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Lake JE, Feng H, Hyatt AN, Miao H, Debroy P, Funderburg N, Ailstock K, Dobs A, Haberlen S, Magnani JW, Margolick JB, McGowan K, Palella FJ, Witt MD, Bhasin S, Budoff MJ, Post WS, Brown TT. Transgender Women With Suppressed Testosterone Display Lower Burden of Coronary Disease Than Matched Cisgender Men. J Endocr Soc 2024; 8:bvae120. [PMID: 38974987 PMCID: PMC11223995 DOI: 10.1210/jendso/bvae120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Indexed: 07/09/2024] Open
Abstract
Context Cardiovascular disease (CVD) in transgender women (TW) may be affected by gender-affirming hormone therapy (GAHT) and HIV, but few data compare TW on contemporary GAHT to well-matched controls. Objective We compared CVD burden and biomarker profiles between TW and matched cisgender men (CM). Methods Adult TW on GAHT (n = 29) were recruited for a cross-sectional study (2018-2020). CM (n = 48) from the former Multicenter AIDS Cohort Study were matched 2:1 to TW on HIV serostatus, age ±5 years, race/ethnicity, BMI category and antiretroviral therapy (ART) type. Cardiac parameters were measured by CT and coronary atherosclerosis by coronary CT angiography; sex hormone and biomarker concentrations were measured centrally from stored samples. Results Overall, median age was 53 years and BMI 29 kg/m2; 69% were non-white. All participants with HIV (71%) had viral suppression on ART. Only 31% of TW had testosterone suppression (<50 ng/dL, TW-S). Traditional CVD risk factors were similar between groups, except that TW-S had higher BMI than TW with non-suppressed testosterone (TW-T). TW-S had no evidence of non-calcified coronary plaque or advanced coronary stenosis, whereas TW-T and CM had similar burden. TW had lower prevalence of any coronary plaque, calcified plaque and mixed plaque than CM, regardless of testosterone concentrations and HIV serostatus. Estradiol but not testosterone concentrations moderately and negatively correlated with the presence of coronary plaque and stenosis. Small sample size limited statistical power. Conclusion Older TW with suppressed total testosterone on GAHT had no CT evidence of non-calcified coronary plaque or advanced coronary stenosis. Longitudinal studies to understand relationships between GAHT and CVD risk in TW are needed.
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Affiliation(s)
- Jordan E Lake
- Department of Medicine, UTHealth Houston, Houston, TX 77030, USA
| | - Han Feng
- Tulane Research and Innovation for Arrhythmia Discoveries-TRIAD Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Ana N Hyatt
- Department of Medicine, UTHealth Houston, Houston, TX 77030, USA
| | - Hongyu Miao
- Department of Statistics and College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Paula Debroy
- Department of Medicine, UTHealth Houston, Houston, TX 77030, USA
| | - Nicholas Funderburg
- Division of Medical Laboratory Science, The Ohio State University, Columbus, OH 43210, USA
| | - Kate Ailstock
- Division of Medical Laboratory Science, The Ohio State University, Columbus, OH 43210, USA
| | - Adrian Dobs
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Sabina Haberlen
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Joseph B Margolick
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kate McGowan
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Frank J Palella
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Mallory D Witt
- Department of Medicine, Lundquist Institute, Torrance, CA 90502, USA
| | - Shalender Bhasin
- Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute, Torrance, CA 90502, USA
| | - Wendy S Post
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Todd T Brown
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
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András IE, Serrano N, Djuraskovic I, Fattakhov N, Sun E, Toborek M. Extracellular Vesicle-Serpine-1 Affects Neural Progenitor Cell Mitochondrial Networks and Synaptic Density: Modulation by Amyloid Beta and HIV-1. Mol Neurobiol 2023; 60:6441-6465. [PMID: 37458985 PMCID: PMC10533645 DOI: 10.1007/s12035-023-03456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/17/2023] [Indexed: 07/28/2023]
Abstract
Brain endothelial extracellular vesicles carrying amyloid beta (EV-Aβ) can be transferred to neural progenitor cells (NPCs) leading to NPC dysfunction. However, the events involved in this EV-mediated Aβ pathology are unclear. EV-proteomics studies identified Serpine-1 (plasminogen activator inhibitor 1, PAI-1) as a major connecting "hub" on several protein-protein interaction maps. Serpine-1 was described as a key player in Aβ pathology and was linked to HIV-1 infection as well. Therefore, the aim of this work was to address the hypothesis that Serpine-1 can be transferred via EVs from brain endothelial cells (HBMEC) to NPCs and contribute to NPC dysfunction. HBMEC concentrated and released Serpine-1 via EVs, the effect that was potentiated by HIV-1 and Aβ. EVs loaded with Serpine-1 were readily taken up by NPCs, and HIV-1 enhanced this event. Interestingly, a highly specific Serpine-1 inhibitor PAI039 increased EV-Aβ transfer to NPCs in the presence of HIV-1. PAI039 also partially blocked mitochondrial network morphology alterations in the recipient NPCs, which developed mainly after HIV + Aβ-EV transfer. PAI039 partly attenuated HIV-EV-mediated decreased synaptic protein levels in NPCs, while increased synaptic protein levels in NPC projections. These findings contribute to a better understanding of the complex mechanisms underlying EV-Serpine-1 related Aβ pathology in the context of HIV infection. They are relevant to HIV-1 associated neurocognitive disorders (HAND) in an effort to elucidate the mechanisms of neuropathology in HIV infection.
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Affiliation(s)
- Ibolya E. András
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
| | - Nelson Serrano
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
| | - Irina Djuraskovic
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
| | - Nikolai Fattakhov
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
| | - Enze Sun
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
| | - Michal Toborek
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, 1011 NW 15Th Street, Gautier Building, Room 528, Miami, FL 33136-1019 USA
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3
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András IE, Serrano N, Djuraskovic I, Fattakhov N, Sun E, Toborek M. Extracellular vesicle-Serpine-1 affects neural progenitor cell mitochondrial functions and synaptic density: modulation by amyloid beta and HIV-1. RESEARCH SQUARE 2023:rs.3.rs-2551245. [PMID: 36824983 PMCID: PMC9949237 DOI: 10.21203/rs.3.rs-2551245/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Brain endothelial extracellular vesicles carrying amyloid beta (EV-Aβ) can be transferred to neural progenitor cells (NPCs) leading to NPC dysfunction. However, the events involved in this EV-mediated Aβ pathology are unclear. EV-proteomics studies identified Serpine-1 (plasminogen activator inhibitor 1, PAI-1) as a major connecting "hub" on several protein-protein interaction maps. Serpine-1 was described as a key player in Aβ pathology and was linked to HIV-1 infection as well. Therefore, the aim of this work was to address the hypothesis that Serpine-1 can be transferred via EVs from brain endothelial cells to NPCs and contribute to NPC dysfunction. HBMEC concentrated and released Serpine-1 via EVs, the effect that was potentiated by HIV-1 and Aβ. EVs loaded with Serpine-1 were readily taken up by NPCs, and HIV-1 enhanced this event. Interestingly, a highly specific Serpine-1 inhibitor PAI039 increased EV-Aβ transfer to NPCs in the presence of HIV-1. PAI039 also partially blocked mitochondrial network morphology and mitochondrial function alterations in the recipient NPCs, which developed mainly after HIV + Aβ-EV transfer. PAI039 partly attenuated HIV-EV-mediated decreased synaptic protein levels in NPCs, while increased synaptic protein levels in NPC projections. These findings contribute to a better understanding of the complex mechanisms underlying EV-Serpine-1 related Aβ pathology in the context of HIV infection. They are relevant to HIV-1 associated neurocognitive disorders (HAND) in an effort to elucidate the mechanisms of neuropathology in HIV infection.
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Affiliation(s)
- Ibolya E András
- University of Miami Miller School of Medicine: University of Miami School of Medicine
| | - Nelson Serrano
- University of Miami Miller School of Medicine: University of Miami School of Medicine
| | - Irina Djuraskovic
- University of Miami Miller School of Medicine: University of Miami School of Medicine
| | - Nikolai Fattakhov
- University of Miami Miller School of Medicine: University of Miami School of Medicine
| | - Enze Sun
- University of Miami Miller School of Medicine: University of Miami School of Medicine
| | - Michal Toborek
- University of Miami Miller School of Medicine: University of Miami School of Medicine
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Schapkaitz E, Jacobson BF, Libhaber E. Pregnancy Related Venous Thromboembolism-Associated with HIV Infection and Antiretroviral Therapy. Semin Thromb Hemost 2022; 49:355-363. [PMID: 36055274 DOI: 10.1055/s-0042-1754391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Human immunodeficiency virus (HIV) infection in pregnancy is associated with substantial morbidity and mortality. Improved access to effective antiretroviral therapy (ART) has shifted the spectrum of pregnancy-related complications among HIV-infected pregnant women. In addition to placental vascular complications and preterm delivery, increased rates of venous thromboembolism (VTE) have been described. HIV infection is characterized by immune activation, inflammation, and endothelial dysfunction, which contribute to the activation of coagulation and its prothrombotic consequences. Indeed, activated coagulation factors have been reported to be increased and natural anticoagulants reduced in HIV. Several mechanisms for this persistent prothrombotic balance on ART have been identified. These may include: co-infections, immune recovery, and loss of the gastrointestinal mucosal integrity with microbial translocation. In addition to the direct effects of HIV and ART, traditional venous and obstetric risk factors also contribute to the risk of VTE. A research priority has been to understand the mechanisms of VTE in HIV-infected pregnant women receiving suppressive ART and to translate this into HIV-specific thromboprophylaxis recommendations. Management requires a multidisciplinary approach and further studies are indicated to guide the prevention and management of pregnancy-associated VTE in this population. The current review describes the epidemiology, mechanisms, and management of VTE in HIV-infected women in pregnancy and the postpartum period.
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Affiliation(s)
- Elise Schapkaitz
- Department of Molecular Medicine and Hematology, University of Witwatersrand, Johannesburg, South Africa
| | - Barry F Jacobson
- Department of Molecular Medicine and Hematology, University of Witwatersrand, Johannesburg, South Africa
| | - Elena Libhaber
- Department of Research Methodology and Statistics, University of Witwatersrand, Johannesburg, South Africa
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Christopher C, Nwogoh B, Akaba K, igwilo H, Abang R. Plasminogen Activator Inhibitor 1 (PAI-1) and Haematologic Parameters in HIV- Positive Patients on Protease Inhibitor-Based HAART Regimen: A Case-Control Study. Clin Appl Thromb Hemost 2022; 28:10760296221126176. [DOI: 10.1177/10760296221126176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Human immunodeficiency virus (HIV) infection is associated with an increased risk of hypercoagulability and treatment with antiretroviral agents especially protease inhibitors has also been reported to contribute to this risk. Altered fibrinolytic activity is reported as a mechanism of increased thrombotic risk in HIV patients on therapy. However, this has not been investigated in our environment. Objective: To evaluate and compare PAI-1 levels as a marker of thrombotic risk in HIV-infected persons on PI-based HAART regimen with those on non-PI-based therapy and to correlate PAI-1 with haematological parameters. Methods: This was a comparative cross-sectional study conducted at the University of Calabar Teaching Hospital (UCTH), Calabar, Cross River State. A total of 125 subjects including 45 HIV-positive patients on PI-based HAART regimen, 42 HIV-positive patients on non-PI-based HAART regimen and 38 Controls. The controls include 18 HIV-positive therapy naïve patients and 20 HIV-negative controls. PAI 1 and blood counts were estimated using standard methods. Data were analyzed using the IBM version of the statistical package for social sciences (SPSS) version 22. Statistical significance was set at 0.05. Result: The median PAI-1 level was significantly increased in patients on PI-based HAART regimen (p = 0.004). The blood counts did not differ significantly between patients on PI and non-PI-based HAART regimens (p > 0.05). There were no significant correlations between PAI-1 levels and blood counts (p > 0.05). Conclusion: PAI-1 level is elevated in HIV patients on PI-based HAART regimen. However, the association with thrombotic events could not be established in the study.
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Affiliation(s)
| | - Benedict Nwogoh
- Department of Haematology, University of Benin Teaching Hospital, Benin, Nigeria
| | - Kingsley Akaba
- Haematology and Blood Transfusion, University of Calabar, Calabar, Nigeria
| | - Hilary igwilo
- Department of Haematology, University of Calabar, Calabar, Nigeria
| | - Roger Abang
- Department of Psychiatry, Federal Neuro-Psychiatric Hospital Calabar, Calabar, Nigeria
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Ghosn J, Abdoul H, Fellahi S, Merlet A, Salmon D, Morini JP, Deleuze J, Blacher J, Capeau J, Bastard JP, Viard JP. Prevalence of Silent Atherosclerosis and Other Comorbidities in an Outpatient Cohort of Adults Living with HIV: Associations with HIV Parameters and Biomarkers. AIDS Res Hum Retroviruses 2021; 37:101-108. [PMID: 33076677 DOI: 10.1089/aid.2020.0182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
People living with HIV (PLWH) are at risk of noninfectious comorbidities. It is important to individualize those at higher risk. In a single-center cohort of PLWH, we performed a cross-sectional analysis of comorbidities, diagnosed according to standard procedures. The primary endpoint was the prevalence of subclinical carotid/coronary atherosclerosis. Secondary endpoints were its association with selected inflammatory/immune activation biomarkers and with other comorbidities. Associations were examined by using Chi-square or Fisher's exact test for categorical variables and Student or Wilcoxon tests for quantitative variables, and a stepwise multivariate logistical model was performed for further exploration. Among 790 participants [median age: 49.8 years (interquartile range, IQR: 44.5-55.6), 77.1% males, median CD4: 536/mm3 (IQR: 390-754), 83.6% with undetectable viral load], asymptomatic atherosclerosis was found in 26% and was associated in multivariate analysis with older age, longer known duration of infection, higher sCD14, and lower adiponectin levels. Hypertension was found in 33.5% of participants, diabetes in 19.4%, renal impairment in 14.6%, elevated low-density lipoprotein-cholesterol in 13.3%, elevated triglyceride/high-density lipoprotein (HDL)-cholesterol ratio in 6.6%, and osteoporosis in 7.9%. The presence of two or more comorbidities was found in 42.1% of participants and was associated in multivariate analysis with older age and longer exposure to antiretrovirals. Comorbidities were diversely associated with biomarkers: osteoporosis with higher IL-6, renal impairment with higher sCD14, hypertension with higher D-dimer, diabetes and elevated triglyceride/HDL-cholesterol ratio both with lower adiponectin and lower 25-hydroxyvitamin D. Asymptomatic atherosclerosis and multimorbidity were frequent in a cohort of middle-aged, well-controlled, PLWH and were associated with traditional and HIV-specific factors. Associations between morbidities and inflammatory/immune activation biomarkers were diverse.
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Affiliation(s)
- Jade Ghosn
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Hendy Abdoul
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Soraya Fellahi
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Audrey Merlet
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Dominique Salmon
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jean-Pierre Morini
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jean Deleuze
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jacques Blacher
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jacqueline Capeau
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jean-Philippe Bastard
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
| | - Jean-Paul Viard
- Immunology-Infectious Diseases Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Centre-Université de Paris, Paris, France
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Ragino YI, Stakhneva EM, Polonskaya YV, Kashtanova EV. The Role of Secretory Activity Molecules of Visceral Adipocytes in Abdominal Obesity in the Development of Cardiovascular Disease: A Review. Biomolecules 2020; 10:biom10030374. [PMID: 32121175 PMCID: PMC7175189 DOI: 10.3390/biom10030374] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/11/2022] Open
Abstract
Adipose tissue is considered one of the endocrine organs in the body because of its ability to synthesize and release a large number of hormones, cytokines, and growth and vasoactive factors that influence a variety of physiological and pathophysiological processes, such as vascular tone, inflammation, vascular smooth muscle cell migration, endothelial function, and vascular redox state. Moreover, genetic factors substantially contribute to the risk of obesity. Research into the biochemical effects of molecules secreted by visceral adipocytes as well as their molecular genetic characteristics is actively conducted around the world mostly in relation to pathologies of the cardiovascular system, metabolic syndrome, and diabetes mellitus. Adipokines could be developed into biomarkers for diagnosis, prognosis, and therapeutic targets in different diseases. This review describes the relevance of secretory activity molecules of visceral adipocytes in cardiovascular disease associated abdominal obesity.
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So-Armah K, Freiberg MS. HIV and Cardiovascular Disease: Update on Clinical Events, Special Populations, and Novel Biomarkers. Curr HIV/AIDS Rep 2019; 15:233-244. [PMID: 29752699 DOI: 10.1007/s11904-018-0400-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The objective of this review is to provide an update on the link between HIV infection and cardiovascular disease (CVD). We will focus our review mainly on literature describing clinical CVD events and understudied topics of importance. RECENT FINDINGS Heart failure, peripheral artery disease, and stroke are CVD modalities deserving more attention in the context of HIV infection in the highly active antiretroviral therapy era. Incidence data on clinical CVD from HIV populations in low- and middle-income countries are limited. Multisubstance use is common in HIV, but understudied as a moderator or mediator of the association between HIV and CVD. CVD risk assessment in HIV remains challenging, but new research into novel biomarkers may provide further insights. There is also a need for inclusion of non-biologic factors in our attempts to understand, quantify, and predict CVD risk among PLWHA. Significant attention has been paid to generating and testing hypotheses to understand the mechanisms of myocardial infarction in HIV. Similar attention is deserving for heart failure, PAD, stroke, and cardiovascular disease risk in resource-limited settings and among substance users with HIV.
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Affiliation(s)
- Kaku So-Armah
- School of Medicine, Boston University, Boston, MA, USA.
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Bastard JP, Couffignal C, Fellahi S, Bard JM, Mentre F, Salmon D, Katlama C, Raffi F, Leport C, Capeau J. Diabetes and dyslipidaemia are associated with oxidative stress independently of inflammation in long-term antiretroviral-treated HIV-infected patients. DIABETES & METABOLISM 2019; 45:573-581. [PMID: 30862472 DOI: 10.1016/j.diabet.2019.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 12/31/2022]
Abstract
AIM Ageing HIV-infected patients controlled by antiretroviral therapy (ART) frequently present age-related comorbidities, such as cardiovascular (CV) events, diabetes, dyslipidaemia, hypertension and chronic kidney disease (CKD). The prevalence of these comorbidities was evaluated in a cohort of long-term-monitored ART-controlled HIV-infected patients, then followed by a search into whether oxidative stress, like inflammation, might be associated with metabolic parameters and/or comorbidities. METHODS Included were 352 long-term ART patients who started with protease inhibitors (PIs) in 1997-1999. They were evaluated at their final visit, 11 years later, for previous CV events, prevalence of diabetes, LDL-related and atherogenic (high TG/HDL) dyslipidaemias, hypertension and CKD. Also measured were circulating biomarkers to explore oxidative stress (Lp-PLA2, oxLDL, oxLDL/LDL ratio, paraoxonase and arylesterase activities), inflammation/immune activation (hsCRP, hsIL-6, D dimer, soluble CD14, β2 microglobulin, cystatin C), adipokines and insulin resistance. Levels were compared in patients with and without each comorbidity or condition using non-parametric correlation tests and multivariate adjusted analyses. RESULTS At the final visit, 81.5% of patients were male and were aged (median, IQR) 49 years (45-56); BMI was 23.0 kg/m2 (21.1-25.4), CD4+ lymphocytes were 620 cells/mm3 (453-790) and 91.5% had undetectable HIV-1 viral loads. The prevalence of diabetes was 11%, and LDL-related dyslipidaemia 28%, atherogenic dyslipidaemia 9%, hypertension 28%, CKD 9% and previous CV events 9%. Diabetes and atherogenic dyslipidaemia were associated with increased oxidative stress and independently with inflammation. LDL-related dyslipidaemia and impaired fasting glucose were associated with increased oxidative stress. No association of these biomarkers was detected with hypertension, CKD and previous CV events. CONCLUSION In long-term-treated HIV-infected patients with frequent comorbid conditions, oxidative stress could be contributing to diabetes and LDL-related and atherogenic dyslipidaemias independently of inflammation.
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Affiliation(s)
- J-P Bastard
- Faculty of medicine, Sorbonne université, inserm UMR_S938, ICAN, AP-HP, hôpital Tenon, 27, rue Chaligny, 75571 Paris cedex 12, Paris, France
| | - C Couffignal
- Université Paris Diderot, Sorbonne Paris Cité, inserm UMR_S1137, COREB APHP, 16, rue Henri-Huchard, 75890 Paris cedex 18, France
| | - S Fellahi
- Faculty of medicine, Sorbonne université, inserm UMR_S938, ICAN, AP-HP, hôpital Tenon, 27, rue Chaligny, 75571 Paris cedex 12, Paris, France
| | - J-M Bard
- UFR des sciences pharmaceutiques et biologiques, MMS - EA 2160, IUML FR3473 CNRS, Nantes and institut de cancérologie de l'Ouest, 4, rue Bras France, BP61112, 44035 Nantes cedex 1, France
| | - F Mentre
- Université Paris Diderot, Sorbonne Paris Cité, inserm UMR_S1137, COREB APHP, 16, rue Henri-Huchard, 75890 Paris cedex 18, France
| | - D Salmon
- Service des maladies infectieuses et tropicales, hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - C Katlama
- Service de maladies infectieuses et tropicales hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Universités, UPMC Université Paris-6, inserm UMR_S1136 IPLESP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - F Raffi
- Service des maladies infectieuses et tropicales, inserm CIC 1413, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - C Leport
- Université Paris Diderot, Sorbonne Paris Cité, inserm UMR_S1137, COREB APHP, 16, rue Henri-Huchard, 75890 Paris cedex 18, France
| | - J Capeau
- Faculty of medicine, Sorbonne université, inserm UMR_S938, ICAN, AP-HP, hôpital Tenon, 27, rue Chaligny, 75571 Paris cedex 12, Paris, France.
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Kamtchum-Tatuene J, Mwandumba H, Al-Bayati Z, Flatley J, Griffiths M, Solomon T, Benjamin L. HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 6:e531. [PMID: 30697583 PMCID: PMC6340379 DOI: 10.1212/nxi.0000000000000531] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/16/2018] [Indexed: 11/15/2022]
Abstract
Objective To study the relationship between endothelial dysfunction, HIV infection, and stroke in Malawians. Methods Using a cross-sectional design, we measured plasma levels of intercellular adhesion molecule-1 (ICAM-1), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), and soluble thrombomodulin (sTM) in stroke patients and controls, stratified by HIV status. These biomarkers were measured using ELISA. After dichotomization, each biomarker was used as the dependent variable in a multivariable logistic regression model. Primary independent variables included HIV and stroke status. Adjustment variables were age, sex, hypertension, diabetes mellitus, tobacco and alcohol consumption, personal/family history of stroke, antiretroviral therapy status, and hypercholesterolemia. Results Sixty-one stroke cases (19 HIV+) and 168 controls (32 HIV+) were enrolled. The median age was 55 years (38.5–65.0) for controls and 52 years (38.0–73.0) for cases (p = 0.38). The median CD4+ T-cell count was 260.1 cells/mm3 (156.3–363.9) and 452 cells/mm3 (378.1–527.4) in HIV-infected cases and controls, respectively. HIV infection was independently associated with high levels of ICAM-1 (OR = 3.6, 95% CI: 1.3–10.6, p = 0.018) in controls but not in stroke cases even after excluding patients with a viral load >1,000 RNA copies/mL (OR = 4.1, 95% CI: 1.3–13.1, p = 0.017). There was no association between the clinical profiles of HIV-positive controls or HIV-positive stroke and high levels of PAI-1, VEGF, and sTM. Conclusions HIV infection is associated with endothelial activation despite antiretroviral treatment. Our findings underscore the need for larger clinical cohorts to better understand the contribution of this perturbation of the endothelial function to the increasing burden of cardiovascular diseases in sub-Saharan Africa.
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Affiliation(s)
- Joseph Kamtchum-Tatuene
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Henry Mwandumba
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Zaid Al-Bayati
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Janet Flatley
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Michael Griffiths
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Tom Solomon
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
| | - Laura Benjamin
- Institute of Infection and Global Health (J.K.-T., Z.A.-B., J.F., M.G., T.S., L.B.), University of Liverpool; Malawi-Liverpool-Wellcome Trust Clinical Research Programme (J.K.-T., H.M.), University of Malawi College of Medicine, Blantyre; Department of Clinical Sciences (H.M.), Liverpool School of Tropical Medicine, United Kingdom
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11
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Moreno-Perez O, Reyes-Garcia R, Muñoz-Torres M, Merino E, Boix V, Reus S, Giner L, Alfayate R, Garcia-Fontana B, Sanchez-Paya J, Picó A, Portilla J. High Irisin levels in nondiabetic HIV-infected males are associated with insulin resistance, nonalcoholic fatty liver disease, and subclinical atherosclerosis. Clin Endocrinol (Oxf) 2018; 89:414-423. [PMID: 29947044 DOI: 10.1111/cen.13800] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 06/24/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE HIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, nonalcoholic fatty liver disease (NAFLD) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV-infected males. DESIGN Cross-sectional study in a cohort of HIV-infected patients. PATIENTS Inclusion criteria: men older than 18 years; antiretroviral therapy (ART) -naïve or on effective ART (<50 HIV-1 RNA copies/mL) without changes in the previous 6 months; no diabetes or hepatitis C. MEASUREMENTS Irisin was measured by enzymatic immunoassay (Phoenix Pharmaceuticals), insulin sensitivity by homeostasis model assessment of insulin resistance (HOMA-IR), as well as the 2-hour continuous infusion of glucose with model assessment (CIGMA-HOMA). Hepatic steatosis was measured by 1-H magnetic resonance spectroscopy, subclinical atherosclerosis by evaluation of carotid intima-media thickness (C-IMT), measured by Ultrasonography. RESULTS Eight nine men (age 42.0 ± 8.3 years, duration of HIV infection 7.9 ± 5.6 years, CD4 count 547 ± 279 cells/mL) were included. Circulating irisin was positively related to HOMA-IR and CIGMA-HOMA, hepatic triglyceride content, and to VAT/SAT ratio. Higher irisin concentrations were associated with higher C-IMT, although this association did not persist in multivariate analysis. Lipodystrophy and a higher baseline PAI-1 concentration were independently associated with C-IMT. CONCLUSIONS In male HIV patients without diabetes, higher irisin concentrations are positively associated with insulin resistance, NAFLD and subclinical atherosclerosis. However, waist-hip-ratio is the main determinant of insulin resistance, and PAI-1 and lipodystrophy were the strongest determinants of IMT in this population.
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Affiliation(s)
- Oscar Moreno-Perez
- Endocrinology and Nutrition Service, University General Hospital of Alicante, Alicante, Spain
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Rebeca Reyes-Garcia
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
- Endocrinology Service, Complejo Hospitalario Torrecardenas, Almeria, Spain
| | - Manuel Muñoz-Torres
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | - Esperanza Merino
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Vicente Boix
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Sergio Reus
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Livia Giner
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Rocío Alfayate
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Hormone Laboratory, University General Hospital of Alicante, Alicante, Spain
| | - Beatriz Garcia-Fontana
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | - Jose Sanchez-Paya
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Preventive Medicine Department, University General Hospital of Alicante, Alicante, Spain
| | - Antonio Picó
- Endocrinology and Nutrition Service, University General Hospital of Alicante, Alicante, Spain
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Joaquín Portilla
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
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12
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Ahlström MG, Knudsen A, Ullum H, Gerstoft J, Kjaer A, Lebech AM, Hasbak P, Obel N. Association between smoking status assessed with plasma-cotinine and inflammatory and endothelial biomarkers in HIV-positive and HIV-negative individuals. HIV Med 2018; 19:679-687. [DOI: 10.1111/hiv.12647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- MG Ahlström
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A Knudsen
- Department of Infectious Diseases; Copenhagen University Hospital; Hvidovre Denmark
| | - H Ullum
- Department of Clinical Immunology; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - J Gerstoft
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A Kjaer
- Department of Nuclear Physiology; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - A-M Lebech
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - P Hasbak
- Department of Nuclear Physiology; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - N Obel
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
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13
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Jung RG, Motazedian P, Ramirez FD, Simard T, Di Santo P, Visintini S, Faraz MA, Labinaz A, Jung Y, Hibbert B. Association between plasminogen activator inhibitor-1 and cardiovascular events: a systematic review and meta-analysis. Thromb J 2018; 16:12. [PMID: 29991926 PMCID: PMC5987541 DOI: 10.1186/s12959-018-0166-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/05/2018] [Indexed: 12/17/2022] Open
Abstract
Background Small studies have implicated plasminogen activator inhibitor-1 (PAI-1) as a predictor of cardiovascular events; however, these findings have been inconsistent. We sought out to examine the potential role of PAI-1 as a marker for major adverse cardiovascular events (MACE). Methods We systematically reviewed all indexed studies examining the association between PAI-1 and MACE (defined as death, myocardial infarction, or cerebrovascular accident) or restenosis. EMBASE, Web of Science, Medline, and the Cochrane Library were searched through October 2016 to identify relevant studies, supplemented by letters to authors and review of citations. Studies reporting the results of PAI-1 antigen and/or activity levels in association with MACE in human subjects were included. Results Of 5961 articles screened, we identified 38 articles published between 1991 to 2016 that reported PAI-1 levels in 11,557 patients. In studies that examined PAI-1 antigen and activity levels, 15.1% and 29.6% of patients experienced MACE, respectively. Patients with MACE had higher PAI-1 antigen levels with a mean difference of 6.11 ng/mL (95% CI, 3.27-8.96). This finding was similar among patients with and without known coronary artery disease. Comparatively, studies that stratified by PAI-1 activity levels were not associated with MACE. In contrast, studies of coronary restenosis suggest PAI-1 antigen and activity levels are negatively associated with MACE. Conclusions Elevated plasma PAI-1 antigen levels are associated with MACE. Definitive studies are needed to ascertain if PAI-1 acts simply as a marker of risk or if it is indeed a bona fide therapeutic target. Electronic supplementary material The online version of this article (10.1186/s12959-018-0166-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Richard G Jung
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Pouya Motazedian
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - F Daniel Ramirez
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada.,5School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON Canada
| | - Trevor Simard
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Pietro Di Santo
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Sarah Visintini
- 6Berkman Library, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Mohammad Ali Faraz
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - Alisha Labinaz
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - Young Jung
- 7Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
| | - Benjamin Hibbert
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
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14
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Song C, Burgess S, Eicher JD, O'Donnell CJ, Johnson AD. Causal Effect of Plasminogen Activator Inhibitor Type 1 on Coronary Heart Disease. J Am Heart Assoc 2017; 6:JAHA.116.004918. [PMID: 28550093 PMCID: PMC5669150 DOI: 10.1161/jaha.116.004918] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Plasminogen activator inhibitor type 1 (PAI‐1) plays an essential role in the fibrinolysis system and thrombosis. Population studies have reported that blood PAI‐1 levels are associated with increased risk of coronary heart disease (CHD). However, it is unclear whether the association reflects a causal influence of PAI‐1 on CHD risk. Methods and Results To evaluate the association between PAI‐1 and CHD, we applied a 3‐step strategy. First, we investigated the observational association between PAI‐1 and CHD incidence using a systematic review based on a literature search for PAI‐1 and CHD studies. Second, we explored the causal association between PAI‐1 and CHD using a Mendelian randomization approach using summary statistics from large genome‐wide association studies. Finally, we explored the causal effect of PAI‐1 on cardiovascular risk factors including metabolic and subclinical atherosclerosis measures. In the systematic meta‐analysis, the highest quantile of blood PAI‐1 level was associated with higher CHD risk comparing with the lowest quantile (odds ratio=2.17; 95% CI: 1.53, 3.07) in an age‐ and sex‐adjusted model. The effect size was reduced in studies using a multivariable‐adjusted model (odds ratio=1.46; 95% CI: 1.13, 1.88). The Mendelian randomization analyses suggested a causal effect of increased PAI‐1 level on CHD risk (odds ratio=1.22 per unit increase of log‐transformed PAI‐1; 95% CI: 1.01, 1.47). In addition, we also detected a causal effect of PAI‐1 on elevating blood glucose and high‐density lipoprotein cholesterol. Conclusions Our study indicates a causal effect of elevated PAI‐1 level on CHD risk, which may be mediated by glucose dysfunction.
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Affiliation(s)
- Ci Song
- Framingham Heart Study, Framingham, MA .,The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - John D Eicher
- Framingham Heart Study, Framingham, MA.,The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Christopher J O'Donnell
- Framingham Heart Study, Framingham, MA.,Cardiology Section and Center for Population Genomics, Boston Veteran's Administration (VA) Healthcare, Boston, MA
| | - Andrew D Johnson
- Framingham Heart Study, Framingham, MA.,The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD
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15
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Biomarcadores inmunológicos de riesgo cardiovascular en la infección por el virus de inmunodeficiencia humana-1. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2016.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Leung V, Chiu YL, Kotler DP, Albu J, Zhu YS, Ham K, Engelson ES, Hammad H, Christos P, Donovan DS, Ginsberg HN, Glesby MJ. Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation. HIV CLINICAL TRIALS 2016; 17:55-62. [PMID: 27077672 DOI: 10.1080/15284336.2015.1126424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVE In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of rhGH and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers. METHODS 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks. Subjects with plasma and serum samples available at weeks 0 (n=63) and 12 (n=46-48) were assessed for adiponectin, C-reactive protein, homocysteine, interleukin-1, interleukin-6, tumor necrosis factor alpha, interferon gamma, fibrinogen, plasminogen activator inhibitor-1 antigen, and tissue plasminogen activator antigen. RESULTS Treatment with both rosiglitazone alone and the combination of rosiglitazone and rhGH for 12 weeks resulted in significant increases in adiponectin levels from baseline. Adiponectin levels did not change significantly in the rhGH arm alone . There were no significant changes in the other biomarkers among the different treatment groups. DISCUSSION In this study of HIV-infected patients with altered fat distribution, treatment with rosiglitazone had beneficial effects on adiponectin concentrations, an effect that was also seen with a combination of rosiglitazone and rhGH. RhGH administration alone, however, did not demonstrate any significant impact on adiponectin levels despite reductions in VAT.
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Affiliation(s)
- Vivien Leung
- a Department of Medicine , Weill Cornell Medical College , New York , NY , USA.,e Department of Medicine , Bronx-Lebanon Hospital Center , Bronx , NY , USA
| | - Ya-Lin Chiu
- b Department of Healthcare Policy and Research , Weill Cornell Medical College , New York , NY , USA
| | - Donald P Kotler
- c Department of Medicine , Mount Sinai St. Luke's-Roosevelt Hospital Center , New York , NY , USA
| | - Jeanine Albu
- c Department of Medicine , Mount Sinai St. Luke's-Roosevelt Hospital Center , New York , NY , USA
| | - Yuan-Shan Zhu
- a Department of Medicine , Weill Cornell Medical College , New York , NY , USA
| | - Kirsis Ham
- a Department of Medicine , Weill Cornell Medical College , New York , NY , USA
| | - Ellen S Engelson
- c Department of Medicine , Mount Sinai St. Luke's-Roosevelt Hospital Center , New York , NY , USA
| | - Hoda Hammad
- b Department of Healthcare Policy and Research , Weill Cornell Medical College , New York , NY , USA
| | - Paul Christos
- b Department of Healthcare Policy and Research , Weill Cornell Medical College , New York , NY , USA
| | - Daniel S Donovan
- d Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA
| | - Henry N Ginsberg
- d Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA
| | - Marshall J Glesby
- a Department of Medicine , Weill Cornell Medical College , New York , NY , USA.,b Department of Healthcare Policy and Research , Weill Cornell Medical College , New York , NY , USA
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17
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Rasmussen LJH, Knudsen A, Katzenstein TL, Gerstoft J, Obel N, Jørgensen NR, Kronborg G, Benfield T, Kjaer A, Eugen-Olsen J, Lebech AM. Soluble urokinase plasminogen activator receptor (suPAR) is a novel, independent predictive marker of myocardial infarction in HIV-1-infected patients: a nested case-control study. HIV Med 2015; 17:350-7. [PMID: 26365671 PMCID: PMC5054925 DOI: 10.1111/hiv.12315] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 01/12/2023]
Abstract
Objectives Patients infected with HIV are at increased risk of myocardial infarction (MI). Increased plasma levels of the inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) have been associated with increased risk of cardiovascular diseases (CVD), including MI in the general population. We tested suPAR as a predictive biomarker of MI in HIV‐1‐infected individuals. Methods suPAR levels were investigated in a nested case‐control study of 55 HIV‐1‐infected cases with verified first‐time MI and 182 HIV‐1‐infected controls with no known CVD. Controls were matched for age, gender, duration of antiretroviral therapy (ART), smoking and no known CVD. suPAR was measured in the four plasma samples available for each patient at different time‐points; 1, Before initiation of ART; 2, 3 months after initiation of ART; 3, 1 year before the case's MI; and 4, The last sample available before the case's MI. Results In unadjusted conditional regression analysis, higher levels of suPAR were associated with a significant increase in risk of MI at all time‐points. Patients in the third and fourth suPAR quartiles had a three‐ to 10‐fold higher risk of MI compared to patients in the lowest suPAR quartile at all time‐points. suPAR remained a strong significant predictor of MI, when adjusting for HIV‐1 RNA, total cholesterol, triglycerides and high‐density lipoprotein. Conclusion Elevated suPAR levels were associated with increased risk of MI in HIV‐infected patients, suggesting that suPAR could be a useful biomarker for prediction of first‐time MI in this patient group, even years before the event.
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Affiliation(s)
- L J H Rasmussen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - A Knudsen
- Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - T L Katzenstein
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - J Gerstoft
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - N Obel
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - N R Jørgensen
- Department of Diagnostics and Medicine, Research Centre for Aging and Osteoporosis, Copenhagen University Hospital Glostrup, Glostrup, Denmark
| | - G Kronborg
- Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - T Benfield
- Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - A Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - J Eugen-Olsen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - A-M Lebech
- Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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18
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The Effect of PAI-1 4G/5G Polymorphism and Clinical Factors on Coronary Artery Occlusion in Myocardial Infarction. DISEASE MARKERS 2015; 2015:260101. [PMID: 26273123 PMCID: PMC4529953 DOI: 10.1155/2015/260101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/06/2015] [Indexed: 01/16/2023]
Abstract
Objective. Data on the impact of PAI-1-675 4G/5G genotype for fibrinolysis during myocardial infarction are inconsistent. The aim of our study was to evaluate the association of clinical and genetic (PAI-1-675 4G/5G polymorphism) factors with coronary artery occlusion in patients with myocardial infarction. Materials and Methods. PAI-1-675 4G/5G detection was achieved by using Sanger sequencing in a sample of patients hospitalized for stent implantation due to myocardial infarction. We categorized the patients into two groups: patients with coronary artery occlusion and patients without coronary artery occlusion according to angiographic evaluation. Results. We identified n = 122 (32.4%) 4G/4G, n = 186 (49.5%) 4G/5G, and n = 68 (18.1%) 5G/5G PAI-1 genotype carriers. Univariate and multivariate analysis showed that only the 4G/5G genotype was associated with coronary artery occlusion (OR: 1.656 and 95% CI: 1.009–2.718, p = 0.046). Conclusions. Our results showed that carriers of PAI-1 4G/5G genotype with myocardial infarction have increased odds of coronary artery occlusion more than 1.6 times in comparison to the carriers of homozygous genotypes.
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19
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Knudsen A, Hag AMF, Loft A, von Benzon E, Keller SH, Møller HJ, Lebech AM, Ripa RS, Kjær A. HIV infection and arterial inflammation assessed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET): a prospective cross-sectional study. J Nucl Cardiol 2015; 22:372-80. [PMID: 25467249 PMCID: PMC4353859 DOI: 10.1007/s12350-014-0032-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/27/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND HIV-infected patients are at increased risk of myocardial infarction and arterial inflammation has been suggested as a pathophysiological explanation. We compared the uptake of (18)F-fluorodeoxyglucose (FDG) by PET in four arterial regions, and factors associated with FDG uptake in well-treated HIV-infected patients without cardiovascular disease (CVD) and healthy controls. METHODS AND RESULTS We prospectively scanned 26 HIV-infected patients on stable antiretroviral therapy and 25 healthy volunteers with FDG PET/CT, measuring standardized uptake values (SUV) in the carotid arteries, the ascending, descending, and abdominal aorta. We performed correlation analyses between FDG uptake and intima-media thickness (IMT), and soluble biomarkers of inflammation. We found no difference in arterial FDG uptake between the HIV-infected patients and healthy controls quantified either as mean SUVmax or target-to background ratio in the carotid region, the ascending aorta, the descending aorta, or the abdominal aorta. Correlations between SUV, IMT, and soluble biomarkers were scarce in both groups. CONCLUSION In a group of optimally treated HIV-infected patients with full viral suppression, low Framingham risk score and no known CVD, we found no evidence of increased arterial inflammation as assessed by FDG PET/CT compared to healthy volunteers.
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Affiliation(s)
- Andreas Knudsen
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, 2650, Hvidovre, Denmark,
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20
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András IE, Rampersaud E, Eum SY, Toborek M. Transcriptional profile of HIV-induced nuclear translocation of amyloid β in brain endothelial cells. Arch Med Res 2014; 45:744-52. [PMID: 25446617 DOI: 10.1016/j.arcmed.2014.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/03/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Increased amyloid deposition in HIV-infected brains may contribute to the pathogenesis of neurocognitive dysfunction in infected patients. We have previously shown that exposure to HIV results in enhanced amyloid β (Aβ) levels in human brain microvascular endothelial cells, suggesting that brain endothelial cells contribute to accumulation of Aβ in HIV-infected brains. Importantly, Aβ not only accumulates in the cytoplasm of HIV-exposed cells but also enters the nuclei of brain endothelial cells. METHODS cDNA microarray analysis was performed in order to examine changes in the transcriptional profile associated with Aβ nuclear entry in the presence of HIV-1. RESULTS Gene network analysis indicated that inhibition of nuclear entry of Aβ resulted in enrichment in gene sets involved in apoptosis and survival, endoplasmic reticulum stress response, immune response, cell cycle, DNA damage, oxidative stress, cytoskeleton remodeling and transforming growth factor β (TGFβ) receptor signaling. CONCLUSIONS The obtained data indicate that HIV-induced Aβ nuclear uptake affects several cellular stress-related pathways relevant for HIV-induced Aβ pathology.
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Affiliation(s)
- Ibolya E András
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, Florida.
| | - Evadnie Rampersaud
- Division of Genetic Epidemiology, Hussman Institute for Human Genomics, Miami, Florida
| | - Sung Yong Eum
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, Florida
| | - Michal Toborek
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, Florida
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Functional stability of plasminogen activator inhibitor-1. ScientificWorldJournal 2014; 2014:858293. [PMID: 25386620 PMCID: PMC4214104 DOI: 10.1155/2014/858293] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/17/2014] [Indexed: 12/23/2022] Open
Abstract
Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of plasminogen activators, such as tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA), and a major regulator of the fibrinolytic system. PAI-1 plays a pivotal role in acute thrombotic events such as deep vein thrombosis (DVT) and myocardial infarction (MI). The biological effects of PAI-1 extend far beyond thrombosis including its critical role in fibrotic disorders, atherosclerosis, renal and pulmonary fibrosis, type-2 diabetes, and cancer. The conversion of PAI-1 from the active to the latent conformation appears to be unique among serpins in that it occurs spontaneously at a relatively rapid rate. Latency transition is believed to represent a regulatory mechanism, reducing the risk of thrombosis from a prolonged antifibrinolytic action of PAI-1. Thus, relying solely on plasma concentrations of PAI-1 without assessing its function may be misleading in interpreting the role of PAI-1 in many complex diseases. Environmental conditions, interaction with other proteins, mutations, and glycosylation are the main factors that have a significant impact on the stability of the PAI-1 structure. This review provides an overview on the current knowledge on PAI-1 especially importance of PAI-1 level and stability and highlights the potential use of PAI-1 inhibitors for treating cardiovascular disease.
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