Significance of Acute Phase Reactants as Prognostic Biomarkers for Pneumonia in Children

Community acquired pneumonia (CAP) is a major contributing cause for the increased rate of childhood mortalities and morbidities in the developing countries. Thus, we aimed in this study to appraise the significance of acute phase reactant proteins in correlation with the modified pneumonia prognostic score to assess the disease severity and outcome in children.This study included 40 children with pneumonia ( age between 6 months 2 years ) and other 40 healthy controls ( age and sex matched). They were enrolled in the study and a detailedhistory’s obtained, full clinical examination and assessment of AGP, CRP and ferritin in serum in addition to CBC.AGP, CRP and ferritin showed significant higher levels in children with pneumonia than healthy controls. Also, their values were significantly higher in nonsuvivors than survivors.The present investigation provides a distinct evidence for the prominence of acute phase reactants (ferritin, CRP and AGP) in comparison with the clinical scores in predicting early high risk prognosis of pneumonia in children.

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Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis

Journal of Medical Biochemistry ◽

10.2478/v10011-008-0031-2 ◽

2009 ◽

Vol 28 (2) ◽

pp. 116-121 ◽

Cited By ~ 1

Author(s):

Irena Kafeđiska ◽

Dejan Spasovski ◽

Todor Gruev ◽

Mane Grličkov ◽

Kočo Cakalaroski ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Acute Phase ◽

Acute Phase Reactant ◽

Control Group ◽

Time Intervals ◽

Acute Phase Reactants ◽

Mean Values ◽

Cell Counts ◽

Phase Reactant ◽

The Mean

Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis The aim of this prospective control study was a quantitative evaluation of the activity of rheumatoid arthritis (RA) in certain time intervals, using articular indexes (set of 28 sensitive and 28 swollen joints), laboratory parameters (Hb, Hct, Er, Le and Plt) and acute phase reactants (ESR, RF, CRP); to determine which of the acute phase reactants is the most useful biochemical marker for the evaluation of disease activity in RA; to quantify the therapeutical and laboratory differences in certain time intervals in the group with and without immunomodulatory therapy with Methotrexate. Sixty patients with RA were included, 27 of who were treated with non-steroid antiinflammatory drugs (NSAIDs) and Methotrexate (MTX). The control group consisted of 33 patients treated only with NSAIDs because of irregular controls. In the first group of patients the disease activity was estimated at four time intervals, and in the control group of patients at three time intervals following the scores of the articular indexes, blood cell counts, ESR and CRP in every patient. In the first group of patients decreased activity of RA was found upon every following control with a consecutive decrease in mean values of the scores of articular indexes with statistically significant differences at the four time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of Hb, Er, Plt, ESR, (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (there were great standard deviations). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of articular indexes with an increse at every following control (in favour of progression of the disease). There were no statistically significant differences considering blood cell counts, ESR and CRP (in favour of permanently active disease). In conclusion, CRP is the most useful marker for the prospective follow-up of patients with RA.

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Analysis of complete blood counts in rotaviral gastroenteritis with special emphasis on platelet indices

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192756 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1567

Author(s):

Mahesh B. Maralihalli ◽

Kavan R. Deshpande ◽

Pallavi K Deshpande

Keyword(s):

Platelet Count ◽

Acute Phase ◽

Acute Phase Reactant ◽

Healthy Controls ◽

Distribution Width ◽

Platelet Counts ◽

Rotavirus Gastroenteritis ◽

Phase Reactant ◽

Significant Difference ◽

Complete Blood Counts

Background: The objectives of this study was to analyze complete blood counts in rotaviral gastroenteritis with special emphasis on platelet indices.Methods: Children diagnosed as rotavirus gastroenteritis and healthy controls were enrolled in this study. Severity of acute gastroenteritis was classified into mild, moderate and severe grades using Vesikari score. Rotavirus was determined in fresh stool samples using rapid diagnostic rotavirus antigen test. Hemoglobin, leukocyte, neutrophil to lymphocyte percentage ratio, platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT) levels were assessed for all children. It’s a case control study conducted at Pediatric Speciality Hospital.Results: There were 30 cases with mean age 1.58 years. Healthy controls were 30 with mean age 2.10 years. Mean Hb was lower in cases. Mean of platelet counts was higher in cases. Mean MPV levels was lower in cases. Mean PCT value was higher in cases. Mean MPV to platelet ratio value was lower in cases. All parameters values showed no significant difference among mild, moderate and severe groups of rotaviral gastroenteritis cases. Platelet count was negatively correlated with Hb, MPVP and positively correlated with TLC and PCT. MPV was positively correlated with MPVP and PDW. PCT was negatively correlated with Hb, MPVP and positively correlated with TLC and platelet count.Conclusions: MPV can be used as negative acute phase reactant in rotavirus gastroenteritis and so is the MPV to platelet ratio. Platelet count is acute phase reactant in rotavirus gastroenteritis and so is the platelet crit value.

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PROTEIN C ACTS AS AN ACUTE PHASE REACTANT IN EQUINE LAMINITIS

10.1055/s-0038-1643183 ◽

1987 ◽

Author(s):

K W Prasse ◽

J N Moore ◽

A Duncan

Keyword(s):

Acute Phase ◽

Protein C ◽

Coagulation Factors ◽

Acute Phase Reactant ◽

Normal Range ◽

Microvascular Damage ◽

Acute Phase Reactants ◽

Intravascular Thrombosis ◽

Phase Reactant ◽

Equine Colic

Equine Colic Syndrome is a disease of horses whose complications include laminatis.This term describes a situation where microvascular damage to the hoof causes degeneration of the interphalangeal laminae,leading to lameness. Vascular studies have suggested that microthrombosis involving the delicate vessels in the hoof,coupled with changes in the platelet count, coagulation factors & elevated FDP's implicate DIC as a potential etiology. Limited test capability in the horse has limited further evaluation of this hypothesis. We have developed an assay for equine protein C activity,our normal range being 70-60% (Mean+/- 2SD). We studied 12 horses with the disease for 5 consecutive days,drawing 1 blood sample per day. Our expectation was that protein C levels would decrease.if DIC was significant,as would be expected in humans. No significant decrease was noted in any horse. However there was a significant increase in the protein C levels beyond the upper limit of the normal range in 10 of the 12 horses by the third day. Five of the 10 horses maintained this elevation beyond the 5th day. Thus protein C changes were more consistent with an acute phase reactant response,rather than reflecting the decrease we anicipated,if the equine DIC parallels human DIC. We are measuring other acute phase reactants to see if equine protein C parallels those. Since our assay is still being evaluated,more data needs to be obtained in this and other equine disease states before any definative role for protein C in equine pathology can be determined. In our laminitis horses,we are devolping assays for antithrombin III and plasminogen which should allow us to evaluate the disease state more completley for any involement of elements of intravascular thrombosis and fibrinolysis in the equine colic syndrome.

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Murine serum glycoprotein gp70 behaves as an acute phase reactant.

Journal of Experimental Medicine ◽

10.1084/jem.155.2.345 ◽

1982 ◽

Vol 155 (2) ◽

pp. 345-357 ◽

Cited By ~ 38

Author(s):

I Hara ◽

S Izui ◽

F J Dixon

Keyword(s):

T Cells ◽

Acute Phase ◽

Viral Genome ◽

Lipid A ◽

Acute Phase Reactant ◽

Acute Phase Reactants ◽

Single Intraperitoneal Injection ◽

Phase Reactant ◽

Immunohistochemical Studies ◽

Parenchymal Cells

A single intraperitoneal injection of bacterial lipopolysaccharide (LPS) or its lipid A component induced high levels of glycoprotein, gp70, in sera of several strains of mice within 24 h. This serum gp70 response induced by LPS was independent of the activation of B cells and the presence of T cells. However, serological and immunohistochemical studies demonstrated the production of gp70 by hepatic parenchymal cells and its subsequent release into the circulating blood. The expression of gp70 in the serum was enhanced not only by LPS but also other inducers of acute phase reactants (APR) such as turpentine oil or polyriboinosinic-polyribocytidylic acid. Further, the serum gp70 response was kinetically identical to those of APR. These results strongly suggest that (a) the liver may be the major source for serum gp70, (b) serum gp70 behaves like an APR, (c) its expression may be controlled by a mechanism similar to that for other APR, and (d) this glycoprotein apparently behaves as a normal host constituent and not a product of a viral genome.

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Glycoprotein biosynthesis during the acute-phase response to inflammation

Canadian Journal of Biochemistry and Cell Biology ◽

10.1139/o83-133 ◽

1983 ◽

Vol 61 (9) ◽

pp. 1041-1048 ◽

Cited By ~ 36

Author(s):

J. C. Jamieson ◽

H. A. Kaplan ◽

B. M. R. N. J. Woloski ◽

M. Hellman ◽

K. Ham

Keyword(s):

Acute Phase ◽

Acute Phase Response ◽

Elevated Serum ◽

Serum Cortisol ◽

Serum Levels ◽

Acute Phase Reactant ◽

Phase Response ◽

Acute Phase Reactants ◽

Acid Glycoprotein ◽

Phase Reactant

Inflammation results in an increase in the levels of a variety of glycoproteins in serum. The glycoproteins that respond in this way are usually referred to as acute-phase reactants. Studies on the acute-phase response of rat α1-acid glycoprotein showed that there was an increase in the liver levels of this glycoprotein at 12 h after turpentine inflammation. This was followed by increased serum levels at 48–72 h after inflammation, suggesting a precursor–product relationship between liver and serum α1-acid glycoprotein. Incorporation studies coupled with measurements of synthesis rates of α1-acid glycoprotein showed that increased synthesis was responsible for the acute-phase response of this protein to inflammation. These studies also showed that albumin was a negative acute-phase reactant. The acute-phase response of α1-acid glycoprotein was accompanied by increased liver pools of UDP–N-acetylglucosamine (UDP–GlcNAc) and UDP–N-acetylgalactosamine (UDP–GalNAc) and increased liver activities of glucosamine-6-phosphate synthase and UDP–GlcNAc 2-epimerase. Activities of galactosyl and sialyl transferases in liver were also elevated and serum sialyl transferase was increased substantially in inflammation, suggesting that it may also be an acute-phase reactant. Liver activities of β-N-acetylhexosaminidase and β-galactosidase declined by about 50% at 24 h after inflammation; there was evidence that serum levels of these enzymes increased at 24–72 h after inflammation, suggesting that the lysosomal glycosidases may be released from liver during inflammation. Inflammation resulted in elevated serum Cortisol, insulin, and adrenocorticotropic hormone and induced increased glycogenosis; liver cAMP levels were also increased during inflammation. Preliminary studies are presented to show that leukocyte-derived factors may be involved in the acute-phase response of α1-acid glycoprotein to inflammation.

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Improved specificity of serum albumin determination and estimation of "acute phase reactants" by use of the bromcresol green reaction.

Clinical Chemistry ◽

10.1093/clinchem/22.5.616 ◽

1976 ◽

Vol 22 (5) ◽

pp. 616-622 ◽

Cited By ~ 119

Author(s):

J E Gustafsson

Keyword(s):

Serum Albumin ◽

Cellulose Acetate ◽

Acute Phase ◽

Acute Phase Reactant ◽

Serum Samples ◽

Acute Phase Reactants ◽

Slow Reaction ◽

Phase Reactant ◽

Control Serum ◽

Bromcresol Green

Abstract The reaction of serum samples with bromcresol green proceeds in two steps. Albumin is responsible for the faster (less than 1 min) reaction; the slower (30-min) reaction is a measure of "acute phase reactant(s)" in serum. Serum is simply mixed with bromcresol green reagent and the absorbance is measured twice, immediately and at 60 min. Albumin concentrations, determined from the absorbance at 0 min, correlate well with those determined by Laurell "rocket" immunoelectrophoresis; r = 0.95 with no certain deviation from unity for the slope and with a negligible difference at zero concentration. The slow reaction was expressed as deltaA% = 100 (deltaAs/deltaAv) where deltaAs and delta Av are the changes in absorbance between 60 and 0 min for the sample and a commercial control serum, respectively. The value for deltaA% correlates well with the percentage of alpha2-fraction as determined by electrophoresis on cellulose acetate, as well as with orosomucoid and ceruloplasmin, all of which are acute phase reactant(s). Whether these proteins or other acute phase reactant(s) actually cause the slow reaction has not yet been established.

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Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183138 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1009

Author(s):

Pawan Kumar Vishwakarma ◽

Umesh Saroj

Keyword(s):

Rheumatoid Arthritis ◽

Combination Therapy ◽

Acute Phase ◽

Uttar Pradesh ◽

Acute Phase Reactant ◽

Joint Space ◽

Chronic Inflammatory Disease ◽

Radiological Progression ◽

Acute Phase Reactants ◽

Phase Reactant

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010. Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.

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Isolation of a lipopolysaccharide-binding acute phase reactant from rabbit serum.

Journal of Experimental Medicine ◽

10.1084/jem.164.3.777 ◽

1986 ◽

Vol 164 (3) ◽

pp. 777-793 ◽

Cited By ~ 310

Author(s):

P S Tobias ◽

K Soldau ◽

R J Ulevitch

Keyword(s):

Acute Phase ◽

Direct Interaction ◽

Acute Phase Reactant ◽

Normal Serum ◽

Amino Acid Sequences ◽

Rabbit Serum ◽

Acute Phase Reactants ◽

Phase Reactant ◽

Acute Phase Serum

This report describes the purification of an acute phase reactant from acute phase rabbit serum, which endows normal serum with the properties of acute phase serum, insofar as LPS is concerned. The acute phase reactant is referred to as LPS-binding protein, or LBP. LBP was purified approximately 2,000-fold by chromatography of acute phase serum on Bio-Rex 70 and Mono-Q resins. The resulting preparation consisted of two glycoproteins having molecular weights of 60,500 and 58,000; the two were obtained in a variable ratio, usually near 10:1, respectively. After separation by SDS-PAGE, the N-terminal 36 amino acid sequences of the two proteins were identical. From the N-terminal sequence, as well as other properties of LBP, LBP appears to be unrelated to any known acute phase reactants. The direct interaction of LPS and LBP was inferred from two types of evidence: first, immunoprecipitation of [3H]LPS from APRS by anti-LBP sera; and second, by the 125I-labeling of LBP when APRS-containing 125I-labeled 2-(p-azidosalicylamido)ethyl 1,3'-dithiopropionyl-LPS was photolysed. The data presented here support the concept that the 60-kD glycoprotein we have termed LBP is a newly recognized acute phase reactant that may modulate the biochemical and biologic properties of LPS in vivo.

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Serum amyloid A3 expression is stimulated by dexamethasone and interleukin-6 in 3T3-L1 adipocytes

Journal of Endocrinology ◽

10.1677/joe.1.05699 ◽

2004 ◽

Vol 183 (3) ◽

pp. 561-567 ◽

Cited By ~ 32

Author(s):

Mathias Fasshauer ◽

Johannes Klein ◽

Susan Kralisch ◽

Margit Klier ◽

Ulrike Lossner ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Acute Phase ◽

Acute Phase Reactant ◽

Janus Kinase ◽

Serum Amyloid ◽

Synthesis Inhibitor ◽

Acute Phase Reactants ◽

Induce Insulin Resistance ◽

Phase Reactant

A chronic increase in systemic levels of acute-phase reactants contributes to the development of insulin resistance and associated disorders such as cardiovascular disease. Recently, serum amyloid A3 (SAA3) has been characterized as an adipocyte-secreted acute-phase reactant, expression of which is dramatically increased in insulin resistance and obesity. To further clarify expression and regulation of this adipocytokine in fat, SAA3 mRNA was measured by quantitative real-time reverse transcriptase PCR during differentiation of 3T3-L1 adipocytes and after treatment with various hormones known to induce insulin resistance and contribute to atherosclerosis. SAA3 mRNA was dramatically induced up to 77-fold during differentiation of 3T3-L1 preadipocytes. Furthermore, 100 nM dexamethasone and 30 ng/ml interleukin (IL)-6 induced SAA3 mRNA by up to 11- and 4.8-fold, respectively, in a time-dependent fashion with significant stimulation observed at concentrations as low as 10 nM dexamethasone and 1 ng/ml IL-6. In contrast, insulin, isoproterenol and growth hormone did not influence SAA3 synthesis. Inhibitor studies suggested that the positive effect of IL-6 on SAA3 expression is at least in part mediated by Janus kinase 2. Taken together, our results show a differential regulation of SAA3 by glucocorticoids and IL-6 supporting an integrative role of this acute-phase reactant in the pathogenesis of insulin resistance and its link to obesity and cardiovascular disease.

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is hypoalbuminemia a new biomarker in severe pneumonia associated with coronavirus disease 2019?

10.22541/au.161371941.17843430/v1 ◽

2021 ◽

Author(s):

Yavuz Otal ◽

GAMZE AVCIOĞLU ◽

Fadime Gullu Haydar

Keyword(s):

Acute Phase ◽

Severe Pneumonia ◽

Acute Phase Reactant ◽

Healthy Control Group ◽

Control Group ◽

City Hospital ◽

Acute Phase Reactants ◽

Neutrophil Lymphocyte Ratio ◽

Phase Reactant ◽

Healthy Control

Objective: In the present study, the importance of albumin level in severe pneumonia due to covid 19 was investigated. Design: This was a retrospective study. Setting:Emergency Department of Ankara City Hospital, between 1 september 2020 and 1 february May 2021. Subjects: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose the relation between hypoalbuminemia and other acute phase reactants was compared in severe pneumonia due to Covid-19. Main outcome measures: The data of 122 patients diagnosed with pneumonia due to Covid 19 and 60 healthy control group were retrospectively analyzed in statistical terms in computer medium. The cases were divided into 3 groups as Healthy Control Group, Intubated Group, and Non-Intubated Group. The lung tomography of patients diagnosed with Covid 19 pneumonia was examined one-by-one. The RT-PCR (Real-Time Polymerized Chance Reaction) test results were recorded from the system. The albumin, WBC (White Blood Cell), N/L (Neutrophil/Lymphocyte Ratio), CRP (C-Reactive Protein) levels, who are acute phase reactant levels, of the patients were compared with the Control Group. Also, the two groups who were intubated and not intubated were also compared. Results: When all the data were examined, it was found that the albumin levels were lower at statistically significant levels in all 3 study groups (p<0.01). The other acute phase reactants, N/L ratio and CRP levels were significantly higher (p<0.05). Hypoalbuminemia was found to be significantly lower as a result of the comparisons of the two groups that were intubated and not intubated (p=0.02), and no differences were detected in terms of other parameters (p>0.05). Conclusion: Serum albumin levels may be lower in severe Covid 19 pneumonia. Hypoalbuminemia can be a biomarker indicating the severity of the disease as an acute phase reactant.

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