Differences In Interleukin-6 Levels Research Articles

العلاقة بين إنترلوكين-6 والعمر في كوفيد-19: رؤى من تحليل مقطعي في مالانج، إندونيسيا

تم تحديد إنترلوكين 6 (IL-6) باعتباره مؤشرًا لشدة ووفيات فيروس كورونا (COVID-19). على الرغم من أن معدلات الإصابة بالمرض والوفيات تزيد بشكل عام مع تقدم العمر، إلا أنه لا يزال من غير المؤكد ما إذا كان هناك ارتباط بين العمر ومستويات IL-6، مما يؤدي إلى تفاقم شدة كوفيد-19 لدى المرضى. كان الهدف من هذه الدراسة هو فحص العلاقة بين العمر ومستويات IL-6 لدى مرضى كوفيد-19. كانت الدراسة عبارة عن تحليل مقطعي للسجلات المخبرية والطبية لـ 3171 مريضًا من مرضى كوفيد-19 الذين تلقوا العلاج في عام 2021 في مستشفى سيف الأنور العام. تم تحليل البيانات باستخدام اختبار كروسكال واليس، واختبار دونيت بوست هوك، واختبار ارتباط سبيرمان. تم تقسيم المرضى إلى أربع فئات عمرية: أقل من 20 عامًا (1.29%)، و20-40 عامًا (18.10%)، و40-60 عامًا (43.74%)، و>60 عامًا (36.87%). وكان متوسط مستويات IL-6 في كل مجموعة هو 39.44، 192.04، 217.27، و252.59 بيكوغرام/مل. ولوحظ وجود اختلاف كبير (قيمة p = 0.000) في مستويات IL-6 بين الفئة العمرية أقل من 20 عامًا والمجموعات الأخرى. علاوة على ذلك، تم تحديد ارتباط إيجابي كبير (قيمة p = 0.000) بين الفئة العمرية ومستويات إنترلوكين-6 لدى مرضى كوفيد-19، مما يشير إلى ارتفاع مستويات إنترلوكين-6 لدى المرضى الأكبر سنا. في الختام، كانت هناك اختلافات في مستويات إنترلوكين-6 على أساس الفئات العمرية، وكان العمر مرتبطًا بشكل إيجابي بمستويات إنترلوكين-6 لدى مرضى كوفيد-19.

EFFECTIVENESS OF CENTELLA ASIATICA EXTRACT ON IL-6 AS BIOLOGICAL MARKER OF POST OPERATIVE WOUND HEALING IN PERIORBITAL REGION

Abstract
 Introduction & Objectives : Centella asiatica (CA) is considered as major herbal plant that beneficial on wound healing process. Wound healing process will stimulate inflammatory cells to release growth factors and cytokines, e.g., interleukin-6 (IL-6). This aim of this study is to determine the effectiveness of CA on IL-6 levels as a biological marker of postoperative wound healing in the periorbital region.
 Methods : A double-blind, randomized controlled study on the first day of postoperative periorbital patients was conducted at the Mohammad Hoesin Hospital in Palembang from March to June 2022. There were 30 patients who met inclusion criteria. The effectiveness of CA and placebo were analyzed using Wilcoxon test, while comparisons of the effectiveness were analyzed using Mann-Whitney test (SPSS ver. 22.0).
 Results : No difference in age, sex, and IL-6 levels before treatment between the CA and placebo groups (p>.05). There was a decrease in IL-6 levels before and after CA administration (p=.005). There was an increase in IL-6 levels before and after giving placebo (p=.031). There was a difference in IL-6 levels between the CA and placebo groups (p=.004) after the intervention.
 Conclusion : There is a difference in IL-6 levels after administration of systemic centella asiatica on periorbital postoperative wound healing in the first week.

THE RELATIONSHIP OF INTERLEUKIN-6 LEVELS AND THE DEGREE OF MYOPIA IN YOUNG ADULTS IN NORTH SUMATRA UNIVERSITY HOSPITAL

Background.
 Myopia is one of the refractive errors where parallel light from infinity is focused in front of the retina without accommodation. Various cytokines have been implicated in the development of myopia, including interleukin-6 (IL6) and matrix metalloproteinase-2 (MMP-2). IL-6 is one of the pro-inflammatory cytokines that play a role in ocular disease pathology. Chronic subclinical inflammation may play a role in elongation of the eyeball, inflammation promotes the breakdown of the scleral extracellular matrix and results in axial elongation.
 Objective.
 To determine the relationship of interleukin-6 levels and the degree of myopia in young adults in North Sumatra University Hospital.
 Methods.
 This research is an analytic observational study with a case control design, held from February 2022. Primary and secondary data are collected from interviews and direct observation. Bivariate analysis of differences in interleukin-6 levels in myopia and emmetropia uses T-independent test, if the data are normally distributed. If the data are not normally distributed, then the Mann Whitney test is used. Bivariate analysis to analyze differences in interleukin-6 levels based on the degree of myopia uses the Kruskal Wallis test, followed by a post hoc test using the Mann Whitney test and t-independent.
 Results.
 A total sample consists of 30 patients who suffer from myopia and 30 control samples. The mean age in the myopia group was 28.87 years with the youngest age being 25 years and oldest age 34 years. Most of them are moderate myopia with 15 people (50%). There was no significant difference in interleukin-6 levels between myopia and control groups (p = 0.147). There was a difference in the mean level of interleukin-6 based on the degree of myopia (p = 0.005).
 Conclusions.
 There is an association between interleukin-6 levels and the degree of myopia in young adult patients. No differences in interleukin-6 levels were found significant between myopia and control groups.

Interleukin 6 Levels and Disease Activity in Takayasu Arteritis: A Systematic Review With Meta-analysis.

Various studies have suggested interleukin 6 (IL-6) as a potential biomarker for detecting disease activity in Takayasu arteritis. A systematic review and meta-analysis was performed to assess differences in IL-6 levels in patients with active (aTA) and inactive Takayasu arteritis (iTA), as well as healthy controls (HCs), using validated activity scores. Study quality and the risk of bias were assessed using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and the Newcastle-Ottawa and Joanna Briggs checklist, respectively. For the meta-analysis, we pooled the raw mean IL-6 levels in each group and then estimated and pooled the crude mean differences between the groups. We applied a random-effects model in all analyses. Of the 93 eligible articles, 10 were included after removing duplicates and studies that met the exclusion criteria. Overall, 1825 patients with a mean age ranging from 24 to 40.6 years were included. The pooled levels of IL-6 increased depending on disease activity as follows: HCs: 3.08 (95% confidence interval [CI], 0.88-5.28), iTA: 7.21 (3.61-10.82), and aTA: 22.67 (12.44-32.91) pg/mL. Patients with aTA had higher IL-6 levels than HCs (21.52 [95% CI, -0.43 to 43.47]) and those with iTA (16.69 [95% CI, 5.32-28.06]), whereas IL-6 levels were not different between HCs and patients with iTA (3.62 [95% CI, -13.18 to 20.42]). Interleukin 6 levels are significantly increased in patients with aTA compared with those with iTA and HCs but not in patients with iTA compared with HCs. More studies are needed to establish the IL-6 cutoff value for assessing disease activity.

Differences in IL-6 Levels Based on Clinical Severity and Outcome of COVID-19 Patients at Dr. M. Djamil Hospital

ground: A cytokine storm is defined by elevated levels of proinflammatory cytokines such as interleukin-6 (IL-6). In COVID-19 infection, IL-6 is superior to C-reactive protein (CRP) and other inflammatory markers in predicting respiratory failure. The IL-6 is the main cytokine triggered by T cells when a cytokine storm occurs. IL-6 is the most important driver of immune dysregulation and ARDS in COVID-19 infection. The purpose of this study is to assess differences of IL-6 levels based on clinical severity and outcomes in COVID-19 patients at Dr. M. Djamil Hospital. Method: The study took place at Dr. M. Djamil Hospital from November 2021 to November 2022. This is a retrospective cohort study in which patients were tested for IL-6 levels between January 1st, 2021 and December 31, 2021. The distribution of the frequency and proportion of each variable is included in univariate analysis; bivariate analysis determines the correlation between the independent variables (clinical severity, length of stay, and final status of hospitalization) and the dependent variable (IL-6 levels in COVID-19 patients). Results: Patients' characteristics in this study, the majority of patients aged 18-49 years. Women and patients with moderate disease were more common. The majority of patients were treated for less than 14 days, and the final status of hospitalization the patients showed that most of the patients recovered. IL-6 levels with median (min-max) was 32.00 (1.50-589.00). The IL-6 levels were higher in clinically critical COVID-19 patients (77.20 mg/L), in patients with a shorter length of stay (14 days) (36.00 mg/L), and at final status of hospitalization were death (58.90 mg/L). Conclusion: There were differences of IL-6 level based on clinical severity and final hospitalization status of COVID-19 patients, but not from the length of stay in COVID-19 patients at Dr. M. Djamil Hospital.

Sex differences in the association of treatment-resistant schizophrenia and serum interleukin-6 levels

BackgroundLow-grade inflammation and altered inflammatory markers have been observed in treatment-resistant schizophrenia (TRS). Interleukin-6 (IL-6) is one of the pro-inflammatory cytokines linked with TRS and receives increasing attention. Previous studies showed that patients with TRS might have higher IL-6 levels compared with healthy individuals and treatment-responsive patients. Besides, emerging evidence has suggested that there are sex differences in the associations between IL-6 levels and various illnesses, including chronic hepatitis C, metabolic syndrome, etc.; however, there is limited study on TRS. In this present study, we aimed to compare the serum IL-6 levels of TRS and partially responsive schizophrenia (PRS) and explore potential sex differences in the association of TRS and IL-6 levels.MethodsThe study population consisted of a total of 90 patients with schizophrenia: 64 TRS patients (45.3% males and 54.7% females) and 26 PRS patients (46.2% males and 53.8% females). We measured serum IL-6 levels using enzyme-linked immunosorbent assay (ELISA) and analyzed them separately by gender, controlling for confounders (age, education, medication, body mass index, and PANSS scores) rigorously.ResultThe results showed that patients with TRS had higher serum IL-6 levels than patients with PRS (p = 0.002). In females, IL-6 levels increased significantly in the TRS group compared with the PRS group (p = 0.005). And a positive correlation tendency was observed between IL-6 levels and PANSS general sub-scores (r = 0.31, p = 0.039), although this correlation was not significant after correcting for multiple comparisons. Whereas, there were no differences in IL-6 levels between the TRS and PRS (p = 0.124) in males.ConclusionOur findings provided evidence supporting the hypothesis that the inflammatory response system (IRS) may play a role in the pathogenesis of TRS in a sex-dependent manner. In addition, sex differences in the immune dysfunction of individuals with schizophrenia cannot be neglected, and inflammation in male and female TRS should be discussed separately.

Comparative Study of Interleukin- 6 (Il-6) and Tumour Necrosis Factor Alpha (Tnf-Α) Levels in Prostate Cancer and Benign Prostatic Hyperplasia Subjects

Prostate cancer (PC) is an age-related malignancy that is very common in adult males with a very high morbidity and mortality rate worldwide. Chronic inflammation is thought to play a role in carcinogenesis. Pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tissue necrosis factor-α(TNF-α), have been implicated in the pathogenesis of prostate cancer (PC). Its diagnosis remains a challenge even with a combination of methods. Serum prostate specific antigen (Serum-PSA) is the universally accepted biomarker for PC detection. However, it is neither specific nor confirmatory. The aim of this study was to compare IL-6 and TNF-α levels in PC and benign prostatic hyperplasia (BPH) subjects. This cross-sectional, descriptive, non-random study involved 60 histologically diagnosed PC and 20 BPH subjects attending the Urology Clinic of the University of Port Harcourt Teaching Hospital (UPTH). The Enzyme Linked Immunosorbent Assay (ELISA) technique was used to assay the cytokines (IL-6 and TNF-α). From this study the peak incidence of PC and BPH subjects was observed at 60-69 years with a mean age of 68.31± 7.72 years and 66.5 ± 10.6 years respectively. The observed difference in IL-6 level in the PC and BPH subjects was not statistically significant (P = .6696). However, the mean serum TNF-α level (29.6 ± 3.2pg/ml) was significantly higher in PC subjects when compared to BPH subject levels (25.3 ± 4.7pg/ml) for TNF α. This study has shown that PC subjects have higher level TNF-α and as such it can serve as a differential marker for PC.

Evaluation of Interleukin 6 Levels in Severe COVID-19 Patients

Objectives: Interleukin 6 (IL-6) plays a leading role in the proliferation and differentiation of immune cells. Level of IL-6 is manifestly increased under many inflammatory conditions, including cytokine release syndrome. We evaluated the IL-6 levels of patients who were hospitalized with the diagnosis of COVID-19.
 Methods: In the study, the test results of 19 cases whose IL-6 levels were measured between March 11, 2020 and May 31, 2020 retrospectively. The inpatients in the covid service (Group 1) and the patients admitted to the Intensive Care Unit (ICU) of our hospital (Group 2) were compared and evaluated. In addition, patients with positive and negative RT-PCR test results were checked for IL-6.
 Results: While 8 (Group 1) of 19 patients observed in the clinic were transferred to the ICU, 11 patients (Group 2) were observed in the covid service until their discharge. Group 1 IL-6 levels (median 34 pg/mL) and Group 2 IL-6 levels (median 116 pg/mL) were found to be high in both groups (p = 0,099). However, it was found to be significantly higher in patients with positive COVID-19 RT-PCR test (median 90.60 pg/mL) than in negative patients (median 29.90 pg/mL) (p = 0.018).
 Conclusion: No significant difference in IL-6 levels between the patients who were monitored in the clinic and transferred to the ICU was found in this study. The significant difference between IL-6 levels among COVID-19 RT-PCR positive and negative patients reveals the importance of IL-6 level with regard to tocilizumab treatment in COVID-19 patients in cytokine storm.
 Keywords: COVID-19, Interleukin 6, Cytokine Storm, Macrophage Activation Syndrome

Association Between Interleukin-6 Levels and Lymph Node Metastasis in Bladder Cancer Patients.

Bladder cancer (BC) is one of the urological cancers with high prevalence, mortality, morbidity, and expenditure rates. Urothelial malignancies account for about 90% cases of BC, with squamous and adenocarcinomas making up the remaining 10%. Lymph node metastasis (LNM), the most common type of BC metastasis, is generally found in the pelvic lymph nodes. LNM significantly affects the chances of survival and prognosis for patients with BC. It is feasible to stratify and assess the malignancy of the tumor and its response to therapies using potential tumor markers. Interleukin-6 (IL-6) has been observed to be a predictor of metastasis in lymph nodes in BC. The aim of this study was to evaluate the relationship between IL-6 levels and lymph node metastases in BC patients. Thirty-two BC patients between August 2021 and January 2022 were admitted to this study. Data on patient characteristics, clinical data, TNM staging, and IL-6 levels were collected. Univariate analysis was used in the characteristics of the patients. The total subjects were 32 with 15 results in LNM. The difference in IL-6 levels between the LNM (+) group and the LNM (-) was statistically significant by Fisher's exact test (P = 0.041) and Mann-Whitney U tests (P = 0.003). The BC patients who had lymph node metastases also had higher serum levels of IL-6.

Translating the observed differences in interleukin-6 levels between some antiretroviral regimens into potential long-term risk of serious non-AIDS events: A modeling study.

Variable levels of systemic inflammation are observed in people with HIV (PWH), but the clinical significance of differences among antiretroviral therapy (ART) regimens on associated levels of inflammatory markers is unclear. Based on data from previous epidemiologic studies that defined the predicted change in risk of serious non-AIDS events (SNAEs)/death by changes in interleukin-6 (IL-6) and D-dimer, we modeled the effects of differences in these markers between specific ART regimens on the long-term risk of clinical outcomes. We used a Markov model to compare the risk of SNAEs/death with differences in IL-6 and D-dimer levels associated with remaining on specific three-drug regimens versus switching to specific two-drug ART regimens over 5 years of treatment. We used IL-6 and D-dimer data based on trajectories over time from the randomized TANGO and observational AIR studies. Age at model entry was set at 39 years. The primary endpoint was the number needed to treat for one additional SNAE/death. Over 144 weeks, PWH on one of the three-drug regimens studied were predicted to spend 22% more time in the low IL-6 quartile and 13% less time in the high IL-6 quartile compared with those on one of the two-drug regimens. Over 144 weeks, the predicted mean number of SNAEs/deaths per 100 PWH was 5.6 for a three-drug regimen associated with lower IL-6 levels versus 6.8 for a two-drug regimen associated with higher IL-6 levels. The number needed to treat for one additional SNAE/death among PWH receiving a two-drug versus three-drug regimen for 240 weeks was 43. Approximately 2,900 participants would be required for a 240-week clinical study to evaluate the accuracy of the model. Our Markov model suggests that higher IL-6 levels associated with switching from specific three- to two- drug ART regimens may be associated with an increase in the risk of SNAEs/death. Clinical studies are warranted to confirm or refute these results.

Inflammatory Response in Patients With Crohn's Disease Compared With Ulcerative Colitis: Secondary Results of a Prospective Pilot Study.

The aim of this study was to compare the inflammatory response (IR) to surgery between patients with Crohn's disease (CD) and patients with ulcerative colitis (UC). This study is a secondary analysis of data collected in a previous study by the authors. We included all adult patients who underwent elective surgery for CD and UC. The primary outcome variable was the difference in postoperative IR as measured by interleukin 6 (IL-6), interleukin 10 (IL-10), C-reactive protein (CRP), and the count of white blood cells (WBCs) in peripheral blood. Two-way repeated-measures analysis of variance with a mixed effect (disease type as the between-patient factor, and time as the within patient factor). We included 46 patients in this pilot study. Median age was 42.5 years (IQR 30.5-42.2), 25/46 were females (54.3%). Patients with CD had a more marked IR to surgery compared with those with UC as shown by significant differences in levels of IL-6, IL-10, and CRP. Patients with CD were more often treated with postoperative epidural analgesia 17 (53.1%) versus 1 (7.1%), P = .009. Patients with colonic CD had a more intense IR to surgery than patients with UC after the same surgical resection. This significant trend continued when patients who underwent small bowel resection compared with those with colectomy. The changes in inflammatory markers and WBC counts from baseline to peak value were also higher in patients with CD indicating a more severe IR. However, there was a similar response in patients undergoing laparoscopic compared with open approaches. The postoperative IR was greater in patients with CD than those with UC. This is important to tackle in preoperative optimization as well as postoperative recovery protocols.

Simultaneous Effect of Aerobic Training and Resveratrol Supplementation on Interleukin-6 Serum Levels in Women With Type 2 Diabetes

Background and Aims Diabetes pathogenesis is driven by a complex network of pro-inflammatory cells and cytokines, of which interleukin-6 (IL-6) plays a key role in the chronic inflammation associated with type 2 diabetes. The use of supplements and plant extracts and exercise to treat type 2 diabetes is common today. The aim of this study was to evaluate the simultaneous effect of aerobic training and resveratrol supplementation on IL-6serum levels in women with type 2 diabetes. Methods This study was a quasi-experimental study with a pre-test-post-test design and a control group, in which 24 women with type 2 diabetes were randomly assigned to three equal groups of supplement (age 55.25±5.11 years), training+supplement (400 mg resveratrol) (age 54.62±7.22 years), and control (age 52.25±8.60 years). The subjects practiced for six weeks and every week for three days for 40-60 min and at a heart rate of 45-65. Data analysis was performed using analysis of covariance and correlated t-test at the significant level of <0.05. Results The results showed that after the intervention, IL-6 serum levels in the aerobic training + supplement group (P=0.01) had a significant decrease compared to the supplement and control groups. Examination of intergroup changes shows that there was a significant difference in IL-6 levels between the training + supplement group and the supplement group (P=0.002, f=1.56). Also, the results of the Tukey post hoc test showed that there was a significant difference between the control group and the training + supplement group (P=0.003) and between the supplement group and the training+supplement group in IL-6 levels (P=0.031). Conclusion Based on the findings of the present study, it seems that concomitant use of resveratrol supplementation and aerobic training can reduce the levels of IL-6 and the supplement have anti-inflammatory and protective effects in women with type 2 diabetes.

The Influence of Treatment with PCSK9 Inhibitors and Variants in the CRP (rs1800947), TNFA (rs1800629), and IL6 (rs1800795) Genes on the Corresponding Inflammatory Markers in Patients with Very High Lipoprotein(a) Levels.

Chronic inflammation contributes significantly to the development and progression of atherosclerosis. However, the factors that lead to an inflammatory imbalance towards a proinflammatory state are not yet fully understood. The CRP rs1800947, TNFA rs1800629, and IL6 rs1800795 polymorphisms may play a role in the pathogenesis of atherosclerosis and were therefore selected to investigate the influence of genetic variability on the corresponding plasma levels after treatment with a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. A group of 69 patients with stable coronary artery disease after myocardial infarction before the age of 50 years and very high lipoprotein(a) levels were enrolled in the study. All patients received a PCSK9 inhibitor (evolocumab or alirocumab). Genotyping was performed using TaqMan assays (CRP rs1800947, TNFA rs1800629, and IL6 rs1800795). Consistent with previous studies, no significant change in levels of inflammatory biomarkers was observed after 6 months of treatment with PCSK9 inhibitors. We also did not detect any significant association between single nucleotide polymorphisms CRP rs1800947, TNFA rs1800629, and IL6 rs1800795 and plasma levels of high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), or interleukin 6 (IL6), respectively, at enrollment. However, the difference in IL6 levels after treatment with PCSK9 inhibitors was statistically significant (p = 0.050) in patients with IL6-74CC genotype, indicating the possible role of the IL6 rs1800795 polymorphism in modulating inflammation.

Increased interleukin-6 levels associated with malaria infection and disease severity: a systematic review and meta-analysis

Interleukin-6 (IL-6) is generated by immune cells during infection with malaria parasites and they are associated with the immunopathogenesis of malaria. The present systematic review and meta-analysis aimed to compare the differences in IL-6 levels between several groups of patients with malaria and healthy control groups. The systematic review was registered at PROSPERO with a registration number: CRD42021290753. Systematic literature searches were conducted in PubMed, Web of Science, and Scopus until November 7, 2021 to obtain studies that documented IL-6 levels in patients with malaria. The quality of the included studies was assessed using critical appraisal tools from the Joanna Briggs Institute. Differences in the mean IL-6 levels among patients with: (1) severe and non-severe malaria, (2) uncomplicated malaria and controls, (3) uncomplicated and asymptomatic malaria, (4) asymptomatic malaria and healthy controls, and (5) those that died or survived were estimated using a random-effects model. Forty-three of 1,969 studies were included in the systematic review. Results of the meta-analysis showed that patients with severe malaria had higher mean IL-6 levels than those with non-severe malaria [P = 0.04, weight mean difference (WMD) = 96.63 pg/mL, 95% confidence interval (CI) = 0.88 − 19.38 pg/mL, I2 = 99.9%, 13 studies]. Patients with uncomplicated malaria had higher mean IL-6 levels than the controls (P < 0.001, WMD = 42.86 pg/mL, 95% CI = 30.17 − 55.56 pg/mL, I2 = 100%, 17 studies). No differences in the mean levels of IL-6 were found between patients with uncomplicated malaria and those with asymptomatic malaria (P = 0.063, WMD = 42.07 pg/mL, 95% CI = − 2.23 pg/mL to − 86.37 pg/mL, I2 = 99.1%, 8 studies), or between patients with asymptomatic malaria and healthy controls (P = 0.45, WMD = 1.67 pg/mL, 95% CI = − 2.73 pg/mL to − 6.07 pg/mL, I2 = 98.1%, 2 studies). A higher mean level of IL-6 was observed in patients who died compared with the levels of those who survived (P = 0.007, WMD = 1,399.19 pg/mL, 95% CI = 384.16 − 2,414.2 pg/mL, I2 = 93.1%, 4 studies). Our meta-analysis of the pooled evidence can be used to guide future studies in which IL-6 levels are measured during malaria outbreaks to monitor malaria severity. Heterogeneity of the effect estimate among the included studies was the main limitation of this analysis. In conclusion, significantly increased levels of IL-6 were observed in patients with severe malaria compared with those in patients with non-severe malaria, which indicates that IL-6 is a candidate marker for severe malaria. Future studies should investigate the sensitivity and specificity of increased IL-6 levels to determine the effectiveness of assessments of IL-6 levels monitoring of malaria infection and severity.

Inflammation markers in moderate and severe obstructive sleep apnea: the influence of sex.

Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder, with a negative impact on cardiovascular health. Different OSA symptoms and treatment response in males and females have been reported. The aim of this study was to investigate inflammatory markers inpatients with OSA and the relationshipof those markers to disease severity in male and female subjects. We considered consecutive subjects referred to the outpatient Sleep Disorder Service of the Respiratory Medicine Department, San Marino Hospital. We included patients with a diagnosis of moderate or severe OSAS and an age range of 45-80years. Concomitant inflammatory conditions were an exclusion criterion. A polygraphic study and a blood draw for inflammatory markers were performed for each subject. Of 110 subjects, 59 weremales. Severe OSA affected 72 subjects. We analyzed data through a 4-level categorical variable according to sex and OSA severity (moderate OSA, males; severe OSA, males; moderate OSA, females; severe OSA, females), which showed significant differences for interleukin-6 (IL-6) and C-reactive protein (CRP) levels. A significant difference in IL-6 levels with a significant ascending trend (p = 0.045) from females with moderate OSAS to males with severe OSAS emerged in our pairwise comparison for estimated marginal means. Also, a significant trend (p = 0.0001) for CRP levels from males with moderate OSAS to females with severe OSAS was shown. OSA and inflammation are interconnected, and both are associated with vascular diseases. Sex-related differences in OSA phenotypes may help the clinicians aim for a more personalized approach.

Clinical efficacy of aspirin combination treatment in the treatment of coronary heart disease and its effect on inflammatory factors: a systematic review and meta-analysis

As the mainstay treatment for coronary heart disease (CHD), aspirin alone is reported to be less effective than in combination when treating CHD. The aim of this analysis was to systematically evaluate the efficacy and safety of aspirin in combination with other drugs for the treatment of CHD, as well as its effect on the levels of inflammatory factors. Electronic databases were searched from 2011 to 2021 and randomized controlled trials (RCTs) on aspirin in CHD patients were included in our study. Data was statistically analyzed using Stata 16.0 (StataCorp). A total of 13 RCTs were included, with a total of 1,442 patients. Compared with control group (aspirin alone) group, the response rate in the treatment group (aspirin in combination with other drugs) was significantly improved [odds ratio (OR) =5.11; 95% confidence interval (CI): 3.56-7.35], while the incidence of adverse reactions was markedly decreased (OR =0.36; 95% CI: 0.25-0.53). Before treatment, no significant differences were identified in the levels of inflammatory factors between the groups The inflammatory factors included C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). After treatment, CRP and TNF-α levels were significantly lower in both groups compared with those before treatment. However, there was no statistically significant difference in IL-6 levels after treatment between the groups. Aspirin is effective in the treatment of CHD, both alone and in combination. However, the latter has higher clinical efficacy and safety, and can significantly reduce the level of inflammatory factors in CHD patients.

Interleukin-6 Receptor Asp358 A>C Polymorphism Is Associated With Postoperative Atrial Fibrillation

This study examined the associations of single-nucleotide polymorphisms in the interleukin-6 receptor gene (Asp358 A>C) and the interleukin-6 promoter (-174G>C and-597G>A) with interleukin-6 levels and postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG). The study enrolled 371 Chinese Han patients who were undergoing CABG. Serum interleukin-6 levels were measured preoperatively and at 6, 12, and 18 hours postoperatively. Genotypes for the 3 polymorphisms were determined. Overall, POAF developed in 30.2% of patients. The CC genotype and C allele frequencies for the interleukin-6 receptor Asp358 A>C polymorphism were significantly higher in patients with POAF than in patients without POAF (P= .003), and the interleukin-6 levels were significantly higher in patients with the CC genotype compared with A allele carriers at 6, 12, and 18 hours in the overall cohort and at 12 and 18 hours in the POAF subgroup, but there were no significant differences in the non-POAF subgroup. However, the allele and genotype frequencies of the interleukin-6-174G>C and-597G>A polymorphisms were similar among groups, and there were no differences in interleukin-6 levels at any time point between the C/A allele carriers and the patients with GG genotypes. Univariate analysis showed that the CC genotype for interleukin-6 receptor Asp358 A>C, age, and history of cerebrovascular disease were associated with POAF. Multivariable regression showed that the CC genotype was independently related to the development of POAF (odds ratio, 2.01; 95% confidence interval: 1.15 to 3.52; P= .014). The interleukin-6 receptor Asp358 A>C polymorphism may contribute to genetic susceptibility to POAF after CABG.

A systematic review of the role of inflammatory biomarkers in acute, subacute and chronic non-specific low back pain

BackgroundLow back pain (LBP) is one of the greatest contributors to disability in the world and there is growing interest on the role of biomarkers in LBP. To purpose of this review was to analyze available evidence on the relationship between inflammatory biomarkers, clinical presentation, and outcomes in patients with acute, subacute and chronic non-specific low back pain (NSLBP).MethodsA search was performed in Medline, Embase, Cinahl and Amed databases. Studies which measured levels of inflammatory biomarkers in participants with NSLBP were included. Two reviewers independently screened titles and abstracts, full-texts, and extracted data from included studies. Methodological quality was assessed using the Newcastle Ottawa Quality Assessment Scale. Level of evidence was assessed using the modified GRADE approach for prognostic studies.ResultsSeven primary studies were included in this review. All results assessed using the modified GRADE demonstrated low to very low quality evidence given the small number of studies and small sample. Three studies examined C-reactive protein (CRP), one of which found significantly higher CRP levels in an acute NSLBP group than in controls and an association between high pain intensity and elevated CRP. Three studies examined tumor necrosis factor alpha (TNF-α), two of which found elevated TNF-α in chronic NSLBP participants compared to controls. Two studies examined interleukin 6 (IL-6), none of which found a significant difference in IL-6 levels between NSLBP groups and controls. Two studies examined interleukin 1 beta (IL-β), none of which found a significant difference in IL-β levels between NSLBP groups and controls.ConclusionsThis review found evidence of elevated CRP in individuals with acute NSLBP and elevated TNF-Α in individuals with chronic NSLBP. There are a limited number of high-quality studies evaluating similar patient groups and similar biomarkers, which limits the conclusion of this review.

Relationships Among and Predictive Values of Obesity, Inflammation Markers, and Disease Severity in Pediatric Patients with Obstructive Sleep Apnea Before and After Adenotonsillectomy.

Both obstructive sleep apnea (OSA) and obesity are major health issues that contribute to increased systemic inflammation in children. To date, adenotonsillectomy (AT) is still the first-line treatment for childhood OSA. However, the relationships among and predictive values of obesity, inflammation, and OSA severity have not been comprehensively investigated. This prospective study investigated body mass index (BMI), serum inflammatory markers, and OSA severity before and after AT in 60 pediatric patients with OSA. At baseline, differences in levels of interleukin-6, interleukin-9, basic fibroblast growth factor, platelet-derived growth factor-BB, as well as regulated on activation, normal T cell expressed and secreted (RANTES) were significant among the various weight status and OSA severity subgroups. After 3 months postoperatively, the differences in these inflammatory markers diminished along with a decrease in OSA severity while obesity persisted. The rate of surgical cure (defined as postoperative obstructive apnea-hypopnea index < 2.0 and obstructive apnea index < 1.0) was 62%. Multivariate analysis revealed that age, BMI z-score, granulocyte-macrophage colony-stimulating factor, monocyte chemotactic protein-1, and RANTES independently predicted surgical cure. Despite the significant reductions in inflammatory markers and OSA severity after AT, an inter-dependent relationship between obesity and OSA persisted. In addition to age and BMI, several inflammatory markers helped to precisely predict surgical cure.

Effect of Structured Physical Activity on Inflammation and Immune Activation Profile of Antiretroviral Therapy-Experienced Children Living With HIV.

To compare the markers of inflammation and immune activation in virally suppressed HIV-infected children on antiretroviral therapy, who practiced regular structured exercise comprising running and yoga to those who did not over a 2-year period. This retrospective cohort study included 72 children aged 8 to 16 years divided into 2 groups, exercisers (n = 36) and the nonexercisers (n = 36) based on their intentional physical activity. The analyses were carried out at baseline and after 2 years (Y2) for the soluble biomarkers of inflammation and immune activation (tumor necrosis factor alpha, interleukin-6, interleukin-10, interferon gamma, sCD14, and sCD163). In addition, cell-associated biomarker (CD38), lipopolysaccharides, and the gene expression of interleukin-2 and brain-derived neurotrophic factor were also measured at Y2. Reduction in levels of sCD14 (effect size [ES], -0.6; 95% confidence interval [CI], -1.08 to -0.14), tumor necrosis factor alpha (ES, -0.7; 95% CI, -1.18 to -0.23), interferon gamma (ES, -0.7; 95% CI, -1.17 to -0.22), and interleukin-10 (ES, -0.6; 95% CI, -1.08 to -0.14) was observed among exercisers as compared with nonexercisers at Y2. In addition, CD38+ expressing CD4+ T cells were found to be lower among exercisers (P = .01) at Y2. However, the differences in levels of interleukin-6, sCD163, lipopolysaccharides, interleukin-2, and brain-derived neurotrophic factor were not significantly different among the 2 groups. The study result suggests that regular structured physical activity improves the inflammatory profile of antiretroviral therapy-treated HIV-infected children.