Interleukin-6 Levels In Patients Research Articles

Levels of Interleukin -10 in Gingival Crevicular Fluid and its Role in the Initiation and Progression of Gingivitis to Periodontitis

Background: Virulence of microorganisms contribute to initiation and progression of periodontal disease but genetic contribution to pathogenesis of periodontitis and specific genetic markers are found to be strong indicators of susceptibility to periodontitis in adults. The purpose of this study was to determine whether interindividual variation in interleukin-10 levels in patients with similar levels of oral hygiene has a role in preventing progression of gingivitis to periodontitis. Methods: In the present study, 91 subjects were divided into three groups based on GI (Gingival Index), OHI-S (Oral Hygiene Index-Simples), PPD (Probing pocket depth) and CAL (Clinical attachment level) into healthy, gingivitis and periodontitis groups. GCF (Gingival Crevicular Fluid) samples were collected from each patient using micropipette and IL-10 (interleukin -10) levels were analyzed using ELISA. Results: The highest mean concentration of IL-10 was obtained for gingivitis group (1128.19 ± 532.90 mg/ml) and lowest for control group (648.96 ± 505.75). The mean IL-10 level of periodontitis (956.22 ± 475.49) group was found to be intermediate between the other two groups. There was statistically significant difference in IL-10 levels between three groups (p 0.05). Conclusions: The results suggest that IL-10 levels are higher in patients with gingivitis than whose condition progressed to periodontitis. In control group, IL-10 level was least suggesting role of bacterial factors in initiating IL-10 response. The data suggests the protective role of anti-inflammatory cytokine, IL-10 in limiting progression of gingivitis to periodontitis.

The features of mucosal immunity and microbiota at different forms of allergic rhinitis

Aim. To assess the parameters of local immune response in patients with different forms of allergic rhinitis, associated with nasal bacterial infection. Methods. Nasal swabs and nasal epithelium samples obtained from 10 patients with seasonal allergic rhinitis aged 12 to 32 years and from 15 patients with persistent allergic rhinitis aged 18 to 45 years, as well as form the 20 healthy subjects aged 18 to 45 years without signs of allergy who were age and gender-comparable, were examined. Swabs were prepared from cell suspension, stained with 0.04% trypan blue solution, and a microscopy with the count of non-stained cells was performed. Epitheliocytes expressing toll-like receptors-2, were determined by flow cytometry. Interleukin-10 concentration in swabs was assessed by ELISA. Results. The number of epitheliocytes expressing toll-like receptors-2 was by 1.9 times lower in patients with seasonal allergic rhinitis and by 1.7 times lower in patients with persistent allergic rhinitis compared to control group. There was a reverse correlation found between the number of epitheliocytes expressing toll-like receptors-2 and interleukin-10 level in nasal swabs of healthy controls, while in patients with allergic rhinitis a it was a direct correlation. In patients with persistent allergic rhinitis S. aureus was a part of microbiota in 100% of cases and was associated with other bacteria (Str. pyogenes - 33.3%, Neisseria spp. - 66.7%). In patients with seasonal allergic rhinitis the association of S. aureus and S. hemolyticus (70.0%) was the most frequent one. In the control group, S. epidermidis (50.0%), Str. viridians (25.0%), S. hominis (25.0%) were among the nasal microbiota. There were no differences revealed between the mean levels of interleukin-10 in patients with allergic rhinitis and healthy controls. Conclusion. The number of epitheliocytes expressing toll-like receptors-2 was significantly reduced by almost 2 times in patients with persistent allergic rhinitis compared to control group. Colonization of nasal mucosa by S. aureus in patients with allergic rhinitis leads to an increase of epithelial cells expressing toll-like receptors-2.

Study of Serum Interleukin-17 Levels in Patients with Chronic Periodontitis and Coronary Heart Disease

Study of Serum Interleukin-17 Levels in Patients with Chronic Periodontitis and Coronary Heart Disease

Interleukin 6 in Hyposmia

Olfaction is a complex sensory process that has not been fully studied. Elevated plasma levels of interleukin 6 (IL-6) have been found in patients with several acute and chronic diseases but have not been reported in patients with smell loss (hyposmia). To determine IL-6 levels in patients with hyposmia. Retrospective study. All measurements were made without reference to the origin of any collected sample. SETTING An ambulatory private practice at The Taste and Smell Clinic in Washington, DC. Fifty-nine consecutive patients who presented to the clinic between 2005 and 2008 for evaluation and treatment of various degrees of hyposmia were studied. Nine volunteers with normal sensory function served as controls. Levels of IL-6 were measured in samples of plasma, urine, saliva, and nasal mucus. All biological fluid samples studied contained IL-6. Mean (SEM) levels in plasma, saliva, and nasal mucus in patients were significantly higher than in controls (0.95 [0.10] vs 0.12 [0.03] pg/mL, 0.57 [0.05] vs 0.30 [0.01] pg/mL, and 29.7 [3.8] vs 11.6 [0.5] pg/mL, respectively; all P < .001). The concentration of IL-6 in nasal mucus in patients was significantly higher than in controls and was more than 30 times higher than in any other biological fluid. Mean (SEM) levels in urine were not significantly different: 0.92 (0.17) pg/mL for patients and 1.26 (0.41) pg/mL for controls (P > .50). Compared with controls, IL-6 in patients was significantly elevated in plasma, saliva, and nasal mucus. Because IL-6 is a proinflammatory cytokine, these changes can relate to local or systemic inflammatory processes, which can be a cause or a result of pathological processes associated with hyposmia. These results support the concept that hyposmia has a biochemical basis and IL-6 may play a role in biochemical pathological processes underlying hyposmia and its treatment.

AB0151 Factors associated with serum IL-6 levels in patients with early arthritis

BackgroundIt is known that serum IL-6 (sIL-6) levels are associated with disease activity and joint destruction in rheumatoid arthritis (RA). Tocilizumab (TCZ) blocks binding of interleukin 6 (IL-6) to both...

Clinical values of urinary IL-6 in asymptomatic renal hematuria and renal hematuria with proteins

Renal hematuria is caused by glomerular disease. Under pathological conditions, the distribution of interleukin-6 (IL-6) in kidney tissue is abnormal and urinary IL-6 levels are increased. Abnormal IL-6 secretion promotes the hyperplasia of mesangial cells and matrix and, thus, affects the permeability of the glomerular filtration membrane. Therefore, the detection of urinary IL-6 levels in patients with renal hematuria is beneficial for disease evaluation. A total of 82 patients with primary renal hematuria were divided into group 1 (UPr/24 h < 150 mg; pure hematuria group), group 2 (150 mg ≤ UPr/24 h ≤ 1,000 mg) and group 3 (UPr/24 h > 1,000 mg). A total of 30 normal individuals were selected as the controls. The urinary IL-6 levels were detected by the enzyme-linked immunosorbent assay (ELISA) method and a renal biopsy was conducted. The urinary IL-6 levels and renal pathological damage scores in groups 1 and 2 were significantly reduced compared with those in group 3, (P<0.001 and 0.01, respectively), with no significant difference between groups 1 and 2 (P>0.05). The correlation coefficient (r) of urinary IL-6 with 24 h urinary protein (UPr/24 h) in groups 1, 2 and 3 was 0.017, 0.045 and 0.747, respectively, and that of urinary IL-6 with renal pathological damage score was 0.627, 0.199 and 0.119, respectively. The UPr/24 h was significantly correlated with IL-6 level (r=0.7320, P<0.000). In group 1, the urinary IL-6 levels were correlated with the degree of renal pathological damage. A positive correlation was observed between urinary IL-6 levels and UPr/24 h.

Interleukin-18 is up-regulated in infectious pleural effusions

The aim of this study was to investigate the pleural and systemic expression of interleukin-18 (IL-18) in patients with pleural effusions (PEs), and the effects of the cytokine in mouse pleural space.One hundred and sixty patients, 23 with pleural effusions (PEs) due to heart failure, 60 malignant, 25 parapneumonic/empyemas, 15 tuberculous and 37 with exudates of miscellaneous etiologies were included in the study. Pleural fluid (PF) and serum IL-18 content was determined using ELISA. IL-18 was injected intrapleurally in mice and pleural inflammation was assessed using pleural lavage.The highest PF IL-18 levels were observed in parapneumonic PEs and the lowest PF IL-18 levels in patients with exudates of miscellaneous aetiologies and transudates. PF IL-18 levels were significantly higher in patients with empyemas compared to those with uncomplicated (p=0.009) or complicated (p=0.028) parapneumonic effusions, while serum levels did not differ significantly among the three groups. Pleural IL-18 content was higher than that of blood only in patients with empyemas. In patients with pleural exudates of all etiologies and in those with parapneumonic PEs/empyema, PF IL-18 levels were correlated with markers of acute pleural inflammation such as the percentage of PF neutrophils, PF LDH and PF/serum LDH ratio, low PF glucose and PF/serum glucose ratio and low PF pH. In mice, intrapleural IL-18 caused neutrophil-predominant pleural inflammation.In conclusion, IL-18 is linked to the intensity of neutrophilic pleural inflammation in patients with PEs, it is up-regulated in the pleural space of patients with empyema and it stimulates the accumulation of neutrophils in mouse pleura.

Relationship of interleukin-6-572C/G promoter polymorphism and serum levels to post-percutaneous coronary intervention restenosis

Background It has been recently reported that inflammatory mechanisms play an important role in in-stent restenosis (ISR) processes. Inflammatory factors after percutaneous coronary intervention (PCI) for dynamic monitoring can probably predict ISR. Functional polymorphisms in the promoter region of genes coding for inflammatory factors might be important for determining the magnitude of the inflammatory response. Thus, in the present study, we aimed to investigate the serial changes in serum interleukin-6 (IL-6) levels before and after PCI and the relationship between the -572C/G polymorphism in the promoter region of the IL-6 gene and ISR. We also discussed genetic polymorphisms in the inflammatory response to PCI. Methods A total of 437 patients who successfully underwent bare metal stent (BMS) implantation with a follow-up angiography were divided into an ISR group (n=166) and a non-ISR (NISR) group (n=271). The IL-6 gene promoter polymorphism at position -572 was determined by restricted fragment length polymorphism using the polymerase chain reaction (PCR-RFLP) method. The serum IL-6 levels before and one day, five days and 180 days after PCI were determined by the radioimmunoassay method. Results ISR patients showed higher IL-6 serum levels than NISR patients before PCI ((324.42±28.14) ng/L vs. (283.22±47.30) ng/L, P &lt;0.001), and one day post-PCI IL-6 serum levels in the ISR group also showed a significantly higher level than in the NISR group (P &lt;0.001). Increased IL-6 after PCI persisted at a statistically significant level throughout the study in ISR patients, whereas IL-6 levels had normalized five days after the procedure in NISR patients. One day post-PCI serum IL-6 level was the most accurate marker for diagnosis of ISR, the area under the ROC curve being 0.927 (95% CI 0.878-0.977). The cut-off value for IL-6 to predict ISR was over 355.50 ng/L, with a sensitivity of 0.968 and a specificity of 0.865. There were no significant differences in frequencies of -572 genotype and allele between the two groups (P &gt;0.05). One day post-PCI IL-6 serum levels in patients with the G allele was significantly higher than in patients without the G allele ((366.99±49.37) ng/L vs. (347.20±55.30) ng/L, P &lt;0.05). In the ISR group, one day post-PCI serum levels of IL-6 in patients with the G allele was also significantly higher than that in patients without the G allele ((405.67±26.56) ng/L vs. (375.69±38.81) ng/L, P &lt;0.05). Multivariate Logistic regression analysis revealed positive correlations between male gender, one day post-PCI serum levels of IL-6, the pre-PCI degree of stenosis, the length of the target lesion stenosis, and restenosis; and there were negative correlations between the stent diameter, the diameter of the reference vessel before stent implantation and restenosis. Conclusions IL-6 is an early post-PCI inflammatory cytokine, and one day post-PCI serum IL-6 level is an independent risk factor for restenosis. The frequencies of IL-6 gene -572 genotype and allele are not different between patients with and without ISR in a Chinese Tianjin Han population, but carrying the IL-6 -572G allele is likely to increase an individual's susceptibility to ISR by promoting serum IL-6 levels.

Increased cerebrospinal fluid interleukin-6 levels in patients with schizophrenia and those with major depressive disorder

Elevated peripheral levels of interleukin-6 (IL-6) are common findings in schizophrenia and depression. However, previous studies that measured cerebrospinal fluid (CSF) IL-6 levels in these disorders reported controversial results. The present study examined whether CSF IL-6 levels are altered in patients with schizophrenia and those with depression. Lumbar punctures were performed in 32 patients with schizophrenia, 30 with major depressive disorder (MDD), and 35 healthy controls. Serum samples were simultaneously collected from all subjects in the patient groups and from 32 of the control group. CSF and serum IL-6 levels were determined by enzyme-linked immunosorbent assay. Both the patients with schizophrenia and MDD had significantly higher CSF IL-6 levels compared to the controls (schizophrenia: P = 0.0027; MDD: P = 0.012). IL-6 levels were significantly higher in the CSF than in the serum. No significant correlation was observed between CSF and serum IL-6 levels. The present findings suggest that IL-6 of central origin is associated with the pathophysiology of schizophrenia and MDD, although confounding effect of smoking status can not be entirely excluded.

Determination of dermatology life quality index, and serum C-reactive protein and plasma interleukin-6 levels in patients with chronic urticaria.

IntroductionC-reactive protein (CRP) and interleukin-6 (IL-6), which is one of its most important simulators, were determined in great amounts in the sera of patients with chronic urticaria (CU).AimTo determine the levels of IL-6 in patients with urticaria, and evaluate its relationship with urticaria activity scores and Dermatology Life Quality Index (DLQI).Material and methodsFifty-three patients with CU were included in the study successively by determining their urticaria activity scores (0-3) and DLQI (0-5). The CRP and IL-6 were measured by immune assay methods. Thirty-two healthy subjects were included as a control group.ResultsSerum levels of IL-6 and CRP were significantly higher in patients with CU compared to healthy controls (p < 0.001, p = 0.026 respectively). There was a statistically significant correlation among urticaria activity scores and IL-6 and CRP concentration (p = 0.004, p = 0.042). This correlation was more significant in patients who had moderate and severe disease activity scores than in those who had mild disease activity score (p < 0.001, p < 0.001, respectively). There was a statistically significant association between DLQI and IL-6 (p = 0.025). This correlation was very significant in patients who had severe and very severe disease activity scores (p < 0.001, p < 0.001, respectively). DLQI scores and serum levels of IL-6 were significantly different in the very severe group compared to healthy controls (p = 0.024).ConclusionsThe levels of CRP and IL-6 are increased in patients with CU. A relationship of DLQI and urticaria activity scores with CRP and IL-6 was found. These findings support the relationship between the inflammatory process in CU and the clinical findings.

129: The interrelation between diastolic function indexes and interleukin-6 level in patients with metabolic cardiomyopathy

Myocardial injury in diabetes mellitus type 2 (DM-2) is associated not only with insulin resistance, hyperinsulinemia and glucose toxicity, but also with the action of anti-inflammatory cytokins, which accelerate the development of atherosclerotic changes. One of the representatives of cytokins is interleukin-6 (IL-6). Its activation is a marker of disease severity and the predictor of development of late cardiovascular complications. However, the extent of IL-6 involvement into the development of diastolic dysfunction (DD), typical for metabolic cardiomyopathy (MC), is not well studied. Therefore, the aim of our research was to evaluate the correlation between the maximal velocity of early diastolic stream E - stream velocity caused by atrial systoles A ratio and the level of IL-6 in patients with DM-2. 38 patients (35-60 years old) with DM-2 without severe complications were examined. Duration of DM-2 was from 1 to 8 years. The level of IL-6 was determined by immune-enzyme assay. The maximal velocity of early diastolic stream E; stream velocity, caused by atrial systoles A; and an E/A ratio were measured by heart sonography. Control group included 20 relatively healthy individuals. Correlation analysis was applied to all studied indexes. Correlation coefficient and degree of reliability of received data were counted. Mean level of E/A composed 0,93±0,04 (p<0,05) in the group of patients with DM-2 and 1,4±0,075 (p<0,05) in the control group. The mean level of IL-6 counted 10,7±0,27 (p<0,05) in group of patients with DM-2 and 8,83±0,22 in the control group (p<0,05). A significant reliable negative correlation was revealed between E/A ratio and IL-6 level (Spearman's rank correlation coefficient R −0,32 (p<0,05)). The received data prove that IL-6 contributes the development of diastolic dysfunction in patients with MC and DM-2. IL-6 favours the development of DD first, following systolic dysfunction in patients with DM-2.

Changes in Inflammatory and Metabolic Parameters After Periodontal Treatment in Patients With and Without Obesity

Non-surgical periodontal treatment decreases serum levels of inflammatory cytokines in patients with and without obesity. However, the changes in metabolic parameters in association with these decreases in levels of inflammatory markers by periodontal treatment have not been evaluated in patients with obesity. The aim of this study is to evaluate the short-term changes in systemic inflammatory, lipid, and glucose parameters in the presence of obesity after periodontal treatment. The study included 22 dyslipemic patients with obesity and 24 healthy individuals without obesity with generalized chronic periodontitis. The periodontal parameters, anthropometric measurements, and serum levels of triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein-a, high-sensitive C-reactive protein, fasting blood glucose, insulin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and leptin were measured. A homeostasis model assessment of the insulin resistance (HOMA-IR) score was calculated before and 3 months after non-surgical periodontal treatment. Both groups responded well to the periodontal treatment in terms of periodontal parameters. The treatment was also associated with a decrease in serum TNF-α and IL-6 levels and HOMA-IR scores in individuals with obesity and with a decrease in IL-6 levels in patients without obesity. Conversely, there were insignificant decreases in lipid profiles and serum fasting glucose of patients with obesity. The non-surgical periodontal treatment causes a decrease in the levels of some circulating proinflammatory cytokines and may be associated with a decrease in insulin resistance in the obese population.

Histone deacetylases enzyme, copper, and IL-8 levels in patients with Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive loss of cognitive abilities. Epigenetic modification, oxidative stress, and inflammation play an important role in the pathogenesis of the disease. We aimed to detect noninvasive peripheral biomarkers with a high degree of sensitivity and specificity in diagnosis and progression of AD. A total of 25 elderly patients with AD and 25 healthy control participants were selected and subjected to cognitive assessment and laboratory measures including histone deacetylases (HDACs), copper, and interleukin 8 (IL-8) levels. The levels of HDACs, copper, and IL-8 were significantly higher in patients with AD (P < .001) and had a significant negative effect on all cognitive assessment tests. Receiver-operating curve (ROC) analysis revealed that HDACs and copper levels had higher sensitivity and specificity. Plasma levels of HDACs and copper may be used as peripheral biomarkers in diagnosis of AD, while IL-8 level could be a useful biomarker in following AD progression.

Serum interleukin-18 levels in patients with systemic lupus erythematosus: Relation with disease activity and lupus nephritis

Aim of the workTo further investigate the possible role of IL-18 in the pathogenesis of systemic lupus erythematosus (SLE) and development of lupus nephritis (LN), and to explore its relationship with pathological classes of LN, degree of acute renal activity and chronic damage. Patients and methodsForty-one SLE patients with LN, thirty-one lupus non-nephritis patients and fifteen age and sex matched healthy controls were enrolled in this study. SLE patients were subjected to disease activity assessment by SLEDAI, renal disease activity assessment by the Systemic Lupus International Collaborating Clinics (SLICC) Renal Activity Score, laboratory investigations including measurement of serum interleukin-18 using Enzyme Linked Immunosorbent Assay. Renal biopsy was obtained from LN patients and pathological classification was made according to World Health Organization (WHO) criteria. Analysis of activity and chronicity indices was done on these biopsy specimens. ResultsSerum levels of IL-18 were significantly higher in patients with LN than lupus non-nephritis patients and healthy controls (p<0.001). There were significant correlations between IL-18 and SLEDAI (p=0.002), proteinuria (p=0.027), renal activity score (p=0.003) and activity index (p=0.039) in patients with LN. There was no significant difference in the serum levels of IL-18 between WHO classes of LN. ConclusionIL-18 appears to have a pathogenic role in the development of SLE and plays a crucial role in triggering inflammation in LN. Serum IL-18 levels could be a useful biomarker to assess the activity of renal disease in SLE.

Tu1445 Correlation of Circulating Mirnas and Interleukin-10 Levels in Patients With and Without Chronic Abdominal Pain

medically diagnosed IBS. The registry includes data collected on motion sickness symptoms and prior experience of nausea and vomiting immediately post-general anaesthetic. Results 3074 (94% female, age 56(17-85) years) cases were evaluable for IBS (96.9% with motion sickness data and 75.3% with post-general anaesthetic nausea data). The prevalence of IBS was 8% for limited Rome III IBS, 22.3% for extended Rome III IBS and 12.6% for medically diagnosed IBS. Motion sickness was associated with limited IBS, odds ratio 1.5(95%CI 1.122.01) (p=0.006) and medically diagnosed IBS, 1.4(95%CI 1.06-1.74) (p=0.015). Similarly nausea immediately post-general anaesthetic was associated with both (1.4(95%CI 1.031.84) (p=0.03) and 1.7(95%CI 1.34-2.17) (p=<0.005) respectively). However with extended criteria IBS the association with motion sickness was lost 1.2(95%CI 0.95-1.43) (p=NS) but maintained for post-general anaesthetic nausea 1.5(95%CI 1.22-1.80) (p=<0.005). Conclusions Post-general anaesthetic nausea is clearly associated with IBS. Motion sickness is associated with limited criteria Rome III and medically diagnosed IBS but not extended criteria IBS, a more heterogeneous phenotype with likely greater environmental influences. We suggest that these associations may indicate the common influence of altered central processing of stimuli in the generation of IBS, motion sickness and post-general anaesthetic nausea.

Serum levels of GRO‐α are elevated in association with disease activity in patients with Behçet’s disease

Although the etiology of Behçet's disease (BD) is still unknown, neutrophils are implicated in its pathogenesis. Growth-related oncogene-α (GRO-α) is a potent chemoattractant and activator for neutrophils. To determine the role of GRO-α in the pathogenesis of BD, we investigated serum GRO-α levels in patients with BD. Sera from patients with BD (n=57) and control subjects (n=26) were measured by enzyme-linked immunosorbent assay. Serum levels of GRO-α were compared with clinical symptoms. Patients with BD had significantly elevated serum GRO-α levels compared with healthy controls (121.7±79.2pg/ml vs. 75.9±20.6pg/ml, P<0.01). Concerning the subgroups of BD, serum GRO-α levels in active patients with BD (n=35) were significantly higher than in inactive patients with BD (n=22; 139.0±92.8 pg/ml vs. 94.3±36.2pg/ml, P<0.05). Also, as seen in previous studies, serum interleukin-8 levels in patients with BD (52.4±81.8pg/ml) were significantly higher than in controls (13.9±19.7pg/ml, P<0.01). Enhanced GRO-α levels correlated with clinical symptoms such as erythema nodosum. Our results indicate that serum levels of GRO-α are elevated in patients with active stage BD, suggesting that GRO-α may serve as a reliable marker for disease activity of BD.

Comparison of interleukin-6 levels in maternal and umbilical cord blood in early- and late-onset preeclampsia

Purpose: Increased inflammatory response and cytokines are claimed to play a significant role in the etiology of preeclampsia. Interleukin-6 (IL-6) is a proinflammatory cytokine. Limited number of studies evaluating IL-6 levels in preeclamptic patients have produced conflicting results. Therefore, the present study sought to compare maternal and umbilical cord serum levels of IL-6 in early- and late-onset preeclamptic pregnancies as well as in normal pregnancies. Materials and methods: A total of 69 participants were enrolled in the study. The control group consisted of 24 participants with normal pregnancies. Preeclampsia group consisted of 45 participants. The preeclampsia group was further classified into the subgroups of early- and late-onset preeclampsia. Late-onset preeclampsia group consisted of 24 women whereas early-onset preeclampsia group consisted of 21 women. Serum and umbilical cord samples of IL-6 were compared. Results: There was no significant difference between maternal and umbilical cord serum IL-6 concentrations between the preeclampsia and control group. No significant difference was observed in maternal and umbilical cord serum IL-6 levels between early- and late-onset preeclampsia groups. Conclusion: Our results do not support an increase in IL-6 levels in patients with early- and late-onset preeclampsia. The clinical relevance of our findings needs to be further investigated.

Serum Levels of Interleukin-6 in Patients with Cutaneous Polyarteritis Nodosa

ulcerations. Cutaneous nodules (100.0%) were the most common skin manifestations and were observed in all of our patients with CPN. Forty (88.9%) of the patients with CPN had livedo racemosa, and 33 (73.3%) had purpuric lesions on their lower extremities. Twenty-seven (60.0%) of the patients with CPN were positive for serum CRP, and LAC activity was observed in 27 of them (60.0%). Nineteen (42.2%) of the patients with CPN had elevated serum IL-6 levels and 29 (66.4%) had elevated serum IL-8 levels, while only 4 (8.9%) had elevated serum TNF-α levels. Seven (15.6%) were positive for serum IgG anti-PS/PT antibody, 33 (73.3%) for IgM anti-PS/ PT antibody, and 6 (13.3%) for IgG aCL antibody. DIF studies were performed on skin biopsy samples from 29 of the patients with CPN, and revealed complement 3 expression within affected vessels of the lesions in 21 (72.4%) of them. In addition, 18 (62.1%) of those 29 patients with CPN showed IgM deposition within affected vessels. Thirty-four (75.6%) of the patients with CPN were treated with warfarin, and prednisolone therapy was administered to 27 (60.0%) of them. We divided the 45 patients with CPN into two groups; the elevated IL-6 group and the normal IL-6 group (Table I). The number of men in the elevated IL-6 group was significantly higher than in the normal IL-6 group. Patients with elevated IL-6 had a significantly higher frequency of arthralgia compared with patients without elevated IL-6. Skin ulcerations were also significantly more prevalent among patients with elevated IL-6 compared with patients without elevated IL-6. Elevated IL-6 patients had significantly higher CRP serum levels than normal IL-6 patients. LAC in the elevated IL-6 group was significantly more prevalent than in the normal IL-6 group. Serum IgG anti-PS/PT antibody levels differed significantly between the elevated IL-6 group and the normal IL-6 group. Similarly, serum IgG aCL antibody levels were significantly higher in the elevated IL-6 group compared with the normal IL-6 group. In contrast, IgM anti-PS/PT antibody levels in patients with CPN with elevated IL-6 were significantly lower than in normal IL-6 level patients with CPN. The selected prevalence of prednisolone in the elevated IL-6 group was significantly higher than in the normal IL-6 level group.

Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study

The clinical usefulness of presepsin for discriminating between bacterial and nonbacterial infections (including systemic inflammatory response syndrome) was studied and compared with procalcitonin (PCT) and interleukin-6 (IL-6) in a multicenter prospective study. Suspected sepsis patients (n=207) were enrolled into the study. Presepsin levels in patients with systemic bacterial infection and localized bacterial infection were significantly higher than in those with nonbacterial infections. In addition, presepsin, PCT, and IL-6 levels in patients with bacterial infectious disease were significantly higher than in those with nonbacterial infectious disease (P<0.0001, P<0.0001, and P<0.0001, respectively). The area under the receiver operating characteristic curve was 0.908 for presepsin, 0.905 for PCT, and 0.825 for IL-6 in patients with bacterial infectious disease and those with nonbacterial infectious disease. The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 600pg/ml, of which the clinical sensitivity and specificity were 87.8% and 81.4%, respectively. Presepsin levels did not differ significantly between patients with gram-positive and gram-negative bacterial infections. The sensitivity of blood culture was 35.4%; that for presepsin was 91.9%. Also there were no significant differences in presepsin levels between the blood culture-positive and -negative groups. Consequently, presepsin is useful for the diagnosis of sepsis, and it is superior to conventional markers and blood culture.

Avaliação dos níveis séricos de interleucina-6 e interleucina-10 nos pacientes submetidos à colecistectomia laparoscópica versus convencional

To correlate serum preoperative and postoperative interleukin-6 and interleukin-10 levels in patients undergoing laparotomy versus laparoscopic cholecystectomy. From a total of 20 patients, 18 were included in the study, nine underwent cholecystectomy by laparoscopy and the other nine by laparotomy. Serum concentrations of IL-6 and IL-10 were measured in both groups. Blood samples were obtained in the times of 24 hours preoperatively and four, 12 and 24 hours after the procedure. The groups were compared regarding age, gender, body mass index (BMI), duration of anesthesia and operation. There was no significant statistical differences between groups related to age, gender, BMI, duration of anesthesia and operation. The comparison between the two procedurs demonstrated statistical differences for IL-6 in time 12 hours after operation (218.64 pg/ml laparotomic versus 67.71 pg/ml laparoscopic, p = 0.0003) and for IL-10 in time 24 hours after the procedure (24.46 pg/ml open versus 10.17 pg/qml laparoscopic, p <0.001). There was an Increase in plasma levels of interleukin-6 and 10 after surgical trauma with a significant increase in levels of interleukins in the laparotomic group in comparison with the laparoscopic group.