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Oliveira VHF, Willig AL, Davey CH, Buford TW, Menezes P, Cachay E, Crane HM, Burkholder GA, Gripshover BM, Fleming JG, Cleveland JD, Webel AR. Brief Report: Relationship Between Adiposity and Biomarkers of Aging and Frailty Among Adults Aging With HIV. J Acquir Immune Defic Syndr 2024; 95:377-382. [PMID: 38100820 PMCID: PMC10922782 DOI: 10.1097/qai.0000000000003362] [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: 09/06/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND This study examined the relationships among adiposity, handgrip, physical function, inflammation (ie, senescence-associated secretory phenotype chemokines as biomarkers of aging and frailty), and sex hormones in aging people with HIV. METHODS This cross-sectional exploratory study included 150 people with HIV aged ≥40 years (67.3% of participants were male). Our measures included (1) body mass index and waist circumference as measures of adiposity; (2) handgrip as a measure of muscle strength; (3) short physical performance battery as a measure of physical function; (4) interleukin-6, tumor necrosis factor alpha receptor II, high sensitivity C-reactive protein, C-X-C motif chemokine 10, and C-X3-C motif chemokine ligand 1 also known as fractalkine as senescence-associated secretory phenotype chemokines; and (5) free testosterone, estradiol, sex hormone-binding globulin, and dehydroepiandrosterone as sex hormones. Quantile regression analyses were used to identify relationships among inflammatory markers and hormones with age, adiposity, handgrip, and physical function. RESULTS Overall, 74% (n = 111) of participants were classified as overweight or obese and 53.3% (n = 80) presented with abdominal obesity. After controlling for age and sex, body mass index was positively associated with estradiol (β = 0.043, P < 0.01), and waist circumference was positively associated with high sensitivity C-reactive protein (β = 2.151, P < 0.01). After controlling for sex, age was positively associated with C-X-C motif chemokine 10 (β = 0.024, P = 0.03) and tumor necrosis factor alpha receptor II (β = 2.205, P = 0.01). After controlling for age and sex, short physical performance battery was negatively associated with dehydroepiandrosterone (β = -0.004, P = 0.01); no statistically significant associations were observed for handgrip. CONCLUSION Adiposity levels and aging were associated with inflammation (ie, C-X-C motif chemokine 10, tumor necrosis factor alpha receptor II, and high sensitivity C-reactive protein) among people with HIV aged 40 years and older.
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Affiliation(s)
| | | | | | - Thomas W Buford
- University of Alabama at Birmingham, Birmingham, AL
- Birmingham/Atlanta VA GRECC, Birmingham VA Medical Center, Birmingham, AL
| | - Prema Menezes
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Frisoli A, Duque G, Paes AT, Diniz AR, Lima E, Azevedo E, Moises VA. Sarcopenic obesity definitions and their associations with physical frailty in older Brazilian adults: data from the SARCOS study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:361-371. [PMID: 37011371 DOI: 10.20945/2359-3997000000587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective To identify the obesity diagnosis with the highest association with physical frailty associated with sarcopenia EWGSOP II (sarcopenic obesity). Subjects and methods We performed a cross-sectional analysis of 371 community-dwelling older adults. Appendicular skeletal lean mass and total body fat (TBF) were assessed using dual-energy x-ray absorptiometry, and physical frailty was defined using Fried's criteria. The phenotypes were identified according to the presence of sarcopenia by EWGSOP II and obesity, which was diagnosed using two concepts: BMI obesity (BMI ≥ 30 kg/m2) and TBF obesity (percentage of TBF ≥ 35% for women and ≥ 25% for men). Finally, the association of each group with physical frailty was evaluated. Results The mean age was 78.15 ± 7.22 years. Sarcopenia EWGSOP II was diagnosed in 19.8% (n = 73), body mass index obesity was identified in 21.8% (n = 81), TBF obesity was identified in 67.7% (n = 251), and physical frailty was identified in 38.5% (n = 142). In a regression analysis for frailty, sarcopenic TBF obesity presented an odds ratio of 6.88 (95% confidence interval 2.60-18.24; p < 0.001). Conclusion In older Brazilian adults, sarcopenic obesity diagnosed by TBF obesity has a robust association with frailty and is independent of body mass index.
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Guimarães NS, Raposo MA, Greco D, Tupinambás U, Premaor MO. People Living With HIV, Lean Mass, and Sarcopenia: A Systematic Review and Meta-Analysis. J Clin Densitom 2022; 25:113-123. [PMID: 33836973 DOI: 10.1016/j.jocd.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/22/2022]
Abstract
This systematic review aims to estimate the prevalence of sarcopenia in people living with HIV (PLHIV) and to assess whether there is a difference between the muscle mass of PLHIV and people living without HIV. A systematic review of randomized controlled trials, cohort studies, cross-sectional and case-control studies was carried out. PLHIV over 18 years of age and that had their muscle mass evaluated by dual-energy X-ray absorptiometry were included. Overall, 4,376 studies were found, of which 118 had their full texts evaluated. A total of 5,532 people living with HIV and 2,986 people living without HIV were identified in 41 studies. The frequency of sarcopenia defined by low muscle mass (Baumgartner's operational definition) alone was 30.3% (95%CI 24.3%, 37.1%) and the frequency of sarcopenia defined by low muscle mass with low muscle strength (EWGSOP definition) was 4.5% (95%CI 1.3%, 13.9%), p-value = 0.0006. The standardized mean differences of muscle mass between PLHIV and controls was -0.211 units of standard deviation (95%CI -0.419, -0.003). In the meta-regression analysis muscle mass mean difference was associated with BMI, CD4, percentage of subjects on ART, and study design. PLHIV have a lower muscle mass when compared to people living without HIV. This difference appears to be attenuated by higher BMI, CD4 levels, and the percentage of subjects using ART. Furthermore, the frequencies of sarcopenia assessed by the operational definition of Baumgartner and the EWGSOP are not comparable and cannot be interchanged in PLHIV.
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Affiliation(s)
| | | | - Dirceu Greco
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Unaí Tupinambás
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Melissa Orlandin Premaor
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Kousari A, Moser C, Olefsky M, Brown TT, Currier JS, McComsey GA, Scherzinger A, Stein JH, Lake JE, Erlandson KM. Poorer Muscle Quality and Quantity With ART Initiation Is Associated With Greater Inflammation and Immune Activation. J Acquir Immune Defic Syndr 2021; 88:399-405. [PMID: 34326283 PMCID: PMC8556226 DOI: 10.1097/qai.0000000000002776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND We have previously shown that the initiation of antiretroviral therapy (ART) is associated with a decrease in skeletal muscle density (greater fat accumulation), suggesting that gains in lean body mass seen in many ART studies may reflect gains in low quality, fatty muscle. Here, we explore whether skeletal muscle density and area are associated with markers of inflammation and immune activation. METHODS ART-naïve people with HIV were randomized to raltegravir or ritonavir-boosted atazanavir or darunavir, each with tenofovir disoproxil fumarate/emtricitabine. Abdominal computed tomography scans from baseline and week 96 were reanalyzed for psoas density and area and correlations explored with inflammation [interleukin-6 (IL-6) and high-sensitivity C-reactive protein] and immune activation [soluble CD14 (sCD14), soluble CD163 (sCD163), and %CD38+HLADR+ on CD4+ or CD8+ T cells]. RESULTS Two hundred twenty-two participants had available inflammation/immune activation markers and paired computed tomography scans. At baseline, lower psoas density (greater fat) correlated with higher IL-6 (r = -0.26, P < 0.001) and sCD163 (r -0.15, P = 0.03) and lower lean psoas area correlated with higher IL-6, high-sensitivity C-reactive protein, sCD14, sCD163, and %CD38+HLADR+ on CD4+ T cells (r = -0.30-0.13; all P ≤ 0.05). From baseline to week 96, greater percent decrease in total psoas density (more fat) correlated with greater increase in IL-6 (r = -0.14; P = 0.04); greater % decrease in lean psoas area correlated greater increases in IL-6, sCD14, sCD163, and %CD38+HLADR+ on CD8+ T cells (r = -0.15 to -0.18; all P < 0.04). CONCLUSIONS Greater fat infiltration within the psoas muscle (lower density) and greater loss in lean psoas muscle area were associated with higher inflammation and immune activation, which may portend important effects on muscle function and cardiometabolic risk.
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Affiliation(s)
| | - Carlee Moser
- Harvard T.H. Chan School of Public Health; Boston, MA
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5
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Tavenier J, Rasmussen LJH, Andersen AL, Houlind MB, Langkilde A, Andersen O, Petersen J, Nehlin JO. Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls. J Gerontol A Biol Sci Med Sci 2021; 76:964-974. [DOI: 10.1093/gerona/glab011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Indexed: 12/20/2022] Open
Abstract
Abstract
Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.
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Affiliation(s)
- Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Line Jee Hartmann Rasmussen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | | | - Morten Baltzer Houlind
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
- The Capital Region Pharmacy, Herlev, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Anne Langkilde
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Janne Petersen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital Frederiksberg, Denmark
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - Jan O Nehlin
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Denmark
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6
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Kamper RS, Schultz M, Hansen SK, Andersen H, Ekmann A, Nygaard H, Helland F, Wejse MR, Rahbek CB, Noerst T, Pressel E, Nielsen FE, Suetta C. Biomarkers for length of hospital stay, changes in muscle mass, strength and physical function in older medical patients: protocol for the Copenhagen PROTECT study-a prospective cohort study. BMJ Open 2020; 10:e042786. [PMID: 33376179 PMCID: PMC7778767 DOI: 10.1136/bmjopen-2020-042786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sarcopenia is generally used to describe the age-related loss of muscle mass and strength believed to play a major role in the pathogenesis of physical frailty and functional impairment that may occur with old age. The knowledge surrounding the prevalence and determinants of sarcopenia in older medical patients is scarce, and it is unknown whether specific biomarkers can predict physical deconditioning during hospitalisation. We hypothesise that a combination of clinical, functional and circulating biomarkers can serve as a risk stratification tool and can (i) identify older acutely ill medical patients at risk of prolonged hospital stays and (ii) predict changes in muscle mass, muscle strength and function during hospitalisation. METHOD AND ANALYSIS The Copenhagen PROTECT study is a prospective cohort study consisting of acutely ill older medical patients admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark. Assessments are performed within 24 hours of admission and include blood samples, body composition, muscle strength, physical function and questionnaires. A subgroup of patients transferred to the Geriatric Department are included in a smaller geriatric cohort and have additional assessments at discharge to evaluate the relative change in circulating biomarker concentrations, body composition, muscle strength and physical function during hospitalisation. Enrolment commenced 4 November 2019, and proceeds until August 2021. ETHICS AND DISSEMINATION The study protocol has been approved by the local ethics committee of Copenhagen and Frederiksberg (H-19039214) and the Danish Data Protection Agency (P-2019-239) and all experimental procedures were performed in accordance with the Declaration of Helsinki. Findings from the project, regardless of the outcome, will be published in relevant peer-reviewed scientific journals in online (www.clinicaltrials.gov). TRIAL REGISTRATION NUMBER NCT04151108.
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Affiliation(s)
- Rikke S Kamper
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Martin Schultz
- Geriatric Research Unit, Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Sofie K Hansen
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Helle Andersen
- Department of Occupational and Physiotherapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Anette Ekmann
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Nygaard
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- CopenAge; Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Fredrik Helland
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Miriam R Wejse
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Camilla B Rahbek
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Tim Noerst
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Eckart Pressel
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Finn Erland Nielsen
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Charlotte Suetta
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Geriatric Research Unit, Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
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7
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Alves TC, Santos AP, Abdalla PP, Venturini ACR, Angelotti PS, Borges FG, Reis HDO, Bollela VR, Mota J, Machado DRL. Resistance training with blood flow restriction: Impact on the muscle strength and body composition in people living with HIV/AIDS. Eur J Sport Sci 2020; 21:450-459. [PMID: 32349629 DOI: 10.1080/17461391.2020.1757765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (GRTBFR) versus, traditional resistance training (GTRT) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre- and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre- and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (GRTBFR=25.7-57.4%; GTRT=24.5-52.3%) and skeletal muscle tissue (GRTBFR=8.4%; GTRT=8.3%). There was also a significant change in body fat (p=0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.
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Affiliation(s)
- Thiago Cândido Alves
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Minas Gerais State University
| | - André P Santos
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Pedro P Abdalla
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Ana Cláudia R Venturini
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | | | - Franciane Góes Borges
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group
| | - Henrique D O Reis
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Valdes R Bollela
- Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Dalmo R L Machado
- Nursing School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.,Anthropometry, Training and Sport Research and Study Group.,Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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8
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Mehta A, Desai SR, Ko YA, Liu C, Dhindsa DS, Nayak A, Hooda A, Martini MA, Ejaz K, Sperling LS, Reiser J, Hayek SS, Quyyumi AA. Sex Differences in Circulating Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels and Adverse Outcomes in Coronary Artery Disease. J Am Heart Assoc 2020; 9:e015457. [PMID: 32089048 PMCID: PMC7335555 DOI: 10.1161/jaha.119.015457] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Women have higher circulating levels of soluble urokinase‐type plasminogen activator receptor (suPAR), and elevated suPAR is associated with cardiovascular risk. The independent association of sex with suPAR and the impact of sex on its association with cardiovascular risk are unknown. Methods and Results Plasma suPAR was measured using ELISA in 2 cohorts of 666 asymptomatic individuals (49 years, 65% women) and 4184 patients with coronary artery disease (63 years, 37% women). Independent association of sex with suPAR was studied using linear regression models adjusted for demographics, risk factors, and visceral adiposity in asymptomatic participants. Impact of sex on association of suPAR with all‐cause mortality was studied in patients with coronary artery disease using multivariable‐adjusted Cox models. Sex‐specific suPAR cutoffs for predicting all‐cause mortality were calculated. Asymptomatic women had 10% higher suPAR compared with men after adjusting for confounders, and visceral adiposity partly accounted for this association. Over a median follow‐up of 5.2 years, 795 deaths were recorded in patients with coronary artery disease. Log2‐transformed suPAR was independently associated with mortality (hazard ratio per 1‐SD 1.72, 95% CI 1.60–1.85) and an interaction with sex was noted (P=0.005). Association of suPAR with mortality was slightly weaker in women (hazard ratio 1.61, 95% CI 1.41–1.83) compared with men (hazard ratio 1.83, 95% CI 1.67–2.00). However, using sex‐specific suPAR cut‐offs (4392 pg/mL for women and 3187 pg/mL for men), a similar mortality incidence was observed for both sexes (38.5% and 35.5%, respectively, P=0.3). Conclusions Women have 10% higher plasma suPAR levels compared with men. Elevated sex‐specific plasma suPAR levels are equally predictive of risk of adverse events in both sexes.
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Affiliation(s)
- Anurag Mehta
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Shivang R Desai
- Department of Medicine Emory University School of Medicine Atlanta GA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics Emory University Atlanta GA
| | - Chang Liu
- Department of Biostatistics and Bioinformatics Emory University Atlanta GA
| | - Devinder S Dhindsa
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Aditi Nayak
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Ananya Hooda
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Mohamed A Martini
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Kiran Ejaz
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Laurence S Sperling
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
| | - Jochen Reiser
- Department of Internal Medicine Rush University Medical Center Chicago IL
| | - Salim S Hayek
- Frankel Cardiovascular Center University of Michigan Ann Arbor MI
| | - Arshed A Quyyumi
- Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA
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9
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Hong SH, Choi KM. Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences. Int J Mol Sci 2020; 21:ijms21020494. [PMID: 31941015 PMCID: PMC7013734 DOI: 10.3390/ijms21020494] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/06/2020] [Accepted: 01/10/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of sarcopenic obesity is increasing worldwide, particularly amongst aging populations. Insulin resistance is the core mechanism of sarcopenic obesity and is also associated with variable cardiometabolic diseases such as cardiovascular disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Fat accumulation in muscle tissue promotes a proinflammatory cascade and oxidative stress, leading to mitochondrial dysfunction, impaired insulin signaling, and muscle atrophy. To compound the problem, decreased muscle mass aggravates insulin resistance. In addition, the crosstalk between myokines and adipokines leads to negative feedback, which in turn aggravates sarcopenic obesity and insulin resistance. In this review, we focus on the molecular mechanisms linking sarcopenic obesity and insulin resistance with various biological pathways. We also discuss the impact and mechanism of sarcopenic obesity and insulin resistance on cardiometabolic disease.
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10
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Langkilde A, Tavenier J, Danielsen AV, Eugen-Olsen J, Therkildsen C, Jensen FK, Henriksen JH, Langberg H, Steiniche T, Petersen J, Holck S, Andersen O. Histological and Molecular Adipose Tissue Changes Are Related to Metabolic Syndrome Rather Than Lipodystrophy in Human Immunodeficiency Virus-Infected Patients: A Cross-Sectional Study. J Infect Dis 2019; 218:1090-1098. [PMID: 29788076 DOI: 10.1093/infdis/jiy284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/13/2018] [Indexed: 01/23/2023] Open
Abstract
Background In human immunodeficiency virus (HIV)-infected patients on combination antiretroviral therapy (cART), lipodystrophy shares many similarities with metabolic syndrome, but only metabolic syndrome has objective classification criteria. We examined adipose tissue changes related to lipodystrophy and metabolic syndrome to clarify whether it may be acceptable to focus diagnosis on metabolic syndrome rather than lipodystrophy. Methods This is a cross-sectional study of 60 HIV-infected men on cART and 15 healthy men. We evaluated lipodystrophy (clinical assessment) and metabolic syndrome (JIS-2009). We compared adipocyte size, leukocyte infiltration, and gene expression in abdominal subcutaneous adipose tissue biopsies of patients with and without lipodystrophy and with and without metabolic syndrome. Results Lipodystrophy was only associated with increased macrophage infiltration (P = .04) and adiponectin messenger ribonucleic acid ([mRNA] P = .008), whereas metabolic syndrome was associated with larger adipocytes (P < .0001), decreased expression of genes related to adipogenesis and adipocyte function (P values between <.0001 and .08), increased leptin mRNA (P = .04), and a trend towards increased expression of inflammatory genes (P values between .08 and .6). Conclusions Metabolic syndrome rather than lipodystrophy was associated with major unfavorable abdominal subcutaneous adipose tissue changes. In a clinical setting, it may be more relevant to focus on metabolic syndrome diagnosis in HIV-infected patients on cART with regards to adipose tissue dysfunction and risk of cardiometabolic complications.
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Affiliation(s)
- Anne Langkilde
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - Juliette Tavenier
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | | | - Jesper Eugen-Olsen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | | | | | - Jens Henrik Henriksen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Hvidovre, Denmark
| | - Henning Langberg
- CopenRehab, Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark
| | | | - Janne Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Biostatistics, University of Copenhagen, Denmark
| | - Susanne Holck
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ove Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
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11
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Abdominal obesity, sarcopenia, and osteoporosis are associated with frailty in men living with and without HIV. AIDS 2018; 32:1257-1266. [PMID: 29794494 DOI: 10.1097/qad.0000000000001829] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The relationships between frailty and body composition in older adults with HIV infection are poorly understood. We sought to describe associations between frailty and measures of body composition among adult men with HIV and without HIV. DESIGN/METHODS Men with and without HIV (age 50-69 years) in the Multicenter AIDS Cohort Study (MACS) Bone Strength Substudy were included if evaluated for frailty (by Fried phenotype) and body composition [BMI, waist circumference, abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, sarcopenia, and osteopenia/osteoporosis]. All participants with HIV infection were on antiretroviral therapy. Multivariate multinomial logistic regression models were used to determine associations of frailty with body composition. RESULTS A total of 399 men, including 199 men with HIV and 200 men without HIV, both with median age 60 years, constituted our study population. Frailty prevalence was 16% (men with HIV) vs. 8% (men without HIV). HIV serostatus was associated with a 2.43 times higher odds of frailty (P = 0.01). Higher waist circumference, VAT, sarcopenia, and femoral neck osteoporosis were associated with increased odds of frailty (aOR 4.18, 4.45, 4.15, and 13.6, respectively, and all P < 0.05); BMI and SAT were not. None of these measures presented a differential association with frailty by HIV serostatus (all P > 0.20). CONCLUSION Higher abdominal obesity and sarcopenia were associated with frailty among men with and without HIV. Assessment of these body composition parameters may help detect frailty in the clinical setting.
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12
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Inflammation and post-operative recovery in patients undergoing total knee arthroplasty-secondary analysis of a randomized controlled trial. Osteoarthritis Cartilage 2017; 25:1265-1273. [PMID: 28323139 DOI: 10.1016/j.joca.2017.03.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 03/01/2017] [Accepted: 03/08/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial (RCT) of physical rehabilitation ± progressive strength training (PST). We aimed to investigate whether (1) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; (2) PST affects inflammation, and the inflammatory state over time; (3) baseline or surgery-induced inflammation modifies the effect of rehabilitation ± PST on change in 6-min walk test (Δ6MWT); and (4) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA. DESIGN In the primary trial report's per-protocol analysis, 72/82 patients were included. Sixty had ≥1 blood sample before and after TKA, and were included in this secondary analysis. Inflammation was measured by interferon γ-inducible protein (IP)-10, soluble urokinase plasminogen activator receptor (suPAR), interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA. RESULTS At baseline, suPAR (P = 006) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation ± PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks-baseline (P = 0.001), also adjusted for 6MWTbaseline, age, sex and body mass index (BMI). CONCLUSION In this secondary analysis, only increased surgery-induced IL-10 response was associated with decreased long-term functional performance after TKA. The importance of controlling the surgery-induced immune response remains to be investigated further. TRIAL IDENTIFICATION NCT01351831.
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13
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Srdic D, Khawla AM, Soldatovic I, Nikolic J, Jevtovic D, Nair D, Dragovic G. Correlation of Leptin, Adiponectin, and Resistin Levels in Different Types of Lipodystrophy in HIV/AIDS Patients. Metab Syndr Relat Disord 2017; 15:153-159. [PMID: 28339344 DOI: 10.1089/met.2016.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Leptin, adiponectin, and resistin may play an important role in the development of lipodystrophy (LD) in HIV/AIDS patients. The aim of this study was to correlate levels of leptin, adiponectin, and resistin between HIV/AIDS patients with LD and without lipodystrophy (non-LD), as well as between subgroups of LD [lipoatrophy (LA), lipohypertrophy (LH), and mixed fat redistribution (MFR)] and non-LD patients. METHODS Cross-sectional study of 66 HIV/AIDS patients. Serum levels of leptin, adiponectin, and resistin were measured. The associations between adipocytokine levels and metabolic variables were estimated by Spearman correlation. Analysis of covariance with bootstrapping method was used to examine the relationship between adiponectin and leptin and lipodystrophy categories. RESULTS The LD was observed in 29 (44%) patients, while 15 (52%) of them had LA, 4 (14%) had LH, and 10 (34%) patients had MFR. No significant differences regarding leptin, adiponectin, and resistin levels, between LD and non-LD patients, were observed. LH patients had significantly higher levels of leptin and adiponectin in comparison with non-LD patients (P = 0.039, P = 0.011, respectively). Within the LD group, LA patients had significantly lower levels of leptin (LA vs. LH, P = 0.020; LA vs. MFR, P = 0.027), while LH patients had significantly higher levels of adiponectin (LH vs. LA, P = 0.027; LH vs. MFR, P = 0.028). Correlation of adiponectin with LD remains significant in the LH subgroup after adjustment for age, body mass index, cystatin-C, plasminogen activator inhibitor-1 (PAI-1), and interferon gamma (IFN-γ) (P = 0.001). CONCLUSIONS Adiponectin and leptin levels differ significantly between LH patients and non-LD patients, as well as between the LD subgroups. Adiponectin may be a more useful marker of LD in HIV/AIDS patients.
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Affiliation(s)
- Danica Srdic
- 1 Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Al Musalhi Khawla
- 2 Department of Clinical Biochemistry, Royal Free Hospital, University College London , London, United Kingdom
| | - Ivan Soldatovic
- 3 Institute for Biomedical Statistics, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Jelena Nikolic
- 4 Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Djordje Jevtovic
- 4 Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Devaki Nair
- 2 Department of Clinical Biochemistry, Royal Free Hospital, University College London , London, United Kingdom
| | - Gordana Dragovic
- 1 Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade , Belgrade, Serbia
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14
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Does persistent HIV replication explain continued lymphoma incidence in the era of effective antiretroviral therapy? Curr Opin Virol 2016; 20:71-77. [PMID: 27665065 DOI: 10.1016/j.coviro.2016.09.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 12/16/2022]
Abstract
Non-Hodgkin lymphomas are highly increased in incidence in individuals infected with HIV, and this continues to be the case in spite of highly effective combined antiretroviral therapy (cART). New evidence has demonstrated that while successful virtual recovery of CD4 counts and elimination of HIV from peripheral blood can be achieved with cART, viral replication can still occur in lymphoid tissues. In addition, recent studies have suggested that adipose tissue provides an additional reservoir for HIV-infected macrophages and T lymphocytes even in the context of successful cART therapy. In this review article, we discuss possible mechanisms leading to the development of lymphoma in the cART era.
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15
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Papagianni M, Tziomalos K. Obesity in patients with HIV infection: epidemiology, consequences and treatment options. Expert Rev Endocrinol Metab 2016; 11:395-402. [PMID: 30058909 DOI: 10.1080/17446651.2016.1220297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Even though wasting used to characterize patients with HIV infection prior to the antiretroviral therapy (ART) era, obesity is becoming increasingly prevalent in this population. Areas covered: In the present review, we discuss the epidemiology, consequences and treatment options for obesity in patients with HIV infection. Expert commentary: Obesity exerts a multitude of detrimental cardiometabolic effects and appears to contribute to the increasing cardiovascular mortality of this population. However, there are very limited data on the optimal management of obesity in patients with HIV infection. Given the potential for interactions between antiobesity agents and ART that might compromise viral control, lifestyle changes should represent the cornerstone for the prevention and management of obesity in HIV infection.
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Affiliation(s)
- Marianthi Papagianni
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
| | - Konstantinos Tziomalos
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
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16
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Lindboe JB, Langkilde A, Eugen-Olsen J, Hansen BR, Haupt TH, Petersen J, Andersen O. Low-dose growth hormone therapy reduces inflammation in HIV-infected patients: a randomized placebo-controlled study. Infect Dis (Lond) 2016; 48:829-37. [PMID: 27417288 DOI: 10.1080/23744235.2016.1201722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Combination antiretroviral therapy (cART) has drastically increased the life expectancy of HIV-infected patients. However, HIV-infected patients exhibit increased inflammation and 33-58% exhibit a characteristic fat re-distribution termed HIV-associated lipodystrophy syndrome (HALS). Recombinant human growth hormone (rhGH) has been tested as treatment of HALS. Low-dose rhGH therapy improves thymopoiesis and fat distribution in HIV-infected patients and appears to be well tolerated. However, since high-dose rhGH is associated with adverse events related to inflammation, we wanted to investigate the impact of low-dose rhGH therapy on inflammation in HIV-infected patients. METHODS Forty-six cART-treated HIV-infected men were included in the HIV-GH low-dose (HIGH/Low) study: a randomized, placebo-controlled, double-blinded trial. Subjects were randomized 3:2 to 0.7 mg/day rhGH, or placebo for 40 weeks. rhGH was self-administered between 1 pm and 3 pm. The primary outcome of this substudy was changes in inflammation measured by plasma C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR). RESULTS Both CRP (-66%, p = 0.002) and suPAR (-9.7%, p = 0.06) decreased in the rhGH group compared to placebo; however, only CRP decreased significantly. The effect of rhGH on inflammation was not mediated through rhGH-induced changes in insulin-like growth factor 1, body composition, or immune parameters. CONCLUSION Daily 0.7 mg rhGH treatment for 40 weeks, administered at nadir endogenous GH secretion, significantly reduced CRP. The effect does not appear to be mediated by other factors. Our findings suggest that low-dose rhGH treatment may minimize long-term risks associated with high-dose rhGH therapy.
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Affiliation(s)
- Johanne Bjerre Lindboe
- a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Anne Langkilde
- a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Jesper Eugen-Olsen
- b Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Birgitte R Hansen
- b Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;,c Department of Infectious Diseases , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Thomas H Haupt
- a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Janne Petersen
- a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;,d Department of Biostatistics , University of Copenhagen , Copenhagen , Denmark
| | - Ove Andersen
- a Optimed, Clinical Research Centre 056, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;,c Department of Infectious Diseases , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
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17
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Aounallah M, Dagenais-Lussier X, El-Far M, Mehraj V, Jenabian MA, Routy JP, van Grevenynghe J. Current topics in HIV pathogenesis, part 2: Inflammation drives a Warburg-like effect on the metabolism of HIV-infected subjects. Cytokine Growth Factor Rev 2016; 28:1-10. [PMID: 26851985 DOI: 10.1016/j.cytogfr.2016.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/01/2016] [Accepted: 01/13/2016] [Indexed: 02/07/2023]
Abstract
HIV-1 infection leads to a depletion of CD4 T-cells associated with a persistent immune inflammation and changes in cellular metabolism. Most effort of managing HIV infection with combination of antiretroviral therapies (ART) has been focused on CD4 T-cell recovery, while control of persistent immune inflammation and metabolism were relatively underappreciated in the past. Recent discoveries on the interplay between innate immunity, inflammation (especially the inflammasome) and metabolic changes in the context of cancer and autoimmunity provide an emerging field for chronic viral infections including HIV-1. In a previous review, we described the deregulated metabolism contributing to immune dysfunctions such as alteration of memory T-cell responses, mucosal protection, and dendritic cell-related antigen presentation. Here, we summarize the latest knowledge on the detrimental influence of long-lasting inflammation and inflammasome activation induced by HIV-1, gut dysbiosis, and bacterial translocation, on metabolism during the course of viral infection. We also report on the inability of ART to fully counteract inflammation, resulting in partial metabolic improvement and leading to an insufficient decrease in the risk of non-AIDS events. Further advances in our understanding of the relationship between inflammation, altered metabolism, and long-term ART is warranted. Additionally, there is a critical need for developing new strategies to regulate the pro-inflammatory signals to enhance cellular metabolism and immune functions in order to improve the quality of life of individuals living with HIV-1.
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Affiliation(s)
- Mouna Aounallah
- INRS-Institut Armand Frappier, Laval, Quebec H7V 1B7, Canada
| | | | | | - Vikram Mehraj
- Division of Hematology and Chronic Viral Illness Service, McGill University Health Centre, Glen site, Montreal, Quebec H4A 3J1, Canada
| | | | - Jean-Pierre Routy
- Division of Hematology and Chronic Viral Illness Service, McGill University Health Centre, Glen site, Montreal, Quebec H4A 3J1, Canada
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18
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Tavenier J, Langkilde A, Haupt TH, Henriksen JH, Jensen FK, Petersen J, Andersen O. Immunosenescence of the CD8(+) T cell compartment is associated with HIV-infection, but only weakly reflects age-related processes of adipose tissue, metabolism, and muscle in antiretroviral therapy-treated HIV-infected patients and controls. BMC Immunol 2015; 16:72. [PMID: 26611787 PMCID: PMC4661963 DOI: 10.1186/s12865-015-0136-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/20/2015] [Indexed: 12/15/2022] Open
Abstract
Background Despite effective antiretroviral therapy (ART), HIV-infected patients exhibit systemic inflammation, early onset of age-related diseases, and features of immunosenescence. The role of inflammation in the development of age-related diseases is widely recognized. However, the role of immunosenescence is not well established. Studying immunosenescence in HIV-infection could give insight into its role in ageing processes. In this cross-sectional study, we aimed to investigate whether ART-treated HIV-infected patients exhibit immunosenescence; and whether immunosenescence is associated with age-related processes of inflammation, metabolism, adipose tissue, and muscle. T cell immunosenescence and exhaustion were assessed by flow cytometry analysis of CD8+ cells from 43 ART-treated HIV-infected patients (HIV+) and ten Controls using markers of differentiation: CD27/CD28; maturation: CD27/CD45RA; senescence: killer cell lectin-like receptor G1 (KLRG1); and exhaustion: programmed death-1 (PD-1). Relationships between CD8+ T cell immunosenescence, exhaustion, and age-related processes were assessed using linear regressions. Results HIV-infection was strongly associated with more highly differentiated and mature CD8+ T cell phenotypes. PD-1 and KLRG1 expression did not differ between HIV+ and Controls, but depended on differentiation and maturation stages of the cells. CD8+ T cell maturation was associated with age. KLRG1 expression was associated with age, metabolic syndrome, visceral adipose tissue, and high muscle mass. PD-1 expression was not associated with age-related parameters. Conclusions HIV-infection strongly affected CD8+ T cell differentiation and maturation, whereas age-related processes were only weakly associated with immune parameters. Our findings suggest that, in contrast to inflammation, immunosenescence appears to be highly dependent on HIV-infection and is only to a small extent associated with age-related parameters in well-treated HIV-infection. Electronic supplementary material The online version of this article (doi:10.1186/s12865-015-0136-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juliette Tavenier
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Anne Langkilde
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Thomas Huneck Haupt
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Jens Henrik Henriksen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Frank Krieger Jensen
- Department of Radiology, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
| | - Janne Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark. .,Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K., Denmark.
| | - Ove Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark. .,Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
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