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Rani A, Stadler JT, Marsche G. HDL-based therapeutics: A promising frontier in combating viral and bacterial infections. Pharmacol Ther 2024; 260:108684. [PMID: 38964560 DOI: 10.1016/j.pharmthera.2024.108684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
Low levels of high-density lipoprotein (HDL) and impaired HDL functionality have been consistently associated with increased susceptibility to infection and its serious consequences. This has been attributed to the critical role of HDL in maintaining cellular lipid homeostasis, which is essential for the proper functioning of immune and structural cells. HDL, a multifunctional particle, exerts pleiotropic effects in host defense against pathogens. It functions as a natural nanoparticle, capable of sequestering and neutralizing potentially harmful substances like bacterial lipopolysaccharides. HDL possesses antiviral activity, preventing viruses from entering or fusing with host cells, thereby halting their replication cycle. Understanding the complex relationship between HDL and the immune system may reveal innovative targets for developing new treatments to combat infectious diseases and improve patient outcomes. This review aims to emphasize the role of HDL in influencing the course of bacterial and viral infections and its and its therapeutic potential.
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Affiliation(s)
- Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria
| | - Julia T Stadler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria; BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Styria, Austria.
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2
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Elkhapery A, Abdelhay A, Boppana HK, Abdalla Z, Mohamed M, Al‐Ali O, Hashem A, Mahmoud A, Mahmoud E, Niu C, Dalbah R, Chow M. Higher body mass index is strongly linked to poor outcomes in adult COVID-19 hospitalizations: A National Inpatient Sample Study. Obes Sci Pract 2024; 10:e692. [PMID: 38264003 PMCID: PMC10804336 DOI: 10.1002/osp4.692] [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: 01/24/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 01/25/2024] Open
Abstract
Aims The coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 6 million deaths worldwide. Studies on the impact of obesity on patients hospitalized with COVID-19 pneumonia have been conflicting, with some studies describing worse outcomes in patients with obesity, while other studies reporting no difference in outcomes. Previous studies on obesity and critical illness have described improved outcomes in patients with obesity, termed the "obesity paradox." The study assessed the impact of obesity on the outcomes of COVID-19 hospitalizations, using a nationally representative database. Materials and Methods ICD-10 code U071 was used to identify all hospitalizations with the principal diagnosis of COVID-19 infection in the National Inpatient Database 2020. ICD-10 codes were used to identify outcomes and comorbidities. Hospitalizations were grouped based on body mass index (BMI). Multivariable logistic regression was used to adjust for demographic characteristics and comorbidities. Results A total of 56,033 hospitalizations were identified. 48% were male, 49% were white and 22% were black. Patients hospitalized with COVID-19 pneumonia in the setting of obesity and clinically severe obesity were often younger. Adjusted for differences in comorbidities, there was a significant increase in mortality, incidence of mechanical ventilation, shock, and sepsis with increased BMI. The mortality was highest among hospitalizations with BMI ≥60, with an adjusted odds ratio of 2.66 (95% Confidence interval 2.18-3.24) compared to hospitalizations with normal BMI. There were increased odds of mechanical ventilation across all BMI groups above normal, with the odds of mechanical ventilation increasing with increasing BMI. Conclusion The results show that obesity is independently associated with worse patient outcomes in COVID-19 hospitalizations and is associated with higher in-patient mortality and higher rates of mechanical ventilation. The underlying mechanism of this is unclear, and further studies are needed to investigate the cause of this.
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Affiliation(s)
- Ahmed Elkhapery
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Ali Abdelhay
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | | | - Zeinab Abdalla
- Department of MedicineUniversity of SharjahSharjahUnited Arab Emirates
| | - Mohamed Mohamed
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Omar Al‐Ali
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Anas Hashem
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Amir Mahmoud
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Eisa Mahmoud
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Chengu Niu
- Rochester General Hospital Internal Medicine Residency ProgramRochesterNew YorkUSA
| | - Rami Dalbah
- Department of Internal MedicineEast Tennessee State UniversityJohnson CityTennesseeUSA
| | - Ming‐Yan Chow
- Department of Pulmonary and Critical CareRochester General HospitalRochesterNew YorkUSA
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3
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Zahid M, Leung V, Nayudu SK, Galiveeti S, Mantri N, Sun H, Gongati S, Perugu V, Chilimuri S. Role of body mass index in outcomes of patients hospitalized with COVID‐19 illness. Obes Sci Pract 2022; 8:748-756. [DOI: 10.1002/osp4.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
| | | | | | | | | | - Haozhe Sun
- BronxCare Health System Bronx New York USA
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4
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Xu DM, Li Q, Yi JX, Cai XJ, Xie L, Fang W, Qiu JF, Xu CW, He CL, Xu XR, Xu JS, Yin J. Investigation of Lymphocyte Subsets in Peripheral Blood of Patients with Dyslipidemia. Int J Gen Med 2021; 14:5573-5579. [PMID: 34548808 PMCID: PMC8449637 DOI: 10.2147/ijgm.s326628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023] Open
Abstract
Objective In order to evaluate the effect of dyslipidemia on cellular or humoral immunity in patients, changes in the absolute number of lymphocyte subsets were detected. Methods Flow cytometry was applied to determine the absolute value of lymphocyte subsets: B cell, NK cell, CD4+ T cell including the functional subset (CD4+CD28+), native subset (CD4+CD45RA+CD62L+), memory T cell subset (CD4+CD45RA-), CD8+ T cell including the functional subset (CD8+CD28+) and activated subsets (CD8+CD38+ and CD8+DR+). The relationship between lymphocyte subsets and hypercholesterolemia and hypertriglyceridemia was analyzed. Results The absolute values of CD19+ B cell, CD3+ T cell, CD4+ Th cell, CD4+CD28+ cell, naive CD4+ T cell and memory CD4+ T cell in patients with dyslipidemia were markedly higher than those in healthy controls (P<0.05). There was no significant difference between healthy controls and dyslipidemia patients in other lymphocyte subsets (P>0.05). The absolute values of CD3+ T cell and naive CD4+ T cell were significantly positively correlated with hypercholesterolemia in peripheral blood (r=0.291 and 0.306, respectively, all P<0.05). There was no significant correlation between hypertriglyceridemia and lymphocyte subsets (P>0.05). Conclusion Dyslipidemia has potential effects on immune profiles in lymphocytes subsets, and changes in lymphocyte subsets in dyslipidemia patients may lead to immune dysfunction.
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Affiliation(s)
- Da-Ming Xu
- Division of Urological Surgery, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Qian Li
- Division of Hematology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Jing-Xing Yi
- Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Xin-Jian Cai
- Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Long Xie
- Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Wei Fang
- Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Jin-Feng Qiu
- Division of Respirology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Cheng-Wei Xu
- Department of Blood Purification, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Chun-Ling He
- Department of Pathology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Xian-Ru Xu
- Division of Interventional Ultrasonic Therapeutics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Jie-Song Xu
- Department of Electroencephalogram, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Jun Yin
- Division of Hematology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China.,Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China
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5
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Dusuel A, Deckert V, Pais de Barros JP, van Dongen K, Choubley H, Charron É, Le Guern N, Labbé J, Mandard S, Grober J, Lagrost L, Gautier T. Human cholesteryl ester transfer protein lacks lipopolysaccharide transfer activity, but worsens inflammation and sepsis outcomes in mice. J Lipid Res 2020; 62:100011. [PMID: 33500240 PMCID: PMC7859855 DOI: 10.1194/jlr.ra120000704] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 11/25/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Bacterial lipopolysaccharides (LPSs or endotoxins) can bind most proteins of the lipid transfer/LPS-binding protein (LT/LBP) family in host organisms. The LPS-bound LT/LBP proteins then trigger either an LPS-induced proinflammatory cascade or LPS binding to lipoproteins that are involved in endotoxin inactivation and detoxification. Cholesteryl ester transfer protein (CETP) is an LT/LBP member, but its impact on LPS metabolism and sepsis outcome is unclear. Here, we performed fluorescent LPS transfer assays to assess the ability of CETP to bind and transfer LPS. The effects of intravenous (iv) infusion of purified LPS or polymicrobial infection (cecal ligation and puncture [CLP]) were compared in transgenic mice expressing human CETP and wild-type mice naturally having no CETP activity. CETP displayed no LPS transfer activity in vitro, but it tended to reduce biliary excretion of LPS in vivo. The CETP expression in mice was associated with significantly lower basal plasma lipid levels and with higher mortality rates in both models of endotoxemia and sepsis. Furthermore, CETPTg plasma modified cytokine production of macrophages in vitro. In conclusion, despite having no direct LPS binding and transfer property, human CETP worsens sepsis outcomes in mice by altering the protective effects of plasma lipoproteins against endotoxemia, inflammation, and infection.
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Affiliation(s)
- Aloïs Dusuel
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Valérie Deckert
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jean-Paul Pais de Barros
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Kevin van Dongen
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Hélène Choubley
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Émilie Charron
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Naig Le Guern
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jérôme Labbé
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Stéphane Mandard
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jacques Grober
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Laurent Lagrost
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France; University Hospital of Dijon, Dijon, France
| | - Thomas Gautier
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France.
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6
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Lucchinetti E, Lou PH, Wawrzyniak P, Wawrzyniak M, Scharl M, Holtzhauer GA, Krämer SD, Hersberger M, Rogler G, Zaugg M. Novel Strategies to Prevent Total Parenteral Nutrition-Induced Gut and Liver Inflammation, and Adverse Metabolic Outcomes. Mol Nutr Food Res 2020; 65:e1901270. [PMID: 32359213 DOI: 10.1002/mnfr.201901270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/09/2020] [Indexed: 12/15/2022]
Abstract
Total parenteral nutrition (TPN) is a life-saving therapy administered to millions of patients. However, it is associated with significant adverse effects, namely liver injury, risk of infections, and metabolic derangements. In this review, the underlying causes of TPN-associated adverse effects, specifically gut atrophy, dysbiosis of the intestinal microbiome, leakage of the epithelial barrier with bacterial invasion, and inflammation are first described. The role of the bile acid receptors farnesoid X receptor and Takeda G protein-coupled receptor, of pleiotropic hormones, and growth factors is highlighted, and the mechanisms of insulin resistance, namely the lack of insulinotropic and insulinomimetic signaling of gut-originating incretins as well as the potentially toxicity of phytosterols and pro-inflammatory fatty acids mainly released from soybean oil-based lipid emulsions, are discussed. Finally, novel approaches in the design of next generation lipid delivery systems are proposed. Propositions include modifying the physicochemical properties of lipid emulsions, the use of lipid emulsions generated from sustainable oils with favorable ratios of anti-inflammatory n-3 to pro-inflammatory n-6 fatty acids, beneficial adjuncts to TPN, and concomitant pharmacotherapies to mitigate TPN-associated adverse effects.
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Affiliation(s)
- Eliana Lucchinetti
- Department of Anesthesiology and Pain Medicine and Cardiovascular Research Centre, University of Alberta, Edmonton, T6G 2R3, Canada
| | - Phing-How Lou
- Department of Pharmacology, University of Alberta, Edmonton, T6G 2R3, Canada
| | - Paulina Wawrzyniak
- Division of Clinical Chemistry and Biochemistry, Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Marcin Wawrzyniak
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, 8091, Switzerland
| | - Michael Scharl
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, 8091, Switzerland
| | - Gregory A Holtzhauer
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, 8093, Switzerland
| | - Stefanie D Krämer
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, 8093, Switzerland
| | - Martin Hersberger
- Division of Clinical Chemistry and Biochemistry, Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, 8091, Switzerland
| | - Michael Zaugg
- Department of Anesthesiology and Pain Medicine and Cardiovascular Research Centre, University of Alberta, Edmonton, T6G 2R3, Canada.,Department of Pharmacology, University of Alberta, Edmonton, T6G 2R3, Canada
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7
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Blauw LL, Wang Y, Willems van Dijk K, Rensen PCN. A Novel Role for CETP as Immunological Gatekeeper: Raising HDL to Cure Sepsis? Trends Endocrinol Metab 2020; 31:334-343. [PMID: 32033866 DOI: 10.1016/j.tem.2020.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/11/2019] [Accepted: 01/09/2020] [Indexed: 12/26/2022]
Abstract
Raising HDL using cholesteryl ester transfer protein (CETP) inhibitors failed to show a clinically relevant risk reduction of cardiovascular disease in clinical trials, inviting reconsideration of the role of CETP and HDL in human physiology. Based on solid evidence from studies with isolated macrophages, rodents, and humans, we propose that a major function of CETP may be to modulate HDL in order to help resolve bacterial infections. When gram-negative bacteria invade the blood, as occurs in sepsis, Kupffer cells lose their expression of CETP to increase HDL levels. This rise in HDL prevents systemic endotoxemia by binding lipopolysaccharide and induces a systemic proinflammatory response in macrophages to mediate bacterial clearance. This raises the interesting possibility to repurpose CETP inhibitors for the treatment of sepsis.
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Affiliation(s)
- Lisanne L Blauw
- Department of Internal Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
| | - Yanan Wang
- Department of Internal Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Ko Willems van Dijk
- Department of Internal Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Patrick C N Rensen
- Department of Internal Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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8
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Bakker GJ, Schnitzler JG, Bekkering S, de Clercq NC, Koopen AM, Hartstra AV, Meessen ECE, Scheithauer TP, Winkelmeijer M, Dallinga‐Thie GM, Cani PD, Kemper EM, Soeters MR, Kroon J, Groen AK, van Raalte DH, Herrema H, Nieuwdorp M. Oral vancomycin treatment does not alter markers of postprandial inflammation in lean and obese subjects. Physiol Rep 2019; 7:e14199. [PMID: 31423751 PMCID: PMC6698488 DOI: 10.14814/phy2.14199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/30/2022] Open
Abstract
Intake of a high-fat meal induces a systemic inflammatory response in the postprandial which is augmented in obese subjects. However, the underlying mechanisms of this response have not been fully elucidated. We aimed to assess the effect of gut microbiota modulation on postprandial inflammatory response in lean and obese subjects. Ten lean and ten obese subjects with metabolic syndrome received oral vancomycin 500 mg four times per day for 7 days. Oral high-fat meal tests (50 g fat/m2 body surface area) were performed before and after vancomycin intervention. Gut microbiota composition, leukocyte counts, plasma lipopolysaccharides (LPS), LPS-binding protein (LBP), IL-6 and MCP-1 concentrations and monocyte CCR2 and cytokine expression were determined before and after the high-fat meal. Oral vancomycin treatment resulted in profound changes in gut microbiota composition and significantly decreased bacterial diversity in both groups (phylogenetic diversity pre- versus post-intervention: lean, 56.9 ± 7.8 vs. 21.4 ± 6.6, P < 0.001; obese, 53.9 ± 7.8 vs. 21.0 ± 5.9, P < 0.001). After intervention, fasting plasma LPS significantly increased (lean, median [IQR] 0.81 [0.63-1.45] EU/mL vs. 2.23 [1.33-3.83] EU/mL, P = 0.017; obese, median [IQR] 0.76 [0.45-1.03] EU/mL vs. 1.44 [1.11-4.24], P = 0.014). However, postprandial increases in leukocytes and plasma LPS were unaffected by vancomycin in both groups. Moreover, we found no changes in plasma LBP, IL-6 and MCP-1 or in monocyte CCR2 expression. Despite major vancomycin-induced disruption of the gut microbiota and increased fasting plasma LPS, the postprandial inflammatory phenotype in lean and obese subjects was unaffected in this study.
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Affiliation(s)
- Guido J. Bakker
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Johan G. Schnitzler
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Siroon Bekkering
- Department of Experimental Internal MedicineRadboud University Medical CentreNijmegenThe Netherlands
| | - Nicolien C. de Clercq
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Annefleur M. Koopen
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Annick V. Hartstra
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Emma C. E. Meessen
- Department of Endocrinology and MetabolismAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Torsten P. Scheithauer
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Maaike Winkelmeijer
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Geesje M. Dallinga‐Thie
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Patrice D. Cani
- WELBIO – Walloon Excellence in Life Sciences and Biotechnology, Metabolism and NutritionLouvain Drug Research Institute, Université Catholique de LouvainBrusselsBelgium
| | - Elles Marleen Kemper
- Department of Clinical PharmacyAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Maarten R. Soeters
- Department of Endocrinology and MetabolismAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Jeffrey Kroon
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Albert K. Groen
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Daniël H. van Raalte
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Hilde Herrema
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Max Nieuwdorp
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Molecular and Clinical Medicine, Wallenberg LaboratorySahlgrenska Academy, University of GothenburgGothenburgSweden
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9
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Gender Dictates the Relationship between Serum Lipids and Leukocyte Counts in the National Health and Nutrition Examination Survey 1999⁻2004. J Clin Med 2019; 8:jcm8030365. [PMID: 30875952 PMCID: PMC6463027 DOI: 10.3390/jcm8030365] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Abstract
Dyslipidemias and leukocytosis are associated with cardiovascular disease and immune disorders. Mechanistic studies have shown lipoprotein metabolism to play a significant role in the regulation of atherosclerosis development and leukocyte activation, whereas lipid-lowering treatments have been shown to exert beneficial anti-inflammatory and immunomodulatory effects in clinical trials. However, the relationship between clinical markers of lipid metabolism and leukocyte counts has not been extensively evaluated at the population level. We aimed to determine whether clinical blood lipid measures are associated with leukocyte counts in the general U.S. population represented in the National Health and Nutrition Examination Survey (NHANES) 1999–2004, and whether differences exist between men and women (n = 5647). We observed a strong positive linear trend between serum triglycerides vs. blood lymphocyte and basophil counts in both men and women, whereas a positive trend between monocytes vs. triglycerides and lymphocytes vs. total cholesterol and LDL-cholesterol (LDL-C) was only detected in women. Conversely, HDL-C was inversely associated with a greater number of leukocyte subsets in men, whereas inverse trends between HDL-C vs. lymphocytes were observed in both men and women. In multiple regression models, a 10% increase in total cholesterol, LDL-C, and triglycerides was associated with a predicted 1.6%, 0.6%, and 1.4% increase in blood lymphocyte counts in women, respectively, whereas no relationship was observed in men. In both men and women, a 10% increase in triglycerides was additionally associated with higher lymphocyte, neutrophil, and basophil counts, whereas 10% increases in HDL-cholesterol were associated with significantly lower lymphocyte, neutrophil, eosinophil, and basophil counts in men, in addition to lower lymphocyte and monocyte counts in women. These findings suggest that clinical lipid markers may be used to predict blood leukocyte distributions, and that a gender-specific relationship exists between distinct classes of serum lipids and immune cell subsets.
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10
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Ning Q. Main Complications of AECHB and Severe Hepatitis B (Liver Failure). ACUTE EXACERBATION OF CHRONIC HEPATITIS B 2019. [PMCID: PMC7498917 DOI: 10.1007/978-94-024-1603-9_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Qin Ning
- Department of Infectious Disease, Tongji Hospital, Wuhan, China
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11
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Golucci APBS, Marson FAL, Ribeiro AF, Nogueira RJN. Lipid profile associated with the systemic inflammatory response syndrome and sepsis in critically ill patients. Nutrition 2018; 55-56:7-14. [PMID: 29960160 DOI: 10.1016/j.nut.2018.04.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/02/2018] [Accepted: 04/22/2018] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Changes in lipid profiles occur in systemic inflammatory response syndrome (SIRS), whether due to sepsis or another cause. Hypocholesterolemia associated with hypertriacylglycerolemia can lead to disease severity and higher mortality. The aim of this systematic review was to describe the principal alterations in markers that participate in the alteration of the lipid profile. METHODS We reviewed articles focused on alterations in the lipid profile in SIRS, sepsis, or both that were indexed in the Scientific Electronic Library Online from 2000 to 2017. The descriptors used were SIRS; sepsis; lipid profile; and lipoproteins. We focused in particular on the relationships among SIRS, sepsis, and lipid profiles. RESULTS We included 29 studies that discussed decreased high-density lipoprotein (HDL), total cholesterol, and low-density lipoprotein, and elevated triacylglycerols concentrations in patients with SIRS, sepsis, or both. The variation in the lipid profile was proportional to the level of inflammation as evaluated by inflammatory markers, including C-reactive protein, interleukin-6 and interleukin-8, lipopolysaccharide-binding protein, and tumor necrosis factor. Additionally, there was a change in the composition of lipoproteins, especially HDL, triacylglycerols, and very low-density lipoprotein. HDL appears to be an inflammatory marker, as reduction of its levels reflects the intensity of the underlying inflammatory process. CONCLUSION Critically ill patients with SIRS, sepsis, or both presented with alterations in lipid metabolism.
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Affiliation(s)
| | - Fernando Augusto Lima Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Center for Research in Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Antônio Fernando Ribeiro
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Roberto José Negrão Nogueira
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Center for Research in Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; São Leopoldo Mandic Faculty, São Paulo, Brazil.
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12
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Taylor SP, Karvetski CH, Templin MA, Heffner AC, Taylor BT. Initial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock. J Crit Care 2018; 43:7-12. [DOI: 10.1016/j.jcrc.2017.08.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/14/2017] [Accepted: 08/15/2017] [Indexed: 01/12/2023]
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13
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Saskin H, Serhan Ozcan K, Yilmaz S. High preoperative monocyte count/high-density lipoprotein ratio is associated with postoperative atrial fibrillation and mortality in coronary artery bypass grafting. Interact Cardiovasc Thorac Surg 2017; 24:395-401. [PMID: 28040764 DOI: 10.1093/icvts/ivw376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/10/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives The monocyte to high-density lipoprotein ratio has recently emerged as an indicator of inflammation and oxidative stress. The aim of this study was to evaluate the association of the monocyte to high-density lipoprotein ratio with postoperative atrial fibrillation and mortality in coronary artery bypass grafting. Methods Six hundred and sixty-two patients who were in sinus rhythm preoperatively and who had isolated coronary artery bypass grafting were retrospectively included in the study. Patients who had atrial fibrillation in the early postoperative period were enrolled in group 1 ( n = 153); patients who remained in sinus rhythm in the early postoperative period were included in group 2 ( n = 509). The clinical and demographic data of the patients, biochemical and complete blood count parameters, preoperative monocyte count/high-density lipoprotein cholesterol ratio, and operative and postoperative data were recorded. Results Preoperative monocyte counts ( P = 0.0001), monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.0001) and C-reactive protein levels ( P = 0.0001) were significantly increased in group 1. In the first month, 8 patients in group 1 (5.2%) and 5 patients in group 2 (1.0%) died, which was statistically significant ( P = 0.003). In univariate and multivariate logistic regression analyses, an elevated preoperative monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.03) and C-reactive protein levels ( P = 0.0001) were predictors of postoperative atrial fibrillation. Preoperative monocyte counts ( P = 0.001), monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.0001) and the use of inotropic support ( P = 0.0001) were also predictors of mortality in the early postoperative period. Conclusions We have observed that high preoperative monocyte count/ high-density lipoprotein ratio was associated with postoperative atrial fibrillation and mortality after coronary artery bypass grafting operation.
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Affiliation(s)
- Hüseyin Saskin
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Kazim Serhan Ozcan
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Seyhan Yilmaz
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey
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14
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Pepper DJ, Sun J, Welsh J, Cui X, Suffredini AF, Eichacker PQ. Increased body mass index and adjusted mortality in ICU patients with sepsis or septic shock: a systematic review and meta-analysis. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:181. [PMID: 27306751 PMCID: PMC4908772 DOI: 10.1186/s13054-016-1360-z] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/27/2016] [Indexed: 12/21/2022]
Abstract
Background At least 25 % of adults admitted to intensive care units (ICU) in the United States have an overweight, obese or morbidly obese body mass index (BMI). The effect of BMI on adjusted mortality in adults requiring ICU treatment for sepsis is unclear. We performed a systematic review of adjusted all-cause mortality for underweight, overweight, obese and morbidly obese BMIs relative to normal BMI for adults admitted to the ICU with sepsis, severe sepsis, and septic shock. Method PubMed, the Cochrane Library, and EMBASE electronic databases were searched through November 18, 2015, without language restrictions. We included studies that reported multivariate regression analyses for all-cause mortality using standard BMI categories for adults admitted to the ICU for sepsis, severe sepsis, and septic shock. Articles were selected by consensus among multiple reviewers. Electronic database searches yielded 10,312 articles, of which six were eligible. Data were extracted by one reviewer and then reviewed by three independent reviewers. For the meta-analyses performed, the adjusted odds ratios (aOR) of mortality were combined using a random-effects model. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale for cohort studies. Results Four retrospective (n = 6609 patients) and two prospective (n = 556) studies met inclusion criteria. Compared to normal BMI, across five studies each, overweight or obese BMIs reduced the adjusted odds ratio (95 % CI) of mortality [aOR] [0.83 (0.75, 0.91) p < 0.001 and 0.82 (0.67, 0.99) p = 0.04, respectively] with low or moderate heterogeneity (I2 = 15.7 %, p = 0.31 and I2 = 53.0 %, p = 0.07, respectively). Across three studies each, morbidly obese BMI and underweight BMI did not alter aOR [0.90 (0.59, 1.39), p = 0.64; I2 = 43.3 %, p = 0.17; and 1.24 (0.79, 1.95), p = 0.35; I2 = 15.6 %, p = 0.31 respectively]. Only one study clearly defined how and when height and weight measurements were calculated. Site of underlying infection and illness severity may have favored overweight and obese BMIs. Conclusions This is the first meta-analysis to show that overweight or obese BMIs reduce adjusted mortality in adults admitted to the ICU with sepsis, severe sepsis, or septic shock. More rigorous studies that address these limitations are needed to clarify the impact of BMI on sepsis ICU outcomes. Trial registration PROSPERO International prospective register of systematic reviews 10.15124/CRD42014010556. Registered on July 11, 2014. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1360-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dominique J Pepper
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Clinical Center Building 10, Room 2C145, 10 Center Drive, Bethesda, MD, 20892, USA.
| | - Junfeng Sun
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Clinical Center Building 10, Room 2C145, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Judith Welsh
- National Institutes of Health Library, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Xizhong Cui
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Clinical Center Building 10, Room 2C145, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Anthony F Suffredini
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Clinical Center Building 10, Room 2C145, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Peter Q Eichacker
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Clinical Center Building 10, Room 2C145, 10 Center Drive, Bethesda, MD, 20892, USA
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15
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Constantinou C, Karavia EA, Xepapadaki E, Petropoulou PI, Papakosta E, Karavyraki M, Zvintzou E, Theodoropoulos V, Filou S, Hatziri A, Kalogeropoulou C, Panayiotakopoulos G, Kypreos KE. Advances in high-density lipoprotein physiology: surprises, overturns, and promises. Am J Physiol Endocrinol Metab 2016; 310:E1-E14. [PMID: 26530157 DOI: 10.1152/ajpendo.00429.2015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/30/2015] [Indexed: 12/21/2022]
Abstract
Emerging evidence strongly supports that changes in the HDL metabolic pathway, which result in changes in HDL proteome and function, appear to have a causative impact on a number of metabolic disorders. Here, we provide a critical review of the most recent and novel findings correlating HDL properties and functionality with various pathophysiological processes and disease states, such as obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease, inflammation and sepsis, bone and obstructive pulmonary diseases, and brain disorders.
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Affiliation(s)
| | - Eleni A Karavia
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | - Eva Xepapadaki
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | | | - Eugenia Papakosta
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | - Marilena Karavyraki
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | - Evangelia Zvintzou
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | | | - Serafoula Filou
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | - Aikaterini Hatziri
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
| | | | | | - Kyriakos E Kypreos
- Pharmacology Department, University of Patras Medical School, Rio Achaias, Greece
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16
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Krishnan S, Huang J, Lee H, Guerrero A, Berglund L, Anuurad E, Lebrilla CB, Zivkovic AM. Combined High-Density Lipoprotein Proteomic and Glycomic Profiles in Patients at Risk for Coronary Artery Disease. J Proteome Res 2015; 14:5109-18. [DOI: 10.1021/acs.jproteome.5b00730] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Lars Berglund
- Department
of Veterans Affairs, Northern California Health Care System, Sacramento, California 95655, United States
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17
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Lack of LCAT reduces the LPS-neutralizing capacity of HDL and enhances LPS-induced inflammation in mice. Biochim Biophys Acta Mol Basis Dis 2015; 1852:2106-15. [DOI: 10.1016/j.bbadis.2015.07.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/11/2015] [Accepted: 07/08/2015] [Indexed: 12/22/2022]
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18
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Abstract
During infection significant alterations in lipid metabolism and lipoprotein composition occur. Triglyceride and VLDL cholesterol levels increase, while reduced HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) levels are observed. More importantly, endotoxemia modulates HDL composition and size: phospholipids are reduced as well as apolipoprotein (apo) A-I, while serum amyloid A (SAA) and secretory phospholipase A2 (sPLA2) dramatically increase, and, although the total HDL particle number does not change, a significant decrease in the number of small- and medium-size particles is observed. Low HDL-C levels inversely correlate with the severity of septic disease and associate with an exaggerated systemic inflammatory response. HDL, as well as other plasma lipoproteins, can bind and neutralize Gram-negative bacterial lipopolysaccharide (LPS) and Gram-positive bacterial lipoteichoic acid (LTA), thus favoring the clearance of these products. HDLs are emerging also as a relevant player during parasitic infections, and a specific component of HDL, namely, apoL-1, confers innate immunity against trypanosome by favoring lysosomal swelling which kills the parasite. During virus infections, proteins associated with the modulation of cholesterol bioavailability in the lipid rafts such as ABCA1 and SR-BI have been shown to favor virus entry into the cells. Pharmacological studies support the benefit of recombinant HDL or apoA-I mimetics during bacterial infection, while apoL-1-nanobody complexes were tested for trypanosome infection. Finally, SR-BI antagonism represents a novel and forefront approach interfering with hepatitis C virus entry which is currently tested in clinical studies. From the coming years, we have to expect new and compelling observations further linking HDL to innate immunity and infections.
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19
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Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis. J Crit Care 2014; 29:723-7. [DOI: 10.1016/j.jcrc.2014.04.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/28/2014] [Accepted: 04/21/2014] [Indexed: 02/04/2023]
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Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. For close to four decades, we have known that high density lipoprotein (HDL) levels are inversely correlated with the risk of CVD. HDL is a complex particle that consists of proteins, phospholipids, and cholesterol and has the ability to carry micro-RNAs. HDL is constantly undergoing remodelling throughout its life-span and carries out many functions. This review summarizes many of the different aspects of HDL from its assembly, the receptors it interacts with, along with the functions it performs and how it can be altered in disease. While HDL is a key cholesterol efflux particle, this review highlights the many other important functions of HDL in the innate immune system and details the potential therapeutic uses of HDL outside of CVD.
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21
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Pulido D, Nogués MV, Boix E, Torrent M. Lipopolysaccharide neutralization by antimicrobial peptides: a gambit in the innate host defense strategy. J Innate Immun 2012; 4:327-36. [PMID: 22441679 DOI: 10.1159/000336713] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 01/20/2012] [Indexed: 01/08/2023] Open
Abstract
Antimicrobial peptides (AMPs) are nowadays understood as broad multifunctional tools of the innate immune system to fight microbial infections. In addition to its direct antimicrobial action, AMPs can modulate the host immune response by promoting or restraining the recruitment of cells and chemicals to the infection focus. Binding of AMPs to lipopolysaccharide is a critical step for both their antimicrobial action and their immunomodulatory properties. On the one hand, removal of Gram-negative bacteria by AMPs can be an effective strategy to prevent a worsened inflammatory response that may lead to septic shock. On the other hand, by neutralizing circulating endotoxins, AMPs can successfully reduce nitric oxide and tumor necrosis factor-α production, hence preventing severe tissue damage. Furthermore, AMPs can also interfere with the Toll-like receptor 4 recognition system, suppressing cytokine production and contributing to modulate the inflammatory response. Here, we review the immune system strategies devised by AMPs to avoid an exacerbated inflammatory response and thus prevent a fatal end to the host.
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Affiliation(s)
- David Pulido
- Department of Biochemistry and Molecular Biology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
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22
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Blomkalns AL, Stoll LL, Shaheen W, Romig-Martin SA, Dickson EW, Weintraub NL, Denning GM. Low level bacterial endotoxin activates two distinct signaling pathways in human peripheral blood mononuclear cells. JOURNAL OF INFLAMMATION-LONDON 2011; 8:4. [PMID: 21352551 PMCID: PMC3056742 DOI: 10.1186/1476-9255-8-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 02/25/2011] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bacterial endotoxin, long recognized as a potent pro-inflammatory mediator in acute infectious processes, has more recently been identified as a risk factor for atherosclerosis and other cardiovascular diseases. When endotoxin enters the bloodstream, one of the first cells activated is the circulating monocyte, which exhibits a wide range of pro-inflammatory responses. METHODS We studied the effect of low doses of E. coli LPS on IL-8 release and superoxide formation by freshly isolated human peripheral blood mononuclear cells (PBMC). RESULTS IL-8 release was consistently detectable at 10 pg/ml of endotoxin, reaching a maximum at 1 ng/ml, and was exclusively produced by monocytes; the lymphocytes neither produced IL-8, nor affected monocyte IL-8 release. Superoxide production was detectable at 30 pg/ml of endotoxin, reaching a maximum at 3 ng/ml. Peak respiratory burst activity was seen at 15-20 min, and superoxide levels returned to baseline by 1 h. IL-8 release was dependent on both membrane-associated CD14 (mCD14) and Toll-like receptor 4 (TLR4. Superoxide production was dependent on the presence of LBP, but was not significantly affected by a blocking antibody to TLR4. Moreover, treatment with lovastatin inhibited LPS-dependent IL-8 release and superoxide production. CONCLUSIONS These findings suggest that IL-8 release and the respiratory burst are regulated by distinct endotoxin-dependent signaling pathways in PBMC in low level of endotoxin exposure. Selectively modulating these pathways could lead to new approaches to treat chronic inflammatory diseases, such as atherosclerosis, while preserving the capacity of monocytes to respond to acute bacterial infections.
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Affiliation(s)
- Andra L Blomkalns
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH USA
| | - Lynn L Stoll
- Department of Emergency Medicine, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Wassim Shaheen
- The Department of Internal Medicine, Division of Cardiovascular Diseases, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Sara A Romig-Martin
- Department of Emergency Medicine, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Eric W Dickson
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Neal L Weintraub
- Department of Internal Medicine, Division of Cardiovascular Diseases, University of Cincinnati, Cincinnati, OH, USA
| | - Gerene M Denning
- Department of Emergency Medicine, Roy J. And Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Bas S, James RW, Gabay C. Serum lipoproteins attenuate macrophage activation and Toll-Like Receptor stimulation by bacterial lipoproteins. BMC Immunol 2010; 11:46. [PMID: 20846396 PMCID: PMC2949775 DOI: 10.1186/1471-2172-11-46] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 09/16/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis was previously shown to express a lipoprotein, the macrophage infectivity potentiator (Mip), exposed at the bacterial surface, and able to stimulate human primary monocytes/macrophages through Toll Like Receptor (TLR)2/TLR1/TLR6, and CD14. In PMA-differentiated THP-1 cells the proinflammatory activity of Mip was significantly higher in the absence than in the presence of serum. The present study aims to investigate the ability of different serum factors to attenuate Mip proinflammatory activity in PMA-differentiated THP-1 cells and in primary human differentiated macrophages. The study was also extend to another lipoprotein, the Borrelia burgdorferi outer surface protein (Osp)A. The proinflammatory activity was studied through Tumor Necrosis Factor alpha (TNF-α) and Interleukin (IL)-8 release. Finally, TLR1/2 human embryonic kidney-293 (HEK-293) transfected cells were used to test the ability of the serum factors to inhibit Mip and OspA proinflammatory activity. RESULTS In the absence of any serum and in the presence of 10% delipidated FBS, production of Mip-induced TNF-α and IL-8 in PMA-differentiated THP-1 cells were similar whereas they were significantly decreased in the presence of 10% FBS suggesting an inhibiting role of lipids present in FBS. In the presence of 10% human serum, the concentrations of TNF-α and IL-8 were 2 to 5 times lower than in the presence of 10% FBS suggesting the presence of more potent inhibitor(s) in human serum than in FBS. Similar results were obtained in primary human differentiated macrophages. Different lipid components of human serum were then tested (total lipoproteins, HDL, LDL, VLDL, triglyceride emulsion, apolipoprotein (apo)A-I, B, E2, and E3). The most efficient inhibitors were LDL, VLDL, and apoB that reduced the mean concentration of TNF-α release in Mip-induced macrophages to 24, 20, and 2%, respectively (p < 0.0001). These lipid components were also able to prevent TLR1/2 induced activation by Mip, in HEK-293 transfected cells. Similar results were obtained with OspA. CONCLUSIONS These results demonstrated the ability of serum lipids to attenuate proinflammatory activity of bacterial lipoproteins and suggested that serum lipoproteins interact with acyl chains of the lipid part of bacterial lipoproteins to render it biologically inactive.
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Affiliation(s)
- Sylvette Bas
- Division of Rheumatology, Department of Internal Medicine, Geneva University Hospital, 1211 Geneva 14, Switzerland.
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Andreasen AS, Pedersen-Skovsgaard T, Berg RMG, Svendsen KD, Feldt-Rasmussen B, Pedersen BK, Møller K. Type 2 diabetes mellitus is associated with impaired cytokine response and adhesion molecule expression in human endotoxemia. Intensive Care Med 2010; 36:1548-55. [PMID: 20229041 DOI: 10.1007/s00134-010-1845-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Accepted: 12/01/2009] [Indexed: 12/19/2022]
Abstract
PURPOSE Type 2 diabetes is associated with an increased risk of acquiring infectious diseases and developing sepsis. This may partly be due to immune dysfunction. We investigated the in vivo innate immune response of type 2 diabetic persons to an intravenous injection of E. coli lipopolysaccharide (LPS). METHODS After ethics approval, informed consent and a thorough physical examination, 19 type 2 diabetic patients and 23 healthy controls were included. LPS was given as an intravenous bolus injection of 0.3 ng/kg. Physiological variables, white blood cell count, and plasma concentrations of tumour necrosis factor (TNF), interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1ra), and the adhesion molecules E-selectin, vascular adhesion molecule (VCAM)-1, and intracellular adhesion molecule (ICAM)-1 were measured hourly for 8 h. RESULTS LPS injection induced a systemic inflammatory response with increases in neutrophils, temperature, heart rate and plasma concentrations of cytokines and adhesion molecules in healthy and type 2 diabetic volunteers. Type 2 diabetes was associated with less pronounced LPS-induced increases in TNF, IL-1ra, VCAM-1 and ICAM-1. There was a trend towards an attenuated upregulation of E-selectin in diabetics, even though the plasma concentration tended to be generally higher compared to healthy controls. CONCLUSIONS Patients with type 2 diabetes exhibit an attenuated increase in plasma levels of TNF and IL-1ra, as well as an attenuated upregulation of VCAM-1 and ICAM-1 to LPS in vivo. This finding may provide a mechanistic explanation for the adverse outcome seen during infectious diseases in diabetic patients.
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Affiliation(s)
- Anne Sofie Andreasen
- Centre of Inflammation and Metabolism, Department of Infectious Diseases, University Hospital Rigshospitalet, Rigshospitalet-M 7641, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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Ren L, Jiang ZQ, Fu Y, Leung WK, Jin L. The interplay of lipopolysaccharide-binding protein and cytokines in periodontal health and disease. J Clin Periodontol 2009; 36:619-26. [DOI: 10.1111/j.1600-051x.2009.01436.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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van Wijk DF, Stroes ESG, Monajemi H. Changing paradigm in HDL metabolism and cellular effects. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/17584299.4.1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Thompson PA, Berbée JFP, Rensen PCN, Kitchens RL. Apolipoprotein A-II augments monocyte responses to LPS by suppressing the inhibitory activity of LPS-binding protein. Innate Immun 2009; 14:365-74. [PMID: 19039060 DOI: 10.1177/1753425908099171] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Lipopolysaccharide (LPS) binding protein (LBP) plays an important role in regulating leukocyte responses to LPS. Remarkably, it may either augment these responses at low LBP concentrations or inhibit them at high concentrations. We previously reported that native high-density lipoprotein (HDL) augments human monocyte responses to LPS by suppressing the inhibitory activity of high concentrations of LBP, a process that occurs before HDL can inhibit the response by subsequently binding and neutralizing LPS. We now show that this novel activity is conferred largely by an HDL component protein, apolipoprotein (apo)A-II. Purified apoA-II was highly active in our assays. We also found that HDL from apoA-II-deficient mice was almost completely inactive, whereas the activities of HDLs that lacked apoA-I, apoC-I, apoE, or apoC-III were similar to that of wild-type HDL. Decreased activity was also observed in rabbit HDL, which is naturally deficient in apoA-II. Incorporating human apoA-II into rabbit HDL increased its activity to levels found in human HDL. Our investigation of the mechanism of apoA-II activity revealed that LBP promoted the formation of large LPS aggregates with low bioactivity and that apoA-II inhibited the formation of these aggregates without binding and directly inhibiting LPS bioactivity. Our results suggest a novel pro-inflammatory activity of apoA-II that may help maintain sensitive host responses to LPS by suppressing LBP-mediated inhibition. Our findings also raise the possibility that the decline of plasma apoA-II during sepsis may help control the response to LPS.
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Affiliation(s)
- Patricia A Thompson
- Department of Internal Medicine, Division of Infectious Diseases, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Huang H, Liu T, Rose JL, Stevens RL, Hoyt DG. Sensitivity of mice to lipopolysaccharide is increased by a high saturated fat and cholesterol diet. JOURNAL OF INFLAMMATION-LONDON 2007; 4:22. [PMID: 17997851 PMCID: PMC2186306 DOI: 10.1186/1476-9255-4-22] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 11/12/2007] [Indexed: 11/16/2022]
Abstract
Background It was hypothesized that a pro-atherogenic, high saturated fat and cholesterol diet (HCD) would increase the inflammatory response to E. coli endotoxin (LPS) and increase its concentration in plasma after administration to mice. Methods C57Bl/6 mice were fed a HCD or a control diet (CD) for 4 weeks, and then treated with saline, 0.5, 1 or 2 mg LPS/kg, ip. Liver injury (alanine:2-oxoglutarate aminotransferase and aspartate aminotransferase, collagen staining), circulating cytokines (tumor necrosis factor-α, interleukin-6 and interferon-γ), factors that can bind LPS (serum amyloid A, apolipoprotein A1, LPS binding protein, and CD14), and plasma levels of LPS were measured. The hepatic response was assessed by measuring vascular cell adhesion molecule (VCAM)-1, inducible nitric oxide synthase (iNOS) and signal transducer and activator of transcription-1 proteins, and VCAM-1 and iNOS mRNAs. Hepatic mRNA encoding the LPS receptor, Toll like receptor 4, was also determined. Results Two mg LPS/kg killed 100% of mice fed HCD within 5 d, while no mice fed CD died. All mice treated with 0 to 1 mg LPS/kg survived 24 h. HCD increased plasma alanine:2-oxoglutarate aminotransferase and aspartate aminotransferase, and the enzymes were increased more by LPS in HCD than CD mice. Induction of plasma tumor necrosis factor-α, interleukin-6, and interferon-γ by LPS was greater with HCD than CD. Hepatic VCAM-1 and iNOS protein and mRNA were induced by LPS more in mice fed HCD than CD. Tyrosine phosphorylation of signal transducer and activator of transcription-1 caused by LPS was prolonged in HCD compared with CD mice. Despite the hepatic effects of HCD, diet had no effect on the LPS plasma concentration-time profile. HCD alone did not affect circulating levels of plasma apolipoprotein A1 or LPS binding protein. However, plasma concentrations of serum amyloid A and CD14, and hepatic toll-like receptor-4 mRNA were increased in mice fed HCD. Conclusion HCD increased the sensitivity of mice to LPS without affecting its plasma level. Although increased serum amyloid A and CD14 in the circulation may inhibit LPS actions, their overexpression, along with hepatic toll-like receptor-4 or other factors, may contribute to the heightened sensitivity to LPS.
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Affiliation(s)
- Hong Huang
- Division of Pharmacology, The Ohio State University College of Pharmacy, Columbus, OH, 43210, USA.
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Levels JHM, Pajkrt D, Schultz M, Hoek FJ, van Tol A, Meijers JCM, van Deventer SJH. Alterations in lipoprotein homeostasis during human experimental endotoxemia and clinical sepsis. Biochim Biophys Acta Mol Cell Biol Lipids 2007; 1771:1429-38. [PMID: 17980169 DOI: 10.1016/j.bbalip.2007.10.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Revised: 09/17/2007] [Accepted: 10/02/2007] [Indexed: 11/26/2022]
Abstract
Cell wall constituents of bacteria are potent endotoxins initiating inflammatory responses which may cause dramatic changes in lipid metabolism during the acute phase response. In this study, the sequential changes in lipoprotein composition and lipid transfer and binding proteins during clinical sepsis and during low-dose experimental endotoxemia were followed. In addition, the effect on (phospho)lipid homeostasis by administration of reconstituted HDL (rHDL) prior to low-dose LPS administration was investigated. Changes in (apo)lipoprotein concentrations typical of the acute phase response were observed during clinical sepsis and experimental endotoxemia with and without the rHDL intervention. During clinical sepsis negative correlations between the acute phase marker C-reactive protein (CRP) and lecithin:cholesterol acyltransferase (LCAT) and cholesterylester transfer protein (CETP) activities were seen, whereas positive correlations between plasma phospholipid transfer protein (PLTP) activity and acute phase markers such as CRP and LPS binding protein were observed. Plasma lipid changes upon rHDL/LPS infusion were comparable with the control group (low-dose LPS only). PLTP activity decreased upon LPS infusion and transiently increased during rHDL infusion, whereas LCAT activity slightly decreased upon both LPS infusion and LPS/rHDL infusion. However, long-lasting increases of circulating HDL cholesterol, apo A-I and a high initial processing of both phosphatidylcholine (PC) and lyso-PC, were indicative for extensive rHDL and LDL remodelling. Both sepsis and experimental endotoxemia lead to a disbalance of lipid homeostasis. Depending on the magnitude of the inflammatory stimulus, LCAT and PLTP activities reacted in divergent ways. rHDL infusion did not prevent the lipid alterations seen during the acute phase response. However profound changes in both HDL and LDL phospholipid composition occurred upon rHDL infusion. This may be explained, at least in part, by the fact that PLTP as a positive acute phase protein, can accelerate the alterations in (phospho)lipid homeostasis thereby playing a role in the attenuation of the acute phase response.
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Affiliation(s)
- Johannes H M Levels
- Department of Experimental Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands.
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Adib-Conquy M, Cavaillon JM. Stress molecules in sepsis and systemic inflammatory response syndrome. FEBS Lett 2007; 581:3723-33. [PMID: 17428476 DOI: 10.1016/j.febslet.2007.03.074] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 03/23/2007] [Accepted: 03/28/2007] [Indexed: 12/19/2022]
Abstract
During sepsis, microbial derived products ("pathogen-associated molecular patterns", PAMPs) are recognized as exogenous danger signals by specific sensors of the host ("pattern recognitions receptors", PRRs). This interaction leads to the release of numerous stress proteins that are a prerequisite to fight infection, though their overzealous production can contribute to tissue damage, organ dysfunction and eventually death. In critically ill patients, translocation of PAMPs can occur from the gut, and injured tissues and cells release endogenous danger signals called "alarmins" (e.g. High mobility group box-1); that share some properties with PAMPs. Thus, numerous similarities occur during infectious and non-infectious systemic inflammation.
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Affiliation(s)
- Minou Adib-Conquy
- Unit Cytokines and Inflammation, Institut Pasteur, 28 rue Dr. Roux, 75015 Paris, France
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