displayed no difference in vaccine response compared to control subjects. LIMITATIONS The limitations of this review include the relatively few articles included (n = 13) and small sample sizes (less than thirty subjects) in the majority of articles. CONCLUSION Vaccine response in adults with a mental disorder remains inconclusive. Notwithstanding the heterogeneity and relatively small number of studies, available evidence does suggest attenuated immune response across disparate vaccinations. Future research is required to confirm vaccine efficacy in persons with mental disorders, especially regarding immune responses to COVID-19 vaccination.
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Affiliation(s)
- Karren Xiao
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Emily S. Gillissie
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Leanna M.W. Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Kayla M. Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Institute of Medical Science, University of Toronto, ON, Canada
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, PR China
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Joshua D. Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Department of Psychiatry, University of Toronto, Canada
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Department of Psychiatry, University of Toronto, Canada,Department of Pharmacology, University of Toronto, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada,Corresponding author at: Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
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41
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Halioua B, Chelli C, Misery L, Taieb J, Taieb C. Sleep Disorders and Psoriasis: An Update. Acta Derm Venereol 2022; 102:adv00699. [PMID: 35191513 PMCID: PMC9574693 DOI: 10.2340/actadv.v102.1991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psoriasis alters patients’ quality of life. Among the disorders associated with psoriasis, sleep disorders are common, although they are not directly assessed by most quality-of-life scores. Thus, the specific evaluation of sleep disorders using dedicated scores is necessary, especially because such disorders alter patients;’ physical and psychological health. The relationship between psoriasis and sleep disorders has been shown in numerous studies, but has not yet been fully elucidated. The aim of this study was to update knowledge of sleep disorders in patients with psoriasis, through a review of the scientific literature since 1980. This work covers several topics of interest, such as sleep assessment methods, the prevalence of sleep disorders in patients with psoriasis, factors predictive of sleep disorders in patients with psoriasis, the impact of sleep disorders on comorbidities and quality of life, pathogenic mechanisms, obstructive sleep apnoea and restless leg syndromes, and the impact of biotherapy treatments on sleep disorders in patients with psoriasis.
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42
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Kim ES, Oh CE. Sleep and vaccine administration time as factors influencing vaccine immunogenicity. KOSIN MEDICAL JOURNAL 2022. [DOI: 10.7180/kmj.22.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The immunogenicity of vaccines is affected by host, external, environmental, and vaccine factors; in addition, sleep or circadian rhythms may also have effects. With the use of vaccines to mitigate the coronavirus disease 2019 (COVID-19) pandemic, research is underway to clarify what time of the day is optimal for COVID-19 vaccination and how disturbances of circadian rhythms will affect the immunogenicity of the vaccine in shift workers. Studies on the relationship between sleep time and the immunogenicity of vaccines for influenza and hepatitis have demonstrated that less sleep time and sleep deprivation tended to adversely affect immunogenicity. In some studies, there were even sex differences in these effects. When comparing shift workers with disturbances in their circadian rhythms and those who only worked during the day, one study found less antibody formation in shift workers; however, further studies on the relationship between shift work and the immunogenicity of vaccines are needed. Studies on the relationship between vaccine administration time and immunogenicity have shown different results according to age and sex. Therefore, future studies on vaccine administration time and immunogenicity may require an individualized approach for each vaccine and each population to be vaccinated. There is accumulating evidence on the effects of sleep and vaccine administration time on the immunogenicity of vaccines. However, further studies are needed to determine whether the association between immunogenicity and circadian rhythms and vaccine administration time can be used as a basis to increase the immunogenicity for individual vaccines.
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43
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Zhuang X, Edgar RS, McKeating JA. The role of circadian clock pathways in viral replication. Semin Immunopathol 2022; 44:175-182. [PMID: 35192001 PMCID: PMC8861990 DOI: 10.1007/s00281-021-00908-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/26/2021] [Indexed: 02/07/2023]
Abstract
The daily oscillations of bi ological and behavioural processes are controlled by the circadian clock circuitry that drives the physiology of the organism and, in particular, the functioning of the immune system in response to infectious agents. Circadian rhythmicity is known to affect both the pharmacokinetics and pharmacodynamics of pharmacological agents and vaccine-elicited immune responses. A better understanding of the role circadian pathways play in the regulation of virus replication will impact our clinical management of these diseases. This review summarises the experimental and clinical evidence on the interplay between different viral pathogens and our biological clocks, emphasising the importance of continuing research on the role played by the biological clock in virus-host organism interaction.
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Affiliation(s)
- Xiaodong Zhuang
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, OX3 7FZ, UK.
| | - Rachel S Edgar
- Faculty of Medicine, Imperial College London, London, UK
| | - Jane A McKeating
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, OX3 7FZ, UK.
- Chinese Academy of Medical Sciences (CAMS), Oxford Institute (COI), University of Oxford, Oxford, UK.
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44
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Schmitz NCM, van der Werf YD, Lammers-van der Holst HM. The Importance of Sleep and Circadian Rhythms for Vaccination Success and Susceptibility to Viral Infections. Clocks Sleep 2022; 4:66-79. [PMID: 35225954 PMCID: PMC8884008 DOI: 10.3390/clockssleep4010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/03/2022] [Accepted: 02/12/2022] [Indexed: 12/14/2022] Open
Abstract
Sleep and circadian rhythms are closely involved in the immune system and its regulation. Here, we describe this relationship and provide recommendations regarding the influence of sleep and circadian rhythms on vaccination success. We review studies investigating how viral susceptibility is influenced by changes in immunological parameters as a consequence of sleep deprivation. Short sleep duration and poor sleep efficiency both appear to be strong factors leading to greater vulnerability. In addition, both sleep duration and the time of day of the vaccination seem to be associated with the magnitude of the antibody response after vaccination. Based on these findings, a recommendation would consist of a sleep duration of 7 h or more every night to both reduce the risk of infection and to optimize the efficacy of vaccination with respect to circadian timing. Improving sleep quality and its circadian timing can potentially play a role in preventing infection and in vaccination benefits. In conclusion, sufficient (or longer) sleep duration is important in both reducing susceptibility to infection and increasing antibody response after vaccination.
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Affiliation(s)
- Nina C. M. Schmitz
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (N.C.M.S.); (Y.D.v.d.W.)
| | - Ysbrand D. van der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (N.C.M.S.); (Y.D.v.d.W.)
| | - Heidi M. Lammers-van der Holst
- Department of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
- Correspondence:
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Mason AE, Kasl P, Hartogensis W, Natale JL, Dilchert S, Dasgupta S, Purawat S, Chowdhary A, Anglo C, Veasna D, Pandya LS, Fox LM, Puldon KY, Prather JG, Gupta A, Altintas I, Smarr BL, Hecht FM. Metrics from Wearable Devices as Candidate Predictors of Antibody Response Following Vaccination against COVID-19: Data from the Second TemPredict Study. Vaccines (Basel) 2022; 10:264. [PMID: 35214723 PMCID: PMC8877860 DOI: 10.3390/vaccines10020264] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 01/27/2023] Open
Abstract
There is significant variability in neutralizing antibody responses (which correlate with immune protection) after COVID-19 vaccination, but only limited information is available about predictors of these responses. We investigated whether device-generated summaries of physiological metrics collected by a wearable device correlated with post-vaccination levels of antibodies to the SARS-CoV-2 receptor-binding domain (RBD), the target of neutralizing antibodies generated by existing COVID-19 vaccines. One thousand, one hundred and seventy-nine participants wore an off-the-shelf wearable device (Oura Ring), reported dates of COVID-19 vaccinations, and completed testing for antibodies to the SARS-CoV-2 RBD during the U.S. COVID-19 vaccination rollout. We found that on the night immediately following the second mRNA injection (Moderna-NIAID and Pfizer-BioNTech) increases in dermal temperature deviation and resting heart rate, and decreases in heart rate variability (a measure of sympathetic nervous system activation) and deep sleep were each statistically significantly correlated with greater RBD antibody responses. These associations were stronger in models using metrics adjusted for the pre-vaccination baseline period. Greater temperature deviation emerged as the strongest independent predictor of greater RBD antibody responses in multivariable models. In contrast to data on certain other vaccines, we did not find clear associations between increased sleep surrounding vaccination and antibody responses.
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Affiliation(s)
- Ashley E. Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Patrick Kasl
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Joseph L. Natale
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY 10010, USA;
| | - Subhasis Dasgupta
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Shweta Purawat
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Danou Veasna
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Leena S. Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Lindsey M. Fox
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Karena Y. Puldon
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Jenifer G. Prather
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Amarnath Gupta
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Ilkay Altintas
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Benjamin L. Smarr
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Frederick M. Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
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46
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Lam MTY, Malhotra A, LaBuzetta JN, Kamdar BB. Sleep in Critical Illness. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Tufik S, Andersen ML, Rosa DS, Tufik SB, Pires GN. Effects of Obstructive Sleep Apnea on SARS-CoV-2 Antibody Response After Vaccination Against COVID-19 in Older Adults. Nat Sci Sleep 2022; 14:1203-1211. [PMID: 35789617 PMCID: PMC9250419 DOI: 10.2147/nss.s361529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/15/2022] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Previous studies have linked sleep disturbances (including sleep deprivation and obstructive sleep apnea) to an impairment in immune response after vaccination for several diseases, although it has not yet been tested for COVID-19. This study sought to evaluate the effects of obstructive sleep apnea on anti-SARS-CoV-2 IgG levels after vaccination against COVID-19 among older adults. METHODS The study was based on a convenience sample of inpatients who underwent full night type-I polysomnography. Inclusion criteria included being ≥60 years with full COVID-19 vaccination schedule. Exclusion criteria included previous COVID-19 diagnosis (assessed via self-report), less than 15 days between last dose and IgG testing, self-report of continuous positive air pressure (CPAP) use in the last three months, having undergone CPAP or split-night polysomnography, or incomplete/invalid data. RESULTS Out of 122 included patients (no/mild OSA: 35; moderate: 31; severe: 56), 9.8% were considered seronegative for the IgG anti-SARS-CoV-2 test (IgG count<50.0 AU/mL), and the median IgG levels for the whole sample was 273 AU/mL (IQR: 744), with no statistically significant differences among OSA severity groups. There was neither association between OSA severity and IgG serostatus nor correlation between IgG levels and apnea-hypopnea index. A linear regression model to predict IgG levels was built, produced an R2 value of 0.066 and the only significant predictor was time from vaccination to testing; while OSA severity was considered non-significant. DISCUSSION Our results demonstrate that the severity of OSA is not correlated with a decrease in anti-SARS-CoV-2 IgG levels among older adults, and that the efficiency of COVID-19 vaccinations are not reduced from mild to severe OSA.
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Affiliation(s)
- Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniela Santoro Rosa
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Brasil Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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48
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Wang W, Balfe P, Eyre DW, Lumley SF, O'Donnell D, Warren F, Crook DW, Jeffery K, Matthews PC, Klerman EB, McKeating JA. Time of Day of Vaccination Affects SARS-CoV-2 Antibody Responses in an Observational Study of Health Care Workers. J Biol Rhythms 2021; 37:124-129. [PMID: 34866459 PMCID: PMC8825702 DOI: 10.1177/07487304211059315] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global crisis with unprecedented challenges for public health. Vaccinations against SARS-CoV-2 have slowed the incidence of new infections and reduced disease severity. As the time of day of vaccination has been reported to influence host immune responses to multiple pathogens, we quantified the influence of SARS-CoV-2 vaccination time, vaccine type, participant age, sex, and days post-vaccination on anti-Spike antibody responses in health care workers. The magnitude of the anti-Spike antibody response is associated with the time of day of vaccination, vaccine type, participant age, sex, and days post-vaccination. These results may be relevant for optimising SARS-CoV-2 vaccine efficacy.
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Affiliation(s)
- Wei Wang
- Division of Sleep and Circadian Disorders and Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Balfe
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David W Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sheila F Lumley
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Denise O'Donnell
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Fiona Warren
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Derrick W Crook
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Katie Jeffery
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Philippa C Matthews
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders and Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jane A McKeating
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, UK
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Cermakian N, Stegeman SK, Tekade K, Labrecque N. Circadian rhythms in adaptive immunity and vaccination. Semin Immunopathol 2021; 44:193-207. [PMID: 34825270 DOI: 10.1007/s00281-021-00903-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Abstract
Adaptive immunity allows an organism to respond in a specific manner to pathogens and other non-self-agents. Also, cells of the adaptive immune system, such as T and B lymphocytes, can mediate a memory of an encounter with a pathogen, allowing a more efficient response to a future infection. As for other aspects of physiology and of the immune system, the adaptive immune system is regulated by circadian clocks. Consequently, the development, differentiation, and trafficking between tissues of adaptive immune cells have been shown to display daily rhythms. Also, the response of T cells to stimuli (e.g., antigen presentation to T cells by dendritic cells) varies according to a circadian rhythm, due to T cell-intrinsic mechanisms as well as cues from other tissues. The circadian control of adaptive immune response has implications for our understanding of the fight against pathogens as well as auto-immune diseases, but also for vaccination, a preventive measure based on the development of immune memory.
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Affiliation(s)
- Nicolas Cermakian
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
| | - Sophia K Stegeman
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
| | - Kimaya Tekade
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
| | - Nathalie Labrecque
- Hôpital Maisonneuve Rosemont Research Centre, Département de Médecine and Département de Microbiologie, infectiologie et immunologie, Université de Montréal, QC, H1T 2M4, Montreal, Canada
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50
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Robinson CH, Albury C, McCartney D, Fletcher B, Roberts N, Jury I, Lee J. The relationship between duration and quality of sleep and upper respiratory tract infections: a systematic review. Fam Pract 2021; 38:802-810. [PMID: 33997896 PMCID: PMC8656143 DOI: 10.1093/fampra/cmab033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Upper respiratory tract infections (URTIs) are common, mostly self-limiting, but result in inappropriate antibiotic prescriptions. Poor sleep is cited as a factor predisposing to URTIs, but the evidence is unclear. OBJECTIVE To systematically review whether sleep duration and quality influence the frequency and duration of URTIs. METHODS Three databases and bibliographies of included papers were searched for studies assessing associations between sleep duration or quality and URTIs. We performed dual title and abstract selection, discussed full-text exclusion decisions and completed 50% of data extraction in duplicate. The Newcastle-Ottawa Quality Assessment Scale assessed study quality and we estimated odds ratios (ORs) using random effects meta-analysis. RESULTS Searches identified 5146 papers. Eleven met inclusion criteria, with nine included in meta-analyses: four good, two fair and five poor for risk of bias. Compared to study defined 'normal' sleep duration, shorter sleep was associated with increased URTIs (OR: 1.30, 95% confidence interval [CI]: 1.19-1.42, I2: 11%, P < 0.001) and longer sleep was not significantly associated (OR: 1.11 95% CI: 0.99-1.23, I2: 0%, P = 0.070). Sensitivity analyses using a 7- to 9-hour baseline found that sleeping shorter than 7-9 hours was associated with increased URTIs (OR: 1.31, 95% CI: 1.22-1.41, I2: 0%, P < 0.001). Sleeping longer than 7-9 hours was non-significantly associated with increased URTIs (OR: 1.15, 95% CI: 1.00-1.33, I2: 0%, P = 0.050, respectively). We were unable to pool sleep quality studies. No studies reported on sleep duration and URTI severity or duration. CONCLUSIONS Reduced sleep, particularly shorter than 7-9 hours, is associated with increased URTIs. Strategies improving sleep should be explored to prevent URTIs.
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Affiliation(s)
| | - Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David McCartney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Benjamin Fletcher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Imogen Jury
- Department of Medical Sciences, University of Oxford, Oxford, UK
| | - Joseph Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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