Therapeutic benefits of Gum Arabic: Evidence from clinical trials

Relationship Between Uncontrolled Risk Factors and C-Reactive Protein Levels in Patients Receiving Standard or Intensive Statin Therapy for Acute Coronary Syndromes in the PROVE IT-TIMI 22 Trial

The aim of the present study was to evaluate the effect of periodontal therapy on serum C-reactive protein (CRP) levels in patients with gingivitis and chronic periodontitis. A total of 60 subjects (30 males and 30 females) were included in the study with 20 subjects in each of the groups classified based on community periodontal index (CPI) scores: I: Healthy, II: Gingivitis, III: Mild periodontitis. Periodontal therapy was performed on groups II and III patients. Venous blood was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using immunoturbidimetric method. The present study demonstrated that the periodontitis group had a higher mean CRP levels (2.49 ± 0.47 ng/ml) as compared to the gingivitis group (1.40 ± 0.32 ng/ml) and healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in group II and 1.30 ± 0.36 ng/ml in group III patients. Within the limitations of this study, it can be concluded that CRP level progressively increases from periodontal health to disease. A decrease in CRP levels with periodontal treatment was also observed. Due to its opsonizing abilities CRP plays an important role in the innate host defence. It can be hypothesized that CRP is a potential biomarker of periodontal disease. A number of studies have reported elevated serum CRP levels in periodontitis subjects. Long standing periodontal disease and raised CRP levels enhance the risk of cardiovascular disease, cerebrovascular accidents and preterm low birth weight infants. There is also evidence that effective periodontal therapy can lower serum CRP levels. However, the data of interventional studies on CRP in gingivitis and periodontitis is scarce.

Background:The number of patients with type 2 diabetes mellitus (T2DM) is surging currently. Synbiotic as a supplement based on gut microbiota may be beneficial to improve the metabolism of T2DM. However, the results of clinical studies show that the role of synbiotic in weight management in patients with T2DM is controversial. In this context, we have formulated this protocol. The study will evaluate the effects of synbiotic supplementation on body weight, body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) levels in patients with T2DM.Methods:The electronic databases PubMed, Embase, and the Cochrane Library will be searched for relevant literature from inception. Literature search, data extraction, and methodological quality assessment will be carried out independently by two researchers. All randomized controlled trials (RCTs) that met the criteria will be included. A meta-analysis will be conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures.Results:This systematic review and meta-analysis will mainly assess the effects of synbiotic supplementation on body weight and BMI in T2DM patients. Secondary outcome indicators will include hs-CRP.Conclusion:This systematic review and meta-analysis will quantify the value of synbiotic supplement in weight management of patients with T2DM through a comprehensive evaluation of the current clinical evidence, so as to provide a basis for clinical application.PROSPERO registration number:CRD42019132974.

Nocturnal intermittent hypoxia and short sleep duration are independently associated with elevated C-reactive protein levels in patients with coronary artery disease

Introduction: There is growing evidence of a relationship between sleep disorders and cardiovascular diseases including coronary artery disease (CAD). However, the mechanism of these association is not well established. Enhanced vascular inflammation is implicated as a pathophysiologic mechanism in CAD. The aim of this study was to evaluate the relationship among sleep-disordered breathing (SDB), sleep duration, and serum C-reactive protein (CRP) level in patients with CAD. Methods and Results: Consecutive 225 patients with CAD who underwent percutaneous coronary intervention were evaluated. We used a nocturnal pulse oximetry as a non-invasive screening method for nocturnal intermittent hypoxia, a surrogate marker of SDB. Nocturnal intermittent hypoxia was evaluated using 3% oxygen desaturation index (3% ODI) which was the number of oxygen desaturation measurement ≤ 3% per hour, and we divided the patients into nocturnal intermittent hypoxia group (3% ODI≥15; n=64) and control group (3% ODI<15; n=161). Sleep quality was assessed using validated questionnaires (Pittsburgh Sleep Quality Index [PSQI]; 5.3±3.4, sleep duration; 385±83 minutes). Nocturnal intermittent hypoxia group had significantly higher BMI compared with control group, but age, gender, other coronary risk factors, sleep disturbance (PSQI≥8), sleep duration, and angiographic findings did not differ between two groups. Laboratory data showed that serum CRP level was significantly higher in patients with nocturnal intermittent hypoxia (0.15 [0.09-0.33] vs 0.06 [0.02-0.21] mg/dl, p=0.003). Short sleep duration (<6 hours) was also associated with increased CRP level (0.22 [0.04-0.40] vs 0.07 [0.03-0.14] mg/dl, p=0.036). In multiple regression analysis adjusted by age, gender, BMI, and acute coronary syndrome, 3% ODI (β=0.25; p=0.016; 95% CI, 0.153 to 1.475) and short sleep duration (β=0.20; p=0.04; 95% CI, 0.022 to 1.299) were independent determinants for log serum CRP level. Conclusions: Nocturnal intermittent hypoxia and short sleep duration were independently associated with elevated serum CRP level in CAD patients, suggesting that SDB and sleep duration could be important modifiable factors for the clinical management of patients with CAD.

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance. A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed. After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group. AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Background: Intradialytic hypotension (IDH) remains the most common complication of hemodialysis (HD) with potentially devastating consequences despite the technological advances regarding the hemodialysis techniques of the last decades. The increasing number of advanced-age patients, diabetics and patients with cardiovascular comorbidities undergoing hemodialysis emphasizes the need on implementation of new IDH avoidance tactics. Aim of the Work: Our work aimed to evaluate serum albumin (Alb) level and C-reactive protein level in hemodialysis patients and their correlation with dialysis-induced hypotension (DIH). Patients and Methods: This prospective study was conducted based on data collected from HD patients treated at Aswan University Hospital, dialysis unit, in a period from 1/1/2017 to 30/5/2017. It included 40 chronic HD patients with no history of endocrine tumors, diabetes mellitus, liver failure, heart failure, or unstable coronary artery disease. Patients with hemoglobin less than 9 mg/dL, feverish patients, and patients with any source of apparent infection were excluded. The age of the patients ranged from over 18 to less than 75 years. Results: : the mean value of serum albumin level in group (A) was (2.97 ± 0.71) with the highest serum albumin was 4.4 and the lowest serum albumin was 2.1, while in Group (B) the mean value of serum albumin level was (4.53 ± 0.74) with the highest serum albumin was 5.5 and the lowest serum albumin was 2.8. There was a significant decrease in serum albumin level in patients in group (A) who had developed hypotensive episodes during hemodialysis ( P value < 0.001), in group (A) also there were 18 patients had positive C-reactive protein (90 %) and 2 patients had negative C-reactive protein (10 %) with a mean value (15.67 ± 13.27), while in group B : there were 2 patients had positive C-reactive protein level (10 %) and 18 patients had negative C-reactive protein level ( 90 %) with a mean value (2.07 ± 1.48) , So, there was a significant increase in C-reactive protein level in patients in group (A) who had developed hypotensive episodes during dialysis ( P value < 0.001). Conclusion: Serum Alb. levels and high levels of CRP may predict an increased risk of DIH in regular HD patients and this was the main issue for our study, however we also found that there were some other biochemical markers, which can come inbetween with our two main markers, which confirm our results. Recommendations: Further studies on a larger scale of patients are needed to confirm these results.

Predictive value of coronary artery stenoses and C-reactive protein levels in patients with stable coronary artery disease

Introduction: Potentially malignant disorders are highly prevalent in India. Therefore, early identification and prevention of these lesions may reduce the incidence and increase the prognosis of oral cancer patients. In the present study, we tried to assess the correlation between the C-reactive protein (CRP) levels in patients who had been diagnosed with oral submucous fibrosis (OSMF) and compared it with normal individuals. We also tried to correlate CRP levels in different stages of diseases. Materials and Methods: This comparative study consisted of 60 patients/subjects coming to the outpatient department of oral medicine and radiology, who were selected according to the inclusion and exclusion criteria for the study. They were further divided into two equal groups. Group 1 comprised OSMF patients, and Group 2 comprised the control group. Detailed case history was taken along with habit history, and the habit index was calculated. Blood was collected from each patient for blood reports. After the histological examination, patients were categorised into different stages of the disease. The Spinreact CRP-turbinates kit (SPINREACT) was utilised to measure serum CRP quantitatively. Data collected were entered into an Excel sheet, and a Chi-square and ANOVA test were used for analysis. A significance threshold of P &lt; 0.05 was set for all tests, meaning that a P value below this threshold indicates statistical significance. Results: OSMF was most common in males and younger to middle age groups. In patients with OSMF, serum CRP levels were elevated; however, this increase was not statistically significant when compared to the control group. There is no discernible change present in OSMF according to stages. Conclusion: The results of this study showed that the OSMF had higher levels of CRP than the healthy subjects, indicating that CRP is a biomarker that can be used to gauge the severity of a disease. It is yet unknown if elevated CRP levels represent a risk factor for the development of cancer or if they are raised before the biological genesis of cancer. Therefore, to evaluate pre- and post-treatment serum CRP levels and determine the disease’s status, more research with larger sample sizes is required.

The aim of this paper is to assess Serum Adenosine Deaminase (ADA), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels in patients with Psoriasis. Sixty- four patients with psoriasis were divided into three groups (mild, moderate, and severe) based on PASI scores. PASI score &lt;10 defined psoriasis as mild, between 10 and 20 as moderate, and &gt;20 as severe. The hsCRP was assayed by an enzyme-linked immunosorbent assay BIOS kit. ADA was measured through kinetic method. ESR was calculated using Westergren method. Group I patients had 8 males (mild), 9 males (moderate) and 10 males (severe) and group II had 20 males. There were 12 females (mild), 14 females (moderate) and 11 females (severe) and group II had 30 females. A non- significant difference was observed (P&gt; 0.05). The mean hSCRP level in group I patients was 54.2 ng/ml and in group II was 19.6 ng/ml. The mean ADA level in group I patients was 22.5 U/L and in group II was 8.1 U/L. The mean ESR was 28.4 mm/h in group I and 13.2 mm/h in group II. A significant difference was observed (P&lt; 0.05). This study demonstrated higher hSCRP, ESR and ADA level among patients suffering from psoriasis compared to healthy control.

To determine the effect of treatment of obstructive sleep apnea (OSA) with custom-made mandibular advancement devices (MADs) on C-reactive protein (CRP) levels in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Case series with chart review. Charts of consecutive patients fitted with custom-made mandibular advancement devices for treatment of OSAHS between December 2011 and November 2012 were reviewed. Demographics such as age, sex, and body mass index (BMI) were collected. Prefitting and postfitting polysomnograms were reviewed. Pre- and posttreatment apnea-hypopnea index (AHI) and average O2 saturation were compared. Only patients with documented CRP levels determined prior to mandibular advancement device fitting and again after improvement of OSAHS symptoms were included. Forty-nine patients (77.6% male, age 47.4 ± 11.7 years, BMI 29.6 ± 5.0 kg/m(2)) were included in this study. Patients initially had elevated CRP levels (2.5 ± 1.8 mg/dl), which decreased significantly following use of their custom-made mandibular advancement device (1.9 ± 1.3 mg/dl, P = 0.006) by approximately 24%. AHI decreased significantly from 33.3 ± 21.7 pretreatment to 12.1 ± 22.3 posttreatment (P < 0.001). Treatment with MADs reduced AHI by approximately 69.3%. Minimum oxygen saturation significantly improved from 85.1% ± 5.9 pretreatment to 90.7% ± 3.6 posttreatment (P < 0.001). Treatment with custom-made mandibular advancement devices significantly reduced elevated CRP levels in patients with mild to severe OSAHS. Therapy achieves reasonable response and cure rates in the observed patients with a significant reduction in AHI.

SARS-CoV-2 infection is a systemic infection that significantly affects hematopoiesis and the patient's immune response. Drastic increase in the production of proinflammatory cytokines like interleukin-6 (IL-6) play a role in mechanism of lymphopenia in COVID-19. Some indicators of inflammation markers include Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP). Objectives:Â To determined the correlation between Erythrocyte sedimentation rate (ESR) and C-Reactive Protein (C-RP) levels in patients with covid-19. Methods:Â This research was an analytic observational study with a cross-sectional approach. The samples in this research were 10 ESR and 10 CRP data in a patient with positive COVID-19 at the Mataram University Hospital. Results: A minimum value of 0.50 was obtained from 10 samples of CRP examination, while the maximum value was 79.90 with an average value of 32.24 and a standard deviation of 30.36. The Erythrocyte sedimentation rate (ESR) examination obtained a minimum value of 6.00 from 10 samples, while the maximum value was 103.00 with an average value of 53.60 and a standard deviation of 36.40. Conclusion:Â There is no correlation between the value of Erythrocyte sedimentation rate and C-Reactive Protein levels in patients with Covid-19.Keywords: Covid-19, Â C-reactive protein, erythrocyte sedimentation rateÂ

Different prospective cohort studies have focused on the C-reactive protein (ie, a pentameric protein) biomarker as a predictor of post-stroke depression. In this review and meta-analysis, we will attempt to synthesize the evidence for the association between C-reactive protein and the development of post-stroke depression. We systematically searched five academic databases for relevant studies according to the PRISMA guidelines. We evaluate the comparative levels of C-reactive protein in patients with stroke and/without depression, and analyzed the hazard ratio to evaluate the overall risk of C-reactive protein levels in patients with stroke. We selected eligible studies with 2534 patients (mean age: 65.2 ± 5.9 years) from the initial 10 926 studies in the databases. Increased C-reactive protein levels (Hedge's g, 0.84) in patients with stroke and depression as compared to patients with stroke without depression. Increased levels of C-reactive protein were associated with the onset of depression (Hazard's ratio, 1.6) in patients with stroke. Our findings provide an association of C-reactive protein with the development of post-stroke depression, and present higher levels than patients with stroke without depression. Additionally, our findings support the role of C-reactive protein levels as markers for predicting depression in patients with stroke.

The pathogenesis of Rheumatoid Arthritis (RA) is not fully understood, probably influenced by genetic and environmental factors. Interstitial Lung Disease (ILD) is an extra-articular manifestation of RA, which contributes significantly to morbidity and mortality. The identification of anti-HLA antibodies has been useful in the transplantation field; however, its contribution to autoimmune diseases as RA has not been fully studied. We aimed to determine the presence of anti-HLA antibodies in RA patients with and without ILD and its possible association with clinical and biochemical markers. One-hundred and forty-seven RA patients, of which 65 had ILD (RA-ILD group), were included. Sera samples for Anti-HLA Class II LABScreen panel-reactive antibodies (PRA) were analyzed. In both groups, women predominated, and lung function was worse in patients with ILD. The anti-CCP+ (UI/mL) was higher in the RA group in comparison to RA-ILD (p < 0.001). Expositional risk factors (tobacco smoking and biomass-burning smoke) were higher in RA-ILD patients. PRA+ was identified in ~25% RA-ILD patients, while ~29% in the RA group. The CRP levels have a positive correlation with the percentage of reactivity (%PRA, p = 0.02, r2 = 0.60) in the RA-ILD group. In conclusion, anti-HLA antibodies correlate with C-reactive protein levels in RA patients with ILD.

High-sensitivity C-reactive protein levels in patients with major depressive disorder and bipolar mania