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Wu JY, Liu MY, Lee MC, Hung KC, Hsu WH, Tsai YW, Liu TH, Huang PY, Chuang MH, Tseng SC, Lu CY, Lai CC. The clinical outcomes and effectiveness of antiviral agents among underweight patients with COVID-19. Expert Rev Anti Infect Ther 2024; 22:343-352. [PMID: 38178687 DOI: 10.1080/14787210.2024.2303017] [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: 07/15/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES This study investigated the outcomes of underweight patients with COVID-19 and the effectiveness of antiviral agents in this population. METHODS A retrospective cohort study using theTriNetX research network was conducted. Propensity score matching (PSM) was employed to balance the first cohort involving COVID-19 patients with underweight and normal-weight. In the second cohort, underweight patients receiving antiviral agents and untreated individuals were matched using PSM. The primary outcome was a composite of all-cause hospitalization and death during the 7-30-day follow-up period. RESULTS After PSM, the first cohort including each group of 13,502 patients with balanced baseline characteristics were identified for comparing the outcome of patients with underweight and normal weight. The underweight group had a higher risk of the composite primary outcome than those with normal weight (hazard ratio [HR], 1.251; 95% confidence interval [CI], 1.132-1.382). The second cohort included each 884 underweight patients with and without receiving antivirals.Compared with untreated patients, those receiving antiviral treatment had a lower risk of composite primary outcomes (HR, 0.426; 95% CI, 0.278-0.653). CONCLUSION Underweight status may be associated with a higher risk of all-cause hospitalization and death in patients with COVID-19.Among underweight patients, antiviral agents demonstrated clinically beneficial effects.
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Affiliation(s)
- Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Yuan Liu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan
- Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
| | - Mei-Chuan Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, Chi Mei Medical Centre, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wan-Hsuan Hsu
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ya-Wen Tsai
- Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Min-Hsiang Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Shu-Ching Tseng
- Department of Examination Room, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Ying Lu
- Department of General Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
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2
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da Silva GB, Manica D, da Silva AP, Valcarenghi E, Donassolo SR, Kosvoski GC, Mingoti MED, Gavioli J, Cassol JV, Hanauer MC, Hellmann MB, Marafon F, Bertollo AG, de Medeiros J, Cortez AD, Réus GZ, de Oliveira GG, Ignácio ZM, Bagatini MD. Peripheral biomarkers as a predictor of poor prognosis in severe cases of COVID-19. Am J Med Sci 2024:S0002-9629(24)01171-6. [PMID: 38636654 DOI: 10.1016/j.amjms.2024.04.011] [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: 10/03/2023] [Revised: 12/29/2023] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
We evaluated glycemia and triglyceride, hepatic, muscular, and renal damage markers, redox profile, and leptin and ghrelin hormone levels of COVID-19 patients. We also realized statistical analysis to verify the potential of biomarkers to predict poor prognosis and the correlation between them in severe cases. We assessed glycemia and the levels of triglycerides, hepatic, muscular, and renal markers in automatized biochemical analyzer. The leptin and ghrelin hormones were assessed by the ELISA assay. Severe cases presented high glycemia and triglyceride levels. Hepatic, muscular, and renal biomarkers were altered in severe patients. An oxidative stress status was found in severe COVID-19 patients. Severe cases also had increased levels of leptin. The ROC curves indicated many biomarkers as poor prognosis predictors in severe cases. The Spearman analysis showed that biomarkers correlate between themselves. Patients with COVID-19 showed significant dysregulation in the levels of several peripheral biomarkers. We bring to light that a robust panel of peripheral biomarkers and hormones predict poor prognosis in severe cases of COVID-19, as well as correlates between them. Early monitoring of these biomarkers may conduct the correct clinical intervention associated with the clinical symptoms for treating patients infected by SARS-CoV-2.
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Affiliation(s)
- Gilnei B da Silva
- Multicentric Postgraduate Program in Biochemistry and Molecular Biology, State University of Santa Catarina, Lages, SC, Brazil
| | - Daiane Manica
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil
| | - Alana P da Silva
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil
| | - Eduarda Valcarenghi
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Sabine R Donassolo
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Greicy C Kosvoski
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Maiqueli E D Mingoti
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Jullye Gavioli
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Joana V Cassol
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Marceli C Hanauer
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Mariélly B Hellmann
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Filomena Marafon
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Amanda G Bertollo
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Jesiel de Medeiros
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Arthur D Cortez
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Gislaine Z Réus
- Postgraduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Gabriela G de Oliveira
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Zuleide M Ignácio
- Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Margarete D Bagatini
- Postgraduate Program in Biochemistry, Federal University of Santa Catarina, SC, Brazil; Postgraduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil.
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3
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Miron VD, Drăgănescu AC, Pițigoi D, Aramă V, Streinu-Cercel A, Săndulescu O. The Impact of Obesity on the Host-Pathogen Interaction with Influenza Viruses - Novel Insights: Narrative Review. Diabetes Metab Syndr Obes 2024; 17:769-777. [PMID: 38371386 PMCID: PMC10874191 DOI: 10.2147/dmso.s434115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024] Open
Abstract
After exposure to a viral pathogen, the host-pathogen interaction is essential to determine whether or not infection will ensue, and what the clinical outline of the infection will be. Recent research has shown that the patient with obesity presents a set of particular pathophysiological changes that lead to higher severity of viral infections, and this is particularly true for infection with influenza viruses. Herein, we describe the main metabolic, endocrine, and immune dysregulations that occur in the presence of obesity and their impact on driving intra-host viral diversity, leading to heightened severity and virulence of influenza. We show that obesity is linked to modified responses of both the innate and adaptive immune systems during viral infections, including influenza. Due to chronic inflammation and metabolic, endocrine, and signaling pathway disruptions, individuals with obesity have a suboptimal immune response. This results in longer illness duration, increased virus shedding, higher risk of hospitalization and complications, and greater mortality rates. Additionally, they may have a blunted response to vaccination and a higher likelihood of genetic mutation selection. Understanding the intricate interplay between obesity and viral pathogenesis is crucial for developing efficacious therapeutic approaches and public health policies, particularly in light of the escalating worldwide incidence of obesity.
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Affiliation(s)
- Victor Daniel Miron
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Anca Cristina Drăgănescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Daniela Pițigoi
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Victoria Aramă
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Adrian Streinu-Cercel
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Oana Săndulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
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Ghag R, Kaushal M, Nwanne G, Knoten A, Kiryluk K, Rosenberg A, Menez S, Bagnasco SM, Sperati CJ, Atta MG, Gaut JP, Williams JC, El-Achkar TM, Arend LJ, Parikh CR, Jain S. Single Nucleus RNA Sequencing of Remnant Kidney Biopsies and Urine Cell RNA Sequencing Reveal Cell Specific Markers of Covid-19 Acute Kidney Injury. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.10.566497. [PMID: 37986991 PMCID: PMC10659401 DOI: 10.1101/2023.11.10.566497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Acute kidney injury (AKI) in COVID-19 patients is associated with high mortality and morbidity. Critically ill COVID-19 patients are at twice the risk of in-hospital mortality compared to non-COVID AKI patients. We know little about the cell-specific mechanism in the kidney that contributes to worse clinical outcomes in these patients. New generation single cell technologies have the potential to provide insights into physiological states and molecular mechanisms in COVID-AKI. One of the key limitations is that these patients are severely ill posing significant risks in procuring additional biopsy tissue. We recently generated single nucleus RNA-sequencing data using COVID-AKI patient biopsy tissue as part of the human kidney atlas. Here we describe this approach in detail and report deeper comparative analysis of snRNAseq of 4 COVID-AKI, 4 reference, and 6 non-COVID-AKI biopsies. We also generated and analyzed urine transcriptomics data to find overlapping COVID-AKI-enriched genes and their corresponding cell types in the kidney from snRNA-seq data. We identified all major and minor cell types and states by using by using less than a few cubic millimeters of leftover tissue after pathological workup in our approach. Differential expression analysis of COVID-AKI biopsies showed pathways enriched in viral response, WNT signaling, kidney development, and cytokines in several nephron epithelial cells. COVID-AKI profiles showed a much higher proportion of altered TAL cells than non-COVID AKI and the reference samples. In addition to kidney injury and fibrosis markers indicating robust remodeling we found that, 17 genes overlap between urine cell COVID-AKI transcriptome and the snRNA-seq data from COVID-AKI biopsies. A key feature was that several of the distal nephron and collecting system cell types express these markers. Some of these markers have been previously observed in COVID-19 studies suggesting a common mechanism of injury and potentially the kidney as one of the sources of soluble factors with a potential role in disease progression. Translational Statement The manuscript describes innovation, application and discovery that impact clinical care in kidney disease. First, the approach to maximize use of remnant frozen clinical biopsies to inform on clinically relevant molecular features can augment existing pathological workflow for any frozen tissue without much change in the protocol. Second, this approach is transformational in medical crises such as pandemics where mechanistic insights are needed to evaluate organ injury, targets for drug therapy and diagnostic and prognostic markers. Third, the cell type specific and soluble markers identified and validated can be used for diagnoses or prognoses in AKI due to different etiologies and in multiorgan injury.
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Gholamalizadeh M, Attari M, Mousavi M, Shekari S, Salimi Z, Rajabi Harsini A, Zeinolabedin M, Barzkar A, Mahmoudi Z, Alami F, Dahka SM, Gholami S, Rahvar M, Pourtaleb M, Khoshdooz S, Kalantari N, Doaei S. The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID-19. Endocrinol Diabetes Metab 2023; 6:e458. [PMID: 37899666 PMCID: PMC10638616 DOI: 10.1002/edm2.458] [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: 06/27/2023] [Revised: 09/07/2023] [Accepted: 09/30/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID-19. METHODS This case-control study was performed on 223 patients with COVID-19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records. RESULTS The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002-1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors. CONCLUSIONS Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID-19 outcomes.
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Affiliation(s)
- Maryam Gholamalizadeh
- Student Research Committee, Cancer Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Mohammad Attari
- Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Mahdi Mousavi
- Student Research CenterTabriz University of Medical SciencesTabrizIran
| | - Soheila Shekari
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Zahra Salimi
- Nutrition and Metabolic Diseases Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Asma Rajabi Harsini
- Department of Clinical NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS)TehranIran
| | - Mobina Zeinolabedin
- Department of Community NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS)TehranIran
| | | | - Zahra Mahmoudi
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Farkhondeh Alami
- Student Research Committee, Department of Nutrition, Faculty of MedicineUrmia University of Medical SciencesUrmiaIran
| | | | - Somayeh Gholami
- Intensive Care Unit (ICU)Razi Hospital, Guilan University of Medical SciencesRashtIran
| | - Masoume Rahvar
- School of HealthGuilan University of Medical SciencesRashtIran
| | | | - Sara Khoshdooz
- Faculty of MedicineGuilan University of Medical ScienceRashtIran
| | - Naser Kalantari
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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6
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Hoti Q, Akan G, Tuncel G, Evren EU, Evren H, Suer K, Sanlidag T, Ergoren MC. Altered expression levels of TAS1R2 and TAS1R3 genes among SARS-CoV-2 variants of concerns. Mol Biol Rep 2023; 50:9343-9351. [PMID: 37817023 DOI: 10.1007/s11033-023-08893-5] [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: 08/09/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The most common symptoms of coronavirus infections are fever, cough, shortness of breath, headache, ache of joints, a loss of smell and loss of taste, and etc. Early studies suggested that smell and taste receptors were associated with pathogenic detection and immunity. Thus, we aimed to evaluate the expression profile of gene receptors that are related to taste, smell, and appetite control in COVID-19 patients and their putative correlation with SARS-CoV-19 variants. METHOD Gene expression levels of TAS1R2, TAS1R3, TAS2R38, OR51E1, LEPR, GHRL were analyzed in 100 COVID-19 patients and 100 SARS-CoV-2 RT-qPCR negative group. RESULTS The expression levels of TAS1R2 and TAS1R3 genes were significantly decreased in COVID-19 patients who were infected with Delta variant. However, the TAS2R38 gene expression level was significantly lower when compared to the control group. The TAS1R2 gene expression was positively correlated with TAS1R3, and TAS2R38 genes (p = 0.001, p = 0.025, respectively). CONCLUSION TAS1R2, TAS1R3, and TAS2R38 gene expression levels were decreased in the Delta variant compared to the Omicron BA.1 variant in the studied groups. These results provided a significant clue for the temporary taste loss, especially in patients infected with the Delta variant, which is the most disruptive and symptomatic variant causing hospitalizations, and deaths compared to other variants may be because ACE2 is expressed in the taste buds and high replication of SARS-CoV-2 in the infected gustatory cells in the taste bud generates inflammation and then could eventually destroy the cells. This gustatory cell damage may cause malfunction of the gustatory system.
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Affiliation(s)
- Qendresa Hoti
- Faculty of Medicine, Department of Medical Biochemistry, Near East University, 99138, Nicosia, Cyprus
| | - Gokce Akan
- DESAM Research Institute, Near East University, 99138, Nicosia, Cyprus
| | - Gulten Tuncel
- DESAM Research Institute, Near East University, 99138, Nicosia, Cyprus
| | - Emine Unal Evren
- Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Girne University, Kyrenia, Cyprus
| | - Hakan Evren
- Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Girne University, Kyrenia, Cyprus
| | - Kaya Suer
- Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Near East University, 99138, Nicosia, Cyprus
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, 99138, Nicosia, Cyprus
| | - Mahmut Cerkez Ergoren
- Faculty of Medicine, Department of Medical Genetics, Near East University, 99138, Nicosia, Cyprus.
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Almond M, Farne HA, Jackson MM, Jha A, Katsoulis O, Pitts O, Tunstall T, Regis E, Dunning J, Byrne AJ, Mallia P, Kon OM, Saunders KA, Simpson KD, Snelgrove RJ, Openshaw PJM, Edwards MR, Barclay WS, Heaney LM, Johnston SL, Singanayagam A. Obesity dysregulates the pulmonary antiviral immune response. Nat Commun 2023; 14:6607. [PMID: 37857661 PMCID: PMC10587167 DOI: 10.1038/s41467-023-42432-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023] Open
Abstract
Obesity is a well-recognized risk factor for severe influenza infections but the mechanisms underlying susceptibility are poorly understood. Here, we identify that obese individuals have deficient pulmonary antiviral immune responses in bronchoalveolar lavage cells but not in bronchial epithelial cells or peripheral blood dendritic cells. We show that the obese human airway metabolome is perturbed with associated increases in the airway concentrations of the adipokine leptin which correlated negatively with the magnitude of ex vivo antiviral responses. Exogenous pulmonary leptin administration in mice directly impaired antiviral type I interferon responses in vivo and ex vivo in cultured airway macrophages. Obese individuals hospitalised with influenza showed dysregulated upper airway immune responses. These studies provide insight into mechanisms driving propensity to severe influenza infections in obesity and raise the potential for development of leptin manipulation or interferon administration as novel strategies for conferring protection from severe infections in obese higher risk individuals.
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Affiliation(s)
- Mark Almond
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Hugo A Farne
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Millie M Jackson
- Centre for Bacterial Resistance Biology. Section of Molecular Microbiology. Department of Infectious Disease, Imperial College London, London, UK
| | - Akhilesh Jha
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Orestis Katsoulis
- Centre for Bacterial Resistance Biology. Section of Molecular Microbiology. Department of Infectious Disease, Imperial College London, London, UK
| | - Oliver Pitts
- Centre for Bacterial Resistance Biology. Section of Molecular Microbiology. Department of Infectious Disease, Imperial College London, London, UK
| | | | - Eteri Regis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Jake Dunning
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Adam J Byrne
- National Heart and Lung Institute, Imperial College London, London, UK
- School of Medicine and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, 4, Ireland
| | - Patrick Mallia
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Onn Min Kon
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | | | | | - Michael R Edwards
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Wendy S Barclay
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
| | - Liam M Heaney
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Aran Singanayagam
- Centre for Bacterial Resistance Biology. Section of Molecular Microbiology. Department of Infectious Disease, Imperial College London, London, UK.
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8
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D'Elia L, Masulli M, Iacone R, Russo O, Strazzullo P, Galletti F. Relationship between leptin and white blood cells: a potential role in infection susceptibility and severity-the Olivetti Heart Study. Intern Emerg Med 2023; 18:1429-1436. [PMID: 37217748 PMCID: PMC10202358 DOI: 10.1007/s11739-023-03313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
A number of evidence showed an emerging role of leptin on immune system, involving inflammation, and innate and adaptive immunity. Few observational studies have evaluated the relationship between leptin and immunity, albeit with low statistical power and methodological differences. Therefore, the aim of this study was to evaluate the potential role of leptin on the immunity, expressed as white blood cells (WBC)-and its subpopulations, by comprehensive multivariate models in a sample of adult men. A cross-sectional evaluation of a general population comprised 939 subjects participating in the Olivetti Heart Study, with available leptin levels and WBC-and its subpopulations. WBC were significantly and positively associated with leptin, C-reactive protein and HOMA index (p < 0.05), but not with age and anthropometric indices (p > 0.05). The multivariate analysis confirmed the association between leptin and WBC, after accounting for main confounders (p < 0.05). Additional analysis on WBC subpopulations showed a positive and significant correlation between leptin and lymphocytes, monocytes and eosinophils (p < 0.05), but not with neutrophils and basophils (p > 0.05). After stratification by body weight, the positive and significant association between leptin and WBC-and its subpopulations-was found in excess body weight participants. The results of this study indicate a direct relationship between leptin levels and WBC-and its subpopulations-in excess body weight participants. These results support the hypothesis that leptin has modulatory functions on immunity and role in the pathophysiology of immune-related diseases, in particular in those associated with excess body weight.
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Affiliation(s)
- Lanfranco D'Elia
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy.
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy
| | - Roberto Iacone
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy
| | - Ornella Russo
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy.
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9
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Nakayasu H, Sakurai S, Sugiyama S, Shiratori K, Okawa K, Kitahara Y, Takahashi S, Masuda T, Kishimoto Y, Saigusa M, Yamamoto A, Akamatsu T, Morita S, Asada K, Shirai T. The liver-to-spleen ratio is a risk factor predicting oxygen demand in COVID-19 patients. INFECTIOUS MEDICINE 2023; 2:105-111. [PMID: 38013740 PMCID: PMC10116163 DOI: 10.1016/j.imj.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 11/29/2023]
Abstract
Background We aimed to investigate risk factors predicting oxygen demand in COVID-19 patients. Methods Patients admitted to Shizuoka General Hospital with COVID-19 from August 2020 to August 2021 were included. First, we divided patients into groups with and without oxygen demand. Then, we compared patients' clinical characteristics and laboratory and radiological findings to determine factors predicting oxygen demand. Results One hundred seventy patients with COVID-19 (aged 58±15 years, 57 females) were enrolled. Common comorbidities were cardiovascular diseases (47.6%), diabetes mellitus (28.8%), and dyslipidemia (26.5%). Elder age, higher body mass index, cardiovascular diseases, diabetes mellitus, lower lymphocyte count, albumin, hepatic attenuation value, and the liver-to-spleen ratio (L/S), higher D-dimer, aspartate aminotransferase, lactate dehydrogenase, troponin-T, C-reactive protein, KL-6, chest and abdominal circumference, and visceral fat were found in patients with oxygen demand. According to the multivariate logistic regression analysis, L/S, lymphocyte count, D-dimer, and abdominal circumference under the diaphragm were independent risk factors predicting oxygen demand in COVID-19 patients. Conclusions On admission, L/S, lymphocyte count, D-dimer, and abdominal circumference were predictive factors for oxygen demand. These factors may help in the appropriate triage of COVID-19 patients in the decision to admit them to the hospital.
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Affiliation(s)
- Hiromasa Nakayasu
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Shogo Sakurai
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Shuichi Sugiyama
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Kotaro Shiratori
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Kohei Okawa
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Yoshihiro Kitahara
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Shingo Takahashi
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Toshihiro Masuda
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Yutaro Kishimoto
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Mika Saigusa
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Akito Yamamoto
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Taisuke Akamatsu
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Satoru Morita
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan
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10
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Barbalho SM, Minniti G, Miola VFB, Haber JFDS, Bueno PCDS, de Argollo Haber LS, Girio RSJ, Detregiachi CRP, Dall'Antonia CT, Rodrigues VD, Nicolau CCT, Catharin VMCS, Araújo AC, Laurindo LF. Organokines in COVID-19: A Systematic Review. Cells 2023; 12:1349. [PMID: 37408184 DOI: 10.3390/cells12101349] [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: 02/22/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 07/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a viral infection caused by SARS-CoV-2 that induces a generalized inflammatory state. Organokines (adipokines, osteokines, myokines, hepatokines, and cardiokines) can produce beneficial or harmful effects in this condition. This study aimed to systematically review the role of organokines on COVID-19. PubMed, Embase, Google Scholar, and Cochrane databases were searched, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and 37 studies were selected, comprising more than 2700 individuals infected with the virus. Among COVID-19 patients, organokines have been associated with endothelial dysfunction and multiple organ failure due to augmented cytokines and increased SARS-CoV-2 viremia. Changes in the pattern of organokines secretion can directly or indirectly contribute to aggravating the infection, promoting immune response alterations, and predicting the disease progression. These molecules have the potential to be used as adjuvant biomarkers to predict the severity of the illness and severe outcomes.
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Affiliation(s)
- Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Avenida Castro Alves, 62, Marília 17500-000, SP, Brazil
| | - Giulia Minniti
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Vitor Fernando Bordin Miola
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Jesselina Francisco Dos Santos Haber
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Centro Interdisciplinar em Diabetes (CENID), School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Patrícia Cincotto Dos Santos Bueno
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Animal Sciences, School of Veterinary Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Luiza Santos de Argollo Haber
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Raul S J Girio
- Department of Animal Sciences, School of Veterinary Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Cláudia Rucco Penteado Detregiachi
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
| | - Camila Tiveron Dall'Antonia
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Victória Dogani Rodrigues
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
| | - Claudia C T Nicolau
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Avenida Castro Alves, 62, Marília 17500-000, SP, Brazil
| | - Virginia Maria Cavallari Strozze Catharin
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Adriano Cressoni Araújo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
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11
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Lempesis IG, Georgakopoulou VE. Implications of obesity and adiposopathy on respiratory infections; focus on emerging challenges. World J Clin Cases 2023; 11:2925-2933. [PMID: 37215426 PMCID: PMC10198078 DOI: 10.12998/wjcc.v11.i13.2925] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Obesity is characterized by excessive adipose tissue accumulation, which impacts physiological, metabolic, and immune functions. Several respiratory infections, including bacterial pneumonia, influenza, and coronavirus disease 2019, appear to be linked to unfavorable results in individuals with obesity. These may be attributed to the direct mechanical/physiological effects of excess body fat on the lungs’ function. Notably, adipose tissue dysfunction is associated with a low-grade chronic inflammatory status and hyperleptinemia, among other characteristics. These have all been linked to immune system dysfunction and weakened immune responses to these infections. A better understanding and clinical awareness of these risk factors are necessary for better disease outcomes.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens 11527, Greece
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12
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Lagrandeur J, Putallaz P, Krief H, Büla CJ, Coutaz M. Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? BMC Geriatr 2023; 23:228. [PMID: 37041477 PMCID: PMC10088129 DOI: 10.1186/s12877-023-03937-8] [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: 06/13/2022] [Accepted: 03/27/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUNDS To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. METHODS Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. RESULTS Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14-0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. CONCLUSIONS In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.
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Affiliation(s)
- Julien Lagrandeur
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland.
| | - Pauline Putallaz
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Hélène Krief
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Christophe J Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Martial Coutaz
- Service of Geriatric Medicine, Hospital of Valais, Avenue de La Fusion 27, 1920, Martigny, Switzerland
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13
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Adiponectin, Leptin, and Resistin Are Dysregulated in Patients Infected by SARS-CoV-2. Int J Mol Sci 2023; 24:ijms24021131. [PMID: 36674646 PMCID: PMC9861572 DOI: 10.3390/ijms24021131] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/28/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
Obesity, through adipose tissue (AT) inflammation and dysregulation, represents a critical factor for COVID-19; here, we investigated whether serum levels of adiponectin, HMW oligomers, leptin, and resistin are modulated and/or correlated with clinical and biochemical parameters of severe COVID-19 patients. This study included 62 severe COVID-19 patients; 62 age and sex-matched healthy subjects were recruited as a control group. Anthropometric and biochemical parameters were obtained and compared. Adiponectin, HMW oligomers, leptin, and resistin were analyzed by ELISA. The adiponectin oligomerization state was visualized by Western blotting. When compared to healthy subjects, total adiponectin levels were statistically lower in severe COVID-19 while, in contrast, the levels of leptin and resistin were statistically higher. Interestingly, HMW adiponectin oligomers negatively correlated with leptin and were positively associated with LUS scores. Resistin showed a positive association with IL-6, IL-2R, and KL-6. Our data strongly support that adipose tissue might play a functional role in COVID-19. Although it needs to be confirmed in larger cohorts, adiponectin HMW oligomers might represent a laboratory resource to predict patient seriousness. Whether adipokines can be integrated as a potential additional tool in the evolving landscape of biomarkers for the COVID-19 disease is still a matter of debate. Other studies are needed to understand the molecular mechanisms behind adipokine's involvement in COVID-19.
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14
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Abend Bardagi A, Dos Santos Paschoal C, Favero GG, Riccetto L, Alexandrino Dias ML, Guerra Junior G, Degasperi G. Leptin's Immune Action: A Review Beyond Satiety. Immunol Invest 2023; 52:117-133. [PMID: 36278927 DOI: 10.1080/08820139.2022.2129381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The adipose tissue is an endocrine organ that secretes adipokines such as leptin, which is one of the most important hormones for controlling satiety, metabolism, and energy homeostasis. This hormone acts in the regulation of innate and adaptive immune responses since immune cells have leptin receptors from which this hormone initiates its biological action. These receptors have been identified in hematopoietic stem cells in the bone marrow and mature immune cells, inducing signaling pathways mediated by JAK/STAT, PI3K, and ERK 1/2. It is known that the bone marrow also contains leptin-producing adipocytes, which are crucial for regulating hematopoiesis through largely unknown mechanisms. Therefore, we have reviewed the roles of leptin inside and outside the bone marrow, going beyond its action in the control of satiety.
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Affiliation(s)
- Alice Abend Bardagi
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Clarissa Dos Santos Paschoal
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Giovanna Ganem Favero
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Luisa Riccetto
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Maria Luisa Alexandrino Dias
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Gil Guerra Junior
- Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, Brazil
| | - Giovanna Degasperi
- Center for Health Sciences, School of Medical Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
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15
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Guglielmi V, Campanelli M, Bianciardi E, Benavoli D, Colangeli L, D'Adamo M, Sbraccia P, Gentileschi P. Bariatric surgery for metabolic unhealthy obesity (MUO) during the COVID era: short-term results of a high-volume center. Eat Weight Disord 2022; 27:3119-3124. [PMID: 35852766 PMCID: PMC9294774 DOI: 10.1007/s40519-022-01438-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE During the coronavirus disease 19 (COVID-19) outbreak, most public hospitals worldwide have been forced to postpone a major part of bariatric surgery (BS) operations with unfavorable consequences for weight and obesity complications. The aim of this study was to evaluate the effectiveness and safety of laparoscopic BS on subjects with metabolically unhealthy obesity (MUO) during COVID-19 pandemic in a high-volume Italian center. METHODS Between March 2020 and January 2021, all patients with MUO submitted to laparoscopic BS (sleeve gastrectomy [SG], one anastomosis gastric bypass [OAGB] and Roux-en-Y gastric bypass [RYGB]) were enrolled according to the ATP III Guidelines, with a minimum follow-up of 3 months. RESULTS In the study period, 210 patients with MUO underwent laparoscopic BS (77 RYGB, 85 SG and 48 OAGB) in our obesity referral center. Postoperative major complications occurred in 4 patients (1.9%) with zero mortality. At 9-month follow-up, a total weight loss (TWL) of 28.2 ± 18.4, 26.1 ± 23.1 and 24.5 ± 11.3% (p = 0.042) was observed in RYGB, OAGB and SG groups, respectively. The rate of comorbidity resolution was very similar for all type of surgeries (p = 0.871). Only two cases of postoperative SARS-CoV-2 infection were registered (0.9%) and both cases resolved with medical therapy and observation. CONCLUSION Among the patients studied, all surgical techniques were safe and effective for MUO during the COVID era. This group of patients is at high risk for general and SARS-CoV-2-related mortality and therefore should be prioritized for BS. LEVEL OF EVIDENCE Level III, single-center retrospective cohort study.
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Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. .,Internal Medicine Unit and Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy.
| | - Michela Campanelli
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Emanuela Bianciardi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Domenico Benavoli
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Luca Colangeli
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,Internal Medicine Unit and Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Monica D'Adamo
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,Internal Medicine Unit and Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Paolo Sbraccia
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,Internal Medicine Unit and Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Paolo Gentileschi
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy
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16
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Vitale C, Spinozzi V, Colangeli L, Sbraccia P, Guglielmi V. Staphylococcal scalded skin syndrome in adults with obesity and type 2 diabetes: A case series. Clin Case Rep 2022; 10:e6471. [DOI: 10.1002/ccr3.6471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Carolina Vitale
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
- Obesity Medical Center University Hospital Policlinico Tor Vergata Rome Italy
| | - Valentina Spinozzi
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
- Obesity Medical Center University Hospital Policlinico Tor Vergata Rome Italy
| | - Luca Colangeli
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
- Obesity Medical Center University Hospital Policlinico Tor Vergata Rome Italy
| | - Paolo Sbraccia
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
- Obesity Medical Center University Hospital Policlinico Tor Vergata Rome Italy
| | - Valeria Guglielmi
- Department of Systems Medicine University of Rome Tor Vergata Rome Italy
- Obesity Medical Center University Hospital Policlinico Tor Vergata Rome Italy
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17
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Obesity and Leptin Resistance in the Regulation of the Type I Interferon Early Response and the Increased Risk for Severe COVID-19. Nutrients 2022; 14:nu14071388. [PMID: 35406000 PMCID: PMC9002648 DOI: 10.3390/nu14071388] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity, and obesity-associated conditions such as hypertension, chronic kidney disease, type 2 diabetes, and cardiovascular disease, are important risk factors for severe Coronavirus disease-2019 (COVID-19). The common denominator is metaflammation, a portmanteau of metabolism and inflammation, which is characterized by chronically elevated levels of leptin and pro-inflammatory cytokines. These induce the “Suppressor Of Cytokine Signaling 1 and 3” (SOCS1/3), which deactivates the leptin receptor and also other SOCS1/3 sensitive cytokine receptors in immune cells, impairing the type I and III interferon early responses. By also upregulating SOCS1/3, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 adds a significant boost to this. The ensuing consequence is a delayed but over-reactive immune response, characterized by high-grade inflammation (e.g., cytokine storm), endothelial damage, and hypercoagulation, thus leading to severe COVID-19. Superimposing an acute disturbance, such as a SARS-CoV-2 infection, on metaflammation severely tests resilience. In the long run, metaflammation causes the “typical western” conditions associated with metabolic syndrome. Severe COVID-19 and other serious infectious diseases can be added to the list of its short-term consequences. Therefore, preventive measures should include not only vaccination and the well-established actions intended to avoid infection, but also dietary and lifestyle interventions aimed at improving body composition and preventing or reversing metaflammation.
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18
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IgG Antibody Response to the Pfizer BNT162b2 SARS-CoV-2 Vaccine in Healthcare Workers with Healthy Weight, Overweight, and Obesity. Vaccines (Basel) 2022; 10:vaccines10040512. [PMID: 35455261 PMCID: PMC9025933 DOI: 10.3390/vaccines10040512] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 12/18/2022] Open
Abstract
Obesity is a significant factor for increased morbidity and mortality upon infection with SARS-CoV-2. Because of the higher potential for negative outcomes following infection of individuals with obesity, the impact of body mass index (BMI) on vaccine immunogenicity and efficacy is an important public health concern. Few studies have measured the magnitude and durability of the vaccine-specific response in relation to BMI. We measured the receptor binding domain (RBD)-specific serum IgG and surrogate neutralizing titers in a cohort of 126 vaccinated individuals with no clinical history or serological evidence of previous SARS-CoV-2 infection 50 and 200 days following vaccination. BMI had no significant impact on RBD-specific IgG titers and surrogate neutralizing titers 50 days following immunization, and leptin levels had no correlation with the response to immunization. Two hundred days following immunization, antibody titers in all groups had declined by approximately 90%. The responses were also similar between male and female participants and did not significantly vary across age groups. These results indicate that the magnitude and durability of the antibody response to mRNA-based vaccines are unaffected by BMI in this cohort.
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19
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Baltodano-Calle MJ, Polo-Vasquez JS, Romani-Pozo A, Gutarra-Saldaña D, Guija-Poma E. Leptin as a potential prognostic marker of the severity of COVID-19 infection in obese patients. Nutr Metab Cardiovasc Dis 2022; 32:743-744. [PMID: 35109999 PMCID: PMC8660140 DOI: 10.1016/j.numecd.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Maria J Baltodano-Calle
- Universidad Peruana Cayetano Heredia Facultad de Medicina, Lima, Peru; Sociedad Científica de Estudiantes De Medicina Cayetano Heredia (SOCEMCH), Lima, Peru.
| | - Jhoanna S Polo-Vasquez
- Universidad Peruana Cayetano Heredia Facultad de Medicina, Lima, Peru; Sociedad Científica de Estudiantes De Medicina Cayetano Heredia (SOCEMCH), Lima, Peru
| | - Alina Romani-Pozo
- Universidad Peruana Cayetano Heredia Facultad de Medicina, Lima, Peru
| | | | - Emilio Guija-Poma
- Universidad de San Martin de Porres Facultad de Medicina Humana, Centro de Investigación de Bioquímica y Nutrición, Lima, Peru
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20
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Bruno A, Ferrante G, Di Vincenzo S, Pace E, La Grutta S. Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection? Front Physiol 2022; 12:776963. [PMID: 35002761 PMCID: PMC8727443 DOI: 10.3389/fphys.2021.776963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Leptin is a pleiotropic adipocytokine involved in several physiologic functions, with a known role in innate and adaptive immunity as well as in tissue homeostasis. Long- and short-isoforms of leptin receptors are widely expressed in many peripheral tissues and organs, such as the respiratory tract. Similar to leptin, microbiota affects the immune system and may interfere with lung health through the bidirectional crosstalk called the “gut-lung axis.” Obesity leads to impaired protective immunity and altered susceptibility to pulmonary infections, as those by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it is known that leptin and microbiota link metabolism and lung health, their role within the SARS-CoV2 coronavirus disease 2019 (COVID-19) deserves further investigations. This review aimed to summarize the available evidence about: (i) the role of leptin in immune modulation; (ii) the role of gut microbiota within the gut-lung axis in modulating leptin sensitivity; and (iii) the role of leptin in the pathophysiology of COVID-19.
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Affiliation(s)
- Andreina Bruno
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Giuliana Ferrante
- Pediatric Division, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Serena Di Vincenzo
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Elisabetta Pace
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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Guglielmi V, El Ghoch M, Bettini S, Holly JMP. Editorial: Covid-19 and obesity. Front Endocrinol (Lausanne) 2022; 13:1122274. [PMID: 36619552 PMCID: PMC9817024 DOI: 10.3389/fendo.2022.1122274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
- *Correspondence: Valeria Guglielmi,
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Silvia Bettini
- Center for the Study and the Integrated Treatment of Obesity, Internal Medicine 3, Padua University Hospital, Padua, Italy
| | - Jeff M. P. Holly
- Faculty of Medicine, School of Translational Health Science, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, United Kingdom
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Heubel AD, Viana AA, Linares SN, do Amaral VT, Schafauser NS, de Oliveira GYO, Ramírez PC, Martinelli B, da Silva Alexandre T, Borghi‐Silva A, Ciolac EG, Mendes RG. Determinants of endothelial dysfunction in noncritically ill hospitalized COVID-19 patients: A cross-sectional study. Obesity (Silver Spring) 2022; 30:165-171. [PMID: 34554646 PMCID: PMC8661847 DOI: 10.1002/oby.23311] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/24/2021] [Accepted: 09/21/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to identify determinants of endothelial dysfunction in patients hospitalized with acute COVID-19. METHODS A total of 109 hospitalized COVID-19 patients in noncritical status were cross-sectionally studied. Clinical data (age, sex, comorbidities, and medications) and BMI were assessed. Laboratory tests included serum hemoglobin, leukocytes, lymphocytes, platelets, C-reactive protein, ferritin, D-dimer, and creatinine. Physical status was evaluated using a handgrip dynamometer. Endothelial function was assessed noninvasively using the flow-mediated dilation (FMD) method. RESULTS The sample average age was 51 years, 51% of patients were male, and the most frequent comorbidity was obesity (62%). Univariate analysis showed association of lower FMD with higher BMI, hypertension, use of oral antihypertensive, higher blood levels of creatinine, and larger baseline artery diameter. After adjusting for confounders, the multivariate analysis showed BMI (95% CI: -0.26 to -0.11; p < 0.001) as the major factor associated with FMD. Other factors associated with FMD were baseline artery diameter (95% CI: -1.77 to -0.29; p = 0.007) and blood levels of creatinine (95% CI: -1.99 to -0.16; p = 0.022). CONCLUSIONS Increased BMI was the major factor associated with endothelial dysfunction in noncritically hospitalized COVID-19 patients. This may explain one of the pathways in which obesity may increase the risk for severe COVID-19.
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Affiliation(s)
- Alessandro Domingues Heubel
- Cardiopulmonary Physiotherapy LaboratoryDepartment of Physical TherapyFederal University of São CarlosSão CarlosSão PauloBrazil
| | - Ariane Aparecida Viana
- Exercise and Chronic Disease Research LaboratoryDepartment of Physical EducationSchool of SciencesSão Paulo State UniversityBauruSão PauloBrazil
| | - Stephanie Nogueira Linares
- Cardiopulmonary Physiotherapy LaboratoryDepartment of Physical TherapyFederal University of São CarlosSão CarlosSão PauloBrazil
| | - Vanessa Teixeira do Amaral
- Exercise and Chronic Disease Research LaboratoryDepartment of Physical EducationSchool of SciencesSão Paulo State UniversityBauruSão PauloBrazil
| | - Nathany Souza Schafauser
- Cardiopulmonary Physiotherapy LaboratoryDepartment of Physical TherapyFederal University of São CarlosSão CarlosSão PauloBrazil
| | - Gustavo Yudi Orikassa de Oliveira
- Exercise and Chronic Disease Research LaboratoryDepartment of Physical EducationSchool of SciencesSão Paulo State UniversityBauruSão PauloBrazil
| | - Paula Camila Ramírez
- Department of Physical TherapyUniversidad Industrial de SantanderBucaramangaSantanderColombia
- Department of GerontologyFederal University of São CarlosSão CarlosSão PauloBrazil
| | - Bruno Martinelli
- Department of Physical TherapySacred Heart University CenterBauruSão PauloBrazil
| | | | - Audrey Borghi‐Silva
- Cardiopulmonary Physiotherapy LaboratoryDepartment of Physical TherapyFederal University of São CarlosSão CarlosSão PauloBrazil
| | - Emmanuel Gomes Ciolac
- Exercise and Chronic Disease Research LaboratoryDepartment of Physical EducationSchool of SciencesSão Paulo State UniversityBauruSão PauloBrazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy LaboratoryDepartment of Physical TherapyFederal University of São CarlosSão CarlosSão PauloBrazil
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Scheffler M, Genton L, Graf CE, Remuinan J, Gold G, Zekry D, Serratrice C, Herrmann FR, Mendes A. Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19. J Clin Med 2021; 10:jcm10235500. [PMID: 34884199 PMCID: PMC8658645 DOI: 10.3390/jcm10235500] [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: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. METHODS This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. RESULTS The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183-0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071-0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523-5.379 95% CI; p = 0.001). CONCLUSION Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.
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Affiliation(s)
- Max Scheffler
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Laurence Genton
- Unit of Clinical Nutrition, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Christophe E. Graf
- Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Jorge Remuinan
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - François R. Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
- Correspondence: ; Tel.: +41-079-553-83-65
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24
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Shinjyo N, Kita K. Infection and Immunometabolism in the Central Nervous System: A Possible Mechanistic Link Between Metabolic Imbalance and Dementia. Front Cell Neurosci 2021; 15:765217. [PMID: 34795562 PMCID: PMC8592913 DOI: 10.3389/fncel.2021.765217] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
Metabolic syndromes are frequently associated with dementia, suggesting that the dysregulation of energy metabolism can increase the risk of neurodegeneration and cognitive impairment. In addition, growing evidence suggests the link between infections and brain disorders, including Alzheimer's disease. The immune system and energy metabolism are in an intricate relationship. Infection triggers immune responses, which are accompanied by imbalance in cellular and organismal energy metabolism, while metabolic disorders can lead to immune dysregulation and higher infection susceptibility. In the brain, the activities of brain-resident immune cells, including microglia, are associated with their metabolic signatures, which may be affected by central nervous system (CNS) infection. Conversely, metabolic dysregulation can compromise innate immunity in the brain, leading to enhanced CNS infection susceptibility. Thus, infection and metabolic imbalance can be intertwined to each other in the etiology of brain disorders, including dementia. Insulin and leptin play pivotal roles in the regulation of immunometabolism in the CNS and periphery, and dysfunction of these signaling pathways are associated with cognitive impairment. Meanwhile, infectious complications are often comorbid with diabetes and obesity, which are characterized by insulin resistance and leptin signaling deficiency. Examples include human immunodeficiency virus (HIV) infection and periodontal disease caused by an oral pathogen Porphyromonas gingivalis. This review explores potential interactions between infectious agents and insulin and leptin signaling pathways, and discuss possible mechanisms underlying the relationship between infection, metabolic dysregulation, and brain disorders, particularly focusing on the roles of insulin and leptin.
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Affiliation(s)
- Noriko Shinjyo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,Laboratory of Immune Homeostasis, WPI Immunology Frontier Research Center, Osaka University, Suita, Japan
| | - Kiyoshi Kita
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,Department of Host-Defense Biochemistry, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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