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Galati D, Mallardo D, Nicastro C, Zanotta S, Capitelli L, Lombardi C, Baino B, Cavalcanti E, Sale S, Labonia F, Boenzi R, Atripaldi L, Ascierto PA, Bocchino M. The Dysregulation of the Monocyte-Dendritic Cell Interplay Is Associated with In-Hospital Mortality in COVID-19 Pneumonia. J Clin Med 2024; 13:2481. [PMID: 38731010 DOI: 10.3390/jcm13092481] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
Background: The monocyte-phagocyte system (MPS), including monocytes/macrophages and dendritic cells (DCs), plays a key role in anti-viral immunity. We aimed to analyze the prognostic value of the MPS components on in-hospital mortality in a cohort of 58 patients (M/F; mean age ± SD years) with COVID-19 pneumonia and 22 age- and sex-matched healthy controls. Methods: We measured frequencies and absolute numbers of peripheral blood CD169+ monocytes, conventional CD1c+ and CD141+ (namely cDC2 and cDC1), and plasmacytoid CD303+ DCs by means of multi-parametric flow cytometry. A gene profile analysis of 770 immune-inflammatory-related human genes and 20 SARS-CoV-2 genes was also performed. Results: Median frequencies and absolute counts of CD169-expressing monocytes were significantly higher in COVID-19 patients than in controls (p 0.04 and p 0.01, respectively). Conversely, percentages and absolute numbers of all DC subsets were markedly depleted in patients (p < 0.0001). COVID-19 cases with absolute counts of CD169+ monocytes above the median value of 114.68/μL had significantly higher in-hospital mortality (HR 4.96; 95% CI: 1.42-17.27; p = 0.02). Interleukin (IL)-6 concentrations were significantly increased in COVID-19 patients (p < 0.0001 vs. controls), and negatively correlated with the absolute counts of circulating CD1c+ cDC2 (r = -0.29, p = 0.034) and CD303+ pDC (r = -0.29, p = 0.036) subsets. Viral genes were upregulated in patients with worse outcomes along with inflammatory mediators such as interleukin (IL)-1 beta, tumor necrosis-α (TNF-α) and the anticoagulant protein (PROS1). Conversely, surviving patients had upregulated genes related to inflammatory and anti-viral-related pathways along with the T cell membrane molecule CD4. Conclusions: Our results suggest that the dysregulated interplay between the different components of the MPS along with the imbalance between viral gene expression and host anti-viral immunity negatively impacts COVID-19 outcomes. Although the clinical scenario of COVID-19 has changed over time, a deepening of its pathogenesis remains a priority in clinical and experimental research.
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Affiliation(s)
- Domenico Galati
- Hematology-Oncology and Stem Cell Transplantation Unit, Department of Hematology and Innovative Diagnostics, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Domenico Mallardo
- Unit of Melanoma and Innovative Therapy, Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Carmine Nicastro
- Clinical Biochemistry Unit, AORN dei Colli, Ospedale Monaldi, 80131 Naples, Italy
| | - Serena Zanotta
- Hematology-Oncology and Stem Cell Transplantation Unit, Department of Hematology and Innovative Diagnostics, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Ludovica Capitelli
- Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Monaldi Hospital, 80131 Naples, Italy
| | - Carmen Lombardi
- Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Monaldi Hospital, 80131 Naples, Italy
| | - Bianca Baino
- Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Monaldi Hospital, 80131 Naples, Italy
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Silvia Sale
- Clinical Biochemistry Unit, AORN dei Colli, Ospedale Monaldi, 80131 Naples, Italy
| | - Francesco Labonia
- Laboratory Medicine Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Rita Boenzi
- Clinical Biochemistry Unit, AORN dei Colli, Ospedale Monaldi, 80131 Naples, Italy
| | - Luigi Atripaldi
- Clinical Biochemistry Unit, AORN dei Colli, Ospedale Monaldi, 80131 Naples, Italy
| | - Paolo Antonio Ascierto
- Unit of Melanoma and Innovative Therapy, Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Marialuisa Bocchino
- Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Monaldi Hospital, 80131 Naples, Italy
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Boccia F, Iossa D, Leonardi S, Peluso AM, Bertolino L, Patauner F, Palmieri E, Boenzi R, Zampino R, Durante-Mangoni E. Clinical correlates of circulating small dense low-density lipoproteins in acute infective endocarditis. Infection 2023:10.1007/s15010-023-02139-z. [PMID: 38114685 DOI: 10.1007/s15010-023-02139-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND AIM Infective endocarditis (IE) is a complex thrombo-inflammatory disorder, the pathogenesis of which involves a multifaceted interplay between vascular damage and bacterial virulence factors. This study aimed to assess the prognostic role of small dense low-density lipoprotein (sdLDL) cholesterol in patients with IE and its correlation with various disease-related features. METHODS A cohort of 198 patients with definite IE was included in this study. Clinical, laboratory, and echocardiographic parameters were meticulously analyzed, with a specific focus on comorbidities. sdLDL levels were measured using stored plasma samples obtained upon admission during the acute phase of the disease. RESULTS The median level of sdLDL was 24 mg/dL [with an interquartile range of 17.9-35.2 mg/dL], and this value showed a statistically significant positive correlation with LDL/HDL cholesterol and triglycerides (p < 0.01 for all). Furthermore, a remarkable inverse correlation between C-reactive protein and D-dimer levels was observed (p < 0.0001). Univariate analysis revealed that patients with sdLDL levels ≤ 24 mg/dL had 2.75 times higher odds of in-hospital mortality (95% Confidence Interval:1.08-6.98, p = 0.031). In addition, nonsurvivors had significantly lower median sdLDL levels (19.7 vs. 26.0 mg/dL, p = 0.041). Lower sdLDL levels were also associated with embolic complications, larger vegetation size, and positive blood cultures for Staphylococci (p = 0.019, p = 0.022, and p < 0.001, respectively). CONCLUSIONS Low circulating sdLDL levels in the acute phase of IE were significantly correlated with unfavorable clinical outcomes. These results suggest that the sdLDL level may serve as an important marker of disease severity in IE and may represent a link between vascular damage, embolic complications, and disease progression.
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Affiliation(s)
- Filomena Boccia
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Domenico Iossa
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy
| | - Silvia Leonardi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Anna Maria Peluso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Lorenzo Bertolino
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Fabian Patauner
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Emilio Palmieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Rita Boenzi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Rosa Zampino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy.
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy.
- Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131, Naples, Italy.
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Cerino P, Coppola A, Pierri B, Volzone P, Bruzzese D, Pierri A, Ferro A, Schiavi D, Coppola A, Miniero S, Atripaldi L, Pirozzi C, Rusciano P, Macri A, Boenzi R, Sale S, Brambilla G, Buonerba C. An observational study of a cohort of citizens receiving the AZD1222 vaccine against SARS-CoV-2. Future Sci OA 2021; 7:FSO739. [PMID: 34290884 PMCID: PMC8216649 DOI: 10.2144/fsoa-2021-0064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
In this retrospective study, a cohort of 67 subjects vaccinated with AZD1222 was retrospectively observed. Consistently with published findings, no serious adverse event was reported, and all adverse events reported (fever, muscle ache and/or pain in the site of injection) had resolved by day 8. Of note, some citizens were prescribed low-dose aspirin and even heparin for thrombosis prevention. We also found variations in laboratory test results (full blood count and chemistry) on day 1 compared with day 8. Physicians should be aware that no prevention therapy for thrombosis is currently recommended, given the very low incidence of this side effect. Additional studies are warranted to interpret our findings.
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Affiliation(s)
- Pellegrino Cerino
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
| | - Annachiara Coppola
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy.,Dipartimento di Medicina Sperimentale, Università degli studi della Campania 'L Vanvitelli', Naples, 80138, Italy
| | - Biancamaria Pierri
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy.,Department of Medicine, Surgery & Dentistry (Scuola Medica Salernitana), University of Salerno, Baronissi, 84081, Italy
| | - Palmiero Volzone
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples 'Federico II', Naples, 80131, Italy
| | - Andrea Pierri
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
| | - Amedeo Ferro
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
| | - Daniela Schiavi
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
| | | | | | - Luigi Atripaldi
- Cotugno Hospital, AORN Ospedali dei Colli, Naples, 80131, Italy
| | | | | | | | - Rita Boenzi
- Cotugno Hospital, AORN Ospedali dei Colli, Naples, 80131, Italy
| | - Silvia Sale
- Cotugno Hospital, AORN Ospedali dei Colli, Naples, 80131, Italy
| | - Gianfranco Brambilla
- Food Safety, Nutrition & Veterinary Public Health Department, Istituto Superiore di Sanità, Rome, 00161, Italy
| | - Carlo Buonerba
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, 80055, Italy
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