Serum Concentrations Of CRP Research Articles

Calprotectin as a Serodiagnostic Marker for Bacterial Sepsis

Introduction: Since sepsis is a major global health problem, a rapid and correct diagnosis and the initiation of therapy are essential to improve the patient consequences. This study aimed to assess the serum levels of calprotectin and a more widely used sepsis biomarker in the patients with bacterial sepsis (BS). Method: Subjects were classified into BS group with the patients who met the sepsis criteria at the beginning of the study and the control group. We investigated the concentrations of biomarkers in 300 blood samples collected at admission from all patients hospitalized in the Fatemeh Al-Zahra Hospital, Najafabad, Isfahan in April 2019 and April 2020. Results: The microbial etiology in the BS group was confirmed in 35 patients (100%). The most frequently cultivated pathogens were Escherichia coli (n=11). The serum concentrations of calprotectin and CRP were significantly higher in the patients with BS (n= 35) than in the healthy controls (n= 20). Conclusion: Our results suggest that the serum level of calprotectin could have the substantial added value to manage BS which is a reliable biomarker of BS.

Pathophysiological and clinical aspects of comorbidity of coronavirus disease and chronic generalized periodontitis (literature review)

The purpose of the literature review was to conduct a general analysis of the literature data on the study of comorbidity between coronavirus disease and inflammatory periodontal diseases. Studies have found that periodontitis is significantly associated with a higher risk of complications from COVID-19, including intensive care unit hospitalization, the need for assisted ventilation and death, as well as increased blood levels of markers associated with worse COVID-19 outcome. 19, such as D-dimer, serum leukocyte level and CRP concentration. The article describes the mechanisms of penetration of the SARS-CoV-2 virus into the human body, the common links of pathogenesis between COVID-19 and periodontitis, the importance of oral hygiene for patients with COVID-19, and considers the clinical and general immunological aspects of inflammation in COVID-19 and periodontitis. Currently, most research is focused on whether the presence of periodontal disease affects the outcome of coronavirus disease. The possibility of cross-talk between SARS-CoV-2 and the oral microbiome, which may affect the subsequent course of periodontitis at the post-covid stage, presents the scientific interest.

Inflammatory Markers in Chronic Kidney Disease

Background: Despite recent advances in chronic kidney disease (CKD) and end-stage renal disease (ESRD) management, morbidity and mortality in this population remain exceptionally high. Persistent, low-grade inflammation has been recognized as an important component of CKD, playing a unique role in its pathophysiology and being accountable in part for cardiovascular and all-cause mortality, as well as contributing to the development of protein-energy wasting. Material and methods; This study was conducted on CKD patients attending OPD & IPD of Civil Hospital tarn taran. The participants having age more than 18 years & less than 60 years. We assessed 120 individuals out of 60 are normal healthy individuals comprising the control groups & rest 60 is of CKD cases. Serum CRP (mg/dl) concentration was measured by Latex agglutination test & ESR (mm/hour) was measured by Wintrobe’s method. Serum Creatinine (mg/dl), Urea (mg/dl) & Uric acid (mg/dl) concentration was measured by Modified Jaffe’s method, Urease & Uricase method respectively. Results: - In the present study, serum CRP & ESR was increased in CKD patients. The mean serum CRP levels of CKD patients & controls were 33.55 ± 22.8 & 2.07 ± 6121 respectively (p< 0.001), highly significant result was observed. Mean level of serum ESR (40.25 ± 14.93) of cases shows statistical significant differences as compared with the mean of serum ESR of controls (13.50 ± 3.421). Conclusion: - CRP & ESR are the markers used to evaluate kidney disease, however, each of these has its own limitation. The use of these inflammatory biomarkers may better assess overall patients’ risk & be able to stage patients more appropriately.

Fekalni kalprotektin kao marker aktivnosti Kronove bolesti

Introduction. Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with periods of remission and exacerbation. Numerous studies have been conducted in order to identify the ideal marker when it comes to the inflammatory bowel diseases. In the literature, fecal calprotectin is mentioned as a marker of inflammation. Elevated levels of calprotectin can be detected in stool and they indicate the migration of neutrophils to the intestinal mucosa that occurs with intestinal inflammation. The aim. The main goal of this study was to examine the concentration of fecal calprotectin and CRP depending on the clinical, endoscopic and histological characteristics of patients with Crohn's disease and whether there is a correlation of these markers with disease activity. Methods. The research was conducted in the period from January 2015 to January 2016. The study included subjects who had been diagnosed with Crohn's disease. The study involved 45 respondents, aged 20 - 58 years. All subjects included in the study underwent a colonoscopic examination with biopsy and pathohistological analysis. Fecal calprotectin was determined in one stool sample in all subjects, and that was done quantitatively by a commercial ELISA assay. Determination of serum CRP concentrations was performed in the Central Biochemical Laboratory by standard methods. Results. Fecal concentrations of calprotectin are elevated in all three forms of the disease, while they are significantly higher in moderately severe (545 vs. 218, p ˂ 0.001) and severe forms of the disease (1000 vs. 218, p ˂ 0.001) compared to the mild form. Fecal concentrations of calprotectin are significantly higher at endoscopic grade 3 compared to the other three endoscopic grades (765.3 vs. 314, p ˂ 0.001), (765.3 vs. 392.8, p ˂ 0.001), (765.3 vs. 448.2, p ˂ 0.001). Fecal concentrations of calprotectin are significantly higher in extensive pathological findings compared to normal epithelial surface (1000 vs. 21, p ˂ 0.001) as well as in extensive pathological findings compared to focal pathological findings (1000 vs. 309, p ˂ 0.001). Conclusion. The more severe form of clinical disease activity is accompanied by higher fecal values of calprotectin and higher endoscopic grade, and a more severe histological grade of disease is accompanied by higher fecal values of calprotectin.

Targeted inhibition of FcRn reduces NET formation to ameliorate experimental ulcerative colitis by accelerating ANCA clearance.

Dysregulated immune responses have now been recognized as an essential stimulator of ulcerative colitis (UC). Neutrophil extracellular traps (NET) were reported as the potential factor in sustaining mucosal inflammation in UC. NET formation further induces antineutrophil cytoplasm autoantibodies (ANCA) that serve as a biomarker in determining the severity of UC, which have a long half-life due to neonatal Fc receptor (FcRn)-mediated recycling. This study aimed to explore the role of the ANCA-NET cycle in UC and evaluate the potential of targeting FcRn in UC treatment. Dextran sodium sulfate-induced mice and rat models were used in this study. anti-rat FcRn monoclonal antibodies were used to block FcRn function in vivo. Disease activity index (DAI) and histopathological score (HS) were estimated to characterize the inflammation severity of UC. Serum concentrations of IgG, ANCA, TNF-α, IL-1β and CRP were measured using specific ELISA kits. Colonic NET-associated protein (NAP) expression was determined by western blotting. Serum ANCA and colonic NAPs showed a positive correlation that varied with changes in serum inflammation-related indexes (IRI; including TNF-α, IL-1β, and CRP) and DAI and HS in mice with UC. Blockade of FcRn significantly reduced serum ANCA levels and colonic NAP expression and effectively decreased serum IRIs, DAI, and HS in rats with UC. Especially during the inflammation recurrence period, blockade of FcRn exerted even better therapeutic effects in rats with UC than salazosulfapyridine. Our results show that anti-FcRn therapy has benefits in UC treatment through reduced colonic NET formation by accelerating serum ANCA clearance.

Excess body weight and specific types of depressive symptoms: Is there a mediating role of systemic low-grade inflammation?

ObjectivesObesity is associated with an increased risk of depression. Systemic low-grade inflammation, a plausible consequence of obesity, has also been linked to depression. However, the potential mediating effects of systemic low-grade inflammation on the association between excess body weight and specific symptom domains of depression remain uncertain. This study examined whether systemic low-grade inflammation mediated the associations of excess body weight (overweight and obesity) with subsequent overall, cognitive-affective, and somatic depressive symptoms. DesignThis study used a prospective cohort design. MethodsThe final analytical sample included 4,942 adults aged ≥50 years drawn from the English Longitudinal Study of Ageing (ELSA). Body mass index (BMI) and covariates were ascertained at baseline (wave 4, 2008/09). Continuous BMI scores were divided into four categories: ‘normal weight’ (18.5 ≤ BMI <25 kg/m2); ‘overweight’ (25 ≤ BMI <30 kg/m2); ‘obesity’ (BMI ≥30 kg/m2); in addition to ‘excess body weight’ (‘overweight’ and ‘obesity’ combined). Covariates included sociodemographic variables, behavioural factors, and chronic physical conditions. Serum concentrations of CRP were measured at wave 6 (2012/13). Depressive symptoms were assessed at baseline and ten years later (wave 9, 2018/19), using the 8-item Centre for Epidemiological Studies Depression (CES-D) Scale. Two symptom domains were constructed, distinguishing between cognitive-affective (depressed mood, loneliness, sadness, enjoyment in life, and happiness) and somatic (sleep problems, low energy levels, and fatigue) symptoms. Mediation analyses were performed to examine whether CRP statistically mediated the associations between BMI categories and depressive symptoms. ResultsIn multivariable-adjusted analyses, excess body weight was associated with elevated somatic (OR = 1.231, 95% CI: 1.029, 1.473), but not cognitive-affective or overall depressive symptoms at follow-up. Higher CRP was associated with elevated somatic (OR = 1.156, 95% CI: 1.061, 1.259), but not cognitive-affective or overall depressive symptoms. CRP acted as a partial mediator (14.92%) of the association between excess body weight and elevated somatic, but not cognitive-affective, or overall depressive symptoms. ConclusionSystemic low-grade inflammation may partially explain the association of excess body weight with somatic depressive symptoms, but not the associations with cognitive-affective or overall depressive symptoms.

Pharmacological Evaluation of Moringa oleifera on Collagen- Induced Arthritis in Rats

Background and Objective: Arthritis associated with oxidative stress and chronic inflammation has been a major health problem among the people worldwide. The present study was aimed to investigate the potential anti-arthritis activity of the methanolic extract of leaves of Moringa oleifera was evaluated on Collagen induced arthritis.&#x0D; Study Design: In-vivo model.&#x0D; Place and Duration of the Study: Department of pharmacology, Karnataka College of pharmacy, Bangalore India, between January to September 2022.&#x0D; Methods: The study was to evaluate anti-arthritic activity of Moringa oleifera (MO) against auto-immune arthritis in Wistar rats, using collagen-induced arthritis (CIA) model. Effect of the methanol extract of Moringa oleifera in inflammatory response during CIA was studied by measuring CRP, different cytokines in serum and assessment of arthritis index, footpad swelling. Level of CRP, LPO, NO and an enzymatic activity of SOD and CAT was determined to assess the effect of the Moringa oleifera extract in neutralizing oxidative stress during CIA. Histology of Synovial membrane experiment has been performed to determine whether Moringa oleifera has any impact on the changes in synovial tissue during CIA.&#x0D; Results: Post oral administration of Moringa oleifera at 250 and 500 mg/kg body weight doses decreased the arthritic index and footpad swelling. Moringa oleifera administration diminished pro-inflammatory cytokines in serum. The concentrations of pro-inflammatory TNFa, TGF-beta, IFNg, and IL-6 were elevated in the serum of the rat challenged with, type II collagen as compared to the std. and MtEMO-fed groups. Treatment with MtEMO in CIA induced rat significantly decreased these cytokines in serum. Decreased the serum level LPO, NO content, and SOD activity along with concomitant rise in CAT with the treatment of MtEMO. In addition decreased CRP in serum was also observed. Serum concentration of CRP, the most common type of acute phase proteins was tested in our experiments and was found to be significantly attenuated in case of CIA rat treated with MtEMO. Protective effect of MtEMO in CIA group is further supported from histopathological studies which showed improvement during bone damage and also shown less inflamed, and lymphocyte accumulation, cartilage damage decreased and less disruption of the synovial lining cell layer.&#x0D; Conclusion: Based on the results it can be concluded that the test drug Moringa oleifera is capable of regulating oxidative stress during CIA and therefore down regulated local and systemic release of pro-inflammatory mediators.

Levels of TNF-α and Soluble TNF Receptors in Normal-Weight, Overweight and Obese Patients with Dilated Non-Ischemic Cardiomyopathy: Does Anti-TNF Therapy Still Have Potential to Be Used in Heart Failure Depending on BMI?

We sought to measure the levels of adipokines, TNF-α and soluble receptors (sTNFr1, sTNFr2) in heart failure patients with reduced ejection fraction (HFrEF) due to non-ischemic cardiomyopathy (nDCM). A total of 123 patients with HFrEF due to nDCM were divided into three groups according to BMI: 34 (27.6%) normal weight, 56 (45.5%) overweight and 33 (26.8%) obese. A six-minute walk test, echocardiography and right heart catheterization were performed. Serum concentrations of adiponectin, leptin, NT-proBNP, blood hemoglobin, sodium, creatinine, ALAT, AspAT, bilirubin, CRP, lipids, TNF-α, sTNFr1 and sTNFr2 receptors were measured. Obese patients had the lowest NT-proBNP concentrations, significantly higher leptin levels and higher leptin/adiponectin ratios. The concentration of sTNFr1 was higher in normal-weight patients. In all groups, TNF-α concentrations correlated positively with sTNFr1 (p &lt; 0.001). Higher levels of sTNFr1 were associated with higher sTNFr2 (p &lt; 0.001) and CRP (p &lt; 0.001). Moreover, the concentration of sTNFr2 positively correlated with CRP (p &lt; 0.05) and adiponectin (p &lt; 0.001). Levels of TNF-α were not associated with elevated CRP. This study demonstrated that changes in the concentrations of TNF and its receptors differ between groups of patients with different BMI. These findings suggest that the effective use of anti-TNF therapy is dependent not only on BMI, but also on concentrations of TNF-α receptors and other laboratory parameters.

Single Nucleotide Polymorphism rs6445975 in the PXK Gene Is Correlated with Susceptibility and Clinical Characteristics of Systemic Lupus Erythematosus.

Background:Recently, genome-wide association studies (GWAS) have discovered several single nucleotide polymorphisms (SNPs) and loci associated with the risk of systemic lupus erythematosus (SLE). rs6445975 (T>G; intronic variant) polymorphism in the PXK gene is one of these loci. However, there was an inconsistency between the results of replicative studies on European and Asia ancestry. This study aimed to assess the possible association between rs6445975 polymorphism with SLE risk in the Iranian population.Methods:Genotype and allele distribution of rs6445975 polymorphism were investigated in 110 patients with SLE and 115 healthy controls in Isfahan University of Medical Sciences, Isfahan, Iran in 2019 via real-time PCR high resolution melting method (HRM).Results:GG and TG genotypes, but not TT genotype, were associated with increased risk of SLE (GG vs TT; OR= 7.538; 95%CI [3.47, 17.066] and TG vs TT; OR=2.21; 95%CI [1.06, 4.72]). Inheritance analysis revealed that TG + GG was correlated with the increased risk of SLE disease in the dominant model (OR=3.928; 95%CI [2.056, 7.74]). Moreover, subjects with the G allele were more frequently affected with SLE than individuals with the T allele (OR= 3.55; 95%CI [2.37, 5.36]). The G allele in patients was correlated with serum concentration of CRP, ESR, anti-dsDNA antibody, C3, and C4 and presentation of some clinical manifestations such as kidney involvements and skin lesions (P<0.05).Conclusion:Our findings suggest a substantial association between rs6445975 polymorphism in the PXK gene with susceptibility and clinical characteristics of SLE in the Iranian population.

Gender Differences Associated with the Prognostic Value of BPIFB4 in COVID-19 Patients: A Single-Center Preliminary Study.

In the ongoing global COVID-19 pandemic, male sex is a risk factor for severe disease and death, and the reasons for these clinical discrepancies are largely unknown. The aim of this work is to study the influence of sex on the course of infection and the differences in prognostic markers between genders in COVID-19 patients. Our cohort consisted of 64 adult patients (n = 34 men and n = 30 women) with PCR-proven SARS-CoV-2 infection. Further, a group of patients was characterized by a different severity degree (n = 8 high- and n = 8 low-grade individuals for both male and female patients). As expected, the serum concentrations of LDH, fibrinogen, CRP, and leucocyte count in men were significantly higher than in females. When serum concentrations of the inflammatory cytokines, including IL-6, IL-2, IP-10 and IL-4 and chemokines like MCP-1, were measured with multiplex ELISA, no significant differences between male and female patients were found. In COVID-19 patients, we recently attributed a new prognostic value to BPIFB4, a natural defensin against dysregulation of the immune responses. Here, we clarify that BPIFB4 is inversely related to the disease degree in men but not in women. Indeed, higher levels of BPIFB4 characterized low-grade male patients compared to high-grade ones. On the contrary, no significant difference was reported between low-grade female patients and high-grade ones. In conclusion, the identification of BPIFB4 as a biomarker of mild/moderate disease and its sex-specific activity would open an interesting field for research to underpin gender-related susceptibility to the disease.

Investigation of BPA Toxicity in Male New Zealand White Rabbits

The current study investigated bisphenol A (BPA) toxicity in rabbits. After the adaptation period of 2 weeks, 24 male New Zealand rabbits were equally assigned to 4 treatment groups. Corn oil was given to the rabbits in the control group, whereas 10, 20, or 100 mg/kg daily BPA in corn oil was administered to the rabbits in the remaining groups orally for 9 weeks. Throughout the experiment, BPA did not cause any clinical symptoms, and serum BPA levels of the rabbits treated with BPA were elevated in a dose-dependent manner. Although no effects of BPA were apparent on feed intake, body weights, or organ weights, BPA altered MDA, CAT, SOD, and GPx levels in all organs examined. Furthermore, BPA treatments negatively affected red blood cell counts, hemoglobin, and serum ALP, AST, ALT, CRP, amylase, creatine, and urea concentrations. The present study concluded that the LOAEL dose of BPA for the hematological and biochemical parameters was 20 mg/kg/day.

The role of thyroid hormones in carotid arterial wall remodeling in women.

Introduction: Thyroid hormones affect the cardiovascular system, but the precise mechanisms of their effects on the development of atherosclerosis are not entirely clear. The relationship between subclinical hypothyroidism, dyslipidemia and carotid atherosclerosis has been widely investigated, but the findings were controversial. The aim of the present study was to determine whether female subjects with subclinical hypothyroidism (SHypo) have increased carotid intima-media thickness (IMT) compared with euthyroid subjects, as well as to examine the association of SHypo, carotid atherosclerosis and dyslipidemia.Methods: This research included 100 women aged 30 to 70 years who were divided into two groups: the SHypo group including subjects with signs of subclinical hypothyroidism and the control group of euthyroid subjects. Carotid IMT thickness using B mode ultrasound was determined and its correlation with serum concentrations of fT4, TSH, CRP, and lipid profile including small dense LDL (sdLDL) was analysed.Results: Subjects with SHypo had significantly increased carotid IMT (IMT ≥ 75th centile) in all three measured segments of the right (p <0.001) and the left (p = 0.001) carotid artery compared to the control group, with a significantly more frequent appearance of plaque (25% vs. 9%; p = 0.05). Significant positive correlations were found between higher TSH and higher IMT values. Increased age, LDL cholesterol, and TSH predicted thickening of the carotid artery IMT.Conclusions: It is important to screen people showing early, subclinical signs of thyroid gland dysfunction due to its impact on carotid atherosclerosis development.

Cytokine profiles in the detection of severe lung involvement in hospitalized patients with COVID-19: The IL-8/IL-32 axis

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disorder caused by a new coronavirus called SARS-CoV-2. The pathophysiology of severe COVID-19 is associated with a “cytokine storm”. IL-32 is a key modulator in the pathogenesis of various clinical conditions and is mostly induced by IL-8. IL-32 modulates important inflammatory pathways (including TNF-α, IL-6 and IL-1b), contributing to the pathogenesis of inflammatory diseases. Il-32 was never evaluated before in COVID-19 patients stratifying as mild-moderate and severe patients. A total of 64 COVID-19 patients, 27 healthy controls were consecutively enrolled in the study. Serum concentrations of biomarkers including IL-1β, IL-10, IFN-γ, TNF-α and IL-6 were quantified by bead-based multiplex analysis and Serum concentration of IL-8 and IL-32 were determined by enzyme-linked immunosorbent assay (ELISA) kits. Interestingly, among the blood parameters, neutrophil and lymphocyte counts were significantly lower in severe COVID-19 patients than in the other, on the contrary, CRP was significantly higher in severe patients than in other groups. The cytokines that best distinguished controls from COVID-19 patients were IL-8 and IL-32, while IL-6 resulted the better variables for discriminate severe group.The best model performance for severe group was obtained by the combination of IL-32, IL-6, IFN-γ, and CRP serum concentration showing an AUC = 0.83. A cut off of 15 pg/ml of IL-6 greatly discriminate survivor from death patients. New insights related to the cytokine storm in COVID-19 patients, highlighting different severity of disease infection.

Relationship between polymorphism rs2794521 in CRP gene and survival of depressive patients with chronic heart failure.

Currently, there is a lack of studies combining the relationship between depression, chronic heart failure (CHF) and CRP polymorphisms (SNPs). The objective of the study was the investigation of the potential influence of rs2794521 in CRP on the survival and clinical profile of patients suffering from both depression and CHF. 103 CHF individuals were studied to evaluate depression occurrence and to compare values of cardiac, laboratory and nutritional parameters depending on CRP genotypes. The higher frequency of CC genotype was found in depressive patients (p=0.021). Serum CRP concentration was significantly higher in depressed patients than in non-depressed ones (p=0.032). CC depressive individuals demonstrated greater frequency of NYHA grade III-IV (p<0.001) and higher level of circulating CRP (p=0.001) and TNF-α (p=0.042) compared with CT or TT carriers. CC individuals were more frequently classified as moderately or severely malnourished according to SGA (p=0.014). CC genotype was associated with a higher risk of early death during the 72 months of the follow-up (HR=4.01; p=0.006 for CC vs. CT vs. TT and HR=4.46; p<0.001 for CC vs. CT+TT). CC genotype of CRP more frequently occurs in depressive CHF patients, and it is associated with worse clinical outcomes and disease prognosis.

Association of C-reactive protein polymorphisms with serum-CRP concentration and viral load among dengue-chikungunya mono/co-infected patients

India being endemic to Dengue (DENV) and chikungunya (CHIKV) infections faces high patient-mortality and morbidity with overlapping clinical features. C-reactive protein (CRP) acts as early defence system in response to these infections. This study investigated role of CRP single-nucleotide polymorphism (SNP) genotypes and protein levels towards DENV/CHIKV mono and co-infection among eastern Indian patients. 128 DENV-CHIKV co-infected, 206 DENV and 167 CHIKV mono-infected patients were subjected to genotyping of two CRP SNPs by PCR-RFLP along with 102 healthy individuals. CRP levels were determined by immunoturbidimetry. Statistical correlation of CRP genotypes with CRP concentration, DENV-CHIKV mono/co-infection and viral load was performed. Patients with rs3093059-CT and rs3091244-TT were more susceptible to DENV-CHIKV co-infection, whereas, rs3091244-CT might have imparted protection against CHIKV mono-infection. DENV-HVL was more prevalent within rs3093059-TT and rs3091244-CT co-infected patients, whereas, CHIKV-HVL among rs3091244-CC. Acute phase co-infected patients had significantly higher CRP level compared to mono-infections. Both mono and co-infected patients with aches/pain exhibited 2-3-fold higher CRP levels compared to those without. rs3093059-CT and rs3091244-CT co-infected patients had higher CRP concentration compared to rs3093059-TT and rs3091244-CC, respectively. Co-infected patients with WHO-defined warning signs had higher anti-dengue IgG/IgM ratio and serum CRP level compared to those without warning signs. Thus, patient's CRP genotype might play significant role in determining serum-CRP concentration, viral load and DENV-CHIKV mono/co-infection.

Heart failure with preserved left ventricular ejection fraction in patients with obstructive sleep apnea syndrome: prognostic value of biomarkers.

Aim To study the role of soluble ST2 (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), and С-reactive protein (CRP) in patients with chronic heart failure and preserved left ventricular ejection fraction (CHF with pLVEF) and syndrome of obstructive sleep apnea (SOSA) in stratification of the risk for development of cardiovascular complications (CVC) during one month of a prospective observation.Material and methods The study included 71 men with SOSA with an apnea/hypopnea index (AHI) &gt;15 per hour, abdominal obesity, and arterial hypertension. Polysomnographic study and echocardiography according to a standard protocol with additional evaluation of left ventricular myocardial fractional changes and work index were performed for all patients at baseline and after 12 months of observation. Serum concentrations of sST2 , NT-proBNP, and CRP were measured at baseline by enzyme-linked immunoassay (ELISA).Results The ROC analysis showed that the cutoff point characterizing the development of CVC were sST2 concentrations ≥29.67 ng/l (area under the curve, AUC, 0.773, sensitivity 65.71 %, specificity 86.11 %; p&lt;0.0001) while concentrations of NT-proBNP (AUC 0.619; p=0.081) and CRP (AUC 0.511; р=0.869) were not prognostic markers for the risk of CVC. According to data of the ROC analysis, all patients were divided into 2 groups based on the sST2 cutoff point: group 1 included 29 patients with ST2 ≥29.67 ng/l and group 2 included 42 patients with ST2 &lt;29.67 ng/l. The Kaplan-Meyer analysis showed that the incidence of CVC was higher in group 1 than in group 2 (79.3 and 28.6 %, respectively, p&lt;0.001). The regression analysis showed that adding values of AHI and left ventricular myocardial mass index (LVMMI) to sST2 in the model increased the analysis predictive significance.Conclusion Measuring sST2 concentration may be used as a noninvasive marker for assessment of the risk of CVC development in patients with CHF with pLVEF and SOSA within 12 months of observation. Adding AHI and LVMMI values to the model increases the predictive significance of the analysis.

Clinico-pathological changes in COVID-19 patients

Background: Novel Corona virus is associated with the respiratory disorder. Corona virus cases disease ranging from a common cold like illness severe acute respiratory syndrome. Biochemical parameters become altered in the patients, and this has been correlated with the severity of the disease. The present study was undertaken to analyse the effect of novel corona virus infection in organs other than lungs.Methods: The study is a retrospective studycarried out in RMCH and RC, Kanpur from July 2020 to June 2021. Haematological, biochemical and inflammatory biomarker study was conducted in 336 COVID-19 patients.Results: Out of 336 COVID-19 patients the maximum number of patients belonged to the age group of 61-70 years. There were 75% symptomatic and 25% asymptomatic cases of confirmed COVID-19. Sore throat was the most common presentation followed by cough and dyspnoea. Other manifestations include fever, myalgia, loss of taste, loss of smell and running nose. Serum CRP and PCT concentration were observed in more severe cases 22.2% and 17% respectively. Haematological findings include decrease in total RBC count (58.33%). Symptomatic COVID-19 patients have thrombocytopenia (30.95%), lymphopenia (25%), leucocytosis (11.90%) and leucopenia 8.33%. Hepatic dysfunction and renal dysfunction was observed in 71.42% and 14.28% symptomatic cases respectively.Conclusions: We concluded that novel corona virus is not only affecting respiratory system but also other vital organs. On the basis of haematological and biochemical findings we can predict the severity of COVID-19 infection which could be helpful for management of the disease.

Increased Serum Levels of S100A4 and S100A15 in Individuals Suffering from Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Recently, some S100 proteins have been suggested to play an important role in the pathogenesis of chronic immune-mediated inflammatory diseases and they may constitute valuable biomarkers for these diseases’ diagnosis and monitoring. The objective of the current study was to investigate, for the first time, serum levels of S100A4 and S100A15 in individuals suffering from HS. Furthermore, we assessed the associations between S100A4 and S100A15 serum levels and the severity of disease, CRP serum concentration and some demographic and clinical data. Serum levels of S100A4 and S100A15 were evaluated with the commercially available ELISA kit according to the manufacturer’s instructions. The serum level of S100A4 in individuals with HS was significantly elevated as compared to controls, with the highest level found in the individuals in Hurley stage II. The S100A15 serum level was positively correlated with the CRP concentration and was associated with the severity of the disease. The serum level of S100A15 in the individuals in Hurley stage III was significantly elevated compared to that of the controls and the individuals with HS in Hurley stages I and II. S100A4 and S100A15 may be considered as new serum biomarkers for the monitoring of HS progression, and they may play a role in the pathogenesis of HS by promoting inflammatory process and fibrosis.

Development and External Validation of a Prognostic Classifier for Elderly Head-and-Neck Cancer Patients Undergoing (Chemo)radiation

Elderly head-and-neck squamous cell carcinoma (HNSCC) patients form a heterogeneous cohort, and survival estimation is often challenging due to underlying comorbidities. Prognostic classifiers and nomograms may therefore be useful for overall survival (OS) estimation in order to provide shared decision-making in the clinical routine.A total of 284 elderly HNSCC patients aged ≥65 years who received a curative (chemo)radiation between 2010 and 2020 at a tertiary cancer center were used for the development of a survival classifier. On the basis of a multivariate Cox regression analysis, significant parameters were identified for which points were given according to the beta regression values. The derived classifier was then validated in a second, external cohort consisting of 217 elderly HNSCC patients undergoing (chemo)radiation. Based on the cumulative data of 501 patients, a nomogram for the 2-year and 4-year OS was created. We then examined in a third independent cohort whether the classifier could also stratify the prognosis of surgically treated elderly HNSCC patients without adjuvant (chemo)radiation (n = 169).In the multivariate backward stepwise Cox regression with likelihood ratio tests using P < 0.1 as inclusion criterion, the Karnofsky Performance Status (KPS, HR = 2.654, P < 0.001), the age-adjusted Charlson Comorbidity Index (CCI, HR = 2.598, P < 0.001) and the pre-radiotherapy CRP serum concentration (HR = 1.634, P = 0.064) were significant prognostic parameters for OS. Following the beta regression values, a KPS ≤70% and a CCI ≥6 points were given 1 point, while a CRP concentration ≥5 mg/L was given 0.5 points. The median OS was 107 (0 points), 34 (0.5 points), 28 (1 point), 11 (1.5 points), 9 (2 points) and 6 months (2.5 points), respectively. In order to obtain considerably distinct prognostic subgroups, 3 prognostic groups were created: A favorable (0 points), an intermediate (0.5-2 points) and a poor (2.5 points) subgroup. While the median OS for the favorable group amounted to 107 months, it was 28 and 6 months for the intermediate and poor cohorts, respectively (P < 0.001, log-rank test). In the external cohort, the median OS was found to range at 130, 29 and 9 months for the favorable, intermediate and poor group, respectively (P = 0.005). Using the aggregated data of both cohorts, a nomogram based on the KPS, CCI and CRP was created for the 2-year and 4-year OS that exhibited a concordance index of 0.65 (Harrell's C). For the surgically treated cohort of elderly HNSCC patients, only the KPS ≤70% (HR = 5.950, P = 0.002) but not the CCI ≥6 points (HR = 1.937, P = 0.232) or the baseline CRP serum value (HR = 1.743, P = 0.328) were significant prognosticators.We developed and externally validated a clinically feasible survival score for elderly HNSCC patients undergoing (chemo)radiation. Both the score and nomogram may be useful aiding shared decision-making of radiation oncologists and medical oncologists treating elderly HNSCC patients.

SIGNIFICANCE OF CIRCULATING CYSTEINE-DEPENDENT ASPARTATE-DIRECTED PROTEASE-1 (CASPASE-1) IN PERITONITIS

"Sepsis is considered the leading cause of death in emergency units. It is known that there are already serum immune parameters/biomarkers useful in predicting the progression from peritonitis to sepsis, respectively septic shock. In the present study, we aimed to measure the serum concentrations of CASP1, CRP and cytokines (IL-23, IL-1β, IL-18); to compare immune-inflammatory cell ratios at the onset of peritonitis, before and after sepsis; to identify correlations between the concentration of the CASP1, IL-23, IL-1β, IL-18, CRP, ESR and the indices that assess the prognosis of patients with peritonitis (MPI) and the severity of sepsis (SOFA, APACHE II) and with different ratios of immunocytes (NLR, MLR, PltLR) and to investigate the usefulness of these immune parameters in predicting the progression from peritonitis to sepsis using the area under the ROC curve. Serum samples were collected from 20 peritonitis patients diagnosed and 14 patients who developed secondary sepsis to peritonitis. For the evaluation of serum concentrations of studied mediators, we used immunoenzymatic technique. In our study, we obtained significantly increased values in the serum of patients who developed sepsis vs the group with peritonitis, for CASP1, CRP and cytokines (IL-23, IL-1β, IL-18). Serum levels of CASP1 correlated much better with the evaluated indices, statistically significant correlations. Two markers investigated, CASP1 and IL-23, had a diagnostic accuracy (71.10% and 70.90%, respectively) almost similar to the performance of IL-1β (accuracy of 71.40%), in the diagnosis of peritonitis. In conclusion, the investigated serological markers (CASP1, IL-23, IL-1β, IL-18) can be used as an independent prognostic markers for differentiation of patients with peritonitis from those with sepsis, in combination with CRP, ESR, NLR and the indices (MPI, SOFA, APACHE II)."