Age-dependent association of clonal hematopoiesis with COVID-19 mortality in patients over 60 years.

Clonal hematopoiesis, especially that of indeterminate potential (CHIP), has been associated with age-related diseases, such as those contributing to a more severe COVID-19. Four studies have attempted to associate CHIP with COVID-19 severity without conclusive findings. In the present work, we explore the association between CHIP and COVID-19 mortality. Genomic DNA extracted from peripheral blood of COVID-19 patients (n = 241 deceased, n = 239 survivors) was sequenced with the Myeloid Solutions™ panel of SOPHiA Genetics. The association between clonality and age and clonality and mortality was studied using logistic regression models adjusted for sex, ethnicity, and comorbidities. The association with mortality was performed with patients stratified into four groups of age according to the quartiles of the distribution: 60–74 years, 75–84 years, 85–91 years, and 92–101 years. Clonality was found in 38% of the cohort. The presence of CHIP variants, but not the number, significantly increased with age in the entire cohort of COVID-19 patients, as well as in the group of survivors (p < 0.001). When patients were stratified by age and the analysis adjusted, CHIP classified as pathogenic/likely pathogenic was significantly more represented in deceased patients compared with survivors in the group of 75–84 years (34.6% vs 13.7%, p = 0.020). We confirmed the well-established linear relationship between age and clonality in the cohort of COVID-19 patients and found a significant association between pathogenic/likely pathogenic CHIP and mortality in patients from 75 to 84 years that needs to be further validated.post-print1034 K

Androgen receptor polyQ alleles and COVID-19 severity in men: a replication study

Background: Ample evidence indicates a sex-related difference in severity of COVID19, with less favorable outcomes observed in men. Genetic factors have been proposed as candidates to explain this difference. The polyglutamine (polyQ) polymorphism in the androgen receptor gene has been recently described as a genetic biomarker of COVID-19 severity. Objective: To test the association between the androgen receptor polyQ polymorphism and COVID-19 severity in a large cohort of COVID-19 male patients. Materials and methods: This study included 1136 male patients infected with SARSCoV-2 as confirmed by positive PCR. Patients were retrospectively and prospectively enrolled from March to November 2020. Patients were classified according to their severity into three categories: oligosymptomatic, hospitalized and severe patients requiring ventilatory support. The number of CAG repeats (polyQ polymorphism) at the androgen receptor was obtained by PCR and patients were classified as either short (<23 repeats) or long (≥23 repeats) allele carriers. The association between polyQ alleles (short or long) and COVID-19 severity was assessed by Chi-squared (Chi2) and logistic regression analysis. Results: The mean number of polyQ CAG repeats was 22 (±3). Patients were classified as oligosymptomatic (15.5%), hospitalized (63.2%), and severe patients (21.3%) requiring substantial respiratory support. PolyQ alleles distribution did not show significant differences between severity classes in our cohort (Chi2 test p > 0.05). Similar results were observed after adjusting by known risk factors such as age, comorbidities, and ethnicity (multivariate logistic regression analysis)Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Science and Innovation (COVID-19 Research Call; COV20/00181) co-financed by European Development Regional Fund (FEDER, A way to achieve Europe); Estrella de Levante (E G-N); Colabora Mujer (E G-N); Instituto de Salud Carlos III (Centro de Investigación en Red de Enfermedades Raras, CIBERer); IIS-Fundación Jiménez Díaz-UAM Chair in Genomic Medicine; Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Science and Innovation (Miguel Servet Contract Number: CP17/00006 and Juan Rodes Contract Number: JR17/00020) co-financied by European Regional Development Fund (FEDER); CEGEN-PRB3-ISCIII is funded by ISCIII and ERDF, Grant Number: PT17/001

Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial

Introduction:Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. Methods and analysis:The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial. 144 patients with anterior STEMI will be assigned to receive calcifediol 0.266 mg capsules (Hidroferol SGC)/15 days or placebo on a 2:1 basis during 12 months. Primary objective:to evaluate the effect of calcifediol on LV remodelling defined as an increase in LV end-diastolic volume >= 10\% (MRI). Secondary objectives:change in LV end-diastolic and end-systolic volumes, ejection fraction, LV mass, diastolic function, sphericity index and size of fibrotic area; endothelial function; plasma levels of aminoterminal fragment of B-type natriuretic peptide, galectin-3 and monocyte chemoattractant protein-1; levels of calcidiol (VD metabolite) and other components of mineral metabolism (fibroblast growth factor-23 (FGF-23), the soluble form of its receptor klotho, parathormone and phosphate). Differences in the effect of VD will be investigated according to the plasma levels of FGF-23 and klotho. Treatment safety and tolerability will be assessed. This is the first study to evaluate the effect of VD on cardiac remodelling in patients with STEMI. Ethics and dissemination: This trial has been approved by the corresponding Institutional Review Board (IRB) and National Competent Authority (Agencia Espanola de Medicamentos y Productos Sanitarios (AEMPS)). It will be conducted in accordance with good clinical practice (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use-Good Clinical Practice (ICH-GCP)) requirements, ethical principles of the Declaration of Helsinki and national laws. The results will be submitted to indexed medical journals and national and international meetings.The VITDAMI trial is an investigator initiated study, sponsored by the Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS-FJD). Funding has been obtained from Fondo de Investigaciones Sanitarias (PI14/01567; http://www.isciii.es/) and Spanish Society of Cardiology (http://secardiologia.es/). In addition, the study medication has been provided freely by the pharmaceutical Company FAES FARMA S.A. (Leioa, Vizcaya, Spain; http://faesfarma.com/). This company was the only funder who collaborated in study design (IG-H).S

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Fosforilación in vitro e in vivo de la proteinasa multicatalítica (proteasoma)

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Bioquímica. Fecha de lectura: 06-10-1995La proteinasa multicatalítica (proteasoma) se encuentra fosforilada in vivo en dos de sus polipéptidos, de 29 kilodalton de peso molecular, identificados como las subunidades C8 y C9, las cuales son fosforiladas in vitro por caseina quinasa 11. Tanto in vivo como in vitro el principal sustrato de fosforilación es la subunidad C8, que se fosforila en resíduos de serina. La comparación de los fosfopéptidos obtenidos por digestión con endo GluC a partir de la subunidad C8 fosforilada in vivo e in vitro por caseina quinasa 11 muestra que los sitios de fosforilación son similares en ambos casos. La fosforilación in vitro de la proteinasa multicatalítica no afecta a su actividad proteasa sobre proteinas o sobre péptidos fluorogé~coss intéticos. Sugerimos que la fosforilación de la proteinasa multicatalítica por caseína quinasa 11 podría servir: como requisito previo para posteriores fosfonlaciones por otras protein quinasas; para la regulación de la asociación del proteasoma con otros componentes celulares para la formación de complejos de orden superior, como el 26s; o para su translocación a núcleoTwo 29 kilodalton subu~t sof the multicatalytic proteinase (proteasome), identified as the C8 and C9 components, are found phosphoiylated in vivo and can be phosphorylated in vitro by casein k m e 11. The major phosphate acceptor, both in vivo and in vitro, is the C8 subunit and its phosphoiylation takes place in serine residues. Comparison of endo Glu-C phosphopeptide maps reveals that the major phosphorylation sites of the C8 s u b u ~otf the proteasome in vivo and in vitro are the same . The in vitro phosphorylation of the multicatalytic proteinase complex by casein U s e II does not affect the proteolytic activity of the enzyme complex, either on proteins or fluorogenic synthetic peptides. It is suggested that the phosphorylation by casein kinase 11 of the multicatalytic proteinase could be: a prerequisite for the phosphorylation by other protein kinases; involved in the regulation of the association of the 20s proteasome with other protein components, i.e: the fonnation of the 26s complex; or participate in the translocation of the proteasome to the nucleus

Influence of dialysis membrane composition on plasma bisphenol A levels during online hemodiafiltration.

Bisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF.A prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron).After a run-in OL-HDF period of at least 6 months with the same membrane, baseline pre-dialysis BPA was lower in patients on polynephron (8.79±7.97 ng/ml) than in those on polysulfone (23.42±20.38 ng/mL, p<0.01), but still higher than in healthy controls (<2 ng/mL). After 3 months of polynephron-to-polysulfone switch, BPA was unchanged (8.98±7.88 to 11.14±15.98 ng/mL, ns) while it decreased on the polysulfone-to-polynephron group (23.42±20.38 to 11.41±12.38 ng/mL, p<0.01).OL-HDF for 3 months with BPA-free dialyzer membranes was associated to a significant decrease in predialysis BPA levels when compared to baseline BPA levels while on a BPA-containing membrane

Summary of clinical and biochemical variables.

<p>Summary of clinical and biochemical variables.</p

Plasma BPA concentration.

<p>Healthy subjects (n = 10); patients on online hemodiafiltration (HDF) (n = 58) and patients on conventional hemodialysis (HD) who were later enrolled in the present study (n = 18) [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0193288#pone.0193288.ref007" target="_blank">7</a>]. Data expressed as mean±SD. For HD and OL-HDF, values correspond to baseline predialysis values in the switch studies. At this point, patients had been on HD or OL-HDF for >6 months. * p<0.05; ** p = 0.017.</p