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Yeung SCJ, Qdaisat A, Bischof JJ, Caterino JM, Kyriacou DN, Coyne Md C. A case series of adrenal insufficiency (likely due to hypophysitis) in cancer patients treated with immune checkpoint inhibitors. Am J Emerg Med 2024:S0735-6757(24)00204-3. [PMID: 38705758 DOI: 10.1016/j.ajem.2024.04.046] [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: 12/05/2023] [Revised: 03/24/2024] [Accepted: 04/26/2024] [Indexed: 05/07/2024] Open
Abstract
The number of approved immune checkpoint inhibitors (ICIs) and their indications have significantly increased over the past decade. Immune-related adverse effects (irAEs) of ICIs vary widely in presentation and symptoms and can present diagnostic challenges to emergency department (ED) physicians. Moreover, when ICIs are combined with radiotherapy, cytotoxic chemotherapy, or targeted therapy, the attribution of signs and symptoms to an immune-related cause is even more difficult. Here, we report a series of 5 ED cases of adrenal insufficiency in ICI-treated cancer patients. All 5 patients presented with severe fatigue and nausea. Four patients definitely had and one patient possibly had central adrenal insufficiency, and 4 patients had undetectable serum cortisol levels. The majority of the patients had nonspecific symptoms that were not recognized at their first ED presentation. These cases illustrate the need for a heightened level of suspicion for adrenal insufficiency in ICI-treated cancer patients with hypotension, nausea and/or vomiting, abdominal pain, fatigue, or hypoglycemia. As ICI use increases, irAE-associated oncologic emergencies will become more prevalent. Thus, ED physicians must update their knowledge regarding the diagnosis and management of irAEs and routinely inquire about the specific antineoplastic therapies that their ED patients with cancer are receiving. A random cortisol level (results readily available in most EDs) with interpretation taking the circadian rhythm and the current level of physiological stress into consideration can inform the differential diagnosis and whether further investigation of this potential irAE is warranted.
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Affiliation(s)
- Sai-Ching Jim Yeung
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Aiham Qdaisat
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jason J Bischof
- Department of Emergency Medicine, Ohio State University, Columbus, OH, United States
| | - Jeffrey M Caterino
- Department of Emergency Medicine, Ohio State University, Columbus, OH, United States
| | - Demetrios N Kyriacou
- Department of Emergency Medicine, Northwestern University, Chicago, IL, United States
| | - Christopher Coyne Md
- Department of Emergency Medicine, University of California San Diego, San Diego, CA, United States
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2
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Farrell SF, Sterling M, Klyne DM, Mustafa S, Campos AI, Kho PF, Lundberg M, Rentería ME, Ngo TT, Cuéllar-Partida G. Genetic impact of blood C-reactive protein levels on chronic spinal & widespread pain. Eur Spine J 2023; 32:2078-2085. [PMID: 37069442 DOI: 10.1007/s00586-023-07711-7] [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: 10/15/2022] [Revised: 02/27/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Causal mechanisms underlying systemic inflammation in spinal & widespread pain remain an intractable experimental challenge. Here we examined whether: (i) associations between blood C-reactive protein (CRP) and chronic back, neck/shoulder & widespread pain can be explained by shared underlying genetic variants; and (ii) higher CRP levels causally contribute to these conditions. METHODS Using genome-wide association studies (GWAS) of chronic back, neck/shoulder & widespread pain (N = 6063-79,089 cases; N = 239,125 controls) and GWAS summary statistics for blood CRP (Pan-UK Biobank N = 400,094 & PAGE consortium N = 28,520), we employed cross-trait bivariate linkage disequilibrium score regression to determine genetic correlations (rG) between these chronic pain phenotypes and CRP levels (FDR < 5%). Latent causal variable (LCV) and generalised summary data-based Mendelian randomisation (GSMR) analyses examined putative causal associations between chronic pain & CRP (FDR < 5%). RESULTS Higher CRP levels were genetically correlated with chronic back, neck/shoulder & widespread pain (rG range 0.26-0.36; P ≤ 8.07E-9; 3/6 trait pairs). Although genetic causal proportions (GCP) did not explain this finding (GCP range - 0.32-0.08; P ≥ 0.02), GSMR demonstrated putative causal effects of higher CRP levels contributing to each pain type (beta range 0.027-0.166; P ≤ 9.82E-03; 3 trait pairs) as well as neck/shoulder pain effects on CRP levels (beta [S.E.] 0.030 [0.021]; P = 6.97E-04). CONCLUSION This genetic evidence for higher CRP levels in chronic spinal (back, neck/shoulder) & widespread pain warrants further large-scale multimodal & prospective longitudinal studies to accelerate the identification of novel translational targets and more effective therapeutic strategies.
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Affiliation(s)
- Scott F Farrell
- RECOVER Injury Research Centre, The University of Queensland, Level 7 STARS Hospital, 296 Herston Rd, Herston, QLD, 4029, Australia.
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, QLD, Australia.
- Tess Cramond Pain & Research Centre, Royal Brisbane & Women's Hospital, Herston, QLD, Australia.
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Level 7 STARS Hospital, 296 Herston Rd, Herston, QLD, 4029, Australia
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, QLD, Australia
| | - David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sanam Mustafa
- Davies Livestock Research Centre, The University of Adelaide, Roseworthy, SA, Australia
| | - Adrián I Campos
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
- Genetic Epidemiology Laboratory, Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Pik-Fang Kho
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Molecular Cancer Epidemiology Laboratory, Population Health Program, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mischa Lundberg
- Institute of Biological Psychiatry, Boserupvej 2, 4000, Roskilde, Denmark
- Transformational Bioinformatics, CSIRO Health & Biosecurity, North Ryde, NSW, Australia
- UQ Diamantina Institute, The University of Queensland & Translational Research Institute, Woolloongabba, QLD, Australia
| | - Miguel E Rentería
- Genetic Epidemiology Laboratory, Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Trung Thanh Ngo
- RECOVER Injury Research Centre, The University of Queensland, Level 7 STARS Hospital, 296 Herston Rd, Herston, QLD, 4029, Australia
| | - Gabriel Cuéllar-Partida
- UQ Diamantina Institute, The University of Queensland & Translational Research Institute, Woolloongabba, QLD, Australia
- Gilead Sciences, Foster City, CA, USA
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Roseiro M, Henriques J, Paredes S, Rocha T, Sousa J. An interpretable machine learning approach to estimate the influence of inflammation biomarkers on cardiovascular risk assessment. Comput Methods Programs Biomed 2023; 230:107347. [PMID: 36645940 DOI: 10.1016/j.cmpb.2023.107347] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/28/2022] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular disease has a huge impact on health care services, originating unsustainable costs at clinical, social, and economic levels. In this context, patients' risk stratification tools are central to support clinical decisions contributing to the implementation of effective preventive health care. Although useful, these tools present some limitations, in particular, some lack of performance as well as the impossibility to consider new risk factors potentially important in the prognosis of severe cardiac events. Moreover, the actual use of these tools in the daily practice requires the physicians' trust. The main goal of this work addresses these two issues: (i) evaluate the importance of inflammation biomarkers when combined with a risk assessment tool; (ii) incorporation of personalization and interpretability as key elements of that assessment. METHODS Firstly, machine learning based models were created to assess the potential of the inflammation biomarkers applied in secondary prevention, namely in the prediction of the six month risk of death/myocardial infarction. Then, an approach based on three main phases was created: (i) set of interpretable rules supported by clinical evidence; (ii) selection based on a machine learning classifier able to identify for a given patient the most suitable subset of rules; (iii) an ensemble scheme combining the previous subset of rules in the estimation of the patient cardiovascular risk. All the results were statistically validated (t-test, Wilcoxon-signed rank test) according to a previous verification of data normality (Shapiro-Wilk). RESULTS The proposed methodology was applied to a real acute coronary syndrome patients dataset (N = 1544) from the Cardiology Unit of Coimbra Hospital and Universitary centre. The first assessment was based on the GRACE tool and a Random Forest classifier, the incorporation of inflammation biomarkers achieved SE=0.83; SP=0.84 whereas the original GRACE risk factors reached SE=0.75; SP=0.85. In the second phase, the proposed approach with inflammation biomarkers achieved SE=0.763 and SP=0.778. CONCLUSIONS This approach confirms the potential of combining inflammation markers with the GRACE score, increasing SE and SP, when compared with the original GRACE. Additionally, it assures interpretability and personalization, which are critical issues to allow its application in the daily clinical practice.
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Affiliation(s)
- M Roseiro
- CISUC, Center for Informatics and Systems of University of Coimbra, Coimbra 3030-290, Portugal
| | - J Henriques
- CISUC, Center for Informatics and Systems of University of Coimbra, Coimbra 3030-290, Portugal
| | - S Paredes
- Polytechnic Institute of Coimbra, Coimbra Institute of Engineering (IPC/ISEC), Rua Pedro Nunes, Coimbra 3030-199, Portugal; CISUC, Center for Informatics and Systems of University of Coimbra, Coimbra 3030-290, Portugal.
| | - T Rocha
- Polytechnic Institute of Coimbra, Coimbra Institute of Engineering (IPC/ISEC), Rua Pedro Nunes, Coimbra 3030-199, Portugal; CISUC, Center for Informatics and Systems of University of Coimbra, Coimbra 3030-290, Portugal
| | - J Sousa
- Cardiology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra 3004-561, Portugal
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Altıparmak İH, Tanrıverdi Z, Taşcanov MB, Fedai H. Response to Letter: C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast-Induced Nephropathy in Patients With Stable Angina Pectoris. Angiology 2023; 74:199-200. [PMID: 36206524 DOI: 10.1177/00033197221132354] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Zülkif Tanrıverdi
- Faculty of Medicine, Department of Cardiology, 52966Harran University, Sanlıurfa, Turkey
| | | | - Halil Fedai
- Department of Cardiology, Sanlıurfa Education and Research Hospital, Sanlıurfa, Turkey
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Zhang J, Fan H, Gross M, Liu N, Carlson H, Wood A, Hoffman K, Petrosino J, Pankratz N, Thyagarajan B, Fisher W. Progressive reduction in circulating levels of carotenoids and other micronutrients in patients with chronic pancreatitis. Pancreatology 2022; 22:1126-1133. [PMID: 36198488 DOI: 10.1016/j.pan.2022.09.243] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/26/2022] [Accepted: 09/21/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although micronutrients modulate immunity and inflammation, it remains elusive whether they are implicated in the development and progression of chronic pancreatitis (CP). This study aimed to investigate differences in the circulating levels of selected carotenoids and vitamins between CP and controls and trends in the levels of these micronutrients across controls, early CP, and definite CP. METHODS Demographic and lifestyle data were extracted from medical records for 53 patients with CP (13 early and 38 definite) and obtained using a questionnaire for 52 controls. Plasma β-carotene, lycopene, cryptoxanthin, zeaxanthin, and α-tocopherol and serum 25(OH)D, folate, IL-6, TNF-α, and MCP-1 were measured with state-of-the-art methods. RESULTS The levels of all micronutrients (except folate) were significantly lower in CP than in controls. There was a progressive decrease in the levels of these micronutrients across controls, early CP, and definite CP (all p values for trend: ≤0.0012); e.g., plasma lycopene was 36.6, 21.5, and 14.5 μg/dL for controls, early CP, and definite CP, respectively. After adjustment for confounders, there were strong, inverse associations between the levels of all micronutrients (except folate) and CP (e.g., OR (95% CI) for ≥ median vs. <median: 0.10 (0.04, 0.27) for lycopene, 0.15 (0.05, 0.38) for α-tocopherol, and 0.24 (0.09, 0.64) for 25(OH)D). These associations became weaker after additional adjustment for inflammation markers (IL-6, TNF-α, and MCP-1). CONCLUSIONS The circulating levels of some carotenoids, α-tocopherol, and vitamin D were reduced in CP patients compared with controls and this reduction was more pronounced in definite CP than in early CP.
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Affiliation(s)
- Jianjun Zhang
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA; Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA.
| | - Hao Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Myron Gross
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Nianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Hannah Carlson
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Amy Wood
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Kristi Hoffman
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Joseph Petrosino
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - William Fisher
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
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Akinyelure OP, Colantonio LD, Chaudhary NS, Jaeger BC, Judd SE, Cushman M, Zakai NA, Kabagambe EK, Howard VJ, Safford MM, Irvin MR. Inflammation biomarkers and incident coronary heart disease: the Reasons for Geographic And Racial Differences in Stroke Study. Am Heart J 2022; 253:39-47. [PMID: 35810789 DOI: 10.1016/j.ahj.2022.07.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/10/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individual inflammation biomarkers are associated with incident coronary heart disease (CHD) events. However, there is limited research on whether the risk for incident CHD is progressively higher with a higher number of inflammation biomarkers in abnormal levels. METHODS We used data from 15,758 Reasons for Geographic and Racial Differences in Stroke (REGARDS) study participants aged ≥45 years without a history of CHD at baseline in 2003-2007. Abnormal levels of baseline high-sensitivity C-reactive protein, leukocyte count and serum albumin were defined as ≥3.8 mg/L (3rd tertile), ≥6.3 x 109 cells/L (3rd tertile), and <4.0 g/dL (1st tertile), respectively. The outcome was a composite of incident myocardial infarction or CHD death. RESULTS Overall, 38.9% (n = 6,123) had 0, 36.6% (n = 5,774) had 1, 19.8% (n = 3,113) had 2 and 4.7% (n = 748) had 3 biomarkers of inflammation in abnormal levels. Over a median follow-up of 11.4 years, 954 (6.1%) participants had incident CHD. The rate of incident CHD per 1000 person-years for individuals with 0, 1, 2, and 3 biomarkers of inflammation in abnormal levels was 4.4 (95% confidence interval [CI]: 3.9-5.0), 6.3 (95% CI: 5.6-6.9), 8.8 (95% CI: 7.8-9.9), and 10.6 (95% CI: 8.1-13.1), respectively. Multi-variable adjusted hazard ratios for incident CHD associated with 1, 2 and 3 versus no inflammation biomarker in abnormal levels were 1.26 (95% CI: 1.07-1.49), 1.72 (95% CI: 1.43-2.07), and 1.84 (95% CI: 1.37-2.47), respectively (P-trend < .001). CONCLUSIONS The number of inflammation markers in abnormal levels was associated with increased risk of incident CHD after multi-variable adjustment.
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Affiliation(s)
| | | | - Ninad S Chaudhary
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, TX
| | - Byron C Jaeger
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Mary Cushman
- Department of Medicine, Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Neil A Zakai
- Department of Medicine, Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Edmond K Kabagambe
- Ochsner Center for Outcomes Research, Division of Academics, Ochsner Health, New Orleans, LA; The Ochsner-Xavier Institute for Health Equity and Research (OXIHER) Ochsner Health, New Orleans, LA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY
| | - Marguerite R Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
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Chen BA, Lee WJ, Chung CP, Peng LN, Chen LK. Age- and Sex-Different Associations between Cognitive Performance and Inflammatory Biomarkers in Community Dwelling Older Adults: towards Precision Preventive Strategies. J Prev Alzheimers Dis 2022; 10:104-111. [PMID: 36641614 DOI: 10.14283/jpad.2022.83] [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: 02/02/2023]
Abstract
BACKGROUND Studies have demonstrated associations between inflammatory biomarkers and cognitive function in people with dementia or stroke, but little is known regarding these associations in healthy middle-aged and older populations. OBJECTIVES This study aims to examine associations between inflammatory biomarkers (both vascular and systemic) and cognitive performance in stroke- and dementia-free middle-aged and older adults without apolipoprotein E4 (ApoE ε4) allele carriers. DESIGN A cross-sectional study. SETTING Social Environment and Biomarkers of Aging Study (SEBAS) 2006. PARTICIPANTS A total of 983 participants aged 53 years and older. MEASUREMENTS Composite cognitive function assessment, including the Short Portable Mental Status Questionnaire, the Rey Auditory Verbal Learning Test, and the Wechsler Adult Intelligence Scale. Overnight venous blood sampling for 6 inflammatory biomarkers (C-reactive protein, interleukin-6, fibrinogen, homocysteine, intercellular adhesion molecule-1 and E-selectin) and ApoE genotyping. RESULTS Among 983 participants (mean age: 65.8±9.5 years), 808 were non-ApoE e4 allele carriers and were stroke- and dementia-free. Higher log fibrinogen was associated with poorer cognitive function after adjustment for potential confounding factors in non-ApoE e4 allele carriers and stroke- and dementia-free populations (unstandardized coefficients β= -1.553, P value= 0.003). In participants aged 65 years or older, both of elevated fibrinogen and homocysteine were associated with poorer cognitive function (β= -2.288, P value= 0.015; β= -1.331, P value= 0.012, respectively). Elevated log CRP was significantly associated with lower cognitive function only in women (β= -0.514, P value= 0.024). CONCLUSION Higher serum levels of fibrinogen were negatively associated with cognitive function, which was independent of ApoE genotyping and prior cerebrovascular events in dementia-free community-dwelling older adults. Further studies are needed to validate the roles of fibrinogen in the pathophysiology of dementia and elucidate the underlying mechanisms.
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Affiliation(s)
- B-A Chen
- Prof Liang-Kung Chen, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital. No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan, E-mail: , Telephone: +886-2-28757830, Fax numbers:+886-2-28757711
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Gogna P, King WD, Villeneuve PJ, Kumarathasan P, Johnson M, Lanphear B, Shutt RH, Arbuckle TE, Borghese MM. Ambient air pollution and inflammatory effects in a Canadian pregnancy cohort. Environ Epidemiol 2021; 5:e168. [PMID: 34934889 DOI: 10.1097/EE9.0000000000000168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/05/2021] [Indexed: 12/04/2022] Open
Abstract
Supplemental Digital Content is available in the text. Background: Epidemiologic studies have consistently reported associations between air pollution and pregnancy outcomes including preeclampsia and gestational diabetes. However, the biologic mechanisms underlying these relationships remain unclear as few studies have collected relevant biomarker data. We examined relationships between ambient PM2.5 and NO2 with markers of inflammation during pregnancy in a prospective cohort of Canadian women. Methods: We analyzed data from 1170 women enrolled in the Maternal-Infant Research on Environmental Chemicals study. Daily residential PM2.5 and NO2 exposures during pregnancy were estimated using satellite-based and land-use regression models and used to create 14-day and 30-day exposure windows before blood-draw. Inflammatory markers C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α were measured in third trimester plasma samples. Multivariable linear regression was used to estimate associations for an interquartile range (IQR) increase in PM2.5 and NO2 and markers of inflammation, while adjusting for individual-level confounders. Results: Fourteen-day (IQR: 6.85 µg/m3) and 30-day (IQR: 6.15 µg/m3) average PM2.5 exposures before blood-draw were positively associated with C-reactive protein after adjustment for covariates (24.6% [95% CI = 9.4, 41.9] and 17.4% [95% CI = 1.0, 35.0] increases, respectively). This association was found to be robust in several sensitivity analyses. Neither PM2.5 nor NO2 exposures were associated with interleukin-6, interleukin-8, or tumor necrosis factor-α. Conclusion: Exposure to ambient PM2.5 is positively associated with maternal inflammatory pathways in late pregnancy. This may contribute to positive associations between ambient PM2.5 and risk of adverse pregnancy outcomes.
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Mayasari DS, Taufiq N, Hariawan H. Association of monocyte-to-high density lipoprotein ratio with arterial stiffness in patients with diabetes. BMC Cardiovasc Disord 2021; 21:362. [PMID: 34330221 PMCID: PMC8325234 DOI: 10.1186/s12872-021-02180-6] [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: 04/08/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies proposed that chronic inflammation in diabetes has a role in abnormal collagen production and elastin degradation, which promotes arterial stiffness. Monocyte-to-High Density Lipoprotein cholesterol ratio (MHR) is a simple measurement associated with inflammation and oxidative stress. However, little is known about the relationship of MHR with arterial stiffness. This study aimed to determine the association of MHR with arterial stiffness in patients with diabetes. METHODS A total of 81 patients with type 2 diabetes mellitus were enrolled in a cross-sectional study. Arterial stiffness factor in this study was Cardio Ankle Vascular Index (CAVI). We analyzed complete blood count and lipid profile in all participants, then performed statistical analysis to determine the relationship between MHR and CAVI. Receiver operating characteristic (ROC) analysis was used to estimate the cut-off values of MHR to predict CAVI ≥ 9. RESULTS Median of MHR in this study was 11.91 with the mean of CAVI was 8.13 ± 0.93. Spearman correlation analysis revealed a significant positive correlation between MHR and CAVI (ρ = 0.239, p = 0.031). Multivariate analysis showed the independent association of MHR to arterial stiffness (β = 0.361, 95% CI 0.023-0.093) and to CAVI ≥ 9 (OR 1.181, 95% CI 1.047-1.332). The cut-off values of MHR for predicting CAVI ≥ 9 were identified as ≥ 13 (OR 3.289, 95% CI 1.036-10.441). CONCLUSION MHR is associated with CAVI in patients with diabetes, irrespective of various potential confounders.
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Affiliation(s)
- Dyah Samti Mayasari
- Department of Cardiology and Vascular Medicine, Public Health and Nursing, Faculty of Medicine, Universitas Gadjah Mada, Jl Farmako No 1, Sekip, Yogyakarta, 55281, Indonesia.
| | - Nahar Taufiq
- Department of Cardiology and Vascular Medicine, Public Health and Nursing, Faculty of Medicine, Universitas Gadjah Mada, Jl Farmako No 1, Sekip, Yogyakarta, 55281, Indonesia.,Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Hariadi Hariawan
- Department of Cardiology and Vascular Medicine, Public Health and Nursing, Faculty of Medicine, Universitas Gadjah Mada, Jl Farmako No 1, Sekip, Yogyakarta, 55281, Indonesia.,Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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Shi N, Olivo-Marston S, Jin Q, Aroke D, Joseph JJ, Clinton SK, Manson JE, Rexrode KM, Mossavar-Rahmani Y, Fels Tinker L, Shadyab AH, Arthur RS, Snetselaar LG, Van Horn L, Tabung FK. Associations of Dairy Intake with Circulating Biomarkers of Inflammation, Insulin Response, and Dyslipidemia among Postmenopausal Women. J Acad Nutr Diet 2021:S2212-2672(21)00151-9. [PMID: 33858777 DOI: 10.1016/j.jand.2021.02.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiometabolic diseases are prevalent in aging Americans. Although some studies have implicated greater intake of dairy products, it is not clear how dairy intake is related to biomarkers of cardiometabolic health. OBJECTIVE Our aim was to test the hypothesis that associations of dairy foods with biomarkers of lipid metabolism, insulin-like growth factor signaling, and chronic inflammation may provide clues to understanding how dairy can influence cardiometabolic health. DESIGN This was a cross-sectional study in the Women's Health Initiative using baseline food frequency questionnaire data to calculate dairy intake. PARTICIPANTS/SETTING Participants were 35,352 postmenopausal women aged 50 to 79 years at 40 clinical centers in the United States. MAIN OUTCOME MEASURES Baseline (1993-1998) concentrations of 20 circulating biomarkers were measured. STATISTICAL ANALYSES Multivariable-adjusted linear regression was used to estimate percent difference in biomarker concentrations per serving of total dairy and individual foods (milk, cheese, yogurt, butter, and low-fat varieties). RESULTS Lower triglyceride concentrations were associated with greater intake of total dairy (-0.8% [95% CI -1.2% to -0.3%]), mainly driven by full-fat varieties. Individual dairy foods had specific associations with circulating lipid components. For example, greater total milk intake was associated with lower concentrations of total cholesterol (-0.4% [95% CI -0.7% to -0.2%]) and high-density lipoprotein cholesterol (-0.5% [95% CI -0.9% to -0.1%]), whereas greater butter intake was associated with higher total cholesterol (0.6% [95% CI 0.2% to 1.0%]) and high-density lipoprotein cholesterol (1.6% [95% CI 1.1% to 2.0%]) concentrations. In contrast, higher total yogurt intake was associated with lower total cholesterol (-1.1% [95% CI -2.0% to -0.2%]) and higher high-density lipoprotein cholesterol (1.8% [95% CI 0.5% to 3.1%]). Greater total dairy intake (regardless of fat content), total cheese, full-fat cheese, and yogurt were consistently associated with lower concentrations of glucose, insulin, and C-reactive protein. However, milk and butter were not associated with these biomarkers. CONCLUSIONS Higher dairy intake, except butter, was associated with a favorable profile of lipids, insulin response, and inflammatory biomarkers, regardless of fat content. Yet, specific dairy foods might influence these markers uniquely. Findings do not support a putative role of dairy in cardiometabolic diseases observed in some previous studies.
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Li L, Tian J, Zhang L, Liu L, Sheng C, Huang Y, Zheng H, Song F, Chen K. Utility of Preoperative Inflammatory Markers to Distinguish Epithelial Ovarian Cancer from Benign Ovarian Masses. J Cancer 2021; 12:2687-2693. [PMID: 33854628 PMCID: PMC8040725 DOI: 10.7150/jca.51642] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/13/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Inflammatory markers have been reported to be predictors for the presence of epithelial ovarian cancer (EOC), however, the cut-off value of each marker remains unclear and predictive capability of the markers in different histology types of EOC is still unknown. Methods: A total of 207 patients with benign ovarian masses and 887 EOC patients who underwent surgical resection, and were pathologically diagnosed were included. We compared the difference of preoperative inflammatory markers between benign ovarian masses and EOC patients. Stratified analysis by histology subtype was further conducted. Logistic regression analyses and receiver operating characteristic (ROC) curves was used to evaluate the predictive capability of the markers. Results: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were significantly associated with all stages and subtypes of EOC (P<0.001). The optimal cut-off points based on ROC curve analyses for NLR, PLR, and LMR were found to be 2.139 (AUC=0.749, P<0.001), 182.698 (AUC=0.730, P<0.001), and 3.619 (AUC = 0.709, P<0.001), respectively. In low CA125 level patients, high level of NLR and PLR increase the risk of endometrioid EOC, while low level of LMR were significantly associated with an increased risk of serous EOC. Conclusions: In addition to CA125, NLR, PLR, and LMR could be used as predictors of EOC and preoperative inflammatory markers may be used as a potential biomarker for predicting different histotypes of EOC.
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Affiliation(s)
- Lian Li
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jing Tian
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Department of Urology, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Liwen Zhang
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Luyang Liu
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Chao Sheng
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yubei Huang
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hong Zheng
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fengju Song
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Kexin Chen
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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12
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Yu J, Ghassabian A, Chen Z, Goldstein RB, Hornig M, Buka SL, Goldstein JM, Gilman SE. Maternal Immune activity during pregnancy and socioeconomic disparities in children's self-regulation. Brain Behav Immun 2020; 90:346-352. [PMID: 32919039 PMCID: PMC7544646 DOI: 10.1016/j.bbi.2020.09.003] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/31/2022] Open
Abstract
Maternal immune activity during pregnancy has been associated with risk for psychiatric disorders in offspring, but less is known about its implications for children's emotional and behavioral development. This study examined whether concentrations of five cytokines assayed from prenatal serum were associated with socioeconomic status (SES) and racial disparities in their offspring's self-regulation abilities. Participants included 1628 women in the Collaborative Perinatal Project (CPP). Seven behavioral items conceptually related to self-regulation were rated by CPP psychologists when children were 4 years old. Concentrations of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and IL-10 were assessed. Covariates included child sex and mother's age, psychiatric disorders, and medical conditions during pregnancy. There were significant SES differences in child self-regulation, with higher SES children scoring higher on self-regulation (β = 0.18, 95% CI [0.11, 0.25]), but no racial differences. The concentration of IL-8 in maternal serum was associated with higher child self-regulation, β = 0.09, 95% CI [0.02, 0.16]. In mediation analyses, variation in maternal IL-8 contributed to the association between family SES and child self-regulation (β = 0.02, 95% CI [0.003, 0.030]), explaining about one-tenth of the SES disparities. This study suggests pregnancy as an early sensitive period and maternal immune activity as an important context for child development.
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Affiliation(s)
- Jing Yu
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States.
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University, 403 East 34th St., New York, NY 10016, United States
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Risë B Goldstein
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States
| | - Mady Hornig
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St. NY, NY 10032, United States
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, 21 South Main Street, Providence, RI 02912, United States
| | - Jill M Goldstein
- Departments of Psychiatry and Medicine, Harvard Medical School, and Department of Psychiatry and Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Stephen E Gilman
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD 20817, United States; Department of Mental Health, Bloomberg School of Public Health, John Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, United States
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Taslimi Y, Agbajogu C, Brynjolfsson SF, Masoudzadeh N, Mashayekhi V, Gharibzadeh S, Östensson M, Nakka SS, Mizbani A, Rafati S, Harandi AM. Profiling inflammatory response in lesions of cutaneous leishmaniasis patients using a non-invasive sampling method combined with a high-throughput protein detection assay. Cytokine 2020; 130:155056. [PMID: 32199248 DOI: 10.1016/j.cyto.2020.155056] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 12/17/2019] [Revised: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is an infection caused by Leishmania (L.) protozoa transmitted through the bite of infected sand fly. Previously, invasive sampling of blood and skin along with low throughput methods were used for determination of inflammatory response in CL patients. AIMS/METHODOLOGY We established a novel approach based on a non-invasive adhesive tape-disc sampling combined with a powerful multiplexing technique called proximity extension assay for profiling 92 inflammatory cytokines, chemokines and surface molecules in the lesions of CL patients infected with L. tropica. Sample collection was done non-invasively by using adhesive tape-discs from lesion and normal skin of 33 L. tropica positive patients. RESULTS Out of 92 inflammatory proteins, the level of 34 proteins was significantly increased in the lesions of CL patients compared to their normal skin. This includes the chemokines CCL2, CCL3, CCL4, CXCL1, CXCL5, CXCL9, CXCL10 and CXCL11, together with the interleukins IL-6, IL-8, IL-18, LIF and OSM. The remaining significantly changed inflammatory proteins include 7 surface molecules and receptors: CD5, CD40, CDCP1, 4E-BP1, TNFRSF9, IL-18R1 and OPG as well as 16 other cytokines and proteins: MMP-1, CSF-1, VEGFA, uPA, EN-RAGE, LAP TGF-β1, HGF, MMP-10, CASP-8, TNFSF14, STAMPB, ADA, TRAIL and ST1A1. Further, 13 proteins showed an increasing trend, albeit not statistically significant, in the CL lesions, including TGF-α, CCL23, MCP-2, IL-12B, CXCL6, IL-24, FGF-19, TNFβ, CD6, TRANCE, IL10, SIR2 and CCL20. CONCLUSION We herein report a novel approach based on a non-invasive sampling method combined with the high-throughput protein assay for profiling inflammatory proteins in CL lesions. Using this approach, we could profile inflammatory proteins in the lesions from CL patients. This new non-invasive approach may have implications for studying skin inflammatory mediators in CL and other skin disorders.
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Affiliation(s)
- Yasaman Taslimi
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran
| | - Christopher Agbajogu
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Nasrin Masoudzadeh
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran
| | - Vahid Mashayekhi
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Malin Östensson
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Sravya Sowdamini Nakka
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Sima Rafati
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran.
| | - Ali M Harandi
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Vaccine Evaluation Center, BC Children's Hospital Research Institute, The University of British Columbia, Canada.
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Cañas L, Iglesias E, Pastor MC, Barallat J, Juega J, Bancu I, Lauzurica R. Inflammation and oxidation: do they improve after kidney transplantation? Relationship with mortality after transplantation. Int Urol Nephrol 2017; 49:533-40. [PMID: 28013471 DOI: 10.1007/s11255-016-1435-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
Patients with chronic kidney disease (CKD) are characterized by a state of inflammation and oxidative stress that seems to improve after kidney transplantation (KT). Nevertheless, there is controversy regarding what is the best marker that better define inflammation and specially oxidative stress. OBJECTIVE To evaluate the biomarkers which are associated with improvements in inflammation and lipid peroxidation in patients who have undergone KT. To evaluate the relationship between inflammation, lipid peroxidation and mortality in KT. PATIENTS 196 KT (between 2003 and 2008). 67.9% men; median age: 51.9 years. Inflammation markers analyzed previous KT and 3 months after KT: c-reactive protein(CRP), interleukin 6(IL-6), tumor necrosis factor alpha(TNFα), soluble tumor necrosis factor receptor alpha(sTNFRα), soluble interleukin-2 receptor (sIL-2R). Lipid peroxidation markers analyzed: oxidized low-density lipoprotein (oxLDL) and anti-oxLDL antibodies. Calculation of glomerular filtration rate after KT: MDRD equation. RESULTS Following KT, there is a significant decrease in CRP (p = 0.006), IL-6 (p = 0.0037), TNFα (p < 0.0001), sTNFRα (p < 0.0001) and sIL-2R (p < 0.0001), while levels of oxLDL increase after KT (p < 0.0001) and there is not a significantly difference in anti-oxLDL. 12.8% of the patients had died in 2012. These patients had higher levels of IL-6 (p = 0.011) and sTNFRα (p < 0.006) after KT and a lower MDRD (p < 0.0001), hemoglobin (p = 0.012) and albumin (p = 0.007). We observed no statistically differences in the levels of markers previous KT. Of the patients who died, the 43.5% of them had anti-oxLDL antibody levels greater than 75th percentile (P75: 3781 UI/ml, p = 0.028). In the multivariate analysis, age (OR:1.12; p = 0.0129), MDRD (OR:0.92; p = 0.013) and P75 of anti-oxLDL(OR: 5.19; p = 0.026) were independent risk factors for mortality. Independent risk factors for survival were: P75 of IL-6 (HR: 2.45; p = 0.027), oxLDL (HR:19.85; p = 0.002) and anti-oxLDL (HR: 9.55; p = 0.003). CONCLUSIONS KT improved inflammation but not lipid oxidative state. KT patients who died had a higher inflammatory state (with higher levels of IL-6 and sTNFRα), a worse lipid oxidative state and a worse renal function 3 months after KT. Age, anti-oxLDL and renal function at 3 months after KT were independent risk factors for mortality.
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Kamińska J, Koper OM, Siedlecka-Czykier E, Matowicka-Karna J, Bychowski J, Kemona H. The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes. Saudi J Biol Sci 2016; 25:1263-1271. [PMID: 30505168 PMCID: PMC6252018 DOI: 10.1016/j.sjbs.2016.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 03/31/2016] [Revised: 09/02/2016] [Accepted: 10/17/2016] [Indexed: 11/24/2022] Open
Abstract
Introduction Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/β-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease. Materials and methods The study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and β-TG were measured using the ELISA method. Results In the whole group of ACS patients WBC, CRP, IL-6, MPV, and β-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed β-TG. Conclusion Markers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and β-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.
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Key Words
- ACC, diagnostic accuracy
- ACS, acute coronary syndrome
- ALT, alanine transaminase
- AST, aspartate transaminase
- AUC, area under the ROC curve
- Activated platelet
- Acute coronary syndrome
- BP, blood pressure
- Beta-thromboglobulin
- CRP, C-reactive protein
- ECG, echocardiogram
- F, female
- HCT, hematocrit
- HDL, high-density lipoprotein cholesterol
- HGB, hemoglobin
- IFN-
ɣ
, interferon gamma
- IL-6, interleukin-6
- Inflammation biomarkers
- L-PLT, large platelet
- LBBB, Left Bundle Branch Block
- LDL, low-density lipoprotein cholesterol
- M, male
- MI, myocardial infarction
- MPV, mean platelet volume
- NPV, negative predictive value
- NS, not statistically significant
- NSTEMI, non-ST-segment elevation myocardial infarction
- PAF, platelet activating factor
- PLT, platelet count
- PPV, positive predictive value
- RBC, red blood cell count
- ROC, Receiver operator characteristic
- SE, Standard Error
- STEMI, ST-segment elevation myocardial infarction
- TCH, total cholesterol
- TG, triglycerides
- TNF-α, tissue necrosis factor alfa
- UA, unstable angina
- WBC, white blood cells count
- cTnI, cardiac troponin I
- eGFR, estimate glomerular filtration rate
- sP-selectin, soluble form of P-selectin
- β-TG, β-thromboglobulin
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Affiliation(s)
- Joanna Kamińska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland
- Corresponding author at: Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15A, 15-269 Białystok, Poland. Fax: +48 857468584.
| | - Olga M. Koper
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland
| | - Edyta Siedlecka-Czykier
- Department of Cardiology Intensive Care with the Hemodynamic Unit of the Jędrzej Śniadecki Provincial Hospital in Bialystok, Poland
| | | | - Jerzy Bychowski
- Department of Cardiology Intensive Care with the Hemodynamic Unit of the Jędrzej Śniadecki Provincial Hospital in Bialystok, Poland
| | - Halina Kemona
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland
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Namas RA, Almahmoud K, Mi Q, Ghuma A, Namas R, Zaaqoq A, Zhu X, Abdul-Malak O, Sperry J, Zamora R, Billiar TR, Vodovotz Y. Individual-specific principal component analysis of circulating inflammatory mediators predicts early organ dysfunction in trauma patients. J Crit Care 2016; 36:146-153. [PMID: 27546764 DOI: 10.1016/j.jcrc.2016.07.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/04/2016] [Accepted: 07/05/2016] [Indexed: 01/15/2023]
Abstract
PURPOSE We hypothesized that early inflammation can drive, or impact, later multiple organ dysfunction syndrome (MODS), that patient-specific principal component analysis (PCA) of circulating inflammatory mediators could reveal conserved dynamic responses which would not be apparent from the unprocessed data, and that this computational approach could segregate trauma patients with regard to subsequent MODS. METHODS From a cohort of 472 blunt trauma survivors, 2 separate subcohorts of moderately/severely injured patients were studied. Multiple inflammatory mediators were assessed in serial blood samples in the first 24 hours postinjury. PCA of these time course data was used to derive patient-specific "inflammation barcodes," followed by hierarchical clustering to define patient subgroups. To define the generalizability of this approach, 2 different but overlapping Luminex kits were used. RESULTS PCA/hierarchical clustering of 24-hour Luminex data segregated the patients into 2 groups that differed significantly in their Marshall multiple organ dysfunction score on subsequent days, independently of the specific set of inflammatory mediators analyzed. Multiple inflammatory mediators and their dynamic networks were significantly different in the 2 groups in both patient cohorts, demonstrating that the groups were defined based on "core" early responses exhibit truly different dynamic inflammatory trajectories. CONCLUSION Identification of patient-specific "core responses" can lead to early segregation of diverse trauma patients with regard to later MODS. Hence, we suggest that a focus on dynamic inflammatory networks rather than individual biomarkers is warranted.
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Affiliation(s)
- Rami A Namas
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213; Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219
| | - Khalid Almahmoud
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | - Qi Mi
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA 15260
| | - Ali Ghuma
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | - Rajaie Namas
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | - Akram Zaaqoq
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213
| | - Xiaoguang Zhu
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | | | - Jason Sperry
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | - Ruben Zamora
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
| | - Timothy R Billiar
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213; Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219
| | - Yoram Vodovotz
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213; Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA 15213; Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219.
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Izuora K, Ezeanolue E, Schlauch K, Neubauer M, Gewelber C, Umpierrez G. Impact of periodontal disease on outcomes in diabetes. Contemp Clin Trials 2015; 41:93-9. [PMID: 25623292 DOI: 10.1016/j.cct.2015.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/16/2015] [Accepted: 01/19/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The prevalence of periodontal disease (POD) among adults aged 30years and older in the United States is reported to be more than 47%, with higher prevalence seen among patients with diabetes mellitus (DM). POD has been associated with systemic inflammation, a known risk factor for cardiovascular and bone disease, both of which are more common in patients with DM. However, there is mixed evidence that treatment of POD reduces inflammation, improves DM control, and reduces DM complications. Our study objectives are to assess factors associated with POD in patients with DM and determine the impact of POD treatment on inflammation and bone turnover biomarkers associated with complications of DM. METHODS In this pilot study, we will first recruit 200 patients with DM to complete a 48-item investigator-administered questionnaire designed to assess socio-economic status, oral health status, adequacy of oral care, glycemic control and presence of DM complications. Responses will be verified by individual chart review. Then, using a crossover design, a subgroup of 24 subjects with responses suggestive of POD will be assigned to undergo POD treatment for three months followed by three months of routine dental care (group 1) or be followed for three months during routine dental care then receive POD treatment for three months (group 2). Outcome measures will be collected before and after POD treatment and include glycemic control and inflammatory and bone turnover biomarkers. RESULTS We hypothesize that the prevalence of POD among DM patients will be associated with inadequate glycemic control and greater DM complications.
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