Increased Serum C-reactive Protein Research Articles

Effect of chronic periodontitis on the endothelial glycocalyx of rat penile corpus cavernosum.

Chronic periodontitis may induce erectile dysfunction (ED), however, the specific mechanism involved is unclear. The endothelial glycocalyx (eGlx) is a structure that can regulate endothelial nitric oxide synthase (eNOS) phosphorylation on the cavity surface of vessels. To investigate whether chronic periodontitis leads to ED by affecting the eGlx. Twenty-four 4-week-old male Sprague‒Dawley rats were randomly divided into four groups (n=6): the control group, chronic periodontitis group, chronic periodontitis + heparin group (subcutaneous heparin 200 U/kg/day, 7 days), and control + heparin group. Four weeks after the induction of periodontitis in the rats, the maximum intra-cavernous pressure/mean arterial pressure (ICPmax/MAP), serum C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), heparin sulfate (HS), syndecan-1 (SDC-1), heparanase (HPSE), eNOS, and phosphor-eNOS (p-eNOS) concentration were measured, and the eGlx of the penile corpus cavernosum was observed by transmission electron microscopy (TEM). Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF-α, and IL-6 levels, reducing the p-eNOS/eNOS ratio and the NO concentration in the penile corpus cavernosum, and resulting in the inhibition of the erectile function. Serum CRP, TNF-α, and IL-6 levels and HPSE expression in penile cavernous tissue were significantly greater in the chronic periodontitis group than in the control group and the chronic periodontitis + heparin group (P<0.05). The average thickness of the eGlx muscle in the penile corpus cavernosum in the chronic periodontitis group was significantly lower than those in the control group and chronic periodontitis + heparin group (P<0.05). The HS concentration, SDC-1 expression, p-eNOS/eNOS, NO concentration, and ICPmax/MAP in the chronic periodontitis group were significantly lower than those in the control group and chronic periodontitis+ heparin group (P<0.01). The eGlx on penile cavernosum vessels may be a new therapeutic target for the treatment of ED. This study revealed that chronic periodontitis promotes the decomposition of vascular eGlx in the rat penile corpus cavernosum, however, it is not clear whether chronic periodontitis inhibits the synthesis of eGlx. Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF-α, and IL-6 levels, reducing the p-eNOS/eNOS ratio and the NO concentration in penile cavernous tissue, and resulting in the inhibition of the erectile function. Heparin inhibited eGlx decomposition and improved erectile function in rats with chronic periodontitis.

New-onset of giant cell arteritis with ischemic optic neuropathy following the seventh-dose of COVID-19 mRNA vaccination: A case report and literature review.

Coronavirus disease (COVID-19) vaccines have demonstrated excellent efficacy in reducing the morbidity and severity of the disease. However, some patients have been reported to develop systemic rheumatic diseases, such as rheumatoid arthritis, myocarditis, Guillain-Barre syndrome, and giant cell arteritis (GCA) following COVID-19 vaccination. We present a case of GCA with ischemic optic neuropathy following COVID-19 mRNA vaccination. A 73-year-old woman developed headache, myalgia, scalp tenderness, and jaw claudication 4 days after her seventh dose of the vaccination; she also developed severe visual disturbances 1 month after the vaccination. The blood examination tests showed an increased serum C-reactive protein level and erythrocyte sedimentation rate. The echogram for the temporal artery showed a halo sign. Ophthalmic examination revealed ischemic optic neuropathy in both eyes. The patient was treated with a high-dose glucocorticoid and tocilizumab under the diagnosis of GCA with ischemic optic neuropathy, obtaining mild improvement of the symptoms. This report underscores the need for clinical vigilance and further data collection regarding GCA cases after COVID-19 vaccination.

The potential presence of infection may be indicated through non-invasive prediction of procalcitonin and C-reactive protein levels within the initial three days after cervical cerclage: a retrospective case-control study

PurposeTo identify which non-invasive infection indicators could better predict post-cervical cerclage (CC) infections, and on which days after CC infection indicators should be closely monitored.MethodsThe retrospective, single-center study included 619 single-pregnancy patients from January 2021 to December 2022. Patients were categorized into infected and uninfected groups based on physicians’ judgments of post-CC infections. Registered information included patient characteristics, cervical insufficiency history, gestational age at CC, surgical method (McDonald/Shirodkar), purpose of CC, mid-pregnancy miscarriage/preterm birth, infection history or risk factors, and infection indices on days 1, 3, 5, and 7 after CC. Propensity score matching (PSM) was applied to reduce patient characteristic bias. Statistical analysis of C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), percentage of neutrophil count (NEU_P), interleukin-6 (IL-6), and procalcitonin (PCT) in the infected group compared with the uninfected group was performed using chi-square tests and t-tests. Receiver operating characteristic (ROC) curves were used to further assess the diagnostic value of CRP, PCT, and CRP-PCT in combination.ResultsAmong the 619 included patients, 206 patients were matched using PSM and subsequently assessed. PCT values on day 1 and day 3 after CC exhibited significant differences between the two groups in two statistical ways (P < 0.01, P < 0.05). The CRP levels on day 1 were significantly higher in the infected group compared to the uninfected group in two statistical ways (P < 0.05). On day 3, the mean CRP value was significantly elevated in the infected group compared to the uninfected group (P < 0.05). Analyses of IL-6, WBC, NEU, and NEU_P did not yield clinically significant results. The area under the ROC curves for CRP, PCT, and CRP-PCT on day 1 and day 3 were all below 0.7. In the preventive CC group, the AUC values of CRP and CRP-PCT obtained on d1 were found to be higher than 0.7, indicating moderate diagnostic accuracy.ConclusionFor women after CC surgery, especially of preventive aim, increased serum CRP and PCT levels from post-CC day 1 to day 3 may signal a potential postoperative infection, warranting close monitoring.

Asthmatic patients with high serum amyloid A have proinflammatory HDL: Implications for augmented systemic and airway inflammation

RationaleSerum amyloid A (SAA) is bound to high-density lipoproteins (HDL) in blood. Although SAA is increased in the blood of asthmatics, it is not known whether this modifies asthma severity. ObjectiveTo define the clinical characteristics of asthmatics with high SAA levels and assess whether HDL from SAA-high asthmatics is pro-inflammatory. MethodsSAA levels in serum from asthmatic and non-asthmatic subjects were quantified by ELISA. HDL isolated from asthmatics with high SAA levels were used to stimulate human monocytes and were intravenously administered to BALB/c mice. ResultsA SAA level > 108.8 μg/ml was defined as the threshold to identify 11% of an asthmatic cohort (n = 146) as being SAA-high. SAA-high asthmatics were characterized by increased serum C-reactive protein, IL-6, and TNF-α; older age; and an increased prevalence of obesity and severe asthma. HDL isolated from SAA-high asthmatics (SAA-high HDL) had an increased content of SAA as compared to HDL from SAA-low asthmatics and induced the secretion of IL-6, IL-1β and TNF-α from human monocytes via a FPR2/ATP/P2X7R axis. Intravenous administration to mice of SAA-high HDL, but not normal HDL, induced systemic inflammation and amplified allergen-induced neutrophilic airway inflammation and goblet cell metaplasia. ConclusionSAA-high asthmatics are characterized by systemic inflammation, older age, and an increased prevalence of obesity and severe asthma. HDL from SAA-high asthmatics is pro-inflammatory and, when intravenously administered to mice, induces systemic inflammation, and amplifies allergen-induced neutrophilic airway inflammation. This suggests that systemic inflammation induced by SAA-high HDL may augment disease severity in asthma.

PSIX-15 The Effects of Torula Yeast as a Protein Source on Digestibility, Inflammation, and Gut Microbiome in Labrador Retrievers with Chronically Poor Stool Quality

Abstract Four Rivers Kennel examined the effects of varying protein sources on digestibility, inflammation, and gut microbiota in Labrador Retrievers with historically poor stool quality. Thirty dogs (n = 15 males and n= 15 females; ages 3 to 10 years) with stool quality scores ≤ 2.5 on a 5 point scale were randomly assigned to 1 of 3 diets meeting AAFCO requirements with differing protein sources and similar nutrient profiles: 1) chicken meal (PC); 2) 10% brewer’s yeast (BY); and 3) 10% torula yeast (TY; SylPro, Arbiom, Durham, NC). Another 10 dogs (n = 5 males and n = 5 females) with normal stool quality (score ≥ 3) received diet 1 and served as negative control (NC). After 7 days acclimation to diet 1, dogs began treatments. Daily stool scores and weekly body weights were recorded. On days 7, 21, and 36, blood serum was analyzed for C-reactive protein (CRP), and feces for S100A12, alpha-1 proteinase inhibitor (a1PI), calprotectin, and microbiota dysbiosis index (MDI). Apparent total tract digestibility was assessed using the indicator method with 2 g titanium dioxide administered orally via gel capsules. Statistical analysis was performed by repeated measures model in SAS for stool scores, body weight, biomarkers, and microbiota or by one-way ANOVA in JMP for digestibility coefficients. Stool scores were greater in NC (P &amp;lt; 0.01), changed daily in all groups (P &amp;lt; 0.01) without noticeable overall trends, and were not affected by treatment*day interaction (P = 0.64). Body weight was greater (P = 0.01) and CRP less (P &amp;lt; 0.01) in NC dogs than poor stool dogs. Dry matter and carbohydrate digestibility did not differ between groups (P ≥ 0.14). NC dogs had greater fat digestibility compared with BY dogs (94.64 ± 1.33 % vs 91.65 ± 1.25%; P = 0.02). Protein digestibility was reduced in PC (58.91 ± 4.68%) and BY (58.26 ± 4.42%) compared with NC (75.52 ± 5.01 %), but TY diet improved protein digestibility to levels similar to NC (72.18 ± 5.01%, P = 0.03). There were no treatment effects on S100A12 or a1PI (P ≥ 0.44). Calprotectin decreased at a greater rate overtime in TY dogs (P &amp;lt; 0.01). There was a treatment*day interaction for MDI; BY and TY fluctuated less overtime (P = 0.01). Blautia (P = 0.03) and Clostridium hiranonis (P = 0.05) abundances were reduced in BY and TY. Dogs never exhibited significant dysbiosis (MDI &amp;lt; 2), and bacterial abundances remained within normal ranges. Dogs with chronically poor stool quality experience reduced body weights, increased serum CRP, and altered nutrient digestibility, but TY helped improve protein and fat digestibility, sustain microbiome, and reduce fecal calprotectin. Feeding torula yeast long-term may help improve plane of nutrition to better maintain weight and reduce inflammation in dogs with chronically poor stool quality.

Clinical characteristics of and risk factors for poor outcomes in children with bacterial culture-negative septic arthritis of the hip

BackgroundSeptic arthritis of the hip is a serious infection in children. However, blood and joint fluid cultures are often negative, which makes the diagnosis and treatment challenging. We analyzed the clinical features of children with septic arthritis of the hip with negative bacterial cultures and identified the risk factors for poor outcomes. MethodsThe clinical data of children with septic arthritis of the hip with negative bacterial cultures who were treated at our hospital from January 2010 to December 2020 were retrospectively analyzed. The clinical characteristics and outcomes of the culture-negative cohort were compared with those of children with positive bacterial cultures treated during the same period. Culture-negative patients were divided into a group with good outcomes and a group with poor outcomes. The differences between the two groups were compared. ResultsThirty-nine children with culture-negative septic arthritis of the hip were compared with 37 children with culture-positive sepsis. Compared with the culture-positive group, the culture-negative group had a significantly younger mean age and a significantly lower mean serum C-reactive protein concentration. Logistic regression analysis of culture-negative patients with good versus poor outcomes revealed that the independent risk factors for poor outcomes were an increased serum C-reactive protein concentration and prolonged time from onset to surgery. The cut-off values for predicting a poor outcome in the culture-negative group were a time from onset to surgery of greater than 21 days and a C-reactive protein concentration of greater than 23 mg/L. ConclusionsCulture-negative septic arthritis of the hip has similar clinical features to culture-positive septic arthritis of the hip and can result in sequelae of varying severity. Therefore, active anti-infective and hip drainage therapy should be performed when children present with clinical symptoms, inflammatory marker concentrations, and imaging findings that are clinically diagnostic for septic arthritis of the hip. Level of evidenceLevel II, retrospective study.

Rare functional variants in the CRP and G6PC genes modify the relationship between obesity and serum C-reactive protein in white British population.

C-reactive protein (CRP) is a sensitive biomarker of inflammation with moderate heritability. The role of rare functional genetic variants in relation to serum CRP is understudied. We aimed to examine gene mutation burden of protein-altering (PA) and loss-of-function (LOF) variants in association with serum CRP, and to further explore the clinical relevance. We included 161,430 unrelated participants of European ancestry from the UK Biobank. Of the rare (minor allele frequency <0.1%) and functional variants, 1,776,249 PA and 266,226 LOF variants were identified. Gene-based burden tests, linear regressions, and logistic regressions were performed to identify the candidate mutations at the gene and variant levels, to estimate the potential interaction effect between the identified PA mutation and obesity, and to evaluate the relative risk of 16 CRP-associated diseases. At the gene level, PA mutation burdens of the CRP (β = -0.685, p = 2.87e-28) and G6PC genes (β = 0.203, p = 1.50e-06) were associated with reduced and increased serum CRP concentration, respectively. At the variant level, seven PA alleles in the CRP gene decreased serum CRP, of which the per-allele effects were approximately three to seven times greater than that of a common variant in the same locus. The effects of obesity and central obesity on serum CRP concentration were smaller among the PA mutation carriers in the CRP (pinteraction = 0.008) and G6PC gene (pinteraction = 0.034) compared to the corresponding non-carriers. PA mutation burdens in the CRP and G6PC genes are strongly associated with decreased serum CRP concentrations. As serum CRP and obesity are important predictors of cardiovascular risks in clinics, our observations suggest taking rare genetic factors into consideration might improve the delivery of precision medicine.

Prognostic serum biomarkers in non-tuberculous mycobacterial pulmonary disease

Increased serum C-reactive protein (CRP) levels at the time of diagnosis predicted worse prognosis in patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD). Approximately one-quarter of the patients with NTM-PD had higher than normal CRP levels, and this elevation led to a higher risk of death.

Divergences between serum C-reactive protein and ferritin concentrations in canine pyometra

The main aim of this report was to investigate and compare the response of serum C-reactive protein (CRP) and ferritin, two positive acute phase proteins (APPs) which usually show an increase in inflammatory processes, in dogs with pyometra. For this purpose, two different studies were made. In the first one , both proteins were measured together in an APPs profile in 25 dogs with pyometra, 25 dogs with pancreatitis (as an example of a positive inflammatory control group), and in 25 healthy dogs. In the second study, to advance the knowledge of the changes and evolution of serum ferritin and CRP in dogs with pyometra after treatment, the concentrations of both APPs were analyzed in 30 dogs with pyometra at diagnosis and after ovariohysterectomy and in 10 clinically healthy female dogs before and after elective spaying. In both studies, bitches with pyometra showed significant increases in serum CRP, indicating an inflammatory condition, but not in serum ferritin despite being a moderate positive APP. This divergence between the dynamics of these APPs could be a useful tool for the suspicion of cases of canine pyometra.

Incidence and risk factors for pressure injury in hospitalized non-small cell lung cancer patients: A retrospective observational study

AimThis study aimed to identify the incidence and risk factors for pressure injury in patients hospitalized for non-small cell lung cancer (NSCLC). MethodsThis retrospective observational study was conducted in 645 adults who were hospitalized for NSCLC. Clinicopathological characteristics were compared between NSCLC patients with pressure injury and those without pressure injury. ResultsAmong total 645 patients, 180 patients showed pressure injury with an incidence of 27.9%. Patients with pressure injury showed increased serum C-reactive protein (CRP) levels (P < 0.001), increased neutrophil-lymphocyte ratio (P = 0.002), and increased platelet-lymphocyte ratio (P = 0.001) more often. Increase in serum CRP levels at the time of admission was the major risk factor for development of pressure injury in NSCLC patients (OR = 2.20; 95% CI [1.40–3.45]; P = 0.001). Also, among major inflammatory markers, serum CRP levels at the time of admission showed weak negative correlation with the period from admission to the development of pressure injury (r = −0.216, P = 0.004). ConclusionBy checking serum CRP levels at the time of admission, the NSCLC patients at high risk for the development of pressure injury can be identified in advance and the occurrence of pressure injury can be reduced by applying more active preventive nursing care. Clinical trial registration numberKCT0006570.

Intestinal uric acid excretion contributes to serum uric acid decrease during acute gout attack.

Spontaneous serum uric acid (SUA) decrease has been found in many patients during acute gout attacks, but its mechanism remains unclear. The spontaneous regulation of SUA during a gout attack and its possible causes were evaluated in patients with gout. The mechanism of the spontaneous SUA decrease was further studied in Caco2 cells and a monosodium urate (MSU)-induced gout model of wild-type mice and ABCG2-/- mice. The urate transport function of intestinal epithelial cells was detected by transwell culture of Caco2 cells. Expression of ATP-binding cassette super-family G member 2 (ABCG2), IL-1β and phosphoinositide 3-kinase (PI3K)/Akt was analysed using real-time PCR, western blotting, or immunofluorescence assays. SUA decreased during acute gout attacks in both the gout patients and MSU-induced gouty mice. Increased serum CRP and IL-1β levels were correlated with the SUA decrease. Intestinal uric acid excretion and expression of ABCG2 were upregulated in the mice during acute gout attacks. In the ABCG2-/- mice, intestinal uric acid excretion significantly decreased during gout attacks. In an in vitro study of a transwell culture, ABCG2 and its upstream PI3K/Akt pathway were significantly upregulated in intestinal epithelial cells. However, ABCG2 expression and its associated intestinal uric acid transport were inhibited when PI3K/Akt was blocked by a PI3K inhibitor, LY294002. Increased intestinal urate excretion resulted in spontaneous SUA downregulation during acute gout attacks. Inflammation-induced PI3K/Akt activation and ABCG2 expression in epithelial cells might contribute to the upregulation of intestinal uric acid excretion.

A retrospective study on parapneumonic effusion in 130 dogs with a clinical diagnosis of pneumonia.

To screen the occurrence of parapneumonic effusion in dogs. Medical records were searched for dogs with a presumptive diagnosis of bacterial pneumonia from 2017 to 2021 at the Liege university teaching hospital. Bacterial pneumonia was presumptively diagnosed based on compatible clinical signs and findings; thoracic radiographs compatible with bacterial bronchopneumonia; and either increased serum C-reactive protein (CRP) levels, a positive bronchoalveolar lavage culture or a positive clinical evolution in response to antibiotic therapy. Patients diagnosed with parasitic or other non-bacterial inflammatory pneumonia or with pulmonary neoplasia were excluded. Signalment, clinical findings, and outcome were recorded. One hundred and thirty dogs were included in the study, of which 44 dogs (33.8%) developed a parapneumonic effusion. Four of these dogs (4/44; 9%) had thoracocentesis performed, displaying a modified transudate (2) or septic exudate (2). Although parapneumonic effusion in dogs with a presumptive diagnosis of bacterial pneumonia appears to be rather common (33.8%), thoracocentesis or chest tube placement was rarely performed. Furthermore, the outcome of dogs with and without parapneumonic effusion appears to be similar.

Relationship between Vitreous IL-6 Levels, Gender Differences and C-Reactive Protein (CRP) in a Blood Sample of Posterior Uveitis

This study retrospectively determined the relationship between vitreous IL-6 levels and clinical and laboratory data collected from uveitis patients. We examined an unknown cause of posterior uveitis, collecting vitreous fluid to investigate vitreous IL-6 levels. The samples were analyzed in consideration of clinical and laboratory factors, such as the male/female ratio. The present study included 82 eyes from 77 patients with a mean age of 66.20 ± 15.41 years. The IL-6 concentrations of the vitreous specimens were 6255.0 ± 14,108.3 pg/mL in males and 277.6 ± 746.3 pg/mL in females, which was found to be a statistically significant difference (p = 0.048) (n = 82). There was also a statistically significant correlation between vitreous IL-6 concentrations, serum C-reactive protein (CRP) value and white blood cell counts (WBCs) (n = 82). In multivariate analysis, vitreous IL-6 levels were significantly correlated with gender and CRP in all cases (p = 0.048 and p < 0.01, respectively) and were also significantly correlated with CRP in non-infectious uveitis (p < 0.01). In infectious uveitis, there were no significant differences between IL-6 level and several variables. Vitreous IL-6 concentrations were higher in males than in females in all cases. In non-infectious uveitis, vitreous IL-6 levels were correlated with serum CRP. These results might suggest that intraocular IL-6 levels depend on gender differences in posterior uveitis, and intraocular IL-6 levels in non-infectious uveitis may reflect systemic inflammations, including increased serum CRP.

Risk of Exacerbation of Rheumatic Disease after COVID-19 Vaccination

Objectives: To investigate the risk of flare-ups after COVID-19 vaccination in patients with rheumatic disease. Methods: A total of 1,617 patients with rheumatic diseases were identified from three rheumatology clinics. Patients were interviewed for demographic data, disease activity, and vaccination status. Disease flare-up was determined clinically by independent rheumatologists. Change of serum markers and medications were retrieved from medical records. The risk of exacerbation of rheumatic disease, change in serum markers, and escalation of rheumatic medications between vaccinated and nonvaccinated patients were determined using Cox, linear, and logistic regression models, respectively. Possible confounding factors were also taken into consideration. Results: Among 562 (34.76%) patients who received COVID-19 vaccination, rheumatic disease (HR = 2.10, [Formula: see text] 0.001), inflammatory arthritis (HR = 2.71, [Formula: see text] 0.001), rheumatoid arthritis (RA) (HR = 2.03, [Formula: see text] = 0.002), spondyloarthritis (SpA) (HR = 4.78, [Formula: see text] 0.001), autoimmune disease (HR = 1.77, [Formula: see text] = 0.01), and systemic lupus erythematosus (SLE) (HR = 1.99, [Formula: see text] = 0.02) were associated with postvaccination clinical flare-up. Adult Still’s disease (B = 12.76, [Formula: see text] = 0.03) was associated with increased serum C-reactive protein (CRP). No association was found between vaccination and escalation of rheumatic medication. Subgroup analyses showed that only the mRNA vaccine was associated with flare-ups. Conclusion: COVID-19 vaccination was associated with minor disease flare-up but not escalation of rheumatic medications. In the absence of absolute contraindications, COVID-19 vaccination is recommended in patients with rheumatic disease. KEY MESSAGES 1. Vaccination is effective in the prevention of morbidity due to COVID-19 in patients with autoimmune diseases. 2. The mRNA vaccine was associated with mild rheumatic disease flare-up. 3. Inactivated virus vaccine is preferable to mRNA vaccine in patients with active autoimmune disease.

Endotoxin-Induced Physiological and Psychological Sickness Responses in Healthy Humans: Insights into the Post-Acute Phase

Introduction: Experimental endotoxemia is a translational model of systemic inflammation that has contributed significantly to our current understanding of sickness behavior and inflammation-associated depression. Previous studies using this model revealed a strong association between cytokine levels, endocrine changes, and psychological sickness symptoms during the acute phase of inflammation. The objective of this randomized, double-blind, placebo-controlled crossover study was to gain insight into potential post-acute physiological and psychological consequences of endotoxin administration that may either persist or newly emerge between 24 and 72 h after injection. The main focus was on associations between serum levels of C-reactive protein (CRP) and affective symptoms as well as alterations in diurnal cortisol profile, the two key features of inflammation-associated depression. Methods: Healthy male volunteers (N = 18) received an injection of either endotoxin (0.8 ng/kg) or placebo on two separate but otherwise identical study days, 7 days apart. Blood and saliva samples were collected during acute and post-acute phases after injection to measure blood inflammatory markers (interleukin [IL]-6, IL-1 receptor antagonist [ra], CRP) and salivary cortisol levels. In addition, participants completed a comprehensive battery of questionnaires to assess physical and psychological sickness symptoms. Results: Endotoxin treatment induced a short-time rise in plasma IL-6 and a longer increase in IL-1ra. The increase in serum CRP was delayed compared to cytokines, peaking at 24 h and gradually decreasing until 72 h after injection. The inflammatory response was accompanied by bodily and psychological sickness symptoms which occurred only in the acute phase, whereas none of the symptoms persisted or recurred in the post-acute phase. Salivary cortisol levels were significantly increased during the acute phase and exhibited pronounced circadian changes. However, no significant differences in diurnal cortisol profiles were observed between placebo and endotoxin conditions on the days after treatment. Conclusion: Our findings suggest that CRP, which is elevated in patients with inflammation-associated depression, does not appear to be responsible for depressive symptomatology. Moreover, a single inflammatory episode is not sufficient to alter diurnal cortisol profiles, as observed in inflammation-associated depression. In addition, the absence of persistent lipopolysaccharide-induced psychological and physiological changes beyond the acute phase further supports the safety of endotoxin administration in humans.

The Role of Increasing Serum C-reactive Protein Level in Diagnosis of Post-surgery Small Bowel Pseudo-obstruction: A Case Report

Introduction: Acute colonic pseudo-obstruction (APCO), which is identified as colon dilatation without any mechanical obstruction, is a rare post-surgery complication. Case Presentation: Herein, we report a 40-year-old woman who underwent total laparoscopic hysterectomy with no complications during the surgery. On post-op visits, she complained of vague abdominal pain, especially in the upper quadrants, with a mild abdominal distention on her physical examination. Despite normal abdominal imaging, C-reactive protein (CRP) level was rising. Although oral intake was discontinued, the abdominal distention progressed gradually, and CRP levels rose continuously. On the fifth post-surgery day, the patient was suffering from bilious vomiting. Additionally, the abdominal distention was accompanied by tenderness. Emergency laparotomy was scheduled for clinically suspected bowel problems that were resistant to conservative management. During emergency laparotomy, the small bowel was distended. Since 20 cm of ileum was ischemic due to bowel congestion, segmental resection and anastomosis were performed. Conclusions: The CRP value can help to predict latent complications. It is also necessary to observe these patients closely to detect and manage probable post-operation complications.

Serum anti-Müllerian hormone recovery after ovarian cystectomy for endometriosis: A retrospective study among Korean women.

Serum anti-Müllerian hormone (sAMH) is a useful marker of ovarian reserve. In many patients, the sAMH levels gradually recover after falling to the lowest level after surgery (nadir phenomenon). This study aimed to analyze the factors related to sAMH recovery from the nadir after an ovarian cystectomy for endometriosis among Korean women. A total of 159 patients with ovarian endometriosis were included in the study. The sAMH levels were measured before surgery and at least twice within 12 months after the surgery. The patients were divided into two groups: those with recovery (nadir group) and those without recovery (reduction group). Postoperative recovery of the sAMH levels from the nadir was not related to the stage and bilaterality of the lesion, surgical methods, such as robot-assisted or laparoscopic surgery, or surgical time. In the nadir group, the level of preoperative cancer antigen 125 was significantly higher, and it decreased significantly after the surgery than in the reduction group (P = .02 and P = .02). Additionally, the postoperative C-reactive protein (CRP) level was significantly higher in the nadir group, and it increased significantly after the surgery than in the reduction group (P = .03 and P = .04). The increasing degree of perioperative CRP level showed a cutoff value on the receiver operating characteristic curve (0.735 mg/dL, area under curve = 0.604; P = .04). Increased serum CRP levels after surgery are significantly related to the recovery of sAMH levels from the nadir. Therefore, postoperative serum CRP level could be used as a marker to predict the sAMH nadir after surgery.

Role of C-reactive protein in the bone marrow of Modic type 1 changes.

Modic type 1 changes (MC1) are vertebral bone marrow lesions and associate with low back pain. Increased serum C-reactive protein (CRP) has inconsistently been associated with MC1. We aimed to provide evidence for the role of CRP in the tissue pathophysiology of MC1 bone marrow. From 13 MC1 patients undergoing spinal fusion at MC1 levels, vertebral bone marrow aspirates from MC1 and intrapatient control bone marrow were taken. Bone marrow CRP, interleukin (IL)-1, and IL-6 were measured with enzyme-linked immunosorbent assays; lactate dehydrogenase (LDH) was measured with a colorimetric assay. CRP, IL-1, and IL-6 were compared between MC1 and control bone marrow. Bone marrow CRP was correlated with blood CRP and with bone marrow IL-1, IL-6, and LDH. CRP expression by marrow cells was measured with apolymerase chain reaction. Increased CRP in MC1 bone marrow (mean difference: +0.22 mg CRP/g, 95% confidence interval[CI] [-0.04, 0.47], p = 0.088) correlated with blood CRP (r = 0.69, p = 0.018), with bone marrow IL-1β (ρ = 0.52, p = 0.029) and IL-6 (ρ = 0.51, p = 0.031). Marrow cells did not express CRP. Increased LDH in MC1 bone marrow (143.1%, 95% CI [110.7%, 175.4%], p = 0.014) indicated necrosis. A blood CRP threshold of 3.2 mg/L detected with 100% accuracy increased CRP in MC1 bone marrow. In conclusion, the association of CRP with inflammatory and necrotic changes in MC1 bone marrow provides evidence for a pathophysiological role of CRP in MC1 bone marrow.

RELATIONSHIP OF WORKERS’ CHARACTERISTICS AND THE USE OF PERSONAL PROTECTIVE EQUIPMENT AGAINST THE ENHANCEMENT OF C-REACTIVE PROTEIN SERUM ON KAPOK-PROCESSING INDUSTRY WORKERS AT BANDREK, PASURUAN

Introduction: The cotton processing industry is an industry that produces cotton dust during the production process. Workers are at risk of exposure to cotton dust, if inhaled and accumulated in the body will cause inflammation that causes an increase in C-Reactive Protein (CRP) serum. The purpose of this research was to determine the relationship between the use of personal protective equipment and worker characteristics that can cause an increase in serum CRP of workers before and after work in the cotton processing industry. Methods: This was observational research with a prospective longitudinal design. Respondents in this study were 11 workers in Bandrek village, Mojotengah, Pasuruan. Data collection of worker characteristics was done by interview and observation. Personal dust content data was collected using a personal dust sampler (PDS) with gravimetric calculation methods. increase in CRP data collection using blood specimen collection before and after and conducted laboratory testing using i-chroma reader. Measurement of average dust levels of 5.49 mg / m3. Result: There was no significant correlation between personal dust level (p = 0.324) and the use of PPE (p= 0,925) with the increase in CRP serum levels. There was a significant correlation between the ages of workers (p = 0.005), years of service (p = 0.006), and length of work (p = 0.004) with the increase in CRP serum level. Conclusion: The older the workers, the longer the working period and the longer the working hour, the higher the increase of CRP serum level would be.

The Higher C-Reactive Protein Levels as a Risk Factor of Stunting in Children with Acyanotic Congenital Heart Disease

BACKGROUND: Children with acyanotic congenital heart disease (CHD) had a high risk of stunting. In addition to inadequate nutrition, chronic inflammatory process also plays an important role. An increase in serum c-reactive protein (CRP) suppresses insulin like growth factor 1 (IGF-1) production, causing disorder in child growth. AIM: The objective f the study was to prove that higher CRP levels as a risk factor of stunting in children with acyanotic CHD aged 6–24 months old. METHODS: This study is an observational analytic study with a case–control design, to assess higher CRP levels as a risk factor of stunting in children with acyanotic CHD aged 6–24 months old. This research was conducted at the Pediatric Cardiology Polyclinic, Sanglah Hospital from May to December 2021 with the consecutive sampling method. Data analysis was performed using the Chi-square test or Fisher’s absolute test. Multivariate analysis with binary logistic regression was performed on all variables. Significance level was p &lt; 0.05. RESULTS: This study involved 60 subjects, consisting of 30 subjects with stunting and 30 subjects with no stunting. Children with stunting had higher mean CRP levels, 2.4 (±3.7) and 1.2 (±0.6). CRP level ≥3 mg/dL (p = 0.031; aOR 22.89; 95% CI 1.32–395.39) was a risk factor of stunting in children with acyanotic CHD. Other risk factors that significant are male, living in rural areas, low birth weight, and under-nutrition. CONCLUSION: Higher CRP levels as a risk factor of stunting in children with acyanotic CHD. Other significant risk factors include males, living in rural areas, low birth weight, and under-nutrition.