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Shaikh SR, Rahman AAU, Makhdoom A. Analysis of human ABO Blood Group as a risk factor with knee osteoarthritis at tertiary care hospital in Pakistan. Pak J Med Sci 2024; 40:896-900. [PMID: 38827876 PMCID: PMC11140333 DOI: 10.12669/pjms.40.5.8865] [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: 10/02/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 06/05/2024] Open
Abstract
Objective To investigate the association and risk estimation of ABO blood group distribution and clinical attributes in patients with Knee Osteoarthritis. Method This was a hospital-based study conducted at, Liaquat University Hospital Hyderabad from December, 2019 to December, 2022 to investigate this least researched area of highly prevalent musculoskeletal disease in Pakistan. Non-Probability Convenience Sampling was used for selecting 190 cases of confirm Knee Osteoarthritis patients diagnosed by Orthopedic surgeon based on standard clinical and radiographic criteria. Data were analyzed using IBM-SPSS version 23.0. Percentages and frequencies were counted for categorical data. Pearson Chi Square test and fisher's exact test were used to check the association and Multinomial Logistic Regression was used to estimate the risk for moderate and severe kellgren grading Knee Osteoarthritis (KOA) cases with ABO blood grouping in comparison of mild Kellgren grading. Results A total of 190 cases of Knee Osteoarthritis (KOA) were included in the study. Females (61.6%) and patients with age 50 and above were 40.5 % were found in greater proportion. Majority (41.6%) were classified radiologically as mild cases with O group (39.5%) and positive Rh antigen (95.8%). Strong association (p = <0.01) was found between gender, age group and ABO blood group with KOA radiological Kellgren and Lawrence score. Conclusion There is strong relation in between radiological grading of knee osteoarthritis severity and A blood group, gender and age.
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Affiliation(s)
- Shazia Rahman Shaikh
- Dr. Shazia Rahman Shaikh, MBBS, MPH. Department of Community Medicine and Public Health Sciences, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
| | - Aneela Atta Ur Rahman
- Prof. Dr. Aneela Atta Ur Rahman, MBBS, MPH, PhD. Department of Community Medicine and Public Health Sciences, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
| | - Asadullah Makhdoom
- Prof. Dr. Asadullah Makhdoom, MBBS, MS. Department of Orthopaedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
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2
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Ferous S, Siafakas N, Boufidou F, Patrinos GP, Tsakris A, Anastassopoulou C. Investigating ABO Blood Groups and Secretor Status in Relation to SARS-CoV-2 Infection and COVID-19 Severity. J Pers Med 2024; 14:346. [PMID: 38672973 PMCID: PMC11051264 DOI: 10.3390/jpm14040346] [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: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of evolution and the constant tug of war between humans and infectious microbes. This comprehensive narrative review aimed to explore the literature and to present the current state of knowledge on reported associations of the ABO, Lewis, and secretor blood groups with SARS-CoV-2 infection and COVID-19 severity. Our main finding was that the A blood group may be associated with increased susceptibility to SARS-CoV-2 infection, and possibly also with increased disease severity and overall mortality. The proposed pathophysiological pathways explaining this potential association include antibody-mediated mechanisms and increased thrombotic risk amongst blood group A individuals, in addition to altered inflammatory cytokine expression profiles. Preliminary evidence does not support the association between ABO blood groups and COVID-19 vaccine response, or the risk of developing long COVID. Even though the emergency state of the pandemic is over, further research is needed especially in this area since tens of millions of people worldwide suffer from lingering COVID-19 symptoms.
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Affiliation(s)
- Stefanos Ferous
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Nikolaos Siafakas
- Department of Clinical Microbiology, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - George P. Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece;
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
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Hathaway A, Qian G, King J, McGuinness S, Maskell N, Oliver J, Finn A, Danon L, Challen R, Toye AM, Hyams C. Association of ABO and Rhesus blood groups with severe outcomes from non-SARS-CoV-2 respiratory infection: A prospective observational cohort study in Bristol, UK 2020-2022. Br J Haematol 2024; 204:826-838. [PMID: 38009561 DOI: 10.1111/bjh.19234] [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: 09/07/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
Despite significant global morbidity associated with respiratory infection, there is a paucity of data examining the association between severity of non-SARS-CoV-2 respiratory infection and blood group. We analysed a prospective cohort of adults hospitalised in Bristol, UK, from 1 August 2020 to 31 July 2022, including patients with acute respiratory infection (pneumonia [n = 1934] and non-pneumonic lower respiratory tract infection [NP-LRTI] [n = 1184]), a negative SARS-CoV-2 test and known blood group status. The likelihood of cardiovascular complication, survival and hospital admission length was assessed using regression models with group O and RhD-negative status as reference groups. Group A and RhD-positive were over-represented in both pneumonia and NP-LRTI compared to a first-time donor population (p < 0.05 in all); contrastingly, group O was under-represented. ABO group did not influence cardiovascular complication risk; however, RhD-positive patients with pneumonia had a reduced odds ratio (OR) for cardiovascular complications (OR = 0.77 [95% CI = 0.59-0.98]). Compared to group O, group A individuals with NP-LRTI were more likely to be discharged within 60 days (hazard ratio [HR] = 1.17 [95% CI = 1.03-1.33]), while group B with pneumonia was less likely (HR = 0.8 [95% CI = 0.66-0.96]). This analysis provides some evidence that blood group status may influence clinical outcome following respiratory infection, with group A having increased risk of hospitalisation and RhD-positive patients having reduced cardiovascular complications.
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Affiliation(s)
- Alice Hathaway
- School of Biochemistry, University of Bristol, Bristol, UK
| | - George Qian
- Engineering Mathematics, University of Bristol, Bristol, UK
| | - Jade King
- Clinical Research and Imaging Centre, UHBW NHS Trust, Bristol, UK
| | - Serena McGuinness
- Bristol Vaccine Centre and Population Health Sciences, University of Bristol, Bristol, UK
| | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Southmead Hospital, Bristol, UK
| | - Jennifer Oliver
- Bristol Vaccine Centre and Population Health Sciences, University of Bristol, Bristol, UK
| | - Adam Finn
- Bristol Vaccine Centre, Cellular and Molecular Medicine and Population Health Sciences, University of Bristol, Bristol, UK
| | - Leon Danon
- Engineering Mathematics, University of Bristol, Bristol, UK
| | - Robert Challen
- Engineering Mathematics, University of Bristol, Bristol, UK
| | - Ashley M Toye
- School of Biochemistry, University of Bristol, Bristol, UK
| | - Catherine Hyams
- Bristol Vaccine Centre, Cellular and Molecular Medicine and Population Health Sciences, University of Bristol, Bristol, UK
- Academic Respiratory Unit and Bristol Vaccine Centre, University of Bristol, Bristol, UK
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4
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Schofield H, Lindsay C, Brohi K, Davenport R. Group B or not group B? An association between ABO, early mortality, and organ dysfunction in major trauma patients with shock. J Thromb Haemost 2024; 22:676-685. [PMID: 38070741 DOI: 10.1016/j.jtha.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/14/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND ABO blood group alters coagulation profiles in the general population and may influence outcomes after trauma. The relationship between trauma-induced coagulopathy, severe injury with hemorrhagic shock, and survival with respect to ABO group is unknown. OBJECTIVES In severe hemorrhagic trauma, we aimed to characterize the association of ABO group with admission coagulation profiles, mortality, and immune-mediated complications. METHODS Clinical and laboratory variables were examined from severely injured adult patients enrolled in a perpetual observational cohort study at a UK Major Trauma Center. Univariate and multivariate analyses were performed to determine differences in clinical outcomes (mortality, organ dysfunction, and critical care support). In a shock subgroup, we performed an exploratory analysis of rotational thromboelastometry parameters and coagulation biomarkers. RESULTS In 1119 trauma patients, we found no difference in mortality between ABO groups. In patients with shock, 24-hour mortality was significantly lower in group B vs non-B groups (7% vs 16%, adjusted odds ratio [aOR], 0.19; P = .030), but there were increased rates of invasive ventilation (aOR, 3.34; P = .033), renal replacement therapy (aOR, 2.55; P = .037), and a trend for infection (aOR, 1.85; P = .067). Comparing patients with shock, group B vs non-B patients had 40% higher fibrinogen, 65% higher factor (F) VIII, 36% higher FIX, 20% higher FXIII, and 19% higher von Willebrand factor. CONCLUSION In this observational study limited by single time-point sampling and subgroup analysis of trauma hemorrhage with shock, group B patients have enhanced hemostatic capability associated with early survival but with increased risk of immune-mediated complications.
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Affiliation(s)
- Henry Schofield
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, United Kingdom; Barts Health National Health Service Trust, London, United Kingdom.
| | - Charlotte Lindsay
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, United Kingdom; Barts Health National Health Service Trust, London, United Kingdom
| | - Karim Brohi
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, United Kingdom; Barts Health National Health Service Trust, London, United Kingdom
| | - Ross Davenport
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, United Kingdom; Barts Health National Health Service Trust, London, United Kingdom
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Esnault P, Houcinat N, de Malleray H, Quere PL, Cardinale M, D'aranda E, Joubert C, Dagain A, Goutorbe P, Meaudre E. ABO blood type and functional neurological outcome in patients with severe traumatic brain injury. J Trauma Acute Care Surg 2023; 95:737-745. [PMID: 37335132 DOI: 10.1097/ta.0000000000004041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND The ABO blood system has been involved in the pathogenesis of several diseases, including coagulopathy and bleeding complications. In trauma patients, blood type A has been associated with acute respiratory distress syndrome, and recently, blood type O has been associated with all-cause mortality. The purpose of this study was to assess the association between ABO blood types and long-term functional outcomes in critically ill patients with severe traumatic brain injury (TBI). METHODS We conducted a single-center, retrospective, observational study including all patients admitted to the intensive care unit with severe TBI (defined as a Glasgow Coma Scale score of ≤8) between January 2007 and December 2018. Patient characteristics and outcomes were extracted from a prospective registry of all intubated patients admitted to the intensive care unit for TBI. ABO blood types were retrospectively retrieved from patient medical records. The association between ABO blood type (A, B, AB, and O) and unfavorable functional outcome (defined by a Glasgow Outcome Scale score between 1 and 3) 6 months after injury was assessed in univariate and multivariate analysis. RESULTS A total of 333 patients meeting the inclusion criteria were included. There were 151 type O (46%), 131 type A (39%), 37 type B (11%), and 12 type AB patients (4%). No significant differences in baseline demographic, clinical, or biological characteristics were observed between blood types. The prevalence of unfavorable outcome was significantly different between the four groups. After adjustment for confounders, blood type O was significantly associated with unfavorable outcome at 6 months (odds ratio, 1.97; confidence interval [1.03-3.80]; p = 0.042). The prevalence of coagulopathy or progressive hemorrhagic injury was not statistically different between blood types ( p = 0.575 and p = 0.813, respectively). CONCLUSION Blood type O appears to be associated with unfavorable long-term functional outcome in critically ill patients with severe TBI. Further studies are needed to detail the mechanism underlying this relationship. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
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Affiliation(s)
- Pierre Esnault
- From the Intensive Care Unit (P.E., N.H., H.d.M., P.-L.Q., M.C., E.D., P.G., E.M.), and Department of Neurosurgery (C.J., A.D.), Sainte Anne Military Hospital, Toulon; and French Military Health Service Academy Unit (A.D., E.M.), Ecole du Val-de-Grâce, Paris, France
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Gutman L, Pauly V, Papazian L, Roch A. Effects of ambient air pollutants on ARDS incidence and outcome: a narrative review. Ann Intensive Care 2023; 13:84. [PMID: 37704926 PMCID: PMC10499767 DOI: 10.1186/s13613-023-01182-1] [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: 04/24/2023] [Accepted: 09/01/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Exposure to air pollutants promotes inflammation, cancer, and mortality in chronic diseases. Acute respiratory distress syndrome (ARDS) is a common condition among intensive care unit patients and is associated with a high mortality rate. ARDS is characterized by significant lung inflammation, which can be replicated in animal models by acute exposure to high doses of various air pollutants. Recently, several clinical studies have been conducted in different countries to investigate the role of chronic or acute air pollutant exposure in enhancing both ARDS incidence and severity. RESULTS Chronic exposure studies have mainly been conducted in the US and France. The results of these studies suggest that some air pollutants, notably ozone, nitrogen dioxide, and particulate matter, increase susceptibility to ARDS and associated mortality. Furthermore, their impact may differ according to the cause of ARDS. A cohort study conducted in an urbanized zone in China showed that exposure to very high levels of air pollutants in the few days preceding intensive care unit admission was associated with an increased incidence of ARDS. The effects of acute exposure are more debatable regarding ARDS incidence and severity. CONCLUSION There is a likely relationship between air pollutant exposure and ARDS incidence and severity. However, further studies are required to determine which pollutants are the most involved and which patients are the most affected. Due to the prevalence of ARDS, air pollutant exposure may have a significant impact and could be a key public health issue.
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Affiliation(s)
- Laëtitia Gutman
- Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Chemin Des Bourrely, 13015, Marseille, France.
- Faculté de Médecine, Centre d'Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France.
| | - Vanessa Pauly
- Faculté de Médecine, Centre d'Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Unité d'Analyse Des Données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France
| | - Laurent Papazian
- Faculté de Médecine, Centre d'Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Médecine Intensive Réanimation, Centre Hospitalier de Bastia, 20600, Bastia, Corsica, France
| | - Antoine Roch
- Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Chemin Des Bourrely, 13015, Marseille, France
- Faculté de Médecine, Centre d'Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
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7
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Zeng X, Fan H, Kou J, Lu D, Huang F, Meng X, Liu H, Li Z, Tang M, Zhang J, Liu N, Hu X. Analysis between ABO blood group and clinical outcomes in COVID-19 patients and the potential mediating role of ACE2. Front Med (Lausanne) 2023; 10:1167452. [PMID: 37425304 PMCID: PMC10327892 DOI: 10.3389/fmed.2023.1167452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the most common coronavirus that causes large-scale infections worldwide. Currently, several studies have shown that the ABO blood group is associated with coronavirus disease 2019 (COVID-19) infection and some studies have also suggested that the infection of COVID-19 may be closely related to the interaction between angiotensin-converting enzyme 2 (ACE2) and blood group antigens. However, the relationship between blood type to clinical outcome in critically ill patients and the mechanism of action is still unclear. The current study aimed to examine the correlation between blood type distribution and SARS-CoV-2 infection, progression, and prognosis in patients with COVID-19 and the potential mediating role of ACE2. With 234 patients from 5 medical centers and two established cohorts, 137 for the mild cohort and 97 for the critically ill cohort, we found that the blood type A population was more sensitive to SARS-CoV-2, while the blood type distribution was not relevant to acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and mortality in COVID-19 patients. Further study showed that the serum ACE2 protein level of healthy people with type A was significantly higher than that of other blood groups, and type O was the lowest. The experimental results of spike protein binding to red blood cells also showed that the binding rate of people with type A was the highest, and that of people with type O was the lowest. Our finding indicated that blood type A may be the biological marker for susceptibility to SARS-CoV-2 infection and may be associated with potential mediating of ACE2, but irrelevant to the clinical outcomes including ARDS, AKI, and death. These findings can provide new ideas for clinical diagnosis, treatment, and prevention of COVID-19.
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Affiliation(s)
- Xianfei Zeng
- School of Medicine, Northwest University, Xi'an, China
- Xi'an Area Medical Laboratory Center, Xi’an, China
| | - Hongyan Fan
- Department of Blood Transfusion, 940 Hospital, Lanzhou, China
| | - Jinxin Kou
- School of Medicine, Northwest University, Xi'an, China
| | - Dongxue Lu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Xi’an, China
| | - Fang Huang
- Department of Laboratory Medicine, Xi’an Chest Hospital, Xi’an, China
| | - Xi Meng
- Xi'an Area Medical Laboratory Center, Xi’an, China
| | - Haiying Liu
- Xi'an Area Medical Laboratory Center, Xi’an, China
| | - Zhuo Li
- Department of Laboratory Medicine, First Affiliated Hospital of Xi'an Medical University, Xi’an, China
| | - Mei Tang
- Department of Blood Transfusion, Tangdu Hospital, Xi’an, China
| | - Jing Zhang
- Department of Blood Transfusion, Xijing Hospital, Xi’an, China
| | - Nannan Liu
- Intensive Care Center, Xijing Hospital, Xi’an, China
| | - Xingbin Hu
- Department of Blood Transfusion, Xijing Hospital, Xi’an, China
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Lubkin DT, Van Gent JM, Cotton BA, Brill JB. Mortality and outcomes by blood group in trauma patients: A systematic review and meta-analysis. Vox Sang 2023. [PMID: 37045792 DOI: 10.1111/vox.13427] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Blood group O contains lower levels of factor VIII and von Willebrand factor. Higher incidence of bleeding among group O is reported in multiple contexts. Results of studies vary regarding outcomes stratified by blood group in trauma. We systematically reviewed the literature for outcomes related to blood group in trauma patients. Meta-analysis of studies evaluating mortality related to blood group was performed. MATERIALS AND METHODS The PubMed and Embase databases were searched for studies analysing relationships between blood group and outcomes in trauma patients. Preferred Reporting Items in Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. We synthesized outcomes data related to blood group. Meta-analysis compared mortality rates between group O and non-O patients. RESULTS Inclusion criteria were met by 13 studies. Statistically significant differences by blood group were reported in 3 of 10 (30%) studies evaluating mortality, 2 of 3 (66.7%) evaluating mortality from haemorrhage and 2 of 9 (22.2%) evaluating transfusion requirement. Meta-analysis was performed on seven studies evaluating mortality (total n = 11,835). There was significant heterogeneity among studies (I2 = 86%, p < 0.00001). No difference was found in mortality between group O and non-O patients (relative risk = 1.21, 95% confidence interval = 0.89-1.64, p = 0.23). CONCLUSION Existing literature does not consistently demonstrate a mortality difference between trauma patients with O and non-O blood groups. High variability in the methods and results among studies limits this conclusion, and further research is needed to delineate under what circumstances blood group may influence outcomes.
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Affiliation(s)
- David T Lubkin
- Department of General Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
| | - Jan-Michael Van Gent
- Department of General Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
| | - Bryan A Cotton
- Department of General Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
| | - Jason B Brill
- Department of General Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
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Dobkin J, Wu L, Mangalmurti NS. The ultimate tradeoff: how red cell adaptations to malaria alter the host response during critical illness. Am J Physiol Lung Cell Mol Physiol 2023; 324:L169-L178. [PMID: 36594846 PMCID: PMC9902222 DOI: 10.1152/ajplung.00127.2022] [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: 04/18/2022] [Revised: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023] Open
Abstract
The human immune system evolved in response to pathogens. Among these pathogens, malaria has proven to be one of the deadliest and has exerted the most potent selective pressures on its target cell, the red blood cell. Red blood cells have recently gained recognition for their immunomodulatory properties, yet how red cell adaptations contribute to the host response during critical illness remains understudied. This review will discuss how adaptations that may have been advantageous for host survival might influence immune responses in modern critical illness. We will highlight the current evidence for divergent host resilience arising from the adaptations to malaria and summarize how understanding evolutionary red cell adaptations to malaria may provide insight into the heterogeneity of the host response to critical illness, perhaps driving future precision medicine approaches to syndromes affecting the critically ill such as sepsis and acute respiratory distress syndrome (ARDS).
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Affiliation(s)
- Jane Dobkin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ling Wu
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nilam S Mangalmurti
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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10
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Sun X, Sammani S, Hufford M, Sun BL, Kempf CL, Camp SM, Garcia JGN, Bime C. Targeting SELPLG/P-selectin glycoprotein ligand 1 in preclinical ARDS: Genetic and epigenetic regulation of the SELPLG promoter. Pulm Circ 2023; 13:e12206. [PMID: 36873461 PMCID: PMC9982077 DOI: 10.1002/pul2.12206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/23/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
We previously identified a missense single nucleotide polymorphism rs2228315 (G>A, Met62Ile) in the selectin-P-ligand gene (SELPLG), encoding P-selectin glycoprotein ligand 1 (PSGL-1), to be associated with increased susceptibility to acute respiratory distress syndrome (ARDS). These earlier studies demonstrated that SELPLG lung tissue expression was increased in mice exposed to lipopolysaccharide (LPS)- and ventilator-induced lung injury (VILI) suggesting that inflammatory and epigenetic factors regulate SELPLG promoter activity and transcription. In this report, we used a novel recombinant tandem PSGL1 immunoglobulin fusion molecule (TSGL-Ig), a competitive inhibitor of PSGL1/P-selectin interactions, to demonstrate significant TSGL-Ig-mediated decreases in SELPLG lung tissue expression as well as highly significant protection from LPS- and VILI-induced lung injury. In vitro studies examined the effects of key ARDS stimuli (LPS, 18% cyclic stretch to simulate VILI) on SELPLG promoter activity and showed LPS-mediated increases in SELPLG promoter activity and identified putative promoter regions associated with increased SELPLG expression. SELPLG promoter activity was strongly regulated by the key hypoxia-inducible transcription factors, HIF-1α, and HIF-2α as well as NRF2. Finally, the transcriptional regulation of SELPLG promoter by ARDS stimuli and the effect of DNA methylation on SELPLG expression in endothelial cell was confirmed. These findings indicate SELPLG transcriptional regulation by clinically-relevant inflammatory factors with the significant TSGL-Ig-mediated attenuation of LPS and VILI highly consistent with PSGL1/P-selectin as therapeutic targets in ARDS.
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Affiliation(s)
- Xiaoguang Sun
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Saad Sammani
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Matthew Hufford
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Belinda L. Sun
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Carrie L. Kempf
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Sara M. Camp
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Joe G. N. Garcia
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
| | - Christian Bime
- Division of Pulmonary and Critical Care Medicine, College of MedicineUniversity of Arizona Health SciencesTucsonArizonaUSA
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Luo J, Craver A, Zakin P, Stepniak L, Moore K, King J, Kibriya MG, Johnson J, Olopade CO, Pinto JM, Kim K, Ahsan H, Aschebrook‐Kilfoy B. Race may modify the association between blood type and COVID-19 infection. EJHAEM 2022; 3:903-907. [PMID: 35945975 PMCID: PMC9353380 DOI: 10.1002/jha2.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
This study aims to investigate the race/ethnicity-specific association between blood type and COVID-19 susceptibility during March, 2020 and December, 2021 using data from the electronic health record at the University of Chicago Medicine. The study population was stratified into four groups: non-Hispanic White, non-Hispanic Black, Hispanic, and other. Log-binomial generalized mixed model was used to estimate the relative risk (RR) and 95% confidence interval (CI). When compared to blood type O, type B was associated with positive COVID-19 test in Blacks (RR = 1.12, 95% CI: 1.02-1.23), Whites (RR = 1.28, 95% CI: 0.99-1.66), and Hispanic (RR = 1.36, 95% CI: 0.97-1.92).
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Affiliation(s)
- Jiajun Luo
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
- Comprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
| | - Andrew Craver
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
| | - Paul Zakin
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
| | - Liz Stepniak
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
- Comprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
| | - Kayla Moore
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
| | - Jaime King
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
| | - Muhammad G. Kibriya
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
| | - Julie Johnson
- Center for Research InformaticsUniversity of ChicagoChicagoIllinois
| | | | | | - Karen Kim
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
- Comprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
- Department of MedicineUniversity of ChicagoChicagoIllinois
| | - Habibul Ahsan
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
- Comprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
| | - Briseis Aschebrook‐Kilfoy
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinois
- Institute for Population and Precision HealthUniversity of ChicagoChicagoIllinois
- Comprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
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12
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Steinvall I, Elmasry M, Abdelrahman I, El-Serafi A, Fredrikson M, Sjöberg F. ABO blood group and effects on ventilatory time, length of stay and mortality in major burns a retrospective observational outcome study. Burns 2022; 48:785-790. [PMID: 35227532 DOI: 10.1016/j.burns.2022.02.001] [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: 09/08/2021] [Revised: 01/05/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022]
Abstract
Blood group has been found to be important in the development of many diseases and the outcome of several disease processes, especially cardiovascular morbidity and mortality, such as caused by trauma and sepsis. The main reason is claimed to be related to glycobiology and effects mediated through the endothelium. This study investigated the possible effect of blood group (ABO) on burn care outcome. Burn outcome prediction models are extremely accurate and as such can be used to identify outcome effects even in single centre settings. In this retrospective risk adjusted observational study, we investigated the effect of ABO blood group on ventilatory time, length of hospital stay (LOS), and 90 day mortality among patients with burns. RESULTS: A total of 225 patients were included (2008-2019) with median TBSA of 26%; interquartile range (IQR) of 20-37%; median age 45 years (IQR 22-65 years); median Baux score (age + TBSA%); 76 (IQR 53- 97); 168 (75%) were male; median duration of hospital stay was 31 days (IQR 19-56); a total of 138 (61%) received treatment with mechanical ventilation; and 29 (13%) died. In a multivariable regression model, we were unable to isolate any significant effect of any blood group (O, A, B, AB) on the outcome measures studied (ventilatory time, LOS, and mortality). IN SUMMARY: contrary to many other major areas of disease in which ABO blood groups affect outcome, we were unable to find any such effect on patients with burns. Given the precision of the outcome models presented (AUC 0.93) any such an effect, if missed due to the limited study cohort, may be considered limited and to have only a minor clinical impact.
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Affiliation(s)
- Ingrid Steinvall
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Moustafa Elmasry
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Islam Abdelrahman
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Ahmed El-Serafi
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Folke Sjöberg
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden; Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden.
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13
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Su S, Guo L, Ma T, Sun Y, Song A, Wang W, Gu X, Wu W, Xie X, Zhang L, Zhang L, Yang J. Association of ABO blood group with respiratory disease hospitalization and severe outcomes: a retrospective cohort study in blood donors. Int J Infect Dis 2022; 122:21-29. [PMID: 35562043 DOI: 10.1016/j.ijid.2022.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Environmental, socioeconomic, and genetic factors all are associated with respiratory diseases. We aimed to investigate the association between the ABO blood group and the susceptibility to respiratory diseases. METHODS We constructed a retrospective cohort study of blood donors in Shaanxi, China between January 1, 2012, and December 31, 2018, to investigate the impacts of the ABO blood group on the risk of hospitalization due to respiratory diseases. RESULTS Of 1,686,263 enrolled participants (680,788 females), 26,597 were admitted to the hospital for respiratory diseases. Compared with blood group O, blood groups A, B, and AB all demonstrated a higher risk for diseases of the upper respiratory tract (International Classification of Diseases, Tenth Revision: J30-J39) (ARR (Adjusted relative risk) 1.139, 95% confidence interval [1.106-1.225]; 1.095 [1.019-1.177]; 1.178 [1.067-1.30], respectively). Conversely, blood group A was found to have a lower risk (0.86 [0.747-0.991]) for influenza (J09-J11) and blood group B had a lower risk for pneumonia (J12-J18) (0.911 [0.851-0.976]) than blood group O. The duration of hospitalization was significantly different across the blood groups in J09-J11 and J30-J39 (P <0.05). CONCLUSION The blood group appears to be a prognostic factor in differentiating the occurrence of specific respiratory diseases and duration.
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Affiliation(s)
- Shu Su
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China; Clinical Research Management Office, The Second Affiliated Hospital of ChongQing Medical University; China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Lingxia Guo
- Planning Development and Information Office, Health Commission of Shaanxi Province
| | - Ting Ma
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yang Sun
- Data Center, Shaanxi Provincial People's Hospital. Xi'an, China
| | - Aowei Song
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Wenhua Wang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xiaoyun Gu
- Department of Information Technological, Shaanxi Health Information Center, Xi'an, Shaanxi, China
| | - Wenjie Wu
- Department of Information Technological, Shaanxi Health Information Center, Xi'an, Shaanxi, China
| | - Xinxin Xie
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Leilei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Lei Zhang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China; Clinical Research Management Office, The Second Affiliated Hospital of ChongQing Medical University; Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia; Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
| | - Jiangcun Yang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, China.
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14
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Kander T, Bjurström MF, Frigyesi A, Jöud M, Nilsson CU. ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients. BMC Anesthesiol 2022; 22:91. [PMID: 35366803 PMCID: PMC8976170 DOI: 10.1186/s12871-022-01626-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients.
Methods
Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28– and 90–days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models.
Results
In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort.
Conclusions
The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.
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15
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Early Plasma Nuclear DNA, Mitochondrial DNA, and Nucleosome Concentrations Are Associated With Acute Kidney Injury in Critically Ill Trauma Patients. Crit Care Explor 2022; 4:e0663. [PMID: 35372847 PMCID: PMC8963825 DOI: 10.1097/cce.0000000000000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Circulating nucleic acids, alone and in complex with histones as nucleosomes, have been proposed to link systemic inflammation and coagulation after trauma to acute kidney injury (AKI). We sought to determine the association of circulating nucleic acids measured at multiple time points after trauma with AKI risk.
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16
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Shokri P, Golmohammadi S, Noori M, Nejadghaderi SA, Carson-Chahhoud K, Safiri S. The relationship between blood groups and risk of infection with SARS-CoV-2 or development of severe outcomes: A review. Rev Med Virol 2022; 32:e2247. [PMID: 34997677 PMCID: PMC8209917 DOI: 10.1002/rmv.2247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/28/2022]
Abstract
The outbreak of coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is considered a global catastrophe that has overwhelmed health care systems. Since initiation of the pandemic, identification of characteristics that might influence risk of infection and poor disease outcomes have been of paramount interest. Blood group phenotypes are genetically inherited characteristics whose association with certain infectious diseases have long been debated. The aim of this review is to identify whether a certain type of blood group may influence an individual’s susceptibility to SARS‐CoV‐2 infection and developing severe outcomes. Our review shows that blood group O protects individuals against SARS‐CoV‐2, whereas blood group A predisposes them to being infected. Although the association between blood groups and outcomes of COVID‐19 is not consistent, it is speculated that non‐O blood group carriers with COVID‐19 are at higher risk of developing severe outcomes in comparison to O blood group. The interaction between blood groups and SARS‐CoV‐2 infection is hypothesized to be as result of natural antibodies against blood group antigens that may act as a part of innate immune response to neutralize viral particles. Alternatively, blood group antigens could serve as additional receptors for the virus and individuals who are capable of expressing these antigens on epithelial cells, which are known as secretors, would then have a high propensity to be affected by SARS‐CoV‐2.
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Affiliation(s)
- Pourya Shokri
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Golmohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, University of South Australia, South Australia, Australia.,School of Medicine, University of Adelaide, South Australia, Australia
| | - Saeid Safiri
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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17
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Hirai S, Yagi K, Hara K, Kanda E, Matsubara S, Uno M. Postoperative recurrence of chronic subdural hematoma is more frequent in patients with blood type A. J Neurosurg 2021; 135:1203-1207. [PMID: 33385994 DOI: 10.3171/2020.7.jns202330] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/27/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Because of an aging society, the incidence of chronic subdural hematoma (CSDH) is increasing. This lesion is treated with simple burr hole irrigation, but one of the major issues is that CSDH frequently recurs. ABO blood type may be associated with a bleeding tendency and inflammation. However, its association with the recurrence of CSDH remains unknown. Therefore, the authors of the present study aimed to retrospectively investigate the association between ABO blood type and CSDH recurrence. METHODS The authors retrospectively analyzed symptomatic CSDHs in 425 cerebral hemispheres of 376 patients who had undergone surgical treatment with irrigation of the hematoma via burr holes at their institution from January 2011 to September 2019. Among these were 366 CSDHs in 320 patients whose ABO blood type had been determined and who were included in this study. RESULTS In the study, 307 patients with CSDHs in 350 hemispheres were followed up postoperatively until the disappearance of the CDSH or for at least 3 months. Recurrence of CSDH was observed in 37 patients (10.6%) after surgical treatment. Blood type A was found to be significantly associated with CSDH recurrence compared to non-A blood types: 24 of 153 CDSHs (15.7%) versus 13 of 197 CDSHs (6.6%) (p = 0.008). In the multivariable regression analysis, blood type A, in addition to thrombocytopenia, was a significant independent predictor of the recurrence of CSDH. CONCLUSIONS The study results showed that blood type A is an independent risk factor for the postoperative recurrence of CSDH and that careful follow-up in these patients may be needed.
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Affiliation(s)
| | | | | | - Eiichiro Kanda
- 2Medical Science, Kawasaki Medical School, Kurashiki, Okayama, Japan
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18
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Giannini HM, Meyer NJ. Genetics of Acute Respiratory Distress Syndrome: Pathways to Precision. Crit Care Clin 2021; 37:817-834. [PMID: 34548135 DOI: 10.1016/j.ccc.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Clinical risk factors alone fail to fully explain acute respiratory distress syndrome (ARDS) risk or ARDS death, suggesting that individual risk factors contribute. The goals of genomic ARDS studies include better mechanistic understanding, identifying dysregulated pathways that may be amenable to pharmacologic targeting, using genomic causal inference techniques to find measurable traits with meaning, and deconvoluting ARDS heterogeneity by proving reproducible subpopulations that may share a unique biology. This article discusses the latest advances in ARDS genomics, provides historical perspective, and highlights some of the ways that the coronavirus disease 2019 (COVID-19) pandemic is accelerating genomic ARDS research.
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Affiliation(s)
- Heather M Giannini
- University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 5038 Gates Building, Philadelphia, PA 19104, USA
| | - Nuala J Meyer
- University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 5038 Gates Building, Philadelphia, PA 19104, USA.
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19
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Matzhold EM, Berghold A, Bemelmans MKB, Banfi C, Stelzl E, Kessler HH, Steinmetz I, Krause R, Wurzer H, Schlenke P, Wagner T. Lewis and ABO histo-blood types and the secretor status of patients hospitalized with COVID-19 implicate a role for ABO antibodies in susceptibility to infection with SARS-CoV-2. Transfusion 2021; 61:2736-2745. [PMID: 34151460 PMCID: PMC8447157 DOI: 10.1111/trf.16567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) targets the respiratory and gastric epithelium, causing coronavirus disease 2019 (COVID-19). Tissue antigen expression variations influence host susceptibility to many infections. This study aimed to investigate the closely linked Lewis (FUT3) and ABO histo-blood types, including secretor (FUT2) status, to infections with SARS-CoV-2 and the corresponding severity of COVID-19. STUDY DESIGN AND METHODS Patients (Caucasians, n = 338) were genotyped for ABO, FUT3, and FUT2, and compared to a reference population of blood donors (n = 250,298). The association between blood types and severity of COVID-19 was addressed by dividing patients into four categories: hospitalized individuals in general wards, patients admitted to the intensive care unit with and without intubation, and deceased patients. Comorbidities were considered in subsequent analyses. RESULTS Patients with blood type Lewis (a-b-) or O were significantly less likely to be hospitalized (odds ratio [OR] 0.669, confidence interval [CI] 0.446-0.971, OR 0.710, CI 0.556-0.900, respectively), while type AB was significantly more prevalent in the patient cohort (OR 1.519, CI 1.014-2.203). The proportions of secretors/nonsecretors, and Lewis a+ or Lewis b+ types were consistent between patients and controls. The analyzed blood groups were not associated with the clinical outcome as defined. DISCUSSION Blood types Lewis (a-b-) and O were found to be protective factors, whereas the group AB is suggested to be a risk factor for COVID-19. The antigens investigated may not be prognostic for disease severity, but a role for ABO isoagglutinins in SARS-CoV-2 infections is strongly suggested.
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Affiliation(s)
- Eva Maria Matzhold
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and DocumentationMedical University of GrazGrazAustria
| | - Maria Karin Berta Bemelmans
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
- FH Campus WienUniversity of Applied SciencesViennaAustria
| | - Chiara Banfi
- Institute for Medical Informatics, Statistics and DocumentationMedical University of GrazGrazAustria
| | - Evelyn Stelzl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Harald Hans Kessler
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal MedicineMedical University of GrazGrazAustria
| | - Herbert Wurzer
- Department of Internal MedicineLandeskrankenhaus Graz IIGrazAustria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
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20
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Takayama W, Endo A, Murata K, Hoshino K, Kim S, Shinozaki H, Harada K, Nagano H, Hagiwara M, Tsuchihashi A, Shimada N, Kitamura N, Kuramoto S, Otomo Y. The impact of blood type on the mortality of patients with severe abdominal trauma: a multicenter observational study. Sci Rep 2021; 11:16147. [PMID: 34373499 PMCID: PMC8352974 DOI: 10.1038/s41598-021-95443-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 07/26/2021] [Indexed: 01/01/2023] Open
Abstract
Few studies have investigated the relationship between blood type and trauma outcomes according to the type of injury. We conducted a retrospective multicenter observational study in twelve emergency hospitals in Japan. Patients with isolated severe abdominal injury (abbreviated injury scale for the abdomen ≥ 3 and that for other organs < 3) that occurred between 2008 and 2018 were divided into four groups according to blood type. The association between blood type and mortality, ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate regression models. A total of 920 patients were included, and were divided based on their blood type: O, 288 (31%); A, 345 (38%); B, 186 (20%); and AB, 101 (11%). Patients with type O had a higher in-hospital mortality rate than those of other blood types (22% vs. 13%, p < 0.001). This association was observed in multivariate analysis (adjusted odds ratio [95% confidence interval] = 1.48 [1.25–2.26], p = 0.012). Furthermore, type O was associated with significantly higher cause-specific mortalities, fewer VFD, and larger transfusion volumes. Blood type O was associated with significantly higher mortality and larger transfusion volumes in patients with isolated severe abdominal trauma.
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Affiliation(s)
- Wataru Takayama
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan. .,Department of Acute Critical Care and Disaster Medicine, Graduate School of Tokyo Medical and Dental University, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan. .,Department of Emergency and Disaster Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan.
| | - Akira Endo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Kiyoshi Murata
- The Shock Trauma and Emergency Medical Center, Matsudo City General Hospital, 933-1, Sendabori, Matsudo, Chiba, Japan
| | - Kota Hoshino
- Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka, Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Hiroharu Shinozaki
- Department of Surgery, Saiseikai Utsunomiya Hospital, 911-1, Takebayashi-machi, Utsunomiya, Tochigi, Japan
| | - Keisuke Harada
- Department of Emergency Medicine, Sapporo Medical University, S1W16, Chuo-ku Sapporo, Hokkaido, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan
| | - Masahiro Hagiwara
- Department of Surgery, Asahikawa Medical University, 1-1-1 Midorigaoka Higashi 2 Jo, Asahikawa, Hokkaido, Japan
| | - Atsuhito Tsuchihashi
- Department Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae Ward, Kawasaki, Kanagawa, Japan
| | - Nagato Shimada
- Department of General Medicine and Emergency Center (Surgery), Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota City, Tokyo, Japan
| | - Naomi Kitamura
- Department of Surgery, Shiga University of Medical Science Hospital, Seta Tsukinowa-Cho, Otsu, Shiga, Japan
| | - Shunsuke Kuramoto
- Department of Acute Care Surgery, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.,Department of Acute Critical Care and Disaster Medicine, Graduate School of Tokyo Medical and Dental University, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
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21
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Abstract
BACKGROUND Prior research has reported an association among trauma patients between blood type O and adverse events. More recently, another study reported that severely injured trauma patients of mostly O Rh positive blood type were more likely to die. OBJECTIVE The objective of the current study is to examine whether the same increased association is observed for blood type O severely injured patients in a more generalizable population comprised of Rh positive and Rh negative individuals. METHODS Patients admitted to a Level-I academic trauma center between 2015 and 2018 with severe injury (Injury Severity Score >15) were included in this retrospective cohort study. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between blood type and mortality. RESULTS Among 3,913 patients, a majority were either blood type O (47.5%) or A (34.7%) and 60% were Rh positive. There was no observed difference in complication rates by blood type, and there was no observed significant association with death overall or by cause of death. There were weak, increased associations for blood type B (OR 1.61, 95% CI 0.74-3.53) and type O (OR 1.57, 95% CI 0.90-2.76) compared with blood type A patients. CONCLUSION Contrary to prior research, the current results suggest no association between blood type and mortality among severely injured trauma patients.
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22
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Sauder MW, Wolff TW, LaRiccia AK, Spalding MC, Pandya UB. The association of ABO blood groups and trauma outcomes: A retrospective analysis of 3779 patients. Int J Crit Illn Inj Sci 2021; 11:73-78. [PMID: 34395208 PMCID: PMC8318166 DOI: 10.4103/ijciis.ijciis_83_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/13/2020] [Accepted: 10/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background: There is currently a lack of understanding regarding the link between ABO blood types with outcomes of traumatically injured patients. The purpose of this study was to determine the association of ABO blood types with outcomes in traumatically injured patients separated by injury type. Methods: This retrospective study evaluated trauma patients at an urban, Level 1 trauma center from January 1, 2017, through December 31, 2017. Patients were excluded if they were pregnant or <16 years old. Recorded outcomes included: ABO blood group, mortality, Injury Severity Score (ISS), race, injury type, mechanism of injury, and complications. Data analysis was performed using descriptive statistics including Chi-squared, Kruskal–Wallis, and F-test calculations. Results: A total of 3779 patients were included in this study. No significant differences were present in mean age or ISS between blood types. In patients with penetrating injuries, blood type O was associated with a significant increase in mortality (P = 0.017), red blood cell transfusion (P = 0.027), and massive transfusion protocol (MTP) (P = 0.026) compared to non-O blood types. In patients with blunt injuries, blood type AB was associated with a significant increase in mortality rate compared to non-AB blood types (P = 0.03). Conclusion: ABO blood type is connected with an underlying process which affects trauma outcomes, including mortality. Blood type O is associated with increased blood transfusion, MTP, and mortality during the initial hospitalization following a traumatic penetrating injury, while blood type AB is associated with increased mortality during the initial hospitalization following a blunt traumatic injury.
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Affiliation(s)
- Michael W Sauder
- Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus.,Ohio University Heritage, College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Timothy W Wolff
- Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus.,Ohio University Heritage, College of Osteopathic Medicine, Dublin, Ohio, USA.,Department of Surgery, OhioHealth Doctors Hospital, Columbus, USA
| | - Aimee K LaRiccia
- Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus.,Ohio University Heritage, College of Osteopathic Medicine, Dublin, Ohio, USA.,Department of Surgery, OhioHealth Doctors Hospital, Columbus, USA
| | - M Chance Spalding
- Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus.,Ohio University Heritage, College of Osteopathic Medicine, Dublin, Ohio, USA.,Department of Surgery, OhioHealth Doctors Hospital, Columbus, USA
| | - Urmil B Pandya
- Division of Trauma and Acute Care Surgery, OhioHealth Grant Medical Center, Columbus.,Ohio University Heritage, College of Osteopathic Medicine, Dublin, Ohio, USA
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23
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Garibaldi PMM, Oliveira LC, da Fonseca BA, Auxiliadora-Martins M, Miranda CH, Almado CEL, Langhi DM, Gilio RN, Palma LC, Gomes BBM, Bottura C, Barrientto LC, Donadel CD, Calado RT, De Santis GC. Histo-blood group A is a risk factor for severe COVID-19. Transfus Med 2021; 32:248-251. [PMID: 34085363 PMCID: PMC8242674 DOI: 10.1111/tme.12796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Evaluate the impact of ABO histo-blood group type on COVID-19 severity. BACKGROUND ABO histo-blood type has been associated with different outcomes in infectious diseases. It has also shown a higher proportion of type A patients with SARS-CoV-2. In this observational study, extracted from an ongoing clinical trial on the efficacy of convalescent plasma transfused in COVID-19 patients, we describe the impact of ABO blood type on the risk of developing severe COVID-19. MATERIALS AND METHODS Seventy-two consecutive patients (37 type A, 23 type O, 11 type B, 1 type AB) with severe (respiratory failure) COVID-19 were included. Control group was composed of 160 individuals randomly selected from the same populational basis. RESULTS Blood group A was overrepresented (51.39%) in the patient group in relation to the control group (30%), whereas blood group O was less represented (31.94%) in patient than in control group (48%). Odds ratio (A vs. O) was 2.581 (1.381-4.817), CI 95%; p = 0.004. Also, blood group A patients appeared to have more severe disease, given by the scores of the Sequential Organ Failure Assessment and Simplified Acute Physiologic Score 3 (p = 0.036 and p = 0.058, respectively). CONCLUSION Histo-blood type A is associated with a higher risk of developing severe COVID-19 in relation to blood type O.
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Affiliation(s)
- Pedro M M Garibaldi
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Luciana C Oliveira
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Benedito A da Fonseca
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Maria Auxiliadora-Martins
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Carlos H Miranda
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Carlos E L Almado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil.,Department of Intensive Care Medicine, Serrana State Hospital, Serrana, Brazil
| | - Dante M Langhi
- Department of Haematology and Hemotherapy, São Camilo Hospital, São Paulo, Brazil
| | - Renato N Gilio
- Department of Intensive Care Medicine, Américo Brasiliense State Hospital, Américo Brasiliense, Brazil
| | - Leonardo C Palma
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Bruno B M Gomes
- Department of Intensive Care Medicine, Serrana State Hospital, Serrana, Brazil
| | - Camila Bottura
- Department of Intensive Care Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Larissa C Barrientto
- Department of Intensive Care Medicine, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Camila D Donadel
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Rodrigo T Calado
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Gil C De Santis
- Department of Medical Imaging, Haematology, and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil
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24
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ABO blood group and COVID-19: an updated systematic literature review and meta-analysis. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2021; 19:317-326. [PMID: 34059188 DOI: 10.2450/2021.0049-21] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/20/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Following the first reports in the literature, the association between the ABO blood group and SARS-CoV-2 infection has been investigated by a number of studies, although with varying results. The main object of this systematic review was to assess the relationship between the ABO blood group and the occurrence and severity of COVID-19. MATERIALS AND METHODS A systematic literature search using appropriate MeSH terms was performed through Medline and PubMed. The outcomes considered were the prevalence of the blood group O vs non-O types in SARS-CoV-2 infected and non-infected subjects, and the severity of SARS-CoV-2 infection according to ABO group. The methodological quality of the studies included in the analysis was assessed with the Newcastle-Ottawa Scale, and the overall quality of the available evidence using the GRADE system. Benchmarks used to evaluate the effect size were odd ratios (ORs) for case control studies and risk ratios (RRs) for cohort studies. RESULTS Twenty-one studies were included in the analysis. Overall, individuals with group O had a lower infection rate compared to individuals of non-O group (OR: 0.81; 95% CI: 0.75, 0.86). However, the difference in the effect size was significantly lower in cohort studies compared to case control studies. No evidence was found indicating an effect of the O type on the disease severity in the infected patients. DISCUSSION We have found low/very low evidence that group O individuals are less susceptible to SARS-CoV-2 infection compared to those in the non-O group. No evidence was found indicating an effect of the O type on disease severity in SARS-CoV-2 infection.
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25
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Sjoding MW, Taylor D, Motyka J, Lee E, Co I, Claar D, McSparron JI, Ansari S, Kerlin MP, Reilly JP, Shashaty MGS, Anderson BJ, Jones TK, Drebin HM, Ittner CAG, Meyer NJ, Iwashyna TJ, Ward KR, Gillies CE. Deep learning to detect acute respiratory distress syndrome on chest radiographs: a retrospective study with external validation. LANCET DIGITAL HEALTH 2021; 3:e340-e348. [PMID: 33893070 PMCID: PMC8182690 DOI: 10.1016/s2589-7500(21)00056-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023]
Abstract
Background Acute respiratory distress syndrome (ARDS) is a common, but under-recognised, critical illness syndrome associated with high mortality. An important factor in its under-recognition is the variability in chest radiograph interpretation for ARDS. We sought to train a deep convolutional neural network (CNN) to detect ARDS findings on chest radiographs. Methods CNNs were pretrained on 595 506 radiographs from two centres to identify common chest findings (eg, opacity and effusion), and then trained on 8072 radiographs annotated for ARDS by multiple physicians using various transfer learning approaches. The best performing CNN was tested on chest radiographs in an internal and external cohort, including a subset reviewed by six physicians, including a chest radiologist and physicians trained in intensive care medicine. Chest radiograph data were acquired from four US hospitals. Findings In an internal test set of 1560 chest radiographs from 455 patients with acute hypoxaemic respiratory failure, a CNN could detect ARDS with an area under the receiver operator characteristics curve (AUROC) of 0·92 (95% CI 0·89–0·94). In the subgroup of 413 images reviewed by at least six physicians, its AUROC was 0·93 (95% CI 0·88–0·96), sensitivity 83·0% (95% CI 74·0–91·1), and specificity 88·3% (95% CI 83·1–92·8). Among images with zero of six ARDS annotations (n=155), the median CNN probability was 11%, with six (4%) assigned a probability above 50%. Among images with six of six ARDS annotations (n=27), the median CNN probability was 91%, with two (7%) assigned a probability below 50%. In an external cohort of 958 chest radiographs from 431 patients with sepsis, the AUROC was 0·88 (95% CI 0·85–0·91). When radiographs annotated as equivocal were excluded, the AUROC was 0·93 (0·92–0·95). Interpretation A CNN can be trained to achieve expert physician-level performance in ARDS detection on chest radiographs. Further research is needed to evaluate the use of these algorithms to support real-time identification of ARDS patients to ensure fidelity with evidence-based care or to support ongoing ARDS research. Funding National Institutes of Health, Department of Defense, and Department of Veterans Affairs.
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Affiliation(s)
- Michael W Sjoding
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Center for Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | - Daniel Taylor
- Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Jonathan Motyka
- Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Elizabeth Lee
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ivan Co
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Dru Claar
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jakob I McSparron
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Sardar Ansari
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Meeta Prasad Kerlin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - John P Reilly
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Translational Lung Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Michael G S Shashaty
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Brian J Anderson
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Tiffanie K Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Translational Lung Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Harrison M Drebin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Translational Lung Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Caroline A G Ittner
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Translational Lung Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nuala J Meyer
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Translational Lung Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Theodore J Iwashyna
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; VA Center for Clinic Management Research, Ann Arbor, MI, USA; Institute for Social Research, Ann Arbor, MI, USA
| | - Kevin R Ward
- Center for Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA
| | - Christopher E Gillies
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA; Michigan Institute for Data Science, University of Michigan, Ann Arbor, MI, USA
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26
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Itenov TS, Sessler DI, Khanna AK, Ostrowski SR, Johansson PI, Erikstrup C, Pedersen OB, Rygård SL, Holst LB, Bestle MH, Hein L, Lindhardt A, Tousi H, Andersen MH, Mohr T, Lundgren JD, Jensen JU. ABO blood types and sepsis mortality. Ann Intensive Care 2021; 11:61. [PMID: 33877463 PMCID: PMC8056100 DOI: 10.1186/s13613-021-00844-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background We aimed to determine if the ABO blood types carry different risks of 30-day mortality, acute kidney injury (AKI), and endothelial damage in critically ill patients with sepsis. This was a retrospective cohort study of three independent cohorts of critically ill patients from the United States and Scandinavia consisting of adults with septic shock. We compared the 30-day mortality across the blood types within each cohort and pooled the results in a meta-analysis. We also estimated the incidence of AKI and degree of endothelial damage, as measured by blood concentrations of soluble thrombomodulin and syndecan-1. Results We included 12,342 patients with severe sepsis. In a pooled analysis blood type B carried a slightly lower risk of 30-day all-cause mortality compared to non-blood type B (adjusted HR 0.88; 95%-CI 0.79–0.98; p = 0.02). There was no difference in the risk of AKI. Soluble thrombomodulin and syndecan-1 concentrations were lower in patients with blood type B and O compared to blood type A, suggesting less endothelial damage. Conclusion Septic patients with blood type B had less endothelial damage, and a small reduction in mortality. The exposure is, however, unmodifiable. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00844-2.
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Affiliation(s)
- Theis S Itenov
- CHIP / PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, The Capital Region of Denmark, Denmark. .,Department of Anaesthesiology, Nordsjællands Hospital, Hillerød, Denmark.
| | - Daniel I Sessler
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ashish K Khanna
- Wake Forest University School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA.,Outcomes Research Consortium, Cleveland, OH, USA
| | - Sisse R Ostrowski
- CHIP / PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, The Capital Region of Denmark, Denmark.,Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Pär I Johansson
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Næstved Sygehus, Næstved, Denmark
| | | | - Lars B Holst
- Department of Intensive Care, Rigshospitalet, Denmark
| | - Morten H Bestle
- Department of Anaesthesiology, Nordsjællands Hospital, Hillerød, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars Hein
- Department of Anaesthesiology, Nordsjællands Hospital, Hillerød, Denmark
| | - Anne Lindhardt
- Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hami Tousi
- Department of Anaesthesiology, Herlev Hospital, Copenhagen, Denmark
| | - Mads H Andersen
- Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Mohr
- Department of Anaesthesiology, Gentofte Hospital, Hellerup, Denmark
| | - Jens D Lundgren
- CHIP / PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, The Capital Region of Denmark, Denmark
| | - Jens-Ulrik Jensen
- CHIP / PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, The Capital Region of Denmark, Denmark.,Respiratory Section, Department of Internal Medicine, Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Outcomes Research Consortium, Cleveland, OH, USA
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27
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Mokra D, Mokry J. Phosphodiesterase Inhibitors in Acute Lung Injury: What Are the Perspectives? Int J Mol Sci 2021; 22:1929. [PMID: 33669167 PMCID: PMC7919656 DOI: 10.3390/ijms22041929] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 12/14/2022] Open
Abstract
Despite progress in understanding the pathophysiology of acute lung damage, currently approved treatment possibilities are limited to lung-protective ventilation, prone positioning, and supportive interventions. Various pharmacological approaches have also been tested, with neuromuscular blockers and corticosteroids considered as the most promising. However, inhibitors of phosphodiesterases (PDEs) also exert a broad spectrum of favorable effects potentially beneficial in acute lung damage. This article reviews pharmacological action and therapeutical potential of nonselective and selective PDE inhibitors and summarizes the results from available studies focused on the use of PDE inhibitors in animal models and clinical studies, including their adverse effects. The data suggest that xanthines as representatives of nonselective PDE inhibitors may reduce acute lung damage, and decrease mortality and length of hospital stay. Various (selective) PDE3, PDE4, and PDE5 inhibitors have also demonstrated stabilization of the pulmonary epithelial-endothelial barrier and reduction the sepsis- and inflammation-increased microvascular permeability, and suppression of the production of inflammatory mediators, which finally resulted in improved oxygenation and ventilatory parameters. However, the current lack of sufficient clinical evidence limits their recommendation for a broader use. A separate chapter focuses on involvement of cyclic adenosine monophosphate (cAMP) and PDE-related changes in its metabolism in association with coronavirus disease 2019 (COVID-19). The chapter illuminates perspectives of the use of PDE inhibitors as an add-on treatment based on actual experimental and clinical trials with preliminary data suggesting their potential benefit.
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Affiliation(s)
- Daniela Mokra
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
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28
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Rizzo AN, Schmidt EP. ABO blood type: a window into the genetics of acute respiratory distress syndrome susceptibility. J Clin Invest 2021; 131:144075. [PMID: 33141764 PMCID: PMC7773403 DOI: 10.1172/jci144075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The genetic factors that determine a patient's risk for developing the acute respiratory distress syndrome (ARDS) remain understudied. In this issue of the JCI, Reilly and colleagues analyzed data from three cohorts of critically ill patients and observed an association between the ABO allele A1 and the onset of moderate-severe ARDS. This association was most notable in patients with non-pulmonary sepsis (an indirect, vasculature-targeted mechanism of lung injury) and persisted in patients who lacked epithelial expression of the A antigen, suggesting an endothelial mechanism of A1-associated ARDS susceptibility. Critically ill patients with blood type A had increased circulating concentrations of endothelium-derived glycoproteins such as von Willebrand factor and soluble thrombomodulin, and marginal lungs from blood type A donors were less likely to recover function during ex vivo perfusion. These findings implicate A antigen glycosylation of endothelial cells as a critical, genetically determined risk factor for indirect lung injury that may contribute to the mechanistic heterogeneity of ARDS.
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Affiliation(s)
- Alicia N. Rizzo
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Eric P. Schmidt
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA
- Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
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29
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Reilly JP, Meyer NJ, Shashaty MG, Anderson BJ, Ittner C, Dunn TG, Lim B, Forker C, Bonk MP, Kotloff E, Feng R, Cantu E, Mangalmurti NS, Calfee CS, Matthay MA, Mikacenic C, Walley KR, Russell J, Christiani DC, Wurfel MM, Lanken PN, Reilly MP, Christie JD. The ABO histo-blood group, endothelial activation, and acute respiratory distress syndrome risk in critical illness. J Clin Invest 2021; 131:139700. [PMID: 32931480 PMCID: PMC7773362 DOI: 10.1172/jci139700] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUNDThe ABO histo-blood group is defined by carbohydrate modifications and is associated with risk for multiple diseases, including acute respiratory distress syndrome (ARDS). We hypothesized that genetically determined blood subtype A1 is associated with increased risk of ARDS and markers of microvascular dysfunction and coagulation.METHODSWe conducted analyses in 3 cohorts of critically ill trauma and sepsis patients (n = 3710) genotyped on genome-wide platforms to determine the association of the A1 blood type genotype with ARDS risk. We subsequently determined whether associations were present in FUT2-defined nonsecretors who lack ABO antigens on epithelium, but not endothelium. In a patient subgroup, we determined the associations of blood type with plasma levels of endothelial glycoproteins and disseminated intravascular coagulation (DIC). Lastly, we tested whether blood type A was associated with less donor lung injury recovery during human ex vivo lung perfusion (EVLP).RESULTSThe A1 genotype was associated with a higher risk of moderate to severe ARDS relative to type O in all 3 populations. In sepsis, this relationship was strongest in nonpulmonary infections. The association persisted in nonsecretors, suggesting a vascular mechanism. The A1 genotype was also associated with higher DIC risk as well as concentrations of thrombomodulin and von Willebrand factor, which in turn were associated with ARDS risk. Blood type A was also associated with less lung injury recovery during EVLP.CONCLUSIONWe identified a replicable association between ABO blood type A1 and risk of ARDS among the critically ill, possibly mediated through microvascular dysfunction and coagulation.FUNDINGNIH HL122075, HL125723, HL137006, HL137915, DK097307, HL115354, HL101779, and the University of Pennsylvania McCabe Fund Fellowship Award.
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Affiliation(s)
- John P. Reilly
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
| | - Nuala J. Meyer
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
| | - Michael G.S. Shashaty
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
- Center for Clinical Epidemiology and Biostatics, and
| | - Brian J. Anderson
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
| | | | - Thomas G. Dunn
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
| | - Brian Lim
- Division of Pulmonary, Allergy, and Critical Care
| | | | | | | | - Rui Feng
- Center for Clinical Epidemiology and Biostatics, and
| | - Edward Cantu
- Center for Translational Lung Biology
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nilam S. Mangalmurti
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
| | - Carolyn S. Calfee
- Department of Medicine and
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Michael A. Matthay
- Department of Medicine and
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Carmen Mikacenic
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Keith R. Walley
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - James Russell
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - David C. Christiani
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Mark M. Wurfel
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | | | - Muredach P. Reilly
- Irving Institute for Clinical and Translational Research, Columbia University Irving Medical Center, New York, New York, USA
| | - Jason D. Christie
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology
- Center for Clinical Epidemiology and Biostatics, and
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30
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Valenti L, Villa S, Baselli G, Temporiti R, Bandera A, Scudeller L, Prati D. Association of ABO blood group and secretor phenotype with severe COVID-19. Transfusion 2020; 60:3067-3070. [PMID: 33009662 PMCID: PMC7675339 DOI: 10.1111/trf.16130] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Transfusion Medicine and Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Villa
- Transfusion Medicine and Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Baselli
- Transfusion Medicine and Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Temporiti
- Transfusion Medicine and Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Bandera
- Infectious Disorders, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luigia Scudeller
- Scientific Direction, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Prati
- Transfusion Medicine and Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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31
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Pourali F, Afshari M, Alizadeh-Navaei R, Javidnia J, Moosazadeh M, Hessami A. Relationship between blood group and risk of infection and death in COVID-19: a live meta-analysis. New Microbes New Infect 2020; 37:100743. [PMID: 32837730 PMCID: PMC7418722 DOI: 10.1016/j.nmni.2020.100743] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/14/2020] [Accepted: 08/07/2020] [Indexed: 02/08/2023] Open
Abstract
The relationship between ABO blood group and the incidence of coronavirus disease 2019 (COVID-19) infection and death has been investigated in several studies. The reported results were controversial, so the objective of the present study was to assess the relationship between different blood groups and the onset and mortality of COVID-19 infection using a meta-analysis method. We searched relevant databases using appropriate MeSH terms. We screened articles on the bases of titles, abstracts and full text, and articles that met the inclusion criteria were selected. Quality assessment was done with the Newcastle-Ottawa scale checklist. The estimated frequency of COVID-19 infection and death in terms of ABO blood group and the overall estimate of the odds ratio between blood group with COVID-19 infection and death was calculated with 95% confidence interval. The pooled frequency of blood groups A, B, O and AB among COVID-19-infected individuals was estimated as 36.22%, 24.99%, 29.67% and 9.29% respectively. The frequency of blood groups A, B, O and AB among patients who died of COVID-19 infection was estimated as 40%, 23%, 29% and 8% respectively. The odds ratio of COVID-19 infection for blood group A versus the other blood groups was estimated as 1.16 (95% confidence interval (CI), 1.02-1.33). The corresponding figures for blood groups O and AB versus other blood groups were estimated as 0.73 (95% CI, 0.60-0.88) and 1.25 (95% CI, 0.84-1.86) respectively. This meta-analysis showed that individuals with blood group A are at higher risk for COVID-19 infection while those with blood group O are at lower risk. Although the odds ratio of death for AB blood group was nonsignificant, it was considerable.
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Affiliation(s)
- F. Pourali
- Student Research Committee, School of Medicine, Iran
| | - M. Afshari
- Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - R. Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - J. Javidnia
- Student Research Committee, School of Medicine, Iran
| | - M. Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - A. Hessami
- Student Research Committee, School of Medicine, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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32
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Leaf RK, Al-Samkari H, Brenner SK, Gupta S, Leaf DE. ABO phenotype and death in critically ill patients with COVID-19. Br J Haematol 2020; 190:e204-e208. [PMID: 32609874 PMCID: PMC7361419 DOI: 10.1111/bjh.16984] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Rebecca K Leaf
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hanny Al-Samkari
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Samantha K Brenner
- Department of Internal Medicine, Hackensack Meridian School of Medicine at Seton Hall, Nutley, NJ, USA.,Department of Internal Medicine, Heart and Vascular Hospital, Hackensack Meridian Health Hackensack University Medical Center, Hackensack, NJ, USA
| | - Shruti Gupta
- Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David E Leaf
- Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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33
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Yao R, Hou W, Shen T, Zhao S, He X, Sun Y, Ma B, Wu G, Xia Z. The Impact of Blood Type O on Major Outcomes in Patients With Severe Burns. J Burn Care Res 2020; 41:1111-1117. [PMID: 32249907 DOI: 10.1093/jbcr/iraa059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABO blood type has been reported to be a predictor of poor prognosis in critically ill patients. Here, we aim to correlate different blood types with clinical outcomes in patients with severe burns. We conducted a single-center retrospective cohort study by enrolling patients with severe burn injuries (≥40% TBSA) between January 2012 and December 2017. Baseline characteristics and clinical outcomes were compared between disparate ABO blood types (type O vs non-O type). Multivariate logistic and linear regression analyses were performed to identify an association between ABO blood type and clinical outcomes, including in-hospital mortality, the development of acute kidney injury (AKI), and hospital or ICU length of stay. A total of 141 patients were finally enrolled in the current study. Mortality was significantly higher in patients with type O blood compared with those of other blood types. The development of AKI was significantly higher in patients with blood type O vs non-O blood type (P = .001). Multivariate analysis demonstrated that blood type O was independently associated with in-hospital mortality and AKI occurrence after adjusting for other potential confounders. Our findings indicated the blood type O was an independent risk factor of both increased mortality and the development of AKI postburn. More prudent and specific treatments are required in treating these patients to avoid poor prognosis.
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Affiliation(s)
- Renqi Yao
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China.,Trauma Research Center, Fourth Medical Center of the Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Wenjia Hou
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Tuo Shen
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Shuo Zhao
- Department of Laboratory Diagnosis, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Xingfeng He
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Yu Sun
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Bing Ma
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Guosheng Wu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Zhaofan Xia
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China
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34
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Rogers AJ. Genome-Wide Association Study in Acute Respiratory Distress Syndrome. Finding the Needle in the Haystack to Advance Our Understanding of Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2019; 197:1373-1374. [PMID: 29438627 DOI: 10.1164/rccm.201801-0098ed] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Angela J Rogers
- 1 Department of Medicine Stanford University Stanford, California
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35
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Stowell SR, Stowell CP. Biologic roles of the ABH and Lewis histo-blood group antigens part II: thrombosis, cardiovascular disease and metabolism. Vox Sang 2019; 114:535-552. [PMID: 31090093 DOI: 10.1111/vox.12786] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 12/14/2022]
Abstract
The ABH and Lewis antigens were among the first of the human red blood cell polymorphisms to be identified and, in the case of the former, play a dominant role in transfusion and transplantation. But these two therapies are largely twentieth-century innovations, and the ABH and related carbohydrate antigens are not only expressed on a very wide range of human tissues, but were present in primates long before modern humans evolved. Although we have learned a great deal about the biochemistry and genetics of these structures, the biological roles that they play in human health and disease are incompletely understood. This review and its companion, which appeared in a previous issue of Vox Sanguinis, will focus on a few of the biologic and pathologic processes which appear to be affected by histo-blood group phenotype. The first of the two reviews explored the interactions of two bacteria with the ABH and Lewis glycoconjugates of their human host cells, and described the possible connections between the immune response of the human host to infection and the development of the AB-isoagglutinins. This second review will describe the relationship between ABO phenotype and thromboembolic disease, cardiovascular disease states, and general metabolism.
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Affiliation(s)
- Sean R Stowell
- Center for Apheresis, Center for Transfusion and Cellular Therapies, Emory Hospital, Emory University School of Medicine, Atlanta, GA, USA.,Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher P Stowell
- Blood Transfusion Service, Massachusetts General Hospital, Boston, MA, USA.,Department of Pathology, Harvard Medical School, Boston, MA, USA
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36
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Reilly JP, Calfee CS, Christie JD. Acute Respiratory Distress Syndrome Phenotypes. Semin Respir Crit Care Med 2019; 40:19-30. [PMID: 31060085 DOI: 10.1055/s-0039-1684049] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The acute respiratory distress syndrome (ARDS) phenotype was first described over 50 years ago and since that time significant progress has been made in understanding the biologic processes underlying the syndrome. Despite this improved understanding, no pharmacologic therapies aimed at the underlying biology have been proven effective in ARDS. Increasingly, ARDS has been recognized as a heterogeneous syndrome characterized by subphenotypes with distinct clinical, radiographic, and biologic differences, distinct outcomes, and potentially distinct responses to therapy. The Berlin Definition of ARDS specifies three severity classifications: mild, moderate, and severe based on the PaO2 to FiO2 ratio. Two randomized controlled trials have demonstrated a potential benefit to prone positioning and neuromuscular blockade in moderate to severe phenotypes of ARDS only. Precipitating risk factor, direct versus indirect lung injury, and timing of ARDS onset can determine other clinical phenotypes of ARDS after admission. Radiographic phenotypes of ARDS have been described based on a diffuse versus focal pattern of infiltrates on chest imaging. Finally and most promisingly, biologic subphenotypes or endotypes have increasingly been identified using plasma biomarkers, genetics, and unbiased approaches such as latent class analysis. The potential of precision medicine lies in identifying novel therapeutics aimed at ARDS biology and the subpopulation within ARDS most likely to respond. In this review, we discuss the challenges and approaches to subphenotype ARDS into clinical, radiologic, severity, and biologic phenotypes with an eye toward the future of precision medicine in critical care.
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Affiliation(s)
- John P Reilly
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carolyn S Calfee
- Department of Medicine and Anesthesia, University of California, San Francisco, San Francisco, California
| | - Jason D Christie
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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37
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Peng YF, Goyal H, Lin H, Liu DC, Li L. Serum amylase activity altered by the ABO blood group system in Chinese subjects. J Clin Lab Anal 2019; 33:e22883. [PMID: 30938472 PMCID: PMC6595472 DOI: 10.1002/jcla.22883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/22/2022] Open
Abstract
Objective The underlying interactions between ABO blood group antigens and pancreatic exocrine tissue have been demonstrated, and serum amylase was synthesized by pancreatic ductal cells. Thus, we investigated the link between ABO blood type and serum amylase activity in Chinese subjects. Methods Our study included 343 relatively healthy Chinese individuals, and the data were retrieved from electronic medical record database. Results A increased trend was observed for serum amylase activity in ABO blood type distribution, and we found that serum amylase activity was remarkable increased in subjects with O blood type compared to those with non‐O blood type (P = 0.013). Logistic regression analysis indicated that serum amylase was independently associated with individuals with O blood group (adjusted odds ratio 1.574; 95% CI, 1.022‐2.425, P = 0.039). Conclusions The present evidence suggests a significant link between serum amylase activity and ABO blood type in the study population, indicating ABO blood type may be associated with the susceptibility of pancreatic disease.
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Affiliation(s)
- You-Fan Peng
- Department of Endocrinology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.,Pancreatic Research Institute, Southeast University, Nanjing, China
| | - Hemant Goyal
- Department of Internal Medicine, School of Medicine, Mercer University, Macon, Georgia, USA
| | - Hao Lin
- Pancreatic Research Institute, Southeast University, Nanjing, China.,Department of Clinical Science and Research, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - De-Chen Liu
- Pancreatic Research Institute, Southeast University, Nanjing, China.,Department of Clinical Science and Research, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ling Li
- Department of Endocrinology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.,Pancreatic Research Institute, Southeast University, Nanjing, China
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38
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Tignanelli CJ, Hemmila MR, Rogers MAM, Raghavendran K. Nationwide cohort study of independent risk factors for acute respiratory distress syndrome after trauma. Trauma Surg Acute Care Open 2019; 4:e000249. [PMID: 30899792 PMCID: PMC6407565 DOI: 10.1136/tsaco-2018-000249] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/11/2018] [Accepted: 12/24/2018] [Indexed: 12/14/2022] Open
Abstract
Background The primary objective of this study was to evaluate the effect of specific direct and indirect factors that accounted, in trauma patients, for the development of acute respiratory distress syndrome (ARDS) and mortality in patients with ARDS. Methods We performed a retrospective cohort study of patients from the National Trauma Data Bank. Multilevel mixed-effects logistic regression was used with the development of ARDS as the primary and mortality in patients with ARDS as the secondary outcome measures. We compared trauma patients with versus without thoracic (direct) and extrathoracic (indirect) risk factors, using patient demographics, physiologic, and anatomic injury severity as covariates. Subset analysis was performed for patients with trauma-induced lung contusion (TILC) and for patients with minor (Injury Severity Score [ISS] ≤15) injury. Results A total of 2 998 964 patients were studied, of whom 28 597 developed ARDS. From 2011 to 2014, the incidence of ARDS decreased; however, mortality in patients with ARDS has increased. Predictors of ARDS included direct thoracic injury (TILC, multiple rib fractures, and flail chest), as well as indirect factors (increased age, male gender, higher ISS, lower Glasgow Coma Scale motor component score, history of cardiopulmonary or hematologic disease, and history of alcoholism or obesity). Patients with ARDS secondary to direct thoracic injury had a lower risk of mortality compared with patients with ARDS due to other mechanisms. Discussion Despite the decreasing incidence of trauma-induced ARDS, mortality in patients with ARDS has increased. Direct thoracic injury was the strongest predictor of ARDS. Knowing specific contributors to trauma-induced ARDS could help identify at-risk patients early in their hospitalization and mitigate the progression to ARDS and thereby mortality. Level of evidence Prognostic study, level III.
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Affiliation(s)
- Christopher J Tignanelli
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark R Hemmila
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary A M Rogers
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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39
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McMahon KE, Habeeb O, Bautista GM, Levin S, DeChristopher PJ, Glynn LA, Jeske W, Muraskas JK. The association between AB blood group and neonatal disease. J Neonatal Perinatal Med 2019; 12:81-86. [PMID: 30347622 DOI: 10.3233/npm-17115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Numerous studies have examined the association between ABO blood groups and adult disease states, but very few have studied the neonatal population. The objective of this study was to determine the relationship between AB blood group and the occurrence of common neonatal disorders such as neutropenia at birth, sepsis, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and patent ductus arteriosus (PDA) compared to all other blood groups. METHODS We performed a retrospective review on 3,981 infants born at 22 0/7 to 42 6/7 weeks' gestational age and compared the relative risk of neonatal diseases in infants with AB blood group to that of infants with all other blood groups (A, B, and O). RESULTS When compared to all other blood groups, AB infants demonstrated an increased risk for developing negative clinical outcomes. AB blood group was significantly associated with a 14-89% increased risk of neutropenia at birth, sepsis, RDS, and ROP. Risks for IVH and PDA were not significant. CONCLUSION We hypothesize that the phenotypic expression of A and B antigens, rather than the antigens themselves, in the AB group may reveal an enhanced susceptibility to injury at the endothelial level resulting in an increased risk for disease development.
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Affiliation(s)
- K E McMahon
- Loyola University Medical Center, Maywood, IL, USA
| | - O Habeeb
- New York University Langone Medical Center, New York, NY, USA
| | - G M Bautista
- Loyola University Medical Center, Maywood, IL, USA
| | - S Levin
- Loyola University Medical Center, Maywood, IL, USA
| | | | - L A Glynn
- Mercy Health Rockford, University of Illinois, Rockford, IL, USA
| | - W Jeske
- Loyola University Medical Center, Maywood, IL, USA
| | - J K Muraskas
- Loyola University Medical Center, Maywood, IL, USA
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40
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Reilly JP, Zhao Z, Shashaty MGS, Koyama T, Christie JD, Lanken PN, Wang C, Balmes JR, Matthay MA, Calfee CS, Ware LB. Low to Moderate Air Pollutant Exposure and Acute Respiratory Distress Syndrome after Severe Trauma. Am J Respir Crit Care Med 2019; 199:62-70. [PMID: 30067389 PMCID: PMC6353017 DOI: 10.1164/rccm.201803-0435oc] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/01/2018] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Exposure to air pollution has molecular and physiologic effects on the lung that may increase the risk of acute respiratory distress syndrome (ARDS) after injury. OBJECTIVES To determine the association of short- and long-term air pollutant exposures and ARDS risk after severe trauma. METHODS We analyzed data from a prospective cohort of 996 critically ill patients presenting with acute trauma and an injury severity score greater than 15. Exposures to ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, and particulate matter less than 2.5 μm were assessed by weighted averages of daily levels from all monitors within 50 km of the geocoded location of a patient's residence. Patients were followed for 6 days for the development of ARDS according to Berlin Criteria. The association between each exposure and ARDS was determined via multivariable logistic regression adjusting for potential confounders. MEASUREMENTS AND MAIN RESULTS ARDS developed in 243 (24%) patients. None of the short-term exposures averaged over the 3 days before presentation was associated with ARDS, except sulfur dioxide, which demonstrated a nonlinear association. Nitrogen dioxide, sulfur dioxide, and particulate matter less than or equal to 2.5 μm in aerodynamic diameter exposure over the 6 weeks before presentation was significantly associated with ARDS (P < 0.05). All long-term exposures (3 yr) were associated with ARDS (P < 0.01) in adjusted models, despite exposure levels largely below U.S. and European Union air quality standards. CONCLUSIONS Long-term low- to moderate-level air pollutant exposure is associated with a greater risk of developing ARDS after severe trauma and represents a novel and potentially modifiable environmental risk factor for ARDS.
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Affiliation(s)
- John P. Reilly
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology, and
| | | | - Michael G. S. Shashaty
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology, and
| | | | - Jason D. Christie
- Division of Pulmonary, Allergy, and Critical Care
- Center for Translational Lung Biology, and
- Center for Clinical Epidemiology and Biostatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Associate Editor, AJRCCM
| | | | | | - John R. Balmes
- Associate Editor, AJRCCM
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California; and
- Department of Medicine and
| | - Michael A. Matthay
- Department of Medicine and
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
| | - Carolyn S. Calfee
- Department of Medicine and
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
| | - Lorraine B. Ware
- Department of Medicine, and
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
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41
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Reilly JP, Wang F, Jones TK, Palakshappa JA, Anderson BJ, Shashaty MGS, Dunn TG, Johansson ED, Riley TR, Lim B, Abbott J, Ittner CAG, Cantu E, Lin X, Mikacenic C, Wurfel MM, Christiani DC, Calfee CS, Matthay MA, Christie JD, Feng R, Meyer NJ. Plasma angiopoietin-2 as a potential causal marker in sepsis-associated ARDS development: evidence from Mendelian randomization and mediation analysis. Intensive Care Med 2018; 44:1849-1858. [PMID: 30343317 PMCID: PMC6697901 DOI: 10.1007/s00134-018-5328-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/18/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE A causal biomarker for acute respiratory distress syndrome (ARDS) could fuel precision therapy options. Plasma angiopoietin-2 (ANG2), a vascular permeability marker, is a strong candidate on the basis of experimental and observational evidence. We used genetic causal inference methods-Mendelian randomization and mediation-to infer potential effects of plasma ANG2. METHODS We genotyped 703 septic subjects, measured ICU admission plasma ANG2, and performed a quantitative trait loci (QTL) analysis to determine variants in the ANGPT2 gene associated with plasma ANG2 (p < 0.005). We then used linear regression and post-estimation analysis to genetically predict plasma ANG2 and tested genetically predicted ANG2 for ARDS association using logistic regression. We estimated the proportion of the genetic effect explained by plasma ANG2 using mediation analysis. RESULTS Plasma ANG2 was strongly associated with ARDS (OR 1.59 (95% CI 1.35, 1.88) per log). Five ANGPT2 variants were associated with ANG2 in European ancestry subjects (n = 404). Rs2442608C, the most extreme cis QTL (coefficient 0.22, 95% CI 0.09-0.36, p = 0.001), was associated with higher ARDS risk: adjusted OR 1.38 (95% CI 1.01, 1.87), p = 0.042. No significant QTL were identified in African ancestry subjects. Genetically predicted plasma ANG2 was associated with ARDS risk: adjusted OR 2.25 (95% CI 1.06-4.78), p = 0.035. Plasma ANG2 mediated 34% of the rs2442608C-related ARDS risk. CONCLUSIONS In septic European ancestry subjects, the strongest ANG2-determining ANGPT2 genetic variant is associated with higher ARDS risk. Plasma ANG2 may be a causal factor in ARDS development. Strategies to reduce plasma ANG2 warrant testing to prevent or treat sepsis-associated ARDS.
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Affiliation(s)
- John P Reilly
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Fan Wang
- Department of Molecular Cardiology, Cleveland Clinic Lerner Research Institute, Cleveland, USA
| | - Tiffanie K Jones
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Jessica A Palakshappa
- Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| | - Brian J Anderson
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Michael G S Shashaty
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Thomas G Dunn
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Erik D Johansson
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Thomas R Riley
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Brian Lim
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Jason Abbott
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California San Francisco, San Francisco, USA
| | - Caroline A G Ittner
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
| | - Edward Cantu
- Divison of Cardiothoracic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Xihong Lin
- Harvard University T.H. Chan School of Public Health, Boston, USA
| | - Carmen Mikacenic
- Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, USA
| | - Mark M Wurfel
- Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, USA
| | - David C Christiani
- Harvard University T.H. Chan School of Public Health, Boston, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, USA
| | - Carolyn S Calfee
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, USA
| | - Michael A Matthay
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California San Francisco, San Francisco, USA
| | - Jason D Christie
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA
| | - Rui Feng
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA
| | - Nuala J Meyer
- Pulmonary, Allergy, and Critical Care Medicine Division, University of Pennsylvania Perelman School of Medicine, 3600 Spruce Street 5039 Gates Building, Philadelphia, PA, 19104, USA.
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Rezoagli E, Gatti S, Villa S, Villa G, Muttini S, Rossi F, Faraldi L, Fumagalli R, Grasselli G, Foti G, Bellani G. ABO blood types and major outcomes in patients with acute hypoxaemic respiratory failure: A multicenter retrospective cohort study. PLoS One 2018; 13:e0206403. [PMID: 30359446 PMCID: PMC6201964 DOI: 10.1371/journal.pone.0206403] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/14/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction ABO blood type A was reported to correlate with an increased risk of acute respiratory distress syndrome (ARDS) in white patients with severe sepsis and major trauma compared with patients with other blood types. Information regarding ABO phenotypes and major outcomes in patients with ARDS is unavailable. The primary aim was to determine the relationship between ABO blood type A and intensive care unit (ICU) mortality in patients with acute hypoxemic respiratory failure (AHRF). The secondary aim was to describe the association between ABO blood type A and ICU length of stay (LOS) in this study population. Methods In a multicenter, retrospective cohort study, we collected the clinical records of patients admitted from January 2012 to December 2014 in five ICUs of Northern Italy. We included adult white patients admitted to the ICU who were diagnosed with AHRF requiring mechanical ventilation. Results The electronic records of 1732 patients with AHRF were reviewed. The proportion of patients with ABO blood type A versus other blood types was 39.9% versus 60.1%. ICU mortality (25%) and ICU LOS (median [interquartile range], 5 [2–12] days) were not different when stratified by ABO blood type (ICU mortality, overall p value = 0.905; ICU LOS, overall p value = 0.609). SAPSII was a positive predictor of ICU mortality (odds ration [OR], 32.80; 95% confidence interval [CI], 18.80–57.24; p < 0.001) and ICU LOS (β coefficient, 0.55; 95% CI, 0.35–0.75; p < 0.001) at multivariate analyses, whereas ABO blood type did not predict ICU outcome when forced into the model. Conclusion ABO blood type did not correlate with ICU mortality and ICU LOS in adult patients with AHRF who were mechanically ventilated.
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Affiliation(s)
- Emanuele Rezoagli
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Lung Biology Group, Regenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, Biomedical Sciences Building, National University of Ireland Galway, Galway, Ireland.,Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, SAOLTA University Health Group, Galway, Ireland
| | - Stefano Gatti
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Silvia Villa
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Giulia Villa
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Stefano Muttini
- Department of Emergency Medicine and Intensive Care, "Ospedale Civile" Vimercate, Vimercate, Monza Brianza, Italy
| | - Fabio Rossi
- Immunotransfusional Unit, San Gerardo Hospital, Monza, Italy
| | - Loredana Faraldi
- Department of Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Roberto Fumagalli
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giacomo Grasselli
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Foti
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy
| | - Giacomo Bellani
- School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy
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43
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Bime C, Pouladi N, Sammani S, Batai K, Casanova N, Zhou T, Kempf CL, Sun X, Camp SM, Wang T, Kittles RA, Lussier YA, Jones TK, Reilly JP, Meyer NJ, Christie JD, Karnes JH, Gonzalez-Garay M, Christiani DC, Yates CR, Wurfel MM, Meduri GU, Garcia JGN. Genome-Wide Association Study in African Americans with Acute Respiratory Distress Syndrome Identifies the Selectin P Ligand Gene as a Risk Factor. Am J Respir Crit Care Med 2018; 197:1421-1432. [PMID: 29425463 PMCID: PMC6005557 DOI: 10.1164/rccm.201705-0961oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 02/08/2018] [Indexed: 12/29/2022] Open
Abstract
RATIONALE Genetic factors are involved in acute respiratory distress syndrome (ARDS) susceptibility. Identification of novel candidate genes associated with increased risk and severity will improve our understanding of ARDS pathophysiology and enhance efforts to develop novel preventive and therapeutic approaches. OBJECTIVES To identify genetic susceptibility targets for ARDS. METHODS A genome-wide association study was performed on 232 African American patients with ARDS and 162 at-risk control subjects. The Identify Candidate Causal SNPs and Pathways platform was used to infer the association of known gene sets with the top prioritized intragenic SNPs. Preclinical validation of SELPLG (selectin P ligand gene) was performed using mouse models of LPS- and ventilator-induced lung injury. Exonic variation within SELPLG distinguishing patients with ARDS from sepsis control subjects was confirmed in an independent cohort. MEASUREMENTS AND MAIN RESULTS Pathway prioritization analysis identified a nonsynonymous coding SNP (rs2228315) within SELPLG, encoding P-selectin glycoprotein ligand 1, to be associated with increased susceptibility. In an independent cohort, two exonic SELPLG SNPs were significantly associated with ARDS susceptibility. Additional support for SELPLG as an ARDS candidate gene was derived from preclinical ARDS models where SELPLG gene expression in lung tissues was significantly increased in both ventilator-induced (twofold increase) and LPS-induced (5.7-fold increase) murine lung injury models compared with controls. Furthermore, Selplg-/- mice exhibited significantly reduced LPS-induced inflammatory lung injury compared with wild-type C57/B6 mice. Finally, an antibody that neutralizes P-selectin glycoprotein ligand 1 significantly attenuated LPS-induced lung inflammation. CONCLUSIONS These findings identify SELPLG as a novel ARDS susceptibility gene among individuals of European and African descent.
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Affiliation(s)
| | - Nima Pouladi
- Department of Medicine
- Center for Biomedical Informatics and Biostatistics
| | | | | | | | | | | | | | | | | | | | - Yves A. Lussier
- Department of Medicine
- Center for Biomedical Informatics and Biostatistics
| | - Tiffanie K. Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - John P. Reilly
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nuala J. Meyer
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jason D. Christie
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jason H. Karnes
- Department of Pharmacy Practice and Science, University of Arizona, Tucson, Arizona
| | | | - David C. Christiani
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | | | - Mark M. Wurfel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington
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44
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Meyer NJ, Reilly JP, Feng R, Christie JD, Hazen SL, Albert CJ, Franke JD, Hartman CL, McHowat J, Ford DA. Myeloperoxidase-derived 2-chlorofatty acids contribute to human sepsis mortality via acute respiratory distress syndrome. JCI Insight 2017; 2:96432. [PMID: 29212955 DOI: 10.1172/jci.insight.96432] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/01/2017] [Indexed: 12/17/2022] Open
Abstract
Sepsis-associated acute respiratory distress syndrome (ARDS) is characterized by neutrophilic inflammation and poor survival. Since neutrophil myeloperoxidase (MPO) activity leads to increased plasma 2-chlorofatty acid (2-ClFA) levels, we hypothesized that plasma concentrations of 2-ClFAs would associate with ARDS and mortality in subjects with sepsis. In sequential consenting patients with sepsis, free 2-ClFA levels were significantly associated with ARDS, and with 30-day mortality, for each log increase in free 2-chlorostearic acid. Plasma MPO was not associated with either ARDS or 30-day mortality but was correlated with 2-ClFA levels. Addition of plasma 2-ClFA levels to the APACHE III score improved prediction for ARDS. Plasma 2-ClFA levels correlated with plasma levels of angiopoietin-2, E selectin, and soluble thrombomodulin. Endothelial cells treated with 2-ClFA responded with increased adhesion molecule surface expression, increased angiopoietin-2 release, and dose-dependent endothelial permeability. Our results suggest that 2-ClFAs derived from neutrophil MPO-catalyzed oxidation contribute to pulmonary endothelial injury and have prognostic utility in sepsis-associated ARDS.
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Affiliation(s)
- Nuala J Meyer
- Pulmonary, Allergy, and Critical Care Division.,Center for Translational Lung Biology, and
| | - John P Reilly
- Pulmonary, Allergy, and Critical Care Division.,Center for Translational Lung Biology, and
| | - Rui Feng
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jason D Christie
- Pulmonary, Allergy, and Critical Care Division.,Center for Translational Lung Biology, and.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Stanley L Hazen
- Department of Cellular and Molecular Medicine, Center for Microbiome and Human Health, and Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Carolyn J Albert
- Department of Biochemistry and Molecular Biology.,Center for Cardiovascular Research and
| | - Jacob D Franke
- Department of Biochemistry and Molecular Biology.,Center for Cardiovascular Research and
| | - Celine L Hartman
- Department of Biochemistry and Molecular Biology.,Center for Cardiovascular Research and
| | - Jane McHowat
- Center for Cardiovascular Research and.,Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - David A Ford
- Department of Biochemistry and Molecular Biology.,Center for Cardiovascular Research and
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45
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The authors reply. Crit Care Med 2017; 44:e454-5. [PMID: 27182882 DOI: 10.1097/ccm.0000000000001790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Association of ABO Blood Types and Clinicopathological Features of Prostate Cancer. DISEASE MARKERS 2017; 2017:9237481. [PMID: 29129952 PMCID: PMC5654337 DOI: 10.1155/2017/9237481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 08/19/2017] [Accepted: 09/06/2017] [Indexed: 12/16/2022]
Abstract
Purpose To investigate the association between ABO blood types and clinicopathological characteristics in patients with prostate cancer (PC). Methods A total of 237 pathologically diagnosed PC patients were enrolled. All patients were classified as low–middle or high-risk group. The correlation of ABO blood types with high-risk PC was determined by univariate and multivariate regression analysis. Results Data indicated 144 (85.7%) patients were stratified as high risk in the non-O group, while 50 (72.5%) patients in the O group (p = 0.025). However, there was no significant difference regarding PSA, Gleason score, stage, or metastasis between O and non-O group (p > 0.05). Univariate logistic regression analyses revealed PSA, Gleason score, and blood type non-O were all correlated with high-risk PC (OR = 1.139, p < 0.001; OR = 9.465, p < 0.001; OR = 2.280, p = 0.018, resp.). In the stepwise multivariate regression analysis, the association between blood type non-O and high-risk PC remained significant (OR = 33.066, 95% CI 2.391–457.323, and p = 0.009) after adjusting for confounding factors as well as PSA and Gleason score. Conclusion The present study firstly demonstrated that non-O blood type was at higher risk of aggressive PC compared with O type, suggesting that PC patients with non-O blood type should receive more attention in clinical practice.
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47
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Potential contribution of mitochondrial DNA damage associated molecular patterns in transfusion products to the development of acute respiratory distress syndrome after multiple transfusions. J Trauma Acute Care Surg 2017; 82:1023-1029. [PMID: 28301393 DOI: 10.1097/ta.0000000000001421] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Massive transfusions are accompanied by an increased incidence of a particularly aggressive and lethal form of acute lung injury (delayed transfusion-related acute lung injury) which occurs longer than 24 hours after transfusions. In light of recent reports showing that mitochondrial (mt)DNA damage-associated molecular patterns (DAMPs) are potent proinflammatory mediators, and that their abundance in the sera of severely injured or septic patients is predictive of clinical outcomes, we explored the idea that mtDNA DAMPs are present in transfusion products and are associated with the occurrence of delayed transfusion-related acute lung injury. METHODS We prospectively enrolled fourteen consecutive severely injured patients that received greater than three units of blood transfusion products and determined if the total amount of mtDNA DAMPs delivered during transfusion correlated with serum mtDNA DAMPs measured after the last transfusion, and whether the quantity of mtDNA DAMPs in the serum-predicted development of acute respiratory distress syndrome (ARDS). RESULTS We found detectable levels of mtDNA DAMPs in packed red blood cells (3 ± 0.4 ng/mL), fresh frozen plasma (213.7 ± 65 ng/mL), and platelets (94.8 ± 69.2), with the latter two transfusion products containing significant amounts of mtDNA fragments. There was a linear relationship between the mtDNA DAMPs given during transfusion and the serum concentration of mtDNA fragments (R = 0.0.74, p < 0.01). The quantity of mtDNA DAMPs in serum measured at 24 hours after transfusion predicted the occurrence of ARDS (9.9 ± 1.4 vs. 3.3 ± 0.9, p < 0.01). CONCLUSION These data show that fresh frozen plasma and platelets contain large amounts of extracellular mtDNA, that the amount of mtDNA DAMPs administered during transfusion may be a determinant of serum mtDNA DAMP levels, and that serum levels of mtDNA DAMPs after multiple transfusions may predict the development of ARDS. Collectively, these findings support the idea that mtDNA DAMPs in transfusion products significantly contribute to the incidence of ARDS after massive transfusions. LEVEL OF EVIDENCE Prognostic study, level II; therapeutic study, level II.
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48
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Reilly JP, Meyer NJ, Christie JD. Genetics in the Prevention and Treatment of Sepsis. SEPSIS 2017. [DOI: 10.1007/978-3-319-48470-9_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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49
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Reilly JP, Anderson BJ, Hudock KM, Dunn TG, Kazi A, Tommasini A, Charles D, Shashaty MGS, Mikkelsen ME, Christie JD, Meyer NJ. Neutropenic sepsis is associated with distinct clinical and biological characteristics: a cohort study of severe sepsis. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:222. [PMID: 27431667 PMCID: PMC4950810 DOI: 10.1186/s13054-016-1398-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 07/01/2016] [Indexed: 12/31/2022]
Abstract
Background Immunocompromised patients who develop sepsis while neutropenic are at high risk for morbidity and mortality; however, it is unknown if neutropenic sepsis is associated with distinct clinical and biological characteristics. Methods We conducted a prospective cohort study of patients admitted to the medical intensive care unit of an academic medical center with severe sepsis. Patients were followed for the development of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and mortality. Plasma proteins, representing the host inflammatory response, anti-inflammatory response, and endothelial leak were measured in 30 % of subjects. Clinical characteristics and plasma protein concentrations of patients with neutropenia at enrollment were compared to patients without neutropenia. Results Of 797 subjects enrolled, 103 (13 %) were neutropenic at ICU admission. The neutropenic subjects were more often in shock, admitted from the hospital ward, had higher APACHE III scores, and more likely bacteremic. Neutropenia was an independent risk factor for AKI (RR 1.28; 95 % CI 1.04, 1.57; p = 0.03), but not ARDS (RR 0.90; 95 % CI 0.70, 1.17; p = 0.42) or 30-day mortality (RR 1.05; 95 % CI 0.85, 1.31; p = 0.65). Neutropenic subjects had higher plasma interleukin (IL)-6 (457 vs. 249 pg/ml; p = 0.03), IL-8 (581 vs. 94 pg/ml; p <0.001), and granulocyte colony-stimulating factor (G-CSF) (3624 vs. 99 pg/ml; p <0.001). Angiopoietin-2 and IL-1 receptor antagonist concentrations did not differ between groups. Conclusions Neutropenic sepsis is associated with a higher AKI risk and concentrations of inflammatory mediators IL-6, IL-8, and G-CSF relative to non-neutropenic patients. These differences may have implications for future therapies targeting neutropenic sepsis. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1398-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John P Reilly
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.
| | - Brian J Anderson
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Kristin M Hudock
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati, Cincinnati, OH, USA.,Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas G Dunn
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA
| | - Altaf Kazi
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA
| | - Anna Tommasini
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA
| | - Dudley Charles
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA
| | - Michael G S Shashaty
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Mark E Mikkelsen
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Jason D Christie
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Nuala J Meyer
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, 19104, PA, USA
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50
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Palakshappa JA, Anderson BJ, Reilly JP, Shashaty MGS, Ueno R, Wu Q, Ittner CAG, Tommasini A, Dunn TG, Charles D, Kazi A, Christie JD, Meyer NJ. Low Plasma Levels of Adiponectin Do Not Explain Acute Respiratory Distress Syndrome Risk: a Prospective Cohort Study of Patients with Severe Sepsis. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:71. [PMID: 26984771 PMCID: PMC4794929 DOI: 10.1186/s13054-016-1244-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/17/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Obesity is associated with the development of acute respiratory distress syndrome (ARDS) in at-risk patients. Low plasma levels of adiponectin, a circulating hormone-like molecule, have been implicated as a possible mechanism for this association. The objective of this study was to determine the association of plasma adiponectin level at ICU admission with ARDS and 30-day mortality in patients with severe sepsis and septic shock. METHODS This is a prospective cohort study of patients admitted to the medical ICU at the Hospital of the University of Pennsylvania. Plasma adiponectin was measured at the time of ICU admission. ARDS was defined by Berlin criteria. Multivariable logistic regression was used to determine the association of plasma adiponectin with the development of ARDS and mortality at 30 days. RESULTS The study included 164 patients. The incidence of ARDS within 5 days of admission was 45%. The median initial plasma adiponectin level was 7.62 mcg/ml (IQR: 3.87, 14.90) in those without ARDS compared to 8.93 mcg/ml (IQR: 4.60, 18.85) in those developing ARDS. The adjusted odds ratio for ARDS associated with each 5 mcg increase in adiponectin was 1.12 (95% CI 1.01, 1.25), p-value 0.025). A total of 82 patients (51%) of the cohort died within 30 days of ICU admission. There was a statistically significant association between adiponectin and mortality in the unadjusted model (OR 1.11, 95% CI 1.00, 1.23, p-value 0.04) that was no longer significant after adjusting for potential confounders. CONCLUSIONS In this study, low levels of adiponectin were not associated with an increased risk of ARDS in patients with severe sepsis and septic shock. This argues against low levels of adiponectin as a mechanism explaining the association of obesity with ARDS. At present, it is unclear whether circulating adiponectin is involved in the pathogenesis of ARDS or simply represents an epiphenomenon of other unknown functions of adipose tissue or metabolic alterations in sepsis.
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Affiliation(s)
- Jessica A Palakshappa
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Brian J Anderson
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - John P Reilly
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Michael G S Shashaty
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Ryo Ueno
- Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Qufei Wu
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Caroline A G Ittner
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Anna Tommasini
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Thomas G Dunn
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Dudley Charles
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Altaf Kazi
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Jason D Christie
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Nuala J Meyer
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
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