Serum Levels Of Inflammatory Markers Research Articles

Effect of vitamin D3 supplementation on cellular immunity and inflammatory markers in COVID-19 patients admitted to the ICU

Vitamin D as an immunomodulator has not been studied in patients with severe COVID-19. This study aimed to estimate the efficacy of vitamin D3 supplementation on cellular immunity and inflammatory markers in patients with COVID-19 admitted to the intensive care unit (ICU). A single-center, double-blind, randomized, placebo-controlled pilot trial was conducted (N = 110). Patients were randomly assigned to receive a weekly oral dose of 60,000 IU of vitamin D3 followed by daily maintenance doses of 5000 IU (n = 55) or placebo (n = 55). Primary outcomes were lymphocyte counts, natural killer (NK) and natural killer T (NKT) cell counts, neutrophil-to-lymphocyte ratio (NLR), and serum levels of inflammatory markers on 7th day of treatment. On day 7, patients in the vitamin D3 group displayed significantly higher NK and NKT cell counts and NLR than those in the placebo group did. The mortality rate (37% vs 50%, P = 0.16), need for mechanical ventilation (63% vs 69%, P = 0.58), incidence of nosocomial infection (60% vs 41%, P = 0.05) did not significantly differ between groups. Vitamin D3 supplementation, compared with placebo, significantly increased lymphocyte counts, but did not translate into reduced mortality in ICU.Trial Registration: ClinicalTrials.gov Identifier: NCT05092698.

Masticadienonic acid from Chios mastic gum mitigates colitis in mice via modulating inflammatory response, gut barrier integrity and microbiota

BackgroundChios mastic gum (CMG) is a traditional Greek medicine used to treat a variety of gastrointestinal disorders, including inflammatory bowel disease (IBD). However, the bioactive compounds of CMG and the mechanisms of action for controlling of IBD remain unknown. PurposeMasticadienonic acid (MDA) is one of the most abundant constituents isolated from CMG. This study aims to investigate the potential effects and underlying mechanisms of MDA in the pathogenesis of colitis. MethodsThe effects of MDA were evaluated using a dextran sulphate sodium (DSS)-induced acute colitis mouse model. The body and spleen weight and colon length and weight were measured and the clinical symptoms were analysed. Blood samples were collected to analyse the level of serum inflammatory markers. Colon tissues were processed for histopathological examination, evaluation of the epithelial barrier function, and investigation of the probable mechanisms of action. The gut microbiota composition was also studied to determine the mechanism for the beneficial effects of MDA on IBD. ResultsMDA could ameliorate the severity of IBD by increasing the body weight and colon length, reducing spleen weight, disease activity index, and histological score. MDA treatments reduce the release of serum inflammatory cytokines tumour necrosis factor-alpha (TNFα), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) via inhibiting the MAPK and NF-κB signalling pathways. MDA supplementation could also improve the intestinal barrier function by activating the NF-E2-related factor-2 (Nrf2) signalling pathway and restoring the expression of tight junction proteins zonula occludens-1 (ZO-1) and occludin. In addition, MDA administration modulates the gut microbiota composition in DSS-induced colitis mice. ConclusionThe results indicate that MDA attenuated experimental colitis by restoring intestinal barrier integrity, reducing inflammation, and modulating the gut microbiota. The present study provides novel insights into CMG-mediated remission of IBD and may facilitate the development of preventive and therapeutic strategies for IBD.

Association of microalbuminuria with serum lipids and inflammatory markers in an adult population in the Dikgale Health and Demographic Surveillance System site, South Africa.

There is evidence that microalbuminuria (urinary albumin excretion) is an early sign of vascular damage and an established risk factor for cardiovascular morbidity and mortality. This study investigated the magnitude of microalbuminuria and its association with serum lipids and inflammatory markers among a rural black population residing in the Dikgale Health and Demographic Surveillance System site, South Africa. Data were collected from 602 presumably healthy participants (225 men and 377 women) aged ≥ 18 years. Biochemical data collection included serum lipids, glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), urine albumin and creatinine. Anthropometry and blood pressure were also measured. Microalbuminuria was diagnosed with an albumin-creatinine ratio of ≥ 2.5 mg/mmol in men and ≥ 3.5 mg/mmol in women. Data were analysed using SPSS version 22.0. The mean age of participants was 48.63 ± 20.89 years. High percentages of microalbuminaria (35.7%), high levels of interleukin 6 (17.8%), hs-CRP (32.9%), triglycerides (TG) (26.1%), low-density lipoprotein cholesterol (52.2%) and total cholesterol (32.0%), and low levels of high-density lipoprotein cholesterol (29.1%) were observed in the population. Increased glucose levels (32.8%), insulin resistance (27.6%), hypertension (45.8%), overweight (26.8%) and obesity (25.4%) were also prevalent. Microalbuminuria was associated with high hs-CRP and TG levels in the men (adjusted odds ratios = 9.434, 95% confidence interval: 1.753 - 50.778, p = 0.01). High prevalence of microalbuminuria, hypertension, insulin resistance, overweight and obesity, as well as abnormal levels of serum lipids and inflammatory markers were observed in the population. Microalbuminuria was associated with high hs-CRP and TG levels among men.

Elevated serum neutrophil-lymphocyte ratio is associated with worse long-term survival in patients with HBV-related intrahepatic cholangiocarcinoma undergoing resection.

This study aimed to examine the influence of serum inflammatory marker levels on long-term outcomes after liver resection in patients with intrahepatic cholangiocarcinoma (ICC). Data from 1189 consecutive ICC patients who underwent liver resection were reviewed. The serum neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were measured before surgery. Overall survival (OS) and tumour recurrence were analysed using the Kaplan-Meier method and compared using the log-rank test. Independent risk factors for OS and tumour recurrence were analysed using the Cox hazard regression model. We identified elevated serum NLR (≥ 2.15) as an independent risk factor for both OS and tumour recurrence (hazard ratio [HR]: 1.327, 95% confidence interval [CI]: 1.105-1.593; HR: 1.274, 95% CI: 1.074-1.510) among the three inflammatory markers assessed. Elevated NLR was associated with higher carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels, larger tumour size, multiple tumours, lymph node metastasis, vascular invasion, and more advanced tumour node metastasis (TNM) stage (III/IV). Subgroup analysis showed that elevated NLR was an independent risk factor for OS and tumour recurrence in patients with hepatitis B virus (HBV) infection compared with patients without HBV infection (HR: 1.347, 95% CI: 1.073-1.690; HR: 1.386, 95% CI: 1.112-1.726). Elevated serum NLR was associated with worse prognosis among ICC patients who underwent liver resection, especially in patients with HBV infection.

Assessing cognitive behavioral therapy for insomnia in individuals with cannabis use disorder utilizing actigraphy and serum biomarkers: A pilot study

Objective/backgroundThis pilot study aims to assess the effect of Cognitive Behavioral Therapy for insomnia (CBTi) in individuals with cannabis use disorder and insomnia. It also aims to investigate the effect of CBTi on levels of serum inflammatory markers in relation to insomnia symptoms. Methods/patientsIndividuals with cannabis use disorder and insomnia symptoms were recruited over 18 months. Data collected included demographics, self-reported sleep parameters, and cannabis use. Blood samples were drawn to measure IL-2, IL-6, CRP, and cortisol. Participants completed the Insomnia Severity Index questionnaire (ISI) and the Patient Health Questionnaire-4 (PHQ-4), and they were provided with an actigraphy (wrist) device for 1 week before CBTi and a subsequent week after completing the 4 CBTi sessions. ResultsNineteen participants were enrolled in the study. The mean ISI score decreased from moderately severe insomnia at baseline to no clinically significant insomnia after CBTi with a sustained decrease at 3- and 6-months follow-up. Actigraphy showed a significant decrease in sleep onset latency (SOL) after CBTi. Three months after CBTi, 80% of participants reported a decrease in their cannabis use. There was also a significant and sustained decrease in mean PHQ-4 scores after CBTi. Although only trending towards significance, the levels of three out of four biomarkers (IL-2, IL-6, CRP) were decreased 6 months after CBTi. ConclusionsCBTi is effective as a short- and long-term treatment of insomnia and comorbid anxiety/depression in individuals who regularly use cannabis. A potential added benefit is a reduction in cannabis consumption and inflammatory serum biomarkers.

Inflammation and cardiorespiratory fitness in overweight women and men: the FATCOR study

Abstract Background Women have more body fat compared to men, and adipose tissue is associated with chronic inflammation. Cardiorespiratory fitness has on the other hand been postulated to lower chronic inflammation. However, sex-specific associations of inflammation with cardiorespiratory fitness is less studied. Purpose To assess inflammatory markers in overweight and obese women and men according to cardiorespiratory fitness in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Methods Cardiorespiratory fitness was assessed by maximal oxygen uptake (VO2max) by cardiopulmonary exercise testing in 566 subjects (mean age was 48±9 years, 60% women) with body mass index (BMI) >27.0 kg/m2. Participants were grouped according to sex, and fitness status identified from sex and age specific VO2max thresholds. C-reactive protein (CRP) and serum amyloid A (SAA) were analysed using Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight mass spectrometry. Serum levels of the kynurenine:tryptophan ratio (KTR) and pyriodoxic acid ratio (PAr) were measured by liquid chromatography tandem mass spectrometry. All inflammatory markers were log transformed before inclusion in linear regression analyses. Results In the total study population, 63% had obesity and 74% were cardiorespiratory unfit. Unfit women had the highest fat percentage and the highest serum levels of CRP and SAA compared to the other groups (p<0.05), while serum levels of KTR and PAr were higher only compared to fit men (p<0.05). In multivariable linear regression analyses in women, higher CRP (β −0.15, p=0.001), SAA (β −0.10, p=0.03) and PAr (β −0.09, p=0.03) were associated with lower VO2max after adjusting for age, fat percentage, hypertension and metabolic syndrome. In men, only higher PAr (β −0.14, p=0.02) was associated with lower VO2max in multivariable analyses adjusted for age, fat percentage and metabolic syndrome. In multivariable analyses in obese women only (n=213), higher CRP (β −0.15, p=0.01) and PAr (β −0.13, p=0.03) remained associated with lower VO2max, while in obese men (n=144) there was no significant associations between inflammatory markers and VO2max. Conclusion Among overweight subjects participating in the FATCOR study, cardiorespiratory unfit women had the highest serum levels of inflammatory markers. The association of inflammation with reduced cardiorespiratory fitness was more pronounced in women than men, in particular when obesity was present. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Western Regional Health Authority of Norway

Protective effect of salidroside on streptozotocin-induced diabetic nephropathy by inhibiting oxidative stress and inflammation in rats via the Akt/GSK-3β signalling pathway

Context Salidroside (SAL), one of the major glycosides isolated from the roots of Rhodiola rosea L. (Crassulaceae), has anti-inflammatory, antioxidant, and antidiabetic properties. Objective Our study assessed whether SAL exerts a protective effect on streptozotocin (STZ)-induced diabetic nephropathy (DN) in rats via the Akt/GSK-3β signalling pathway. Materials and methods Adult male Wistar rats were divided into three groups (n = 8): normal control, DN + vehicle, and DN + SAL. SAL (50 mg/kg/day, oral) was administered for 8 weeks. Biochemical and histopathologic examinations were performed to evaluate the therapeutic effects of SAL on oxidative stress, inflammation, renal function, and apoptosis. Results SAL induced rats demonstrated ameliorated levels of FBG (20.53 ± 0.72 mmol/L vs. 26.02 ± 1.44 mmol/L), urine albumin excretion (27.00 ± 1.46 mmol/L vs. 41.00 ± 1.59 mmol/L), blood urea nitrogen (14.42 ± 0.70 mmol/L vs. 17.77 ± 0.72 mmol/L), and serum creatinine (112.80 ± 6.98 mmol/L vs. 159.00 ± 3.81 mmol/L) compared to normal control rats, along with the alleviation of renal pathologic changes by improving the irregular shape of glomeruli tissues. Biochemical analysis showed that SAL-treated animals displayed suppressed levels of serum inflammatory cytokines and kidney oxidative stress markers and attenuated apoptotic characteristics. Moreover, it increased the phosphorylation levels of Akt and GSK-3β in kidneys. Discussion and conclusion The present study validated the involvement of the Akt/GSK-3β signalling pathway in renal improvement. These findings can form the basis to investigate the protective effect of SAL in DN in clinical trials.

A Study of Vitamin D and Its Correlation With Severity and Complication of Congestive Heart Failure: A Systematic Review.

Many studies have shown that vitamin D is a crucial modulator of hypertension and cardiovascular illness, including heart failure. Heart failure (HF) is still the leading cause of mortality worldwide. Patients with heart failure who have low vitamin D levels experience worse outcomes, which associate with known clinical correlations and biomarkers. Additionally, patients with low vitamin D levels are more likely to have diabetes, hypertension, atherosclerosis, and other precursor conditions to heart failure. There are some hints in recent experimental research on how vitamin D can have cardioprotective effects. Vitamin D supplementation might improve ventricular remodeling in heart failure patients, however, this is still unclear. It aims to evaluate the association between vitamin D and congestive heart failure (CHF). This systematic review used research from the previous ten years (January 2012-2022) retrieved from the following databases: PubMed/PMC (PubMed Central)/Medline and Cochrane Library. Using the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) 2020 guidelines, removing duplicates, screening of title and abstract, application of eligibility criteria, and quality appraisal, 13 articles were retained for systemic review. There were 10 randomized controlled trials and three observational studies. Vitamin D supplementation lowers serum inflammatory marker levels and improves the quality of life in CHF patients. Vitamin D treatment inhibits ventricular remodeling and improves cardiac function in a patient with CHF.

Longitudinal change in serum inflammatory markers in women with tubo-ovarian abscess after successful surgical treatment: a retrospective study

High levels of serum inflammatory markers are related to extended hospitalisation and more severe disease in the case of tubo-ovarian abscess (TOA). There is scarce information on the serial measurement of inflammatory markers during the postoperative follow-up period of surgically treated TOA. The present study aimed to assess the postoperative longitudinal changes in serum inflammatory markers following surgery for TOA. In this retrospective cohort study, patients who underwent surgery for TOA between January 2010 and March 2020 were reviewed. All inflammatory markers peaked within 48 hours after surgical intervention and then declined with time. The predicted mean of white blood cell count (WBC) to return to normal was 2.5 days (95% CI: 1.0–4.3), which was followed by neutrophil to lymphocyte ratio (NLR) (7.1 days, 95% CI: 4.7–10.8) and C-reactive protein (CRP) (+14 days). In conclusion, serum inflammatory markers increase in the very early post-operative period. While the normalisation period is very slow, it may not be appropriate to use CRP for evaluating the treatment success of TOA surgery. However, WBC and NLR measurements might be useful for follow-up and predicting the need for medical or surgical intervention. Impact statement What is already known on this subject? Serum inflammatory markers such as C-reactive protein, white blood cell count, and neutrophil to lymphocyte ratio are usually elevated in women with tubo-ovairan abscess, and high levels of these markers are associated with extended hospitalisation and more severe disease. What do the results of this study add? Our results indicate that the serum inflammatory markers increase and peak within the first 48 hours after surgery for tubo-ovarian abscess. Normalisation of white blood cell count is the fastest in successfully treated patients. However, normalisation of C-reactive protein is slowest, reaching 14 days and might not be as feasible as white blood cell count and neutrophil to lymphocyte ratio in postoperative patient follow-up. What are the implications of these findings for clinical practice and further research? The serum inflammatory markers should be interpreted with caution within 48 hours after surgical treatment for tubo-ovarian abscess. Instead of C-reactive protein white blood cell count, and neutrophil to lymphocyte ratio measurements can be preferred in post-operative follow-up to predict the need for further medical or surgical intervention.

Early Clinical and Radiographic Outcomes of Robot-Assisted Versus Conventional Manual Total Knee Arthroplasty: A Randomized Controlled Study.

ObjectiveRobot‐assisted surgery has been promoted worldwide in recent years. The development of a domestic orthopaedic robot and its clinical application are therefore of great significance. This study aimed to compare the early clinical and radiographic outcomes of domestic robot‐assisted total knee arthroplasty (RA‐TKA) with conventional manual total knee arthroplasty (CM‐TKA).MethodsA total of 77 patients who underwent primary single‐sided TKA from June to December 2020 were prospectively enrolled; resulting in the inclusion of 72 patients. The patients were randomly divided into the RA‐TKA group (37 cases, with TKA being assisted by the Yuanhua Orthopaedic Robotic System) and the CM‐TKA group (35 cases, with TKA being performed using conventional tools). Knee function was evaluated by the knee range of motion (ROM), the American Knee Society Score (KSS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Postoperative radiographic results were evaluated by full‐length weight‐bearing X‐rays of the lower limb and anteroposterior and lateral X‐rays of the knee were obtained preoperatively and at 90 days postoperative. The operative duration, blood loss, postoperative knee function, radiographic outcomes, and incidence of complications were compared by Student's t‐test, Mann–Whitney U test, or chi‐square test. Serum levels of inflammatory markers before the operation and 1, 3, and 30 days after the operation were recorded and compared between the two groups.ResultsThe operation was significantly longer in the RA‐TKA group than in the CM‐TKA group (154.3 vs 115.2 min, p < 0.001). There was no significant difference in blood loss (933 vs 863 ml, p = 0.519) between the two groups. The knee ROM, KSS, and WOMAC were significantly improved in both groups 90 days after the operation compared with before the operation (p < 0.05), but there were no significant differences between the two groups (p > 0.05). The incidence of postoperative deep vein thrombosis was not statistically different between the two groups. In the radiographic findings at 90 days postoperatively we found the frequency of lateral tibial component (LTC) angle outliers was significantly lower in the RA‐TKA group (3.0% vs 29.4%, p = 0.003). The neutrophil‐to‐lymphocyte ratio (NLR) was significantly lower in the RA‐TKA group than in the CM‐TKA group on day 1 after surgery (9.9 vs 12.7, p = 0.024).ConclusionsRA‐TKA requires more time than CM‐TKA, which may be related to the learning curve and intraoperative registration. The short‐term postoperative knee functional outcomes had no differences between the two groups, and RA‐TKA improved the accuracy of tibial component alignment. Further follow‐up studies are required to investigate the long‐term outcomes.

Periodontal disease and muscle recovery: the concise systematic review

Introduction: Periodontal Disease (PD) occurs with high frequency in the adult population, being an infectious and inflammatory disease of the soft and hard tissues around the teeth. PD can increase the levels of several pro-inflammatory cytokines. Objective: Was to conduct a concise systematic review of the relationship between periodontal disease and muscle repair. Methods: The present study was followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases, following the rules of the word PICOS (Patient; Intervention; Control; Outcomes; Study Design). The Cochrane Instrument was used to assess the risk of bias of the included studies. Results and Conclusion: The results showed that it is possible that changes in serum levels of inflammatory markers, triggered by different chronic inflammatory situations such as periodontal disease, may indirectly influence the muscle repair process. It was observed that periodontal disease was able to modify the leukocyte count and the levels of IL-6, IL-10, and TNF-α. When related to physical exercise, periodontal disease negatively influenced the muscle repair process.

Serum Hepcidin and Ferritin Have Not Correlation With Inflammatory Markers in Kidney Transplant Patients

In renal transplant patients, increased ferritin is associated with an increased risk of cardiovascular disease, transplant rejection, and mortality. Serum ferritin elevates in renal transplant patients due to blood product transfusion, inflammation, and malignancies. Hepcidin is also a peptide hormone produced in the liver in response to anemia, hypoxia, or inflammation. The aim of this study was to investigate the relationship between ferritin, hepcidin, iron, TIBC, and serum inflammatory markers in renal transplant patients. The cross-sectional descriptive-analytical study was conducted on 60 renal transplant patients referred to Hazrat-Rasool and Imam-Ali clinics and Al-Mahdi Laboratory of Shahrekord selected by convenience sampling method. Serum ferritin, hepcidin, iron, TIBC, and inflammatory markers levels were determined by standard kits by ELISA. Data were analyzed by SPSS software. Serum iron had a significant negative correlation with erythrocyte sedimentation rate (ESR) (r= -0.418, P=0.001) and a negative correlation with C reactive protein (CRP) (r= - 0.243, P=0.061). TIBC had a significantly negative association with ferritin (r= - 0.27, P=0.037). Ferritin, hepcidin, and TIBC were not significantly correlated with inflammatory factors. The results of the study showed no significant relationship between ferritin, hepcidin, and TIBC with inflammatory factors in renal transplant patients.

Cytokine Profile in Patients with Multiple Sclerosis Following Exercise: A Systematic Review of Randomized Clinical Trials.

Multiple sclerosis (MS) is one of the most prevalent causes of nontraumatic neurological impairment in young adults. This review aims to determine the impact of exercise on cytokine and adipokine profile levels as inflammatory markers in MS patients across various exercise paradigms. We used specific keywords in PubMed, Web of Science, The Cochrane Library, and Scopus to find randomized clinical trials addressing the effects of physical activity and exercise training on inflammatory markers levels in MS patients. The majority of the research showed no considerable changes in IL-6 levels, while three studies reported declining levels after the intervention. Approximately half of the trials observed a change in TNF-α and IL-10 levels after exercise interventions, while the other half showed no meaningful changes. Other markers such as IL-17, IL-4, IL-12, adipokines, and BDNF showed fluctuations in levels. We found no universal agreement on the effects of different exercise training protocols on the serum level of inflammatory markers in patients with MS. More research is needed to fully identify the effects of exercise on cytokines in MS patients.

The Variable Nature of Vitamin C-Does It Help When Dealing with Coronavirus?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still spreading worldwide. For this reason, new treatment methods are constantly being researched. Consequently, new and already-known preparations are being investigated to potentially reduce the severe course of coronavirus disease 2019 (COVID-19). SARS-CoV-2 infection induces the production of pro-inflammatory cytokines and acute serum biomarkers in the host organism. In addition to antiviral drugs, there are other substances being used in the treatment of COVID-19, e.g., those with antioxidant properties, such as vitamin C (VC). Exciting aspects of the use of VC in antiviral therapy are its antioxidant and pro-oxidative abilities. In this review, we summarized both the positive effects of using VC in treating infections caused by SARS-CoV-2 in the light of the available research. We have tried to answer the question as to whether the use of high doses of VC brings the expected benefits in the treatment of COVID-19 and whether such treatment is the correct therapeutic choice. Each case requires individual assessment to determine whether the positives outweigh the negatives, especially in the light of populational studies concerning the genetic differentiation of genes encoding the solute carriers responsible forVC adsorption. Few data are available on the influence of VC on the course of SARS-CoV-2 infection. Deducing from already-published data, high-dose intravenous vitamin C (HDIVC) does not significantly lower the mortality or length of hospitalization. However, some data prove, among other things, its impact on the serum levels of inflammatory markers. Finally, the non-positive effect of VC administration is mainly neutral, but the negative effect is that it can result in urinary stones or nephropathies.

The Efficacy of Probiotic Supplementations on Glycemic Control, Lipid Profile, Inflammation Biomarkers and Anthropometric Measurements Among Type 2 Diabetes Patients

Background: Probiotics was defined as living organisms by the World Health Organization. These organisms when consumed as in food items or in the form of supplements, can lead to improvements in the health status of the host. Disturbances of intestinal biology contribute to the development of DM. Many trials have shown that the gut microbiome plays a role in the etiology and progression of type 1 and type 2 diabetes and its complications. This trial was designed to identify the effects of multi-species of probiotic supplementation on fasting blood glucose, lipid profile, inflammatory biomarkers, and in type 2 diabetic patients. Participants and methods: 65 type 2 diabetics were divided into 2 groups T (trial) and C (control) or placebo. The T group received daily one capsule of 14 differnt species of probiotic and C group received capsules filled with roasted ground chickpea. Fasting blood glucose, Serum Tumor Necrosis Factor alpha (TNFα) and C Reactive Protein (CRP), HDLC, LDLC, TG, TC levels were measured and anthropometric measurements such as weight, height, waist circumference and BMI were recorded at beginning and the end of the study which lasted for 10 weeks. Results and discussion: In the probiotic group, fasting plasma glucose decreased significantly (P &lt;0.05) compared to the control group, 131.1 ± 10.1 vs 145.7 ± 9.8 (mg/dL). Furthermore, a significant reduction was also apparent TC level in the trial group before and after supplementation (184 ± 31 vs 199 ± 21 ) the difference was significant (P &lt; 0.05). The group which received probiotic also showed significant reduction in TG (P &lt; 0.05) compare to control group ( 128 ± 23 vs 1 1 ± 32 respectively). Also, the LDL value, significantly reduced in the probiotic compared to the control group 137 ± 30 and 149 ± 31 ( P &lt; 0.05). Probiotic supplementation significantly increased HDL 41 ± 13 vs 29.8 ± 12 (P &lt; 0.05). Significant differences (P &lt;0.05) in the serum levels of inflammatory markers at the end of the study were observed. Probiotic supplementation decreases CRP (mg/dL) levels and TNFa (pg/ml) (2.11± 4.3 vs 1.68 ± 3.33 and 2.51 ±2.3 vs 2.31 ± 3.6 respectively).. A significant reduction in TNF-α level was observed. The level was 6.8 5.6 ± at the beginning of the trial and reduced to 5.4± 5.1 whereas in the control group TNF-α levels were 5.6 ± 7.6 and 5.6 ± 7.8 at the beginning and at the end of the study respectively .Probiotics supplementations reduced significantly (P &lt;0.05(BMI of participants in trial group (27.6 ± 5.2 vs 33.8 ± 10.1). Conclusion: The results obtained from this study suggest that probiotic supplementation may have positive effects and can be considered as method to control glucose levels, lipids, inflammatory biomarkers, and reduce body weight in type 2 diabetic patients.

The effects of l-Carnitine supplementation on inflammatory markers, clinical status, and 28 days mortality in critically ill patients: A double-blind, randomized, placebo-controlled trial.

Critical ill patients experience catabolic stress, which results in a systemic inflammatory response. The inflammatory response is associated with increased complications, including infection, multi-organ dysfunction, increased length of ICU stays, and mortality. l-Carnitine supplementation may play an important role in these patients by regulating inflammatory cell function. The purpose of the present study was to investigate the effect of l-Carnitine supplementation on clinical status, inflammatory markers, and mortality rate in critically ill patients admitted to the intensive care unit (ICU). This randomized, double-blind, placebo-controlled trial was performed on critically ill patients. Subjects were randomly assigned into placebo (n=27) and l-Carnitine (n=27) groups. l-Carnitine (3000mg/day) was administered via nasogastric tube for the intervention group for 7 days, while the other group received a placebo for the same duration. Serum levels of inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6) were measured. Nutritional status and the acute physiology and chronic health evaluation (APACHE) score, sequential organ failure assessment (SOFA) score, and 28-day mortality were also recorded. Fifty-one critically ill patients completed the study. l-Carnitine supplementation significantly reduced the levels of CRP (mean change±SE:-34.9±6.5) and IL-6 (mean change±SE:-10.64±2.16) compared to the baseline, which is both statistically significant compared with the control group (p<0.05). The SOFA and APACHE scores were significantly reduced in the l-Carnitine group compared with the placebo group (p=0.02 and p<0.001, respectively). l-Carnitine supplementation showed beneficial effects on inflammatory and clinical outcomes of critically ill patients. Trial registration: IRCT, Registered 30 May 2018, https://www.irct.ir/trial/30748.

Risk of non-typhoidal Salmonella vascular infections is increased with degree of atherosclerosis and inflammation: A multicenter study in southern Taiwan.

Atherosclerosis and vascular inflammatory response have been considered as risk factors for non-typhoidal Salmonella (NTS) vascular infection. The study aims to assess the risk of vascular infection by measuring atherosclerosis severity, NTS vascular infection (NTSVI) score, and serum levels of inflammatory markers in people with NTS bacteremia. A prospective observational study was conducted in two medical centers and two regional hospitals. Adults aged ≥50 years with NTS bacteremia who underwent computed tomography (CT) scan for revealing vascular infections were enrolled. The degree of atherosclerosis was scaled by a calcium score determined by a CT scan. Serum concentrations of inflammatory biomarkers were determined in the patients enrolled in a medical center. Fourteen (20.3%) of 69 patients with NTS bacteremia had vascular infections. Calcium scores over the thoracic (12,540 vs. 3,261, P=0.0005) and abdominal (9755 vs. 3,461, P=0.0006) aorta of those with vascular infections were higher than those without vascular infection. All vascular infections were present in the high-risk group (NTSVI score ≥1), yielding a sensitivity of 100% and specificity of 30.9%. Among 17 low-risk patients (NTSVI score <1), none had vascular infections, resulting in a negative predictive value of 100%. Higher plasma concentrations of IL-1β were detected in the cases of vascular infection than those in the control group (23.6 vs. 1.06pg/mL, P=0.001). Atherosclerosis of the aorta which is associated with a positive NTSVI score can predict the occurrence of vascular infections and serum IL-1β could be a biomarker for vascular infection in patients with NTS bacteremia.

Complex study of Cancer Morbidity and Inflammatory Markers, Presented in the Blood Serum of the Rural Population of Sachkhere District of Georgia.

Aim:The purpose of the study was to compare the morbidity from cancer (expressed as incidence) to the average levels of blood serum inflammatory markers in the population of the Sachkhere region (Georgia).Methods:healthy residents of the Sachkhere district were examined. In the blood serum samples of patients, the cytokines (IL-1α, IL-10, TGF-β, IL-12, IL-17, TNF-α, IL-6) and NOx content, as well as the total antioxidant activity of the non-enzymatic system (TAA) were determined; using light microscopy, buccal micronuclei (MnB) of epithelial cells of the oral mucosa, as indicators of chromosomal disorders, were studied. Results:Study results show, that cancer incidence in Sareki was statistically significantly higher as in Chorvila and Sairkhe (p=0.002; p=0.004); in Sareki inhabitant’s blood serum levels of the IL-6, NO are increased (p=0.004, p=0.05), and IL-17, TGFβ, and IL-10 levels are decreased (p=0.010, p=0.001, p=0.033) in comparison to data in Chorvila; in Chorvila inhabitants’ indicators of TAA of blood serum and MnB of epithelium cell levels were lower (p=0.001,p=0.045) then in Sairkhe and Sareki. Conclusion:The existence of statistically reliable associations between the levels of cancer incidence in the populations of the surveyed villages and the indicators of immune and oxidative status in their virtually healthy subpopulations, with a high degree of persuasiveness, allows us to assume a close causal link between them. Clarifying the reasons for the identified patterns and their significance requires more detailed studies.

Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study.

IntroductionCancer patients may be susceptible to poorer outcomes in COVID‐19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions.MethodsThis was a population‐based retrospective cohort study of COVID‐19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30‐day mortality.ResultsThe following study consisted of 6089 COVID‐19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID‐19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D‐dimer, lactate dehydrogenase, high sensitivity troponin‐I and C‐reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four‐fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer‐free COVID‐19 counterparts.ConclusionsCOVID‐19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.

An association between low vitamin D status and childhood pneumonia severity in hospitalized bulgarian patients

Lower respiratory tract infections are among the most important causes of morbidity and mortality in the pediatric population worldwide. Despite advances in treatment and prevention, childhood pneumonia is the major reason for hospital admissions and remains a leading cause of death claiming an estimated 800 000 childrens lives in 2018. Globally, over 1.23 million children died of pneumonia before reaching their 5th birthday the equivalent of over 3400 deaths per day worldwide. There is growing evidence that vitamin D plays an important role in the immune system by modulating both innate and adaptive immunity. Vitamin D is an additional factor in the inflammatory response regulation. Its action is mediated via the vitamin D receptor (VDR), which is present in almost all types of immune cells, including activated CD4+ and CD8+ cells, B cells, macrophages, neutrophils and dendritic cells. Vitamin D deficiency is associated with decreased host defenses against infections. Therefore, our aim was to investigate whether low vitamin D status was a risk factor for pneumonia complications, usage of multiple antibiotics and prolonged hospital stay among hospitalized pediatric patients with community-aquired pneumonia. Total of 200 children (102 healthy controls and 98 with severe pneumonia) from 11 days to 17 years old were included in the study. Cases with severe pneumonia were subdivided into groups with and without complications (36 and 62, respectively). Electrochemiluminescence immunoassay was used to measure the serum 25-hydroxyvitamin D levels. The control group showed lower values than the study group. Cases with complicated pneumonia had significantly lower levels whitin the range of 29.768.0 nmol/l, compared with 49.188.6 nmol/l in cases without complications. A significant negative correlation was found between vitamin D concentrations and duration of hospital stay, the number of antibiotics used for treatment, and serum levels of inflammatory markers. The low status of vitamin D is related to the severity of the disease but has not been associated with the incidence/frequency of the disease. Children with low vitamin D levels may be at higher risk of developing life-threatening complications, intensive care admissions and a higher inflammatory response.