Response Index Research Articles

The role of serum biomarkers in determining systemic inflammation and cardiovascular risk in pseudoexfoliation syndrome.

To investigate the role of hematological and atherogenic biomarkers in evaluating systemic inflammation and cardiovascular risk in patients with pseudoexfoliation syndrome. This retrospective study included 200 patients, 90 with pseudoexfoliation (PEX) syndrome (Group 1) and 110 healthy controls (Group 2). Twelve-hour fasting blood samples were collected to measure complete blood count, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) (neutrophil x platelet/lymphocyte), systemic inflammatory response index (SIRI) (neutrophil x monocyte/lymphocyte), pan-immune inflammation value (PIV) (neutrophil x platelet x monocyte/lymphocyte), C-reactive protein (CRP), uric acid, glucose, triglycerides(TG), total cholesterol, HDL, LDL, non-HDL, and triglyceride-glucose (TyG) index (Ln (TG [mg/dL] × glucose [mg/dL]/2)). The groups were compared based on these measurements. The two groups were similar in terms of age and gender (p > 0.05). No statistically significant differences were observed between the groups for PLR, SII, CRP, glucose, total cholesterol, HDL, LDL, and non-HDL (all p > 0.05). However, systemic inflammation markers-NLR, MLR, SIRI, PIV, and uric acid were significantly higher in Group 1 compared to Group 2 (all p < 0.05). Among the atherogenic biomarkers used to assess cardiovascular risk, triglycerides and the TyG index were significantly higher in Group 1 (p < 0.05, p < 0.001). Pseudoexfoliation syndrome is characterized by the accumulation of fibrogranular material primarily on the anterior lens capsule and pupillary border. PEX deposits are not limited to ocular structures but are also found in the heart, liver, and various vascular structures. It has been suggested that PEX is an independent risk factor for cardiovascular diseases and that systemic inflammation plays a role in the disease's pathogenesis. The significant biomarkers identified in this study may provide guidance in monitoring the disease.

Correlations between frailty index and inflammatory markers derived from blood cell count in the United States

BackgroundComplete blood cell count (CBC)-derived inflammatory biomarkers are crucial indicators of adverse outcomes and possess predictive value for a wide range of diseases. The objective of this study was to evaluate the links between CBC-derived inflammatory biomarkers and frailty index.MethodsInformation was gathered from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2016. The research investigated the correlation between inflammatory biomarkers derived from CBC, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII), and Rockwood’s frailty index, using logistic regression analyses.ResultsIn total, the cross-sectional study involved 13,507 U.S. adults aged 50 and older, with 3,729 individuals (24%) meeting the criteria for frailty. After adjusting for confounding factors, elevated levels of logNLR (odds ratio [OR] 3.45, 95% confidence interval [CI] 2.52–4.73), logMLR (OR 3.58, 95% CI 2.44–5.25), logSIRI (OR 2.77, 95% CI 2.17–3.55), and logSII (OR 1.89, 95% CI 1.44–2.48) were significantly associated with an increased frailty index in the entire study population. We also found that frailty index and inflammatory biomarkers derived from CBC have a non-linear relationship by restricted cubic spline.ConclusionsOur findings indicate a correlation between frailty index and NLR, MLR, SIRI, and SII among elderly adults. Considering their wide accessibility in both clinical and laboratory practice, these biomarkers may be recommended as potential indicators for the development of frailty.

The Role of Inflammatory and Nutritional Indices in Postmenopausal Osteoporosis: A Retrospective Study

Background: Postmenopausal osteoporosis is characterized by impaired bone metabolism, inflammation, and nutritional deficiencies. This study aimed to evaluate the potential of inflammatory and nutritional markers in identifying decreased bone mineral density (BMD) in postmenopausal women. Methods: This cross-sectional study retrospectively analyzed postmenopausal women from January 2018 and December 2023. A total of 368 women were divided into three groups based on T-scores: 61 women with osteoporosis (T-score ≤ −2.5), 153 women with osteopenia (−1 &gt; T-score &gt; −2.5), and 154 women with normal BMD (T-score &gt; −1). Inflammatory and nutritional biomarkers included the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune inflammation value (PIV), geriatric nutritional risk index (GNRI), triglycerides, total cholesterol, and body weight index (TCBI), prognosis nutritional index (PNI), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, 25-OH Vitamin D level, Na, K, Ca, Mg, and their ratios. Results: The GNRI was significantly lower in the osteoporosis group compared to the control group. The NLR, PLR, SII, SIRI, PIV, TCBI, PNI, and HALP were similar between the groups. The GNRI and TCBI showed a positive correlation with T-scores. The Mg level was lower in the osteoporosis group than in the control group and osteopenia group, and the Na/Mg ratio was higher. Additionally, the Ca/Mg ratio was lower in the osteoporosis group than in the control group. The T-score was positively correlated with Mg and Ca/Mg, while the Na/Mg ratio showed a significant negative correlation. Vitamin D, other minerals, and their ratios did not show significant differences between the groups. Conclusions: Our findings suggest that the GNRI could serve as a useful indicator for assessing bone health and the risk of osteoporosis. Furthermore, maintaining appropriate levels of Mg and balanced Na/Mg and Ca/Mg ratios appears crucial for BMD.

In-Season Nitrogen Management in the Root Zone of Wheat in a Calcareous Soil Using the Response Index

ABSTRACT Excessive and inappropriate nitrogen (N) fertilizer applications on calcareous soils result in significant losses, necessitating a targeted approach for improved efficiency and yield. Field experiments were conducted over two seasons to develop a strategy for root-zone (RZ) N fertilization for wheat. In the first season, three methods of N fertilizer application were used: surface (SF), in the RZ at a depth of 10 cm (RZF10), and in the RZ at a depth of 20 cm (RZF20). The N fertilizer was applied in a range of 0–280 kg N ha−1. In the second season, another experiment was carried out to validate the results. The data showed that to achieve maximum yield levels, N fertilizer rates of 264 kg ha−1 for SF, 218 kg ha−1 for RZF10, and 183 kg ha−1 for RZF20 were required. The findings also revealed that relocating the application from the surface to depths of 10 and 20 cm resulted in an increase in recovery efficiency by 11.2% and 31.2%, respectively. A linear equation established the relationship between the response index at harvest (RI-Harvest) and the corrective N rate for RZF20. The in-season response index of the normalized difference vegetation index effectively predicted RI-Harvest, leading to the development of an empirical equation to predict the corrective N rate. The validation experiment demonstrated the effectiveness of the proposed strategy in adjusting N rates based on crop-specific needs. This approach allows growers to optimize profits by carefully applying N in the RZ, eliminating both excessive and inadequate use.

Retrospective evaluation of novel serum inflammatory biomarkers in first-episode psychiatric disorders: diagnostic potential and immune dysregulation

BackgroundThis study assessed the diagnostic capabilities of eight inflammatory biomarkers in first-episode schizophrenia (SCZ), bipolar disorder (BD), and depression (D), examining their differential expression across these psychiatric disorders. The markers studied include neutrophils/lymphocyte ratio (NLR), aggregate index of systemic inflammation (AISI), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), lymphocytes/high-density lipoprotein (HDL) ratio (LHR), monocytes/HDL ratio (MHR), neutrophils/HDL ratio (NHR), and platelets/HDL ratio (PHR).MethodsWe conducted a retrospective observational study involving 335 individuals with SCZ, 68 with BD, 202 with D, and 282 healthy controls (C) to evaluate hematologic parameters from untreated patients and controls.ResultsSignificant differences in biomarker levels were found between patient groups and controls. Logistic regression analysis indicated that NHR and MHR (p &amp;lt; 0.001), as well as LHR and NLR (p &amp;lt; 0.01), were predictive factors for SCZ. MHR was a predictive factor for BD (p &amp;lt; 0.05). NHR (p &amp;lt; 0.01) and MHR (p &amp;lt; 0.001) were predictive factors for distinguishing between D and C. The area under the curve (AUC) value of the NHR + MHR + NLR composite index model for the SCZ group was 0.846 (p &amp;lt; 0.001). In the BD group, the AUC value for the MHR was 0.816 (p &amp;lt; 0.001). The D group’s combined AUC value of NHR + MHR was 0.824 (p &amp;lt; 0.001).ConclusionThis study highlights the diagnostic value of inflammatory biomarkers in distinguishing SCZ, BD, and D based on their differential expression.

Associations of systemic inflammation and systemic immune inflammation with serum uric acid concentration and hyperuricemia risk: the mediating effect of body mass index

BackgroundWith the development of lifestyle, elevated uric acid and hyperuricemia have become important factors affecting human health, but the biological mechanism and risk factors are still unclear.MethodsA multi-stage, cross-sectional study of 41,136 adults from the NHANES 2003-2018 was conducted. Serum uric acid concentrations, platelet, neutrophil, lymphocyte, and monocyte counts were measured. The systemic inflammation response (SIRI) index and systemic immune-inflammatory (SII) index were calculated to reflect systemic inflammation and systemic immune inflammation. The height and weight data were obtained to assess body mass index (BMI). Generalized linear models were used to examine the relationships of SIRI and SII with uric acid and hyperuricemia risk, as well as the associations of SIRI and SII with BMI, and BMI with uric acid and hyperuricemia risk. Causal mediation effect model was used to assess the mediating effect of BMI in the relationships of SIRI, and SII with uric acid concentration and hyperuricemia risk.ResultsThe prevalence of hyperuricemia in US adults is 19.78%. Positive associations were found in the relationships of SIRI and SII with uric acid level, hyperuricemia risk, and BMI, as well as the relationships of BMI with uric acid and hyperuricemia risk. Causal mediation effect model showed that BMI played an important mediating role in the relationships of SIRI, and SII with uric acid concentration and hyperuricemia risk, with the proportion of mediating effect ranging from 23.0% to 35.9%.ConclusionExposure to higher SIRI and SII is associated with increased uric acid concentration and hyperuricemia risk in adults, and BMI plays an important mediating effect. Reducing systemic inflammation and systemic immune inflammation and proper weight control could be effective ways to reduce hyperuricemia prevalence and related health problems.

Hemogram and inflammatory indices in pain-free periods in migraine patients without aura

ABSTRACT Objectives Since neurogenic inflammation and hemoconcentration have a prominent role in the pathophysiology of migraine, evaluation of hemogram parameters and indices showing inflammation can yield important information. In this study, we have investigated blood cell counts and ratios, systemic inflammation index (SII), systemic inflammation response index (SIRI) and red cell index (RCI) in the painless periods between pain attacks in patients with episodic migraine without aura. Methods Hemogram data of both 309 patients diagnosed with migraine without aura related to pain-free periods and 199 healthy individuals were retrospectively retrieved from hospital records. Data related to erythrocyte, leukocyte, lymphocyte, platelet, monocyte, eosinophil counts; hemoglobin, hematocrit, mean corpuscular volume, red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio (MLR), and neutrophil/monocyte ratio, SII, SIRI and RCI values were scanned to reveal intergroup differences in terms of these parameters. Results A comparison of laboratory parameters revealed that certain indices differed significantly between the migraine and control groups. MLR (p = 0.005) and RDW (p < 0.001) values were significantly lower, while platelet (p = 0.016), MPV (p < 0.001) and hematocrit (p = 0.014) were significantly higher in the migraine patient group compared to the control group. There was no significant difference between the two groups regarding other parameters. Discussion Higher hematocrit, platelet, mean platelet volume and lower monocyte/lymphocyte ratio values in this study support that hemoconcentration and chronic inflammation persist even in the absence of pain attacks in migraine patients without aura.

New systemic inflammatory indices as predictors of ascending aortic dilation in children with bicuspid aortic valve: A retrospective cross-sectional study.

Systemic inflammatory indices, originally developed to predict the prognosis of cancer patients, have found increasing application in various medical areas, including cardiovascular research. This study aimed to investigate the relationship between ascending aortic dilatation in bicuspid aortic valve patients and systemic inflammatory indices. This retrospective cross-sectional study included 122 patients with bicuspid aortic valves. These patients were divided into 2 groups based on the presence or absence of dilatation according to ascending aorta z-scores. Complete blood counts were analyzed, focusing on leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts. Additionally, systemic inflammatory indices including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and monocyte-to-lymphocyte ratio (MLR) and pan-immune-inflammation value (PIV) were calculated from these parameters. MLR, SIRI, and PIV demonstrated acceptable diagnostic power in detecting ascending aortic dilatation in bicuspid aortic valve patients, with area under the curve (AUC) values of 0.709, 0.741, and 0.779, respectively. PLR and SII exhibited fair diagnostic power, with AUC values of 0.673 and 0.688, respectively. According to the receiver operating characteristic analysis, PIV had the highest AUC value of 0.779 (95% confidence interval [CI] = 0.69-0.86), with a sensitivity of 70.9% and specificity of 70.8% at a cutoff value of 224.93. A relationship exists between PLR, MLR, SII, SIRI, PIV, and ascending aorta dilatation in pediatric patients with bicuspid aortic valves. These findings suggest that inflammation may play a role in the dilatation of the ascending aorta in bicuspid aortic valve patients.

Associations of systemic immune-inflammation index and systemic inflammation response index with maternal gestational diabetes mellitus: Evidence from a prospective birth cohort study.

The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM. A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII=neutrophil (Neut) count×platelet (PLT) count/lymphocyte (Lymph) count, SIRI=Neut count×monocyte (Mono) count/Lymph count, with participants being stratified into quartiles. Follow-up included a 75-g, 2-h oral glucose tolerance test (OGTT) at 20-32weeks of gestation, using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the SII, SIRI, and GDM risk. Among the 28,124 women included in the study, the average age was 31.8±3.8years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The SII and SIRI were positively correlated with GDM risk. The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses. The SII and SIRI are potential independent risk factors contributing to the onset of GDM.

Prognostic value of the systemic inflammation response index on 3-year outcomes of elderly patients with acute coronary syndrome after stent implantation.

Few studies have focused on the relationship between the systemic inflammation response index (SIRI) and the prognosis of elderly patients with acute coronary syndrome (ACS). This study aimed to evaluate the predictive value of the SIRI for predicting 3-year outcomes in patients >60 years old after stent implantation and to assess variables associated with SIRI. A total of 1,758 patients with ACS who underwent percutaneous coronary intervention (PCI) were enrolled and divided into an older group (n = 960) and a younger group (n = 798) using a cutoff of >60 years. Major adverse cardiac events (MACEs) including all-cause death, nonfatal acute myocardial infarction (AMI) and nonfatal stroke were recorded. During follow-up, 165 patients experienced 1 or more MACEs. Patients in the older group had a greater incidence of recurrent MACEs and mortality than those in the younger group. The SIRIs were significantly greater in the older group. Multiple linear regression analysis revealed that the level of the SIRI was significantly associated with age, hypertension, diagnosis of AMI, number of diseased vessels, and platelet count. The SIRI was an independent predictive risk factor for MACEs in patients >60 years old. Similar relationships between the SIRI and MACEs were also observed in ACS patients with and without AMI. The SIRI was an independent predictive risk factor for MACEs in patients aged >60 years with ACS and ACS with or without AMI after stent implantation during 3 years of follow-up. The SIRI can be used as an indicator for identifying high-risk patients for intensive therapy to further reduce MACEs in the PCI era.

Predictive Factors for Primary and Secondary Nonresponders to Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Study.

Background: Some patients with atopic dermatitis (AD) do not sufficiently respond to upadacitinib, a Janus kinase 1 inhibitor. However, predictive factors for nonresponders remain unclear in real-world practice. Objective: To identify predictive factors for primary and secondary nonresponders to upadacitinib 15 mg; primary nonresponders are defined as patients with investigator's global assessment (IGA) >2 at week 12, while secondary nonresponders are defined as patients with IGA ≤2 at week 12 and IGA >2 at week 24. Methods: A prospective study was conducted from August 2021 to March 2024, involving 204 Japanese AD patients treated with upadacitinib 15 mg. Baseline clinical and laboratory indexes were compared between nonresponders and responders. Results: Primary nonresponders showed higher baseline eczema area and severity index (EASI), immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) compared with responders. Secondary nonresponders had a higher proportion of previous systemic therapies, dupilumab, and corticosteroids. Conclusions: Higher baseline EASI, IgE, TARC, LDH, NLR, CRP, SII, and SIRI may predict primary nonresponders to upadacitinib 15 mg, while previous systemic dupilumab or corticosteroids may predict secondary nonresponders.

Identification of health trajectories of patients with persistent spinal pain syndrome type 2 using latent class trajectory methods.

Persistent spinal pain syndrome Type 2 (PSPS-T2) is a long-lasting condition that consists of persistent pain following spinal surgery. Although this condition has long-term effects, it is currently studied at a given time point or over a limited period of time, which does not reflect the true impact of pain patients. To bridge this gap, we used latent class trajectory models to extract clusters with different trajectories of patients with PSPS-T2. Data from the PREDIBACK study, an observational, multicentric, and longitudinal investigation carried out prospectively, were used. This study focuses on patients with PSPS-T2, tracking their outcomes at 3-month intervals over a one-year period. Health status was evaluated using a novel multidimensional clinical response index (MCRI). The trajectories of patients' health status were extracted using mixture of mixed effect models. Two hundred (200) PSPS-T2 patients were included. Two clusters were identified, including 'persistent low health' trajectories (63.1%) and 'improving health' trajectories (36.9%). Regarding the factors associated with these trajectories, our results showed that lower age, lower body mass index, lower pain intensity, lower functional disability, lower anxiety and less extended pain surface were associated with improving health status. Clustering methods provide an opportunity to identify two distinct clusters of pain-related health trajectories of PSPS-T2 patients. Persistence of the symptoms was not observed in one third of the PSPS-T2 study patients, who belong to the improving pain-related health cluster, while the other two thirds did not achieve improved health over a 1-year follow-up. Our study findings suggest that the use of trajectory-based methods could improve patient evaluation and pain management as it allows for obtaining a global view of patients during their care pathway compared to conventional methods, which only focus on specific visits. Our study also advocates for multidimensional assessment and management of pain by targeting not only pain intensity but also the psychological distress, functional capacity and pain surface at an early stage of pain onset after spine surgery.

Enhanced Rapid Screening for Multidrug-resistant tuberculosis through combined cardiometabolic and inflammatory indices: a cross-sectional study

Multidrug-resistant tuberculosis (MDR-TB) remains a global public health challenge. We aimed to investigate the utility of combining the cardiometabolic index (CMI) and systemic inflammation response index (SIRI) as biomarkers for rapid MDR-TB screening. Data were collected from 2,620 TB patients in Zibo city from 2018 to 2021. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate the associations and diagnostic performance of CMI and SIRI with MDR-TB. The prevalence of MDR-TB was 5.0% in new TB patients and 20.5% in recurrent TB patients. Both CMI and SIRI were significantly associated with MDR-TB in all models (P < 0.05). In new TB patients, the area under the curve (AUC) values of the ROC curves for SIRI, CMI, and their combination were 0.845, 0.806, and 0.910, respectively. In recurrent TB patients, the AUC values were 0.730, 0.875, and 0.902, respectively. The optimal cut-off points for SIRI and CMI were 0.72 and 1.81 in new TB patients, and 1.05 and 1.48 in recurrent TB patients, respectively. In conclusion, combining CMI and SIRI shows promise as a low-invasive, cost-effective tool for early MDR-TB screening, warranting further validation in diverse populations and TB subtypes.

State Machine and Internal Model Control-based Hybrid Controller for Improved Transient Performance of Microgrids

The transient performance of microgrids is measured by their transient stability and transient response indices. The quality of these indices depends upon the design of the microgrid’s closed-loop control scheme, which is a cascaded combination of outer power controller and inner voltage-current (VA) controllers. Generally, the power controller is realized by droop control logic (fixed droop or adaptive droop), and VA controllers by conventional proportional-integral (PI) control. Control schemes with fixed droop coefficient logic and PI-based VA controllers suffer from stability and response issues. In this scheme, when these PI-based VA controllers are replaced with internal model control (IMC) based VA controllers, the response aspect is improved, while the stability aspect shows no improvement. Therefore, when fixed droop logic is replaced with adaptive droop control logic, stability is improved. However, adaptive droop coefficient schemes with PI-based VA controllers provide a limited improvement in stability. Moreover, conventional machine learning-based adaptive droop coefficient logic suffers from severe computational difficulties. It is verified in this work that IMC-based VA controllers which cannot improve stability with fixed droop logic, will contribute to stability enhancement when a suitable adaptive droop control logic is deployed. Therefore, to enhance both stability and response aspects with reduced computational effort, this paper proposes a hybrid control scheme made of a state machine-based droop controller (SMD) supported by IMC-based VA controllers. From the simulation results, while the conventional schemes could not withstand load power factors lesser than 0.707, the proposed hybrid controller scheme maintained stability at a power factor of 0.47 with a total harmonic distortion of less than 5%.

In Reply to the Letter to the Editor Regarding “System Inflammation Response Index and Serum Glucose-Potassium Ratio as Prognostic Indicators for Hemorrhagic Moyamoya Disease”

In Reply to the Letter to the Editor Regarding “System Inflammation Response Index and Serum Glucose-Potassium Ratio as Prognostic Indicators for Hemorrhagic Moyamoya Disease”

Iodine activates NLRP3 inflammasomesin PBMCs of patients with autoimmune thyroiditis, and regulates Th1 and Th17 cell differentiation.

Inflammasomes are associated with various autoimmune diseases. Herein, we aimed to study the occurrence of inflammasomes in peripheral blood mononuclear cells (PBMCs) from patients with autoimmune thyroiditis (AIT), and the relationship between their abundance and the inflammatory response index of AIT. Furthermore, we examined the effect of iodine on inflammasomes containing NLR family pyrin domain containing 3 (NLRP3) and inflammasome activation of helper T cell (Th) differentiation regulation in cultured PBMCs.

Strong Positive Correlations Between the Levels of Systemic Inflammation Markers and the Occurrence of Persistent Atrial Fibrillation.

In this study, a retrospective analysis was conducted to investigate the associations between systemic inflammation markers and persistent atrial fibrillation (pAF), intending to identify potential biomarkers for early detection of pAF.In the analysis, a total of 207 patients were included, with 109 in the pAF group and 98 in the non-pAF group. The associations between three systemic inflammation markers were investigated, namely, the systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), and pAF.The proportion of pAF showed a gradual increase with increasing logSII, logSIRI, and logAISI tertiles. Compared with those in the lowest tertiles, those in the highest logSII and logSIRI tertiles had 3.196- and 2.884-fold higher risks of developing pAF, respectively. Nonetheless, no significant correlation between logAISI and pAF risk was observed in the highest tertile of logAISI. The restricted cubic spline analysis revealed a nonlinear relationship between the elevation of systemic inflammation markers and the risk of pAF, with logSII ≥ 2.56, logSIRI ≥ -0.10, and logAISI ≥ 2.28 identified as significant predictors. The receiver operating characteristic analysis of logSII, logSIRI, and logAISI showed AUC values of 0.629, 0.721, and 0.646, respectively. It also presented favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of pAF.To conclude, our cross-sectional study shows significant positive correlations between the SII, SIRI, and AISI with the incidence of pAF.

Elucidation of the Active Agents in a West African Ground Herbal Medicine Formulation That Elicit Antimalarial Activities in In Vitro and In Vivo Models

Agunmu (ground herbal medicine) is a form of West African traditional medicine consisting of a cocktail of herbs. The goal of this study is to evaluate a formulation of Agunmu made from M. indica, A. repens, E. chlorantha, A. boonei, and B. ferruginea, sold in the open market and commonly used for the treatment of malaria by the locals, for its antimalarial effects and to determine the active principles that may contribute to the antimalarial effect. The ethanolic extract obtained from this formulation (Ag-Iba) was analyzed, using TLC, LC-MS, and Tandem-MS techniques, to determine its phytochemical properties. The extract was tested in vitro against representative bacteria strains, cancer and normal human cell lines, and susceptible (D6) and resistant (W2) Plasmodium falciparum. In subsequent in vivo experiments, graded doses of the extract were used to treat mice infected with chloroquine-susceptible (NK-65) and chloroquine-resistant (ANKA) strains of Plasmodium berghei. Bacteria growth was monitored with a disc diffusion assay, cancer cell viability was determined with MTS assay, and percentage parasitemia and parasite clearance were determined by microscopy. Bound heme content, host mitochondria permeability transition (mPT) pore opening, F0F1-ATPase, and lipid peroxidation were determined via spectrophotometry. Indices of oxidative stress, anti-oxidant activities, toxicity, cell death, and inflammatory responses were obtained using biochemical and ELISA techniques. The histology of the liver and spleen was performed using the standard method. We elucidated the structures of the critical active principles in the extract to be flavonoids: kaempferol, quercetin, myricetin, and their glycosides with little or no detectable levels of the toxic Aristolochic acids that are found in Aristolochia repens, one of the components of the formulation. The extract also showed anti-plasmodial activity in in vitro and in vivo models. Furthermore, the extract dose-dependently decreased mitochondrial dysfunction, cell death, and inflammatory and oxidative damage but increased antioxidant potentials. Presumably, the active principles in the extract work as a combinatorial therapy to elicit potent antimalarial activity. Overall, our study unraveled the active components from a commercial herbal formulation that could be reformulated for antimalarial therapy.

Volatile organic compounds (VOC) metabolites in urine are associated with increased systemic inflammation levels, and smokers are identified as a vulnerable population

BackgroundPrevious studies indicated that exposure to VOCs was linked to increased systemic inflammation levels. However, the dose-response relationships between urine VOCs metabolites and systemic inflammation have not been established, and the key metabolite of the toxic compounds has not been identified. MethodsWe used data in 7007 US adults in the NHANES cycles (2011–2018) across 8 years. Urinary VOC metabolites were measured using ultra-performance liquid chromatography and electrospray tandem mass spectrometry (UPLC-ESI/MSMS). VOC metabolites were adjusted by urinary creatinine level before analysis. Systemic inflammation was assessed by systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) indices. Generalized linear models, restricted cubic splines (RCS), and weighted quantile sum (WQS) regression were applied to evaluate the associations, exposure-response (E-R) curve and identify the key contributor compound, adjusting for gender, age, race, BMI, marital condition, education level, smoking level, alcohol consumption and physical activity. Smoking status was assessed as an effect modifier. ResultsSignificant and robust positive correlations were found between 8 VOC metabolites and both SII and SIRI. They were N-Acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA), N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA), N-Acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA), N-Acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA), mandelic acid (MA), N-Acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3), phenylglyoxylic acid (PGA), and N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (HPMMA). The RCS curves showed J-shaped or exponential shaped E-R relationships for most VOC metabolites. WQS regression found that exposure to the mixture of VOC metabolites was related to increased systemic inflammation, and MA was the key VOC metabolite contributing most to systemic inflammation levels. Smokers exhibited higher levels of urinary VOCs and larger susceptibility to VOC-related increases in SII and SIRI compared to non-smokers. ConclusionThis study demonstrated a strong link between urinary VOC metabolites and increased systemic inflammation, and smokers were more susceptible. Our findings highlighted the significance of reducing VOC exposure to mitigate the inflammation levels, particularly for smokers.

Systemic Immune Inflammation Index, Systemic Inflammation Response Index, Aggregate Index of Systemic Inflammation, and Follistatin-Like Protein-1 Levels in Children Diagnosed with Pneumonia.

Background: This study aims to evaluate systemic immune inflammation index, systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and follistatin-like protein-1 (FSTL-1) levels in children with pneumonia and healthy controls. Methods: The study was carried out at the Seydisehir State Hospital between February 1, 2024 and June 1, 2024. The patient group included 44 children diagnosed with pneumonia and the control group included 45 healthy children without any disease. Index values obtained from hemogram data. Enzyme-linked immunosorbent assay was used to measure FSTL-1 levels. Results: A total of 89 participants, 44 in the patient group and 45 in the healthy control group, were included in the study. White blood cells, monocyte, eosinophil, neutrophil, c-reactive protein, SIRI, and AISI levels were significantly higher in the patient group than in the control group. FSTL-1 levels were higher in the patient group, but did not differ statistically significant. The patient and control groups were compared in the receiver operating characteristics analysis, we found the highest area under curve (AUC) in the SIRI (AUC: 0.754) and AISI (AUC: 0.713) parameters. Conclusion: In conclusion, compared to healthy controls, SIRI and AISI levels were significantly higher in the patient group, and the highest AUC values belonged to these indices. Therefore, we believe that SIRI and AISI indices, which are inexpensive and simple tests, are useful for early diagnosis and treatment of pneumonia.