About

Kate Ailstock is a faculty member at the School of Health and Rehabilitation Sciences at The Ohio State University. She holds a Master of Laboratory Science (MLS) and is certified as an American Society for Clinical Pathology (ASCP) CM Research Associate in the Division of Medical Laboratory Science. Her professional interests include hematology, immunology, and infectious disease. She has a background in biology and clinical laboratory science from East Carolina University. Her research and professional activities focus on advancing knowledge in these areas to improve health outcomes.

Research topics

• Gastroenterology
• Medicine
• Internal medicine
• Biology
• Immunology
• Cardiology

Selected publications

• Ultra-Processed Food Intake Is Not Associated with Systemic Inflammation in People with HIV

  Nutrients · 2026-04-11

  articleOpen access

  Background/Objectives: People with HIV (PWH) remain at high risk for cardiovascular and metabolic complications despite effective antiretroviral therapy (ART). Diet quality is an important modifiable factor that may influence these complications. Diets high in ultra-processed foods (UPF) have been linked to adverse metabolic and inflammatory profiles in the general population, but their impact on PWH remains poorly understood. The NOVA 4 classification categorizes foods by degree of processing, from unprocessed/minimally processed (NOVA 1) to UPF (NOVA 4). Methods: We conducted a cross-sectional study of adults with virologically suppressed HIV on stable ART. Assessments included dietary intake consisting of 24 h recalls analyzed with Nutrition Data System for Research software (NDSR) and classified into NOVA categories by a registered dietitian and the following characteristics: body composition (total and regional fat by DEXA and CT scan abdomen), cardiometabolic variables (glucose, HbA1C, HOMA-IR, lipids, blood pressure), and biomarkers of inflammation, immune activation, and gut integrity quantified by ELISA. Patients were stratified into NOVA 4 groups based on the median and quartile proportions of total energy intake from NOVA 4 foods. Associations between dietary NOVA and outcomes were analyzed using generalized additive models (GAMs) adjusted for age, sex, race, and CD4 count. Results: Among 222 PWH (mean age 45.4 ± 14.2 years; 31% female; 66% non-white; BMI 30.61 ± 7.91 kg/m2), median NOVA 4 intake was 45.6% of total energy intake. Participants with higher vs. lower NOVA 4 intake showed differences in diet quality, but in GAMs, higher NOVA 4 intake was not associated with higher levels of inflammatory, cardiometabolic, gut integrity, and body composition variables. Conclusions: In PWH, UPF consumption was high but not associated with markers of cardiometabolic health, systemic inflammation, or gut integrity. This may reflect the multifactorial nature of the heightened inflammation in PWH, potentially obscuring the effect of diet.

  PublisherOA PDFDOI

• Comparison of Immune Activation and Gut Barrier Dysfunction Between Long COVID and HIV Infection

  The Journal of Infectious Diseases · 2026-03-31

  article

  BACKGROUND: Human Immunodeficiency Virus (HIV) infection is characterized by persistent immune dysregulation and inflammation, with emerging evidence suggesting overlapping pathophysiological mechanisms with Long COVID. Biomarkers of systemic inflammation and gut integrity may provide insight into shared and distinct pathways underlying these conditions. The status of the anti-inflammatory vitamin K may play a role in sustained inflammation in these conditions. METHODS: This cross-sectional study enrolled participants belonging to one of 3 groups: individuals with Long COVID (Long COVID; n=108) without HIV, participants with HIV (PWH), virologically suppressed with no previous COVID-19 infection (HIV+; n=256), and controls without Long COVID or HIV (controls; n=193). Plasma samples were analyzed for inflammatory, gut integrity biomarkers, and dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP) as an established marker of vitamin K status. Associations were assessed using multivariable linear and logistic regression models adjusted for demographic, metabolic, and lifestyle covariates. RESULTS: 557 participants were included. Long COVID was independently associated with elevated oxLDL (β=0.39 vs. HIV, β=0.54 vs. controls; P<0.001 for both). PWH had higher odds of worse vitamin K status [OR: 1.5; 95% CIs (1.02-2.2), P=0.04]. Independent of Long COVID or HIV status, worse vitamin K status was strongly associated with higher levels of inflammatory markers. CONCLUSION: Long COVID and HIV share chronic immune dysregulation features but demonstrate distinct inflammatory profiles. Those findings highlight the importance of large longitudinal studies to delineate shared versus unique inflammatory pathways to guide potential Long COVID therapeutic strategies.

  PublisherDOI

• Inflammation in frailty, cognitive impairment, clinical events, and mortality among older adults with HIV in the ACTG HAILO cohort

  AIDS · 2025-08-14 · 1 citations

  articleOpen access

  OBJECTIVES: Associations between inflammatory markers and prevalent or incident frailty, cognitive impairment, clinical events, and mortality in older people with HIV are poorly understood. DESIGN: An observational cohort study. METHODS: Participants aged at least 50 years from the ACTG HAILO cohort study were included. Participants completed annual evaluations for cognitive impairment and frailty. Clinical events included non-AIDS-defining cancers, diabetes, and cardiovascular, liver, and kidney diseases. Associations between inflammatory markers (hsCRP, IL-6, TNFR1, CXCL-9, and inflammatory index score [IIS]) at baseline and prevalence and incidence of frailty, cognitive impairment, any clinical event, and non-accidental mortality were examined. We used 10-fold cross validation to evaluate whether the combination of inflammatory markers and frailty improved the ability to predict incident outcomes. RESULTS: Among 484 participants (17% assigned female at birth, 25% Black, and 20% Hispanic), median age was 56 years. Median BMI was 27 kg/m 2 , median CD4 + cell count was 627 cells/μl, and 95% had HIV-1 RNA less than 200 copies/ml. HsCRP, IL-6, TNFR1, CXCL-9, and IIS were associated with increased risk of prevalent frailty and clinical events, but not cognitive impairment. CXCL-9 (Q4 vs. Q1) and TNFR1 were associated with an increased incidence of both frailty and clinical events; Q4 vs. Q1 of the IIS was associated with clinical events; increased inflammatory markers (except CXCL-9) were associated with an increased risk of mortality. TNFR1 combined with frailty modestly improved the predictability of incident clinical events and mortality over frailty alone. CONCLUSION: Several inflammatory markers were associated with increased risk of frailty, clinical events, and mortality, but not cognitive impairment.

  PublisherDOI

• The Effect of COVID-19 on Arterial Stiffness and Inflammation: A Longitudinal Prospective Study

  Viruses · 2025-03-11 · 4 citations

  articleOpen access

  Data are limited for assessing the effect of COVID infection on endothelial function, pre- and post-pandemic. The objective of this study was to assess changes in pre-pandemic cardiovascular parameters after COVID-19 infection. This prospective cohort study used EndoPAT2000 Itamar Medical Ltd., Caesarea, Israel, to measure the augmentation index (AI; arterial elasticity) and reactive hyperemic index (RHI; endothelial function). Markers of endothelial function, inflammation, and gut integrity were collected at pre- and post-pandemic visits. COVID-negative and COVID-positive participants were matched on pre-pandemic covariates, and AI ≥ 5.0 was defined as having worse AI. Among the 156 participants, 50% had documented COVID-19 infection. Groups were balanced (p &gt; 0.05) on pre-pandemic characteristics. Increases in oxLDL (p = 0.03) were observed in the COVID-positive group, and COVID infection had a negative effect on inflammatory markers (sVCAM-1, sTNF-RI, sTNF-RII, sCD14) and gut integrity (I-FABP, BDG) compared to COVID-negative participants (p &lt; 0.05). There was a 16.7% (p = 0.02) increase in the proportion of COVID-positive participants with AI ≥ 5.0, without a significant change (p = 0.09) among the COVID-negative group. COVID-positive status, female sex, and higher IL-6 and sCD163 were associated (p &lt; 0.05) with an increase in having worse AI. COVID infection is independently associated with arterial stiffness. For COVID survivors, female sex and higher markers of inflammation were associated with arterial stiffness.

  PublisherOA PDFDOI

• Circulating fibroblast growth factor 21 and growth differentiation factor 15 are associated with severity of hepatic steatosis in people with <scp>HIV</scp>

  HIV Medicine · 2025-06-11 · 3 citations

  articleOpen access

  BACKGROUND: Hepatic steatosis poses a significant health burden in people with HIV. Fibroblast growth factor 21 (FGF21) production from the liver regulates glucose metabolism. Higher serum levels of FGF21 are associated with hepatic steatosis and liver fibrosis in the general population. Growth differentiation factor 15 (GDF15) secretion from the liver is also upregulated in chronic inflammatory diseases and is associated with cardiovascular dysfunction in people with HIV. Here, we measured serum FGF21 and GDF15 concentrations in people with HIV and hepatic steatosis. METHODS: A total of 177 people with HIV with no other known cause of liver disease underwent vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) quantification. Hepatic steatosis was defined as CAP ≥ 263 dB/m and advanced fibrosis as LSM > 12 kPa. Fasting serum total FGF21 and GDF15 concentrations were measured by ELISA. Relationships between biomarkers and hepatic parameters were analysed using a Censored Tobit Model. RESULTS: Participants with hepatic steatosis exhibited significantly higher mean (SD) levels of serum FGF21 (p = 0.002) and GDF15 (p = 0.02) than participants without steatosis. FGF21 levels increased with BMI (p = 0.04). Higher FGF21 and GDF15 levels correlated modestly with higher CAP (FGF21 r = 0.30, p < 0.001; GDF15 r = 0.21, p = 0.01) and LSM scores (FGF21 r = 0.25, p < 0.001; GDF15 r = 0.27, p = 0.01). FGF21 concentrations were 40% higher and GDF15 17% higher in persons with steatosis. Participants with the highest FGF21 levels (quartile 4) showed significantly higher mean CAP and LSM values, and longer mean duration of HIV compared with persons in quartile 1. Similar trends were also seen with GDF15 level quartiles. CONCLUSIONS: People with HIV and hepatic steatosis had higher levels of serum FGF21 and GDF15 than those without steatosis, and levels correlated with disease severity. FGF21 and GDF15 may aid in identifying people with HIV at risk of steatotic liver disease.

  PublisherOA PDFDOI

• Vitamins K2 and D3 Improve Long COVID, Fungal Translocation, and Inflammation: Randomized Controlled Trial

  Nutrients · 2025-01-16 · 21 citations

  articleOpen access

  Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition. The anti-inflammatory effect of vitamins K2 and D3 was shown to help attenuate the course of acute COVID-19 infection. Objective and hypothesis: This trial aims to investigate the effects of vitamins K2/D3 on LC symptoms, as well as gut and inflammatory markers, in people with established long COVID. Our hypothesis is that by attenuating systemic inflammation, vitamins K2/D3 will improve long COVID symptoms. Methods: This single-site randomized controlled study enrolled adults experiencing ≥2 moderate LC symptoms at least 3 months after a COVID-19 infection. The RECOVER Long COVID Research Index and number and type of LC symptoms were considered. Participants were randomized 2:1 to daily 240 µg K2 (pure MK-7 form) and 2000 UI vitamin D3 or standard of care (SOC) for 24 weeks. The endpoints were changes in symptomatology and in select inflammatory, metabolic, and gut biomarkers at 24 weeks. Results: We enrolled 151 participants (n = 98 received vit K2/D3 and 53 received SOC). The median age was 46 years; 71% were female and 29% were non-white. Baseline demographics were balanced between groups. At 24 weeks, the active treatment group only had a sharp increase in 25(OH) D, indicating good treatment adherence. In the vitamin K2/D3 arm, there was a 7.1% decrease in the proportion who had an LC Index ≥12 (vs. a 7.2% increase in the SOC group; p = 0.01). The average number of LC symptoms remained stable in the vitamin K2/D3 arm but increased in the SOC arm (p = 0.03). Additionally, reductions in oxidized LDL, inflammatory markers sTNF-RI and sCD163, and fungal translocation marker (1,3)-β-d-glucan were observed in the vitamin K2/D3 arm compared to the SOC arm (p &lt; 0.01) over 24 weeks. Conclusions: Vitamins K2/D3 improved the RECOVER Long COVID Index, the number of LC symptoms, and several gut and inflammatory markers. Vitamins K2/D3 provide a promising safe intervention for people suffering from long COVID.

  PublisherOA PDFDOI

• The Effects of Semaglutide on Inflammation and Immune Activation in HIV-associated Lipohypertrophy

  Open Forum Infectious Diseases · 2025-03-20 · 4 citations

  articleOpen access

  Abstract Background Cardiovascular and metabolic comorbidities are common in people with HIV (PWH) and are linked to chronic inflammation and immune activation. We assessed the effects of semaglutide on plasma markers of immune activation/inflammation that are known to be increased in PWH and are associated with morbidity and mortality in this population. Methods We conducted a single-site, randomized, double-blinded, placebo-controlled trial of virologically suppressed, nondiabetic PWH ≥18 years of age on stable antiretroviral therapy with body mass index ≥ 25 kg/m2, increased waist circumference/waist-to-hip ratio, and subjective increased abdominal girth after antiretroviral therapy initiation (clinicaltrials.gov: NCT04019197). Participants were randomized 1:1 to 32 weeks of semaglutide (8-week titration + 24 weeks of 1.0 mg weekly subcutaneous injection) or matching placebo. Signed-rank tests were used to determine changes over 32 weeks in soluble markers and cellular phenotypes of inflammation/immune activation within groups; semaglutide effects were assessed using linear or quantile regression analyses. Results A total of 108 participants were enrolled and evenly randomized to semaglutide versus placebo. Eight (15%) in each group withdrew prematurely. Thirty-two weeks of semaglutide treatment reduced baseline levels of C-reactive protein, interleukin-6, and soluble CD163 (all P &amp;lt; .02) and trended to reduce levels of sCD14 (P = .08). Circulating monocyte proportions and T-cell phenotypes were not altered by semaglutide. Conclusions In this randomized controlled trial of semaglutide in PWH, we report significant decreases in markers of inflammation that are associated with morbidity and mortality in this population. These results add to the growing literature demonstrating the anti-inflammatory effects of semaglutide. Further studies in PWH are warranted.

  PublisherOA PDFDOI

• Zinc Supplementation, Inflammation, and Gut Integrity Markers in HIV Infection: A Randomized Placebo-Controlled Trial

  Nutrients · 2025-05-14 · 1 citations

  articleOpen access

  Background: Low levels of zinc are prevalent in patients living with HIV and are associated with higher morbidity. Zinc has major immunomodulatory effects. This study aimed to assess the effect of zinc supplementation on inflammatory and gut integrity markers and on zinc levels among HIV patients with zinc deficiency. Methods: This was a double-blind randomized placebo-controlled trial assessing the efficacy and safety of zinc supplementation on inflammation and gut markers in people with HIV (PWH) ≥ 18 years old, on stable antiretroviral therapy (ART) with undetectable HIV-1 viral load, and with zinc levels of ≤0.75 mg/L. Participants were randomized 2:1 to zinc gluconate tablets at a dose of 90 mg of elemental zinc or a matching placebo daily for 24 weeks. At baseline and at week 24, we measured plasma levels of zinc and markers of inflammation and gut barrier integrity. Results: Among the 95 participants enrolled in this study, 74% were male, and 65% were non-white, with a median CD4 count of 722 cells/μL. The primary analysis showed an increase in zinc levels in the active group. A decrease in the monocyte activation marker soluble CD14 was observed in the treatment group at −56.31 ng/mL (−263.24; 134.19), compared to an increase in the placebo group of 101.71 ng/mL (−90.50; 243.20); p = 0.021. The stratified analysis showed that the group with the lowest zinc levels at baseline had the greatest improvements in soluble CD14 levels during zinc supplementation. No changes were seen in other inflammation markers or gut integrity markers. Conclusions: This is the most comprehensive study on the effect of zinc supplementation in PWH on inflammatory and gut integrity markers. Decreases were seen in the monocyte activation marker sCD14. In the contemporary HIV era with potent effective therapies, suppressed viremia, and high CD4 cells, zinc supplementation does not offer consistent benefits on inflammation.

  PublisherOA PDFDOI

• Distinct Metabolic and Inflammation Signatures in Urban vs Rural Ugandan Youth With HIV on Dolutegravir

  Open Forum Infectious Diseases · 2025-07-18

  articleOpen access

  Abstract Background In sub-Saharan Africa, the majority of the metabolic data are from youth living in urban areas. In youth with perinatally acquired HIV (YPHIV) and seronegative (HIV–), we examined inflammatory and metabolic signatures in urban versus rural Uganda. Methods YPHIV (n = 100) were enrolled from urban and rural Uganda in an observational cohort study along with age- and sex- matched, population-based HIV– (n = 99) comparators. YPHIVs were on antiretroviral with HIV-1 RNA level ≤400 copies/mL. We compared variables using Wilcoxon rank-sum tests and chi-squared tests. General linear regression models were used to assess factors associated with metabolic and inflammatory biomarkers, adjusting for HIV status, socioeconomic factors, and other covariates. Results Median age was 16.2 years, 52% rural versus 96% urban YPHIV had HIV-RNA &amp;lt;50 copies/mL, 93% of YPHIV were on Tenofovir, Lamivudine, and Dolutegravir. Overall, rural participants lived in extreme poverty compared to urban participants (P &amp;lt; .001). Urban YPHIV were more likely to have higher body mass index, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), total cholesterol, and low-density lipoprotein than rural YPHIV (P &amp;lt; .001); however sCD14, sCD163, high sensitivity C-reactive protein, interleukin-6, soluble tumor necrosis factor alspha receptor I (TNFRI), and lipopolysacchiride binding protein (LBP) were higher in rural YPHIV (P ≤ .001). After adjusting for demographic, socioeconomic, viral load and antiretroviral duration, only sCD14 remained elevated in the rural YPHIV (β: 1.1; 95% confidence interval, .2–2.0), and β D glucan in urban YPHIV (β 1.11; 95% confidence interval, .3–1.89). Conclusions The monocyte activation marker sCD14, was associated with HIV status and remained elevated in rural YPHIV even after adjusting for differences in HIV factors. Increasing the inclusion of rural populations in sub-Saharan Africa is paramount as we focus on preventing comorbidities in aging YPHIV.

  PublisherOA PDFDOI

• The Long-Term Effect of COVID-19 Infection on Body Composition

  Nutrients · 2024-04-30 · 5 citations

  articleOpen access

  Background: The effect of COVID-19 infection versus the indirect effect of the pandemic on body composition remains unclear. This study investigates the long-term changes in body composition in COVID-19 survivors compared to a contemporary control group. Method: This is a prospective study involving adults who underwent a pre-pandemic whole-body DXA scan (DXA#1) between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including their medical and COVID-19 history. Inflammation markers and fasting lipids were measured. For those participants who experienced a COVID-19 infection between the two DXAs, DXA#2 was acquired at least one year after COVID-19 infection. Results: Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n = 80) of the participants experienced a COVID-19 infection between their two DXA scans (COVID-19+ group), and the other half had never had COVID-19. COVID-19-negative participants displayed an increase in annualized trunk fat (g) [922.5 vs. 159.7; p = 0.01], total fat (g) [1564.3 vs. 199.9; p = 0.2], and LBM (g) [974.9 vs. −64.5; p = 0.0002] when compared to the COVID-19+ group. However, among the COVID-19+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p &gt; 0.05). Conclusion: During the pandemic, both the COVID-19 survivors and the COVID-19-negative group exhibited increases in weight, total fat, and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19 survivors displayed a decline in lean body mass over the same period, regardless of PASC symptoms.

  PublisherOA PDFDOI

Frequent coauthors

• Grace A. McComsey

  Case Western Reserve University

  21 shared

• Nicholas Funderburg

  The Ohio State University

  12 shared

• Sahera Dirajlal‐Fargo

  Case Western Reserve University

  11 shared

• Victor Musiime

  Joint Clinical Research Centre

  7 shared

• Jared Durieux

  Center for Clinical Research (United States)

  6 shared

• Danielle Labbato

  University Hospitals of Cleveland

  5 shared

• Jhony Baissary

  Case Western Reserve University

  4 shared

• Christian Mouchati

  4 shared