Increase In C-reactive Protein Concentration Research Articles

Fabrication and sensing properties of a molecularly imprinted polymer on a photonic PDMS substrate for the optical detection of C-reactive protein

This work presents the development of a novel photonic-based sensor on a nanoscale patterned polydimethylsiloxane (PDMS) substrate acting as transducer, combined with a molecularly imprinted polymer for the rapid and sensitive detection of C-reactive protein (CRP). A silicon wafer was patterned using electron-beam lithography with a one-dimensional (1D) reflective grating (periodicity of about 400 nm) and then replicated using nanoimprint lithography. The latter silicon mould was used for replica moulding to generate a patterned PDMS. The unique 1D design gave PDMS photonic properties that were suitable as a substrate to assemble the biorecognition layer. The surface of the photonic PDMS was modified to become hydrophilic and additionally functionalized with vinyl silane groups to bind the imprinted polymer, resulting in a photonic molecularly imprinted polymer substrate (PMIPS). The developed method was successfully used to detect CRP in serum samples. The reflectance intensity decreased with increasing CRP concentrations, and the sensing PMIPS showed a linear response between 0.005 and 1.215 µg mL−1, a limit of detection of 0.003 µg mL−1, and a selective response to CRP when tested against serum calprotectin. Overall, this novel optical sensor can be used to detect CRP, a serum biomarker of inflammation, particularly in inflammatory bowel diseases.

C-reactive protein concentration has limited value in the diagnosis of meningoencephalitis of unknown origin in dogs.

To evaluate blood and cerebrospinal fluid (CSF) concentrations of C-reactive protein (CRP) in dogs with meningoencephalitis of unknown origin (MUO); to evaluate whether blood CRP concentration is associated with epidemiological, clinicopathologic, and MRI findings; and to investigate blood CRP predictive power in survival. 30 client-owned dogs with MUO, 15 client-owned dogs with steroid-responsive meningitis arteritis (SRMA; positive control group), and 15 healthy dogs (negative control group). Blood CRP concentration was measured in each group, while it was performed in CSF only in the MUO and SRMA groups. The analysis of epidemiological data included breed, age, sex, duration of clinical signs, and history of seizures. Blinded analysis of MRI was performed based on a classification grid, and traditional CSF analysis parameters were assessed. The predictive power of blood CRP concentration regarding survival at 6 months was investigated. Of the 30 dogs with MUO, 9 (30%) had an increased CRP concentration in blood, and 3 (10%) showed a measurable CRP in CSF. Median blood CRP concentration in dogs with MUO was 0.1 mg/L (range, 0.1 to 102 mg/L), which was not statistically different from the healthy dog group but significantly lower than the SRMA control group. Only the duration of clinical signs was positively associated with an increased blood CRP level. Blood CRP concentration was not associated with survival at 6 months. Blood CRP concentration is of limited value for the diagnosis and prognosis of dogs with MUO. Chronicity of the disease may be associated with an increased concentration of blood CRP.

C-Reactive Protein Levels Correlate with Measures of Dysglycemia and Gut Microbiome Profiles.

C-reactive protein (CRP) is a commonly used marker of low-grade inflammation as well as a marker of acute infection. CRP levels are elevated in those with diabetes and increased CRP concentrations are a risk factor for developing type 2 diabetes. Gut microbiome effects on metabolism and immune responses can impact chronic inflammation, including affecting CRP levels, that in turn can lead to the development and maintenance of dysglycemia. Using a high-sensitivity C-reactive protein (hsCRP) assay capable of detecting subtle changes in C-reactive protein, we show that higher hsCRP levels specifically correlate with worsening glycemia, reduced microbial richness and evenness, and with a reduction in the Firmicutes/Bacteroidota ratio. These data demonstrate a pivotal role for CRP not only in the context of worsening glycemia and changes to the gut microbiota, but also highlight CRP as a potential target for mitigating type 2 diabetes progression or as a therapeutic target that could be manipulated through the microbiome. Understanding these processes will provide insights into the etiology of type 2 diabetes in addition to opening doors leading to possible novel diagnostic strategies and therapeutics.

Is Inconsistency in the Association between Frontal Alpha Asymmetry and Depression a Function of Sex, Age, and Peripheral Inflammation?

Although alpha asymmetry has been found to correlate with depression, there is some inconsistency across the wider literature, suggesting the influence of other factors. Some of these may be the presence of peripheral inflammation, age, and sex of participants. To test the interaction of these factors in terms of the association between alpha asymmetry and depression in a community sample, in this study, data were collected on resting frontal alpha asymmetry (FAA) under eyes closed and eyes open conditions, serum C-reactive protein (CRP), age, and self-rated depression in a sample of 44 males and 56 females aged from 18 to 75 years (M = 32.5 yr, SD = 14.1 yr). Using regression models, the results indicated a complex set of associations. FAA values across the FP2-FP1 sites predicted depression in the eyes open condition, but not for any other pairing of sites. Increases in CRP concentration predicted increases in depression for women but not for men. CRP predicted FAA across two frontal sites (F8-F7) under the eyes open condition only. As CRP increased, FAA favoured the left hemisphere for that pair of frontal sites, a result found more strongly for males. Age did not influence these associations. By reflecting a complex, multi-factor interaction, these findings may tentatively provide some explanation for the inconsistency in the wider literature for the FAA–depression hypothesis.

Intraluminal assessment of inflammatory factors in patients with intracranial aneurysms.

The formation, growth, and rupture of intracranial aneurysms (IA) are due to several pathophysiological mechanisms, including focal hemodynamic injury and inflammation of the arterial wall. We investigated the differences between venous, parent artery, and intra-aneurysmal blood by measuring inflammatory factors and antibodies in patients with ruptured (rIA) or unruptured intracranial aneurysms (uIA). A prospective study was performed in patients who presented with IA and required endovascular treatment. Blood was drawn from the lumen of the aneurysm sac, the parent artery, and the peripheral veins, to determine the serum concentrations of complement factors C3, C4, IgG, IgM, IgA antibodies, and C-reactive protein (CRP). Thirty-six patients (15 with uIA and 21 with rIA) were enrolled in the study. In both groups, C3, C4, IgM, IgG, and IgA showed a gradual decrease from venous to intra-aneurysmal samples, but only IgG in the parent artery and intra-aneurysmal samples reached a significant decrease in uIA compared with venous samples. Accordingly, C3 and IgG concentrations in the intra-aneurysmal samples showed a significant decrease in rIA compared with venous samples. A significant increase in CRP concentrations was observed in parent artery and intra-aneurysmal samples from patients with rIA compared with patients with uIA; a significant increase in C3 concentrations was observed in parent artery samples from patients with rIA compared with patients with uIA, and a significant decrease in IgM concentrations was observed in venous, parent artery, and intra-aneurysmal samples from patients with rIA compared with patients with uIA. A decrease in C3 and IgG in the aneurysm sac indicates activation of the complement system in the arterial wall. CRP in the aneurysm sac and lumen of the parent artery was significantly increased in ruptured compared with unruptured aneurysms, whereas venous, parent artery, and intra-aneurysmal IgM were decreased in ruptured compared with unruptured aneurysms. These results argue for the role of an ongoing inflammatory process in aneurysms leading to their growth and rupture.

БІОХІМІЧНІ ПОКАЗНИКИ КРОВІ У ХВОРИХ НА РОЗСІЯНИЙ СКЛЕРОЗ, ЯКІ ПЕРЕНЕСЛИ ІНФЕКЦІЮ SARS-CoV-2

B a c k g r o u n d. Currently, multiple sclerosis (MS) is an important medical and social problem. There are already more than 2.8 million people with MS worldwide, and due to the lack of effective methods of treatment and prevention, the number of patients is increasing constantly. Therefore, the search for new ways and approaches aimed towards stabilizing the patient's condition is a priority task of modern neurobiology. It is also important to identify triggers that can lead to accelerating the rate of disease progression. Since MS is an immune-mediated disorder, we hypothesized that concomitant diseases of infectious etiology, via the activation of an inflammatory reactions cascade, can lead to a worsening of the MS patient's condition. However, the final answer to the question of whether acute viral infections affect the condition of patients with MS has not been obtained yet. In the context of the epidemiological situation that has developed in recent years, due to the spread of the SARS-CoV-2 coronavirus infection, it is interesting to study the possible negative consequences of COVID-19 in people suffering from MS. The aim of the study was to analyze the general biochemical status of patients with MS who had or did not have a confirmed history of COVID-19. M e t h o d s. A total of 271 participants were enrolled in this study, including 97 MS patients and 30 healthy volunteers who matched for age and sex. Patients with MS were divided into two groups: group I (n= 56; 36 women and 20 men, average age: 41.3±5.5, disease duration: 4.4±1.5 years) – patients with MS who did not have confirmed history of COVID-19 and group II (n= 41; 27 women and 14 men, average age: 40.2±5.6, disease duration: 4.6±1.3 years) – patients with MS, who had a laboratory-verified diagnosis of COVID-19 in the past 4-7 months. Blood serum samples of patients and healthy donors were obtained from the University Clinic of O.O. Bogomolets National Medical University, Kyiv, Ukraine. All patients were diagnosed with MS according to the 2017 McDonald criteria. R e s u l t s. It was established that both groups of MS patients had similar changes in blood biochemical parameters compared to the healthy indicators: a decrease in creatinine and uric acid concentrations; decrease in the levels of particular lipid fractions, namely VLDL and TAG; decrease in the activities of AP and LDH; increase in C-reactive protein concentration. The only significant differences between groups I and II were noted due to multidirectional changes in serum ferritin concentration and an increase in the level of amylase activity in the blood serum of patients with MS in post- COVID period. C o n c l u s i o n s. The absence of statistically significant differences between the blood biochemical parameters in patients with MS who had or did not have confirmed history of COVID-19 indicates the absence of a relationship between SARS-CoV-2 infection and changes of particular studied parameters. Among the results obtained, the multidirectional changes in ferritin concentration in MS patients before and after COVID-19 could be of great interest to further research.

Influence of Vitamin A supplementation on inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials.

Vitamin A is an anti-oxidant which has been presumed to act as an anti-infective vitamin in many studies. This study aimed to evaluate the association between vitamin A supplementation and c-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6) levels in randomized control trials (RCTs) studies on adults. A systematic search was performed on databases including PUBMED, SCOPUS, and the Cochrane library. The studies included were considered for data extraction and subsequently assessed for effect. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were evaluated. Among 13,219 articles 13 studies were included for analysis of CRP and TNF-α, as well as 9 studies included for IL-6 in quality and quantity. The pooled WMD analysis of CRP demonstrated that vitamin A supplementation significantly increased CRP concentration with (WMD: 0.84mg/L; 95% CI 0.29-1.39, I2 = 0.96.2% and p value < 0.003). However, there was no significant correlation between vitamin A supplementation and lower plasma TNF-α (p < 0.45)). Subgroup analysis by dosage demonstrate significant association between vitamin A supplementation and IL-6 in dosage with 50,000 with (WMD: - 1.53mg/L; 95% CI - 2.36 to - 0.71, p value < 0.00001) as well as a negative significant association was seen at 44weeks of supplementation with 50,000IU/day retinyl palmitate and TNF-a in chronic hepatitis B conditions with (- 0.94 (- 1.19, - 0.69) p < 0.0001). The result of this study demonstrates that supplementation of vitamin A at low and high dosages for short and long durations increases the CRP plasma concentrations on adults and vitamin A supplementation decreases the TNF-α concentrations in chronic hepatitis B on adults. Therefore, there is an inverse association between vitamin A supplementation and plasma and fecal IL-6 concentrations in many infection conditions.

Fabrication and evaluation of optical nanobiosensor based on localized surface plasmon resonance (LSPR) of gold nanorod for detection of CRP

C-reactive protein (CRP) is a plasma protein that is one of the most expressed proteins in acute phase inflammation cases. It is a well-known biomarker for inflammatory disorders. There is a significant correlation between increasing CRP concentration and the risk of being exposed to cardiovascular diseases (CVD) and sepsis; thus, monitoring and quantifying CRP levels in a simple, inexpensive, and quick manner can improve clinical diagnostics and help prevent major inflammatory conditions. Here a nanobiosensor was developed, benefiting from the LSPR property of gold-nanorod (GNR) to measure CRP concentration. Nanorods were fabricated using One-pot synthesis by trimethyl ammonium bromide (CTAB) as a surfactant. This method provides the advantage of both step and time reduction in synthesis and decreases the contamination probability of nanorods as the products. The nanorods were characterized using TEM with an average size of (24 ± 1 nm) × (5 ± 1 nm) and a typical aspect ratio of ∼4.9. The surface of the rods was modified with a specific aptamer for the target protein, and the LSPR shifts due to the gold nanorod's refractive index change as the result of protein interaction with the biosensor investigated using a 100–900 nm UV absorption device. The results indicated that the nanobiosensor could respond to different CRP concentrations within 30 min. The selectivity test has shown nonresponsive results of nanobiosensor to BSA and TNF-α proteins which are used to evaluate the biosensor behavior in non-target proteins. The detection limit was evaluated at 2 nM, and the sensor's linear response ranged between 2 - 20 nM.

Psychiatric symptoms are not associated with circulating CRP concentrations after controlling for medical, social, and demographic factors

Elevated serum concentrations (>3 mg/L) of the acute-phase protein, C-reactive protein (CRP), is used as a clinical marker of inflammation and is reported to be a strong risk factor for cardiovascular disease. In psychiatric populations, CRP concentration is reported to be higher in depressed versus healthy individuals. Positive associations between CRP and depression have been established in both clinical and community samples, but effect sizes are attenuated after controlling for confounding variables. Similarly, emerging research has begun to draw a link between inflammation, symptoms of anxiety, and substance abuse. Given the high level of comorbid anxiety and substance use disorders in many depressed populations, this study examined whether depression (Patient Health Questionnaire 9 [PHQ-9]) and substance use-related (Drug Abuse Screening Test [DAST]) symptoms were associated with CRP concentrations in the blood after adjusting for relevant medical, social, and demographic covariates in a large sample undergoing screening for several transdiagnostic psychiatric research studies. A total of 1,724 participants were analyzed for association of CRP with variables using multivariate linear regression. An unadjusted model with no covariates showed that PHQ-9 was significantly associated with CRP in All (β = 0.125), Female (β = 0.091), and Male (β = 0.154) participants, but DAST was significantly associated with CRP in males only (β = 0.120). For the adjusted model, in both males and females, mood-stabilizer treatment (β = 0.630), opioid medication (β = 0.360), body mass index (β = 0.244), percent body fat (β = 0.289), nicotine use (β = 0.063), and self-reported sleep disturbance (β = 0.061) were significantly associated with increased CRP concentrations. In females, oral contraceptive use (β = 0.576), and waist-to-hip ratio (β = 0.086), and in males, non-steroidal anti-inflammatory drug use (β = 0.367) were also associated with increased CRP concentrations. There was no significant association between CRP and individual depressive, anxiety, or substance use-related symptoms when covariates were included in the regression models. These results suggest that associations between circulating CRP and the severity of psychiatric symptoms are dependent on the type of covariates controlled for in statistical analyses.

C-reactive protein and 10-year cardiovascular risk in rheumatoid arthritis

ObjectivesTo evaluate the association between C-reactive protein (CRP) and 10-year risk of cardiovascular (CV) events using the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA), based on conventional and RA-specific risk factors but not CRP, in RA patients without previous cardiovascular events. MethodsERS-RA was calculated in 1,251 “Cardiovascular Obesity and Rheumatic Disease Study (CORDIS)” database patients [(age 60.4(9.3) years; 78% female; disease duration, 11.6(8) years; CDAI, 9(9); CRP, 6.8(12) mg/L]. ResultsThe mean (SD) 10-year risk of CV events was 12.9% (10). After adjusting for the use of DMARDs and biologics, CRP concentrations were significantly associated with 10-year risk of CV events (coefficient=0.005 for each 10 mg/L CRP increment; 95%CI 0.000–0.111; p = 0.047). In mediation analysis, the association between CRP and ERS-RA was not explained by disease activity. ConclusionIn a large cohort of RA patients without previous cardiovascular events, a 20 mg/L increase in CRP concentrations was associated with a 1% increase in 10-year risk of CV events. This suggests that actively targeting residual inflammatory risk beyond conventional and RA-specific risk factors might further reduce CV event rates in RA patients.

Electrolyte concentration in blood serum as prognostic of severe course COVID-19

THE AIM. To study the key homeostatic physicochemical parameters of blood serum characterizing the patient's state with COVID-19 of varying severity. Patients and methods. The study involved 94 patients with COVID-19, age from 24 to 102 years, median – 67 years, men – 43, women – 51. Patients were divided into 3 groups: 1st – 40 patients with a relatively mild course, 2nd – 22 patients with a severe course of the disease, after treatment they were discharged from the clinic, the 3rd – 32 patients with a very severe course of COVID-19 and a fatal outcome. The concentration of ions in blood serum was measured on a Gem Premier 3000 (Instrumentation Laboratory, USA), clinical analysis was performed on a BC-5380c Mindray hematology analyzer (Mindray, China), biochemical studies were performed on an Architech c4000 analyzer (Abbott Laboratories, USA). RESULTS. The harbingers of a serious impairment in patients with COVID-19 were an increase in the Na+/K+ ratio in blood serum from 32,7±0,8 to 44,7 ± 2.1 (p&lt;0,01), a decrease in the concentration of ionized Ca2+ from 1,08 ± 0,01 to 0,9 ± 0,03 mmol/l (p&lt;0,01), a sharp increase in the concentration of C-reactive protein from 43,6±8,6 to 175 ± 14,7 mg/l (p&lt;0,01). Within the reference values with COVID-19 the concentration of bilirubin and creatinine in the blood serum remained normal; the concentration of total protein was at the lower limits of the normal range, the glucose level was slightly higher than normal, and ferritin was increased compared to the reference values. CONCLUSION. Harbingers of a sharp impairment in COVID-19 are an increase in the Na+/K+ ratio in the blood serum, a decrease of the of ionized Ca2+ concentration, a sharp increase in C-reactive protein concentration.

Improved perioperative outcomes and reduced inflammatory stress response in malignant robot-assisted colorectal resections: a retrospective cohort study of 298 patients

BackgroundRobot-assisted surgery is increasingly implemented for the resection of colorectal cancer, although the scientific evidence for adopting this technique is still limited. This study’s main objective was to compare short-term complication rates, oncological outcomes, and the inflammatory stress response after colorectal resection for cancer performed laparoscopic or robot-assisted.MethodsWe conducted a retrospective cohort study comparing the robot-assisted approach to laparoscopic surgery for elective malignant colorectal neoplasm. Certified colorectal and da Vinci ® robotic surgeons performed resections at a Danish tertiary colorectal high volume center from May 2017 to March 2019. We analyzed the two surgical groups using uni- and multivariate regression analyses to detect differences in intra- and postoperative clinical outcomes and the inflammatory stress response.ResultsTwo hundred and ninety-eight patients were enrolled in the study. Significant differences favoring robot-assisted surgery was demonstrated for; length of hospital stay (4 days, interquartile range (4, 5) versus 5 days, interquartile range (4–7), p < 0.001), and intraoperative blood loss (50 mL, interquartile range (20–100) versus 100 mL, interquartile range (50–150), p < 0.001) compared to laparoscopic surgery. The inflammatory stress response was significantly higher after laparoscopic compared to robot-assisted surgery reflected by an increase in C-reactive protein concentration (exponentiated coefficient = 1.23, 95% confidence interval (1.06–1.46), p = 0.008). No differences between the two groups were found concerning mortality, microradical resection rate, conversion to open surgery, and surgical or medical short-term complication rates.ConclusionRobot-assisted surgery is feasible and can be safely implemented for colorectal resections. The robot-assisted approach, when compared to laparoscopic surgery, was associated with improved intra- and postoperative outcomes. Extensive prospective studies are needed to determine the short- and long-term outcomes of robotic surgery for colorectal cancer.

Association between central obesity indices and iron status indicators among Qatari adults.

Co-existence of iron deficiency and obesity in adults has been reported in many countries. However, little is known on the association between obesity and iron deficiency in Qatar. This study aimed to investigate the link between abdominal obesity indices and iron status among adults in Qatar. A random sample of 1000 healthy Qatari adults, aged 20–50 years, was obtained from Qatar Biobank study. Body weight, waist circumference, dual x-ray absorptiometry (DXA) parameters and iron status indicators were measured using standard techniques. Multiple regression analysis was used to examine the associations. The prevalence of iron deficiency and anaemia were 35.4 and 25%, respectively. Of the participants with a large waist circumference, 31.7% had anaemia. Ferritin significantly increased with the increase in the android fat to gynoid fat ratio and visceral fat in both genders. Serum iron and transferring saturation decreased significantly with the increase in waist circumference in women. In both genders, C-reactive protein increased with the increase in all obesity indices. Standardized values of waist circumference, android fat, gynoid fat ratio and visceral fat were significantly associated with log transformed ferritin in men and women. Waist circumference was inversely related to serum iron (β:-0.95, 95% CI:-1.50,-0.39) and transferrin saturation (β:-1.45, 95%CI:-2.46, -0.43) in women. In men, waist circumference was positively associated with haemoglobin level (β: 0.16, 95% CI:0.04, 0.29). Central obesity coexists with anaemia among the study population. Elevated central obesity indices were associated with an increase in ferritin concentration. The increased ferritin concentration may be attributed to the increase in inflammatory status as a result of an increase in c-reactive protein concentration associated with central obesity.

Dynamics of concentration of C-reactive protein after hernioplasty and simultaneous interventions

Were analyzed 127 case histories of patients aged (54.3±13.6) years; 44 women (34.6%) who underwent hernia plastic surgery of different localization: 26 (20.5 %) umbilical and paraumbilical; 25 (19.7%) - incisional, 68 (53.6%)-inguinal and 8 (6.3%)-hiatalhernia. 64 (50.4%) patients underwent simultaneous operations: for multiple hernias - 35 (27.6%), cholecystolithiasis I, chronic cholecystitis - 14 (11.0%), gynecological pathology - 6 (4.7%), chronic appendicitis - 3 (1.4%), or abdominoplasty due to fatty deformity of the anterior abdomen walls (fat «apron») - 6 (4.7%). The initial condition of the patient features of surgery and the dynamics of the concentration of C-reactive protein (CRP), which was determined before surgery, in the first, third and fifth days after. It was found that the initial concentration of CRP is increased in some cases in patients with overweight and obesity, as well as in the presence of chronic cholecystitis or chronic appendicitis. In the postoperative period, regardless of the location of the hernia and the method of surgery, there is an increase in the concentration of CRP, which is most pronounced in the first day after surgery and indicates the activation of systemic inflammatory responses. The increase in CRP concentration on the first day was greatest after hiatal hernia repair and after simultaneous operations, especially after abdominoplasty. In overweight and obese patients, an increase in CRP is observed up to the fifth day after surgery, indicating a prolonged activation of the inflammatory response. The concentration of CRP on the first and third days after isolated operations did not depend on the method of operation («open» alloplastic, open autoplastic or laproscopic hemioplasty), but was the lowest on the fifth day after laparoscopic hemioplasty. Keywords: hemioplasty, simultaneous operations, C-reactive protein, dynamics.

Is C-reactive protein associated with influenza A or B in primary care patients with influenza-like illness? A cross-sectional study

Objective Identifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. An accurate, cheap and easy to use biomarker might enhance targeting influenza-specific management in primary care. The aim of this study was to investigate if C-reactive protein (CRP) is associated with influenza A or B, confirmed with PCR testing, in patients presenting with ILI. Design Cross-sectional study. Setting Primary care in Lithuania, Norway and Sweden. Subjects A total of 277 patients at least 1 year of age consulting primary care with ILI during seasonal influenza epidemics. Main outcome measures Capillary blood CRP analysed as a point-of-care test and detection of influenza A or B on nasopharyngeal swabs in adults, and nasal and pharyngeal swabs in children using PCR. Results The prevalence of positive tests for influenza A among patients was 44% (121/277) and the prevalence of influenza B was 21% (58/277). Patients with influenza A infection could not be identified based on CRP concentration. However, increasing CRP concentration in steps of 10 mg/L was associated with a significantly lower risk for influenza B with an adjusted odds ratio of 0.42 (0.25–0.70; p<.001). Signs of more severe symptoms like shortness of breath, sweats or chills and dizziness were associated with higher CRP. Conclusions There was no association between CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. Hence, CRP testing should be avoided in ILI, unless bacterial pneumonia is suspected. Key points Identifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. There was no association between concentration of CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. A consequence is that CRP testing should be avoided in ILI, unless bacterial pneumonia or similar is suspected.

Sacroiliitis in systemic lupus erythematosus

Although musculoskeletal system involvement is awell-known manifestation in systemic lupus erythematosus (SLE), the probability of sacroiliac joint involvement and its effect on patients might be ignored. The aim of the study was to investigate the association between SLE and sacroiliitis and to evaluate the relationship between clinical parameters and sacroiliitis in SLE. The study was designed as acase-control study. A total of 63 patients with SLE and 31 age- and sex-matched healthy controls were included in the study. The clinical and demographic variables of the study population were documented. The sacroiliac joints of patients and controls were evaluated with sacroiliac magnetic resonance imaging. Human leukocyte antigen (HLA) B27 was assessed using flow cytometry (Beckman Coulter Navios-model 3, Beckman Coulter Inc., Brea, CA, USA). Multinomial logistic regression analysis was used to determine the clinical risk factors related to sacroiliitis. Among the 63patients, acute sacroiliitis was found in 25patients (39.7%) and chronic sacroiliitis was found in 21patients (33.3%). Sacroiliitis was higher in patients than in controls (p = 0.001). Acute sacroiliitis was more frequently observed in patients when compared with the control group (p = 0.001). Higher C‑reactive protein (CRP) concentrations (odds ratio = 1.75, 95% confidence interval: 1.30-2.35; p < 0.001) were found to be arisk factor for acute sacroiliitis. The ratio of sacroiliitis was higher in patients with SLE than in controls. Increased CRP concentrations were determined as arisk factor for acute sacroiliitis. Thus, one should keep in mind that patients with SLE and higher CRP concentrations may have sacroiliitis.

Physiological performance and inflammatory markers as indicators of complications after oesophageal cancer surgery.

BackgroundThe extent to which physiological factors influence outcome following oesophageal cancer surgery is poorly understood. This study aimed to evaluate the extent to which cardiorespiratory fitness and selected metabolic factors predicted complications after surgery for carcinoma.MethodsTwo hundred and twenty‐five consecutive patients underwent preoperative cardiopulmonary exercise testing to determine peak oxygen uptake (V˙ o 2peak), anaerobic threshold and the ventilatory equivalent for carbon dioxide (V˙ e/V˙ co 2). Cephalic venous blood was assayed for serum C‐reactive protein (CRP) and albumin levels, and a full blood count was done. The primary outcome measure was the Morbidity Severity Score (MSS).ResultsOne hundred and ninety‐eight patients had anatomical resection. A high MSS (Clavien–Dindo grade III or above) was found in 48 patients (24·2 per cent) and was related to an increased CRP concentration (area under the receiver operating characteristic (ROC) curve (AUC) 0·62, P = 0·001) and lower V˙ o 2peak (AUC 0·36, P = 0·003). Dichotomization of CRP levels (above 10 mg/l) and V˙ o 2peak (below 18·6 ml per kg per min) yielded adjusted odds ratios (ORs) for a high MSS of 2·86 (P = 0·025) and 2·92 (P = 0·002) respectively. Compared with a cohort with a low Combined Inflammatory and Physiology Score (CIPS), the OR was 1·70 (95 per cent c.i. 0·85 to 3·39) for intermediate and 27·47 (3·12 to 241·69) for high CIPS (P < 0·001).ConclusionCRP and V˙ o 2peak were independently associated with major complications after potentially curative oesophagectomy for cancer. A composite risk score identified a group of patients with a high risk of developing complications.

Electroimmunodetection of cardiac C-reactive protein for determining myocardial Injury.

C-reactive protein (CRP) is an acute phase reactant to be a marker of inflammation and has been correlated with the cardiac injury. An immunoassay was performed using anti-human CRP antibody on an InterDigitated electrode (IDE) sensor to determine and specify CRP concentration for diagnosing the condition of myocardial inflammation. To promote the detection, gold nanoparticle (GNP) was seeded on the aminated-IDE surface. Anti-CRP was hitched on the GNP-seeded surface and identified the abundance of CRP. The limit of quantification was found as 100 fM, and the higher current response was noticed by increasing CRP concentrations with the sensitivity at 1 pM. Furthermore, CRP-spiked human serum did not interfere the determination of CRP and increased the current response, indicating suitability for a real-life sample. Similarly, the control experiments with nonimmune antibody Troponin I are not showing the definite current responses, proving the selective identification of CRP. This method of diagnosing is needful to determine the cardiovascular injury at the right time.

Clinical and epidemiological features and organ dysfunction in newborns with neonatal sepsis

Purpose. To evaluate clinical and epidemiological features of neonatal sepsis and assess the impact of organ dysfunction on its outcome.Characteristics of children and research methods. The authors carried out a retrospective analysis of 66 patients with neonatal sepsis hospitalized to the neonatal intensive care unit of the Kazan City Children’s Hospital No. 1 from 2013 to 2017. The diagnosis was based on the development of a systemic inflammatory response syndrome, an increase in C-reactive protein concentration in the blood more than 1 mg/dl, the presence of one or more foci of infection, the development of organ dysfunction and the isolation of the microorganism from venous blood. Bacteremia was a mandatory inclusion criterion.Results. In the most cases (54.5%) neonatal sepsis was caused by gram-negative bacteria. 41 and 4.5% of cases were caused by gram-positive bacteria and fungi, respectively. Among the gram-negative bacteria, the main causative agents of sepsis were Klebsiella pneumoniae (27 cases, 41%), among the gram-positive bacteria –staphylococci (24 cases, 36.5%). Fungal sepsis was caused by Candida kruzei (2 cases) and Candida albicans (1 case). In 11 (17%) cases there was a dysfunction of a single organ, in 31 (47%) cases – dysfunction of 2 organs and in 24 (36%) cases – dysfunction of more than 2 organs. The most common impairments were respiratory dysfunction (86%) and hemostatic disorders in the form of thrombocytopenia (58%). Neonatal sepsis was fatal in 11 (17%) cases. It was found that the multiple organ dysfunction was associated with a risk of death (odds ratio – OR = 29.3; 95% CI 3.4–249.7). Among the signs of organ dysfunction, coma (OR = 30.8; 95% CI 3.0–316.6), elevated blood lactate level of more than 5 mmol/l (OR = 22.1; 95% CI 3.5–139,6) and a low platelet count of less than 50 · 109/l (OR = 5; 95% CI 1.2–21.3) had the prognostic significance.Conclusion. Modern neonatal sepsis has a diverse etiology with gram-negative bacteria as causative agents in half of the cases. Despite modern treatment methods, neonatal sepsis remains a formidable infectious pathology. The risk of fatal outcome is associated with organ dysfunction. Coma, elevated blood lactate level and severe thrombocytopenia are the most significant predictors of fatal outcome in neonatal sepsis.

Adverse childhood experiences, inflammation, and depressive symptoms in later life: a prospective cohort study

BackgroundExposure to adverse childhood experiences (ACEs) has been associated with both inflammation and depression. However, little research has examined the potential mediational role of inflammation in the link between ACEs and depression using longitudinal data. Therefore, we investigated the direct and indirect effects of ACEs on inflammation, depression, and their change trajectories over time. MethodsWe used data from the English Longitudinal Study of Ageing. Four ACE categories were assessed retrospectively at wave 3 (2006–07): abuse (physical or sexual abuse or physical assault), family dysfunction (parent arguments, parent mental illness or substance abuse, or parent separation or divorce), poor parent–child bonding (maternal or paternal), and loss of an attachment figure (separation from mother for >6 months, parent death, foster care or adoption, or institutionalisation). A cumulative ACE score was calculated representing the total number of ACEs experienced by the participants. Concentration of C-reactive protein (CRP), an inflammatory marker, was measured at waves 2 (2004–05), 4 (2008–09), and 6 (2012–13). Depressive symptoms were ascertained using the 8-item Centre for Epidemiological Studies Depression Scale from waves 6 to 8 (2016–17). The longitudinal direct and indirect effects of ACEs were estimated using parallel process latent growth curve modelling. All analyses were adjusted for relevant confounders. Missing data were estimated using multiple imputation. ResultsAmong the study sample (N=4382; mean age 70 years; 56% female), 24% of participants reported one ACE and 13% had two or three ACEs. The percentage of participants with three or more depressive symptoms was 21% at baseline. Greater cumulative exposure to ACEs was associated with increased CRP concentration (β=0·042, p=0·010) and depressive symptoms (β=0·164, p<0·0001) at baseline and predicted a steeper increase in these outcomes throughout the study (βCRP=0·074, p=0·011; βDepression=0·338, p<0·0001). However, indirect effects of ACEs on depression mediated by CRP were not observed, with only weak associations between CRP and depressive symptoms (βiDepression=0·032, p=0·173; βsDepression=0·067, p=0·240). Sensitivity analyses using only somatic depressive symptoms as the outcome revealed a positive association between CRP and somatic symptoms at baseline (βiDepression=0·068, p=0·008), although the indirect effects remained non-significant in this model. InterpretationBiological mechanisms other than inflammation might underlie the relationship between ACEs and depression. Psychosocial interventions to reduce the negative effects of ACEs on children's development could help to reduce the risk of depression and of other medical conditions linked to inflammation. FundingEconomic and Social Research Council–Biotechnology and Biological Sciences Research Council Soc-B Centre for Doctoral Training (ES/P000347/1).