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Claudio U, Antonio A, Marcella R, Erica C, Jacopo V, Katia F. Association of inflammatory biomarkers and cardiovascular risk scores in an Italian cohort of HIV positive patient undergoing antiretroviral therapy. Curr HIV Res 2022; 20:CHR-EPUB-124764. [PMID: 35748553 DOI: 10.2174/1570162x2002220623163705] [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: 12/31/2021] [Revised: 01/28/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Several algorithms have been developed to predict cardiovascular risk (CVR) over time, however none of them seem to be accurate when applied to HIV patients. OBJECTIVE The aim of this study was to assess plasma inflammatory biomarkers in relation to multiple CVR scores (FRS, ASCVD, PROCAM and the DAD-5 Years-Estimated-Risk) in an Italian cohort of HIV patients undergoing a combined Antiretroviral Therapy (cART). METHODS We enrolled HIV patients undergoing cART without any change in the HIV-related pharmacological therapy over the last 48 weeks Demographic and anamnestic data were collected, and a biochemical panel including the following biomarkers was collected: CRP, Cystatin-C, microalbuminuria, IL-18, IL-2, IL-4, IL-6, IL-10, TNF-α and IFN- γ. CVR scores were obtained for each patient and compared to the biochemical panel to assess statistical correlation. RESULTS 90 Caucasian HIV patients were enrolled. Assessment of CVR scores showed FRS values of 6.98±6.11%, ASCVD 7.18±6.25%, PROCAM 6.7±7.4% and DAD-5 Years Estimated Risk 3.10±3.41%. We found correlations between the levels of circulating cytokines measured and the cardiovascular risk prediction scores. CONCLUSIONS Our data showed that the values of selected inflammatory biomarkers strongly correlate with the CVR scores, suggesting that they can be employed as reliable predictors of cardiovascular disease in HIV patients. The routine use of selected biomarkers associated with systemic inflammation could be a valid and readily available tool for clinicians to assess and monitor cardiovascular risk in HIV patients. .
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Affiliation(s)
- Ucciferri Claudio
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d' Annunzio", Chieti-Pescara, Italy
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Auricchio Antonio
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d' Annunzio", Chieti-Pescara, Italy
| | - Reale Marcella
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University \'G. d\'Annunzio\', Chieti- Pescara, Italy
| | - Costantini Erica
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University \'G. d\'Annunzio\', Chieti- Pescara, Italy
| | - Vecchiet Jacopo
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d' Annunzio", Chieti-Pescara, Italy
| | - Falasca Katia
- Clinic of Infectious Diseases Dept. of Medicine and Science of Aging University "G. d'Annunzio" Chieti-Pescara Via dei Vestini 31, Chieti, Italy
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2
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Martinez CA, Rikhi R, Pester MS, Parker M, Gonzalez A, Larson M, Chavez J, Mendez A, Raines JK, Kolber MA, Schulman IH, Alcaide ML, Hurwitz BE. Abacavir antiretroviral therapy and indices of subclinical vascular disease in persons with HIV. PLoS One 2022; 17:e0264445. [PMID: 35271614 PMCID: PMC8912137 DOI: 10.1371/journal.pone.0264445] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 02/10/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Indices of cardiovascular disease (CVD) risk, vascular endothelial dilation, arterial stiffness and endothelial repair were examined in persons with HIV (PWH) on an antiretroviral therapy (ART) that included abacavir (ABC+) in comparison with PWH on ART without abacavir (ABC-), and with HIV seronegative (HIV-) individuals. Approach The 115 participants (63% men), aged 30–50 years, did not have CVD, metabolic, endocrine, or chronic renal conditions. PWH were on stable ART for six-months or more. Vascular assessments included flow-mediated dilation (FMD), aortic, radial and femoral arterial stiffness (cAIx, crPWV, cfPWV), and thigh and calf arterial compliance (Vmax50). Endothelial repair was indexed by endothelial progenitor cell colony forming units (EPC-CFU). Traditional CVD risk measures included blood pressure, central adiposity, lipids, insulin resistance (HOMA-IR), CRP and ASCVD score. Analyses controlled for demographics (age, sex, education), medications (antihypertensive, statin/fibrate, antipsychotic), and substance abuse (ASSIST). Results No group differences were observed in central adiposity, HOMA-IR, CRP, or ASCVD risk score. However, the ABC- group displayed greater dyslipidemia. The ABC+ group displayed no difference on FMD, cAIx, cfPWV or calf Vmax50 compared with other groups. When CD4 count and viral load were controlled, no additional differences between the ABC+ and ABC- groups emerged. Analyses of crPWV and thigh Vmax50 suggested supported by a trend toward lower EPC-CFU in the HIV+ groups than the HIV- group. Conclusions Findings indicate that ABC treatment of 30–50 year-old PWH on stable ART is not likely to contribute in a robust way to higher CVD risk.
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Affiliation(s)
- Claudia A. Martinez
- Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
| | - Rishi Rikhi
- Division of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Mollie S. Pester
- Behavioral Medicine Research Center, University of Miami, Miami, Florida, United States of America
- Department of Psychology, University of Miami, Coral Gables, Florida, United States of America
| | - Meela Parker
- Behavioral Medicine Research Center, University of Miami, Miami, Florida, United States of America
| | - Alex Gonzalez
- Behavioral Medicine Research Center, University of Miami, Miami, Florida, United States of America
| | - Michaela Larson
- Department of Public Health Science, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Jennifer Chavez
- Department of Public Health Science, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Armando Mendez
- Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Jeffrey K. Raines
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Michael A. Kolber
- Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Ivonne H. Schulman
- Katz Family Division of Nephrology & Hypertension, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Maria L. Alcaide
- Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Barry E. Hurwitz
- Behavioral Medicine Research Center, University of Miami, Miami, Florida, United States of America
- Department of Psychology, University of Miami, Coral Gables, Florida, United States of America
- Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
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3
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Arnaiz de Las Revillas F, Gonzalez-Quintanilla V, Parra JA, Palacios E, Gonzalez-Rico C, Armiñanzas C, Gutiérrez-Cuadra M, Oterino A, Fariñas-Alvarez C, Fariñas MC. Evaluation of endothelial function and subclinical atherosclerosis in patients with HIV infection. Sci Rep 2021; 11:18431. [PMID: 34531450 PMCID: PMC8446055 DOI: 10.1038/s41598-021-97795-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/29/2021] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to analyse the association between human immunodeficiency virus (HIV) related clinical and analytical parameters and the presence of subclinical atherosclerosis as well as endothelial dysfunction. This was a prospective cohort study of HIV-positive patients who underwent intima media thickness (IMT) determination and coronary artery calcium scoring to determine subclinical atherosclerosis. To detect endothelial dysfunction, the breath holding index, flow-mediated dilation and the concentration of endothelial progenitor cells (EPCs) were measured. Patients with an IMT ≥ 0.9 mm had an average of 559.3 ± 283.34 CD4/μl, and those with an IMT < 0.9 mm had an average of 715.4 ± 389.92 CD4/μl (p = 0.04). Patients with a low calcium score had a significantly higher average CD4 cell value and lower zenith viral load (VL) than those with a higher score (707.7 ± 377.5 CD4/μl vs 477.23 ± 235.7 CD4/μl (p = 0.01) and 7 × 104 ± 5 × 104 copies/ml vs 23.4 × 104 ± 19 × 104 copies/ml (p = 0.02)). The number of early EPCs in patients with a CD4 nadir < 350/µl was lower than that in those with a CD4 nadir ≥ 350 (p = 0.03). In HIV-positive patients, low CD4 cell levels and high VL were associated with risk of developing subclinical atherosclerosis. HIV patients with CD4 cell nadir < 350/µl may have fewer early EPCs.
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Affiliation(s)
- F Arnaiz de Las Revillas
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, 39008, Santander, Spain
| | | | - J A Parra
- Radiology Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Santander, Spain
| | - E Palacios
- Neurology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - C Gonzalez-Rico
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, 39008, Santander, Spain
| | - C Armiñanzas
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, 39008, Santander, Spain
| | - M Gutiérrez-Cuadra
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, 39008, Santander, Spain
| | - A Oterino
- Neurology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - C Fariñas-Alvarez
- Quality Unit. Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - M C Fariñas
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, 39008, Santander, Spain.
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Zhu Z, Li T, Chen J, Kumar J, Kumar P, Qin J, Hadigan C, Sereti I, Baker JV, Catalfamo M. The Role of Inflammation and Immune Activation on Circulating Endothelial Progenitor Cells in Chronic HIV Infection. Front Immunol 2021; 12:663412. [PMID: 34079548 PMCID: PMC8165313 DOI: 10.3389/fimmu.2021.663412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Endothelial inflammation and damage are the main drivers of cardiovascular risk/disease. Endothelial repair is mediated in part by recruitment of bone marrow endothelial progenitor/endothelial colony forming cells (EPC/ECFC). People with HIV (PWH) have increased cardiovascular risk and the impact of infection in endothelial repair is not well defined. The low frequencies and challenges to in vitro isolation and differentiation of EPC/ECFC from PBMCs had made it difficult to study their role in this context. We hypothesized that HIV driven inflammation induces phenotypic changes that reflects the impact of infection. To test this hypothesis, we evaluated expression of markers of trafficking, endothelial differentiation, and angiogenesis, and study their association with biomarkers of inflammation in a cohort of PWH. In addition, we investigated the relationship of circulating endothelial progenitors and angiogenic T cells, a T cell subset with angiogenic function. Using a flow cytometry approach, we identified two subsets of circulating progenitors LIN4-CD45-CD34+ and LIN4-CD45dimCD34+ in PWH. We found that the phenotype but not frequencies were associated with biomarkers of inflammation. In addition, the percentage of LIN4-CD45dimCD34+ was associated with serum levels of lipids. This data may provide a new tool to better address the impact of HIV infection in endothelial inflammation and repair.
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Affiliation(s)
- Ziang Zhu
- Department of Microbiology and Immunology. Georgetown University School of Medicine, Washington, DC, United States
| | - Tong Li
- Department of Microbiology and Immunology. Georgetown University School of Medicine, Washington, DC, United States
| | - Jinya Chen
- Department of Microbiology and Immunology. Georgetown University School of Medicine, Washington, DC, United States
| | - Jai Kumar
- Division of Infectious Diseases and Tropical Medicine, Georgetown University School of Medicine, Washington, DC, United States
| | - Princy Kumar
- Division of Infectious Diseases and Tropical Medicine, Georgetown University School of Medicine, Washington, DC, United States
| | - Jing Qin
- Biostatistics Research Branch, Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Colleen Hadigan
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Irini Sereti
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Jason V Baker
- Hennepin Healthcare Research Institute, University of Minnesota, Minneapolis, MN, United States
| | - Marta Catalfamo
- Department of Microbiology and Immunology. Georgetown University School of Medicine, Washington, DC, United States
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5
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Ucciferri C, Falasca K, Reale M, Tamburro M, Auricchio A, Vignale F, Vecchiet J. Pidotimod and Immunological Activation in Individuals Infected with HIV. Curr HIV Res 2021; 19:260-268. [PMID: 33430735 DOI: 10.2174/1570162x18666210111102046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The improvements in HIV infection therapy and the large availability of antiretroviral drugs have led to an increased survival among HIV infected people, and simultaneously to a raised morbidity and mortality due to not-AIDS-related events in this group compared to the general population. An increased systemic inflammation and a persistent immune activation play a pivotal role in determining high rates of non-AIDS comorbidities. In the last years, many natural or synthetic immunomodulatory molecules acting by different mechanisms have been conceived. Pidotimod is a synthetic dipeptide molecule showing immunomodulatory properties. The aim of this pilot study was to evaluate the effects of Pidotimod supplementation on residual inflammation in HIV infected population. METHODS Forty HIV positive individuals under cART were enrolled: 30 were treated with Pidotimod supplementation (study group) and 10 served as control group (without Pidotimod supplementation). For all participants, Cystatin C, PCR, ESR, microalbuminuria, TNF-α, INF-γ, IL-4, IL-10, IL1β, IL-18 and IL-2 were measured at enrolment (T0), 4 weeks after of Pidotimod supplementation (T1), and 4 weeks after completing supplementation (T2). RESULTS In HIV positive participants treated with Pidotimod, the evaluation of cytokine levels showed that IL-10, IFN gamma, and IL-4 were significantly higher at enrolment compared to the control group. The increase under Pidotimod treatment persisted after supplementation suspension, while the pro-inflammatory cytokines levels were reduced. Salivary IgA also increased during 4 weeks of supplementation and persisted at 4 weeks after completing supplementation. On the other hand, the Cystatin C and microalbuminuria levels decreased over time, at a greater extent the Cystatin C serum levels. CONCLUSION The study findings showed that the HIV population receiving Pidotimod achieved a rebalancing of pro-inflammatory and anti-inflammatory cytokines as well as a significant reduction in cystatin C levels. The treatment further allowed for an increase in salivary IgA levels at all the analyzed times, as a secondary event to a remodulation of the immunological status obtained with pidotimod. This approach could represent a new way to design new intervention strategies aimed at improving the persistent immune activation status in the virologically suppressed HIV population.
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Affiliation(s)
- Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Marcella Reale
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti- Pescara, Italy
| | - Manuela Tamburro
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Antonio Auricchio
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Francesca Vignale
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
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6
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Orlando N, Babini G, Chiusolo P, Valentini CG, De Stefano V, Teofili L. Pre-Exposure to Defibrotide Prevents Endothelial Cell Activation by Lipopolysaccharide: An Ingenuity Pathway Analysis. Front Immunol 2020; 11:585519. [PMID: 33343567 PMCID: PMC7744778 DOI: 10.3389/fimmu.2020.585519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/04/2020] [Indexed: 01/11/2023] Open
Abstract
Defibrotide (DFB) effects on different endothelial cell pathways have been investigated focusing on a limited number of genes or molecules. This study explored the modulation of the gene expression profile of steady-state or lipopolysaccharide (LPS)-activated endothelial cells, following the DFB exposure. Starting from differentially regulated gene expression datasets, we utilized the Ingenuity Pathway Analysis (IPA) to infer novel information about the activity of this drug. We found that effects elicited by LPS deeply differ depending on cells were exposed to DFB and LPS at the same time, or if the DFB priming occurs before the LPS exposure. Only in the second case, we observed a significant down-regulation of various pathways activated by LPS. In IPA, the pathways most affected by DFB were leukocyte migration and activation, vasculogenesis, and inflammatory response. Furthermore, the activity of DFB seemed to be associated with the modulation of six key genes, including matrix-metalloproteinases 2 and 9, thrombin receptor, sphingosine-kinase1, alpha subunit of collagen XVIII, and endothelial-protein C receptor. Overall, our findings support a role for DFB in a wide range of diseases associated with an exaggerated inflammatory response of endothelial cells.
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Affiliation(s)
- Nicoletta Orlando
- Department of Image, Radiation therapy, Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gabriele Babini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Patrizia Chiusolo
- Department of Image, Radiation therapy, Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Caterina Giovanna Valentini
- Department of Image, Radiation therapy, Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valerio De Stefano
- Department of Image, Radiation therapy, Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luciana Teofili
- Department of Image, Radiation therapy, Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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7
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Falasca K, Reale M, Di Nicola M, Ucciferri C, Zecca IA, Santilli F, Pontolillo M, Liani R, D'Angelo C, Costantini E, Vecchiet J. Circulating CD40 ligand, Dickkopf-1 and P-selectin in HIV-infected patients. HIV Med 2019; 20:681-690. [PMID: 31424619 DOI: 10.1111/hiv.12789] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the circulating levels of CD40 ligand (CD40 L), Dickkopf-1 (DKK-1) and P-selectin, their relationships and their contributions to cardiovascular risk in subjects with HIV infection. METHODS The study population included 80 HIV-infected patients, 14 (17.5%) of whom had diabetes mellitus (DM) and 32 (40.0%) of whom had arterial hypertension (AH). The HIV-infected patients were compared with a control group with similar demographic and clinical features. CD40L, DKK-1 and P-selectin levels were measured using an enzyme-linked immunosorbent assay. RESULTS The HIV-infected patients showed higher levels of all the cardiovascular disease (CVD) markers. Both serum CD40L and DKK-1 were significantly higher in HIV-infected patients than in the HIV-negative controls (P < 0.001), while soluble P-selectin showed no significant between-group difference (P = 0.133), reflecting the role of HIV infection in CVD. In the HIV-infected group, patients with DM showed lower levels of CD40L and DKK-1 in comparison with the nondiabetic patients and patients with AH (P < 0.05, with Bonferroni correction). In contrast, patients with AH showed higher levels of CD40L and DKK-1 in comparison to patients without DM or AH (P < 0.05, with Bonferroni correction). Patients with AH showed higher levels of CD40L and DKK-1 than patients with DM (P < 0.05, with Bonferroni correction). CONCLUSIONS In this study, we found that HIV-infected patients displayed significantly higher circulating levels of both CD40L and DKK-1, which were linearly and directly correlated, when compared to HIV-negative patients. The presence of diabetes was associated with lower levels of both CD40L and DKK-1, whereas the presence of hypertension was associated with higher levels of CD40L.
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Affiliation(s)
- K Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - M Reale
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - M Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - C Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy.,Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - I A Zecca
- Division of Hygene, Epidemiology and Public Health, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - F Santilli
- Department of Medicine and Aging, Center of Aging Science and Translational Medicine (CESI-Met), University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - M Pontolillo
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - R Liani
- Department of Medicine and Aging, Center of Aging Science and Translational Medicine (CESI-Met), University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - C D'Angelo
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - E Costantini
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
| | - J Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy
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8
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Deciphering Endothelial Dysfunction in the HIV-Infected Population. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1134:193-215. [PMID: 30919339 DOI: 10.1007/978-3-030-12668-1_11] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cardiovascular disease (CVD), as a possible consequence of endothelial dysfunction, is prevalent among HIV-infected patients despite successful administration of antiretroviral drugs. This warrants the routine clinical assessment of endothelial function in HIV-positive patients to circumvent potential CVD events. Several different non-invasive strategies have been employed to assess endothelial function in clinical research studies yielding inconsistencies among these reports. This review summarises the different techniques used for assessing endothelial function, with a focus on proposed blood-based biomarkers, such as endothelial leukocyte adhesion molecule-1 (E-selectin), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor (vWF), TNF-α, interleukin 6 (IL6) and soluble thrombomodulin (sTM). The identification of suitable blood-based biomarkers, especially those that can be measured using a point-of-care device, would be more applicable in under-resourced countries where the prevalence of HIV is high.
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9
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Echeverría P, Gómez-Mora E, Roura S, Bonjoch A, Puig J, Pérez-Alvarez N, Bayés-Genís A, Clotet B, Blanco J, Negredo E. Variable endothelial cell function restoration after initiation of two antiretroviral regimens in HIV-infected individuals. J Antimicrob Chemother 2018; 72:2049-2054. [PMID: 28369542 DOI: 10.1093/jac/dkx074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background The effect of ART on endothelial cell function is incompletely characterized. Methods We performed a 24 week prospective, case-control and comparative pilot study of ART-naive HIV-infected patients who started a darunavir- or rilpivirine-based regimen, matched with non-HIV-infected volunteers, to compare changes at week 24 from baseline in levels of circulating endothelial cells (CECs), endothelial progenitor cells (EPCs) and circulating angiogenic cells, as well as changes in immune-activation markers. Results The study population comprised 24 HIV-infected patients and 24 non-infected volunteers. Both HIV groups completely suppressed viraemia. HIV-infected patients had higher levels of activation markers than the control group in CD8 T cells at baseline; these decreased after 24 weeks of treatment, but without reaching the levels of the control group. No statistical differences in immune activation were seen between the darunavir and rilpivirine groups. Levels of CECs were higher and levels of EPCs and circulating angiogenic cells were lower in HIV-infected patients than in the control group, although these parameters were similar between the darunavir group and the control group, but not the rilpivirine group, at week 24. An unfavourable association was observed between rilpivirine, age and increased number of CECs. Conclusions Restoration of circulating levels of EPCs and CECs in darunavir-treated patients was greater than in those treated with rilpivirine, suggesting ongoing endothelial repair mechanisms.
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Affiliation(s)
- P Echeverría
- Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Catalonia 08916, Spain
| | - E Gómez-Mora
- AIDS Research Institute-IRSICAIXA, Institut Germans Trias I Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Badalona 08916, Spain
| | | | - A Bonjoch
- Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Catalonia 08916, Spain
| | - J Puig
- Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Catalonia 08916, Spain
| | - N Pérez-Alvarez
- Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Catalonia 08916, Spain.,Statistics and Operations Research, Technical University of Catalunya, Barcelona 08020, Spain
| | - A Bayés-Genís
- Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona 08916, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona 08020, Spain
| | - B Clotet
- Universitat de Vic - Universidad Central de Catalunya UVIC-UCC, Vic 08500, Spain
| | - J Blanco
- AIDS Research Institute-IRSICAIXA, Institut Germans Trias I Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Badalona 08916, Spain.,Universitat de Vic - Universidad Central de Catalunya UVIC-UCC, Vic 08500, Spain
| | - E Negredo
- Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Catalonia 08916, Spain.,Universitat de Vic - Universidad Central de Catalunya UVIC-UCC, Vic 08500, Spain
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10
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Seang S, Kelesidis T, Huynh D, Park S, Moe AA, Currier JS, Lake JE. Low Levels of Endothelial Progenitor Cells and Their Association with Systemic Inflammation and Monocyte Activation in Older HIV-Infected Men. AIDS Res Hum Retroviruses 2018; 34:39-45. [PMID: 29226690 DOI: 10.1089/aid.2017.0057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Endothelial progenitor cells (EPCs) repair damaged vascular endothelium, and low circulating EPC levels have been associated with cardiovascular disease (CVD). CD34+/KDR+ EPCs are commonly reported in the literature and CD34+/CD133+/KDR+ EPCs are rare in circulation but highly specific for endothelial lineage. HIV-infected (HIV+) adults have chronic inflammation and increased CVD risk, but the relationship between CVD, vascular inflammation, and EPCs in HIV remains unclear. In a pilot study, EPCs were measured in 57 HIV+ men [≥50 years old, HIV-1 RNA <50 copies/ml on antiretroviral therapy (ART)] by real-time flow cytometry using cellular immaturity (CD34 and/or CD133) and endothelial commitment (KDR) markers. Fasting inflammatory biomarker levels were measured by ELISA. Median age was 57 years; CD4+ T lymphocyte count was 570 cells/mm3. Prevalent CVD risk factors included 16% diabetes, 28% hypertension, 53% dyslipidemia, and 33% smoking. Median (interquartile range) EPC values were CD34+/KDR+ 0.1 (0.0-0.9) cells/105 peripheral blood mononuclear cells (PBMCs) and CD34+/CD133+/KDR+ 0.1 (0.0-0.9) cells/105 PBMCs. We observed a high prevalence of undetectable CD34+/KDR+ (40%) and CD34+/CD133+/KDR+ EPCs (44%). Men with undetectable EPCs were more likely to have ≥2 CVD risk factors, lower interleukin-6 (IL-6), and higher sCD163 levels. In these older HIV+ men on suppressive ART, CD34+/KDR+ and CD34+/CD133+/KDR+ EPC levels were low and often undetectable. Undetectable EPC levels were associated with greater CVD risk factor burden, lower IL-6 (consistent with decreased EPC production stimulus), and higher sCD163 (consistent with monocyte activation and prior CVD associations) levels, suggesting a potential relationship between EPCs and atherosclerotic burden in this population.
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Affiliation(s)
- Sophie Seang
- Infectious Diseases Department, AP-HP Pitié-Salpêtrière Hospital, Paris, France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne University, UPMC Univ Paris 06INSERM, Paris, France
| | - Theodoros Kelesidis
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Diana Huynh
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Sangeun Park
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ardis A. Moe
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Judith S. Currier
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Jordan E. Lake
- University of Texas Health Science Center at Houston, Houston, Texas
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11
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Lake JE, Seang S, Kelesidis T, Currier JS, Yang OO. Telmisartan increases vascular reparative capacity in older HIV-infected adults: a pilot study. HIV CLINICAL TRIALS 2016; 17:225-232. [PMID: 27658740 DOI: 10.1080/15284336.2016.1234222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) are bone marrow-derived cells that contribute to vascular repair. EPCs may be reduced in HIV-infected (HIV+) persons, contributing to cardiovascular disease (CVD). Telmisartan is an angiotensin receptor blocker that increases EPCs in HIV-uninfected adults. OBJECTIVE To assess telmisartan's effects on EPC number and immunophenotype in older HIV + adults at risk for CVD. METHODS HIV + persons ≥50 years old with HIV-1 RNA < 50 copies/mL on suppressive antiretroviral therapy and ≥1 CVD risk factor participated in a prospective, open-label, pilot study of oral telmisartan 80 mg daily for 12 weeks. Using CD34 and CD133 as markers of early maturity and KDR as a marker of endothelial lineage commitment, EPCs were quantified via flow cytometry and defined as viable CD3-/CD33-/CD19-/glycophorin- cells of four immunophenotypes: CD133+/KDR+, CD34+/KDR+, CD34+/CD133+, or CD34+/KDR+/CD133+. The primary endpoint was a 12-week change in EPC subsets (NCT01578772). RESULTS Seventeen participants (88% men, median age 60 years and peripheral CD4+ T lymphocyte count 625 cells/mm3) enrolled and completed the study. After 6 and 12 weeks of telmisartan, frequencies of all EPC immunophenotypes were higher than baseline (all p < 0.10 except week 12 CD133+/KDR+ EPC, p = 0.13). Participants with lower baseline EPC levels had the largest gains. Additionally, the percentage of CD34+ cells with endothelial commitment (KDR+) increased. CONCLUSIONS Our data suggest that telmisartan use is associated with an increase in circulating EPCs in older HIV + individuals with CVD risk factors. Further controlled studies are needed to assess whether EPC increases translate to a reduction in CVD risk in this population.
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Affiliation(s)
- Jordan E Lake
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Sophie Seang
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Theodoros Kelesidis
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Judith S Currier
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Otto O Yang
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA.,b Department of Microbiology, Immunology, and Molecular Genetics , University of California , Los Angeles , CA , USA.,c AIDS Healthcare Foundation , Los Angeles , CA , USA
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12
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Effect of Probiotic Supplement on Cytokine Levels in HIV-Infected Individuals: A Preliminary Study. Nutrients 2015; 7:8335-47. [PMID: 26426044 PMCID: PMC4632416 DOI: 10.3390/nu7105396] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/31/2015] [Accepted: 09/21/2015] [Indexed: 12/24/2022] Open
Abstract
Inflammation persists in patients infected with HIV. Reduction of inflammatory cytokines and microbial translocation might be one way that this could be managed. Purpose: The anti-inflammatory properties of certain probiotic strains prompted us to investigate whether a probiotic could reduce the inflammatory index of HIV-infected patients. Methods: The study involved 30 HIV+ males on antiretroviral therapy, who were given one bottle of fermented milk Yakult Light® containing Lactobacillus casei Shirota (LcS) twice a day for four weeks. Results: The probiotic LcS was associated with an increase of T lymphocytes and a significant increase of CD56+ cells (p = 0.04). There was also a significant decrease of mRNA levels of TGFβ, IL-10 and IL-12 (p < 0.001) and IL-1β expression (p < 0.001) and an increase of serum IL-23 (p = 0.03). In addition, decreased inflammation and cardiovascular risk were observed, as shown by a reduction of cystatin C (p < 0.001). Conclusions: These data provide preliminary evidence that probiotic supplementation may modulate certain immunological parameters and some of the cytokines that were analyzed. Thus, we propose that LcS may be an inexpensive and practical strategy to support the immune function of HIV+ patients.
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13
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Salvatore P, Zullo A, Sommese L, Colicchio R, Picascia A, Schiano C, Mancini FP, Napoli C. Infections and cardiovascular disease: is Bartonella henselae contributing to this matter? J Med Microbiol 2015; 64:799-809. [PMID: 26066633 DOI: 10.1099/jmm.0.000099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease is still the major cause of death worldwide despite the remarkable progress in its prevention and treatment. Endothelial progenitor cells (EPCs) have recently emerged as key players of vascular repair and regenerative medicine applied to cardiovascular disease. A large amount of effort has been put into discovering the factors that could aid or impair the number and function of EPCs, and also into characterizing these cells at the molecular level in order to facilitate their therapeutic applications in vascular disease. Interestingly, the major cardiovascular risk factors have been associated with reduced number and function of EPCs. The bacterial contribution to cardiovascular disease represents a long-standing controversy. The discovery that Bartonella henselae can infect and damage EPCs revitalizes the enduring debate about the microbiological contribution to atherosclerosis, thus allowing the hypothesis that this infection could impair the cardiovascular regenerative potential and increase the risk for cardiovascular disease. In this review, we summarize the rationale suggesting that Bartonella henselae could favour atherogenesis by infecting and damaging EPCs, thus reducing their vascular repair potential. These mechanisms suggest a novel link between communicable and non-communicable human diseases, and put forward the possibility that Bartonella henselae could enhance the susceptibility and worsen the prognosis in cardiovascular disease.
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Affiliation(s)
- Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Advanced Biotechnologies, Naples, Italy
| | - Alberto Zullo
- CEINGE-Advanced Biotechnologies, Naples, Italy.,Department of Sciences and Technologies, University of Sannio, Benevento, Italy
| | - Linda Sommese
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU) and Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy.,Department of Experimental Medicine, Section of Microbiology, Second University of Naples, Naples, Italy
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Antonietta Picascia
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU) and Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - Concetta Schiano
- Foundation SDN, Institute of Diagnostic and Nuclear Development, IRCCS, Naples, Italy
| | | | - Claudio Napoli
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU) and Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy.,Foundation SDN, Institute of Diagnostic and Nuclear Development, IRCCS, Naples, Italy
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14
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Ghasemzadeh N, Zhang L, Al Mheid I, Li Q, Sperling L, Waller EK, Taylor WR, Guest J, Quyyumi AA, Mavromatis K. Circulating progenitor cells are reduced in HIV-positive, anti-retroviral naïve patients. Int J Cardiol 2014; 176:1150-2. [PMID: 25175523 DOI: 10.1016/j.ijcard.2014.07.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 07/27/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Nima Ghasemzadeh
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Lane Zhang
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ibhar Al Mheid
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Qunna Li
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Laurence Sperling
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Edmund K Waller
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - W Robert Taylor
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jodie Guest
- Department of Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Arshed A Quyyumi
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Kreton Mavromatis
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA.
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15
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Nemeth CL, Bekhbat M, Neigh GN. Neural effects of inflammation, cardiovascular disease, and HIV: Parallel, perpendicular, or progressive? Neuroscience 2014; 302:165-73. [PMID: 25239371 DOI: 10.1016/j.neuroscience.2014.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/01/2014] [Accepted: 09/02/2014] [Indexed: 12/19/2022]
Abstract
The pervasive reach of the inflammatory system is evidenced by its involvement in numerous disease states. Cardiovascular disease, marked by high levels of circulating inflammatory mediators, affects an estimated 83.6 million Americans. Similarly, human immunodeficiency virus (HIV) produces a paradoxical state of generalized immune activity despite widespread immunosuppression, and affects 35 million people worldwide. Patients living with HIV (PLWH) suffer from inflammatory conditions, including cardiovascular disease (CVD), at a rate exceeding the general population. In this combined disease state, immune mechanisms that are common to both CVD and HIV may interact to generate a progressive condition that contributes to the exacerbated pathogenesis of the other to the net effect of damage to the brain. In this review, we will outline inflammatory cell mediators that promote cardiovascular risk factors and disease initiation and detail how HIV-related proteins may accelerate this process. Finally, we examine the extent to which these comorbid conditions act as parallel, perpendicular, or progressive sequela of events to generate a neurodegenerative environment, and consider potential strategies that can be implemented to reduce the burden of CVD and inflammation in PLWH.
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Affiliation(s)
- C L Nemeth
- Department of Physiology, Emory University, 615 Michael Street, Atlanta, GA 30322, United States
| | - M Bekhbat
- Department of Physiology, Emory University, 615 Michael Street, Atlanta, GA 30322, United States
| | - G N Neigh
- Department of Physiology, Emory University, 615 Michael Street, Atlanta, GA 30322, United States; Department of Psychiatry, Emory University, 615 Michael Street, Atlanta, GA 30322, United States.
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16
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Falasca K, Ucciferri C, Di Nicola M, Vignale F, Di Biase J, Vecchiet J. Different strategies of 25OH vitamin D supplementation in HIV-positive subjects. Int J STD AIDS 2014; 25:785-92. [PMID: 24469972 DOI: 10.1177/0956462414520804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary A high incidence of 25OH vitamin D deficiency has been observed in HIV-infected subjects. The objective of this study was to evaluate the effect of cholecalciferol administration on serum 25OH vitamin D levels in HIV-infected patients. This prospective cohort study included 153 HIV-positive subjects; 47 were treated with 300,000 IU intramuscular cholecalciferol, 67 with 25,000 IU oral cholecalciferol monthly, while the remaining 39 did not receive any treatment. The group treated orally had an increase of serum 25OH vitamin D concentration, changing from 15.7 ± 12.2 ng/mL to 27.4 ± 11.6 ng/mL after 10 months (T10). The group treated with intramuscular supplementation had an improvement, changing from 18.5 ± 10.5 ng/mL to 32.9.0 ± 12.2 ng/mL at T10. One-way repeated measures analysis of variance indicated a significant difference for 25OH vitamin D variation (p = 0.002) among the three groups. A significant effect of time (p < 0.001) and group × time interaction (p < 0.001) was found: at T10, 25OH vitamin D values were significantly higher in the oral and intramuscular groups with respect to the control group. Our findings showed that the supplementation with cholecalciferol in patients with HIV-infection improved 25OH vitamin D serum levels, and suggest that the two types of administration are equivalent, but are insufficient for severe forms of hypovitaminosis.
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Affiliation(s)
- Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Experimental and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Francesca Vignale
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Jessica Di Biase
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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17
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O’Halloran JA, Satchell CS, Mallon PWG. Dyslipidemia, atherosclerosis and cardiovascular disease: an increasingly important triad in an aging population living with HIV. Future Virol 2013. [DOI: 10.2217/fvl.13.87] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
As a result of major advances in the management of HIV over the last two decades, patients living with HIV are now encountering comorbidities commonly associated with aging. Cardiovascular disease is the leading cause of death worldwide. As the population living with HIV ages, understanding cardiovascular disease in the setting of HIV is of increasing importance. This review examines the complex interplay between cardiovascular disease, HIV infection and the drugs used to treat it, with particular emphasis on the contribution of dyslipidemia.
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Affiliation(s)
- Jane A O’Halloran
- HIV Molecular Research Group, University College Dublin School of Medicine and Medical Science, Catherine McAuley Education & Research Centre, Nelson Street, Dublin 7, Ireland
| | - Claudette S Satchell
- Justice Health Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Patrick WG Mallon
- HIV Molecular Research Group, University College Dublin School of Medicine and Medical Science, Catherine McAuley Education & Research Centre, Nelson Street, Dublin 7, Ireland
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
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18
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Costiniuk CT, Hibbert BM, Simard T, Ghazawi FM, Angel JB, O’Brien ER. Circulating endothelial progenitor cells in HIV infection: A systematic review. Trends Cardiovasc Med 2013; 23:192-200. [DOI: 10.1016/j.tcm.2012.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 12/04/2012] [Accepted: 12/05/2012] [Indexed: 11/29/2022]
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19
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Adult and cord blood endothelial progenitor cells have different gene expression profiles and immunogenic potential. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s367-74. [PMID: 23867184 DOI: 10.2450/2013.0042-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 03/26/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Endothelial colony-forming cells (ECFC) are endowed with vascular regenerative ability in vivo and in vitro. In this study we compared the genotypic profile and the immunogenic potential of adult and cord blood ECFC, in order to explore the feasibility of using them as a cell therapy product. MATERIALS AND METHODS ECFC were obtained from cord blood samples not suitable for haematopoietic stem cell transplantation and from adult healthy blood donors after informed consent. Genotypes were analysed by commercially available microarray assays and results were confirmed by real-time polymerase chain reaction analysis. HLA antigen expression was evaluated by flow-cytometry. Immunogenic capacity was investigated by evaluating the activation of allogeneic lymphocytes and monocytes in co-cultures with ECFC. RESULTS Microarray assays revealed that the genetic profile of cord blood and adult ECFC differed in about 20% of examined genes. We found that cord blood ECFC were characterised by lower pro-inflammatory and pro-thrombotic gene expression as compared to adult ECFC. Furthermore, whereas cord blood and adult ECFCs expressed similar amount of HLA molecules both at baseline and after incubation with γ-interferon, cord blood ECFC elicited a weaker expression of pro-inflammatory cytokine genes. Finally, we observed no differences in the amount of HLA antigens expressed among cord blood ECFC, adult ECFC and mesenchymal cells. CONCLUSIONS Our observations suggest that cord blood ECFC have a lower pro-inflammatory and pro-thrombotic profile than adult ECFC. These preliminary data offer level-headed evidence to use cord blood ECFC as a cell therapy product in vascular diseases.
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20
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Vecchiet J, Iachininoto MG, Capodimonti S, Nuzzolo ER, Falasca K, Martini M, Mancino P, Bianchi M, Leone AM, Ucciferri C, Larocca LM, Teofili L. Effect of antiviral therapy on pro-angiogenic hematopoietic and endothelial progenitor cells in HIV-infected people. Thromb Res 2013; 131:238-43. [DOI: 10.1016/j.thromres.2012.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 11/29/2012] [Accepted: 12/10/2012] [Indexed: 12/21/2022]
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21
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Authors' Reply: association of HIV-infection and antiretroviral therapy with levels of endothelial progenitor cells and subclinical atherosclerosis. J Acquir Immune Defic Syndr 2013; 62:e23-5. [PMID: 23262979 DOI: 10.1097/qai.0b013e3182794759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Association of HIV-Infection and antiretroviral therapy with levels of endothelial progenitor cells and subclinical atherosclerosis. J Acquir Immune Defic Syndr 2013; 61:545-51. [PMID: 22842847 DOI: 10.1097/qai.0b013e31826afbfc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although in the general population circulating vascular progenitor cell levels have been implicated in the homeostasis of the vascular wall through differentiation into endothelium and/or smooth muscle cells, it has not yet been assessed in HIV-infected patients. We herein investigated the number of progenitor cell subpopulations in HIV-infected patients and its relationship to carotid intima-media thickness (c-IMT). METHODS Blood samples were collected from 200 HIV-infected patients and CD34/KDR, CD34/VE-cadherin, and CD14/Endoglin progenitor cells were identified by flow cytometry. c-IMT was determined by ultrasonography. A group of 27 healthy subjects was used as control group. RESULTS In our population (20 ART-naive patients and 180 treated patients), traditional cardiovascular risk factors were not found predictive of vascular progenitor cell levels. However, antiretroviral therapy (ART)-treatment was identified as the main predictive value for low CD34/KDR cells and high CD14/Endoglin cells after adjustment by cardiovascular risk factors (age, sex, hypertension, diabetes, and hyperlipidaemia) and HIV-related characteristics (HIV duration and ART treatment). Low levels of circulating CD34/KDR or CD34/VE-cadherin endothelial progenitor cells tended to be associated with increased c-IMT. However, a positive association was found between CD14/Endoglin cells and c-IMT. Low number of CD34/KDR cells was also associated with the longest exposure to nucleoside reverse transcriptase inhibitors and/or protease inhibitors. CONCLUSIONS ART exposure is the main predictor of circulating vascular progenitor cell levels. However, their levels are only partially associated with high c-IMT in HIV-infected patients. ART has already been found to have proatherogenic effect, but our data first describe its relationship with vascular progenitor cells and c-IMT.
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23
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Falasca K, Ucciferri C, Teofili L, Iachininoto MG, Capodimonti S, Nuzzolo ER, Bianchi M, Martini M, Vignale F, Pizzigallo E, Vecchiet J. Short communication: proangiogenic hematopoietic cells in acute HIV infection. AIDS Res Hum Retroviruses 2013; 29:307-10. [PMID: 23145916 DOI: 10.1089/aid.2012.0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Chronic HIV infection induces significant changes in the trafficking of circulating endothelial progenitor cells (EPCs). Specifically, it causes marked depletion of proangiogenic hematopoietic cells, the so-called colony-forming unit-endothelial cells (CFU-ECs). In this study we evaluated CFU-ECs in two subjects with acute HIV infection. We found that both patients already had a low CFU-EC level at the time of diagnosis. Nevertheless, after 6 months of antiretroviral therapy, the CFU-EC concentration reverted to normal values in both cases. HIV significantly depletes the CFU-EC compartment even in the early phase of infection, while 6-month therapy appears to be able to restore it.
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Affiliation(s)
- Katia Falasca
- Division of Infectious Diseases, Department of Medicine and Sciences of Aging, “G. d'Annunzio” University School of Medicine, Chieti, Italy
| | - Claudio Ucciferri
- Division of Infectious Diseases, Department of Medicine and Sciences of Aging, “G. d'Annunzio” University School of Medicine, Chieti, Italy
- Infectious Disease Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | | | | | | | - Maria Bianchi
- Department of Hematology, Catholic University, Rome, Italy
| | | | - Francesca Vignale
- Division of Infectious Diseases, Department of Medicine and Sciences of Aging, “G. d'Annunzio” University School of Medicine, Chieti, Italy
| | - Eligio Pizzigallo
- Division of Infectious Diseases, Department of Medicine and Sciences of Aging, “G. d'Annunzio” University School of Medicine, Chieti, Italy
| | - Jacopo Vecchiet
- Division of Infectious Diseases, Department of Medicine and Sciences of Aging, “G. d'Annunzio” University School of Medicine, Chieti, Italy
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24
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25
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Costiniuk CT, Hibbert BM, Filion LG, O'Brien ER, Angel JB. Reply to: Cardiovascular Disease Risk in HIV Infection and Endothelial Progenitor Cells. J Infect Dis 2012. [DOI: 10.1093/infdis/jis519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Endothelial dysfunction—An important factor in the progression of atherosclerosis in HIV-infected persons. HIV & AIDS REVIEW 2012. [DOI: 10.1016/j.hivar.2012.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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López M, Vispo E, San Román J, Herrero D, Peris A, Corral A, Soriano V, Benito JM. Short communication high risk of endothelial dysfunction in HIV individuals may result from deregulation of circulating endothelial cells and endothelial progenitor cells. AIDS Res Hum Retroviruses 2012; 28:656-9. [PMID: 21830853 DOI: 10.1089/aid.2011.0152] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Endothelial progenitor cells (EPC) and circulating endothelial cells (CEC) have recently been considered as biomarkers of cardiovascular risk (CVDR) in healthy subjects. The impact of HIV infection on these cells is not well known. A case-control study was conducted in 15 antiretroviral-naive HIV(+) patients and 15 HIV-negative controls. The quantitative profile of CEC and EPC differed significantly in HIV(+) and HIV(-) subjects. HIV(+) subjects had significantly more CEC and less EPC than HIV(-) controls. A quantitative impairment in the balance of the CEC and EPC might contribute to the increased subclinical CVDR in HIV(+) patients.
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Affiliation(s)
- Mariola López
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
| | - Eugenia Vispo
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
| | - Jesús San Román
- Department of Medicine, Medical School, Rey Juan Carlos I University, Madrid, Spain
| | - Dolores Herrero
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
| | - Alejandra Peris
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
| | - Angelica Corral
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
| | - Vicente Soriano
- Infectious Disease Department, Hospital Carlos III, Madrid, Spain
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Endothelial progenitor cells and thrombosis. Thromb Res 2012; 129:309-13. [DOI: 10.1016/j.thromres.2011.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 12/04/2011] [Accepted: 12/05/2011] [Indexed: 11/24/2022]
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Gresele P, Falcinelli E, Sebastiano M, Baldelli F. Endothelial and platelet function alterations in HIV-infected patients. Thromb Res 2012; 129:301-8. [DOI: 10.1016/j.thromres.2011.11.022] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 11/10/2011] [Accepted: 11/14/2011] [Indexed: 11/28/2022]
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Costiniuk CT, Hibbert BM, Filion LG, Kovacs CM, Benko E, O'Brien ER, Angel JB. Circulating endothelial progenitor cell levels are not reduced in HIV-infected men. J Infect Dis 2012; 205:713-7. [PMID: 22238473 DOI: 10.1093/infdis/jir836] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Reduced levels of endothelial progenitor cells (EPCs) have been associated with increased cardiovascular (CV) risk, but limited data are available on EPC levels in the human immunodeficiency virus (HIV)-infected population. EPCs (CD45(dim)/CD34(+)/kinase domain receptor(+)) from 36 HIV-uninfected and 30 antiretroviral therapy-naive HIV-infected men without known CV risk factors were enumerated using flow cytometry. The mean EPC levels (± standard error of the mean) were 1.4 ± 0.5 cells/μL in the HIV-infected group and 3.7 ± 2.2 cells/μL in the control group (P = .92). EPC levels were not associated with disease parameters, such as CD4 cell count or viral load. Reductions in EPC levels do not seem to explain the increased risk of CV disease among HIV-infected men.
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Affiliation(s)
- Cecilia T Costiniuk
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Canada
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Papasavvas E, Hsue P, Reynolds G, Pistilli M, Hancock A, Martin JN, Deeks SG, Montaner LJ. Increased CD34+/KDR+ cells are not associated with carotid artery intima-media thickness progression in chronic HIV-positive subjects. Antivir Ther 2011; 17:557-63. [PMID: 22300770 DOI: 10.3851/imp2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2011] [Indexed: 01/01/2023]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) are involved in the endothelium repair. Low circulating EPC levels are predictive of cardiovascular events in HIV-negative subjects. The impact of HIV infection on EPCs, and the role of EPCs in HIV-associated cardiovascular disease, is not known. We hypothesized that circulating EPCs would be inversely associated with carotid artery intima-media thickness (c-IMT) changes in HIV-infected subjects. METHODS EPCs (CD34(+)/KDR(+), CD133(+)/KDR(+) and CD34(+)/CD133(+)/KDR(+)) were defined retrospectively by flow cytometry in cryopreserved peripheral blood mononuclear cells collected longitudinally from 66 chronic HIV-infected subjects and cross-sectionally from 50 at-risk HIV-negative subjects. The HIV-infected subjects participated in the Study of the Consequences of the Protease Inhibitor Era (SCOPE) cohort, were receiving antiretroviral therapy (59/66) and had two sequential measurements of c-IMT 1 year apart. Two distinct groups of HIV-infected subjects were identified a priori: rapid c-IMT progressors (subjects with rapid c-IMT progression, n=13, Δc-IMT>0.2 mm) and slow c-IMT progressors (subjects with slow or no c-IMT progression, n=53, Δc-IMT<0.2 mm). RESULTS Although cryopreservation reduced sensitivity of detection, EPC frequency in HIV-infected subjects was still significantly higher compared to at-risk HIV-negative subjects (CD34(+)/KDR(+); P=0.01) and correlated positively with CD4(+) T-cell count (CD34(+)/KDR(+), r=0.27; P=0.03). No association was found between the change of EPC frequencies over time (ΔEPC) and Δc-IMT or between EPC frequencies and c-IMT or Δc-IMT. CONCLUSIONS The lack of an association between EPCs and c-IMT in our cohort does not support HIV-associated reductions in EPC frequency as a cause of accelerated atherosclerosis.
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