Intensity Of Systemic Inflammatory Response Research Articles

Right heart condition in patients with COVID-19 pneumonia

Aim. To assess right heart condition in patients with coronavirus disease 2019 (COVID-19) pneumonia.Material and methods. One hundred and five patients with COVID-19 pneumonia were divided into 3 groups depending on the involvement of lung parenchyma: group I — 0-25%, II — 25-50%, III — 50-75%. The clinical status of patients was assessed using the NEWS2 and SHOKS-COVID scales. A complete blood count and biochemical blood tests were performed to determine the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin I. Echocardiography was performed to assess the right heart structural, hemodynamic and functional parameters.Results. In patients with COVID-19 pneumonia, with an increase in lung parenchyma involvement, the intensity of systemic inflammatory response increased: C-reactive protein, group I — (4 [1,9; 35] mg/l), in III — (70,5 [33; 144] mg/l) (pI-III=0,012); myocardial stress marker level increased: NT-proBNP, group I — 77 [48; 150] ng/l, group III — 165 [100; 287] ng/l (pI-III=0,047). The dependence of NT-proBNP on C-reactive protein level was revealed (r=0,335, p=0,03). Intergroup comparison did not reveal significant differences between the main right heart functional parameters: TAPSE, Tei index (PW and TDI), FAC of the right ventricle (RV) (p>0,05). However, differences in the tricuspid annular peaks were found as follows: group I — 0,14 [0,12; 0,14] m/s, group II — 0,14 [0,12; 0,15] m/s, group III — 0,16 [0,14; 0,17] m/s (pI-II=0,012, pI-III=0,014) and RV global longitudinal strain: group I — 19,63±7,72%, group III — 27,4±5,93% (pI-III=0,014). The relationship between the RV global longitudinal strain and SHOKS-COVID score was confirmed (r=0,381; p=0,024).Conclusion. Patients with COVID-19 pneumonia showed no signs of right heart dysfunction. The development of RV hyperfunction was noted. Most likely, this is a compensatory mechanism in response to acute RV afterload. NT-proBNP increase under conditions of an inflammatory response may indicate myocardial stress. The results obtained allow to expand our understanding of the right heart condition in patients with COVID-19 pneumonia.

Age-Specific Features of Hypoxia Tolerance and Intensity of Lipopolysaccharide-Induced Systemic Inflammatory Response in Wistar Rats.

Hypoxia tolerance and the intensity of systemic inflammatory response during endotoxemia were examined in newborn, prepubertal, and mature Wistar rats. To assess the sensitivity to hypoxia, the rats were placed into a pressure chamber simulating an altitude of 11,500 m. The systemic inflammatory response was provoked by intraperitoneal injection of LPS from E. coli O26:B6. Serum concentrations of HIF-1α, neopterin, C-reactive protein, and endotoxin were measured. In histological sections of the liver, the area of necrosis was assessed. The smallest tolerance of the prepubertal males to hypoxia correlated with the greatest manifestations of hepatic inflammation and elevated endotoxin, neopterin, and C-reactive protein. Elevation of serum HIF-1α in 3 h after LPC injection was observed in only prepubertal rats. The data obtained should be taken into account during the development of therapeutic strategy for prepubertal children with infectious and inflammatory diseases.

ВЫРАЖЕННОСТЬ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА У БОЛЬНЫХ ТУБЕРКУЛЕЗОМ, АССОЦИИРОВАННЫМ С ВИЧ-ИНФЕКЦИЕЙ

238 tuberculosis cases with concurrent HIV infection were examined. The age of patients varied from 24 to 57 years old. Men made 189 (79.4%), and women 49 (20.6%). The CD4 count in the examined patients varied from 0 to 1.216 × 10 9 /L. The intensity of systematic inflammatory response was evaluated as per the rates of acute phase reactants: С-reactive protein (СRP), α 1 -antitrypsin (α 1 -АТ), haptoglobin (HG) and fibrinogen (F). It was found out that tuberculosis patients with concurrent HIV infection demonstrated confidently increased levels of C-reactive protein, α 1 -antitrypsin, and haptoglobin, which was the evidence of systemic inflammatory response. However, the increase of fibrinogen level was not typical of tuberculosis patients with concurrent HIV infection. The comparative analysis proved that the intensity of systemic inflammatory response was increasing simultaneously with the severity of the immune deficiency, and the growth of acute phase reactants' level with a parallel reduction of CD4 count was the evidence of the above. C-reactive protein and α 1 -antitrypsin were the most informative markers of systemic inflammatory response intensity in tuberculosis patients with concurrent HIV infection.

The intensity of systemic inflammatory response in patients with chronic obstructive pulmonary disease

Summary. We analyzed plasma level of an inflammatory mediator lipoxin A4 in patients with chronic obstructive pulmonary disease (COPD) which could be used as a marker of systemic inflammation in COPD patients. Relationships between the lipoxin A4 level and cellular markers of inflammation, persistent lipid peroxidation and reduced exercise tolerance have been found. Improvement in lipoxin A4 level could be an attractive contribution to rehabilitation of COPD patients and should be considered in predictive multivariable models of clinical course and in therapeutic algorithms.

Effect of intensive exercise on plasmatic neutrophil elastase level in eventing and endurance horses

Intensive exercise induces a systemic inflammatory response characterised by an increase of blood neutrophil count and myeloperoxidase (MPO) release. Neutrophil elastase (NE) could also contribute to tissues lesions by its proteinase activities. To compare plasmatic NE concentrations before and after different forms of intensive exercise. EDTA blood samples were taken from 51 eventing horses (EvH) and 32 endurance horses (EndH) were sampled before the race (T0). Blood sampling was performed 2 h (T1) after completing either phase D of a one or 2 star eventing competition (n = 51), or a 120 or 160 km endurance race (n = 32). Plasmatic NE and MPO were measured by a specific equine ELISA. Neutrophil counts and creatine kinase (CK) levels were also measured. A Wilcox on test for paired samples was used to compare mean values of neutrophils, CK, MPO and NE at T0 and T1 in EvH and in EndH. Correlations were calculated between all the 4 parameters in EvH and EndH. At T0, mean NE levels were 14.43 ± 3.63 ng/ml for EvH and 11.7 ± 2.11 ng/ml for EndH. The competition induced a significant increase of NE levels in (58.57 ± 24.06 ng/ml) EvH and (95.74 ± 22.70 ng/ml) EndH (P < 0.05). NE was significantly (P < 0.0001) correlated to MPO in EvH (r = 0.293) and EndH (r = 0.594) and to CK (r = 0.297) in EndH (P < 0.0001). Neutrophils, CK and MPO were significantly increased between T0 and T1 in both types of horses. Significant increase of NE (EndH) was observed after intense exercise with a significant correlation between NE and MPO. The huge variability in MPO and NE indicates that not all horses show the same intensity of systemic inflammatory response.

Elevated exhalation of hydrogen peroxide and thiobarbituric acid reactive substances in patients with community acquired pneumonia

Background: Bacterial pneumonia involves influx of activated phagocytes into distal airways. These cells release oxidants including H 2O 2, that may be exhaled or induce peroxidative damage to lung tissues with formation of thiobarbituric reactive substances (TBARs). Study objectives: To determine whether concentrations of H 2O 2 and TBARs in exhaled breath condensate (EBC) is elevated and correlate with systemic response to pneumonia during 10 days of hospital treatment. Design: The concentration of H 2O 2 and TBARs was measured in EBC of 43 inpatients with community acquired pneumonia (CAP) and 20 healthy never smoked subjects over 10 days and were accompanied by monitoring of WBC count, serum concentration of C-reactive protein (CRP) and peroxyl radical-trapping capacity. Results: Patients with CAP exhaled 4.6-, 3.7-, 3.9-, 3.3-times more H 2O 2 than healthy controls at 1st, 3rd, 5th and 10th day of treatment ( P<0.05), respectively. EBC concentrations of TBARs were elevated at 1st and 3rd day. H 2O 2 and TBARs levels decreased along with treatment course. Correlation ( P<0.05) was found between H 2O 2 levels and CRP and WBC count ( r=0.31) at 1st day and between TBARs and CRP at 5th ( r=0.34) and 10th day ( r=0.46). The mean H 2O 2 exhalation estimated over ten days of treatment correlated with pneumonic chest X-ray score ( r=0.42), CRP levels ( r=0.46) and WBC count ( r=0.33) at admission ( P<0.05). Conclusions: Pneumonia is accompanied by oxidative stress in airways that moderately correlates with intensity of systemic inflammatory response. Determination of H 2O 2 in EBC may be helpful for non-invasive monitoring of oxidants production during lower respiratory tract infection.

Tissue production of pro-inflammatory cytokines (IL-1 , TNF and IL-6) correlates with the intensity of the systemic inflammatory response and with corticosteroid requirements in giant-cell arteritis

To investigate proinflammatory cytokine expression in temporal arteries from patients with giant-cell arteritis (GCA) and to analyse its relationship with the intensity of the initial systemic inflammatory reaction and response to corticosteroid therapy. Quantification of interleukin-1beta (IL-1beta), tumor necrosis factor alpha (TNFalpha), and interleukin-6 (IL-6) mRNA by real-time quantitative PCR in temporal artery samples from 36 patients with biopsy-proven GCA and 11 controls. Immunohistochemical detection of IL-1beta, TNFalpha, and IL-6 in temporal artery sections from 74 patients with GCA and 15 controls. Clinical and biochemical parameters of inflammation as well as the time (weeks) required to reach a maintenance prednisone dose <10 mg/day were recorded. IL-1beta (13.8 +/- 2.5 vs 5.4 +/- 1.3 relative units, P = 0.012) and IL-6 transcripts (34 +/- 13.7 vs 7.8 +/- 4.5 relative units, P = 0.034) were significantly more abundant in patients with a strong systemic inflammatory response compared with those with no inflammatory parameters. Immunohistochemical scores for IL-1beta (2.7 +/- 0.3 vs 1.9 +/- 0.2, P = 0.018), TNFalpha (3.2 +/- 0.2 vs 2.4 +/- 0.3, P = 0.028) and IL-6 (3 +/- 0.2 vs 2.1 +/- 0.3, P = 0.023) were also significantly higher in patients with strong systemic inflammatory reaction. A significant correlation was found between the amount of tissue TNFalpha mRNA and the time required to reach a maintenance dose of prednisone <10 mg/day (r = 0.586, P = 0.001). GCA patients with a strong systemic inflammatory response, who have been previously shown to be more resistant to corticosteroid therapy, have elevated tissue expression of proinflammatory cytokines IL-1beta, TNFalpha and IL-6. High production of TNFalpha is associated with longer corticosteroid requirements.