Non-specific Marker Of Inflammation Research Articles

Supplementary management of symptomatic hand osteoarthritis with Pycnogenol®.

The aim of this 4-week pilot registry, supplement study was to assess the effects of Pycnogenol® compared to a standard management on hand osteoarthritis associated with pain. As Pycnogenol® decreases inflammation and pain, chronic use of drugs, causing side effects may be reduced. The registry patients included suffered finger pain associated with hand osteoarthritis All subjects used a standard management (SM). A supplementary group additionally used 150 mg Pycnogenol® per day. In addition, a retrospective group with 40 comparable subjects using oral diclofenac was used for comparison. Forty-two subjects with hand osteoarthritis completed the study. The registry patients were former sport professionals, fishermen and subjects working with their hands in a common manual activity. 22 subjects took Pycnogenol® in addition to standard management and 20 subjects followed the standard management only and served as controls. The two groups were comparable at inclusion. No subject had to stop supplementation or the SM. No side effects were observed. After 4 weeks, spontaneous pain in the morning and pain after work were significantly reduced with Pycnogenol® supplementation compared to controls (P<0.05). Residual pain at rest in the evening was significantly improved after 4 weeks with the supplement compared to controls (P<0.05). The number of subjects requiring pain medication during the 4-week study period was significantly lower in the supplement group (2/22) compared to controls (8/20) (P<0.05). Hand dynamometry results show significant improvement in hand-finger strength (due to decreased pain and stiffness) with the supplement compared to controls (P<0.05). At inclusion, all subjects presented hyperthermic joints, 2°C higher than the surrounding tissues as shown by thermography. After 4 weeks, the number of subjects with hyperthermic joints was lower in the Pycnogenol® group than in controls (P<0.05). Both nonspecific markers of inflammation (ESR and C-reactive protein levels in blood) were significantly lower after 4 weeks in the Pycnogenol® group than in controls (P<0.05). Other routine blood tests were normal at inclusion and at the end of the study. Within 4 weeks, plasma oxidative stress decreased by 14.4% (P<0.05) in the Pycnogenol® group vs 5.5% in the control group. The retrospective comparison with a group of 40 comparable subjects using oral diclofenac showed that after 4 weeks, the efficacy of Pycnogenol® on improving pain in the morning, after work and in the evening, on hand-finger strength and on decreasing C-reactive protein was significantly higher (P<0.05) than in the diclofenac group (comparable, non-parallel group, CNPG). In conclusion, supplementation with Pycnogenol® was well tolerated and effectively controlled pain while improving grip strength in patients with hand osteoarthritis. All supplement subjects showed an improved operativity.

Non-specific markers of inflammation in bare-nosed wombats (Vombatus ursinus) with sarcoptic mange.

Sarcoptic mange, caused by epidermal infection with Sarcoptes scabiei, negatively impacts the health, welfare, and local abundance of bare-nosed wombats (Vombatus ursinus) in Australia. Improved understanding of the host immune response to disease and its contribution to pathophysiology could be used to inform management actions for this species in and ex situ. To evaluate the immune response of bare-nosed wombats to sarcoptic mange, we validated three assays (haptoglobin, agarose gel electrophoresis, and micro-erythrocyte sedimentation rate) measuring non-specific markers of inflammation using serum samples from free-living wombats from Tasmania (n = 33). We then analysed correlations between the assay results for each non-specific marker of inflammation and wombat's sarcoptic mange scores, and performed histopathological examinations to investigate association of the acute phase response with systemic amyloidosis. We present evidence that haptoglobin and erythrocyte sedimentation rate increased, and albumin decreased, in association with sarcoptic mange scores. This research demonstrates links between the acute phase response and sarcoptic mange severity in bare-nosed wombats, highlighting the utility of non-specific markers of inflammation for aiding assessment of the systemic effects of mange. Showing the value of agarose gel electrophoresis, we also identified specific acute phase proteins warranting future evaluation and found evidence of an immunoglobulin response in mange-affected wombats, revealed by increasing γ-globulins in association with apparent disease severity. Meanwhile, owing to its relatively low resource requirements and rapidity, the erythrocyte sedimentation rate assay may be useful as a point-of-care test to support therapeutic decisions in the field. Our methods and findings are likely to be applicable to a range of other clinical and population health scenarios in captive and free-living wombats, and species impacted by sarcoptic mange globally.

Efficacy of the Coordinative compound of Aluminium and N-(2,3-dimethylphenyl)-anthranilic (mefenamic) acid on the Model of Chronic Alcohol-Induced Pancreatitis

The aim of the study is to determine the efficacy of the innovative coordinative compound of aluminium and N-(2,3-dimethylphenyl)-anthranilic (mefenamic) acid (CCAA, possessing hepatoprotective and antioxidative activity) on the model of chronic alcohol-induced pancreatitis in rats (Lieber–DeCarli isocaloric alcohol liquid diet for 10 weeks + LPS administration once a week for the three last weeks, 3 mg/kg intravenously). CCA was administered for 21 days at doses of 30, 60, and 120 mg/kg intragastrically. Leucocyte content in the peripheral blood and erythrocyte sedimentation rate, basal glycemia, total lipids level, α-amylase and pancreatic elastase activity in blood serum and the duodenal contents as well as histological structure of the pancreas were evaluated. In the blood serum and the homogenate of the pancreas, glutathione content, superoxide dismutase (SOD), catalase, glutathione reductase, glutathione-S-transferase, and glutathione peroxidase activities were measured. The dose-dependent normalizing effect of CCAA was registered by the influence on the non-specific inflammatory markers, pancreatic exocrine function, and cytoarchitectonics of the pancreas (the highest efficacy – at a dose of 120 mg/kg). The normalizing influence on the prooxidant-antioxidant balance markers was not dose-dependent with an especially significant normalizing influence on SOD activity. The results substantiate expanding indications for the of the studied drug.

Results of a monocentric field study: value of histology compared to sonication method and conventional tissue culture in the diagnosis of periprosthetic joint infection (PJI).

To confirm the diagnosis of periprosthetic joint infection (PJI), the Infectious Diseases Society of America (IDSA) and the International Consensus Meeting (ICM) have defined criteria that include histology as a minor criterion and the sonication method only as an additional criterion. The aim of this monocentric, retrospective study was to investigate the value of histology and whether sonication leads to a more accurate diagnosis. All revision surgeries for knee and hip arthroplasty between 2017 and 2020 were included. With regard to microbiological diagnostic, conventional culture of periprosthetic biopsies and sonication of explant material were performed. In addition, histology and non-specific inflammatory markers (CRP, leukocytes) were recorded. A total of 78 patients with PJI and 62 aseptic controls were included. From both microbiological methods (conventional culture / sonication), Staphyloccus (S.) epidermidis and S. aureus were detected most frequently. However, compared to the conventional microbiology, a higher sensitivity was calculated for sonication, albeit with a lower specificity in relation to a PJI. In two logistic regression models for the significance of all diagnostic parameters in PJI, the AUC was 0.92 and 0.96 with histology in particular making the decisive contribution in both models (p < 0. 001, both models). Since histology showed the highest accuracy in the current study, its importance in the PJI criteria should be reevaluated. Sonication shows a high sensitivity for germ detection with a lower specificity and should only be used in combination with the conventional culture for microbiolgical diagnostics.

Characteristics Of Pathogenetic Links In Vascular Remodeling And Bone Tissue Destruction In Postmenopausal Women With Arterial Hypertension

Background — Much attention is drawn to the role of the nonspecific immune inflammatory vascular response as a link of general pathogenetic mechanisms with changes in the elastic properties of arteries and the phenomena of destructive changes in bones. Objective — We aimed to study the role of nonspecific immune inflammatory markers, parathyroid hormone and female sex hormones as predictors of cardiovascular and degenerative bone changes in postmenopausal women with arterial hypertension (AH) and osteoporosis (OP). Methods — We examined 104 patients (mean age: 54.03±9.56 years) distributed among three groups: healthy women, females with AH and osteopenia, and women with AH and OP. The markers of immune inflammatory response, endothelial dysfunction, hormonal, mineral, and vitamin statuses were analyzed simultaneously with 24-hour ambulatory monitoring of blood pressure, and parameters of vascular wall stiffness and densitometry to elucidate the predictors of cardiovascular and degenerative bone changes in postmenopausal women. Results — For patients with AH and osteopenia, a significant parameter associated with the risk of OP was pulse wave velocity (PWV); its increase exceeding 12.05 m/s was associated with a 3.8-fold increase in the risk of OP. Levels of proinflammatory indicators, interleukins IL-6 and IL-8, tumor necrosis factor-α, high-sensitivity C-reactive protein, and parathyroid hormone were elevated, while levels of progesterone and IL-10 were decreased. Conclusion — Timely specialized multidirectional research of biochemical and instrumental parameters (PWV and densitometry) could become the basis for the development of a personalized strategy for the prevention and treatment of women in order to avoid dangerous cardiovascular and bone complications.

Neutrophil to Lymphocyte Ratio in Patients with Major Depressive Disorder

Introduction: Depression is common mood disorder that is linked to systemic inflammation. The neutrophil-lymphocyte ratio (NLR) is a non-specific inflammatory marker that is inexpensive and easy to measure. Low-grade inflammation occurs in a subgroup of patients with Major Depressive disorder (MDD). Objective: To examine the role of inflammation in the etiology of depression based on the NLR in MDD patients who are undergoing no pharmacological therapy. Methods: This observational study was carried out in the Department of Psychiatry of Jahurul Islam Medical College Hospital (JIMCH), Bajitpur, Kishoregonj between December 2013 and May 2014. Subjects between the ages of 18 and 65 were included in the study that involved 61 subjects with diagnosed MDD, who received no pharmacological therapy of depression within the past 01 month were included in the study, while the control group included 67 healthy subjects with having no psychiatric disease. A sociodemographic information form and a Beck Depression Scale were administered, and the blood was taken for biochemical analysis and complete blood parameters were evaluated in the hematology laboratory of JIMCH. All data were expressed as mean±SD. For statistical analysis, Chi-square test (χ2) was used to compare categorical variables, frequencies, and ratios. An independent sample ‘t’ test was used to compare normally distributed variables between two groups. Results: In the present study, we found Significance difference in the NLR, neutrophil count, lymphocyte percentage and leukocyte values of the patient group when compared with control group (P&lt;0.05). Conclusion: The study reveals that NLR tends to be higher in patients with MDD, and a high NLR value supports the view that inflammation is a critical factor in the etiology of MDD. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 72-75

Whole Blood Reactivity to Viral and Bacterial Pathogens after Non-Emergent Cardiac Surgery during the Acute and Convalescence Periods Demonstrates a Distinctive Profile of Cytokines Production Compared to the Preoperative Baseline in Cohort of 108 Patients, Suggesting Immunological Reprogramming during the 28 Days Traditionally Recognized as the Post-Surgical Recovery Period.

The release of danger signals from tissues in response to trauma during cardiac surgery creates conditions to reprogram the immune system to subsequent challenges posed by pathogens in the postoperative period. To demonstrate this, we tested immunoreactivity before surgery as the baseline (tbaseline), followed by subsequent challenges during the acute phase (t24h), convalescence (t7d), and long-term recovery (t3m). For 108 patients undergoing elective heart surgery, whole blood was stimulated with lipopolysaccharide (LPS), Influenza A virus subtype N2 (H3N2), or the Flublok™ vaccine to represent common pathogenic challenges. Leukocytosis, platelet count, and serum C-reactive protein (CRP) were used to measure non-specific inflammation. Cytokines were measured after 18 h of stimulation to reflect activation of the various cell types (activated neutrophils-IL-8; activated T cells-IL-2, IFNγ, activated monocyte (MO)-TNFα, IL-6, and deactivated or atypically activated MO and/or T cells-M-CSF, IL-10). IL-2 and IL-10 were increased at t7d, while TNFα was suppressed at t24h when LPS was utilized. Interestingly, M-CSF and IL-6 production was elevated at seven days in response to all stimuli compared to baseline. While some non-specific markers of inflammation (white cell count, IL-6, and IL-8) returned to presurgical levels at t3m, CRP and platelet counts remained elevated. We showed that surgical stimulus reprograms leukocyte response to LPS with only partial restoration of non-specific markers of inflammation.

Comparative evaluation of efficiency of burn wound healing with derma-based hydrogel: a preclinical experimental study

Background. Burn wound healing is recognized as a complex process involving synergetic interactions between different cells, cytokines and growth factors. The adverse interactions can underlie chronicization of the process. Accordingly, the paper presents a relevant study into mechanisms of natural wound dressings, capable of influencing the processes of inflammation, angiogenesis, and skin resurfacing.Objective. To carry out a comparative evaluation of efficiency of burn wound healing with derma-based hydrogel according to the dynamics of proand anti-inflammatory factors.Methods. Development of a hydrogel material involved dermis samples of Landrace breed of pig, subjected to partial alkaline hydrolysis. In order to carry out a comparative evaluation of burn wound healing efficiency, the authors simulated direct thermal injury in three groups of sphinx (hairless) rats: group 1 (control group) — rats without treatment (n = 20), group 2 (comparison group) — rats treated with Levomekol ointment (n = 20), and group 3 (experimental group) — rats treated with hydrogel material (n = 20). Before and after injuring on days 1, 3, 7, 14, the content of cytokines interleukin-1β, interleukin-4, interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor-α by enzyme immunoassay. The wound samples were explanted for histological examination on days 3, 7 and 14 after the beginning of the experiment. Statistical processing of the obtained results on DNA content in hydrogel, cytokine content in serum and morphometric data was performed using GraphPadPrism 6.04, Microsoft Excel 2016 (Microsoft, USA).Results. When determining the content dynamics of nonspecific markers of inflammation, an increase in the concentrations of interleukin-1β and tumor necrosis factor-α on day 1 after the hydrogel application was recorded, as well as an increase in interleukin-6 on days 3 and 7, while the concentrations of interleukin-8 did not change significantly throughout the experiment. Thus, dermal components are indicated to participate in the inhibition of acute-phase immune reactions. With regard to anti-inflammatory factors, the study revealed a decrease in the concentration of interleukin-10 on days 1 and 7, an increase in interleukin-4 on day 3 as compared to the control group, thereby indicating a pronounced anti-inflammatory effect and prolonged action of the hydrogel.Conclusion. Comparative analysis of the pro-inflammatory cytokines levels (interleukin-1β, interleukin-8) showed pronounced anti-inflammatory effects of the derma-based hydrogel material. Introduction of exogenous biological components of the extracellular matrix (collagen and its hydrolysates) had a significant influence on the regulation of anti-inflammatory cytokines synthesis, presumably contributing to faster successful epithelization and wound healing.

New Inflammatory Marker Associated with Disease Activity in Gouty Arthritis: The Systemic Inflammatory Response Index.

The systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI), as novel non-specific inflammatory markers, have recently drawn attention. At present, no studies have been conducted to investigate the value of SII and SIRI in gouty arthritis (GA), so we explored their possible association with GA disease activity. The study enrolled 474 patients with acute gouty arthritis (AG), 399 patients with intercritical gouty arthritis (IG) and 194 healthy controls (HC). The differences in Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, and SIRI levels among different groups were assessed. The changes in the above indicators before and after treatment in the AG and IG groups were evaluated. Multivariate logistic regression analysis was assessed influencing factors for the acute gout attack. ROC curves were plotted to evaluate their diagnostic value for AG. Compared with the IG group, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PLR, and incidence of hyperlipidemia in the AG group were significantly higher, and the duration of disease was significantly shorter (P < 0.05). The MLR, NLR, SII and SIRI in the AG group were significantly higher than those in the IG and HC groups (P < 0.05). Compared with baseline, decreased MLR, NLR, PLR, SII and SIRI were observed in the AG group after treatment (P < 0.05), while there was no significant difference in the IG group before and after treatment (P > 0.05). SIRI was positively correlated with ESR and CRP (P < 0.05). Multivariate logistic regression analysis result showed that duration of disease, hyperlipidemia, ESR, CRP, and SIRI were influencing factors of acute gout attack (P < 0.05). The AUC of ESR, CRP and SIRI on the diagnosis in AG were 0.664, 0.755, and 0.674, respectively. SIRI may be used as a new inflammatory marker of disease activity with gouty arthritis.

A-087 Relationship among Different Inflammatory Markers in Patients with COVID-19 Infections

Abstract Introduction Acute phase reactants (APRs) are inflammation biomarkers that exhibit significant changes in their serum concentrations due to infectious and noninfectious conditions. APRs such as C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, Lactate dehydrogenase (LDH); coagulation biomarkers such as D-dimer, Fibrinogen; cardiac biomarkers such as Creatine kinase-MB (CK-MB), and hematological biomarkers such as Neutrophil to Lymphocyte ratio (NLR) have been used extensively during the COVID-19 pandemic for early diagnosis, monitoring of response to treatment and prognostication. Amongst these, CRP, although a non-specific marker of inflammation has been widely used in COVID-19 patients. Objectives In this study, we tried to evaluate the relationship of the other markers like IL-6, Ferritin, LDH, D-dimer, Fibrinogen, CK-MB and NLR with CRP levels in COVID-19 patients. Methods This cross-sectional study was carried out in a tertiary care hospital, New Delhi India, July 2020 to Dec 2020. Total 282 adults, confirmed COVID positive by RT-PCR were included in the study. The investigations were performed on day 0 or day 1 of COVID positivity. Correlation of CRP with other markers was studied by regression analysis using Minitab ver.17. Results Among the 282 patients, gender distribution was 190 males to 92 females with an average age of 52.5 ± 15.1 years. All the markers were observed to have non-parametric distribution. CRP was raised in 92.5% cases (n = 239), IL-6 in 83.2% (n = 279), Ferritin in 66.8% (n = 238), LDH in 99.1% (n = 233), D-dimer in 96.6% (n = 30), Fibrinogen in 68.4% (n = 19), CK-MB in 84.6% (n = 98) and NLR of more than 4 in 82.8% (n = 280). The median and range for the different markers were as follows: CRP (44.8 U/L; 15.6–736), IL-6 (67.3 pg/mL; 0.8–1624), LDH (608.0 U/L; 161–6705), Ferritin (643.5 ng/mL; 7.9–11 932), D-dimer (7 µg/mL; 0–5250), NLR (9.43; 0.05–157.17); Fibrinogen (475 mg/dL; 285–759) CK-MB (9.9 mg/L; 0.1–46.7) respectively. Significant correlation was not observed between CRP and any of the inflammatory markers. Conclusion Inflammatory markers are raised in most patients with COVID-19, however, all markers are not raised in all patients. Sequential evaluation of these markers may be beneficial rather than at one time point.

Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic

Aim. To determine additional factors and sex differences associated with the intermediate probability of heart failure (HF) with preserved ejection fraction (HFpEF) in asymptomatic patients working in the Arctic on a rotating basis.Material and methods. In the polar village of Yamburg (68° 21' 40 "N), 99 men and 81 women with grade 1 and 2 hypertension (HTN) and normal blood pressure, comparable by age (p=0,450), length of service in the north (p=0,956), office systolic blood pressure (BP) (p=0,251), diastolic BP (p=0,579) were simultaneously examined. We performed echocardiography and assessed the risk of HFpEF by H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure). A treadmill test, Baevsky index, 24-hour BP monitoring, and biochemical blood tests were performed.Results. Depending on H2FPEF score, participants were divided into groups: from 0 to 1 (group 1 — normal), from 2 to 5 (group 2 — intermediate probability of HFpEF). In men with intermediate probability of HFpEF, the Baevsky index (p=0,0048) and the incidence of resting body reserve dysaptation (p=0,0394) were higher, as well as a rapid BP increase during dosed exercise (p=0,0058) and a decrease in chronotropic reserve (p&lt;0,0001) were noted. The presence of HTN in men increased the intermediate probability of HFpEF by 3,6 times, dyspnea at dosed exercise by 10 times, dysaptation to exercise by 5 times, the presence of left ventricular concentric remodeling by 8-10 times. In females with intermediate probability of HFpEF, dysaptation to exercise at rest (p=0,0120) and lower level of oxygen consumption during dosed exercise was more often determined (p=0,0485). The intermediate probability of HFpEF in women increased with autonomic nervous system dysfunction, an increase in the mean 24-hour systolic BP variability, the presence of dyspnea during dosed exercise (10 times), concentric left ventricular remodeling, and an increase in nonspecific inflammation markers (high-sensitivity C-reactive protein, IL-1β, IL-6).Conclusion. Early identification of additional risk factors for intermediate probability of HFpEF in asymptomatic hypertensive patients has the potential to reduce the risk of subsequent clinical heart failure, allowing focus on prevention and intervention strategies in this group of patients.

Exploration for the reference interval of C-reactive protein in the Chinese longevity people over 90 years of age

BackgroundOlder individuals tend to develop chronic inflammation. As a commonly used nonspecific inflammatory marker, C-reactive protein (CRP) can predict metabolic syndrome, cardiovascular diseases, etc. However, little is known about CRP levels in longevity people. ObjectivesInvestigate the distribution and correlates of CRP and provide a reference for the establishment of normal interval values in Chinese longevity people over 90 years of age. MethodsWe performed a correlation analysis to evaluate the correlation between CRP levels and longevity based on the basic demographic characteristics, anthropometric measurements and blood data of 4,418 participants in the 2015 China Health and Retirement Longitudinal Study and 636 participants in an ongoing longitudinal study of natural longevity people in Guangxi. On this basis, the CRP reference interval for longevity was explored. ResultsThe CRP concentration was significantly different among the three age groups, with a median of 3.80 mg/L for those older than 90 years, which was significantly higher than that for those aged 45–64 years (median 1.20 mg/L, p < 0.001) and 65–89 years (median 1.30 mg/L, p < 0.001). Body mass index, waist circumference, the waist-to-height ratio, systolic blood pressure, diastolic blood pressure, and fasting and postprandial blood glucose, triglyceride, total cholesterol and low-density lipoprotein cholesterol levels were positively correlated with CRP levels, while fasting high-density lipoprotein cholesterol was negatively correlated with CRP levels. The CRP reference interval (RI) value in longevity people was 0.25–9.22 mg/L. ConclusionThe concentrations of CRP increased with advancing age, and the CRP reference interval was different between older and younger adults.

Роль биомаркеров мочи в диагностике туберкулеза легких (обзор)

Diagnosis of tuberculosis (TB) based on sputum analysis has limitations for certain categories of patients (older adults, children, and people living with HIV). An alternative approach is a non-invasive urine-based method, which provides a large sample volume and a quick result. We searched for English-language publications from 2010 to 2021 in PubMed and Cochrane databases using the terms tuberculosis + urine + biomarkers. Papers on urine lipoarabinomannan testing were excluded as this topic has been sufficiently studied elsewhere. The reviewed publications cover more than 30 urine biomarkers used to diagnose TB and evaluate treatment effectiveness. Urine transrenal DNA extraction continues to be investigated, although its diagnostic sensitivity and specificity depend on the extraction method and patient’s HIV status. IP-10 is likely to be a non-specific inflammatory marker; however, its level correlates with TB/HIV status and may be useful for assessing TB treatment response. Further, the article shows the potential of metabolomic biomarkers and biosignatures for measuring the activity of TB infection and distinguishing it from other respiratory diseases. The number of reliable biomarkers predicting TB treatment outcomes is limited. Numerous untargeted studies have used mass spectrometry to detect metabolomic and proteomic biomarkers in urine. The publications are heterogeneous in design and methods; few studies have analysed the specificity and sensitivity of the diagnostic methods covered. In future, a combination of host and pathogen biomarkers could increase the sensitivity and specificity of TB diagnosis.

New-Onset Arthritis Following COVID-19 Vaccination: A Systematic Review of Case Reports

Coronavirus disease 2019 (COVID-19) vaccine has effectively suppressed the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and alleviated its symptoms, but there are also many adverse events. Joint diseases caused by COVID-19 vaccine have been reported in many studies. Some are well-controlled arthritis patients who developed arthritis after COVID-19 vaccination, while others are new-onset joint pain and swelling problems after COVID-19 vaccination. The purpose of this systematic review is to examine the literature reports in existing databases and analyze the incidence of new-onset arthritis after COVID-19 vaccination. We included 31 eligible articles and described 45 patients, ranging in age from 17 to over 90, with more females than males. The majority (84.4%) of patients received the adenovirus vector vaccine (ChAdOx1) and the mRNA-based vaccine (BNT126b2 and mRNA-1273). Most (64.4%) patients developed joint-related symptoms after the first dose of vaccine, and 66.7% developed symptoms within the first week of vaccination. The joint symptoms involved were mainly joint swelling, joint pain, limited range of motion, and so on. A total of 71.1% of the patients involved multiple joints, both large and small; 28.9% of patients involved only a single joint. Some (33.3%) patients were confirmed by imaging, and the most common diagnoses were bursitis and synovitis. Two nonspecific inflammatory markers, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), were monitored in almost all cases, and all patients showed varying degrees of increase in these two markers. Most of the patients received the treatment of glucocorticoid drugs or nonsteroidal anti-inflammatory drugs (NSAIDs). Clinical symptoms markedly improved in most patients, with 26.7% making a full recovery and no relapse after a few months of follow-up. To determine whether there is a causal relationship between COVID-19 vaccination and the triggering of arthritis, large-scale and well-controlled research studies are needed in the future to verify this relationship and to further study its pathogenesis in detail. Clinicians should raise awareness of this complication with a view to early diagnosis and appropriate treatment.

An observational study demonstrating the measurement, characterization and validation of expression of calprotectin in human sweat through a sweat wearable

Inflammatory bowel diseases (IBD) comprising Crohn's disease (CD) and ulcerative colitis (UC) are typically characterized by chronic episodes of inflammation within and through the gastrointestinal (GI) tract. Calprotectin (CP) is a biomarker employed by clinicians effectively guide diagnostic and therapeutic decisions. However, there exists several challenges in sample collection and fecal CP testing for patient-use and patient enablement. Hence, there is a current unmet need to access CP in a completely non-invasive manner. This work is the first demonstration of CP in sweat using a wearable sweat sensor device. The sweat sensor device demonstrated a wide dynamic range of 0.1–10 μg/mL with a limit of detection of 0.1 μg/mL. The sensor was also specific to CP and demonstrated negligible to no response for non-specific inflammatory markers such as C-reactive protein, interleukin-6. Excellent correlation was achieved between ELISA and the sweat sensor device with Pearson's r > 0.95. Human subject studies demonstrated that elevated basal levels in IBD subject (500 ng/mL) as compared to healthy cohort (∼350 ng/mL). Further, 3 times increase in CP levels was observed due to flare-up in the IBD subject with a mean concentration ∼1300 ng/mL as compared to the basal levels. The pre-clinical results of elevated CP levels will be of significant interest to clinicians as it provides a non-invasive and non-intrusive tracking flare-ups in IBD patients and can aid in better management of the disease.

C-Reactive Protein Levels Are Associated with Complement C4 Deposits and Interstitial Arteritis in ANCA-Associated Renal Vasculitis.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a potentially life-threatening systemic small-vessel vasculitis that is characterized by pauci-immune glomerulonephritis in case of kidney involvement, representing a major denominator of AAV mortality. Innate immunity with complement system activation is increasingly recognized in the pathogenesis of AAV and as an attractive therapeutic target. Although C-reactive protein (CRP) was thought to be a passive, nonspecific marker of inflammation, recent studies indicate that CRP plays a key role in the innate immune system by recognizing pathogens and altered self-determinants. Elevated baseline CRP at disease onset of AAV has already been described as a determinant of poor long-term outcomes. However, its clinical implications at disease onset of AAV, with respect to vasculitis manifestations and complement system activation that might also affect long-term outcomes, remain elusive. CRP levels were retrospectively analyzed in 53 kidney-biopsy-confirmed cases of ANCA-associated renal vasculitis; a total of 138 disease controls were also evaluated. Univariate and multivariate regression analysis was performed on clinicopathological parameters associated with CRP levels in ANCA-associated renal vasculitis. Results: Compared to disease controls, CRP elevation was common in ANCA-associated renal vasculitis and associated with de novo disease (p = 0.0169), critical illness (p = 0.0346), and severe deterioration of kidney function (p = 0.0167), independent of extrarenal disease manifestations. As confirmed by multiple regression analysis, CRP levels were correlated with active lesions predominated by interstitial arteritis in renal vasculitis, specifically with MPO-ANCA seropositivity (p = 0.0017). Based on analysis of systemic complement system activation and intrarenal complement deposits, CRP elevation was correlated specifically with complement C4 deposits in interstitial arteries in the subgroup with myeloperoxidase (MPO)-ANCA seropositivity (p = 0.039). Finally, this association was independent of systemic complement system activation, as reflected by the consumption of respective complement components. Here, we expand our current understanding of CRP in ANCA-associated renal vasculitis not only as an inflammatory marker, but potentially also as being involved in the pathogenesis of kidney injury by interaction with the complement system.

Relationship between Glucose-6-Phosphate Dehydrogenase Deficiency, X-Chromosome Inactivation and Inflammatory Markers.

Recent studies suggest that X-linked glucose-6-phosphate dehydrogenase (G6PD) deficiency entails a proinflammatory state that may increase the risk of several disease conditions. However, it is not clear how this relates to the degree of enzyme insufficiency and, in heterozygous females, to skewed inactivation of the X chromosome. This study aimed to (i) investigate the enzyme activity in a cohort of 232 subjects (54.3% females) from Northern Sardinia, Italy, further stratified into three subgroups (G6PD normal, partial deficiency and total deficiency); (ii) measure the levels of some non-specific inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and those derived from cell counts, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), in relation to the underlying molecular defect and X inactivation. G6PD activity was measured in red blood cells according to G6PD/6PGD ratio, and X-chromosome inactivation was assessed by the HUMARA method. Overall, ESR was increased in males with total deficiency compared with normal males (15.0 ± 7.2 vs. 11.9 ± 6.2, p = 0.002, Tukey's test), albeit not in males with partial deficiency. High-sensitivity CRP was slightly increased in males with total deficiency, compared to males with normal G6PD activity (5.96 ± 3.39 vs. 3.95 ± 2.96, p = 0.048). In females, neither marker showed significant differences across the subgroups. MLR was significantly and progressively increased from normal to totally deficient subjects with intermediate values in partially deficient subjects (0.18, 0.31 and 0.37, ANOVA p = 0.008). The NLR and PLR were not different in the three subgroups. Our findings show that G6PD deficiency may be associated with a proinflammatory profile, especially in elderly females, and worsened by the concomitant asymmetric inactivation of the X chromosome.

AN OBSERVATIONAL STUDY DEMONSTARTING THE MEASUREMENT, CHARACTERIZATION AND VALIDATION OF EXPRESSIONS OF CALPROTECTIN IN HUMAN SWEAT THROUGH A SWEAT WEARABLE

Abstract BACKGROUND Inflammatory bowel diseases (IBD) comprising Crohn’s disease (CD) and ulcerative colitis (UC) are typically characterized by chronic episodes of inflammation within and through the gastrointestinal (GI) tract. In many inflammatory conditions including IBD, Calprotectin (CP) is well-studied (systemic and fecal) and employed by clinicians due to assay stability and low cost to effectively guide diagnostic and therapeutic decisions. While, accessing fecal CP is non-invasive, there is significant resistance to continuous fecal CP testing from patient-use and patient enablement aspects due to the challenges is sample collection, hence there is a current unmet need to access CP in a completely non-invasive manner. METHODS The sweat sensor device and reference ELISA was used to investigate and quantify CP levels in sweat. The immunoassay on the sweat sensor was developed by immobilizing specific capture probe antibody to capture CP in sweat. The sensor response was measured using impedance spectroscopy. Sweat samples from seven healthy and one IBD subject were collected and correlation analysis between the sweat sensor device and ELISA was performed to evaluate CP levels in sweat. RESULTS The sweat sensor device demonstrated a wide dynamic range of 0.1- 10 μg/mL with a limit of detection of 0.1 μg/mL. The sensor was also specific to CP and demonstrated negligible to no response for non-specific inflammatory markers such as C-reactive protein, interleukin-6. Excellent correlation was achieved between ELISA and the sweat sensor device with Pearson’s r&amp;gt;0.95. Human subject studies demonstrated that elevated basal levels in IBD subject (500 ng/mL) as compared to healthy cohort (~ 350 ng/mL). Further, 3 times increase in CP levels was observed due to flare-up in the IBD subject with a mean concentration ~1300 ng/mL as compared to the basal levels. CONCLUSION This work is the first demonstration of CP in sweat. The pre-clinical results of elevated CP levels will be of significant interest to clinicians as it provides a non-invasive and non-intrusive tracking flare-ups in IBD patients and can aid in better management of the disease.

THE RELATIONSHIP OF NEUTROPHIL LYMPHOCYTE RATIO WITH PROGNOSIS AND DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background: Rheumatoid arthritis (RA) is an autoimmune disease associated with systemic inflammation. Laboratory parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and various disease evaluation indexes (such as DAS 28; HAQ, SF-36) are used as indicators of the severity of inflammatory activity. Neutrophil-to-lymphocyte ratio (NLR); It has attracted attention in recent years as a non-specific inflammatory marker. In our study, it was aimed to investigate the possible role of peripheral blood NLR, which is easy and inexpensive to measure, in demonstrating disease activity and prognosis in patients with RA.&#x0D; &#x0D; Materials and Methods: Forty-three patients who were diagnosed with RA according to the criteria of the American Rheumatology Association and who had not received prior specific treatment for RA were included in the study. Laboratory parameters such as ESR, CRP, and disease assessment indices (DAS 28; HAQ) were compared with the NLR at the time of diagnosis and at the time of enrollment after treatment.&#x0D; &#x0D; Results: There were no significant correlation found between the mean NLR and DAS 28, HAQ which provide information about the prognosis of the disease. When the relationship between NLR and ESR and CRP was examined in order to evaluate the relatonship between the disease activity and inflamation during the diagnosis instead of a composite index such as DAS 28, moderately weak relationship between NLR and CRP level was found (p=0.033, r=0,343) while the tendency between NLR and the average ESR was found to be also moderately weak (p=0.056, r=0.301).&#x0D; &#x0D; Conclusions: Moderate to weak correlation between mean NLR and mean CRP levels (p=0.033, r=0.343); between the mean ESR level, a moderate-weak correlation was found (p=0.056, r=0.301). The association with baseline CRP and the trend towards association with ESR suggest that NLR may be associated with inflammation. It was thought that the loss of this relationship during the study, that is, after the treatment, may be due to the fact that other factors such as medication affect this rate.

537. First Week Post-Operative C-Reactive Protein Kinetics Show Different Patterns of Association with Infection Depending on the Type of Surgery

Abstract Background C-reactive protein (CRP) is a nonspecific marker of inflammation and due to surgery alone CRP levels are increased post-operatively. Although multiple studies investigated the potential of post-operative CRP levels to predict post-operative infection, its discriminative capacity remained unclear. We aimed to describe the kinetics of CRP for post-operative patients with- and without a post-operative infection for different types of surgery in the first seven post-operative days. Methods We conducted a single center cohort study in adult patients undergoing surgery between 2011 and 2021 with the use of whole digital case file extraction (big data). All patients that had either an infectious complication registered, non-prophylactic antibiotics prescribed and/or an infection related surgical re-intervention within 7 days after having undergone surgery, were labelled as having an infection. We analyzed the CRP kinetics in the first seven post-operative days for all these patients. Results A total of 39.985 individual patients were included of which 12.002 patients had at least one CRP measurement and 4.014 patients had an infection in the first seven post-operative days. CRP was measured in 66% of the patients with an infection and in 26% of the patients without an infection. In all patients CRP increased during the first two post-operative days regardless of infection status (Figure 1). In cardiothoracic, orthopedic, ear-nose-throat, general and urological surgery CRP decreased after day 2 or 3 in all patients but the absolute CRP value remained higher in the following days in patients with an infection compared to patients without an infection. In gynecological and oral surgery CRP decreased on day 3 in patients without an infection but not before day 4 in patients with an infection. CRP was not discriminative in neurosurgical or plastic surgery patients (Figure 2). CRP kinetics in the first seven post-operative days for patients with- and without an infection CRP kinetics for different subspecialties in the first seven post-operative days CTS = cardiothoracic surgery; ENT = ear-nose-throat surgery; GEN = general surgery; GYN = gynecological surgery; NEUR = neurosurgery; ORAL = oral surgery; ORT = orthopedic surgery; PLA = plastic surgery; URO = urological surgery. Conclusion In the first 2 post-operative days CRP increases in both patients with- and without an infection which is probably due to the surgical procedure itself. After the second post-operative day differences in CRP kinetics develop between patients with- and without an infection, but how they differ depends, among other factors, on the type of surgery. Disclosures Siri L. van der meijden, MSc, Healthplus.ai: Employee Bart F. Geerts, MD. PhD., Healthplus.ai: Board Member.