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Melton A, Rowe LA, Penney T, Krzykwa C, Goff K, Scheuermann SE, Melton HJ, Williams K, Golden N, Green KM, Smith B, Russell-Lodrigue K, Dufour JP, Doyle-Meyers LA, Schiro F, Aye PP, Lifson JD, Beddingfield BJ, Blair RV, Bohm RP, Kolls JK, Rappaport J, Hoxie JA, Maness NJ. The Impact of SIV-Induced Immunodeficiency on SARS-CoV-2 Disease, Viral Dynamics, and Antiviral Immune Response in a Nonhuman Primate Model of Coinfection. Viruses 2024; 16:1173. [PMID: 39066335 PMCID: PMC11281476 DOI: 10.3390/v16071173] [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: 06/20/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
The effects of immunodeficiency associated with chronic HIV infection on COVID-19 disease and viral persistence have not been directly addressed in a controlled setting. In this pilot study, we exposed two pigtail macaques (PTMs) chronically infected with SIVmac239, exhibiting from very low to no CD4 T cells across all compartments, to SARS-CoV-2. We monitored the disease progression, viral replication, and evolution, and compared these outcomes with SIV-naïve PTMs infected with SARS-CoV-2. No overt signs of COVID-19 disease were observed in either animal, and the SARS-CoV-2 viral kinetics and evolution in the SIVmac239 PTMs were indistinguishable from those in the SIV-naïve PTMs in all sampled mucosal sites. However, the single-cell RNA sequencing of bronchoalveolar lavage cells revealed an infiltration of functionally inert monocytes after SARS-CoV-2 infection. Critically, neither of the SIV-infected PTMs mounted detectable anti-SARS-CoV-2 T-cell responses nor anti-SARS-CoV-2 binding or neutralizing antibodies. Thus, HIV-induced immunodeficiency alone may not be sufficient to drive the emergence of novel viral variants but may remove the ability of infected individuals to mount adaptive immune responses against SARS-CoV-2.
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Affiliation(s)
- Alexandra Melton
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Biomedical Science Training Program, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Lori A. Rowe
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Toni Penney
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Clara Krzykwa
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Kelly Goff
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Sarah E. Scheuermann
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Hunter J. Melton
- Department of Statistics, Florida State University, Tallahassee, FL 32306, USA;
| | - Kelsey Williams
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Nadia Golden
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Kristyn Moore Green
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Brandon Smith
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Kasi Russell-Lodrigue
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jason P. Dufour
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Lara A. Doyle-Meyers
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Faith Schiro
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Pyone P. Aye
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jeffery D. Lifson
- AIDS and Cancer Viruses Program, Frederick National Laboratory, Frederick, MD 21701, USA;
| | - Brandon J. Beddingfield
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Robert V. Blair
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
| | - Rudolf P. Bohm
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jay K. Kolls
- Departments of Medicine and Pediatrics, Center for Translational Research in Infection and Inflammation, Tulane University School of Medicine, New Orleans, LA 70112, USA;
- Department of Pulmonary Critical Care and Environmental Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jay Rappaport
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - James A. Hoxie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Nicholas J. Maness
- Tulane National Primate Research Center, Covington, LA 70433, USA; (A.M.); (L.A.R.); (T.P.); (C.K.); (K.G.); (S.E.S.); (K.W.); (N.G.); (K.M.G.); (B.S.); (K.R.-L.); (J.P.D.); (L.A.D.-M.); (F.S.); (P.P.A.); (B.J.B.); (R.V.B.); (R.P.B.); (J.R.)
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
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Hopkins G, Gomez N, Tucis D, Bartlett L, Steers G, Burns E, Brown M, Harvey-Cowlishaw T, Santos R, Lauder SN, Scurr M, Capitani L, Burnell S, Rees T, Smart K, Somerville M, Gallimore A, Perera M, Potts M, Metaxaki M, Krishna B, Jackson H, Tighe P, Onion D, Godkin A, Wills M, Fairclough L. Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort). J Clin Immunol 2024; 44:147. [PMID: 38856804 PMCID: PMC11164737 DOI: 10.1007/s10875-024-01739-0] [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: 01/23/2024] [Accepted: 05/20/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Asymptomatic SARS-CoV-2 infections were widely reported during the COVID-19 pandemic, acting as a hidden source of infection. Many existing studies investigating asymptomatic immunity failed to recruit true asymptomatic individuals. Thus, we conducted a longitudinal cohort study to evaluate humoral- and cell-mediated responses to infection and vaccination in well-defined asymptomatic young adults (the Asymptomatic COVID-19 in Education [ACE] cohort). METHODS Asymptomatic testing services located at three UK universities identified asymptomatic young adults who were subsequently recruited with age- and sex-matched symptomatic and uninfected controls. Blood and saliva samples were collected after SARS-CoV-2 Wuhan infection, and again after vaccination. 51 participant's anti-spike antibody titres, neutralizing antibodies, and spike-specific T-cell responses were measured, against both Wuhan and Omicron B.1.1.529.1. RESULTS Asymptomatic participants exhibited reduced Wuhan-specific neutralization antibodies pre- and post-vaccination, as well as fewer Omicron-specific neutralization antibodies post-vaccination, compared to symptomatic participants. Lower Wuhan and Omicron-specific IgG titres in asymptomatic individuals were also observed pre- and post-vaccination, compared to symptomatic participants. There were no differences in salivary IgA levels. Conventional flow cytometry analysis and multi-dimensional clustering analysis indicated unvaccinated asymptomatic participants had significantly fewer Wuhan-specific IL-2 secreting CD4+ CD45RA+ T cells and activated CD8+ T cells than symptomatic participants, though these differences dissipated after vaccination. CONCLUSIONS Asymptomatic infection results in decreased antibody and T cell responses to further exposure to SARS-CoV-2 variants, compared to symptomatic infection. Post-vaccination, antibody responses are still inferior, but T cell immunity increases to match symptomatic subjects, emphasising the importance of vaccination to help protect asymptomatic individuals against future variants.
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Affiliation(s)
- Georgina Hopkins
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Nancy Gomez
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Davis Tucis
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Laura Bartlett
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Graham Steers
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Ellie Burns
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Michaela Brown
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | | | - Rute Santos
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | | | - Martin Scurr
- School of Medicine, Cardiff University, Cardiff, UK
- ImmunoServ Ltd, Cardiff, UK
| | | | | | - Tara Rees
- School of Medicine, Cardiff University, Cardiff, UK
| | | | | | | | - Marianne Perera
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Martin Potts
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Marina Metaxaki
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | - Hannah Jackson
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Paddy Tighe
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - David Onion
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Andrew Godkin
- School of Medicine, Cardiff University, Cardiff, UK
- ImmunoServ Ltd, Cardiff, UK
| | - Mark Wills
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Lucy Fairclough
- School of Life Sciences, University of Nottingham, Nottingham, UK.
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Chang D, Dela Cruz C, Sharma L. Beneficial and Detrimental Effects of Cytokines during Influenza and COVID-19. Viruses 2024; 16:308. [PMID: 38400083 PMCID: PMC10892676 DOI: 10.3390/v16020308] [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: 12/15/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Cytokines are signaling molecules that play a role in myriad processes, including those occurring during diseases and homeostasis. Their homeostatic function begins during embryogenesis and persists throughout life, including appropriate signaling for the cell and organism death. During viral infections, antiviral cytokines such as interferons and inflammatory cytokines are upregulated. Despite the well-known benefits of these cytokines, their levels often correlate with disease severity, linking them to unfavorable outcomes. In this review, we discuss both the beneficial and pathological functions of cytokines and the potential challenges in separating these two roles. Further, we discuss challenges in targeting these cytokines during disease and propose a new method for quantifying the cytokine effect to limit the pathological consequences while preserving their beneficial effects.
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Affiliation(s)
- De Chang
- College of Pulmonary and Critical Care Medicine of Eighth Medical Center, Chinese PLA General Hospital, Beijing 100028, China;
- Department of Pulmonary and Critical Care Medicine of Seventh Medical Center, Chinese PLA General Hospital, Beijing 100028, China
| | - Charles Dela Cruz
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA;
- Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA
| | - Lokesh Sharma
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA;
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Melton A, Rowe LA, Penney T, Krzykwa C, Goff K, Scheuermann S, Melton HJ, Williams K, Golden N, Green KM, Smith B, Russell-Lodrigue K, Dufour JP, Doyle-Meyers LA, Schiro F, Aye PP, Lifson JD, Beddingfield BJ, Blair RV, Bohm RP, Kolls JK, Rappaport J, Hoxie JA, Maness NJ. The Impact of SIV-Induced Immunodeficiency on Clinical Manifestation, Immune Response, and Viral Dynamics in SARS-CoV-2 Coinfection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.15.567132. [PMID: 38014096 PMCID: PMC10680717 DOI: 10.1101/2023.11.15.567132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Persistent and uncontrolled SARS-CoV-2 replication in immunocompromised individuals has been observed and may be a contributing source of novel viral variants that continue to drive the pandemic. Importantly, the effects of immunodeficiency associated with chronic HIV infection on COVID-19 disease and viral persistence have not been directly addressed in a controlled setting. Here we conducted a pilot study wherein two pigtail macaques (PTM) chronically infected with SIVmac239 were exposed to SARS-CoV-2 and monitored for six weeks for clinical disease, viral replication, and viral evolution, and compared to our previously published cohort of SIV-naïve PTM infected with SARS-CoV-2. At the time of SARS-CoV-2 infection, one PTM had minimal to no detectable CD4+ T cells in gut, blood, or bronchoalveolar lavage (BAL), while the other PTM harbored a small population of CD4+ T cells in all compartments. Clinical signs were not observed in either PTM; however, the more immunocompromised PTM exhibited a progressive increase in pulmonary infiltrating monocytes throughout SARS-CoV-2 infection. Single-cell RNA sequencing (scRNAseq) of the infiltrating monocytes revealed a less activated/inert phenotype. Neither SIV-infected PTM mounted detectable anti-SARS-CoV-2 T cell responses in blood or BAL, nor anti-SARS-CoV-2 neutralizing antibodies. Interestingly, despite the diminished cellular and humoral immune responses, SARS-CoV-2 viral kinetics and evolution were indistinguishable from SIV-naïve PTM in all sampled mucosal sites (nasal, oral, and rectal), with clearance of virus by 3-4 weeks post infection. SIV-induced immunodeficiency significantly impacted immune responses to SARS-CoV-2 but did not alter disease progression, viral kinetics or evolution in the PTM model. SIV-induced immunodeficiency alone may not be sufficient to drive the emergence of novel viral variants.
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Affiliation(s)
- Alexandra Melton
- Tulane National Primate Research Center, Covington, Louisiana
- Biomedical Science Training Program, Tulane University School of Medicine, New Orleans, Louisiana
| | - Lori A Rowe
- Tulane National Primate Research Center, Covington, Louisiana
| | - Toni Penney
- Tulane National Primate Research Center, Covington, Louisiana
| | - Clara Krzykwa
- Tulane National Primate Research Center, Covington, Louisiana
| | - Kelly Goff
- Tulane National Primate Research Center, Covington, Louisiana
| | | | - Hunter J Melton
- Florida State University, Department of Statistics, Tallahassee, Florida
| | - Kelsey Williams
- Tulane National Primate Research Center, Covington, Louisiana
| | - Nadia Golden
- Tulane National Primate Research Center, Covington, Louisiana
| | | | - Brandon Smith
- Tulane National Primate Research Center, Covington, Louisiana
| | - Kasi Russell-Lodrigue
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jason P Dufour
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Lara A Doyle-Meyers
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Faith Schiro
- Tulane National Primate Research Center, Covington, Louisiana
| | - Pyone P Aye
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jeffery D Lifson
- AIDS and Cancer Viruses Program, Frederick National Laboratory, Frederick, Maryland, United States of America
| | - Brandon J Beddingfield
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Robert V Blair
- Tulane National Primate Research Center, Covington, Louisiana
| | - Rudolf P Bohm
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
- Present address: Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Oregon
| | - Jay K Kolls
- Departments of Medicine and Pediatrics, Center for Translational Research in Infection and Inflammation, Tulane University School of Medicine, New Orleans, LA 70112, USA
- Department of Pulmonary Critical Care and Environmental Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jay Rappaport
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana
| | - James A Hoxie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicholas J Maness
- Tulane National Primate Research Center, Covington, Louisiana
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana
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Zhu Y, Sharma L, Chang D. Pathophysiology and clinical management of coronavirus disease (COVID-19): a mini-review. Front Immunol 2023; 14:1116131. [PMID: 37646038 PMCID: PMC10461092 DOI: 10.3389/fimmu.2023.1116131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
An unprecedented global pandemic caused by a novel coronavirus named SARS-CoV-2 has created a severe healthcare threat and become one of the biggest challenges to human health and the global economy. As of July 2023, over 767 million confirmed cases of COVID-19 have been diagnosed, including more than 6.95 million deaths. The S protein of this novel coronavirus binds to the ACE2 receptor to enter the host cells with the help of another transmembrane protease TMPRSS2. Infected subjects that can mount an appropriate host immune response can quickly inhibit the spread of infection into the lower respiratory system and the disease may remain asymptomatic or a mild infection. The inability to mount a strong initial response can allow the virus to replicate unchecked and manifest as severe acute pneumonia or prolonged disease that may manifest as systemic disease manifested as viremia, excessive inflammation, multiple organ failure, and secondary bacterial infection among others, leading to delayed recovery, hospitalization, and even life-threatening consequences. The clinical management should be targeted to specific pathogenic mechanisms present at the specific phase of the disease. Here we summarize distinct phases of COVID-19 pathogenesis and appropriate therapeutic paradigms associated with the specific phase of COVID-19.
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Affiliation(s)
- Ying Zhu
- College of Pulmonary and Critical Care Medicine, 8th Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, 7th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lokesh Sharma
- Section of Pulmonary and Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - De Chang
- College of Pulmonary and Critical Care Medicine, 8th Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, 7th Medical Center of Chinese PLA General Hospital, Beijing, China
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Chen CS, Jian MJ, Chang CK, Chung HY, Li SY, Lin JC, Yeh KM, Yang YS, Chen CW, Hsieh SS, Tang SH, Perng CL, Chang FY, Shang HS. Monitoring algorithm of hospitalized patients in a medical center with SARS-CoV-2 (Omicron variant) infection: clinical epidemiological surveillance and immunological assessment. PeerJ 2023; 11:e14666. [PMID: 36710871 PMCID: PMC9879147 DOI: 10.7717/peerj.14666] [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: 09/28/2022] [Accepted: 12/09/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major healthcare threat worldwide. Since it was first identified in November 2021, the Omicron (B.1.1.529) variant of SARS-CoV-2 has evolved into several lineages, including BA.1, BA.2-BA.4, and BA.5. SARS-CoV-2 variants might increase transmissibility, pathogenicity, and resistance to vaccine-induced immunity. Thus, the epidemiological surveillance of circulating lineages using variant phenotyping is essential. The aim of the current study was to characterize the clinical outcome of Omicron BA.2 infections among hospitalized COVID-19 patients and to perform an immunological assessment of such cases against SARS-CoV-2. Patients and Methods We evaluated the analytical and clinical performance of the BioIC SARS-CoV-2 immunoglobulin (Ig)M/IgG detection kit, which was used for detecting antibodies against SARS-CoV-2 in 257 patients infected with the Omicron variant. Results Poor prognosis was noted in 38 patients, including eight deaths in patients characterized by comorbidities predisposing them to severe COVID-19. The variant-of-concern (VOC) typing and serological analysis identified time-dependent epidemic trends of BA.2 variants emerging in the outbreak of the fourth wave in Taiwan. Of the 257 specimens analyzed, 108 (42%) and 24 (9.3%) were positive for anti-N IgM and IgG respectively. Conclusion The VOC typing of these samples allowed for the identification of epidemic trends by time intervals, including the B.1.1.529 variant replacing the B.1.617.2 variant. Moreover, antibody testing might serve as a complementary method for COVID-19 diagnosis. The combination of serological testing results with the reverse transcription-polymerase chain reaction cycle threshold value has potential value in disease prognosis, thereby aiding in epidemic investigations conducted by clinicians or the healthcare department.
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Affiliation(s)
- Chi-Sheng Chen
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Ming-Jr Jian
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Kai Chang
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Hsing-Yi Chung
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Shih-Yi Li
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Jung-Chung Lin
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Kuo-Ming Yeh
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Ya-Sung Yang
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Chien-Wen Chen
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Shan-Shan Hsieh
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Sheng-Hui Tang
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Cherng-Lih Perng
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
| | - Feng-Yee Chang
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Hung-Sheng Shang
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan
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Homocysteine as a Predictor of Paroxysmal Atrial Fibrillation-Related Events: A Scoping Review of the Literature. Diagnostics (Basel) 2022; 12:diagnostics12092192. [PMID: 36140593 PMCID: PMC9498051 DOI: 10.3390/diagnostics12092192] [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] [Received: 08/04/2022] [Revised: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 12/06/2022] Open
Abstract
High levels of homocysteine (Hcy) have been linked with adverse cardiovascular outcomes, such as arrhythmias and stroke. In the context of paroxysmal atrial fibrillation (PAF), hyperhomocysteinemia has been demonstrated to be an independent predictor of future events. The aim of this report was to address the potential value of Hcy levels in predicting future paroxysms of atrial fibrillation (AF), as well as to identify the potential mechanisms of action. We searched PubMed and the Cochrane Database on 16 January 2022. Keywords used were homocysteine or hyperhomocysteinemia paired with a total of 67 different keywords or phrases that have been implicated with the pathogenesis of AF. We included primary reports of clinical and non-clinical data in the English language, as well as systematic reviews with or without meta-analyses. We placed no time constraints on our search strategy, which yielded 3748 results. Following title review, 3293 reports were excluded and 455 reports were used for title and abstract review, after which 109 reports were finally used for full-text review. Our review indicates that Hcy levels seem to hold a predictive value in PAF. Herein, potential mechanisms of action are presented and special considerations are made for clinically relevant diagnostic procedures that could complement plasma levels in the prediction of future PAF events. Finally, gaps of evidence are identified and considerations for future clinical trial design are presented.
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8
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Sen R, Sengupta D, Mukherjee A. Mechanical dependency of the SARS-CoV-2 virus and the renin-angiotensin-aldosterone (RAAS) axis: a possible new threat. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:62235-62247. [PMID: 34859345 PMCID: PMC8638800 DOI: 10.1007/s11356-021-16356-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/01/2021] [Indexed: 04/12/2023]
Abstract
Pathogens in our environment can act as agents capable of inflicting severe human diseases. Among them, the SARS-CoV-2 virus has recently plagued the globe and paralyzed the functioning of ordinary human life. The virus enters the cell through the angiotensin-converting enzyme-2 (ACE-2) receptor, an integral part of the renin-angiotensin system (RAAS). Reports on hypertension and its relation to the modulation of the RAAS are generating interest in the scientific community. This short review focuses on the SARS-CoV-2 infection's direct and indirect effects on our body through modulation of the RAAS axis. A patient having severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, which causes COVID-19 relates to hypertension as a pre-existing disease or develops it in a post-COVID scenario. Several studies on how SARS-CoV-2 modulates the RAAS axis indicate that it alters our body's physiological balance. This review seeks to establish a hypothesis on the mechanical dependency of SARS-CoV-2 and RAAS modulation in the human body. This study intends to impart ideas on drug development and designing by targeting the modulation of the RAAS axis to inactivate the pathogenicity of the SARS-CoV-2 virus. A systematic hypothesis can severely attenuate the pathogenicity of the dreadful viruses of the future.
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Affiliation(s)
- Rohit Sen
- Department of Zoology, Charuchandra College, University of Calcutta, 22, Lake Road, Kolkata, 700029 India
| | | | - Avinaba Mukherjee
- Department of Zoology, Charuchandra College, University of Calcutta, 22, Lake Road, Kolkata, 700029 India
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9
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Role of T Regulatory Cells and Myeloid-Derived Suppressor Cells in COVID-19. J Immunol Res 2022; 2022:5545319. [PMID: 35497875 PMCID: PMC9042623 DOI: 10.1155/2022/5545319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/13/2022] [Accepted: 03/28/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been raised as a pandemic disease since December 2019. Immunosuppressive cells including T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSCs) are key players in immunological tolerance and immunoregulation; however, they contribute to the pathogenesis of different diseases including infections. Tregs have been shown to impair the protective role of CD8+ T lymphocytes against viral infections. In COVID-19 patients, most studies reported reduction, while few other studies found elevation in Treg levels. Moreover, Tregs have a dual role, depending on the different stages of COVID-19 disease. At early stages of COVID-19, Tregs have a critical role in decreasing antiviral immune responses, and consequently reducing the viral clearance. On the other side, during late stages, Tregs reduce inflammation-induced organ damage. Therefore, inhibition of Tregs in early stages and their expansion in late stages have potentials to improve clinical outcomes. In viral infections, MDSC levels are highly increased, and they have the potential to suppress T cell proliferation and reduce viral clearance. Some subsets of MDSCs are expanded in the blood of COVID-19 patients; however, there is a controversy whether this expansion has pathogenic or protective effects in COVID-19 patients. In conclusion, further studies are required to investigate the role and function of immunosuppressive cells and their potentials as prognostic biomarkers and therapeutic targets in COVID-19 patients.
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10
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Sharma L, Peng X, Qing H, Hilliard BK, Kim J, Swaminathan A, Tian J, Israni-Winger K, Zhang C, Habet V, Wang L, Gupta G, Tian X, Ma Y, Shin HJ, Kim SH, Kang MJ, Ishibe S, Young LH, Kotenko S, Compton S, Wilen CB, Wang A, Dela Cruz CS. Distinct Roles of Type I and Type III Interferons during a Native Murine β Coronavirus Lung Infection. J Virol 2022; 96:e0124121. [PMID: 34705554 PMCID: PMC8791255 DOI: 10.1128/jvi.01241-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/21/2021] [Indexed: 12/15/2022] Open
Abstract
Coronaviruses are a major health care threat to humankind. Currently, the host factors that contribute to limit disease severity in healthy young patients are not well defined. Interferons are key antiviral molecules, especially type I and type III interferons. The role of these interferons during coronavirus disease is a subject of debate. Here, using mice that are deficient in type I (IFNAR1-/-), type III (IFNLR1-/-), or both (IFNAR1/LR1-/-) interferon signaling pathways and murine-adapted coronavirus (MHV-A59) administered through the intranasal route, we define the role of interferons in coronavirus infection. We show that type I interferons play a major role in host survival in this model, while a minimal role of type III interferons was manifested only in the absence of type I interferons or during a lethal dose of coronavirus. IFNAR1-/- and IFNAR1/LR1-/- mice had an uncontrolled viral burden in the airways and lung and increased viral dissemination to other organs. The absence of only type III interferon signaling had no measurable difference in the viral load. The increased viral load in IFNAR1-/- and IFNAR1/LR1-/- mice was associated with increased tissue injury, especially evident in the lung and liver. Type I but not type III interferon treatment was able to promote survival if treated during early disease. Further, we show that type I interferon signaling in macrophages contributes to the beneficial effects during coronavirus infection in mice. IMPORTANCE The antiviral and pathological potential of type I and type III interferons during coronavirus infection remains poorly defined, and opposite findings have been reported. We report that both type I and type III interferons have anticoronaviral activities, but their potency and organ specificity differ. Type I interferon deficiency rendered the mice susceptible to even a sublethal murine coronavirus infection, while the type III interferon deficiency impaired survival only during a lethal infection or during a sublethal infection in the absence of type I interferon signaling. While treatment with both type I and III interferons promoted viral clearance in the airways and lung, only type I interferons promoted the viral clearance in the liver and improved host survival upon early treatment (12 h postinfection). This study demonstrates distinct roles and potency of type I and type III interferons and their therapeutic potential during coronavirus lung infection.
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Affiliation(s)
- Lokesh Sharma
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xiaohua Peng
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Qing
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brandon K. Hilliard
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jooyoung Kim
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Anush Swaminathan
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Justin Tian
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kavita Israni-Winger
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Cuiling Zhang
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Victoria Habet
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lin Wang
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gayatri Gupta
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xuefei Tian
- Section of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Yina Ma
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hyeon-Jun Shin
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sang-Hun Kim
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Min-Jong Kang
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Shuta Ishibe
- Section of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lawrence H. Young
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sergei Kotenko
- Department of Biochemistry and Molecular Biology, Rutgers New Jersey Medical School, New Brunswick, New Jersey, USA
| | - Susan Compton
- Molecular and Serological Diagnostics, Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Craig B. Wilen
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Andrew Wang
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Charles S. Dela Cruz
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, Connecticut, USA
- Veterans Affairs Medical Center, West Haven, Connecticut, USA
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11
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Melton A, Doyle-Meyers LA, Blair RV, Midkiff C, Melton HJ, Russell-Lodrigue K, Aye PP, Schiro F, Fahlberg M, Szeltner D, Spencer S, Beddingfield BJ, Goff K, Golden N, Penney T, Picou B, Hensley K, Chandler KE, Plante JA, Plante KS, Weaver SC, Roy CJ, Hoxie JA, Gao H, Montefiori DC, Mankowski JL, Bohm RP, Rappaport J, Maness NJ. The pigtail macaque (Macaca nemestrina) model of COVID-19 reproduces diverse clinical outcomes and reveals new and complex signatures of disease. PLoS Pathog 2021; 17:e1010162. [PMID: 34929014 PMCID: PMC8722729 DOI: 10.1371/journal.ppat.1010162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/03/2022] [Accepted: 12/01/2021] [Indexed: 01/08/2023] Open
Abstract
The novel coronavirus SARS-CoV-2, the causative agent of COVID-19 disease, has killed over five million people worldwide as of December 2021 with infections rising again due to the emergence of highly transmissible variants. Animal models that faithfully recapitulate human disease are critical for assessing SARS-CoV-2 viral and immune dynamics, for understanding mechanisms of disease, and for testing vaccines and therapeutics. Pigtail macaques (PTM, Macaca nemestrina) demonstrate a rapid and severe disease course when infected with simian immunodeficiency virus (SIV), including the development of severe cardiovascular symptoms that are pertinent to COVID-19 manifestations in humans. We thus proposed this species may likewise exhibit severe COVID-19 disease upon infection with SARS-CoV-2. Here, we extensively studied a cohort of SARS-CoV-2-infected PTM euthanized either 6- or 21-days after respiratory viral challenge. We show that PTM demonstrate largely mild-to-moderate COVID-19 disease. Pulmonary infiltrates were dominated by T cells, including CD4+ T cells that upregulate CD8 and express cytotoxic molecules, as well as virus-targeting T cells that were predominantly CD4+. We also noted increases in inflammatory and coagulation markers in blood, pulmonary pathologic lesions, and the development of neutralizing antibodies. Together, our data demonstrate that SARS-CoV-2 infection of PTM recapitulates important features of COVID-19 and reveals new immune and viral dynamics and thus may serve as a useful animal model for studying pathogenesis and testing vaccines and therapeutics.
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Affiliation(s)
- Alexandra Melton
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Biomedical Science Training Program, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Lara A. Doyle-Meyers
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Robert V. Blair
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Cecily Midkiff
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Hunter J. Melton
- Florida State University, Department of Statistics, Tallahassee, Florida, United States of America
| | - Kasi Russell-Lodrigue
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Pyone P. Aye
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Faith Schiro
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Marissa Fahlberg
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Dawn Szeltner
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Skye Spencer
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | | | - Kelly Goff
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Nadia Golden
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Toni Penney
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Breanna Picou
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Krystle Hensley
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Kristin E. Chandler
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
| | - Jessica A. Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Kenneth S. Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Scott C. Weaver
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Chad J. Roy
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - James A. Hoxie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Hongmei Gao
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, North Carolina, United States of America
| | - David C. Montefiori
- Duke University Medical Center, Duke Human Vaccine Institute, Durham, North Carolina, United States of America
| | - Joseph L. Mankowski
- Department of Molecular and Comparative Pathobiology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Rudolf P. Bohm
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Jay Rappaport
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Nicholas J. Maness
- Tulane National Primate Research Center, Covington, Louisiana, United States of America
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
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12
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Boyton RJ, Altmann DM. The immunology of asymptomatic SARS-CoV-2 infection: what are the key questions? Nat Rev Immunol 2021; 21:762-768. [PMID: 34667307 PMCID: PMC8525456 DOI: 10.1038/s41577-021-00631-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
An important challenge during the COVID-19 pandemic has been to understand asymptomatic disease and the extent to which this may be a source of transmission. As asymptomatic disease is by definition hard to screen for, there is a lack of clarity about this aspect of the COVID-19 spectrum. Studies have considered whether the prevalence of asymptomatic disease is determined by differences in age, demographics, viral load, duration of shedding, and magnitude or durability of immunity. It is clear that adaptive immunity is strongly activated during asymptomatic infection, but some features of the T cell and antibody response may differ from those in symptomatic disease. Areas that need greater clarity include the extent to which asymptomatic disease leads to persistent symptoms (long COVID), and the quality, quantity and durability of immune priming required to confer subsequent protection.
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Affiliation(s)
- Rosemary J Boyton
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
- Lung Division, Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Daniel M Altmann
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK.
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13
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Bellio MA, Bennett C, Arango A, Khan A, Xu X, Barrera C, Friedewald V, Mitrani MI. Proof-of-concept trial of an amniotic fluid-derived extracellular vesicle biologic for treating high risk patients with mild-to-moderate acute COVID-19 infection. BIOMATERIALS AND BIOSYSTEMS 2021; 4:100031. [PMID: 34841370 PMCID: PMC8611818 DOI: 10.1016/j.bbiosy.2021.100031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/11/2021] [Accepted: 11/21/2021] [Indexed: 12/09/2022] Open
Abstract
A pandemic brought on by COVID-19 has created a scalable health crisis. The search to help alleviate COVID-19-related complications through therapeutics has become a necessity. Zofin is an investigational, acellular biologic derived from full-term perinatal amniotic fluid that contains extracellular vesicles. Extracellular nanoparticles as such have been studied for their immunomodulatory benefits via cellular therapeutics and, if applied to COVID-19-related inflammation, could benefit patient outcome. Subjects (n = 8) experiencing mild-to-moderate COVID-19 symptoms were treated with the experimental intervention. Complete blood count, complete metabolic panel, inflammatory biomarkers, and absolute lymphocyte counts were recorded prior to and on days 4, 8, 14, 21, and 30 as markers of disease progression. Additionally, chest x-rays were taken of the patients prior to and on days 8 and 30. Patients experienced no serious adverse events. All COVID-19-associated symptoms resolved or became stable with no indication of disease worsening as found by patient and chest x-ray reports. Inflammatory biomarkers (CRP, IL-6, TNF- α ) and absolute lymphocyte counts improved throughout the study period. Findings from a proof-of-concept, expanded access trial for COVID-19 patients prove the acellular biologic is safe and potentially effective to prevent disease progression in a high-risk COVID-19 population with mild-to-moderate symptoms.
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Affiliation(s)
| | - Cassie Bennett
- Organicell Regenerative Medicine, Miami, FL 33136, United States
| | - Alissa Arango
- Organicell Regenerative Medicine, Miami, FL 33136, United States
| | - Aisha Khan
- Assure Immune LLC., Miami, FL 33136, United States
| | - Xiumin Xu
- Assure Immune LLC., Miami, FL 33136, United States
| | - Cesar Barrera
- United Memorial Medical Center, Houston, TX 77091, United States
| | | | - Maria Ines Mitrani
- Organicell Regenerative Medicine, Miami, FL 33136, United States,Corresponding author at: Organicell Regenerative Medicine, Inc. 1951 Northwest 7th Ave, Suite #300, Miami, FL 33136, United States.
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14
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Debisarun PA, Gössling KL, Bulut O, Kilic G, Zoodsma M, Liu Z, Oldenburg M, Rüchel N, Zhang B, Xu CJ, Struycken P, Koeken VACM, Domínguez-Andrés J, Moorlag SJCFM, Taks E, Ostermann PN, Müller L, Schaal H, Adams O, Borkhardt A, ten Oever J, van Crevel R, Li Y, Netea MG. Induction of trained immunity by influenza vaccination - impact on COVID-19. PLoS Pathog 2021; 17:e1009928. [PMID: 34695164 PMCID: PMC8568262 DOI: 10.1371/journal.ppat.1009928] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/04/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022] Open
Abstract
Non-specific protective effects of certain vaccines have been reported, and long-term boosting of innate immunity, termed trained immunity, has been proposed as one of the mechanisms mediating these effects. Several epidemiological studies suggested cross-protection between influenza vaccination and COVID-19. In a large academic Dutch hospital, we found that SARS-CoV-2 infection was less common among employees who had received a previous influenza vaccination: relative risk reductions of 37% and 49% were observed following influenza vaccination during the first and second COVID-19 waves, respectively. The quadrivalent inactivated influenza vaccine induced a trained immunity program that boosted innate immune responses against various viral stimuli and fine-tuned the anti-SARS-CoV-2 response, which may result in better protection against COVID-19. Influenza vaccination led to transcriptional reprogramming of monocytes and reduced systemic inflammation. These epidemiological and immunological data argue for potential benefits of influenza vaccination against COVID-19, and future randomized trials are warranted to test this possibility.
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Affiliation(s)
- Priya A. Debisarun
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Katharina L. Gössling
- Department for Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Ozlem Bulut
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gizem Kilic
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martijn Zoodsma
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Zhaoli Liu
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Marina Oldenburg
- Department for Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Nadine Rüchel
- Department for Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Bowen Zhang
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Cheng-Jian Xu
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Patrick Struycken
- Department of Occupational Health & Safety, and Environmental Service, Radboud University Medical Center, Nijmegen, Netherlands
| | - Valerie A. C. M. Koeken
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Jorge Domínguez-Andrés
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Esther Taks
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Philipp N. Ostermann
- Institute of Virology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Lisa Müller
- Institute of Virology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Heiner Schaal
- Institute of Virology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Ortwin Adams
- Institute of Virology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Arndt Borkhardt
- Department for Pediatric Oncology, Hematology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, Dusseldorf, Germany
| | - Jaap ten Oever
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yang Li
- Department of Computational Biology for Individualised Infection Medicine, Centre for Individualised Infection Medicine (CiiM), a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
- TWINCORE, a joint venture between the Helmholtz-Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Mihai G. Netea
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- Human Genomics Laboratory, Craiova University of Medicine and Pharmacy, Craiova, Romania
- Department for Immunology & Metabolism, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
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