Stephanie M. Levine

American Physical Therapy Association

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i-10 index

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Co-Authors

Luis F. Angel

New York University

Antonio Anzueto

The University of Texas Health Science Center at San Antonio

Jay I. Peters

The University of Texas Health Science Center at Houston

Marcos I. Restrepo

The University of Texas Health Science Center at San Antonio

Charles L. Bryan

The University of Texas Health Science Center at San Antonio

John Calhoon

The University of Texas Health Science Center at San Antonio

Stephen Jenkinson

Pfizer (United States)

Edward Y. Sako

The University of Texas Health Science Center at San Antonio

Deborah J. Levine

Stanford University

Nilam J. Soni

The University of Texas Health Science Center at San Antonio

Cooperative Institutions

RELX Group (United States)

392

Parks Victoria

204

Hamilton Health Sciences

202

Nephrologisches Zentrum Goettingen

201

The University of Texas Health Science Center at San Antonio

200

La Jolla Alcohol Research

198

South Texas Veterans Health Care System

191

Footscray Hospital

184

Dialyse Centrum Groningen

165

Cooperative Trials Group for Neuro-Oncology

147

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Immune resilience despite inflammatory stress promotes longevity and favorable health outcomes including resistance to infection

Nature Communications (2023)

Sunil K. Ahuja Muthu Saravanan Manoharan Grace C. Lee Lyle R. McKinnon Justin A. Meunier

Abstract Some people remain healthier throughout life than others but the underlying reasons are poorly understood. Here we hypothesize this advantage is attributable in part to optimal immune resilience (IR), defined as the capacity to preserve and/or rapidly restore immune functions that promote disease resistance (immunocompetence) and control inflammation in infectious diseases as well as other causes of inflammatory stress. We gauge IR levels with two distinct peripheral blood metrics that quantify the balance between (i) CD8 + and CD4 + T-cell levels and (ii) gene expression signatures tracking longevity-associated immunocompetence and mortality-associated inflammation. Profiles of IR metrics in ~48,500 individuals collectively indicate that some persons resist degradation of IR both during aging and when challenged with varied inflammatory stressors. With this resistance, preservation of optimal IR tracked (i) a lower risk of HIV acquisition, AIDS development, symptomatic influenza infection, and recurrent skin cancer; (ii) survival during COVID-19 and sepsis; and (iii) longevity. IR degradation is potentially reversible by decreasing inflammatory stress. Overall, we show that optimal IR is a trait observed across the age spectrum, more common in females, and aligned with a specific immunocompetence-inflammation balance linked to favorable immunity-dependent health outcomes. IR metrics and mechanisms have utility both as biomarkers for measuring immune health and for improving health outcomes.

Immunocompetence

Stressor

10.1038/s41467-023-38238-6

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Citations (51)

Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study

The Lancet Infectious Diseases (2016)

Stefano Aliberti Luis Felipe Reyes Paola Faverio Giovanni Sotgiu Simone Dore

10.1016/s1473-3099(16)30267-5

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Citations (137)

A 55-Year-Old Woman With an Intrapulmonary Nodule in a Transplanted Lung

CHEST Journal (2001)

Stephanie M. Levine

Nodule (geology)

Lung biopsy

Left lung

Solitary pulmonary nodule

10.1378/chest.120.6.2057

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Citations (1)

Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

CHEST Journal (2020)

Judith Marín‐Corral Sergi Pascual-Guàrdia Francesco Amati Stefano Aliberti Joan Ramón Masclans

Aspiration Pneumonia

10.1016/j.chest.2020.06.079

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Citations (35)

Buthionine sulfoximine treatment impairs rat diaphragm function.

American Journal of Respiratory and Critical Care Medicine (1994)

Carlos F. Morales Antonio Anzueto Fernando Andrade Jacqueline Brassard Stephanie M. Levine

Activation of the glutathione (GSH) redox cycle with production of glutathione disulfide (GSSG) has been shown to occur in the diaphragm during inspiratory resistive loading (RB). Buthionine sulfoximine (BSO) lowers tissue GSH by irreversibly inhibiting the rate-limiting synthesis enzyme gamma-glutamylcysteine synthetase. We investigated the effects of BSO on rat diaphragm function, both at rest and after a period of RB. Rats in the RB groups underwent inspiratory RB until they were unable to sustain 70% of their maximal airway pressure. A portion of the diaphragm was analyzed for GSH and GSSG levels, and measurements of in vitro contractile properties included contraction times, maximal tetanic tension (Po), maximal twitch tension (Pt), and force frequency curves. BSO treatment produced a profound depletion of diaphragmatic GSH. Neither BSO nor RB alone significantly altered diaphragm contractile properties at this load of RB. But, in BSO-RB rats, there was a significant decrease in Pt, Po, and tetanic tension at all frequencies of stimulation compared with those in other groups. These data reveal that animals treated with BSO followed by inspiratory resistive loading exhibit marked diaphragm impairment, suggesting that GSH may play an important role in protecting the diaphragm from the stress induced by this resistive breathing protocol.

Diaphragm (acoustics)

Buthionine sulfoximine

Tetanic stimulation

10.1164/ajrccm.149.4.7908245

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Citations (13)

A Low Incidence of Posttransplant Lymphoproliferative Disorder in 109 Lung Transplant Recipients

CHEST Journal (1999)

Stephanie M. Levine Luis F. Angel Antonio Anzueto Irawan Susanto Jay I. Peters

Immunosuppression

Lymphoproliferative Disorders

10.1378/chest.116.5.1273

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Citations (78)

Single lung transplantation. Factors in postoperative cytomegalovirus infection.

PubMed (1992)

John Calhoon L. Nichols R. Duane Davis CHRISTINE BRYANT Stephanie M. Levine

Thirty-one single lung transplantations were performed between March 17, 1988, and November 1, 1990. Postoperative infection, especially with cytomegalovirus, has been the major cause of morbidity and mortality. Eighteen of the 31 patients were receiving prednisone before transplantation. Every patient was prepared preoperatively with oral cyclosporine 5 mg/kg and azathioprine (Imuran) 2 mg/kg. Every patient received methylprednisolone for 3 days postoperatively, followed by prednisone 1.0 mg/kg/day, oral cyclosporine, and azathioprine. Ten patients additionally had cytolytic therapy with OKT3 and 12 with antilymphocyte globulin. Nine patients had no cytolytic therapy. Cytolytic therapy was chronologic, not randomized. Postoperative infection occurred in 20 patients, 13 of whom had cytomegalovirus infection. Preoperative use of prednisone did not correlate with postoperative infection, cytomegalovirus, or death. Postoperative infection occurred in 17 of 22 patients with cytolytic therapy compared with three of nine without cytolytic therapy (p = 0.035). Cytomegalovirus infection occurred in 13 of 22 with cytolytic therapy and in none of the nine without cytolytic agents (p = 0.003). Therefore preoperative prednisone does not appear to be a contraindication to single lung transplantation. Cytolytic therapy with either OKT3 or antilymphocyte globulin increases the prevalence of postoperative infection with cytomegalovirus and should not be used in patients undergoing lung transplantation.

Cytomegalovirus

Immunosuppression

Source

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Citations (77)

Costal Exostosis: A Rare Cause of Hemothora

CHEST Journal (2012)

Karla Diaz Diego J. Maselli Manuel Rivera Stephanie M. Levine

Exostosis

10.1378/chest.1385958

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Citations (0)