Expression alteration of serum exosomal circular RNAs in obstructive sleep apnea patients with acute myocardial infarction.

PURPOSE: Circular RNAs (circRNAs) are recently identified as a class of non-coding RNAs that participate in the incidence of acute myocardial infarction (AMI). However, circRNAs expression pattern in obstructive sleep apnea (OSA) with AMI remains unknown. The aim was to investigate circRNAs expression alteration in serum exosomes derived from OSA patients with AMI. METHODS: The serum exosomal circRNAs profile of three healthy subjects, three OSA without AMI and three OSA with AMI were analyzed using high-throughput sequencing. Bioinformatic analyses were carried out to assess potential core circRNAs and functional analyses were conducted to study biological functions. RESULTS: Compared to healthy subjects, there were 5225 upregulated and 5798 downregulated circRNAs in exosomes from OSA with AMI patients. And our study also identified 5210 upregulated and 5813 downregulated circRNAs in OSA with AMI patients compared to OSA without AMI. The differential expression of 2 circRNAs (hsa_circRNA_101147, hsa_circRNA_101561) between healthy subjects and OSA without AMI, and 4 circRNAs (hsa_circRNA_101328, hsa_circRNA_104172, hsa_circRNA_104640, hsa_circRNA_104642) between healthy subjects and OSA with AMI were confirmed by qRT-PCR. In addition, we demonstrated that miR-29a-3p targeted hsa_circRNA_104642 directly. CONCLUSIONS: This study demonstrated that there were a number of dysregulated circRNAs in exosomes from OSA with AMI patients, which might be effectively served as a promising diagnostic biomarker and therapeutic targets.

Exhausting T Cells During HIV Infection May Improve the Prognosis of Patients with COVID-19.

T-cell reduction is an important characteristic of coronavirus disease 2019 (COVID-19), and its immunopathology is a subject of debate. It may be due to the direct effect of the virus on T-cell exhaustion or indirectly due to T cells redistributing to the lungs. HIV/AIDS naturally served as a T-cell exhaustion disease model for recognizing how the immune system works in the course of COVID-19. In this study, we collected the clinical charts, T-lymphocyte analysis, and chest CT of HIV patients with laboratory-confirmed COVID-19 infection who were admitted to Jin Yin-tan Hospital (Wuhan, China). The median age of the 21 patients was 47 years [interquartile range (IQR) = 40-50 years] and the median CD4 T-cell count was 183 cells/µl (IQR = 96-289 cells/µl). Eleven HIV patients were in the non-AIDS stage and 10 were in the AIDS stage. Nine patients received antiretroviral treatment (ART) and 12 patients did not receive any treatment. Compared to the reported mortality rate (nearly 4%-10%) and severity rate (up to 20%-40%) among COVID-19 patients in hospital, a benign duration with 0% severity and mortality rates was shown by 21 HIV/AIDS patients. The severity rates of COVID-19 were comparable between non-AIDS (median CD4 = 287 cells/µl) and AIDS (median CD4 = 97 cells/µl) patients, despite some of the AIDS patients having baseline lung injury stimulated by HIV: 7 patients (33%) were mild (five in the non-AIDS group and two in the AIDS group) and 14 patients (67%) were moderate (six in the non-AIDS group and eight in the AIDS group). More importantly, we found that a reduction in T-cell number positively correlates with the serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP), which is contrary to the reported findings on the immune response of COVID-19 patients (lower CD4 T-cell counts with higher levels of IL-6 and CRP). In HIV/AIDS, a compromised immune system with lower CD4 T-cell counts might waive the clinical symptoms and inflammatory responses, which suggests lymphocyte redistribution as an immunopathology leading to lymphopenia in COVID-19.

[Ventilatory and hemodynamic effects of continuous positive airway pressure in dogs with acute cardiogenic pulmonary edema].

OBJECTIVE: To investigate the ventilatory and hemodynamic effects of continuous positive airway pressure (CPAP) in acute cardiogenic pulmonary edema (ACPE) in dogs. METHODS: Cardiac output (CO), heart rate (HR), blood pressure (BP), pulmonary artery wedge pressure (PAWP), central venous pressure (CVP) and intrathoracic negative pressure (Pt) were measured. These parameters were recorded at spontaneous breath, 5 cm H2O, 10 cm H2O, and 15 cm H2O CPAP in ten dogs before (healthy state) and after the induction of ACPE. RESULTS: When ACPE occurred, the dogs showed rapid breath, higher Pt [-(10.90 +/- 0.75) versus -(4.90 +/- 0.09) cm H2O], decreased CVP and CO [(10.1 +/- 0.4) versus (8.0 +/- 0.7) mm Hg and (1.52 +/- 0.13) versus (0.85 +/- 0.09) L/min, respectively], increased PAWP [(9.64 +/- 0.54) versus (17.77 +/- 0.79) mm Hg, all P < 0.05]. The correlation coefficient of the change of CVP and the change of Pt was 0.78 (P < 0.01). The addition of 5 or 10 cm H2O CPAP decreased Pt [-(6.53 +/- 0.11), -(5.14 +/- 0.25) cm H2O], which resulted in increased cardiac function. CO was also increased [(1.45 +/- 0.11), (1.24 +/- 0.11) L/min], with decreased PAWP [(15.80 +/- 0.55), (17.40 +/- 0.70) mm Hg; P < 0.05]. After the application of 15 cm H2O CPAP, Pt reached nearly zero [-(0.82 +/- 0.37) cm H2O], CO decreased to (0.82 +/- 0.07) L/min and PAWP increased to (19.23 +/- 0.73) mm Hg (P < 0.05). CONCLUSIONS: ACPE induced rapid breath, elevated Pt and decreased CVP and CO. Proper CPAP can improve CO by regulating Pt, hence the improvement of other hemodynamic parameters.