AUTHOR=Rønn Christian , Knudsen Andreas Dehlbæk , Arentoft Nicoline Stender , Thudium Rebekka Faber , Heidari Safura-Luise , Sivapalan Pradeesh , Ulrik Charlotte S. , Benfield Thomas , Ostrowski Sisse Rye , Jensen Jens Ulrik Stæhr , Nielsen Susanne D. 

TITLE=Endothelial injury and decline in lung function in persons living with HIV: a prospective Danish cohort study including 698 adults

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1337609

DOI=10.3389/fmed.2024.1337609

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objectives</title><p>Endothelial injury may promote declining lung function. We aimed to investigate in well-treated persons living with HIV (PLWH) whether elevated levels of thrombomodulin (TM) and syndecan-1 (SDC1) are associated with excess lung function decline and worsening dyspnea.</p></sec><sec id="sec2"><title>Methods</title><p>A prospective cohort study comprising patients from the Copenhagen municipality. We included 698 PLWH with undetectable viral load. Biomarkers and demographics were measured at baseline, spirometry [forced expiratory volume in one second (FEV<sub>1</sub>) and forced vital capacity (FVC)] and dyspnea score both at baseline and 2-year follow-up.</p><p>Both biomarkers were dichotomized at the 3rd quartile. Decline in lung function was estimated using a linear mixed model with patient-specific random effect. Increase in dyspnea score was estimated using a general mixed logistic regression model.</p></sec><sec id="sec3"><title>Results</title><p>We did not find an association between elevated SDC1 or TM and an excess decline in neither FEV<sub>1</sub>: SDC1: 4.5 mL/year (95% CI: −3.9–12.9, <italic>p</italic> = 0.30), TM: 2.2 mL/year (95% CI: −6.0–10.4, <italic>p</italic> = 0.60) nor FVC: SDC1: 4.1 mL/year (95% CI: −6.0–14.2, <italic>p</italic> = 0.42), TM: 1.4 mL/year (95% CI: −8.3–11.1, <italic>p</italic> = 0.78). A subgroup analysis of never-smokers was consistent with the main analysis.</p><p>Likewise, we did not find any association between elevated SDC1 and TM and increase in dyspnea score: SDC1: OR 1.43 (95% CI: 0.89–2.30, <italic>p</italic> = 0.14), TM: OR 1.05 (95% CI: 0.65–1.71, <italic>p</italic> = 0.26).</p></sec><sec id="sec4"><title>Conclusion</title><p>We did not find a significant association between elevated biomarkers of endothelial injury and decline in lung function nor dyspnea.</p></sec>