Acute Phase Proteins In Patients Research Articles

Acute phase proteins in patients with recurrent pulmonary tuberculosis

Objective. Study of initial levels of acute phase proteins in patients with pulmonary tuberculosis with and without relapse as predictors of unfavorable disease progression. Materials and methods. 2 groups of patients were examined: the base group - 55 patients with pulmonary tuberculosis with relapse and the control group - 55 patients with pulmonary tuberculosis without relapse. Acute phase protein content was studied in patients before and after the intensive phase of treatment. The content of complement factors C3 and C4, haptoglobin, ceruloplasmin, properdin, C-reactive protein, IL-6, VSH, leukocyte content was studied. Results. The obtained results reveal that acute phase proteins can be considered basic predictors of ineffective antituberculosis treatment: the high indices of leukocyte, C-reactive protein, IL-6, ESR, and haptoglobin.

Review paper: Effect of periodontal treatment on the negative acute phase proteins in patients with periodontitis

Periodontitis is an inflammatory-infectious disease of tooth-supporting structures that results in the progressive destruction of the periodontal ligament and alveolar bone due to an imbalance between the host defense and microorganisms. Subgingival microbiota has a significant role in the initiation and progression of periodontitis, affecting the innate and acquired immune responses by the infiltration of immune cells such as monocytes and polymorphonuclear cells that are abundant under inflammatory conditions. The immune cells induce the release of proinflammatory cytokines that lead to the destruction of periodontal connective tissue and the alveolar bone. Cytokines activate hepatocytes to produce acute phase proteins as a component of the nonspecific response. These proteins are a group of proteins that increase (positive type) and decrease (negative type) under inflammatory conditions. This response is called the acute phase response (APR) that occurs after the initiation of a systemic inflammatory reaction. Nonsurgical periodontal therapy is the first stage of treatment for periodontitis. Its aim is to eliminate etiologic agents and decrease inflammation. The aim of this review article was to evaluate the effect of periodontitis as an inflammatory condition and its treatment on the concentrations of negative acute phase proteins

Impact of type and duration of use of antipsychotic drugs on plasma levels of selected acute-phase proteins in patients with major mental illnesses

Background: Disorders of the hemostatic system such as hypercoagulation and hypofibrinolysis are clinical manifestations in patients with schizophrenia, depression, and bipolar disorder. However, the role of the type of antipsychotic medication as well as the duration of use on disturbances in the hemostatic system is poorly understood. This study was, therefore, carried out to determine the possible impact of antipsychotic treatment as well as the duration of use on selected acute-phase proteins involved in coagulation and fibrinolysis. Materials and Methods: Plasma levels of fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were determined in 124 patients with major mental illnesses: schizophrenia, depression, and bipolar disorder. Thereafter, the participants were grouped based on the type of antipsychotic medication (typical vs. atypical) and the duration of antipsychotic use. Results: Patients on typical antipsychotics had a slightly elevated level of PAI-1 but a similar level of fibrinogen when compared with patients on atypical antipsychotics. Furthermore, the median plasma levels of fibrinogen and PAI-1 in patients who have been on antipsychotic use for more than 10 years were slightly higher than in patients who have been on the drug for 10 years or less. Conclusion: It could be concluded from this study that patients on typical antipsychotics and those who have used any form of antipsychotics for more than 10 years might benefit from periodic assessment of markers of prothrombosis as it could facilitate early identification of those at risk of venous thromboembolism.

The evaluation of NT-proCNP, C-reactive protein and serum amyloid A protein concentration in patients with multiple myeloma undergoing stem cell transplantation

The importance of proinflamatory cytokines and acute phase proteins in pathogenesis and progression of MM is well known. However, there are any studies evaluating the role of NT-proCN in management and treatment of MM. The aim of our study was to evaluate the concentration of NT-proCNP and acute phase proteins in patients with MM before and after stem cell transplantation. We involved 40 newly diagnosed MM patients in stage III according to the Durie-Salmon classification and treated with high dose of melphalan (200mg/m2) prior to ASCT. Concentration of NT-proCNP, hs-CRP and SAA were measured before conditioning treatment and every 4days until the 24th day after stem cell infusion. We observed low NT-proCNP levels before conditioning treatment (0.121±0.04pmol/l), the higher in day on ASCT (0.28±0.14pmol/l). Further we showed significant gradual increase concentration of NT-proCNP up to 12days after stem cells infusion (1.07±0.72pmol/l). The kinetics of hs-CRP and SAA levels were similar to NT-proCNP. We showed positive correlation between NT-proCNP levels and absolute neutrophil and platelets count in patients after ASCT. NT-proCNP can be useful parameter to assess effectiveness of treatment and monitoring of hematopoetic recovery time in patients with MM after stem cell transplantations.

Negative acute phase proteins in patients with chronic urticaria

Objective To investigate the relationship between negative acute phase proteins and chronic urticaria (CU) . Methods Fifty patients with CU were enrolled into this study, and divided into three grades, i.e., mild (grade 1) , moderate (grade 2) and severe (grade 3) according to symptoms. Twenty-eight health checkup examinees served as the control group. Immunoturbidimetry was performed to determine serum levels of prealbumin (PA) and transferrin (TRF) . Enzyme-linked immunosorbent assay was conducted to measure serum levels of insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α) . Statistical analysis was carried out to assess differences in these indices between these two groups, the relationship among these indices and between these indices and disease severity. Results Compared with the control group, the patients with CU showed reduced serum levels of PA ( (229.99 ± 54.16) vs. (272.06 ± 36.42) mg/L, t =3.667, P 0.05) . The serum level of PA showed a significant negative correlation with that of TNF-α (r = - 0.312, P 0.05) in the patients with CU. Conclusions Serum levels of some negative acute phase proteins decrease and negatively correlate with disease severity in patients with CU. Acute phase response may be involved in the occurrence of CU. Key words: Urticaria; Prealbumin; Transferrin; Insulin-like growth factor binding protein 1; Tumor necrosis factor-α

Acute phase proteins in patients with cirrhosis

Acute phase proteins in patients with cirrhosis

Influence of hypertension, obesity and nicotine abuse on quantitative and qualitative changes in acute-phase proteins in patients with essential hypertension

SummaryBackgroundHypertension is a powerful risk factor for cardiovascular disease and frequently occurs in conjunction with obesity. Accumulative evidence suggests a link between inflammation and hypertension. The aim of study was to evaluate whether blood pressure, obesity and smoking may influence acute-phase response.Material/MethodsNinety-two patients with essential hypertension and 75 healthy volunteers as a control group were studied. In all subjects assessment of hsCRP, α1-acid glycoprotein (AGP), α1-antichymotrypsin, transferrin, α1-antitrypsin, and C3 and C4 complement were performed. Evaluation of glycosylation profile and reactivity coefficient (RC) for AGP was done by means of affinity immunoelectrophoresis with concanavalin A as a ligand.ResultsWhen compared to the controls, hypertensive subjects presented significantly higher hsCRP concentrations and lower transferrin level. Hypertensive patients had elevated AGP-AC. The intensification of the inflammatory reaction was greater in the subgroup of hypertensive patients smoking cigarettes. In obese hypertensives, elevated serum C3 complement level was found.ConclusionsWe conclude that arterial hypertension may evoke the acute-phase response in humans. Markers of acute-phase response are particularly strongly expressed in smokers. Serum C 3 complement, but not other APPs, is elevated in hypertension coexisting with obesity.

Plasma Hepcidin Correlates Positively With Interleukin-6 in Patients Undergoing Pulmonary Endarterectomy

Hepcidin, a recently discovered antimicrobial peptide synthesized in the liver, was identified to be the key mediator of iron metabolism and distribution. Despite our knowledge of hepcidin increased in recent years, there are only limited data on hepcidin regulation during systemic inflammatory response in human subjects. In a prospective study, the time course of plasma hepcidin was analyzed in relations to six inflammatory parameters - plasma cytokines and acute-phase proteins in patients undergoing uncomplicated pulmonary endarterectomy. Twenty-four patients (males, aged 52.6+/-10.2 years, treated with pulmonary endarterectomy in a deep hypothermic circulatory arrest) were enrolled into study. Hepcidin, interleukin (IL)-6, IL-8, tumor necrosis factor-alpha, C-reactive protein, alpha(1)-antitrypsin and ceruloplasmin arterial concentrations were measured before surgery and repeatedly within 120 h post-operatively. Hemodynamic parameters, hematocrit and markers of iron metabolism were followed up. In a postoperative period, hepcidin increased from preoperative level 8.9 ng/ml (6.2-10.7) (median and interquartile range) to maximum 16.4 ng/ml (14.1-18.7) measured 72 h after the end of surgery. Maximum post-operative concentrations of hepcidin correlated positively with maximum IL-6 levels. Both hepcidin and IL-6 maximum concentrations correlated positively with extracorporeal circulation time. In conclusions, the study demonstrated that plasma hepcidin is a positive acute-phase reactant in relation to an uncomplicated large cardiac surgery. Hepcidin increase was related to IL-6 concentrations and to the duration of surgical procedure. Our clinical findings are in conformity with recent experimental studies defining hepcidin as a type II acute-phase protein.

Circulation levels of acute phase proteins in patients with Takayasu arteritis

Takayasu arteritis (TA) is an immune-mediated disease with an unknown etiology. Assessment of disease activity in patients with TA is challenging owing to the absence of reliable serologic markers. Because circulation levels of acute-phase proteins fluctuate with the severity and extent of the inflammatory reaction, they may be potential biomarkers for the identification of TA activity. To test this hypothesis, certain acute-phase proteins were examined in TA patients and controls. The study included 43 prospectively selected TA patients, with 18 in active phase and 25 in inactive phase. The Sharma modified criteria were used for disease diagnosis, and the National Institutes of Health criteria were used for TA activity assessment. Circulation levels of acute-phase proteins, including serum amyloid A (SAA), fibrinogen, complement C4-binding protein (C4BP), C-reactive protein, serum amyloid P, haptoglobin, alpha-acid glycoprotein, transthyretin, alpha1-microglobin, and complement fraction C3c and C4a were investigated by enzyme-linked immunosorbent assay in each participant. Circulating levels of SAA and C4BP were significantly increased in active TA patients compared with inactive TA patients and in controls, with (SAA: 95.9 [interquartile range, 51.9] vs 49.2 [82.0], P = .009; and 23.9 [50.1] mg/L, P = .001, respectively; C4BP: 88.5 [72.6] vs 61.7 [57.7], P = .023; and 32.6 [32.1] mg/L, P < .001, respectively). The levels of both proteins in inactive TA patients were still higher than those in controls (SAA: 49.2 [82.0] vs 23.9 [50.1] mg/L, P = .021; C4BP: 61.7 [57.7] vs 32.6 [32.1] mg/L, P = .025). No difference was found in the levels of the other acute-phase proteins studied. SAA and C4BP may be useful biomarkers in determining the disease activity of TA. More work should be done to test these results in a large cohort of patients in a longitudinal manner.

Neurochemical and behavioral responses to inflammatory immune stressors

Activation of the inflammatory immune system has been associated with the development of psychological disorders such as major depressive disorder (MDD). In this regard, the release of pro-inflammatory cytokines (signaling molecules of the immune system) provokes a constellation of neurochemical and behavioral alterations, reminiscent of the effects of traditional stressors, which if sustained could influence psychological functioning. In animal models, exogenously administered cytokines, as well as bacterial endotoxins and viral analogues, induce a variety of behavioral disturbances collectively known as sickness behavior. Although it is difficult to differentiate the general malaise of sickness engendered by cytokines from the depressogenic effects, clinical studies have revealed increased levels of circulating cytokines and acute phase proteins in patients diagnosed with MDD. Furthermore, the incidence of MDD is increased in patients suffering from chronic inflammatory conditions, and immunotherapy used to treat chronic illnesses such as Hepatitis C was related to high levels of depression that could be attenuated by antidepressant treatment. Together, these findings indicate that activation of the inflammatory immune system may favor the evolution of psychological disturbances.

Neurochemical and behavioral responses to inflammatory immune stressors

Activation of the inflammatory immune system has been associated with the development of psychological disorders such as major depressive disorder (MDD). In this regard, the release of pro-inflammatory cytokines (signaling molecules of the immune system) provokes a constellation of neurochemical and behavioral alterations, reminiscent of the effects of traditional stressors, which if sustained could influence psychological functioning. In animal models, exogenously administered cytokines, as well as bacterial endotoxins and viral analogues, induce a variety of behavioral disturbances collectively known as sickness behavior. Although it is difficult to differentiate the general malaise of sickness engendered by cytokines from the depressogenic effects, clinical studies have revealed increased levels of circulating cytokines and acute phase proteins in patients diagnosed with MDD. Furthermore, the incidence of MDD is increased in patients suffering from chronic inflammatory conditions, and immunotherapy used to treat chronic illnesses such as Hepatitis C was related to high levels of depression that could be attenuated by antidepressant treatment. Together, these findings indicate that activation of the inflammatory immune system may favor the evolution of psychological disturbances.

Changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins in patients with critical illness

Insulin resistance develops rapidly during critical illness. The release of adipokines from adipose tissue is thought to play a key role in the development of insulin resistance, as are elevated levels of acute-phase proteins. The aim of this study was to identify changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins during critical illness. From 8 patients with subarachnoidal hemorrhage, consecutive blood samples and adipose tissue biopsies were obtained at 3 time points, twice during intensive care (1-2 days [IC1] and 7-9 days after subarachnoidal hemorrhage) and once after 8 months (recovery). The patients received a continuous insulin infusion to maintain normal glucose levels reflecting insulin resistance. The DNA microarray analysis showed increased zink-alpha2 glycoprotein (ZAG) and phospholipase A2, group IIA messenger RNA levels during intensive care compared with recovery ( P < .05). Real-time polymerase chain reaction confirmed the increased expression of ZAG and phospholipase A2, group IIA. Plasma levels of ZAG, serum amyloid A, and C-reactive protein were higher at 7 to 9 days after subarachnoidal hemorrhage compared with either IC1 or recovery ( P = .0001); and plasma levels of retinol-binding protein 4 and adiponectin were lower at IC1 compared with recovery ( P = .05). The described changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins may influence the development of insulin resistance during critical illness.

Procalcitonin in Early Detection of Postoperative Infectious Complications. the Comparison with a Set of Cytokines, Soluble Cytokine Receptors and Acute Phase Proteins

Background: Infections and sepsis are relevant complications in patients undergoing large abdominal surgery and still constitute a diagnostic challenge. Only limited markers can differentiate incipient postoperative sepsis from uncomplicated early postoperative reaction. A prospective clinical study was performed to examine the accuracy of procalcitonin (PCT), set of cytokines, soluble cytokine receptors and acute phase proteins in patients following major abdominal surgery. Subjects and Methods: Between January 2006 and February 2008, 48 patients with febrile episode of the early postoperative period after abdominal surgery were entered into the study. Blood samples were obtained on the first day of fever for the measurement of plasma PCT (Kryptor), TNFalpha, IL-1beta, IL-1ra, IL-2, IL-6, sIL-6R, IL-8 (ELISA), and 10 acute phase proteins (nephelometry). Data were compared with reference group: 24 patients with the planned resection of colorectal cancer at stage Ib-IV and uncomplicated healing; venous blood samples were obtained repeatedly before surgery, 6, 12, 18, 24, 48, and 72 h after start of surgery Results: Febrile reaction of 26/48 patients was linked with positive blood culture results. PCT and IL-6 concentrations of blood culture positive subjects differed significantly from non-bacteremic patients (p < 0.01 for both parameters) as well as from uncomplicated patients (p < 0.003 and p < 0.001). Cutoff levels to distinguish blood culture positive and negative subgroups using ROC were 0.96 ng/ml for PCT and 345 pg/ml for IL-6. Other inflammatory parameters showed high sensitivity but lower specificity for bacterial complications in relation to uncomplicated postsurgical course. PCT and monitored cytokines culminated 18—36 h following uncomplicated surgery and postoperative PCT levels did not exceed 1.02 ng/ml in this group Conclusions: Simultaneous PCT and IL-6 examination is a reliable approach to distinguish incipient infectious complications in early postoperative period. Their measurement is well founded for daily monitoring of high-risk patients after large abdominal surgical procedures. Supported with grant IGA-MZ-CR-4825—3.

α-1 Microglobulin as a New Inflammatory Marker in Newly Diagnosed Hypertensive Patients

The alpha-1 microglobulin (A1M) is considered to be a marker of renal insufficiency, suggesting disturbed tubular function. In the present study we examined the ability of urinary A1M excretion to reflect the overall inflammatory status in patients with newly diagnosed essential hypertension and normal renal function. The study population consisted of 1445 nondiabetic patients with newly diagnosed arterial hypertension and no evidence of renal insufficiency. Serum levels of C-reactive protein (CRP), serum amyloid alpha (SAA), and plasma fibrinogen, as well as urinary A1M excretion, were estimated. Multivariate analysis was performed to evaluate the associations between hypertension; A1M urinary excretion; and circulating levels of CRP, SAA, and fibrinogen. Patients with systolic hypertension had higher CRP, SAA, fibrinogen, and A1M compared with patients with isolated diastolic hypertension (P < .0001 for all). In multivariate analysis, systolic (but not diastolic) blood pressure (BP) was independently associated with A1M, CRP, and SAA (P < .0001 for all), whereas urinary A1M was also independently correlated with inflammatory markers such as CRP (P = .0001) and SAA (P = .0001). Urinary A1M is independently associated with circulating acute phase proteins in patients with newly diagnosed hypertension, whereas it is closely associated with systolic but not diastolic BP. Our findings suggest that urinary alpha-1 microglobulin may reflect the overall inflammatory status in patients with newly diagnosed essential hypertension, beyond its value as a marker of renal function.

Pro-inflammatory cytokines IL6, TNF-α, IL1β, procalcitonin, lipopolysaccharide binding protein and C-reactive protein in infective endocarditis

To evaluate the serum levels and diagnostic value of cytokines and acute phase proteins in patients with infective endocarditis (IE). Serum samples from 63 patients diagnosed with IE and 71 control patients were analysed for the following markers: interleukin-6 (IL6), tumour necrosis factor-alpha (TNF-alpha), interleukin 1-beta (IL1beta), procalcitonin (PCT), lipopolysaccharide binding protein (LBP) and C-reactive protein (CRP). Serum levels of IL6, IL1beta and CRP were significantly elevated in patients with IE as compared to controls. PCT, TNF-alpha and LBP were not elevated. Serum CRP and IL6 are elevated in IE. IL 6 may aid in establishing the diagnosis. There was no correlation between IL 6 levels and CRP, causative microorganism, echocardiographic features or outcome.

Acute phase proteins in patients with acute coronary syndrome: Correlations with diagnosis, clinical features, and angiographic findings

Background C-reactive protein (CRP) plasma levels increase in patients with acute coronary syndrome (ACS). The role and implications of increased plasma concentrations of other acute phase proteins (APPs), such as alpha-1-antitrypsin (A1AT), alpha-1 glycoprotein (A1GP), haptoglobin (HG), ceruloplasmin (CP), and C3c and C4 complement fraction, in patients with ACS are still not completely defined. Methods A total of 218 consecutive patients with ACS were included in the study, 185 with acute myocardial infarction (AMI) and 33 with unstable angina (UA). In all patients, A1AT, A1GP, HG, CP, C3c and C4 complement fraction, and CRP were evaluated within 12 h after the onset of symptoms. Sixty-two patients with AMI underwent coronary angiography. Results APPs showed a significant correlation with CRP concentrations. Patients with AMI had higher concentrations of A1AT and HG than UA patients. Cholesterol levels were correlated with APPs in patients with AMI. Patients with three coronary vessel disease or LAD disease had significantly higher C3c concentrations. Coronary collateral flow was associated with higher A1GP and CP concentrations, and total coronary occlusion with A1AT and CP. Conclusions APPs were correlated with CRP concentrations in subjects with ACS. The increase in APPs in patients with ACS seems to be linked to the entity of myocardial damage and coronary atherosclerotic burden.

Microheterogeneity of acute phase proteins in patients with ulcerative colitis.

To estimate the serum alpha1-antichymotrypsin (ACT), alpha1-acid glycoprotein (AGP) and transferrin (Tf) concentrations and to evaluate the microheterogeneity of these acute phase proteins in patients with ulcerative colitis. Twenty-seven patients with ulcerative colitis (UC) and 17 healthy control subjects were studied. The patients were categorised as severe (n = 9), moderate (n = 10) and mild groups (n = 8) using Truelove and Witts' classification of ulcerative colitis. Microheterogeneity of ACT, AGP and Tf was analysed by crossed immunoaffinity electrophoresis (CIAE) with concanavalin A. In all serum samples standard electrophoresis of serum proteins was performed, iron (Fe) concentration, total iron binding capacity (TIBC) and C-reactive protein (CRP) were also measured. Our patients suffering from ulcerative colitis had significantly higher serum ACT and AGP concentrations and lower serum transferrin concentration in comparison to healthy subjects. Changes in concentrations of acute phase proteins were dependent on the activity of the inflammatory process. The glycosylation patterns of transferrin were related to the inflammation status. We also observed the correlation between ACT and AGP concentrations, patterns of transferrin glycosylation and changes in standard protein electrophoresis or blood cell count. The glycosylation patterns of transferrin obtained from patients suffering from ulcerative colitis are highly branched and sialylated compared with those obtained from healthy subjects. In contrast, the glycosylation patterns of transferrin do not differ according to the activity index of ulcerative colitis. The microheterogeneity patterns of AGP and ACT are similar in ulcerative colitis patients and healthy subjects.

Essential Trace Elements Selenium, Zinc, Copper, and Iron Concentrations and Their Related Acute-Phase Proteins in Patients with Vivax Malaria

The aim of the present study is to evaluate the status of plasma essential trace elements selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) concentrations and their related acute-phase proteins, ceruloplasmin (Cp), ferritin, transferrin (Tf), and albumin levels in patients with vivax malaria. Plasma Cu and Zn concentrations were determined by atomic absorption spectrometry (AAS). Se concentrations were determined by graphite furnace AAS. Fe, Cp, Tf, and albumin levels were determined by colorimetric methods. Plasma Se, Fe, and albumin levels were found to be significantly lower (p < 0.01, p < 0.001, and p < 0.05, respectively) and Cu, Cp, and ferritin levels and Cu/Zn ratios were significantly higher (p < 0.001, p < 0.001, p < 0.001, and p < 0.05, respectively) in patients when compared with those of healthy subjects. Plasma, Tf, and Zn levels were not found to be significantly different (p > 0.05) in patients and controls. There were positive important correlations between Cu and Cp (r = 0.908, p < 0.001), Zn and albumin (r = 0.633, p < 0.001), and negative correlations between Fe and ferritin content (r = -0.521, p < 0.05) and Fe and Tf (r = -0.616, p < 0.01) in the patients group. Our findings demonstrated that plasma essential trace elements Se, Cu, and Fe change, but these changes might be dependent on acute-phase proteins, which were regulated as a part of defense strategies of the organism, induced by hormonelike substances.

Clinical evaluation of the measurement of serum procalcitonin: comparative study of procalcitonin and serum amyloid A protein in patients with high and low concentrations of serum C‐reactive protein

Levels of C‐reactive protein (CRP) and serum amyloid A protein (SAA) in blood are increased as acute phase proteins in patients with inflammatory conditions. Most of the currently used inflammatory markers, such as erythrocyte sedimentation rate and CRP or SAA levels, are non‐specific parameters. By contrast, procalcitonin (PCT) has been reported to be selectively induced by severe infection in systemic inflammatory response syndrome (SIRS) and also in sepsis or multiorgan dysfunction syndrome. PCT expression is induced only slightly, if at all, by viral infections, autoimmune disorders, neoplastic disorders and trauma arising from surgical intervention. Serum PCT and SAA levels were compared in 93 patients with a CRP concentration higher than 100 mg/L and in 26 patients with a CRP concentration lower than 1.5 mg/L. In patients with high levels of CRP, all patients with sepsis and severe bacterial infection showed a significantly increased PCT concentration of more than 1.0 μg/L and it was possible to differentiate between the patients with neoplastic disorders and those with other inflammatory diseases. In patients with low levels of CRP, the PCT concentration was less than 0.3 μg/L and an increased PCT level was not seen in patients with autoimmune disorders or viral and fungal infections. These results suggest that determining the serum PCT level may be useful in the differential diagnosis of severe infection.

Portal and systemic serum growth factor and acute-phase response after laparotomy or partial hepatectomy in patients with colorectal liver metastases: a prognostic role for C-reactive protein and hepatocyte growth factor

Background: Growth factors play a role in wound healing and tumour growth. The aim of this study was to compare the effect of partial hepatectomy (PH) and laparotomy on serum levels of growth factors and acute-phase proteins in patients with colorectal liver metastases and to correlate these levels with prognosis after PH. Methods: Epidermal growth factor (EGF), hepatocyte growth factor (HGF), insulin like growth factor-I (IGF-I), insulin, interleukin-6 (IL-6), C-reactive protein (CRP) and serum amyloid-A (SAA) were determined in portal and systemic serum in 24 PH patients and 9 laparotomy patients. Results: No differences were found in the clinicopathological characteristics of PH and laparotomy patients with the exception of the number of metastases, blood loss and operation time. The response of SAA, CRP and IGF-I was lower in PH patients than in laparotomy patients (P < 0.02). PH was associated with a higher IL-6 (P = 0.02) and HGF (P = 0.055) response than laparotomy. A higher HGF and CRP response was associated with a poorer prognosis. Total IGF-I was negatively correlated with the resected liver volume (r = −0.48, P < 0.05). Conclusions: PH is associated with a lower acute-phase and total IGF-I response and a higher HGF and IL-6 response compared with laparotomy. HGF and CRP responses had an influence on the prognosis.