Blood Serum Concentration of C-Reactive Protein and Interleukin-6 in Diagnosis of Neonatal Infections

Abstract Introduction Pulmonary endarterectomy leads to a decrease in systemic inflammation and improvement in endothelial function in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in patients with inoperable CTEPH. Aim To assess changes in systemic inflammation and endothelial dysfunction after a single BPA session and after completion of the treatment. Methods We enrolled consecutive, inoperable CTEPH patients who underwent BPA. Interleukin 6, 10 (IL-6, IL-10), and C-reactive protein (hsCRP) constituted markers of systemic inflammation. Endothelin-1 (ET-1) served as a marker of endothelial dysfunction. Serum concentration of selected markers was assessed in every patient before, 24 hours after the first BPA session and 6 months after completion of the BPA treatment. Age- and sex-matched healthy subjects served as a control group. Results We recruited 20 patients with inoperable CTEPH (6 males [30%]), aged 67 [61–74] years in New York Heart Association class III (n=19 [95%]) and II (n=1 [5%]). BPA treatment was completed with a median of 5 [2–8] BPA sessions per patient. Before starting the treatment CTEPH patients, as compared to controls (n=10), had raised serum level of IL-6 (3.82 [2.75 - 6.03] vs. 2.64 [0.88 - 4.75] pg/ml; p=0.04), hsCRP (2.47 [0.93 - 4.27] vs. 1.23 [0.48–3.21] ng/ml; p=0.02) and ET-1 (2.68 [2.24 - 3.64] vs. 1.47 [1.4 - 1.82] pg/ml; p=0.004). There was no difference in IL-10 level. 24 hours after a BPA session we observed an increased level of IL-6, IL-10 and hsCRP. (Tab.) 6 months after completion of the BPA treatment there was a reduced level of IL-6, hsCRP and ET-1 (Tab.) Table 1. Changes (Δ) in serum concentration of analyzed markers 24 hours after a single BPA session and at 6-months assessment after completion of the BPA treatment (n=20) Initial Δ at 24 hours after single BPA p Δ at 6-months follow-up p ET-1 [pg/ml] 2.68 [2.24; 3.64] −0.2 [−0.5; 0.23] 0.21 −0.47 [−0.96; 0.05] 0.004 IL-6 [pg/ml] 3.82 [2.75; 6.03] 3.67 [1.41; 7.16] 0.008 −0.82 [−3.11; 0.54] 0.04 IL-10 [pg/ml] 0.53 [0.44; 0.58] 0.32 [0.21; 0.87] 0.006 −0.11 [−0.33; 0.14] 0.94 hsCRP [ng/ml] 2.47 [0.93; 4.27] 5.4 [3.96; 10.59] 0.008 −0.36 [−0.94; 0.16] 0.02 ET-1, endothelin 1; hsCRP, C-reactive protein; IL-6, interleukin 6; IL-10, interleukin 10. Conclusions Patients with inoperable CTEPH, as compared to healthy controls, exhibit an increased systemic inflammation and endothelial dysfunction, which both improve after completion of the BPA treatment. At short-term follow-up after single BPA session there is an increase in systemic inflammatory response.

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The role of visceral-abdominal obesity in the development of gastroesophageal reflux disease.

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2018-96-7-658-662 ◽

2018 ◽

Vol 96 (7) ◽

pp. 658-662

Author(s):

E. I. Andreeva

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Serum Concentration ◽

Metabolic Activity ◽

Interleukin 6 ◽

Visceral Fat ◽

Reflux Disease ◽

Main Group ◽

C Reactive Protein ◽

Reactive Protein

Studies of recent years show that the problem of abdominal-visceral obesity is gaining in importance, the steady growth of which is observed in almost all countries. Gastroesophageal reflux disease belongs to the most common diseases in patients with obesity. At present, the question of the metabolic activity of visceral fat as a factor in the pathogenesis of GERD is being investigated. Aim. Investigation of the level of serum concentration of the proinflammatory cytokine (interleukin 6), the biologically active substance -adipokin (leptin) and C-reactive protein, taking into account the BMI of patients with obesity and intra-arterialpH monitoring data and esophagogastroduodenoscopy. Material and methods. The main group consisted of 51 patients, in the age group from 30 to 60 years, suffering from GERD and obesity. The average age of the patients was 42.3 ± 2.11 years. Obesity of the 1st degree in BMI was in 19 people; obesity of the 2nd degree - in 23 people; obesity of the third degree in 9 patients. The level of leptin, interleukin 6 and C-reactive protein was determined, anthropometric examination with calculation of body mass index (BMI) and waist measurement (OT) to determine the degree of obesity and its type. To verify the diagnosis of GERD and determine its endoscopic form, esophagogastroduodenoscopy was performed using flexible endoscopes and intra-esophageal pH monitoring. Results. The level of serum concentration of interleukin 6, leptin and C-reactive protein in patients of the main group is higher than in the control group. A correlation between these indicators, the degree of obesity and the DeMeester index, reflecting the presence and severity of gastroesophageal reflux and the results of esophagogastroduodenoscopy, was revealed. Conclusion. Thus, the metabolic activity of visceral fat is one of the factors contributing to the increase in the duration and the number ofpathological refluxes leading to the development of erosive forms of esophagitis, which must be taken into account when choosing a program for the treatment ofpatients suffering from GERD and obesity.

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