scholarly journals PROFILE OF BRONCHIAL INFLAMMATION AND CLINICAL FEATURES OF MILD BRONCHIAL ASTHMA

2018 ◽  
Vol 1 (70) ◽  
pp. 8-14 ◽  
Author(s):  
Алексей Пирогов ◽  
Aleksey Pirogov ◽  
Юлий Перельман ◽  
Yuliy Perelman ◽  
Анна Приходько ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Clinical Symptoms ◽  
Persistent Asthma ◽  
Mild Asthma ◽  
Asthma Control Test ◽  
Bronchial Inflammation ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

Heterogeneity of respiratory tract inflammation determines the clinical course and control of mild asthma. The aim of the research was to study the relationship between clinical and functional parameters and the form of bronchial inflammation in patients with mild persistent asthma against the background of standard basic anti-inflammatory therapy. In 198 patients with mild asthma (the mean age was 41.5±0.7 years old) against the background of maintenance therapy with low doses of inhaled glucocorticosteroids (ICS at a dose ≤500 mcg/day by beclomethasone dipropionate), there were determined the level of asthma control according to the questionnaire Asthma Control Test (ACT), lung function, airway reaction to 3-minute isocapnic hyperventilation with cold (-20ºC) air; there was done the collection of induced sputum (IS). The content of cells in cytograms of IS was assessed. The activity of myeloperoxidase (MPO) (in pixels) was measured by cytochemical method in neutrophilic and eosinophilic granulocytes. Group 1 (n=43; 22%) included patients with the eosinophilic pattern of bronchial inflammation, group 2 (n=155; 78%) included patients with mixed pattern of inflammation. In group 2, unlike the patients of group 1, in the inflammatory profile of infiltrate against the background of high neutrophil content (34.6±1.1 and 10.8±0.5%, respectively; p=0.000001), there was found an increased level of eosinophils (17.0±1.1 vs. 21.2±1.8%, respectively; p=0.048), and there was revealed a higher intragranular deposition of MPO (85.8±3.5 vs. 77.0±3.2 pixels, respectively; p=0.057). The mixed type of inflammation with the dominant neutrophil component and the greatest activity of MPO was associated with more pronounced clinical symptoms of the disease and low level of asthma control (16.0±0.7 vs. 18.7±0.4 ACT points, respectively; p=0.004), lung function decrease (FEV1 was 89.4±1.4 vs. 97.9±2.2%, respectively; p=0.005) and degree of FEV1 drop in response to bronchial provocation by cold air (-10.1±1.1 vs. -3.4±1.1%, respectively; p=0.002), due to insufficient anti-inflammatory effect of the used controller therapy. A discriminant equation is proposed, which can serve as an additional criterion for the effectiveness of anti-inflammatory therapy.

DYNAMICS OF INFLAMMATORY-CELLULAR PROFILE OF THE INDUCED SPUTUM IN PATIENTS WITH BRONCHIAL ASTHMA AND COLD AIRWAY HYPERRESPONSIVENESS UNDER BASIC ANTI-INFLAMMATORY THERAPY

2016 ◽  
Vol 1 (60) ◽  
pp. 15-22 ◽  
Author(s):  
Приходько ◽  
Anna Prikhodko ◽  
Пирогов ◽  
Aleksey Pirogov ◽  
Перельман ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Airway Hyperresponsiveness ◽  
Good Control ◽  
Induced Sputum ◽  
Asthma Control Test ◽  
Clinical Criteria ◽  
Bronchial Inflammation ◽  
Before And After ◽  
Anti Inflammatory

The character of changes of inflammatory-cellular pattern of bronchial secretion in patients with asthma in association with cold airway hyperresponsiveness (CAHR) under the influence of standard therapy has been studied little. The aim of the present work is to study dynamics of cellular profile, neutrophilic component of bronchial inflammation under the combination therapy of asthmatics with CAHR. 12 asthma patients with CAHR were studied upon the number of cells of the induced sputum (IS), peroxidase, cytolytic and destructive activity of eosinophils and neutrophils in the sputum, lung function and asthma control with the help of questionnaire Asthma Control Test (АСТ) before and after the therapy with the combination of budesonide/formoterol. Before the therapy the patients had a low level of asthma control (14.4±1.2 points of ACT), FEV1 was 87.4±3.3% from predicted values; in IS neutrophils prevailed (26.4±1.7%) over eosinophils (18.5±2.6%); the level of myeloperoxidase (mean cytochemical coefficient) was 65.9±5.4 pixels. After 48 weeks of the observation only in 58% of patients the criteria of good control of asthma and the improvement of lung function were achieved. In IS there was a decrease of eosinophils (11.4±3.2%; p=0.045); the intensiveness of eosinophils and neutrophils cytolysis dropped; intracellular concentration of myeloperoxidase grew (98.2±14.1 pixels; p=0.0637); destructive changes in granulocytes were registered but the number of neutrophils remained high (34.0±8.2%, р=0.34), which was considered as the factor of stable initiation of inflammation and oxidative stress. Thus, the use of anti-inflammatory treatment regime lasting 48 weeks with combination of budesonide/formoterol oriented to achieve clinical criteria of asthma control in patients with CAHR does not allow to achieve correction of the level of neutrophilic inflammatory component. Quantitative index of neutrophils in IS in these patients has prognostic value for the possible loss of achieved asthma control.

INFLUENCE OF NEUTROPHILIC COMPONENT OF BRONCHIAL INFLAMMATION ON THE LEVEL OF DISEASE CONTROL AND LUNG FUNCTION IN PATIENTS WITH ASTHMA

2016 ◽  
Vol 1 (61) ◽  
pp. 16-24 ◽  
Author(s):  
Приходько ◽  
Anna Prikhodko ◽  
Пирогов ◽  
Aleksey Pirogov ◽  
Перельман ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Persistent Asthma ◽  
Close Correlation ◽  
Airway Responsiveness ◽  
Asthma Control Test ◽  
Bronchial Inflammation ◽  
Asthma Patients ◽  
Airway Response ◽  
Mild Persistent Asthma

The cell pattern of bronchi inflammatory infiltrate has a significant impact on the course of the disease and may affect the achievement and maintenance of the asthma control. The aim of the study was to determine the influence of neutrophilic component of the bronchial inflammation on the asthma control, lung function and airway responsiveness. 114 patients with mild persistent asthma were assessed upon the level of the asthma control by Asthma Control Test (ACT); lung function (FEV1) by spirometry; airway responsiveness (∆FEV1) to 3-minute isocapnic hyperventilation with cold air (-20ºС) (IHCA) and 3-minute ultrasound inhalation with distilled water (IDW). The cell composition of the induced sputum (IS) was also studied. The patients were divided into groups with low contents of neutrophils in IS (39 people; 1st group) and with high contents of neutrophils (75 people, 2nd group). The contents of neutrophils in the 1st group was 10.9±0.53%, eosinophils – 19.4±2.1%; in the 2nd group – 29.9±1.6% (р=0.0001) and 20.4±1.4% (р=0.66), respectively. By ACT data the people of the 2nd group managed their disease worse than in 1st group (15.0±0.6 and 19.0±0.8 points, respectively; р=0.0001). They also had lower FEV1 (88.0±2.0 and 96.7±2.4%; р=0.009) and more intensive airway response to IHCA and DW (-13.7±1.7% and -11.2±1.9%, respectively) in comparison with the 1st group (-2.7±0.86%; р=0.0001 and -5.3±1.90%; р=0.055). The patients of the 2nd group had a close correlation between baseline neutrophils in IS and ∆FEV1 in response to IHCA (r=-0.22; р=0.045) as well as the content of myeloperoxidase in IS (r=0.31; р=0.0008). A level of myeloperoxidase in IS correlated with ∆FEV1 in response to IDW (r=0.29; р=0.030) in these patients. The increase of neutrophilic component of inflammation in asthma patients worsens the asthma control, lung function and enhances airway responsiveness to exogenous stimuli.

scholarly journals Life Quality and Cytokines Profile in Patients with Asthma and Osteoarthritis

2021 ◽  
Vol 11 (2) ◽  
pp. 137-140
Author(s):  
Yuliya Ivanchuk ◽  
Ludmila Tribuntceva ◽  
Andrey Budnevsky ◽  
Yanina Shkatova ◽  
Evgeniy Ovsyannikov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oxidative Damage ◽  
Asthma Control ◽  
Antioxidant Status ◽  
Life Questionnaire ◽  
Asthma Control Test ◽  
Tnf Α ◽  
Group 2 ◽  
Group 1

The objective of this study was to evaluate levels of leptin, adiponectin, IL-4, IL-6, TNF-α, oxidative damage, and antioxidant status in patients with bronchial asthma (BA), compared to patients who suffer from both BA and osteoarthritis (OA), and analyze the quality of life in such patients. Methods and Results: The study included 103 patients (34 men and 69 women) diagnosed with moderate asthma aged from 30 to 70 years (mean age of 58.52±7.14 years). The levels of IL-4, IL-6, TNF-α, adiponectin, leptin, total antioxidant status (TAS), and total oxidative damage (TOD) were measured. Two questionnaires were used in this study: Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (АСТ). The levels of leptin, TNF-α, and Il-6 were significantly higher in Group 2 than in Group 1. On the contrary, the IL-4 level was higher in Group 1 than in Group 2. The TAS value was significantly higher in Group 1 than in Group 2 (P=0.0001). The TOD value was significantly higher in Group 2 than in Group 1 (P=0.0000). The domains of AQLQ(S) activity, symptoms, and emotions were decreased in patients of Group 2. The values of the ACT test were 18.0±2.61 points and 16.78±1.92 points in Group 1 and Group 2, respectively (P=0.0077). Conclusion: In patients with both asthma and osteoarthritis, levels of inflammatory cytokines, such as leptin, IL-6, and TNF-α, are significantly elevated as well as values of total oxidative status, which correlate with poorer asthma control and quality of life.

scholarly journals Effect of combination of Nigella sativa and Bee’s honey on lung function, respiratory muscle power, and asthma control in patients with persistent asthma

2016 ◽  
Vol 5 (1) ◽  
pp. 236 ◽  
Author(s):  
Jehan E. Abdelrahman ◽  
Aamir A. Magzoub ◽  
Randa E. Ibrahim ◽  
Mohamed A. Elnoor ◽  
Omer A. Musa
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Respiratory Muscle ◽  
Muscle Power ◽  
Inhaled Corticosteroids ◽  
Nigella Sativa ◽  
Persistent Asthma ◽  
Airflow Limitation ◽  
Control Test ◽  
Asthma Control Test

Background: Persistent asthma is a serious global medical problem, usually controlled by long term use of inhaled corticosteroids (ICS). However, ICS are expensive particularly in the developing countries and despite their use, a proportion of patients still suffer from uncontrolled symptoms and may progress into intractable airflow limitation. Nigella sativa and Bee’s honey are relatively cheap and safe natural products with anti- inflammatory and anti-allergic properties; they are used traditionally in treatment of so many diseases.Methods: In this study, we investigated the adjuvant effect of combination of Nigella Sativa and Bee’s honey on lung function, respiratory muscle power and asthma control in patients with persistent asthma. An oral dose of Nigella sativa (2 mg once daily), and bee’s honey (7.5 ml twice a day) were given to patients with uncontrolled persistent asthma (n=30, 14 females and 16 males with mean age of 43.91±5.8) for three months duration. Lung function tests (FEV1, FVC and PEFR) and respiratory muscle power indicators (MEP, MIP) were measured initially as baseline records and monthly for 3 months. The baseline score for asthma control test (ACT) was calculated for all patients and repeated after three months.Results: There was statistically significant improvement in lung function and respiratory muscle power. The need for asthma relieving β2 agonists was remarkably decreased and a significant improvement in asthma control test score in both asthma groups was observed.Conclusions: Combination of Nigella sativa and Bee's Honey as an adjuvant therapy with ICS decreases asthma severity grade and hence the need for both asthma controlling and relieving drugs and improves patient’s quality of life.

Glucocorticoid regulation of clinical and functional manifestations of asthma in patients with different airway response to hyposmolar stimulus during anti-inflammatory therapy

2021 ◽  
pp. 37-44
Author(s):  
A. B. Pirogov ◽  
А G. Prikhodko ◽  
А. N. Odireev ◽  
N. V. Ul'yanychev ◽  
V. F. Ul'yanycheva ◽  
...  
Keyword(s):  
Lung Function ◽  
Osmotic Stress ◽  
Inhaled Corticosteroids ◽  
Regulatory Function ◽  
Blood Leukocytes ◽  
Adaptive Capabilities ◽  
Asthma Patients ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

Introduction. The role of an alternative adenylate cyclase pathway of hormonal signal transmission under the action of synthetic glucocorticosteroids with the participation of endogenous stress-limiting activity of the adrenal cortex in conjunction with the adaptive capabilities of airway homeostasis in patients with asthma under conditions of osmotic stress has not been studied at present. Aim. To assess the dynamics of cortisol and cyclic adenosin monophosphate (cAMP) in asthma patients with different airway responses to hypoosmolar stimuli when using anti-inflammatory combination therapy with inhaled corticosteroids/long-acting β2 -agonists (ICS/LABA). Materials and methods. 96 patients diagnosed with asthma received combined anti-inflammatory therapy with ICS/LABA for 24 weeks. Group 1 included patients (n=18) with airway hyperresponsiveness to hypoosmolar stimulus, group 2 (n=78) – with no reaction of the bronchi to a 3-minute ultrasonic inhalation of distilled water. At baseline and at the end of treatment, the lung function was studied; to assess the regulatory function of glucocorticoids using non-genomic signaling pathways, the levels of cortisol in blood serum and cAMP in blood leukocytes were determined. Results. Patients of group 1 in comparison with the second one initially had a lower FEV1 ‒ 88.2±5.3 and 98.5±1.7%, respectively (p<0.05), after treatment in both groups there was a slight tendency to an increase in FEV1 (98.5±5.7 and 101.4±2.5%, respectively, p>0.05). The concentration of cortisol and cAMP at baseline and after 24 weeks of therapy in patients of group 1 was 588.7±32.0 and 495.0±48.7 nmol/L, 61.7±5.1 and 76.5±5, 2 pmol/106 cells (p<0.01); in group 2 − 610.5±20.1 and 522.2±15.60 nmol/L (p<0.001), 76.2±2.2 and 90.6±2.5 pmol/106 cells (p<0.001). Conclusion. In asthma patients with airway osmotic hyperresponsiveness, persistent adaptation to osmotic stress is traced, which is combined with a more significant impairment of the lung function and indicates insufficient therapeutic control over glucocorticoid regulation of osmotic stress by the selected volume of ICS/LABA therapy.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

scholarly journals Physical Activity and Life Quality in Patients with Asthma and Osteoarthritis

2021 ◽  
Vol 15 (7) ◽  
pp. 2343-2347
Author(s):  
YU. S. Ivanchuk ◽  
L.V. Tribuntсeva ◽  
A.V. Budnevsky ◽  
N.I. Ostroushko ◽  
YA. S. Shkatova ◽  
...  
Keyword(s):  
Physical Activity ◽  
Asthma Control ◽  
Life Quality ◽  
Sitting Time ◽  
Control Group ◽  
Moderate Activity ◽  
Life Questionnaire ◽  
Asthmatic Patients ◽  
Group 2 ◽  
Group 1

Background. Physical activity is associated with better asthma control and life quality in asthma. Osteoarthritis is one of the less studied comorbidities in asthmatic patients. Methods. The study included 38 patients diagnosed with asthma, 65 patients with asthma and osteoarthritis, and 40 volunteers who did not suffer from asthma and osteoarthritis. During the study, 3 groups were formed: Group 1 consisted of patients with asthma; Group 2 included patients with both asthma and osteoarthritis, Control group consisted of volunteers. Spirometry, Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Test (АСТ) were used in asthmatic patients. International Physical Activity Questionnaire (IPAQ) in its short from was filled by all the participants. Results. Both Group 1 and Group 2 did not engage in vigorous physical activity. Median of MET-min/week total (1825) was significantly less in Group 2 compared with Control and Group 1 (p=0.0000 and p=0.0169, respectively). MET-min/week total had positive correlations with ACT (r=0.50, p<0.05), AQLQ(S) total (r=0.58, p<0.05), AQLQ(S) activity domain (r=0.28, p<0.05), AQLQ(S) emotions domain (r=0.24, p<0.05), AQLQ (S) symptoms domain (r=0.34, p<0.05), FVC (r=0,28, p<0.05), FEV1 (r=0,37, p<0.05), Index Tiffno (r=0,18, p<0.05). Minutes/week sitting time had a negative correlation with ACT values (r=-0.33, p<0.05), AQLQ(S) total values (r=-0.39, p<0.05). Conclusion. Patients with asthma and osteoarthritis spend significantly less time on moderate activity, walking compared with asthmatics not suffering from osteoarthritis; they avoid vigorous activity. Higher physical activity is associated with better life quality, asthma control and lung function, thus paying attention to osteoarthritis in asthmatic patients is crucial. Key words: life quality, physical activity, asthma, osteoarthritis

Retrospective comparative study of efficacy, safety and outcome of percutaneous intervention for Budd-Chiari syndrome patients with bilirubin less than 3 and 3–6 mg/dl

2021 ◽  
Vol 94 (1120) ◽  
pp. 20201157
Author(s):  
Yashwant Patidar ◽  
Chandan Kumar Pal ◽  
Amar Mukund ◽  
Guresh Kumar ◽  
Shiv Kumar Sarin
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Clinical Symptoms ◽  
Percutaneous Intervention ◽  
Technical Success ◽  
Budd Chiari Syndrome ◽  
Related Complication ◽  
Chiari Syndrome ◽  
Group 2 ◽  
Group 1

Objective: Comparing the efficacy, safety and outcome of percutaneous intrervention for Budd-Chiari Syndrome (BCS) patients with bilirubin less than 3 and 3–6 mg dl−1. Methods and materials: 188 BCS patients having serum bilirubin ≤6 mg dl−1 and underwent percutaneous interventions were divided into two groups based on bilirubin level: 151 patients having bilirubin <3 mg dl−1 were included in Group 1; and 37 patients having bilirubin 3–6 mg dl−1 were included in Group 2. Both group were compare for technical success (successful recanalization of hepatic venous stenosis or creation of portocaval shunt with post-procedure gradient ≤5 mm of Hg), Safety (procedure-related mortality/morbidity or patient required transplantation) and outcome (resolution of clinical symptoms and survival). Results: Technical success was 94.7% in Group 1–89.1% in Group 2 with overall success rate was 93.6%. No significant differences observed between the two groups in regards to procedure related complication. Overall transplant-free survival at 1 and 5 years after intervention in both groups was 96.3 and 91.2% respectively. 1-year and 5-year survivals in Group 1 was 96.7%, and 93.1%, whereas Group 2 was 94.6 and 90.1% with no statically significantly difference between the two groups (p = 0.59). Percutaneous intervention results are good in patients having bilirubin up to 6 mg dl−1, i.e. mild to moderate liver dysfunctions. Conclusion: Technical success, survival and outcome of percutaneous intervention in BCS patients having serum bilirubin 3–6 mg dl−1 was comparable to patients having bilirubin level <3 mg dl−1. Advances in knowledge: Percutaneous intervention treatment is suitable for treatment for symptomatic BCS patients having bilirubin up to 6 mg  dl−1.

scholarly journals Regular Training Increases sTWEAK and Its Decoy Receptor sCD163–Does Training Trigger the sTWEAK/sCD163-Axis to Induce an Anti-Inflammatory Effect?

2020 ◽  
Vol 9 (6) ◽  
pp. 1899 ◽  
Author(s):  
Robert Schönbauer ◽  
Michael Lichtenauer ◽  
Vera Paar ◽  
Michael Emich ◽  
Monika Fritzer-Szekeres ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Performance Gain ◽  
Group 4 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Background: Low levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) were reported in patients with coronary artery disease, heart failure, chronic kidney disease and diabetes mellitus. Soluble cluster differentiation 163 (sCD163) serum levels are related to M2 macrophages, having anti-inflammatory attributes. As sport is well-known for its anti-inflammatory and cardioprotective effects we aimed to investigate the influence of eight months of physical activity on serum sCD163 and sTWEAK levels. Methods: In total, 109 subjects with at least one cardiovascular risk factor were asked to perform endurance training within the calculated training pulse for eight months. Overall, 98 finished the study. The performance gain was measured/quantified by bicycle stress tests at the beginning and end of the observation period. The cohort was divided into four groups, dependent on their baseline performance and performance gain. sCD163 and sTWEAK were measured at baseline and after two, six and eight months by ELISA. Results: Those participants who had a performance gain of ≤2.9% (mean gain 12%) within eight months showed a significant increase in sTWEAK (group 2: from 133 to 200 pg/mL, p = 0.002 and group 4: from 166 to 212 pg/mL, p = 0.031) and sCD163 levels (group 2: from 255 to 348 ng/mL, p = 0.035 and group 4: from 247 to 288 ng/mL, p = 0.025) in contrast to subjects without performance gain (sTWEAK: group 1: from 161 to 177 pg/mL, p = 0.953 and group 3: from 153 to 176 pg/mL, p = 0.744; sCD163: group 1: from 289 to 256 ng/mL, p = 0.374 and group 4: from 291 to 271 ng/mL, p = 0.913). Baseline sCD163 correlated with erythrocyte count, hematocrit, ASAT and lipoprotein a, the presence of hypertension and a BMI > 30 kg/m2. Conclusion: Regular physical activity leads to a significant increase in sCD163 and sTWEAK levels of up to 37% and 50%, respectively. It is well-known that physical activity prevents or retards the onset and genesis of chronic inflammatory disease. One possible way of how training evolves its beneficial effect might be by modifying the inflammation status using the sTWEAK–sCD163 axis. Brief Summary: Regular physical activity leads to a significant increase in sTWEAK and sCD163 levels. Both factors are diminished in patients with chronic (inflammation-based) diseases, such as coronary artery disease, heart failure, pulmonary artery hypertension, chronic kidney disease and diabetes mellitus. It seems that the amounts of soluble TWEAK and CD163 are essential for a healthy balance and modulation between pro- and anti-inflammatory processes, and regular physical training could use the sCD163–sTWEAK axis to unfold its beneficial effect.

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