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Obesity Is Associated with Attenuated Tissue Immunity in COVID-19.
Am J Respir Crit Care Med. 2023 03 01; 207(5):566-576.AJ

Abstract

Rationale: Obesity affects 40% of U.S. adults, is associated with a proinflammatory state, and presents a significant risk factor for the development of severe coronavirus disease (COVID-19). To date, there is limited information on how obesity might affect immune cell responses in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Objectives: To determine the impact of obesity on respiratory tract immunity in COVID-19 across the human lifespan. Methods: We analyzed single-cell transcriptomes from BAL in three ventilated adult cohorts with (n = 24) or without (n = 9) COVID-19 from nasal immune cells in children with (n = 14) or without (n = 19) COVID-19, and from peripheral blood mononuclear cells in an independent adult COVID-19 cohort (n = 42), comparing obese and nonobese subjects. Measurements and Main Results: Surprisingly, we found that obese adult subjects had attenuated lung immune or inflammatory responses in SARS-CoV-2 infection, with decreased expression of IFN-α, IFN-γ, and TNF-α (tumor necrosis factor α) response gene signatures in almost all lung epithelial and immune cell subsets, and lower expression of IFNG and TNF in specific lung immune cells. Peripheral blood immune cells in an independent adult cohort showed a similar but less marked reduction in type-I IFN and IFNγ response genes, as well as decreased serum IFNα, in obese patients with SARS-CoV-2. Nasal immune cells from obese children with COVID-19 also showed reduced enrichment of IFN-α and IFN-γ response genes. Conclusions: These findings show blunted tissue immune responses in obese patients with COVID-19, with implications for treatment stratification, supporting the specific application of inhaled recombinant type-I IFNs in this vulnerable subset.

Authors+Show Affiliations

Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus.Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus.Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus.Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus.Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.UCL Respiratory, Division of Medicine, University College London, London, United Kingdom.UCL Respiratory, Division of Medicine, University College London, London, United Kingdom.Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; and.Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; and.Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom. Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.UCL Respiratory, Division of Medicine, University College London, London, United Kingdom.Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; and.John V. Farman Intensive Care Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom.Division of Anaesthesia, Department of Medicine. Division of Immunology, Department of Pathology, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, United Kingdom. John V. Farman Intensive Care Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.Molecular Immunity Unit. Cambridge Institute for Therapeutic Immunology and Infectious Disease. Department of Medicine, Cambridge Biomedical Campus. Cellular Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom. NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; and.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36095143

Citation

Guo, Shuang A., et al. "Obesity Is Associated With Attenuated Tissue Immunity in COVID-19." American Journal of Respiratory and Critical Care Medicine, vol. 207, no. 5, 2023, pp. 566-576.
Guo SA, Bowyer GS, Ferdinand JR, et al. Obesity Is Associated with Attenuated Tissue Immunity in COVID-19. Am J Respir Crit Care Med. 2023;207(5):566-576.
Guo, S. A., Bowyer, G. S., Ferdinand, J. R., Maes, M., Tuong, Z. K., Gillman, E., Liao, M., Lindeboom, R. G. H., Yoshida, M., Worlock, K., Gopee, H., Stephenson, E., Gao, C. A., Lyons, P. A., Smith, K. G. C., Haniffa, M., Meyer, K. B., Nikolić, M. Z., Zhang, Z., ... Clatworthy, M. R. (2023). Obesity Is Associated with Attenuated Tissue Immunity in COVID-19. American Journal of Respiratory and Critical Care Medicine, 207(5), 566-576. https://doi.org/10.1164/rccm.202204-0751OC
Guo SA, et al. Obesity Is Associated With Attenuated Tissue Immunity in COVID-19. Am J Respir Crit Care Med. 2023 03 1;207(5):566-576. PubMed PMID: 36095143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity Is Associated with Attenuated Tissue Immunity in COVID-19. AU - Guo,Shuang A, AU - Bowyer,Georgina S, AU - Ferdinand,John R, AU - Maes,Mailis, AU - Tuong,Zewen K, AU - Gillman,Eleanor, AU - Liao,Mingfeng, AU - Lindeboom,Rik G H, AU - Yoshida,Masahiro, AU - Worlock,Kaylee, AU - Gopee,Hudaa, AU - Stephenson,Emily, AU - Gao,Catherine A, AU - Lyons,Paul A, AU - Smith,Kenneth G C, AU - Haniffa,Muzlifah, AU - Meyer,Kerstin B, AU - Nikolić,Marko Z, AU - Zhang,Zheng, AU - Wunderink,Richard G, AU - Misharin,Alexander V, AU - Dougan,Gordon, AU - Navapurkar,Vilas, AU - Teichmann,Sarah A, AU - Conway Morris,Andrew, AU - Clatworthy,Menna R, PY - 2022/9/13/pubmed PY - 2023/3/4/medline PY - 2022/9/12/entrez KW - COVID-19 KW - bronchoalveolar lavage KW - obesity KW - single-cell RNA sequencing KW - type-I interferon SP - 566 EP - 576 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 207 IS - 5 N2 - Rationale: Obesity affects 40% of U.S. adults, is associated with a proinflammatory state, and presents a significant risk factor for the development of severe coronavirus disease (COVID-19). To date, there is limited information on how obesity might affect immune cell responses in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Objectives: To determine the impact of obesity on respiratory tract immunity in COVID-19 across the human lifespan. Methods: We analyzed single-cell transcriptomes from BAL in three ventilated adult cohorts with (n = 24) or without (n = 9) COVID-19 from nasal immune cells in children with (n = 14) or without (n = 19) COVID-19, and from peripheral blood mononuclear cells in an independent adult COVID-19 cohort (n = 42), comparing obese and nonobese subjects. Measurements and Main Results: Surprisingly, we found that obese adult subjects had attenuated lung immune or inflammatory responses in SARS-CoV-2 infection, with decreased expression of IFN-α, IFN-γ, and TNF-α (tumor necrosis factor α) response gene signatures in almost all lung epithelial and immune cell subsets, and lower expression of IFNG and TNF in specific lung immune cells. Peripheral blood immune cells in an independent adult cohort showed a similar but less marked reduction in type-I IFN and IFNγ response genes, as well as decreased serum IFNα, in obese patients with SARS-CoV-2. Nasal immune cells from obese children with COVID-19 also showed reduced enrichment of IFN-α and IFN-γ response genes. Conclusions: These findings show blunted tissue immune responses in obese patients with COVID-19, with implications for treatment stratification, supporting the specific application of inhaled recombinant type-I IFNs in this vulnerable subset. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/36095143/Obesity_Is_Associated_with_Attenuated_Tissue_Immunity_in_COVID_19_ DB - PRIME DP - Unbound Medicine ER -