223 Association of levels of IL-6, IL-10, IL-18 and TNF-alpha with rheumatic mitral stenosis and subsequent pulmonary hypertension

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
GAURAV Tripathi ◽  
SANJAY Tyagi ◽  
BHAWNA Mahajan ◽  
VIMAL Mehta
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Stenosis ◽  
Chronic Phase ◽  
Public Health Problem ◽  
Serum Levels ◽  
Rheumatic Mitral Stenosis ◽  
Tnf Α ◽  
Group A ◽  
Hs Crp ◽  
Group B

Abstract Background Rheumatic heart disease (RHD) remains a serious public health problem in developing countries. The pattern of immune response after exposure to streptococcal infection is one of the main determinants of the rheumatic inflammatory process, making it essential to identify the patients who have a higher risk of disease progression. Objective To give an insight into the pathophysiology of the rheumatic afflicted valves and the role of IL-6, IL-10, IL-18 and TNF-α in the different stages of RHD.  Methods  The study included 84 consecutive patients (62 females, mean age 34.6 ± 10.6 years) with symptomatic, severe chronic rheumatic mitral stenosis (Group-A). 79 age and gender matched normal healthy volunteers were enrolled as controls (Group-B). Patients with chronic rheumatic mitral stenosis were further divided into subgroups based on severity of mitral stenosis [MVA ≤ 1 cm2 (Subgroup Aa) and MVA > 1 cm2 (Subgroups Ab)] and presence or absence of pulmonary hypertension [RVSP ≥ 36 mm Hg (Subgroup Ac) and RVSP < 36 mm Hg (Subgroup Ad)]. IL-6, IL-10, IL-18, TNF-α and hs-CRP levels were assessed in both groups. Results The mean serum levels of IL-6, IL-10, IL-18, TNF-α and hs-CRP in Group-A and Group-B were 6.57 ± 3.53 pg/mL and 2.73 ± 1.01 pg/mL (p <0.001), 8.19 ± 2.80 pg/mL and 3.51 ± 0.86 pg/mL (p  <0.001), 136.31 ± 89.02 pg/mL and 47.96 ± 9.76 pg/mL (p <0.001), 21.26 ± 18.59 pg/mL and 5.36 ± 3.57 pg/mL (p <0.001), 4.69 ± 6.31 pg/mL and 2.63 ± 2.22 pg/mL (p <0.008) respectively. On subgroup analysis mean TNF-α in subgroup Aa was 20.71 ± 16.84 pg/mL, while in subgroup Ab it was 7.56 ± 1.93 pg/mL (p <0.001). Mean IL-10 in subgroup Ac and Ad was 8.74 ± 3.29 pg/mL and 7.47 ± 1.82 pg/mL respectively (p <0.028). Conclusions Chronic rheumatic mitral stenosis patients have increased IL-6, IL-10, IL-18, TNF-α and hs-CRP levels suggesting a continuous ongoing inflammatory activity even in chronic phase. Further subjects having severe mitral stenosis had increased TNF-α levels in comparison to subjects with mild to moderate mitral stenosis suggesting its possible role in acceleration of rheumatic process. Cytokines in various subgroup Parameter IL-6 (pg/ml) p IL-10 (pg/ml) p IL-18 (pg/ml) p TNF-α (pg/ml) p hs-CRP (pg/ml) p Subgroup Aa 5.63 ± 3.25 0.13 8.38 ± 3.06 0.32 146.35 ± 103.84 0.20 20.71 ± 16.84 <0.001 3.72 ± 3.43 0.67 Subgroup Ab 6.90 ± 3.57 7.72 ± 2.04 112.28 ± 22.79 7.56 ± 1.93 4.27 ± 3.81 Subgroup Ac 6.86 ± 3.50 0.44 8.74 ± 3.29 0.02 145.29 ± 103.01 0.29 20.25 ± 17.02 0.53 4.77 ± 0.93 0.93 Subgroup Ad 6.21 ± 3.49 7.47 ± 1.82 124.67 ± 66.95 22.91 ± 20.68 4.66 ± 3.44 Abstract 223 Figure. Cytokines in case and control

scholarly journals Association of level of IL-6, IL-10, IL-18, tumour necrosis factor-α with rheumatic mitral stenosis and subsequent pulmonary hypertension

2022 ◽  
Author(s):  
Gaurav Tripathi ◽  
Vimal Mehta ◽  
Vijay Trehan
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Stenosis ◽  
Tumour Necrosis ◽  
Rheumatic Mitral Stenosis ◽  
Tnf Α ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Necrosis Factor ◽  
Rheumatic Heart

Background: Objective of the study was to provide insight on the immune response in patients of rheumatic heart disease, mitral stenosis and evaluation of various cytokines in pulmonary hypertension secondary to rheumatic heart disease.Methods: Total 163 subjects, more than 18 year of age, were enrolled in this study. 84 subjects with rheumatic mitral stenosis (group A) diagnosed on two-dimensional echocardiography (2D echo) and 79 normal healthy volunteers (group B). Patients with mitral stenosis were further divided into subgroups based on severity of mitral stenosis [mitral valve area (MVA >1 cm2 and MVA <1 cm2) (subgroup Aa and Ab)] and presence or absence of pulmonary hypertension [pulmonary arterial systolic pressure (PASP >36 mm Hg) (subgroup Ac and Ad)]. Interleukins IL-6, IL-10, IL-18, tumour necrosis factor alpha (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) levels were assessed in both groups.Results: Mean IL-6, IL-10, IL-18, TNF-α and hs-CRP in group A and group B was 6.57±3.53 and 2.73±1 (p≤0.001), 8.185±2.8 and 3.51±0.86 (p≤0.001), 136.31±89.0 and 47.96±9.76 (p≤0.001), 21.26±18.59 and 5.36±3.57 (p≤0.001), 4.69±6.3 and 2.63±2.22 (p≤0.008) respectively. On subgroup analysis mean TNF-α in subgroup Aa was 20.71±16.84, while in subgroup Ab was 7.56±1.93 (p≤0.001). Mean IL-10 in subgroup Ac and Ad was 8.74±3.29 and 7.47±1.82, respectively. Differences in levels of other cytokines in these subgroups were not found statistically significant.Conclusions: This study finds increased IL-6, IL-10, IL-18, TNF-α and hs-CRP levels in subjects with rheumatic mitral stenosis. Subjects with severe mitral stenosis had increased TNF-α levels. Subjects of mitral stenosis having pulmonary hypertension had increased IL-10 levels. 

scholarly journals Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jing Wang ◽  
Ming Zeng ◽  
Guang Yang ◽  
Yaoyu Huang ◽  
Buyun Wu ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
High Sensitivity ◽  
Serum Levels ◽  
Serum Phosphate ◽  
Tumoral Calcinosis ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Effective Group

Abstract Background Tumoral calcinosis (TC) is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). However, parathyroidectomy (PTX) seems to be ineffective at relieving TC in some patients. In this study, we investigated the relationship between PTX and TC shrinkage. Methods We retrospectively followed up nine TC patients who underwent PTX, dividing them into two groups: those with TC size reduced by > 80% were in the “effective group” (group A), and the rest in the “ineffective group” (group B). Results We enrolled nine patients (7 men; mean age 38.6 ± 10.9 years) with SHPT-related TC. One patient with calciphylaxis was excluded due to sudden death. The efficiency of PTX in causing TC regression was 62.5% (5 patients in group A). Group A had a shorter overall duration of TC (6 [5.5, 6.0] vs. 9 [8.0, 10.0] months; P = 0.02) and higher serum levels of alkaline phosphatase (ALP; 408.0 [217.9, 1101.7] vs. 90.8 [71.0, 102.1] pg/ml; P = 0.03) and high-sensitivity C-reactive protein (hs-CRP; 82.7 [55.0, 112.4] vs. 3.1 [3.1, 4.5] mg/l; P = 0.02). Average calcium supplementation within 1 week of surgery was significantly greater in group A than in group B (96.8 [64.1, 105.3] vs. 20.1 [13.1, 32.7] g; P = 0.04). Patients in both the groups demonstrated similar serum phosphate levels before PTX, but these levels were higher in group B than in group A at follow-up times (3 months, P = 0.03; 6 months, P = 0.03). Conclusions The shorter duration of pre-existing TC and higher ALP levels before PTX, as well as lower serum phosphate levels after PTX, were correlated with effective SHPT-TC shrinkage.

Circulating Cytokines as Biological Indicators for PE and Ceramics Articulations

2007 ◽  
Vol 361-363 ◽  
pp. 1323-1326
Author(s):  
Silvana Fiorito ◽  
Laura Magrini ◽  
Robert Streicher
Keyword(s):  
Hip Prosthesis ◽  
Ultrahigh Molecular Weight Polyethylene ◽  
Normal Subjects ◽  
Serum Levels ◽  
Biological Indicators ◽  
Tnf Α ◽  
Hip Prosthesis Implantation ◽  
Group A ◽  
Group B ◽  
Circulating Cytokines

We studied the role of cytokines (TNF-α, IL-6,IL-1β, TGF-β) as markers of osteolysis in patients who underwent to a hip prosthesis implantation subdivided in two groups: group A with an ultrahigh molecular weight polyethylene (UHMWPE) insert articulating against a metal ball head , and group B with an all alumina ceramic combination. Profibrogenic (TGF-β) and pro-inflammatory cytokines (TNF-α, IL-6,IL-1β) are secreted by the periprosthetic synovial-like fibrous membrane in hip artificial implants. They are secreted by inflammatory activated cells and trigger the cascade of biochemical events leading to the activation of osteoclasts and bone resorption. A statistically significant increase of TGF-β serum levels was observed between TGF-β values in implanted patients as compared to normal subjects and between TGF-β values after versus before implantation in Group A. A progressive decrease in TNF-α and IL-6 serum levels has been observed in both Groups, when compared with the initial values before the implantation. IL-1β levels decreased up to 60 months after the implantation Our data suggest that monitoring circulating cytokines could be a good indicator for the proliferation and activity of the periprosthetic synovial-like membrane and potential osteolysis. This could allow for an adequate early treatment.

scholarly journals Effect of Dexmedetomidine Administation on Analgesic, Respiration and Inflammatory Responses in Patients Undergoing Percutaneous Endoscopic Lumbar Discectomy: A Prospective Observational Study

2021 ◽  
Author(s):  
Xiaoli Zhang ◽  
Wenping Zhao ◽  
Cong Sun ◽  
Zhihua Huang ◽  
Lifang Zhan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Serum Levels ◽  
Lumbar Discectomy ◽  
Lower Serum ◽  
Inflammatory Reactions ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Tnf Α ◽  
Group A ◽  
Group B ◽  
Endoscopic Lumbar Discectomy

Abstract BackgroundLocal anesthesia has been recommended for percutaneous endoscopic lumbar discectomy (PELD) in recent years; however, the efficacy, including oxidative stress, inflammatory reactions and ventilation effects, when intravenous dexmedetomidine (DEX) is administered during PELD has not been thoroughly described.MethodsSixty patients undergoing PELD were randomly allocated to either an intravenous DEX sedation group (Group A) or a normal saline group (Group B). Respiratory data, including minute ventilation (MV), tidal volume (TV), and respiratory rate (RR), were recorded using a respiratory volume monitor (RVM), and pulse oxygen saturation (SpO2) was measured by pulse oximetry. The visual analog score (VAS) and the plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) were also recorded to evaluate oxidative stress and inflammatory reactions.ResultsThere were no significant differences in RR, MV, TV and SpO2 between the two groups at any time point (p>0.05). Group B exhibited lower serum levels of GSH-PX (p<0.0001) and higher serum levels of MDA (p<0.0001) than Group A at the end of surgery. Twenty-four hours after surgery, Group B exhibited higher serum levels of IL-6 (p=0.0033), TNF-α(p=0.0002), and MDA (p<0.0001) and lower serum levels of GSH-PX (p<0.0001) than Group A. In addition, Group B exhibited lower VAS (p<0.0001) than Group A.ConclusionsDEX administration using an RVM not only provides convenient analgesia and ventilation but also alleviates oxidative stress and inflammatory reactions in patients undergoing PELD .Trial registration ChiCTR2100044715(http://www.chictr.org.cn/index.aspx)

The Effects of Serum hs-CRP on the Incidence of Lung Cancer in Male Patients with Pulmonary Tuberculosis

2020 ◽  
Author(s):  
Youhua JIANG ◽  
Kewei NI ◽  
Meiyu FANG ◽  
Junling LIU
Keyword(s):  
Lung Cancer ◽  
Pulmonary Tuberculosis ◽  
Cancer Patients ◽  
Serum Levels ◽  
Incidence Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Male Patients ◽  
Hs Crp ◽  
Group B

Background: This study intended to investigate the effects of serum high-sensitivity C-reactive protein (hs-CRP) on the incidence of lung cancer in male patients with pulmonary tuberculosis. Methods: A total of 1091 male patients with pulmonary tuberculosis in Zhejiang Cancer Hospital, Hangzhou, China from Jan 2009 to Jan 2012 were selected as the research objects. All patients were followed up from the beginning of hospitalization. According to serum hs-CRP level, patients were divided into two groups: group A (hs-CRP < 1 mg/L) and group B (hs-CRP > 3 mg/L). The relationship between baseline hs-CRP and the risk of lung cancer in patients with pulmonary tuberculosis was analyzed by multivariate Cox proportional risk regression model, and the serum levels of hs-CRP between lung cancer patients in all groups and other non-lung cancer patients were compared. Results: There were differences in age, drinking, smoking, diabetes history, body mass index (BMI), thyroglobulin (TG), history of hypertension and hyperglycemia among the three groups (P=0.036, 0.018, 0.040, 0.029, 0.006, 0.034, 0.020, 0.010). The serum levels of hs-CRP in patients with squamous carcinoma, adenocarcinoma and small cell carcinoma were significantly higher than those in non-lung cancer patients (P=0.022, 0.043, 0.011). The incidence rates of lung cancer in patients in group B and C were 1.37 and 1.69 times higher than that in group A, respectively. Conclusion: The increased serum level of hs-CRP will increase the incidence rate of lung cancer in male patients with pulmonary tuberculosis.

scholarly journals ASSOCIATION OF LEVEL OF IL-6, IL-10, IL-18, TNF-α WITH RHEUMATIC MITRAL STENOSIS AND SUBSEQUENT PULMONARY HYPERTENSION

2018 ◽  
Vol 70 ◽  
pp. S26
Author(s):  
Gaurav Tripathi ◽  
Vimal Mehta ◽  
Vijay Trehan ◽  
Puja Sakhuja ◽  
Bhawna Mahajan ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Stenosis ◽  
Rheumatic Mitral Stenosis ◽  
Tnf Α

scholarly journals Posterior leaflet preservation during mitral valve replacement for rheumatic mitral stenosis

2006 ◽  
Vol 53 (1) ◽  
pp. 13-17 ◽  
Author(s):  
P.L. Djukic ◽  
B.B. Obrenovic-Kircanski ◽  
M.R. Vranes ◽  
M.J. Kocica ◽  
A.Dj. Mikic ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Stenosis ◽  
Posterior Leaflet ◽  
Rheumatic Mitral Stenosis ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B

Mitral valve replacement with posterior leaflet preservation was shown beneficial for postoperative left vetricular (LV) performance in patients with mitral regurgitation. Some authors find it beneficial even for the long term LV function. We investigated a long term effect of this technique in patients with rheumatic mitral stenosis. We studied 20 patents with mitral valve replacement due to rheumatic mitral stenosis, in the period from January 1988. to December 1989. In group A (10 patients) both leaflets and coresponding chordal excision was performed, while in group B (10 patients) the posterior leaflet was preserved. In all patients a Carbomedics valve was inserted. We compared clinical pre and postoperative status, as well as hemodynamic characteristics of the valve and left ventricle in both groups. Control echocardiographyc analysis included: maximal (PG) and mean (MG) gradients; effective valve area (AREA); telediastolic (TDV) and telesystolic (TSV) LV volume; stroke volume (SV); ejection fraction (EF); fractional shortening (FS) and segmental LV motion. The mean size of inserted valve was 26.6 in group A and 27.2 in group B. Hemodynamic data: PG (10.12 vs 11.1); MG (3.57 vs 3.87); AREA (2.35 vs 2.30); TDV 126.0 vs 114.5); TSV (42.2 vs 36.62); SV (83.7 vs 77.75); EF (63.66 vs 67.12); FS (32.66 vs 38.25) Diaphragmal segmental hypokinesis was evident in one patient from group A and in two patients from group B. In patients with rheumatic stenosis, posterior leaflet preservation did not have increased beneficial effect on left ventricular performance during long-term follow-up. An adequate posterior leaflet preservation does not change hemodynamic valvular characteristics even after long-term follow-up.

scholarly journals Prevalence and Predictors of Left Atrial Appendage Inactivity in patients of Rheumatic Mitral Stenosis in Sinus Rhythm- An observational study.

2021 ◽  
Author(s):  
Saibal Mukhopadhyay ◽  
yogesh dwivedi ◽  
Jamal Yusuf ◽  
abhimanyu uppal ◽  
VIMAL MEHTA
Keyword(s):  
Mitral Valve ◽  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Independent Predictor ◽  
Atrial Appendage ◽  
Rheumatic Mitral Stenosis ◽  
Group A ◽  
Group B

BACKGROUND: Systemic thromboembolism is a known complication of rheumatic mitral stenosis (RMS) in sinus rhythm (SR). Left atrial appendage (LAA), the commonest site of thrombus formation is usually hypocontractile (inactive) in such patients. We aimed to study the prevalence of LAA inactivity (LAAI) in severe RMS and assess its independent predictors. METHODS: The study population consisted of 100 patients of severe RMS in sinus rhythm. Transthoracic and transesophageal echocardiography were done to assess LAA contractile function. Patients with LAA-peak emptying velocity <25 cm/sec were defined as having LAAI. RESULTS: The mean age of study subjects was 31.66±8.69 years and 56% were females. 73% patients had LAAI (Group A), while remaining 27% had normal LAA function (Group B). Mitral-valve area (MVA) and lateral annulus systolic velocity (Sa-wave) were significantly lower while mean pressure gradient across mitral valve (MGMV) and serum fibrinogen were significantly higher (all p-values <0.001) in group A patients. On multivariate regression analysis, MGMV (p<0.001), Sa-wave (p=0.02) and serum fibrinogen (p=0.005) were independent predictors of LAAI. Optimal cut-off values of MGMV, Sa-wave and serum fibrinogen for predicting LAAI were 11.5mmHg, 6.8cm/sec and 300mg/dL respectively.67(90.55%) patients in group A compared to 13(48.1%) in group B had LA/LAA smoke. LAAI was the only independent predictor of left atrium (LA)/LAA smoke and associated thrombus. CONCLUSION: There is high prevalence of LAAI in patients of severe MS in SR. MGMV, Sa-wave and serum fibrinogen levels are independent predictors of LAAI. LAAI is an independent predictor of LA/LAA smoke and associated thrombus.

scholarly journals EFFICACY OF ROLLING BOARD PERTURBATION TRAINING ON BALANCE AMONG HEMIPARETIC STROKE PATIENTS - A COMPARATIVE STUDY

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Dr. Senthil kumar ◽  
Dr. Franklin Shaju M.K m k ◽  
Dr. Vijaya Senthil Kumar kumar ◽  
Dr. A. velmurugan
Keyword(s):  
Public Health Problem ◽  
Berg Balance Scale ◽  
Major Public Health Problem ◽  
Stroke Patients ◽  
Perturbation Training ◽  
Before And After ◽  
Group A ◽  
Hemiparetic Stroke ◽  
Conventional Physiotherapy ◽  
Group B

Background of the study: Stroke is a major public health problem that ranks in the top four causes of death in most of the countries and is responsible for a large proportion of the burden of neurologic disorders. Patients with stroke have poor balance because they cannot control dynamically the size of the base of support or the location of the line of gravity. Perturbation training undergoes the maximal sway possible without losing his balance. Objective of the study: The objective of the study is to find the effects of rolling board perturbation training on balance among hemiparetic stroke patients. Methodology: Thirty clinically diagnosed hemiparetic stroke patients were selected based on the inclusion and exclusion criteria. They were randomly allocated into two groups (Group A and Group B) consists of 15 subjects each. Group A received conventional physiotherapy alone and group B received rolling board perturbation training along with conventional physiotherapy. Intervention lasted for 4 weeks, three days in a week and one hour per day. Balance was measured before and after 4 weeks of intervention by berg balance scale. Conclusion: Both conventional physiotherapy alone and rolling board perturbation training along with conventional physiotherapy significantly improved balance among hemiparetic stroke patients. When comparing both rolling board perturbation training along with conventional physiotherapy is more effective than conventional physiotherapy alone in improving balance among hemiparetic stroke patients.

scholarly journals Protective effect of LIF-huMSCs on the retina of diabetic model rats

2021 ◽  
Vol 14 (10) ◽  
pp. 1508-1517
Author(s):  
Shan-Na Chen ◽  
◽  
Ying-Xue Ma ◽  
Song Chen ◽  
Guang-Hui He ◽  
...  
Keyword(s):  
Diabetic Rats ◽  
Control Group ◽  
Diabetic Model ◽  
Group A ◽  
Retinal Structure ◽  
Hs Crp ◽  
Group B ◽  
And Function ◽  
Group D ◽  
Control Group Group

AIM: To investigate the protective effect of human umbilical cord mesenchymal stem cells (hUCMSCs) modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism. METHODS: A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor (LIF) was constructed. Overexpression was verified by fluorescent quantitative polymerase chain reaction (qPCR). Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group (group A), streptozotocin-induced diabetic control group (group B), diabetic rats at 3mo injected with empty vector-transfected hUCMSCs (group C) or injected with LIF-hUCMSCs (group D). Four weeks after the intravitreal injection, analyses in all groups included retinal function using flash electroretinogram (F-ERG), retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran (FITC-dextran), and retinal structure examination of sections using hematoxylin and eosin staining. Expression levels of adiponectin (APN), high-sensitivity C-reactive protein (hs-CRP), and neurotrophin-4 (NT-4) in each group was detected using immunohistochemistry, PCR, Western blotting, and ELISA, respectively. RESULTS: A stable transgenic cell line of LIF-hUCMSCs was constructed. F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A, severe damage of the retinal blood vessels and function in group B, and improved retinal structure and function in group C and especially group D. qPCR, ELISA, and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B, C, and D than in group A. hs-CRP expression was significantly higher in group B than in groups A, C, and D, and was significantly higher in group C than in group D (P<0.05). CONCLUSION: LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.

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