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Al Katatbeh M, Al-Mashakbeh Y, Freihat H, Gharam H, Mohammad R, Aldalki R, Eid S, Sharman R, Heissat N, Al-Samarraie G, Al-Shaibie A, Khasawneh L. Incidence of narcolepsy symptoms after taking COVID-19 vaccines: a Jordanian cross-sectional study. Clin Exp Vaccine Res 2024; 13:218-224. [PMID: 39144130 PMCID: PMC11319113 DOI: 10.7774/cevr.2024.13.3.218] [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: 01/15/2024] [Accepted: 06/26/2024] [Indexed: 08/16/2024] Open
Abstract
Purpose Sleeping disorders were reported in many patients who took vaccines during previous pandemics. We aim to investigate the relationship between coronavirus disease 2019 (COVID-19) vaccines and the incidence of narcolepsy symptoms in the Jordanian population. Materials and Methods We used a descriptive, cross-sectional, online self-administered survey conducted between December 2022 and May 2023. The survey targeted males and females above the age of 18 years who took any type of COVID-19 vaccine, had no chronic diseases, and had no sleep disorders prior to taking the vaccine. The survey was distributed via social media platforms. Results A total of 873 participants were included in this study, consisting of 44.4% males and 55.6% females, with the majority being in the 18-29 age group. Most participants (79.8%) received two vaccine doses, with the Pfizer vaccine being the most common. Nearly half of the participants reported excessive daytime sleepiness. Sleep paralysis and hypnagogic hallucinations were reported by a notable proportion of participants, but no significant differences were found among the vaccine types. Sleep attacks and fragmented nighttime sleep were associated with the number of vaccine doses received, suggesting a possible influence of the dose count on these symptoms. The presence of excessive daytime sleepiness, sudden loss of muscle tone, sleep paralysis, and hypnagogic hallucinations showed no significant association with the number of doses taken. Conclusion We hypothesize a possible link between COVID-19 vaccination and the emergence of narcolepsy symptoms in Jordanian individuals. Additional investigations and continuous monitoring to determine the extent of the risk and uncover potential mechanisms behind this connection should be performed.
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Affiliation(s)
- Mohammad Al Katatbeh
- Department of Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Yazan Al-Mashakbeh
- Department of Ear Throat Nose, New Zarqa Governmental Hospital, Zarqa, Jordan
| | - Hadeel Freihat
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Hiba Gharam
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Rahmeh Mohammad
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Rahma Aldalki
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Sadeen Eid
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Reema Sharman
- Department of Obstetrics and Gynecology, Princess Badea Teaching Hospital, Irbid, Jordan
| | - Nizar Heissat
- Department of Anesthesia, Al Hussain New Salt Hospital, Salt, Jordan
| | | | - Ahmad Al-Shaibie
- Department of Emergency Medicine, Bashir Hospital, Amman, Jordan
| | - Laith Khasawneh
- Department of Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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2
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Zhao J, He P, Wei Q, Zhou L, Ers SA, Gu J. Novel electrical therapy to improve sleep disturbance in patients with autoimmune rheumatic diseases. Int J Rheum Dis 2024; 27:e15181. [PMID: 38831523 DOI: 10.1111/1756-185x.15181] [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: 01/01/2024] [Revised: 03/25/2024] [Accepted: 04/23/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Sleep disturbance is common in autoimmune rheumatism diseases (ARD) and it plays an important role in activating disease and affects the quality of life. This study aims to evaluate the efficacy and acceptability of the novel electrical therapy on sleep disturbance in ARD patients and its effect on immunologic factors. METHODS A total of 51 ARD patients (26 treatment group and 25 control group) with sleep disturbance were enrolled in this study. Sleep parameters and immunological indicators (serum level of 12 cytokines and immune function) were collected. The novel electrical therapy was prescribed for 15-30 min 3-6 times a day. The Pittsburg Sleep Index (PSQI) was assessed before and after 3 months' treatment by Mi Energy equipment. Immune function and serum levels of cytokines of all participants at baseline and after treatment were tested with flow cytometry and flow immunofluorescence, respectively. Correlation analysis was used to analyze the relationship between sleep disturbance and immunologic factors. Multiple linear regression analysis was employed to investigate the risk of sleep disturbance in ARD. RESULTS The global score of PSQI (Baseline: 12.81 ± 4.07, After novel electrical therapy: 4.88 ± 2.76) was effectively improved after 3 months of adjuvant therapy by electrical therapy. We also found that serum levels of IL-8 and IL-1β statistically significantly decreased after novel electrical therapy. This adjuvant therapy can also significantly decrease the percentage of CD4 + CD8 + T cell, effector memory CD8 + T cell, Memory CD8 + T cell, Th17 cell, and plasma cell and significantly can increase the percentage of naïve CD8 + T cell, Th2 cell, and Tfh2 cell. Nevertheless, all serum level of 12 cytokines and the percentage of immune cells did not correlate with the PSQI global score except the Tc17 cell. Furthermore, age is an independent risk factor influencing PSQI scores (OR = 1.15, p < 0.05) in patients with autoimmune diseases through multiple linear regression analysis. CONCLUSIONS Novel electrical therapy can effectively improve sleep disturbance in patients with ARD. It can also change the serum level of some cytokines (IL-8 and IL-1β) and percentage of immune cells (CD4 + CD8 + T cell, effector memory CD8 + T cell, Memory CD8 + T cell, Th17 cell, naïve CD8 + T cell, Th2 cell, Tfh2 cell, and plasma cell).
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Affiliation(s)
- Jiaoshi Zhao
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Peili He
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiujing Wei
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liuzhong Zhou
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Suleyman Ahmed Ers
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jieruo Gu
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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3
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Wyse CA, Rudderham LM, Nordon EA, Ince LM, Coogan AN, Lopez LM. Circadian Variation in the Response to Vaccination: A Systematic Review and Evidence Appraisal. J Biol Rhythms 2024; 39:219-236. [PMID: 38459699 PMCID: PMC11141079 DOI: 10.1177/07487304241232447] [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] [Indexed: 03/10/2024]
Abstract
Molecular timing mechanisms known as circadian clocks drive endogenous 24-h rhythmicity in most physiological functions, including innate and adaptive immunity. Consequently, the response to immune challenge such as vaccination might depend on the time of day of exposure. This study assessed whether the time of day of vaccination (TODV) is associated with the subsequent immune and clinical response by conducting a systematic review of previous studies. The Cochrane Library, PubMed, Google, Medline, and Embase were searched for studies that reported TODV and immune and clinical outcomes, yielding 3114 studies, 23 of which met the inclusion criteria. The global severe acute respiratory syndrome coronavirus 2 vaccination program facilitated investigation of TODV and almost half of the studies included reported data collected during the COVID-19 pandemic. There was considerable heterogeneity in the demography of participants and type of vaccine, and most studies were biased by failure to account for immune status prior to vaccination, self-selection of vaccination time, or confounding factors such as sleep, chronotype, and shiftwork. The optimum TODV was concluded to be afternoon (5 studies), morning (5 studies), morning and afternoon (1 study), midday (1 study), and morning or late afternoon (1 study), with the remaining 10 studies reporting no effect. Further research is required to understand the relationship between TODV and subsequent immune outcome and whether any clinical benefit outweighs the potential effect of this intervention on vaccine uptake.
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Affiliation(s)
- Cathy A. Wyse
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Laura M. Rudderham
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Enya A. Nordon
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
| | - Louise M. Ince
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA
| | - Andrew N. Coogan
- Kathleen Lonsdale Institute for Human Health Research and Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Lorna M. Lopez
- Kathleen Lonsdale Institute for Human Health Research and Department of Biology, Maynooth University, Maynooth, Ireland
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4
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Martínez-Albert E, Lutz ND, Hübener R, Dimitrov S, Lange T, Born J, Besedovsky L. Sleep promotes T-cell migration towards CCL19 via growth hormone and prolactin signaling in humans. Brain Behav Immun 2024; 118:69-77. [PMID: 38369248 DOI: 10.1016/j.bbi.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Sleep strongly supports the formation of adaptive immunity, e.g., after vaccination. However, the underlying mechanisms remain largely obscure. Here we show in healthy humans that sleep compared to nocturnal wakefulness specifically promotes the migration of various T-cell subsets towards the chemokine CCL19, which is essential for lymph-node homing and, thus, for the initiation and maintenance of adaptive immune responses. Migration towards the inflammatory chemokine CCL5 remained unaffected. Incubating the cells with plasma from sleeping participants likewise increased CCL19-directed migration, an effect that was dependent on growth hormone and prolactin signaling. These findings show that sleep selectively promotes the lymph node homing potential of T cells by increasing hormonal release, and thus reveal a causal mechanism underlying the supporting effect of sleep on adaptive immunity in humans.
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Affiliation(s)
- Estefanía Martínez-Albert
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany
| | - Nicolas D Lutz
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany
| | - Robert Hübener
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Stoyan Dimitrov
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, 23562 Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany
| | - Luciana Besedovsky
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University of Tübingen, 72076 Tübingen, Germany; Institute of Medical Psychology, Ludwig-Maximilians-Universität München, 80336 Munich, Germany.
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5
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Wagenhäuser I, Reusch J, Gabel A, Mees J, Nyawale H, Frey A, Lâm TT, Schubert-Unkmeir A, Dölken L, Kurzai O, Frantz S, Petri N, Krone M, Krone LB. The relationship between mental health, sleep quality and the immunogenicity of COVID-19 vaccinations. J Sleep Res 2024; 33:e13929. [PMID: 37177872 DOI: 10.1111/jsr.13929] [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: 03/02/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
Sleep modulates the immune response, and sleep loss can reduce vaccine immunogenicity; vice versa, immune responses impact sleep. We aimed to investigate the influence of mental health and sleep quality on the immunogenicity of COVID-19 vaccinations and, conversely, of COVID-19 vaccinations on sleep quality. The prospective CoVacSer study monitored mental health, sleep quality and Anti-SARS-CoV-2-Spike IgG titres in a cohort of 1082 healthcare workers from 29 September 2021 to 19 December 2022. Questionnaires and blood samples were collected before, 14 days, and 3 months after the third COVID-19 vaccination, as well as in 154 participants before and 14 days after the fourth COVID-19 vaccination. Healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before the third COVID-19 vaccination. However, this effect was mediated by higher median age and body mass index in this subgroup. Antibody titres following the third and fourth COVID-19 vaccinations ("booster vaccinations") were not significantly different between subgroups with and without psychiatric disorders. Sleep quality did not affect the humoral immunogenicity of the COVID-19 vaccinations. Moreover, the COVID-19 vaccinations did not impact self-reported sleep quality. Our data suggest that in a working population neither mental health nor sleep quality relevantly impact the immunogenicity of COVID-19 vaccinations, and that COVID-19 vaccinations do not cause a sustained deterioration of sleep, suggesting that they are not a precipitating factor for insomnia. The findings from this large-scale real-life cohort study will inform clinical practice regarding the recommendation of COVID-19 booster vaccinations for individuals with mental health and sleep problems.
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Affiliation(s)
- Isabell Wagenhäuser
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Julia Reusch
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Gabel
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - Juliane Mees
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Anna Frey
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Thiên-Trí Lâm
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | | | - Lars Dölken
- Institute for Virology and Immunobiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Oliver Kurzai
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knoell-Institute, Jena, Germany
| | - Stefan Frantz
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Nils Petri
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Manuel Krone
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
- Institute for Hygiene and Microbiology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Lukas B Krone
- Department of Physiology, Anatomy and Genetics, Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
- Department of Neurology, Centre for Experimental Neurology, University of Bern, Bern, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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6
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Tauman R, Henig O, Rosenberg E, Marudi O, Dunietz TM, Grandner MA, Spitzer A, Zeltser D, Mizrahi M, Sprecher E, Ben-Ami R, Goldshmidt H, Goldiner I, Saiag E, Angel Y. Relationship among sleep, work features, and SARS-cov-2 vaccine antibody response in hospital workers. Sleep Med 2024; 116:90-95. [PMID: 38437781 DOI: 10.1016/j.sleep.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
STUDY OBJECTIVES Immunity is influenced by sleep and the circadian rhythm. Healthcare workers are predisposed to both insufficient sleep and circadian disruption. This study aimed to evaluate the relationship between sleep and work characteristics and the antibody response to the mRNA SARS-CoV-2 vaccine BNT162b2. METHODS The authors' prospective cohort study ("COVI3") evaluated the effect of a third (booster) dose of the BNT162b2 vaccine. A subset of participants provided information on anthropometric measures, sleep, stress and work characteristics including shift work and number of work hours per week. Blood samples for anti-S1-RBD IgG antibody levels were obtained 21 weeks following receipt of the third dose of the vaccine. RESULTS In total, 201 healthcare workers (73% women) were included. After adjustment for age, body mass index (BMI), shift work, smoking status, and perceived stress, short sleep duration (<7 h per night) was associated with lower anti-S1-RBD IgG levels (Odds ratio 2.36 [95% confidence interval 1.08-5.13]). Participants who performed shift work had higher odds of lower anti-S1-RBD IgG levels compared to those who did not work in shifts [odds ratio = 2.99 (95% confidence interval 1.40, 6.39)] after accounting for age, short sleep duration, BMI, smoking status and perceived stress. CONCLUSIONS Shift work and self-reported short sleep duration were associated with a lower antibody response following a booster dose of the SARS-CoV-2 vaccine. These findings suggest that the efficacy of vaccination, particularly among healthcare workers, may be augmented by addressing both sleep and circadian alignment.
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Affiliation(s)
- Riva Tauman
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Oryan Henig
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Or Marudi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Talia M Dunietz
- Sieratzki-Sagol Institute for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michael A Grandner
- Department of Psychiatry, Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Avishay Spitzer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Departments of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - David Zeltser
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Mizrahi
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Research and Development, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hanoch Goldshmidt
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Goldiner
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Esther Saiag
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Information Systems and Operations, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yoel Angel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Pain Management and Intensive care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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7
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Schilling C, Nieters A, Schredl M, Peter RS, Rothenbacher D, Brockmann SO, Göpel S, Kindle G, Merle U, Steinacker JM, Kern W. Pre-existing sleep problems as a predictor of post-acute sequelae of COVID-19. J Sleep Res 2024; 33:e13949. [PMID: 37227000 DOI: 10.1111/jsr.13949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/13/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
Several months after COVID-19 many individuals still report persisting symptoms, the so-called 'post-COVID-19 syndrome'. An immunological dysfunction is one of the main pathophysiological hypotheses. As sleep is central to the functioning of the immune system, we investigated whether self-reported pre-existing sleep disturbance might be an independent risk factor for the development of post-COVID-19 syndrome. A total of 11,710 participants of a cross-sectional survey (all tested positive for severe acute respiratory syndrome coronavirus-2) were classified into probable post-COVID-19 syndrome, an intermediate group, and unaffected participants at an average of 8.5 months after infection. The case definition was based on newly occurring symptoms of at least moderate severity and ≥20% reduction in health status and/or working capacity. Unadjusted and adjusted odds ratios were calculated to investigate the association between pre-existing sleep disturbances and subsequent development of post-COVID-19 syndrome while controlling for a variety of demographic, lifestyle, and health factors. Pre-existing sleep disturbances were found to be an independent predictor of subsequent probable post-COVID-19 syndrome (adjusted odds ratio 2.7, 95% confidence interval 2.27-3.24). Sleep disturbances as part of the post-COVID-19 syndrome were reported by more than half of the participants and appeared to be a new symptom and to occur independent of a mood disorder in most cases. Recognition of disturbed sleep as an important risk factor for post-COVID-19 syndrome should promote improved clinical management of sleep disorders in the context of COVID-19. Further, it may stimulate further research on the effect of improving sleep on the prognosis of COVID-19 long-term sequelae and other post-viral conditions.
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Affiliation(s)
- Claudia Schilling
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Sleep Laboratory, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Alexandra Nieters
- Institute for Immunodeficiency, Medical Centre and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - Michael Schredl
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Sleep Laboratory, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Raphael S Peter
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Stefan O Brockmann
- Department of Health Protection, Infection Control and Epidemiology, Baden-Wuerttemberg Federal State Health Office, Ministry of Social Affairs, Health and Integration Stuttgart, Stuttgart, Germany
| | - Siri Göpel
- Division of Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany
| | - Gerhard Kindle
- Institute for Immunodeficiency, Medical Centre and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - Uta Merle
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Ulm, Germany
| | - Winfried Kern
- Division of Infectious Diseases, Department of Medicine II, Medical Centre and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
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8
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Jaiswal SJ, Gadaleta M, Quer G, Radin JM, Waalen J, Ramos E, Pandit J, Owens RL. Objectively measured peri-vaccination sleep does not predict COVID-19 breakthrough infection. Sci Rep 2024; 14:4655. [PMID: 38409137 PMCID: PMC10897487 DOI: 10.1038/s41598-024-53743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 02/04/2024] [Indexed: 02/28/2024] Open
Abstract
Prior studies have shown that sleep duration peri-vaccination influences an individual's antibody response. However, whether peri-vaccination sleep affects real-world vaccine effectiveness is unknown. Here, we tested whether objectively measured sleep around COVID-19 vaccination affected breakthrough infection rates. DETECT is a study of digitally recruited participants who report COVID-19-related information, including vaccination and illness data. Objective sleep data are also recorded through activity trackers. We compared the impact of sleep duration, sleep efficiency, and frequency of awakenings on reported breakthrough infection after the 2nd vaccination and 1st COVID-19 booster. Logistic regression models were created to examine if sleep metrics predicted COVID-19 breakthrough infection independent of age and gender. Self-reported breakthrough COVID-19 infection following 2nd COVID-19 vaccination and 1st booster. 256 out of 5265 individuals reported a breakthrough infection after the 2nd vaccine, and 581 out of 2583 individuals reported a breakthrough after the 1st booster. There was no difference in sleep duration between those with and without breakthrough infection. Increased awakening frequency was associated with breakthrough infection after the 1st booster with 3.01 ± 0.65 awakenings/hour in the breakthrough group compared to 2.82 ± 0.65 awakenings/hour in those without breakthrough (P < 0.001). Cox proportional hazards modeling showed that age < 60 years (hazard ratio 2.15, P < 0.001) and frequency of awakenings (hazard ratio 1.17, P = 0.019) were associated with breakthrough infection after the 1st booster. Sleep duration was not associated with breakthrough infection after COVID vaccination. While increased awakening frequency during sleep was associated with breakthrough infection beyond traditional risk factors, the clinical implications of this finding are unclear.
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Affiliation(s)
| | | | - Giorgio Quer
- The Scripps Research Institute, La Jolla, CA, USA
| | | | - Jill Waalen
- The Scripps Research Institute, La Jolla, CA, USA
| | - Edward Ramos
- The Scripps Research Institute, La Jolla, CA, USA
| | - Jay Pandit
- The Scripps Research Institute, La Jolla, CA, USA
| | - Robert L Owens
- University of California San Diego School of Medicine, La Jolla, CA, USA
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9
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Hove C, Chua KJ, Martin MA, Hubble M, Boddy AM. Variation in maternal lactation practices associated with changes in diurnal maternal inflammation. Sci Rep 2024; 14:4376. [PMID: 38388564 PMCID: PMC10883910 DOI: 10.1038/s41598-024-54963-4] [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: 12/06/2023] [Accepted: 02/19/2024] [Indexed: 02/24/2024] Open
Abstract
While the importance of human milk in shaping infant immune function is well established, the impact of at-the-nipple (ATN) breastfeeding on maternal immune status has been understudied. Since lactation evolved to support infant survival and boost maternal fitness, we predict that ATN breastfeeding will confer benefits on maternal immune function. We measure the absolute and relative frequency of different infant feeding methods (ATN breastfeeding, pumping, donated milk, other supplementation) used by postpartum women in Seattle, WA (USA). We implement Bayesian modeling to estimate the effects of ATN breastfeeding on diurnal change in secretion rate of "pro-inflammatory" salivary cytokines and C-reactive protein (CRP). Our results show that most mothers in our sample used a variety of infant feeding methods, with pumping as the most common alternative to ATN breastfeeding. We find that ATN breastfeeding is associated with non-linear effects on diurnal IL-8 and CRP. Furthermore, we find that women who report zero versus ubiquitous ATN breastfeeding exhibit opposing diurnal patterns in CRP secretion rate. This study provides evidence that variation in maternal lactation practices corresponds to differences in maternal immune responses, highlighting how measuring lactation as a continuous variable can further enhance understanding of postpartum maternal physiology.
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Affiliation(s)
- Carmen Hove
- University of California, Santa Barbara, USA.
| | | | | | | | - Amy M Boddy
- University of California, Santa Barbara, USA.
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10
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Berezin L, Waseem R, Merikanto I, Benedict C, Holzinger B, De Gennaro L, Wing YK, Bjorvatn B, Korman M, Morin CM, Espie C, Landtblom AM, Penzel T, Matsui K, Hrubos-Strøm H, Mota-Rolim S, Nadorff MR, Plazzi G, Reis C, Chan RNY, Cunha AS, Yordanova J, Bjelajac AK, Inoue Y, Dauvilliers Y, Partinen M, Chung F. Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID. J Clin Sleep Med 2024; 20:111-119. [PMID: 37858285 PMCID: PMC10758549 DOI: 10.5664/jcsm.10818] [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: 04/08/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023]
Abstract
STUDY OBJECTIVES Preliminary evidence suggests that the risk of Long COVID is higher among people with pre-existing medical conditions. Based on its proven adjuvant role in immunity, habitual sleep duration may alter the risk of developing Long COVID. The objective of this study was to determine whether the odds of Long COVID are higher among those with pre-existing medical conditions, and whether the strength of this association varies by habitual sleep duration. METHODS Using data from 13,461 respondents from 16 countries who participated in the 2021 survey-based International COVID Sleep Study II (ICOSS II), we studied the associations between habitual sleep duration, pre-existing medical conditions, and Long COVID. RESULTS Of 2,508 individuals who had COVID-19, 61% reported at least 1 Long COVID symptom. Multivariable logistic regression analysis showed that the risk of having Long COVID was 1.8-fold higher for average-length sleepers (6-9 h/night) with pre-existing medical conditions compared with those without pre-existing medical conditions (adjusted odds ratio [aOR] 1.84 [1.18-2.90]; P = .008). The risk of Long COVID was 3-fold higher for short sleepers with pre-existing medical conditions (aOR 2.95 [1.04-8.4]; P = .043) and not significantly higher for long sleepers with pre-existing conditions (aOR 2.11 [0.93-4.77]; P = .073) compared with average-length sleepers without pre-existing conditions. CONCLUSIONS Habitual short nighttime sleep duration exacerbated the risk of Long COVID in individuals with pre-existing conditions. Restoring nighttime sleep to average duration represents a potentially modifiable behavioral factor to lower the odds of Long COVID for at-risk patients. CITATION Berezin L, Waseem R, Merikanto I, et al. Habitual short sleepers with pre-existing medical conditions are at higher risk of long COVID. J Clin Sleep Med. 2024;20(1):111-119.
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Affiliation(s)
- Linor Berezin
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Rida Waseem
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Orton Orthopaedics Hospital, Helsinki, Finland
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, Uppsala, Sweden
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria
- Medical University Vienna, Postgraduate Master Program Medical Sleep Coaching, Vienna, Austria
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Maria Korman
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Charles M. Morin
- Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Anne-Marie Landtblom
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Thomas Penzel
- Sleep Medicine Center, Charite University Hospital Berlin, Berlin, Germany
| | - Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sérgio Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael R. Nadorff
- Department of Psychology, Mississippi State University, Starkville, Mississippi, Mississippi
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Catia Reis
- Universidade Católica Portuguesa, Católica Research Centre for Psychological Family and Social Wellbeing, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Rachel Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Juliana Yordanova
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | | | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Guide Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland
- Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Frances Chung
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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11
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Punj M, Desai A, Hashash JG, Farraye FA, Castillo PR. COVID-19 breakthrough infections and sleep disorders: A population-based propensity matched analysis. Sleep Med X 2023; 6:100089. [PMID: 37881352 PMCID: PMC10594631 DOI: 10.1016/j.sleepx.2023.100089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/30/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Objectives Examine risks for breakthrough COVID-19 infections in vaccinated patients with selected sleep disorders. Methods Real-time search and analysis using the TriNetX platform to evaluate risk of COVID-19 breakthrough infections (BTI) for patients having ICD-10 diagnoses relating to insomnia, circadian rhythm disorders, and inadequate sleep. The sleep disorder and control cohorts underwent propensity matching including factors for age, gender, race, ethnicity, and multiple co-morbid conditions. Results Of 24,720 patients identified as having a sleep disturbance relating to insomnia, circadian rhythm disorder, or inadequate sleep, 815 (3.2 %) were found to have a developed a BTI. There was a significant increased risk of BTI noted between the sleep disorder and control cohorts (adjusted odds ratio (aOR) of 1.40, 95 % confidence interval (CI) of 1.23-1.58). Subgroup analysis showed an elevated risk for BTI receiving two doses (aOR 1.53, 95 % CI 1.24-1.89) versus three doses (aOR 1.45, 95 % CI 1.24-1.69). Patients with the sleep disturbance were not found to be at an increased risk of hospitalization, intubation, death, or composite outcome of death and intubation. Conclusion The presence of having a diagnosis of insomnia, circadian rhythm disorder, or inadequate sleep was associated with increased risk of COVID-19 breakthrough infection.
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Affiliation(s)
| | - Aakash Desai
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jana G. Hashash
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Francis A. Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Pablo R. Castillo
- Department of Allergy, Pulmonary, and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA
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12
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Zhao Q, Maci M, Miller MR, Zhou H, Zhang F, Algamal M, Lee YF, Hou SS, Perle SJ, Le H, Russ AN, Lo EH, Gerashchenko D, Gomperts SN, Bacskai BJ, Kastanenka KV. Sleep restoration by optogenetic targeting of GABAergic neurons reprograms microglia and ameliorates pathological phenotypes in an Alzheimer's disease model. Mol Neurodegener 2023; 18:93. [PMID: 38041158 PMCID: PMC10693059 DOI: 10.1186/s13024-023-00682-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/17/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) patients exhibit memory disruptions and profound sleep disturbances, including disruption of deep non-rapid eye movement (NREM) sleep. Slow-wave activity (SWA) is a major restorative feature of NREM sleep and is important for memory consolidation. METHODS We generated a mouse model where GABAergic interneurons could be targeted in the presence of APPswe/PS1dE9 (APP) amyloidosis, APP-GAD-Cre mice. An electroencephalography (EEG) / electromyography (EMG) telemetry system was used to monitor sleep disruptions in these animals. Optogenetic stimulation of GABAergic interneurons in the anterior cortex targeted with channelrhodopsin-2 (ChR2) allowed us to examine the role GABAergic interneurons play in sleep deficits. We also examined the effect of optogenetic stimulation on amyloid plaques, neuronal calcium as well as sleep-dependent memory consolidation. In addition, microglial morphological features and functions were assessed using confocal microscopy and flow cytometry. Finally, we performed sleep deprivation during optogenetic stimulation to investigate whether sleep restoration was necessary to slow AD progression. RESULTS APP-GAD-Cre mice exhibited impairments in sleep architecture including decreased time spent in NREM sleep, decreased delta power, and increased sleep fragmentation compared to nontransgenic (NTG) NTG-GAD-Cre mice. Optogenetic stimulation of cortical GABAergic interneurons increased SWA and rescued sleep impairments in APP-GAD-Cre animals. Furthermore, it slowed AD progression by reducing amyloid deposition, normalizing neuronal calcium homeostasis, and improving memory function. These changes were accompanied by increased numbers and a morphological transformation of microglia, elevated phagocytic marker expression, and enhanced amyloid β (Aβ) phagocytic activity of microglia. Sleep was necessary for amelioration of pathophysiological phenotypes in APP-GAD-Cre mice. CONCLUSIONS In summary, our study shows that optogenetic targeting of GABAergic interneurons rescues sleep, which then ameliorates neuropathological as well as behavioral deficits by increasing clearance of Aβ by microglia in an AD mouse model.
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Affiliation(s)
- Qiuchen Zhao
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Megi Maci
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Morgan R Miller
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Heng Zhou
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Fang Zhang
- Departments of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Moustafa Algamal
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yee Fun Lee
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Steven S Hou
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Stephen J Perle
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Hoang Le
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Alyssa N Russ
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Eng H Lo
- Departments of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Dmitry Gerashchenko
- Department of Psychiatry, Harvard Medical School and Veterans Affairs Boston Healthcare System, West Roxbury, MA, 02132, USA
| | - Stephen N Gomperts
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Brian J Bacskai
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Ksenia V Kastanenka
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA.
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13
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Buckner JH. Translational immunology: Applying fundamental discoveries to human health and autoimmune diseases. Eur J Immunol 2023; 53:e2250197. [PMID: 37101346 PMCID: PMC10600327 DOI: 10.1002/eji.202250197] [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: 01/04/2023] [Revised: 03/10/2023] [Accepted: 04/25/2023] [Indexed: 04/28/2023]
Abstract
Studying the human immune system is challenging. These challenges stem from the complexity of the immune system itself, the heterogeneity of the immune system between individuals, and the many factors that lead to this heterogeneity including the influence of genetics, environment, and immune experience. Studies of the human immune system in the context of disease are increased in complexity as multiple combinations and variations in immune pathways can lead to a single disease. Thus, although individuals with a disease may share clinical features, the underlying disease mechanisms and resulting pathophysiology can be diverse among individuals with the same disease diagnosis. This has consequences for the treatment of diseases, as no single therapy will work for everyone, therapeutic efficacy varies among patients, and targeting a single immune pathway is rarely 100% effective. This review discusses how to address these challenges by identifying and managing the sources of variation, improving access to high-quality, well-curated biological samples by building cohorts, applying new technologies such as single-cell omics and imaging technologies to interrogate samples, and bringing to bear computational expertise in conjunction with immunologists and clinicians to interpret those results. The review has a focus on autoimmune diseases, including rheumatoid arthritis, MS, systemic lupus erythematosus, and type 1 diabetes, but its recommendations are also applicable to studies of other immune-mediated diseases.
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Affiliation(s)
- Jane H Buckner
- Center for Translational Immunology, Benaroya Research Institute, Virginia Mason Hospital, Seattle, WA, USA
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14
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Anderson MS, Chinoy ED, Harrison EM, Myers CA, Markwald RR. Sleep, Immune Function, and Vaccinations in Military Personnel: Challenges and Future Directions. Mil Med 2023; 188:296-299. [PMID: 37104811 DOI: 10.1093/milmed/usad119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
The U.S. military invests substantial resources to vaccinate all personnel, including recruits, against operationally important infectious disease threats. However, research suggests that vaccine immune response and, therefore, vaccine effectiveness may be inadvertently reduced because of chronic and/or acute sleep deficiency experienced by recipients around the time of vaccination. Because sleep deficiency is expected and even necessary in deployed and training contexts, research investigations of the impacts of sleep and related physiological systems such as circadian rhythms on vaccine effectiveness in military settings are needed. Specifically, research should be aimed at understanding the effects of sleep deficiency, as well as vaccine administration schedules, on response to vaccination and clinical protection. Furthermore, knowledge gaps among military medical leadership on sleep, vaccines, and immune health should be assessed. This area of research may benefit the health and readiness of service members while also decreasing health care utilization and associated costs from illness.
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Affiliation(s)
- Melissa S Anderson
- Operational Infectious Diseases, Naval Health Research Center, San Diego, CA 92106, USA
- General Dynamics Information Technology, San Diego, CA 92106, USA
| | - Evan D Chinoy
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA
- Leidos Inc., San Diego, CA 92106, USA
| | - Elizabeth M Harrison
- Leidos Inc., San Diego, CA 92106, USA
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92106, USA
| | - Christopher A Myers
- Operational Infectious Diseases, Naval Health Research Center, San Diego, CA 92106, USA
| | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA
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15
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Whittaker AC, De Nys L, Brindle RC, Drayson MT. Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults. Brain Behav Immun Health 2023; 32:100661. [PMID: 37456624 PMCID: PMC10344668 DOI: 10.1016/j.bbih.2023.100661] [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: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.
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Affiliation(s)
| | - Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, UK
| | - Ryan C. Brindle
- Department of Cognitive and Behavioural Science & Neuroscience Program, Washington and Lee University, USA
| | - Mark T. Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, UK
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16
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Thorkildsen MS, Gustad LT, Damås JK. The Effects of Shift Work on the Immune System: A Narrative Review. Sleep Sci 2023; 16:e368-e374. [PMID: 38196768 PMCID: PMC10773516 DOI: 10.1055/s-0043-1772810] [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: 08/11/2022] [Accepted: 11/23/2022] [Indexed: 01/11/2024] Open
Abstract
Working a shift work schedule has been hypothesized to have negative effects on health. One such described consequence is altered immune response and increased risk of infections. Former reviews have concluded that more knowledge is needed to determine how shift work affects the immune system. Since the last review focusing on this subject was published in 2016, new insight has emerged. We performed a search of the topic in PubMed, Scopus and Embase, identifying papers published after 2016, finding a total of 13 new studies. The articles identified showed inconsistent effect on immune cells, cytokines, circadian rhythms, self-reported infections, and vaccine response as a result of working a shift schedule. Current evidence suggests working shifts influence the immune system, however the clinical relevance and the mechanism behind this potential association remains elusive. Further studies need to include longitudinal design and objective measures of shift work and immune response.
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Affiliation(s)
- Marianne Stenbekk Thorkildsen
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
| | - Lise Tuset Gustad
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Trøndelag, Norway
- Department of Medicine and Rehabilitation, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Jan Kristian Damås
- Gemini Center for Sepsis Research at Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Centre of Molecular Inflammation Research, Norwegian University og Science and Technology, Trondheim, Trøndelag, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Department of Infectious Diseases, St. Olavs Hospital, Trondheim, Trøndelag, Norway
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17
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Coppeta L, Ferrari C, Verno G, Somma G, Trabucco Aurilio M, Di Giampaolo L, Treglia M, Magrini A, Pietroiusti A, Rizza S. Protective Anti-HBs Antibodies and Response to a Booster Dose in Medical Students Vaccinated at Childhood. Vaccines (Basel) 2023; 11:1326. [PMID: 37631894 PMCID: PMC10460060 DOI: 10.3390/vaccines11081326] [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] [Received: 07/07/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/28/2023] Open
Abstract
The immune system in humans is regulated by the circadian rhythm. Published studies have reported that the time of vaccination is associated with the immune response to vaccine for some pathogens. Our study aimed to evaluate the association between time of dose administration of challenge HBV vaccine and seroconversion for anti-HBs in medical students vaccinated at birth who were found to be unprotected at pre-training screening. Humoral protection for HBV was assessed in 885 medical students vaccinated during childhood. In total, 359 (41.0%) of them showed anti-HBs titer < 10 UI/mL and received a challenge dose of HBV vaccine followed by post-vaccination screening 30-60 days later. The challenge dose elicited a protective immune response (anti-HBs IgG titer > 10 UI/mL) in 295 (83.8%) individuals. Seroconversion was significantly associated with female gender and time of vaccination after controlling for age group and nationality at logistic regression analysis. Students who received the booster dose in the morning had a higher response rate than those who received the vaccine in the afternoon (OR 1.93; 95% C.I. 1.047-3.56: p < 0.05). This finding suggests that morning administration of the HBV booster may result in a better immune response in susceptible individuals.
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Affiliation(s)
- Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
| | - Cristiana Ferrari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Greta Verno
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Giuseppina Somma
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Luca Di Giampaolo
- Department of Occupational Medicine, University of Chieti “G. D’Annunzio”, 66100 Chieti, Italy;
| | - Michele Treglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Antonio Pietroiusti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.); (G.S.); (M.T.); (A.M.); (A.P.)
| | - Stefano Rizza
- Faculty of Medicine, University “Nostra Signora del Buon Consiglio”, Tirana 1000, Albania;
- Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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18
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Liu S, Sun Q, Ren X. Novel strategies for cancer immunotherapy: counter-immunoediting therapy. J Hematol Oncol 2023; 16:38. [PMID: 37055849 PMCID: PMC10099030 DOI: 10.1186/s13045-023-01430-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/15/2023] Open
Abstract
The advent of immunotherapy has made an indelible mark on the field of cancer therapy, especially the application of immune checkpoint inhibitors in clinical practice. Although immunotherapy has proven its efficacy and safety in some tumors, many patients still have innate or acquired resistance to immunotherapy. The emergence of this phenomenon is closely related to the highly heterogeneous immune microenvironment formed by tumor cells after undergoing cancer immunoediting. The process of cancer immunoediting refers to the cooperative interaction between tumor cells and the immune system that involves three phases: elimination, equilibrium, and escape. During these phases, conflicting interactions between the immune system and tumor cells result in the formation of a complex immune microenvironment, which contributes to the acquisition of different levels of immunotherapy resistance in tumor cells. In this review, we summarize the characteristics of different phases of cancer immunoediting and the corresponding therapeutic tools, and we propose normalized therapeutic strategies based on immunophenotyping. The process of cancer immunoediting is retrograded through targeted interventions in different phases of cancer immunoediting, making immunotherapy in the context of precision therapy the most promising therapy to cure cancer.
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Affiliation(s)
- Shaochuan Liu
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China
| | - Qian Sun
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China.
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China.
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China.
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China.
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
| | - Xiubao Ren
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, 300060, Tianjin, China.
- Key Laboratory of Cancer Immunology and Biotherapy, 300060, Tianjin, China.
- Key Laboratory of Cancer Prevention and Therapy, 300060, Tianjin, China.
- Tianjin's Clinical Research Center for Cancer, 300060, Tianjin, China.
- Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, 300060, Tianjin, China.
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Spiegel K, Rey AE, Cheylus A, Ayling K, Benedict C, Lange T, Prather AA, Taylor DJ, Irwin MR, Van Cauter E. A meta-analysis of the associations between insufficient sleep duration and antibody response to vaccination. Curr Biol 2023; 33:998-1005.e2. [PMID: 36917932 DOI: 10.1016/j.cub.2023.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/06/2023] [Accepted: 02/03/2023] [Indexed: 03/14/2023]
Abstract
Vaccination is a major strategy to control a viral pandemic. Simple behavioral interventions that might boost vaccine responses have yet to be identified. We conducted meta-analyses to summarize the evidence linking the amount of sleep obtained in the days surrounding vaccination to antibody response in healthy adults. Authors of the included studies provided the information needed to accurately estimate the pooled effect size (ES) and 95% confidence intervals (95% CI) and to examine sex differences.1,2,3,4,5,6,7 The association between self-reported short sleep (<6 h/night) and reduced vaccine response did not reach our pre-defined statistical significant criteria (total n = 504, ages 18-85; overall ES [95% CI] = 0.29 [-0.04, 0.63]). Objectively assessed short sleep was associated with a robust decrease in antibody response (total n = 304, ages 18-60; overall ES [95% CI] = 0.79 [0.40, 1.18]). In men, the pooled ES was large (overall ES [95% CI] = 0.93 [0.54, 1.33]), whereas it did not reach significance in women (overall ES [95% CI] = 0.42 [-0.49, 1.32]). These results provide evidence that insufficient sleep duration substantially decreases the response to anti-viral vaccination and suggests that achieving adequate amount of sleep during the days surrounding vaccination may enhance and prolong the humoral response. Large-scale well-controlled studies are urgently needed to define (1) the window of time around inoculation when optimizing sleep duration is most beneficial, (2) the causes of the sex disparity in the impact of sleep on the response, and (3) the amount of sleep needed to protect the response.
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Affiliation(s)
- Karine Spiegel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, PAM Team, F-69500 Bron, France.
| | - Amandine E Rey
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, FORGETTING Team, F-69500 Bron, France
| | - Anne Cheylus
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR 5292, PAM Team, F-69500 Bron, France
| | - Kieran Ayling
- Centre for Academic Primary Care, School of Medicine, Applied Health Research Building, University of Nottingham, Nottingham NG7 2RD, UK
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology (Sleep Science Laboratory), Uppsala University, 751 24 Uppsala, Sweden
| | - Tanja Lange
- Department of Rheumatology & Clinical Immunology, University of Lübeck, 23538 Lübeck, Germany
| | - Aric A Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94118, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Eve Van Cauter
- The Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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20
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Prevalence of Comorbid Depression and Insomnia Among Veterans Hospitalized for Heart Failure with Alzheimer Disease and Related Disorders. Am J Geriatr Psychiatry 2023; 31:428-437. [PMID: 36863973 DOI: 10.1016/j.jagp.2023.01.026] [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] [Received: 10/25/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To examine prevalence of Alzheimer Disease and related dementias (ADRD) and patient characteristics as a function of comorbid insomnia and/or depression among heart failure (HF) patients discharged from hospitals. DESIGN Retrospective cohort descriptive epidemiology study. SETTING VA Hospitals. PARTICIPANTS N = 373,897 Veterans hospitalized with heart failure from October 1, 2011 until September 30, 2020. MEASUREMENTS We examined VA and Center for Medicare & Medicaid Services (CMS) coding in the year prior to admission using published ICD-9/10 codes for dementia, insomnia, and depression. The primary outcome was the prevalence of ADRD and the secondary outcomes were 30-day and 365-day mortality. RESULTS The cohort were predominantly older adults (mean age = 72 years, SD = 11), male (97%), and White (73%). Dementia prevalence in participants without insomnia or depression was 12%. In those with both insomnia and depression, dementia prevalence was 34%. For insomnia alone and depression alone, dementia prevalence was 21% and 24%, respectively. Mortality followed a similar pattern with highest 30-day and 365-day mortality higher in those with both insomnia and depression. CONCLUSIONS These results suggest that persons with both insomnia and depression are at an increased risk of ADRD and mortality compared to persons with one or neither condition. Screening for both insomnia and depression, especially in patients with other ADRD risk factors, could lead to earlier identification of ADRD. Understanding comorbid conditions which may represent earlier signs of ADRD may be critical in the identification of ADRD risk.
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21
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Persistent short nighttime sleep duration is associated with a greater post-COVID risk in fully mRNA-vaccinated individuals. Transl Psychiatry 2023; 13:32. [PMID: 36726008 PMCID: PMC9890416 DOI: 10.1038/s41398-023-02334-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Short nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously been linked to lower odds of long-lasting COVID-19 symptoms). Post-COVID was defined as experiencing at least one core COVID-19 symptom for at least three months (e.g., shortness of breath). Multivariate logistic regression adjusting for age, sex, BMI, and other factors showed in 9717 respondents (age span 18-99) that two mRNA vaccinations lowered the risk of suffering from post-COVID by about 21% (p < 0.001). When restricting the analysis to double-vaccinated respondents (n = 5918), short and long sleepers exhibited a greater post-COVID risk than normal sleepers (adjusted OR [95%-CI], 1.56 [1.29, 1.88] and 1.87 [1.32, 2.66], respectively). Among respondents with persistent sleep duration patterns during the pandemic compared to before the pandemic, short but not long sleep duration was significantly associated with the post-COVID risk (adjusted OR [95%-CI], 1.59 [1.24, 2.03] and 1.18 [0.70, 1.97], respectively). No significant association between sleep duration and post-COVID symptoms was observed in those reporting positive SARS-CoV-2 test results (n = 538). Our findings suggest that two mRNA vaccinations against SARS-CoV-2 are associated with a lower post-COVID risk. However, this protection may be less pronounced among those sleeping less than 6 h per night. Our findings warrant replication in cohorts with individuals with confirmed SARS-CoV-2 infection.
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22
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Ince LM, Barnoud C, Lutes LK, Pick R, Wang C, Sinturel F, Chen CS, de Juan A, Weber J, Holtkamp SJ, Hergenhan SM, Geddes-McAlister J, Ebner S, Fontannaz P, Meyer B, Vono M, Jemelin S, Dibner C, Siegrist CA, Meissner F, Graw F, Scheiermann C. Influence of circadian clocks on adaptive immunity and vaccination responses. Nat Commun 2023; 14:476. [PMID: 36717561 PMCID: PMC9885059 DOI: 10.1038/s41467-023-35979-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/11/2023] [Indexed: 02/01/2023] Open
Abstract
The adaptive immune response is under circadian control, yet, why adaptive immune reactions continue to exhibit circadian changes over long periods of time is unknown. Using a combination of experimental and mathematical modeling approaches, we show here that dendritic cells migrate from the skin to the draining lymph node in a time-of-day-dependent manner, which provides an enhanced likelihood for functional interactions with T cells. Rhythmic expression of TNF in the draining lymph node enhances BMAL1-controlled ICAM-1 expression in high endothelial venules, resulting in lymphocyte infiltration and lymph node expansion. Lymph node cellularity continues to be different for weeks after the initial time-of-day-dependent challenge, which governs the immune response to vaccinations directed against Hepatitis A virus as well as SARS-CoV-2. In this work, we present a mechanistic understanding of the time-of-day dependent development and maintenance of an adaptive immune response, providing a strategy for using time-of-day to optimize vaccination regimes.
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Affiliation(s)
- Louise Madeleine Ince
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Pharmacology & Toxicology, College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Coline Barnoud
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Lydia Kay Lutes
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Robert Pick
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Chen Wang
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Flore Sinturel
- Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Patient Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland
| | - Chien-Sin Chen
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Alba de Juan
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Jasmin Weber
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Stephan J Holtkamp
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Sophia Martina Hergenhan
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Jennifer Geddes-McAlister
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | - Stefan Ebner
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Systems Immunology and Proteomics, Institute of Innate Immunity, Medical Faculty, University of Bonn, Bonn, Germany
| | - Paola Fontannaz
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Vono
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Jemelin
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Charna Dibner
- Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Patient Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,World Health Organization Collaborating Center for Vaccine Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Felix Meissner
- Experimental Systems Immunology, Max Planck Institute of Biochemistry, Martinsried, Germany.,Systems Immunology and Proteomics, Institute of Innate Immunity, Medical Faculty, University of Bonn, Bonn, Germany
| | - Frederik Graw
- BioQuant - Center for Quantitative Biology, Heidelberg University, Heidelberg, Germany.,Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Christoph Scheiermann
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Institute of Genetics and Genomics of Geneva (iGE3), University of Geneva, Geneva, Switzerland. .,Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany. .,Geneva Centre for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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23
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Xiao N, Xu X, Ma Z, Yu X, Feng Y, Li B, Liu Y, He G, Fan J, Li B, Zhao X. Sleep quality was associated with adverse reactions after coronavirus disease 2019 vaccination among healthcare workers: A longitudinal paired study. Front Behav Neurosci 2023; 16:867650. [PMID: 36688124 PMCID: PMC9845944 DOI: 10.3389/fnbeh.2022.867650] [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: 02/09/2022] [Accepted: 11/15/2022] [Indexed: 01/05/2023] Open
Abstract
Background Many countries have currently relied on various types of vaccines for the public to control the coronavirus disease 2019 (COVID-19) pandemic. The adverse reactions (ARs) after vaccination may affect vaccination coverage and confidence. However, whether sleep quality was associated with ARs after vaccination remains unclear. Methods We designed a longitudinal paired study within a hospital setting. We collected data about the side effects within 7 days after two doses of scheduled vaccination among healthcare workers (HCWs). All HCWs were asked to complete a sleep survey indexed by the Pittsburgh Sleep Quality Index (PSQI) before vaccination and after a 1-month follow-up. Then, we explored the relationship between sleep quality before or after vaccination and the occurrence of ARs. Results A total of 345 HCWs were recruited to receive COVID-19 vaccination. The sleep quality became worse after vaccination. All local and systemic reactions were mild or moderate in severity (32.46%), and no serious adverse event was reported. Binary logistic regression showed participants with poor sleep quality (PSQI > 5) than good sleep quality (PSQI ≤ 5) before the two doses of vaccination, respectively, exhibited 1.515 and 1.107 times risk of ARs after each vaccination (both p < 0.001). Conclusion There is an apparently complex bidirectional relationship between sleep quality and COVID-19 vaccination adverse effects. Poor sleep quality significantly increases the risk of mild ARs after vaccination, while vaccination may cause a temporary decline in sleep quality.
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Affiliation(s)
- Ning Xiao
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Xingli Xu
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiyue Ma
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoxu Yu
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Feng
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bilan Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuping Liu
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Gang He
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangang Fan
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Jiangang Fan,
| | - Bin Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Bin Li,
| | - Xiaolong Zhao
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,*Correspondence: Xiaolong Zhao,
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24
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Bocek J, Prasko J, Genzor S, Hodny F, Vanek J, Pobeha P, Belohradova K, Ociskova M. Sleep Disturbance and Immunological Consequences of COVID-19. Patient Prefer Adherence 2023; 17:667-677. [PMID: 36941925 PMCID: PMC10024468 DOI: 10.2147/ppa.s398188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/18/2023] [Indexed: 03/14/2023] Open
Abstract
The overarching importance of sleep was further emphasized during the pandemic of COVID-19. The subjects infected by COVID-19 frequently experience sleep disturbances; some are long-lasting problems and decrease the quality of life. Insomnia is the most studied sleep disorder associated with COVID-19. Insomnia affects patients who have experienced an infection and the general population. Good sleep is important in maintaining mental and physical health, including immune system functions. The interconnections between insomnia, the immune system, and COVID-19 are complex. Insomnia triggers numerous immune system dysregulations and makes individuals more vulnerable to respiratory infections. This narrative review overviews the influence of the COVID-19 pandemic on the immune system through sleep disorders.
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Affiliation(s)
- Jonas Bocek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
- Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
- Correspondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, Olomouc, 77520, The Czech Republic, Tel +420 603 414 930, Email
| | - Samuel Genzor
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Palacky Olomouc and University Hospital, Olomouc, The Czech Republic
| | - Frantisek Hodny
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Pavol Pobeha
- Department of Respiratory Diseases and Tuberculosis University Hospital and Faculty of Medicine and Dentistry Pavol Jozef Safarik University, Kosice, The Slovak Republic
| | - Kamila Belohradova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
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25
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Shayea AMF, Alotaibi NM, Nadar MS, Alshemali K, Alhadlaq HW. Effect of Physical Activity and Exercise on the Level of COVID-19 Antibodies and Lifestyle-Related Factors among Vaccinated Health Science Center (HSC) Students: A Pilot Randomized Trial. Vaccines (Basel) 2022; 10:vaccines10122171. [PMID: 36560580 PMCID: PMC9788485 DOI: 10.3390/vaccines10122171] [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: 10/21/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
A vaccine is a type of medicine that increases immunity and the number of antibodies (IgM and IgG) when injected into the body, preparing it in case of an actual viral infection. It has been shown in several studies that there is a significant relationship between physical activity and vaccination. Furthermore, it has been documented that physical activity can play a major role in reducing stress. Evidence also shows the existence of a relationship between immunity, vaccine response, and sleep duration. To investigate the effects of physical activity on the level of COVID-19 antibodies and lifestyle-related factors, Health Science Center (HSC) students who had taken the third dose of the vaccine and had no prior infection of the COVID-19 virus were investigated. To serve the purpose of this study, an anti-SARS-CoV-2 test was applied by taking a blood sample from the students. The Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires and the Borg’s 15-point scale were given to the participants to fill out. The study utilized a two-arm randomized control research design in which 40 participants were randomly assigned into one of two groups, either the control group (n = 20) or the treatment group (n = 20). All tests and assessments were performed before and after intervention for both groups. The control group walked less than 5000 steps every day for one month with a 20 min rest during the exercise session, while the treatment group walked more than 12,000 steps every day for the same time and exercise task session. The students’ steps were monitored using an Apple watch. There was a significant decrease in the IgG antibody level in the treatment group compared to the control group (p < 0.001). The IgM antibody level of all groups did not show any significant difference before starting the intervention. However, there was a significant (p < 0.05) decrease in the IgM level of the treatment group after treatment compared to before treatment. Moreover, there was a significant decrease in the treatment group’s stress level and sleep disruption, indicating better sleep quality, compared to the control group (p < 0.035). The levels of IgG and IgM did not improve for the treatment group. However, the treatment group improved their stress level and sleep disruption. Therefore, further rigorous research is needed to investigate vaccine efficacy among more physically active people.
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Affiliation(s)
- Abdulaziz M. F. Shayea
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Department of Molecular Biology, Faculty of Graduate Studies, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence: (N.M.A.); (A.M.F.S.)
| | - Naser M. Alotaibi
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence: (N.M.A.); (A.M.F.S.)
| | - Mohammed Shaban Nadar
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
| | - Kawthar Alshemali
- Department of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
| | - Hussah W. Alhadlaq
- Department of Environmental and Occupational Health, College of Public Health, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
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26
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Influences of sleep and lifestyle factors on the risk for covid-19 infections, from internet survey of 10,000 Japanese business workers. Sci Rep 2022; 12:19640. [PMID: 36385119 PMCID: PMC9666950 DOI: 10.1038/s41598-022-22105-3] [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: 04/17/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
We conducted an internet survey to assess sociodemographic variables, lifestyle factors, sleep problems, and comorbidities for sleep apnea syndrome (SAS) in COVID-19 and influenza (FLU) infections. Data from 10,323 workers (50.0% male) were analyzed. COVID-19 was diagnosed in 144 subjects (COVID-19+), and 8,693 were classified as not suspected to be infected (COVID-19-). SAS had been diagnosed in 35.4% of the COVID-19+ subjects, but only 231 (2.7%) of the 8,693 COVID-19- subjects. COVID-19+ subjects were more susceptible to FLU (35.4%) compared to COVID-19- subjects (3.0%). A multivariate analysis revealed that higher risks of COVID-19+ were linked to the following factors: going out without a face mask (OR 7.05, 95% CI 4.53-11.00), FLU+ (OR 6.33, 95% CI 3.80-10.54), excessive exercise before going to sleep (OR 2.10, 95% CI 1.63-2.70), SAS+ (OR 5.08, 95% CI 2.88-8.94), younger age (OR 1.05, 95% CI 1.03-1.07), falling sleep while sitting or talking with someone (OR 3.70, 95% CI 2.30-5.95), and use of hypnotics (OR 2.28, 95% CI 1.20-4.30). Since sleep impairment played a relatively small role in COVID-19+/SAS- subjects, we assume that SAS itself was a more significant risk factor for COVID-19 infection rather than sleep impairment. A better understanding of the mechanisms that result in increased susceptibility to COVID-19 in SAS is vital for helping prevent COVID-19.
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Identifying Modifiable Predictors of COVID-19 Vaccine Side Effects: A Machine Learning Approach. Vaccines (Basel) 2022; 10:vaccines10101747. [PMID: 36298612 PMCID: PMC9608090 DOI: 10.3390/vaccines10101747] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023] Open
Abstract
Side effects of COVID-19 or other vaccinations may affect an individual's safety, ability to work or care for self or others, and/or willingness to be vaccinated. Identifying modifiable factors that influence these side effects may increase the number of people vaccinated. In this observational study, data were from individuals who received an mRNA COVID-19 vaccine between December 2020 and April 2021 and responded to at least one post-vaccination symptoms survey that was sent daily for three days after each vaccination. We excluded those with a COVID-19 diagnosis or positive SARS-CoV2 test within one week after their vaccination because of the overlap of symptoms. We used machine learning techniques to analyze the data after the first vaccination. Data from 50,484 individuals (73% female, 18 to 95 years old) were included in the primary analysis. Demographics, history of an epinephrine autoinjector prescription, allergy history category (e.g., food, vaccine, medication, insect sting, seasonal), prior COVID-19 diagnosis or positive test, and vaccine manufacturer were identified as factors associated with allergic and non-allergic side effects; vaccination time 6:00-10:59 was associated with more non-allergic side effects. Randomized controlled trials should be conducted to quantify the relative effect of modifiable factors, such as time of vaccination.
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Garrido-Suárez BB, Garrido-Valdes M, Garrido G. Reactogenic sleepiness after COVID-19 vaccination. A hypothesis involving orexinergic system linked to inflammatory signals. Sleep Med 2022; 98:79-86. [PMID: 35792321 PMCID: PMC9212783 DOI: 10.1016/j.sleep.2022.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/24/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022]
Abstract
Coronavirus disease 2019 (COVID-19) represents a global healthcare crisis that has led to morbidity and mortality on an unprecedented scale. While studies on COVID-19 vaccines are ongoing, the knowledge about the reactogenic symptoms that can occur after vaccination and its generator mechanisms can be critical for healthcare professionals to improve compliance with the future vaccination campaign. Because sleep and immunity are bidirectionally linked, sleepiness or sleep disturbance side effects reported after some of the COVID-19 vaccines advise an academic research line in the context of physiological or pathological neuroimmune interactions. On the recognized basis of inflammatory regulation of hypothalamic neurons in sickness behavior, we hypothesized that IL-1β, INF-γ and TNF-α pro-inflammatory cytokines inhibit orexinergic neurons promoting sleepiness after peripheral activation of the innate immune system induced by the novel COVID-19 vaccines. In addition, based on knowledge of previous vaccines and disease manifestations of SARS-CoV-2 infection, it also suggests that narcolepsy must be included as potential adverse events of particular interest to consider in pharmacovigilance studies.
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Walsh NP, Kashi DS, Edwards JP, Richmond C, Oliver SJ, Roberts R, Izard RM, Jackson S, Greeves JP. Good perceived sleep quality protects against the raised risk of respiratory infection during sleep restriction in young adults. Sleep 2022; 46:6702165. [PMID: 36112383 PMCID: PMC9832516 DOI: 10.1093/sleep/zsac222] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/09/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY OBJECTIVES Prospectively examine the association between sleep restriction, perceived sleep quality (PSQ) and upper respiratory tract infection (URTI). METHODS In 1318 military recruits (68% males) self-reported sleep was assessed at the beginning and end of a 12-week training course. Sleep restriction was defined as an individualized reduction in sleep duration of ≥2 hours/night compared with civilian life. URTIs were retrieved from medical records. RESULTS On commencing training, approximately half of recruits were sleep restricted (52%; 2.1 ± 1.6 h); despite the sleep debt, 58% of recruits with sleep restriction reported good PSQ. Regression adjusted for covariates showed that recruits commencing training with sleep restriction were more likely to suffer URTI during the course (OR = 2.93, 95% CI 1.29-6.69, p = .011). Moderation analysis showed this finding was driven by poor PSQ (B = -1.12, SE 0.50, p = .023), as no significant association between sleep restriction and URTI was observed in recruits reporting good PSQ, despite a similar magnitude of sleep restriction during training. Associations remained in the population completing training, accounting for loss to follow-up. Recruits reporting poor PSQ when healthy at the start and end of training were more susceptible to URTI (OR = 3.16, 95% CI 1.31-7.61, p = .010, vs good PSQ). CONCLUSION Good perceived sleep quality was associated with protection against the raised risk of respiratory infection during sleep restriction. Studies should determine whether improvements in sleep quality arising from behavioral sleep interventions translate to reduced respiratory infection during sleep restriction.
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Affiliation(s)
- Neil P Walsh
- Corresponding author: Neil P. Walsh, Faculty of Science, Liverpool John Moores University, Liverpool, UK.
| | - Daniel S Kashi
- Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Jason P Edwards
- Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Claudia Richmond
- Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | | | - Ross Roberts
- College of Human Sciences, Bangor University, Bangor, UK
| | | | - Sarah Jackson
- Army Health and Performance Research, Army HQ, Andover, UK
| | - Julie P Greeves
- Army Health and Performance Research, Army HQ, Andover, UK,Norwich Medical School, University of East Anglia, Norwich, UK
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Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
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Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
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Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionBy the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function.ObjectiveWe investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.MethodsWe enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models.ResultsPrevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder.ConclusionOur results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- *Correspondence: Gaia Pellitteri
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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Irwinda R, Harzif AK, Prameswari N, Hiksas R, Lokeswara AW, Wibowo N. Serum Antibodies SARS-CoV-2 Spike (S) Protein Receptor-Binding Domain in OBGYN Residents and Effectiveness 3 Months after COVID-19 Vaccination. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The health care workers are considered as vulnerable people who had higher infecting dose of SARS-CoV-2 infection compared to other society. Among more than 500 deaths of Indonesians physicians, obstetrics and gynecologist (OBGYN) has become the most specialists who died in this pandemic.
AIM: The objective of our study is to evaluate the antibodies of SARS-CoV-2 in serum OBGYN residents post-vaccination as well as the presence of infection 3 months after the vaccination.
METHODS: A prospective cohort study was conducted in OBGYN residents Universitas Indonesia. Serum antibodies SARS-CoV-2 spike (S) protein receptor-binding domain (RBD) was measured using electrochemiluminescence immunoassay, 21 days after Sinovac vaccination, with basic characteristics being recorded. Within 3 months follow-up, the participants were monthly checked related to post-vaccination infection.
RESULTS: The median antibodies SARS-CoV-2 for all participants were 50.72 (19.09–98.57) U/mL. There were 20 residents (24.1%) who had post-vaccination infection within 3 months and dominated by asymptomatic to mild symptoms. Body mass index (r = –0.221, p = 0.044) and sleep hours (r = –0.225, p = 0.041) were found to be inversely correlated with antibodies SARS-CoV-2 S RBD.
CONCLUSION: Antibodies SARS-CoV-2 S RBD found to be correlated with BMI and sleep hours. The 3-month post-vaccine infection among OBGYN residents was almost similar to Jakarta’s positivity rate and the efficacy rate was higher than expected by National Agency of Drug and Food Control.
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Athanasiou N, Baou K, Papandreou E, Varsou G, Amfilochiou A, Kontou E, Pataka A, Porpodis K, Tsiouprou I, Kaimakamis E, Kotoulas S, Katsibourlia E, Alexopoulou C, Bouloukaki I, Panagiotarakou M, Dermitzaki A, Charokopos N, Pagdatoglou K, Lamprou K, Pouriki S, Chatzivasiloglou F, Nouvaki Z, Tsirogianni A, Kalomenidis I, Katsaounou P, Vagiakis E. Association of sleep duration and quality with immunological response after vaccination against severe acute respiratory syndrome coronavirus-2 infection. J Sleep Res 2022; 32:e13656. [PMID: 35670298 PMCID: PMC9348328 DOI: 10.1111/jsr.13656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 02/03/2023]
Abstract
Growing evidence suggests that sleep could affect the immunological response after vaccination. The aim of this prospective study was to investigate possible associations between regular sleep disruption and immunity response after vaccination against coronavirus disease 2019 (COVID-19). In total, 592 healthcare workers, with no previous history of COVID-19, from eight major Greek hospitals were enrolled in this study. All subjects underwent two Pfizer-BioNTech messenger ribonucleic acid (mRNA) COVID-19 vaccine BNT162b2 inoculations with an interval of 21 days between the doses. Furthermore, a questionnaire was completed 2 days after each vaccination and clinical characteristics, demographics, sleep duration, and habits were recorded. Blood samples were collected and anti-spike immunoglobulin G antibodies were measured at 20 ± 1 days after the first dose and 21 ± 2 days after the second dose. A total of 544 subjects (30% males), with median (interquartile range [IQR]) age of 46 (38-54) years and body mass index of 24·84 (22.6-28.51) kg/m2 were eligible for the study. The median (IQR) habitual duration of sleep was 6 (6-7) h/night. In all, 283 participants (52%) had a short daytime nap. In 214 (39.3%) participants the Pittsburgh Sleep Quality Index score was >5, with a higher percentage in women (74·3%, p < 0.05). Antibody levels were associated with age (r = -0.178, p < 0.001), poor sleep quality (r = -0.094, p < 0.05), insomnia (r = -0.098, p < 0.05), and nap frequency per week (r = -0.098, p < 0.05), but after adjusting for confounders, only insomnia, gender, and age were independent determinants of antibody levels. It is important to emphasise that insomnia is associated with lower antibody levels against COVID-19 after vaccination.
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Affiliation(s)
- Nikolaos Athanasiou
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Katerina Baou
- Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece,4 Pulmonary DepartmentSotiria General Hospital of Chest Diseases of AthensAthensGreece
| | - Eleni Papandreou
- Department of Critical CareO Agios Dimitrios, General Hospital of ThessalonikiThessalonikiGreece
| | - Georgia Varsou
- Sleep LaboratorySismanogleio Amalia Phlemink General HospitalAthensGreece
| | | | - Elisavet Kontou
- Immunology‐Histocompatibility DepartmentEvaggelismos General HospitalAthensGreece
| | - Athanasia Pataka
- Respiratory Failure UnitAristotle University of Thessaloniki George Papanikolaou HospitalThessalonikiGreece
| | - Konstantinos Porpodis
- Pulmonary Department‐Oncology UnitGeorge Papanikolaou General Hospital, Aristotle University of ThessalonikiThessalonikiGreece
| | - Ioanna Tsiouprou
- Pulmonary DepartmentAristotle University of Thessaloniki, George Papanikolaou General HospitalThessalonikiGreece
| | - Evangelos Kaimakamis
- 1st Intensive Care UnitGeorge Papanikolaou General Hospital, Aristotle University of ThessalonikiThessalonikiGreece
| | | | - Evgenia Katsibourlia
- Department of Immunology – HistocompatibilityGeorge Papanikolaou HospitalThessalonikiGreece
| | | | - Izolde Bouloukaki
- Primary Health Care Center of KastelliSleep Disorders Center, Department Of Thoracic Medicine, University Of CreteHeraklionGreece
| | | | | | | | | | - Kallirroi Lamprou
- Pulmonary DepartmentGeneral Oncologic Hospital Of AthensAthensGreece
| | - Sofia Pouriki
- Intensive Care UnitSotiria General Hospital of Chest Diseases of AthensAthensGreece
| | | | - Zoi Nouvaki
- Intensive Care UnitGeneral Hospital of Nikaia – Peiraia Agios PanteleimonAthensGreece
| | | | - Ioannis Kalomenidis
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Paraskevi Katsaounou
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
| | - Emmanouil Vagiakis
- First Intensive Care Unit (ICU) DepartmentEvaggelismos Hospital, National and Kapodistrian University of AthensAthensGreece,Sleep LaboratoryFirst ICU Clinic, Evaggelismos HospitalAthensGreece
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Roenneberg T, Foster RG, Klerman EB. The circadian system, sleep, and the health/disease balance: a conceptual review. J Sleep Res 2022; 31:e13621. [PMID: 35670313 PMCID: PMC9352354 DOI: 10.1111/jsr.13621] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
The field of "circadian medicine" is a recent addition to chronobiology and sleep research efforts. It represents a logical step arising from the increasing insights into the circadian system and its interactions with life in urbanised societies; applying these insights to the health/disease balance at home and in the medical practice (outpatient) and clinic (inpatient). Despite its fast expansion and proliferating research efforts, circadian medicine lacks a formal framework to categorise the many observations describing interactions among the circadian system, sleep, and the health/disease balance. A good framework allows us to categorise observations and then assign them to one or more components with hypothesised interactions. Such assignments can lead to experiments that document causal (rather than correlational) relationships and move from describing observations to discovering mechanisms. This review details such a proposed formal framework for circadian medicine and will hopefully trigger discussion among our colleagues, so that the framework can be improved and expanded. As the basis of the framework for circadian medicine, we define "circadian health" and how it links to general health. We then define interactions among the circadian system, sleep, and the health/disease balance and put the framework into the context of the literature with examples from six domains of health/disease balance: fertility, cancer, immune system, mental health, cardiovascular, and metabolism.
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Affiliation(s)
- Till Roenneberg
- Institute of Medical Psychology and Institute for Occupational, Social and Environmental Medicine, Munich, Germany
| | - Russell G Foster
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, New Biochemistry Building, University of Oxford, Oxford, UK
| | - Elizabeth B Klerman
- Department of Neurology, Massachusetts General Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Xiao K, Gillissie ES, Lui LM, Ceban F, Teopiz KM, Gill H, Cao B, Ho R, Rosenblat JD, McIntyre RS. Immune response to vaccination in adults with mental disorders: A systematic review. J Affect Disord 2022; 304:66-77. [PMID: 35167926 PMCID: PMC8837484 DOI: 10.1016/j.jad.2022.02.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mental disorders are associated with immune dysregulation as measured by serum levels of biological markers of immunity. Adults with mental disorders have also been reported to have attenuated post vaccine immune response. The COVID-19 pandemic has invited the need to determine whether individuals with mental disorders exhibit differential immune response following the administration of vaccines for other infections. METHODS A systematic search of MEDLINE, Embase, Cochrane, and PsycInfo was conducted from inception to May 2021 investigating vaccine response in persons with mental disorders, as measured by biological markers of immunity (i.e., antibodies, cytokines). RESULTS Thirteen articles were identified which evaluated vaccine efficacy in persons with mental disorders. Individuals with major depressive disorder (MDD) or schizophrenia revealed attenuated immune response to vaccination, or no statistical difference compared to control subjects. Individuals with anorexia nervosa or post-traumatic stress disorder (PTSD) displayed no attenuated post-vaccination antibody level. Individuals with insomnia displayed lower levels of antibodies after vaccination, whereas individuals with obstructive sleep apnea (OSA) displayed no difference in vaccine response compared to control subjects. LIMITATIONS The limitations of this review include the relatively few articles included (n = 13) and small sample sizes (less than thirty subjects) in the majority of articles. CONCLUSION Vaccine response in adults with a mental disorder remains inconclusive. Notwithstanding the heterogeneity and relatively small number of studies, available evidence does suggest attenuated immune response across disparate vaccinations. Future research is required to confirm vaccine efficacy in persons with mental disorders, especially regarding immune responses to COVID-19 vaccination.
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Affiliation(s)
- Karren Xiao
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Emily S. Gillissie
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Leanna M.W. Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Kayla M. Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Institute of Medical Science, University of Toronto, ON, Canada
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, PR China
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Joshua D. Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Department of Psychiatry, University of Toronto, Canada
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada,Department of Psychiatry, University of Toronto, Canada,Department of Pharmacology, University of Toronto, Canada,Brain and Cognition Discovery Foundation, Toronto, ON, Canada,Corresponding author at: Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada
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36
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Kim ES, Oh CE. Sleep and vaccine administration time as factors influencing vaccine immunogenicity. KOSIN MEDICAL JOURNAL 2022. [DOI: 10.7180/kmj.22.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The immunogenicity of vaccines is affected by host, external, environmental, and vaccine factors; in addition, sleep or circadian rhythms may also have effects. With the use of vaccines to mitigate the coronavirus disease 2019 (COVID-19) pandemic, research is underway to clarify what time of the day is optimal for COVID-19 vaccination and how disturbances of circadian rhythms will affect the immunogenicity of the vaccine in shift workers. Studies on the relationship between sleep time and the immunogenicity of vaccines for influenza and hepatitis have demonstrated that less sleep time and sleep deprivation tended to adversely affect immunogenicity. In some studies, there were even sex differences in these effects. When comparing shift workers with disturbances in their circadian rhythms and those who only worked during the day, one study found less antibody formation in shift workers; however, further studies on the relationship between shift work and the immunogenicity of vaccines are needed. Studies on the relationship between vaccine administration time and immunogenicity have shown different results according to age and sex. Therefore, future studies on vaccine administration time and immunogenicity may require an individualized approach for each vaccine and each population to be vaccinated. There is accumulating evidence on the effects of sleep and vaccine administration time on the immunogenicity of vaccines. However, further studies are needed to determine whether the association between immunogenicity and circadian rhythms and vaccine administration time can be used as a basis to increase the immunogenicity for individual vaccines.
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Schmitz NCM, van der Werf YD, Lammers-van der Holst HM. The Importance of Sleep and Circadian Rhythms for Vaccination Success and Susceptibility to Viral Infections. Clocks Sleep 2022; 4:66-79. [PMID: 35225954 PMCID: PMC8884008 DOI: 10.3390/clockssleep4010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/03/2022] [Accepted: 02/12/2022] [Indexed: 12/14/2022] Open
Abstract
Sleep and circadian rhythms are closely involved in the immune system and its regulation. Here, we describe this relationship and provide recommendations regarding the influence of sleep and circadian rhythms on vaccination success. We review studies investigating how viral susceptibility is influenced by changes in immunological parameters as a consequence of sleep deprivation. Short sleep duration and poor sleep efficiency both appear to be strong factors leading to greater vulnerability. In addition, both sleep duration and the time of day of the vaccination seem to be associated with the magnitude of the antibody response after vaccination. Based on these findings, a recommendation would consist of a sleep duration of 7 h or more every night to both reduce the risk of infection and to optimize the efficacy of vaccination with respect to circadian timing. Improving sleep quality and its circadian timing can potentially play a role in preventing infection and in vaccination benefits. In conclusion, sufficient (or longer) sleep duration is important in both reducing susceptibility to infection and increasing antibody response after vaccination.
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Affiliation(s)
- Nina C. M. Schmitz
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (N.C.M.S.); (Y.D.v.d.W.)
| | - Ysbrand D. van der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (N.C.M.S.); (Y.D.v.d.W.)
| | - Heidi M. Lammers-van der Holst
- Department of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
- Correspondence:
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Lam MTY, Malhotra A, LaBuzetta JN, Kamdar BB. Sleep in Critical Illness. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Stenger S, Grasshoff H, Hundt JE, Lange T. Potential effects of shift work on skin autoimmune diseases. Front Immunol 2022; 13:1000951. [PMID: 36865523 PMCID: PMC9972893 DOI: 10.3389/fimmu.2022.1000951] [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: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 02/16/2023] Open
Abstract
Shift work is associated with systemic chronic inflammation, impaired host and tumor defense and dysregulated immune responses to harmless antigens such as allergens or auto-antigens. Thus, shift workers are at higher risk to develop a systemic autoimmune disease and circadian disruption with sleep impairment seem to be the key underlying mechanisms. Presumably, disturbances of the sleep-wake cycle also drive skin-specific autoimmune diseases, but epidemiological and experimental evidence so far is scarce. This review summarizes the effects of shift work, circadian misalignment, poor sleep, and the effect of potential hormonal mediators such as stress mediators or melatonin on skin barrier functions and on innate and adaptive skin immunity. Human studies as well as animal models were considered. We will also address advantages and potential pitfalls in animal models of shift work, and possible confounders that could drive skin autoimmune diseases in shift workers such as adverse lifestyle habits and psychosocial influences. Finally, we will outline feasible countermeasures that may reduce the risk of systemic and skin autoimmunity in shift workers, as well as treatment options and highlight outstanding questions that should be addressed in future studies.
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Affiliation(s)
- Sarah Stenger
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Jennifer Elisabeth Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany.,Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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40
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Immunization of preterm infants: current evidence and future strategies to individualized approaches. Semin Immunopathol 2022; 44:767-784. [PMID: 35922638 PMCID: PMC9362650 DOI: 10.1007/s00281-022-00957-1] [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: 02/10/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Abstract
Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vaccine safety and efficacy due to preterm infants' distinct immunological features. A significant proportion of infants remains un- or under-immunized when discharged from primary hospital stay. Educating health care professionals and parents, promoting maternal immunization and evaluating the potential of new vaccination tools are important means to reduce the overall burden from infectious diseases in preterm infants. In this narrative review, we summarize the current knowledge about vaccinations in premature infants. We discuss the specificities of early life immunity and memory function, including the role of polyreactive B cells, restricted B cell receptor diversity and heterologous immunity mediated by a cross-reactive T cell repertoire. Recently, mechanistic studies indicated that tissue-resident memory (Trm) cell populations including T cells, B cells and macrophages are already established in the fetus. Their role in human early life immunity, however, is not yet understood. Tissue-resident memory T cells, for example, are diminished in airway tissues in neonates as compared to older children or adults. Hence, the ability to make specific recall responses after secondary infectious stimulus is hampered, a phenomenon that is transcriptionally regulated by enhanced expression of T-bet. Furthermore, the microbiome establishment is a dominant factor to shape resident immunity at mucosal surfaces, but it is often disturbed in the context of preterm birth. The proposed function of Trm T cells to remember benign interactions with the microbiome might therefore be reduced which would contribute to an increased risk for sustained inflammation. An improved understanding of Trm interactions may determine novel targets of vaccination, e.g., modulation of T-bet responses and facilitate more individualized approaches to protect preterm babies in the future.
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41
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Genzor S, Mizera J, Kiml J, Jakubec P, Sova M. Chronic lung diseases and sleep. VNITRNI LEKARSTVI 2022; 68:398-401. [PMID: 36316202 DOI: 10.36290/vnl.2022.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sleep is vitally important part of our life. Its quality and quantity influence all physiological processes in our organism. The relationship between the lung diseases and sleep is bidirectional - the lack of quality sleep worsens the compensation and the course of the diseases and in the same time chronic lung diseases are negatively affecting sleep quality. The coexistence of the sleep disordered breathing and lung disorders is another important issue to discuss. In case of chronic obstructive pulmonary disease the overlap with sleep disordered breathing is characterized by higher prevalence of hypercapnia and overall worse prognosis. Moreover, there is a growing body of evidence about possible links of sleep disordered breathing to lung fibrosis and tumors. The complex healthcare in patients with respiratory diseases should not omit sleep examination.
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42
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Morales JS, Valenzuela PL, Castillo-García A, Butragueño J, Jiménez-Pavón D, Carrera-Bastos P, Lucia A. The Exposome and Immune Health in Times of the COVID-19 Pandemic. Nutrients 2021; 14:24. [PMID: 35010900 PMCID: PMC8746533 DOI: 10.3390/nu14010024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023] Open
Abstract
Growing evidence supports the importance of lifestyle and environmental exposures-collectively referred to as the 'exposome'-for ensuring immune health. In this narrative review, we summarize and discuss the effects of the different exposome components (physical activity, body weight management, diet, sun exposure, stress, sleep and circadian rhythms, pollution, smoking, and gut microbiome) on immune function and inflammation, particularly in the context of the current coronavirus disease 2019 (COVID-19) pandemic. We highlight the potential role of 'exposome improvements' in the prevention-or amelioration, once established-of this disease as well as their effect on the response to vaccination. In light of the existing evidence, the promotion of a healthy exposome should be a cornerstone in the prevention and management of the COVID-19 pandemic and other eventual pandemics.
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Affiliation(s)
- Javier S. Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, Universidad de Cádiz, 11519 Cadiz, Spain;
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
| | - Pedro L. Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (P.L.V.); (A.L.)
- Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12′), 28041 Madrid, Spain
| | | | - Javier Butragueño
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Polytechnic University of Madrid (UPM), 28040 Madrid, Spain;
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, Universidad de Cádiz, 11519 Cadiz, Spain;
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Pedro Carrera-Bastos
- Centre for Primary Health Care Research, Lund University, Skane University Hospital, 205 02 Malmö, Sweden;
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (P.L.V.); (A.L.)
- Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12′), 28041 Madrid, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
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43
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Liu Z, Ting S, Zhuang X. COVID-19, circadian rhythms and sleep: from virology to chronobiology. Interface Focus 2021; 11:20210043. [PMID: 34956600 PMCID: PMC8504895 DOI: 10.1098/rsfs.2021.0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/15/2022] Open
Abstract
Various aspects of our physiology and immune response to pathogens are under 24 h circadian control and its role in clinical and research practice is becoming increasingly recognized. Severe acute respiratory syndrome coronavirus-2, the causative agent of Coronavirus disease 2019 (COVID-19) has affected millions of people to date. Cross-disciplinary approaches and collaborative efforts have led to an unprecedented speed in developing novel therapies and vaccines to tackle the COVID-19 pandemic. Circadian misalignment and sleep disruption have a profound impact on immune function and subsequently on the ability of individuals to combat infections. This review summarizes the evidence on the interplay between circadian biology, sleep and COVID-19 with the aim to identify areas of translational potentials that may inform diagnostic and therapeutic strategies in this pandemic.
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Affiliation(s)
- Zulian Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sharlene Ting
- National Institute for Health and Care Excellence, UK
| | - Xiaodong Zhuang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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44
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Effects of poor sleep on the immune cell landscape as assessed by single-cell analysis. Commun Biol 2021; 4:1325. [PMID: 34824394 PMCID: PMC8617259 DOI: 10.1038/s42003-021-02859-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 01/20/2023] Open
Abstract
Poor sleep has become an important public health issue. With loss of sleep durations, poor sleep has been linked to the increased risks for diseases. Here we employed mass cytometry and single-cell RNA sequencing to obtain a comprehensive human immune cells landscape in the context of poor sleep, which was analyzed in the context of subset composition, gene signatures, enriched pathways, transcriptional regulatory networks, and intercellular interactions. Participants subjected to staying up had increased T and plasma cell frequency, along with upregulated autoimmune-related markers and pathways in CD4+ T and B cells. Additionally, staying up reduced the differentiation and immune activity of cytotoxic cells, indicative of a predisposition to infection and tumor development. Finally, staying up influenced myeloid subsets distribution and induced inflammation development and cellular senescence. These findings could potentially give high-dimensional and advanced insights for understanding the cellular and molecular mechanisms of pathologic conditions related to poor sleep.
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45
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Cermakian N, Stegeman SK, Tekade K, Labrecque N. Circadian rhythms in adaptive immunity and vaccination. Semin Immunopathol 2021; 44:193-207. [PMID: 34825270 DOI: 10.1007/s00281-021-00903-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Abstract
Adaptive immunity allows an organism to respond in a specific manner to pathogens and other non-self-agents. Also, cells of the adaptive immune system, such as T and B lymphocytes, can mediate a memory of an encounter with a pathogen, allowing a more efficient response to a future infection. As for other aspects of physiology and of the immune system, the adaptive immune system is regulated by circadian clocks. Consequently, the development, differentiation, and trafficking between tissues of adaptive immune cells have been shown to display daily rhythms. Also, the response of T cells to stimuli (e.g., antigen presentation to T cells by dendritic cells) varies according to a circadian rhythm, due to T cell-intrinsic mechanisms as well as cues from other tissues. The circadian control of adaptive immune response has implications for our understanding of the fight against pathogens as well as auto-immune diseases, but also for vaccination, a preventive measure based on the development of immune memory.
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Affiliation(s)
- Nicolas Cermakian
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
| | - Sophia K Stegeman
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
| | - Kimaya Tekade
- Douglas Research Centre, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
| | - Nathalie Labrecque
- Hôpital Maisonneuve Rosemont Research Centre, Département de Médecine and Département de Microbiologie, infectiologie et immunologie, Université de Montréal, QC, H1T 2M4, Montreal, Canada
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46
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Garbarino S, Lanteri P, Bragazzi NL, Magnavita N, Scoditti E. Role of sleep deprivation in immune-related disease risk and outcomes. Commun Biol 2021; 4:1304. [PMID: 34795404 PMCID: PMC8602722 DOI: 10.1038/s42003-021-02825-4] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 10/26/2021] [Indexed: 12/11/2022] Open
Abstract
Modern societies are experiencing an increasing trend of reduced sleep duration, with nocturnal sleeping time below the recommended ranges for health. Epidemiological and laboratory studies have demonstrated detrimental effects of sleep deprivation on health. Sleep exerts an immune-supportive function, promoting host defense against infection and inflammatory insults. Sleep deprivation has been associated with alterations of innate and adaptive immune parameters, leading to a chronic inflammatory state and an increased risk for infectious/inflammatory pathologies, including cardiometabolic, neoplastic, autoimmune and neurodegenerative diseases. Here, we review recent advancements on the immune responses to sleep deprivation as evidenced by experimental and epidemiological studies, the pathophysiology, and the role for the sleep deprivation-induced immune changes in increasing the risk for chronic diseases. Gaps in knowledge and methodological pitfalls still remain. Further understanding of the causal relationship between sleep deprivation and immune deregulation would help to identify individuals at risk for disease and to prevent adverse health outcomes.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, 16132, Genoa, Italy.
| | - Paola Lanteri
- Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada
| | - Nicola Magnavita
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Woman/Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Egeria Scoditti
- National Research Council (CNR), Institute of Clinical Physiology (IFC), 73100, Lecce, Italy
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47
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Lammers-van der Holst HM, Lammers GJ, van der Horst GTJ, Chaves I, de Vries RD, GeurtsvanKessel CH, Koch B, van der Kuy HM. Understanding the association between sleep, shift work and COVID-19 vaccine immune response efficacy: Protocol of the S-CORE study. J Sleep Res 2021; 31:e13496. [PMID: 34617358 PMCID: PMC8646925 DOI: 10.1111/jsr.13496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
This protocol describes an innovative study to investigate the relationship between sleep, shift work and the immune response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) vaccination. As the COVID-19 pandemic is a global crisis with devastating health, social and economic impacts, there is a pressing need for effective vaccination programmes. Previous influenza and hepatitis vaccination studies suggest that lack of sleep can negatively alter immune responsiveness, while circadian misalignment most likely may also play an important role in the immune response to vaccination. Our present study will be the first to address this question in actual shift workers and in relation to COVID-19 vaccination. We hypothesise that the occurrence of recent night shifts and diminished sleep will negatively alter the immune response to vaccination in shift workers compared to dayworkers. We aim to recruit 50 shift workers and 50 dayworkers. Participants will receive an mRNA-based vaccination, through the Dutch vaccination programme. To assess immune responsiveness, blood will be drawn at baseline (before first vaccination), 10 days after first vaccination, the day prior to the second vaccination; and 28 days, 6 and 12 months after the second vaccination. Actigraphy and daily sleep e-diaries will be implemented for 7 days around each vaccination to assess sleep. The Pittsburgh Sleep Quality Index will be used to monitor sleep in the long term. Optimising the efficacy of the COVID-19 vaccines is of outmost importance and results of this study could provide insights to develop sleep and circadian-based interventions to enhance vaccination immunity, and thereby improve global health.
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Affiliation(s)
| | - Gert Jan Lammers
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Sleep Wake Center SEIN, Stichting Epilepsie Instellingen Nederland, Heemstede, the Netherlands
| | | | - Inês Chaves
- Department Molecular Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Rory D de Vries
- Department Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Birgit Koch
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hugo M van der Kuy
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands
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48
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Tune C, Hahn J, Autenrieth SE, Meinhardt M, Pagel R, Schampel A, Schierloh LK, Kalies K, Westermann J. Sleep restriction prior to antigen exposure does not alter the T cell receptor repertoire but impairs germinal center formation during a T cell-dependent B cell response in murine spleen. Brain Behav Immun Health 2021; 16:100312. [PMID: 34589803 PMCID: PMC8474616 DOI: 10.1016/j.bbih.2021.100312] [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: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
It is well known that sleep promotes immune functions. In line with this, a variety of studies in animal models and humans have shown that sleep restriction following an antigen challenge dampens the immune response on several levels which leads to e.g. worsening of disease outcome and reduction of vaccination efficiency, respectively. However, the inverse scenario with sleep restriction preceding an antigen challenge is only investigated in a few animal models where it has been shown to reduce antigen uptake and presentation as well as pathogen clearance and survival rates. Here, we use injection of sheep red blood cells to investigate the yet unknown effect on a T cell-dependent B cell response in a well-established mouse model. We found that 6 h of sleep restriction prior to the antigen challenge does not impact the T cell reaction including the T cell receptor repertoire but dampens the development of germinal centers which correlates with reduced antigen-specific antibody titer indicating an impaired B cell response. These changes concerned a functionally more relevant level than those found in the same experimental model with the inverse scenario when sleep restriction followed the antigen challenge. Taken together, our findings showed that the outcome of the T cell-dependent B cell response is indeed impacted by sleep restriction prior to the antigen challenge which highlights the clinical significance of this scenario and the need for further investigations in humans, for example concerning the effect of sleep restriction preceding a vaccination.
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Key Words
- Antigen presentation
- BCZ, B cell zone
- CCL, C–C motif ligand
- CCR, C–C motif receptor
- CD, cluster of differentiation
- CIITA, class II major histocompatibility complex transactivator
- CXCL, C-X-C motif ligand
- FDR, false discovery rate
- GC, germinal center
- Germinal center
- IFN, interferon
- IL, interleukin
- IgG, Immunglobulin G
- MHC-II, major histocompatibility complex II
- Mouse
- RP, red pulp
- SD, standard deviation
- SLO, secondary lymphoid organ
- SRBC, sheep red blood cells
- Sheep red blood cells
- Sleep deprivation
- Spleen
- T cell-dependent B cell response
- TCR, T cell receptor
- TCR-R, T cell receptor repertoire
- TCZ, T cell zone
- Tfh, follicular T helper cells
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Affiliation(s)
- Cornelia Tune
- Institute of Anatomy, University of Luebeck, Germany
| | - Julia Hahn
- Department of Internal Medicine II, University of Tuebingen, Germany
| | | | | | - Rene Pagel
- Institute of Anatomy, University of Luebeck, Germany
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49
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Lee RU, Glickman GL. Sleep, Circadian Health and Melatonin for Mitigating COVID-19 and Optimizing Vaccine Efficacy. Front Neurosci 2021; 15:711605. [PMID: 34489630 PMCID: PMC8416504 DOI: 10.3389/fnins.2021.711605] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rachel U Lee
- Department of Allergy, Immunology & Immunizations, Walter Reed National Military Medical Center, Bethesda, MD, United States.,Department of Psychiatry and Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Gena L Glickman
- Department of Psychiatry and Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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50
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Nature-Based Therapies for Sleep Disorders in People Living with Human Immunodeficiency Virus. Nurs Clin North Am 2021; 56:189-202. [PMID: 34023115 DOI: 10.1016/j.cnur.2021.02.002] [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: 11/23/2022]
Abstract
Following diagnosis of human immunodeficiency virus (HIV), getting adequate sleep may be the farthest thing from the mind of patients or providers. Even further from mind are the potential benefits on both sleep and HIV from nature-based therapy. In developing and developed countries, access to high-quality natural spaces has the potential to support physical and mental health. This article provides a review of sleep disorders, conventional and nature-based therapies, and the potential of nature-based therapy to support the health of people living with HIV through increased restorative sleep and immune function.
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