1
|
Ren J, Gao Q, Zhou X, Chen L, Guo W, Feng K, Huang T, Cai YD. Identification of key gene expression associated with quality of life after recovery from COVID-19. Med Biol Eng Comput 2024; 62:1031-1048. [PMID: 38123886 DOI: 10.1007/s11517-023-02988-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Post-acute sequelae of COVID-19 (PASC) is a persistent complication of severe acute respiratory syndrome coronavirus 2 infection that includes symptoms, such as fatigue, cognitive impairment, and respiratory distress. These symptoms severely affect the quality of life of patients after their recovery from COVID-19. In this study, a group of machine learning algorithms analyzed the whole blood RNA-seq data from patients with different PASC levels. The purpose of this analysis was to identify the gene markers associated with PASC and the special expression patterns for different PASC levels. By comparing the quality of life of patients after the acute phase of COVID-19 and before the disease, samples in the dataset were divided into three groups, namely, "Better," "The Same," and "Worse." Each patient was represented by the expression levels of 58,929 genes. The machine learning-based workflow included six feature-ranking algorithms, incremental feature selection (IFS), and four classification algorithms. The feature ranking algorithms were in charge of assessing feature importance, whereas IFS with classification algorithms were used to extract essential genes and to construct efficient classifiers and classification rules. The expression of top genes in the results was associated with the immune response to viral infection, which is supported by the published literature. For example, patients with low CCDC18 expression and high CPED1 expression had good quality of life, whereas those with low CDC16 expression had poor quality of life.
Collapse
Affiliation(s)
- JingXin Ren
- School of Life Sciences, Shanghai University, Shanghai, 200444, China
| | - Qian Gao
- Department of Pharmacy, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - XianChao Zhou
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lei Chen
- College of Information Engineering, Shanghai Maritime University, Shanghai, 201306, China
| | - Wei Guo
- Key Laboratory of Stem Cell Biology, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai, 200030, China
| | - KaiYan Feng
- Department of Computer Science, Guangdong AIB Polytechnic College, Guangzhou, 510507, China
| | - Tao Huang
- Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Yu-Dong Cai
- School of Life Sciences, Shanghai University, Shanghai, 200444, China.
| |
Collapse
|
2
|
Gu M, Lv S, Song Y, Wang H, Zhang X, Liu J, Liu D, Han X, Liu X. Predictive Value of Lysophosphatidylcholine for Determining the Disease Severity and Prognosis of Elderly Patients with Community-Acquired Pneumonia. Clin Interv Aging 2024; 19:517-527. [PMID: 38528884 PMCID: PMC10961246 DOI: 10.2147/cia.s454239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose To investigate the clinical value of serum lysophosphatidylcholine (LPC) as a predictive biomarker for determining disease severity and mortality risk in hospitalized elderly patients with community-acquired pneumonia (CAP). Methods This prospective, single-center study enrolled 208 elderly patients, including 67 patients with severe CAP (SCAP) and 141 with non-SCAP between November 1st, 2020, and November 30th, 2021 at the Qingdao Municipal Hospital, Shandong Province, China. The demographic and clinical parameters were recorded for all the included patients. Serum LPC levels were measured on day 1 and 6 after admission using ELISA. Propensity score matching (PSM) was used to balance the baseline variables between SCAP and non-SCAP patient groups. Receiver operative characteristic (ROC) curve analysis was used to compare the predictive performances of LPC and other clinical parameters in discriminating between SCAP and non-SCAP patients and determining the 30-day mortality risk of the hospitalized CAP patients. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors associated with SCAP. Cox proportional hazard regression analysis was used to determine if serum LPC was an independent risk factor for the 30-day mortality of CAP patients. Results The serum LPC levels at admission were significantly higher in the non-SCAP patients than in the SCAP patients (P = 0.011). Serum LPC level <24.36 ng/mL, and PSI score were independent risk factors for the 30-day mortality in the elderly patients with CAP. The risk of 30-day mortality in the elderly CAP patients with low serum LPC levels (< 24.36ng/mL) was >5-fold higher than in the patients with high serum LPC levels (≥ 24.36ng/mL). Conclusion Low serum LPC levels were associated with significantly higher disease severity and 30-day mortality in the elderly patients with CAP. Therefore, serum LPC is a promising predictive biomarker for the early identification of elderly CAP patients with poor prognosis.
Collapse
Affiliation(s)
- Minghao Gu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
- School of Medicine, Qingdao University, Qingdao, 266071, People’s Republic of China
| | - SenSen Lv
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Yihui Song
- Department of Neurology, Weihai Municipal Hospital, Weihai, 264200, People’s Republic of China
| | - Hong Wang
- Hospital-Acquired Infection Control Department, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Xingyu Zhang
- Human Resources Department, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Jing Liu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Deshun Liu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Xiudi Han
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| | - Xuedong Liu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266011, People’s Republic of China
| |
Collapse
|
3
|
Sun J, Liu Y, Chen C, Quarm AK, Xi S, Sun T, Zhang D, Qian J, Ding H, Gao J. Cyclophilin D-mediated angiotensin II-induced NADPH oxidase 4 activation in endothelial mitochondrial dysfunction that can be rescued by gallic acid. Eur J Pharmacol 2023; 940:175475. [PMID: 36563952 DOI: 10.1016/j.ejphar.2022.175475] [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: 07/12/2022] [Revised: 11/21/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Vascular endothelial dysfunction plays a central role in the most dreadful human diseases, including stroke, tumor metastasis, and the coronavirus disease 2019 (COVID-19). Strong evidence suggests that angiotensin II (Ang II)-induced mitochondrial dysfunction is essential for endothelial dysfunction pathogenesis. However, the precise molecular mechanisms remain obscure. Here, polymerase-interacting protein 2 (Poldip 2) was found in the endothelial mitochondrial matrix and no effects on Poldip 2 and NADPH oxidase 4 (NOX 4) expression treated by Ang II. Interestingly, we first found that Ang II-induced NOX 4 binds with Poldip 2 was dependent on cyclophilin D (CypD). CypD knockdown (KD) significantly inhibited the binding of NOX 4 to Poldip 2, and mitochondrial ROS generation in human umbilical vein endothelial cells (HUVECs). Similar results were also found in cyclosporin A (CsA) treated HUVECs. Our previous study suggested a crosstalk between extracellular regulated protein kinase (ERK) phosphorylation and CypD expression, and gallic acid (GA) inhibited mitochondrial dysfunction in neurons depending on regulating the ERK-CypD axis. Here, we confirmed that GA inhibited Ang II-induced NOX 4 activation and mitochondrial dysfunction via ERK/CypD/NOX 4/Poldip 2 pathway, which provide novel mechanistic insight into CypD act as a key regulator of the NOX 4/Poldip 2 axis in Ang II-induced endothelial mitochondrial dysfunction and GA might be beneficial in the treatment of wide variety of diseases, such as COVID-19, which is worthy further research.
Collapse
Affiliation(s)
- Jing Sun
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China; Department of Traditional Chinese Medicine & Pharmacy, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China.
| | - Yunxi Liu
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Chen Chen
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Anthony Kwesi Quarm
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Siyu Xi
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Tingkai Sun
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Dingqi Zhang
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| | - Jinjun Qian
- Department of Neurology, The Fourth People's Hospital of Zhenjiang, Zhenjiang, 212001, PR China
| | - Hongqun Ding
- Department of Clinical Laboratory Diagnostics, School of Medicine, Jiangsu University, Zhenjiang, 212013, PR China
| | - Jing Gao
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, 212013, PR China; Effective & Toxicity Monitoring Innovative Practice Center for Food Pharmaceutical Specialty, Jiangsu University, Zhenjiang, 212013, PR China
| |
Collapse
|
4
|
Tsuchida Y, Shoda H, Sawada T, Fujio K. Role of autotaxin in systemic lupus erythematosus. Front Med (Lausanne) 2023; 10:1166343. [PMID: 37122329 PMCID: PMC10130763 DOI: 10.3389/fmed.2023.1166343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease characterized by the production of various autoantibodies and deposition of immune complexes. SLE is a heterogenous disease, and the pattern of organ involvement and response to treatment differs significantly among patients. Novel biological markers are necessary to assess the extent of organ involvement and predict treatment response in SLE. Lysophosphatidic acid is a lysophospholipid involved in various biological processes, and autotaxin (ATX), which catalyzes the production of lysophosphatidic acid in the extracellular space, has gained attention in various diseases as a potential biomarker. The concentration of ATX is increased in the serum and urine of patients with SLE and lupus nephritis. Recent evidence suggests that ATX produced by plasmacytoid dendritic cells may play an important role in the immune system and pathogenesis of SLE. Furthermore, the production of ATX is associated with type I interferons, a key cytokine in SLE pathogenesis, and ATX may be a potential biomarker and key molecule in SLE.
Collapse
Affiliation(s)
- Yumi Tsuchida
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- *Correspondence: Yumi Tsuchida,
| | - Hirofumi Shoda
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuji Sawada
- Department of Rheumatology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
5
|
Jeon K, Kim Y, Kang SK, Park U, Kim J, Park N, Koh J, Shim MS, Kim M, Rhee YJ, Jeong H, Lee S, Park D, Lim J, Kim H, Ha NY, Jo HY, Kim SC, Lee JH, Shon J, Kim H, Jeon YK, Choi YS, Kim HY, Lee WW, Choi M, Park HY, Park WY, Kim YS, Cho NH. Elevated IFNA1 and suppressed IL12p40 associated with persistent hyperinflammation in COVID-19 pneumonia. Front Immunol 2023; 14:1101808. [PMID: 36776879 PMCID: PMC9911526 DOI: 10.3389/fimmu.2023.1101808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Despite of massive endeavors to characterize inflammation in COVID-19 patients, the core network of inflammatory mediators responsible for severe pneumonia stillremain remains elusive. Methods Here, we performed quantitative and kinetic analysis of 191 inflammatory factors in 955 plasma samples from 80 normal controls (sample n = 80) and 347 confirmed COVID-19 pneumonia patients (sample n = 875), including 8 deceased patients. Results Differential expression analysis showed that 76% of plasmaproteins (145 factors) were upregulated in severe COVID-19 patients comparedwith moderate patients, confirming overt inflammatory responses in severe COVID-19 pneumonia patients. Global correlation analysis of the plasma factorsrevealed two core inflammatory modules, core I and II, comprising mainly myeloid cell and lymphoid cell compartments, respectively, with enhanced impact in a severity-dependent manner. We observed elevated IFNA1 and suppressed IL12p40, presenting a robust inverse correlation in severe patients, which was strongly associated with persistent hyperinflammation in 8.3% of moderate pneumonia patients and 59.4% of severe patients. Discussion Aberrant persistence of pulmonary and systemic inflammation might be associated with long COVID-19 sequelae. Our comprehensive analysis of inflammatory mediators in plasmarevealed the complexity of pneumonic inflammation in COVID-19 patients anddefined critical modules responsible for severe pneumonic progression.
Collapse
Affiliation(s)
- Kyeongseok Jeon
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yuri Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Shin Kwang Kang
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Deajon, Republic of Korea
| | - Uni Park
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Nanhee Park
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jaemoon Koh
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Man-Shik Shim
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Deajon, Republic of Korea
| | - Minsoo Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn Ju Rhee
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Deajon, Republic of Korea
| | - Hyeongseok Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Deajon, Republic of Korea
| | | | | | - Jinyoung Lim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyunsu Kim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Na-Young Ha
- Chungnam National University Hospital, Biomedical Research Institute, Deajon, Republic of Korea
| | - Hye-Yeong Jo
- Division of Healthcare and Artificial Intelligence, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sang Cheol Kim
- Division of Healthcare and Artificial Intelligence, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ju-Hee Lee
- Division of Healthcare and Artificial Intelligence, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jiwon Shon
- Department of Biohealth Regulatory Science, School of Pharmacy, Sungkyunkwan University, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Hoon Kim
- Department of Biohealth Regulatory Science, School of Pharmacy, Sungkyunkwan University, Suwon-si, Gyeonggi-do, Republic of Korea.,Biopharmaceutical Convergence Major, School of Pharmacy, Sungkyunkwan University, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn-Soo Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hye Young Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Won-Woo Lee
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Murim Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Woong-Yang Park
- Geninus Inc., Seoul, Republic of Korea.,Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeon-Sook Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Deajon, Republic of Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Endemic Diseases, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.,Wide River Institute of Immunology, Seoul National University, Hongcheon, Gangwon-do, Republic of Korea
| |
Collapse
|
6
|
Shimura T, Kurano M, Okamoto K, Jubishi D, Hashimoto H, Kano K, Igarashi K, Shimamoto S, Aoki J, Moriya K, Yatomi Y. Decrease in serum levels of autotaxin in COVID-19 patients. Ann Med 2022; 54:3189-3200. [PMID: 36369824 PMCID: PMC9665086 DOI: 10.1080/07853890.2022.2143554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION In order to identify therapeutic targets in Coronavirus disease 2019 (COVID-19), it is important to identify molecules involved in the biological responses that are modulated in COVID-19. Lysophosphatidic acids (LPAs) are involved in the pulmonary inflammation and fibrosis are one of the candidate molecules. The aim of this study was to evaluate the association between the serum levels of autotaxin (ATX), which are enzymes involved in the synthesis of lysophosphatidic acids. MATERIAL AND METHODS We enrolled 134 subjects with COVID-19 and 58 normal healthy subjects for the study. We measured serum ATX levels longitudinally in COVID-19 patients and investigated the time course and the association with severity and clinical parameters. RESULTS The serum ATX levels were reduced in all patients with COVID-19, irrespective of the disease severity, and were negatively associated with the serum CRP, D-dimer, and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels. DISCUSSION Considering the biological properties of LPAs in the pulmonary inflammation and fibrosis, modulation of ATX might be compensatory biological responses to suppress immunological overreaction especially in the lung, which is an important underlying mechanism for the mortality of the disease. CONCLUSIONS COVID-19 patients showed a decrease in the serum levels of ATX, irrespective of the disease severity. Key MessagesAutotaxin (ATX) is an enzyme involved in the synthesis of lysophosphatidic acid (LPA), which has been reported to be involved in pulmonary inflammation and fibrosis. Patients with COVID-19 show decrease in the serum levels of ATX. Modulation of ATX might be compensatory biological responses to suppress immunological overreaction.
Collapse
Affiliation(s)
- Takuya Shimura
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Daisuke Jubishi
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Kuniyuki Kano
- Department of Health Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Koji Igarashi
- Bioscience Division, TOSOH Corporation, Kanagawa, Japan
| | | | - Junken Aoki
- Department of Health Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
7
|
Saito K, Gemma A, Tatsumi K, Hattori N, Ushiki A, Tsushima K, Saito Y, Abe M, Horimasu Y, Kashiwada T, Mori K, Sato M, Nishiya T, Takamatsu K, Sun Y, Arakawa N, Izumi T, Ohno Y, Saito Y, Hanaoka M. Identification and characterization of lysophosphatidylcholine 14:0 as a biomarker for drug-induced lung disease. Sci Rep 2022; 12:19819. [PMID: 36396675 PMCID: PMC9671920 DOI: 10.1038/s41598-022-24406-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
Drug-induced interstitial lung disease (DILD) occurs when drug exposure causes inflammation of the lung interstitium. DILD can be caused by different types of drugs, and some DILD patterns results in a high mortality rate; hence, DILD poses a serious problem in clinical practice as well as drug development, and strategies to diagnose and distinguish DILD from other lung diseases are necessary. We aimed to identify novel biomarkers for DILD by performing lipidomics analysis on plasma samples from patients with acute and recovery phase DILD. Having identified lysophosphatidylcholines (LPCs) as candidate biomarkers for DILD, we determined their concentrations using validated liquid chromatography/mass spectrometry biomarker assays. In addition, we evaluated the ability of LPCs to discriminate patients with acute phase DILD from those with recovery phase DILD, DILD-tolerant, or other lung diseases, and characterized their association with clinical characteristics. Lipidomics analysis revealed a clear decrease in LPC concentrations in the plasma of patients with acute phase DILD. In particular, LPC(14:0) had the highest discriminative index against recovery phase and DILD-tolerant patients. LPC(14:0) displayed no clear association with causal drugs, or subjects' backgrounds, but was associated with disease severity. Furthermore, LPC(14:0) was able to discriminate between patients with DILD and other lung diseases, including idiopathic interstitial pneumonia and lung disease associated with connective tissue disease. LPC(14:0) is a promising biomarker for DILD that could improve the diagnosis of DILD and help to differentiate DILD from other lung diseases, such as idiopathic interstitial pneumonia and connective tissue disease.
Collapse
Affiliation(s)
- Kosuke Saito
- grid.410797.c0000 0001 2227 8773Division of Medical Safety Science, National Institute of Health Sciences, Kawasaki, 210-9501 Japan
| | - Akihiko Gemma
- grid.410821.e0000 0001 2173 8328Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603 Japan
| | - Koichiro Tatsumi
- grid.136304.30000 0004 0370 1101Department of Respirology (B2), Graduate School of Medicine, Chiba University, Chiba, 260-8677 Japan
| | - Noboru Hattori
- grid.470097.d0000 0004 0618 7953Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, 734-8551 Japan
| | - Atsuhito Ushiki
- grid.263518.b0000 0001 1507 4692First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, 390-8621 Japan
| | - Kenji Tsushima
- grid.410797.c0000 0001 2227 8773Division of Medical Safety Science, National Institute of Health Sciences, Kawasaki, 210-9501 Japan ,grid.411731.10000 0004 0531 3030School of Medicine, International University of Health and Welfare, Narita, 286-8686 Japan
| | - Yoshinobu Saito
- grid.410821.e0000 0001 2173 8328Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603 Japan
| | - Mitsuhiro Abe
- grid.136304.30000 0004 0370 1101Department of Respirology (B2), Graduate School of Medicine, Chiba University, Chiba, 260-8677 Japan
| | - Yasushi Horimasu
- grid.470097.d0000 0004 0618 7953Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, 734-8551 Japan
| | - Takeru Kashiwada
- grid.410821.e0000 0001 2173 8328Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603 Japan
| | - Kazuhiko Mori
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd., Tokyo, 134-8630 Japan
| | - Motonobu Sato
- grid.418042.b0000 0004 1758 8699Astellas Pharma Inc., Tsukuba, 305-8585 Japan
| | - Takayoshi Nishiya
- grid.410844.d0000 0004 4911 4738Daiichi Sankyo RD Novare Co., Ltd., Tokyo, 134-8630 Japan
| | - Kazuhiko Takamatsu
- grid.418042.b0000 0004 1758 8699Astellas Pharma Inc., Tsukuba, 305-8585 Japan
| | - Yuchen Sun
- grid.410797.c0000 0001 2227 8773Division of Medical Safety Science, National Institute of Health Sciences, Kawasaki, 210-9501 Japan
| | - Noriaki Arakawa
- grid.410797.c0000 0001 2227 8773Division of Medical Safety Science, National Institute of Health Sciences, Kawasaki, 210-9501 Japan
| | - Takashi Izumi
- Kihara Memorial Foundation, Yokohama, 230-0045 Japan
| | - Yasuo Ohno
- Kihara Memorial Foundation, Yokohama, 230-0045 Japan
| | - Yoshiro Saito
- grid.410797.c0000 0001 2227 8773Division of Medical Safety Science, National Institute of Health Sciences, Kawasaki, 210-9501 Japan
| | - Masayuki Hanaoka
- grid.263518.b0000 0001 1507 4692First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, 390-8621 Japan
| |
Collapse
|
8
|
Tsuchida Y, Shoda H, Nakano M, Ota M, Okamura T, Yamamoto K, Kurano M, Yatomi Y, Fujio K, Sawada T. Autotaxin is a potential link between genetic risk factors and immunological disturbances of plasmacytoid dendritic cells in systematic lupus erythematosus. Lupus 2022; 31:1578-1585. [PMID: 36134766 DOI: 10.1177/09612033221128494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The importance of autotaxin, an enzyme that catalyzes lysophospholipid production, has recently been recognized in various diseases, including cancer and autoimmune diseases. Herein, we examined the role of autotaxin in systemic lupus erythematosus (SLE), utilizing data from ImmuNexUT, a comprehensive database consisting of transcriptome data and expression quantitative trait locus (eQTL) data of immune cells from patients with immune-mediated disorders. METHODS Serum autotaxin concentrations in patients with SLE and healthy controls (HCs) were compared. The transcriptome data of patients with SLE and age- and sex-matched HCs were obtained from ImmuNexUT. The expression of ENPP2, the gene encoding autotaxin, was examined in peripheral blood immune cells. Next, weighted gene correlation network analysis (WGCNA) was performed to identify genes with expression patterns similar to ENPP2. The ImmuNexUT eQTL database and public epigenomic databases were used to infer the relationship between autotaxin and pathogenesis of SLE. RESULTS Autotaxin levels were elevated in the serum of patients with SLE compared to HCs. Furthermore, the expression of ENPP2 was higher in plasmacytoid dendritic cells (pDCs) than in other immune cell subsets, and its expression was elevated in pDCs of patients with SLE compared to HCs. In WGCNA, ENPP2 belonged to a module that correlated with disease activity. This module was enriched in interferon-associated genes and included genes whose expression was influenced by single-nucleotide polymorphisms associated with SLE, suggesting that it is a key module connecting genetic risk factors of SLE with disease pathogenesis. Analysis utilizing the ImmuNexUT eQTL database and public epigenomic databases suggested that the increased expression of ENPP2 in pDCs from patients with SLE may be caused by increased expression of interferon-associated genes and increased binding of STAT3 complexes to the regulatory region of ENPP2. CONCLUSIONS Autotaxin may play a critical role in connecting genetic risk factors of SLE to disease pathogenesis in pDCs.
Collapse
Affiliation(s)
- Yumi Tsuchida
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Hirofumi Shoda
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Masahiro Nakano
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan.,Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Mineto Ota
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan.,Department of Functional Genomics and Immunological Diseases, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Tomohisa Okamura
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan.,Department of Functional Genomics and Immunological Diseases, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Yamamoto
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan.,Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, 13143The University of Tokyo, Tokyo, Japan
| | - Tetsuji Sawada
- Department of Rheumatology, 38548Tokyo Medical University Hospital, Tokyo, Japan
| |
Collapse
|
9
|
Curran CS, Kopp JB. RAGE pathway activation and function in chronic kidney disease and COVID-19. Front Med (Lausanne) 2022; 9:970423. [PMID: 36017003 PMCID: PMC9395689 DOI: 10.3389/fmed.2022.970423] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/21/2022] [Indexed: 12/23/2022] Open
Abstract
The multi-ligand receptor for advanced glycation end-products (RAGE) and its ligands are contributing factors in autoimmunity, cancers, and infectious disease. RAGE activation is increased in chronic kidney disease (CKD) and coronavirus disease 2019 (COVID-19). CKD may increase the risk of COVID-19 severity and may also develop in the form of long COVID. RAGE is expressed in essentially all kidney cell types. Increased production of RAGE isoforms and RAGE ligands during CKD and COVID-19 promotes RAGE activity. The downstream effects include cellular dysfunction, tissue injury, fibrosis, and inflammation, which in turn contribute to a decline in kidney function, hypertension, thrombotic disorders, and cognitive impairment. In this review, we discuss the forms and mechanisms of RAGE and RAGE ligands in the kidney and COVID-19. Because various small molecules antagonize RAGE activity in animal models, targeting RAGE, its co-receptors, or its ligands may offer novel therapeutic approaches to slowing or halting progressive kidney disease, for which current therapies are often inadequate.
Collapse
Affiliation(s)
- Colleen S. Curran
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Jeffrey B. Kopp
- Kidney Disease Section, NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases), National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
10
|
Autotaxin Has a Negative Role in Systemic Inflammation. Int J Mol Sci 2022; 23:ijms23147920. [PMID: 35887265 PMCID: PMC9322786 DOI: 10.3390/ijms23147920] [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: 05/26/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 02/05/2023] Open
Abstract
The pathogenesis of sepsis involves complex interactions and a systemic inflammatory response leading eventually to multiorgan failure. Autotaxin (ATX, ENPP2) is a secreted glycoprotein largely responsible for the extracellular production of lysophosphatidic acid (LPA), which exerts multiple effects in almost all cell types through its at least six G-protein-coupled LPA receptors (LPARs). Here, we investigated a possible role of the ATX/LPA axis in sepsis in an animal model of endotoxemia as well as in septic patients. Mice with 50% reduced serum ATX levels showed improved survival upon lipopolysaccharide (LPS) stimulation compared to their littermate controls. Similarly, mice bearing the inducible inactivation of ATX and presenting with >70% decreased ATX levels were even more protected against LPS-induced endotoxemia; however, no significant effects were observed upon the chronic and systemic transgenic overexpression of ATX. Moreover, the genetic deletion of LPA receptors 1 and 2 did not significantly affect the severity of the modelled disease, suggesting that alternative receptors may mediate LPA effects upon sepsis. In translation, ATX levels were found to be elevated in the sera of critically ill patients with sepsis in comparison with their baseline levels upon ICU admission. Therefore, the results indicate a role for ATX in LPS-induced sepsis and suggest possible therapeutic benefits of pharmacologically targeting ATX in severe, systemic inflammatory disorders.
Collapse
|
11
|
付 彬, 钟 兰, 叶 婷, 韩 燕, 邱 小. [Value of autotaxin in predicting refractory Mycoplasma pneumoniae pneumonia in children and its correlation with inflammatory cytokines]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:765-770. [PMID: 35894191 PMCID: PMC9336629 DOI: 10.7499/j.issn.1008-8830.2203030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To study the value of autotaxin (an autocrine motility factor) level in serum and bronchoalveolar lavage fluid (BALF) in predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children and its correlation with interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP). METHODS A retrospective analysis was performed on 238 children with Mycoplasma pneumoniae pneumonia who were admitted from January 2019 to December 2021. According to disease severity, they were divided into two groups: RMPP (n=82) and general Mycoplasma pneumoniae pneumonia (GMPP; n=156). The two groups were compared in terms of the levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF to study the value of autotaxin level in serum and BALF in predicting RMPP in children, as well as the correlation of autotaxin level with IL-6, IL-8, and CRP in children with RMPP. RESULTS Compared with the GMPP group, the RMPP group had significantly higher levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF (P<0.05). For the children with RMPP, the levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF in the acute stage were significantly higher than those in the convalescent stage (P<0.05). The receiver operating characteristic (ROC) curve showed that the level of autotaxin in serum and BALF had a good value in predicting RMPP in children, with an area under the curve of 0.874 (95%CI: 0.816-0.935) and 0.862 (95%CI: 0.802-0.924), respectively. The correlation analysis showed that the level of autotaxin in serum and BALF was positively correlated with IL-6, IL-8, and CRP levels (P<0.001). CONCLUSIONS The level of autotaxin in serum and BALF increases and is correlated with the degree of disease recovery and inflammatory cytokines in children with RMPP. Autotaxin can be used as a predictive indicator for RMPP in children.
Collapse
|
12
|
Labropoulou S, Vassilaki N, Milona RS, Terpos E, Politou M, Pappa V, Pagoni M, Grouzi E, Dimopoulos MA, Mentis A, Emmanouil M, Angelakis E. Characterizing Kinetics and Avidity of SARS-CoV-2 Antibody Responses in COVID-19 Greek Patients. Viruses 2022; 14:758. [PMID: 35458488 PMCID: PMC9024518 DOI: 10.3390/v14040758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 02/06/2023] Open
Abstract
In-depth understanding of the immune response provoked by SARS-CoV-2 infection is necessary, as there is a great risk of reinfection and a difficulty in achieving herd immunity due to a decline in both antibody concentration and avidity. Avidity testing, however, could overcome variability in the immune response associated with sex or clinical symptoms, and thus differentiate between recent and past infections. In this context, here, we analyzed SARS-CoV-2 antibody kinetics and avidity in Greek hospitalized (26%) and non-hospitalized (74%) COVID-19 patients (N = 71) in the course of up to 15 months after their infection to improve the accuracy of the serological diagnosis in dating the onset of the infection. The results showed that IgG-S1 levels decline significantly at four months (p = 0.0239) in both groups of patients and are higher in hospitalized ones (up to 2.1-fold, p < 0.001). Additionally, hospitalized patients’ titers drop greatly and are equalized to non-hospitalized ones only at a time-point of twelve to fifteen months. Antibody levels of women in total remain more stable months after infection, compared to men. Furthermore, we examined the differential maturation of IgG avidity after SARS-CoV-2 infection, showing an incomplete maturation of avidity that results in a plateau at four months after infection. We also defined 38.2% avidity (sensitivity: 58.9%, specificity: 90.91%) as an appropriate “cut-off” that could be used to determine the stage of infection before avidity reaches a plateau.
Collapse
Affiliation(s)
- Stavroula Labropoulou
- Diagnostics Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (S.L.); (A.M.); (M.E.); (E.A.)
| | - Niki Vassilaki
- Laboratory of Molecular Virology, Hellenic Pasteur Institute, 127 Vasilissis Sofias Avenue, 11521 Athens, Greece;
| | - Raphaela S. Milona
- Laboratory of Molecular Virology, Hellenic Pasteur Institute, 127 Vasilissis Sofias Avenue, 11521 Athens, Greece;
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.T.); (M.A.D.)
| | - Marianna Politou
- Hematology Laboratory Blood Bank, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Vasiliki Pappa
- Hematology Unit, Second Department of Internal Medicine, School of Medicine, Attikon University General Hospital, National and Kapodistrian University of Athens, 12461 Athens, Greece;
| | - Maria Pagoni
- BMT Unit, Department of Hematology and Lymphomas, Evangelismos General Hospital, 10676 Athens, Greece;
| | - Elisavet Grouzi
- Department of Transfusion Service and Clinical Hemostasis, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece;
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.T.); (M.A.D.)
| | - Andreas Mentis
- Diagnostics Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (S.L.); (A.M.); (M.E.); (E.A.)
| | - Mary Emmanouil
- Diagnostics Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (S.L.); (A.M.); (M.E.); (E.A.)
| | - Emmanouil Angelakis
- Diagnostics Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (S.L.); (A.M.); (M.E.); (E.A.)
- IHU-Méditerranée Infection, Aix-Marseille University, 19-21 Boulevard Jean Moulin, 13005 Marseille, France
| |
Collapse
|
13
|
Ntatsoulis K, Karampitsakos T, Tsitoura E, Stylianaki EA, Matralis AN, Tzouvelekis A, Antoniou K, Aidinis V. Commonalities Between ARDS, Pulmonary Fibrosis and COVID-19: The Potential of Autotaxin as a Therapeutic Target. Front Immunol 2021; 12:687397. [PMID: 34671341 PMCID: PMC8522582 DOI: 10.3389/fimmu.2021.687397] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Severe COVID-19 is characterized by acute respiratory distress syndrome (ARDS)-like hyperinflammation and endothelial dysfunction, that can lead to respiratory and multi organ failure and death. Interstitial lung diseases (ILD) and pulmonary fibrosis confer an increased risk for severe disease, while a subset of COVID-19-related ARDS surviving patients will develop a fibroproliferative response that can persist post hospitalization. Autotaxin (ATX) is a secreted lysophospholipase D, largely responsible for the extracellular production of lysophosphatidic acid (LPA), a pleiotropic signaling lysophospholipid with multiple effects in pulmonary and immune cells. In this review, we discuss the similarities of COVID-19, ARDS and ILDs, and suggest ATX as a possible pathologic link and a potential common therapeutic target.
Collapse
Affiliation(s)
- Konstantinos Ntatsoulis
- Institute of Bio-Innovation, Biomedical Sciences Research Center Alexander Fleming, Athens, Greece
| | - Theodoros Karampitsakos
- Department of Respiratory Medicine, School of Medicine, University of Patras, Patras, Greece
| | - Eliza Tsitoura
- Laboratory of Molecular & Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Elli-Anna Stylianaki
- Institute of Bio-Innovation, Biomedical Sciences Research Center Alexander Fleming, Athens, Greece
| | - Alexios N. Matralis
- Institute of Bio-Innovation, Biomedical Sciences Research Center Alexander Fleming, Athens, Greece
| | - Argyrios Tzouvelekis
- Department of Respiratory Medicine, School of Medicine, University of Patras, Patras, Greece
| | - Katerina Antoniou
- Laboratory of Molecular & Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Vassilis Aidinis
- Institute of Bio-Innovation, Biomedical Sciences Research Center Alexander Fleming, Athens, Greece
| |
Collapse
|