1
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Murphy SL, Halvorsen B, Holter JC, Huse C, Tveita A, Trøseid M, Hoel H, Kildal AB, Holten AR, Lerum TV, Skjønsberg OH, Michelsen AE, Aaløkken TM, Tonby K, Lind A, Dudman S, Granerud BK, Heggelund L, Bøe S, Dyrholt-Riise AM, Aukrust P, Barratt-Due A, Ueland T, Dahl TB. Circulating markers of extracellular matrix remodelling in severe COVID-19 patients. J Intern Med 2023; 294:784-797. [PMID: 37718572 DOI: 10.1111/joim.13725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Abnormal remodelling of the extracellular matrix (ECM) has generally been linked to pulmonary inflammation and fibrosis and may also play a role in the pathogenesis of severe COVID-19. To further elucidate the role of ECM remodelling and excessive fibrogenesis in severe COVID-19, we examined circulating levels of mediators involved in various aspects of these processes in COVID-19 patients. METHODS Serial blood samples were obtained from two cohorts of hospitalised COVID-19 patients (n = 414). Circulating levels of ECM remodelling mediators were quantified by enzyme immunoassays in samples collected during hospitalisation and at 3-month follow-up. Samples were related to disease severity (respiratory failure and/or treatment at the intensive care unit), 60-day total mortality and pulmonary pathology after 3-months. We also evaluated the direct effect of inactivated SARS-CoV-2 on the release of the different ECM mediators in relevant cell lines. RESULTS Several of the measured markers were associated with adverse outcomes, notably osteopontin (OPN), S100 calcium-binding protein A12 and YKL-40 were associated with disease severity and mortality. High levels of ECM mediators during hospitalisation were associated with computed tomography thorax pathology after 3-months. Some markers (i.e. growth differential factor 15, galectin 3 and matrix metalloproteinase 9) were released from various relevant cell lines (i.e. macrophages and lung cell lines) in vitro after exposure to inactivated SARS-CoV-2 suggesting a direct link between these mediators and the causal agent of COVID-19. CONCLUSION Our findings highlight changes to ECM remodelling and particularly a possible role of OPN, S100A12 and YKL-40 in the pathogenesis of severe COVID-19.
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Affiliation(s)
- Sarah Louise Murphy
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jan Cato Holter
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Camilla Huse
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders Tveita
- Department of Internal Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
- Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Department of Internal Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anders Benjamin Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UIT - The Arctic University of Norway, Tromsø, Norway
| | - Aleksander Rygh Holten
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Tøri Vigeland Lerum
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Ole Henning Skjønsberg
- Department of Internal Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Radiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trond M Aaløkken
- Department of Internal Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway
| | - Kristian Tonby
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway
| | - Andreas Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Susanne Dudman
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Beathe Kiland Granerud
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Lars Heggelund
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Simen Bøe
- Department of Anesthesiology and Intensive Care, Hammerfest County Hospital, Hammerfest, Norway
| | - Anne Ma Dyrholt-Riise
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Andreas Barratt-Due
- Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo, Norway
- Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Thrombosis Research Center (TREC), Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Tuva Børresdatter Dahl
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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2
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Thudium RF, Arentoft NS, Hoel H, Afzal S, von Stemann JH, Forman JL, Wilcke JT, Benfield T, Trøseid M, Borges ÁH, Ostrowski SR, Vestbo J, Kunisaki KM, Jensen JUS, Nielsen SD. Elevated Levels of Interleukin-1β and Interleukin-10 Are Associated With Faster Lung Function Decline in People With Well-Treated Human Immunodeficiency Virus. J Infect Dis 2023; 228:1080-1088. [PMID: 37366576 DOI: 10.1093/infdis/jiad233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/05/2023] [Accepted: 06/25/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND People with human immunodeficiency virus (PWH) have an increased risk of chronic lung diseases and chronic inflammation. We aimed to investigate if inflammatory markers and monocyte activation are associated with faster lung function decline in PWH. METHODS We included 655 PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study. Eligible participants were aged ≥25 years and had 2 spirometries separated by >2 years. Inflammatory markers (interleukin [IL]-1β, IL-2, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ) were measured at baseline by Luminex, and soluble CD14 and soluble CD163 by enzyme-linked immunosorbent assay. Using linear mixed models, we investigated whether elevated cytokine levels were associated with faster lung function decline. RESULTS The majority of PWH were males (85.2%) with undetectable viral replication (95.3%). We found a faster decline in forced expiratory volume in 1 second (FEV1) in PWH with elevated IL-1β and IL-10, with an additional decline of 10.3 mL/year (95% confidence interval [CI], 2.1-18.6; P = .014) and 10.0 mL/year (95% CI, 1.8-18.2; P = .017), respectively. We found no interaction between smoking and IL-1β or IL-10 on FEV1 decline. CONCLUSIONS Elevated IL-1β and IL-10 were independently associated with faster lung function decline in PWH, suggesting that dysregulated systemic inflammation may play a role in the pathogenesis of chronic lung diseases.
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Affiliation(s)
- Rebekka F Thudium
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Nicoline S Arentoft
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Hedda Hoel
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Shoaib Afzal
- The Copenhagen General Population Study, Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Herlev
- Department of Clinical Medicine, Faculty of Health and Medical Sciences
| | | | - Julie L Forman
- Department of Public Health, Section of Biostatistics, University of Copenhagen
| | - Jon T Wilcke
- Department of Respiratory Medicine, Herlev-Gentofte Hospital, Gentofte
| | - Thomas Benfield
- Department of Clinical Medicine, Faculty of Health and Medical Sciences
- Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre Hospital, Hvidovre
| | - Marius Trøseid
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Álvaro H Borges
- Department of Infectious Diseases Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Sciences
- Department of Clinical Immunology, Rigshospitalet
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Ken M Kunisaki
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jens-Ulrik S Jensen
- Department of Respiratory Medicine, Herlev-Gentofte Hospital, Gentofte
- Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre Hospital, Hvidovre
| | - Susanne D Nielsen
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences
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3
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Trøseid M, Arribas JR, Assoumou L, Holten AR, Poissy J, Terzić V, Mazzaferri F, Baño JR, Eustace J, Hites M, Joannidis M, Paiva JA, Reuter J, Püntmann I, Patrick-Brown TDJH, Westerheim E, Nezvalova-Henriksen K, Beniguel L, Dahl TB, Bouscambert M, Halanova M, Péterfi Z, Tsiodras S, Rezek M, Briel M, Ünal S, Schlegel M, Ader F, Lacombe K, Amdal CD, Rodrigues S, Tonby K, Gaudet A, Heggelund L, Mootien J, Johannessen A, Møller JH, Pollan BD, Tveita AA, Kildal AB, Richard JC, Dalgard O, Simensen VC, Baldé A, de Gastines L, del Álamo M, Aydin B, Lund-Johansen F, Trabaud MA, Diallo A, Halvorsen B, Røttingen JA, Tacconelli E, Yazdanpanah Y, Olsen IC, Costagliola D, Dyrhol-Riise AM, Stiksrud B, Jenum S, MacPherson ME, Aarskog NR, Røstad K, Skeie LG, Dahl Å, Steen JK, Nur S, Segers F, Korsan KA, Sethupathy A, Sandstå AJ, Paulsen GJ, Ueland T, Michelsen A, Aukrust P, Berdal JE, Melkeraaen I, Tollefsen MM, Andreassen J, Dokken J, Müller KE, Woll BM, Opsand H, Bogen M, Rød LT, Steinsvik T, Åsheim-Hansen B, Bjerkreim RH, Berg Å, Moen S, Kvalheim S, Strand K, Gravrok B, Skogen V, Lorentzen EM, Schive SW, Rossvoll L, Hoel H, Engebråten S, Martinsson MS, Thallinger M, Ådnanes E, Hannula R, Bremnes N, Liyanarachi K, Ehrnström B, Kvalshaug M, Berge K, Bygdås M, Gustafsson L, AballiB S, Strand M, Andersen B, Aukrust P, Barratt-Due A, Henriksen KN, Kåsine T, Dyrhol-Riise AM, Berdal JE, Favory R, Nseir S, Preau S, Jourdain M, Ledoux G, Durand A, Houard M, Moreau AS, Rouzé A, Tortuyaux R, Degouy G, Levy C, Liu V, Dognon N, Mariller L, Delcourte C, Reguig Z, Cerf A, Cuvelliez M, Kipnis E, Boyer-Beysserre M, Bignon A, Parmentier L, Meddour D, Frade S, Timsit JF, Peiffer-Smadja N, Wicky PH, De Montmollin E, Bouadma L, Dessajan J, Sonneville R, Patrier J, Presente S, Sylia Z, Rioux C, Thy M, Collias L, Bouaraba Y, Dobremel N, Dureau AF, Oudeville P, Pointurier V, Rabouel Y, Stiel L, Alzina C, Ramstein C, Ait-Oufella H, Hamoudi F, Urbina T, Zerbib Y, Maizel J, Wilpotte C, Piroth L, Blot M, Sixt T, Moretto F, Charles C, Gohier S, Roux D, Le Breton C, Gernez C, Thiry I, Baboi L, Malvy D, Boyer A, Perreau P, Armellini M, De Luca G, Di Pietro OSMM, Romanin B, Brogi M, Castelli F, Amadasi S, Barchiesi F, Canovari B, Coppola N, Pisaturo M, Russo A, Occhiello L, Cataldo F, Rillo MM, Queiruga J, Seco E, Stewart S, Borobia AM, Moraga P, Prieto R, García I, Rivera C, Narro JL, Chacón N, de la Rosa S, Macías M, Barrera L, Serna A, Palomo V, Sánchez MIG, Gutiérrez D, Campos AS, Garfia MÁG, Toyos EB, Cabrera JS, Lucena MI, Lapique EL, Englert P, Khalil Z, Jacobs F, Malaise J, Mukangenzi O, Smissaert C, Hildebrand M, Martiny D, Vervacke A, Scarnière A, Yin N, Michel C, Seyler L, Allard S, Van Laethem J, Verschelden G, Meeuwissen A, De Waele A, Van Buggenhout V, Monteyne D, Noppe N, Belkhir L, Yombi JC, De Greef J, Mesland JB, De Ghellinck L, Kin V, D’Aoust C, Bouvier A, Dekeister AC, Hawia E, Gaillet A, Deshorme H, Halleux S, Galand V, Roncon-Albuquerque R, Santos LL, Vieira CB, Magalhaes R, Ferreira S, Bernardo M, Jackson A, Sadlier C, O’Connell S, Blair M, Manning E, Cusack F, Kelly N, Stephenson H, Keane R, Murphy A, Cunnane M, Keane F, O’Regan MC, de Barra E, Bellone AM, O’Regan S, Carey P, Harte J, Coakley P, Heeney A, Ryan D, Curley G, McConkey S, Sulaiman I, Costello R, McNally C, Foley C, Trainor S, Jacob B, Vengathodi S, Kent B, Bergin C, Townsend L, Kerr C, Panti N, Sanz AG, Benny B, Dea EO, Galvin N, Burke C, Galvin A, Aisiyabi S, Lobo D, Laffey J, McNicolas B, Cosgrave D, Sheehan JR, Nita C, Hanley C, Kelly C, Kernan M, Murray J, Staub T, Henin T, Damilot G, Bintener T, Colling J, Ferretti C, Werer C, Stammet P, Braquet P, Arendt V, Calvo E, Michaux C, Mediouni C, Znati A, Montanes G, Garcia L, Thomé C, Breitkopf R, Peer A, Lehner G, Bellman R, Ditlbacher A, Finkenstedt A, Zotter K, Hernandez CP, Rajsic S, Lanthaler B, Greil R, Tamás K, Kovácsné-Levang S, Sipos D, Kappéter A, Halda-Kiss B, Madarassi-Papp E, Hajdu E, Bende B, Konstantinos T, Moschopoulos C, Labrou E, Tsakona M, Grigoropoulos I, Kotanidou A, Fragkou P, Theodorakopoulou M, Pantazi E, Jahai E, Moukouli M, Siafakas D, Mühlbauer B, Dembinski R, Stich K, Schneider G, Nagy A, Grodová K, Kubelová M, Součková L, Švábová HK, Demlová R, Sonderlichová S, Unal S, Inkaya AC, de Bono S, Kartman CE, Adams DH, Crowe B, Yazdanapanah Y, Unal S, Schneider G, Mühlbauer B, Ødegård T, Bakkehøi G, Autran B, Bjørås M, Lambellerie XD, Mezzarri F, Guedj J, Esperou H, Lumbroso J, Welte T, Calmy A, Pischke S, Treweek S, Goetghebeur E, Doussau A, Weiss L, Hulstaert F, Botgros R, del Alamo M, Chung F, Lumbroso J, Zeitlinger M, Escalera BN, Csajka C, Williams C, Amstutz A, Rüegg CS, Burdet C, Massonnaud C, Belhadi D, Mentré F, Aroun M, Mentré F, Ehrmann S, Espoerou H, Burdet C, Falk RS, Bjordal K, Bakkehøi G, Ødegård T, Barratt-Due A. Efficacy and safety of baricitinib in hospitalized adults with severe or critical COVID-19 (Bari-SolidAct): a randomised, double-blind, placebo-controlled phase 3 trial. Crit Care 2023; 27:9. [PMID: 36627655 PMCID: PMC9830601 DOI: 10.1186/s13054-022-04205-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-controlled trials have focused specifically on severe/critical COVID, including vaccinated participants. METHODS Bari-SolidAct is a phase-3, multicentre, randomised, double-blind, placebo-controlled trial, enrolling participants from June 3, 2021 to March 7, 2022, stopped prematurely for external evidence. Patients with severe/critical COVID-19 were randomised to Baricitinib 4 mg once daily or placebo, added to standard of care. The primary endpoint was all-cause mortality within 60 days. Participants were remotely followed to day 90 for safety and patient related outcome measures. RESULTS Two hundred ninety-nine patients were screened, 284 randomised, and 275 received study drug or placebo and were included in the modified intent-to-treat analyses (139 receiving baricitinib and 136 placebo). Median age was 60 (IQR 49-69) years, 77% were male and 35% had received at least one dose of SARS-CoV2 vaccine. There were 21 deaths at day 60 in each group, 15.1% in the baricitinib group and 15.4% in the placebo group (adjusted absolute difference and 95% CI - 0.1% [- 8·3 to 8·0]). In sensitivity analysis censoring observations after drug discontinuation or rescue therapy (tocilizumab/increased steroid dose), proportions of death were 5.8% versus 8.8% (- 3.2% [- 9.0 to 2.7]), respectively. There were 148 serious adverse events in 46 participants (33.1%) receiving baricitinib and 155 in 51 participants (37.5%) receiving placebo. In subgroup analyses, there was a potential interaction between vaccination status and treatment allocation on 60-day mortality. In a subsequent post hoc analysis there was a significant interaction between vaccination status and treatment allocation on the occurrence of serious adverse events, with more respiratory complications and severe infections in vaccinated participants treated with baricitinib. Vaccinated participants were on average 11 years older, with more comorbidities. CONCLUSION This clinical trial was prematurely stopped for external evidence and therefore underpowered to conclude on a potential survival benefit of baricitinib in severe/critical COVID-19. We observed a possible safety signal in vaccinated participants, who were older with more comorbidities. Although based on a post-hoc analysis, these findings warrant further investigation in other trials and real-world studies. Trial registration Bari-SolidAct is registered at NCT04891133 (registered May 18, 2021) and EUClinicalTrials.eu ( 2022-500385-99-00 ).
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Affiliation(s)
- Marius Trøseid
- grid.55325.340000 0004 0389 8485Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - José R. Arribas
- grid.81821.320000 0000 8970 9163Infectious Diseases Unit, Internal Medicine Department, La Paz University Hospital, IdiPAZ, Madrid, Spain ,grid.512890.7Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Lambert Assoumou
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - Aleksander Rygh Holten
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Julien Poissy
- grid.503422.20000 0001 2242 6780Lille University, Lille, France/CHU Lille - Hôpital Roger Salengro, Lille, France ,grid.457369.aL’Institut National de La Santé Et de La Recherche Médicale (Inserm), Paris, France
| | - Vida Terzić
- Maladies Infectieuses Emergentes, 75015 Paris, France ,grid.7429.80000000121866389Institut National de La Santé Et de La Recherche Médicale, INSERM, 75013 Paris, France
| | - Fulvia Mazzaferri
- grid.5611.30000 0004 1763 1124Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jesús Rodríguez Baño
- grid.411375.50000 0004 1768 164XDepartment of Medicine, Virgen Macarena University Hospital, Seville, Spain ,grid.9224.d0000 0001 2168 1229University of Sevilla and Biomedicines Institute of Seville (IBiS)/CSIC, Seville, Spain ,grid.413448.e0000 0000 9314 1427CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Joe Eustace
- grid.7872.a0000000123318773University College Cork, Cork, Ireland
| | - Maya Hites
- grid.412157.40000 0000 8571 829XBrussels University Hospital-Erasme, Brussels, Belgium ,grid.4989.c0000 0001 2348 0746Université Libre de Bruxelles, Brussels, Belgium
| | - Michael Joannidis
- grid.5361.10000 0000 8853 2677Medical University Innsbruck, Innsbruck, Austria
| | - José-Artur Paiva
- grid.414556.70000 0000 9375 4688Intensive Care Medicine Department, Centro Hospitalar Universitário Sao Joao, Porto, Portugal ,grid.5808.50000 0001 1503 7226Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Reuter
- grid.418041.80000 0004 0578 0421Centre Hospitalier de Luxembourg, Service de Réanimation-Soins Intensifs, 1210 Luxembourg, Luxembourg
| | - Isabel Püntmann
- Institute of Pharmacology, Hospital Group Gesundheit Nord gGmbH, Bremen, Germany
| | - Thale D. J. H. Patrick-Brown
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Elin Westerheim
- grid.55325.340000 0004 0389 8485Section for Monitoring, Clinical Trial Unit (CTU), Oslo University Hospital, Oslo, Norway
| | - Katerina Nezvalova-Henriksen
- grid.55325.340000 0004 0389 8485Department of Haematology, Oslo University Hospital and Oslo Hospital Pharmacy, Oslo, Norway
| | - Lydie Beniguel
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - Tuva Børresdatter Dahl
- grid.55325.340000 0004 0389 8485Research Institute for Internal Medicine, Oslo University Hospital, Oslo, Norway ,grid.55325.340000 0004 0389 8485Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Maude Bouscambert
- grid.413852.90000 0001 2163 3825Laboratoire de Virologie, Institut Des Agents Infectieux de Lyon, Centre National de Reference Des Virus Des Infections Respiratoires France Sud, Hospices Civils de Lyon, 69317 Lyon, France
| | - Monika Halanova
- grid.11175.330000 0004 0576 0391Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovakia
| | - Zoltán Péterfi
- grid.9679.10000 0001 0663 94791St Department of Internal Medicine, Division of Infectology, University of Pécs, Pécs, Hungary
| | - Sotirios Tsiodras
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens, Athens, Greece ,grid.411449.d0000 0004 0622 4662University Hospital of Athens Attikon, Athens, Greece
| | - Michael Rezek
- grid.412554.30000 0004 0609 2751St. Anne University Hospital, Brno, Czech Republic
| | - Matthias Briel
- grid.410567.1Swiss Clinical Trial Organisation and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Serhat Ünal
- grid.411920.f0000 0004 0642 1084Hacettepe University Hospital, Ankara, Turkey
| | - Martin Schlegel
- grid.6936.a0000000123222966Department of Anesthesiology and Intensive Care Medicine, Klinikum Rechts Der Isar, Technische Universität München, Munich, Germany
| | - Florence Ader
- grid.413852.90000 0001 2163 3825Hospices Civils de Lyon, Département Des Maladies Infectieuses Et Tropicales, 69004 Lyon, France ,grid.15140.310000 0001 2175 9188Centre International de Recherche en Infectiologie (CIRI), Inserm 1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Univ Lyon, 69007 Lyon, France
| | - Karine Lacombe
- grid.7429.80000000121866389Sorbonne Université, Institut Pierre-Louis d’Épidemiologie Et de Santé Publique, INSERM, 75013 Paris, France ,grid.412370.30000 0004 1937 1100APHP, Hôpital Saint-Antoine, Service de Maladies Infectieuses Et Tropicales, 75012 Paris, France
| | - Cecilie Delphin Amdal
- grid.55325.340000 0004 0389 8485Research support service and Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Serge Rodrigues
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - Kristian Tonby
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Deptartment of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Alexandre Gaudet
- grid.410463.40000 0004 0471 8845Critical Care Center, Department of Intensive Care Medicine, CHU Lille, 59000 Lille, France ,grid.503422.20000 0001 2242 6780Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d’Infection Et d’Immunité de Lille, 59000 Lille, France
| | - Lars Heggelund
- grid.459157.b0000 0004 0389 7802Medical Department, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway ,grid.7914.b0000 0004 1936 7443Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Joy Mootien
- grid.414085.c0000 0000 9480 048XService, de Réanimation Médiale, GHRMSA Hopital Emile Muller, Mulhouse, France
| | - Asgeir Johannessen
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.417292.b0000 0004 0627 3659Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jannicke Horjen Møller
- grid.412835.90000 0004 0627 2891Department of Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Beatriz Diaz Pollan
- grid.81821.320000 0000 8970 9163Infectious Diseases Unit, Internal Medicine Department, La Paz University Hospital, Madrid, Spain ,grid.81821.320000 0000 8970 9163Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), IdiPAZ, Madrid, Spain
| | - Anders Aune Tveita
- grid.414168.e0000 0004 0627 3595Department of Medicine, Bærum Hospital, Vestre Viken, Bærum, Norway
| | - Anders Benjamin Kildal
- grid.412244.50000 0004 4689 5540Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Jean-Christophe Richard
- grid.413306.30000 0004 4685 6736Service de Médecine Intensive-Réanimation, Hôpital de La Croix - Rousse - HCL, Lyon, France ,grid.7429.80000000121866389CREATIS INSERM U1206-CNRS UMR 5220, Lyon, France
| | - Olav Dalgard
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.411279.80000 0000 9637 455XAkershus University Hospital, Lørenskog, Norway
| | - Victoria Charlotte Simensen
- grid.418193.60000 0001 1541 4204Division of Health Services, Department of Global Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Aliou Baldé
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - Lucie de Gastines
- Maladies Infectieuses Emergentes, 75015 Paris, France ,grid.7429.80000000121866389Institut National de La Santé Et de La Recherche Médicale, INSERM, 75013 Paris, France
| | | | - Burç Aydin
- grid.55325.340000 0004 0389 8485Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Fridtjof Lund-Johansen
- grid.55325.340000 0004 0389 8485Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Mary-Anne Trabaud
- grid.134996.00000 0004 0593 702XLaboratoire de Virologie, Institut Des Agents Infectieux de Lyon, Centre National de Reference Des Virus Respiratoires France Sud, 69317 Hospices Civils de LyonLyon, France
| | - Alpha Diallo
- Maladies Infectieuses Emergentes, 75015 Paris, France ,grid.7429.80000000121866389Institut National de La Santé Et de La Recherche Médicale, INSERM, 75013 Paris, France
| | - Bente Halvorsen
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - John-Arne Røttingen
- grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway
| | - Evelina Tacconelli
- grid.5611.30000 0004 1763 1124Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy ,grid.411475.20000 0004 1756 948XVerona University Hospital, Verona, Italy
| | - Yazdan Yazdanpanah
- grid.512950.aUniversité de Paris, IAME, INSERM, 75018 Paris, France ,grid.411119.d0000 0000 8588 831XAP-HP, Hôpital Bichat, Service de Maladies Infectieuses Et Tropicales, 75018 Paris, France
| | - Inge C. Olsen
- grid.55325.340000 0004 0389 8485Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | - Dominique Costagliola
- grid.7429.80000000121866389Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie Et de Santé Publique (IPLESP), Paris, France
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4
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Olsen MB, Huse C, de Sousa MML, Murphy SL, Sarno A, Obermann TS, Yang K, Holter JC, Jørgensen MJ, Christensen EE, Wang W, Ji P, Heggelund L, Hoel H, Dyrhol-Riise AM, Gregersen I, Aukrust P, Bjørås M, Halvorsen B, Dahl TB. DNA Repair Mechanisms are Activated in Circulating Lymphocytes of Hospitalized Covid-19 Patients. J Inflamm Res 2022; 15:6629-6644. [PMID: 36514358 PMCID: PMC9741826 DOI: 10.2147/jir.s379331] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Reactive oxygen species (ROS) are an important part of the inflammatory response during infection but can also promote DNA damage. Due to the sustained inflammation in severe Covid-19, we hypothesized that hospitalized Covid-19 patients would be characterized by increased levels of oxidative DNA damage and dysregulation of the DNA repair machinery. Patients and Methods Levels of the oxidative DNA lesion 8-oxoG and levels of base excision repair (BER) proteins were measured in peripheral blood mononuclear cells (PBMC) from patients (8-oxoG, n = 22; BER, n = 17) and healthy controls (n = 10) (Cohort 1). Gene expression related to DNA repair was investigated in two independent cohorts of hospitalized Covid-19 patients (Cohort 1; 15 patents and 5 controls, Cohort 2; 15 patients and 6 controls), and by publicly available datasets. Results Patients and healthy controls showed comparable amounts of oxidative DNA damage as assessed by 8-oxoG while levels of several BER proteins were increased in Covid-19 patients, indicating enhanced DNA repair in acute Covid-19 disease. Furthermore, gene expression analysis demonstrated regulation of genes involved in BER and double strand break repair (DSBR) in PBMC of Covid-19 patients and expression level of several DSBR genes correlated with the degree of respiratory failure. Finally, by re-analyzing publicly available data, we found that the pathway Hallmark DNA repair was significantly more regulated in circulating immune cells during Covid-19 compared to influenza virus infection, bacterial pneumonia or acute respiratory infection due to seasonal coronavirus. Conclusion Although beneficial by protecting against DNA damage, long-term activation of the DNA repair machinery could also contribute to persistent inflammation, potentially through mechanisms such as the induction of cellular senescence. However, further studies that also include measurements of additional markers of DNA damage are required to determine the role and precise molecular mechanisms for DNA repair in SARS-CoV-2 infection.
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Affiliation(s)
- Maria Belland Olsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Camilla Huse
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mirta Mittelstedt Leal de Sousa
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway,Proteomics and Modomics Experimental Core Facility (PROMEC), NTNU, Trondheim, Norway
| | - Sarah Louise Murphy
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Antonio Sarno
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway,Department of Fisheries and New Biomarine Industry, SINTEF Ocean, Trondheim, Norway
| | - Tobias Sebastian Obermann
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kuan Yang
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Jan Cato Holter
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Microbiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Marte Jøntvedt Jørgensen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Erik Egeland Christensen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Wei Wang
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ping Ji
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Heggelund
- Department of Internal Medicine, Vestre Viken Hospital Trust, Drammen, Norway,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anne Margarita Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Ida Gregersen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway,Department of Microbiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tuva Børresdatter Dahl
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway,Correspondence: Tuva Børresdatter Dahl, Division of Critical Care and Emergencies and Research Institute of Internal Medicine, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway, Tel +4723072786, Email
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5
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Gregersen I, Ueland T, Holter JC, Olsen MB, Michelsen AE, Murphy SL, Tveita AA, Henriksen KN, Hoel H, Nordberg LB, Holten AR, Edvardsen T, Yang K, Heggelund L, Trøseid M, Müller F, Kildal AB, Dyrhol-Riise AM, Barratt-Due A, Dahl TB, Aukrust P, Halvorsen B. CXCL16 associates with adverse outcome and cardiac involvement in hospitalized patients with Covid-19. J Infect 2022; 85:702-769. [PMID: 36216188 PMCID: PMC9546500 DOI: 10.1016/j.jinf.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Ida Gregersen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Corresponding author
| | - Thor Ueland
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway
| | - Jan Cato Holter
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Department of Microbiology, Oslo University Hospital, Oslo 0424, Norway
| | - Maria Belland Olsen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway
| | - Annika E Michelsen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway
| | - Sarah L Murphy
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway
| | - Anders Aune Tveita
- Department of Internal Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum 1346, Norway,Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo 0424, Norway
| | - Katerina Nezvalova Henriksen
- Department of Hematology, Oslo University Hospital, Oslo, Norway,Hospital Pharmacies, South-Eastern Norway Enterprise, Oslo, Norway
| | - Hedda Hoel
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Aleksander Rygh Holten
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Kuan Yang
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway
| | - Lars Heggelund
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen 3004, Norway,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen 5009, Norway
| | - Marius Trøseid
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Fredrik Müller
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Department of Microbiology, Oslo University Hospital, Oslo 0424, Norway
| | - Anders Benjamin Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Anne Ma Dyrhol-Riise
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Department of Infectious Diseases, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Andreas Barratt-Due
- Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo 0424, Norway,Department of Anaesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway
| | - Tuva B Dahl
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Pål Aukrust
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Bente Halvorsen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo 0027, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway
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6
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Trøseid M, Dahl TB, Holter JC, Kildal AB, Murphy SL, Yang K, Quiles-Jiménez A, Heggelund L, Müller KE, Tveita A, Michelsen AE, Bøe S, Holten AR, Hoel H, Mathiessen A, Aaløkken TM, Fevang B, Granerud BK, Tonby K, Henriksen KN, Lerum TV, Müller F, Skjønsberg OH, Barratt-Due A, Dyrhol-Riise AM, Aukrust P, Halvorsen B, Ueland T. Persistent T-cell exhaustion in relation to prolonged pulmonary pathology and death after severe COVID-19: Results from two Norwegian cohort studies. J Intern Med 2022; 292:816-828. [PMID: 35982589 PMCID: PMC9805032 DOI: 10.1111/joim.13549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND T-cell activation is associated with an adverse outcome in COVID-19, but whether T-cell activation and exhaustion relate to persistent respiratory dysfunction and death is unknown. OBJECTIVES To investigate whether T-cell activation and exhaustion persist and are associated with prolonged respiratory dysfunction and death after hospitalization for COVID-19. METHODS Plasma and serum from two Norwegian cohorts of hospitalized patients with COVID-19 (n = 414) were analyzed for soluble (s) markers of T-cell activation (sCD25) and exhaustion (sTim-3) during hospitalization and follow-up. RESULTS Both markers were strongly associated with acute respiratory failure, but only sTim-3 was independently associated with 60-day mortality. Levels of sTim-3 remained elevated 3 and 12 months after hospitalization and were associated with pulmonary radiological pathology after 3 months. CONCLUSION Our findings suggest prolonged T-cell exhaustion is an important immunological sequela, potentially related to long-term outcomes after severe COVID-19.
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Affiliation(s)
- Marius Trøseid
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tuva B Dahl
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Jan C Holter
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Anders B Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Sarah L Murphy
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kuan Yang
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Ana Quiles-Jiménez
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Lars Heggelund
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Karl Erik Müller
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Anders Tveita
- Department of Internal Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.,Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Annika E Michelsen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Simen Bøe
- Department of Anesthesiology and Intensive Care, Hammerfest County Hospital, Hammerfest, Norway
| | - Aleksander R Holten
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Hedda Hoel
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Department of Internal Medicine, Lovisenberg Diakonal Hospital, Oslo, Norway
| | | | - Trond M Aaløkken
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Børre Fevang
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Beathe K Granerud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Kristian Tonby
- Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway
| | - Katerina N Henriksen
- Hospital Pharmacies, South-Eastern Norway Enterprise, Oslo, Norway.,Department of Hematology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tøri V Lerum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Fredrik Müller
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Ole H Skjønsberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Andreas Barratt-Due
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway.,Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Anne M Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital Ullevål, Oslo, Norway
| | - Pål Aukrust
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Medicine, Thrombosis Research and Expertise Center (TREC), UiT-The Arctic University of Norway, Tromsø, Norway
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7
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Vestad B, Ueland T, Lerum TV, Dahl TB, Holm K, Barratt-Due A, Kåsine T, Dyrhol-Riise AM, Stiksrud B, Tonby K, Hoel H, Olsen IC, Henriksen KN, Tveita A, Manotheepan R, Haugli M, Eiken R, Berg Å, Halvorsen B, Lekva T, Ranheim T, Michelsen AE, Kildal AB, Johannessen A, Thoresen L, Skudal H, Kittang BR, Olsen RB, Ystrøm CM, Skei NV, Hannula R, Aballi S, Kvåle R, Skjønsberg OH, Aukrust P, Hov JR, Trøseid M. Respiratory dysfunction three months after severe COVID-19 is associated with gut microbiota alterations. J Intern Med 2022; 291:801-812. [PMID: 35212063 PMCID: PMC9115297 DOI: 10.1111/joim.13458] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although coronavirus disease 2019 (COVID-19) is primarily a respiratory infection, mounting evidence suggests that the gastrointestinal tract is involved in the disease, with gut barrier dysfunction and gut microbiota alterations being related to disease severity. Whether these alterations persist and are related to long-term respiratory dysfunction remains unknown. METHODS Plasma was collected during hospital admission and after 3 months from the NOR-Solidarity trial (n = 181) and analyzed for markers of gut barrier dysfunction and inflammation. At the 3-month follow-up, pulmonary function was assessed by measuring the diffusing capacity of the lungs for carbon monoxide (DLCO ). Rectal swabs for gut microbiota analyses were collected (n = 97) and analyzed by sequencing the 16S rRNA gene. RESULTS Gut microbiota diversity was reduced in COVID-19 patients with respiratory dysfunction, defined as DLCO below the lower limit of normal 3 months after hospitalization. These patients also had an altered global gut microbiota composition, with reduced relative abundance of 20 bacterial taxa and increased abundance of five taxa, including Veillonella, potentially linked to fibrosis. During hospitalization, increased plasma levels of lipopolysaccharide-binding protein (LBP) were strongly associated with respiratory failure, defined as pO2 /fiO2 (P/F ratio) <26.6 kPa. LBP levels remained elevated during and after hospitalization and were associated with low-grade inflammation and respiratory dysfunction after 3 months. CONCLUSION Respiratory dysfunction after COVID-19 is associated with altered gut microbiota and persistently elevated LBP levels. Our results should be regarded as hypothesis generating, pointing to a potential gut-lung axis that should be further investigated in relation to long-term pulmonary dysfunction and long COVID.
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Affiliation(s)
- Beate Vestad
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tøri Vigeland Lerum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Tuva Børresdatter Dahl
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Kristian Holm
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Andreas Barratt-Due
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway.,Division of Laboratory Medicine, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Trine Kåsine
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Anne Ma Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Birgitte Stiksrud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Kristian Tonby
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Inge Christoffer Olsen
- Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | - Katerina Nezvalova Henriksen
- Department of Haematology, Oslo University Hospital, Oslo, Norway.,Hospital Pharmacies, South-Eastern Norway Enterprise, Oslo, Norway
| | - Anders Tveita
- Medical Department, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Mette Haugli
- Department of Infectious Diseases, Sørlandet Hospital SSK, Kristiansand, Norway
| | - Ragnhild Eiken
- Department of Infectious Diseases, Innlandet Hospital Trust, Lillehammer, Norway
| | - Åse Berg
- Department of Infectious Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Trine Ranheim
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Annika Elisabeth Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders Benjamin Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Asgeir Johannessen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| | - Lars Thoresen
- Department of Medicine, Ringerike Hospital, Vestre Viken Hospital Trust, Ringerike, Norway
| | - Hilde Skudal
- Division of Infectious Diseases, Telemark Hospital Trust, Skien, Norway
| | | | | | | | - Nina Vibeche Skei
- Department of Anesthesia and Intensive Care, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Raisa Hannula
- Department of Infectious Diseases, Trondheim University Hospital, Trondheim, Norway
| | - Saad Aballi
- Department of Infectious Diseases, Østfold Hospital Kalnes, Grålum, Norway
| | - Reidar Kvåle
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Ole Henning Skjønsberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Johannes Roksund Hov
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
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8
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Kåsine T, Dyrhol-Riise AM, Barratt-Due A, Kildal AB, Olsen IC, Nezvalova-Henriksen K, Lund-Johansen F, Hoel H, Holten AR, Tveita A, Mathiessen A, Haugli M, Eiken R, Berg Å, Johannessen A, Heggelund L, Dahl TB, Halvorsen B, Mielnik P, Le LAK, Thoresen L, Ernst G, Hoff DAL, Skudal H, Kittang BR, Olsen RB, Tholin B, Ystrøm CM, Skei NV, Hannula R, Dalgard O, Finbråten AK, Tonby K, Aballi S, Müller F, Mohn KGI, Trøseid M, Aukrust P, Ueland T. Neutrophil count predicts clinical outcome in hospitalized COVID-19 patients: Results from the NOR-Solidarity trial. J Intern Med 2022; 291:241-243. [PMID: 34411368 PMCID: PMC8447398 DOI: 10.1111/joim.13377] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Trine Kåsine
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Anne Ma Dyrhol-Riise
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Andreas Barratt-Due
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Anders Benjamin Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | | | | | | | - Hedda Hoel
- Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Anders Tveita
- Department of Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Mette Haugli
- Infectious Disease Department, Sørlandet Hospital SSK, Kristiansand, Norway
| | | | - Åse Berg
- Department of Infectious Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Asgeir Johannessen
- Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| | - Lars Heggelund
- Department of Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Bente Halvorsen
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Pawel Mielnik
- Department for Neurology, Rheumatology and Physical Medicine, Førde Central Hospital, Førde, Norway
| | - Lan Ai Kieu Le
- Division of Pulmonary Medicine, Haugesund Hospital, Haugesund, Norway
| | - Lars Thoresen
- Department of Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Gernot Ernst
- Department of Medicine, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Dag Arne Lihaug Hoff
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Hilde Skudal
- Division of infectious Diseases, Telemark Hospital Trust, Skien, Norway
| | | | - Roy Bjørkholt Olsen
- Department of Anaesthesiology, Sorlandet Hospital Arendal, Kristiansand, Norway
| | - Birgitte Tholin
- Department of Internal Medicine, Molde Hospital, Møre & Romsdal Hospital Trust, Molde, Norway
| | | | - Nina Vibeche Skei
- Department of Anesthesia and Intensive Care, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Raisa Hannula
- Department of Infectious Diseases, Trondheim University Hospital, Trondheim, Norway
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway
| | | | - Kristian Tonby
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Saad Aballi
- Department of Infectious Diseases, Østfold Hospital Kalnes, Grålum, Norway
| | - Fredrik Müller
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | | | - Marius Trøseid
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Pål Aukrust
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
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- Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
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9
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Vestad B, Nyman TA, Hove-Skovsgaard M, Stensland M, Hoel H, Trøseid AMS, Aspelin T, Aass HCD, Puhka M, Hov JR, Nielsen SD, Øvstebø R, Trøseid M. Plasma extracellular vesicles in people living with HIV and type 2 diabetes are related to microbial translocation and cardiovascular risk. Sci Rep 2021; 11:21936. [PMID: 34754007 PMCID: PMC8578564 DOI: 10.1038/s41598-021-01334-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/22/2021] [Indexed: 11/09/2022] Open
Abstract
HIV and type 2 diabetes (T2D) are both associated with gut microbiota alterations, low-grade endotoxemia and increased cardiovascular risk. We investigated the potential role of plasma extracellular vesicles (EVs) in relation to these processes. Plasma EVs were isolated by size exclusion chromatography in fasting individuals with HIV and T2D (n = 16), T2D only (n = 14), HIV only (n = 20) or healthy controls (n = 19), and characterized by transmission electron microscopy, western blot, nanoparticle tracking analysis and quantitative proteomics. The findings were compared to gut microbiota alterations, lipopolysaccharide levels and cardiovascular risk profile. Individuals with concomitant HIV and T2D had higher plasma EV concentration, which correlated closely with plasma lipopolysaccharides, triglycerides and Framingham score, but not with gut microbiota alterations. Proteomic analyses identified 558 human proteins, largely related to cardiometabolic disease genes and upstream regulation of inflammatory pathways, including IL-6 and IL-1β, as well as 30 bacterial proteins, mostly from lipopolysaccharide-producing Proteobacteria. Our study supports that EVs are related to microbial translocation processes in individuals with HIV and T2D. Their proteomic content suggests a contributing role in low-grade inflammation and cardiovascular risk development. The present approach for exploring gut-host crosstalk can potentially identify novel diagnostic biomarkers and therapeutic targets.
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Affiliation(s)
- Beate Vestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Postboks 4590, 0424, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway. .,Norwegian Society for Extracellular Vesicles, NOR-EV, Oslo, Norway.
| | - Tuula A Nyman
- Department of Immunology, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Malene Hove-Skovsgaard
- Department of Infectious Diseases, University Hospital of Copenhagen Rigshospitalet, Copenhagen, Denmark
| | - Maria Stensland
- Department of Immunology, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Postboks 4590, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anne-Marie Siebke Trøseid
- Norwegian Society for Extracellular Vesicles, NOR-EV, Oslo, Norway.,The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Trude Aspelin
- Norwegian Society for Extracellular Vesicles, NOR-EV, Oslo, Norway.,The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Hans Christian D Aass
- Norwegian Society for Extracellular Vesicles, NOR-EV, Oslo, Norway.,The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Maija Puhka
- Institute for Molecular Medicine Finland FIMM, EV and HiPrep Cores, University of Helsinki, Helsinki, Finland
| | - Johannes R Hov
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Postboks 4590, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Surgery, Inflammatory Medicine and Transplantation, Norwegian PSC Research Center and Section of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Susanne Dam Nielsen
- Department of Infectious Diseases, University Hospital of Copenhagen Rigshospitalet, Copenhagen, Denmark
| | - Reidun Øvstebø
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Norwegian Society for Extracellular Vesicles, NOR-EV, Oslo, Norway.,The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Postboks 4590, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
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10
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Barratt-Due A, Olsen IC, Nezvalova-Henriksen K, Kåsine T, Lund-Johansen F, Hoel H, Holten AR, Tveita A, Mathiessen A, Haugli M, Eiken R, Kildal AB, Berg Å, Johannessen A, Heggelund L, Dahl TB, Skåra KH, Mielnik P, Le LAK, Thoresen L, Ernst G, Hoff DAL, Skudal H, Kittang BR, Olsen RB, Tholin B, Ystrøm CM, Skei NV, Tran T, Dudman S, Andersen JT, Hannula R, Dalgard O, Finbråten AK, Tonby K, Blomberg B, Aballi S, Fladeby C, Steffensen A, Müller F, Dyrhol-Riise AM, Trøseid M, Aukrust P. Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19 : A Randomized Trial. Ann Intern Med 2021; 174:1261-1269. [PMID: 34251903 PMCID: PMC8279143 DOI: 10.7326/m21-0653] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND New treatment modalities are urgently needed for patients with COVID-19. The World Health Organization (WHO) Solidarity trial showed no effect of remdesivir or hydroxychloroquine (HCQ) on mortality, but the antiviral effects of these drugs are not known. OBJECTIVE To evaluate the effects of remdesivir and HCQ on all-cause, in-hospital mortality; the degree of respiratory failure and inflammation; and viral clearance in the oropharynx. DESIGN NOR-Solidarity is an independent, add-on, randomized controlled trial to the WHO Solidarity trial that included biobanking and 3 months of clinical follow-up (ClinicalTrials.gov: NCT04321616). SETTING 23 hospitals in Norway. PATIENTS Eligible patients were adults hospitalized with confirmed SARS-CoV-2 infection. INTERVENTION Between 28 March and 4 October 2020, a total of 185 patients were randomly assigned and 181 were included in the full analysis set. Patients received remdesivir (n = 42), HCQ (n = 52), or standard of care (SoC) (n = 87). MEASUREMENTS In addition to the primary end point of WHO Solidarity, study-specific outcomes were viral clearance in oropharyngeal specimens, the degree of respiratory failure, and inflammatory variables. RESULTS No significant differences were seen between treatment groups in mortality during hospitalization. There was a marked decrease in SARS-CoV-2 load in the oropharynx during the first week overall, with similar decreases and 10-day viral loads among the remdesivir, HCQ, and SoC groups. Remdesivir and HCQ did not affect the degree of respiratory failure or inflammatory variables in plasma or serum. The lack of antiviral effect was not associated with symptom duration, level of viral load, degree of inflammation, or presence of antibodies against SARS-CoV-2 at hospital admittance. LIMITATION The trial had no placebo group. CONCLUSION Neither remdesivir nor HCQ affected viral clearance in hospitalized patients with COVID-19. PRIMARY FUNDING SOURCE National Clinical Therapy Research in the Specialist Health Services, Norway.
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Affiliation(s)
| | | | | | - Trine Kåsine
- Oslo University Hospital, Oslo, Norway (A.B., I.C.O., T.K., T.T., C.F.)
| | - Fridtjof Lund-Johansen
- Oslo University Hospital and ImmunoLingo Convergence Centre, University of Oslo, Oslo, Norway (F.L.)
| | - Hedda Hoel
- Institute of Clinical Medicine and Research Institute of Internal Medicine, Oslo University Hospital, and Lovisenberg Diaconal Hospital, Oslo, Norway (H.H.)
| | - Aleksander Rygh Holten
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Anders Tveita
- Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway (A.T.)
| | | | - Mette Haugli
- Sørlandet Hospital SSK, Kristiansand, Norway (M.H.)
| | | | | | - Åse Berg
- Stavanger University Hospital, Stavanger, Norway (Å.B.)
| | - Asgeir Johannessen
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, and Vestfold Hospital Trust, Tønsberg, Norway (A.J.)
| | - Lars Heggelund
- Drammen Hospital, Vestre Viken Hospital Trust, Drammen, and University of Bergen, Bergen, Norway (L.H.)
| | - Tuva Børresdatter Dahl
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway (T.B.D., K.H.S.)
| | - Karoline Hansen Skåra
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway (T.B.D., K.H.S.)
| | | | | | - Lars Thoresen
- Ringerike Hospital, Vestre Viken Hospital Trust, Ringerike, Norway (L.T.)
| | - Gernot Ernst
- Kongsberg Hospital, Vestre Viken Hospital Trust, Drammen, Norway (G.E.)
| | | | | | | | | | - Birgitte Tholin
- Molde Hospital, Møre and Romsdal Hospital Trust, Molde, Norway (B.T.)
| | | | - Nina Vibeche Skei
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway (N.V.S.)
| | - Trung Tran
- Oslo University Hospital, Oslo, Norway (A.B., I.C.O., T.K., T.T., C.F.)
| | - Susanne Dudman
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Jan Terje Andersen
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Raisa Hannula
- Trondheim University Hospital, Trondheim, Norway (R.H.)
| | - Olav Dalgard
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, and Akershus University Hospital, Lørenskog, Norway (O.D.)
| | | | - Kristian Tonby
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Bjorn Blomberg
- Haukeland University Hospital and University of Bergen, Bergen, Norway (B.B.)
| | - Saad Aballi
- Østfold Hospital Kalnes, Grålum, Norway (S.A.)
| | - Cathrine Fladeby
- Oslo University Hospital, Oslo, Norway (A.B., I.C.O., T.K., T.T., C.F.)
| | - Anne Steffensen
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Fredrik Müller
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Anne Ma Dyrhol-Riise
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Marius Trøseid
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway (A.R.H., S.D., J.T.A., K.T., A.S., F.M., A.M.D., M.T.)
| | - Pål Aukrust
- Institute of Clinical Medicine and Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway (P.A.)
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11
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Thudium RF, Ringheim H, Ronit A, Hoel H, Benfield T, Mocroft A, Gerstoft J, Trøseid M, Borges ÁH, Ostrowski SR, Vestbo J, Nielsen SD. Independent Associations of Tumor Necrosis Factor-Alpha and Interleukin-1 Beta With Radiographic Emphysema in People Living With HIV. Front Immunol 2021; 12:668113. [PMID: 33936110 PMCID: PMC8080065 DOI: 10.3389/fimmu.2021.668113] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background People living with HIV (PLWH) have increased systemic inflammation, and inflammation has been suggested to contribute to the pathogenesis of emphysema. We investigated whether elevated cytokine concentrations (interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-2, IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor-alpha (TNFα), interferon-gamma (IFNγ), soluble CD14 (sCD14) and sCD163 were independently associated with radiographic emphysema in PLWH. Methods We included PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study without hepatitis B and C co-infection and with a plasma sample and a chest computed tomography scan available. Emphysema plus trace emphysema was defined as the percentage of low attenuation area under −950 Houndsfield Unit (%LAA-950) using a cut-off at 5%. Cytokine concentrations were measured by ELISA or Luminex immunoassays. An elevated cytokine concentration was defined as above the 75th percentile. Results Of 783 PLWH, 147 (18.8%) had emphysema. PLWH were predominantly male (86.0%) and 743 (94.9%) had undetectable viral replication. PLWH with emphysema had higher concentrations of TNFα (median (IQR): 8.2 (6.4-9.8) versus 7.1 (5.7-8.6) pg/ml, p<0.001), IL-1β (0.21 (0.1-0.4) versus 0.17 (0.1-0.3) pg/ml, p=0.004) and IL-6 (3.6 (2.6-4.9) versus 3.1 (2.0-4.3) pg/ml, p=0.023) than PLWH without. In a logistic regression model adjusted for age, sex, ethnicity, smoking status, BMI and CD4 nadir, elevated TNFα (adjusted odds ratio (aOR): 1.78 [95%CI: 1.14-2.76], p=0.011) and IL-1β (aOR: 1.81 [95%CI: 1.16-2.81], p=0.009) were independently associated with emphysema. The association between IL-1β and emphysema was modified by smoking (p-interaction=0.020) with a more pronounced association in never-smokers (aOR: 4.53 [95%CI: 2.05-9.98], p<0.001). Conclusion Two markers of systemic inflammation, TNFα and IL-1β, were independently associated with emphysema in PLWH and may contribute to the pathogenesis of emphysema. Importantly, the effect of IL-1β seems to be mediated through pathways that are independent of excessive smoking. Clinical Trial Registration clinicaltrials.gov, identifier NCT02382822.
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Affiliation(s)
- Rebekka F Thudium
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hedda Ringheim
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Ronit
- Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre Hospital, Hvidovre, Denmark
| | - Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Thomas Benfield
- Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre Hospital, Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Amanda Mocroft
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, United Kingdom.,Centre for Health and Infectious Diseases (CHIP), Department of Infectious Diseases, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jan Gerstoft
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Álvaro H Borges
- Department of Infectious Diseases Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Susanne D Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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12
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Hoel H, Heggelund L, Reikvam DH, Stiksrud B, Ueland T, Michelsen AE, Otterdal K, Muller KE, Lind A, Muller F, Dudman S, Aukrust P, Dyrhol-Riise AM, Holter JC, Trøseid M. Elevated markers of gut leakage and inflammasome activation in COVID-19 patients with cardiac involvement. J Intern Med 2021; 289:523-531. [PMID: 32976665 PMCID: PMC7536991 DOI: 10.1111/joim.13178] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND A high proportion of COVID-19 patients have cardiac involvement, even those without known cardiac disease. Downregulation of angiotensin converting enzyme 2 (ACE2), a receptor for SARS-CoV-2 and the renin-angiotensin system, as well as inflammatory mechanisms have been suggested to play a role. ACE2 is abundant in the gut and associated with gut microbiota composition. We hypothesized that gut leakage of microbial products, and subsequent inflammasome activation could contribute to cardiac involvement in COVID-19 patients. METHODS Plasma levels of a gut leakage marker (LPS-binding protein, LBP), a marker of enterocyte damage (intestinal fatty acid binding protein, IFABP), a gut homing marker (CCL25, ligand for chemokine receptor CCR9) and markers of inflammasome activation (IL-1β, IL-18 and their regulatory proteins) were measured at three time points (day 1, 3-5 and 7-10) in 39 hospitalized COVID-19 patients and related to cardiac involvement. RESULTS Compared to controls, COVID-19 patients had elevated plasma levels of LBP and CCL25 but not IFABP, suggesting impaired gut barrier function and accentuated gut homing of T cells without excessive enterocyte damage. Levels of LBP were twice as high at baseline in patients with elevated cardiac markers compared with those without and remained elevated during hospitalization. Also, markers of inflammasome activation were moderately elevated in patients with cardiac involvement. LBP was associated with higher NT-pro-BNP levels, whereas IL-18, IL-18BP and IL-1Ra were associated with higher troponin levels. CONCLUSION Patients with cardiac involvement had elevated markers of gut leakage and inflammasome activation, suggestive of a potential gut-heart axis in COVID-19.
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Affiliation(s)
- H Hoel
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L Heggelund
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - D H Reikvam
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - B Stiksrud
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - T Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway
| | - A E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - K Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - K E Muller
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - A Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - F Muller
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - S Dudman
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - P Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - A M Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - J C Holter
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - M Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
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13
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Gelpi M, Vestad B, Hansen SH, Holm K, Drivsholm N, Goetz A, Kirkby NS, Lindegaard B, Lebech AM, Hoel H, Michelsen AE, Ueland T, Gerstoft J, Lundgren J, Hov JR, Nielsen SD, Trøseid M. Impact of Human Immunodeficiency Virus-Related Gut Microbiota Alterations on Metabolic Comorbid Conditions. Clin Infect Dis 2020; 71:e359-e367. [PMID: 31894240 DOI: 10.1093/cid/ciz1235] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/30/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We aimed to identify a human immunodeficiency virus (HIV)-related microbiota signature, independent of sexual preferences and demographic confounders, in order to assess a possible impact of the microbiome on metabolic comorbid conditions. METHODS Bacterial 16S ribosomal RNA analyses were performed on stool samples from 405 HIV-infected and 111 uninfected participants of the Copenhagen Comorbidity in HIV Infection (COCOMO) study. Individuals were stratified according to sexual behavior (men who have sex with men [MSM] vs non-MSM). RESULTS After excluding MSM-associated microbiota traits and adjusting for confounders, we identified an HIV-related microbiota signature, consisting of lower biodiversity, increased relative abundance of the bacterial clades Gammaproteobacteria and Desulfovibrionaceae and decrease in several Clostridia. This microbiota profile was associated with a 2-fold excess risk of metabolic syndrome, driven by increase in Desulfovibrionaceae and decrease in Clostridia (Butyrivibrio, Coprococcus 2, Lachnospiraceae UCG-001 and CAG-56). This association was accentuated (5-fold excess risk) in individuals with previous severe immunodeficiency, which also modified the association between HIV-related microbiota signature and visceral adipose tissue (VAT) area (P for interaction = .01). Accordingly, HIV-related microbiota was associated with 30-cm2 larger VAT in individuals with history of severe immunodeficiency, but not in those without. CONCLUSION The HIV-related microbiota was associated with increased risk of metabolic syndrome and VAT accumulation, particularly in individuals with previous severe immunodeficiency, driven by increased Desulfovibrionaceae and lower abundance of several Clostridia. Our findings suggest a potential interplay between HIV-related microbiota, immune dysfunction and metabolic comorbid conditions. Interventions targeting the gut microbiome may be warranted to reduce cardiovascular risk, particularly in individuals with previous immunodeficiency.
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Affiliation(s)
- Marco Gelpi
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Beate Vestad
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Simen Hyll Hansen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Kristian Holm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Ninna Drivsholm
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Alexandra Goetz
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Nicolai Søren Kirkby
- Department of Microbiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Lindegaard
- Center for inflammation and Metabolism, Rigshospitalet, København, Denmark
- Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hedda Hoel
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Medical Department, Lovisenberg Hospital, Oslo, Norway
| | - Annika E Michelsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Jan Gerstoft
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Lundgren
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Johannes Roksund Hov
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Susanne Dam Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marius Trøseid
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Department of Rheumatology, Dermatology and Infectious Diseases, Oslo, Norway
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Thudium RF, Knudsen AD, Von Stemann JH, Hove-Skovsgaard M, Hoel H, Mocroft A, Reekie J, Ronit A, Gerstoft J, Vestbo J, Trøseid M, Borges ÁH, Ostrowski SR, Nielsen SD. Independent Association of Interleukin 6 With Low Dynamic Lung Function and Airflow Limitation in Well-Treated People With Human Immunodeficiency Virus. J Infect Dis 2020; 223:1690-1698. [PMID: 33141877 DOI: 10.1093/infdis/jiaa600] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 07/07/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection is associated with an increased risk of chronic pulmonary diseases. We compared cytokine concentrations (interleukin 6 [IL-6], interleukin 1β, 2, 4, 10, and 17A, tumor necrosis factor α, interferon γ, soluble CD14 [sCD14] and soluble CD163 [sCD163]) in people with HIV (PWH) and uninfected controls and investigated whether elevated cytokine concentrations were independently associated with lung function indices in PWH. METHODS We performed spirometry and measured cytokine concentrations by Luminex immunoassays or enzyme-linked immunoassay in 951 PWH and 79 uninfected controls from the Copenhagen Comorbidity in HIV Infection study. Regression analyses were used to explore associations between elevated cytokine concentrations and lung function indices. RESULTS PWH were predominantly male (84.6%) and 94.2% had undetectable viral replication. In PWH, elevated IL-6 was associated with lower forced expiratory volume in 1 second (-212 mL [95% confidence interval, -308 to -116 mL]), lower forced vital capacity (-208 mL [-322 to -93 mL]), and airflow limitation (aOR, 2.62 [1.58-4.36]) (all P < .001) in models adjusted for age, sex, ethnicity, smoking status, body mass index, and CD4 T-cell nadir. The association between IL-6 and dynamic lung function was modified by smoking (P for interaction = .005). CONCLUSION IL-6 levels were elevated and independently associated with low dynamic lung function and airflow limitation in well-treated PWH, suggesting that systemic inflammation may contribute to the pathogenesis of chronic pulmonary diseases.
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Affiliation(s)
- Rebekka F Thudium
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D Knudsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Hjorth Von Stemann
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Malene Hove-Skovsgaard
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hedda Hoel
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Amanda Mocroft
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, United Kingdom
| | - Joanne Reekie
- Centre for Health and Infectious Diseases (CHIP), Department of Infectious Diseases, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Ronit
- Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Jan Gerstoft
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Marius Trøseid
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Álvaro H Borges
- Department of Infectious Diseases Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne D Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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15
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Hoel H, Ueland T, Knudsen A, Kjær A, Michelsen AE, Sagen EL, Halvorsen B, Yndestad A, Nielsen SD, Aukrust P, Lebech AM, Trøseid M. Soluble Markers of Interleukin 1 Activation as Predictors of First-Time Myocardial Infarction in HIV-Infected Individuals. J Infect Dis 2020; 221:506-509. [PMID: 31077280 DOI: 10.1093/infdis/jiz253] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/05/2019] [Accepted: 05/10/2019] [Indexed: 12/12/2022] Open
Abstract
People with human immunodeficiency virus (HIV) infection (PWH) have an increased risk of cardiovascular disease (CVD), compared with the general population. In a nested case-control study of 55 PWH with first-time myocardial infarction (MI; cases) and 182 PWH with no CVD (controls), we measured soluble markers of interleukin 1 (IL-1) activation at 4 different time points before the case's MI. Cases had higher levels of IL-1 receptor antagonist (IL-1Ra) at all time points leading up to first-time MI, and higher levels of IL-1Ra were associated with an approximately 1.5-fold increased risk of MI, supporting the rationale to target IL-1 activation to reduce cardiovascular risk in PWH.
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Affiliation(s)
- Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Medical Department, Lovisenberg Diaconal Hospital, University of Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Andreas Knudsen
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre.,Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Ellen Lund Sagen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Susanne Dam Nielsen
- Viro-Immunology Research Unit, Department of Infectious Diseases, Rigshospitalet
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet.,Institute of Clinical Medicine, University of Oslo, Norway
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16
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Hoel H, Ueland T, Hove-Skovsgaard M, Hartling HJ, Gelpi M, Benfield T, Ullum H, Michelsen AE, Aukrust P, Nielsen SD, Trøseid M. Soluble T-Cell Immunoglobulin Mucin Domain-3 Is Associated With Hepatitis C Virus Coinfection and Low-Grade Inflammation During Chronic Human Immunodeficiency Virus Infection. Open Forum Infect Dis 2020; 7:ofaa033. [PMID: 32055642 PMCID: PMC7009472 DOI: 10.1093/ofid/ofaa033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/02/2020] [Accepted: 01/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background In well treated human immunodeficiency virus infection (HIV), there is a residual immune activation and immune exhaustion that may contribute to increased risk of comorbidities. T-cell immunoglobulin mucin domain-3 (Tim-3) is an inhibitory molecule involved in HIV-associated T-cell dysfunction. The Tim-3 can be cleaved to soluble Tim-3 (sTim-3) that may serve as a soluble marker of immune exhaustion. Methods We measured sTim-3 with enzyme-linked immunosorbent assay DuoSets in a cross-sectional cohort of 1010 people with HIV (PWH) on antiretroviral therapy (ART), and 76 controls from the Copenhagen Co-Morbidity in HIV Infection (COCOMO) study, and in a longitudinal cohort of 60 PWH before and during ART. Results In the cross-sectional cohort, levels of sTim-3 were elevated in PWH on ART compared with controls, especially in hepatitis C virus (HCV)-coinfected individuals, and were associated with HCV viremia and inflammation. In the longitudinal cohort, pretreatment sTim-3 correlated with HIV viral load and decreased after ART initiation. Pretreatment sTim-3 correlated inversely with CD4 counts, but it did not predict immunological response in multivariable analyses. Conclusions Levels of sTim-3 decreased after ART initiation. In a cross-sectional cohort, levels of sTIM-3 were higher in PWH than in controls and were independently associated with HCV coinfection and high-sensitivity C-reactive protein, representing a potential link between immune exhaustion, inflammation, and risk of comorbidities.
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Affiliation(s)
- Hedda Hoel
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Malene Hove-Skovsgaard
- Department of Infectious diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Viro-Immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hans Jakob Hartling
- Department of Infectious diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Viro-Immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marco Gelpi
- Department of Infectious diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Viro-Immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Benfield
- Department of Infectious Diseases, Amager Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Susanne Dam Nielsen
- Department of Infectious diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Viro-Immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marius Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
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17
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Hestnes J, Hoel H, Risa OJ, Romstøl HO, Røksund O, Frisk B, Thorsen E, Halvorsen T, Clemm HH. Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm. Front Physiol 2017; 8:499. [PMID: 28751866 PMCID: PMC5508024 DOI: 10.3389/fphys.2017.00499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/12/2017] [Accepted: 06/29/2017] [Indexed: 11/14/2022] Open
Abstract
Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals. Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46) and 1991–92 (n = 35) were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (V˙E) and carbon dioxide output (V˙CO2) was described by a linear model, and the relationship between tidal volume (VT) and V˙E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term−born, sex, age, height, weight and forced expiratory volume in 1 s (FEV1) as independent variables. Results: In adjusted analyses, the slope of the V˙E−V˙CO2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV1 only. Conclusion: EP-born participants breathed with higher V˙E for any given CO2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term−born groups when adjusted for FEV1.
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Affiliation(s)
- Julie Hestnes
- Department of Clinical Science, University of BergenBergen, Norway
| | - Hedda Hoel
- Department of Clinical Science, University of BergenBergen, Norway
| | - Ole J Risa
- Department of Clinical Science, University of BergenBergen, Norway
| | - Hanna O Romstøl
- Department of Clinical Science, University of BergenBergen, Norway
| | - Ola Røksund
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied ScienceBergen, Norway
| | - Bente Frisk
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied ScienceBergen, Norway.,Department of Physiotherapy, Haukeland University HospitalBergen, Norway
| | - Einar Thorsen
- Department of Clinical Science, University of BergenBergen, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of BergenBergen, Norway.,Department of Paediatrics, Haukeland University HospitalBergen, Norway
| | - Hege H Clemm
- Department of Clinical Science, University of BergenBergen, Norway.,Department of Paediatrics, Haukeland University HospitalBergen, Norway
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18
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Hoel H, Giga SI, Davidson MJ. Expectations and realities of student nurses' experiences of negative behaviour and bullying in clinical placement and the influences of socialization processes. Health Serv Manage Res 2016; 20:270-8. [DOI: 10.1258/095148407782219049] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper explores nursing students' experiences and perceptions of negative behaviour and bullying in clinical placement measured against expectations at the start of their education. It explores their understanding and how they make sense of their circumstances and their experiences of negative behaviour, emphasizing socialization processes and factors which may prevent or reproduce negative behaviour and bullying. To this end, a focus group study was conducted, and this revealed that many students felt exploited, ignored or were made to feel unwelcome, although few reported personal experience of bullying. These frequent but less severe negative experiences appear to play a key role in institutionalizing an unwelcoming culture within which bullying could easily be triggered or take hold. Students' coping mechanisms may also contribute to reproducing such negative behaviour. The paper concludes that while the vulnerable position of student nurses might offer some protection against outright bullying, it is unable to shield them from unfriendly and negative behaviour, with implications for their learning and professional socialization. If student nurses respond to their experiences by suppressing their feelings and developing a hard front, such responses may themselves contribute to a reproduction of such behaviour with implications for personal wellbeing and retention rates.
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Affiliation(s)
- H Hoel
- Manchester Business School, The University of Manchester, Manchester, UK
| | - S I Giga
- Centre for Inclusion and Diversity, The University of Bradford, Bradford, UK
| | - M J Davidson
- Centre for Equality and Diversity at Work, Manchester Business School, The University of Manchester, Manchester, UK
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19
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Johnson SJ, Holdsworth L, Hoel H, Zapf D. Customer stressors in service organizations: The impact of age on stress management and burnout. European Journal of Work and Organizational Psychology 2013. [DOI: 10.1080/1359432x.2013.772581] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Viet L, Lan NTN, Ty PX, Björkvoll B, Hoel H, Gutteberg T, Husebekk A, Larsen S, Skjerve E, Husum H. Prevalence of hepatitis B & hepatitis C virus infections in potential blood donors in rural Vietnam. Indian J Med Res 2012; 136:74-81. [PMID: 22885267 PMCID: PMC3461722] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Safe blood and blood products should be offered to all patients in need for blood transfusion. The objectives of the present study were to establish prevalence estimates for hepatitis B and hepatitis C virus infections as a foundation for safe blood transfusion in rural Vietnam, and to check the accuracy of the laboratory analysis used for hepatitis testing of blood donors in Vietnam. METHODS A cross-sectional study was conducted in two rural communities in Quang Tri, Vietnam. A total of 1,200 blood samples collected from potential blood donors were tested by an enzyme immunoassay technique (EIA) for detection of hepatitis surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis C antigen (anti-HCV). The EIA test outcome was validated by a chemiluminescent micro particle immunoassay technique (CMIA). RESULTS The prevalence of HBsAg and anti-HBc in the study population was 11.4 per cent (95% CI 9.6 - 13.2) and 51.7 per cent (95% CI 48.8 - 54.5), respectively, the prevalences being higher in males than females. The prevalence of anti-HCV was 0.17 per cent. The test agreement between the EIA and CMIA techniques was high both for HBsAg detection (κ = 0.91; 95% CI: 0.83 - 0.99) and for anti-HBc detection (κ = 0.89; 95% CI 0.81 - 0.97). Compared to CMIA results, the positive and negative predictive values of the EIA tests were found to be 94.9 per cent (95% CI 87.5 - 98.6) and 97.5 per cent (95% CI 86.8 - 99.9) for HBsAg, and 92.4 per cent (95% CI 84.2 - 97.2) and 100 per cent (95% CI 91.2 - 100) for anti-HBc. INTERPRETATION & CONCLUSIONS The study shows that hepatitis B virus infection is endemic in rural areas of Vietnam and that almost half of the population is or has been infected. Hepatitis C infection is rare, but false negative test results cannot be ruled out. Also, the results indicate that the EIA performance in blood donor screening in Vietnam may be sub-optimal, missing 2.5 per cent of hepatitis B virus carriers and falsely excluding more than 7 per cent of blood donors. As the prevalence of hepatitis B infection is high, occult hepatitis B infection may represent a threat to safe blood transfusion. Therefore, nucleic acid amplification testing for HBV should be considered for blood donor screening in Vietnam.
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Affiliation(s)
- Le Viet
- Quang Tri Provincial Preventive Medicine Centre, Quang Tri Health Service, Vietnam,Faculty of Health Sciences, University of Tromsoe, Norway
| | - Nguyen Thi Ngoc Lan
- Quang Tri Provincial Preventive Medicine Centre, Quang Tri Health Service, Vietnam
| | - Phung Xuan Ty
- Quang Tri Provincial Preventive Medicine Centre, Quang Tri Health Service, Vietnam
| | - Björn Björkvoll
- Tromsoe Mine Victim Resource Centre, University Hospital North Norway, Tromsoe, Norway
| | - Hedda Hoel
- Tromsoe Mine Victim Resource Centre, University Hospital North Norway, Tromsoe, Norway
| | - Tore Gutteberg
- Tromsoe Mine Victim Resource Centre, University Hospital North Norway, Tromsoe, Norway,Department of Microbiology & Infectious Control, University Hospital North Norway
| | - Anne Husebekk
- Tromsoe Mine Victim Resource Centre, University Hospital North Norway, Tromsoe, Norway,Department of Immunology & Transfusion Medicine, University Hospital North Norway, Tromsoe, Norway
| | - Stig Larsen
- Centre of Epidemiology & Biostatistics, Norwegian School of Veterinary Science, Tromsoe, Norway
| | - Eystein Skjerve
- Centre of Epidemiology & Biostatistics, Norwegian School of Veterinary Science, Tromsoe, Norway
| | - Hans Husum
- Quang Tri Provincial Preventive Medicine Centre, Quang Tri Health Service, Vietnam,Faculty of Health Sciences, University of Tromsoe, Norway,Reprint requests: Dr Hans Husum, PO Box 80, N-9038, University Hospital North Norway, Tromsoe, Norway, e-mail:
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21
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Bjoerkvoll B, Viet L, Ol HS, Lan NTN, Sothy S, Hoel H, Gutteberg T, Husebekk A, Larsen S, Husum H. Screening test accuracy among potential blood donors of HBsAg, anti-HBc and anti-HCV to detect hepatitis B and C virus infection in rural Cambodia and Vietnam. Southeast Asian J Trop Med Public Health 2010; 41:1127-1135. [PMID: 21073033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of this study was to determine the accuracy of rapid tests for HBsAg, anti-HBc and anti-HCV in rural Cambodia and Vietnam to detect hepatitis B and C. In a cross-sectional epidemiological study of two populations of 1,200 potential blood donors in rural Cambodia and Vietnam the prevalence rates of HBsAg, anti-HBc and anti-HCV as established by enzyme immunoassay (EIA) tests were compared to rapid test outcomes. The EIA reference test results were validated by Architect Chemiluminescent Microparticle Immunoassay (CMIA) technique. The actual rapid test demonstrated high specificity for all three test categories as claimed by the manufacturer. The test sensitivity observed was significantly lower than that claimed by the manufacturer: 86.5% for HBsAg, 86.6% for anti-HBc, and 76.4% for anti-HCV. There were large and significant variations in test performance between the two countries, especially for HBsAg detection. The low sensitivity of the actual rapid tests for HBsAg, anti-HBc and anti-HCV make them useless for blood donor screening in rural Southeast Asia. Rapid tests may be useful screening tools in blood transfusion services in low-resource settings, but tests should be carefully validated locally before being used for screening purposes since test performance varies by location.
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Affiliation(s)
- Bjoern Bjoerkvoll
- Tromsoe Mine Victim Resource Center, University Hospital of North Norway
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Ol HS, Bjoerkvoll B, Sothy S, Van Heng Y, Hoel H, Husebekk A, Gutteberg T, Larsen S, Husum H. Prevalence of hepatitis B and hepatitis C virus infections in potential blood donors in rural Cambodia. Southeast Asian J Trop Med Public Health 2009; 40:963-971. [PMID: 19842380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aims of the present study were to provide accurate prevalence of acute and occult hepatis B infection and hepatis C infection among potential blood donors in Cambodia and to study the accuracy of ELISA tests used for blood donor screening. A cross-sectional study was performed on samples collected from potential volunteer blood donors (n = 1,200) in two districts in rural Cambodia. The samples were tested using the ELISA technique for HBsAg, anti-HBc, and anti-HCV at a local blood bank. To validate the ELISA outcomes, a subset (n = 319) was analyzed by Automated Chemiluminescent Microparticle Immunoassay Technique (CMIA) at the University Hospital North Norway. The overall prevalence of the HBsAg positives was 7.7% (95% CI 6.2-9.3); the prevalence of anti-HBc positive samples was 58.6% (95% CI 55.8-61.4), and the prevalence of anti-HCV positive samples was 14.7% (95% CI 12.7-16.7). The prevalence rate of samples being both HBsAg positive and anti-HBc positive was 7.3% (95% CI 5.9 - 9.0), and the prevalence rate of HBsAg negative and anti-HBc positive samples was 51.2% (95% CI 48.4 - 54.1). The overall agreement between the ELISA and the CMIA test results was very high both for HBsAg and anti-HBc (kappa 0.93), and high for anti-HCV measurements (kappa 0.83). However, the false-negative rate for the ELISA anti-HCV test was as high as 15% (95% CI 6 - 30).
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Abstract
This paper describes and discusses a method for collecting data relating to the potential for illness or injury to occur in an organization. The reason for using the term 'grey' is explained and the underpinning philosophy of fuzzy thinking is also discussed. The method used was an audit which attempted to measure the degree to which certain types of failure were present in one organization. The audit used a term approach in design and execution and was found to be a useful and useable tool for collecting information relating potential causes of injury or illness.
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Affiliation(s)
- L Falconer
- Research Centre for the Built and Human Environment (Department of Environmental Management), University of Salford, UK
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Abstract
Perceptions of line and senior managers in relation to their role in managing workplace injury and illness were investigated with a large UK manufacturing company. The significance of this research to occupational health practitioners lies in the fact that increased understanding of the perceptions of senior and line managers is fundamental to the success of occupational safety and health programmes. Documentary analysis and semi-structured interviews were used to assess perceptions. The findings showed that the managers had a much sounder understanding of their role in injury prevention than that related to illness prevention. The way in which information relating to injury and illness data is presented to managers to aid decision making was found likely to be a fruitful area for further research.
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Affiliation(s)
- L Falconer
- Department of Applied Sciences, University College Salford, UK
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