Inflammatory Index Research Articles

Systemic Inflammatory Immune Index (SII) Predicts Disease Activity in Systemic Lupus Erythematosus (SLE) Patients: A Cross-Sectional Study

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by widespread inflammation and diverse clinical manifestations. The systemic inflammatory immune index (SII), calculated as platelet count * neutrophil count/lymphocyte count, has emerged as a potential marker of systemic inflammation in various conditions. This study aimed to investigate the relationship between SII and disease activity in SLE patients. Methods: We conducted a cross-sectional study involving 60 SLE patients diagnosed according to the 2019 EULAR/ACR classification criteria. Demographic and clinical data were collected, and disease activity was assessed using the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI). Blood samples were analyzed to determine SII values. Statistical analysis included Spearman's correlation to assess the relationship between SII and MEX-SLEDAI scores. Results: The study population predominantly consisted of women (98.3%), with a median age of 29 years. A strong positive correlation was observed between SII and MEX-SLEDAI scores (r = 0.931, p < 0.001). Patients with higher SII values exhibited significantly greater disease activity. Conclusion: Our findings suggest that SII is a promising predictor of disease activity in SLE patients. This readily available index may aid clinicians in assessing disease severity and tailoring treatment strategies. Further research is warranted to validate these findings and explore the utility of SII in monitoring disease progression and treatment response.

Early and Long-Term Outcomes of Patients Undergoing Surgery for Native and Prosthetic Valve Endocarditis: The Role of Preoperative Neutrophil-to-Lymphocyte Ratio, Neutrophil-to-Platelet Ratio, and Monocyte-to Lymphocyte Ratio

Background/Objectives: Previous studies evaluated the prognostic role of hematological parameters in predicting outcome in patients with infective endocarditis (IE). However, only a few studies evaluated the role of hematological parameters in patients undergoing surgery for IE. The aim of this study was to review our 20-year experience with the treatment of native (NVE) and prosthetic (PVE) valve endocarditis and to evaluate the role of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to monocyte ratio (NMR), and systemic inflammatory index (SII) on early and long-term outcomes of patients undergoing surgery for NVE and PVE. Methods: All adult patients undergoing surgery for NVE and PVE at our institution between January 2001 and December 2022 were included in the study. Preoperative NLR, NPR, PLR, MLR, NMR, and SII were calculated using hemograms with complete blood count. Results: During the study period, 503 patients, 371 (74%) males, median age 65 (52–73) years, underwent surgery for NVE (n = 337, 67%) or PVE (n = 166, 33%). Patients with PVE had significantly more aortic annulus abscess (95 (57%) vs. 51 (15%); p < 0.001), longer CPB (180 (131–235) vs. 105 (84–145) min; p < 0.001) and aortic cross-clamping times (129 (96–175) vs. 82 (64–114) min; p < 0.001), and received more aortic homografts (47 (28%) vs. 28 (9%); p < 0.001) and postoperative pacemaker implantation (25 (15%) vs. 20 (6%); p < 0.001 compared to patients with NVE. Preoperative NLR was 3.7 (2.4–6.1), NPR was 23 (16–37), PLR was 159 (106–210), NMR was 8.4 (6.6–12), MRL was 0.41 (0.29–0.62], and SII was 790 (485–1396). NLR, NPR, and MLR were significantly lower in patients with NVE compared to patients with PVE and in survivors compared to non-survivors. Overall mean survival time was 12.2 ± 0.5 years, with patients with NVE having better early and late survival compared to patients with PVE. Patients with preoperative NLR < 3.8, NPR < 30.9, and MLR < 0.4 had significantly better mean survival time compared to patients with preoperative NLR > 3.8, NPR > 30.9, and MLR > 0.4, respectively. Conclusions: In patients undergoing surgery for IE, preoperative higher NLR, NPR, and MLR are associated with increased early and long-term mortality.

Erythrocyte modified controlling nutritional status as a biomarker for predicting poor prognosis in post-surgery breast cancer patients

Nutrition and inflammation are closely related to prognosis in breast cancer patients. However, current nutritional and inflammatory measures predict disease free survival (DFS) of breast cancer are still different, and the most predictive measures remain unknown. This study aimed to compare the predictive effects of commonly used nutritional and inflammatory measures on DFS and to improve existing nutritional or inflammatory measures in order to develop a new model that is more effective for predicting postoperative recurrence and metastasis in breast cancer patients. The clinical data of 536 female breast cancer patients with invasive ductal carcinoma who underwent surgery at Shaoxing People’s Hospital from January 2012 to December 2018 were retrospectively evaluated. The predictive effects of nutritional and inflammatory indicators on DFS were evaluated. Machine learning was used to evaluate and rank laboratory indicators, select relatively important variables to modify nutritional or inflammatory indicators with the best predictive power, and evaluate their predictive role in patients’ postoperative recurrence and metastasis. Among various metrics predicting DFS, the CONUT score emerged paramount with an area under the curve (AUC) of 0.667. Interestingly, the combination of the erythrocyte levels with the CONUT score (ECONUT) achieved the highest AUC (0.722). The Kaplan-Meier survival analysis showed that the group exhibiting high ECONUT scores experiencing a notably poorer DFS. ECONUT was identified as an independent risk factor for postoperative DFS (P < 0.001). The ECONUT model could provide an effective assessment tool for predicting DFS in breast cancer patients.

The role of the Systemic Inflammatory Response Index (SIRI) and other maternal biochemical markers in determining the severity of intrahepatic cholestasis of pregnancy.

To investigate the roles of the systemic inflammatory response index (SIRI) and other biochemical markers obtained from maternal blood in determining the diagnosis and severity of pregnancy cholestasis. In this retrospective case-control study, a total of 815 pregnant women including 546 healthy pregnant women [serum total bile acid (TBA) level < 10 μmol/L, control group], 185 patients with mild cholestasis [serum TBA level < 40 μmol/L, mild intrahepatic cholestasis of pregnancy (ICP) group] and 84 patients with severe cholestasis (serum TBA level ≥ 40 μmol/L, severe ICP group) were evaluated. The groups were compared regarding demographic data, clinical characteristics, SIRI (neutrophilcount*monocytecount/lymphocyte count), and other laboratory data. Cut-off values that could predict ICP were calculated. The average neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were found to be statistically significantly higher in the severe ICP group compared with the control group and mild ICP group (p < 0.01 and p < 0.05). The best SIRI cut-off value was 2.3302 (60.3% sensitivity and 52.2% specificity) [area under the curve: 0.590 ± 0.023, 95% confidence interval (CI): 0.546-0.634; p < 0.001]. SIRI may be a useful marker in determining the diagnosis and severity of ICP. However, were commend that studies be conducted in larger groups and indifferent trimesters.

Selective Gamma-Secretase Inhibition by CHF5074 Attenuates Inflammation and Neovascularization in a Murine Model of Choroidal Neovascularization

Purpose Chronic inflammation plays an important role in the pathogenesis of choroidal neovascularization (CNV). This study aimed to investigate the effect of the CHF5074, a γ-secretase inhibitor, on angiogenesis in a laser-induced CNV model and elucidate its possible molecular mechanism. Methods Male C57/BL6J mice aged between 6 to 8 weeks were employed to set up a laser-induced model of CNV. Then, CHF5074 was injected intraperitoneally on the day after laser modeling, as well as on the second, third, and fourth days. Immunofluorescence staining was used to evaluate the retinal and choroidal complex. The markers used were CD31 for neovascularization and IBA1 for microglia staining in ocular tissue slices. Fundus fluorescein angiography on days 3d, 7d, and 14d analyzed neovascularization and leakage areas. Inflammatory indicators were examined by Western blot (WB) and enzyme-linked immunosorbent assay (ELISA). High-throughput whole-tissue sequencing of retinal choroids identified relevant cell pathways. Key regulatory factors modulated by CHF5074 were identified via WB. Co-culture of BV2 cells and human umbilical vein endothelial cells (HUVEC) were used to explore the function of CHF5074 on the inhibition of tube formation. Results CHF5074 significantly decreased CD31 expression in the choroid on 3d, 7d, and 14d post-laser modeling (p < 0.05) and decreased both neovascularization and leakage areas (p < 0.05). Additionally, CHF5074 significantly lowered TNF-α, IL-10, and IL-1β expression levels in the choroid (p < 0.05), as demonstrated by WB analysis and ELISA. High-throughput whole-tissue sequencing identified P38-MAPK, JNK, and Wnt signaling pathways associated with neovascularization. CHF5074 decreased P38 protein phosphorylation (p < 0.05) as confirmed by WB analysis. CHF5074 inhibited the tube formation of HUVECs co-cultured with LPS and ATP-treated BV2 cells. Conclusion CHF5074 significantly suppresses angiogenesis in laser-induced choroidal neovascularization models, suggesting its potential as a novel agent for preventing and treating CNV.

Prognostic value of inflammation and nutritional indicators for sinonasal squamous cell carcinoma: A single‐center retrospective study

AbstractIntroductionSystemic inflammatory and nutritional markers are associated with the prognosis of various cancers. However, their association with sinonasal squamous cell carcinoma (SNSCC) prognosis remains unclear. This study aimed to identify systemic inflammatory and nutritional markers associated with the postoperative prognosis of patients with SNSCC and to clarify the clinical value of these markers.Materials and methodsData from 129 patients with SNSCC were included. The optimal prognostic systemic inflammatory and nutritional markers were identified using the area under the curve. The prognostic value was evaluated using COX regression and subgroup analyses; a nomogram was built based on these data.ResultsThe advanced lung cancer inflammation index (ALI) and systemic immune‐inflammatory index (SII) had higher prognostic values than the other indices; their cut‐off values were 27.80 and 791.35, respectively. The nomogram included tumor stage, ALI, and tumor primary site; the calibration and decision curves indicated that the model had good clinical value.ConclusionThe ALI and SII have potential prognostic value for postoperative patients with SNSCC. The nomogram constructed in this study could be used as a tool to assist physicians in making clinical decisions.Level of evidence4.

Predictive value of lymphocyte-associated inflammation index in post-stroke cognitive impairment: a systematic review and meta-analysis

BackgroundThe predictive role of the lymphocyte-associated inflammation index in post-stroke cognitive impairment (PSCI) remains controversial. Therefore, we performed an updated meta-analysis to update the evidence.MethodsThis meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases were systematically searched from their inception to May 5, 2024. Two investigators independently conducted literature screening and data extraction for the included studies. Two investigators independently assessed the quality of the included studies using the Newcastle-Ottawa Scale (NOS). Combined effect sizes were calculated using weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs). Heterogeneity was tested using the chi-square (χ2) test (Cochran’s Q) and index of inconsistency (I2), Publication bias was assessed using funnel plots and Egger’s regression test.ResultsThis systematic review included a total of 16 studies, encompassing 3,406 patients. Meta-analysis revealed that neutrophil-to-lymphocyte ratio (NLR) levels were significantly higher in the PSCI group compared to the non-PSCI group (WMD: 1.12; 95% CI: 0.85, 1.40; p &amp;lt; 0.00001). Similarly, the platelet-to-lymphocyte ratio (PLR) levels were significantly higher in the PSCI group compared to the non-PSCI group (WMD: 16.80; 95% CI: 4.30, 29.29; p = 0.008). However, there was no statistically significant difference between the two groups concerning hemoglobin, albumin, lymphocyte, and platelet (HALP) scores (WMD: -12.78; 95% CI: −25.95, 0.38; p = 0.06) and lymphocyte count (WMD: -0.13; 95% CI: −0.34, 0.07; p = 0.20).ConclusionIncreased levels of PLR and NLR are strongly associated with the PSCI, which may serve as an effective tool for predicting PSCI. However, there is insufficient evidence to support a direct relationship between HALP scores, lymphocyte count, and PSCI.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023462232.

Systemic inflammatory response index improves prognostic predictive value in intensive care unit patients with sepsis

Sepsis is a severe infectious disease with high mortality. However, the indicators used to evaluate its severity and prognosis are relatively complicated. The systemic inflammatory response index (SIRI), a new inflammatory indicator, has shown good predictive value in chronic infection, stroke, and cancer. The purpose of this study was to investigate the connection between sepsis and SIRI and evaluate its predictive usefulness. A total of 401 patients with sepsis were included in this study. Multiple linear regression and logistic regression analyses were performed to evaluate the relationship between SIRI and sepsis. The restricted cubic spline (RCS) method was employed to illustrate the dose-response relationship. The area under the curve (AUC) and decision curve analysis (DCA) were used to evaluate the prognostic value of SIRI. Multiple linear regression analysis revealed a significant positive correlation between SIRI and both blood cell count and Sequential Organ Failure Assessment (SOFA) score. Additionally, higher SIRI levels were significantly linked to a higher risk of sepsis worsening, according to logistic regression analysis. The RCS curve demonstrated that the risk of poor prognosis rose with increasing SIRI, particularly when SIRI exceeded 6.1. Furthermore, AUC and DCA results showed that SIRI had superior predictive value compared to traditional indicators. A higher SIRI is linked to a worse prognosis and more severe sepsis. SIRI may serve as a novel prognostic indicator in sepsis, though further clinical studies are necessary to confirm these findings.

Improvement of IL-4, IL-6, IL-10, TNF-α and IFN-γ in children with mycoplasma pneumonia through the combination of video scenario-based breathing training and antibiotics.

This study aims to investigate the effects of video scenario-based breathing training on interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in children with Mycoplasma pneumonia. A total of 106 children with Mycoplasma pneumonia treated in our hospital from February 2022 to April 2024 were selected. According to different nursing methods, children receiving routine intervention were assigned to the control group, while those undergoing video scenario-based breathing training were assigned to the training group. The serum inflammatory indexes, improvement time of clinical symptoms and lung function recovery were compared between the two groups before training, and at 1 and 2 weeks after training. Before training, there was no statistically significant difference in serum inflammatory and lung function indexes between the two groups (p > 0.05). After 1 and 2 weeks of training, the forced expiratory volume in 1s (FEV1), peak expiratory flow rate (PEF), and the ratio of FEV1 to forced vital capacity (FEV1/FVC) in both groups increased, with higher values in the training group than in the control group, and the difference was statistically significant (p < 0.05). The time for cough disappearance, wheezing disappearance, lung rales disappearance and high fever abatement in the training group was lower than that in the control group, with statistically significant differences (p < 0.05). The levels of IL-4, IL-6, IL-10, TNF-α, and IFN-γ decreased in both groups, with lower levels in the training group than in the control group, and the difference was statistically significant (p < 0.05). Video scenario-based breathing training can improve lung function, alleviate clinical symptoms and signs, and reduce serum inflammatory levels of IL-4, IL-6, IL-10, TNF-α and IFN-γ in children with Mycoplasma pneumonia.

Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation

ObjectiveResearch on the link between inflammatory indicators and markers of bone metabolism is currently lacking, especially the interaction between Procollagen type 1 N-terminal propeptide (P1NP), the β-C-terminal telopeptide of type 1 collagen (β-CTX), and the fibrinogen-to-albumin ratio (FAR). This study intends to fill that knowledge gap by investigating the possible link between inflammatory indicators and bone metabolism.MethodsThis observational study included 718 individuals diagnosed with osteoporotic fractures from Kunshan Hospital Affiliated to Jiangsu University between January 2017 and July 2022. After accounting for several confounders, the independent connection between FAR levels and β-CTX and P1NP was investigated via Generalized Estimating Equations (GEE). On top of that, we used a generalized additive model (GAM) to find any non-linear correlations, and a two-piecewise linear regression model to find the threshold effects in the smoothing curves that came out of it. To ensure the aforementioned result was stable, a subgroup analysis was carried out.ResultsThe results showed a positive linear correlation between FAR and β-CTX [β = 1.077, 95% confidence interval (CI): 0.24 to 1.92, P = 0.012]. The study’s findings demonstrated that FAR and P1NP fit curves in an inverted U-shaped pattern, and an inflection point K = 0.0685 for FAR was detected. P1NP showed a positive correlation with FAR below the inflection point (β = 306.10, 95% CI: 47.37 to 564.83, P = 0.021), and a negative correlation with FAR beyond the inflection point (β = -117.57, 95% CI: -231.34 to -3.80, P = 0.043). The subgroup analysis revealed that women had a more significant association between FAR and β-CTX in women than in men.ConclusionsThe results provide useful insights into the potential association between FAR and markers of bone metabolism. The study may provide a novel clinical implication by introducing FAR as a potential reference indicator for assessing bone health, offering a cost-effective and conveniently obtainable biomarker to monitor inflammation to improve bone metabolism in the treatment of osteoporosis.

Assessment of the Severity of Intermediate Coronary Artery Stenosis Using the Systemic Inflammatory Response Index

Background: Fractional Flow Reserve (FFR) is a method that enables the hemodynamic assessment of coronary artery stenosis. The Systemic Inflammatory Response Index (SIRI) is a new marker calculated by multiplying the neutrophil-to-lymphocyte ratio (NLR) with the monocyte count. It is indicative of the presence and severity of coronary artery disease. This study evaluates the relationship between the functional significance of FFR measurements and the SIRI in intermediate coronary stenosis. Methods: A total of 294 patients with 50–70% stenosis in their coronary arteries based on quantitative measurement following angiography who underwent FFR measurement were included in the study before the FFR procedure. Total and differential leukocyte counts and routine biochemical tests were performed. Results: A total of 37% of the patients were found to have a positive FFR, while 63% had a negative FFR. Significant differences were observed in the neutrophil count, monocyte count, Systemic Inflammation Response Index (SIRI), total cholesterol, and amount of adenosine used between the groups (p &lt; 0.05). A SIRI value of 1.16 was 77% sensitive and 55% specific for FFR positivity. Multivariate logistic regression analysis identified the SIRI as an independent predictor of FFR positivity. Conclusions: Our study has demonstrated that high values of the SIRI may serve as a new biomarker for predicting FFR positivity.

The change of inflammatory markers may predict long-term major adverse cardiovascular events in elderly patients with coronary heart disease: a retrospective cohort study

BackgroundAt present, the relationship among inflammatory markers [monocytes/HDL-c (MHR), neutrophils/HDL-c (NHR) and lymphocytes/HDL-c (LHR)] and long-term prognosis of coronary heart disease (CHD) is still unclear. Therefore, this study explores the relationship between inflammatory indicators and the risk of long-term major adverse cardiovascular events (MACE) in elderly patients with CHD.MethodsA retrospective analysis was conducted on 208 elderly patients who underwent coronary angiography at Wuhan Fourth Hospital from August 2022 to August 2023. They were divided into the CHD group (N = 116) and control group (N = 92). Patients in the CHD group were followed up for 1 year and divided into the MACE group (N = 36) and the non-MACE group (N = 80) according to whether MACE occurred.ResultsIn elderly patients, logistic regression analysis shows that MHR is an independent risk factor for CHD (OR = 3.050, 95% CI 1.318–1.772). ROC curve analysis found that MHR (AUC = 0.865, 95% CI 0.811–0.919, p &amp;lt; 0.001) is higher than NHR and LHR. In patients with CHD, the spearman analysis show that MHR is positively correlated with Gensini score (R = 0.266, p = 0.004). The logistic regression analysis found that MHR is independent risk factors for MACE (OR = 6.048, 95% CI 1.224–1.941, p = 0.002). ROC analysis showed that the critical value of MHR to predict MACE was 0.651, the sensitivity of 58.3% and specificity of 90.0% could predict MACE, and the AUC was 0.793 (95% CI 0.702–0.884, p &amp;lt; 0.001) is higher than LHR.ConclusionIn elderly patients, MHR is an independent predictor of CHD and long-term MACE and is positively correlated with the severity of coronary artery lesions.

Are IL-17 inhibitors superior to IL-23 inhibitors in reducing systemic inflammation in moderate-to-severe plaque psoriasis? A retrospective cohort study.

IL-17 and IL-23 inhibitors have shown successful results in improving skin lesions in the treatment of moderate-to-severe plaque psoriasis. However, psoriasis is a chronic inflammatory disease characterized by systemic inflammation including joints in addition to skin lesions. Therefore, in this retrospective and observational cohort study, we aimed to evaluate the effect of IL-17 inhibitors (secukinumab and ixekizumab) and IL-23 inhibitors (risankizumab and guselkumab) on systemic inflammation in psoriasis. We included 214 treatment courses with IL-17 inhibitors (n = 116, 54.2%) and IL-23 inhibitors (n = 98, 45.8%) and compared the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (d-NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-monocyte ratio (PMR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) at baseline and Week 16 of treatment. In patients receiving IL-17 inhibitor, NLR, d-NLR, PLR, SII, SIRI, and AISI were significantly decreased at Week 16 (p = 0.003, p = 0.001, p = 0.024, p = 0.001, p = 0.008, and p = 0.002, respectively). There was no significant reduction in systemic inflammatory markers in the anti-IL-23 group. At week 16, the anti-IL-17 group showed a significantly higher mean decrease from the baseline values of NLR, d-NLR, SII, SIRI, and AISI than the anti-IL-23 group (p = 0.021, p = 0.009, p = 0.012, p = 0.028, and p = 0.021, respectively). The PASI75/90/100 scores didn't significantly differ between the IL-17 and IL-23 groups. Achieving PASI90 response at Week 16 in the IL-17 group was associated with the change in AISI (p = 0.037). The PASI75 response at Week 16 in the IL-23 group was associated with the change in NLR, d-NLR, and SII (p = 0.044, p = 0.037, and p = 0.031, respectively). NLR (rho = 0.173, p = 0.014), d-NLR (rho = 0.189, p = 0.007), SII (rho = 0.158, p = 0.024), SIRI (rho = 0.156, p = 0.026), and MLR (rho = 0.165, p = 0.019) showed positive correlations with the baseline PASI, but no correlation was found with the change in systemic inflammatory markers and the change in PASI score. In the treatment of moderate-to-severe psoriasis, IL-17 inhibitors appear to have a greater decreasing effect on systemic inflammatory markers than IL-23 inhibitors. However, more evidence-based data are needed to conclude that IL-17 inhibitors are superior to IL-23 inhibitors in suppressing systemic inflammation in psoriatic disease.

Protective effects of myrtenol against paraquat-induced toxicity in rats

BackgroundParaquat (PQ) is a widely used pesticide, can cause severe intoxication and respiratory failure. Myrtenol (Mrl), an essential oil derived in various plants, exhibits several biological properties, including anti-inflammatory and antioxidant activities. This study aims to investigate the protective potential of Mrl against oxidative stress and inflammation caused by PQ exposure.MethodsTwenty-five Wistar albino rats were divided into the following groups (n = 5 in each group): a control group (treated by dimethyl sulfoxide (DMSO)), a PQ group (exposed to 54 mg/m³ aerosol PQ), and two treatment groups that were exposed to PQ aerosol and administered oral Mrl at doses of 25 mg/kg/day and 50 mg/kg/day, respectively. The final group was exposed to PQ aerosol and treated with oral dexamethasone at a dose of 0.03 mg/kg/day. Various hematological, oxidative, inflammatory, and pathological indices were measured at the conclusion of the treatment period.ResultsPQ decreases the levels or activities of superoxide dismutase (SOD), catalase (CAT), and Thiol, while increasing the levels or activities of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and malondialdehyde (MDA). Mrl restored activites of SOD, and CAT, as well as thiol levels to near-control values while reducing TNF-α, IL-6, and MDA levels. Pathological studies further confirmed the therapeutic effects of Mrl.ConclusionThe results of this study demonstrate the promising therapeutic effects of Mrl against inhaled PQ in rats.

Astragaloside IV Relieves Central Sensitization by Regulating Astrocytic ROS/NF-κB Nuclear Translocation Signaling in Chronic Migraine Male Rats.

Chronic migraine (CM) is a disabling neurological disease. Astragaloside IV (AS-IV), a natural product derived from Astragalus membranaceus, shows great potential in treating chronic pain by relieving inflammation and oxidative stress. This study aimed to investigate the effects and mechanisms of action of AS-IV on CM. An inflammatory soup comprising histamine, bradykinin, serotonin, and prostaglandin E2 was used to establish a CM rat model, while lipopolysaccharide was applied to induce an inflammatory response in primary astrocytes. Pain threshold measurements were used to evaluate nociceptive hypersensitivity, while qPCR and Western blotting were applied to detect inflammatory indicators and synaptic protein expression, and Golgi-Cox staining was applied to observe dendritic spine density, while transmission electron microscopy was used to observe synaptic ultrastructure. Mitochondrial function and oxidative stress were assessed using JC-1 staining, Mitotracker staining, reactive oxygen species (ROS) quantification, and glutathione content. AS-IV pretreatment alleviated central sensitization and ameliorated astrocyte activation and neuroinflammation. AS-IV pretreatment alleviated mitochondrial dysfunction invitro, and reduced the nuclear translocation of NF-κB and the production of IL-1β, which were reversed by ROS scavengers invitro or mitochondrial respiratory chain disruptors invivo. Our study indicates that AS-IV can inhibit neuroinflammation by alleviating astrocyte mitochondrial dysfunction to mitigate central sensitization in CM, thereby providing an experimental basis for AS-IV and A. membranaceus in CM prevention and treatment.

Perinatal outcomes of patients who underwent cervical cerclage and their relationship to systemic inflammatory indices

Aims: This study aimed to evaluate the perinatal outcomes of patients who underwent cervical cerclage and to investigate the relationship between these outcomes and systemic inflammatory indices. Methods: A retrospective study was conducted at Ankara Etlik City Hospital between November 2022 and November 2023. Patients were divided into three groups based on the indication for cerclage: history-indicated cerclage (H-IC), ultrasound-indicated cerclage (U-IC) and physical examination-indicated cerclage (PE-IC). The systemic inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), pan-immune inflammation value (PIV) and multi-inflammation indices (MII), were measured. The perinatal outcomes, including gestational age at delivery, birth weight and APGAR Scores, were compared among the groups. Results: Seventy patients were included in the study. The rate of preterm birth was highest in the PE-IC group (61.1%), followed by the U-IC group (40.9%) and the H-IC group (36.7%). Birth weight, 1- and 5-minute APGAR Scores were significantly lower in the PE-IC group, and neonatal intensive care unit admission rates were significantly higher in the PE-IC group. Inflammatory markers NLR, SII and PIV were significantly higher in the U-IC group compared to the H-IC group. However, no significant differences were observed between the U-IC and PE-IC groups in terms of these markers. Conclusion: Patients who underwent PE-IC had poorer perinatal outcomes compared to those who underwent H-IC or U-IC. The systemic inflammatory indices NLR, SII and PIV may serve as useful markers for predicting pregnancy outcomes and guiding early interventions in patients at risk of preterm birth. Further large-scale prospective studies are needed to validate these findings.

Association Between Chewing Capacity and Mortality Risk: The Role of Diet and Ageing.

Masticatory dysfunction due to tooth loss is a potentially modifiable risk for mortality, but the pathway behind that remains to be investigated. This prospective study aimed to examine the role of diet and ageing in the associations between chewing capacity and long-term mortality. Data were obtained from participants (aged ≥ 20) in the National Health Nutritional and Health Survey (NHANES 1999-2010, n = 22,900). The mortality follow-up ended on 31 December 2019. Chewing capacity was determined by the number of functional tooth units (FTUs). Diet information in NHANES was collected using a 24-h-recall questionnaire, and diet quality was measured by three index-based dietary patterns, namely the nutrition index (NI), energy-adjusted dietary inflammatory index (E-DII) and healthy eating index-2015 (HEI-2015). The biological ageing process was reflected using phenotypic age acceleration (PhenoAgeAccel) and frailty index. Mediation analyses were conducted to assess the role of diet quality in the association between FTUs and ageing, as well as the role of ageing in the association between impaired chewing capacity (ICC) and mortality. Participants with more FTUs were found to have a slower biological ageing process. Diet quality scores were estimated to mediate 9.0%-23.0% of the association between chewing capacity and biological ageing. Multivariable Cox proportional hazards regression models found a positive association between ICC and all-cause mortality (hazard ratio = 1.282 [95% confidence interval: 1.189-1.382]). Also, ICC was significantly associated with a 28.9% higher risk of mortality due to cardiovascular disease (CVD) and a 32.7% higher risk of mortality due to cancer. Mediation analyses indicated that PhenoAgeAccel mediated the effect of ICC on all-cause, CVD and cancer mortality with proportions of 18.1%, 17.3% and 12.5%, respectively. Similar mediating proportions were observed in the frailty index (range: 11.6%-23.5%). ICC was associated with poorer diet quality and accelerated ageing, resulting in higher mortality risk. Therefore, it is plausible that dietary interventions and oral rehabilitation would promote healthy longevity, although further investigations are needed.

Associations of nutritional intake and inflammatory factors with sarcopenia in community-dwelling older adults: a cross-sectional study.

Sarcopenia is an age-related disease that is related to nutritional intake and chronic low-grade inflammation. The aim of this study was to investigate the association of dietary intake, inflammatory markers and sarcopenia among the community-dwelling older adults. A total of 1001 older adults aged 60 and above were recruited. According to the criteria established by the Asian Working Group for Sarcopenia 2019, this paper assessed the presence of sarcopenia and using a Food Frequency Questionnaire to evaluate daily dietary intake. Serum levels of inflammatory markers were measured using the ELISA method. A total of 1001 participants took part in the study (mean 70.6years), comprising 396 males and 605 females, the prevalence of sarcopenia was 19.6%. Multivariate analysis revealed that high levels of leucine, methionine, threonine, histidine, aspartic acid, calcium, zinc, and vitamin C were associated with a lower risk of sarcopenia. Higher dietary inflammatory index scores were associated with a higher risk of sarcopenia (OR 1.67, 95% CI 1.12-2.47). Higher tumor necrosis factor-like weak inducer of apoptosis (TWEAK) (OR 1.04, 95% CI 1.02-1.07) was associated with a higher risk of sarcopenia, and a lower skeletal muscle mass, strength, and physical function. Conversely, higher insulin-like growth factor-1 (IGF-1) (OR 0.83, 95% CI 0.74-0.94) and glutathione S-transferase (GST) (OR 0.75, 95% CI 0.61-0.91) were associated with a lower risk of sarcopenia. This cross-sectional study revealed alterations in amino acid and micronutrient intake among older adults with sarcopenia. The levels of TWEAK were associated with an increased risk of sarcopenia, whereas IGF-1 and GST were associated with a reduced risk of sarcopenia.

The mediating role of inflammatory biomarkers in the association between serum copper and sarcopenia

This study aims to investigate the association between serum copper (Cu), selenium (Se), zinc (Zn), Se/Cu and Zn/Cu ratios and the risk of sarcopenia. In this study, which involved 2766 adults aged ≥ 20 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016, multivariable logistic regression, restricted cubic spline (RCS) models and mediation analyses were used. After full adjustment, multivariable logistic regression revealed that higher serum copper levels were correlated with an increased risk of sarcopenia. Conversely, higher serum Se/Cu (OR 0.45, 95% CI 0.23–0.89, P = 0.023) and Zn/Cu (OR 0.49, 95% CI 0.27–0.90, P = 0.024) were associated with a decreased risk of sarcopenia. The RCS curve indicated a non-linear, roughly inverted L-shaped relationship between serum Cu and sarcopenia risk (P non-linear < 0.001). Additionally, Se/Cu (P non-linear = 0.179) and Zn/Cu (P non-linear = 0.786) showed negative linear associations with sarcopenia risk. Furthermore, white blood cell (WBC) count, neutrophil count, and systemic inflammation index (SII) were identified as significant mediators in the relationship between serum Cu and the risk of sarcopenia, with mediation proportions of 6.34%, 6.20%, and 4.37%, respectively (all P < 0.05). Therefore, balancing essential trace metals is crucial for maintaining muscle health.

Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy

To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and various stages of type 2 diabetic retinopathy (T2DR). Additionally, the diagnostic value of these markers in T2DR was evaluated. Clinical data were collected from a total of 397 patients with type 2 diabetes who visited the ophthalmology department at Mian Yang Central Hospital and the Affiliated Hospital of Southwest Medical University from January 2023 to December 2023. Based on the results of fundus photography, patients were categorized into a non-diabetic retinopathy group (NDR, n = 121), a non-proliferative diabetic retinopathy group (NPDR, n = 77), and a proliferative diabetic retinopathy group (PDR, n = 199). General patient information and systemic inflammatory markers, including the SII, SIRI, AIRI, NLR, PLR, and MLR, were compared among the groups, and their correlations with T2DR were analyzed. The SII values were found to be significantly higher in the PDR group compared to the NPDR group, which in turn were higher than those in the NDR group (P < 0.05). Similarly, the AISI values were significantly elevated in the PDR group compared to both the NPDR and NDR groups (P < 0.05). The SIRI and MLR values were significantly higher in the PDR group than in the NDR group (P < 0.05). Furthermore, the NLR and PLR values were significantly higher in the NPDR and PDR groups compared to the NDR group (P < 0.05). The Mantel‒Haenszel chi-square test revealed a significant linear trend between the SII and PLR and the incidence of PDR (P < 0.001), with the incidence of PDR increasing as the quartile levels of the SII and PLR increased. Multivariate logistic regression analysis indicated that, compared with NDR, a higher SII was found to be an independent risk factor for NPDR (ORSII = 1.002, p = 0.001) and PDR (ORSII = 1.002, P < 0.001). The ROC curve analysis suggested that the combined assessment of the six inflammatory indices had the highest accuracy in the evaluation of DR, with an area under the curve (AUC) of 0.69, a sensitivity of 54%, and a specificity of 75%. The results of this study indicate that the SII is an independent risk factor for T2DR. A close correlation was observed between the SII and PLR and the occurrence and progression of T2DR. The high accuracy of the combined diagnosis of T2DR via various serological inflammatory markers underscores their potential as early biological indicators for the diagnosis of T2DR.