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Aladev SD, Sokolov DK, Strokotova AV, Kazanskaya GM, Volkov AM, Aidagulova SV, Grigorieva EV. Multiple Administration of Dexamethasone Possesses a Deferred Long-Term Effect to Glycosylated Components of Mouse Brain. Neurol Int 2024; 16:790-803. [PMID: 39051219 PMCID: PMC11270268 DOI: 10.3390/neurolint16040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/13/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
Glucocorticoids are used during glioblastoma treatment to prevent the cerebral edema effect surrounding normal brain tissue. The aim of our study was to investigate the long-term effects of multiple administrations of glucocorticoids onto the glycosylated components (proteoglycans and glycosaminoglycans) of normal brain extracellular matrix and the glucocorticoid receptor (GR, Nr3c1) in an experimental model in vivo. Two-month-old male C57Bl/6 mice (n = 90) were injected intraperitoneally with various doses of dexamethasone (DXM) (1; 2.5 mg/kg) for 10 days. The mRNA levels of the GR, proteoglycans core proteins, and heparan sulfate metabolism-involved genes were determined at the 15th, 30th, 60th, and 90th days by a real-time RT-PCR. The glycosaminoglycans content was studied using dot blot and staining with Alcian blue. A DXM treatment increased total GAG content (2-fold), whereas the content of highly sulfated glycosaminoglycans decreased (1.5-2-fold). The mRNA level of the heparan sulfate metabolism-involved gene Hs3St2 increased 5-fold, the mRNA level of Hs6St2 increased6-7-fold, and the mRNA level of proteoglycan aggrecan increased 2-fold. A correlation analysis revealed an association between the mRNA level of the GR and the mRNA level of 8 of the 14 proteoglycans-coding and 4 of the 13 heparan sulfate metabolism-involved genes supporting GR involvement in the DXM regulation of the expression of these genes. In summary, multiple DXM administrations led to an increase in the total GAG content and reorganized the brain extracellular matrix in terms of its glycosylation pattern.
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Affiliation(s)
- Stanislav D. Aladev
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
| | - Dmitry K. Sokolov
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
| | - Anastasia V. Strokotova
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
| | - Galina M. Kazanskaya
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
- E.N. Meshalkin National Medical Research Center, Novosibirsk 630055, Russia;
| | - Alexander M. Volkov
- E.N. Meshalkin National Medical Research Center, Novosibirsk 630055, Russia;
| | - Svetlana V. Aidagulova
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
- Laboratory of Cellular Biology, Novosibirsk State Medical University, Novosibirsk 630091, Russia
| | - Elvira V. Grigorieva
- Institute of Molecular Biology and Biophysics FRC FTM, Novosibirsk 630117, Russia; (D.K.S.); (A.V.S.); (G.M.K.); (S.V.A.); (E.V.G.)
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Sedik S, Boyer J, Egger M, Dichtl K, Prattes J, Prüller F, Hoenigl M. Comparative Analysis of the Clarus Aspergillus Galactomannan Enzyme Immunoassay Prototype for the Diagnosis of Invasive Pulmonary Aspergillosis in Bronchoalveolar Lavage Fluid. Mycopathologia 2024; 189:67. [PMID: 39023825 PMCID: PMC11258175 DOI: 10.1007/s11046-024-00876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Galactomannan (GM) testing using Platelia Aspergillus enzyme immunoassay (Platelia AGM) from bronchoalveolar lavage fluid (BALF) aids in early diagnosis of invasive pulmonary aspergillosis (IPA). Globally, only a minority of laboratories have the capability to perform on-site GM testing, necessitating accessible and affordable alternatives. Hence, we conducted a comparative evaluation of the new clarus Aspergillus GM enzyme immunoassay prototype (clarus AGM prototype) with Platelia AGM using BALF samples. METHODS This is a single-center, prospective, cross-sectional study, where Platelia AGM testing was routinely performed followed by clarus AGM prototype testing in those with true positive or true negative AGM test results according to the 2020 EORTC/MSG and the 2024 FUNDICU consensus definitions. Descriptive statistics, ROC curve analysis, and Spearman's correlation analysis were used to evaluate analytical performance of the clarus AGM prototype assay. RESULTS This study enrolled 259 adult patients, of which 53 (20%) were classified as probable IPA, while 206 did not fulfill IPA-criteria. Spearman's correlation analysis revealed a strong correlation between the two assays (rho = 0.727, p < 0.001). The clarus AGM prototype had a sensitivity of 96% (51/53) and a specificity of 74% (153/206) for differentiating probable versus no IPA when using the manufacturer recommended cut-off. ROC curve analysis showed an AUC of 0.936 (95% CI 0.901-0.971) for the clarus AGM prototype, while the Platelia AGM yielded an AUC of 0.918 (95% CI 0.876-0.959). CONCLUSIONS Clarus AGM prototype demonstrated a strong correlation and promising test performance, comparable to Platelia AGM, rendering it a viable alternative in patients at risk of IPA.
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Affiliation(s)
- Sarah Sedik
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, ECMM Excellence Center, Auenbruggerplatz 15, 8036, Graz, Austria
- Translational Mycology, Medical University of Graz, Graz, Austria
| | - Johannes Boyer
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, ECMM Excellence Center, Auenbruggerplatz 15, 8036, Graz, Austria
- Translational Mycology, Medical University of Graz, Graz, Austria
| | - Matthias Egger
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, ECMM Excellence Center, Auenbruggerplatz 15, 8036, Graz, Austria
- Translational Mycology, Medical University of Graz, Graz, Austria
| | - Karl Dichtl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Juergen Prattes
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, ECMM Excellence Center, Auenbruggerplatz 15, 8036, Graz, Austria.
- Translational Mycology, Medical University of Graz, Graz, Austria.
| | - Florian Prüller
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Martin Hoenigl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, ECMM Excellence Center, Auenbruggerplatz 15, 8036, Graz, Austria.
- Translational Mycology, Medical University of Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
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Feys S, Carvalho A, Clancy CJ, Gangneux JP, Hoenigl M, Lagrou K, Rijnders BJA, Seldeslachts L, Vanderbeke L, van de Veerdonk FL, Verweij PE, Wauters J. Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients. THE LANCET. RESPIRATORY MEDICINE 2024:S2213-2600(24)00151-6. [PMID: 39025089 DOI: 10.1016/s2213-2600(24)00151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 07/20/2024]
Abstract
Influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) are increasingly recognised as important complications in patients requiring intensive care for severe viral pneumonia. The diagnosis can typically be made in 10-20% of patients with severe influenza or COVID-19, but only when appropriate diagnostic tools are used. Bronchoalveolar lavage sampling for culture, galactomannan testing, and PCR forms the cornerstone of diagnosis, whereas visual examination of the tracheobronchial tract during bronchoscopy is required to detect invasive Aspergillus tracheobronchitis. Azoles are the first-choice antifungal drugs, with liposomal amphotericin B as an alternative in settings where azole resistance is prevalent. Despite antifungal therapy, IAPA and CAPA are associated with poor outcomes, with fatality rates often exceeding 50%. In this Review, we discuss the mechanistic and clinical aspects of IAPA and CAPA. Moreover, we identify crucial knowledge gaps and formulate directions for future research.
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Affiliation(s)
- Simon Feys
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium; Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's Associate Laboratory, Braga/ Guimarães, Portugal
| | - Cornelius J Clancy
- Division of Infectious Diseases, University of Pittsburgh, PA, USA; VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU Rennes, INSERM, EHESP, IRSET, UMR_S 1085, Rennes, France; Centre Hospitalier Universitaire de Rennes, Laboratoire de Parasitologie-Mycologie, ECMM Excellence Center in Medical Mycology, French National Reference Center on Mycoses and Antifungals (CNRMA-LA AspC), Rennes, France
| | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center in Medical Mycology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Translational Medical Mycology Research Group, Medical University of Graz, Graz, Austria; Bio TechMed-Graz, Graz, Austria
| | - Katrien Lagrou
- Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium; Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Bart J A Rijnders
- Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | | | - Lore Vanderbeke
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Paul E Verweij
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands; Center of Expertise for Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Joost Wauters
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium; Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
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Hashim Z, Nath A, Tripathy NK. High-dose corticosteroid therapy in COVID-19: the RECOVERY trial. Lancet 2024; 403:1337-1338. [PMID: 38582559 DOI: 10.1016/s0140-6736(23)02882-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/21/2023] [Indexed: 04/08/2024]
Affiliation(s)
- Zia Hashim
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Alok Nath
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Naresh Kumar Tripathy
- Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
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Hoenigl M, Prattes J. Risk of COVID-19-associated pulmonary aspergillosis: time for a nuanced approach to antifungal prophylaxis? THE LANCET. RESPIRATORY MEDICINE 2024; 12:183-185. [PMID: 38185136 DOI: 10.1016/s2213-2600(23)00435-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; BioTechMed, Graz, Austria.
| | - Juergen Prattes
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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Zeng G, Wang L. Covid-19-associated pulmonary aspergillosis in mechanically ventilated patients. Ann Intensive Care 2024; 14:34. [PMID: 38429410 PMCID: PMC10907554 DOI: 10.1186/s13613-024-01268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024] Open
Affiliation(s)
- Guangting Zeng
- Department of Pharmacy, The First People's Hospital of Chenzhou, Xiangnan University, Chenzhou, China.
| | - Linlin Wang
- Department of Pharmacy, Cancer Center(Xiamen), Fudan University, Xiamen, China
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Hashim Z, Nath A, Tripathy NK. Steroid treatment for COVID-19: Suitable dose and patients. Lung India 2023; 40:481-482. [PMID: 37787370 PMCID: PMC10553781 DOI: 10.4103/lungindia.lungindia_233_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 10/04/2023] Open
Affiliation(s)
- Zia Hashim
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India,
| | - Alok Nath
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India,
| | - Naresh K. Tripathy
- Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. E-mail:
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