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Song YX, Chen ST, Zhao YT, Feng YP, Chen JY, Li ZS, Du YQ. Nomogram for the prediction of infected pancreatic necrosis in moderately severe and severe acute pancreatitis. J Dig Dis 2024. [PMID: 38779802 DOI: 10.1111/1751-2980.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES As a serious complication of moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), infected pancreatic necrosis (IPN) can lead to a prolonged course of interventional therapy. Most predictive models designed to identify such patients are complex or lack validation. The aim of this study was to develop a predictive model for the early detection of IPN in MSAP and SAP. METHODS A total of 594 patients with MSAP or SAP were included in the study. To reduce dimensionality, least absolute shrinkage and selection operator regression analysis was used to screen potential predictive variables, a nomogram was then constructed using logistic regression analysis. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the discrimination, accuracy, and clinical efficacy of the model. External data were also obtained to further validate the constructed model. RESULTS There were 476, 118, and 82 patients in the training, internal validation, and external validation cohorts, respectively. Platelet count, hematocrit, albumin/globulin, severity of acute pancreatitis, and modified computed tomography severity index score were independent factors for predicting IPN in MSAP and SAP. The area under the ROC curves were 0.923, 0.940, and 0.817, respectively, in the three groups. There was a good consistency between the actual probabilities and the predicted probabilities. DCA revealed excellent clinical utility. CONCLUSION The constructed nomogram is a simple and feasible model that has good clinical predictive value and efficacy in clinical decision-making for IPN in MSAP and SAP.
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Affiliation(s)
- Ying Xiao Song
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shu Tong Chen
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ya Ting Zhao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yong Pu Feng
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jia Yu Chen
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhao Shen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yi Qi Du
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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Yusof B, Kamal I, Lee KM, Chai SK, Zuo XL, Ravichandran M, Ding KX, Fuloria NK, Tham SK. A case series on safety and tolerability of human umbilical cord-derived mesenchymal stem cells on patients in Malaysia. SAGE Open Med Case Rep 2024; 12:2050313X241249622. [PMID: 38694904 PMCID: PMC11062224 DOI: 10.1177/2050313x241249622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/08/2024] [Indexed: 05/04/2024] Open
Abstract
Umbilical cord-derived mesenchymal stem cells for regenerative therapy are a promising treatment option for chronic illnesses. Umbilical cord-derived mesenchymal stem cells offer several advantages over other sources, which makes them an attractive option in tissue repair and regeneration. This clinical study describes a 1-year follow-up on the safety and tolerance of umbilical cord-derived mesenchymal stem cell therapy on nine patients in Malaysia. Patients were assessed for adverse effects, and liver function tests were carried out on both pre- and post-treatments. Umbilical cord-derived mesenchymal stem cells' effectiveness and safety were assessed by follow-up evaluations. All nine patients responded positively towards umbilical cord-derived mesenchymal stem cell therapy, without any adverse effects. After umbilical cord-derived mesenchymal stem cell therapy, a significant improvement was observed in liver functioning test outcomes, as haematological parameters and tumour markers were stable. The present study concludes that umbilical cord-derived mesenchymal stem cell therapy is well tolerated by Malaysian patients; however, further clinical screening must be done over a large number of patients population.
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Affiliation(s)
- Basmullah Yusof
- ALPS Medical Centre, ALPS Global Holding, Kuala Lumpur, Malaysia
| | | | - Ka Man Lee
- Celestialab Sdn Bhd, Kuala Lumpur, Malaysia
| | | | - Xia Lin Zuo
- ALPS Medical Centre, ALPS Global Holding, Kuala Lumpur, Malaysia
- Institute of Neurosciences, Guangzhou Medical University Hospital, Guangzhou, China
| | - Manickam Ravichandran
- Mygenome, ALPS Global Holding, Kuala Lumpur, Malaysia
- Department of Biotechnology, Faculty of Applied Sciences, AIMST University, Bedong, Kedah, Malaysia
| | - Ke Xiang Ding
- ALPS Medical Centre, ALPS Global Holding, Kuala Lumpur, Malaysia
- Southern Medical University of China, Guangzhou, Guangdong, China
| | - Neeraj Kumar Fuloria
- Faculty of Pharmacy, AIMST University, Kedah, Malaysia
- Centre for Transdisciplinary Research, Department of Pharmacology, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospital, Saveetha University, Chennai, Tamil Nadu, India
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Hu J, Huang Y, Jia R, Wang X, Wang Y. Absolute monocyte counts could predict disease activity and secondary loss of response of patients with Crohn's disease treated with anti-TNF-α drug. PLoS One 2024; 19:e0301797. [PMID: 38598519 PMCID: PMC11006187 DOI: 10.1371/journal.pone.0301797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Assessing Crohn's disease (CD) activity is critical for monitoring disease progression. In CD, monocytes could release TNF-α. Thus, it is extremely important to study its role in the disease activity and loss of response to anti-TNF-α biologics. METHODS In this study, we collected CD patients treated with biologics from January 2017 to May 2022. Indicators associated with disease activity were evaluated by Spearman correlation analysis and Mann-Whitney U test. Specifically, logistic analyses were used to explore the predictors of primary nonresponse (PNR) and secondary loss of response (SLOR) within 1 year of anti-TNF-α agents. In addition, a nomogram was developed for therapeutic effect prediction. RESULTS 283 patients with CD were identified. Disease activity group, defined as CDAI equal to or greater than 150, had significant elevated absolute monocyte counts than disease remission group based on CDAI score (p = 0.019, Z = -2.354). Logistic analyses showed that absolute monocyte counts could be an independent predictor of 1-year SLOR of anti-TNF-α agents in CD patients (p = 0.013). A nomogram established based on gender, absolute monocyte counts, and hemoglobin could predict SLOR within 1 year of anti-TNF-α agents reliably. CONCLUSION The results of this study support the utility of absolute monocyte counts detecting disease activity and anti-TNF-α therapy effect in patients with CD.
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Affiliation(s)
- Jia Hu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Research Center of Digestive Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yin Huang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Research Center of Digestive Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ruonan Jia
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Research Center of Digestive Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Research Center of Digestive Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yongjun Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Research Center of Digestive Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Das D, Banerjee A, Manna K, Sarkar D, Shil A, Sikdar Ne E Bhakta M, Mukherjee S, Maji BK. Quercetin counteracts monosodium glutamate to mitigate immunosuppression in the thymus and spleen via redox-guided cellular signaling. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 126:155226. [PMID: 38387276 DOI: 10.1016/j.phymed.2023.155226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/13/2023] [Accepted: 11/18/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Chronic inflammation brought on by oxidative stress can result in several immunopathologies. Natural compounds with antioxidant characteristics, like quercetin, have shown effectiveness in reducing oxidative damage and regulating the immune response. PURPOSE The commonly used food additive monosodium glutamate (M) causes immunosuppression by disrupting redox equilibrium and inducing oxidative stress. The goal of this work is to examine the therapeutic potential of quercetin against immunotoxicity brought on by M, revealing the molecular route implicated in such immunopathology by targeting the thymus and spleen, to support the development of future anti-inflammatory and antioxidant therapies. STUDY DESIGN AND METHODS M-fed rats were employed as an immunotoxicity model and were supplemented with quercetin for four weeks. Hematological and biochemical parameters were measured; H&E staining, immunohistochemistry, flow cytometry, real-time quantitative PCR, and western blotting were performed. RESULTS Based on the findings, TLR4 was activated by M to cause oxidative stress-mediated inflammation, which was alleviated by the supplementation of quercetin by modulating redox homeostasis to neutralize free radicals and suppress the inflammatory response. To prevent M-induced inflammation, quercetin demonstrated anti-inflammatory functions by blocking NF-kB activation, lowering the production of pro-inflammatory cytokines, and increasing the release of anti-inflammatory cytokines. By normalizing lipid profiles and lowering the potential risk of immunological deficiency caused by M, quercetin also improves lipid metabolism. Additionally, it has shown potential for modifying insulin levels, suggesting a possible function in controlling M-induced alteration in glucose metabolism. The addition of quercetin to M enhanced the immune response by improving immunoglobulin levels and CD4/CD8 expression in the thymus and spleen. Additionally, quercetin inhibited apoptosis by controlling mitochondrial caspase-mediated cellular signaling, suggesting that it may be able to halt cell death in M-fed rats. CONCLUSION The results of this study first indicate that quercetin, via modulating redox-guided cellular signaling, has a promising role in reducing immune disturbances. This study illuminates the potential of quercetin as a safe, natural remedy for immunopathology caused by M, including thymic hypoplasia and/or splenomegaly, and paves the way for future anti-inflammatory and antioxidant supplements.
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Affiliation(s)
- Debasmita Das
- Department of Physiology (UG & PG), Serampore College, 9 William Carey Road, Serampore, Hooghly-712201, West Bengal, India
| | - Arnab Banerjee
- Department of Physiology (UG & PG), Serampore College, 9 William Carey Road, Serampore, Hooghly-712201, West Bengal, India
| | - Krishnendu Manna
- Department of Food & Nutrition, University of Kalyani, Kalyani, Nadia, West Bengal, India
| | - Deotima Sarkar
- Department of Bacteriology, National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research (ICMR-NICED), Kolkata 700010, India
| | - Aparna Shil
- Microbiology, Nutrition and Dietetics Laboratory, Physiology Unit, Department of Life Sciences, Presidency University, Kolkata-700073, India
| | - Mausumi Sikdar Ne E Bhakta
- Microbiology, Nutrition and Dietetics Laboratory, Physiology Unit, Department of Life Sciences, Presidency University, Kolkata-700073, India
| | - Sandip Mukherjee
- Department of Physiology (UG & PG), Serampore College, 9 William Carey Road, Serampore, Hooghly-712201, West Bengal, India
| | - Bithin Kumar Maji
- Department of Physiology (UG & PG), Serampore College, 9 William Carey Road, Serampore, Hooghly-712201, West Bengal, India.
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Godala M, Gaszyńska E, Walczak K, Małecka-Wojciesko E. Evaluation of Albumin, Transferrin and Transthyretin in Inflammatory Bowel Disease Patients as Disease Activity and Nutritional Status Biomarkers. Nutrients 2023; 15:3479. [PMID: 37571416 PMCID: PMC10421392 DOI: 10.3390/nu15153479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is often accompanied by malnutrition that manifests itself as nutrient deficiencies and body mass loss or deficit. The purpose of this study is to evaluate the utility of albumin, transferrin and transthyretin levels in the assessment of nutritional status and IBD activity. The case-control study included 82 IBD patients. The serum concentrations of albumin, transferrin and transthyretine were determined by a quantitative sandwich enzyme-linked immunosorbent assay (ELISA). Significantly lower median concentrations of albumin were found in the IBD patients vs. controls and in CD patients compared to the UC patients. Significantly higher median transthyretin concentrations were found in the IBD patients compared to the healthy subjects. There were no significant differences in median transferrin concentrations between the IBD patients and the healthy subjects. Significantly higher albumin levels were found in IBD patients in remission compared to patients with moderate and severe exacerbation of IBD symptoms. There were no significant differences in the median transferrin or transthyretin levels in patients with IBD depending on disease activity. No differences were identified in the median transferrin or transthyretin levels in the IBD patients according to nutritional status. The median albumin concentrations in the IBD subjects were significantly higher in patients with normal body fat, normal BMI and normal waist circumferences compared to those with an abnormal nutritional status. The albumin levels reflect both nutritional status and disease activity and therefore cannot be considered a prognostic marker of malnutrition in IBD. As regards the utility of transferrin and transthyretin as markers of activity and nutritional status in IBD patients, further studies are required.
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Affiliation(s)
- Małgorzata Godala
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland;
| | - Ewelina Gaszyńska
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland;
| | - Konrad Walczak
- Department of Internal Medicine and Nephrodiabetology, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Ewa Małecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, 90-647 Lodz, Poland;
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Cagnasso F, Borrelli A, Bottero E, Benvenuti E, Ferriani R, Marchetti V, Ruggiero P, Bruno B, Maurella C, Gianella P. Comparative Evaluation of Peripheral Blood Neutrophil to Lymphocyte Ratio, Serum Albumin to Globulin Ratio and Serum C-Reactive Protein to Albumin Ratio in Dogs with Inflammatory Protein-Losing Enteropathy and Healthy Dogs. Animals (Basel) 2023; 13:ani13030484. [PMID: 36766371 PMCID: PMC9913579 DOI: 10.3390/ani13030484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023] Open
Abstract
Few routinely available biomarkers are clinically useful in assessing dogs with inflammatory protein-losing enteropathy caused by immunosuppressive-responsive enteropathy (IRE-PLE). Only the neutrophil to lymphocyte ratio (NLR) has been studied, while no information exists on the use of the albumin to globulin ratio (AGR) and C-reactive protein to albumin ratio (CRP/ALB). We aimed to evaluate the clinical significance of the NLR, AGR and CRP/ALB in a population of dogs with IRE-PLE. The medical records of 53 IRE-PLE dogs were reviewed at the time of diagnosis (T0) and 1 month after the initiation of immunosuppressants (T1). A control group of 68 healthy dogs was used for comparison. At T0, the median values of the NLR and AGR of sick dogs were significantly higher and lower than those of healthy dogs, respectively. With the increase in the chronic enteropathy activity index, AGR and CRP/ALB significantly decreased and increased, respectively. At T1, NLR and AGR significantly increased, while CRP/ALB significantly decreased. NLR, AGR and CRP/ALB did not differ significantly between dogs classified as responders and nonresponders according to the chronic enteropathy activity index. Further studies are needed to provide more information on this subject.
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Affiliation(s)
- Federica Cagnasso
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - Antonio Borrelli
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | | | | | | | - Veronica Marchetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56121 Pisa, Italy
| | | | - Barbara Bruno
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - Cristiana Maurella
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Via Bologna, 220, 10154 Torino, Italy
| | - Paola Gianella
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
- Correspondence:
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Li X, Yan L, Wang X, Ouyang C, Wang C, Chao J, Zhang J, Lian G. Predictive models for endoscopic disease activity in patients with ulcerative colitis: Practical machine learning-based modeling and interpretation. Front Med (Lausanne) 2022; 9:1043412. [PMID: 36619650 PMCID: PMC9810755 DOI: 10.3389/fmed.2022.1043412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Endoscopic disease activity monitoring is important for the long-term management of patients with ulcerative colitis (UC), there is currently no widely accepted non-invasive method that can effectively predict endoscopic disease activity. We aimed to develop and validate machine learning (ML) models for predicting it, which are desired to reduce the frequency of endoscopic examinations and related costs. Methods The patients with a diagnosis of UC in two hospitals from January 2016 to January 2021 were enrolled in this study. Thirty nine clinical and laboratory variables were collected. All patients were divided into four groups based on MES or UCEIS scores. Logistic regression (LR) and four ML algorithms were applied to construct the prediction models. The performance of models was evaluated in terms of accuracy, sensitivity, precision, F1 score, and area under the receiver-operating characteristic curve (AUC). Then Shapley additive explanations (SHAP) was applied to determine the importance of the selected variables and interpret the ML models. Results A total of 420 patients were entered into the study. Twenty four variables showed statistical differences among the groups. After synthetic minority oversampling technique (SMOTE) oversampling and RFE variables selection, the random forests (RF) model with 23 variables in MES and the extreme gradient boosting (XGBoost) model with 21 variables in USEIS, had the greatest discriminatory ability (AUC = 0.8192 in MES and 0.8006 in UCEIS in the test set). The results obtained from SHAP showed that albumin, rectal bleeding, and CRP/ALB contributed the most to the overall model. In addition, the above three variables had a more balanced contribution to each classification under the MES than the UCEIS according to the SHAP values. Conclusion This proof-of-concept study demonstrated that the ML model could serve as an effective non-invasive approach to predicting endoscopic disease activity for patients with UC. RF and XGBoost, which were first introduced into data-based endoscopic disease activity prediction, are suitable for the present prediction modeling.
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Affiliation(s)
- Xiaojun Li
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Lamei Yan
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,Department of Gastroenterology, The First Affiliated Hospital of Shaoyang College, Shaoyang, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Chunhui Ouyang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Chunlian Wang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Jun Chao
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,Hunan Aicortech Intelligent Research Institute Co., Changsha, Hunan, China
| | - Jie Zhang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,*Correspondence: Jie Zhang,
| | - Guanghui Lian
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Guanghui Lian,
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Ai R, Xu J, Ji G, Cui B. Exploring the Phosphatidylcholine in Inflammatory Bowel Disease: Potential Mechanisms and Therapeutic Interventions. Curr Pharm Des 2022; 28:3486-3491. [PMID: 36424797 DOI: 10.2174/1381612829666221124112803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a significant health problem with an increasing financial burden worldwide. Although various treatment strategies have been used, the results were not satisfactory. More and more researches have proved that the application of phosphatidylcholine (PC) may become an alternative therapy for IBD. OBJECTIVE This review aims to provide an overview of the possible mechanisms of PC and promote the potential application of PC for IBD therapy further. METHODS A comprehensive literature search was performed in PubMed with the following keywords: 'phosphatidylcholine', 'inflammatory bowel disease', 'Crohn's disease', 'inflammation', 'ulcerative colitis', 'therapy', 'nanomedicines', 'PKCζ', 'lysophosphatidylcholine', 'microbiota' and 'drug carrier'. The logical operators "AND" and "OR" were applied to combine different sets of the search results. RESULTS Studies suggested that PC displays a significant effect in the treatment of IBD by modulating gut barrier function, remodeling gut microbiota structure, regulating polarization of macrophages, and reducing the inflammatory response. PC has also been exploited as a drug carrier for anticancer or anti-inflammation agents in multiple forms, which implies that PC has immense potential for IBD therapy. CONCLUSION PC has shown promising potential as a new therapeutic agent or a drug carrier, with a novel, stable, prolonged mechanism of action in treating IBD. However, more high-quality basic and clinical studies are needed to confirm this.
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Affiliation(s)
- Rujun Ai
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing 211100, China
| | - Jie Xu
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing 211100, China
| | - Guozhong Ji
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing 211100, China
| | - Bota Cui
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.,Key Lab of Holistic Integrative Enterology, Nanjing Medical University, Nanjing 211100, China
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Wang Z, Mao H, Xu G. Combination of albumin-to-globulin ratio and plasma fibrinogen is a sensitive tool for preoperative screening of infected nonunion in patients undergoing reoperation after open reduction and internal fixation: a retrospective study. J Orthop Surg Res 2022; 17:471. [PMID: 36309703 PMCID: PMC9618180 DOI: 10.1186/s13018-022-03363-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Accurate preoperative diagnosis of infected nonunion remains a challenge. Here, we evaluated the diagnostic potential of novel biomarkers for infected nonunion. Methods A cohort of 275 patients who underwent surgery for suspected septic nonunion after open reduction and internal fixation were enrolled. Preoperatively analyzed clinical parameters included white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, plasma fibrinogen, platelet count (PC), monocyte-lymphocyte ratio (MLR), neutrophil–lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Receiver operating characteristic (ROC) curves, sensitivity, and specificity were utilized to compare the diagnostic potential of those biomarkers. Results The WBC count and levels of CRP, ESR, NLR, MLR, PLR, PC, plasma D-dimer, plasma fibrinogen, and globulin in infected nonunion patients were significantly higher (p < 0.05) than those in aseptic patients. The albumin and AGR levels of the infected nonunion group were significantly lower (p < 0.05) than the aseptic group. The ROC curve analysis showed that the diagnostic accuracy of AGR and plasma fibrinogen was good. The combination of AGR with plasma fibrinogen had the highest area under the curve (AUC) (0.916). The sensitivity and specificity were 70.27% and 91.04% for AGR, and 67.57% and 84.08% for plasma fibrinogen, respectively. The combination of AGR with plasma fibrinogen showed a sensitivity of 86.49% and specificity of 92.54%. In patients with comorbidities, the diagnostic accuracy of the combination of AGR with plasma fibrinogen was also good. Conclusions AGR and plasma fibrinogen are promising biomarkers to improve the diagnosis of infected nonunion. The combination of AGR with plasma fibrinogen is a sensitive tool for screening infected nonunion.
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Ciftci AB, Bük ÖF, Yemez K, Polat S, Yazıcıoğlu İM. Risk Factors and the Role of the Albumin-to-Globulin Ratio in Predicting Recurrence Among Patients with Idiopathic Granulomatous Mastitis. J Inflamm Res 2022; 15:5401-5412. [PMID: 36158516 PMCID: PMC9499730 DOI: 10.2147/jir.s377804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Idiopathic granulomatous mastitis (IGM) is a rare inflammatory disease of the breast with a high recurrence rate. The serum albumin to globulin ratio (AGR) is a relatively novel biomarker in inflammatory diseases, and one whose role in the recurrence of IGM remains unknown. This study primarily investigated the potential risk factors for IGM recurrence and whether AGR can be used as a predictive factor. Methods Patients diagnosed with IGM from pathology reports between 2016 and 2021 were enrolled in the study, and their medical records were analyzed retrospectively. The patients were divided into two groups – recurrence and non-recurrence. Clinical, demographic characteristics, and laboratory parameters were compared. Results Eighty-five patients were included in the study, recurrence being detected in 16 (18.8%) of these, with a median follow-up time of 39.99±18.93 months. No relationship was determined between childbearing, breastfeeding, disease severity, or therapeutic approaches and IGM recurrence. While AGR was significantly lower in the recurrence group (p < 0.001), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) results were comparable in the two groups (p = 0.472 and p = 0.421, respectively). Multivariate analysis identified low AGR (odds ratio (OR): 50.7, 95% CI 5.93–434.1 P < 0.001) and smoking (OR: 4.45, 95% CI 1.04–18.9 P = 0.044) as independent risk factors for IGM recurrence. Conclusion The study findings indicated that AGR at a cut-off value of ≤1.179 at diagnosis and smoking exhibited a remarkable performance in predicting the recurrence of IGM. Developing new risk stratification systems for IGM recurrences and using AGR in these classifications may increase the success of treatment. Trial Registration This study was registered with ClinicalTrials.gov, NCT05409586.
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Affiliation(s)
- Ahmet Burak Ciftci
- Department of General Surgery, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ömer Faruk Bük
- Department of General Surgery, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Kürşat Yemez
- Department of General Surgery, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Süleyman Polat
- Department of General Surgery, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
| | - İrem Melike Yazıcıoğlu
- Department of Pathology, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
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