IL-6 Levels In Patients Research Articles

Clinical Analysis of Echocardiography and Serum IL-6 and TNF-α Changes in Pregnant Women with Hypertension.

In order to explore the changes and clinical significance of serum TNF-α and IL-6 and ET levels in the pathogenesis of hypertensive disorders of pregnancy (HDIP), echocardiography, and serum IL-6 and TNF-α changes in pregnant women with a hypertensive disorder, a clinical analysis method was proposed. A retrospective analysis of 59 pregnant women who visited the obstetrics department of a provincial hospital was divided into 2 groups. The normal control group consisted of 32 normal, uncomplicated pregnant women; the preeclampsia group included 27 patients with systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg who developed proteinuria after 20 weeks of gestation. The levels of TNF-α and IL-6 in serum of normal pregnant women and pregnant women with preeclampsia were detected by enzyme-linked immunosorbent assay (ELISA). The results showed that compared with normal pregnant women, the serum levels of TNF-α and IL-6 in the early pregnant women of Zizhi were significantly increased, and the trend of increased TNF-α and IL-6 levels was related to the severity of complications. With the mean pulmonary arterypressure > 50 mmHg, the serum TNF-α level of pregnant women was significantly higher than that of pregnant women with mean pulmonary arterypressure < 50 mmHg. The analysis found that the serum levels of TNF-α and IL-6 in patients with hypoxic gestational hypertension were significantly increased, and the results of lung tissue immunohistochemistry also showed that serum TNF-α and IL-6 levels in patients with hypoxic gestational hypertension were significantly increased. And serum TNF-α and IL-6 levels were positively correlated with right ventricular systolic blood pressure (RVSP). Conclusion. This study revealed that the elevated levels of serum TNF-α and IL-6 are closely related to the pathophysiological process of gestational hypertension. Serum levels of TNF-α and IL-6 and ET were significantly increased, and the changes of serum TNF-α and IL-6 and ET levels had important clinical value for closely monitoring the severity of the disease and the development of the disease.

IL-10 Gene Rs1800871, Rs1800872, and Rs1800896 Polymorphisms and IL-10 Serum Levels Association with Pituitary Adenoma.

The aim and objective of this study is to determine the association between the rs1800871, rs1800872, and rs1800896 polymorphisms of the gene IL-10 and the serum levels of IL-10 in patients with pituitary adenoma. Methods: Data from 106 patients with pituitary adenoma and 192 control patients were used for the study. DNA was isolated from peripheral blood using the salt precipitation method. The samples were genotyped in real-time using the polymerase chain reaction method. IL-10 serum levels were evaluated using an ELISA kit. The data obtained were systematized using the computer program IBM SPSS Statistics. Results: The AG genotype of IL-10 rs1800871 was statistically significantly lower in the inactive PA group than in the control group (22.7% vs. 40.6%, p = 0.027). The TG genotype of IL-10 rs1800872 was also statistically significantly lower in the inactive PA group than in the control group (22.7% vs. 40.6%, p = 0.027). A binary logistic regression analysis of the polymorphisms in the IL-10 gene in PA and control groups based on the pituitary adenoma activity showed that the AG genotype of IL-10 rs1800871 increased the chance of inactive PA by 2.2-fold in codominant (OR: 2.272, CI: 1.048–4.925, p = 0.038) and overdominant (OR: 2.326, CI: 1.086–4.982, p = 0.030) models. Moreover, the TG genotype of IL-10 rs1800872 increased the probability of inactive PA by 2.2-fold in codominant (OR: 2.272, CI: 1.048–4.925, p = 0.038) and overdominant (OR: 2.326, CI: 1.086–4.982, p = 0.030) models. The association of the IL-10 polymorphisms with PA invasiveness and recurrence in PA and control groups did not yield statistically significant results. Conclusions: IL-10 rs1800871 and IL-10 rs1800872 may be associated with the development of inactive PA.

Effect of Baricitinib on the epithelial-mesenchymal transition of alveolar epithelial cells induced by IL-6

ObjectiveInterstitial lung disease (ILD) is one of the common complications of Connective tissue disease (CTD). Epithelial-mesenchymal transition (EMT) is one of the main pathological mechanisms of ILD. IL-6 may induce ILD through the JAK/STAT pathway. Therefore, exploring the mechanism of IL-6 on the EMT of alveolar epithelial cells and inhibition JAK/STAT pathway with Baricitinib on the EMT of alveolar epithelial cells is helpful in revealing the pathogenesis of CTD-ILD and guiding treatment. MethodsElectrochemiluminescence was applied to detect the changes in serum IL-6 levels before and after treatment in 37 patients with anti-synthetase syndrome-associated ILD; A549 cells (a human AEC cell line) were incubated with IL-6, Baricitinib, or both IL-6 and Baricitinib, and changes in EMT-related markers levels were measured using real-time PCR, western blotting and fluorescence microscopy. The related proteins in the JAK/STAT signaling pathways were examined by western blot. The level of Connective tissue growth factor (CTGF) and Hydroxyproline (Hyp) in cell supernatants was measured by ELISA. ResultsSerum IL-6 level in patients with anti-synthetase syndrome-associated ILD was significantly higher than that in health (6.78(4.19, 16.14)pg/ml vs. 2.10(1.43, 5.18)pg/ml, p < 0.01). The level of IL-6 in the improvement group of ASS-ILD was considerably decreased than that before treatment(before(7.48(4.54, 22.76) pg/mL vs. 5.00(3.46, 11.32)pg/mL, p < 0.01), p < 0.01), and the level of IL-6 in the progressive group of ASS-ILD was significantly higher than that before treatment(before(7.49(6.77, 35.80) pg/mL vs. 30.02(8.01, 82.98) pg/mL, p < 0.05). IL-6 increased the expression of epithelial phenotypic marker E-cadherin and inhibited mesenchymal phenotypic markers, including vimentin and N-cadherin in A549 cells. Moreover, IL-6-induced EMT was attenuated by Baricitinib. Furthermore, we found that IL-6 activated the phosphorylation of JAK1/2, STAT3, and Baricitinib, partially inhibiting these changes in this process. Baricitinib reduced the secretion of CTGF and Hyp in A549 cells. ConclusionThe significant higher level of IL-6 in patients with anti-synthase syndrome-associated ILD may be related to disease activity and recurrence. Our results suggest that Baricitinib attenuates epithelial-mesenchymal transition in alveolar epithelial cells in the presence of IL-6 through the JAK/STAT signaling pathway.

A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity

BackgroundInterleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled.MethodsThe systematic review was registered at PROSPERO (CRD42022323387). Searches for relevant articles on IL-4 levels in patients with severe malaria and studies that examined IL-4 levels in both uncomplicated malaria and healthy controls were performed in PubMed, Embase, and Scopus using the search strategy without limitation to publication years or language. The quality of all included studies was evaluated using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: standards for reporting observational studies. Qualitative and quantitative data syntheses were performed. The random-effects model, which weights each study according to its between- and within-study variance, was used to pool the mean difference (MD) of individual studies. The degree of heterogeneity was determined using Cochran's Q and I2 statistics. Additionally, meta-regression and subgroup analyses were perfomed to investigate possible sources of heterogeneity. The outliers were identified using the leave-one-out method and assessed publication bias using funnel plots, Egger’s test, and a contour-enhanced funnel plot.ResultsA total of 2300 studies were identified through database searches, and 36 were included for analyses. The meta-analysis results showed lower mean IL-4 levels in severe malaria (434 cases) than in uncomplicated malaria (611 cases) (P = 0.01, pooled MD: −3.36 pg/mL, 95% confidence intervals CI −5.55 to −1.16 pg/mL, I2: 98.15%, 11 studies). The meta-analysis results showed no difference in mean IL-4 levels between cerebral malaria (96 cases) and noncerebral severe malaria (108 cases) (P = 0.71, pooled MD: 0.86 pg/mL, 95% CI −3.60 to 5.32 pg/mL, I2 92.13%, four studies). Finally, no difference was found in mean IL-4 levels between uncomplicated malaria (635 cases) and healthy controls (674 cases) (P = 0.57, pooled MD: 0.79 pg/mL, 95% CI −1.92 to 3.50 pg/mL, I2: 99.89%, 11 studies).ConclusionThe meta-analysis revealed lower IL-4 levels in patients with severe malaria than in those with uncomplicated malaria, though a trend toward comparable IL-4 levels between both groups was more likely because several sources of heterogeneities were observed. Based on the limited number of studies included in the meta-analysis, until additional investigations have been conducted, IL-4 consideration as an alternative prognostic factor for malaria severity is not warranted.

The Effect of Bacterial DNA and Hemodialysis Therapy Conditions on Interleukin 6 Levels Variation in End-stage Renal Disease Patients

Hemodialysis (HD) is the most common therapy to treat end-stage renal disease (ESRD) patients. That is used to clear blood from metabolism end products and maintain water and electrolyte balance in patients’ body when failed kidneys unable to do that. Patient’s blood contact via dialysis filter (dialyzer) about 400 L of dialysis fluid that is mainly form of water and some electrolyte, this quantity of fluid contact can stimulate the production of pre-inflammatory markers due to carrying pathogens such as bacterial DNA fragments even in small quantity that can pass all filters to bloodstream stimulating production of IL-6. A total of 90 blood samples were collected from 45 patients under hemodialysis therapy in Baghdad Teaching Hospital, Gazy Alhariry general hospital, Al-khayal private hospital and Al-Muayad private hospital before and after 3 hours of HD therapy to detect IL-6 by ELISA technique. And from the same centers dialysis fluid and water samples were collected to detect bacterial DNA fragments. PCR technique using 16s universal bacterial primer showed presence of bacterial DNA fragments in dialysis fluid and water used to prepare it.The ELISA readings showed a variety in IL-6 levels higher in patients with low ultrafiltration UF rate than its level in patients with high UF and generally, the level of IL-6 in patients treated in centers with DF preparation direct water distribution system were lower than its level in patients treated in centers with indirect water distribution systems.

IL-6 levels in patients with hypertension in combination with coronavirus disease

IL-6 levels in patients with hypertension in combination with coronavirus disease

Chronic inflammation in hemodialysis patients with secondary hyperparathyroidism

Abstract. Our study aimed to establish a possible correlation between parathyroid hormone (PTH) levels and biomarkers of inflammation in hemodialysis patients with secondary hyperparathyroidism.&#x0D; Methods. This observational сross-sectional study involved 108 hemodialysis patients with secondary hyperparathyroidism. The levels of serum cytokines interleukin-1 (IL-1), IL-6 and tumor necrosis factor-alpha (TNF-alpha) were determined in all patients. The correlations between the levels of inflammatory mediators on the one hand and the level of PTH on the other were studied. The effects of diabetes, heart failure (HF), fractures, and smoking on the inflammatory status and PTH levels were assessed.&#x0D; Results. The level of IL-1 in patients with diabetes was more than 2 times higher than in patients without diabetes (p&lt;0.05). The level of IL-6 in patients with diabetes was more than 3 times higher than in patients without diabetes (p&lt;0.05). The level of TNF-alpha in patients with diabetes was more than 1.5 times higher than in patients without diabetes (p&lt;0.05). The level of PTH was more than 2.4 times higher in patients with diabetes compared with patients without diabetes (p&lt;0.05). The level of IL-1 in patients with HF was 1.7 times higher than that in patients without HF (p&lt;0.05). The level of IL-6 in patients with HF was more than 3 times higher than in patients without HF (p&lt;0.05). The level of TNF-alpha did not differ significantly in patients with and without HF. The level of PTH was more than 2.3 times higher in patients with HF compared with patients without HF (p&lt;0.05). The level of IL-1 in patients with fractures was more than 2.8 times higher than in patients without fractures (p&lt;0.05). The level of IL-6 in patients with fractures was more than 3.6 times higher than in patients without fractures (p &lt;0.05). The level of TNF-alpha in patients with fractures was more than 1.5 times higher than in patients without fractures (p&lt;0.05). The level of PTH was more than 2.4 times higher in patients with fractures compared to patients without fractures (p&lt;0.05). Smoking status in our study did not affect the levels of both PTH and inflammatory mediators. A positive correlation between the concentration of IL-6 and serum PTH was found (r = 0.7; p &lt;0.001).&#x0D; Conclusions. The presence of chronic inflammation is characteristic of hemodialysis patients with secondary hyperparathyroidism. Proinflammatory cytokine levels are significantly higher in patients with diabetes, HF, and a history of fractures. A positive correlation between the level of IL-6 and PTH may indicate a relationship between the development of secondary hyperparathyroidism and chronic inflammation.

Early use of corticosteroids and sarilumab in SARS-Cov-2 pneumonia.

The cytokine storm underlying the inflammatory phase of COVID19 has been suggested since the beginning of the pandemic as a target for treatment of the disease. The identification of the presence of elevated IL6 levels in patients with severe SARS-CoV-2 infection led to the hypothesis that the use of already marketed drugs whose mechanism of action is the inhibition of IL6 could result in clinical benefit for these patients. We hypothesised that the use of glucocorticoid-associated sarilumab in early stages of the proinflammatory phase of COVID19 could prevent progression to respiratory distress syndrome and death. Hospitalised patients with SARS-CoV2 pneumonia, treated with nasal cannula and with analytical parameters of inflammation, were randomised (1:1 ratio) to receive sarilumab + standard therapy (sarilumab group) or standard therapy (control group). In all cases, standard therapy included glucocorticoid treatment for at least 3 days at a dose equivalent to methylprednisolone mg/kg/day. The primary endpoint was the percentage of patients who progressed to severe respiratory failure (defined as a BRESCIA-COVID score ≥3), intensive care unit (ICU) admission or death at any time up to day 15. A total of 201 patients were included, of whom 99 were randomised to the sarilumab group and 102 to the control group. The percentage of patients who progressed to severe respiratory failure (BRESCIA≥3), ICU admission or death at any time up to day 15 was 16.6% in the sarilumab group and 15.69% in the control group (RR 1.03; 95% CI, 0.48 to 2.20). No differences in the safety profile between the two groups were detected. Mortality at day 28 was 2.02% in the sarilumab group vs. 1.96% in the control group (RR 1.03; 95% CI 0.14 - 7.46). In conclusion, an early intervention with sarilumab and glucocorticoids did not demonstrate clinical benefit in our study population compared to standard therapy.

TELOMERE LENGTH IS NEGATIVELY ASSOCIATED WITH BMI, R WAVE IN AVL AND IL-6 LEVEL IN PATIENTS WITH NEW CASES OF HYPERTENSION

Objective: The aim of the study was to investigate the association between lymphocyte telomere length and cardiovascular risk factors in patients with new cases of hypertension according to 10-years prospective study in urban randomised population. Design and method: In 2007/2008 10-years prospective study of 3500 persons living in a district of Vitebsk (Belarus) and selected by the random number method started (coverage of the survey was 97.9%). According to the results of first examination 2170 persons had normal blood pressure. 1862 of them were examined on the second stage of the study in 2012/2013 (coverage of the survey was 85,8%). 286 new cases of hypertension were revealed and they had significant positive relationship with the IV quartile of uric acid level (&gt; = 339 mol/l), determined on the first stage of the study. A 10-years prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed on the second stage of the study. Results: We examined 2170 persons with normal blood pressure in 2007/2008. On the second stage of the study 286 new cases of hypertension were diagnosed in these subjects (14,4% of men and 12,2% of women). According to multifactorial regression analysis of 145 randomized subjects of 286 new cases of hypertension, adjusted for age and sex, the IV quartile of uric acid level (339–527 mol/l), determined on the first stage of the study, was associated with the I quartile of telomere length in 10 years (df = 1; 2Wald = 4,5; p &lt; 0,05). Cross-sectional analysis of these subjects showed that the level of telomere length had a significant negative association with BMI (=-0,19; p &lt; 0,05), R wave in aVL (=-0,18; p &lt; 0,05), IL-6 level (=-0,20; p &lt; 0,05) in 2017/2018. Conclusions: Regardless of age and sex, telomere length has negative association with BMI, R wave in aVL and IL-6 level in patients with new cases of hypertension.

Oral fluid cytokine balance characteristics in patients with iron deficiency anemia and inflammatory periodontal diseases

Relevance. Iron deficiency anemia (IDA) has various clinical manifestations, including those in the oral cavity, connected with depressed humoral and cell-mediated immunity. However, there is no clear understanding of the character of the cytokine storm in the oral cavity of these patients. Hence, the study aimed to investigate the amount of pro- and anti-inflammatory cytokines in the oral cavity of patients with iron-deficiency anemia before and after iron therapy.Material and Methods. The study included 168 females aged 29.6±1.65 years old, who formed three groups: the main group comprised the patients with IDA, the comparison group included patients with inflammatory periodontal diseases without systemic diseases, and the control group contained the patients without oral inflammatory and systemic diseases. We examined all the patients, determined DMF index, OHI-S (Greene-Vermillion), PBI (Muhlemann-Saxer), gingival inflammation by the РМА index modified by Рarma and determined the level of IL-1β, IL-6, IL-4 and INF-γ in the oral cavity by enzyme immunoassay.Results. The study determined the clinical signs of periodontal inflammation in all patients with IDA before treatment. Inflammatory periodontal diseases and IDA combination caused a significant decrease of pro-inflammatory cytokines IL-1β and IL-6 (9.67 pcg/ml and 20.52 pcg/ml, respectively) in the oral fluid of all the examined compared to the periodontal patients without systemic diseases. Patients with IDA demonstrated an increase of IL-1β (40.58 pcg/ml) and a decrease of IL-4 (25.18 pcg/ml) and INF-γ (46.93 pcg/ml) in the oral fluid after the completion of the iron therapy course.Conclusion. A decrease in pro-inflammatory cytokine IL-1β and IL-6 levels in patients with IDA and oral inflammation evidenced the changes in the immune response compared to the group of periodontal patients without systemic diseases, which may lead to an unfavourable prognosis. After the iron therapy course, the oral cytokine concentration in patients with IDA corresponded to the oral fluid cytokine profile of comparison group patients, which indicated the compensation of secondary immune deficiency.

IL-6 Gene Expression as a Marker of Pathological State in Psoriasis and Psoriatic Arthritis

The expression of the IL-6 gene in mononuclear blood cells of 45 patients with psoriatic arthritis and 31 patients with plaque psoriasis was studied for possible differential diagnosis of the pathologies. The expression level of IL-6 in psoriatic arthritis and psoriasis surpassed that in healthy controls by 192 and 147 times, respectively. Significant differences in the gene expression were revealed between the patients with psoriatic arthritis and mild psoriasis. The level of IL-6 in patients with severe psoriasis approached that in patients with psoriatic arthritis. High level of IL-6 gene expression can be a marker of possible joint damage in patients with psoriasis and a signal for revising the therapeutic approach in a particular patient.

Analysis of serum Vitamin C expression level and its correlation with immune function in adult patients with chronic sinusitis

Objective:To investigate the expression of Vitamin C in adult patients with chronic rhinosinusitis（CRS） and its correlation with immune function. Methods:A total of 315 patients who underwent nasal endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery and undergoing nasal endoscopic surgery were collected from Renmin Hospital of Wuhan University from May 2018 to June 2020, including 207 CRS patients, who were divided into CRS without nasal polyps（CRSsNP） group（110 cases） and CRS with nasal polyps（CRSwNP） group（97 cases）; 108 patients with nasal septum correction were selected as the control group. All patients underwent serum Vitamin A, C, D, and E tests. Among them, 107 patients（39 in the control group, 35 in the CRSsNP group, and 33 in the CRSwNP group） were treated with serum IL-2, TNF-α, IFN-γ, IL-4, IL-5, IL-6, IL-10, etc. Detection of cytokines and immune protein levels such as IgA, IgM, IgG, C3, and C4. Results:The serum levels of Vitamin C and IL-10 in the CRSwNP group were significantly lower than those in the control group（P<0.05）, and the serum C4 level was significantly higher（P<0.05）; the serum Vitamin C level decreased with the level of IL-10, the decline is positively correlated, while negatively correlated with C4 levels; CRSsNP patients also had lower Vitamin C levels and higher C3 and C4 levels. Conclusion:The Vitamin C level in adult patients with CRS is lower than that in the normal population, and the level of C4 is higher; the level of IL-10 in patients with CRSwNP is lower; Vitamin C affects the immune balance and antioxidant level of patients, and in the pathogenesis of CRS and nasal polyps play a certain role.

Effects of Ulinastatin on Myocardial Ischemia-Reperfusion Injury, Cardiac Function, and Serum TNF-α and IL-10 Levels in Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass.

Background Myocardial ischemia-reperfusion injury (MIRI) is a very common adverse reaction after cardiac valve replacement (CVR) under cardiopulmonary bypass, which seriously affects the rehabilitation and prognosis of patients. Objective The prevention and treatment of MIRI are a hotspot of modern medical research, and this study is aimed at providing reliable reference and guidance for future clinical prevention and treatment of MIRI by analyzing the effects of ulinastatin (UL) on cardiac function and MIRI of patients after CVR. Methods A total of 104 patients undergoing CVR under cardiopulmonary bypass in our hospital were selected as research participants. Among them, 52 patients treated with UL were assigned to the observation group, and the rest 52 patients given the same amount of normal saline were assigned to the control group. The cardiopulmonary bypass status, postoperative status, cardiac function, inflammatory response, oxidative stress response, and hemodynamics were observed and compared between the two groups. In addition, clinical efficacy and safety and patient prognosis were compared. Results Through experimental analysis, we found that UL had no significant effect on the clinical efficacy, safety, and prognosis of patients after surgery (P > 0.05) but had obvious protective effects on cardiopulmonary bypass status, cardiac function, inflammation, oxidative stress, and hemodynamics (P < 0.05). Conclusion UL can effectively prevent the occurrence of MIRI after CVR under cardiopulmonary bypass, which is worthy of clinical application.

OPTIONS OF CORRECTING INSULIN RESISTANCE AND PROINFLAMMATORY CYTOKINE LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

The objective of this study was to investigate the effect of empagliflozin on insulin resistance, leptin and proinflammatory cytokine levels in patients with type 2 diabetes. Materials and methods. 100 patients with type 2 diabetes with normal weight, overweight and obesity of various degrees were examined. Anthropometric indicators were taken. Levels of leptin, IL-6, CRP in blood serum were determined, HOMA index was calculated. Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r = 0.505, p &lt; 0.05), (r = 0.846, p &lt; 0.05), (r = 0.886, p &lt; 0.05), (r = 0.736, p &lt; 0.05) in patients from Group I-IV. Patients of all examined groups have shown a significant increase in IL-6 levels, compared with the control group (p &lt; 0.05), but the level of IL-6 in patients from Group II, III and IV have been significantly higher than those from Group I (p &lt; 0.05) and the control group (p &lt; 0.05) and has increased along with the weight gain. Similarly, the highest indices of CRP levels have been found in patients from Group IV which proves a high pro-inflammatory activity in these patients with type 2 diabetes and obesity. After a 6-month course of treatment patients taking empagliflozin, regardless of BMI, have shown significantly decreased levels of both IL-6 (p &lt; 0.05), and CRP (p &lt; 0.05). Levels of leptin (p &lt; 0.05) and HOMA index (p &lt; 0.05) were significantly reduced in obese patients, too. Conclusions. As a result of the study, it has been established that the use of empagliflozin in the dose of 10 mg per day for 6 months has had a significant effect on anthropometric parameters and markers of insulin resistance (HOMA index, leptin) in patients with type 2 diabetes and obesity. A significant decrease in the levels of IL-6 and CRP under the influence of empagliflozin, regardless of the patient’s weight has been revealed.

Effects of Gegen Qinlian Decoction combined with Chinese herbal hot package on the expression of PCT, CRP and IL-6 in patients with acute gastroenteritis.

This study was carried out to investigate the clinical efficacy of Gegen Qinlian Decoction combined with a Chinese herbal hot package in the treatment of acute gastroenteritis (AGE), and to analyze the effects on serum PCT, CRP and IL-6 levels. For this purpose, 100 patients with AGE admitted to the hospital from January 2019 to January 2022 were selected for the study and randomly divided into observation and control groups, with 50 cases in each group. Patients in the control group were given conventional Western medical treatment, while patients in the observation group were treated with Gegen Qinlian Decoction combined with a Chinese herbal hot package on this basis. The clinical efficacy, symptom relief time, main symptom scores and serum PCT, CRP and IL-6 levels before and after treatment were compared between the two groups. Results showed that the total effective rate of patients in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the disappearance time of diarrhea, abdominal pain, fever and vomiting was significantly shorter in the observation group than in the control group (P<0.05). After treatment, the stool properties, number of stools and abdominal pain symptom scores of patients in both groups were lower than those before treatment, and the symptom scores of patients in the observation group were lower than those in the control group (P<0.05). The PCT, CRP and IL-6 levels of patients in both groups were significantly lower after treatment than before treatment, and the PCT, CRP and IL-6 levels of patients in the observation group were significantly lower than those in the control group (P<0.05). It was concluded that the clinical efficacy of Gegen Qinlian Decoction combined with Chinese herbal hot package in the treatment of AGE is remarkable, which can effectively improve the clinical symptoms and reduce the inflammatory reaction of patients and is worthy of clinical promotion.

Elevated RAP1A expression correlates with the severity of acute GVHD after umbilical cord blood transplantation

BackgroundAcute graft-versus-host disease (aGVHD) is a complication of allogeneic hematopoietic stem cell transplantation. Ras-related protein 1A (RAP1A) has been recently identified as a novel oncoprotein in several human malignancies. However, its specific role in aGVHD remains unclear. ObjectiveTo study the role of RAP1A in the pathogenesis of aGVHD. Material and methodsStudy participants included six patients with grade 2–4 aGVHD, 13 patients with grade 1 aGVHD, 11 patients without aGVHD, and 12 healthy people. The expression level of RAP1A in whole cells was detected by western blot and qRT-PCR. The proportions of CD4+CD25+FoxP3+ Treg cells (T regulatory cells) and the expression of RAP1A in Treg cells in peripheral blood mononuclear cells (PBMCs) were detected by flow cytometry and the levels of related cytokines in the serum was detected by cytometric bead array. ResultsWe found the level of RAP1A was higher in patients than in healthy individuals. A negative correlation was noted between RAP1A and the number of Treg cells. In addition, the level of IL-10 in patients with grade 2–4 aGVHD was significantly lower than that in healthy donors, however, the level of TNF-ɑ in patients with grade 2–4 aGVHD was higher. Furthermore, we found a negative correlation between levels of IL-10 and RAP1A, and a positive correlation between TNF-ɑ and RAP1A. ConclusionThe expression of RAP1A in patients with aGVHD was significantly increased, and shows potential as a target for the prevention and treatment of aGVHD.

High plasma IL-6 levels following haploidentical allogeneic hematopoietic stem cell transplantation post-transplant cyclophosphamide as predictor of early death and worse outcome

IntroductionHaploidentical hematopoietic stem cell transplantation (haplo-HSCT) can be used as an alternative procedure in the absence of HLA-compatible donors. The use of high doses of cyclophosphamide after infusion improves the prognosis and eliminates the need for T cell depletion in vivo. Among the main complications of haplo-HSCT are acute graft-versus-host disease (a-GVHD) and cytokine release syndrome (CRS). This is a systemic inflammatory response that leads to the release of inflammatory proteins, including IL-6. This syndrome has several clinical features, with mild to severe symptoms. This study aimed to compare plasma IL-6 levels in patients submitted to different HSCT types and to associate them with the presence of acute graft versus host disease (a-GVHD), CRS and survival. MethodsA total of 84 patients (22 haploidentical and 62 non-haploidentical) were evaluated at different times. The IL-6 levels in haplo and non-haplo-HSCT recipients were measured before transplantation and on days D7, D14, D28, D60, and D100. ResultsIL-6 levels were higher in haplo-HSCT recipients than in non-haplo-HSCT recipients, remaining elevated from D14 until D100 (P = 0.006) and a cut-off ≥11 pg/mL on D7, which is related to worse overall survival. In our study, we found no association with a-GVHD (P = 0.239), a common complication of this type of transplant, but we found a relationship between the increase in IL-6 and CRS (P = 0.021). ConclusionIL6 can be used as a biomarker for patients submitted to haplo-HSCT, allowing clinical interference in patients having levels of IL-6 times larger than normality values, avoiding early death in this group of patients.

A randomised controlled trial on roles of prostaglandin E1 nebulization among patients undergoing one lung ventilation

BackgroundProstaglandin E1 (PGE1) has been reported to maintain adequate oxygenation among patients under 60% FiO2 one-lung ventilation (OLV). This research aimed to explore whether PGE1 is safe in pulmonary shunt and oxygenation under 40% FiO2 OLV and provide a reference concentration of PGE1.MethodsTotally 90 esophageal cancer patients treated with thoracotomy were enrolled in this study, randomly divided into three groups (n = 30/group): Group A (60% FiO2 and 0.1 µg/kg PGE1), Group B (40% FiO2 and 0.1 µg/kg PGE1), and Group C (40% FiO2, 0.2 µg/kg PGE1). Primary outcomes were oxygenation and pulmonary shunt during OLV. Secondary outcomes included oxidative stress after OLV.ResultsDuring OLV, patients in Group C and B had lower levels of PaO2, SaO2, SpO2, MAP, and Qs/Qt than those in Group A (P < 0.05). At T2 (OLV 10 min), patients in Group C and B exhibited a lower level of PaO2/FiO2 than those in Group A, without any statistical difference at other time points. The IL-6 levels of patients in different groups were different at T8 (F = 3.431, P = 0.038), with IL-6 in Group C being lower than that in Group B and A. MDA levels among the three groups differed at T5 (F = 4.692, P = 0.012) and T7 (F = 5.906, P = 0.004), with the MDA level of Group C being lower than that of Group B and A at T5, and the MDA level of Group C and B being lower than that of Group A at T7. In terms of TNF-α level, patients in Group C had a lower level than those in Group B and A at T8 (F = 3.598, P = 0.033). Compared with patients who did not use PGE1, patients in Group C had comparable complications and lung infection scores.ConclusionThe concentration of FiO2 could be reduced from 60 to 40% to maintain oxygenation. 40% FiO2 + 0.2 µg/kg PGE1 is recommended as a better combination on account of its effects on the inflammatory factors.Trial registration: Chictr.org.cn identifier: ChiCTR1800018288, 09/09/2018.

Characteristics of Changes in Serum IL-6 and IL-10 Levels in Patients with COVID-19 and Their Relationship with Disease Progression: A Possible Hypothesis

Characteristics of Changes in Serum IL-6 and IL-10 Levels in Patients with COVID-19 and Their Relationship with Disease Progression: A Possible Hypothesis

Interleukin – 6 Serum Level and Single Nucleotide Gene -174 G/C promoter Polymorphism in Patients with Rheumatoid Arthritis / Iraq

Objective: To 1) assess IL-6 levels in the serum of patients with rheumatoid arthritis (RA). 2) study IL-6 promoter -174 G>C “single nucleotide polymorphism (SNP)” as an imminent factor for the disease development. 3) find any relation between the level of serum IL-6 cytokine and other parameters such as age, gender, clinical severity of diseases and “disease activity scores (DAS28)”. Materials & methods: This research was carried out through a case – control approach at “Ibn – Senna Teaching Hospital” in Mosul city between November 2020 and July 2021. It included 61 RA patients diagnosed according to “ACR / EULAR 2010 criteria” and 50 healthy individuals. IL-6 serum levels were ascertained by ELISA and genotyping of IL-6 promoter was accomplished by “sequence-specific primer-polymerase chain reaction (SSP-PCR)”. Results: Mean IL-6 level in RA (69.42 ng /l ± 62.99) was elevated in comparison to healthy people (14.66 ng /l ± 23.58), P < 0.001. No age or gender effects on IL-6 concentration were noted. The ideal cut-off of IL-6 for discrimination of RA with best discriminative utility compared to healthy controls was 22.80 ng/l. At this value the IL-6 sensitivity was 91.8%, specificity 82.0% and accuracy rate 73.80%. G/G genotype was the most pervasive genotype in both RA patients and controls (70.5% in RA and 64% in healthy controls). However, it did not seem to be a risk factor for RA development compared to G/C or C/C genotypes “(OR = 1.3438, 95% CI=0.605-2.984,P=0.469)”. The mean IL-6 level in patients with GG genotype was (73.70 ng / l ± 71.09) compared to (58.37 ng /l ± 37.86) in patients with GC genotype. There was no significant difference in the IL-6 level between patients with GG and patients with GC genotypes (P = 0.2375). Although higher IL-6 mean concentration was reported in severe RA, however, no significant difference was found between patients with mild, moderate and severe RA respectively. No correlation of serum levels of IL-6 with genetic promoter polymorphism, clinical severity of diseases or DAS 28 score were reported. Conclusion: The concentration of serum IL-6 was elevated in RA in regard to healthy controls which confirmed its pivotal role in RA pathogenesis. Our data did not support the role of IL-6 promoter -174 G> C polymorphism as a risk factor for RA, nor seem to play a major role in the increase of IL-6 level among our patients with RA.