C-reactive Proteins Research Articles

Geraniol enhances peroxiredoxin‐1, and prevents isoproterenol‐induced oxidative stress and inflammation associated with myocardial infarction in experimental animal models

This study has explored the fact that geraniol prevents isoproterenol(ISO)-induced oxidative stress and inflammation-mediated myocardial infarction (MI) through enhanced expression of peroxiredoxin-1 (Prdx-1) in experimental animal models. The experimental strategies of MI were stimulated through the subcutaneous direction of ISO (85 mg/kg body weight) for 14 days. ISO-directed models showed elevated heart rate levelsand cardiac markers (serum creatine kinase [CK], serum CK-myocardial band, serum C-reactive proteins, and plasma homocysteine); increased cardiac-troponins-T, and troponin-I levels in both serum and myocardium. Moreover, we perceived that a higher level of lipid peroxidation molecules (thiobarbituric acid reactive substances and lipid hydroperoxides) reduced the antioxidant enzyme levels in plasma and heart tissue of ISO-directed rats. However, geraniol treatment prevents ISO-directed enhancement of the heart rate, cardiac and lipid peroxidative genes; reverted the blood pressure, and antioxidant status in ISO-directedrats. Furthermore, gene expression results revealed that geraniol treatment inhibited the mitogen-activatedproteinkinase (MAPK) proteins, inflammatory responder (tumor necrosis factor-α,interleukin6, nuclear factor-κB), and cardiac fibrotic proteins (matrix metalloproteinase-2[MMP-2], MMP-9) in ISO directed rats. Prdx-1 is an antioxidant response element, and it can regulate all the antioxidant proteins and it scavenges harmful radicals. Therefore, enhanced Prdx-1 expression is considered to have a pivotal role in preventing cardiac infarction. In this study, an elevated expression of Prdx1 was noticed in geraniol treated with ISO-directed rats. Hence, we concluded that geraniol is considered a potential phytodrug, and it prevents ISO-directed MAPKs, inflammation, and cardiac markers by enhancing the expression of Prdx1.

A multistrain probiotic improves handgrip strength and functional capacity in patients with COPD: A randomized controlled trial

PurposeThe age-related muscle loss, termed sarcopenia and functional dependency, are common findings in patients with chronic obstructive pulmonary disease (COPD). However, an effective bedside treatment remains elusive. ObjectiveTo assess the effects of probiotics on sarcopenia and physical capacity in COPD patients. MethodsRandomized, double-blind, computer-controlled, multicenter trial in two tertiary-care hospitals for 16 weeks. A central computer system randomly allocated male, 63—73 years old COPD patients into placebo (n=53) and probiotic (n=51) groups. The intervention was Vivomix 112 billion*, one capsule a day for 16 weeks. The main outcomes measured were sarcopenia phenotype, short physical performance battery (SPPB), plasma markers of intestinal permeability (zonulin and claudin-3) and neuromuscular junction degradation (CAF22), body composition, and handgrip strength (HGS) before and following the probiotics treatment. Findings4 patients discontinued intervention due to poor compliance and 100 patients, including placebo (n=53) and probiotic (n=47) groups were analyzed. Probiotics reduced plasma zonulin, claudin-3, and CAF22, along with an improvement in HGS, gait speed, and SPPB scores (all p<0.05). Probiotic treatment also reduced the plasma c-reactive proteins and 8-isoprostane levels, the markers of systemic inflammation and oxidative stress (p<0.05). Correlation analysis revealed varying degrees of association of plasma biomarkers with sarcopenia indexes. Despite a statistical trend, we did not find a reduction in sarcopenia prevalence in the probiotic group. ConclusionTaken together, the multistrain probiotic improves muscle strength and functional performance in COPD patients by reducing intestinal permeability and stabilizing neuromuscular junction. Trial registrationGMC clinical trial unit, GMC-CREC-00263

Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle-aged adults

SummaryTargeting mitophagy to activate the recycling of faulty mitochondria during aging is a strategy to mitigate muscle decline. We present results from a randomized, placebo-controlled trial in middle-aged adults where we administer a postbiotic compound Urolithin A (Mitopure), a known mitophagy activator, at two doses for 4 months (NCT03464500). The data show significant improvements in muscle strength (∼12%) with intake of Urolithin A. We observe clinically meaningful improvements with Urolithin A on aerobic endurance (peak oxygen oxygen consumption [VO2]) and physical performance (6 min walk test) but do not notice a significant improvement on peak power output (primary endpoint). Levels of plasma acylcarnitines and C-reactive proteins are significantly lower with Urolithin A, indicating higher mitochondrial efficiency and reduced inflammation. We also examine expression of proteins linked to mitophagy and mitochondrial metabolism in skeletal muscle and find a significant increase with Urolithin A administration. This study highlights the benefit of Urolithin A to improve muscle performance.

Effect of thymogen immunocorrected boar castration on biochemical indicators

The article presents the results of the dynamics of indicators of protein, nitrogen and carbohydrate metabolism during castration of boars in industrial production against the background of immunocorrection with thymogen. The studies were carried out on 14 boars (aged 5 months), selected by random sampling from 38 animals in compliance with the principle of paired analogues and divided into two groups ‒ control and experimental ones (n=7 in each). All boars were castrated by an open method with preoperative medical support according to the methodology adopted in the farm. Animals of the experimental group were additionally injected with thymogen for a five-day course. During the experiment, the content of C-reactive and total proteins, albumin, globulin, urea, creatinine, glucose was determined in the blood serum. Albumin-globulin ratio was determined by the calculation method. According to the results of the experiment, it was found that castration of boars was accompanied in both groups at all stages of the experiment by an increase in the content of C-reactive protein, changes in protein metabolism, mainly in the catabolic phase of the postoperative period ‒ a decrease in the concentration of total protein, globulin below the norm in the control group with similar dynamics of indicators in the experimental group, but within the reference intervals. Further dynamics were positive in the direction of normalization at the anabolic phase. The dynamics of urea and creatinine in both groups had a wave-like character, not going beyond the normative values, the level of urea increased with a subsequent decrease, creatinine – vice versa. Their final levels were lower than the original ones.The use of thymogen largely leveled the intensity of changes in the catabolic phase of the pathological process and contributed to the normalization of the biochemical profile at the final stage of the experiment.

High Sensitivity C-Reactive Protein Level and Ischemic Heart Disease

Aim: To know the relation between serum hs CRP levels and IHD. Methods: This study was done in the Department of cardiology Hayatabad Medical Complex, Peshawar after approval from the hospital ethical committee. It was a cross-sectional descriptive study. The duration of the study was one and a half years, with a sample of 160 IHD patients.The sample size was calculated based on a universally validated calculator with a 95% confidence interval and a 5% margin of error. Results: Among the total 160 IHD patients included in this study, 102(63.7%) were male and 58(36.3%) females. Mean±SD age was 57.8±13.7. Among 160 patients, 32(20%) patients were having hs CRP below 1 mg/L, 45(28.1%) patients having between 1 to 3mg/L, and 83(51.9%) patients &gt;3 mg/L. Mean±SD hs CRP level was 4.52±3.2mg/L. Conclusion: High sensitivity C-reactive proteins (hs CRP) is one of the important risk factors of IHD and its level is directly related to the frequency of IHD Keywords: Ischemic Heart Disease (IHD), cardiovascular disease (CVD), hs CRP

The effects of continuous renal replacement therapy with different anticoagulation methods on the expression of cytokines in severe acute pancreatitis

ObjectiveSevere acute pancreatitis (SAP) is a highly morbid condition in general population as well as in solid organ transplant (SOT) recipients. The present study aimed to investigate the effect of continuous renal replacement therapy (CRRT) with different anticoagulation methods on the expression levels of cytokines in SAP. MethodsA total of 120 patients with SAP, admitted into our hospital between September 2017 and July 2020, were enrolled as the research subjects and randomly divided into a control group (60 cases) and a study group (60 cases). CRRT with low molecular weight (LMW) heparin‑calcium anticoagulation was conducted on patients in the control group, and CRRT with topical citrate + low-dose LMW heparin‑calcium anticoagulation was conducted on patients in the study group. The expressions of cytokines in the two groups were compared after treatment. ResultsThere was no significant difference in white blood cells (WBC), C-reactive proteins (CRP), and procalcitonin (PCT) before treatment between the two groups (P > 0.05). After treatment, the levels of WBC (P = 0.006), CRP (P < 0.001), and PCT (P < 0.001) were significantly lower in the study group when compared with those in the control group. There was no significant difference in the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) between the two groups before treatment (P > 0.05). After treatment, the concentrations of IL-6, IL-8, and TNF-α were significantly lower in the study group when compared with those in the control group. The APACHEII, SOFA and Ranson scores of the two groups were analyzed, and there was no difference between the two groups before treatment (P > 0.05). After treatment, the score of the study group was lower than that of the control group (P < 0.05). ConclusionCRRT with topical citrate + low-dose LMW heparin‑calcium anticoagulation in the treatment of patients with SAP reduces the levels of WBC, CRP, and PCT and the concentrations of cytokines, including IL-6, IL-8, and TNF-α. This inhibits the release of inflammatory mediators in patients with SAP and reduces damage to the body caused by the inflammatory response, thus effectively improving the patients' condition.

Role of procalcitonin as a predictor of clinical outcomes in hospitalized patients with COVID-19

ObjectivesIn this study, we aimed to determine the correlation between procalcitonin (PCT) levels and clinical outcomes including in-hospital mortality, intensive care unit (ICU) length of stay, and hospital length of stay in patients hospitalized with COVID-19. MethodsClinical, laboratory, and demographic data of 223 patients who met inclusion criteria were analyzed. PCT measurements of 0.25 ng/mL and 0.50 ng/mL were used to stratify patients into 2 mutually exclusive groups. ResultsPatients with PCT above 0.25 ng/mL on admission had significantly elevated Acute Physiology and Chronic Health Evaluation II scores (9 vs 8; P = 0.042) and C-reactive proteins levels (111 μg/mL vs 79 μg/mL; P = 0.007). A multivariable binary logistic regression model demonstrated no relationship between PCT and mortality (OR = 1.00; 95% Cl: 0.97 to 1.02; P = 0.713). Kaplan-Meier analysis revealed no statistical evidence of a difference between PCT groups and hospital length of stay (P = 0.144 for 0.25 ng/mL, P = 0.368 for 0.50 ng/mL) or intensive care unit length of stay (P = 0.986 for 0.25 ng/mL, P = 0.771 for 0.50 ng/mL). ConclusionsElevated PCT levels were associated with severity of illness but did not correlate with in-hospital mortality, hospital length of stay, or ICU length of stay.

Small Vessel Disease: Ancient Description, Novel Biomarkers.

Small vessel disease (SVD) is one of the most frequent pathological conditions which lead to dementia. Biochemical and neuroimaging might help correctly identify the clinical diagnosis of this relevant brain disease. The microvascular alterations which underlie SVD have common origins, similar cognitive outcomes, and common vascular risk factors. Nevertheless, the arteriolosclerosis process, which underlines SVD development, is based on different mechanisms, not all completely understood, which start from a chronic hypoperfusion state and pass through a chronic brain inflammatory condition, inducing a significant endothelium activation and a consequent tissue remodeling action. In a recent review, we focused on the pathophysiology of SVD, which is complex, involving genetic conditions and different co-morbidities (i.e., diabetes, chronic hypoxia condition, and obesity). Currently, many points still remain unclear and discordant. In this paper, we wanted to focus on new biomarkers, which can be the expression of the endothelial dysfunction, or of the oxidative damage, which could be employed as markers of disease progression or for future targets of therapies. Therefore, we described the altered response to the endothelium-derived nitric oxide-vasodilators (ENOV), prostacyclin, C-reactive proteins, and endothelium-derived hyperpolarizing factors (EDHF). At the same time, due to the concomitant endothelial activation and chronic neuroinflammatory status, we described hypoxia-endothelial-related markers, such as HIF 1 alpha, VEGFR2, and neuroglobin, and MMPs. We also described blood–brain barrier disruption biomarkers and imaging techniques, which can also describe perivascular spaces enlargement and dysfunction. More studies should be necessary, in order to implement these results and give them a clinical benefit.

Effect of Trichilia monadelpha (Thonn.) J. J. de Wilde (Meliaceae) extracts on C-reactive proteins levels and acute inflammation

Trichilia monadelpha is reported to have acute anti-inflammatory effects. This study sought to establish the possible effects of the petroleum ether, ethyl acetate, and ethanolic extracts of Trichilia monadelpha stem bark (i.e., PEE, EAE, and EthE, respectively) on C-reactive proteins, using various acute inflammatory models. Changes in hind paw volume of Sprague-Dawley rats were measured before and after intraplantar injection of; 50 μL of 0.5% λ-carrageenan, 0.1 ml of 0.1% histamine, 0.1 ml of 0.02% serotonin, 1 nmol Prostaglandin E2, or 10 nmol bradykinin, to induce paw oedema, and during treatment with 10, 30, or 100 mgkg−1 PEE, EAE, or EthE, or various reference drugs. Changes in rectal temperature, and plasma C-reactive protein levels were also measured after injecting, intraperitoneally, 0.1 mgkg−1 Lipopolysaccharide (Escherichia coli) to induce pyrexia.PEE, EAE, and EthE reduced significantly (P ≤ 0.01–0.001; maximum inhibition at 100 mgkg−1 (imax) = 55.0–76.7%) paw oedema induced by carrageenan; comparable to diclofenac (P ≤ 0.0001; imax = 93.1%). PEE, EAE and chlorpheniramine prevented significantly (P ≤ 0.0001; imax = 115–144%) or reduced significantly (P ≤ 0.0001; imax = 80–85%) histamine-induced paw oedema. PEE, EAE and ondansetron significantly decreased (curative: P ≤ 0.01–0.001, imax = 51–82%; prophylactic: P ≤ 0.01–0.001, imax = 56–77%) serotonin-induced inflammation. In prostaglandin E2 –induced inflammation PEE and EAE significantly reduced (curative: P ≤ 0.05–0.01, imax = 60–70%; prophylactic: P ≤ 0.0001, imax = 86–332%) oedema; PEE and EAE also significantly decreased (curative: P ≤ 0.050–0001, imax = 46–98%; prophylactic: P ≤ 0.01–0.001 imax = 62–78%) in bradykinin-induced inflammation. PEE, EAE, Diclofenac and Dexamethasone significantly reduced (P ≤ 0.05–0.001) plasma C-reactive protein levels. PEE, EthE, EAE and Aspirin significantly reduced (P ≤ 0.05–0.001) febrile response.Trichilia monadelpha stem bark extracts had anti-inflammatory and anti-pyretic properties and significantly reduced C-reactive proteins associated with carrageenan-induced inflammation.

SARS-CoV-2 RNA elements share human sequence identity and upregulate hyaluronan via NamiRNA-enhancer network.

SummaryBackgroundSince late 2019, SARS-CoV-2 infection has resulted in COVID-19 accompanied by diverse clinical manifestations. However, the underlying mechanism of how SARS-CoV-2 interacts with host and develops multiple symptoms is largely unexplored.MethodsBioinformatics analysis determined the sequence similarity between SARS-CoV-2 and human genomes. Diverse fragments of SARS-CoV-2 genome containing Human Identical Sequences (HIS) were cloned into the lentiviral vector. HEK293T, MRC5 and HUVEC were infected with laboratory-packaged lentivirus or transfected with plasmids or antagomirs for HIS. Quantitative RT-PCR and chromatin immunoprecipitation assay detected gene expression and H3K27ac enrichment, respectively. UV-Vis spectroscopy assessed the interaction between HIS and their target locus. Enzyme-linked immunosorbent assay evaluated the hyaluronan (HA) levels of culture supernatant and plasma of COVID-19 patients.FindingsFive short sequences (24–27 nt length) sharing identity between SARS-CoV-2 and human genome were identified. These RNA elements were highly conserved in primates. The genomic fragments containing HIS were predicted to form hairpin structures in silico similar to miRNA precursors. HIS may function through direct genomic interaction leading to activation of host enhancers, and upregulation of adjacent and distant genes, including cytokine genes and hyaluronan synthase 2 (HAS2). HIS antagomirs and Cas13d-mediated HIS degradation reduced HAS2 expression. Severe COVID-19 patients displayed decreased lymphocytes and elevated D-dimer, and C-reactive proteins, as well as increased plasma hyaluronan. Hymecromone inhibited hyaluronan production in vitro, and thus could be further investigated as a therapeutic option for preventing severe outcome in COVID-19 patients.InterpretationHIS of SARS-CoV-2 could promote COVID-19 progression by upregulating hyaluronan, providing novel targets for treatment.FundingThe National Key R&D Program of China (2018YFC1005004), Major Special Projects of Basic Research of Shanghai Science and Technology Commission (18JC1411101), and the National Natural Science Foundation of China (31872814, 32000505).

The Salutary Effects of Catalpol on Diesel Exhaust Particles-Induced Thrombogenic Changes and Cardiac Oxidative Stress, Inflammation and Apoptosis.

Inhaled particulate air pollution exerts pulmonary inflammation and cardiovascular toxicity through secondary systemic effects due to oxidative stress and inflammation. Catalpol, an iridiod glucoside, extracted from the roots of Rehmannia glutinosa Libosch, has been reported to possess anti-inflammatory and antioxidant properties. Yet, the potential ameliorative effects of catalpol on particulate air pollution—induced cardiovascular toxicity, has not been studied so far. Hence, we evaluated the possible mitigating mechanism of catalpol (5 mg/kg) which was administered to mice by intraperitoneal injection one hour before the intratracheal (i.t.) administration of a relevant type of pollutant particle, viz. diesel exhaust particles (DEPs, 30 µg/mouse). Twenty-four hours after the lung deposition of DEPs, several cardiovascular endpoints were evaluated. DEPs caused a significant shortening of the thrombotic occlusion time in pial microvessels in vivo, induced platelet aggregation in vitro, and reduced the prothrombin time and the activated partial thromboplastin time. All these actions were effectively mitigated by catalpol pretreatment. Likewise, catalpol inhibited the increase of the plasma concentration of C-reactive proteins, fibrinogen, plasminogen activator inhibitor-1 and P- and E-selectins, induced by DEPs. Moreover, in heart tissue, catalpol inhibited the increase of markers of oxidative (lipid peroxidation and superoxide dismutase) and nitrosative (nitric oxide) stress, and inflammation (tumor necrosis factor α, interleukin (IL)-6 and IL-1β) triggered by lung exposure to DEPs. Exposure to DEPs also caused heart DNA damage and increased the levels of cytochrome C and cleaved caspase, and these effects were significantly diminished by the catalpol pretreatment. Moreover, catalpol significantly reduced the DEPs-induced increase of the nuclear factor κB (NFκB) in the heart. In conclusion, catalpol significantly ameliorated DEPs–induced procoagulant events and heart oxidative and nitrosative stress, inflammation, DNA damage and apoptosis, at least partly, through the inhibition of NFκB activation.

The Benefits of Mindfulness Meditation on Trait Mindfulness, Perceived Stress, Cortisol, and C-Reactive Protein in Nursing Students: A Randomized Controlled Trial.

PurposeMindfulness meditation was used to reduce stress and its responses such as cortisol and C-reactive protein (CRP) among healthy and ill individuals in various cultures, but its effect has not yet been studied among nursing students, experiencing tremendous stress. The objective of this study was to examine the effects of mindfulness meditation on trait mindfulness, perceived stress, serum cortisol, and serum C-reactive proteins (CRP) in nursing students.Patients and MethodsUsing a two-arm, randomized, parallel study (conducted in a large university in Jordan, 108 nursing students were randomly assigned to experimental group receiving five 30-minute weekly sessions of mindfulness meditation and control group sitting quiet during the experimental sessions. Trait mindfulness, perceived stress, serum cortisol, and CRP were measured at baseline and end of the intervention.ResultsUsing one-way MANOVA and post-hoc comparisons, the results showed that mindfulness meditation was significantly effective in decreasing serum cortisol levels and perceived stress. The mindfulness meditation also decreased CRP and increased trait mindfulness although the results did not reach statistically significant levels.ConclusionThese findings underscore the need for serious consideration of mindfulness meditation in nursing colleges to improve stress and raise immunity in this vulnerable population.Trial RegistrationMindfulness Meditation for Nursing Students: clinicaltrials.gov, identifier: NCT05099224.

Triglyceride/High-Density Lipoprotein Cholesterol Ratio is Associated with the Mortality of COVID-19: A Retrospective Study in China.

BackgroundTriglyceride to high density lipoprotein cholesterol ratio (TG/HDL-c) is crucial when researching metabolic and vascular diseases, and its involvement in COVID-19 was sparsely elaborated on. The purpose of the study was to explore the inflammatory associations between the TG/HDL-c ratio and COVID-19 prognosis.MethodsA total of 262 COVID-19 patients consisting of 244 survivors and 18 non-survivors were retrospectively investigated. The clinical features and baseline hematological parameters were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to explore the role of TG/HDL-c in predicting the mortality of COVID-19, the Spearman’s rank correlation coefficients were used to measure the correlation between TG/HDL-c and inflammatory indicators, and the Kaplan–Meier (KM) curve was used to estimate the survival of COVID-19 patients with high and low TG/HDL-c ratio. Logistic regression analyses were performed to investigate the role of TG/HDL-c ratio on mortality of COVID-19 with no underlying diseases.ResultsCompared with the survivors, the non-survivors of COVID-19 had significantly higher levels of white blood cells (4.7 vs 13.0 × 109/L; P < 0.001), neutrophils (3.0 vs 11.6 × 109/L; P < 0.001), C-reactive proteins (15.7 vs 76.7 mg/L; P < 0.001) and TG/HDL-c ratio (1.4 vs 2.5; P = 0.001). The ROC curve [area under the curve (AUC), 0.731; 95% confidence interval (CI), 0.609–0.853; P = 0.001] suggested that the TG/HDL-c ratio could predict the mortality of COVID-19. The TG/HDL-c ratio was positively correlated with white blood cells (r = 0.255, P < 0.001), neutrophils (r = 0.243, P < 0.001) and C-reactive proteins (r = 0.170, P < 0.006). Patients with high TG/HDL-c ratio showed a worse survival compared with those with low TG/HDL-c ratio (Log rank P = 0.003). Moreover, TG/HDL-c ratio was an independent factor in predicting the mortality of COVID-19 patients with no underlying diseases.ConclusionOur study demonstrated that TG/HDL-c ratio might potentially be a predictive marker for mortality in COVID-19 patients.

Biomimetic -mineralized multifunctional nanoflowers for anodic-stripping voltammetric immunoassay of rehabilitation-related proteins.

C-reactive proteins (CRPs; an acute-phase protein) in patients with initial acute cerebral infarction neurological rehabilitation prediction have a significant correlation. In this work, a simple and sensitive anodic-stripping voltammetric (ASV) immunosensing system was innovatively designed for the quantitative screening of target CRPs using biomimetic-mineralized bifunctional antibody-Cu3(PO4)2 nanoflowers as molecular tags. In this system, a monoclonal anti-CRP antibody-anchored microtiter plate was utilized to specifically capture target CRPs from the sample. For detection, a sandwiched immunoreaction mode was employed with the antibody-Cu3(PO4)2 nanoflowers in the presence of analytes. Subsequent ASV measurement of copper ions (Cu2+) released under acidic conditions from the bifunctional nanoflowers was conducted at an in situ prepared mercury film electrode. The introduction of hybrid nanoflowers greatly increased the loading amount of copper ions on the molecular tag, thereby amplifying the detectable signal of electrochemical immunoassay. Meanwhile, factors influencing the analytical properties of the electrochemical immunoassay were investigated in detail. By combining the high-efficiency nanohybrids with signal amplification, the dynamic concentration range of electrochemical immunoassay spanned from 0.01 ng mL-1 to 100 ng mL-1 toward the target CRP. The limit of detection was calculated to be 0.0079 ng mL-1 at 3Sblank criterion. Intra- and interassay imprecisions (relative standard deviations: RSDs) were less than or equal to 6.72%. Good anti-interference ability, long-term storage stability, and acceptable accuracy for the evaluation of human serum specimens were observed during a series of procedures to determine the target protein. In addition, the bifunctional nanoflower-based immunosensing system offers promise for the simple, cost-effective analysis of disease-related proteins.

Serum ferritin levels are associated with frequent consumption of iron- and ascorbate-rich foods among women of childbearing age in Nandi County, Kenya.

Information on consumption patterns of iron- and ascorbate-rich foods and their influence on iron status among women of childbearing age (WCA) is scarce in Kenya despite iron deficiency being rampant. The present study investigated consumption patterns of iron- and ascorbate-rich foods on iron status among WCA in Kapsabet Ward, Kenya. The study adopted a cross-sectional analytical design. A sample of 160 respondents was systematically selected proportionately in the eight villages. Consumption patterns of iron- and ascorbate-rich foods were assessed using a modified 7-d Food Frequency Questionnaire. Venous blood (2 ml) was drawn from participants. Serum ferritin and C-reactive proteins were measured by enzyme immunoassay. Consumption patterns of iron- and ascorbate-rich foods were analysed using descriptive statistics. Multivariable regression was conducted to investigate the association between iron- and ascorbate-rich foods consumption and iron status. Confounding variables such as consumption of foods high phytate levels, milk and milk products, recent major blood losses and parasitic infections were controlled for during analysis. The prevalence of iron deficiency among the WCA was 45⋅0 %. Iron-rich foods were rarely (<2 times/week) consumed by the respondents with the majority reporting infrequent consumption: meat (61⋅3 %), sardines (61⋅9 %), oranges (54⋅4 %) and fortified breakfast cereals (94⋅4 %), except for kale and beans. Iron- (iron-fortified porridge, meat, sardines, beans, amaranth and spider plants) and ascorbate- (oranges and mangoes) rich foods positively predicted (AOR = 4⋅851, P = 0⋅021) the normal iron status of WCA. WCA should consume above 2 intakes per week of each iron- and ascorbate-rich food for better iron status outcomes.

Associations of circulating C-reactive proteins, APOE ε4, and brain markers for Alzheimer’s disease in healthy samples across the lifespan

The apolipoprotein E gene ε4 allele (APOE ε4) and higher circulating level of C-reactive protein (CRP) have been extensively investigated as risk factors for Alzheimer’s disease (AD). Paradoxically, APOE ε4 has been associated with lower levels of blood CRP in middle-aged and older populations. However, few studies have investigated this intriguing relation and its impact on neurological markers for AD in younger ages, nor across the whole lifespan. Here, we examine associations of blood CRP levels, APOE ε4, and biomarkers for AD in a cognitively healthy lifespan cohort (N up to 749; 20–81 years of age) and replicate the findings in UK Biobank (N = 304 322; 37–72 years of age), the developmental ABCD study (N = 10 283; 9–11 years of age), and a middle-aged sample (N = 339; 40–65 years of age). Hippocampal volume, brain amyloid-β (Aβ) plaque levels, cerebrospinal fluid (CSF) levels of Aβ and tau species, and neurofilament protein light protein (NFL) were used as AD biomarkers in subsamples. In addition, we examined the genetic contribution to the variation of CRP levels over different CRP ranges using polygenic scores for CRP (PGS-CRP). Our results show APOE ε4 consistently associates with low blood CRP levels across all age groups (p < 0.05). Strikingly, both ε4 and PGS-CRP associated mainly with blood CRP levels within the low range (<5mg/L). We then show both APOE ε4 and high CRP levels associate with smaller hippocampus volumes across the lifespan (p < 0.025). APOE ε4 was associated with high Aβ plaque levels in the brain (FDR-corrected p = 8.69x10-4), low levels of CSF Aβ42 (FDR-corrected p = 6.9x10-2), and lower ratios of Aβ42 to Aβ40 (FDR-corrected p = 5.08x10-5). Blood CRP levels were weakly correlated with higher ratio of CSF Aβ42 to Aβ40 (p = 0.03, FDR-corrected p = 0.4). APOE ε4 did not correlate with blood concentrations of another 9 inflammatory cytokines, and none of these cytokines correlated with AD biomarkers. ConclusionThe inverse correlation between APOEε 4 and blood CRP levels existed before any pathological AD biomarker was observed, and only in the low CRP level range. Thus, we suggest to investigate whether APOEε 4 can confer risk by being associated with a lower inflammatory response to daily exposures, possibly leading to greater accumulation of low-grade inflammatory stress throughout life. A lifespan perspective is needed to understand this relationship concerning risk of developing AD.

Covid-19: An Update on Clinical Features, Diagnosis, and Treatment Strategies

: The coronavirus disease 2019 (COVID-2019) has emerged as a new public health crisis, with the WHO officially declaring it as a pandemic on 30 January 2020. In December 2019, the virus was reported to be transmitted to humans through an unknown intermediary animal in Wuhan, Hubei province, China. As of 18 May 2020, there were 4,730,968 reported cases of Covid-19, with 315,488 deaths. Direct contact among individuals is the most common transmission method, primarily through droplets released during coughing or sneezing. The incubation period of the virus oscillates between 2 to 14 days. The commonly reported symptoms include fatigue, sore throat, cough, and fever. Most of the people are asymptomatic or show mild symptoms. The elderly and people with comorbidities show severe symptoms. The disease is diagnosed by using the real- time reverse transcription-polymerase chain reaction (RT-PCR) testing method. A blood test is also used to detect the antibodies to the virus, which are usually released after infection. The typical laboratory findings indicate elevated C-reactive proteins (CRP) with normal or low white blood cell counts; the chest CT scan demonstrates ground-glass opacities (GGO) and bilateral pneumonia in most patients. Supportive treatment is available, and research on the right treatment using existing drugs is ongoing. Several pharmaceutical companies and research institutions are focusing on the development of a vaccine. The review summarizes and provides an update on the pathogenesis, diagnosis, and treatment strategies in the management of Covid-19.

High-Sensitivity C-Reactive Protein to HDL-C Ratio.

Inflammation and lipid signaling are involved in the pathogenesis and progression of coronary artery disease (CAD). We proposed that high-sensitivity C-reactive proteins, as a marker of the pro-inflammatory state, and high-density lipoprotein cholesterol (HDL-C), as an anti-atherosclerosis component, should be integrated into a single novel biomarker. Our work was conducted to discuss and compare the predictive ability of the high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) with other existing indices, for example, neutrophil high-density lipoprotein ratio (NHR) and neutrophil lymphocyte ratio (NLR), in the severity of CAD patients.Based on the results of coronary angiography, patients were divided into the CAD+ group, CAD- group, and control group. The relationship between various serum markers and the severity of coronary artery disease was examined via Spearman's correlation analysis. Logistic regression analysis was conducted to identify the influencing factors of the coronary artery disease severity.This study included 420 patients. The Gensini score was positively correlated with CHR. Multiple regression analysis revealed that the CHR was significantly associated with CAD. CHR is an independent predictor of CAD. The receiver operating characteristic (ROC) analysis provided a cut-off value of 1.17 for CHR to predict CAD, with a specificity of 86.7%, Yoden index of 0.264, and area under the ROC curve of 0.662 (95% confidence intervals 0.606-0.719, P < 0.001). At the same time, the area under the ROC curve of the NHR was 0.652, and that of the NLR was 0.579. The results of the DeLong test indicated that the area under the ROC curve of the CHR was larger than that of the NLR (P = 0.0306). This suggests that the CHR as a predictor of CAD has better diagnostic performance than the NLR.CHR was not only closely related to the presence and severity of CAD but also an independent predictor of severe CAD.

Sixteen cases of severe pneumonia caused by Chlamydia psittaci in South China investigated via metagenomic next-generation sequencing.

Introduction. Chlamydia psittaci is an important cause of community-acquired pneumonia (CAP). The spectrum of CAP due to Chlamydia psittaci ranges from mild, self-limited to acute respiratory failure and the early identification of this disease can be challenging. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to improve the pathogen identification in severe CAP.Hypothesis/Gap Statement. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to rapidly identify pathogens in severe CAP. The early identification and appropriate use of antibiotics can improve the prognosis of severe CAP caused by Chlamydia psittaci.Aim. The aim of the study is to describe the clinical spectrum of severe psittacosis pneumonia to provide a better understanding of this disease and to demonstrate that mNGS is an effective method for pathogen detection.Methodology. Retrospective case analysis from November 2019 to November 2020 was performed. Sixteen cases of severe psittacosis pneumonia were diagnosed through mNGS. Clinical features, laboratory findings, imaging features, treatment and outcome were summarized.Results. Frequent symptoms included fever (16/16, 100%), dyspnoea (16/16, 100%), cough (12/16, 75%), sputum (11/16, 69%) and headache (9/16, 56%). The median leukocytosis was within the normal range, while C-reactive proteins, CK, LDH, AST, D-Dimer were significantly elevated. The feature of computed tomography included ground-glass opacity with consolidation and multiple lobar distributions. The total number of sequences of Chlamydia psittaci identified from bronchoalveolar lavage by mNGS varied from 58 to 57115. Five patients underwent noninvasive mechanical ventilation, four patients underwent high flow humidified oxygen therapy and one patient underwent invasive mechanical ventilation. Two patients had septic shock needing vasoactive medications. All of the sixteen patients experienced full recoveries.Conclusion. The symptoms of severe CAP caused by Chlamydia psittaci were not typical while laboratory results may have some clues. The mNGS technology can early detect of psittacosis, reduce unnecessary use of antibiotics and short the course of the disease.

Exploring Machine Learning Techniques to Predict the Response to Omalizumab in Chronic Spontaneous Urticaria.

Background: Omalizumab is the best treatment for patients with chronic spontaneous urticaria (CSU). Machine learning (ML) approaches can be used to predict response to therapy and the effectiveness of a treatment. No studies are available on the use of ML techniques to predict the response to Omalizumab in CSU. Methods: Data from 132 CSU outpatients were analyzed. Urticaria Activity Score over 7 days (UAS7) and treatment efficacy were assessed. Clinical and demographic characteristics were used for training and validating ML models to predict the response to treatment. Two methodologies were used to label the data based on the response to treatment (UAS7 ≥ 6): (A) at 1, 3 and 5 months; (B) classifying the patients as early responders (ER), late responders (LR) or non-responders (NR) (ER: UAS 7 ≥ 6 at first month, LR: UAS 7 ≥ 6 at third month, NR: if none of the previous conditions occurred). Results: ER were predominantly characterized by hypertension, while LR mainly suffered from asthma and hypothyroidism. A slight positive correlation (R2 = 0.21) was found between total IgE levels and UAS7 at 1 month. Variable Importance Analysis (VIA) reported D-dimer and C-reactive proteins as the key blood tests for the performance of learning techniques. Using methodology (A), SVM (specificity of 0.81) and k-NN (sensitivity of 0.8) are the best models to predict LR at the third month. Conclusion: k-NN plus the SVM model could be used to identify the response to treatment. D-dimer and C-reactive proteins have greater predictive power in training ML models.