Serological Markers In Patients Research Articles

Kinetics of IL-6, C-reactive Protein and Fibrinogen Levels in COVID-19 Outpatients Who Evolved to Hypoxemia.

Despite the efficacy of the COVID-19, the search for improvements in the management of severe/critical cases continues to be important. The aim is to demonstrate the kinetics of 4 serological markers in patients with COVID-19 who evolved in hypoxemia. From June to December 2020, the Health Secretariat of Rondônia State, Brazil, established a home medical care service team (HMCS) that provided clinical follow-up for health professionals and military personnel with COVID-19. The clinical and laboratory monitoring was individualized at home by a nursing and medical team. In addition to laboratory parameters, C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, and D-dimer levels were periodically taken to monitor the evolution of treatment. Of 218 patients telemonitored, 48 patients needed special care by the HMCS team due to shortness of breath. Chest tomography showed multiple ground-glass shadows and lung parenchymal condensations that was compatible with secondary bacterial infection associated with leukocytosis, for which antibiotics were prescribed. The symptoms were accompanied by increases of CRP and IL-6 levels followed by fibrinogen after a few days, for which an anticoagulant therapy was included. Thirty-three patients evolved to improvements in clinical signs and laboratory results. Between the sixth and eighth day of illness, 15 patients presented signs of hypoxemia with low O2 saturation accompanied with an increase in the respiratory rate, with some of them requiring oxygen therapy. As they did not present signs of clinical severity, but their laboratory markers showed an abrupt IL-6 peak that was higher than the increase in CRP and a new alteration in fibrinogen levels, they received a supplemental dose of anticoagulant and a high dose of corticosteroids, which resulted in clinical improvement. Our study demonstrates that monitoring of IL-6 and CRP may identify precocious hypoxemia in COVID-19 patients and prevented the progressive deterioration of the lung injury.

Distinct gene dysregulation patterns herald precision medicine potentiality in systemic lupus erythematosus

ObjectivesWe aimed at investigating the whole-blood transcriptome, expression quantitative trait loci (eQTLs), and levels of selected serological markers in patients with SLE versus healthy controls (HC) to gain insight into pathogenesis and identify drug targets. MethodsWe analyzed differentially expressed genes (DEGs) and dysregulated gene modules in a cohort of 350 SLE patients and 497 HC from the European PRECISESADS project (NTC02890121), split into a discovery (60%) and a replication (40%) set. Replicated DEGs qualified for eQTL, pathway enrichment, regulatory network, and druggability analysis. For validation purposes, a separate gene module analysis was performed in an independent cohort (GSE88887). ResultsAnalysis of 521 replicated DEGs identified multiple enriched interferon signaling pathways through Reactome. Gene module analysis yielded 18 replicated gene modules in SLE patients, including 11 gene modules that were validated in GSE88887. Three distinct gene module clusters were defined i.e., “interferon/plasma cells”, “inflammation”, and “lymphocyte signaling”. Predominant downregulation of the lymphocyte signaling cluster denoted renal activity. By contrast, upregulation of interferon-related genes indicated hematological activity and vasculitis. Druggability analysis revealed several potential drugs interfering with dysregulated genes within the “interferon” and “PLK1 signaling events” modules. STAT1 was identified as the chief regulator in the most enriched signaling molecule network. Drugs annotated to 15 DEGs associated with cis-eQTLs included bortezomib for its ability to modulate CTSL activity. Belimumab was annotated to TNFSF13B (BAFF) and daratumumab was annotated to CD38 among the remaining replicated DEGs. ConclusionsModulation of interferon, STAT1, PLK1, B and plasma cell signatures showed promise as viable approaches to treat SLE, pointing to their importance in SLE pathogenesis.

Serum midkine level as a diagnostic biomarker of hepatocellular carcinoma in Egyptian patients with chronic hepatitis C

Background Early diagnosis and treatment are the keys for effective treatment of patients with hepatocellular carcinoma (HCC). The use of serological markers in patients at the highest risk of developing HCC may thus decrease HCC mortality and reduce medical costs. Midkine (MK) has an essential role in activities related to carcinogenesis such as proliferation, anti-apoptosis, transformation, migration, and angiogenesis, in many types of tumors, including HCC. Aim To evaluate serum levels of MK as a diagnostic biomarker for early detection of HCC in relation to conventional markers, such as alpha-fetoprotein (AFP). Patients and methods This study was conducted on 90 individuals who attended the Hepatogastroenterology and Infectious Diseases Department, Al-Zahraa University Hospital, Al Azhar University. The patients were divided into three groups: group I comprised 30 patients with HCC on top of hepatitis C virus and group II comprised 30 patients with cirrhotic liver post-hepatitis C virus. Control group The control group comprised 30 healthy adult participants. Results Highly statistically significant increase in serum MK in groups I and II in comparison to the control group and statistically significant increase in group I in comparison to group II. Serum MK can be used to discriminate between groups I and II at a cutoff level of more than 97.7,with 80% sensitivity, 90% specificity, 88.9% positive predictive value and 81.8% negative predictive value and area under curve=0.94. Also, it used to discriminate between groups I and III at a cutoff level of more than 76.5, with 100% sensitivity, specificity, positive predictive value, and negative predictive value with area under the curve=1.0. Conclusion MK is more accurate than AFP in diagnosing HCC, especially in detecting early stage HCC and AFP-negative HCC.

SPECTRUM OF HISTOPATHOLOGICAL PATTERNS OF DUODENAL BIOPSIES IN PATIENTS WITH UNEXPLAINED ANAEMIA AND CHRONIC DIARRHEA AND THEIR CORRELATION WITH ENDOSCOPIC FINDINGS AND SEROLOGICAL MARKERS

Objective: To evaluate different histopathological patterns and correlate them with indications, findings of Esophagogastroduodenoscopy Esophago-gastro-duodenal (EGD) and serological markers in patients presenting of unexplained anemia and chronic diarrhea.
 Study Design: Cross sectional study.
 Place and Duration of Study: Departments of Pathology and Gastroenterology, Combined Military Hospital Lahore Pakistan, from Jul to Dec 2020.
 Methodology: Histopathological patterns of endoscopic duodenal biopsies, submitted for evaluation of unexplained anemia and chronic diarrhea were studied. Hemoglobin and anti-tTG levels were recorded. Adults with history of unexplained diarrhea and anaemia were included. Biopsies with malignant diagnosis or unfit for evaluation were excluded. Histopathological patterns were correlated with indications and findings of Esophagogastroduodenoscopy and serological markers of celiac disease.
 Results: The most common indication for Esophagogastroduodenoscopy in 145 patients was chronic diarrhea. Upper gastrointestinal endoscopy in 2/3rd of patients revealed no pathology. Histopathological patterns of duodenal biopsies revealed only 15% cases suggestive of celiac disease. Only 12 patients were suggestive of celiac disease both on Esophagogastroduodenoscopy and histopathology combined. Half of patients with anti tTG level >100 u/ml, showed histopathological features of celiac disease on. There was no correlation between histopathological patterns, indications of Esophagogastroduodenoscopy, morphology of Esophagogastroduodenoscopy and serological markers of celiac disease.
 Conclusion: Indications for Esophagogastroduodenoscopy, Esophagogastroduodenoscopic findings and histopathological patterns cannot diagnose celiac disease alone.

COVID-19 and Immunological Dysregulation: Can Autoantibodies be Useful?

Coronavirus disease 2019 (COVID‐19) is often associated with interstitial pneumonia. However, there is insufficient knowledge on the presence of autoimmune serological markers in patients with COVID‐19. We analyzed the presence and role of autoantibodies in patients with COVID‐19‐associated pneumonia. We prospectively studied 33 consecutive patients with COVID‐19, 31 (94%) of whom had interstitial pneumonia, and 25 age‐matched and sex‐matched patients with fever and/or pneumonia with etiologies other than COVID‐19 as the pathological control group. All patients were tested for the presence of antinuclear antibodies (ANAs), anti‐antiphospholipid antibodies, and anti‐cytoplasmic neutrophil antibodies (ANCAs). Clinical, biochemical, and radiological parameters were also collected. Fifteen of 33 patients (45%) tested positive for at least one autoantibody, including 11 who tested positive for ANAs (33%), 8 who tested positive for anti‐cardiolipin antibodies (immunoglobulin (Ig)G and/or IgM; 24%), and 3 who tested positive for anti‐β2‐glycoprotein antibodies (IgG and/or IgM; 9%). ANCA reactivity was not detected in any patient. Patients that tested positive for auto‐antibodies had a significantly more severe prognosis than other patients did: 6 of 15 patients (40%) with auto‐antibodies died due to COVID‐19 complications during hospitalization, whereas only 1 of 18 patients (5.5%) who did not have auto‐antibodies died (P = 0.03). Patients with poor prognosis (death due to COVID‐19 complications) had a significantly higher respiratory rate at admission (23 breaths per minute vs. 17 breaths per minute; P = 0.03) and a higher frequency of auto‐antibodies (86% vs. 27%; P = 0.008). In conclusion, auto‐antibodies are frequently detected in patients with COVID‐19 possibly reflecting a pathogenetic role of immune dysregulation. However, given the small number of patients, the association of auto‐antibodies with an unfavorable prognosis requires further multicenter studies.

Diagnostic utility of serological biomarkers in patients with Crohn's disease: A case-control study.

The aim of this study was to examine the expression of serological markers in patients with inflammatory bowel disease in China, and determine the diagnostic utility of serological markers, individually and in combination, for the diagnosis and differential diagnosis of Crohn's disease (CD).Serum samples were obtained from 160 participants in Eastern China. Among the participants, 98 were diagnosed with CD, 33 had ulcerative colitis (UC), and 29 were healthy controls (HC). The serum samples were tested for the presence of antibodies against outer membrane porin C (anti-OmpC), Pseudomonas fluorescens bacterial sequence I2 (anti-I2), anti-laminarin (anti-L), anti-chitin (anti-C), anti-chitobioside carbohydrate antibody (ACCA), anti-laminaribioside carbohydrate antibody (ALCA), anti-mannobioside carbohydrate antibody (AMCA), and anti-Saccharomyces cerevisiae antibody (ASCA) by indirect enzyme-linked immunosorbent assay (ELISA).Individually, anti-C, anti-L, ASCA-IgG, and ALCA lacked diagnostic value in the differentiation of CD. ASCA-IgA remained the most accurate marker for the diagnosis of CD, with an area under the curve (AUC) of 0.77; however, its sensitivity and specificity were both lower than 75%. Among the combinations of the 5 markers with significant diagnosing ability for CD, combinations with any 2 of the 3 markers, ASCA IgA, AMCA, and ACCA positive, provided the best accuracy in the diagnosis and differential diagnosis of CD (sensitivity and specificity both above 75%) and had the highest Youden index.Serological antibodies, when considered in combination, have remarkable value in the diagnosis and differential diagnosis of CD. Especially, the combination of any 2 of the 3 markers, ASCA-IgA, AMCA, ACCA positive, appears to be optimal.

Matrix Metalloproteinases and Their Tissue Inhibitors in Blood Serum of Patients with Endometrial Cancer: Clinical and Morphological Correlations.

In patients with endometrial cancer (N=94), endometrial polyps (N=28), endometrial hyperplasia (N=25), and healthy women (N=77), the serum contents of MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 were measured by ELISA. Both carcinoma and benign neoplasms were accompanied by significant elevation of MMP-7 and TIMP-2 in blood serum. The greatest elevation (in comparison with the control) was observed for MMP-7, although serum concentration of this marker was practically identical in patients with carcinoma and benign tumors. In contrast, the levels of MMP-2 and TIMP-1 were lower in cancer patients in comparison with the control; in these patients, the levels of MMP-9 and TIMP-1 were also lower than the corresponding levels in patients with polyps and endometrial hyperplasia. There were no significant correlations between the levels of examined markers with tumor metastasizing, its histological structure, and differentiation degree of endometrial cancer. No differences were observed between examined serological markers in patients with polyps and endometrial hyperplasia of various severities. The examined MMPs and TIMPs cannot be advanced as potential diagnostic markers of endometrial cancer, but they can be used to monitor and prognosticate the disease and to assess effectiveness of the targeted therapy.

Intestinal inflammation markers in inflammatory bowel disease

During the past few decades, extensive researches were conducted to identify serological markers in patients with inflammatory bowel disease (IBD) that can reliably diagnose and monitor disease activity and help in predicting relapses. To date, several serological markers have been identified. This review will address the different serological markers and their clinical significance and applicability in medical practice. Serological markers include antibodies against microbial antigens, peptide antigens, autoantibodies, and basic inflammatory markers. Some serological markers such as anti-Saccharomyces cerevisiae antibodies (ASCA) and antibodies against exocrine pancreas (PAB) help the confirmation of the diagnosis of IBD to differentiate it from other non-IBD. Perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) and ASCA can distinguish Chron’s disease and ulcerative colitis. Certain markers can aid stratification of Chron’s disease including antibodies to Pseudomonas fluorescens associated sequence I2 (Anti-I2), antibodies to bacterial flagellin (Anti-CBir1), ASCA, and antibodies to outer membrane porin C (Anti-OmpC). ASCA and pANCA can predict disease response to therapeutic agents (e.g. Infliximab). ASCA can also unaffected family members at risk of developing Chron’s disease.

P151 NONIMMUNITY AGAINST HEPATITIS B VIRUS IN PATIENTS WITH NEWLY DIAGNOSED INFLAMMATORY BOWEL DISEASE

Currently, there are no data on the prevalence rate of hepatitis B virus (HBV) serologic markers in patients with newly diagnosed inflammatory bowel disease (IBD) in Korea, which is a hepatitis B endemic area. There has been controversy over the prevalence of HBV in patients with IBD. There are some reports that even if patients were inoculated with the HBV vaccine when they were toddlers, antibody titers are low when they were checked as adults because of the effect of immunosuppressant. However, these studies showed the effects of low titers are caused by external factors such as drugs; IBD itself was not mentioned as a factor. This study aimed to elucidate the prevalence of HBV serologic markers in Korean patients newly diagnosed with but not yet treated for inflammatory bowel disease (IBD). We prospectively enrolled 210 patients with newly diagnosed IBD (109 with ulcerative colitis [UC] and 101 with Crohn’s disease [CD]). Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) levels were measured and compared with those of 1,100 sex- and age-matched controls. Patients with IBD aged <20 years were at a higher susceptibility risk (nonimmune) of HBV infection than the controls (IBD 41.5% vs. control 22.4%; P = 0.018). On multivariate analysis, patients of age < 20 years (P = 0.024) and with symptom duration > 12 months before diagnosis (P = 0.027) were identified as independent risk factors for nonimmunity against HBV. Newly diagnosed patients with IBD were susceptible to HBV infection. The frequency of nonimmune status was high, especially in patients < 20 years of age and those with a longer duration of symptoms before diagnosis. Therefore, it is necessary to screen for HBV serologic markers and generate a detailed vaccination plan for newly diagnosed patients with IBD.

Utility of specific serological markers in patients with community-acquired pneumonia after initial treatment

Utility of specific serological markers in patients with community-acquired pneumonia after initial treatment

Diagnostic value of the Epstein-Barr virus serological markers in patients with nasopharyngeal carcinoma in cases of undetectable primary tumor location

The goal of this work was to describe a method for diagnosis of the non-keratinizing nasopharyngeal carcinoma (nNPC) in cases of the undetectable primary tumor location. The method is based on evaluation of IgG and IgA antibody levels to the capsid (VCA) and early antigens (EA) of the Epstein-Barr virus (EBV). The diagnosis of nNPC is established by a so-called decision rule. The latter was created by mathematical processing of the method of multifactor analysis of the results of anti-EBV antibody testing of 72 patients with clinically and morphologically confirmed nNPC and 72 patients with other head and neck benign tumors (OHNT) not associated with EBV, which were tested as a control group. The diagnostic value of the decision rule which was tested in the group of 77 patients with confirmed nNPC and 231 patients of a control group was high. The numbers of false negative and false positive cases were equal to 5.2% (4/77) and 6.5% (17/231), respectively. Among 32 patients with undetectable primary tumors the decision rule was able to identify 11 cases of nNPC. This diagnosis later was confirmed by morphological and instrumental methods of study. Only in two cases, false negative result was obtained (2/32; 6.3%) indicating that the serological diagnostics of nNPC with the decision rule is highly specific but not exact. Thus, the data obtained allowed us to conclude that the serological testing of EBV specific antibody evaluated by the decision rule can be recommended as an important test supplementing the standard methods of pdNPC diagnostics including cases with undetected primary tumor location.

Association between experimental pain biomarkers and serologic markers in patients with different degrees of painful knee osteoarthritis.

To assess the association between pain mechanisms (sensitization) and biochemical markers for cartilage, bone, and inflammation in patients with knee pain. The study group comprised 281 patients with different degrees of knee pain intensity and radiographic findings (using the Kellgren/Lawrence [K/L] scale). The following structurally related serologic biomarkers were measured in serum: high-sensitivity C-reactive protein (hsCRP), matrix metalloproteinase (MMP)-mediated breakdown of CRP (CRPM), MMP-mediated degradation of type I collagen (C1M), C2M, and C3M. Pressure-pain thresholds (PPT) (peripheral and spreading sensitization), temporal summation of pain, and conditioning pain modulation (CPM) (with the latter 2 biomarkers representing generalized sensitization) were assessed. For each pain parameter, the patients were categorized as most sensitized or least sensitized. Correlations were observed between the pain biomarkers PPT, temporal summation, and CPM and maximal pain intensity during the last 24 hours. Significant associations between most of the serologic biomarkers were observed. A high CRPM level was associated with centralized sensitization (temporal summation and CPM). None of the serologic markers correlated with the intensity or duration of knee pain, and only hsCRP correlated with the K/L grade. The most-sensitized group contained more women than men, and the least-sensitized group contained more men than women. A platform of mechanistic pain biomarkers in combination with structure-related serologic biomarkers provides new possibilities for understanding how osteoarthritis-related structural features may be associated with pain and pain sensitization. This study showed significant correlations between central pain sensitization and CRPM as a possible measure for chronic inflammation. Future pain association studies should include biomarkers representing the local joint environment more specifically.

Clinical correlation between Anti-CCP antibody, rheumatoid factor and clinical parameters of patients with rheumatoid arthritis

BACKGROUND: The main clinically useful serological markers in patients with Rheumatoid Arthritis are Rheumatoid Factor and Anti-citrullinated Protein Antibodies (ACPA) for both diagnosis and prediction of functional and radiographic outcomes. We do not have data from Nepalese patients about gender differences and association of these antibodies with disease nature. OBJECTIVE: To identify the difference in nature of disease in relation to ACPA and gender. METHODS: A cross sectional open labeled study including consecutive patients who were diagnosed as RA according to ACR/EULAR 2010 attending the rheumatology OPD from October 2010 to October 2012 at Alka Hospital, Nepal. Data collection was done by direct patient interview and all data were recorded electronically in a predesigned performa. ACPA and RF were tested in the serum samples of 184 patients. RESULTS: Out of 184 patients, 114 of them were ACPA positive and 54 were Rheumatoid factor positive. The median duration of symptoms was 30.3±7.0 months lesser in ACPA positive patients as compared to negative ones. Mean age of females was 10.7 years less than male patients. No other significant differences were noted between male and female patients. Also, 52.3%ofRF negative patients were found to have ACPA positivity. CONCLUSION: Anti cyclic citrullinated peptide antibodies are excellent serological markers of rheumatoid arthritis, which shows good diagnostic value. This can increase the diagnostic value in addition to rheumatoid factor and its use in clinical practice may contribute to increased ability of rheumatologists to make judicious treatment decisions. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9566 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 13-16

Alcohol Induces Sensitization to Gluten in Genetically Susceptible Individuals: A Case Control Study

BackgroundThe mechanisms of cerebellar degeneration attributed to prolonged and excessive alcohol intake remain unclear. Additional or even alternative causes of cerebellar degeneration are often overlooked in suspected cases of alcohol-related ataxia. The objectives of this study were two fold: (1) to investigate the prevalence of gluten-related serological markers in patients with alcohol-related ataxia and; (2) to compare the pattern of brain involvement on magnetic resonance imaging between patients with alcohol and gluten ataxias.Materials & MethodsPatients diagnosed with alcohol and gluten ataxias were identified from a retrospective review of patients attending a tertiary clinic. HLA genotype and serological markers of gluten-related disorders were recorded. Cerebellar volumetry, MR spectroscopy and voxel-based morphometric analyses were performed on patients and compared with matched control data.ResultsOf 904 registered patients, 104 had alcohol ataxia and 159 had gluten ataxia. 61% of the alcohol ataxia group and 70% of the gluten ataxia group had HLA DQ2/DQ8 genotype compared to 30% in healthy local blood donors. 44% of patients with alcohol ataxia had antigliadin antibodies compared to 12% in the healthy local population and 10% in patients with genetically confirmed ataxias. None of the patients with alcohol ataxia and antigliadin antibodies had celiac disease compared to 40% in patients with gluten ataxia. The pattern of structural brain abnormality in patients with alcohol ataxia who had antigliadin antibodies differed from gluten ataxia and was identical to that of alcohol ataxia.ConclusionsAlcohol related cerebellar degeneration may, in genetically susceptible individuals, induce sensitization to gluten. Such sensitization may result from a primary cerebellar insult, but a more systemic effect is also possible. The duration and amount of exposure to alcohol may not be the only factors responsible for the cerebellar insult.

Celiac disease markers in patients with liver diseases: A single center large scale screening study

To study the coincidence of celiac disease, we tested its serological markers in patients with various liver diseases. Large-scale screening of serum antibodies against tissue transglutaminase (tTG), and deamidated gliadin using enzyme-linked immunosorbent assay and serum antibodies against endomysium using immunohistochemistry, in patients with various liver diseases (n = 962) and patients who underwent liver transplantation (OLTx, n = 523) was performed. The expression of tTG in liver tissue samples of patients simultaneously suffering from celiac disease and from various liver diseases using immunohistochemistry was carried out. The final diagnosis of celiac disease was confirmed by histological analysis of small-intestinal biopsy. We found that 29 of 962 patients (3%) with liver diseases and 5 of 523 patients (0.8%) who underwent OLTx were seropositive for IgA and IgG anti-tTG antibodies. However, celiac disease was biopsy-diagnosed in 16 patients: 4 with autoimmune hepatitis type I, 3 with Wilson's disease, 3 with celiac hepatitis, 2 with primary sclerosing cholangitis, 1 with primary biliary cirrhosis, 1 with Budd-Chiari syndrome, 1 with toxic hepatitis, and 1 with non-alcoholic steatohepatitis. Unexpectedly, the highest prevalence of celiac disease was found in patients with Wilson's disease (9.7%), with which it is only rarely associated. On the other hand, no OLTx patients were diagnosed with celiac disease in our study. A pilot study of the expression of tTG in liver tissue using immunohistochemistry documented the overexpression of this molecule in endothelial cells and periportal hepatocytes of patients simultaneously suffering from celiac disease and toxic hepatitis, primary sclerosing cholangitis or autoimmune hepatitis type I. We suggest that screening for celiac disease may be beneficial not only in patients with associated liver diseases, but also in patients with Wilson's disease.

HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis

Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. The prevalence was 30% for anti-HBc total and/or HBsAg and 7.4% for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

Characterization of Hepatitis B Virus Molecular Genotypes in Chongqing and Quantitative Serological Markers in Patients during Natural Phases of Chronic Hepatitis B Infection

Background/Aims: The present study was launched to systematically characterize the molecular genotypes and quantitative serological biomarkers during the natural course of chronic hepatitis B (CHB) infection in a patient population from Chongqing, China. Methods: A total of 140 patients were enrolled and grouped according to the natural phases of HBV infection: HBeAg (+) immune tolerance, immune clearance, HBeAg (–) low replicative and reactivation phase. Nested PCR was used for HBV molecular genotyping and chemiluminescent microparticle immunoassay for quantitative serological detection. Results: Subgenotypes B2 and C2 were found to be most prevalent with genotype B patients showing more potent viral activity. HBsAg level was found to be significantly correlated with HBV DNA, HBeAg, age, ALT and AST levels during some phases of CHB. Conclusion: These results indicated that molecular genotyping and quantitative serological detection might be helpful for earlier prediction of the long-term disease outcomes.

Serial pro-gastrin-releasing peptide and neuron specific enolase in predicting radiological response and overall survival of patients with small-cell lung cancer

e22144 Background: Pro-gastrin-releasing peptide (ProGRP: P) and Neuron specific enolase (NSE: N) are specific serological markers in patients (pts) with small-cell lung cancer (SCLC). The aim of this study was to investigate whether decreasing of these tumor markers correlate with radiological response and prognosis in pts with SCLC. Methods: Out of 194 newly diagnosed SCLC pts from September 2002- April 2008 at our institution, we retrospectively reviewed consecutive 118 pts who had measurable lesions and elevated baseline levels of P and N before initial therapy (IT) including chemotherapy or chemoradiotherapy, and survived more than one month. P and N were measured on the first day of the every treatment course and after the final course of IT. Computed tomography (CT) was documented on baseline and every 2 courses of IT. Results: Forty-six (38.9%) pts had limited stage disease (LD) and 72 (61.0%) pts had extensive stage disease (ED). Both P and N levels at baseline were significantly correlated with the sum of longest diameter (SLD) in baseline CT; Spearman's ρ was 0.34 (P=0.001) and 0.44 (p&lt;0.0001), respectively. Also, the decreasing rate of P and N correlated with the decreasing rate of SLD, ρ= 0.45 (p&lt;0.0001) and 0.21 (p=0.03), respectively. Furthermore, the normalization of both P (&lt;46pg/ml) and N (&lt;10ng/ml) levels after 3 courses of IT was significantly associated with radiological response (p=0.015) including partial and complete response assessed by the Response Evaluation Criteria in Solid Tumors. In Cox's multivariate analysis, the normalization of both P and N levels after 3 courses of the IT (p=0.03, hazard ratio: 0.47, 95% CI 0.23–0.93) was significantly associated with prolonged survival, when adjusted by age, PS, and disease extent (LD or ED). Conclusion: Levels of P and N at baseline, and decreasing rate of P and N in IT were both associated with radiological response. In addition, the normalization of both P and N levels might be meaningful in predicting prognosis of SCLC pts. No significant financial relationships to disclose.

Prevalence of Bartonella spp., Babesia microti, and Anaplasma phagocytophilum Serologic Markers in Patients with Lyme Disease

Prevalence of Bartonella spp., Babesia microti, and Anaplasma phagocytophilum Serologic Markers in Patients with Lyme Disease

The High False Positive Rate of Inflammatory Bowel Disease Serologic Markers in Patients with Irritable Bowel Syndrome

The High False Positive Rate of Inflammatory Bowel Disease Serologic Markers in Patients with Irritable Bowel Syndrome