Significant Reduction In hsCRP Research Articles

IMPACT OF ANTIHYPERTENSIVE DRUGS ON C REACTIVE PROTEIN (HS-CRP) AND NEUTROPHIL LYMPHOCYTE RATIO (NLR)

Many studies showed the association between inflammation and Hypertension. Inflammatory markers may highlight the state of inflammation in hypertensive patients. This study aimed to investigate impact of antihypertensive drugs on high sensitive C-reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR). A comparative cross sectional study was conducted on 86 hypertensive patients attending cardiology outpatient clinic in Al-Gamhuoria Modern General Hospital, Aden, in the period from October to December 2023. Participants were divided into three groups: patients treated with mono-therapy from inhibitors of renin angiotensin aldosterone system (RAASI), patients treated with mono-therapy antihypertensive not acting on RAAS (NRAASI) and patients treed with combination of them (drug combination). Data on Age, Sex, BP level, BMI, duration of hypertension (HTN), family history of HTN, and medications used were collected. Blood samples for measuring HsCRP, neutrophils, lymphocytes were drawn. Descriptive statics and chi-square tests were used for data analysis. Almost equivalent distribution for males and females between groups, with a large proportion of the patients within each group laid in the age group 35-55 years. The median values of hypertension duration were 36, 48, and 54 months for RAASIs, NRAASIs and drug combination group, respectively. The target BP was obtained by 46.9% 45.5% and 50% of patients treated with RAASIs, NRAASIs and drug combination respectively. There was a statistically significant difference between SBP and DBP in patients with controlled BP and those with uncontrolled SBP levels and treated by different drug regimens (P=0.000 for each Bp level). There were significant differences between values of hs-CRP of patients with controlled (P=0.000) or uncontrolled (P=0.046) BP and treated with different modalities. The median differences in NLR between the groups were statistically significant; including groups of all patients P=.032, of patients having controlled BP P=0.014 as well as uncontrolled BP P=0.038. Comparing the uncontrolled of BP of the three groups we found the highest prevalence (9.3%)of patients with uncontrolled BP and had the lower level hsCRP (≤3mg /l) was in RAASIs group, while those with higher prevalence (11.6%) of uncontrolled BP and higher level of hs-CRP ( >3mg/l) was in drug combination group. In conclusion, hypertensive patients treated with RAASI, NRAASI and drug combination and reached BP target showed significant reduction in hsCRP and NLR. Patients with uncontrolled BP treated with RAASIs revealed slightly lower hs-CRP than other groups. Careful selection of antihypertensive drugs may affect risks of CVD. This study recommends further prospective studies exploring the anti-inflammatory effect of antihypertensive drugs to ameliorate possible risks of cardiovascular disease.

Inflammatory markers and noncoding-RNAs responses to low and high compressions of HIIT with or without berberine supplementation in middle-aged men with prediabetes.

This study compared the capacity of two different models of HIIT [high-(HC) and low-(LC) compression], with or without the use of berberine (BBR), on NOD-like receptor pyrin domain-containing protein-3 (NLRP3), H19, interleukin (IL)-1β, high-sensitivity C-reactive protein (hs-CRP), and insulin resistance markers. Fifty-four middle-aged men with overweight or obesity and prediabetes [fasting blood glucose (FBG) 110-180 mg/dL] were randomly and equally assigned to the HC, LC, HC + BBR, LC + BBR, BBR, and non-exercising control (CON) groups. The HC (2:1 work-to-rest) and LC (1:1 work-to-rest) home-based training programs included 2-4 sets of 8 exercises at 80%-95% HRmax, twice a week for 8 weeks. Participants in the berberine groups received approximately 1000 mg daily. All exercise interventions led to a significant reduction in hs-CRP, IL-1β, insulin, FBG, and insulin resistance index (HOMA-IR) versus CON. Notably, there was a significant reduction in FBG and HOMA-IR with the BBR group compared to the baseline. Both NLRP3 and H19 experienced a significant drop only with LC in comparison to the baseline. While both exercise protocols were beneficial overall, LC uniquely exhibited more anti-inflammatory effects, as indicated by reductions in H19 and NLRP3. However, the addition of berberine to the exercise programs did not demonstrate additional benefits.

Pleiotropic effect of teneligliptin versus glimepiride add-on therapy on hs-CRP and cardiorenal parameters in Indian type 2 diabetes patients: An open-labeled randomized controlled trial

Abstract Objective: The objective of the study was to estimate the pleiotropic effect of teneligliptin on high-sensitivity C-reactive protein (hs-CRP) levels and some cardiorenal parameters in comparison to glimepiride, both as add-on therapy to metformin. Methodology: This 12-week open-label, parallel-group, randomized controlled trial was conducted among Indian people with type 2 diabetes mellitus and on metformin monotherapy with poor glycemic control (glycated hemoglobin >7% or 53 mmol/mol). The endpoints were mean change in hs-CRP levels, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, blood urea, estimated glomerular filtration rate (eGFR), and change in cardiovascular (CV) risk categories from baseline to end of 12 weeks. Results: Seventy participants were randomized (1:1) to receive either teneligliptin 20 mg once daily (n = 35) or glimepiride 1 mg twice daily (BD) (n = 35) as an add-on to metformin 500 mg BD. The mean age of the participants was 50.65 and 50.7 years in arms 1 and 2, respectively. At 12-weeks end, teneligliptin add-on caused a statistically significant reduction in hs-CRP compared to glimepiride in both per-protocol (PP) and intention-to-treat (ITT) sets. No significant difference was observed for changes in SBP and DBP, creatinine, urea, eGFR levels, and CV risk category in both PP and ITT sets. Conclusion: Teneligliptin add-on resulted in favorable effects on hs-CRP levels and comparable effects on cardiorenal parameters compared to glimepiride add-on therapy at 12-weeks end. This trial has been prospectively registered in CTRI (Clinical Trials Registry of India). Registration number: CTRI/2021/08/035342.

Inflammatory markers in patients who presented with acute coronary syndrome and history of COVID-19 infection: a cross-sectional study

Background: During the COVID-19 outbreak, the number of patients who have developed acute coronary syndromes (ACS) has soared rapidly, cardiovascular disease and mortality are influenced by the elevated inflammatory biomarkers. The aim of this study is to compare inflammatory markers between patients with ACS who hadn’t previously had COVID-19 and those who’d be infected within the preceding three months; as well as, evaluating the effect of statins on inflammatory biomarkers. Methods: This is a comparative cross-sectional study of 42 patients who presented with ACS and had previously had COVID-19 and 48 patient who had never had COVID-19, who were admitted to the coronary care unit at the Iraqi Center for Heart Disease and Baghdad Teaching Hospital, Iraq. Inflammatory biomarkers (TNF-α, IL-6, and HS-CRP) levels were determined in serum samples of all patients at admission to these centers then one month later, after administration of statins daily using the Sandwich-ELISA Principle, and Immunofluorescence technique for these markers. Result: The baseline for patients who had ACS and COVID-19 three months previously, were IL6 (85.87 ±45.80), HS-CRP (23.19 ± 14.49), and TNF-α (161.94± 240.96) were higher than patients that had ACS but not COVID-19; IL6 (50.77±22.48), HS-CRP (13.64± 12.09), and TNF-α (117.73 ±71.23),(p<0.0001), (p=0.003) and (p=0.201) for IL6, HS-CRP, and TNF-α respectively. Rosuvastatin showed a significant reduction in HS-CRP and IL6 (P<0.001), while Atorvastatin a significant reduction in HS-CRP (P<0.001) after one month of therapy. Yet there was no significant difference in the level of TNF α in these two groups at the end of this study. Conclusions: The patients with previous COVID-19 still had higher inflammatory markers than those who didn’t. Rosuvastatin 40mg had a more reduction in IL6 than Atorvastatin 40mg after one month and both of them could reduce HS-CRP, but neither could reduce TNF-α in this short period.

P1618: CLINICAL OUTCOME OF COVID-19 CONVALESCENT PLASMA TRANSFUSION IN CHRONIC KIDNEY DISEASE PATIENTS ON RENAL REPLACEMENT THERAPY WITH SEVERE TO CRITICAL COVID-19 DISEASE

Background: Convalescent plasma therapy (CPT) has been explored for Coronavirus disease 2019 (COVID-19), but limited data exists for Chronic Kidney Disease (CKD) patients. Since the effects of COVID-19 therapies are still under study, CPT remains an option for these patients in the absence of other effective therapy. Aims: This study aimed to compare the clinical outcome of severe to critical COVID-19 patients with CKD on RRT who received COVID-19 CPT versus those who did not. Methods: Retrospective study. Primary outcome was clinical improvement defined as mortality or whether discharged alive or improvement in WHO 6-point severity scale within 28 days. Secondary outcomes include factors associated with clinical improvement such as CPT’s effect on pulmonary status, timing of CPT, effects on hematologic profile and inflammatory markers. Results: Total of 44 CKD patients were included. Half were given CPT, half were not. Mean age was 59±12.7 and 51±15.6 respectively; 68.2% male, 31.8% female. No significant difference was found in the clinical outcome of severe to critical COVID-19 CKD patients who received CPT and those who did not. However, significant reduction in HsCRP, procalcitonin and ferritin pre and post CPT was found. This provide support in the role of CPT in reducing the inflammatory cytokine course of COVID-19 in CKD patients. Image:Summary/Conclusion: Convalescent plasma transfusion did not show significant difference in the clinical outcome of severe to critical COVID-19 CKD patients, but was associated with decreasing trends of HsCRP, procalcitonin and ferritin, which are poor prognosticators of COVID-19 disease.

Changes of omentin-1 and chemerin during 4 weeks of lifestyle intervention and 1 year follow-up in children with obesity

Data about the influence of short-term lifestyle intervention in children with obesity on long-term follow-up body weight, adipokines and cardiometabolic risk parameters is scarce. In a subgroup of the LOGIC-trial (Long-term Effects of Lifestyle Intervention in Obesity and Genetic Influence in Children), we assessed anthropometry (BMI, BMI-SDS (Standard Deviation Score), adipokines (omentin-1, chemerin, leptin, adiponectin) and cardiometabolic risk parameters, (e.g. hsCRP) in children with overweight/obesity after 4 weeks of lifestyle intervention (n=156, 14.0±1.8yrs) and after one year follow-up (n=50). Data were compared to normal weight children (JuvenTUM school cohort; n=152, 13.3±0.7yrs). Short-term lifestyle intervention was associated with a significant reduction in BMI and BMI-SDS (p<0.001), with significant reductions in hsCRP, leptin, and chemerin levels, and an increase in adiponectin and omentin-1 levels (p<0.001 for all). After one year follow-up a significant reduction in BMI and BMI-SDS was observed in children from the LOGIC-trial (p<0.001). Improvements in adiponectin (p=0.025) and chemerin levels (p=0.027) were seen in children with clear weight loss success (BMI-SDS reduction ≥ 0.2), whereas children with no or only mild weight loss success showed an increase in leptin levels (p<0.001). An increase in omentin-1 levels was observed after 1 year independent of weight change (p<0.001). Effects of short-term weight reduction on mean BMI and BMI-SDS persist over one year. Improvements in omentin-1 levels were independent of short-term or long-term weight loss. ClinicalTrials.gov: LOGIC-trial: NCT01067157, JuvenTUM-trial: NCT00988754.

The Effect of the Hydroalcoholic Extract of Watercress on the Levels of Protein Carbonyl, Inflammatory Markers, and Vitamin E in Chronic Hemodialysis Patients.

Introduction Chronic kidney disorder is a main public health concern. Inflammatory processes and oxidative stress are common in end-stage renal disease patients. We aimed to evaluate the effect of the hydroalcoholic extract of watercress (WC) on the inflammatory cytokines and protein carbonyl (PCO) contents in chronic hemodialysis patients. Methods This was a double-blind randomized clinical trial performed on 46 hemodialysis patients. The participants were randomly divided into two groups: intervention group (500 mg hydroalcoholic extract of WC every day for 4 weeks) and control group (500 mg of white flour every night for 4 weeks). The blood samples were taken to determine the levels of vitamin E, PCO, and inflammatory cytokines at baseline and the end of treatment. Results Forty-five patients completed the study (22 patients in the intervention group and 23 patients in the control group). There was a significant reduction in the PCO level (20.33 ± 4.40 vs. 15.06 ± 6.41, P=0.001) in the intervention group; also, this change was statistically significant relative to the control group. Furthermore, there were significant reductions in hs-CRP (8953.30 ± 5588.06 vs. 7249.86 ± 5091.62, P=0.007) and IL-6 (60.10 (55.99, 73.10) vs. 55.21 (53.39, 60.48), P=0.050) in the intervention group, but these changes were not significant in comparison with the control group. Conclusion We conclude that the hydroalcoholic extract of WC reduced the PCO content in hemodialysis patients via inhibition of protein oxidation. Although WC administration had caused a significant reduction in IL-6 and CRP levels, these differences were not statistically significant relative to the control group. Further research is needed to identify the antioxidant and anti-inflammatory effects of WC in hemodialysis patients.

Effects of Incretin-based Therapy on High-sensitivity C-reactive Protein in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Recently, studies had shown that incretin-based therapies could reduce the levels of pro-inflammatory markers. The data on the effects of incretin-based therapies on serum high-sensitivity C-reactive protein (hs-CRP) in type 2 diabetes (T2DM) were inconsistent. The objective of the study was to assess the effects of incretin-based therapies on hs- CRP in patients with T2DM by meta-analysis. We searched PubMed, EMBASE, the Cochrane Collaboration Library, and Web of Science to identify the eligible randomized clinical trials until August 2019. The pooled standard mean differences (SMD) were calculated by random-effects model using STATA 11.0. Twenty-five studies with 28 randomized controlled trials were finally included into the meta-analysis. Meta-analysis revealed a significant reduction in hs-CRP following treatment with incretin-based regimens compared to controls (SMD = -0.452, p < 0.001). Subgroup analysis of different class of incretinbased drugs showed that therapy with both dipeptidyl peptidase 4 inhibitors (DPP-4Is, SMD = -0.338, p = 0.026) and glucagonlike peptide 1 receptor agonists (GLP-1 RAs, SMD = -0.544, p = 0.003) caused significant reductions in hs-CRP. Besides, there was a significant reduction in hs-CRP with an intervention duration more than 24 weeks (SMD = -0.465, p = 0.001), while no significant difference with < 24 weeks. Meta-regression analyses showed that better glycemic control and more body mass index (BMI) decline were associated with hs-CRP reduction after incretin-based therapies. This meta-analysis suggests that incretin-based therapies, both GLP-1 RAs and DPP-4Is, can cause a significant reduction in hs-CRP in patients with T2DM, which is related to long intervention duration, better glycemic control, and more BMI decline.

Gene expression profile of CD14+ blood monocytes following lifestyle-induced weight loss in individuals with metabolic syndrome

Lifestyle-induced weight loss is regarded as an efficient therapy to reverse metabolic syndrome (MetS) and to prevent disease progression. The objective of this study was to investigate whether lifestyle-induced weight loss modulates gene expression in circulating monocytes. We analyzed and compared gene expression in monocytes (CD14+ cells) and subcutaneous adipose tissue biopsies by unbiased mRNA profiling. Samples were obtained before and after diet-induced weight loss in well-defined male individuals in a prospective controlled clinical trial (ICTRP Trial Number: U1111-1158-3672). The BMI declined significantly (− 12.6%) in the treatment arm (N = 39) during the 6-month weight loss intervention. This was associated with a significant reduction in hsCRP (− 45.84%) and circulating CD14+ cells (− 21.0%). Four genes were differentially expressed (DEG’s) in CD14+ cells following weight loss (ZRANB1, RNF25, RB1CC1 and KMT2C). Comparative analyses of paired CD14+ monocytes and subcutaneous adipose tissue samples before and after weight loss did not identify common genes differentially regulated in both sample types. Lifestyle-induced weight loss is associated with specific changes in gene expression in circulating CD14+ monocytes, which may affect ubiquitination, histone methylation and autophagy.

Effect of Vitamin D Supplementation on Inflammatory Markers in Non-Obese Lebanese Patients with Type 2 Diabetes: A Randomized Controlled Trial.

Background: A low serum 25-hydroxyvitamin D (25(OH) D) concentration has been associated with a higher risk of type 2 diabetes mellitus (T2DM), especially in older people. Our aim in this randomized controlled trial was to evaluate the effect of vitamin D treatment on inflammatory markers in non-obese Lebanese patients with T2DM, living in Beirut, Lebanon. Methods: Non-Obese patients with T2DM (n = 88), deficient/insufficient in vitamin D, were randomly assigned into one of two groups—a treatment group receiving 30,000 IU cholecalciferol/week for a period of six months, and a placebo group. Serum concentrations of TNF-α, high-sensitivity C-reactive protein (hs-CRP), and Interleukin-6 (IL-6) were the primary outcomes. A homeostatic model of insulin resistance (HOMA-IR) was assessed, in addition to serum concentrations of fasting blood glucose (FBG), HbA1C, (25(OH) D), and PTH. Results: The vitamin D group showed higher blood levels of (25(OH) D) (p < 0.0001), and a significant reduction in hs-CRP and TNF-α concentrations (p < 0.0001) compared to placebo. The decrease perceived in IL-6 concentrations was not significant (p = 0.1). No significant changes were seen in FBG (p = 0.9) and HbA1c levels (p = 0.85). Conclusion: Six months of vitamin D supplementation led to a decrease in some inflammatory markers in patients with T2DM. Additional studies with a larger sample and a longer period are advised in this regard. This trial was registered at ClinicalTrial.gov; Identifier number: NCT 03782805.

Effect of Moringa oleifera Leaf Extract on High Sensitivity C-Reactive Protein, ESR And MEX SLEDAI Score in Lupus Patients

Introduction: No definitive treatment is available for SLE. Moringa oleifera Leaf Extract is one of promising novel treatments in SLE because of anti inflammatory and immunomodulatory effect. Our study aimed to identify the effect of Moringa oleifera Leaf Extract on the level of hs-CRP, ESR and MEX SLEDAI score in lupus patients. HsCRP and ESR levels are related to the pathogenesis of SLE and they are positively correlated with the disease activity. The MEX SLEDAI score is a simple method that is quite valid for finding the degree of SLE activity, and MEX SLEDAI has the ability to evaluate clinical changes in SLE patients.Methods: Experimental study consisted of 29 samples of SLE patients, divided into 2 groups, namely 13 SLE patients who received Moringa oleifera leaf extract as much as 40.5 mg / kg per day and 16 SLE patients who received placebo. The study was conducted for 28 days. MEX SLEDAI scores, hsCRP and ESR levels were measured before and after administration of therapy. Statistical analysis was applied using SPSS 23, with different t-test, Mann Whitney, and Will Coxon tests. P is significant if p &lt;0.05.Result: Result of the study showed that before Moringa oleifera leaf extract was given, the average MEX SLEDAI score was (1.56 ± 2.16) for control, and (2.69 ± 3.01) for treatment, hsCRP (0.24 ± 0.22) for control and ( 0.76 ± 1.01) for treatment, ESR (25.56 ± 23.44) for control and (26.00 ± 25.27) for treatment. There was a significant decrease in MEX SLEDAI score in the treatment group. There was no significant reduction in hsCRP and ESR of SLE patients in both groups.Conclusion: This study showed that the effect of lowering the MEX SLEDAI score on the administration of Moringa leaf extract was significant and could not significantly reduce hsCRP and ESR levels.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 291-297

Effect of grape polyphenols on selected inflammatory mediators: A systematic review and meta-analysis randomized clinical trials.

Grapes contain different polyphenols and might prevent inflammation by reducing Nitric Oxide (NO) inactivation through antioxidative enzymes. The aim of this article was to demonstrate the effects of grape polyphenols on the selected inflammatory mediators, such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), and high-sensitivity C-reactive protein (hs-CRP). To find papers assessing the effects of grape polyphenols on inflammatory mediators, electronic data bases, including ISI web of science, PubMed/Medline, SCOPUS, and Google scholar, were searched up to March 2019. Delphi checklist was used for evaluating the qualities of the included articles. The protocol was registered in PROSPERO (No. CRD42019116695). The mean changes in the intervention and control groups were calculated by subtracting the end values from the baselines. Then, the difference between the two changes was measured and utilized as the effect size in meta-analysis. 9 and 8 articles were included in the systematic review and meta-analysis, respectively. Our results indicated that grape polyphenols did not reduce hs-CRP levels, but omission of one article could lead to a significant reduction in hs-CRP (Weight Mean Difference (WMD): −0.54 mg/L, 95 % CI: −1.02, -0.06; P=0.026, I2=0.0 %). Regarding IL-6 and TNF-α, no significant changes were observed in the intervention compared to the control group (WMD: 0.04 pg/mL, 95 % CI: −0.02, 0.28; P=0.744, I2=0.0 %, WMD: -0.10 pg/mL, 95 % CI: −0.25, 0.05; P=0.183, I2=0.0 %, respectively). We found no beneficial effects of grape polyphenols on the selected inflammatory mediators. Still, more studies with higher doses of polyphenols, longer treatment durations, different sources of grape polyphenols, and larger numbers of participants are required.

P3471Anti-inflammatory effects of direct oral anticoagulants in patients with non-valvular atrial fibrillation: insights from 2216 patients in the DIRECT registry

Abstract Background Several previous studies reported anti-inflammatory effect of direct oral anticoagulant (DOAC). However, it was limited to basic pathological data with small sample size. Real-world large clinical data is still scarce. Methods We conducted a single-center prospective observational registry of NVAF patients treated with DOACs: the DIRECT registry (UMINehz745.034333283). All patients with nonvalvular atrial fibrillation (NVAF) (N=2216) who were users of dabigatran (N=648), rivaroxaban (N=538), apixaban (N=599), or edoxaban (N=431) from June 2011 to November 2017 were enrolled (71.6±10.8 years, 36.4% female, follow-up duration: 407.2±388.3 days). High sensitive C-reactive protein (hsCRP) test was performed before (within 3 months from the start) and after the start of DOAC prescription (6±3 months after the start). Patients with a hsCRP value &gt;1.00 mg/dL were excluded from the analysis due to possibility of other systemic inflammatory conditions. The present post-hoc study of the DIRECT registry assessed anti-inflammatory effect of DOAC. Pre-hsCRP and post-hsCRP were compared by Wilcoxon Signed Ranks test. Results A total of 1,855 patients were analyzed in the present study (71.0±10.7 years, 677/1,855 (36%) females). In the overall cohort, hsCRP significantly decreased after the start of DOAC prescription (pre median 0.08 interquartile range [0.04–0.17] mg/dL vs. post 0.06 [0.03–0.12] mg/dL, p&lt;0.001). The significant reduction of hsCRP was consistent across all DOACs (p=0.301) [dabigatran (N=562), pre 0.08 [0.04–0.1625] mg/dL vs. post 0.06 [0.03–0.12] mg/dL, p&lt;0.001: rivaroxaban (N=457), pre 0.07 [0.04–0.16] mg/dL vs. post 0.07 [0.03–0.125] mg/dL, p&lt;0.001: apixaban (N=494), pre 0.09 [0.04–0.19] mg/dL vs. post 0.06 [0.03–0.13] mg/dL, p&lt;0.001: edoxaban (N=342), pre 0.08 [0.04–0.19] mg/dL vs. post 0.06 [0.03–0.13] mg/dL, p&lt;0.001]. Conclusions The present study of DIRECT registry suggested anti-inflammatory effect of DOAC presented as a significant reduction of hsCRP. Although further investigation would be warranted to evaluate the clinical significance of the suppressed systemic inflammation, the recent favorable clinical data of DOACs might be attributed to the present finding.

Probiotic and selenium co-supplementation, and the effects on clinical, metabolic and genetic status in Alzheimer's disease: A randomized, double-blind, controlled trial

Combined probiotic and selenium supplementation may improve Alzheimer's disease (AD) by correcting metabolic abnormalities, and attenuating inflammation and oxidative stress. This study aimed to determine the effects of probiotic and selenium co-supplementation on cognitive function and metabolic status among patients with AD. This randomized, double-blind, controlled clinical trial was conducted among 79 patients with AD. Patients were randomly assigned to receive either selenium (200μg/day) plus probiotic containing Lactobacillus acidophilus, Bifidobacterium bifidum, and Bifidobacterium longum (2×109CFU/day each) (n=27), selenium (200μg/day) (n=26) or placebo (n=26) for 12 weeks. Selenium supplementation, compared with the placebo, significantly reduced serum high sensitivity C-reactive protein (hs-CRP) (P<0.001), insulin (P=0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (P=0.002), LDL-cholesterol (P=0.04) and total-/HDL-cholesterol ratio (P=0.004), and significantly increased total glutathione (GSH) (P=0.001) and the quantitative insulin sensitivity check index (QUICKI) (P=0.01). Compared with only selenium and placebo, probiotic and selenium co-supplementation resulted in a significant increase in mini-mental state examination score (+1.5±1.3 vs.+0.5±1.2 and-0.2±1.1, respectively, P<0.001). Probiotic plus selenium intake resulted in a significant reduction in hs-CRP (-1.6±1.4 vs.-0.8±1.0 and+0.1±0.5mg/L, respectively, P<0.001), and a significant increase in total antioxidant capacity (+89.4±129.6 vs.+20.0±62.5 and-0.7±27.2mmol/L, respectively, P=0.001) and GSH (+122.8±136.5 vs.+102.2±135.2 and+1.5±53.2μmol/L, respectively, P=0.001) compared with only selenium and placebo. In addition, subjects who received probiotic plus selenium supplements had significantly lower insulin levels (-2.1±2.5 vs.-1.0±1.3 and+0.7±2.0 μIU/mL, respectively, P<0.001), HOMA-IR (-0.5±0.6 vs.-0.2±0.3 and+0.1±0.4, respectively, P<0.001), and higher QUICKI (+0.01±0.01 vs.+0.005±0.007 and-0.002±0.01, respectively, P<0.006) compared with only selenium and placebo. Additionally, probiotic and selenium co-supplementation resulted in a significant reduction in serum triglycerides (-17.9±26.1 vs.-3.5±33.9 and+0.3±9.3mg/dL, respectively, P=0.02), VLDL- (-3.6±5.2 vs.-0.7±6.8 and+0.05±1.8mg/dL, respectively, P=0.02), LDL- (-8.8±17.8 vs.-8.1±19.2 and+2.7±19.0mg/dL, respectively, P=0.04) and total-/HDL-cholesterol (-0.3±0.7 vs.-0.4±0.9 and+0.3±0.6, respectively, P=0.005) compared with only selenium and placebo. Overall, we found that probiotic and selenium co-supplementation for 12 weeks to patients with AD improved cognitive function and some metabolic profiles. This study was registered in the Iranian website (www.irct.ir) for registration of clinical trials (http://www.irct.ir: IRCT20170612034497N5).

Effect of Central Sympathoinhibition With Moxonidine on Sympathetic Nervous Activity in Polycystic Ovary Syndrome-A Randomized Controlled Trial.

Sympathetic nervous system (SNS) activity is increased in polycystic ovary syndrome (PCOS). Moxonidine is a centrally acting sympatholytic drug with known beneficial effects on hypertension, insulin sensitivity, dyslipidemia and inflammation. In this double-blind placebo controlled randomized clinical trial we examined the effect of moxonidine on modulating sympathetic activity and downstream metabolic abnormalities in 48 pre-menopausal women with PCOS (Rotterdam diagnostic criteria), recruited from the community (January 2013–August 2015). Participants received moxonidine (0.2 mg daily initially, up titrated to 0.4 mg daily in 2 weeks) (n = 23) or placebo (n = 25) for 12 weeks. Multiunit muscle sympathetic activity (by microneurography) and plasma noradrenaline levels were measured (primary outcomes). Fasting lipids, insulin resistance, serum androgens, and inflammatory markers were measured as secondary outcomes. Forty three women completed the trial (19 moxonidine, 24 placebo). Mean change in burst frequency (−3 ± 7 vs. −3 ± 8 per minute) and burst incidence (−3 ± 10 vs. −4 ± 12 per 100 heartbeat) did not differ significantly between moxonidine and placebo groups. Women on moxonidine had a significant reduction in hs-CRP compared to placebo group (−0.92 ± 2.3 vs. −0.04 ± 1.5) which did not persist post Bonferroni correction. There was a significant association between markers of insulin resistance at baseline and reduction in sympathetic activity with moxonidine. Moxonidine was not effective in modulating sympathetic activity in PCOS. Anti-inflammatory effects of moxonidine and a relationship between insulin resistance and sympathetic response to moxonidine are suggested which need to be further explored.Clinical Trial Registration Number: (NCT01504321)

Low dose combination of aspirin and clopidogrel retards the progression of atherosclerosis in hypercholesterolemia rabbits via interfering with inflammatory and oxidative responses.

The objective of this study to evaluate the effect of the combination of aspirin and clopidogrel in low doses on the progression of atherosclerosis.A total of 35 local domestic rabbits was assigned to five groups. Blood samples were collected at the end of the experiment (8-weeks) for measurement of serum triglycerides,total cholesterol (TC),HDL-C,plasma high sensitive C-reactive protein,plasma malondialdehyde andplasma reduced glutathione. Compared to normal control,levels of lipid profile, atherogenic index,hsCRP,and MDA are increased while GSH were decreased in animals on an atherogenic diet. immunohistochemical analysis showed that aortic expression of VCAM-1,MCP-1,TNF-α and IL-17A were significantly increased in the atherogenic control group compared to a normal control group. A combination of low doses aspirin and clopidogrel causes statistically significant reduction in hsCRP and MDA. A combination of low doses aspirin and clopidogrel treatment significantly reduced aortic expression of VCAM-1,MCP-1,TNF-α and IL-17A. Histopathologic examination of aortic arch showed that the combination of low doses aspirin and clopidogrel significantly reduced atherosclerotic lesion. Aspirin treatment considerably reduced aortic expression of VCAM-1,MCP-1,TNF-α and IL-17A. It thus can conclude that a combination of aspirin and clopidogrel in low doses has a reducing effect on lipid peroxidation,systemic inflammation and aortic expression of inflammatory marker and hence reduce the progression of atherosclerosis.

The effect of 12 weeks of aerobic training on serum levels high sensitivity C-reactive protein, tumor necrosis factor-alpha, lipid profile and anthropometric characteristics in middle-age women patients with type 2 diabetes

AimsThe aim of this study was to investigate the effect of 12 weeks of aerobic training on serum levels of high sensitivity C- reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), lipid profile and anthropometric characteristics in middle-aged women patients with type-2 diabetes. MethodsA quasi-experimental study, 20 women patients with type-2 diabetes (mean age, 50.25 ± 4.36 years, Body mass index, 25.51 ± 2.91 kg/m2, and body fat percentage 23.67 ± 3.05%) were randomly categorized into two experimental and control groups. The protocol aerobic training included eight-minute jogging and eight-minute running with 75–85 percent maximum heart rate reserve in the first session. Per both sessions, one minute added to running time and it increased up to 32 min after 12 weeks. Blood sampling and anthropometric measurements, 24 h before and 48 h after the last training session were conducted. ResultThe result showed a significant reduction in hs-CRP and TNF-α in the experimental than control group (P = 0.01). Exercise training-treated patients showed a significant decrease in TG, LDL and increase HDL in comparison with baseline and the control group (P < .05). The results also showed a significant decrease in weight, body mass index, body fat percentage, and waist–hip ratio (P values 0.02, 0.03, 001, 0.04 respectively) following the 12 weeks aerobic training. ConclusionIt seems that long-term aerobic training, improved some important anthropometric and biochemical parameters in patients with type-2 diabetes. These observations give a new insight into the mechanisms by which aerobic training can reduce the cardiovascular risk in diabetes.

Antiatherosclerotic potential of aspirin: Antioxidant and anti-inflammatory approaches

Objective: this study was undertaken to evaluate the effect of aspirin on the progression of atherosclerosis. Materials and methods: A total of 28 local domestic rabbits were assigned to four groups: Group I (normal control), Group II (atherogenic control), Group III (vehicle control),Group IV (aspirin 10 mg\kg daily). Blood samples were collected at the end of experiment (8 weeks) for measurement of serum triglycerides (TG), total cholesterol (TC), HDL-C, plasma high sensitive C-reactive protein (hsCRP), plasma malondialdehyde (MDA) and plasma reduced glutathione (GSH). Immunohistochemical analysis (VCAM-1, MCP-1, and TNF-α) and histopathologic assessment of aortic atherosclerotic changes were also performed.&#x0D; Results: Compared to NC, levels of lipid profile, atherogenic index, hsCRP, and MDA are increased while GSH were decreased in animals on atherogenic diet (p&lt; 0.05). Immunohistochemical analysis showed that aortic expression of VCAM 1, MCP-1, and TNF-α were significantly increased in AC group compared to NC group (p&lt;0.001). Histopathologic finding showed that animals on atherogenic diet have significant atherosclerotic lesion compared to NC group. Compared to AC group aspirin don’t have significant effect on lipid profile. Aspirin causes statistically significant reduction in hsCRP and MDA (p&lt;0.05). Aspirin treatment causes significantly increase the level of GSH. Aspirin treatment significantly reduced aortic expression of VCAM-1, MCP-1, and TNF-α (p&lt;0.05). Histopathologic examination of aortic arch showed that aspirin significantly reduced atherosclerotic lesion (p&lt;0.05).Conclusions: It thus can conclude that aspirin reduces lipid peroxidation, systemic inflammation and aortic expression of inflammatory markers used in this study and hence reduce the progression of atherosclerosis.

Effect of montelukast on progression of atherosclerosis

Objective: this study was undertaken to evaluate the effect of montelukast on the progression of atherosclerosis. Materials and methods: A total of 28 local domestic rabbits were assigned into four groups: Group I (normal control), Group II (atherogenic control), Group III (vehicle control),Group IV (montelukast 1.5 mg\kg daily). Blood samples were collected at the end of experiment (8 weeks) for measurement of serum triglycerides (TG), total cholesterol (TC), HDL-C, plasma high sensitive C-reactive protein (hsCRP), plasma malondialdehyde (MDA) and plasma reduced glutathione (GSH). Immunohistochemical analysis (VCAM-1, MCP-1, and TNF-α) and histopathologic assessment of aortic atherosclerotic changes were also performed.&#x0D; Results: Compared to NC, levels of lipid profile, atherogenic index, hsCRP, and MDA are increased while GSH were decreased in animals on atherogenic diet (p&lt; 0.05). Immunohistochemical analysis showed that aortic expression of VCAM 1, MCP-1, and TNF-α were significantly increased in AC group compared to NC group (p&lt;0.001). Histopathologic finding showed that animals on atherogenic diet have significant atherosclerotic lesion compared to NC group. Compared to AC group montelukast don’t have significant effect on lipid profile. Montelukast causes statistically significant reduction in hsCRP and MDA (p&lt;0.05). Montelukast treatment causes significantly increase the level of GSH. Montelukast treatment significantly reduced aortic expression of VCAM-1, MCP-1, and TNF-α (p&lt;0.005). Histopathologic examination of aortic arch showed that montelukast significantly reduced atherosclerotic lesion (p&lt;0.005).Conclusions: It thus can conclude that montelukast reduces lipid peroxidation, systemic inflammation and aortic expression of inflammatory markers used in this study and hence reduce the progression of atherosclerosis.

Chronic apical periodontitis as risk factor atherosclerosis and artery disease

Periodontitis is caused by bacteria that are present in periodontal tissues also under physiological condition. Neglected hygiene may increase the number of microorganisms and the formation of chronic apical periodontitis (CAP). The aim of the study was to evaluate changes in inflammatory expression (hsCRP and LpPLA2 in adult patients one year after the end of endodontic treatment, thereby the risk analysis of cardiovascular disease. Material and methods: Twenty-six patients who had history of inflammation outside the oral cavity were diagnosed with CAP before the treatment and one year after the end of endodontic treatment. The studied men and women were divided into two age groups: 50 above years (N = 13) and below 50 years (N = 13). In addition, the study groups were separated in relation to apoAI concentration, taking a cut-off of 150mg/dl. The therapeutic effect was achieved in 26 patients after endodontic treatment. The concentration of bio- chemical parameters – hsCRP and LpPLA2 as well as apoAI was evaluated using the commercially available methods. Statistical analysis was performed using the pair test for dependent samples. Results: In patients below 50 years of age and 1 year after the end of treatment a significant reduction in hsCRP and LpPLA2 level was observed. Similarly, a statistically significant decrese in LpPLA2 concentration was observed in patients with apoAI&gt;150 mg/dl. Conclusions: In patients &lt; 50years of age, after 1 year CAP treatment, the CAP inflammatory foci CAP were reduced and the inflammatory markers were normalized. Also in patients with a high apoAI level, reduced and the after treat suggested that elevated level of apoAI and LpPLA2 in HDL particles might reduce the inflammatory lesion size in CAP and might systemic complications. CAP, particularly in patients over 50 years of age and at an apoAI&lt;150mg/dl and higher level of LpPLA2, is a risk factor for atherosclerosis and destabiliza- tion of atherosclerotic plaque. Endodontic treatment should be induced in medication of atherosclerosis and its complications both in primary and secondary prevention.