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Bacârea A, Coman O, Bacârea VC, Văsieşiu AM, Săplăcan I, Fodor RŚ, Grigorescu BL. Immune profile of patients‑a new approach in management of sepsis and septic shock? Exp Ther Med 2024; 27:203. [PMID: 38590571 PMCID: PMC11000046 DOI: 10.3892/etm.2024.12489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/29/2024] [Indexed: 04/10/2024] Open
Abstract
The present study was a prospective observational single center study, enrolling 102 patients with sepsis, admitted in the Intensive Care Unit of the County Emergency Clinical Hospital in Târgu Mureș (Mureș, Romania). The main goal of the present study was to compare the changes of the following parameters on day 1 compared with day 5, in sepsis compared with septic shock, as well as in survivors compared with non-survivors: Cell blood count parameters, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic inflammation index, C reactive protein (CRP), ferritin, procalcitonin (PCT), CD 3+ T cells, CD4+ T cells, CD8+ T cells, CD16+CD56+/CD3-NK cells and CD19+ B cells. The relationship between the subcategories of lymphocytes with the inflammatory markers was evaluated. The serum concentration of CRP and PCT was significantly lower on day 5 compared with day 1 and serum ferritin was significantly higher in patients with septic shock. The percentage of cytotoxic T lymphocytes was significantly decreased and the percentage of NK lymphocytes was significantly increased in patients who developed septic shock. The results indicated a negative significant correlation between the proportion of T lymphocytes and PCT concentration and a positive significant correlation between the proportion of B lymphocytes and PCT concentration.
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Affiliation(s)
- Anca Bacârea
- Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Oana Coman
- Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Vladimir Constantin Bacârea
- Department of Scientific Research Methodology, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Anca Meda Văsieşiu
- Department of Infectious Disease, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Irina Săplăcan
- Clinic of Anesthesiology and Intensive Care, Emergency County Hospital, Târgu Mureș, Mureș 540136, Romania
| | - Raluca Śtefania Fodor
- Department of Anesthesiology and Intensive Therapy, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Bianca Liana Grigorescu
- Department of Anesthesiology and Intensive Therapy, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
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TURHAN NÖZGEDİK, ARISOY Ö, ULAŞ F, BUĞDAYCI G, GÜLNER MALTINTAŞ. Vitamin D: An Overlooked Parameter in Studies of Depression Using Optic Coherence Tomography. Noro Psikiyatr Ars 2024; 61:66-72. [PMID: 38496230 PMCID: PMC10943944 DOI: 10.29399/npa.28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/16/2023] [Indexed: 03/19/2024] Open
Abstract
Introduction The relationship between depression and inflammation and the resulting vascular/neuronal damage have been demonstrated in recent studies. In this study we aimed to investigate inflammation and the possible degeneration that can be caused by depression and accompanying vitamin D deficiency using a non-invasive imaging method of optical coherence tomography (OCT). Methods Twenty-four healthy controls and 42 drug free major depressive patients matched for age, sex and eye measurements were compared in terms of vitamin D, C Reactive Protein (CRP) and OCT parameters. The Hamilton Depression Rating Scale (HAM-D), The Clinical Global Impressions Scale (CGI) and Global Assessment of Functioning Scale (GAF) were used to assess disease severity. Results CRP level and choroidal thickness in the major depression group were significantly higher than the healthy controls. Vitamin D level and the ganglion cell layer (GCL) volume was significantly lower in the major depression group compared to healthy controls. Positive correlation was found between HAM-D and CRP in major depressive patients; a negative correlation was found between current attack duration and GCL volume. CGI was positively correlated with CRP and HAM-D. GAS was negatively correlated with CRP and HAM-D. Conclusion It has been shown that major depression might be an inflammatory disorder with possible degenerative processes observed with OCT and CRP measurements. But longitudinal follow up studies are needed to demonstrate a cause and effect relationship.
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Affiliation(s)
- Nur ÖZGEDİK TURHAN
- İzzet Baysal Mental Health and Diseases Hospital, Department of Psychiatry, Bolu, Turkey
| | - Özden ARISOY
- Bolu Abant İzzet Baysal Training and Research Hospital, Department of Psychiatry, Bolu, Turkey
| | - Fatih ULAŞ
- Bolu Abant İzzet Baysal Training and Research Hospital, Department of Ophthalmology, Bolu, Turkey
| | - Güler BUĞDAYCI
- Halic University Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey
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Cao C, Wang S, Liu Y, Yue S, Wang M, Yu X, Ding Y, Lv M, Fang K, Chu M, Liao Z. Factors influencing C-reactive protein status on admission in neonates after birth. BMC Pediatr 2024; 24:89. [PMID: 38302903 PMCID: PMC10832075 DOI: 10.1186/s12887-024-04583-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To explore the factors influencing C-reactive protein (CRP) status in neonates on admission after birth. METHODS 820 newborns born and hospitalized at Xiangya Hospital of Central South University from Jan. 2020 to Dec. 2020 were retrospectively analyzed. Maternal medical history and medication use during pregnancy, neonatal demographic information and status at birth were collected through the electronic medical record system. Statistical software was used to analyze the possible relationship between perinatal factors and CRP on admission after birth. RESULTS A total of 820 neonates were analyzed, including 463 males and 357 females with a mean gestational age (GA) of 36.07 ± 3.30 weeks. (1) Multifactor Logistic regression analysis: larger GA (OR: 1.13, 95%CI: 1.00-1.28, P = 0.042), premature rupture of membranes (PROM) ≥ 18 h (OR: 2.39, 95%CI: 1.35-4.23, P = 0.003) and maternal autoimmune diseases (OR: 5.30, 95%CI: 2.15-13.07, P < 0.001) were independent risk factors for CRP ≥ 8 mg/L. Cesarean delivery (OR 0.40, 95%CI: 0.26-0.60, P < 0.001) was independent protective factor for CRP ≥ 8 mg/L. (2) Threshold effect analysis: A non-linear relationship was found between GA and CRP. When GA is less than 33.9 weeks, the risk of CRP ≥ 8 mg/L was reduced by 28% with one week increased (P < 0.001), and when GA is more than 33.9 weeks, the risk of CRP ≥ 8 mg/L was increased by 61% with one week increased (P < 0.001). CONCLUSIONS GA, PROM, maternal autoimmune diseases and cesarean delivery were all independent influences neonatal CRP ≥ 8 mg/L on admission, and there was a nonlinear relationship between GA and neonatal CRP ≥ 8 mg/L on admission.
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Affiliation(s)
- Chuanding Cao
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Shuo Wang
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Yang Liu
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Shaojie Yue
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Mingjie Wang
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Xiaohe Yu
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Ying Ding
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Mei Lv
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Keren Fang
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Meiyan Chu
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Zhengchang Liao
- Department of Neonatology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China.
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Dharmadas S, Kumar H, Pillay M, Sukumaran Mangalanandan T, Vivek L, Praveen VP, Bal A. Biomarkers for Early Detection of Charcot Arthropathy: A Prospective Study on Type 2 Diabetes Patients with Severe Neuropathy. Foot Ankle Int 2024; 45:175-178. [PMID: 38102799 DOI: 10.1177/10711007231213645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND Charcot arthropathy (CA) is a progressive noninfectious inflammatory disease that causes irreversible destruction to pedal architecture in diabetic neuropathy (DN) patients. The debilitating prognosis demands early detection to prevent the development and progression of this disorder. Dysregulated and persistent production of inflammatory cytokines is reported as the key element in initiating osteoclastogenesis in CA. The study analyzed the potential association of markers of inflammation and bone turnover of prediagnostic serum samples on CA. METHODS Seventy-one type 2 severe DN patients were selected based on inclusion-exclusion criteria. Serum samples of interleukin 6 (IL-6), osteoprotegerin (OPG), bone alkaline phosphatase (BALP), and C-reactive protein (CRP) were analyzed. These patients were followed for the development of symptoms of CA for 12 months. In the year of monitoring, 7 patients developed CA (group 1), whereas the remaining 64 patients did not develop CA (group 2). RESULTS The rate of development of CA in patients with severe DN was 9.8%. In this group, significantly increased median values of HbA1c (group 2: 8.00 [7.00-9.00], group 1: 10.00 [9.25-11.50], P = .013); IL-6 (group 2: 1.21 [0.72-2.16], group 1: 11.08 [6.65-63.64], P = .008); and CRP (group 2: 1.25 [0.78-3.20], group 1: 3.31 [1.18-41.33], P = .041) were found. The receiver operating characteristic analysis showed that IL-6 was more strongly associated with the onset of CA (IL-6: area under the curve = 0.808; P = .008) than CRP. Cut-off values of ≥6.6 for IL-6 show potential to rule out CA in high-risk patients, with a positive predictive value of 26.1%, a negative predictive value of 97.9%, a sensitivity of 85.7%, and a specificity of 73.4%. CONCLUSION In our study population, we found that an exacerbated inflammatory state, reflected by IL-6 values, generally occurred in DN patients before the clinical detection of CA. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Affiliation(s)
- Salini Dharmadas
- Department of Anatomy, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Harish Kumar
- Department of Endocrinology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Minnie Pillay
- Department of Anatomy, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Thacho Sukumaran Mangalanandan
- Department of Endocrinology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Lakshmanan Vivek
- Department of Endocrinology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Valiyaparambil Pavithran Praveen
- Department of Endocrinology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
| | - Arun Bal
- Department of Endocrinology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, India
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Bernardi L, Bossù G, Dal Canto G, Giannì G, Esposito S. Biomarkers for Serious Bacterial Infections in Febrile Children. Biomolecules 2024; 14:97. [PMID: 38254697 PMCID: PMC10813546 DOI: 10.3390/biom14010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Febrile infections in children are a common cause of presentation to the emergency department (ED). While viral infections are usually self-limiting, sometimes bacterial illnesses may lead to sepsis and severe complications. Inflammatory biomarkers such as C reactive protein (CRP) and procalcitonin are usually the first blood exams performed in the ED to differentiate bacterial and viral infections; nowadays, a better understanding of immunochemical pathways has led to the discovery of new and more specific biomarkers that could play a role in the emergency setting. The aim of this narrative review is to provide the most recent evidence on biomarkers and predictor models, combining them for serious bacterial infection (SBI) diagnosis in febrile children. Literature analysis shows that inflammatory response is a complex mechanism in which many biochemical and immunological factors contribute to the host response in SBI. CRP and procalcitonin still represent the most used biomarkers in the pediatric ED for the diagnosis of SBI. Their sensibility and sensitivity increase when combined, and for this reason, it is reasonable to take them both into consideration in the evaluation of febrile children. The potential of machine learning tools, which represent a real novelty in medical practice, in conjunction with routine clinical and biological information, may improve the accuracy of diagnosis and target therapeutic options in SBI. However, studies on this matter are not yet validated in younger populations, making their relevance in pediatric precision medicine still uncertain. More data from further research are needed to improve clinical practice and decision making using these new technologies.
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Affiliation(s)
| | | | | | | | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.B.); (G.B.); (G.D.C.); (G.G.)
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Pascreau T, Zia-Chahabi S, Vasse M. Letter to the editor regarding "Protein Z and Protein Z-dependent protease inhibitor in patients with acute ischemic stroke: A prospective mechanistic study". J Stroke Cerebrovasc Dis 2024; 33:107480. [PMID: 37953074 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- Tiffany Pascreau
- Biology Department, Foch Hospital, Suresnes & Université Paris-Saclay, INSERM, Hémostase Inflammation Thrombose HITh U1176, 94276, Le Kremlin-Bicêtre, France
| | | | - Marc Vasse
- Biology Department, Foch Hospital, Suresnes & Université Paris-Saclay, INSERM, Hémostase Inflammation Thrombose HITh U1176, 94276, Le Kremlin-Bicêtre, France.
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Hoban R, Nir H, Somerset E, Lewis J, Unger S, O’Connor DL. Inflammatory Markers in Mother's Own Milk and Infant Stool of Very Low Birthweight Infants. J Hum Lact 2023; 39:656-665. [PMID: 37653641 PMCID: PMC10580668 DOI: 10.1177/08903344231192441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/16/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Mother's breastmilk is the gold standard for feeding preterm infants. Preterm delivery may be precipitated by inflammatory maternal states, but little is known about milk cytokine profiles and how they correlate with markers of infant gut inflammation (i.e., stool calprotectin) in this vulnerable population. RESEARCH AIM To assess cytokines and inflammatory markers in milk from parents of very preterm infants over time as well as correlations between milk and infant's stool calprotectin. METHOD This is a secondary analysis of milk samples collected during OptiMoM, a triple-blind randomized clinical trial of infants born < 1250 g (NCT02137473). Longitudinally collected samples were analyzed for cytokines, choline, and inflammatory markers (C-reactive protein [CRP], IFN-γ, IL-10, IL-1β, IL-1ra, IL-6, IL-8, TNF-α). Infant stools were collected for longitudinal calprotectin analysis. Generalized estimating equations quantified longitudinal profiles of milk markers and stool calprotectin, their associations, and the correlation between free choline and C-reactive protein over follow-up. RESULT Participants included 92 parents and infants (median weeks of gestation 27.3, median birth weight 845 g, and prevalence of male infants 45%). In all, 212 milk samples and 94 corresponding stool calprotectin levels were collected 1-11 weeks postpartum. C-reactive protein was present in much higher concentrations than other markers, and was highest in Week 1 postpartum. It decreased over time. IL-8 and free choline also changed over time while other markers did not. There was no correlation between any milk markers and stool calprotectin. CONCLUSION Milk from mothers of very preterm infants has detectable inflammatory markers, some of which change over time. Research is needed to determine if infant outcomes are associated with these markers.
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Affiliation(s)
- Rebecca Hoban
- Department of Paediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Hadar Nir
- Department of Paediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Neonatology, Shamir Medical Center, Tel-Aviv University, Israel
| | - Emily Somerset
- Rogers Computational Program, Ted Rogers Centre for Heart Research, The Hospital for Sick Children, University Health Network, Toronto, ON, Canada
| | - Jordan Lewis
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- University of Toronto School of Medicine, Toronto, ON, Canada
| | - Sharon Unger
- Department of Paediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Nutrition, University of Toronto, Toronto, ON, Canada
| | - Deborah L. O’Connor
- Department of Nutrition, University of Toronto, Toronto, ON, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
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Cefalo CMA, Riccio A, Fiorentino TV, Succurro E, Miceli S, Mannino GC, Perticone M, Sciacqua A, Andreozzi F, Sesti G. Metabolic Syndrome and C-reactive Protein are Associated With a Reduced Myocardial Mechano-energetic Efficiency. J Clin Endocrinol Metab 2023; 108:e1264-e1271. [PMID: 37235788 DOI: 10.1210/clinem/dgad300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/02/2023] [Accepted: 05/23/2023] [Indexed: 05/28/2023]
Abstract
CONTEXT Metabolic syndrome and elevated high-sensitivity C-reactive protein (hsCRP) levels are associated with risk of cardiovascular diseases. A reduced myocardial mechano-energetic efficiency (MEE) has been found to be an independent predictor of cardiovascular disease. OBJECTIVE To evaluate the association between metabolic syndrome and hsCRP levels with impaired MEE. METHODS Myocardial MEE was assessed by a validated echocardiography-derived measure in 1975 nondiabetic and prediabetic individuals subdivided into 2 groups according to the presence of metabolic syndrome. RESULTS Individuals with metabolic syndrome exhibited increased stroke work and myocardial oxygen consumption estimated by rate pressure product, and a reduced MEE per gram of left ventricular mass (MEEi) compared with subjects without metabolic syndrome, after adjusting for age and sex. Myocardial MEEi progressively decreased in parallel with the increase in the number of metabolic syndrome components. In a multivariable regression analysis, both metabolic syndrome and hsCRP contributed to reduced myocardial MEEi independently of sex, total cholesterol, high-density lipoprotein, triglycerides, fasting, and 2-hour postload glucose levels. When the study population was divided into 4 groups by the presence or absence of metabolic syndrome and by hsCRP levels above and below 3 mg/L, hsCRP levels ≥3 mg/L were associated with reduced myocardial MEEi both in subjects with metabolic syndrome and in those without the syndrome. CONCLUSION Nondiabetic and prediabetic individuals with metabolic syndrome exhibit increased stroke work and myocardial oxygen consumption, and an impaired MEEi, an established predictor of adverse cardiovascular events, and elevated hsCRP levels in combination with metabolic syndrome aggravate the myocardial MEEi impairment.
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Affiliation(s)
- Chiara M A Cefalo
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome 00189, Italy
| | - Alessia Riccio
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome 00189, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome 00189, Italy
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Saleh QW, Mohammadnejad A, Tepel M. Lower levels of FOXP3 are associated with prolonged inflammatory responses in kidney transplant recipients. Front Immunol 2023; 14:1252857. [PMID: 37771580 PMCID: PMC10525697 DOI: 10.3389/fimmu.2023.1252857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023] Open
Abstract
Background Immunosuppressive treatment of kidney transplant recipients is mainly aimed at pro-inflammatory T effector cells, yet they also target the immunosuppressive T regulatory cells. Here, we test the hypothesis that low levels of the master gene regulator of T regulatory cells, forkhead box P3 (FOXP3) splice variants, are associated with prolonged inflammatory responses to stimuli. Methods From blood samples obtained the first - and 29th day post-transplant, we extracted peripheral blood mononuclear cells and measured mRNA levels of Total FOXP3, pre-mature RNA FOXP3 (pre-mRNA FOXP3), full length FOXP3 (FOXP3fl) and, FOXP3 splice variant excluding exon two (FOXP3d2). We defined the primary outcome as the number of days in which C reactive protein (CRP) was above 50 mg/L. CRP levels were gathered in two periods, the first from the second to 29 days post-transplant, and the second from 30 to 57 days post-transplant. The association was tested using adjusted negative binomial regression. Results From 507 included kidney transplant recipients, 382 recipients had at least one CRP measurement >50 mg/L in the first period, median duration of elevated CRP was 4 days [interquartile range (IQR) 2 to 6]. In the second period, 69 recipients had at least one CRP measurement >50 mg/L, median duration of elevated CRP was 3 days [IQR 2 to 5]. In the first period, we found a significant association between lower levels of Total FOXP3 and prolonged duration of CRP elevation, incidence rate ratio 0.61 (95% confidence interval 0.46-0.80), p<0.01. Conclusion Lower levels of total FOXP3 mRNA levels in peripheral blood of kidney transplant recipients are associated with prolonged duration of inflammatory responses regardless of the underlying stimuli.
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Affiliation(s)
- Qais W. Saleh
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Cardiovascular and Renal Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Afsaneh Mohammadnejad
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Martin Tepel
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Cardiovascular and Renal Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Greer RC, Althaus T, Dittrich S, Butler CC, Cheah PY, Wangrangsimakul T, Smithuis FM, Day NP, Lubell Y. The impact of C-reactive protein testing on treatment-seeking behavior and patients' attitudes toward their care in Myanmar and Thailand. Healthc Low Resour Settings 2023; 11:11278. [PMID: 38332803 PMCID: PMC7615608 DOI: 10.4081/hls.2023.11278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
C-reactive protein (CRP) point-of-care testing can reduce antibiotic prescribing in primary care patients with febrile and respiratory illness, yet little is known about its effects on treatment-seeking behavior. If patients go on to source antibiotics elsewhere, the impact of CRP testing will be limited. A randomized controlled trial assessed the impact of CRP testing on antibiotic prescriptions in Myanmar and Thai primary care patients with a febrile illness. Here we report patients' treatment-seeking behavior before and during the two-week study period. Self-reported antibiotic use is compared against urine antibacterial activity. Patients' opinions towards CRP testing were evaluated. Antibiotic use before study enrolment was reported by 5.4% while antimicrobial activity was detected in 20.8% of samples tested. During the study period, 14.8% of the patients sought additional healthcare, and 4.3% sourced their own antibiotics. Neither were affected by CRP testing. Overall, patients' satisfaction with their care and CRP testing was high. CRP testing did not affect patients' treatment-seeking behavior during the study period whilst modestly reducing antibiotic prescriptions. CRP testing appears to be acceptable to patients and their caregivers.
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Affiliation(s)
- Rachel C. Greer
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thomas Althaus
- The Department of Health Action, Monaco, Monaco
- Monaco Scientific Centre, Monaco, Monaco
| | - Sabine Dittrich
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- FIND, global alliance for diagnostic, Geneva, Switzerland
- Deggendorf Institute of Technology, European-Campus Rottal Inn, Pfarrkirchen, Germany
| | - Christopher C. Butler
- Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tri Wangrangsimakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Frank M. Smithuis
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Medical Action Myanmar, Yangon, Myanmar
| | - Nicolas P.J. Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Yoel Lubell
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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11
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Hou S, Tian Z, Zhao D, Liang Y, Dai S, Ji Q, Fan Z, Liu Z, Liu M, Yang Y. Efficacy and Optimal Dose of Coenzyme Q10 Supplementation on Inflammation-Related Biomarkers: A GRADE-Assessed Systematic Review and Updated Meta-Analysis of Randomized Controlled Trials. Mol Nutr Food Res 2023; 67:e2200800. [PMID: 37118903 DOI: 10.1002/mnfr.202200800] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/23/2023] [Indexed: 04/30/2023]
Abstract
SCOPE Coenzyme Q10 (CoQ10) has become a popular nutritional supplement due to its wide range of beneficial biological effects. Previous meta-analyses show that the attenuation of CoQ10 on inflammatory biomarkers remains controversial. This meta-analysis aims to assess the efficacy and optimal dose of CoQ10 supplementation on inflammatory indicators in the general population. METHODS AND RESULTS Databases are searched up to December 2022 resulting in 6713 articles, of which 31 are retrieved for full-text assessment and included 1517 subjects. Double-blind randomized controlled trials (RCTs) of CoQ10 supplementation are eligible if they contain C reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). CoQ10 supplementation can significantly reduce the levels of circulating CRP (SMD: -0.40, 95% CI: [-0.67 to -0.13], p = 0.003), IL-6 (SMD: -0.67, 95% CI: [-1.01 to -0.33], p < 0.001), and TNF-α (SMD: -1.06, 95% CI: [-1.59 to -0.52], p < 0.001) and increase the concentration of circulating CoQ10. CONCLUSION This meta-analysis provides evidence for CoQ10 supplementation to reduce the level of inflammatory mediators in the general population and proposes that daily supplementation of 300-400 mg CoQ10 show superior inhibition of inflammatory factors.
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Affiliation(s)
- Shanshan Hou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Dan Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Ying Liang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Suming Dai
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Qiuhua Ji
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Zhiying Fan
- School of Public Health, Baotou Medical College, Baotou, Inner Mongolia, 014040, P. R. China
| | - Zhihao Liu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Meitong Liu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, P. R. China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, P. R. China
- China-DRIs Expert Committee, Beijing, P. R. China
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12
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Perrotta AM, Gigante A, Rotondi S, Menè P, Notturni A, Schiavetto S, Tanzilli G, Pellicano C, Guaglianone G, Tinti F, Palange P, Mazzaferro S, Cianci R, Lai S. Contrast-Induced Acute Kidney Injury and Endothelial Dysfunction: The Role of Vascular and Biochemical Parameters. J Pers Med 2023; 13:jpm13040701. [PMID: 37109087 PMCID: PMC10143233 DOI: 10.3390/jpm13040701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be one of the most feared complications of coronary angiography, causing a notable worsening of the prognosis with high morbidity and mortality. AIM To evaluate a possible association between the renal resistive index (RRI) and the development of CIAKI, as well as an association with the main subclinical markers of atherosclerosis and the main cardiovascular risk factors. MATERIALS AND METHODS We enrolled 101 patients with an indication for coronary angiography. Patients underwent an assessment of renal function (serum nitrogen and basal creatinine, 48 and 72 h after administration of contrast medium), inflammation (C reactive protein (CRP), serum calcium and phosphorus, intact parathormone (iPTH), 25-hydroxyvitaminD (25-OH-VitD), serum uric acid (SUA), total cholesterol, serum triglycerides, serum glucose and insulin). All patients also carried out an evaluation of RRI, intima-media thickness (IMT), interventricular septum (IVS) and the ankle-brachial index (ABI). RESULTS 101 patients (68 male), with a mean age of 73.0 ± 15.0 years, were enrolled for the study; 35 are affected by type 2 diabetes mellitus. A total of 19 cases of CIAKI were reported (19%), while among diabetic patients we reported an incidence of 23% (8 patients). In our study, patients with CIAKI had significantly higher RRI (p < 0.001) and IMT (p < 0.001) with respect to the patients who did not develop CIAKI. Furthermore, patients with CIAKI had significantly higher CRP (p < 0.001) and SUA (p < 0.006). CONCLUSIONS We showed a significant difference in RRI, IMT, SUA and CRP values between the population developing CIAKI and patients without CIAKI. This data appears relevant considering that RRI and IMT are low-cost, non-invasive and easily reproducible markers of endothelial dysfunction and atherosclerosis.
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Affiliation(s)
- Adolfo Marco Perrotta
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Silverio Rotondi
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Menè
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Adriano Notturni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00189 Rome, Italy
| | - Stefano Schiavetto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00189 Rome, Italy
| | - Gaetano Tanzilli
- Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Guaglianone
- Department of Chemistry and Drug Technologies, School of Hospital Pharmacy, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Tinti
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00189 Rome, Italy
| | - Sandro Mazzaferro
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Rosario Cianci
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Lai
- Nephrology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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13
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Abensur Vuillaume L, Lefebvre F, Benhamed A, Schnee A, Hoffmann M, Godoy Falcao F, Haber N, Sabah J, Lavoignet CE, Le Borgne P. Lymphocyte-to-C-Reactive Protein (LCR) Ratio Is Not Accurate to Predict Severity and Mortality in Patients with COVID-19 Admitted to the ED. Int J Mol Sci 2023; 24:ijms24065996. [PMID: 36983064 PMCID: PMC10051361 DOI: 10.3390/ijms24065996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Health care systems worldwide have been battling the ongoing COVID-19 pandemic. Since the beginning of the COVID-19 pandemic, Lymphocytes and CRP have been reported as markers of interest. We chose to investigate the prognostic value of the LCR ratio as a marker of severity and mortality in COVID-19 infection. Between 1 March and 30 April 2020, we conducted a multicenter, retrospective cohort study of patients with moderate and severe coronavirus disease 19 (COVID-19), all of whom were hospitalized after being admitted to the Emergency Department (ED). We conducted our study in six major hospitals of northeast France, one of the outbreak's epicenters in Europe. A total of 1035 patients with COVID-19 were included in our study. Around three-quarters of them (76.2%) presented a moderate form of the disease, while the remaining quarter (23.8%) presented a severe form requiring admission to the ICU. At ED admission, the median LCR was significantly lower in the group presenting severe disease compared to that with moderate disease (versus 6.24 (3.24-12) versus 12.63 ((6.05-31.67)), p < 0.001). However, LCR was neither associated with disease severity (OR: 0.99, CI 95% (0.99-1)), p = 0.476) nor mortality (OR: 0.99, CI 95% (0.99-1)). In the ED, LCR, although modest, with a threshold of 12.63, was a predictive marker for severe forms of COVID-19.
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Affiliation(s)
| | - François Lefebvre
- Department of Public Health, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Axel Benhamed
- Service SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot, Hospices Civils de Lyon, 69000 Lyon, France
| | - Amandine Schnee
- Emergency Department, CHR Metz-Thionville, 57000 Metz, France
| | | | | | - Nathan Haber
- Emergency Department, CHR Metz-Thionville, 57000 Metz, France
| | - Jonathan Sabah
- Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | | | - Pierrick Le Borgne
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), 67000 Strasbourg, France
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14
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Posada-López A, Duque JD, Pineda-Tamayo RA, Bedoya-Giraldo E, Botero JE. Lack of association between periodontitis and rheumatoid arthritis. Reumatol Clin (Engl Ed) 2023; 19:123-129. [PMID: 36906387 DOI: 10.1016/j.reumae.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/17/2022] [Indexed: 03/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis and rheumatoid arthritis (RA) have been associated in a bidirectional way. The objective of this study was to determine the association between clinical parameters of periodontitis and RA. MATERIALS AND METHODS Seventy-five (75) participants distributed in 3 groups (21 patients with periodontitis without RA, 33 patients with periodontitis with RA and 21 patients with reduced periodontium with RA) were included in this cross-sectional study. A full periodontal and medical examination was performed in each patient. Additionally, subgingival plaque samples for the detection of Porphyromonas gingivalis (P. gingivalis) and blood samples for biochemical markers of RA were also taken. Logistic regression analysis adjusted for confounding variables, Spearman's rank correlation coefficient and a linear multivariate regression were used to analyze the data. RESULTS Patients with RA presented less severity of periodontal parameters. The highest levels of anti-citrullinated protein antibodies were detected in non-periodontitis patients with RA. Covariates such as age, P. gingivalis, diabetes, smoking, osteoporosis and use of medication were not associated with RA. All periodontal variables and P. gingivalis expressed a negative correlation with biochemical markers of RA (P<0.05). CONCLUSIONS Periodontitis was not associated with RA. Furthermore, there was no correlation between periodontal clinical parameters and biochemical markers of RA.
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Affiliation(s)
| | - Jose Daniel Duque
- Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
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15
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Inflammatory factors and restless legs syndrome: A systematic review and meta-analysis. Sleep Med Rev 2022; 68:101744. [PMID: 36634410 DOI: 10.1016/j.smrv.2022.101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
The possible role of inflammatory factors in the pathogenesis of restless legs syndrome (RLS) is not well understood. Because several inflammatory diseases have shown an association with the risk for RLS, the measurement of serum/plasma levels of inflammatory factors has been a matter of a scarce number of studies. We performed a systematic review and a meta-analysis to assess the possible association of serum/plasma levels of inflammatory markers with the risk for RLS. Our results showed a significant trend towards higher serum/plasma C reactive protein (CRP) levels and higher neutrophil-to-lymphocyte (NLR) ratio in patients diagnosed with RLS than in controls, although statistical significance disappeared after applying the random-effects model. Further studies are needed to confirm the suggested possible role of inflammatory factors in the pathogenesis of RLS.
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Affiliation(s)
| | | | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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16
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Cut TG, Ciocan V, Novacescu D, Voicu A, Marinescu AR, Lazureanu VE, Muresan CO, Enache A, Dumache R. Autopsy Findings and Inflammatory Markers in SARS-CoV-2: A Single-Center Experience. Int J Gen Med 2022; 15:8743-8753. [PMID: 36597439 PMCID: PMC9805743 DOI: 10.2147/ijgm.s389300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose The systemic inflammatory response related to COVID-19 can be easily investigated in living patients. Unfortunately, not every biomarker is suitable for postmortem analysis since several factors may interfere. The aim of this study was to summarize key histopathological findings within each organ system due to COVID-19 and to assess if serological inexpensive and widely available biomarkers such as CRP, IL-6, fibrinogen and d-Dimers, associated with adverse outcomes in COVID-19, can be implemented in a post-mortem assessment. Patients and Methods A total of 60 subjects divided in 2 groups were included. All subjects died outside a hospital setting and therefore did not receive specific or symptomatic therapies that could have modulated the inflammatory response. The first group included 45 subjects in which mandatory autopsy was performed in order to establish the cause of death and macroscopic examination of the lungs was highly suggestive of SARS-CoV-2 infection. As controls (Group 2), 20 subjects who died from polytrauma in high velocity car accidents and suicide were selected. Bronchial fluids collected during the autopsy procedure were used for the RT-PCR diagnosis of SARS-CoV-2 and serum samples were sent for analysis of IL-6, CRP, d-Dimers and fibrinogen. Results Compared with the control group, the subjects of the COVID-19 group were older (59±19.5 vs.38±19.15 years, p=0.0002) and had more underlying comorbidities such as hypertension (60% vs 35%, p=0.06) or were overweight (53.3% vs 30%, p=0.08). The levels of CRP, IL-6, fibrinogen and d-Dimers in postmortem plasma samples were significantly higher in COVID-19 subjects than in control group (p< 0.0001). Moreover, the level of IL-6 was significantly higher in overweight patients (r=0.52, P<0.001). In all COVID-19 subjects, the histological examination revealed features corresponding to the exudative and/or proliferative phases of diffuse alveolar damage. Large pulmonary emboli were observed in 7 cases. Gross cardiac enlargement with left ventricular hypertrophy was observed in 19 cases. The most frequent pathological finding of the central nervous system was acute/early-subacute infarction. Conclusion Due to the complexity of the inflammatory response, we postulate that a combination of biomarkers, rather than a single laboratory parameter, might be more effective in obtaining a reliable postmortem COVID-19 diagnosis.
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Affiliation(s)
- Talida Georgiana Cut
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology Timisoara, Timisoara, Romania,Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Academy of Romanian Scientists, Bucharest, Romania
| | - Veronica Ciocan
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Correspondence: Veronica Ciocan, Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania, Tel +40722944453, Email
| | - Dorin Novacescu
- Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Academy of Romanian Scientists, Bucharest, Romania
| | - Adrian Voicu
- Department of Medical Informatics and Biostatistics, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Adelina Raluca Marinescu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology Timisoara, Timisoara, Romania
| | - Voichita Elena Lazureanu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology Timisoara, Timisoara, Romania
| | - Camelia Oana Muresan
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Alexandra Enache
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Raluca Dumache
- Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania,Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
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17
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Bagiu IC, Scurtu IL, Horhat DI, Mot IC, Horhat RM, Bagiu RV, Capraru ID, Diaconu MM, Adam O, Ciornei B, Vulcanescu DD, Juganaru I, Bondar AC, Horhat FG. COVID-19 Inflammatory Markers and Vitamin D Relationship in Pediatric Patients. Life (Basel) 2022; 13. [PMID: 36676040 DOI: 10.3390/life13010091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Biomarkers play an important role in COVID-19, and more research in this regard is needed, especially in the case of children. This study aimed to look for a link between the C reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), vitamin D and COVID-19 in pediatric patients. METHODS This is a retrospective cohort study, performed on children diagnosed positively with COVID-19 at a children's hospital in western Romania. Available CRP, LDH, CK vitamin D and clinical severity were recorded. For each biomarker, groups were formed by patients' age. Mean/median group differences were assessed using Student's t test or Mann-Whitney and Kruskal-Wallis with Dunn's post hoc tests. Association was assessed using the chi2 test, while correlation was assessed using Spearman's rank correlation. RESULTS 181 positive children were studied between 1 August 2021 and 1 February 2022. Average age was 8.76 years (SD = 3.93). There were 94 (51.93%) males and 87 (48.07%) females. The cases were: 62 asymptomatic (34.25%), 107 mild (59.12%), 9 moderate (4.97%), 3 severe (1.66%). Regarding CRP, a significant difference between older and younger patients was observed (p = 0.0034). Clinical severity was associated with CRP (p = 0.0281), LDH (p = 0.0410) and vitamin D (p = 0.0444). Regarding CK, no differences or associations proved significant. Correlation testing was conducted for CRP, LDH, vitamin D and clinical signs. With the exception of LDH-CRP and LDH-vitamin D, all relationships proved statistically significant. CONCLUSIONS CRP, LDH and vitamin D levels are important biomarkers for COVID-19-positive pediatric patients, while CK was mostly within normal ranges.
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18
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Avazpour S, Amini A, Shirvani H, Arabzadeh E. Exercise modulation in inflammation and metabolic hormonal disorders of COVID-19 to decrease risk factors in coronary heart disease. Horm Mol Biol Clin Investig 2022:hmbci-2022-0040. [PMID: 36560914 DOI: 10.1515/hmbci-2022-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Sedentary life style separated during COVID-19 pandemic. Patients with cardiovascular diseases (CVD) are vulnerable with sedentary life style. Therefore, the aim of this study was to investigate the effect of 8 weeks of combined and high intensity interval training (HIIT) on C Reactive protein, galectin-3, leptin, fibrinogen and insulin resistance index in coronary heart disease after COVID-19. METHODS Thirty-six cardiovascular patients (55.14 ± 1.4 years, 78.6 ± 5.1 kg) were divided into three groups of combined exercise (n=13), HIIT (n=12) and control group (n=11). Combined exercise consisted of aerobic (4 weeks) and aerobic + HIIT exercise (4 weeks), three sessions per weeks. The protocol of the HIIT group included performing high intensity interval training, three sessions per weeks for 8 weeks. Blood samples were taken 24 h before the first training session and 48 h after the last training. C Reactive protein (CRP), galectin-3, leptin, fibrinogen measured with ELISA kit. RESULTS CRP, galectin-3 and fibrinogen decreased significantly after 8 weeks of combined training and HIIT (compare to pre-test). Also, insulin resistance index after 8 weeks of combined exercise showed a significant decrease compare to pre-test (p<0.05). After 8 weeks, CRP, galectin-3 and insulin resistance significantly decreased compare to control group (p<0.05). CONCLUSIONS In the patient with CVD, combined exercise training may be more effective than HIIT in reducing metabolic and heart risk factors after an epidemic such as COVID-19. However, change of leptin need to more studies.
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Affiliation(s)
- Sahar Avazpour
- Department of Sports Sciences, Sports Biochemistry and Metabolism, Faculty of Educational Sciences, Gerash University of Medical Science, Gerash, Iran
| | - Amin Amini
- Faculty of Artificial Intelligence and Cognitive Sciences, Imam Hossein University, Tehran, Iran
| | - Hossein Shirvani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ehsan Arabzadeh
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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19
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Liu Z, Zhang R, Zhou W, Ma R, Han L, Zhao Z, Ge Z, Ren X, Zhang W, Sun A, Chen Z. High levels of C-reactive protein-to-albumin ratio (CAR) are associated with a poor prognosis in patients with severe fever with thrombocytopenia syndrome in early stage. J Med Virol 2022; 94:5375-5384. [PMID: 35790466 PMCID: PMC9540880 DOI: 10.1002/jmv.27972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 12/15/2022]
Abstract
C-reactive protein-to-albumin ratio (CAR) can be used to assess the prognosis of various diseases. This study aimed to evaluate the relationship between CAR on the prognosis of patients with severe fever with thrombocytopenia syndrome (SFTS). This study included 155 SFTS patients from the Public Health Clinical Center of Dalian from January to December 2021. They were divided into survival and deceased groups based on the clinical prognosis. The independent risk factors for poor prognosis of SFTS patients at an early stage were determined by Cox regression. The efficacy of CAR prediction was assessed by the receiver operating characteristic (ROC) curve. A total of 155 patients were included in this study, with an average age of 61.98± 11.70 years, including 77 males and 65 females. The mortality rate of the patients enrolled in this study was 14.19%. Multivariate Cox regression indicated that CAR (hazard ratio = 2.585, 95% confidence interval [CI] 1.405-4.753, p = 0.002) could be an independent predictor for prognosis in SFTS patients at an early stage. CAR had an AUC of 0.781 (95% CI, 0.665-0.898, p = 0.000), a cutoff value of 0.57, a sensitivity of 0.77, and a specificity of 0.80, with better predictive efficacy, compared to neutrophil-to-lymphocyte ratio (NLR). High levels of CAR are associated with poor prognosis in SFTS patients, and CAR can be used as an independent predictor for SFTS patients.
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Affiliation(s)
- Zishuai Liu
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Rongling Zhang
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Wei Zhou
- Department of Public Health Clinical CenterDalianChina
| | - Ruize Ma
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Leqiang Han
- Department of Public Health Clinical CenterDalianChina
| | - Zhe Zhao
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Ziruo Ge
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Xingxiang Ren
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Wei Zhang
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Aijun Sun
- Department of Public Health Clinical CenterDalianChina
| | - Zhihai Chen
- Department of Infectious Disease, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
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Liu S, Li J, Li Y, Liu Y, Wang K, Pan W. Correlation of CRP genotypes with serum CRP levels and the risk of rheumatoid arthritis in Chinese Han population. Clin Rheumatol 2022; 41:3325-3330. [PMID: 35896901 DOI: 10.1007/s10067-022-06306-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/05/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE C-reactive protein (CRP) is an important index for evaluating the disease activity of rheumatoid arthritis (RA). CRP may play a direct role in bone destruction in RA. Studies have demonstrated that serum CRP levels had a close correlation with tissue inflammation scores in patients with RA. In addition, genetic factors play a crucial role in the development of RA. In this study, we aimed to investigate the relationship between the CRP gene variants (rs1205 polymorphism) and the risk of RA in Chinese Han population. METHODS 502 RA patients and 581 controls were included in this study. The associations between CRP gene variants and CRP levels and RA risk were investigated. RESULTS We found that TT/ TT + CT genotype was significantly related with an increased risk of RA (TT vs CC: OR, 1.56, 95%CI, 1.01-2.40, P = 0.045; TT + CT vs CC: OR, 1.30, 95%CI, 1.02-1.65, P = 0.032). In addition, T allele was shown to associate with an elevated risk of RA. After subgroup analysis, we found that rs1205 polymorphism was significantly related with an enhanced risk of RA among females, individuals lower than 60 years, and subjects with a BMI > 25 kg/m2. Furthermore, data showed that the CRP gene rs1205 polymorphism correlated with CRP and ESR levels. Furthermore, the TT genotype was significantly associated with a reduction of CRP levels compared with CT or CC genotype. CONCLUSIONS To sum up, this study reveals that rs1205 polymorphism of the CRP gene is related with an increased risk of RA and CRP levels in Chinese Han population. Key Points • The CRP gene rs1205 polymorphism is related with a higher risk of RA. • The CRP gene rs1205 polymorphism correlates with CRP and ESR levels. • The TT genotype of rs1205 polymorphism is linked with a reduction of CRP levels.
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Affiliation(s)
- Shanshan Liu
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China.
| | - Ju Li
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China
| | - Yongsheng Li
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China
| | - Yan Liu
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China
| | - Kai Wang
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China
| | - Wenyou Pan
- Department of Rheumatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, Jiangsu, China
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Musunuri B, Tripathy R, Padhi S, Panda AK, Das BK. The role of MBL, PCT, CRP, neutrophil-lymphocyte ratio, and platelet lymphocyte ratio in differentiating infections from flares in lupus. Clin Rheumatol 2022. [PMID: 35835900 DOI: 10.1007/s10067-022-06285-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/22/2022] [Accepted: 07/02/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The distinction between infection and flare in systemic lupus erythematosus (SLE) has always been a dilemma for clinicians as the clinical and biochemical profiles overlap. The present study evaluated affordable biomarkers to distinguish infection from flare in an SLE cohort in a tertiary care center in eastern India. METHODS One hundred and fifty-two SLE patients were clinically evaluated and enrolled in the present study. Hematological, immunological, and biochemical profiles and various biomarkers such as C reactive protein (CRP), procalcitonin (PCT), and Mannose-binding lectin (MBL) were quantified. RESULTS One hundred and fifty-two patients (152) were enrolled in the present study and all had SLEDAI scores of more than 4. From which 70 had infection, and the common infections were urinary tract infection (34.28%) followed by pneumonia (27.14%). Neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) were significantly elevated in SLE with infections (NLR: 5.84 ± 2.47; CRP: 30.56 ± 41.63) than those with flare (NLR: 3.87 ± 2.62; CRP: 8.73 ± 9.53). The receiver operating characteristic curve (ROC) analysis revealed CRP, PLR, and NLR as important markers for predicting infections (CRP: AUC = 0.682, p = 0.0001; PLR: AUC = 0.668, p = 0.0008; NLR: AUC = 0.742, p < 0.0001). The MBL and PCT levels were comparable among SLE flare and those with infections. CONCLUSIONS NLR and CRP levels are affordable biomarkers to distinguish infections from flares in SLE. MBL and PCT could not differentiate flare from an infection. Key Points • Biomarkers for the differentiation of infection and flare in SLE are limited. • NLR, PLR, and CRP are promising biomarkers to enable differentiation. • PCT and MBL are not ideal biomarkers to differentiate infection from flare.
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Saripalli A, Ramapuram J. C-Reactive Protein as a Screening Test for Tuberculosis in People Living with HIV in Southern India: A Cross-Sectional, Observational Study. J Clin Med 2022; 11. [PMID: 35806852 DOI: 10.3390/jcm11133566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Tuberculosis is the leading cause of mortality in people living with HIV(PLHIV). We assessed the utility of C-reactive protein (CRP) as a screening test for tuberculosis (TB) in PLHIV. Methods: We performed a cross-sectional, observational study on 150 HIV patients visiting the Anti-Retroviral Therapy (ART) center for the follow up of their ART treatment. Patients who screened positive on the WHO symptom screen were included in the study. C-reactive protein levels in the blood were measured, and the patients were followed up with for a confirmatory diagnosis of tuberculosis. Results: The ideal cut-off for CRP was found to be 8.25. There was a statistically significant relationship between the CRP value and tuberculosis positivity (p value < 0.001). The CRP value had a sensitivity of 70.13%, a specificity of 69.86%, a positive predictive value of 71.05%, a negative predictive value of 68.92%, and a total diagnostic accuracy of 70% in patients who screened positive on the WHO symptom screen. Conclusion: CRP is a valuable screening tool and should be added to the tuberculosis screening algorithm to improve the diagnostic accuracy of screening for tuberculosis in people living with HIV.
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Limon-de la Rosa N, Cervantes-Alvarez E, Méndez-Guerrero O, Gutierrez-Gallardo MA, Kershenobich D, Navarro-Alvarez N. Time-Dependent Changes of Laboratory Parameters as Independent Predictors of All-Cause Mortality in COVID-19 Patients. Biology (Basel) 2022; 11:biology11040580. [PMID: 35453779 PMCID: PMC9028239 DOI: 10.3390/biology11040580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/31/2022] [Accepted: 04/07/2022] [Indexed: 12/16/2022]
Abstract
Independent predictors of mortality for COVID-19 patients have been identified upon hospital admission; however, how they behave after hospitalization remains unknown. The aim of this study is to identify clinical and laboratory parameters from admission to discharge or death that distinguish survivors and non-survivors of COVID-19, including those with independent ability to predict mortality. In a cohort of 266 adult patients, clinical and laboratory data were analyzed from admission and throughout hospital stay until discharge or death. Upon admission, non-survivors had significantly increased C reactive protein (CRP), neutrophil count, neutrophil to lymphocyte ratio (NLR) (p < 0.0001, each), ferritin (p < 0.001), and AST (aspartate transaminase) (p = 0.009) compared to survivors. During the hospital stay, deceased patients maintained elevated CRP (21.7 mg/dL [admission] vs. 19.3 [hospitalization], p = 0.060), ferritin, neutrophil count and NLR. Conversely, survivors showed significant reductions in CRP (15.8 mg/dL [admission] vs. 9.3 [hospitalization], p < 0.0001], ferritin, neutrophil count and NLR during hospital stay. Upon admission, elevated CRP, ferritin, and diabetes were independent predictors of mortality, as were persistently high CRP, neutrophilia, and the requirement of invasive mechanical ventilation during hospital stay. Inflammatory and clinical parameters distinguishing survivors from non-survivors upon admission changed significantly during hospital stay. These markers warrant close evaluation to monitor and predict patients’ outcome once hospitalized.
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Affiliation(s)
- Nathaly Limon-de la Rosa
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (N.L.-d.l.R.); (E.C.-A.); (O.M.-G.); (D.K.)
| | - Eduardo Cervantes-Alvarez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (N.L.-d.l.R.); (E.C.-A.); (O.M.-G.); (D.K.)
- PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04360, Mexico;
| | - Osvely Méndez-Guerrero
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (N.L.-d.l.R.); (E.C.-A.); (O.M.-G.); (D.K.)
| | | | - David Kershenobich
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (N.L.-d.l.R.); (E.C.-A.); (O.M.-G.); (D.K.)
| | - Nalu Navarro-Alvarez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (N.L.-d.l.R.); (E.C.-A.); (O.M.-G.); (D.K.)
- School of Medicine, Universidad Panamericana, Campus México, Mexico City 03920, Mexico
- Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
- Correspondence:
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Gao Y, Xiong X, Jiao X, Yu Y, Chi J, Zhang W, Chen L, Li S, Gao Q. PRCTC: a machine learning model for prediction of response to corticosteroid therapy in COVID-19 patients. Aging (Albany NY) 2022; 14:54-72. [PMID: 35021153 PMCID: PMC8791209 DOI: 10.18632/aging.203819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/25/2021] [Indexed: 01/08/2023]
Abstract
Corticosteroid has been proved to be one of the few effective treatments for COVID-19 patients. However, not all the patients were suitable for corticosteroid therapy. In this study, we aimed to propose a machine learning model to forecast the response to corticosteroid therapy in COVID-19 patients. We retrospectively collected the clinical data about 666 COVID-19 patients receiving corticosteroid therapy between January 27, 2020, and March 30, 2020, from two hospitals in China. The response to corticosteroid therapy was evaluated by hospitalization time, oxygen supply duration, and the outcomes of patients. Least Absolute Shrinkage and Selection Operator (LASSO) was applied for feature selection. Five prediction models were applied in the training cohort and assessed in an internal and an external validation dataset, respectively. Finally, two (C reactive protein, lymphocyte percent) of 36 candidate immune/inflammatory features were finally used for model development. All five models displayed promising predictive performance. Notably, the ensemble model, PRCTC (prediction of response to corticosteroid therapy in COVID-19 patients), derived from three prediction models including Gradient Boosted Decision Tree (GBDT), Neural Network (NN), and logistic regression (LR), achieved the best performance with an area under the curve (AUC) of 0.810 (95% confidence interval [CI] 0.760-0.861) in internal validation cohort and 0.845 (95% CI 0.779-0.911) in external validation cohort to predict patients' response to corticosteroid therapy. In conclusion, PRCTC proposed with universality and scalability is hopeful to provide tangible and prompt clinical decision support in management of COVID-19 patients and potentially extends to other medication predictions.
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Affiliation(s)
- Yue Gao
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Xiaoming Xiong
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Xiaofei Jiao
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Yang Yu
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Jianhua Chi
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Wei Zhang
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Lingxi Chen
- Department of Computer Science, City University of Hong Kong, Kowloon Tong 999077, Hong Kong
| | - Shuaicheng Li
- Department of Computer Science, City University of Hong Kong, Kowloon Tong 999077, Hong Kong
| | - Qinglei Gao
- Cancer Biology Research Center, Key Laboratory of Chinese Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
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Krishnamurthy V, Suhail KM, Aslam SSM, Raj MP, Patil P, Phaniraj P. Study of early warning efficiency of different laboratory markers in predicting progression of disease in COVID-19. Ann Afr Med 2022; 21:371-376. [PMID: 36412337 PMCID: PMC9850887 DOI: 10.4103/aam.aam_117_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction COVID 19 pandemic has given rise to several challenges to clinicians and one of the keys in this is to predict the set of patients who progress from mild disease to moderate and severe. Apart from the symptomatology and signs, there are several lab parameters varying from biochemical, hematological to radiological parameters which help us in stratifying the stage of disease and also in deciding on which set of patients need close and vigilant monitoring. This would help us in better stratification of disease and utilize the available infrastructure and resources in an optimum way for better management of the disease. Aim To analyze the early warning efficiency of laboratory parameters individually or in combination in predicting the progress of disease in patients from mild to moderate/severe disease. Materials and Methods This was taken up as a retrospective study with 100 cases and 100 controls. The demographic details, inflammatory markers, biochemical markers and hematological markers were analyzed. Test of significance was employed to compare categorical variables while student t-test was employed to test the difference in the mean value such as age between case and control (Mann-Whitney U-test in parameters not having normal distribution). Receiver operating characteristic (ROC) curve was constructed for these parameters using cases and controls and area under the curve (AUC) were estimated which was used as an indicator of sensitivity and specificity of the parameter in their early warning efficiency. The critical values for each of the parameters either individually or in combination was estimated as well. Results Among the parameters C reactive protein (CRP), d-dimers and eosinopenia have the best early warning efficiency. The area under the ROCs curve for neutrophil lymphocyte ratio (NLR), CRP. Ferritin, lactate dehydrogenase, Eosinopenia was 0.609, 0.947, 0.614, 0.554, 0.617 respectively at triage. However, a combination of eosinopenia with CRP (AUC-0.732) or NLR with CRP (AUC-0.728) have a good sensitivity and specificity in predicting the outcome regarding the progression of the disease. Conclusions Among the parameters, CRP, d-dimers, Eosinopenia and NLR have the best early warning efficiency. However, a combination of Eosinopenia and CRP at triage should also serve as a red flag sign in patients apart from the well-known NLR and IL6 values.
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Affiliation(s)
- Vishwanath Krishnamurthy
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India,Address for correspondence: Dr. Vishwanath Krishnamurthy, New BEL Road, M.S. Ramaiah Nagar, MSRIT Post, Bengaluru - 560 054, Karnataka, India. E-mail:
| | - K. Mohammed Suhail
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - S. Shaikh Mohammed Aslam
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Madhu P. Raj
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Prashanth Patil
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Priyanka Phaniraj
- Department of Internal Medicine, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
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Jin YH, Shi SY, Zheng Q, Shen J, Ying XZ, Zhu B. [A preliminary study on the surgical timing of spinal tuberculosis]. Zhongguo Gu Shang 2021; 34:717-24. [PMID: 34423614 DOI: 10.12200/j.issn.1003-0034.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To observe the changes of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and nerve function in patients with spinal tuberculosis before and after surgery, explore the timing of surgical intervention, and evaluate its influence on surgical safety. METHODS A retrospective analysis was conducted on 387 patients with spinal tuberculosis who received surgical treatment from March 2012 to March 2017, including 278 males and 109 females, aged 12 to 86 years old with an average of (49.9±19.1) years. There were 64 cases of cervical tuberculosis, 86 cases of thoracic tuberculosis, 76 cases of thoracolumbar tuberculosis and 161 cases of lumbar tuberculosis. There were 297 patients with single segmental involvementand 90 patients with multiple segmental involvement. Among them, 62 cases presented neurological damage, and preoperative spinal cord neurological function depended on ASIA grade, 5 cases of grade A, 8 cases of grade B, 39 cases of grade C, and 10 cases of grade D. According to the duration of preoperative antituberculosis treatment, the patients were divided into group A (256 cases, receiving conventional quadruple antituberculosis treatment for 2-4 weeks before surgery) and group B (131 cases, receiving conventional quadruple antituberculosis treatment for more than 4 weeks before surgery). The two groups were compared in terms of gender, age, preoperative complicated pulmonary tuberculosis, lesion site, lesion scope, surgical approach, drug resistance and other general clinical characteristics. ESR, CRP, visual analogue scale(VAS), Oswestry Disability Index (ODI), Frankel grade and postoperative complications were observed. RESULTS All 387 patients were followed up for 12 to 36 (18.3±4.5) months. There were no significant differences in gender, age, preoperative pulmonary tuberculosis, lesion site, lesion range, surgical approach, preoperative drug resistance and other characteristics between two groups. A total of 32 patients in two groups did not heal after surgery, with an incidence rate of 8.27%. The VAS and spinal cord dysfunction index of the two groups were significantly improved after surgery (P<0.05), but there was no significant difference between two groups at the same time point (P>0.05) . From 1 to 14 days after operation, the neurological function began to gradually recover, and the neurological function grade was increased by 1 to 3 grades. From 3 months after operation to the final follow up, 52 cases recovered completely, 8 cases partially recovered, and 2 cases did not improve. There was no significant difference in ESR and CRP between two groups before admission, 1 month after surgery, and final follow-up (P>0.05). CONCLUSION After 2-4 weeks of anti tuberculosis treatment before operation, patients with spinal tuberculosis could be operated upon with ESR and CRP in a descending or stable period. In principle, patients with spinal tuberculosis and paraplegia should be treated as soon as possible after active preoperative management of the complication without emergency surgery.
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Affiliation(s)
- Yang-Hui Jin
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
| | - Shi-Yuan Shi
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
| | - Qi Zheng
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
| | - Jian Shen
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
| | - Xiao-Zhang Ying
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
| | - Bo Zhu
- Department of Orthopaedics, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang, China
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Tarantino G, Citro V, Balsano C, Capone D. Age and Interleukin-15 Levels Are Independently Associated With Intima-Media Thickness in Obesity-Related NAFLD Patients. Front Med (Lausanne) 2021; 8:634962. [PMID: 34095164 PMCID: PMC8175965 DOI: 10.3389/fmed.2021.634962] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/06/2021] [Indexed: 01/06/2023] Open
Abstract
Common carotid intima-media thickness (IMT) represents a functional and structural marker of early, precocious, and subclinical atherosclerosis, independently from the carotid plaque. Macrophage cells, which have been detected in adipose tissue and atherosclerotic plaques, are regulated by interleukin-15 (IL-15). At the light of the conflicting results concerning the role of IL-15 in atherosclerosis, the aim of the study was to retrospectively evaluate in a population of 80 obese patients, with median age of 46 years (IQR 34–53 years), with a low rate of comorbidities but with non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis (HS), the relationship between IMT and serum concentrations of IL-15. Anthropometric measures, metabolic profile, and serum inflammatory markers, as well as the levels of IL-15, MCP-1, b FGF, and GM-CSF, were analyzed by a bead-based assay. IMT, HS, subcutaneous, and visceral adipose tissues were detected by ultrasonography. The IL-15 levels of the obese patients were increased with respect to those of 44 young healthy subjects, i.e., 2.77 (1.21–4.8) vs. 1.55 (1–2.4) pg/mL (P = 0.002). In the univariate analysis, IL-15 levels were associated to IMT and to those of MCP-1, b FGF, and GM-CSF, without any relation to other inflammatory markers such as CRP and ferritin, except fibrinogen. In the multivariate analysis, after adjusting the HS severity for the extent of visceral adiposity, a dramatic change in prediction of IMT by HS was shown (β from 0.29 to 0.10, P from 0.008 to 0.37). When the visceral adipose tissue was combined with IL-15, on the one hand, and the well-known coronary artery disease (CAD) risk factors—i.e., age, gender, smoking status, HDL-cholesterol concentrations, triglycerides levels, and HOMA—on the other, only age and IL-15 remained the predictors of IMT (β = 0.60, P = 0.0001 and β = 0.25, P = 0.024, respectively). There was no association of IL-15 with various anthropometric parameters nor with body fat distribution and severity of HS, also after adjusting for age. Age is resulted to be the main factor in the prediction of IMT and thus of early atherosclerosis. The prediction of IMT by IL-15 coupled with the lack of prediction by the well-known CAD risks is in agreement with recent data, which emphasizes the main role of the immune system in the onset/worsening of atherosclerosis, even though the role of visceral adiposity should be further deepened. Age and IL-15 levels were both predictors of early atherosclerosis in this population of obese patients with NAFLD, suggesting a possible role of this cytokine in the atherosclerosis process.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Vincenzo Citro
- Department of General Medicine, "Umberto I" Hospital, Nocera Inferiore, Italy
| | - Clara Balsano
- Department of Clinical Medicine, Life, Health and Environmental Sciences-MESVA, University of L'Aquila, L'Aquila, Italy
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Mac Giollabhui N, Alloy LB, Hartman CA. Investigating whether depressed youth exhibiting elevated C reactive protein perform worse on measures of executive functioning, verbal fluency and episodic memory in a large, population based sample of Dutch adolescents. Brain Behav Immun 2021; 94:369-380. [PMID: 32889083 PMCID: PMC7921209 DOI: 10.1016/j.bbi.2020.08.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
Cognitive functioning is disrupted during a depressive episode and cognitive dysfunction persists when depression is in remission. A subtype of depressed individuals who exhibit elevated inflammatory biomarkers may be at particular risk for cognitive dysfunction. We examined whether an elevated inflammatory biomarker (C-reactive protein: CRP) in acute and/or remitted depression was associated with specific deficits in executive functioning, episodic memory, and verbal fluency. Data were drawn from a population-based sample of Dutch adolescents (N = 1066; 46% male) recruited at the age of 11 and followed over the course of eight years. We tested whether adolescents with either, (i) a history of depression (Wave 1-3) or (ii) current depression (Wave 4), and elevated levels of C-reactive protein measured in blood at Wave 3 performed worse on cognitive assessments at Wave 4. Eight measures of cognitive functioning were hypothesized to load on to one of three dimensions of cognitive functioning (executive functioning, episodic memory, and verbal fluency) within a structural equation model framework. Higher levels of CRP were associated with worse future executive functioning in adolescents with and without current/prior depression. A current depression diagnosis also was associated with worse executive functioning. There was consistent evidence linking low socioeconomic status and health-related covariates (high body mass index/sedentary behavior) with worse performance across multiple measures of cognitive functioning and, importantly, the association of depression/CRP and executive functioning was no longer significant when controlling for these covariates. Future studies may benefit from investigating whether specific depressogenic behaviors (e.g., sedentary behavior/substance use) mediate a relationship between depression and worse executive functioning, potentially via a prospective pathway through elevated inflammation.
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Manciuc C, Nemescu D, Vata A, Lacatusu GA. SARS-CoV-2 infection and diabetes mellitus: A North Eastern Romanian experience. Exp Ther Med 2021; 21:279. [PMID: 33603886 PMCID: PMC7851682 DOI: 10.3892/etm.2021.9710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023] Open
Abstract
As it spread globally, the new SARS-CoV-2 virus was first confirmed in Romania in February 2020, inevitably infecting individuals with diabetes mellitus (DM) along the way. Diabetes is known to affect the response of the body to pathogens and, according to studies conducted in the last 3 months, it appears that diabetic patients are at a higher risk for developing severe forms of the disease and multiple complications. We performed a retrospective study in order to assess the patients with SARS-CoV-2 infection and DM admitted to 'Sf. Parascheva' Clinical Hospital of Infectious Diseases from March 4th until June 30th, 2020. Of the total 1,080 patients admitted during this period, 85 patients (7.87%) had underlying DM, mostly type 2 (82 cases, 96.46%); the mean age of these patients was 62, and 42 were men (49.41%). Chest CTs revealed indicative SARS-CoV-2 images for all patients and their treatment included individually tailored administration of hydroxychloroquine/lopinavir + ritonavir/enoxaparin sodium/tocilizumab/antibiotherapy according to the then national and international guidelines. In total, 70 patients (82.35%) were cured and 15 succumbed to MODS and/or associated neoplasia, bringing the fatality rate to 17.64%. Although advanced age and DM have been associated with aggravated forms of SARS-CoV-2 infection, over 80% of the patients included in the present study were cured. Nonetheless, diabetes appears to be a significant predictor of morbidity and mortality in the SARS-CoV-2 infection.
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Affiliation(s)
- Carmen Manciuc
- Department of Infectious Diseases, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania
| | - Dragos Nemescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania
| | - Andrei Vata
- Department of Infectious Diseases, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania
| | - Georgiana Alexandra Lacatusu
- Department of Infectious Diseases, ‘Sf. Parascheva’ Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
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Mac Giollabhui N, Alloy LB, Swistun D, Coe CL, Ellman LM, Moriarity DP, Stumper AC, Abramson LY. Concurrent and Longitudinal Associations of Sex and Race with Inflammatory Biomarkers during Adolescence. J Youth Adolesc 2021; 50:711-23. [PMID: 33449289 DOI: 10.1007/s10964-020-01369-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/03/2020] [Indexed: 01/15/2023]
Abstract
Chronic, systemic inflammation is implicated in physical and mental health; little is known about whether sex and racial differences detected in adulthood are observed during adolescence or about normative changes occurring during adolescence. This longitudinal, United States-based study examined four biomarkers of systemic inflammation [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and IL-8) in 315 adolescents (51% female; 58% black; baseline age = 16.49 years (SD = 1.56; range: 12.14-21.28)] at three timepoints. Notable results included: general decline in inflammatory biomarkers in older adolescents, lower levels of TNF-α/IL-8 in black adolescents, elevated CRP/IL-6 in females, and especially higher levels of IL-6 in black, female adolescents. Implications are discussed, particularly the potential health implications of elevated IL-6 in black females.
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Carvelli J, Le Saux A, Bourenne J, Gainnier M, Kaplanski G. Evolution Toward Severe Covid-19 From Biological Monitoring to Therapeutic Considerations. Front Immunol 2020; 11:562038. [PMID: 33384683 PMCID: PMC7770161 DOI: 10.3389/fimmu.2020.562038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Julien Carvelli
- Réanimation des Urgences, CHU Timone, AP-HM, Aix-Marseille Université, Marseille, France
- Marseille Immunopôle, CHU Timone, AP-HM, Marseille, France
| | - Audrey Le Saux
- Réanimation des Urgences, CHU Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - Jeremy Bourenne
- Réanimation des Urgences, CHU Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - Marc Gainnier
- Réanimation des Urgences, CHU Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - Gilles Kaplanski
- Médecine Interne et Immunologie clinique, CHU Conception, AP-HM, Aix-Marseille Université, Marseille, France
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Zheng XZ, Gu YH, Su T, Zhou XJ, Huang JW, Sun PP, Jia Y, Xu DM, Wang SX, Liu G, Yang L. Elevation of erythrocyte sedimentation rate and C-reactive protein levels reflects renal interstitial inflammation in drug-induced acute tubulointerstitial nephritis. BMC Nephrol 2020; 21:514. [PMID: 33243164 PMCID: PMC7689990 DOI: 10.1186/s12882-020-02175-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A renal biopsy is needed to define active inflammatory infiltration and guide therapeutic management in drug-induced acute tubulointerstitial nephritis (D-ATIN). However, factors such as various contraindications, refusal of informed consent and limited technical support may stop the biopsy process. It is thus of great importance to explore approaches that could deduce probable pathologic changes. METHODS A total of 81 biopsy-proven D-ATIN patients were enrolled from a prospective cohort of ATIN patients at Peking University First Hospital. The systemic inflammation score (SIS) was developed based on the CRP and ESR levels at biopsy, and patients were divided into high-SIS, median-SIS, and low-SIS groups. The demographic data, clinicopathologic features, and renal outcomes were compared. RESULTS The SIS was positively correlated with inflammatory cell infiltration and was inversely correlated with interstitial fibrosis. The number of interstitial inflammatory cells increased significantly with increasing SISs. The proportions of neutrophils and plasma cells were the highest in the high-SIS group compared with the other two groups. Prednisone (30-40 mg/day) was prescribed in all patients. The high-SIS group tended to have more favorable renal restoration than the other two groups. By 12 months postbiopsy, a decreased eGFR (< 60 mL/min/1.73 m2) was observed in 66.7% of medium-SIS patients, 32.4% of high-SIS patients, and 30.4% of low-SIS patients. CONCLUSION The SIS was positively correlated with active tubulointerstitial inflammation and therefore could help to aid therapeutic decisions in D-ATIN.
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Affiliation(s)
- Xi-Zi Zheng
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China
| | - Yang-Hui Gu
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China.,Cardiovascular Division, Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, 518033, People's Republic of China
| | - Tao Su
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China
| | - Xu-Jie Zhou
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China
| | - Jun-Wen Huang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China
| | - Ping-Ping Sun
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China
| | - Yan Jia
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China
| | - Da-Min Xu
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China
| | - Su-Xia Wang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China.,Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Gang Liu
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China.,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China
| | - Li Yang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, People's Republic of China. .,Renal Pathology Center, Peking University Institute of Nephrology, Beijing, 100034, People's Republic of China.
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D'Ardes D, Carrarini C, Russo M, Dono F, Speranza R, Digiovanni A, Martinotti G, Di Iorio A, Onofrj M, Cipollone F, Bonanni L. Low molecular weight heparin in COVID-19 patients prevents delirium and shortens hospitalization. Neurol Sci 2020; 42:1527-1530. [PMID: 33185785 PMCID: PMC7664586 DOI: 10.1007/s10072-020-04887-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/05/2020] [Indexed: 12/24/2022]
Abstract
Background COVID-19 patients present with delirium during their hospitalization. Aims To assess the incidence of delirium in hospitalized COVID-19 patients and analyze the possible association with demographic, clinical, laboratory, and pharmacological factors. Methods COVID-19 patients were assessed for clinical signs of delirium and administered the assessment test for delirium and cognitive impairment (4AT) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scales. Results Out of the 56 patients of our cohort, 14 (25.0%) experienced delirium. The use of low molecular weight heparin (LMWH) (enoxaparin 1 mg/kg/daily) was less frequent in patients with delirium (p = 0.004) and was accompanied by lower C reactive protein (CRP) levels (p = 0.006). Discussion The use of LMWH was associated with absence of delirium, independently of comorbidities and age. Conclusions The use of LMWH may help preventing the occurrence of delirium in COVID-19 patients, with possible reduction of length of stay in the hospital and sequelae. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-020-04887-4.
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Affiliation(s)
- Damiano D'Ardes
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Rino Speranza
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Angelo Di Iorio
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Francesco Cipollone
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
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Blossom V, Gokul M, Kumar NA, Kini RD, Nayak S, Bhagyalakshmi K. Chronic unpredictable stress-induced inflammation and quantitative analysis of neurons of distinct brain regions in Wistar rat model of comorbid depression. Vet World 2020; 13:1870-1874. [PMID: 33132599 PMCID: PMC7566234 DOI: 10.14202/vetworld.2020.1870-1874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/25/2020] [Indexed: 01/08/2023] Open
Abstract
Background and Aim: Depression and anxiety are the most prominent neuropsychiatric disease and have been considered as the most burdensome diseases of society. The hippocampus and prefrontal cortex have a prominent role in stress-induced neurological disorders. Chronic unpredictable stress exposed rats are a perfect model in understanding comorbid depression and anxiety disorders. The inflammatory response occurring in the body has been linked to C-reactive protein (CRP) in many diseased conditions. The present research primarily focus on the possible correlation of Cortisol, CRP level and neuronal assay in different regions of hippocampus, dentate gyrus (DG), and prefrontal cortex. Materials and Methods: The control group of rats (n=6) was not exposed to any stress. Whereas, the experimental stress group (n=6) of rats was exposed to various stressors for 15 days. After the experimentation procedures, the blood samples were collected and brain dissection was done. The neurons in the prefrontal cortex, the DG along with various hippocampal regions was counted. Statistical analysis was performed using student’s t-test and p<0.05 was expressed as statistically significant. Results: Animals exposed to chronic unpredictable stressors showed a significant (p<0.0001) decrease in the neuronal count in prefrontal cortex and hippocampus. A significant rise in the serum cortisol (p<0.0001) and CRP (p<0.001) was witnessed in the stressed group. Conclusion: Our results demonstrate that chronic unpredictable stress exposure has affected neurogenesis in prefrontal cortex and hippocampal regions. Decreased neurogenesis was well in coordinance with the increase in cortisol and CRP. The chronic unpredictable stress-induced inflammatory response correlated to various brain regions might provoke insights into a variety of new drugs targeting neurogenesis.
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Affiliation(s)
- Vandana Blossom
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Megha Gokul
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nayanatara Arun Kumar
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rekha D Kini
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shyamala Nayak
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - K Bhagyalakshmi
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Qazi WA, Babur MN, Malik AN, Begum R. Effects of structured exercise regime on Glycosylated Hemoglobin and C reactive protein in patients with Gestational Diabetes Mellitus - A randomized controlled trial. Pak J Med Sci 2020; 36:1449-1453. [PMID: 33235555 PMCID: PMC7674915 DOI: 10.12669/pjms.36.7.2488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To evaluate the effects of structured exercise regime on Glycosylated hemoglobin and C reactive protein in patients with gestational diabetes mellitus. METHODS This two arm parallel randomized controlled trial was conducted at Fauji Foundation Hospital, Rawalpindi from November 2018 till December 2019 on the 54 diagnosed gestational diabetes mellitus patients (Dropped out=4 Analyzed= 50) with age 20 to 40 years and gestational age from 20 to 36 weeks. Selection was done via convenient sampling technique and randomized into two groups (n=25) by sealed envelope method. Structured exercise regime group received combination of moderate intensity aerobics, stabilization and pelvic floor muscles exercises twice a week for 5 weeks (40 min per session) along with dietary and medical interventions while control group received only medical and dietary interventions with postural education. Demographics, glycosylated hemoglobin and C reactive protein were recorded at baseline then after 5 weeks of intervention. Analysis was done by SPSS 20. RESULTS Mean age was 35.92 ± 5.24 years in control group while 34.36 ± 5.21 years in interventional group. Between group analysis for HbA1c showed no significant difference at base line (p >0.05) but showed significant difference (p <0.05) after five weeks' interventions. Similarly, for C reactive protein both groups showed no significant difference (p >0.05) at baseline but after five weeks of interventions showed significant difference (p<0.05). CONCLUSION Structured exercise regime helps in reducing values of glycosylated hemoglobin and C reactive protein in patients with gestational diabetes mellitus.
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Affiliation(s)
- Wardah Ajaz Qazi
- Dr. Wardah Ajaz Qazi, PhD in Rehabilitation Sciences, Foundation University Institute of Rehabilitation Sciences, Foundation University Islamabad, Pakistan
| | - Muhammad Naveed Babur
- Prof. Dr. Muhammad Naveed Babur, PhD in Rehabilitation Sciences. Dean, Faculty of Rehabilitation Sciences, Isra University, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Prof. Dr. Arshad Nawaz Malik, PhD in Rehabilitation Sciences, Riphah college of Rehabilitation & Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Ruqia Begum
- Ruqia Begum, MS-OMPT. Foundation University Institute of Rehabilitation Sciences, Foundation University Islamabad, Pakistan
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Tantucci C, Bottone D, Levi G, Uccelli S, Venturoli N, Magri R, Garrafa E, Pini L. Respiratory function, autonomic dysfunction, and systemic inflammation are closely linked in patients with COPD and tidal flow limitation: An exploratory study. Respir Physiol Neurobiol 2020; 284:103565. [PMID: 33091628 DOI: 10.1016/j.resp.2020.103565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023]
Abstract
RATIONALE The study aimed to investigate the interplay among respiratory function, autonomic dysfunction, and systemic inflammation in COPD patients. METHODS In 19 COPD patients, functional respiratory parameters, heart rate variability (HRV), and plasma high-sensitivity-C-reactive-protein (hs-CRP) were assessed. Forced oscillation technique (FOT) was used to detect the absence (NFL) or presence (FL) of resting tidal expiratory flow limitation. Subsequently, patients underwent an incremental shuttle walking test (ISWT). Twenty healthy subjects were also shown as controls. RESULTS FEV1, DLCO, and lung volumes displayed significant correlations with LH/FH ratio (0.56 < r2<0.27,p < 0.01). A significant relationship was found between LH/FH ratio with IC/TLC ratio% (r2 = 0.29,p < 0.05) and hs-CRP (r2 = 0.26,p < 0.05). Patients with FL had greater hs-CRP plasma levels (p < 0.05), lower IC/TLC% (p < 0.05), and higher LH/FH ratio (p<0.001). CONCLUSIONS Worse airflow obstruction was associated with a higher LH/HF ratio, directly related, to hs-CRP and indices of dynamic hyperinflation. The presence of resting tidal FL with dynamic pulmonary hyperinflation is a strong driver of systemic inflammation and autonomic dysfunction.
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Affiliation(s)
- Claudio Tantucci
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Damiano Bottone
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Guido Levi
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Silvia Uccelli
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Nicola Venturoli
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Roberto Magri
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Emirena Garrafa
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Pini
- Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
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Yaacobi Shilo D, Ben Assayag E, Berliner S, Saranga H, Shilo L, Kesler A. The Usefulness of the Erythrocyte Sedimentation Rate and C-reactive Protein for the Differential Diagnosis of Non-Arteritic Anterior Ischemic Optic Neuropathy in the Era of Microinflammation. Ocul Immunol Inflamm 2020; 30:439-443. [PMID: 32946299 DOI: 10.1080/09273948.2020.1800750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE The presence of a microinflammatory response is one of the possible pathological mechanisms related to the development of nonarteritic anterior ischemic optic neuropathy (NAAION), a common cause of optic neuropathy in old age.We tested whether individuals with NAAION harbor a heightened microinflammatory response compared to controls. METHODS We measured the erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hs-CRP) in NAAION patients during hospital admission and in four matched controls for each patient, retrieved from a large cohort of 20,000 apparently healthy individuals. RESULTS We included 128 NAAION patients and 512 controls. No significant differences were found between patients and controls regarding the inflammatory biomarkers. CONCLUSIONS This is the first report showing a lack of difference in ESR and hs-CRP levels between NAAION patients and matched controls, suggesting NAAION is not associated with a heightened inflammatory response, such as the one associated with multiple atherothrombotic risk factors.
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Affiliation(s)
- Dafna Yaacobi Shilo
- Department of Plastic Surgery & Burns, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Einor Ben Assayag
- Department of Neurology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Berliner
- Department of Internal Medicine 'D', Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hila Saranga
- Department of Internal Medicine 'D', Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lotan Shilo
- Department of Internal Medicine 'C', Meir Hospital, Sapir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Kesler
- Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Wang G, Wu C, Zhang Q, Yu B, LÜ J, Zhang S, Wu G, Wu Y, Zhong Y. Clinical characteristics and the risk factors for severe events of elderly coronavirus disease 2019 patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2020; 45:542-548. [PMID: 32879104 DOI: 10.11817/j.issn.1672-7347.2020.200292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the clinical characteristics and risk factors for severe events of coronavirus disease 2019 (COVID-19) in elderly patients. METHODS Retrospective analysis was performed on the clinical data of all elderly COVID- 19 patients treated in Changsha Public Health Treatment Center from January 17, 2020 to March 15, 2020, which included basic diseases, symptoms, test results, and other clinical characteristics, and prognostic indicators such as severity of illness, length of hospital stay, virus shedding time and mortality rate. The differences in clinical characteristics and prognostic indicators between elderly, middle-aged, and young COVID-19 patients were also analyzed. Logistic regression model was used to conduct univariate and multivariate analysis of risk factors for developing severe events in elderly COVID-19 patients; receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction efficacy. RESULTS Of the 230 COVID-19 adult patients, 34 were young patients (14.8%), 136 were middle-aged patients (59.1%), and 60 were elderly (26.1%). Among the 60 elderly patients, 23 were male (38.3%) and 37 were female (61.7%), with a medium age of 66 years old. Common symptoms were fever (66.7%), cough (50.0%), and fatigue (41.7%). C reactive protein (CRP) was increased significantly. The proportion of severe cases was 31.7%, and mortality was 1.7%. The median length of hospitalization and median virus shedding time were 18.5 days and 21 days, respectively. Compared with the young and the middle-aged patients, the elderly had a higher proportion of hypertension, diabetes, and cardiovascular diseases, more common shortness of breath, higher proportions of pneumonia and severe cases (all P<0.05), and the decreased lymphocyte count and lymphocyte percentage (both P<0.05), as well as higher CRP and erythrocyte sedimentation rate (ESR) levels (both P<0.05). Compared with non-severe cases, severe elderly patients demonstrated higher CRP and aspartate aminotransferase (AST) levels (all P<0.05), the reduced lymphocyte count (P<0.05), and the prolonged length of hospitalization and virus shedding duration (both P<0.05). Univariate logistic regression analysis indicated that the lymphocytes proportion, CRP and AST levels were significantly correlated with the risk for developing severe events in elderly COVID-19 patients (all P<0.05). Multivariate logistic regression found that severe events in elderly patients with COVID-19 were significantly correlated with CRP level (OR=1.041, P=0.013). ROC curve analysis revealed that the area under the curve (AUC) for CRP to diagnose severe events in elderly COVID 19 patients was 0.851. CONCLUSIONS The proportion of severe cases in elderly COVID-19 patients is higher than that in young and middle-aged patients. CRP level has a good predictive value for the possibility of severe events in elderly COVID-19 patients.
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Affiliation(s)
- Guyi Wang
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011.
| | - Chenfang Wu
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Quan Zhang
- Department of Critical Care Medicine, First Hospital of Changsha, Changsha 410005, China
| | - Bo Yu
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Jianlei LÜ
- Department of Critical Care Medicine, First Hospital of Changsha, Changsha 410005, China
| | - Siye Zhang
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Guobao Wu
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Ying Wu
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Yanjun Zhong
- Department of Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011.
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Acampa M, Lazzerini PE, Guideri F, Tassi R, Cartocci A, Martini G. P Wave Dispersion and Silent Atrial Fibrillation in Cryptogenic Stroke: The Pathogenic Role of Inflammation. Cardiovasc Hematol Disord Drug Targets 2020; 19:249-252. [PMID: 30968778 DOI: 10.2174/1871529x19666190410145501] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/23/2019] [Accepted: 03/11/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cryptogenic stroke (CS) represents 25% of ischemic strokes. Especially after CS, the detection of atrial fibrillation (AF) is important because it provides clues to the mechanism of stroke. However, the relationship between AF and stroke appears more complex than a simple cause-effect mechanism, suggesting that the association between AF and stroke may be due to other systemic and atrial factors including systemic inflammation that may lead to atrial remodeling and subsequent atrial cardiopathy. OBJECTIVE The aim of this study was to evaluate the relationship among different electrocardiographic parameters, inflammatory markers and in-hospital AF occurrence after acute CS. METHODS 222 patients with CS underwent 12-lead resting ECG at admission and 7-day in-hospital ECG monitoring. The following indices were evaluated: P-wave dispersion (PWD), P-wave index, P-wave axis, atrial size and high-sensitivity-C reactive protein (CRP). RESULTS AF was detected in 44 patients. AF-group had significantly higher PWD, P-wave index, PR interval, CRP and greater frequency of abnormal P-wave axis in comparison with no-AF group. There was a significant correlation between CRP and PWD (r=0.28). By using the mediation analysis, performed according to the "bootstrapping" method, we found that PWD is a significant mediator variable of the relationship between CRP and AF occurrence, accounting for 40% of the association. CONCLUSIONS In cryptogenic stroke, high PWD is partly due to systemic inflammation that increases AF risk possibly via atrial electric remodeling. These findings could also suggest inflammation as a possible therapeutic target in order to prevent atrial electrical alterations and finally AF occurrence in CS.
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Affiliation(s)
- Maurizio Acampa
- Stroke Unit, Department of Neurological and Neurosensorial Sciences, Azienda Ospedaliera Universitaria Senese, "Santa Maria alle Scotte" General Hospital, Siena, Italy
| | - Pietro E Lazzerini
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Francesca Guideri
- Stroke Unit, Department of Neurological and Neurosensorial Sciences, Azienda Ospedaliera Universitaria Senese, "Santa Maria alle Scotte" General Hospital, Siena, Italy
| | - Rossana Tassi
- Stroke Unit, Department of Neurological and Neurosensorial Sciences, Azienda Ospedaliera Universitaria Senese, "Santa Maria alle Scotte" General Hospital, Siena, Italy
| | | | - Giuseppe Martini
- Stroke Unit, Department of Neurological and Neurosensorial Sciences, Azienda Ospedaliera Universitaria Senese, "Santa Maria alle Scotte" General Hospital, Siena, Italy
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40
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Lucijanic M, Galusic D, Krecak I, Sedinic M, Soric E, Holik H, Perisa V, Moric Peric M, Zekanovic I, Stoos-Veic T, Kusec R. C reactive protein to albumin ratio as prognostic marker in primary and secondary myelofibrosis. Leuk Lymphoma 2020; 61:2969-2974. [PMID: 32654566 DOI: 10.1080/10428194.2020.1789627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We retrospectively investigated C reactive protein to albumin ratio (CAR) in a cohort of 142 patients with myelofibrosis [101 primary (PMF); 41 secondary (SMF)] and compared it to hematological and clinical parameters. Among other associations, higher CAR was significantly associated with higher grade of bone marrow fibrosis, lower frequency of Calreticulin (CALR) mutations, presence of constitutional symptoms, massive splenomegaly, transfusion dependency, blast phase disease, lower hemoglobin, lower platelets, higher ferritin and higher lactate dehydrogenase (LDH) (p < .05 for all analyses). Higher CAR was able to predict inferior survival in PMF independently of DIPSS [hazard ratio (HR)=2.17; p = .015 for high CAR and HR = 2.05; p < .001 for DIPSS] and in SMF independently of Mysec-PM (HR = 6.48; p = .022 for high CAR and HR = 2.63; p = .013 for Mysec-PM) demonstrating its good prognostic potential. CAR seems to be an independent and prognostically relevant parameter, both in PMF and SMF, and might aid in timely recognition of most vulnerable patients.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Split, Croatia
| | - Ivan Krecak
- Hematology Department, General Hospital Sibenik, Sibenik, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Bencevic" General Hospital, Ul. Andrije Štampara, Slavonski Brod, Croatia
| | - Vlatka Perisa
- Department of Hematology, Osijek University Hospital, Osijek, Croatia.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | | | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Mac Giollabhui N, Ellman LM, Coe CL, Byrne ML, Abramson LY, Alloy LB. To exclude or not to exclude: Considerations and recommendations for C-reactive protein values higher than 10 mg/L. Brain Behav Immun 2020; 87:898-900. [PMID: 32014579 PMCID: PMC7316621 DOI: 10.1016/j.bbi.2020.01.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 01/30/2020] [Indexed: 11/26/2022] Open
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McFarland DC, Breitbart W, Miller AH, Nelson C. Depression and Inflammation in Patients With Lung Cancer: A Comparative Analysis of Acute Phase Reactant Inflammatory Markers. Psychosomatics 2020; 61:527-537. [PMID: 32331769 DOI: 10.1016/j.psym.2020.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression and inflammation are intertwined, which is particularly relevant for patients with lung cancer who have an abundance of inflammation and experience depression. Acute phase reactants (APRs), albumin and C-reactive protein (CRP), are easily interpretable indirect markers of inflammation that have never been concomitantly compared with depression. Inflammation increases CRP (positive APR) and decreases albumin (negative APR). We hypothesize that albumin will be similarly associated with depression, thereby helping to inform the diagnosis of inflammatory depression. OBJECTIVE Compares the relationship between depression and representative positive and negative acute phase reactants in patients with metastatic lung cancer. METHODS Patients (n = 109) with metastatic lung cancer were evaluated for depression using the Hospital Anxiety and Depression Scale. Inflammation as measured by positive (CRP) and negative (albumin) APRs along with demographic and treatment variables were analyzed for associations with depression. RESULTS Depression was associated with lower albumin (r = -0.35, P < 0.001), higher CRP (r = 0.47, P < 0.001), and the CRP/albumin ratio (r = 0.45, P < 0.001). Hierarchical linear regression modeling found that albumin was associated with depression when controlling for demographics, disease, and treatment types (β = -0.28, P = 0.01). When both APRs were in the model, only CRP predicted depression (β = 0.31, P = 0.01), and albumin did not moderate CRP and depression. CRP/albumin ratio did not add to understanding depression variability, but patients with both low albumin and high CRP had particularly severe depression. CONCLUSION Albumin is associated with depression but not to a greater extent than CRP. The coupling of lower albumin and higher CRP describes more severe depression. Positive and negative APRs may form a distinct biologic signature to help identify patients with inflammatory depression in the lung cancer setting.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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Michaud M, Catros F, Gaches F. Usefulness of serum amyloid a protein dosage for monitoring patients receiving tocilizumab. Eur J Intern Med 2020; 74:115-116. [PMID: 31926783 DOI: 10.1016/j.ejim.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Martin Michaud
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France.
| | - Florian Catros
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France
| | - Francis Gaches
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France
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Rincón-Arévalo H, Quintero JC, Fortich F, Rojas M, Vásquez G, Castaño D, Yassin LM. Low frequency of IL-10 + B cells in patients with atherosclerosis is related with inflammatory condition. Heliyon 2020; 6:e03441. [PMID: 32154409 DOI: 10.1016/j.heliyon.2020.e03441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/11/2019] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aims B cells involvement in animal models of atherosclerosis has been unequivocally established. However, the role of these cells in patients with atherosclerosis is almost unknown. Besides the production of antibodies, B cells can also exhibit regulatory functions mainly through IL-10. Here, we characterized human B cell subsets, their production of IL-10 in patients with atherosclerosis and their potential association with inflammation. Methods Patients with confirmed atherosclerotic events and controls with low cardiovascular risk were included. B cells subsets were determined in mononuclear cells (PBMC) using flow cytometry. PBMC were cultured ex vivo (5 h) and in vitro (48 h) to determine IL-10+ B cells and in some cases TNF-α+ and IFN-γ+ CD4+ T cells. The inflammatory state of the participants was determined through high sensitivity C reactive protein levels. Results Increase in percentage and number of plasmablasts was observed in patients with atherosclerosis compared with controls. A decreased frequency of IL-10+ B cells was observed in patients, both in ex vivo and in vitro cultures. This decrease was detected in transitional, memory, and plasmablast subsets. Interestingly, the reduction of IL-10+ B cells negatively and significantly correlated with the inflammatory condition of the studied subjects and associated with an increased frequency of TNF-α+ and IFN-γ+ CD4+ T cells. The blockade of IL-10R did not show further effect in T cells activation. Conclusions There is an association between the inflammatory state and a reduction of IL-10+ B cells that could contribute to the development of atherosclerosis.
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Wu J, Guo N, Chen X, Xing C. Coexistence of micro-inflammatory and macrophage phenotype abnormalities in chronic kidney disease. Int J Clin Exp Pathol 2020; 13:317-323. [PMID: 32211115 PMCID: PMC7061787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 06/10/2023]
Abstract
The heterogeneity of macrophages promotes renal fibrosis and plays an important role in the repair of kidney damage. The "microinflammation state" is closely related to accelerated mortality in patients with chronic kidney disease (CKD). The aim of this study was to investigate the relationship between microinflammation and macrophage polarization in CKD. The levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in peripheral blood of 30 non-dialysis CKD-5 patients (CKD group) and 20 healthy subjects (Con group) were measured. Peripheral mononuclear cells (PBMC) of each group were obtained, induced to differentiate into mature macrophages, and the expression of CD206 on the surface of macrophage M2 was detected. The expression of IL-10, TGF-β1 and TNF-α in the supernatant of macrophage culture medium was detected by real time RCR and ELISA. We found that the levels of hs-CRP, IL-6 and TNF-α in peripheral blood of patients with CKD were significantly higher than those of the control group. The expression of CD206 in macrophages was significantly decreased in CKD patients. The anti-inflammatory cytokines IL-10 and TGF-β1 in the supernatant of CKD macrophages decreased significantly, while the pro-inflammatory factor TNF-α did not change significantly. Our results demonstrate that the expressions of macrophage phenotype and anti-inflammatory cytokine in CKD patients are abnormal, which may be related to the microinflammation state prevalent in CKD patients.
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Affiliation(s)
- Jianhua Wu
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital)Jiangsu, P. R. China
- Department of Nephrology, Affiliated Hospital of Nantong UniversityJiangsu, P. R. China
| | - Naifeng Guo
- Department of Nephrology, Affiliated Hospital of Nantong UniversityJiangsu, P. R. China
| | - Xiaolan Chen
- Department of Nephrology, Affiliated Hospital of Nantong UniversityJiangsu, P. R. China
| | - Changying Xing
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital)Jiangsu, P. R. China
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Fellahi S, Béraud L, Capeau J, Grateau G, Hentgen V, Georgin-Lavialle S, Bastard JP. [Validation of the usual values provided by a supplier without access to a control population: example of serum amyloid A]. Ann Biol Clin (Paris) 2019; 77:255-9. [PMID: 31021321 DOI: 10.1684/abc.2019.1439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As part of the laboratory accreditation process, it may be required to determine the laboratory's own reference values. Thus, we have accredited in our laboratory, the serum amyloid A (SAA) assay for which the supplier gave the usual values. However, we did not have a reference population to check them. MATERIALS AND METHODS We extracted from our laboratory information management system, the values of all SAA and C-reactive protein (CRP) assays performed simultaneously from 2014 to 2018. We selected all SAA-CRP couples with a CRP <5 mg/L and <3 mg/L assuming that these subjects were comparable to the general population. For each of the selected CRP thresholds, we quantified the number of subjects with SAA ≤6.4 mg/L (provider's data), then SAA ≤10 mg/L (threshold below which the risk of kidney complications is low). We compared annual averages of SAA-CRP couples (2014-2018) by analysis of variance (ANOVA). RESULTS AND DISCUSSION For subjects with CRP <5 mg/L, we found SAA value ≤6.4 mg/L in 84.6% and ≤10 mg/L in 92.8% of cases. These results were respectively 89.6% et 95.6% when considering CRP <3 mg/L. Similar thresholds were observed for adults and children. The ANOVA analysis did not show any difference per year from 2014 to 2018 for both SAA and CRP in children, adults and the total population. CONCLUSION Our reference values were comparable to those given in the supplier's record and those issued from the literature both for children and adults. The analysis of the evolution of the biomarker average level as a function of time could be an additional relevant element.
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Marinović T, Bašić S, Romić D, Nevajda B, Đerek L, Maraković J, Raguž M. Dynamics of inflammatory factors expression in ischemic brain tissue injury. Neurol Int 2019; 11:8282. [PMID: 31871601 PMCID: PMC6908952 DOI: 10.4081/ni.2019.8282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 11/22/2022] Open
Abstract
Ischemic stroke is one of the most common cause of mortality and disability in the modern world. Still, therapeutic options remain modest. Aim of the study was to present dynamics of inflammatory factors expression (C reactive protein, procalcitonin, interleukin 10) in patients after ischemic stroke. Our study included 101 patients divided in thrombolised and nonthrombolised groups. Inflammatory factors concentration in serum was determinate at admission, 24, 48 hours and seven days after the initial onset, while neurological assessment was measured at the admission, 24 hours, seven days and three months after the initial onset using National Institute of Health Stroke Scale and Rankin Scale. Certain pattern was observed in dynamics of inflammatory factors: intensive increase in first and second day after the stroke, followed by decrease till day seven in both groups. Additionally, thrombolised group showed significant neurological improvement. Although well investigated, the role of inflammatory factors in the ischemic stroke still stays controversial. High association of C reactive protein and interleukin 10 values suggest potential prognostic role in patient’s follow-up, while the role of procalcitonin values still remains unclear.
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Affiliation(s)
- Tonko Marinović
- Department of Neurosurgery, University Hospital Dubrava, Zagreb.,Department of Neurology and Neurosurgery, Faculty of Dental Medicine and Health, University of J.J. Strossmayer Osijek, Osijek, Croatia
| | - Silvio Bašić
- Department of Neurology and Neurosurgery, Faculty of Dental Medicine and Health, University of J.J. Strossmayer Osijek, Osijek, Croatia.,Department of Neurology, University Hospital Dubrava, Zagreb, Croatia
| | - Dominik Romić
- Department of Neurosurgery, University Hospital Dubrava, Zagreb
| | - Branimir Nevajda
- Basildon University Hospital, Basildon and Thurrock NHS Foundation Trust, Basildon, UK
| | - Lovorka Đerek
- Department of Chemistry, University Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - Jurica Maraković
- Department of Neurosurgery, University Hospital Dubrava, Zagreb.,Department of Surgery and Neurosurgery, School of Medicine, J.J. Strossmayer University of Osijek, Croatia
| | - Marina Raguž
- Department of Neurosurgery, University Hospital Dubrava, Zagreb
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Domínguez-Comesaña E, Domínguez-Fernández R, Quiroga-Veiga N, López-Gómez V, Estévez-Fernández S. Are reactive C protein and procalcitonin useful for early diagnosis of postoperative intraabdominal infection after pancreaticoduodenectomy for pancreatic cancer? CIR CIR 2019; 87:662-666. [PMID: 31631192 DOI: 10.24875/ciru.19000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the relationship between C reactive protein and procalcitonin levels and the appearance of post-operative intraabdominal infection, in patients with pancreaticoduodenectomy due to pancreatic cancer. Method A prospective observational study, including 35 patients, was made. Procalcitonin and C reactive protein were measured before surgery, as well as 24, 48 and 72 h after the surgical procedure. Patients were divided in two groups, with and without intraabdominal infection. Results Six patients (17.1%) presented post-operative intraabdominal infection. Both, procalcitonin and C reactive protein, increased in all patients after surgery, but there were no significant differences between the two groups. However, the ratio between the C reactive protein concentrations on post-operative day 3 and the concentrations on post-operative day 1 was significantly increased in the group of patients with intraabdominal infection. The predictive positive value and the predictive negative value for this ratio were 60% and 95%, respectively, for a cut-off point of 2.3. Conclusions The ratio between C reactive protein value on post-operative day 3 and the value on post-operative day 1 is a good predictor of post-operative intraabdominal infection after pancreaticoduodenectomy.
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Affiliation(s)
| | | | | | - Victoria López-Gómez
- Servicio de Análisis Clínicos. Complejo Hospitalario de Pontevedra, Pontevedra, España
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Liu L, Liang J, Liu Q, Luo C, Liu J, Fan R, Chen Z, Chen Y, Peng F, Jiang Y. Elevated Plasma Homocysteine Levels in Anti-N-methyl-D-aspartate Receptor Encephalitis. Front Neurol 2019; 10:464. [PMID: 31130913 PMCID: PMC6509947 DOI: 10.3389/fneur.2019.00464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/16/2019] [Indexed: 01/10/2023] Open
Abstract
Objective: Homocysteine (Hcy) levels have been investigated in many diseases, such as neurodegenerative and autoimmune diseases. However, changes in Hcy levels in anti-N-Methyl-D-aspartate receptor (anti-NMDAR) encephalitis have not been investigated thus far. Methods: Case data were collected from 45 patients with anti-NMDAR encephalitis and 179 age- and sex-matched healthy controls (HCs). Clinical characteristics, Hcy levels, C reactive protein (CRP) levels, and cerebrospinal fluid (CSF) parameters were determined. Association of Hcy and clinical parameters were evaluated in these patients. Among these 45 patients, 15 had a follow-up evaluation at 3 months after treatment. Results: Hcy levels (p < 0.001) and CRP levels (p = 0.005) from the patients with anti-NMDAR encephalitis were significantly higher than those from HCs. Hcy levels from male patients were significantly lower than those from male HCs (p < 0.001). Comparing anti-NMDAR encephalitis patients after treatment with before treatment, the former has significantly higher Hcy levels (p = 0.004), CRP levels (p = 0.041) and mRS scores (p = 0.002). Furthermore, a significant negative correlation between the changes in Hcy levels and the changes in mRS scores (r = −0.534, p = 0.040) was observed. Conclusion: Elevated plasma homocysteine occurs in anti-NMDAR encephalitis, and seems associated with male sex.
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Affiliation(s)
- Lizhi Liu
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China
| | - Jie Liang
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qing Liu
- Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China
| | - Chongliang Luo
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Jia Liu
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rong Fan
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhigang Chen
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yong Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Fuhua Peng
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Jiang
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Hering S, Wiegand S. Systemic inflammatory response after endoscopic surgery of Zenker's diverticulum. Acta Otorhinolaryngol Ital 2019; 39:230-234. [PMID: 30745590 PMCID: PMC6734204 DOI: 10.14639/0392-100x-1576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 12/01/2017] [Indexed: 11/23/2022]
Abstract
Zenker’s diverticulum can be treated with a carbon dioxide laser or linear stapling device. A retrospective study on patients undergoing elective surgery for Zenker`s diverticulum with carbon dioxide laser or stapler was performed to analyse possible differences in inflammatory responses during the postoperative period. Leucocyte counts and C-reactive protein levels in peripheral blood were measured before and on days 1, 2, 3 and 5 after the operation. Statistical analysis was performed using the Mann-Whitney U-test. Of 34 patients, 16 were treated by laser and 18 by stapler. Age, sex ratio and ASA grade did not differ between the groups. Postoperative leukocytosis was significantly milder in the stapler group compared with patients who were treated by carbon dioxide laser. The mean C-reactive protein (CRP) level on day 1, 2 and 3 after surgery was significantly higher in the CO2 laser group than in the stapler group. Leukocyte counts recovered on day 3 after surgery in both groups while CRP levels did not decline to preoperative levels at day 5 after the operation in either group. No inflammatory complications such as mediastinitis or pneumonia occurred. In conclusion, the inflammatory response in the early period after carbon dioxide laser diverticulotomy of Zenker’s diverticulum is higher than after stapler-assisted surgery of Zenker’s diverticulum.
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Affiliation(s)
- S Hering
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - S Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
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