Serum C-reactive Protein Levels Research Articles

Astragaloside for Improving Diabetic Vasculopathy Based on Microalbuminuria and C-Reactive Protein

Astragaloside has an ameliorative effect on diabetic vasculopathy. In this experiment, we investigated the role of astragaloside in improving diabetic vasculopathy. Eighty cases of type 2 diabetes mellitus (T2DM) patients with microalbuminuria (MAU) symptoms were selected and divided into T2DM group, astragaloside group, astragaloside+SRI-011381 group and astragaloside+ LDN193189 group. Another 20 healthy check-ups were selected as control group. We detected the content of C-reactive protein (CRP), ankle-brachial index (ABI) for both lower limbs, ultrasound examination of both lower limbs, and determined the vascular internal diameter (D), peak flow rate (Vmax), blood flow (Vol) of these three arteries, as well as grading the degree of lesion and scoring. T2DM group showed an increase in CRP level and UAlb content, decreased vessel internal diameter, an increased peak flow rate, decreased blood flow and ABI index, and a higher incidence of arteriopathy, which were all reversed in the Astragaloside group. The incidence of arterial lesions was lower. Compared with astragaloside group, serum CRP level and urine albumin content were increased in the astragaloside+SRI-011381 group, and serum CRP level and urine albumin content were decreased in the astragaloside+LDN193189 group. Moreover, inhibition of TGF-β/Smad pathway improved diabetic vasculopathy. Astragaloside therefore improves diabetic vasculopathy and slows diseased progression by inhibiting TGF-β/Smad signaling, lowering CRP levels as well as urinary albumin levels, hindering vasoconstriction and increasing blood flow.

Study on correlation between Vitamin D status and proinflammatory cytokines in children with RSV bronchiolitis

The objective of our study was to evaluate vitamin D status and serum levels of C-reactive protein (CRP) alongside the proinflammatory cytokines IL-1β, IL-6, and TNF-α, in order to investigate their correlation with the incidence and severity of acute RSV bronchiolitis in children. The study included 39 children, aged 1 month to 2 years, divided into two subgroups: children with acute RSV bronchiolitis (n=20) and a control group of healthy children (n=19). No significant difference in vitamin D status was found between the patient and control groups. The patient group exhibited elevated levels of IL-1β and TNF-α compared to healthy children, while IL-6 levels did not differ significantly between the two groups. Correlation analysis demonstrated a positive, statistically significant association between IL-6 and TNF-α. However, no statistically significant correlations were observed between the severity of broncho obstructive syndrome and other indicators, including 25(OH)D, parathyroid hormone (PTH), IL-1β, IL-6, TNF-α, and CRP. Furthermore, no correlation was found between vitamin D levels and any of the cytokines. These findings suggest that while inflammatory markers may play a role in RSV bronchiolitis, vitamin D status does not appear to be a contributing factor to the incidence or severity of the disease in the pediatric population studied.

Erythropoietin for the prevention of postoperative neurocognitive disorder in older adult patients undergoing total joint arthroplasty: a randomized controlled study.

Post-operative delirium (PD) is a common post-operative complication with significant clinical and financial impacts on patients. Erythropoietin (EPO), a multi-functional glycoprotein hormone, exhibits erythropoietic and non-erythropoietic anti-inflammatory properties. This study aimed to determine the role of perioperative EPO administration in the development of postoperative delirium in older adult patients undergoing total joint arthroplasty. Seventy-one patients (> 65 years old) scheduled for total joint arthroplasty were randomly assigned to two groups: EPO-treated (EPO, n = 35) and placebo (control, n = 36). All patients completed the Mini Mental State Examination (MMSE) pre-operatively and on post-operative day (POD) 2. The confusion assessment method (CAM) was used to assess the patients until discharge (POD 5). Serum C-reactive protein (CRP) and inflammatory cytokine levels were measured and compared pre- and post-operatively. The development of delirium and cognitive dysfunction was evaluated post-operatively. One patient in the control group developed delirium on POD 2 (3.2%), whereas no patient in the EPO group developed PD (0% vs. 3.2%, p = 0.500). Post-operatively there was no significant difference in MMSE scores between groups. Both groups showed increases in pro- and anti-inflammatory cytokine levels, with no significant differences. Similarly, CRP levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) showed no intergroup differences in post-operative inflammatory responses. Perioperative EPO reduced the incidence of post-operative delirium, although not statistically significant, with no differences in post-operative cognitive function and inflammatory responses. The trial was registered on December 12, 2023 at http//clinicaltrials.gov, registration number NCT06178835.

99mTc]-PentixaTec SPECT/CT for Imaging of Chemokine Receptor 4 Expression After Myocardial Infarction.

Accumulation of CXCR4 (C-X-C motif chemokine receptor 4)-positive immune cells after acute myocardial infarction (AMI) can be visualized by positron emission tomography. For a broader clinical application, there is a need for CXCR4-directed radiotracers labeled with isotopes that can be used with single-photon emission computed tomography (SPECT). We report on the detection of CXCR4 expression after AMI in humans using the novel tracer [99mTc]-PentixaTec. In this retrospective analysis, 9 patients with AMI after mechanical revascularization underwent myocardial inflammation imaging with [99mTc]-PentixaTec SPECT/computed tomography and rest perfusion SPECT imaging. Tracer uptake in the infarcted area, spleen, bone marrow, and blood pool were used for semiquantitative analysis and calculation of signal-to-background ratios. The extent and intensity of SPECT-derived inflammatory changes were compared with serological markers and perfusion defects. CXCR4-directed SPECT was positive in all patients. Increased CXCR4 expression was only detected in areas with diminished perfusion corresponding to the affected vessel in coronary angiography, with a signal-to-background ratio (infarcted area-to-blood pool) of 2.36±0.74. Uptake in bone marrow and spleen showed a significant correlation with CXCR4 expression in the infarcted areas (r=0.73 and P=0.03 for spleen and r=0.81 and P=0.008 for bone marrow, respectively). The extent and intensity of SPECT-derived inflammatory changes showed no significant association with serum troponin, CK (creatine kinase), leukocyte, or CRP (C-reactive protein) levels. This is the first report of in vivo CXCR4 imaging after AMI using a 99mTc-labeled tracer. Increased CXCR4 expression was observed locally in the infarcted region and was related to a systemic inflammatory response in the reticuloendothelial system. This proof-of-concept investigation demonstrates the general feasibility of evaluating the inflammation-related CXCR4 expression in the myocardium after AMI using conventional scintigraphy or SPECT and might, thus, broaden its worldwide application in clinical practice.

Comparative clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis vs. chemical pleurodesis in the management of spontaneous pneumothorax

ObjectiveThis study aims to observe the clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis compared to traditional iodine chemical pleurodesis in the treatment of patients with spontaneous pneumothorax.MethodsA total of 128 patients with spontaneous pneumothorax who underwent surgical treatment at our institution from January 2021 to December 2022 were selected. Patients were categorized into the study group (n = 65) and the control group (n = 63) based on the surgical method used. The study group received C-shaped pleura cautery for pleurodesis, while the control group underwent traditional iodine chemical pleurodesis. Surgical and clinical outcomes were evaluated, and recurrence rates within one year postoperatively were compared. Serum C-reactive protein (CRP) levels and visual analog scale (VAS) scores were measured at different time points.ResultsNo significant differences were observed between the two groups regarding surgical duration, intraoperative blood loss, or postoperative hospital stay (p > 0.05). However, the study group demonstrated significantly lower serum CRP levels and VAS scores on postoperative days 1 and 2, as well as reduced drainage volumes compared to the control group (p < 0.05). The recurrence rates of pneumothorax within one year postoperatively did not differ significantly between the groups (p > 0.05).ConclusionSingle-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis is an effective treatment for spontaneous pneumothorax. Compared to traditional iodine chemical pleurodesis, this method causes less pleural irritation, results in lower postoperative pain and drainage, and facilitates patient recovery, making it a safe and reliable option for the management of spontaneous pneumothorax.

Abstract 4137907: Elevated Plasma Neopterin Levels in Patients with Takotsubo Cardiomyopathy

Background: Takotsubo cardiomyopathy (TC) is characterized by left ventricular apical ballooning and intact coronary arteries. The pathogenesis of this disorder is likely to be catecholamine-mediated myocyte damage, microvascular dysfunction and subsequent oxidative stress; however, a number of possible alternative theories have been suggested. Neopterin is produced by activated macrophages following stimulation by interferon-g produced by T-lymphocytes and is capable of enhancing the oxidative potential of reactive oxygen species. The aim of this study was to compare plasma neopterin levels between TC patients and patients with coronary artery disease. Methods: Plasma neopterin levels were measured on admission in patients with TC (n=37), stable angina pectoris (SAP, n=66), unstable angina pectoris (UAP, n=72) and acute myocardial infarction (AMI, n=67) using HPLC. A frozen myocardium specimen was obtained by biopsy from a patient with TC and stained for neopterin, macrophages, and microvessels using immunohistochemistry. Results: Plasma neopterin levels were significantly higher in TC patients compared with SAP patients ( P <0.0001) or UAP patients ( P <0.05), although they were not significantly different from those in AMI patients. In TC patients, plasma neopterin levels correlated positively with neutrophil count (R=0.47, P<0.05) and serum C-reactive protein levels (R=0.38, P<0.05). Immunohistochemical staining showed abundant neopterin-positive macrophages in the myocardium specimen from the patient with TC. Conclusions: This study demonstrates, for the first time, that plasma neopterin levels are elevated in TC patients compared with those in SAP and UAP patients. These findings suggest that neopterin may play an important role in the pathophysiology of Takotsubo cardiomyopathy.

COVID-19 inflammatory signature in a Mozambican cohort: unchanged red blood series and reduced levels of IL-6 and other proinflammatory cytokines.

Alterations in haematological, biochemical parameters and cytokine levels, were reported in patients with COVID-19, however, there is an underrepresentation of the African population, which could provide evidence for understanding SARS-CoV-2 pathogenesis and useful tools for clinical management of cases. In this study, we aimed to determine the haematological, biochemical and cytokine profile in Mozambican individuals with SARS-CoV-2. A cohort of 85 Mozambican individuals with RT-PCR SARS-CoV-2 results, was stratified into negative, asymptomatic, mild, moderate, and severe categories. Haematological, biochemical and cytokines measurement were performed on samples from the study participants. Principal component analysis (PCA) was performed to identify similar patterns among the study cases. Comparisons between groups were performed using the Kruskal-Wallis test. Receiver operating characteristic (ROC) and area under the curve (AUC) analysis were conducted to evaluate the ability of these parameters to distinguish severe from non-severe cases of SARS-CoV-2 infection. SARS-CoV-2 infection was associated with a significant (p < 0.05) decrease in peripheral blood absolute counts of total lymphocytes and eosinophils, below the reference values along with no abnormal change (p > 0.05) in red blood cell count, haemoglobin, platelets and other red series parameters. At the serum level, SARS-CoV-2 infection was associated with an increase in serum levels of C-reactive protein (C-RP) and glucose above the reference values and to a significant reduction a significant (p < 0.05) reduction in levels of interferon-gamma (INF-γ), Tumour Necrosis Factor alfa (TNF-α) and the interleukin 1 beta (IL-1β) and IL-6 in severe cases, when compared to negative cases. Haematological, biochemical and cytokine profiles segregate severe from non-severe cases of COVID-19 with an excellent performance of C-RP (AUC = 0.95; p < 0.001) and good performance of lymphocytes (AUC = 0.88; p < 0.001) and IL-15 (AUC = 0.86; p < 0.001). The lack of variation in red and platelet series, coupled with a decrease in the levels of classical pro-inflammatory in severe cases, deviates from what has been reported in other contexts suggesting, that there may be peculiarities in COVID-19 manifestation within the context of this study population. Furthermore, these results identify parameters with potential for clinical management of COVID-19 and therefore good resource allocation, particularly for severe cases.

Analysis of periodontal status in Polish patients with rheumatoid arthritis treated with biological therapies

IntroductionPeriodontitis, characterized by inflammation affecting the tooth-supporting tissues, may increase the risk of rheumatoid arthritis (RA) or cardiovascular diseases. The aim of the study was to evaluate the periodontal status in RA patients and its impact on the inflammatory markers and red cell parameters obtained from complete blood laboratory tests to study the risk of cardiovascular disease development.Material and methodsThe cross-sectional study included 50 patients with RA treated with biologi­cal therapies: tumor necrosis factor inhibitors, interleukin-6 blockers. Rheumatoid arthritis disease activity was assessed with Disease Activity Score with 28-joint count (DAS28). The periodontal indices modified Approximal Periodontal Index, modified Papillary Bleeding Index, and Periodontal Screening Index (PSI) were used to assess patients’ periodontal status. Serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used as inflammatory markers and a potential cardiovascular risk factor.ResultsNo statistically significant correlation was found between the periodontal status and RA activity. However, a statistically significant correlation was found between the CRP results and the PSI scores (&lt;i&gt;R&lt;/i&gt; = –0.264510, &lt;i&gt;p&lt;/i&gt; = 0.048837). Evaluation of the red cell parameters showed statistically significant differences in the markers of inflammation ESR (&lt;i&gt;R&lt;/i&gt; = 0.369398, &lt;i&gt;p&lt;/i&gt; = 0.008289) and CRP (&lt;i&gt;R&lt;/i&gt; = 0.367405, &lt;i&gt;p&lt;/i&gt; = 0.008672). Red cell distribution width values were also correlated with RA activity (&lt;i&gt;R&lt;/i&gt; = 0.286387, &lt;i&gt;p&lt;/i&gt; = 0.043769) and duration of the disease (&lt;i&gt;R&lt;/i&gt; = 0.339425, &lt;i&gt;p&lt;/i&gt; = 0.015889).ConclusionsA satisfactory periodontal status was found in most of the study group. Increased CRP levels in patients with periodontitis may indicate the negative impact of periodontal status on the general clinical condition of the patient.

Effects of an anti-inflammatory diet (AID) on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease treated with infliximab (IFX)

Objective This study aimed to evaluate the effects of an anti-inflammatory diet (AID) combined with Infliximab (IFX) therapy on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease (IBD). Methods IBD patients treated with steady IFX maintenance therapy at the time of conception were randomly assigned to either the IBD-AID group (n = 49), which received an anti-inflammatory diet intervention during the third trimester, or the habitual diet group (n = 49). Primary outcomes included assessments of disease activity, inflammatory markers, and neonatal health. Secondary outcomes included health-related quality of life (HRQoL) in patients and functional gastrointestinal disorders (FGIDs) in infants. Results The IBD-AID intervention significantly reduced disease activity scores in IBD patients at 4 weeks post-intervention and 1 month postpartum compared to the habitual diet group, and also improved HRQoL. Serum C-reactive protein (CRP) and fecal calprotectin (FC) levels were significantly lower in the IBD-AID group at these times, with a trend towards lower levels at 6 months postpartum. Birth weight and Apgar scores were higher in the IBD-AID group but did not reach statistical significance. The incidence of at least one FGID in infants was significantly lower in the IBD-AID group (24.5%) compared to the habitual diet group (46.9%, p = 0.034). Conclusion The IBD-AID intervention combined with IFX therapy significantly improved disease activity, inflammatory markers, and QoL in maternal IBD patients, and was associated with a lower incidence of FGIDs in infants, indicating benefits for both maternal and neonatal health.

Noninvasive, Multimodal Inflammatory Biomarker Discovery for Systemic Inflammation (NOVA Study): Protocol for a Cross-Sectional Study.

Prolonged systemic inflammation is recognized as a major contributor to the development of various chronic inflammatory diseases. Daily measurements of inflammatory biomarkers can significantly improve disease monitoring of systemic inflammation, thus contributing to reducing the burden on patients and the health care system. There exists, however, no scalable, cost-efficient, and noninvasive biomarker for remote assessment of systemic inflammation. To this end, we propose a novel, multimodal, and noninvasive approach for measuring inflammatory biomarkers. This study aimed to evaluate the relationship between the levels of inflammatory biomarkers in serum (gold standard) and those measured noninvasively in urine, sweat, saliva, exhaled breath, stool, and core body temperature in patients with systemic inflammation. This study is a single-center, cross-sectional study and includes a total of 20 participants (10 patients with systemic inflammation and 10 control patients). Eligible participants provide serum, urine, sweat, saliva, exhaled breath, and stool samples for biomarker analyses. Core body temperature is measured using a sensor. The primary end point is the level of C-reactive protein (CRP). The secondary end points are interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor-α levels. The tertiary end points are fractional exhaled nitric oxide, calprotectin, and core body temperature. Samples will be collected in 2 batches, enabling preliminary analysis of the first batch (patients 1-5 from each group). The full analysis will include both batches. CRP and cytokine levels will be measured using enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay. For statistical analysis, the Shapiro-Wilk test will be used to evaluate the normality of the distribution in each variable. We will perform the 2-tailed t test or Wilcoxon rank sum test to compare the levels of inflammatory biomarkers between patients with systemic inflammations and control patients. Pearson and Spearman correlation coefficients will assess the relationship between inflammatory biomarkers from noninvasive methods and serum biomarkers. Using all-subset regression analysis, we will determine the combination of noninvasive methods yielding the highest predictive accuracy for serum CRP levels. Participants' preferences for sampling methods will be assessed through a questionnaire. The study received ethics approval from the independent research ethics committee of Canton Zurich on October 28, 2022. A total of 20 participants participated in the study measurements. Data collection started on February 22, 2023, and was completed on September 22, 2023. Participants were on average 52.8 (SD 14.4; range 24-82) years of age, and 70% (14/20) of them were women. The analysis results reporting findings are expected to be published in 2025. This study aims to evaluate the feasibility of noninvasive, multimodal assessment of inflammatory biomarkers in patients with systemic inflammation. Promising results could lead to the creation of noninvasive and potentially digital biomarkers for systemic inflammation, enabling continuous monitoring and early diagnosis of inflammatory activity in a remote setting. DERR1-10.2196/62877.

The causal effects of lifestyle, circulating, pigment, and metabolic factors on early age-related macular degeneration: a comprehensive Mendelian randomization study

PurposeEarly detection of lifestyle factors, skin and hair color, circulating parameters, and metabolic comorbidities is crucial for personalized prevention and treatment of early age-related macular degeneration (AMD). This study aimed to assess the relationships between genetically predicted comprehensive risk factors and early AMD.Methods and resultsPublicly available genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with each trait. We applied a Bonferroni-corrected significance level of P < 0.0017. P values between 0.0017 and 0.05 were considered suggestive associations. Univariable Mendelian randomization (MR) analyses revealed that elevated serum HDL-C, lower serum TG, and decreased three circulating fatty acids levels were robust indicators of an increased risk of early AMD (all P < 0.0017), with odds ratios (ORs) and 95% confidence intervals (CIs) of 1.218 (1.140–1.303), 0.784 (0.734–0.837), 0.772 (0.698–0.855), 0.776 (0.706–0.852), and 0.877 (0.798–0.963), respectively. Additionally, the “never eat wheat products”, “age started wearing glasses”, and “skin color” were significantly associated with the risk of early AMD (both P < 0.0017), with ORs (95% CIs) of 23.853 (2.731–208.323), 1.605 (1.269–2.030) and 1.190 (1.076–1.317), respectively. Multivariable MR analysis confirmed that elevated serum HDL-C (OR = 1.187, 1.064–1.324) increased the risk of early AMD, while higher serum TG (OR = 0.838, 0.738–0.950) was associated with a significantly lower risk. Furthermore, validation results indicated that serum HDL-C 1.201 (1.101–1.310) and TG 0.795 (0.732–0.864) were significantly associated with the risk of early AMD. There were suggestive associations of smoothies, chronotype, and hair color (0.0017 < P < 0.05), but sun/UV protection, smoking, BMI, diabetes, high blood pressure, cardiovascular diseases, fresh fruit intake, fish oil/cod liver oil supplement, sleeplessness, serum C-reactive protein level, and iron level were not associated with the risk of early AMD.ConclusionsOur comprehensive MR analysis demonstrated that elevated circulating HDL-C levels increase the risk of early AMD, while TG and fatty acid levels are associated with a decreased risk. These findings provide robust evidence for improved diagnosis and personalized prevention and treatment of early AMD.

Expression of NLRP3 in serum and induced sputum of children with asthma and their relationship with disease severity

ObjectivesThe aim of this cross-sectional study is to investigate the levels of NLRP3 in the serum and induced sputum of children with asthma and their potential association with lung function and disease severity.MethodsThis cross-sectional study included 83 children with bronchial asthma who sought medical care at our hospital from May 2023 to February 2024. Portable spirometry was used to monitor lung function parameters, including forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow. The expression of C-reactive protein (CRP), interleukin (IL)-6, IL-1β, TNF-α, and Nod-like receptor family pyrin domain-containing 3 (NLRP3) in the serum and induced sputum were measured by enzyme-linked immunosorbent assay. Data analysis was performed using SPSS 25.0 and differences with P < 0.05 were considered statistically significant.ResultsChildren with asthma exhibited significantly elevated levels of serum NLRP3, CRP, IL-6, IL-1β, and TNF-α compared to healthy controls. In addition, children with moderate–severe asthma had significantly higher levels of serum and induced sputum NLRP3 and IL-1β compared to children with mild asthma. Spearman’s correlation analysis revealed a positive correlation between induced sputum NLRP3 and IL-6. Moreover, induced sputum NLRP3 was negatively correlated with lung function parameters. The results of receiver operating characteristic curves showed that induced sputum NLRP3 could be used for diagnosing children with moderate–severe asthma, with an AUC was 0.758, cutoff value of 3.33 ng/mL, sensitivity of 66.1%, and specificity of 70.8%. Furthermore, the logistic regression analysis revealed that serum and induced sputum NLRP3, induced sputum IL-6 and IL-1β were risk factors for children with moderate–severe asthma.ConclusionsIn this cross-sectional study, we found a significant increase in NLRP3 levels in induced sputum of children with asthma, which further increased in those with moderate–severe disease. The levels of NLRP3 in induced sputum could serve as potential biomarkers for assessing disease severity.

Effect of dietary protein on serum hepcidin and iron in adults with obesity and insulin resistance: A randomized single blind clinical trial.

Background and AimsBoth obesity and iron deficiency are public health problems. The association between the two problems could be explained by chronic low-grade inflammation in obesity, which could stimulate hepcidin expression and modify iron concentration that the consumption of high-protein diets could prevent. Thus, this study aimed to compare the effects of high-protein diets with a predominance of animal or vegetable protein on serum hepcidin and iron concentrations in adults with obesity. Methods and ResultsThis randomized clinical trial involved adults with obesity and insulin resistance, who were assigned to either a high animal protein (AP) group or a high vegetable protein (VP) group for a one-month intervention. Both groups followed a calorie-restricted diet, reducing energy intake by 750 kcal/day. Baseline and final measurements included serum concentrations of hepcidin and iron, biochemical parameters, anthropometric data, and body composition. A total of 33 participants (63% female) were included in the study. Significant weight loss was observed in both groups after the intervention. Adjusted for weight loss percentage, the AP group showed a significant increase in hepcidin concentration (from 22.3 ± 14.7 to 27.5 ± 19.5 ng/mL) compared to the VP group (from 17.9 ± 15.1 to 17.2 ± 10.1 ng/mL) (p < 0.01), with no changes in serum iron concentration. Additionally, the VP diet significantly reduced serum adiponectin (p = 0.04) and C-reactive protein (p = 0.03) levels. ConclusionsIn adults with obesity following the AP diet for one month, hepcidin levels increased without affecting serum iron concentrations. Trial registrationNCT03627104

Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.

Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023. Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared. The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01). The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI. Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.

Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.

Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023. Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared. The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01). The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI. Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.

Well-Being and Performance of Nursery Pigs Subjected to Different Commercial Vaccines Against Porcine Circovirus Type 2, Mycoplasma hyopneumoniae and Lawsonia intracellularis

Background/Objectives: Vaccination is a strategy in pig farming for the control of several pathogens, but commercial vaccines may have detrimental side effects. This study aimed to evaluate the effects of commercial vaccines on the control of porcine circovirus type 2 (PCV2), Mycoplasma hyopneumoniae (Mhp), and Lawsonia intracellularis (L. intracellularis) and their potential side effects on welfare, behavior, acute inflammation biomarkers (C-reactive protein and haptoglobin), and the performance of piglets during the nursery phase. Methods: A total of 240 piglets, both female and castrated males, with an average weight of 6.3 ± 0.9 kg were subjected to four treatments: T1-FLEXcombo® (Ingelvac®CircoFLEX and Ingelvac®MycoFLEX) + Enterisol® Ileitis; T2-FLEXCombo® + Porcilis® Ileitis; T3-Porcilis® PCV M HYO + Porcilis® Ileitis; and T4-FLEXCombo® + 0.9% saline solution. This study measured therapeutic interventions, body condition score, behavioral changes, rectal temperature, and inflammation biomarkers post-vaccination. Results: The T3 group required more therapeutic interventions and exhibited a 23.1% higher incidence of thin body condition (p &lt; 0.05) and 10 times more animals with depressed behavior than T1 (p &lt; 0.05). The piglets vaccinated for L. intracellularis (T2 and T3) had rectal temperatures exceeding 39.7 °C post-vaccination, significantly higher than in T1 (p &lt; 0.05). The T1 animals showed five times more positive behavior traits 24 h after vaccination (p &lt; 0.05). Touch response was 29% lower in the T2 and T3 groups, and the lying down behavior was higher in these groups compared to T1. Additionally, 41.7% of the T3 animals exhibited a sitting posture 48 h after vaccination. Higher serum C-reactive protein and haptoglobin levels were observed in T3 (p &lt; 0.05) at 24 and 48 h post-vaccination. Feed intake was higher in T1 compared to T3 between 29 and 35 days of age. It is important to note that this study did not measure immune responses to the pathogens and did not include challenge tests, and therefore, it does not assess which vaccine is superior in pathogen control. Conclusions: The vaccine programs resulted in similar zootechnical performance. However, T1, T2, and T4 showed better effects on piglet welfare and behavior compared to T3.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C-reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars.This study aimed to correlate and compare the impact of aescin and diclofenac on salivary PGE2 levels and serum C-reactive protein levels after surgical extraction of the mandibular third molar. The study will also evaluate and compare the effectiveness of individual drug therapy in managing postoperative pain, swelling and mouth opening. The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar.Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C-reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). The proposed study is expected to show a clinically acceptable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery.The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C-reactive protein, which are reliable inflammatory markers.The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Effect of Phytosterols on Serum Levels of C-Reactive Protein: A Time- and Dose-Response Meta-analysis of Randomized Controlled Trial.

Phytosterols are recognized for their cholesterol-reducing effects and are commonly used as dietary supplements or added to foods due to their potential cardiovascular benefits. However, evidence regarding the impact of phytosterol supplementation on inflammatory markers remains inconclusive. This systematic review and meta-analysis aim to evaluate the effect of phytosterols in reducing levels of C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP). A systematic literature search of the primary databases was conducted up to May 2024 to identify eligible studies. The measurement of effect sizes was determined using WMD (weighted mean difference) and 95% CI. For the meta-analysis, 14 publications (19 study arms) for hs-CRP and 10 publications (16 study arms) for CRP were included. The pooled analysis showed that the administration of phytosterol did not significantly reduce CRP compared to control with WMD= -0.04mg/l (95% CI: -0.28 to 0.20, P = 0.74). However, phytosterol supplementation significantly decreased the hs-CRP level compared to the control group with WMD of -0.25mg/l (95% CI: -0.42 to -0.07, P = 0.006). The WMD for hs-CRP reduction was - 0.36mg/l (95% CI: -0.53 to -0.18, P < 0.001) for supplementation with a phytosterol dose ≥ 2000mg/day compared to the control group. Phytosterol supplementation may be effective in reducing hs-CRP levels.

Analgesic Effects of Methanol Leaf Extracts from Datura alba ness in Male Wistar Rats through Reduction of C-reactive Protein Levels

Introduction: The increasing interest in utilizing natural products from medicinal plants for pain management stems from their wide availability and minimal side effects. This study aims to evaluate the toxicity profile of Datura alba ness (DAN) extracts and assess their potential analgesic activity through preventive and therapeutic analgesia models in Wistar rats, as well as to investigate the possible mechanisms of action using molecular docking. Materials and Methods: Fresh leaves of DAN were collected from a garden in the Abua/Odua Local Government Area of Rivers State, Nigeria. The leaves were extracted using cold maceration to obtain ethanolic extracts of Datura alba ness (MEDAN). Twelve mice (19-30g) were used for toxicity study, while sixty Wistar rats (140-180g) were used for analgesic studies. Serum C-reactive protein levels were determined using ELISA methods, and molecular docking simulations were conducted using AutoDock and Discovery Studio Visualizer. Results: The results indicated that MEDAN was very safe, with an LD50 of 5000 mg/kg. The findings demonstrate that MEDAN significantly increased the pain threshold in male Wistar rats after three weeks of administration in a dose-dependent manner during the preemptive analgesia study, while pain thresholds increased within one hour but decreased over time in the therapeutic analgesia study. The combination of MEDAN with a standard drug (Flexicam) resulted in improved analgesic effects at the 500 mg/kg dose. Additionally, the study revealed that MEDAN significantly reduced serum C-reactive protein levels after three weeks of oral administration. Molecular docking studies indicated that stigmasterol, gamma-sitosterol, and cholest-5-en-3-ol, 24-propylidene-(3β) from MEDAN demonstrated binding affinity to C-reactive protein receptors, mimicking the effects of the reference drug, celecoxib. Conclusion: This study concludes that ethanolic extracts of Datura alba ness exhibited significant efficacy in pain reduction by lowering C-reactive protein levels. This effect was especially enhanced when the 500 mg/kg dose of MEDAN was combined with the standard drug, Flexicam. The findings provide a scientific basis supporting the traditional medicinal use of Datura alba ness for pain management.

Association Between Serum C-Reactive Protein (CRP) And D-Dimer Levels In Covid-19 Patients In A Tertiary Level Hospital, Khulna

Background: The novel corona virus disease 2019 (COVID-19) is major public health issue. It is the most significant global health challenge in the world. Biomarkers play a significant role to detect the severity of COVID-19 infection in the perspective of management of the patients. Aim and objective: We aimed to assess the association between the levels of C-Reactive Protein and D-dimer in COVID-19 patients. Methods: This cross-sectional study was conducted in the department of Pathology and department of Microbiology GMCH, Khulna. 152 patients with SARS-CoV-2 (COVID -19) positive patients were enrolled in this study. C-reactive protein and D-dimer levels are measured in the laboratory of Pathology department, GMCH, Khulna. All statistical computations were performed by using window-based computer software devised with Statistical Packages for Social Sciences (IBM SPSS Statistics 21 version). Results: In this study CRP level was found of mean value of 62.84± 44.64 mg/L with a range of 1.40-195.20 mg/L. It was normal in 21 (13.8%) patients and increased in in 131 patients (86.2 %). The mean value of D-dimer was 2.48 ± 02.20 mg/L with a range of 0.10-9.35 mg/L. D-dimer was normal in 26 (17.1%) patients, whereas it was increased in 126 patients (82.9 %). We performed Pearson’s correlation-coefficient (r) test to compare the association between the levels of CRP with D-dimer in COVID-19 positive patients. There was moderately positive and significant correlation (r = +0.647, p &lt;0.05) between the levels of CRP and D-dimer. Conclusion: There was statistically significant correlation between the levels of serum CRP with D-dimer in COVID-19 positive patients. These two biomarkers can be used to assess the severity in patients with COVID-19 positive with thrombotic disorder for reduction of morbidity and mortality of COVID positive patients. J Dhaka Med Coll. 2023; 32(1) : 57-62