Immunoturbidimetric Method Research Articles

Abstract 4138388: Lipoprotein(a): Real-world Impact of Assay Change

Background and aims: Different assays have been used to analyze lipoprotein(a) over time, and the need for standardization of Lp(a) assays is well-known. Nonetheless, the impact of the use of different assays for clinical decision making and risk stratification of individuals is understudied. We aimed to investigate how transitioning between Lp(a) assays at a large central laboratory affected the proportion of individuals with Lp(a) result above clinical thresholds. Methods: We studied nationwide clinical laboratory data from Norway including 185,493 individuals between 18-50 years of age with 272,463 Lp(a) measurements between 2000-2019. Lp(a) was analyzed in non-frozen serum samples using immunoturbidimetric methods from Roche Tina-quant assay (generation 1) in 2000–2009 (N individuals = 75,221) and Siemens LPA assay (N individuals = 123,824) in 2009-2019 in mg/dL units. Because some lipid-lowering drugs can modestly alter plasma Lp(a), the data material was restricted to individuals <50 years due to a low use of medication in this age group. Results: The Roche assay detected 35% more individuals with Lp(a) > 50 mg/dL than the Siemens assay in the total population. In individuals that had measurements analyzed by both Roche and Siemens assays (N = 13,494), the Roche assay detected 40% more individuals with Lp(a) > 50 mg/dL than the Siemens assay (25%, N = 3,373 vs. 18%, N = 2,475), and 70% more individuals with Lp(a) >85 mg/dL than the Siemens assay (11%, N = 1,478 vs. 6.5%, N = 881). Conclusion: The choice of Lp(a) immunoassay can influence interpretation of Lp(a) results and decisions, particularly in individuals approaching clinically relevant Lp(a) thresholds.

Reliability of albumin bromocresol green colorimetric method and clinical impact

Measuring plasma albumin is a common and important laboratory test. We compared the results obtained with the bromocresol green (BCG) colorimetric, immunoturbidimetric (IT), and capillary electrophoresis (CE) methods and evaluated the clinical reliability of the colorimetric test. Samples from 320 patients including 227 patients with hypoalbuminemia (albumin levels <35 g/L) were analyzed. Results were compared between different patient groups. The BCG method indicated significantly higher plasma albumin levels than the CE and IT methods, especially in patients with elevated C-reactive protein, alpha-1 globulin (a1G), and alpha-2 globulin (a2G) values. A significant proportion of patients with mild hypoalbuminemia tested using the BCG method (albBCG) and were classified as severely hypoalbuminemic (albumin <20 g/L) when switching to the CE or IT method (albCE and albIT). These patients had elevated a1G and/or a2G levels. This change of result implied an additional indication for albumin replacement therapy. The BCG method significantly overestimates albumin levels in patients with inflammation and hypoalbuminemia, which may lead to inappropriate therapeutic decisions.

Lipoprotein(a) levels in acute myocardial infarction patients and their associations with prior events and coronary artery disease severity: a real-world cohort study

Abstract Introduction Circulating lipoprotein(a) [Lp(a)] has been associated with the risk of atherosclerotic coronary artery disease (CAD) and is an emergent therapeutic target. The objective of this study is to explore the association between serum levels of Lp(a) and previous myocardial infarction (MI) and/or coronary revascularization and the extension of obstructive CAD in patients with acute MI undergoing coronary angiography. Methods All consecutive patients with MI who underwent coronary angiography and Lp(a) measurement between May and November 2023 were included. Patient data were either registered prospectively or completed retrospectively using electronic health records. Lp(a) was measured using the Immunoturbidimetric Assay method with reaction intensification by particles, employing the World Health Organization/International Federation of Clinical Chemistry and Laboratory Medicine (WHO/IFCC) International Reference Reagent (SRM2B), on the "Roche Cobas C702" chemistry analyzer. The number of major coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) with stenosis &amp;gt;50% on the coronary angiography were registered. In the primary analysis we explored the association between Lp(a) levels using tertiles and previous occurrence of MI/revascularization, as well as the extension of obstructive CAD. In the secondary analysis we compared Lp(a) levels in patients with and without previous MI/revascularization and patients with 3-4 major vessels CAD vs. 0-2 vessels. Results A total of 116 patients were enrolled, with a mean age of 62±13 years, 79% males, 29% with known coronary artery disease, 71% with dyslipidemia, 24% with diabetes, 65% with hypertension, and 58% were either active or former smokers. The median Lp(a) level was 72 (20-183) nmol/L. In the primary analysis (table 1), the number of previous MI/revascularizations was significantly higher in the third tertile of Lp(a) (T3) versus T1 (p=0.044). No significant differences were found for the remaining analyses. In the secondary analysis (figure 1) the level of Lp(a) was significantly higher in patients with 3-4 vessel CAD vs. 0-2 vessel (158.4±145.2 nmol/L vs. 103.16±104.6 p=0.044). Conclusion In this small real-world cohort population with acute MI, the number of previous MI or coronary revascularization was higher in patients with increased levels of Lp(a) and this marker of atherosclerotic disease was greater in patients with more extensive CAD.

Геронтологические особенности влияния новой коронавирусной инфекции на показатели интерлейкинового профиля, воспаления и эндогенной интоксикации у пациентов зрелого и пожилого возраста с ишемической болезнью сердца

Background: Coronary heart disease (CHD) is considered as an independent risk factor for COVID19, however, the indicators of inflammation and endogenous intoxication in patients with CHD 3-4 weeks after recovery from COVID-19 have not been the subject of scientific research. The aim of the study: Assessment of the gerontological features of the effect of the transferred new coronavirus infection on the indicators of the interleukin profile, inflammation and endogenous intoxication of mature and elderly patients with coronary heart disease in the early stages of recovery. Materials and methods: The study included 58 mature-age patients with coronary heart disease 3-4 weeks after recovery from COVID-19 of moderate severity, who made up the comparison group. The main group of patients was represented by 62 elderly people with coronary heart disease who had suffered a new coronavirus infection and were examined in the same way as the previous group, 3-4 weeks after recovery. The level of C-reactive protein and highly sensitive C-reactive protein in the blood was studied using the Nicomed-reader express analyzer, and antistreptolysin-O was studied using an immunoturbidimetric method on the Cobas 600 analyzer (Switzerland). The blood levels of bilirubin, urea, creatinine and sialic acids were studied using the ROKI biochemical analyzer. The content of systemic cytokines was determined by the Beckton Dickinson FACS Canto 2 (USA). The level of anxiety and depression was studied on the HADS scale. Results: 3-4 weeks after recovery from COVID-19, antistreptolysin-O levels ranged from 120.9 МЕ/ml to 208.1 МЕ/ml. Significant changes among the considered parameters of inflammation and endogenous intoxication in patients with coronary heart disease in old age during recovery from a new coronavirus infection were accompanied by a change in the content of highly sensitive C-reactive protein in peripheral blood. In the early stages of recovery after COVID-19, in elderly patients with coronary heart disease, the concentration of many studied cytokines in blood plasma remained elevated compared with those aged 45-59 years. The excess of reference values in both groups was found for IL-17, TNF-α and IFN-α, and among elderly patients – for IL-3, IL-4, IL-6, IL-7, IL-17. Conclusion: Antistreptolysin-O, highly sensitive C-reactive protein, C-reactive protein can be considered markers of recovery in patients with combined coronary heart disease in the early stages after a new coronavirus infection.

Vitamin D and CRP are associated in hospitalized inflammatory bowel disease (IBD) patients in Shanghai.

Patients with inflammatory bowel disease (IBD) are more likely to be confirmed with vitamin D deficiency. However, the association between inflammation and vitamin D remains unclear. The purpose of this study was to evaluate the association between inflammation and vitamin D in hospitalized patients with IBD. All the participants were recruited from one teaching hospital from June 2018 to October 2022. Inflammation was evaluated by serum concentration of C-reactive protein (CRP), using an immunoturbidimetric method at admission. We further divided the participants into five groups based on serum CRP levels: <5, 5-9.9, 10-19.9, 20-39.9, and >40mg/L. Serum 25-hydroxy-vitamin D (25-(OH)-D) was assessed by liquid chromatography tandem mass spectrometry. Addi-tional information, including age, sex, body mass index (BMI), IBD (ulcerative colitis vs. Crohn's disease) subtype, was abstracted from medical records. This study included 1,989 patients with IBD (average age was 39.4 years, 33.8% of them were women, 1,365 CD and 624 UC patients). The median CRP was 5.49 mg/L (range of quartiles: 1.64~19.5 mg/L) and the prevalence of 25-(OH)-D deficiency was 69.8%. CRP was significantly associated with serum level of 25-(OH)-D. The difference in 25-(OH)-D was -4.28 ng/ml (-5.27 ng/ml, -3.31 ng/ml) between two extremist CRP groups after adjustment of potential covariates (age, sex, BMI, type of IBD, dietary type, season, and lymphocyte count). Subgroup analysis in sex, type of IBD, and age, were similar to the main analysis results. There was a negative association between CRP levels and vitamin D in hospitalized patients with IBD.

Weak association between urea-creatinine ratio and c-reactive protein with nutritional risk in hospitalized patients with COVID-19: A cross-sectional study

BackgroundCOVID-19 is a systemic infection with a significant impact on nutrition risk and the hematopoietic system. The neutrophil-lymphocyte ratio (NLR) may have prognostic value in determining severe cases of COVID-19 and the urea-creatinine ratio (UCR) is currently being studied as a potential biomarker of catabolism associated with critical illness. The aim was to assess the association between the NLR, UCR and C-reactive protein (CRP) with nutritional risk in hospitalized patients with COVID-19. MethodsThis is a retrospective cross-sectional study that assessed 589 hospitalized patients with COVID-19, 18 years of age or older, of both sexes. Nutritional risk was assessed by Nutritional Risk Screening (NRS, 2002) and NLR by neutrophils divided by lymphocyte count. The UCR was calculated by the ratio between urea and creatinine and quantified by the calorimetric biochemical method and CRP by the immunoturbidimetric method. Differences between groups were applied by the Mann-Whitney U test and the automated binary regression test. ResultsOf the 589 patients, 87.4% were at nutritional risk. When evaluating patients admitted to the ICU, 91.9% were at nutritional risk. Patients with NRS ≥3 are older, with lower body mass and BMI, higher NLR and UCR and lower CRP values. However, 73% of patients admitted to the ward were at nutritional risk, and only age differed between groups, being higher in patients with NRS ≥3. Logistic regression showed a weak association between nutritional risk in NRS and UCR (Model 1) (OR=0.96, p=0.003) and NRS with CRP (Model 1) (OR=1.01, p<0.001) in patients in the ICU. On the other hand, the logistic regression in ward patients found association only for CRP in both models (Model 1, OR=1.01, p=0.041) and (Model 2, OR=1.01, p=0.031). ConclusionWe found a low association between nutritional risk and UCR and CRP in patients admitted to the ICU, while in the ward patients the nutritional risk also had weak association with CRP.

Assessment of Serum Beta 2-Microglobulin Levels in Crimean-Congo Hemorrhagic Fever Patients: Implications for Immune Activation and Disease Pathogenesis

Crimean-Congo Hemorrhagic Fever (CCHF) presents a spectrum of clinical manifestations, ranging from asymptomatic cases to severe, life-threatening conditions. Despite extensive research on CCHF pathogenesis, comprehensive understanding remains elusive. Our investigation focused on assessing serum beta 2-microglobulin (β2M) levels in CCHF patients, aiming to elucidate its potential as an immune activation marker and its involvement in disease pathogenesis. The study enrolled 45 CCHF patients and 45 healthy volunteers as a control group. Serum β2M levels were quantified using the immunoturbidimetric analysis method. The patient group was divided into two groups, mild and moderate-severe, using scoring systems. The mean β2M values for the control, mild, and moderate-severe patient groups were 2.27±0.50, 4.37±1.29, and 5.82±2.62 mg/L, respectively (p&amp;lt;0.001). Positive correlations were noted between β2M concentrations and markers such as BUN, creatinine, uric acid, creatine kinase, and aPTT (p&amp;lt;0.001, r=0.684; p&amp;lt;0.001, r=0.602; p=0.003, r=0.439; p=0.008, r=0.392; p=0.019, r=0.348, respectively). Conversely, negative correlations were observed with total protein, albumin, and platelet count (p=0.021, r=-0.342; p=0.003, r=-0.434; p=0.048, r=-0.296, respectively). The findings suggest a prominent inflammatory response in CCHF, indicated by elevated β2M levels, implying its potential role in the molecular mechanisms of the disease

Развитие синдрома алкогольной дислипидемии — фактор нарушения социальной безопасности в Арктическом регионе.

Alcoholism aggravates the nutritional component of developing comorbid somatic pathology risk in the Arctic region. Against the background of alcohol dependence syndrome (ADS) development peculiar changes in lipid metabolism are revealed: a low low-density lipoproteins (LDL) and triglycerides (TG) content, but a high high-density lipoproteins (HDL) content. The revealed changes stimulate the search for new diagnostic approaches, with the help of which it is possible to identify hidden alcohol-associated changes in lipid metabolism and influence the mechanisms of cardiovascular system (CVS) pathology development at different stages. The aim was to identify lipid metabolism disorders in practically healthy individuals and in individuals with alcohol dependence to substantiate the specific clinical and biological syndrome isolation — alcoholic dyslipidemia and to develop an algorithm for detecting hidden alcohol-associated disorders. 208 men were examined: 96 people — with II stage SCA; 112 — practically healthy individuals. The content of total cholesterol, TG, HDL was determined by enzymatic colorimetric method, LDL — by turbidimetric method, concentrations of apolipoproteins (apo-A and apo-B) — by immuno-turbidimetric method, fatty acids — by gas-liquid chromatography. A low content of SFA (pentadecanoic, margarine, arachine, geneicosene), multidirectional changes in MSFA with a low content of myristooleic and eicosene lipid acids, but high palmitooleic and heptadecanoic; PUFA ω-6 linoleic, arachidonic. At the same time, an increase in the content of linoleic lipid acids trans-form was noted, the content of ω-3 PUFA was also lower than that of PP due to α-linolenic (C18:3ω3), docosohexaenoic (DHA), but the content of eicosopentaenoic (EPA) was higher. In narcological patients, weak correlations between LDL, TG and NLC were found, which indicates a lipid acids into LDL and TG integration violation. The absence of interrelations of ω-3 linoleic acid with EPA and DHA forming from it in patients with ADS may indicate anenzymatic processes violation.

Effects of Cranberry Extract (Vaccinium macrocarpon) Supplementation on Lipid Peroxidation and Inflammation in Patients with Chronic Kidney Disease (Stages 3-4): A Randomized Controlled Trial.

Growing evidence suggests that bioactive compounds in berry fruits may mitigate inflammation in patients with chronic kidney disease (CKD). To evaluate cranberry (Vaccinium macrocarpon) supplementation effects on modulation of transcription factors involved in inflammation and oxidative stress in nondialysis (stages 3 and 4) patients with CKD. Design/Participants. A randomized, double-blind, placebo-controlled study was performed with 30 patients to receive capsules containing cranberry extract (1000 mg/day) or placebo (1000 mg/day of corn starch) for two months. Measurements. The mRNA expression of nuclear factor-erythroid 2-related factor-2 (Nrf2) and nuclear factor-kB (NF-kB) was evaluated in peripheral blood mononuclear cells (PBMCs) by quantitative real-time polymerase chain reaction. Thiobarbituric acid reactive substances (TBARS) were measured in the plasma to assess oxidative stress. Interleukin-6 (IL-6) plasma levels were assessed by enzyme-linked immunosorbent assay and C-reactive protein (CRP) by immunoturbidimetric method. Twenty-five patients completed the study: 12 in the cranberry group (56.7 ± 7.5 years and body mass index (BMI) of 29.6 ± 5.5 kg/m2) and 13 in the placebo group (58.8 ± 5.1 years and BMI 29.8 ± 5.4 kg/m2). There were no differences in NF-kB or Nrf2 mRNA expressions (p = 0.99 and p = 0.89) or TBARS, CRP, and IL-6 plasma levels after cranberry supplementation. The cranberry extract administration (1000 mg/day) did not affect Nrf2 and NF-kB mRNA expression, oxidative stress, or inflammatory markers levels in nondialysis CKD patients. This trial is registered with NCT04377919.

Exploration of the application potential of serum multi-biomarker model in colorectal cancer screening

Analyzing blood lipid and bile acid profile changes in colorectal cancer (CRC) patients. Evaluating the integrated model's diagnostic significance for CRC. Ninety-one individuals with colorectal cancer (CRC group) and 120 healthy volunteers (HC group) were selected for comparison. Serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoproteins (Apo) A1, ApoA2, ApoB, ApoC2, and ApoC3 were measured using immunoturbidimetric and colorimetric methods. Additionally, LC–MS/MS was employed to detect fifteen bile acids in the serum, along with six tumor markers: carcinoembryonic antigen (CEA), carbohydrate antigens (CA) 125, CA19-9, CA242, CA50, and CA72-4. Group comparisons utilized independent sample t-tests and Mann–Whitney U tests. A binary logistic regression algorithm was applied to fit the indicators and establish a screening model; the diagnostic accuracy of individual Indicators and the model was analyzed using receiver operating characteristic (ROC) curves. The CRC group showed significantly lower levels in eight serum lipid indicators and eleven bile acids compared to the HC group (P < 0.05). Conversely, serum levels of TG, CA19-9, and CEA were elevated (P < 0.05). Among the measured parameters, ApoA2 stands out for its strong correlation with the presence of CRC, showcasing exceptional screening efficacy with an area under the curve (AUC) of 0.957, a sensitivity of 85.71%, and a specificity of 93.33%. The screening model, integrating ApoA1, ApoA2, lithocholic acid (LCA), and CEA, attained an impressive AUC of 0.995, surpassing the diagnostic accuracy of individual lipids, bile acids, and tumor markers. CRC patients manifest noteworthy alterations in both blood lipids and bile acid profiles. A screening model incorporating ApoA1, ApoA2, LCA, and CEA provides valuable insights for detecting CRC.

Investigation of Cytokines, Biochemical Parameters and Oxidative Stress Levels in Serum of Patients with Acute Pancreatitis

Objective: This study aimed to find new serum biochemistry parameters, especially for the early identification of severe AP. In the study serum cytokine levels (TNF-A, IL-1, IL-6, IL-10, IL-21), biochemical parameters (Aquaporin-1, Hepcidine, Iron, Zinc, Copper, Nitric Oxide, C-Reactive protein), and oxidative stress parameters analysis were performed. Method: A total of 46 patients with AP and 46 healthy controls were included in this study. Serum cytokine levels, biochemical, and oxidative stress parameters by the ELISA method, and CRP by the immunoturbidimetric method were measured. Results: When patients with AP and control groups were compared, all studied parameters were found to be statistically significant (p&amp;lt;0.05). However, IL-1 was found to be insignificant (p&amp;gt;0.05). Therefore, the Mann-Whitney U test, which is a non-parametric test, was found suitable to determine whether there was a significant difference between the patient and control groups. Conclusions: Investigating the role of cytokines, oxidative stress and other biochemical parameters in the pathogenesis and course of the disease may contribute to a better understanding of the disease process and its therapeutic value. It showed a significant increase in oxidative stress parameters and biochemical parameters such as aquaporin-1, hepcidin, lipase, and amylase, which may help in the diagnosis of AP.

Comparison of lipemia interference created with native lipemic material and intravenous lipid emulsion in emergency laboratory tests.

This study aimed to investigate the effects of lipemia on clinical chemistry and coagulation parameters in native ultralipemic (NULM) and intravenous lipid emulsion (IVLE) spiked samples. The evaluation of biochemistry (photometric, ion-selective electrode, immunoturbidimetric method), cardiac (electrochemiluminescence immunoassay method) and coagulation (the viscosity-based mechanical method for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and the immunoturbidimetric method for D-dimer) parameters were conducted. In addition to the main pools, five pools were prepared for both types of lipemia, each with triglyceride (TG) concentrations of approximately 2.8, 5.7, 11.3, 17.0 and 22.6 mmol/L. All parameters' mean differences (MD%) were presented as interferographs and compared with the desirable specification for the inaccuracy (bias%). Data were also evaluated by repeated measures of ANOVA. Prothrombin time and APTT showed no clinically relevant interference in IVLE-added pools but were negatively affected in NULM pools(P < 0.001 in both parameters). For biochemistry, the most striking difference was seen for CRP; it is up to 134 MD% value with NULM (P < 0.001) at the highest TG concentration, whereas it was up to - 2.49 MD% value with IVLE (P = 0.009). Albumin was affected negatively upward of 5.7 mmol/L TG with IVLE, while there was no effect for NULM. Creatinine displayed significant positive interferences with NULM starting at the lowest TG concentration (P = 0.028). There was no clinically relevant interference in cardiac markers for both lipemia types. Significant differences were scrutinized in interference patterns of lipemia types, emphasizing the need for careful consideration of lipemia interferences in clinical laboratories. It is crucial to note that lipid emulsions inadequately replicate lipemic samples.

Apo Lipoproteins A1 and B in Multidrug-Resistant Tuberculosis (MDR-TB)

Aims: The medical management of multidrug-resistant tuberculosis (MDR-TB) has become a major public health issue. Apolipoproteins play a key role in lipoprotein metabolism such as the recognition of receptors involved in lipoprotein metabolism. Thus, the study of the inter- relationships between apolipoproteins (A1 and B) and MDR-TB could represent an important approach to the biological management of MDR-TB patients. Methodology: This is an experimental study carried out on eighty-two (82) patients including thirty-eight (38) MDR-TB patients which age ranged from 18 to 60 years old recruited from three tuberculosis centers (CAT) in the city of Abidjan and forty-four (44) non-tuberculosis patients used as control aged 18 to 60 years old recruited at the National Blood Transfusion Center (CNTS) in Treichville (Abidjan, Côte d’Ivoire). Total cholesterol, HDL-cholesterol and triglycerides were measured by the colorimetric-enzymatic method. Apolipoproteins A1 and B were measured using the immunoturbidimetric method. Results and Conclusion: Showed a dyslipidemia concerning cholesterol and its HDL fraction, triglycerides and apolipoproteins A1 and B suggest an atherogenic profile in multidrug-resistant TB patients.

Correlation study of CBC derivatives and biochemical prognostic marker in covid-19 patients

: SARS-CoV2 infection induces inflammatory responses and acute lung injury in human beings. Infection causes certain haematological and biochemical changes in patients. This study aimed analyze the correlation between CBC derivatives and biochemical prognostic marker in COVID-19.: Total 80 individuals selected, 50 COVID-19 positive patients and 30 subjects negative for COVID-19 RT-PCR test. Blood collected was sent to NLR, RDW, assayed in Beckman Coulter DxH 800. Serum CRP estimated by Immuno-turbidimetric method, ferritin by CLIA. Plasma collected estimate for D-DIMER by CLIA. Unpaired T test &amp; Pearson correlation (IBM SPSS 22.0) were used. : Elevated levels of NLR (p value &amp;#60;0.001), RDW (p value &amp;#60;0.001), FERRITIN (p value &amp;#60;0.001), D-D-DIMER (p value &amp;#60;0.001), CRP (p value &amp;#60;0.001) some research parameters like LHD and RSF show significant decrease. In current study the NLR positively correlate to CRP (r value=0.5, p value &amp;#60;0.001), NLR positively correlate to D-DIMER (r value=0.3, p value&amp;#60;0.05), RDW positively correlated to CRP (r value=, 0.3, p value &amp;#60;0.05), RDW negatively correlated to ferritin (r value=-0.439, p value &amp;#60;0.001)LHD negatively correlated ferritin (r value=-0.316, p value=&amp;#60;0.05), MAF negatively correlated to D-dimer (r value=-0.244 &amp;#60;0.05), MSCV positively correlated with CRP (r value=0.336, p value= &amp;#60;0.05).: The cytokine storm produced during covid-19 infection which inturn develop neutrophilia and lymphopenia, CRP production and also cause elevation of procoagulants &amp;D-dimer. RDW and CRP are positively correlated they are elevated during inflammatory conditions.RDW and FERRITIN show negative correlation. Retrospective study have some limitation so future studies will reveal more information.

Distinct age-adjusted D-dimer threshold to rule out acute pulmonary embolism in outpatients and inpatients.

The diagnosis of acute pulmonary embolism (PE) is combinations of clinical probability assessments, plasma D-dimer (DD) test results, and/or computed tomographic pulmonary angiography (CTPA). The aim of this study is to explore the appropriate DD cutoff using the immunoturbidimetric method in outpatients and inpatients. We retrospectively enrolled 2689 patients with suspected PE between January 2014 and December 2019. All patients underwent clinical probability assessments, DD tests, and CTPA. We investigated the appropriate cutoff level for plasma DD tests in the correlation analysis and receiver operating characteristic (ROC) curves. Among all patients, 1263 were confirmed acute PE. The age-adjusted DD level was determined to be age × 10μg/L (for patients aged >50 years) in outpatients. This cutoff value resulted in a sensitivity of 96.75% and a specificity of 87.02%, with the area under the curve (AUC) of 0.908 and the number needed to treat (NNT) of 1.18. For inpatients, the age-adjusted cutoff values for the biomarker DD demonstrated poor specificity (13.34%) and NNT (9.88). However, when the DD cutoff was adjusted to 2 × the upper limit of normal (ULN), the sensitivity increased to 93.19%, while the specificity remained at 29.55%, with the AUC of 0.610 and the NNT of 4.76. The optimal DD cut-off value was 3010 μg/L (about 5 × ULN), resulting in a sensitivity of 75.22% and specificity of 61.72%, with the AUC of 0.727 and the NNT of 2.7. Using the immunoturbidimetric method to measure DD, an age-adjusted DD cutoff (age × 10μg/L, if aged >50 years) should be considered for outpatients with suspected PE. For inpatients, increasing the DD cutoff value to at least 2 × ULN yields the best test performance.

Serum Albumin Level Can Predict Immunotherapy Response of Neuromyelitis Optica Spectrum Disorders in the Acute Phase.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system. However, few biomarkers have been found to predict the outcome of immunotherapy. We investigated the relationship between the serum albumin (S-Alb) and response to immunotherapy in acute NMOSD patients. A total of 107 consecutive Chinese patients with acute NMOSD diagnosed between January 2013 and January 2022 were included in our prospective observational study. S-Alb was measured by the use of bromocresol green and immunoturbidimetric methods on admission. The immunotherapy response was assessed by the percentage change in the expanded disability status scale (EDSS) score from admission to discharge after treatment. We evaluated the association between S-Alb and immunotherapy response through multivariate logistic regression analysis. S-Alb levels were significantly lower in patients who were resistant to immunotherapy than in those who were responsive to treatment (p<0.001). S-Alb levels were positively related to a favorable response to immunotherapy (r=0.386, p<0.001). The odds ratio (95% CI) for the association between S-Alb level and response to immunotherapy was 1.27 (95% CI=1.08, 1.50; p=0.004) after adjusting for potential factors. ROC analysis showed that patients with S-Alb levels lower than 40.85 g/L were likely to be resistant to immunotherapy. Our study indicated that a higher S-Alb was an independent indicator of response to immunotherapy in acute NMOSD patients.

Prognostic value of serum protein electrophoresis constituents for arthritis development in anti-citrullinated protein antibody-positive patients with musculoskeletal pain

Objective Predictors of arthritis development in patients with anti-citrullinated protein antibodies (ACPAs) and musculoskeletal symptoms are needed for risk stratification and to improve clinical outcomes. The aim of this study was to assess the relationship between serum protein electrophoresis (SPE) constituents and the development of clinical arthritis in ACPA-positive patients with musculoskeletal pain. Method We prospectively followed 82 ACPA-positive patients with musculoskeletal pain but no baseline arthritis during a median of 72 months (interquartile range 57–81 months). The primary outcome was arthritis development, as judged by clinical examination. SPE constituents were evaluated in baseline sera by immunoturbidimetric methods. Serum levels of the analysed proteins (albumin, orosomucoid, α1-anti-trypsin, haptoglobin, and immunoglobulins IgA, IgG, and IgM) were related to arthritis development by Cox regression analyses. Results During the follow-up period, 39/82 patients (48%) progressed to arthritis. Median baseline levels of orosomucoid and α1-anti-trypsin were higher in patients who developed arthritis than in those who did not (p = 0.04), while median albumin levels were significantly lower (p = 0.03). Immunoglobulin levels did not differ between the groups. Univariable analysis demonstrated a significantly increased risk of arthritis with elevated baseline haptoglobin [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.32–4.85, p = 0.005] and orosomucoid levels (HR 2.63, 95% CI 1.09–6.31, p = 0.03). However, neither remained significant in multivariable analysis adjusting for elevated C-reactive protein (CRP) levels. Conclusion SPE does not add prognostic value for arthritis development in ACPA-positive patients with musculoskeletal pain.

Evaluation of Some Renal Biomakers in Patients with Benign Prostatic Hyperplasia/Prostate Cancer Attending Nnamdi Azikiwe University Teaching Hospital Nnewi

Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are among the urological conditions that affect aging men. Patients with this pathology could develop renal impairment. Renal biomarkers like beta-2-microglobulin (BMG), urea, urine creatinine, microalbumin (MALB), and albumin to creatinine ratio (ACR) were assessed with total (tPSA) and free prostate specific antigen (fPSA), systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight and BMI. This cross sectional study recruited 120 men using convenient sampling technique which comprised 40 BPH, 40 PCa and 40 control attending Urology Clinic of NAUTH Nnewi, Anambra State. Five (5) milliliters of blood/ urine samples were collected from the patients and the necessary data were obtained from clinical records of the patients. The weight (kg) and height (m) were measured using standard beam balance scale and a stadiometer respectively and the BMI calculated. Blood pressure was measured using sphygmomanometer and stethoscope. PSA (ng/ml) was estimated by Enzyme immunoassay technique, BMG (mg/l) and MALB (mg/l) by immunoturbidimetric method, urea and creatinine were determined spectrophotometrically using modified Urease-Berthelot method and Jaffe slot alkaline picrate method respectively. Data analysis was conducted using SPSS version 21.0. The results were presented as median. Kruskal Wallis was used to determine significant differences between the mean values. P&lt;0.05 was considered to be statistically significant. The results showed a significantly higher median values of tPSA, fPSA BMG and MALB in patients with BPH /PCa when compared with the control. MALB had a strong correlation with ACR in all the groups. Despite the significant increase in BMG and MALB in this study, routine indices of renal function remained normal. The increase in the sensitive markers in patients with BPH/PCa is an indication of early renal impairment.

СИСТЕМНОЕ ВОСПАЛЕНИЕ У БОЛЬНЫХ СО СТАБИЛЬНОЙ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА В ПОСТКОВИДНОМ ПЕРИОДЕ В ЗАВИСИМОСТИ ОТ ТЯЖЕСТИ ПЕРЕНЕСЕННОЙ COVID-19

Background. In the post-covid period, systemic inflammation plays an important role in the development of coronary heart disease (CHD) and has a significant impact on the cardiovascular system by improving inflammatory responses, which may lead to progression of atherosclerosis, worsen the condition, and increase the likelihood of complications in patients with stable CHD. Objective. To evaluate clinical and laboratory indices of systemic inflammation in patients with stable coronary heart disease in the post-covid period depending on the severity of COVID-19. Material and methods. An observational descriptive study of two parallel groups including 416 patients with stable CHD who underwent COVID-19 more than 12 weeks ago was conducted. Patients were divided into two groups according to the severity of COVID-19 in the acute period. Group 1 included 203 patients (male 132 (65.3%), female 71 (34.7%)) aged 59.7±6.9 years who had mild SARS-CoV-2 infection; Group 2 included 213 patients (male 132 (62.0%), female 81 (38.0%)) aged 61.1±6.1 years who had moderate COVID-19. Monocyte chemoattractant protein-1 (MCP-1); vascular endothelial growth factor (VEGF); interleukins; interleukins (ILs): IL-1β, IL-4, IL-6, IL-8, IL-10, and IL-18 were determined by PCR. The C3 and C4 components of the complement system were also determined by the immunoturbidimetric method. Statistical calculations were performed in the RStudio software (version 2022.07.2+576, USA) in the R language (version 4.1.3 (2022-03-10), Austria). Results. Uncontrolled hypertension (p&lt;0.001) and grade II obesity (p=0.005) were more frequent in the group of patients with stable CHD who underwent moderate COVID-19. In the same group, type 2 DM (p=0.031), atrial fibrillation (p = 0.029), and grade III angina pectoris (p=0.006) were more frequent, and Simpson's EF was lower (p&lt;0.001) compared to the group of patients with mild SARS-CoV-2 infection. In patients with IBS who underwent COVID-19 of moderate severity, there was a statistically significant increase in the levels of pro-inflammatory cytokines - MCP-1, TNF-α, IL-1β (p&lt;0.01) and the C3 component of the complement system (p=0.048) compared to patients with a mild course of infection in the acute period. In patients with stable coronary heart disease who underwent COVID-19, significant correlations were observed between the studied pro-inflammatory blood markers. Multiple and strongest associations were found for MCP-1, IL-10, IL-1β, IL-2, VEGF and the components of the complement system C3 and C4, which can be used as markers of the unfavorable course of the post-acute period in patients with IBS. Conclusion. Patients with stable CHD who underwent moderate SARS-CoV-2 infection are characterized by a higher incidence of uncontrolled AH, type 2 DM, and atrial fibrillation in the remote period. These patients also have higher levels of pro-inflammatory cytokines MCP-1, TNF-α and IL-1β, which correlate significantly with the severity of the disease and can serve as a predictor of its progression.

Reduction of Complements C3 and C4 in Saliva and Serum of Patients Suffering SARS-CoV-2 Infection

Background: The complement system plays a role in chronic immune activation during viral infections. Objectives: This study aimed to evaluate the levels of saliva and serum complements C3 and C4 in coronavirus disease 2019 (COVID-19) patients and healthy individuals. Methods: This cross-sectional study included 36 severe and 22 critical COVID-19 hospitalized patients and 22 healthy individuals. Serum and unstimulated salivary C3 and C4 levels were assessed using the immunoturbidimetric method and analyzed using one-way analysis of variance (ANOVA) with the Student-Newman-Keuls test as a post hoc analysis. Results: Salivary C3 and C4 levels were significantly lower in patients with severe and critical COVID-19 than in healthy individuals. There was no significant difference between the groups infected with severe and critical COVID-19. Serum C3 and C4 levels were lower in critical COVID-19 patients than in healthy individuals; nevertheless, no significant difference was observed between severe COVID-19 patients and healthy individuals. Additionally, serum C4 levels were lower in critical COVID-19 patients than in severe COVID-19 patients. Conclusions: It appears that serum and salivary C3 and C4 levels decrease in patients with COVID-19 infection.