Inflammatory Activity Index Research Articles

The importance of oxygen free radicals in the etiopathogenesis of diversion colitis in rats

Quantify the levels of oxidative DNA damage of epithelial colon cells comparing segments with and without fecal stream. Sixty Wistar rats were subjected to deviation of fecal stream by proximal colostomy and a distal mucosal fistula. Animals were divided into three experimental groups that were sacrificed 6, 12 and 24 weeks after surgery. In each experimental group, five animals underwent laparotomy without intestinal deviation (sham subgroup). The diagnosis of colitis was made by histopathological analysis and the inflammatory activity index by graduated scale. The neutrophil infiltration was determined by myeloperoxidase tissue levels and the intensity of oxidative DNA damage by comet assay. The Mann-Withney and Student t test were used to compare the results among experimental subgroups and the Kruskal-Wallis test for variance analysis, adopting a significance level of 5% (p<0.05). Colon segments without fecal stream was shown higher histological inflammatory score of the colon wall after 12 and 24 weeks (p=0.001) that increased with the time of diversion (p=0.01). The activity of myeloperoxidase in segments without fecal stream decreased with the time (p=0.001). Oxidative DNA damage levels were significantly higher in the segments without fecal stream, (p=0.0001), independent of time of colon diversion, and increase with the time (p=0.0007). Colon segments without fecal stream showed high levels of oxidative DNA damage related to histological alterations observed in diversion colitis. The levels of oxidative DNA damage in segments devoid of the fecal stream increase with the time of intestinal exclusion.

Comparisons between cats with normal and increased fPLI concentrations in cats diagnosed with inflammatory bowel disease

The aim of this study was to compare age, serum albumin and cobalamin concentrations, serum alanine amino transferase and alkaline phosphatase activities, feline inflammatory bowel disease clinical disease activity index, pancreatic ultrasound findings, intestinal histopathology scores, outcome, treatment and clinical response between cats diagnosed with inflammatory bowel disease with normal or increased serum feline pancreatic lipase immunoreactivity concentrations. Medical records for 23 cats diagnosed with inflammatory bowel disease and with serum feline pancreatic lipase immunoreactivity concentrations available were reviewed. Three groups were compared; cats with serum feline pancreatic lipase immunoreactivity concentrations 2·0 to 6·8 µg/l (group A), 6·9 to 11·9 µg/l (group B) and ≥12·0 µg/l (group C). Sixteen of the 23 cats had increased serum feline pancreatic lipase immunoreactivity concentrations; 9 cats in group B and 7 cats in group C. The remaining seven cats were in group A. Cats with serum feline pancreatic lipase immunoreactivity concentrations ≥12·0 µg/l had significantly lower median serum albumin and cobalamin concentrations. No significant differences were identified between the three groups for age, serum alanine amino transferase and alkaline phosphatase activities, feline inflammatory bowel disease clinical disease activity index, pancreatic ultrasound findings, intestinal histopathology scores, clinical outcome, treatment or clinical response. Hypoalbuminaemia and hypocobalaminaemia were more frequently observed in cats with serum feline pancreatic lipase immunoreactivity concentrations ≥12·0 µg/l.

Usefulness of anterior chamber depth measurement for efficacy assessment of steroid pulse therapy in patients with Vogt-Koyanagi-Harada disease

To clarify the usefulness of measuring anterior chamber depth by the IOLMaster for early-stage assessment of the therapeutic effect of steroid pulse therapy in patients with Vogt-Koyanagi-Harada (VKH) syndrome with active uveitis. Seven patients with VKH syndrome (three men and four women) participated in the study (14 eyes). All patients had exudative retinal detachment in addition to iritis, and received steroid pulse therapy: infusion of methylprednisolone (1000 mg × 3 days) followed by tapering oral administration of prednisolone (40, 30, 20, 15, 10, and 5 mg/day) over a week. Corrected visual acuity, manifest spherical equivalent, anterior chamber flare, axial length, and anterior chamber depth were measured before and after the pulse therapy. Anterior chamber flare was measured using a laser flare-cell meter, and axial length and anterior chamber depth were measured using the IOLMaster. After 1 week of steroid pulse therapy, anterior chamber depth significantly increased from the initial value of 2.94 ± 0.34 mm to 3.12 ± 0.38 mm (Wilcoxon signed-rank test, P = 0.002). After 1 month of steroid pulse therapy, significant changes were observed in corrected visual acuity (P = 0.01), manifest spherical equivalent (P = 0.002), anterior chamber flare (P = 0.03), axial length (P = 0.02), and anterior chamber depth (P = 0.002). Measurement of anterior chamber depth using the IOLMaster is useful for early-stage assessment of the effect of steroid pulse therapy in patients with VKH syndrome who develop active uveitis. Change in anterior chamber depth is the most sensitive indicator of inflammatory activity in patients with this syndrome.

Infección crónica por el virus de la hepatitis C y enfermedad hepática asociada en una prisión española

The objective of this study was to determine the prevalence and genotype distribution of chronic hepatitis C virus (HCV) infection in a penitentiary population. The secondary objective was to describe histological findings in liver of the biopsied population, and identify risk factors associated with liver fibrosis and inflammatory activity. Among 800 inmates, 730 accepted HCV antibody screening and PCR confirmation. Sociodemographic, behavioral, and incarceration-related variables were analyzed. Liver biopsy was offered to individuals with chronic HCV infection. Advanced liver disease was defined as fibrosis 3 and/or an inflammatory activity index score 8). HCV antibodies were found in 279 inmates. PCR confirmed HCV infection in 250 inmates, yielding a prevalence of 34.2% (95% confidence interval [CI]: 30.8-37.8). Intravenous drug use was independently associated with HCV infection, odds ratio (OR) 51.7 (95% CI: 31-86). Genotypes were 1a 32.9%, 3 29.7%, 1b 18.4% and 4 17.1%. Fifty-one liver biopsies were performed; advanced liver disease was found in 7 patients (13.7%) based on fibrosis and in 31 patients (60.7%) based on the inflammatory activity index. High AST and ALT levels were associated with advanced liver disease established on both fibrosis and inflammatory activity (P<.05). Lengthy intravenous drug use was associated with inflammatory activity (P=.02; OR 1.2; 95% CI: 1.03-1.7). Persistent HCV infection is highly prevalent among prison inmates and is associated with intravenous drug abuse. HCV genotype diversity is higher in prison inmates than in the general population. Higher transaminase levels are associated with advanced liver disease.

Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

BackgroundResearch has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD). The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity.FindingsA total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI), Mayo Disease Activity Index (MDAI), and Crohn's Disease Endoscopic Index of Severity (CDEIS) were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy.A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000). Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000), with CDAI values (p = 0.043; 0.010), CDEIS values in DC cases (p = 0,000; 0.000), and with MDAI values in UC cases (p = 0.000).ConclusionFecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.

Microalbuminuria associated with indicators of inflammatory activity in an HIV-positive population

Background. The survival of human immunodeficiency virus (HIV)-infected patients has increased significantly since the introduction of combination antiretroviral therapy, leading to the development of important long-term complications including cardiovascular disease (CVD) and renal disease. Microalbuminuria, an indicator of glomerular injury, is associated with an increased risk of progressive renal deterioration, CVD and mortality. However, the prevalence of microalbuminuria has barely been investigated in HIV-infected individuals.Methods. Based on three prospective urine samples in an unselected nonhypertensive, nondiabetic HIV-positive cohort (n = 495), we analysed the prevalence of microalbuminuria and compared the Caucasian share with that of a nonhypertensive, nondiabetic population-based control group (n = 2091). Significant predictors for microalbuminuria were analysed within the HIV-positive cohort.Results. The prevalence of microalbuminuria was 8.7% in the HIV-infected cohort, which is three to five times higher than that in the general population. HIV-infected patients with microalbuminuria were older, and had higher blood pressure, longer duration of HIV infection, higher serum beta 2-microglobulin, higher serum creatinine and a reduced glomerular filtration rate of ≤90 mL/min, compared with those with normal albumin excretion. In multivariate analysis, systolic blood pressure, serum beta 2-microglobulin and duration of HIV infection were found to be independent predictors of microalbuminuria.Conclusions. Our findings indicate that in addition to haemodynamic effects, inflammatory activity may be implicated as a cause of the development of microalbuminuria. With respect to the increasing risk of developing CVD or renal diseases and mortality, the high prevalence of microalbuminuria in HIV-infected individuals warrants special attention.

Compensated hepatitis C: unenhanced MR imaging correlated with pathologic grading and staging

We prospectively examined unenhanced MR imaging findings in relation to pathologic fibrosis, inflammation and steatosis in patients with compensated chronic hepatitis C viral infection (HCV). Unenhanced MRI at 1.5 T was obtained within one month of core liver biopsy in 64 consecutive candidates for antiviral therapy for compensated HCV. Two pathologists independently graded inflammatory activity index (HAI) and steatosis, and staged fibrosis (grades 0-6). Morphologic MRI findings of cirrhosis, periportal lymph nodes, and MR fat signal ratio from dual gradient echo images were assessed independently by two radiologists blinded to clinical data. MRI and laboratory liver function results were correlated with pathologic results, using Spearman correlation coefficient and stepwise multiple regression. MR fat signal ratio correlation coefficient with pathologic steatosis was 0.71 (p < 0.0001). Coefficients with fibrosis stage were highest for surface nodularity (r (s) = 47, p < 0.0001) and expanded gallbladder fossa (r (s) = 0.42, p = 0.0006). Coefficients with HAI were highest for lymph node size (r (s) = 0.355, p = 0.0040), surface nodularity (r = 0.47, p < 0.0001), expanded gallbladder fossa (r = 0.332, p = 0.0073), and caudate/right lobe ratio (r = 0.326, p = 0.0110). Combined lab and MRI variables provided the best prediction of fibrosis stage (r (2) = 0.656) and HAI (r (2) = 0.597). A combination of MRI and laboratory findings was most predictive of fibrosis and inflammation.

Rethinking Primary Prevention of Atherosclerosis-Related Diseases

Crucial advances in our understanding of basic pathogenic mechanisms involved in atherogenesis have been achieved during the past 2 decades. The historical hypothesis of pathogenesis (“lipid accumulation”) has evolved to integrate several causal events contributing to the initiation and evolution of atherosclerosis. Vascular inflammation and apoptosis may play a joint pivotal role in its progression and onset. Hypercholesterolemia and hypertension have synergistic deleterious effects on coronary endothelial function.1 Impaired fasting glucose, triglycerides and triglyceride-rich lipoprotein remnants, lipoprotein(a), homocysteine, and high-sensitivity C-reactive protein (hsCRP) might contribute to an increased risk of atherosclerosis.2 The disease also has been related to infiltration of immune cells, which are involved in both systemic and local, innate as well as adaptive, immune responses.3 Distinct pathways of atherothrombosis seem to develop at different sites of the vascular system (brain, heart, and peripheral circulation). Endothelial dysfunction induced by cardiovascular risk factors is considered to be 1 of the earliest stages in vascular damage and is associated independently with cardiovascular events.4 There is a synergic action between genetic, ambient, local, and systemic factors, and ultimately the progression of atherosclerosis is responsible for coronary heart disease (CHD) and its complications (such as unstable “in crescendo” angina, myocardial infarction, and sudden death), peripheral arterial disease, and ischemic stroke. The evolution of atherosclerosis, however, is characterized by a long lag time between onset and clinical manifestation, thereby providing an opportunity for implementation of early detection, prevention, and intervention strategies. Because the development of atherosclerosis commences early in humans, we need to rethink the timing of what is currently considered to be “primary” prevention of atherosclerosis-related diseases. It is likely that we need to start administering effective treatments much earlier than previously assumed. Indeed, much attention would be important when subjects are in a state of wellness before the …

Careful patient selection may improve response rates to infliximab in inflammatory bowel disease

The use of infliximab in the treatment of Crohn's disease (CD) is acceptable and appears to be effective in ulcerative colitis (UC). Careful patient selection, resulting in infliximab only for truly refractory inflammatory bowel disease (IBD), may improve its efficacy. The present study aimed to determine if careful patient selection improved infliximab efficacy in IBD. CD or UC/IBD unclassified patients (Montreal classification) were considered for infliximab treatment only after failure of disease control with conventional therapies and confirmation of active disease. Patients with purely luminal IBD received a single infliximab dose. Patients with fistulizing disease (with or without luminal disease) received infliximab at 0, 2 and 6 weeks. Changes to Harvey Bradshaw (HBI) for inflammatory CD and Colitis Activity Index (CAI) for UC/IBDU were used to determine the response and remission rates. In fistulizing CD, a remission was sustained cessation of drainage and resolution of the fistula. Response was correlated to inflammatory marker levels. Seventy IBD patients were treated. In CD, 85.2% (46/54) had active luminal and 40.7% (22/54) had fistulizing disease. In luminal CD, at 8 weeks a single infliximab dose induced remission in 75% (24/32) of patients compared to 92.9% (13/14) after infliximab at 0, 2 and 6 weeks. Fistulizing disease responded in 77.2% (17/22) and remitted in 50% (11/22) of patients at 8 weeks. In UC/IBDU, 75% (12/16) responded and 43.8% (7/16) of patients were in remission at 8 weeks. Careful patient selection may improve infliximab's efficacy and clinical remission appears greater after induction with three infliximab doses in CD. Clinical efficacy is suggested for UC/IBDU.

A NOVEL METHOD OF SONOGRAPHIC TISSUE PERFUSION MEASUREMENT TO EVALUATE GRADE OF INFLAMMATION IN CROHN DISEASE

Problemstellung: Inflammatory hyperperfusion is a mainstay of diagnosis and the main therapeutic target in chronic inflammatory bowel diseases. It's exact measurement at the local site of it's development inside the bowel wall is therefore very important. We present a quite novel approach to sonographic inflammation grading in inflammatory bowel diseases via dynamic quantification of color Doppler signals along a complete heart cycle inside the bowel wall. The aim was to describe bowel wall perfusion in Crohn disease patients in comparison with healthy probands and to compare a conventional activity index (Pediatric Crohn Disease Activity Index) with perfusion measurements as an indicator of inflammatory activity.

Management of ocular manifestations of Behcet's disease: outcome with cytotoxic drugs

AbstractBackground and aim: Cytotoxic drugs, combined with steroids, are the first line of treatment for serious ocular manifestations in Behcet's disease (BD) such as uveitis and retinal vasculitis. If used judiciously, they are effective and safe, even in the long‐term. In our unit, the following cytotoxic drugs have been used for this purpose – oral or pulse cyclophosphamide, weekly methotrexate, chlorambucil, cyclosporin, azathioprine, or a combination of these. In our experience, these cytotoxic drugs had a similar range of efficacy regarding improvement in visual acuity. Having obtained the same treatment response, we pooled all our data together to evaluate the overall outcome of the eye complications in our cohort of BD patients.Methods: The treatment protocol was the same regardless of which cytotoxic drug was used. Prednisolone was given to all patients at an initial dose of 0.5 mg per kilogram of body weight per day. The dose was later tapered as necessary. If a patient was resistant to a given cytotoxic drug, the drug was changed to another. In pooled data, the results before the first treatment were compared with those after the last treatment. Visual acuity (VA) was measured using a Snellen chart (on a scale of 10). The Disease Activity Index (DAI) for anterior uveitis (AU), posterior uveitis (PU), and retinal vasculitis (RV) was measured according to the criteria of Ben Ezra. The Total Inflammatory Activity Index (TIAI) and the Total Adjusted Disease Activity Index (TADAI) were also calculated. Statistical analysis was performed using a Student's t‐test for paired samples comparing the data obtained before and after treatment.Results: At the last evaluation of our database (March 2004) on patients who had an active posterior uveitis and/or retinal vasculitis, 1104 were treated with cytotoxic drugs, of whom 290 patients received more than one treatment protocol. The mean duration of eye lesions was 32.8 months (SD 37.6). The mean treatment time was 20.1 months (SD 20.3). Overall, the VA of 70% of patients improved or maintained after treatment. The mean VA improved from 3.8 to 4.7 (t = 10.099, P &lt; 0.000001). The mean DAI of AU improved from 2.5 to 0.8 (t = 19.575, P &lt; 0.000001). The mean DAI of posterior uveitis improved from 2.1 to 0.9 (t = 28.616, P &lt; 0.000001). The mean DAI of retinal vasculitis improved from 2.5 to 1.5 (t = 12.070, P &lt; 0.000001). The mean TIAI improved from 16.5 to 7.9 (t = 20.13, P &lt; 0.000001). The mean TADAI improved from 37.1 to 25.6 (t = 20.24, P &lt; 0.000001). Further analysis showed methotrexate at a dose of 15 mg/week, and azathioprine at 2 mg/kg/day were preferred for posterior uveitis, while low dose pulsed cyclophosphamide (0.5 g/m2/month) – azathioprine combination therapy for retinal vasculitis.Conclusion: Cytotoxic drugs are efficacious in the treatment of serious ocular manifestations of BD.

Dynamic Color Doppler Sonography of Intestinal Wall in Patients with Crohn Disease Compared with Healthy Subjects

Chronic inflammatory bowel diseases are characterized by inflammatory hyperperfusion of the intestinal wall in affected bowel segments. We applied a novel method to quantify color Doppler signals dynamically along a complete heart cycle inside the bowel wall. The aim was to describe bowel wall perfusion in Crohn disease patients in comparison with healthy probands and to compare a conventional activity index (Pediatric Crohn Disease Activity Index) with perfusion measurements as an indicator of inflammatory activity. Color Doppler sonographic videos of bowel wall perfusion from 34 healthy children (aged 5 to 18 years) and from 14 patients with Crohn disease (aged 8.2 to 15.9 years) were recorded under defined conditions. Perfusion signals (color hue, color area) were automatically measured inside the bowel wall. Specific tissue perfusion was calculated as mean flow velocity of a region of interest during one full heart cycle. Bowel wall perfusion was compared using the Pediatric Crohn Disease Activity Index in 12 patients. Specific bowel wall perfusion was significantly elevated in bowel segments of Crohn disease patients compared with healthy subjects (P < 0.001). Specific flow in small bowel was 0.025 cm/s in healthy probands and 0.095 cm/s in patients with Crohn disease, whereas large bowel wall perfusion of 0.012 cm/s in healthy probands clearly differed from 0.082 cm/s in patients with Crohn disease. No differences of perfusion between moderate and high Pediatric Crohn Disease Activity Index levels could be demonstrated despite a weak significant overall correlation. The new method of dynamic, automatic noninvasive perfusion quantification is useful to describe local inflammatory activity in bowel segments affected by Crohn disease and adds new information to activity evaluation by Pediatric Crohn Disease Activity Index. Specific wall perfusion in intestines of Crohn patients is significantly elevated and reaches up to sevenfold intensity compared with healthy subjects.

Retrospective analysis of cyclosporine A (sandimmun neoral) efficacy and safety in patients with juvenile idiopathic arthritis

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

Fecal excretion of human deoxyribonucleic acid as an index of inflammatory activity in ulcerative colitis

Background & Aims: Several indices evaluate disease activity in ulcerative colitis, but most have drawbacks to their application (invasiveness, complexity, or lack of specificity), and discrepancies between them are frequent. Assuming that desquamation of epithelial and inflammatory cells increases in damaged colonic mucosa, we hypothesized that fecal excretion of human DNA is an index of mucosal inflammation and damage. The aim of our study was to determine whether excretion of human DNA is useful in the evaluation of disease activity in ulcerative colitis. Methods: Thirty-one controls and 36 ulcerative colitis patients were included. Ulcerative colitis patients and controls underwent colonoscopic examination after preparation by gut lavage with polyethylene-glycol electrolyte solution. In patients, disease activity was established using the clinical index of Rachmilewitz and an endoscopic score. Feces and gut lavage fluid were obtained and DNA levels were measured by quantitative polymerase chain reaction of the human β-globin gene. Results: Fecal DNA excretion correlated with the clinical index ( r = 0.59, P < 0.05) and the endoscopic score ( r = 0.76, P < 0.01). Gut lavage fluid DNA levels also correlated with clinical and endoscopic activity scores ( r = 0.41 and 0.51, respectively, P < 0.05). Fecal DNA excretion was significantly higher in patients with endoscopically or clinically active disease than in controls or patients in remission. Fecal DNA excretion discriminates between endoscopically active disease and remission (sensitivity 0.67, specificity 1.00, P < 0.01). Conclusions: Excretion of human DNA in feces, as an expression of cellular desquamation, is a novel noninvasive technique to objectively assess disease activity in ulcerative colitis.

Serum Level of Soluble Tumor Necrosis Factor Receptor II (sTNF-R75) Is Apparently an Index of Overall Monocyte-Related Infectious and Inflammatory Activity

ABSTRACT Background The serum level of soluble tumor necrosis factor receptor II (sTNF-R75) has been recently found to correlate with the activity and/or severity of several different infectious and inflammatory diseases. These results have led us to presume that the serum sTNF-R75 level reflects the active immune activity of all causes and may correlate well with nonspecific infectious and inflammatory markers such as peripheral leukocyte counts and serum C-reactive protein level. Methods In total, 110 apparently healthy adults, 55 men and 55 women, were enrolled in the study. Serum levels of sTNF-R75, C-reactive protein, globulin, alkaline phosphatase, lactate dehydrogenase, creatinine, urea nitrogen, and counts of neutrophils, lymphocytes, monocytes, eosinophils, and basophils were checked. The relationships between the serum sTNF-R75 level and other parameters were analyzed using the SAS statistical program. Results By various statistical methods, the serum sTNF-R75 level showed consistently significant positive links with peripheral monocyte count, serum C-reactive protein level, and two parameters of renal clearance function (serum urea nitrogen and creatinine levels). Serum levels of alkaline phosphatase and lactate dehydrogenase had significant positive links with the serum sTNF-R75 level by multivariate regression analysis. There was no significant link between the serum sTNF-R75 level and counts of neutrophils, lymphocytes, eosinophils, or basophils. Conclusions Our results, together with those of recent reports showing positive correlations between the serum sTNF-R75 level and activities/severities of different infectious and inflammatory diseases, and also that TNF- α is principally produced by monocytes and macrophages, suggest that the serum sTNF-R75 level is very probably an index of overall monocyte-related infectious and inflammatory activities.

Dynamic magnetic resonance imaging of the metacarpophalangeal joints in rheumatoid arthritis, early unclassified polyarthritis, and healthy controls

Objective. To introduce dynamic magnetic resonance imaging (MRI) as an indicator of inflammatory activity in the metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) or early unclassified polyarthritis, and to compare the results with a healthy control group. Materials and Methods. We examined 42 RA and 23 early unclassified polyarthritis patients, and 12 healthy controls in a cross-sectional study. Dynamic MRI (repeated FLASH-MR images after injection of a contrast agent) was performed through the 2nd to the 5th MCP joint. Two methods for identification of the enhancing synovial membrane were compared: 1) outlining of enhancing synovial membrane on subtraction images and 2) automated recognition by principal component analysis (PCA). The early enhancement (EE) rate was calculated on the basis of the first method. Results. Method 1) and 2) were closely associated (P<0.00001). From the healthy control group, an upper limit (mean+2SD) of normal enhancement was established for the 2nd to 5th MCP joints, which served to identify abnormal EE rates in the corresponding joints of patients. The patients had higher EE rates in the 2nd to 5th MCP joints than had the healthy controls (P<0.01). There were no significant differences between the two patient groups (P>0.09). Conclusion. PCA seems to be a promising method for automated identification of enhancing tissue. EE rates of the finger joints may be useful in the assessment of the inflammatory activity in the joints of patients with RA and early unclassified polyarthritis and may reflect other aspects of disease activity than clinical evaluation.

Serum eosinophil cationic protein in asthma of farmers

Objective: There is need for relevant markers of bronchial inflammation in epidemiologic studies of asthma. Serum eosinophil cationic protein (ECP) is a marker of eosinophil inflammation and asthma activity. We have studied serum ECP in atopic farmers with current asthma, in non-atopic asthmatics and in non-asthmatic, non-atopic controls. Methods and results: In a cross-sectional study of a representative sample of 8482 farmers in Norway, asthma was recorded using a self-administered questionnaire; spirometry and serum sampling were performed on all of them. Atopy was screened with Phadiatop and RAST analyses to the mites Lepidoglyphus destructor and Tyrophagus putrescentiae in all asthma cases and controls. All the identified atopics had additional RAST analyses on a set of allergens. Serum ECP was tested in 60 persons with current asthma and atopy (mean 16.2, 95% CI 13.2-19.3), 127 non-atopic asthmatics (mean 9.1, 95% CI 8.0-10.2) and 39 non-atopic controls (mean 5.5, 95% CI 4.0-7.0). ECP levels in atopic asthmatics were associated with number of positive allergens and reduction of FEV1 values. Moreover, the ECP levels were elevated with allergy to swine, cow, D. pteronyssinus, L. destructor, A. siro, T. putrescentiae, timothy grass and the cereal grains: wheat, oat, barley and rye. Conclusion: Serum ECP seems feasible as an indicator of inflammatory activity in epidemiological studies of current allergic asthma, and may help to indicate the importance of specific allergens. Although the ECP values were significantly more elevated in atopic than in non-atopic asthma, elevated serum ECP was not specific for atopic asthma.

Association of humoral markers of inflammation and dehydroepiandrosterone sulfate or cortisol serum levels in patients with chronic inflammatory bowel disease

Objectives: Dehydroepiandrosterone sulfate (DHEAS) and cortisol are multifunctional adrenal hormones with immunomodulating properties. DHEAS levels were found to be very low in chronic inflammatory diseases. This study aimed to shed more light on the interrelation between DHEAS and cortisol (and humoral markers of inflammation) in chronic inflammatory bowel disease. Methods: DHEAS and cortisol serum levels were measured by ELISA in the serum of 66 normal subjects, 115 patients with Crohn’s disease (CD) and 64 patients with ulcerative colitis (UC). Humoral markers of inflammation and disease activity scores were assessed by standard techniques. Results: DHEAS was lower in patients with CD ( p < 0.005) and UC ( p < 0.005) than in controls, which was, in part, dependent on previous corticosteroid treatment ( p < 0.01). In CD patients, z-normalized DHEAS was inversely correlated with blood sedimentation rate ( p = 0.017). Z-normalized DHEAS was negatively correlated with interleukin-6 (IL-6) in the form of a trend ( p = 0.068), and z-normalized DHEAS was significantly positively correlated with hemoglobin ( p = 0.001) but not with the Crohn’s disease activity index. Cortisol, however, was positively correlated with blood sedimentation rate ( p = 0.034) and C-reactive protein ( p = 0.006). In contrast, in UC patients no such correlation of z-normalized DHEAS or cortisol and parameters of humoral inflammatory activity or Rachmilewitz index exist. Conclusions: DHEAS as a marker of inflammation was low in CD and UC. In CD patients, low DHEAS and high cortisol serum levels were associated with higher humoral inflammatory activity. With respect to humoral inflammatory activity in CD patients, DHEAS and cortisol seem to be inversely regulated, which may have an impact on several immune functions, such as IL-6 secretion.

Association of humoral markers of inflammation and dehydroepiandrosterone sulfate or cortisol serum levels in patients with chronic inflammatory bowel disease.

Dehydroepiandrosterone sulfate (DHEAS) and cortisol are multifunctional adrenal hormones with immunomodulating properties. DHEAS levels were found to be very low in chronic inflammatory diseases. This study aimed to shed more light on the interrelation between DHEAS and cortisol (and humoral markers of inflammation) in chronic inflammatory bowel disease. DHEAS and cortisol serum levels were measured by ELISA in the serum of 66 normal subjects, 115 patients with Crohn's disease (CD) and 64 patients with ulcerative colitis (UC). Humoral markers of inflammation and disease activity scores were assessed by standard techniques. DHEAS was lower in patients with CD (p < 0.005) and UC (p < 0.005) than in controls, which was, in part, dependent on previous corticosteroid treatment (p < 0.01). In CD patients, z-normalized DHEAS was inversely correlated with blood sedimentation rate (p = 0.017). Z-normalized DHEAS was negatively correlated with interleukin-6 (IL-6) in the form of a trend (p = 0.068), and z-normalized DHEAS was significantly positively correlated with hemoglobin (p = 0.001) but not with the Crohn's disease activity index. Cortisol, however, was positively correlated with blood sedimentation rate (p = 0.034) and C-reactive protein (p = 0.006). In contrast, in UC patients no such correlation of z-normalized DHEAS or cortisol and parameters of humoral inflammatory activity or Rachmilewitz index exist. DHEAS as a marker of inflammation was low in CD and UC. In CD patients, low DHEAS and high cortisol serum levels were associated with higher humoral inflammatory activity. With respect to humoral inflammatory activity in CD patients, DHEAS and cortisol seem to be inversely regulated, which may have an impact on several immune functions, such as IL-6 secretion.

Evaluation and Validation of a Crohn's Disease Inflammatory Activity Index Reflecting Pattern of Endoscopic Severity

Background: This study was designed to investigate objective variables assessing the inflammatory activity of Crohn's disease accessible for routine management and their suitability to act as surrogate indicators for endoscopic alterations. Methods