1
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Barreto EA, Cruz AS, Veras FP, Martins R, Bernardelli RS, Paiva IM, Lima TM, Singh Y, Guimarães RC, Damasceno S, Pereira N, Alves JM, Gonçalves TT, Forato J, Muraro SP, Souza GF, Batah SS, Proenca-Modena JL, Mori MA, Cunha FQ, Louzada-Junior P, Cunha TM, Nakaya HI, Fabro A, de Oliveira RDR, Arruda E, Réa R, Réa Neto Á, Fernandes da Silva MM, Leiria LO. COVID-19-related hyperglycemia is associated with infection of hepatocytes and stimulation of gluconeogenesis. Proc Natl Acad Sci U S A 2023; 120:e2217119120. [PMID: 37186819 PMCID: PMC10214153 DOI: 10.1073/pnas.2217119120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Occurrence of hyperglycemia upon infection is associated with worse clinical outcome in COVID-19 patients. However, it is still unknown whether SARS-CoV-2 directly triggers hyperglycemia. Herein, we interrogated whether and how SARS-CoV-2 causes hyperglycemia by infecting hepatocytes and increasing glucose production. We performed a retrospective cohort study including patients that were admitted at a hospital with suspicion of COVID-19. Clinical and laboratory data were collected from the chart records and daily blood glucose values were analyzed to test the hypothesis on whether COVID-19 was independently associated with hyperglycemia. Blood glucose was collected from a subgroup of nondiabetic patients to assess pancreatic hormones. Postmortem liver biopsies were collected to assess the presence of SARS-CoV-2 and its transporters in hepatocytes. In human hepatocytes, we studied the mechanistic bases of SARS-CoV-2 entrance and its gluconeogenic effect. SARS-CoV-2 infection was independently associated with hyperglycemia, regardless of diabetic history and beta cell function. We detected replicating viruses in human hepatocytes from postmortem liver biopsies and in primary hepatocytes. We found that SARS-CoV-2 variants infected human hepatocytes in vitro with different susceptibility. SARS-CoV-2 infection in hepatocytes yields the release of new infectious viral particles, though not causing cell damage. We showed that infected hepatocytes increase glucose production and this is associated with induction of PEPCK activity. Furthermore, our results demonstrate that SARS-CoV-2 entry in hepatocytes occurs partially through ACE2- and GRP78-dependent mechanisms. SARS-CoV-2 infects and replicates in hepatocytes and exerts a PEPCK-dependent gluconeogenic effect in these cells that potentially is a key cause of hyperglycemia in infected patients.
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Affiliation(s)
- Ester A. Barreto
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Amanda S. Cruz
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Flavio P. Veras
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Ronaldo Martins
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Rafaella S. Bernardelli
- Federal University of Paraná, Center for Study and Research in Intensive Care Medicine, Curitiba82530-200, Brazil
| | - Isadora M. Paiva
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Thais M. Lima
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Youvika Singh
- Hospital Israelita Albert Einstein, São Paulo05652-900, Brazil
| | - Raphael C. Guimarães
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
| | - Samara Damasceno
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Nayara Pereira
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - João Manoel Alves
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Tiago T. Gonçalves
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Julia Forato
- Department of Genetics, Microbiology and Immunology, Laboratory of Emerging Viruses, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
| | - Stéfanie P. Muraro
- Department of Genetics, Microbiology and Immunology, Laboratory of Emerging Viruses, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
| | - Gabriela F. Souza
- Department of Genetics, Microbiology and Immunology, Laboratory of Emerging Viruses, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
| | - Sabrina Setembre Batah
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - José L. Proenca-Modena
- Department of Genetics, Microbiology and Immunology, Laboratory of Emerging Viruses, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
- Experimental Medicine Research, Cluster University of Campinas, Campinas13083-970, Brazil
| | - Marcelo A. Mori
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas13083-970, Brazil
- Experimental Medicine Research, Cluster University of Campinas, Campinas13083-970, Brazil
- Obesity and Comorbidities Research Center, University of Campinas, Campinas13083-864, Brazil
| | - Fernando Q. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Paulo Louzada-Junior
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Divisions of Clinical Immunology, Emergency, Infectious Diseases, and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Thiago M. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Helder I. Nakaya
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Hospital Israelita Albert Einstein, São Paulo05652-900, Brazil
| | - Alexandre Fabro
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Renê D. R. de Oliveira
- Divisions of Clinical Immunology, Emergency, Infectious Diseases, and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Eurico Arruda
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
| | - Rosângela Réa
- Federal University of Paraná, Center for Study and Research in Intensive Care Medicine, Curitiba82530-200, Brazil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba80060-900, Brazil
| | - Álvaro Réa Neto
- Federal University of Paraná, Center for Study and Research in Intensive Care Medicine, Curitiba82530-200, Brazil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba80060-900, Brazil
| | | | - Luiz Osório Leiria
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
- Center for Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto14049-900, Brazil
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2
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Pontelli MC, Castro IA, Martins RB, La Serra L, Veras FP, Nascimento DC, Silva CM, Cardoso RS, Rosales R, Gomes R, Lima TM, Souza JP, Vitti BC, Caetité DB, de Lima MHF, Stumpf SD, Thompson CE, Bloyet LM, Kawahisa JTE, Giannini MC, Bonjorno LP, Lopes MIF, Batah SS, Li S, Assad RL, Almeida SCL, Oliveira FR, Benatti MN, Pontes LLF, Santana RC, Vilar FC, Martins MA, Shi PY, Cunha TM, Calado RT, Alves-Filho JC, Zamboni DS, Fabro A, Louzada-Junior P, Oliveira RDR, Whelan SPJ, Cunha FQ, Arruda E. SARS-CoV-2 productively infects primary human immune system cells in vitro and in COVID-19 patients. J Mol Cell Biol 2022; 14:6572370. [PMID: 35451490 PMCID: PMC9384834 DOI: 10.1093/jmcb/mjac021] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/30/2021] [Accepted: 04/19/2022] [Indexed: 12/04/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a hyperinflammatory state and lymphocytopenia, a hallmark that appears as both signature and prognosis of disease severity outcome. Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion, it is still unclear whether direct SARS-CoV-2 infection of immune cells could also play a role in this scenario by harboring viral replication. We found that monocytes, as well as both B and T lymphocytes, were susceptible to SARS-CoV-2 infection in vitro, accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis. In addition, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019 (COVID-19) patients. The rates of SARS-CoV-2-infected monocytes in peripheral blood mononuclear cells from COVID-19 patients increased over time from symptom onset, with SARS-CoV-2-positive monocytes, B cells, and CD4+ T lymphocytes also detected in postmortem lung tissue. These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in COVID-19 patients might have important implications for disease pathogenesis and progression, immune dysfunction, and virus spread within the host.
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Affiliation(s)
- Marjorie C Pontelli
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Italo A Castro
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Ronaldo B Martins
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Leonardo La Serra
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Flávio P Veras
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Daniele C Nascimento
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Camila M Silva
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Ricardo S Cardoso
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Roberta Rosales
- Department of Cell and Molecular Biology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Rogério Gomes
- Blood Center of Ribeirao Preto, 14049-900, Ribeirao Preto, São Paulo, Brazil
| | - Thais M Lima
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Juliano P Souza
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Brenda C Vitti
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Diego B Caetité
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Mikhael H F de Lima
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Spencer D Stumpf
- Department of Biochemistry & Molecular Biology, the University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Cassandra E Thompson
- Department of Biochemistry & Molecular Biology, the University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Louis-Marie Bloyet
- Department of Biochemistry & Molecular Biology, the University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Juliana T E Kawahisa
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Marcela C Giannini
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Letícia P Bonjorno
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Maria I F Lopes
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Sabrina S Batah
- Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Siyuan Li
- Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Rodrigo L Assad
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Sergio C L Almeida
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Fabiola R Oliveira
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Maíra N Benatti
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Lorena L F Pontes
- Blood Center of Ribeirao Preto, 14049-900, Ribeirao Preto, São Paulo, Brazil
| | - Rodrigo C Santana
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Fernando C Vilar
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Maria A Martins
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Pei-Yong Shi
- Department of Biochemistry & Molecular Biology, the University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Thiago M Cunha
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Rodrigo T Calado
- Blood Center of Ribeirao Preto, 14049-900, Ribeirao Preto, São Paulo, Brazil
| | - José C Alves-Filho
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Dario S Zamboni
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Alexandre Fabro
- Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Paulo Louzada-Junior
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Rene D R Oliveira
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Divisions of Clinical Immunology, Infectious Diseases and Intensive Care Unit, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Sean P J Whelan
- Department of Molecular Microbiology, Washington University in St. Louis, Saint Louis, MO 63110, USA
| | - Fernando Q Cunha
- Center of Research in Inflammatory Diseases, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
| | - Eurico Arruda
- Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirao Preto Medical School, University of Sao Paulo, 14049-900, Ribeirao Preto, Sao Paulo, Brazil
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3
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Azevedo PS, Polegato BF, Paiva S, Costa N, Santos P, Bazan S, Fernandes AAH, Fabro A, Pires V, Tanni SE, Leal Pereira F, Lo A, Grassi L, Campos D, Androcioli V, Zornoff L, Minicucci M. The role of glucose metabolism and insulin resistance in cardiac remodelling induced by cigarette smoke exposure. J Cell Mol Med 2021; 25:1314-1318. [PMID: 33300293 PMCID: PMC7812248 DOI: 10.1111/jcmm.16053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to evaluate whether the alterations in glucose metabolism and insulin resistance are mechanisms presented in cardiac remodelling induced by the toxicity of cigarette smoke. Male Wistar rats were assigned to the control group (C; n = 12) and the cigarette smoke-exposed group (exposed to cigarette smoke over 2 months) (CS; n = 12). Transthoracic echocardiography, blood pressure assessment, serum biochemical analyses for catecholamines and cotinine, energy metabolism enzymes activities assay; HOMA index (homeostatic model assessment); immunohistochemistry; and Western blot for proteins involved in energy metabolism were performed. The CS group presented concentric hypertrophy, systolic and diastolic dysfunction, and higher oxidative stress. It was observed changes in energy metabolism, characterized by a higher HOMA index, lower concentration of GLUT4 (glucose transporter 4) and lower 3-hydroxyl-CoA dehydrogenase activity, suggesting the presence of insulin resistance. Yet, the cardiac glycogen was depleted, phosphofructokinase (PFK) and lactate dehydrogenase (LDH) increased, with normal pyruvate dehydrogenase (PDH) activity. The activity of citrate synthase, mitochondrial complexes and ATP synthase (adenosine triphosphate synthase) decreased and the expression of Sirtuin 1 (SIRT1) increased. In conclusion, exposure to cigarette smoke induces cardiac remodelling and dysfunction. The mitochondrial dysfunction and heart damage induced by cigarette smoke exposure are associated with insulin resistance and glucose metabolism changes.
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Affiliation(s)
- Paula Schmidt Azevedo
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Bertha F. Polegato
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Sergio Paiva
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Nara Costa
- Faculty of NutritionUFG – Univ Federal de GoiásGoiâniaBrazil
| | - Priscila Santos
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Silmeia Bazan
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | | | - Alexandre Fabro
- Department of Pathology and Legal MedicineRibeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Vanessa Pires
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Suzana E. Tanni
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Filipe Leal Pereira
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Angelo Lo
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Leticia Grassi
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Dijon Campos
- Department of Pathology and Legal MedicineRibeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Vickeline Androcioli
- Experimental Research Unit – UNIPEXBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Leonardo Zornoff
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
| | - Marcos Minicucci
- Department of Internal MedicineBotucatu Medical SchoolSão Paulo State University‐UNESPBotucatuBrazil
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4
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Veras FP, Pontelli MC, Silva CM, Toller-Kawahisa JE, de Lima M, Nascimento DC, Schneider AH, Caetité D, Tavares LA, Paiva IM, Rosales R, Colón D, Martins R, Castro IA, Almeida GM, Lopes MIF, Benatti MN, Bonjorno LP, Giannini MC, Luppino-Assad R, Almeida SL, Vilar F, Santana R, Bollela VR, Auxiliadora-Martins M, Borges M, Miranda CH, Pazin-Filho A, da Silva LLP, Cunha LD, Zamboni DS, Dal-Pizzol F, Leiria LO, Siyuan L, Batah S, Fabro A, Mauad T, Dolhnikoff M, Duarte-Neto A, Saldiva P, Cunha TM, Alves-Filho JC, Arruda E, Louzada-Junior P, Oliveira RD, Cunha FQ. SARS-CoV-2-triggered neutrophil extracellular traps mediate COVID-19 pathology. J Exp Med 2020. [PMID: 32926098 DOI: 10.1101/2020.06.08.20125823] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Severe COVID-19 patients develop acute respiratory distress syndrome that may progress to cytokine storm syndrome, organ dysfunction, and death. Considering that neutrophil extracellular traps (NETs) have been described as important mediators of tissue damage in inflammatory diseases, we investigated whether NETs would be involved in COVID-19 pathophysiology. A cohort of 32 hospitalized patients with a confirmed diagnosis of COVID-19 and healthy controls were enrolled. The concentration of NETs was augmented in plasma, tracheal aspirate, and lung autopsies tissues from COVID-19 patients, and their neutrophils released higher levels of NETs. Notably, we found that viable SARS-CoV-2 can directly induce the release of NETs by healthy neutrophils. Mechanistically, NETs triggered by SARS-CoV-2 depend on angiotensin-converting enzyme 2, serine protease, virus replication, and PAD-4. Finally, NETs released by SARS-CoV-2-activated neutrophils promote lung epithelial cell death in vitro. These results unravel a possible detrimental role of NETs in the pathophysiology of COVID-19. Therefore, the inhibition of NETs represents a potential therapeutic target for COVID-19.
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Affiliation(s)
- Flavio Protasio Veras
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marjorie Cornejo Pontelli
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Camila Meirelles Silva
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Juliana E Toller-Kawahisa
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mikhael de Lima
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniele Carvalho Nascimento
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ayda Henriques Schneider
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Diego Caetité
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucas Alves Tavares
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Isadora M Paiva
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Roberta Rosales
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - David Colón
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ronaldo Martins
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Italo Araujo Castro
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Glaucia M Almeida
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Isabel Fernandes Lopes
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maíra Nilson Benatti
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Letícia Pastorelli Bonjorno
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcela Cavichioli Giannini
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Luppino-Assad
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio Luna Almeida
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Vilar
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Santana
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Valdes R Bollela
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Auxiliadora-Martins
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcos Borges
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Henrique Miranda
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Pazin-Filho
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luis Lamberti P da Silva
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Larissa Dias Cunha
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Dario S Zamboni
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Luiz O Leiria
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Li Siyuan
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sabrina Batah
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Fabro
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Mauad
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Amaro Duarte-Neto
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Saldiva
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Thiago Mattar Cunha
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Carlos Alves-Filho
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paulo Louzada-Junior
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renê Donizeti Oliveira
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Queiroz Cunha
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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5
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Veras FP, Pontelli MC, Silva CM, Toller-Kawahisa JE, de Lima M, Nascimento DC, Schneider AH, Caetité D, Tavares LA, Paiva IM, Rosales R, Colón D, Martins R, Castro IA, Almeida GM, Lopes MIF, Benatti MN, Bonjorno LP, Giannini MC, Luppino-Assad R, Almeida SL, Vilar F, Santana R, Bollela VR, Auxiliadora-Martins M, Borges M, Miranda CH, Pazin-Filho A, da Silva LLP, Cunha LD, Zamboni DS, Dal-Pizzol F, Leiria LO, Siyuan L, Batah S, Fabro A, Mauad T, Dolhnikoff M, Duarte-Neto A, Saldiva P, Cunha TM, Alves-Filho JC, Arruda E, Louzada-Junior P, Oliveira RD, Cunha FQ. SARS-CoV-2-triggered neutrophil extracellular traps mediate COVID-19 pathology. J Exp Med 2020; 217:152086. [PMID: 32926098 PMCID: PMC7488868 DOI: 10.1084/jem.20201129] [Citation(s) in RCA: 569] [Impact Index Per Article: 142.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/11/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
Severe COVID-19 patients develop acute respiratory distress syndrome that may progress to cytokine storm syndrome, organ dysfunction, and death. Considering that neutrophil extracellular traps (NETs) have been described as important mediators of tissue damage in inflammatory diseases, we investigated whether NETs would be involved in COVID-19 pathophysiology. A cohort of 32 hospitalized patients with a confirmed diagnosis of COVID-19 and healthy controls were enrolled. The concentration of NETs was augmented in plasma, tracheal aspirate, and lung autopsies tissues from COVID-19 patients, and their neutrophils released higher levels of NETs. Notably, we found that viable SARS-CoV-2 can directly induce the release of NETs by healthy neutrophils. Mechanistically, NETs triggered by SARS-CoV-2 depend on angiotensin-converting enzyme 2, serine protease, virus replication, and PAD-4. Finally, NETs released by SARS-CoV-2–activated neutrophils promote lung epithelial cell death in vitro. These results unravel a possible detrimental role of NETs in the pathophysiology of COVID-19. Therefore, the inhibition of NETs represents a potential therapeutic target for COVID-19.
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Affiliation(s)
- Flavio Protasio Veras
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marjorie Cornejo Pontelli
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Camila Meirelles Silva
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Juliana E Toller-Kawahisa
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mikhael de Lima
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniele Carvalho Nascimento
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ayda Henriques Schneider
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Diego Caetité
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucas Alves Tavares
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Isadora M Paiva
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Roberta Rosales
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - David Colón
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ronaldo Martins
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Italo Araujo Castro
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Glaucia M Almeida
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Isabel Fernandes Lopes
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maíra Nilson Benatti
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Letícia Pastorelli Bonjorno
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcela Cavichioli Giannini
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Luppino-Assad
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio Luna Almeida
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Vilar
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Santana
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Valdes R Bollela
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Auxiliadora-Martins
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcos Borges
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Henrique Miranda
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Pazin-Filho
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luis Lamberti P da Silva
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Larissa Dias Cunha
- Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Dario S Zamboni
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Luiz O Leiria
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Li Siyuan
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sabrina Batah
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Fabro
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Mauad
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Amaro Duarte-Neto
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Saldiva
- Department Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Thiago Mattar Cunha
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Carlos Alves-Filho
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paulo Louzada-Junior
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renê Donizeti Oliveira
- Divisions of Clinical Immunology, Emergency, Infectious Diseases and Intensive Care Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Queiroz Cunha
- Center of Research in Inflammatory Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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6
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Pontelli MC, Castro IA, Martins RB, Veras FP, Serra LL, Nascimento DC, Cardoso RS, Rosales R, Lima TM, Souza JP, Caetité DB, de Lima MHF, Kawahisa JT, Giannini MC, Bonjorno LP, Lopes MIF, Batah SS, Siyuan L, Assad RL, Almeida SCL, Oliveira FR, Benatti MN, Pontes LLF, Santana RC, Vilar FC, Martins MA, Cunha TM, Calado RT, Alves-Filho JC, Zamboni DS, Fabro A, Louzada-Junior P, Oliveira RDR, Cunha FQ, Arruda E. Infection of human lymphomononuclear cells by SARS-CoV-2. bioRxiv 2020. [PMID: 34013264 PMCID: PMC8132220 DOI: 10.1101/2020.07.28.225912] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although SARS-CoV-2 severe infection is associated with a hyperinflammatory state, lymphopenia is an immunological hallmark, and correlates with poor prognosis in COVID-19. However, it remains unknown if circulating human lymphocytes and monocytes are susceptible to SARS-CoV-2 infection. In this study, SARS-CoV-2 infection of human peripheral blood mononuclear cells (PBMCs) was investigated both in vitro and in vivo . We found that in vitro infection of whole PBMCs from healthy donors was productive of virus progeny. Results revealed that monocytes, as well as B and T lymphocytes, are susceptible to SARS-CoV-2 active infection and viral replication was indicated by detection of double-stranded RNA. Moreover, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from COVID-19 patients, and less frequently in CD4 + T lymphocytes. The rates of SARS-CoV-2-infected monocytes in PBMCs from COVID-19 patients increased over time from symptom onset. Additionally, SARS-CoV-2-positive monocytes and B and CD4+T lymphocytes were detected by immunohistochemistry in post mortem lung tissue. SARS-CoV-2 infection of blood circulating leukocytes in COVID-19 patients may have important implications for disease pathogenesis, immune dysfunction, and virus spread within the host.
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7
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Pontelli MC, Castro IA, Martins RB, Veras FP, Serra LL, Nascimento DC, Cardoso RS, Rosales R, Lima TM, Souza JP, Caetité DB, de Lima MHF, Kawahisa JT, Giannini MC, Bonjorno LP, Lopes MIF, Batah SS, Siyuan L, Assad RL, Almeida SCL, Oliveira FR, Benatti MN, Pontes LLF, Santana RC, Vilar FC, Martins MA, Cunha TM, Calado RT, Alves-Filho JC, Zamboni DS, Fabro A, Louzada-Junior P, Oliveira RDR, Cunha FQ, Arruda E. Infection of human lymphomononuclear cells by SARS-CoV-2. bioRxiv 2020. [PMID: 34013264 DOI: 10.1101/2020.01.07.896506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Although SARS-CoV-2 severe infection is associated with a hyperinflammatory state, lymphopenia is an immunological hallmark, and correlates with poor prognosis in COVID-19. However, it remains unknown if circulating human lymphocytes and monocytes are susceptible to SARS-CoV-2 infection. In this study, SARS-CoV-2 infection of human peripheral blood mononuclear cells (PBMCs) was investigated both in vitro and in vivo . We found that in vitro infection of whole PBMCs from healthy donors was productive of virus progeny. Results revealed that monocytes, as well as B and T lymphocytes, are susceptible to SARS-CoV-2 active infection and viral replication was indicated by detection of double-stranded RNA. Moreover, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from COVID-19 patients, and less frequently in CD4 + T lymphocytes. The rates of SARS-CoV-2-infected monocytes in PBMCs from COVID-19 patients increased over time from symptom onset. Additionally, SARS-CoV-2-positive monocytes and B and CD4+T lymphocytes were detected by immunohistochemistry in post mortem lung tissue. SARS-CoV-2 infection of blood circulating leukocytes in COVID-19 patients may have important implications for disease pathogenesis, immune dysfunction, and virus spread within the host.
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8
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Parra E, Jang M, Machado-Rugolo J, Farhat C, Nagai M, Takagaki T, Terra R, Fabro A, Capelozzi V. P1.14 Immune Profiling Data and Mutational Status Improves Prediction of Risk of Death in Non-Small Cell Lung Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Rugolo-Machado J, Fabro A, Farhat C, Parra E, Capelozzi V. P1.09-01 Immunoprofiling Depends on Molecular Determinants to Predict Metastases and Target Therapy in Non-Small Cell Lung Carcinomas. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Machado-Rugolo J, Fabro A, Rainho C, Farhat C, De Sa V, Herbst A, De Lima V, Parra E, Capelozzi V. P1.04-83 Combining Immune Gene Polymorphism and Immune Profile Predicts Brain Metastases and Death in a Brazilian Cohort of Non-Small Cell Lung Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Machado J, Ascheri D, Leao P, Milsoni P, Oliveira R, Parra E, Sá V, Farhat C, Rainho C, Ab'saber A, Nagai M, Takagaki T, Fabro A, Capelozzi V. P2.03b-034 Clinical Relevant Oncogenic Drivers in Advanced Adenocarcinoma Discloses New Therapeutic Targets in Negative EGFR/ALK/KRAS Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Antonângelo L, Tuma T, Fabro A, Acencio M, Terra R, Parra E, Vargas F, Takagaki T, Capelozzi V. Id-1, Id-2, and Id-3 co-expression correlates with prognosis in stage I and II lung adenocarcinoma patients treated with surgery and adjuvant chemotherapy. Exp Biol Med (Maywood) 2016; 241:1159-68. [PMID: 26869608 DOI: 10.1177/1535370216632623] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/22/2016] [Indexed: 12/25/2022] Open
Abstract
Inhibitors of DNA binding/inhibitors of differentiation (Id) protein family have been shown to be involved in carcinogenesis. However, the roles of Id during lung adenocarcinoma (ADC) progression remain unclear. Eighty-eight ADC samples were evaluated for Id-1,2,3 level and angiogenesis (CD 34 and VEGF microvessel density) by immunohistochemistry and morphometry. The impact of these markers was tested on follow-up until death or recurrence. A significant difference between tumor and normal tissue was found for Id-1,2,3 expression (P < 0.01). In addition, high levels of nuclear Id-1 were associated with higher angiogenesis in the tumor stroma (P < 0.01). Equally significant was the association between patients in T1-stage and low cytoplasmic Id-2, as well as patients in stage-IIb and low Id-3. High cytoplasm Id-3 expression was also directly associated to lymph nodes metastasis (P = 0.05). Patients at stages I to III, with low Id-1 and Id-3 cytoplasm histoscores showed significant long metastasis-free survival time than those with high Id-1 or Id-3 expression (P = 0.04). Furthermore, high MVD-CD34 and MVD-VEGF expression were associated with short recurrence-free survival compared to low MVD-CD34 and MVD-VEGF expressions (P = 0.04). Cox model analyses controlled for age, lymph node metastasis, and adjuvant treatments showed that nuclear Id-1, cytoplasmic Id-3, and MVD-CD34 were significantly associated with survival time. Median score for nuclear Id-1 and cytoplasmic Id-3 divided patients in two groups, being that those with increased Id-1 and Id-3 presented higher risk of death. Ids showed an independent prognostic value in patients with lung ADC, regardless of disease stage. Id-1 and Id-3 should be considered new target candidates in the development of personalized therapy in lung ADC.
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Affiliation(s)
- Leila Antonângelo
- Department of Pathology, University of Sao Paulo, Sao Paulo 01246903,Brazil
| | - Taila Tuma
- Department of Pathology, University of Sao Paulo, Sao Paulo 01246903,Brazil
| | - Alexandre Fabro
- Department of Pathology, University of Sao Paulo, Sao Paulo 01246903,Brazil
| | - Milena Acencio
- Pulmonary Division, Heart Institute Clinics Hospital, University of Sao Paulo, Sao Paulo 01246903, Brazil
| | - Ricardo Terra
- Pulmonary Division, Heart Institute Clinics Hospital, University of Sao Paulo, Sao Paulo 01246903, Brazil
| | - Edwin Parra
- Department of Pathology, University of Sao Paulo, Sao Paulo 01246903,Brazil
| | - Francisco Vargas
- Pulmonary Division, Heart Institute Clinics Hospital, University of Sao Paulo, Sao Paulo 01246903, Brazil
| | - Teresa Takagaki
- Pulmonary Division, Heart Institute Clinics Hospital, University of Sao Paulo, Sao Paulo 01246903, Brazil
| | - Vera Capelozzi
- Department of Pathology, University of Sao Paulo, Sao Paulo 01246903,Brazil
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Pessin A, Fracalossi T, Branco A, Fabro A, Gonçalves T, Martins R. MORPHOMETRIC ANALYSIS OF THE EPITELIUM AND THE PROPER BLADE OF THE VOCAL FOLDS OF AGED. Int Arch Otorhinolaryngol 2012. [DOI: 10.7162/s1809-9777201200s1o-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Martins RHG, Defaveri J, Custódio Domingues MA, de Albuquerque E Silva R, Fabro A. Vocal fold nodules: morphological and immunohistochemical investigations. J Voice 2009; 24:531-9. [PMID: 19853410 DOI: 10.1016/j.jvoice.2009.01.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Accepted: 01/06/2009] [Indexed: 11/18/2022]
Abstract
The objective of this study was to investigate the morphological and immunohistochemical characteristics of vocal fold nodules. The study design was prospective and retrospective. For the histological study, we reviewed 15 slides from the surgical cases of vocal fold nodules, in which we analyzed epithelium, basal membrane (bm), and lamina propria. For the transmission and scanning electron microscopy (TEM, SEM) studies, five new cases on vocal fold nodules were included. Immunohistochemistry study was carried out in the 15 specimens, using antifibronectin, antilaminin, and anticollagen IV antibodies. The main histological alterations were epithelial hyperplasia (73.33%), basement membrane thickening (86.66%), edema, and fibrosis (93.33%). SEM--reduction in mucous lacing and increase in the desquamating cells, without epithelial erosion. TEM--hyperplasia of the epithelium, enlargement of the intercellular junctions, which was filled by fluid, subepithelial thickening of the lamina reticularis, and break points in the basal membrane. Immunohistochemistry--we identified greater immunoexpression of fibronectin on the basal membrane, on the lamina propria, and around the vessels. Antilaminin and anticollagen IV antibodies showed higher pigmentation on the endothelium of the vessels than that on the basal membrane. In vocal fold nodules, combined assessment using light microscopy, electron microscopy, and immunohistochemistry can reveal important morphological details useful in characterizing these lesions.
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Affiliation(s)
- Regina Helena Garcia Martins
- Department of Otorhinolaryngology, Ophthalmology and Head and Neck Surgery, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil.
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