scholarly journals THE ROLE OF MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE IN THE POSTOPERATIVE PERIOD. REVIEW

2021 ◽  
pp. 30-38
Author(s):  
V. A. Kubyshkin ◽  
L. M. Samokhodskaya ◽  
Yu. M. Korolev
Keyword(s):  
Inflammatory Response ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Complete Information ◽  
Infectious Complications ◽  
Diagnostic Measures ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
The Moment

Despite all the achievements of modern surgery, the number of postoperative infectious complications in the world remains high. Their occurrence leads to a longer period of patients’ hospitalization, requires the use of additional medical and diagnostic measures, which ultimately leads to higher treatment costs and significant financial losses in the health care system. Therefore, it is important to identify postoperative complications at an early stage, even before the development of pronounced clinical symptoms, and to predict their possible development in a certain category of patients. For these purposes, scientists try to use various laboratory markers. In this paper, we analyzed both well-known indicators of the inflammatory response, such as: C-reactive protein, albumin, their ratio, procalcitonin and interleukin-6, and relatively new parameters that research teams are trying to apply for these purposes: neutrophil granularity intensity and neutrophil reactivity intensity, pancreatic stone protein and pancreatitis-associated protein. We tried to collect the most complete information available at the moment, evaluate the opinions of researchers, identify contradictions in their works and try to explain their cause. As a result, it turned out that even the markers of inflammation known for many years are not absolutely specific for postoperative infectious complications. We concluded that most of the laboratory parameters described in this article can be used to some extent in the early diagnosis of postoperative infectious complications, but if we want to obtain more complete information in this area of knowledge, it is necessary to conduct new largescale studies.

scholarly journals Interactions of C-reactive protein with the complement system. II. C-reactive protein-mediated consumption of complement by poly-L-lysine polymers and other polycations.

1975 ◽  
Vol 142 (3) ◽  
pp. 709-721 ◽  
Author(s):  
J Siegel ◽  
A P Osmand ◽  
M F Wilson ◽  
H Gewurz
Keyword(s):  
Inflammatory Response ◽  
Potential Role ◽  
Egg White ◽  
Phosphate Esters ◽  
C Reactive Protein ◽  
Cationic Proteins ◽  
Reactive Protein ◽  
Naturally Occurring ◽  
The Complement System

Cationic homopolymers of poly-L-lysine were found to activate complement (C) via C-reactive protein (CRP) and deplete C3 and C5 as well as early-acting C components. Maximum C consumption was obtained with polymers of 2,000-8,000 daltons; polymers of 1,700, 11,000, and 23,000 daltons were intermediate in reactivity, while L-lysine, lysyl-L-lysine, tetra-L-lysine, and polymers of 70,000-400,000 daltons lacked significant C-consuming activity. Naturally occurring polycations which consumed C in the presence of CRP included myelin basic proteins, cationic proteins of rabbit leukocytes, and both lysine- and arginine-rich histones; poly-L-arginine polymers of 17,000 but not 65,000 daltons also were C-consuming. Polycations without such reactivity included poly-L-orithine (5,000 and 165,000 daltons), egg white and human lysozymes, and Polybrene. The polycations which failed to induce C consumption via CRP, inhibited its consumption by both active polycations and by C-polysaccharide (CPS). The relative inhibitory capacity of phosphorylcholine and polycations in CPS- and polycations-CRP systems was consistent with the concept that phosphate esters and polycations react at the same or an overlapping combining site. The ability of certain polycations to activate C via CRP increases the potential for initiation of host reactions via C. The capacity of other polycations to inhibit C activation via CRP introduces a potential for physiologic or pharmacologic manipulation. These considerations would seem to expand the potential role of CRP in the initiation and modulation of the inflammatory response.

scholarly journals Impact of early malnourishment on the chronic inflammatory response and its implications for the effect of indomethacin on Wistar rats

2011 ◽  
Vol 106 (6) ◽  
pp. 845-851 ◽  
Author(s):  
Thiago de Oliveira Assis ◽  
Teresinha Gonçalves da Silva ◽  
Eryvelton de Souza Franco ◽  
Ana Catarina Rezende Leite ◽  
Silvia Regina Arruda de Moraes ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Blood Levels ◽  
Lactation Period ◽  
Chronic Inflammatory Response ◽  
Plantar Surface ◽  
Reactive Protein ◽  
Balanced Diet ◽  
Markers Of Inflammation ◽  
Anti Inflammatory ◽  
Inflammatory Effect

The objective of the present study was to investigate whether early undernutrition changes the chronic inflammatory response, so as to study its influence on pharmacological response to indomethacin. Rat offspring of dams fed from the first day of gestation to term or throughout the lactation period received a balanced diet (NN) or a basic regional diet (BRD) from northeast Brazil. According to their dams, the offspring were divided into three groups: NN; basic regional diet during gestation (BRD-g, undernourished during gestation); basic regional diet during gestation and lactation (BRD-gl, undernourished during gestation and lactation). At 2 months of age, Freund's adjuvant (0·2 ml) was inoculated into the plantar surface of the hind paw (day 0) of animals. All animals orally received saline (0·9 %) for 28 d. Another group of adult offspring was subjected to the same procedure as described above, but orally received indomethacin (2 mg/kg) instead of saline, and divided into three subgroups: NN treated with indomethacin (NNI); BRD-g treated with indomethacin (BRDI-g); BRD-gl treated with indomethacin (BRDI-gl). The hind paw volume was calculated on days 0 (initial paw volume), 7, 14 and 28. Hind paw swelling, blood albumin and C-reactive protein (CRP) levels and leucocyte counts were evaluated as markers of inflammation. Reduced hind paw swelling and the blood levels of serum albumin and CRP were found in the BRD-g and BRD-gl offspring. However, no difference was found in the leucocyte count. Compared with their respective saline-treated groups (NN, BRD-g and BRD-gl), the anti-inflammatory effect of indomethacin was lower in the BRDI-g and BRDI-gl groups than in the NNI group. We conclude that early undernutrition attenuated the chronic inflammatory response and the anti-inflammatory effect of indomethacin.

Systemic inflammatory response syndrome without systemic inflammation in acutely ill patients admitted to hospital in a medical emergency

1999 ◽  
Vol 96 (3) ◽  
pp. 287-295 ◽  
Author(s):  
Annika TAKALA ◽  
Irma JOUSELA ◽  
Klaus T. OLKKOLA ◽  
Sten-Erik JANSSON ◽  
Marjatta LEIRISALO-REPO ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammation ◽  
Interleukin 6 ◽  
Systemic Inflammatory Response ◽  
Composite Score ◽  
C Reactive Protein ◽  
Cd11b Expression ◽  
Reactive Protein ◽  
Markers Of Inflammation

Criteria of the systemic inflammatory response syndrome (SIRS) are known to include patients without systemic inflammation. Our aim was to explore additional markers of inflammation that would distinguish SIRS patients with systemic inflammation from patients without inflammation. The study included 100 acutely ill patients with SIRS. Peripheral blood neutrophil and monocyte CD11b expression, serum interleukin-6, interleukin-1β, tumour necrosis factor-α and C-reactive protein were determined, and severity of inflammation was evaluated by systemic inflammation composite score based on CD11b expression, C-reactive protein and cytokine levels. Levels of CD11b expression, C-reactive protein and interleukin-6 were higher in sepsis patients than in SIRS patients who met two criteria (SIRS2 group) or three criteria of SIRS (SIRS3 group). The systemic inflammation composite score of SIRS2 patients (median 1.5; range 0–8, n = 56) was lower than that of SIRS3 patients (3.5; range 0–9, n = 14, P = 0.013) and that of sepsis patients (5.0; range 3–10, n = 19, P< 0.001). The systemic inflammation composite score was 0 in 13/94 patients. In 81 patients in whom systemic inflammation composite scores exceeded 1, interleukin-6 was increased in 64 (79.0%), C-reactive protein in 59 (72.8%) and CD11b in 50 (61.7%). None of these markers, when used alone, identified all patients but at least one marker was positive in each patient. Quantifying phagocyte CD11b expression and serum interleukin-6 and C-reactive protein concurrently provides a means to discriminate SIRS patients with systemic inflammation from patients without systemic inflammation.

scholarly journals Populações Celulares Periféricas (CD4+, CD8+ e CD19+) em Indivíduos Dislipidémicos

2013 ◽  
Vol 26 (6) ◽  
pp. 676
Author(s):  
Jose Pereira de Moura ◽  
Manuel Santos Rosa ◽  
Vera Alves ◽  
Anabela Mota Pinto ◽  
Victor Rodrigues ◽  
...  
Keyword(s):  
Potential Role ◽  
Inflammatory Cells ◽  
Control Group ◽  
Cd4 Cells ◽  
Reactive Protein ◽  
The Past ◽  
Markers Of Inflammation ◽  
The People ◽  
Risk Predictors

Introduction: The past decade has witnessed an increasing recognition that inflammatory mechanisms play a central role in the pathogenesis of atherosclerosis and its complications. Recently, attention was focused on the potential role of plasma markers of inflammation as risk predictors among those at risk for cardiovascular events. Of these potential markers, C-reactive protein (CRP), IL6, metalloproteinases, ICAM, VCAM and other molecules, have been extensively studied. On the other hand, to our knowledge, there are only a few studies on the role of inflammatory cells, like T and B lymphocytes in the atherosclerosis.Material and Methods: By Flow Cytrometry analysis we have determined on dyslipidemic people and on a control group, the percentage of some peripheral inflammatory cells, like CD3+, CD4+, CD8+, CD19+, CD56+, CD56CD8+, DN, CD25+, CD26+, CD25CD3+, CD26CD3+, CD25CD26CD3+, CCR5+, CCR5CD3+, CCR5CD4+, HLADR+, HLADRCD4+, HLADRCD8h+, HLADRCD8low+, HLADRCD8+, CD95+, CD95CD95L+, CD3CD95+, CD3CD95L+, CD62L+, CD3CD62L+, CD69+, CD69CD3+ e CD69CD4+.Results: In the present study we have particularly studied the percentage of CD4+, CD8+ and CD19+ cells. The CD4+ cells have been significantly reduced in the people with dyslipidemia.Discussion: We do not know the peripheral numbers of the subtype Th1 and Th2, neither the percentage of CD4+CD25+ cells (regulatory T cells). We have not find any differences on the percentage from the CD8+ and CD19+ cells.Conclusions: In spite of the identified limitations resulting from the small-sized samples, it was possible to show a reduction of some molecules after application of acetylsalicylic acid.

scholarly journals Algoritm for diagnostics of appendicitis in childhood and SIRS

2018 ◽  
Vol 16 (3) ◽  
pp. 218-223
Author(s):  
Y. Dimcheva ◽  
Kr. Kalinova ◽  
K. Georgiev
Keyword(s):  
Inflammatory Response ◽  
Outcome Measure ◽  
Clinical Symptoms ◽  
Primary Outcome Measure ◽  
Systemic Inflammatory Response ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

The specific purpose of this study was to describe and characterize the systemic inflammatory response to appendicitis in childhood. The clinical symptoms of SIRS are present in a large proportion of patients . A study of high-risk patients showed that over a given period of time, 44-68% of the patients met the criteria for this condition, while at the same time they had proven infection up to 50%.The incidence of SIRS is even higher in the post-operative period and in trauma regardless of the presence or absence of infection. On the other hand, between 10% and 43% of patients with proven sepsis do not meet the SIRS criteria.The inclusion of a number of biological markers (C-reactive protein, procalcitonin, cytokines) aims to help differentiate SIRS with infectious and noninfectious etiology. Sixty six patients were studied, divided into four groups from onset of symptoms to diagnosis. The primary outcome measure was to determine the systemic inflammatory response to appendicitis according to the established groups of time intervals. The secondary outcome measure was the analysis of C-reactive protein for the same purpose. The variables of the systemic inflammatory response, according to diagnostic intervals, showed non-significant differences in white blood cell count. The temperature rose constantly after 48 h, reaching its peak after 72 h (p = 0.001), and the respiratory rate rose after 72 h (p < 0.0001). After 73 h, most patients had three or four systemic inflammatory response criteria (p < 0.0001). C-reactive protein levels rose progressively, showing higher levels after 48 h (p = 0.005). The inflammatory response to appendicitis is progressive, being more marked along the timeline from onset of symptoms to diagnosis. Key words: appendicitis, diagnostic SIRS, children, algoritm.

The Role of Serum Procalcitonin and Interleukin-6 in the Differentiation and Surveillance of Sepsis and Non-Infectious Systemic Inflammatory Response Syndrome.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3792-3792 ◽  
Author(s):  
Xiaoli Liu ◽  
Bin Du ◽  
Jiaqi Pan ◽  
Baolai Hua
Keyword(s):  
Length Of Stay ◽  
Inflammatory Response ◽  
Interleukin 6 ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Receiver Operating Characteristic Curves ◽  
Reactive Protein ◽  
Clinical Onset ◽  
Icu Length Of Stay

Abstract To evaluate the discrimination of serum procalcitonin (PCT) and interleukin-6 (IL-6) between patients with sepsis and non-infectious inflammatory response syndrome (SIRS) and the pridicton power of clinical outcome, a perspective study was performed in 27 patients with sepsis and 30 patients with non-infectious SIRS. The serum concentrations of PCT, IL-6, and C-reactive protein (CRP), white blood cell count, percentage of neutrophil, and maximal body temperature were obtained less than 24 hours after clinical onset of SIRS. The serum levels of PCT and IL-6, and percentage of neutrophil were significantly higher in patients of sepsis than in those of SIRS (PCT 5.54 [1.20, 32.74] μg/L vs 0.77 [0.22, 3.90] μg/L, P=0.001; IL-6 163.66 [33.60, 505.26] ng/L vs 37.72 [22.52,110.78] ng/L, P=0.004; CRP 15.28±8.41 g/L vs 9.51±7.65 g/L, P=0.010; and percentage of neutrophil 91%±4% vs 88%±4%, P=0.010). Receiver operating characteristic curves showed that the power of PCT and IL-6 were the best of all above. There was significant correlation between serum concentrations of PCT or IL-6 and the APACHE II or SOFA score, so was between serum PCT concentration and the ICU length of stay. Serum concentrations of PCT and IL-6 are more reliable indicators to differentiate sepsis and non-infectious SIRS than the conventional inflammatory markers, and correlate with the disease severity. And PCT levels were significantly correlated with ICU length of stay. (Supported by research grants from PUMCH, China)

Increase in Proportion of Th-17 Lymphocytes in Blood Heralds Overt Acute Graft Versus Host Disease in HSCT Patients.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2226-2226
Author(s):  
Andrzej Lange ◽  
Dorota Dlubek ◽  
Emilia Jaskula ◽  
Daria Drabczak-Skrzypek ◽  
Mariola Sedzimirska ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Wilcoxon Test ◽  
Cd4 Cells ◽  
Post Transplantation ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Th 17

Abstract IL-17 is involved in chronic inflammation and autoimmunity, this cytokine producing cells are well characterized in the mouse model. In man, situation is more complex due to the genetic variability, co-morbidities and environmental factors influencing the immune response. In patients post HSCT alloreactivity with the presence of aGvHD is a major factor affecting the outcome of transplantation. Understanding of the role of cells involved in regulation of the immune system is crucial for the treatment tailoring to favour tolerance but not making the recipient more prone to opportunistic infections and leukaemia relapse. In this study 27 patients post HSCT were investigated for the presence of regulatory cells and those producing IFNgamma and IL-17 in blood. Blood was collected at the time of haematological recovery or when the first clinical symptoms of aGvHD became apparent and then in one week intervals until +60 day post transplantation. PBMC were stimulated for 4 hrs with BD Leukocyte Activation Cocktail in the presence of Golgi Stop (BD, Erembodegen, Belgium) and then stained extracellularly with anti-CD4, permeabilized with Fixation/Permeabilization Concentrate and Diluent (eBioscience, San Diego, CA) and finally stained with anti-IFNgamma (BD), anti-IL-17 (eBioscience) anti FoxP3 (eBioscience). CD4+ cells subpopulations were analysed according to the expression of the stained features. It was found: FoxP3+CD4+ cells were in higher proportions in pts with aGvHD (results from all time-points taken together) (9.93%±0.61 vs 8.2%±0.50, n=98, p=0.040, U Mann-Whitney test) IFNgamma producing CD4+ lymphocytes were in higher proportions (0,34 vs 0.14, ns) in blood samples taken from patients lacking as compared to those having aGvHD. CD4+IL-17+ lymphocytes proportions increased from 1.39%±0.42 to 5.33%±2.45 (p=0.04, Wilcoxon Test for pairs) one week before aGvHD. Notably, at the time of full blown aGvHD the proportions of CD4+IL-17+ cells were lower as compared to the results of previous measurements (0.74%±0.29, p=0.008, Wilcoxon Test for pairs). Taking all results together the proportion of CD4+IL17+ lymphocytes were lower in patients having as compared to those lacking aGVHD (0.93%±0.27 vs 1,53%±0,41, p=0.05, U Mann-Whitney test). It appears that: FoxP3 positive cells expand during aGvHD likely as a response to alloreactive stimulation. INFgamma+ CD4+ cells benefit the course post HSCT making the patients less susceptible to aGvHD. CD4+IL17+ cells are likely involved at the early stage of aGvHD patho-mechanism heralding the clinical manifestation of this complication, but then they disappear from blood, possibly being marginalized in the inflamed tissues.

scholarly journals Evaluation of the role of CRP as an early predictor of chorioamnionitis in PPROM

2018 ◽  
Vol 7 (4) ◽  
pp. 1351 ◽  
Author(s):  
Amika Aggarwal ◽  
Sangeeta Pahwa
Keyword(s):  
Predictive Value ◽  
Early Stage ◽  
Control Group ◽  
Total Leucocyte Count ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
A Prospective Study ◽  
Early Predictor

Background: Preterm birth is one of the most important cause of perinatal morbidity and mortality. PROM is defined as spontaneous rupture of membranes before the onset of uterine contraction. Objective of present study was to evaluate the role of CRP as an early predictor of Chorioamnionitis in PPROM.Methods: A prospective study was done on 50 cases with PPROM and 50cases of control group without PPROM. All mothers and babies were observed from the time of admission to the time of discharge.Results: C-reactive protein appears to be the most sensitive acute phase protein; rising of less than 24 hours makes it suitable to serve as a marker for diagnosing an infective process in early stage. On comparing C-reactive protein levels with other laboratory tests and indicators of infection (e.g. total leucocyte count DLC, maternal fever, maternal tachycardia, fetal tachycardia) we found CRP level to be more sensitive (100%) but less specific (69.56%) in identifying clinical Chorioamnionitis. The positive predictive value was 22.22% and negative predictive value was 100%.Conclusions: In cases of PPROM, raised CRP is an early predictor of clinical Chorioamnionitis as well as histological Chorioamnionitis.

scholarly journals AB0739 MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-COV-2 INFECTION AND E.COLI SEPSIS: THE POTENTIAL ROLE OF PROCALCITONINE AS A RAPID DIAGNOSTIC BIOMARKER TO DISTINGUISH TWO DIFFERENT PHASES OF SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1399.1-1399
Author(s):  
M. Gilio ◽  
S. B. Morella ◽  
F. Picaro ◽  
C. Acierno ◽  
D. Palazzo ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Systemic Inflammatory Response ◽  
Critically Ill Children ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Inflammatory Syndrome

Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology.Objectives:We report a case of multisystem inflammatory syndrome in children (MIS-C) in patient with SARS-CoV-2 infection and Enteropathogenic Escherichia coli (EPEC) sepsis due to acute enteritis, observed at end of December 2020 to a tertiary-care center (San Carlo Hospital), in Basilicata region (Italy).Methods:This healthy 12-year- old male patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Clinical presentations was characterized by fever, abdominal pain, gastrointestinal complaints and evanescent rash. Laboratory values were remarkable for high levels of procalcitonin, C-reactive protein (CRP), D-dimers, B-type natriuretic peptide (BNP), and troponin. He also had low albumin levels. Autoantibodies tests were negative. Chest tomography showed ground-glass opacities in less than 25% of the lungs, small bilateral pleural effusion and increased cardiac area; abdominal tomography showed enlargement of the lymphnodes and ascites. Evaluation for other infectious etiologies showed molecular test positivity on fecal samples for EPEC E. coli. He received broad spectrum intravenous antibiotics (macrolids and quinolones and then carbapenems). On the seventh day the enteritis resolved and procalcitonin normalized, however he continued to have lymphopenia, thrombocytopenia, hypoalbuminemia, elevated levels of CRP, D-dimers, ferritin, troponin, and increased BNP. On the ninth day he was feverish again and developed severe cardiac and respiratory failure requiring advanced respiratory support and admission to the intensive care unit. He received IVIG (intravenous immunoglobulin at 2 g/Kg, glucocorticoids (Methylprednisolone 1mg/kg) and enoxaparin.Results:The patient was discharged asymptomatic at home after 28 days of hospital stay.Conclusion:We observed multisystem inflammatory syndrome in children (MIS-C) in a previously healthy patient with SARS-CoV-2 infection and E.coli sepsis, who became critically ill with multisystem involvement. In this case viral and bacterial infections could be considered as a double hit for the etiopathogenesis of MIS-C. The trend of procalcitonin was better than C-reactive protein for differentiating bacterial from non-bacterial phase of systemic inflammatory response syndrome (SIRS) in this critically ill child. Although the accuracy of both tests is moderate. Diagnostic accuracy could be enhanced by combining these tests with bedside clinical judgment.References:[1]Consiglio CR, Cotugno N, Sardh et al. The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. Cell. 2020 Nov 12;183(4):968-981.e7. doi: 10.1016/j.cell.2020.09.016. Epub 2020 Sep 6. PMID: 32966765; PMCID: PMC7474869.[2]Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management. Children (Basel). 2020 Jul 1;7(7):69. doi: 10.3390/children7070069. PMID: 32630212; PMCID: PMC7401880.[3]Simon L, Saint-Louis P, Amre DK, Lacroix J, Gauvin F. Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome. Pediatr Crit Care Med. 2008 Jul;9(4):407-13. PMID: 18496408.Disclosure of Interests:None declared

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