Inflammatory Risk Factors Research Articles

Soluble urokinase plasminogen activator receptor (suPAR) predicts critical illness and kidney failure in patients admitted to the intensive care unit

Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker and risk factor for kidney diseases, with a potential prognostic value in critically ill patients. In this monocentric prospective study, we measured plasma suPAR levels immediately after ICU admission in unselected 237 consecutive patients using a turbidimetric assay. Primary objective was the prognostic value for ICU- and 28-day mortality. Secondary objectives were association with sequential organ failure assessment (SOFA) score, coagulation and inflammation markers, AKI-3 and differences in prespecified subgroups. Median suPAR levels were 8.0 ng/mL [25th-75th percentile 4.3–14.4], with lower levels in ICU survivors than non-survivors (6.7 vs. 11.6 ng/mL, p < 0.001). SuPAR levels were higher in COVID-19, kidney disease, moderate-to-severe liver disease, and sepsis. ICU mortality increased by an odds ratio (OR) of 4.7 in patients with the highest compared to lowest quartile suPAR. Kaplan–Meier overall survival estimates at 3 months were 63% and 49%, in patients with suPAR below/above 12 ng/mL (log-rank p = 0.027). Due to an observed interaction between SOFA score and suPAR, we performed a random forest method identifying cutoffs. ICU mortality was 53%, 17% and 2% in patients with a SOFA score > 7, SOFA ≤ 7 & suPAR > 8 ng/mL, and SOFA score ≤ 7 & suPAR ≤ 8 ng/mL, respectively. suPAR was a significant predictor for AKI-3 occurrence (OR per doubling 1.89, 95% CI: 1.20–2.98; p = 0.006). suPAR levels at ICU admission may offer additional value for risk stratification especially in ICU patients with moderate organ dysfunction as reflected by a SOFA score ≤ 7.

Metabolic and inflammatory risk reduction in response to lipid-lowering and lifestyle modification in the medically underserved individuals

IntroductionMedically underserved (US) populations have an increased level of atherosclerotic cardiovascular disease (ASCVD) risk, however, few studies investigated ASCVD risk reduction in US. MethodsOf 217 subjects with ApoB ≥120 mg/dL and carotid atherosclerosis (≥15% stenosis by ultrasound) enrolled in the Carotid Plaque Composition by MRI (CPC) study between 2005 and 2011, US (n=33) was defined as those without adequate healthcare insurance, while AS (n=184) included those with adequate healthcare coverage. All subjects received atorvastatin-based lipid therapies and lifestyle intervention for 2 years. Metabolic and inflammatory risk factors were compared between AS and US. ResultsAt baseline, compared to AS, US displayed higher levels of metabolic and inflammatory risk including systolic blood pressure (140±27 vs. 131±18 mmHg, p=0.04), fasting glucose (125±59 vs. 102±22 mg/dL, p=0.03) and fasting insulin (39±33 vs. 28±20 µU/dL, p=0.03) which resulted in higher insulin resistance (HOMA-IR 2.2±0.4 vs. 1.3±0.1, p=0.03), and hsCRP (5.6±1.5 vs. 2.8±0.2 mg/L, p=0.03). Over 2 years of intervention, US and AS showed similar reductions in LDL-C (-10.7% vs. -16% per year, p=0.2), triglycerides (-16.7% vs. -15.9% per year, p=0.4), and hsCRP (-0.11% vs. -0.04% per year, p=0.1). However, US continued to show significantly higher levels of fasting blood glucose (115±6.0 vs. 101±2.0 mg/dL, p=0.03) and HOMA-IR (1.9±0.2 vs. 1.5±0.1, p=0.047), and hsCRP (3.9±0.7 vs. 1.9±0.2 mg/L, p<0.001) than AS following 2 years of interventions. ConclusionsUS displayed higher ASCVD risk than AS at baseline and over 2 years despite similar reductions following the intervention. These findings highlight the unmet needs for improved intervention strategies and implementation methods for ASCVD risk reduction in US. Clinical Trial RegistrationNCT00715273 at ClinicalTrials.gov

Twelve Months of Time-restricted Eating and Resistance Training Improves Inflammatory Markers and Cardiometabolic Risk Factors.

Recently, a modified intermittent fasting protocol was demonstrated to be able to maintain muscle mass and strength, decrease fat mass, and improve some inflammation and cardiovascular risk factors in healthy resistance-trained males after 2 months. The present study sought to investigate the long-term effects on these parameters. The experiment was a single-blind randomized study. Twenty healthy subjects were enrolled and underwent 12 months of either a time-restricted eating (TRE) diet or a normal diet (ND) protocol, along with resistance training. In the TRE protocol, subjects consumed their energy needs in three meals during an 8-h period of time each day (1 pm, 4 pm, and 8 pm). Subjects in the ND group also had three meals, which were consumed at 8 am, 1 pm, and 8 pm. Groups were matched for kilocalories consumed and macronutrient distribution at baseline. After 12 months of TRE, body mass, fat mass, insulin-like growth factor 1, and testosterone were significantly lower compared with ND. Moreover, inflammatory markers (interleukin 6, interleukin 1β, and tumor necrosis factor α), insulin sensitivity (fasting glucose, insulin, and homeostatic model assessment for insulin resistance index), and lipid profile (cholesterol, HDL, and LDL) significantly improved after TRE compared with ND. Finally, subjects in TRE spontaneously decreased their daily energy intake, whereas those in ND maintained their starting kilocalories per day. No adverse events were reported. Our results suggest that long-term TRE combined with a resistance training program is feasible, safe, and effective in reducing inflammatory markers and risk factors related to cardiovascular and metabolic diseases.

Longitudinal study of inflammatory, behavioral, clinical, and psychosocial risk factors for chemotherapy-induced peripheral neuropathy.

Purpose.Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting side effect of taxane and platinum chemotherapy for breast cancer. Clinicians cannot accurately predict CIPN severity partly because its pathophysiology is poorly understood. Although inflammation may play a role in CIPN, there are limited human studies. Here, we identified the strongest predictors of CIPN using variables measured before taxane- or platinum-based chemotherapy, including serum inflammatory markers.Methods.116 sedentary women with breast cancer (mean age 55 years) rated (1) numbness and tingling and (2) hot/coldness in hands/feet on 0–10 scales before and after six weeks of taxane- or platinum-based chemotherapy. A sub-study was added to collect cytokine data in the final 55 patients. We examined all linear models to predict CIPN severity at 6 weeks using pre-chemotherapy assessments of inflammatory, behavioral, clinical, and psychosocial factors. The final model was selected via goodness of fit.Results.The strongest pre-chemotherapy predictors of numbness and tingling were worse fatigue/anxiety/depression (explaining 27% of variance), older age (9%), and baseline neuropathy (5%). The strongest predictors of hot/coldness in hands/feet were worse baseline neuropathy (11%) and fatigue/anxiety/depression (6%). Inflammation was a risk for CIPN, per more pro-inflammatory IFN-γ (12%) and IL-1β (6%) and less anti-inflammatory IL-10 (6%) predicting numbness/tingling and more IFN-γ (17%) and less IL-10 (9%) predicting hot/coldness in hands/feet.Conclusions.The strongest pre-chemotherapy predictors of CIPN included worse fatigue/anxiety/depression and baseline neuropathy. A pro-inflammatory state also predicted CIPN. Because this is an exploratory study, these results suggest specific outcomes (e.g., IL-1β) and effect size estimates for designing replication and extension studies.Trial Registration. NCT00924651

Effects of Six-Week Endurance Training in Liver Enzymes, Lipid Profile, Interleukin-6 and High-Sensitivity C-Reactive Protein (hs-CRP) Responses in People with a Family History of Coronary Artery Disease

Background: Research on the effects of moderate-intensity endurance training on inflammatory indices and cardiovascular risk factors is limited. Objectives: The aim of this study was to determine the effects of six weeks of endurance training on liver enzymes, body composition, lipid profile, interleukin-6, and C-reactive protein responses in people with a family history of coronary artery disease (CAD). Methods: Thirty men (30 - 45years) participated in this study who were divided into two groups, including the control group (n = 10) and training group (n = 20) systematically. The training group program consisted of running on a treadmill for 30 minutes with an intensity of 55 to 60% of maximum heart rate. These training programs were continued three times a week for six weeks. The control group did not perform any exercise program. ELISA technique was used to measure lipid profile, liver enzymes, interlukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), respectively. Results: The results showed that the variables of weight, liver enzymes, lipid profile, IL-6, and hs-CRP were significantly different from the pre-test (P &lt; 0.05). Also, in between-group comparison, the results showed that except for the variables of fat percentage and BMI in the other variables of the study, a significant difference was observed (P &lt; 0.05). Conclusions: The results of this study suggest that moderate-intensity endurance training could be used as a useful way to reduce weight, levels of inflammatory markers, liver enzymes and cardiovascular risk factors in people with a family history of CAD.

Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis

BackgroundThis study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission.Materials and methodsBetween January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded.ResultsThe records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05).ConclusionsAlthough the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.

Dietary Inflammatory Index and Cardiovascular Disease Risk Factors in Patients With Chronic Kidney Disease and Type 2 Diabetes

Abstract Objectives Inflammation is associated with several chronic diseases, including chronic kidney disease (CKD) and type 2 diabetes (T2D). Because dietary choices may impact chronic inflammation, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of the diet. Using the DII, this study examined the association of cardiovascular disease (CVD) risk factors and diet in patients with CKD and T2D. Methods Baseline three-day food records were obtained from 241 participants in a lifestyle intervention study, and analyzed using Nutrition Data System for Research (2014). DII scores were calculated, with higher scores suggesting a more pro-inflammatory diet. Participants were dichotomized into an anti-inflammatory diet (AID; DII &amp;lt; 0; n = 118) or pro-inflammatory diet (PID; DII ≥ 0; n = 123) group, based on DII score. CVD risk factors included estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), systolic blood pressure (BP), diastolic BP, pulse wave velocity, fasting lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), and hemoglobin A1C (HbA1C). Independent two sample t-tests assessed differences in CVD risk factors between groups. Results Participants were 50% male, 88% non-Hispanic, 66% white, and 65 ± 9SD years of age with a mean body mass index of 33.7 ± 5.1SD kg/m2. Approximately 51% of the participants followed a diet that would be considered pro-inflammatory. Participants in the AID group had a higher eGFR (AID: 75 ± 21SD mL/min/1.73m2, PID: 68 ± 20SD mL/min/1.73m2; p = 0.017) compared to the PID group. No significant differences were found between groups for the other CVD risk factors (CRP, systolic BP, diastolic BP, pulse wave velocity, fasting lipids [total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides], and HbA1C). Conclusions Participants reporting an AID had a higher eGFR than those reporting a PID. Contrary to expectations, other CVD risk factors did not differ between groups. Additional research should examine the role of an AID, emphasizing whole grains, fruits, vegetables, fatty fish, nuts, and legumes, for disease management in patients with CKD and T2D. Funding Sources Supported by NIH RO1 DK100492.

Body Mass Index Predicts Cardiovascular Risk Factors and Inflammatory Status in Postmenopausal Women

ObjectivesSome studies have shown that hormonal changes during menopause transition may lead to weight gain. Higher body mass index (BMI) may be beneficial for bone health but not for heart health. However, these phenomena are still unclear. The present study aimed to determine whether BMI is associated with cardiovascular risk factors, and bone and inflammatory biomarkers in osteopenic postmenopausal women. MethodsIn a cross-sectional study, 132 healthy osteopenic postmenopausal women (1 to 10 years) not on hormone therapy (HT) and other pharmacological agents known to affect bone were recruited. Overnight fasting blood and urine samples were collected. Multiple linear regression analyses were conducted to examine the associations between BMI and changes in CVD risk factors and inflammatory and bone biomarkers. ResultsHigher BMI was significantly associated with elevated serum fasting glucose, C-reactive protein (CRP), apolipoprotein B (ApoB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) levels after controlling for age, years of menopause, physical activity level, and total energy intake. Based on the regression model, every one unit increase in BMI was predicted to increase fasting glucose, CRP, ApoB, TC, LDL, TG by 1.0 mg/dL, 0.1 mg/L, 1.6 mg/dL, 2.8 mg/dL, 3.2 mg/dL, and 3.3 mg/dL, respectively. BMI was not associated with bone formation and resorption biomarkers. ConclusionsBMI is a good predictor of inflammatory marker and CVD risk factors but not bone biomarkers in postmenopausal women. Future studies are needed to examine the associations of body composition (lean mass and fat mass) on CVD risk factors and bone biomarkers. Funding SourcesN/A.

Sex‐specific associations of circulating soluble prorenin receptor with cardiometabolic risk factors among healthy women and men

The prorenin receptor (PRR), a component of the renin angiotensin system, is involved in blood pressure control, fluid homeostasis, tissue development and vesicular trafficking and play an important role in cardiovascular diseases. PRR can be cleaved to generate soluble PRR (sPRR) in plasma. sPRR concentrations vary with clinical conditions such as metabolic syndrome, pregnancy, chronic kidney disease and heart failure in humans. However, whether sPRR is associated with aging and healthy obesity in men and women is unknown. We aimed to evaluate if there are sex-specific associations of sPRR with cardiometabolic risk factors among healthy women and men varying in age and obesity. Circulating cardiometabolic, vascular and inflammatory risk factors and sPRR (via ELISA) were measured in unmedicated healthy men (n=55; age 39 ± 16 yrs; BMI 29 ± 4 kg/m2) and women (n=34; age 44 ± 16 yrs; BMI 30 ± 7 kg/m2) at the University of Iowa. Women were classified by menopausal status [non-menopausal, non-M (n=18) and post-menopausal, post-M (n=16)]. Independent t-test was used to compare means and pearson correlation was examined. In men, sPRR was not related to age, systolic blood pressure (SBP), BMI, cholesterol or endothelial function (brachial artery flow mediated dilation, FMD), but was correlated with plasma TNFα (r=0.50, P<0.05). sPRR was higher in overweight/obese (BMI ≥ 25 kg/m2) compared with non-obese men (n=48; 10.8 ± 0.4 vs. n=7; 8.3 ± 0.4 ng/ml, P<0.05). In women, sPRR did not correlate with BMI or SBP, but correlated with total cholesterol (r=0.49, P<0.05) and TNFα (r=0.49, P<0.05). sPRR correlated with age in women with a BMI<30 (r=0.54, P<0.05) but not a BMI ≥30 kg/m2. sPRR was significantly higher in post-M compared with non-M women independent of obesity or hypertension status (12.1 ± 0.5 vs. 10.1 ± 0.4 ng/ml, P<0.05). sPRR correlated with FMD only in obese women (%FMD: r=-0.50, P<0.05), indicating a relation of sPRR with endothelial dysfunction in obese women. Interestingly, sPRR was significantly higher in non-M compared with non-obese men, and menopause further exacerbated the difference. In conclusion, sPRR is associated with TNFα in both men and women, but there are sex differences in the relation with BMI, age, cholesterol and endothelial function in humans. sPRR concentrations were higher in post-M compared with non-M women, suggesting that PRR could contribute to cardiovascular risk in post-M women.

Circulating TNFrII levels predict incidence of ischemic heart disease and total mortality, independently of intima media thickness and pulse wave velocity in male with type 2 diabetes.

New and clinically useful markers of cardiovascular risk are of great importance in patients with type 2 diabetes since cardiovascular disease is a major cause of death in these patients. We analyzed inflammatory markers and other risk factors for heart disease in 761 patients who participated in the CARDIPP-study, Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care. All participants had type 2 diabetes and were 55-66years old at recruitment during the years 2005-2008. Patients were followed for incidence of stroke, myocardial infarction, or death from cardiovascular disease until the end of the year 2018 using the national Swedish Cause of Death and Hospitalization Registries. Besides traditional risk-markers for vascular disease, we also measured carotid-femoral pulse-wave velocity and intima-media thickness of carotid arteries. During a median period of 13years, 165 men and 65 women died or were hospitalized for ischemic heart disease and stroke. TNFrII showed statistically significance as a risk factor for stroke, ischemic heart disease, and total mortality in male patients with diabetes type 2, independently of age, diabetes duration, BMI, Hba1c, systolic blood pressure, triglycerides, IMT and PWV (p = 0.002, HR 2.70, CI 1.42:5.13, p = 0.002). Circulating TNFrII levels failed to present a similar correlation in women (p = 0.48, CI 0.48:4.84). TNFrII stayed significant in males when HDL/LDL-ratio, CRP and smoking were added to the statistical analysis. Our data support the use of serum TNFrII in male type 2 diabetes patients to add independent prognostic information in terms of mortality and heart disease independently of other strong and well-established risk markers including cholesterol, inflammatory cytokines, PWV and IMT.Trial registration: ClinicalTrials.gov NCT01049737.

The association of resistance training with risk of ovarian cancer.

ABSTRACTBackgroundIncreasing evidence, including multiple putative inflammatory risk factors (e.g., c‐reactive protein, and adiposity), supports that inflammation plays an important role in ovarian carcinogenesis. Resistance training (RT) is associated with lower levels of circulating inflammatory markers, independent of physical activity.MethodsWe evaluated the relationship between RT and risk of ovarian cancer accounting for other physical activity (e.g., walking) in two large prospective cohorts, the Nurses’ Health Study (NHS) and NHSII.Key ResultsIn total, analyses included 42,005 NHS participants (2000–2016) and 67,289 NHSII participants (2001–2017) with RT assessed every 4 years. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of RT with ovarian cancer risk overall and by tumor subtype, adjusting for known and putative ovarian cancer risk factors. We identified a total of 609 cases over 1,748,884 person‐years. No association was observed with overall ovarian cancer risk (RT ≥60 vs 0 min/wk, HR = 0.95, 95%CI: 0.74–1.22) or by histotype (comparable HR = 0.86 and 0.98 for type I and II tumors, respectively). Results did not differ by body mass index (Pinteraction = 0.97), or other physical activity (Pinteraction = 0.31).Conclusions & InferencesWe observed no evidence that moderate levels of RT were associated with risk of ovarian cancer. Further investigations are required to confirm these findings.

The Effectiveness of Aerobic Training With Supplementation With Vitamins C and E on Some Inflammatory and Cardiovascular Risk Factors in Overweight Men

Background: The purpose of this study was to investigate the effectiveness of aerobic training with supplementation of vitamins C and E on some inflammatory markers and cardiovascular risk factors in overweight men. Methods: In this semi-experimental study, 30 overweight men were randomly assigned into three groups (n=10, AT+Sup, AT+Placebo, and control). The exercise program consisted of three sessions per week at the intensity of 60-75% of maximal heart rate for six weeks. The supplement group received 300 mg of vitamin E daily and 400 mg vitamin C tablet and the placebo group received one gelatin capsule daily during this period. Before and after six weeks of intervention, were measured interleukin-6 (IL-6), -reactive protein (CRP), Triglyceride (TG), Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), and insulin resistance index. Data were analyzed by t-test, one-way ANOVA, and Tukey post hoc test at a significance level of P&lt;0.05. Result: The results showed that aerobic training significantly reduced the body fat percentage, TG, and LDL in both supplement and placebo groups(P&lt;0.05). However, this reduction was observed in IL-6 and CRP only in the supplement group (P&lt;0.05). On the other hand, the results showed that exercise and supplementation did not change the insulin resistance of subjects. The results of one-way ANOVA showed that there was a significant difference between the three groups in fat percentage, IL-6, CRP, TG, and LDL (P&lt;0.05). Conclusion: According to the results of this research, probably six weeks of aerobic training plus supplementation with vitamin E and C may help to reduce inflammatory symptoms, body fat percentage, and some cardiovascular risk factors.

Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women

Risk profiles for premature coronary heart disease (CHD) are unclear. To examine baseline risk profiles for incident CHD in women by age at onset. A prospective cohort of US female health professionals participating in the Women's Health Study was conducted; median follow-up was 21.4 years. Participants included 28 024 women aged 45 years or older without known cardiovascular disease. Baseline profiles were obtained from April 30, 1993, to January 24, 1996, and analyses were conducted from October 1, 2017, to October 1, 2020. More than 50 clinical, lipid, inflammatory, and metabolic risk factors and biomarkers. Four age groups were examined (<55, 55 to <65, 65 to <75, and ≥75 years) for CHD onset, and adjusted hazard ratios (aHRs) were calculated using stratified Cox proportional hazard regression models with age as the time scale and adjusting for clinical factors. Women contributed to different age groups over time. Of the clinical factors in the women, diabetes had the highest aHR for CHD onset at any age, ranging from 10.71 (95% CI, 5.57-20.60) at CHD onset in those younger than 55 years to 3.47 (95% CI, 2.47-4.87) at CHD onset in those 75 years or older. Risks that were also noted for CHD onset in participants younger than 55 years included metabolic syndrome (aHR, 6.09; 95% CI, 3.60-10.29), hypertension (aHR, 4.58; 95% CI, 2.76-7.60), obesity (aHR, 4.33; 95% CI, 2.31-8.11), and smoking (aHR, 3.92; 95% CI, 2.32-6.63). Myocardial infarction in a parent before age 60 years was associated with 1.5- to 2-fold risk of CHD in participants up to age 75 years. From approximately 50 biomarkers, lipoprotein insulin resistance had the highest standardized aHR: 6.40 (95% CI, 3.14-13.06) for CHD onset in women younger than 55 years, attenuating with age. In comparison, weaker but significant associations with CHD in women younger than 55 years were noted (per SD increment) for low-density lipoprotein cholesterol (aHR, 1.38; 95% CI, 1.10-1.74), non-high-density lipoprotein cholesterol (aHR, 1.67; 95% CI, 1.36-2.04), apolipoprotein B (aHR, 1.89; 95% CI, 1.52-2.35), triglycerides (aHR, 2.14; 95% CI, 1.72-2.67), and inflammatory biomarkers (1.2- to 1.8-fold)-all attenuating with age. Some biomarkers had similar CHD age associations (eg, physical inactivity, lipoprotein[a], total high-density lipoprotein particles), while a few had no association with CHD onset at any age. Most risk factors and biomarkers had associations that attenuated with increasing age at onset. In this cohort study, diabetes and insulin resistance, in addition to hypertension, obesity, and smoking, appeared to be the strongest risk factors for premature onset of CHD. Most risk factors had attenuated relative rates at older ages.

Local and Systemic Effects of Cyclosporine A on the Severity of Gingival Overgrowth in Post-Transplant Renal Patients.

Background:Cyclosporine A (CsA) is a potent immunosuppressant widely used to prevent renal post transplantation rejection. Gingival overgrowth (GO) is among various side effects of the long-term administration of CsA. Up to 90% of the patients under CsA therapy has been reported to develop CsA-induced GO.Objectives:The aim of the present prospective pilot study is to determine the local and systemic effects of Cyclosporine A (CsA) on the severity of gingival overgrowth and its relationship with periodontal parameters in post-transplant renal patientsMethods:Twenty post-transplant renal patients, 12 females and 8 males, presenting gingival overgrowth were selected from Rizk Hospital’s clinic in Beirut. Patient’s CsA plaque levels were evaluated when CsA is administered by syrup and capsules mode. Periodontal parameters including gingival overgrowth, papillary bleeding, plaque and gingival indices were assessed for all patients.Results:Plaque concentration CsA levels, when administered in syrup mode, affected significantly the severity of gingival overgrowth as opposed to the administration by capsule mode. Significant correlations between severity of gingival overgrowth on one hand and plaque index, gingival index, and papillary bleeding index on the other hand were only observed in the Capsule group but not in the syrup group. A significant relationship was established between the severity of gingival overgrowth and all periodontal parameters (gingival, papillary and plaque).Conclusion:The present study underlines CsA dental plaque local effect, as a co-factor, in the development of gingival overgrowth. Cyclosporine plaque accumulation acts as a reservoir in the gingival inflammation and the periodontal indices seem to be the most accurate parameters associated with gingival overgrowth severity. Plaque CsA concentrations could be considered as a risk factor for inflammation and gingival overgrowth depending on CsA delivery mode in renal transplant patients.

Profiling Inflammatory Cytokines in a Cohort Study of Egyptian Patients with COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) pandemic is an international public health emergency with major disruptions and devastating health consequences resulting from the associated cytokine storm syndrome. The aim of our research was to assess the inflammatory biomarkers and risk factors associated with severity of (COVID-19) patients. A cross-sectional study was conducted and included 150 Egyptian patients with COVID-19. Patients were classified into mild, moderate, and severe according to the clinical and CT chest findings. Blood samples were collected from patients for laboratory assessment of inflammatory biomarkers. Our results showed significant negative correlation between oxygen saturation percent and serum levels of inflammatory markers. The correlations were statistically significant with IL-6, CRP, ferritin, LDH, and D-dimer which can be used as sensitive biomarkers for assessment of the risk of severity of infection in COVID 19 patients. The study revealed that the risk factors associated with severity of COVID 19 infection included older age, male gender, presence of underlying chronic disease, and increased levels of inflammatory biomarkers: CRP, LDH, ferritin, IL-6, and D-dimer.

Chronic Stress, C-Reactive Protein, and Cognition Among Racially and Ethnically Diverse Older Adults

Objective: Previous research suggests that chronic stress is associated with worse cognitive aging, but minimal research has examined potential mechanisms and moderators of these associations. Chronic stress is known to increase inflammation (e.g., C-reactive protein [CRP]), which has in turn been associated with worse cognition among older adults. The present study examined whether (1) CRP mediates associations between chronic stress and episodic memory and verbal fluency; and (2) these relationships differ by race/ethnicity. Methods: Participants included 18,968 adults (64% non-Hispanic White; 19% non-Hispanic Black; 14% Hispanic; 3% non-Hispanic other race/ethnicity; Mage=71.8; SDage=6.0) from the Health and Retirement Study. Chronic stress was operationalized as the occurrence and impact of eight ongoing stressors. Cross-sectional, stratified mediation models were conducted for three cognitive outcomes: immediate recall, delayed recall, and verbal fluency. Covariates included sociodemographics and vascular disease burden. Results: Chronic stress was associated worse immediate recall (beta=-.028). Higher CRP was not associated with any cognitive domains. Non-Hispanic Black participants reported more chronic stress than non-Hispanic White and Hispanic participants. Chronic stress was less strongly associated with higher CRP in non-Hispanic Black (beta=-.035) participants than non-Hispanic White (beta=.046) or Hispanic (beta=.059) participants. Discussion: Chronic stress may negatively influence episodic memory, but findings do not suggest that CRP mediates links between chronic stress and cognition. CRP may not track as closely with chronic stress among non-Hispanic Black older adults who may experience additional risk factors for inflammation and/or adapt to increased chronic stress.

Peripheral inflammatory biomarkers and risk factors of dementia in the Chilean GERO cohort

AbstractBackgroundDementia is one of the mean causes of disability in elderly. Peripheral inflammatory biomarkers and ApoE‐ε4 allele have been described as important biological risk factors of dementia in Caucasian population. Currently, there is scarce information about the specific age‐related and predisposition factors to develop dementia in Latino populations. The aim of this study is to investigate these biological risks factors in Chilean elderly with healthy and pathological brain ageing.MethodWe evaluated and quantified plasma samples obtained from the GERO cohort (114 elderly subjects, &gt;70 years, classified in 51 subjects with subjective cognitive complaint (SCC) and 63 with mild cognitive impairment (MCI)), in addition to 36 healthy brain controls (HBC) and 31 subjects with Alzheimer’s disease dementia (ADD). Genotyping of ApoE gene was analyzed by qPCR. We analyzed inflammatory biomarkers using Luminex technique including IL‐2, IL‐6, IL‐10, TNF‐α, CRP and SAP proteins. All subjects receive a clinical and neuropsychological assessment.ResultCRP protein was found significant decrease expression in SCC and ADD groups compared to MCI and HBC (p=0.048). In SAP protein was found a significant decrease in expression in the SSC (p=0.04) and MCI (p=0.0178) groups compared to HBC. It was observed a positive correlation in the SCC, MCI and ADD groups with the IL‐6 and TNFα, and, SAP and CRP. A negative correlation between IL‐2, IL‐6 and IL‐10 cytokines was found with Direct Span Digit test, which assess attentional capacity. Also was identified a negative correlation between SAP protein and the Free and Cued Selective Reminding Test (FCSRT), which assess verbal episodic memory, and IL‐10 cytokine and Montreal Cognitive Assessment (MoCA), which assess global cognition. Finally, a positive correlation was found in CRP protein with Pfeffer Functional Activity Questionnaire. Frequency of the ApoE‐ε4 allele, was significantly higher in ADD (52%) and SCC (27%) patients than controls and MCI (p=1x10‐4).ConclusionThe results shown correlations between the different inflammatory proteins and performance in neuropsychological test suggesting that inflammatory biomarkers are associated with pathological brain ageing. The correlations in SCC and MCI are not being reported previously. Additionally, the frequency of ApoE‐ε4 allele in ADD group is higher than worldwide populations.

Endotoxemia is associated with an adverse metabolic profile.

Our aim was to analyze whether endotoxemia, i.e. translocation of LPS to circulation, is reflected in the serum metabolic profile in a general population and in participants with cardiometabolic disorders. We investigated three Finnish cohorts separately and in a meta-analysis (n = 7178), namely population-based FINRISK97, FinnTwin16 consisting of young adult twins, and Parogene, a random cohort of cardiac patients. Endotoxemia was determined as serum LPS activity and metabolome by an NMR platform. Potential effects of body mass index (BMI), smoking, metabolic syndrome (MetS), and coronary heart disease (CHD) status were considered. Endotoxemia was directly associated with concentrations of VLDL, IDL, LDL, and small HDL lipoproteins, VLDL particle diameter, total fatty acids (FA), glycoprotein acetyls (GlycA), aromatic and branched-chain amino acids, and Glc, and inversely associated with concentration of large HDL, diameters of LDL and HDL, as well as unsaturation degree of FAs. Some of these disadvantageous associations were significantly stronger in smokers and subjects with high BMI, but did not differ between participants with different CHD status. In participants with MetS, however, the associations of endotoxemia with FA parameters and GlycA were particularly strong. The metabolic profile in endotoxemia appears highly adverse, involving several inflammatory characters and risk factors for cardiometabolic disorders.

Roux-en-Y gastric bypass decreases serum inflammatory markers and cardiovascular risk factors in obese diabetics

BackgroundObesity and type 2 diabetes mellitus are associated with elevated levels of inflammatory markers. This chronic inflammation is known to contribute to increased risk of cardiovascular disease in these populations. Laparoscopic Roux-en-Y gastric bypass is associated with a high rate of diabetes remission. We hypothesize that laparoscopic Roux-en-Y gastric bypass decreases systemic inflammatory markers and cardiovascular disease risk factors in obese diabetics. MethodsThis was a single-institution prospective cohort study of 61 obese patients with type 2 diabetes mellitus. A total of 30 patients underwent laparoscopic Roux-en-Y gastric bypass surgery, and 31 patients underwent standard medical therapy with diabetes support and education. Collected data included preoperative and postoperative inflammatory biomarkers and clinical parameters. ResultsTwelve months after undergoing laparoscopic Roux-en-Y gastric bypass, controlling for sex and age, there was a significant correlation between a change in interleukin-6 and a change in systolic blood pressure (Spearman r = 0.41, P = .03). Similarly, when sex and age were controlled for in the laparoscopic Roux-en-Y gastric bypass group, a statistically significant relationship remained between percent excess weight loss and change in interleukin-6 (P = .001). ConclusionA significant relationship exists between decreased systemic interleukin-6 levels and both excess weight loss and lowered systolic blood pressure after laparoscopic Roux-en-Y gastric bypass in obese patients with diabetes mellitus. These correlations may explain the decreased risk of cardiovascular disease after surgical weight reduction in this patient population.

Dietary inflammatory index score, glucose control and cardiovascular risk factors profile in people with type 2 diabetes

We examined the relationships between the dietary inflammatory index (DII®), dietary habits and cardiovascular risk factor profiles in people with type 2 diabetes mellitus (T2DM). Energy-adjusted DII (E-DII™) scores were calculated from a Food Frequency Questionnaire in 2568 T2DM patients from different parts of Italy. Analyses were conducted according to quartiles of sex-specific E-DII scores. Higher, more pro-inflammatory, (quartile 4) E-DII scores were associated with overall poor quality of the diet characterised by higher content of refined carbohydrates, added sugars, saturated fat and cholesterol and lower unsaturated fat, fibre and polyphenols compared to quartile 1. Higher E-DII scores also were associated with higher waist circumference (105.4 vs. 103.5 cm; p = 0.002), triglycerides (154.6 vs. 146.1 mg/dL; p = 0.005), diastolic blood pressure (80.05 vs. 78.6 mmHg; p = 0.04) and lower HDL-cholesterol (45.3 vs. 47.4 mg/dL; p = 0.04). In conclusion, E-DII is a potent marker of overall quality of the diet and is associated with an unfavourable cardiovascular risk factor profile.