Muscle biopsy features in critical ill patients with 2009 influenza A (H1N1) virus infection

Lorenzoni, Paulo José; Kay, Cláudia Suemi Kamoi; Scola, Rosana Hermínia; Júnior, Hipólito Carraro; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2012000500004

Cited by 7 publications

(10 citation statements)

References 6 publications

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“…In this study, CK levels were high in patients with septic shock patients or SIRS and could be a biomarker of the severity of disease (45). CK levels are observed in metabolic dysfunction associated with in uenza H1N1 infection (46). Since high CK levels were consistent with the high levels of serum GLUT4, we suggest that both probably have a similar mechanism of release into the serum, and can act as clinical indicators or biomarkers predicting the severity of the disease.…”

Section: Discussionsupporting

confidence: 54%

A Potential Role for GLUT4 in Predicting Sepsis in Critically ill Children

Peng¹,

Liu²,

Pei-qing³

et al. 2020

Preprint

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Background: Glucose transporter (GLUT) 4 is an insulin-sensitive transporter that uptakes blood glucose into muscles and adipose tissue. This study aimed to investigate serum GLUT4 levels in critically ill children and to examine the potential relationship between serum GLUT4 levels and illness severity.Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls; routine health check-up) who were admitted between 07/2015 and 05/2016. Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed.Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 µg/L, P<0.001), and in septic shock compared with sepsis (116.8 vs. 64.3 µg/L, P<0.05), but not compared to non-sepsis/systemic inflammatory response syndrome (105.7 µg/L, P>0.05). Compared to healthy children, hyperglycemic patients (n=48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P<0.001). Serum GLUT4 levels were higher in patients who died (n=16, P<0.05) than in those who survived (n=57). Serum GLUT4 levels were positively correlated with the neutrophil count, creatine kinase levels, and glucose levels (P<0.05). GLUT4 levels for the diagnosis of sepsis had an area under the curve of 0.70 (P=0.03) when using a 51-µg/L cut-off value, resulting in 74.6% sensitivity and 80% specificity.Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity in critically ill children.

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Section: Discussionsupporting

confidence: 54%

A Potential Role for GLUT4 in Predicting Sepsis in Critically ill Children

Peng¹,

Liu²,

Pei-qing³

et al. 2020

Preprint

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“…In a range of ages, elevated circulating markers of muscle damage, such as creatine kinase (CK), myoglobin, and lactate dehydrogenase, have been reported during flu infection [ 7 - 13 ]. Additionally, during flu pandemics there have been cases of rhabdomyolysis reported [ 14 - 16 ] and muscle biopsies have confirmed atrophic/necrotic muscle fibers, though inflammatory cell infiltration seems less common [ 7 , 17 ]. Furthermore, during the 2009 H1N1 flu pandemic, elevated serum CK was associated with worse flu outcomes (length of intensive care unit stay, increased pulmonary, kidney, and other non-pulmonary complications) [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Aging augments the impact of influenza respiratory tract infection on mobility impairments, muscle-localized inflammation, and muscle atrophy

Bartley

Pan

Keilich

et al. 2016

Aging

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Although the influenza virus only infects the respiratory system, myalgias are commonly experienced during infection. In addition to a greater risk of hospitalization and death, older adults are more likely to develop disability following influenza infection; however, this relationship is understudied. We hypothesized that upon challenge with influenza, aging would be associated with functional impairments, as well as upregulation of skeletal muscle inflammatory and atrophy genes. Infected young and aged mice demonstrated decreased mobility and altered gait kinetics. These declines were more prominent in hind limbs and in aged mice. Skeletal muscle expression of genes involved in inflammation, as well as muscle atrophy and proteolysis, increased during influenza infection with an elevated and prolonged peak in aged mice. Infection also decreased expression of positive regulators of muscle mass and myogenesis components to a greater degree in aged mice. Gene expression correlated to influenza-induced body mass loss, although evidence did not support direct muscle infection. Overall, influenza leads to mobility impairments with induction of inflammatory and muscle degradation genes and downregulation of positive regulators of muscle. These effects are augmented and prolonged with aging, providing a molecular link between influenza infection, decreased resilience and increased risk of disability in the elderly.

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“…The study of Lorenzoni et al 12 that shows the presence of very high CK and muscle findings not characteristic of critical illness myopathy reinforces the association between the skeletal muscle-biopsy alterations described and influenza A (H1N1) infection. The mechanisms of viral pathogenesis are most likely complex.…”

mentioning

confidence: 64%

“…In this issue, a paper is presented, demonstrating abnormalities findings in skeletal muscle of ten critical ill patients (within 20 to 57 of age) with influenza A (H1N1) virus infection, the highest series in the literature, containing important clinical considerations about interaction between virus and muscle 12 .…”

mentioning

confidence: 99%