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Clinical Utility of Circulating Pneumoproteins as Diagnostic and Prognostic Biomarkers in COVID-19: A Systematic Review and Meta-analysis. Infect Dis Ther 2022; 11:1981-1998. [PMID: 36006559 PMCID: PMC9403970 DOI: 10.1007/s40121-022-00686-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION This study explored circulating pneumoproteins in the diagnosis, severity, and prognosis of COVID-19 by meta-analysis. METHODS We searched five databases and other sources until December 16, 2021. Standardized mean difference (SMD) and 95% confidence interval (CI) were the overall outcomes. RevMan 5.3, Stata 16, and Meta-DiSc 1.4 were utilized for pooled analysis. RESULTS A total of 2432 subjects from 26 studies were included. Patients with COVID-19 had higher circulating KL-6, SP-D, and SP-A levels (SMD 1.34, 95% CI [0.60, 2.08]; SMD 1.74, 95% CI [0.64, 2.84]; SMD 3.42, 95% CI [1.31, 5.53], respectively) than healthy individuals. Circulating SP-D levels were not significantly different in survivors and non-survivors (SMD - 0.19, 95% CI [- 0.78, 0.40]). Circulating KL-6, SP-D, and RAGE levels in patients with mild to moderate COVID-19 were significantly lower (SMD - 0.93, 95% CI [- 1.22, - 0.65]; SMD - 1.32, 95% CI [- 2.34, - 0.29]; SMD - 1.17, 95% CI [- 2.06, - 0.28], respectively) than in patients with severe COVID-19. Subgroup analysis suggested that country and total number may be related to the heterogeneity when analyzing SP-D in patients with mild to moderate vs. severe COVID-19. The meta-analysis of diagnostic accuracy including KL-6 for severity, KL-6 for mortality, and SP-D for severity demonstrated that they all had limited diagnostic value. CONCLUSION Therefore, circulating pneumoproteins (KL-6, SP-D, and RAGEs) reflect the diagnosis, severity, and prognosis of COVID-19, and follow-up studies are still needed.
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Veerapaneni VV, Upadhyay S, Thimraj TA, Siddaiah JB, Krishnarao CS, Lokesh KS, Thimmulappa R, Palmberg L, Ganguly K, Anand MP. Circulating Secretoglobin Family 1A Member 1 (SCGB1A1) Levels as a Marker of Biomass Smoke Induced Chronic Obstructive Pulmonary Disease. TOXICS 2021; 9:toxics9090208. [PMID: 34564359 PMCID: PMC8472904 DOI: 10.3390/toxics9090208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 11/25/2022]
Abstract
Secretoglobin family 1A member 1 (SCGB1A1) alternatively known as club cell protein 16 is a protective pneumo-protein. Decreased serum levels of SCGB1A1 have been associated with tobacco smoke induced chronic obstructive pulmonary disease (TS-COPD). Exposure to biomass smoke (BMS) is an important COPD risk factor among women in low and lower-middle income countries. Therefore, in a cross-sectional study (n = 50/group; total 200 subjects) we assessed serum SCGB1A1 levels in BMS-COPD subjects (11 male, 39 female) compared to TS-COPD (all male) along with TS-CONTROL (asymptomatic smokers, all male) and healthy controls (29 male, 21 female) in an Indian population. Normal and chronic bronchitis like bronchial mucosa models developed at the air–liquid interface using human primary bronchial epithelial cells (3 donors, and three replicates per donor) were exposed to cigarette smoke condensate (CSC; 0.25, 0.5, and 1%) to assess SCGB1A1 transcript expression and protein secretion. Significantly (p < 0.0001) decreased serum SCGB1A1 concentrations (median, interquartile range, ng/mL) were detected in both BMS-COPD (1.6; 1.3–2.4) and TS-COPD (1.8; 1.4–2.5) subjects compared to TS-CONTROL (3.3; 2.9–3.5) and healthy controls (5.1; 4.5–7.2). The levels of SCGB1A1 were positively correlated (r = 0.7–0.8; p < 0.0001) with forced expiratory volume in 1 s, forced vital capacity, their ratios, and exercise capacity. The findings are also consistent within the BMS-COPD sub-group as well. Significantly (p < 0.03) decreased SCGB1A1 concentrations were detected with severity of COPD, dyspnea, quality of life, and mortality indicators. In vitro studies demonstrated significantly (p < 0.05) decreased SCGB1A1 transcript and/or protein levels following CSC exposure. Circulating SCGB1A1 levels may therefore also be considered as a potent marker of BMS-COPD and warrant studies in larger independent cohorts.
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Affiliation(s)
- Vivek Vardhan Veerapaneni
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India; (V.V.V.); (J.B.S.); (C.S.K.); (K.S.L.)
| | - Swapna Upadhyay
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden; (S.U.); (T.A.T.); (L.P.)
| | - Tania A. Thimraj
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden; (S.U.); (T.A.T.); (L.P.)
| | - Jayaraj Biligere Siddaiah
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India; (V.V.V.); (J.B.S.); (C.S.K.); (K.S.L.)
| | - Chaya Sindaghatta Krishnarao
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India; (V.V.V.); (J.B.S.); (C.S.K.); (K.S.L.)
| | - Komarla Sundararaja Lokesh
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India; (V.V.V.); (J.B.S.); (C.S.K.); (K.S.L.)
| | - Rajesh Thimmulappa
- Department of Biochemistry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India;
| | - Lena Palmberg
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden; (S.U.); (T.A.T.); (L.P.)
| | - Koustav Ganguly
- Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, 17177 Stockholm, Sweden; (S.U.); (T.A.T.); (L.P.)
- Correspondence: (K.G.); (M.P.A.)
| | - Mahesh Padukudru Anand
- Department of Pulmonary Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru 570015, India; (V.V.V.); (J.B.S.); (C.S.K.); (K.S.L.)
- Correspondence: (K.G.); (M.P.A.)
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Li XX, Peng T, Gao J, Feng JG, Wu DD, Yang T, Zhong L, Fu WP, Sun C. Allele-specific expression identified rs2509956 as a novel long-distance cis-regulatory SNP for SCGB1A1, an important gene for multiple pulmonary diseases. Am J Physiol Lung Cell Mol Physiol 2019; 317:L456-L463. [PMID: 31322430 DOI: 10.1152/ajplung.00275.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
SCGB1A1 (secretoglobin family 1A member 1) is an important protein for multiple pulmonary diseases, especially asthma, chronic obstructive pulmonary disease, and lung cancer. One single-nucleotide polymorphism (SNP) at 5'-untranslated region of SCGB1A1, rs3741240, has been suggested to be associated with reduced protein expression and further asthma susceptibility. However, it was still unclear whether there were other cis-regulatory elements for SCGB1A1 that might further contribute to pulmonary diseases. Allele-specific expression (ASE) is a novel approach to identify the functional region in human genome. In the present study, we measured ASE on rs3741240 in lung tissues and observed a consistent excess of G allele over A (P < 10-6), which indicated that this SNP or the one(s) in linkage disequilibrium (LD) could regulate SCGB1A1 expression. By analyzing 1000 Genomes Project data for Chinese, one SNP locating ~10.2 kb away and downstream of SCGB1A1, rs2509956, was identified to be in strong LD with rs3741240. Reporter gene assay confirmed that both SNPs could regulate gene expression in the lung cell. By chromosome conformation capture, it was verified that the region surrounding rs2509956 could interact with SCGB1A1 promoter region and act as an enhancer. Through chromatin immunoprecipitation and overexpression assay, the related transcription factor RELA (RELA proto-oncogene, NF-kB subunit) was recognized to bind the region spanning rs2509956. Our work identified a novel long-distance cis-regulatory SNP for SCGB1A1, which might contribute to multiple pulmonary diseases.
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Affiliation(s)
- Xiu-Xiong Li
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Key Laboratory of the Ministry of Education for Medicinal Resources and Natural Pharmaceutical Chemistry, College of Life Sciences, Shaanxi Normal University, Xi'an, People's Republic of China
| | - Tao Peng
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Key Laboratory of the Ministry of Education for Medicinal Resources and Natural Pharmaceutical Chemistry, College of Life Sciences, Shaanxi Normal University, Xi'an, People's Republic of China
| | - Jing Gao
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Key Laboratory of the Ministry of Education for Medicinal Resources and Natural Pharmaceutical Chemistry, College of Life Sciences, Shaanxi Normal University, Xi'an, People's Republic of China
| | - Jia-Gang Feng
- Department of Respiratory Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Dan-Dan Wu
- State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Kunming, People's Republic of China
| | - Ting Yang
- Department of Respiratory Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Li Zhong
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Key Laboratory of the Ministry of Education for Medicinal Resources and Natural Pharmaceutical Chemistry, College of Life Sciences, Shaanxi Normal University, Xi'an, People's Republic of China.,Provincial Demonstration Center for Experimental Biology Education, Shaanxi Normal University, Xi'an, People's Republic of China
| | - Wei-Ping Fu
- Department of Respiratory Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Chang Sun
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Key Laboratory of the Ministry of Education for Medicinal Resources and Natural Pharmaceutical Chemistry, College of Life Sciences, Shaanxi Normal University, Xi'an, People's Republic of China
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Lam DCL, Kwok HH, Yu WC, Ko FWS, Tam CY, Lau ACW, Fong DYT, Ip MSM. CC16 levels correlate with cigarette smoke exposure in bronchial epithelial cells and with lung function decline in smokers. BMC Pulm Med 2018; 18:47. [PMID: 29548305 PMCID: PMC5857103 DOI: 10.1186/s12890-018-0607-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/01/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Club cell protein-16 (CC16) expression has been associated with smoking-related lung function decline. The study hypothesis was that CC16 expression in both serum and bronchial epithelium is associated with lung function decline in smokers, and exposure to cigarette smoke will lead to reduction in CC16 expression in bronchial epithelial cells. METHODS In a cohort of community-based male Chinese subjects recruited for lung function test in 2000, we reassessed their lung function ten years later and measured serum levels of CC16. CC16 expression was further assayed in bronchial epithelium from endobronchial biopsies taken from an independent cohort of subjects undergoing autofluorescence bronchoscopy, and tested for correlation between CC16 immunostaining intensity and lung function. In an in-vitro model, bronchial epithelial cells were exposed to cigarette smoke extract (CSE), and the expression levels of CC16 were measured in bronchial epithelial cells before and after exposure to CSE. RESULTS There was a significant association between FEV1 decline and serum CC16 levels in smokers. Expression of CC16 in bronchial epithelium showed significant correlation with FEV1/FVC. Bronchial epithelial cells showed significant decrease in CC16 expression after exposure to CSE, followed by a subsequent rise in CC16 expression upon removal of CSE. CONCLUSIONS Results of these clinical and laboratory investigations suggested that low serum CC16 was associated with smoking-related decline in lung function, demonstrated the first time in a Chinese cohort. The data also lend support to the putative role of CC16 in protection against smoking-related bronchial epithelial damage. (Abstract word count: 243) US CLINICAL TRIAL REGISTRY: NCT01185652 , first posted 20 August, 2010.
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Affiliation(s)
- David Chi-Leung Lam
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Hoi-Hin Kwok
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai King, HK China
| | - Fanny Wai-San Ko
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Shatin, HK China
| | - Cheuk-Yin Tam
- Department of Medicine and Geriatrics, Tuen Mun Hospital, 23, Tsing Chung Koon Rd, Tuen Mun, HK China
| | - Arthur Chun-Wing Lau
- Department of Intensive Care, Pamela Youde Nethersole Hospital, 3, Lok Man Rd, Chai Wan, HK China
| | - Daniel Yee-Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Mary Sau-Man Ip
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
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Lu Y, Jin W, Zhang H, Zhang X. [Multicenter clinical efficacy observation of integrated Traditional Chinese Medicine-Western Medicine treatment in acute onset period of pulmonary heart disease]. J TRADIT CHIN MED 2016; 36:283-90. [PMID: 27468541 DOI: 10.1016/s0254-6272(16)30039-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the efficacy of integrated Traditional Chinese Medicine-Western Medicine (TCM-WM) in the treatment of acute onset pulmonary heart disease (PHD). METHODS A total of 240 patients met the inclusion criteria and were enrolled. These inpatients were divided into group A (treatment group) and B (control group) in order of admission according to the principles of randomization and control. The research was performed simultaneously in three hospitals. Two groups were given basic treatment that included: controlled oxygen therapy, active and effective anti-infection, maintaining airway patency, correcting O2 deficiency and CO2 retention, correcting acid-base imbalance and electrolyte disturbance, reducing pulmonary hypertension and treating right heart failure, nutritional support and treatment of.complications. Group A was given basic treatment and integrated Traditional Chinese Medicine (TCM) differentiating therapy; group B was given basic therapy and a placebo that was similar in appearance and taste to TCM medicinal broth of pharmaceutical preparations, provided by Yibin Pharmaceutical Company (Yibin, China, Wuliangye Group). RESULTS The mortality in the treatment group decreased by 4.98% compared with the control group. The treatment group reported improved ventilation, corrected hypoxemia, improved nutritional status and promoted digestive functions. It also significantly improved the patient's self-life skills, improved the patient's quality of life and could shorten the length of hospital stay. CONCLUSION Comprehensive integrated TCM-WM treatment showed good clinical efficacy toward the acute onset period of PHD patients.
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Chen Q, Deeb RS, Ma Y, Staudt MR, Crystal RG, Gross SS. Serum Metabolite Biomarkers Discriminate Healthy Smokers from COPD Smokers. PLoS One 2015; 10:e0143937. [PMID: 26674646 PMCID: PMC4682670 DOI: 10.1371/journal.pone.0143937] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 11/11/2015] [Indexed: 12/16/2022] Open
Abstract
COPD (chronic obstructive pulmonary disease) is defined by a fixed expiratory airflow obstruction associated with disordered airways and alveolar destruction. COPD is caused by cigarette smoking and is the third greatest cause of mortality in the US. Forced expiratory volume in 1 second (FEV1) is the only validated clinical marker of COPD, but it correlates poorly with clinical features and is not sensitive enough to predict the early onset of disease. Using LC/MS global untargeted metabolite profiling of serum samples from a well-defined cohort of healthy smokers (n = 37), COPD smokers (n = 41) and non-smokers (n = 37), we sought to discover serum metabolic markers with known and/or unknown molecular identities that are associated with early-onset COPD. A total of 1,181 distinct molecular ions were detected in 95% of sera from all study subjects and 23 were found to be differentially-expressed in COPD-smokers vs. healthy-smokers. These 23 putative biomarkers were differentially-correlated with lung function parameters and used to generate a COPD prediction model possessing 87.8% sensitivity and 86.5% specificity. In an independent validation set, this model correctly predicted COPD in 8/10 individuals. These serum biomarkers included myoinositol, glycerophopshoinositol, fumarate, cysteinesulfonic acid, a modified version of fibrinogen peptide B (mFBP), and three doubly-charged peptides with undefined sequence that significantly and positively correlate with mFBP levels. Together, elevated levels of serum mFBP and additional disease-associated biomarkers point to a role for chronic inflammation, thrombosis, and oxidative stress in remodeling of the COPD airways. Serum metabolite biomarkers offer a promising and accessible window for recognition of early-stage COPD.
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Affiliation(s)
- Qiuying Chen
- Department of Pharmacology, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
| | - Ruba S. Deeb
- Department of Genetic Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
| | - Yuliang Ma
- Department of Pharmacology, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
| | - Michelle R. Staudt
- Department of Genetic Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
| | - Ronald G. Crystal
- Department of Genetic Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
- * E-mail: (RGC); (SSG)
| | - Steven S. Gross
- Department of Pharmacology, Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, United States of America
- * E-mail: (RGC); (SSG)
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Yilmaz MZ, Guzel A, Torun AC, Okuyucu A, Salis O, Karli R, Gacar A, Guvenc T, Paksu S, Urey V, Murat N, Alacam H. The therapeutic effects of anti-oxidant and anti-inflammatory drug quercetin on aspiration-induced lung injury in rats. J Mol Histol 2013; 45:195-203. [PMID: 24122261 DOI: 10.1007/s10735-013-9542-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/20/2013] [Indexed: 02/02/2023]
Abstract
Aspiration pneumonitis refers to acute chemical lung injury caused by aspiration of sterile gastric contents. The aim of this study was to evaluate the role of quercetin (QC) in acid aspiration-induced lung injury in rats. Twenty-eight female Sprague-Dawley rats were used and divided into the following groups (n = 7): sham (aspirated normal saline, S), hydrochloric acid (aspirated HCl), S plus treatment with QC (S + QC), and HCl plus treatment with QC (HCl + QC). After aspiration, the treatment groups received QC 60 mg/kg/day intraperitoneally once a day for 7 days. As a result of acid aspiration, an increase was observed in the levels of serum clara cell protein-16 (CC-16) and advanced oxidation protein products, whereas there was a decrease in serum thiobarbituric acid-reactive substances, superoxide dismutase (SOD), and catalase levels. There was a significant decrease in peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, and alveolar exudate scores, except in the alveolar histiocytes in the HCl + QC group. The expression of nitric oxide synthase, which increased after aspiration in the HCl group, showed a statistically significant decrease after the QC treatment. After the treatment with QC, an increase in the serum SOD level was observed, whereas a significant decrease was determined in the serum CC-16 level relative to that of the aspiration group (HCl). The antioxidant QC is effective in the treatment of lung injury following acid aspiration and can be used as a serum CC-16 biomarker in predicting the severity of oxidative lung injury.
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Affiliation(s)
- Mehmet Ziya Yilmaz
- Department of Pedodontia, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey,
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