Serum C-reactive Protein Levels In Patients Research Articles

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance.

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance. A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed. After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group. AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Assessment of Changes in Serum C-Reactive Protein Levels in Patients after Ischemic Stroke Undergoing Rehabilitation-A Retrospective Observational Study.

Inflammation plays a key role in the pathogenesis and prognosis of ischemic stroke. C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect the progression of vascular disease. Using a biomarker such as CRP to predict recovery rather than mortality may present clinical value in providing rehabilitation. The primary aim of the study was to analyze changes in serum CRP levels in patients after ischemic stroke during the regenerative-compensatory period and to assess the usefulness of CRP as a potential biomarker during the rehabilitation period. The project was carried out as a retrospective analysis of prospectively collected data from post-stroke patients from the Department of Neurological Rehabilitation of the Regional Specialist Hospital in Wrocław. A group of 52 patients, after their first-ever ischemic stroke with subsequent hemiplegia, was finally qualified to participate in the study. Serum CRP levels were determined during blood laboratory tests. The Modified Rankin Scale (mRS) and Barthel Index (BI) were used to assess functional outcomes. Rehabilitation using neurophysiological methods was applied five days a week (each session lasted 60 min, and the entire period was 42 days). At the first test, serum CRP levels were found to be above 5 mg/L in 19 patients, the second test in 12 patients, the third test in five patients, and the fourth test in 9 patients. Only three patients had values higher than 5 mg/L in all consecutive assessments (p > 0.05). There was a statistically significant increase in BI scores after therapy (p < 0.001) as well as a decrease in the mRS score by 2.2 points (p < 0.001), in CRP values by 5.02 mg/L (p = 0.019), and in cortisol levels by 2.5 nmol/L (p = 0.002). Statistically significant relationships were observed between the CRP levels after rehabilitation and the corresponding mRS scores (rs = 0.29, p = 0.038). Furthermore, the effect of BMI on CRP levels was demonstrated (B = 0.20, p = 0.038). In conclusion, despite demonstrating a significant relationship between CRP levels and corresponding mRS scores, CRP levels alone may not serve as an independent predictor of long-term functional outcomes in ischemic stroke patients undergoing rehabilitation.

Evaluation of serum levels of homocysteine and C-reactive protein in patients with ischemic stroke

Stroke is the third most common cause of death in the world. Plasma homocysteine is an emerging risk factor for stroke. Also, previous studies have shown that serum levels of C-reactive protein (CRP) are significantly associated with mortality and function in patients with ischemic stroke. In the present study, we examined homocysteine and serum CRP levels in patients with ischemic stroke. This descriptive-analytical study was performed on 100 patients with ischemic stroke. Blood samples were taken in the first 24 hours of a stroke to measure homocysteine and CRP. The Axis homocysteine ELISA kit (IBL, Germany) measured plasma homocysteine. Doppler ultrasound of cerebral arteries was also performed in the first five days. Independent chi-square, ANOVA, and t-tests were used to analyze the data. It was observed that the NIHSS mean was not significantly different from the age of the patients (P = 0.876). Significant relationship was not observed between NIHSS level with HTN (p = 0.070), HLP (p = 0.103), DM (p = 0.999), history of CVA (p = 0.946), history of MI (p = 0.262), smoking (p = 0.109), and the number of CVA risk factors (p = 0.383). Data analysis showed that homocysteine level was significantly associated with hypertension (p = 0.021). There was also a significant relationship between serum CRP level and the location of internal carotid artery stenosis (p = 0.015) and middle cerebral artery (p = 0.006). In general, this study showed that increased homocysteine in the high range in patients with stroke has a high frequency. Also, stenosis of the internal carotid artery and middle cerebral artery is more common in patients with ischemic stroke whose serum CRP levels are high. This finding suggests that abnormal CRP may be more associated with stenosis of some cerebral arteries.

C-Reactive Protein Levels

Background: C-reactive protein (CRP) is a nonglycosylated pentameric polypeptide comprising 206 amino acid residues. CRP causes activation of the classical complement pathway by binding to various autologous and extrinsic ligands exposed on membranes of injured, necrotic, or cells undergoing apoptosis. There is evolving evidence which strongly suggests that CRP is an inflammatory marker and is significantly elevated in patients diagnosed with tumors such as hepatocellular, pulmonary, and breast carcinomas. In addition, serum CRP level has been shown to be associated with size of tumor (T), clinic-pathological characteristics, and metastasis to lymph nodes. Aim: The aim of this study was to compare serum CRP levels in potentially malignant disorders and oral malignancies. Materials and Methods: This cross-sectional prospective study was designed to study serum CRP levels in patients with oral potentially malignant disorders (leukoplakia and oral submucous fibrosis), patients with oral squamous cell carcinoma, and normal controls. Study participants were divided into four groups: (1) Group I comprising 40 patients with leukoplakia, (2) Group II comprising 40 patients with oral submucous fibrosis, (3) Group III comprising 40 patients with oral squamous cell carcinoma, and (4) Group IV comprising 40 controls. Five milliliters of venous blood was collected after venipuncture from the antecubital vein followed by centrifugation, and serum was separated. This separated serum was analyzed for CRP levels using SPINREACT kit and semi-automated biochemical analyzer (Kyoto, Japan). All obtained data were entered into Microsoft Excel Worksheet 2007, and tabulations were performed using SPSS 16 (Statistical Package for the Social Sciences) software (IBM Corporation, Chicago, IL, USA). P &lt; 0.05 was considered statistically significant. Results: Mean ± standard deviation values derived were 5.5 ± 4.8 mg/dl (Group I), 6.1 ± 4.9 mg/dl (Group II), 10.5 ± 2.4 mg/dl (Group III), and 2.1 ± 1.6 mg/dl (Group IV), respectively. On applying one-way analysis of variance for comparison of three groups, P &lt; 0.003 was obtained. The results implied that an extremely significant statistical correlation existed between all studied groups when serum CRP levels were compared. Conclusion: Serum CRP levels are prognostic markers in oral potentially malignant disorders and oral malignancies.

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Anastomotic leakage is a complication of colorectal surgery. C-reactive protein (CRP) is an acute-phase marker that can indicate surgical complications. We determined whether serum CRP levels in patients who had undergone colorectal surgery can be used to exclude the presence of anastomotic leakage and allow safe early discharge. We included 90 patients who underwent colorectal surgery with primary anastomosis. Serum CRP levels were measured retrospectively on postoperative days (PODs) 1 – 7. Patients with anastomotic leakage (n = 11) were compared to those without leakage (n = 79). We statistically analysed data and plotted receiver operating characteristic curves. The incidence of anastomotic leakage was 12.2%. Diagnoses were made on PODs 3 – 24. The overall mortality rate was 3.3% (18.2% in the leakage group, 1.3% in the non-leakage group; P < 0.045). CRP levels were most accurate on POD 4, with a cutoff level of 180 mg/L, showing an area under the curve of 0.821 and a negative predictive value of 97.2%. Lower CRP levels after POD 2 and levels <180 mg/L on POD 4 may indicate the absence of anastomotic leakage and may allow safe discharge of patients who had undergone colorectal surgery with primary anastomosis.

Serum C-reactive protein in oral submucous fibrosis and oral squamous cell carcinoma: A cross-sectional study.

Context:Early detection of oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSMF) transforming into malignancy can drastically improve the treatment outcomes and prognosis. Carcinoma development is an intricate complex mechanism and the multifactorial causation makes it more difficult to find specific prognostic and therapeutic biomarkers. Thus, the development of newer diagnostic and predictive approaches that are less invasive, economical and amenable to repeated sampling is imperative. Serum C-reactive protein (CRP) serves a useful marker for prognosis and monitoring of oral potentially malignant disorders (OPMDs) including OSMF as well as OSCC. Secreted by hepatocyte as an acute inflammatory marker, various studies have shown association between serum CRP and presence of OPMDs, as well as with presence and prognosis of OSCC.Aims:The aim of this study was to measure and compare serum CRP levels in patients with OSMF and OSCC as compared to healthy individuals and to establish baseline data for serum CRP levels in patients with OSMF and OSCC.Settings and Design:Cross-sectional observational prospective study.Materials and Methodology:The study includes 150 individuals, with 50 healthy, 50 OSMF and 50 OSCC individuals. Spinreact CRP-turbilatex Kit (SPINREACT) and Prietest-EXP semi-automatic biochemical analyzer were used for quantitative determination of serum CRP.Statistical Analysis Used:Data were analyzed by SPSS 16© (Statistical Package for the Social Sciences) software.Results:The mean value of serum CRP in Group I was 2.20 mg/L with standard deviation of 1.74; in Group II, it was 5.40 mg/L with standard deviation of 4.79 mg/L and in Group III, it was 12.17 mg/L with standard deviation of 11.38.Conclusions:Serum CRP levels in patients with OSMF were raised, but not statistically significant as compared to the control group. Values of serum CRP were significantly higher in patients with OSCC as compared to the control group, and it was statistically significant; these values also showed positive association with primary tumor size.

The effect of biological agent treatment on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, and C-reactive protein in psoriasis patients.

IntroductionIn recent years, the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV) and C reactive protein (CRP) have been shown to be important indicators of systemic inflammation. Studies have shown that NLR, PLR, MPV and CRP are higher in psoriasis patients than in the control group.AimTo investigate the NLR, PLR, MPV and serum CRP levels in patients who were treated with biological agents for psoriasis.Material and methodsIn our study, 75 patients who were followed up and had a diagnosis of psoriasis vulgaris and took a biological agent therapy between January 2014 and December 2017 in the Dermatology Clinic of the Dicle University Medical Faculty Hospital were evaluated before treatment, and 3 and 6 months after treatment.ResultsNeutrophil count, lymphocyte count, thrombocyte count, NLR, PLR, MPV and CRP values before the biological agent treatment were statistically higher than the values at 3 and 6 months of treatment. There was no statistically significant difference between pre-treatment neutrophil, lymphocyte, leukocyte, platelet, NLR, PLR, MPV, CRP values and values at 3 and 6 months after treatment when we compared four different biological agents.ConclusionsIt was seen that NLR, PLR, MPV and CRP values decreased independently of the type of the biological agent used in our study. Therefore, we think that these parameters can be used to evaluate the effects of biological agent treatment on systemic inflammation in psoriasis patients and to monitor the course of the disease.

Impact of C‐reactive protein on Band 3 protein function in human erythrocytes

C‐reactive protein (CRP) has a functional role in the inflammatory process and its concentration increases in circulation during inflammatory events. Transcriptional induction of the CRP gene mainly occurs in hepatocytes in the liver in response to increased levels of inflammatory cytokines, especially interleukin‐6 (IL‐6), therefore CRP is used as a clinical marker of inflammation. Elevated serum CRP levels are related to different inflammatory diseases such as cholecystitis, cardiovascular disease, cancer, type 2 diabetes, appendicitis and pancreatitis. The present study addressed the impact of CRP on Band 3 protein (B3p) function in human erythrocytes. The activity of B3p, mediating Cl−/HCO3− exchange through erythrocytes membrane, can be monitored by measuring the rate constant for SO4= uptake. Blood was withdrawn from both patients with acute inflammation (13 ♀, 9 ♂, age range 28–75 years) and healthy volunteers (10 ♀, 10 ♂, age 28–70 years). CRP levels higher than 8 mg/L were considered as a strong predictor of inflammatory disease and the rate constant for SO4= uptake was measured by a turbidimetric method. Elevated serum CRP levels induced a significant increase in both anion exchange capability through B3p and in SO4= trapped by the cells with respect to control (healthy volunteers). Once serum CRP levels in patients with acute inflammation were brought back to control values, anion exchange capability through B3p was restored. The present findings show that: i) measurement of the rate constant for SO4= uptake is a suitable tool to monitor the effect of elevated serum CRP levels on human erythrocytes due to acute inflammation; ii) high CRP levels seem to accelerate anion exchange capability through B3p; iii) inflammation remission seems to correspond to B3p function restoration. Future studies will evaluate whether this acceleration may depend on an altered Bp3 conformation possibly affecting B3p crosslink with Hb, or on altered oxidative and phosphorylative signaling on B3p function, in an attempt of better understanding the impact of inflammation processes on erythrocytes homeostasis.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease.

ObjectivesThis study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsWe performed an observational, analytical case–control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing.ResultsThe mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels.ConclusionsAECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.

Association Between Serum C-Reactive Protein Concentration and Nutritional Status of Malignant Tumor Patients

Background: The level of the systemic inflammatory marker C-reactive protein (CRP) is elevated in many patients with malignant disease and may be related to nutritional status.Objective: To analyze the association between serum CRP levels in patients with malignant tumors and their nutritional status.Method: A total of 3,692 cases were analyzed and the serum CRP levels were determined using an immunometric assay. Nutritional status was assessed by using patient-generated subjective global assessment (PG-SGA). The biochemical evaluation of prealbumin (PA), albumin (ALB), cholesterol (CHOL), and triglycerides (TG) were assayed within 48 h admission to the hospital. The association between serum CRP concentration and the nutritional status, the stage of the tumor and other factors was analyzed by univariate and multivariate logistic regression analysis.Result: Elevated serum CRP was observed in 47.6% (1,548/3,269) of patients compared with the reference value, and the median CRP concentration was 18.29 mg/l. Patient serum CRP concentrations in the malnourished group (PG-SGA B + C) were higher than in the well-nourished (PG-SGA A) patients (P < 0.05). The serum CRP level was related to the patients' age, gender, tumor stage, and was affected by hepatitis, liver cirrhosis, diabetes, but it has no effect on hypertension. The CRP high patients had lower PA and ALB levels, lower Karnofsky performance status scores, and higher PG-SGA scores (P < 0.05), and there was no relationship with CHOL and TG levels. Weight loss in the previous 1 mo was seen with CRP positive patients (P < 0.05).Conclusion: Almost 50% of malignant tumor patients had elevated serum CRP levels indicating a systemic inflammatory state. The nutritional status was worse in cancer patients with higher concentrations of serum CRP. The level of CRP was associated with the tumor stage, and, as stage is a prognostic factor, so can CRP be used as a prognostic maker in malignant tumors patients.

Predicative values of C-reactive protein for the therapeutic effects of ulinastatin combined with somatostatin in severe acute pancreatitis and for the severity of gastrointestinal failure.

Severe acute pancreatitis (SAP) is a serious systemic disease with high mortality. Ulinastatin is a drug widely used for patients with SAP and multiple organ failure syndrome. The present study aimed to investigate the capacity of the serum C-reactive protein (CRP) levels to predict the therapeutic effects of ulinastatin combined with somatostatin as well as determine the severity of SAP. SAP patients were treated with ulinastatin combined with somatostatin and serum CRP levels were measured. The computed tomography severity index (CTSI), acute physiology and chronic health evaluation II (APACHE II) and gastrointestinal failure scores were used to determine the therapeutic effects. All patients were assigned to the effective group and the ineffective group. Receiver operating characteristic curve analysis was performed to determine the sensitivity and specificity of CRP levels in predicting the severity of SAP and patient prognosis. Logistic regression analysis was adopted to investigate the factors influencing the therapeutic effects. Prior to and after treatment, serum CRP levels in patients of the effective and ineffective groups were significantly different. After treatment, serum CRP levels in patients of the effective group exhibited a more obvious reduction. The sensitivity and specificity of serum CRP levels in predicting the therapeutic effects of ulinastatin combined with somatostatin in SAP patients upon hospital admission were 0.813 and 0.934, respectively. Serum CRP levels were positively correlated with APACHE II, CTSI and gastrointestinal failure scores of SAP patients. The logistic regression demonstrated that serum albumin, creatinine and CRP levels on admission were factors influencing the therapeutic effects of ulinastatin combined with somatostatin in SAP patients. These results indicate that serum CRP levels may have a predictive value regarding the therapeutic effects of ulinastatin combined with somatostatin and are an indicator of the severity of gastrointestinal failure in SAP.

Use of C response protein in predicting postoperative anastomotic leakage in patients with rectal cancer

To investigate the value and feasibility of C reactive protein (CRP) in predicting postoperative anastomotic leakage in rectal cancer patients with enhanced recovery after surgery (ERAS) for safer implementation of this ERAS. A cohort study on serum CRP of 455 rectal cancer patients undergoing laparoscopic radical resection according to the ERAS procedure at Gastrointestinal Unit of General Surgery Department, Guangdong General Hospital from August 2014 to June 2017 was retrospectively carried out. The serum CRP level was measured before operation and at postoperative days 1-7, and the serum CRP level of the groups with and without anastomotic leakage was compared to analyze its prediction for anastomotic leakage. Diagnostic standard of anastomotic leakage was based on the definition of postoperative anastomotic leakage in rectal cancer from International Study Group of Rectal Cancer (ISREC): (1) Postoperative localized or diffuse peritonitis occurred, or fecal liquid was found from the abdominal drainage tube; (2) When anastomotic leakage was uncertain, peritoneal or pelvic computed tomography scan should be used to confirm. All the 455 patients underwent surgery successfully, and 41 patients (9.0%) had anastomotic leakage postoperatively. Patients with anastomotic leakage were diagnosed (4.0±2.0) days postoperatively, of whom 8 cases (19.5%) were diagnosed more than 5 days postoperatively. Serum CRP levels in patients with anastomotic leakage continued to increase within 1-4 days postoperatively [(50.04±27.98) mg/L to (122.75±52.98) mg/L] and decreased 5 days postoperatively [(92.02±58.26) mg/L], both were higher than those of non-anastomotic leakage group, and the difference was statistically significant (all P<0.05, except postoperative day 2). The serum CRP level of non-anastomotic leakage group reached the peak on the second postoperative day [(83.10±37.45) mg/L] and decreased 3 days postoperatively [(48.01±27.59) mg/L]. The ROC curve was drawn with the anastomotic leakage as the state variable, and the CRP level as the detection variable. The area under the curve (AUC) at postoperative 1, 2, 4, 5, 6 and 7 days was 0.74, 0.58, 0.83, 0.82, 0.65, and 0.70, respectively. The maximum was at postoperative day 3 [0.93(95%CI: 0.86-0.99)]. The Youden index was 0.72, and the threshold of CRP was 80.09 mg/L, as the cut-off point to predict anastomotic leakage, with sensitivity, specificity, and positive predictive value of 79.3%, 92.3%, and 74.2%, respectively. Monitoring the postoperative serum CRP level can help predict the occurrence of anastomotic leakage after laparoscopic surgery for rectal cancer. When the serum CRP level is >80.09 mg/L on the third postoperative day, the CRP level has the largest value in predicting postoperative anastomotic leakage, and the safety of ERAS has a certain clinical significance as well.

Prognostic role of C-reactive protein in patients with nasopharyngeal carcinoma: A meta-analysis and literature review.

Background:C-reactive protein (CRP) has been shown to be associated with several tumors. However, its association with nasopharyngeal carcinoma (NPC) is not well characterized. We performed a literature review and meta-analysis to assess the prognostic relevance of elevated CRP levels in patients with NPC.Methods:A literature search for relevant studies was performed on PubMed (Medline), the Cochrane Library, and Web of Science databases. Hazard ratios (95% confidence intervals) were calculated to assess the association between elevated CRP levels and survival outcomes.Results:Five studies with a combined study population of 5215 patients with NPC were included. Pooled hazard ratios for overall survival and distant metastasis-free survival were 1.84 (95% CI = 1.57–2.17) and 1.81 (95% CI = 1.53–2.14), respectively. Subgroup analyses showed that types of indicators and treatment before inclusion had no significant impact on the observed association.Conclusion:Elevated serum CRP levels in patients with NPC were associated with worse prognosis.

Preoperative C-reactive protein serum levels as a predictive diagnostic marker in patients with adnexal masses.

To evaluate C-reactive protein (CRP) serum levels as a preoperative predictive marker for ovarian cancer in patients with adnexal masses. CRP serum levels of 1843 adnexal masses and subsequent surgery were investigated (patients with benign ovarian tumors: n=1423; borderline tumor of the ovary [BTO]: n=83; EOC: n=337). Test characteristics and predictive values of CRP serum levels were investigated by univariate analysis and multivariate binary logistic regression models. Median (interquartile range) serum CRP levels in patients with benign ovarian tumors, BTO, and EOC were 0.4 (0.1-0.6)mg/dL, 0.5 (0.2-0.9)mg/dL, and 1.6 (0.5-5.4)mg/dL, respectively (p<0.001). Sensitivity and specificity of the combination of CRP and CA-125 was 80.1% and 90.8%, negative predictive value (NPV) and positive predictive value (PPV) was 92.2% and 76.9%, respectively. In univariate and multivariate analysis, CRP serum levels were independently associated with presence of BTO and EOC (HR 6.7 [5.2-8.5], p<0.001 and HR 2.2 [1.4-3.3], p<0.001). The combination of CRP and CA-125 serum levels resulted in a number needed to treat of 2.11 to detect one case of EOC or BTO. CRP serum levels independently predicted the presence of BTO and EOC in patients with suspicious adnexal masses. CRP serum levels seem to be of additional value to CA-125 in the preoperative differential diagnosis of adnexal masses and might be particularly in combination with CA-125 clinically useful.

Diagnostic value of a combined C-reactive protein and haptoglobin tests in new cases of upper tract urothelial carcinoma

Introduction: Serum C-reactive protein (CRP) is believed to be increased in metastatic urothelial cancer of the bladder. However, the changes depend on the stage and grade of the upper tract urothelial carcinoma (UTUC). This study aimed to compare low-range and high-range serum CRP and haptoglobin in new cases of UTUC. Materials and methods: Blood was collected from newly diagnosed patients with UTUC (n=43 patients; 39 male/4 female) and normal individuals (n=26; 24 male and 2 female) with no sign of infection or cancer. All the patients showed clinical symptoms of bladder cancer. Serum CRP and haptoglobin were estimated based on conventional methods. Results: Haematuria and polyuria were common symptoms in 65.12% of the patients suffering from UTUC. The serum level of HAPT in control and UTUC patients was 126±13 and 181±14.5 mg/dl respectively. No significant difference was observed in HAPT level in patients and controls. The HAPT was in the high-range level in 27% of controls and 30% of the patients. The average serum CRP level in patients and controls was 11.87±3.5 mg/l and 11.45±4.2 mg/l, respectively. Serum CRP was above 3.5 mg/l (>3.5 mg/l) in 46% of patients (20/43). The CRP level was significantly higher (P=0.023) in patients having CRP above 3.5 mg/l compared to respective controls. The UTUC patients were separated into two groups based on low-range ( 3.5 mg/l).Serum CRP was 3.5 mg/l. However, 46% of UTUC patients had serum CRP > 3.5 mg/l and 54% of UTUC patients had serum CRP < 3.5 mg/l. Conclusion: Although there was no difference in haptoglobin levels in patients and controls, but serum CRP was significantly increased in patients and it was associated with clinical symptoms of UTUC, suggesting that serum CRP can be considered as a complementary test for detection of low-grade UTUC.

Mucosal MicroRNAs Expression Profiles before and after Exclusive Enteral Nutrition Therapy in Adult Patients with Crohn's Disease.

MicroRNAs (miRNAs) have been shown to be important for the pathogenesis of Crohn’s disease (CD). Exclusive enteral nutrition (EEN) is an effective therapy for inducing remission in CD. We aimed to investigate the alteration of miRNAs expression profile in the terminal ileal mucosa of CD patients before and after EEN. Twenty-five patients and ten healthy individuals were included. MiRNAs expression profile was firstly assessed using microarray technology and then validation was performed by qRT-PCR. The correlations between miRNAs and CD activity index (CDAI) score and serum C–reactive protein (CRP) level were also evaluated. Microarray analysis showed that mucosal miRNAs expression profile after EEN therapy was significantly changed compared with inflamed mucosa before treatment, and was most similar to the healthy one among all CD groups. Altered expressions of hsa-miR-192-5p, hsa-miR-423-3p, hsa-miR-99a-5p, hsa-miR-124-3p, hsa-miR-301a-5p, hsa-miR-495-5p, and hsa-let-7b-5p were confirmed by qRT-PCR. hsa-let-7b-5p was significantly correlated with serum CRP levels before and after EEN treatment (r = −0.518, p = 0.008, and r = −0.569, p = 0.003). Our study showed EEN induction therapy was associated with a trend for normalizing of the mucosal miRNAs expression profile, and expression of mucosal hsa-let-7b-5p was correlated with serum CRP level in patients with CD.

Serum C-reactive protein and overall survival of patients with osteosarcoma.

Increased level of serum C-reactive protein (CRP) has been identified as an important prognostic factor in several types of cancers. However, the prognostic significance of serum CRP levels in patients with osteosarcoma was still unclear. A retrospective cohort study of 85 patients was performed to assess the prognostic significance of serum CRP level in osteosarcoma. Both log-rank test and multivariable analysis by Cox regression model were used to assess the impact of serum CRP levels on the overall survival in patients with osteosarcoma. Among those 85 patients, 28 (32.9 %) had high serum CRP level (>1 mg/dL), while the other 57 (67.1 %) patients had normal serum CRP level (≤ 1 mg/dL). There was no obvious difference in the baseline characteristics between high CRP group and normal CRP group. Kaplan-Meier product-limit method showed that patients with high serum CRP levels had significantly poorer overall survival than those patients with normal serum CRP levels (log-rank test P = 0.0008). Multivariable analysis by Cox regression model further showed that high serum CRP level was an independent predictor of poor overall survival (hazard ratio [HR] = 2.39; 95 % confidence interval [95 % CI] 1.22-4.67, P = 0.01). Thus, serum CRP level has an important prognostic significance in patients with osteosarcoma, and high CRP level is associated with worse overall survival.

Differences in C-reactive Protein Level in Patients with Alzheimers Disease and Mild Cognitive Impairment

Background: Numerous studies are supporting the hypothesis that neuroinflammation may play an important role in the pathogenesis of Alzheimer’s disease (AD). Reports on increased serum C-reactive protein (CRP) concentration as a risk factor for AD are conflicting. We examined the differences in the serum CRP levels in patients with AD and mild cognitive impairment (MCI) and normal controls. Methods: We enrolled 56 subjects with AD, 29 subjects with MCI, and 24 healthy control subjects in the study. A total of 109 subjects agreed to blood sampling to evaluate serum CRP levels. A dementia screening test was performed using the Korean version of the Mini-Mental Status Examination. Inclusion criteria for MCI used the Petersen guidelines Results: Among AD, MCI, and control groups, there were no significant differences in serum CRP levels. There was no association between CRP levels and MMSE scores in AD and MCI groups. Also CRP level did not significantly correlated with age or level of education. Conclusion: We observed no significant association between serum CRP values and the diagnosis of MCI and AD. Further longitudinal studies involving larger study population are needed to clarify possible role of CRP in the pathogenesis of this disease.

Levels of C-reactive protein (CRP) in patients with schizophrenia, unipolar depression and bipolar disorder

Objective: C-reactive protein (CRP) is the major acute-phase plasma protein. Studies show that patients with various mental disorders have elevated levels of CRP. The aim of the study was to determine differences in CRP serum level in patients with acute schizophrenia, unipolar depression, bipolar depression and bipolar mania. Method: Serum level of CRP was measured in 950 Caucasian inpatients (589 women, 62.0%; mean age 50.3 years). Results: Mean concentration of CRP in study groups was: schizophrenia (n = 485) 5.30 mg/l, unipolar depression (n = 319) 5.61 mg/l, bipolar disorder (n = 146) 4.65 mg/l, bipolar depression (n = 114) 3.82 mg/l and bipolar mania (n = 32) 7.36 mg/l. There was no difference for CRP levels between patients with schizophrenia, unipolar depression, bipolar depression and bipolar mania (P = 0.58). The overall rate of being above the high level of CRP (set at 3.0 mg/l) was 35.7% for schizophrenia, 38.6% for unipolar depression, 40.4% for bipolar disorder, 40.4% for bipolar depression and 40.6% for bipolar mania. There were no significant differences in the risk of having high level of CRP between the clinical groups. The rate of patients being above high level was higher in women. We also found that in whole study group CRP level was positively correlated with age (P = 0.002). Conclusions: Although there is no statistically significant difference in CRP serum level between patients with schizophrenia, unipolar depression, bipolar depression and bipolar mania, our results show that more than one-third (37.4%) of all subjects had CRP level > 3 mg/l, which is the cut-off point for high cardiovascular risk.

High preoperative C-reactive protein values predict poor survival in patients on chronic hemodialysis undergoing nephrectomy for renal cancer

ObjectivesPrevious studies have reported that elevated pretreatment C-reactive protein (CRP) levels are associated with poor outcome in various malignancies, including renal cell carcinoma (RCC), in the general population. However, there is no evidence of such an association in dialysis patients. Therefore, the aim of this study is to evaluate the prognostic significance of preoperative serum CRP levels in patients with RCC related to end-stage renal disease (ESRD) requiring hemodialysis (HD). Materials and methodsWe evaluated 315 patients with ESRD requiring HD who underwent nephrectomy for RCC as the first-line treatment at our hospital from 1982 to 2013. Complete patient- and tumor-specific characteristics as well as preoperative CRP levels were assessed. We defined a serum CRP level >0.5mg/dl as elevated and divided these patients into 2 groups according to their preoperative CRP levels (CRP≤0.5 and >0.5mg/dl). The median follow-up was 51 months. ResultsPreoperative CRP levels were elevated in 75 patients (23.8%). The Kaplan-Meier 5-year cancer-specific survival rates were 95.2% and 69.9% in patients with CRP levels≤0.5 and>0.5mg/dl, respectively (P<0.0001). Multivariate analysis identified preoperative CRP level as an independent predictor for cancer-specific survival, along with a pathological TNM stage and tumor grade (CRP>0.5: hazard ratio = 3.47; 95% CI: 1.35–9.18; P = 0.0098). The concordance index of multivariable base models increased after including the preoperative CRP levels. ConclusionsPreoperative serum CRP level might be an independent predictor of postoperative survival in patients with RCC related to ESRD requiring HD. Its routine use, together with the TNM classification and tumor grade, could allow better risk stratification and risk-adjusted follow-up of these patients.