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Belov BS, Tarasova GM, Muravyeva NV. Role of biomarkers in the diagnosis of bacterial infections in rheumatic diseases. НАУЧНО-ПРАКТИЧЕСКАЯ РЕВМАТОЛОГИЯ 2019. [DOI: 10.14412/1995-4484-2019-333-338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In modern rheumatology, the problem of differential diagnosis of bacterial infection and active rheumatic process still retains its relevance. At the same time, it is very important to search for a biomarker - the gold standard for the diagnosis of an infection in patients with rheumatic diseases (RDs) in order to rapidly determine a treatment policy. This review analyzes the diagnostic significance and possibility of using some laboratory markers for bacterial infections in modern rheumatology. It emphasizes the importance of a multimarker approach that allows increasing the significance of individual parameters in the diagnosis of infections in RD.
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Affiliation(s)
- B. S. Belov
- V.A. Nasonova Research Institute of Rheumatology
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Accuracy of neutrophil CD64 expression in diagnosing infection in patients with autoimmune diseases: a meta-analysis. Clin Rheumatol 2019; 38:1319-1328. [PMID: 30915651 DOI: 10.1007/s10067-019-04518-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 12/23/2022]
Abstract
We aimed to systematically evaluate the accuracy of nCD64 in diagnosing infection in patients with autoimmune diseases. Studies were searched in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases up to October 2018. There was no restriction for language and age. Prospective studies examining the accuracy of nCD64 in diagnosing infection in patients with autoimmune diseases were included. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of eligible studies. Stata 15.1 and Meta-DiSc 1.4 software were used for data analysis. Eleven studies fulfilled the inclusion criteria (677 patients, 229 patients with bacterial infection, and 448 without infection). The pooled sensitivity and specificity of nCD64 were 89% (95% confidence interval (CI) 82-93) and 94% (95% CI 91-96), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 14.9 (95% CI 9.3-23.8) and 0.12 (95% CI 0.07-0.20), respectively. The diagnostic odds ratio and area under the summary receiver operating characteristic curve were 123 (95% CI 53-283) and 0.97 (95% CI 0.95-0.98), respectively. The univariate meta-regression analysis showed that region, type of disease, antibiotic therapy, and presentation of nCD64 measurement results were responsible for the heterogeneity. The Deeks' funnel plot asymmetry test showed that there was no publication bias (p = 0.15). nCD64 has a good overall diagnostic performance for differentiating infection from disease flare in patients with autoimmune diseases. Further studies are needed to confirm the optimized cutoff value.
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Neonatal corticosterone mitigates autoimmune neuropsychiatric disorders associated with streptococcus in mice. Sci Rep 2018; 8:10188. [PMID: 29976948 PMCID: PMC6033871 DOI: 10.1038/s41598-018-28372-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/12/2018] [Indexed: 01/27/2023] Open
Abstract
Increased glucocorticoid concentrations have been shown to favor resilience towards autoimmune phenomena. Here, we addressed whether experimentally induced elevations in circulating glucocorticoids mitigate the abnormalities exhibited by an experimental model of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS). This is a pathogenic hypothesis linking repeated exposures to Group-A-beta-hemolytic streptococcus (GAS), autoantibodies targeting selected brain nuclei and neurobehavioral abnormalities. To persistently elevate glucocorticoid concentrations, we supplemented lactating SJL/J mice with corticosterone (CORT; 80 mg/L) in the drinking water. Starting in adolescence (postnatal day 28), developing offspring were exposed to four injections - at bi-weekly intervals - of a GAS homogenate and tested for behavioral, immunological, neurochemical and molecular alterations. GAS mice showed increased perseverative behavior, impaired sensorimotor gating, reduced reactivity to a serotonergic agonist and inflammatory infiltrates in the anterior diencephalon. Neonatal CORT persistently increased circulating glucocorticoids concentrations and counteracted these alterations. Additionally, neonatal CORT increased peripheral and CNS concentrations of the anti-inflammatory cytokine IL-9. Further, upstream regulator analysis of differentially expressed genes in the striatum showed that the regulatory effect of estradiol is inhibited in GAS-treated mice and activated in GAS-treated mice exposed to CORT. These data support the hypothesis that elevations in glucocorticoids may promote central immunomodulatory processes.
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Piroozmand A, Soltani B, Razavizadeh M, Matini AH, Moosavi GA, Salehi M, Soltani S. Comparison of gastric juice soluble triggering receptor expressed on myeloid cells and C-reactive protein for detection of Helicobacter pylori infection. Electron Physician 2017; 9:6111-6119. [PMID: 29560167 PMCID: PMC5843441 DOI: 10.19082/6111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/20/2017] [Indexed: 12/11/2022] Open
Abstract
Background and aim Triggering receptor expressed on myeloid cells (TREM-1) is a receptor on phagocytes that is triggered by infectious agents. The soluble form of it (sTREM-1) can be elevated in gastric juice by Helicobacter pylori (H. pylori) infection of gastric mucosa. The aim of this study was to compare the diagnostic values of sTREM-1 and C-reactive protein (CRP) for detection of H. pylori infection in gastric mucosa. Methods In this diagnostic accuracy study on cases who underwent endoscopy from March 2015 to July 2016 in Shahid Beheshti Hospital, Kashan, Iran, gastric juice sTREM-1 and CRP concentrations were measured by enzyme-linked immunosorbent assays (ELISA) and their diagnostic values were compared to detect H. pylori infection. Gold standard test was histopathology. Data were entered into SPSS software version 16. Statistical analysis was made by Kolmogorov-Smirnov, Chi-square, Independent-samples t-test, Kruskal-Wallis, Mann-Whitney U, Pearson product-moment correlation, Receiver operating characteristic curve (ROC), Brier score, Nagelkerke R square and scaled reliability test. Results Of a total of 160 cases, 81 (50.6%) were H. pylori-positive based on pathology. The level of sTREM-1 in H. pylori-positive patients was significantly higher than H. pylori-negative patients (p=0.000), but no significant difference between CRP concentrations was shown between groups (p=0.7). Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of sTREM-1 were 82%, 75%, 3.3, 0.25, 78% and for CRP were 62%, 40%, 1.02, 0.98, 51% respectively for diagnosis of H. pylori infection. True positive and negative rates were 66 (81.5%) and 59 (74.7%) for sTREM-1 and 50 (61.7%) and 31 (39.2%) for CRP. The levels of sTREM-1 and CRP were not significantly different between endoscopic finding groups (p=0.97, p=0.2 respectively). Conclusion Despite CRP, sTREM-1 was a relatively acceptable indicator of H. pylori infection of gastric mucosa.
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Affiliation(s)
- Ahmad Piroozmand
- Ph.D. of Virology, Associate Professor, Department of Microbiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Babak Soltani
- M.D., Pediatric Infectious Diseases Specialist, Associate Professor, Department of Pediatrics, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Razavizadeh
- M.D., Gastroenterologist, Assistant Professor, Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Hasan Matini
- M.D., Pathologist, Assistant Professor, Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Gholam Abbas Moosavi
- M.Sc. of Biostatistics, Lecturer, Department of Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Salehi
- M.D., Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Siamak Soltani
- M.D., Forensic Medicine Specialist, Associate Professor, Department of Forensic Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Ðerek L, Servis D, Unić A. Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Inflammatory Markers in Colorectal Cancer Surgery: A Prospective Cohort Study. Chin Med J (Engl) 2017; 130:2691-2696. [PMID: 29133757 PMCID: PMC5695054 DOI: 10.4103/0366-6999.218022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Major abdominal surgery, including colorectal cancer (CRC) surgery, leads to systemic inflammatory response syndrome that can be detected and monitored with inflammatory markers testing. The aims of the study were to evaluate the usefulness of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) in following the inflammatory response in CRC surgery and postoperative period, as well as to determine if duration of the surgery and the time that the colon has been opened during the surgery (open colon time [OCT]) reflect a larger surgical stress through inflammatory markers rise. Methods: The study included 20 patients who underwent CRC surgery and 19 healthy volunteers from June 2011 to September 2012. We determined inflammatory markers 1 day before surgery (T0), 24 h (T1), 48 h (T2), and 7 days after the surgery (T3). All statistical analyses were calculated using MedCalc Statistical Software version 14.8.1 (MedCalc Software bvba, Ostend, Belgium). Results: Concentrations of CRP, PCT, and IL-6 in all measurement times were statistically different and sTREM-1 did not yield statistical significance. A weak positive correlation was found between IL-6 in T1 and T2 with the duration of the surgery (T1: r = 0.4060, P < 0.0001; T2: r = 0.3430, P < 0.0001) and OCT (T1: r = 0.3640, P < 0.0001, T2: r = 0.3430, P < 0.0001). A weak positive correlation between CRP in T2 and OCT (r = 0.4210, P < 0.0001) was also found. The interconnectivity of tested parameters showed a weak positive correlation between CRP and IL-6 in T1 (r = 0.3680; P < 0.0001), moderate positive correlation in T2 (r = 0.6770; P < 0.0001), and a strong positive correlation in T3 (r = 0.8651; P < 0.0001). Conclusions: CRP, IL-6, and PCT were shown to be reliable for postoperative monitoring. Simultaneous determination of CRP and IL-6 might not be useful as they follow similar kinetics. sTREM-1 might not be useful in CRC postoperative monitoring. Trial Registration: www.ClinicalTrials.gov, NCT01244022;https://www.clinicaltrials.gov/ct2/show/NCT01244022?term=01244022&rank=1.
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Affiliation(s)
- Lovorka Ðerek
- Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Center, Zagreb 10000, Croatia
| | - Dražen Servis
- Department of General and Abdominal Surgery, St. Anna Hospital, Sulzbach-Rosenberg 92237, Germany
| | - Adriana Unić
- Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Center, Zagreb 10000, Croatia
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Ge X, Hu D, Cao Y, Liu Z, Ding C, Tian H, Gong J, Zhu W, Li N, Li J. Procalcitonin in Crohn's disease with fever episodes, a variable to differentiate intra-abdominal abscess from disease flares. Int J Surg 2016; 36:34-39. [PMID: 27743896 DOI: 10.1016/j.ijsu.2016.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 09/18/2016] [Accepted: 10/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Crohn's Disease (CD) is a chronic inflammatory disease accompanied by many complications, such as intra-abdominal abscess (IAA). A frequent problem in CD is the discrimination of fever caused by exacerbated bowel inflammation or IAA. METHODS A total of 80 CD patients complaining with fever episodes were included prospectively. PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) were evaluated on admission. IAA was identified based on image studies and response to antibiotic therapy by physicians blind to the serum PCT level. At last, correlation between serum PCT level and patients' disease activity was also investigated. RESULTS Sixteen patients were identified with IAA, which showed significantly higher serum PCT level when compared with those patients who have no IAA (0.505 ng/ml vs 0.112 ng/ml, p < 0.01). PCT is a better biomarker of IAA in CD patients compared with CRP, ESR and WBC (AUC = 0.954, 0.757, 0.771 and 0.554, respectively). And the cutoff value for PCT in differentiating patients with and without IAA was 0.35 ng/ml. Correlation between serum PCT level and CDAI score (r = 0.575) was weaker than that of CRP and ESR (r = 0.628 and 0.634 respectively), but stronger than that of WBC (r = 0.162). CONCLUSION PCT can be an additional marker for detecting IAA in CD patients with fever episodes, and may serve as a new serological marker of disease activity.
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Affiliation(s)
- Xiaolong Ge
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dong Hu
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Surgery, The First Affiliated Hospital of Nanchang University, China
| | - Yu Cao
- Drum Tower Hospital, Medical School of Nanjing University, China
| | - Zhijian Liu
- Drum Tower Hospital, Medical School of Nanjing University, China
| | - Chao Ding
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hongliang Tian
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jianfeng Gong
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Weiming Zhu
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ning Li
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Jieshou Li
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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