Marker Of Low-grade Systemic Inflammation Research Articles

Examining systemic inflammation as a pathway linking peer victimization to depressive symptoms in adolescence.

Adolescents exposed to victimization are at an increased risk for a variety of adverse mental health outcomes, including depressive symptoms. Yet, the biological pathways underlying these associations remain poorly understood. Focusing on within-person processes, we examined whether low-grade systemic inflammation mediated the longitudinal associations between peer victimization and depressive symptoms in adolescence. 207 adolescents (at baseline Mage = 12.69 years; SD = 0.49; 43.5% female) participated in a multi-wave longitudinal study, with assessments repeated every 6 months over 1.5 years. At each assessment wave, participants self-reported their peer victimization experiences and depressive symptoms. Dried blood spots were collected at each wave using a finger prick procedure to assay a key marker of low-grade systemic inflammation, interkeukin-6 (IL-6). Data were analyzed using random-intercept cross-lagged panel models. The cross-lagged paths from IL-6 to depressive symptoms were significant across all models and waves (β12 = .13; β23 = .12; β34 = .08), indicating that when adolescents' levels of low-grade systemic inflammation were above their person-specific average, they reported increased levels of depressive symptoms in the subsequent months. However, no significant cross-lagged within-person associations emerged between peer victimization and either IL-6 or depressive symptoms. The findings provide no evidence for the hypothesized mediating role of inflammation in the within-person associations between peer victimization and depressive symptoms. Nevertheless, they extend prior research by indicating that elevated levels of low-grade systemic inflammation predict the development of depressive symptoms in adolescence.

Mediation of the Association Between Vascular Risk Factors and Depressive Symptoms by C-Reactive Protein

BackgroundThis study examined whether C-reactive protein (CRP), a marker of low-grade systemic inflammation, mediates the association between vascular risk factor (VRF) burden and depressive symptoms. MethodsWe drew on the prospective design of the UK Biobank to include participants with longitudinal data on VRF burden, CRP, and depressive symptoms. Total, direct, and indirect effects were estimated using regression-based mediation models while controlling for confounding by sociodemographic factors, baseline CRP, and baseline depression. Sensitivity analyses probed the robustness of results to unmeasured confounding. ResultsWe analyzed data from 10,470 participants from the UK Biobank (mean age = 56.75 years at baseline). Net of covariates, VRFs at baseline were associated with higher depressive symptoms at follow-up (total effect = 0.099; 95% CI, 0.002–0.163). CRP mediated this association (indirect effect = 0.010; 95% CI, 0.004–0.017), accounting for 10.0% (95% CI, 0.3%–30.0%) of the total effect of VRF burden on depressive symptoms. Exploratory analyses suggested that the total and indirect effects pertained to somatic depressive symptoms (tiredness and appetite). ConclusionsThese results suggest that inflammation-promoting effects of VRFs may contribute to depressive symptoms in mid- and later life. However, the mediating pathway via CRP explains only a small part of the association between VRFs and depression after accounting for important covariates and may pertain to specific depressive symptoms. Future studies leveraging similar longitudinal designs are needed to further disentangle the time-varying effects between VRFs, inflammation, and certain depressive symptoms while addressing important confounders.

Serum Cholinesterase Level as a Marker of Systemic Low-Grade Inflammation in Isolated Systolic Hypertension: A Cross-Sectional Study

Background: Autonomic regulation of local and systemic inflammation through the ‘cholinergic anti-inflammatory pathway’ may have role in persistence of low-grade systemic inflammation in isolated systolic hypertension (ISH). The augmented activity of the enzyme cholinesterase (ChE) leads to degradation of the main anti-inflammatory neurotransmitter ‘acetylcholine’ of this pathway. Despite the role of inflammation in hypertension, serum level of cholinesterase enzyme has not been determined till now in ISH. The study aimed to measure the serum levels of inflammatory marker ChE in comparison to high sensitivity C-reactive protein (hsCRP) to predict the presence of low-grade systemic inflammation and their correlation with blood pressure in ISH patients.
 Methods: A cross-sectional study was conducted in ISH patients (n=30; mean age, 51.00±1.24 years; male/female (M/F) number=18/12). Age and sex matched healthy subjects (n=30, mean age, 51.86±1.40 years; M/F=16/14) were taken as control. Subjects were divided into three groups based on hsCRP levels; group I (healthy: hsCRP≤1.0mg/L), group IIa (patients with mild inflammation: hsCRP≤1.0mg/L), group IIb (patients with moderate to severe inflammation: hsCRP 1.0-10.0mg/L). Overnight fasting blood samples were collected and ChE and hsCRP were assessed using Cholinesterase Liqui-Check and hsCRP turbi-latex diagnostic kits, respectively.
 Results: hsCRP and ChE levels were found significantly high in hypertensive patients than in healthy subjects (p<0.05). In patients at mild stage of inflammation, there was an increase in both ChE and hsCRP, but not linearly as they had no significant correlation with each other. But at moderate to severe inflammation stage, there was a linear rise in both hsCRP and ChE levels. SBP, DBP and PP were significantly correlated with both ChE and hsCRP in patients (p<0.01). Moreover, as the SBP was increased from grade I to II, both hsCRP and ChE levels were also increased.
 Conclusion: Many factors interplay in propagating inflammatory cascade in ISH and all biomarkers of inflammation may not elevate at same point in time and in linear manner. ChE may act as a marker of low-grade systemic inflammation but its comparison must be tested against a standard marker such as hsCRP in large scale studies for finding its true significance in predicting cardiovascular disease risk.

Low Serum Paraoxonase-1 Activity Associates with Incident Cardiovascular Disease Risk in Subjects with Concurrently High Levels of High-Density Lipoprotein Cholesterol and C-Reactive Protein.

Paroxonase-1 (PON1) is a key enzyme that inhibits low-density lipoprotein oxidation and consequently atherogenesis. Here, we assessed whether low serum PON1 activity associates with incident cardiovascular disease (CVD) in subjects with high levels of high-density cholesterol (HDL-C) and C-reactive protein (CRP), a marker of low-grade systemic inflammation. Cox proportional-hazards modeling of incident CVD risk (11 years mean follow-up) adjusted for relevant clinical and biomarker covariates was performed on a population-based study (N = 7766) stratified into three groups: low CRP—(LR; event rate 4.9%); low HDL-C/high CRP—(HR1; event rate 14.4%); and high HDL-C/high CRP—(HR2; event rate 7.6%). Modeling results for PON1 activity in HR2 were significant and robust (hazard ratio/SD unit—0.68, 95% CI 0.55–0.83, p = 0.0003), but not so for LR and HR1. Analyses in HR2 of the interaction of PON1 with HDL-C, apoA-I, apoA-II, and apoE levels were significant only for PON1 with apoE (hazard ratio—1.77, 95% CI 1.29–2.41, p = 0.0003). Subsequent subgroup analysis revealed inverse risk dependence for apoE at low PON1 levels. In conclusion, in a population-based study of subjects with concurrently high HDL-C and CRP levels, low serum PON1 activity associates with incident CVD risk with risk accentuated at low apoE levels.

A healthy peer status: Peer preference, not popularity, predicts lower systemic inflammation in adolescence

In adolescence, sensitivity to peers is heightened, which makes peer experiences highly salient. Recent work suggests that these experiences may influence individuals’ immune system functioning. Although there is a need to investigate which types of developmental salient social experiences affect inflammation, no studies have examined the role of peer status in inflammatory activity so far. This study is the first to examine the unique role of different types of peer status (i.e., peer preference and peer popularity) on systemic inflammation in adolescence, and the extent to which this association is moderated by early childhood adversity. Participants were 587 Dutch adolescents from the TRacking Adolescents´ Individual Lives Survey (TRAILS). Data were collected when participants were 11 (SD = .56), 13 (SD = .53) and 16 (SD = .71) years old, respectively. At age 11, early childhood adversity (e.g., hospitalization, death within the family) between 0–5 years was assessed via parent interviews. At age 13, peer preference and peer popularity were assessed with peer nominations of classmates. At age 16, high sensitive C-reactive protein (hsCRP), a marker of low-grade systemic inflammation, was assessed with a venipuncture blood draw. Results showed that adolescents who were rated low on peer preference at age 13 exhibited higher levels of hsCRP at age 16. Importantly, these effects remained after controlling for several covariates, including age, sex, peer victimization, smoking behavior, SES, fat percentage, physical activity and temperament. Additionally, we found a positive effect of peer popularity on hsCRP that depended on early childhood adversity exposure. This suggests that for those adolescents who experienced little early childhood adversity, high levels of peer popularity were associated with high levels of hsCRP. Overall, these findings suggest that it is important to take into account the independent roles of peer preference and peer popularity, as specific types of peer status, to better understand adolescent systemic inflammation.

A Study on Highly Sensitive C-Reactive Protein (Hs-CRP) in Patients with Bronchial Asthma

Background: Asthma is a chronic inflammatory disorder of the airways. Relevance of highly sensitive C-reactive protein (hs-CRP), an acute phase reactant and a sensitive marker of low-grade systemic inflammation in bronchial asthma has not been fully studied.Objectives: Reported studies have found an inverse relationship between lung function and markers of systemic inflammation. The aim of this study was to clarify the relationship between serum level of hs-CRP and bronchial asthma.Materials and method: In this study, hs-CRP was measured in 60 patients with asthma and 40 healthy control subjects. Of all asthmatics, 39 patients had partially controlled and uncontrolled asthma and 21 patients had asthma during exacerbation.Results: Highly sensitive CRP was significantly higher (p<0.000) in asthmatic patients as compared to the control group. In asthmatics with exacerbation, serum hs-CRP was significantly higher than in partially controlled and uncontrolled asthmatic patients (p<0.006) and control subjects (p<0.0001).Conclusion: Serum hs-CRP may be a non specific marker of asthma and its exacerbation.Delta Med Col J. Jan 2018 6(2): 62-67

Systemic inflammation and intelligence in early adulthood and subsequent risk of schizophrenia and other non-affective psychoses: a longitudinal cohort and co-relative study

Schizophrenia is associated with impaired neurodevelopment as indexed by lower premorbid IQ. We examined associations between erythrocyte sedimentation rate (ESR), a marker of low-grade systemic inflammation, IQ, and subsequent schizophrenia and other non-affective psychoses (ONAP) to elucidate the role of neurodevelopment and inflammation in the pathogenesis of psychosis. Population-based data on ESR and IQ from 638 213 Swedish men assessed during military conscription between 1969 and 1983 were linked to National Hospital Discharge Register for hospitalisation with schizophrenia and ONAP. The associations of ESR with IQ (cross-sectional) and psychoses (longitudinal) were investigated using linear and Cox-regression. The co-relative analysis was used to examine effects of shared familial confounding. We examined mediation and moderation of effect between ESR and IQ on psychosis risk. Baseline IQ was associated with subsequent risk of schizophrenia (adjusted HR per 1-point increase in IQ = 0.961; 95% confidence interval (CI) 0.960-0.963) and ONAP (adjusted HR = 0.973; 95% CI 0.971-0.975). Higher ESR was associated with lower IQ in a dose-response fashion. High ESR was associated with increased risk for schizophrenia (adjusted HR = 1.14; 95% CI 1.01-1.28) and decreased risk for ONAP (adjusted HR = 0.85; 95% CI 0.74-0.96), although these effects were specific to one ESR band (7-10 mm/hr). Familial confounding explained ESR-IQ but not ESR-psychoses associations. IQ partly mediated the ESR-psychosis relationships. Lower IQ is associated with low-grade systemic inflammation and with an increased risk of schizophrenia and ONAP in adulthood. Low-grade inflammation may influence schizophrenia risk by affecting neurodevelopment. Future studies should explore the differential effects of inflammation on different types of psychosis.

Cross-Sectional Association Between Number of Teeth and High-Sensitivity C-Reactive Protein Among Middle-Aged Germans.

The association between number of teeth and low-grade systemic inflammation deserves consideration within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam since the association between number of teeth and myocardial infarction has been established. Two subsamples (n = 2,439 and 728) were randomly selected from EPIC-Potsdam. Participants provided information on number of natural teeth, anthropometry, lifestyle factors, and illness-related factors. High-sensitivity C-reactive protein (hsCRP) was measured from serum. Adjusted means of hsCRP across five categories of numbers of teeth in each subsample and in the combined sample were determined, and linear trends were checked. Non-linear associations were investigated with restricted cubic spline (RCS) regression. In the first subsample, the full multivariable-adjusted model showed that participants with 28 to 32, 24 to 27, 18 to 23, 1 to 17, and 0 teeth had mean hsCRP values of 1.32, 1.39, 1.54, 1.38, and 1.48 mg/L, respectively; in the second subsample, mean hsCRP values were 1.64, 1.67, 1.73, 1.47, and 1.87 mg/L; combined hsCRP values were 1.49, 1.53, 1.64, 1.44, and 1.65 mg/L. No linear trend was observed in these models, and RCS regression showed no non-linear association. This study shows that number of teeth has a weak association with hsCRP, if any, thereby excluding this marker of low-grade systemic inflammation as a possible explanation for the association between number of teeth and myocardial infarction.

Positive association between high‐sensitivity C‐reactive protein and incidence of type 2 diabetes mellitus in Japanese workers: 6‐year follow‐up

Elevated high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, may be involved in the etiology of type 2 diabetes mellitus (T2DM). However, whether inflammation precedes development of T2DM independent of cigarette smoking and obesity remains to be confirmed. We studied 4213 civil servants in a local government in Japan aged 35-66 years at baseline in 2002, who donated blood samples and were followed 6 years. Hazard ratios (HR) of T2DM according to the hs-CRP quartiles [range Q1: 0.02-0.18 (reference), Q2: 0.18-0.33, Q3: 0.33-0.67 and Q4: 0.67-9.62 mg/L) were estimated by Cox proportional hazards model adjusted for gender, age, body mass index, alcohol intake, smoking status (current, past and never), number of cigarettes per day, physical activity, family history of diabetes (Model 1) and variables in Model 1 + glucose (Model 2). The geometric mean [95% confidence interval (CI)] of hs-CRP was 0.36 mg/L (0.34-0.37). During the follow-up, 156 new T2DM cases were confirmed. In total sample, Model 2 HRs (95% CIs) for hs-CRP quartiles Q2-Q4 compared with Q1 were 0.69 (0.36-1.26), 1.47 (0.91-2.39) and 1.78 (1.10-2.88), respectively (p for linear trend = 0.014). Stratified analysis revealed that a statistically significant association was observed only in normal weight non-current smokers with Model 2 HRs (CIs) being 0.79 (0.29-2.17), 2.63 (1.25-5.56) and 3.19 (1.49-6.86) for Q2-Q4 compared with Q1, respectively (p for linear trend = 0.0006). The relationship did not change materially after further adjusting for log-homeostasis model assessment or exclusion of past smokers. These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.

Molecular Interaction Study of N1-p-fluorobenzyl-cymserine with TNF-α , p38 Kinase and JNK Kinase

Alzheimer's disease (AD) is an age-related neurodegenerative disease distinguished by progressive memory loss and cognitive decline. It is accompanied by classical neuropathological changes, including cerebral deposits of amyloid- beta peptide (Aβ) containing senile plaques, neurofibrillary tangles (NFTs) of phosphorylated tau (p-tau), and clusters of activated glial cells. Postmortem studies strongly support a critical role for neuroinflammation in the pathogenesis of AD, with activated microglia and reactive astrocytes surrounding senile plaques and NFTs. These are accompanied by an elevated expression of inflammatory mediators that further drives Aβ and p-tau generation. Although epidemiological and experimental studies suggested that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) may lessen AD risk by mitigating inflammatory responses, primary NSAID treatment trials of AD have not proved successful. Elevated systemic butyrylcholinesterase (BuChE) levels have been considered a marker of low-grade systemic inflammation, and BuChE levels are reported elevated in AD brain. Recent research indicates that selective brain inhibition of BuChE elevates acetylcholine (ACh) and augments cognition in rodents free of the characteristic undesirable actions of acetylcholinesterase- inhibitors (AChE-Is). Hence, centrally active BuChE-selective-inhibitors, cymserine analogs, have been developed to test the hypothesis that BuChE-Is would be efficacious and better tolerated than AChE-Is in AD. The focus of the current study was to undertake an in-silico evaluation of an agent to assess its potential to halt the self-propagating interaction between inflammation,Aβ and p-tau generation. Molecular docking studies were performed between the novel BuChE-I, N1-p-fluorobenzyl-cymserine (FBC) and inflammatory targets to evaluate the potential of FBC as an inhibitor of p38, JNK kinases and TNF-α with respect to putative binding free energy and IC50 values. Our in-silico studies support the ability of FBC to bind these targets in a manner supportive of anti-inflammatory action that is subject to molecular dynamics and physiochemical studies for auxiliary confirmation.

High‐sensitivity C reactive protein as a biomarker for grading of childhood asthma in relation to clinical classification, induced sputum cellularity, and spirometry

Asthma is the most common chronic inflammatory disease in childhood and some reports have demonstrated systemic inflammation. The relevance of high-sensitivity assays for C-reactive protein (hs-CRP), which are known to be a sensitive marker of low-grade systemic inflammation, has not been fully studied in childhood asthma. This cross sectional case-control study aimed at evaluating serum hs-CRP in asthmatic children with different grades of severity and control. Serum hs-CRP, sputum cytology study, and forced expiratory volume in 1 sec (FEV1) % of predicted for age and sex were estimated in 60 asthmatic children (30 uncontrolled steroid-naïve, and 30 controlled on inhaled steroid). They were recruited from Pediatric Chest Clinic, Children's Hospital, Ain Shams University. Sixty healthy children-age and sex-matched were included as a control group. Serum hs-CRP concentrations were significantly higher in asthmatics than in controls with a median of 1.93 mg/L and 0.24 mg/L, respectively. Serum hs-CRP levels were significantly higher in uncontrolled steroid-naïve asthmatics than those controlled on inhaled steroid with a median of 3.15 mg/L and 1.55 mg/L, respectively. Serum hs-CRP showed a sensitivity of 72% and a specificity of 93%. Despite that pulmonary function tests and clinical classification are the gold standard for grading of asthma, hs-CRP can be considered as a new marker for assessment of different grades of asthma severity and control. It can be used for indirect detection and monitoring of airway inflammation, disease severity, and response to steroid treatment in asthmatic children.

Proteins of the Esterase Family: Patents for Some Proteins in Search of Metabolic Functions

Butyrylcholinesterase (BChE) and acetylcholinesterase belong to the esterase family. They have roles in neurotransmission and in metabolizing drugs and toxins. Sharing similar biochemical and structural properties, they have overlapping functions. Patents obtained on these enzymes relate to the sequence of genes coding for the proteins, as well as methodological issues about screening of individuals who are susceptible to anticholinesterase drugs. Newer methods were described for production of large quantities of the protein that could be used in cocaine toxicity and overdose. The proteins were produced both in transgenic animals and in plant sources. In animals, they are excreted in milk and in urine. In view of their pathogenic roles in neurodegenerative diseases, methods were developed to identify Alzheimer's disease and to treat the fibril related diseases using antisense compounds related to the group of proteins. Lastly BChE was proposed to be a marker of low-grade systemic inflammation. In summary, for proteins with so few definitely known functions, there has been extensive work to utilize it in diagnosis and treatment. Some important patents on cholinesterases have been summarized in this review.

Abstract 2791: Blood C-reactive protein levels and colon cancer risk

Abstract Background: Circulating C-reactive protein (CRP), a sensitive marker of low-grade systemic inflammation, has been associated with an increased risk of colon cancer in some but not all studies. Few studies have evaluated the association by the time interval between blood collection and cancer diagnosis. Objective: To prospectively evaluate the association between blood CRP levels and colon cancer risk, as well as the potential effect of time window of CRP measures on the association. Design: A nested case-control study of 209 cases of colon cancer and 279 controls identified from the Shanghai Women's Health Study with up to 10 years of follow-up. Conditional logistic regression was used to estimate odds ratios (OR) of developing colon cancer and their 95% confidence intervals (CI) associated with blood CRP levels. Results: Blood CRP levels were positively associated with colon cancer risk (P trend = 0.003). Women in the highest quartile of CRP had an adjusted OR of 2.52 (95% CI: 1.36 − 4.70) compared with women in the lowest quartile. The risk was higher for women whose CRP was measured in blood collected ≤5 years prior to diagnosis (OR for the highest quartile of CRP = 3.67; 95% CI: 1.41 − 9.56; P for trend = 0.006), compared to women with samples collected >5 years before diagnosis (corresponding OR = 1.98; 95% CI: 0.83 − 4.74; P for trend = 0.15). Conclusion: Our findings support the hypothesis that low-grade systemic inflammation is associated with an increased risk of colon cancer. Cancer-induced inflammation may partly explain the observed association. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2791.

Metabolic syndrome and its association with white blood cell count in children and adolescents in Korea: The 2005 Korean National Health and Nutrition Examination Survey

Background and aims To estimate the prevalence of metabolic syndrome (MS) and determine its association with white blood cell (WBC) count as a marker of low-grade systemic inflammation in children and adolescents in Korea. Methods and results We investigated the prevalence of MS and its association with WBC count in 928 children and adolescents. MS was defined as having 3 or more conditions based on the modified criteria of the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III). The odds ratios (ORs) for MS were also calculated using multivariate logistic regression analysis across WBC count quartiles (Q1, <5200; Q2, 5200–6100; Q3, 6200–7200; and Q4, ≥7300 cells/μL for boys; Q1, <5200; Q2, 5200–6000; Q3, 6100–7000; and Q4, ≥7100 cells/μL for girls). The prevalence of MS in children and adolescents in Korea was 6.7% (8.5% in boys, 4.5% in girls, P < 0.001). MS was more prevalent in overweight and obese children and adolescents in both boys and girls. The mean WBC counts continuously increased with each additional component of MS in both boys and girls. The ORs (95% CIs) for MS in each WBC quartile were 1.00, 1.56 (0.43–5.67), 4.47 (1.42–14.07), and 5.25 (1.71–16.07) in boys and 1.00, 1.05 (0.15–7.61), 2.89 (0.55–15.17), and 7.47 (1.61–36.67) in girls after adjusting for age, household income, and residential area. Conclusion In summary, this study shows that a substantial number of children and adolescents in Korea have MS, and elevated WBC count may be a surrogate marker for MS.

Elevated C-reactive protein levels and metabolic syndrome in the elderly: The role of central obesity: Data from the InChianti study

Metabolic syndrome (MS) and “low grade” systemic inflammation (LGSI) are very common findings in the older population. Although MS and LGSI have been associated in adults, it is not known what is the real contribution of MS, and its single components, to LGSI in older persons, due to the potential confounding effect of comorbidity and aging. We investigated the relationship between increased C-reactive protein (CRP) plasma levels, a marker of LGSI, and MS in 1044 older (≥65 years) community dwelling Italian individuals enrolled the InChianti study. Metabolic syndrome was defined by the NCEP-ATP III-AHA/NHLBI criteria. High sensitivity CRP (hs.CRP) levels were measured by enzyme-linked immunosorbent assay, and defined as high when >3 mg/L. The overall prevalence of MS was 31%. The prevalence of high hs.CRP was 54.5% in subjects with, and 41.3% in those without MS ( p < 0.001). MS was associated with high hs.CRP levels after adjustment for age, gender, and comorbidity (OR: 1.93, 95% CI: 1.46–2.55). Compared to subjects with MS and no LGSI, individuals with MS and LGSI were characterized by higher waist circumference, BMI, and HOMA score. Multivariate logistic regression analysis confirmed the association between waist circumference and high hs.CRP levels in subjects with MS (waist circumference III vs. I tertile OR: 2.60, 95% CI: 1.79–3.77) independent of age, gender, and important confounding variables including comorbidity. Additional analyses, conducted with and without dichotomization of hs.CRP levels, confirmed the central role of waist circumference in the LGSI phenomenon, independent of gender and diagnosis of MS. We conclude that in older individuals, MS is associated with LGSI, but the association is mainly supported by a strong independent correlation between waist circumference and high hs.CRP levels. In the absence of this specific MS component, it seems that the contribution of MS to LGSI would be modest at best.

Training Improves Physical Fitness and Decreases CRP Also in Asthmatic Conscripts

To study the respiratory and physical health of young men, 224 asthmatic and 668 non-asthmatic military conscripts were recruited from the intake groups of July 2004 and January 2005 in Kajaani, Finland. Factors affecting respiratory health were elicited by a questionnaire at the beginning of the service, and results of high sensitive C-reactive protein (hsCRP) determination, peak expiratory flow (PEF), and 12-minute running test were collected at the beginning and the end of the service. Respiratory infections were diagnosed by a study physician. Upon entering military service, asthmatics had frequent exercise- and cold-related asthma symptoms (69.6% and 76.3%), and 48% of them had no medication for asthma. At the beginning, 25.8% of asthmatics and 19.1% of non-asthmatics had a poor result of less than 2,200 m (p = 0.05) in the 12-minute running test, and after 180 to 362 days of service, the corresponding percentages were 11.7% and 9.7% (p = 0.434). The levels of hsCRP, a marker of low-grade systemic inflammation, decreased significantly among both asthmatics, 1.5 (p = 0.001), and non-asthmatics, 1.6 mg/L (p < 0.001). Asthmatic men had 0.2 and non-asthmatics 0.1 respiratory infections per month (p < 0.001). In summary, asthmatic conscripts can enhance their physical fitness by training similarly to non-asthmatic ones. Their levels of hsCRP also decrease.

High sensitivity C-reactive protein in asthma

Asthma is characterised by chronic inflammation of the airways, but the relevance of high-sensitivity assays for C-reactive protein (hs-CRP), which are known to be a sensitive marker of low-grade systemic inflammation, has not been fully studied in asthma. The objective was to examine serum hs-CRP levels in patients with asthma and their relationship to clinical characteristics and degree of airway inflammation. Serum hs-CRP levels were cross-sectionally examined in steroid-naive (n = 22) and steroid-inhaling (n = 23) adult patients with asthma and healthy controls (n = 14). All were nonsmokers. Serum hs-CRP levels were significantly increased in steroid-naive patients (mean+/-sd 1.33+/-1.48 mg.L(-1)) compared with controls (0.21+/-0.30 mg.L(-1)), but not in patients on inhaled corticosteroid. Among steroid-naive patients, serum hs-CRP levels significantly negatively correlated with indices of pulmonary function (forced expiratory volume in one second/forced vital capacity and forced mid-expiratory flow) and positively with sputum eosinophil count. Among patients on inhaled corticosteroid, hs-CRP levels did not correlate with any indices. In conclusion, an increase in serum C-reactive protein levels measured by high-sensitivity assays may be associated with airflow obstruction and airway inflammation, and may serve as a surrogate marker of airway inflammation in asthma.

Chlamydia pneumoniae Infection and Inflammation in Adults with Asthma

Background:Chlamydia pneumoniae infection and immune response to the C. pneumoniae heat shock protein 60 (CpHsp60) have been suggested to be associated with asthma. Objectives: To study whether a slightly elevated C-reactive protein (CRP) level as a marker of low-grade systemic inflammation has a role in this association, we collected serum and sputum samples from 103 asthma patients with disease severity ranging from mild to moderate and from 30 healthy volunteers. Methods: IgA and IgG antibodies to C. pneumoniae elementary bodies (CpEB) and CpHsp60 were measured by enzyme immunoassay. Serum CRP levels were measured with a rapid two-site ultra-sensitive assay based on time-resolved immunofluorometry. Results: The asthma patients, especially those with moderate asthma, had higher serum IgA antibody levels to CpHsp60 than the healthy controls (test for trend, p = 0.05), whereas antibody levels to CpEB antigen did not differ between the study groups. CRP levels were higher in both asthma groups compared to the control group and moreover, the patients with moderate asthma had higher CRP levels than those with mild asthma (test for trend, p < 0.01). The subjects with a slightly elevated CRP level, defined as ≧1.8 mg/l, had higher CpEB IgA (p = 0.001), CpEB IgG (p = 0.008) and CpHsp60 IgA (p = 0.023) antibody levels in serum compared to the subjects with lower CRP levels. Conclusions: Slightly elevated CRP levels as a marker of low-grade systemic inflammation may be associated with C. pneumoniae infection in asthma patients.