Treatment of Refractory Takayasu Arteritis with Tocilizumab: 7 Italian Patients from a Single Referral Center

2013 ◽  
Vol 40 (12) ◽  
pp. 2047-2051 ◽  
Author(s):  
Enrico Tombetti ◽  
Stefano Franchini ◽  
Maurizio Papa ◽  
Maria Grazia Sabbadini ◽  
Elena Baldissera
Keyword(s):  
Takayasu Arteritis ◽  
Inflammatory Markers ◽  
Tumor Necrosis ◽  
Tnf Inhibitors ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Activity Assessment ◽  
Erythrocyte Sedimentation ◽  
Necrosis Factor ◽  
Disease Activity Assessment

Objective.The aim of our study was to evaluate the safety and the efficacy of tocilizumab (TCZ) for refractory Takayasu arteritis (TA).Methods.We retrospectively assessed the outcome of blocking interleukin (IL)-6 with TCZ in 7 consecutive patients with refractory TA using a combination of clinical and imaging assessment.Results.During a median followup visit at 14 months, 4 patients taking TCZ [including 2 nonresponders to tumor necrosis factor (TNF) inhibitors] achieved clinical response, suggesting a nonredundant role for IL-6 in TA. Inflammatory markers normalized in all patients treated with TCZ. However, vascular progression occurred in 4 patients, suggesting the involvement of other inflammatory pathways and confirming the limitations of erythrocyte sedimentation rate and C-reactive protein for disease activity assessment while taking TCZ. Three patients experienced adverse events and 2 suspended TCZ.Conclusion.TCZ may be effective in a subset of patients with refractory TA, even in cases of unresponsiveness to TNF inhibitors. Inflammatory markers are not valid markers of TA activity on TCZ. Further studies are needed to confirm these preliminary observations.

scholarly journals Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Tomas Hucl ◽  
Marek Benes ◽  
Matej Kocik ◽  
Alla Splichalova ◽  
Jana Maluskova ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Inflammatory Markers ◽  
Tumor Necrosis ◽  
C Reactive Protein ◽  
Postoperative Course ◽  
Reactive Protein ◽  
Endoscopic Closure ◽  
Baseline Levels ◽  
Temporary Rise ◽  
Necrosis Factor

Aims.The aim of our study was to determine the physiologic impact of NOTES and to compare the transgastric and transcolonic approaches.Methods.Thirty pigs were randomized to transgastric, transcolonic, or laparoscopic peritoneoscopy. Blood was drawn and analyzed for C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin- (IL-) 1β, IL-6, WBCs, and platelets.Results.Endoscopic closure with an OTSC was successful in all 20 animals. The postoperative course was uneventful in all animals. CRP values rose on day 1 in all animals and slowly declined to baseline levels on day 14 with no differences between the groups (P>0.05, NS). The levels of TNF-αwere significantly increased in the transcolonic group (P<0.01); however this difference was already present prior to the procedure and remained unchanged. No differences were observed in IL1-βand IL-6 values. There was a temporary rise of WBC on day 1 and of platelets on day 7 in all groups (P>0.05, NS).Conclusions.Transgastric, transcolonic, and laparoscopic peritoneoscopy resulted in similar changes in systemic inflammatory markers. Our findings do not support the assumption that NOTES is less invasive than laparoscopy.

scholarly journals Inflammatory markers and occurrence of falls

2019 ◽  
Vol 53 ◽  
pp. 35
Author(s):  
Juleimar Soares Coelho de Amorim ◽  
Karen Cecília Lima Torres ◽  
Andréa Teixeira-Carvalho ◽  
Olindo Assis Martins-Filho ◽  
Maria Fernanda Lima-Costa ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Services ◽  
Inflammatory Markers ◽  
Tumor Necrosis ◽  
Health Condition ◽  
C Reactive Protein ◽  
Proper Understanding ◽  
Reactive Protein ◽  
Multiple Occurrence ◽  
Necrosis Factor

OBJECTIVE: Analyze whether inflammatory markers are associated with falls among older adults living in Bambuí. METHODS: Study that analyzed baseline data from a Bambuí Cohort Study of Aging, involving 1,250 participants. Data about falls were collected from previous 12 months, classified as single or multiple occurrence and severity (participant seeking health services). Information about sociodemographic characteristics, health behaviors and health condition was also collected and used as confounding factors. The exposures of interest included interleukins (IL-1β, IL-6, IL-8, IL-10, IL-12), tumor necrosis factor (TNF), ultra-sensitive C-reactive protein (us-CRP) and chemokines (CXCL9, CCL5, CCL10, MCP1). Data were processed through logistic regression, obtaining odds ratio and 95% confidence interval (95%CI). RESULTS: The prevalence of falls was 27.1%; 40.1% of the older adults reported multiple falls and 33.3% sought health services. After adjustments, the following elevated levels were associated with falls: us-CRP (OR = 1.46, 95%CI 1.04–2.03), CCL5 (OR = 1.38, 95%CI 1.01–1.90) and CXCL9 (OR = 1.43, 95%CI 1.02–2.02). An association was observed between the number of elevated markers and the occurrence of falls: two (OR = 1.47, 95%CI 1.02–2.12) and three (OR = 2.08, 95%CI 1.12–3.87) elevated biomarkers indicated fall probability of 32.0% and 39.4%, respectively. CONCLUSIONS: Elevated levels of us-CRP, CCL5 and CXCL9, which were associated with falls, may contribute to a proper understanding of the mechanism associated with the occurrence of falls among older people.

Which Measure of Inflammation to Use? A Comparison of Erythrocyte Sedimentation Rate and C-Reactive Protein Measurements from Randomized Clinical Trials of Golimumab in Rheumatoid Arthritis

2009 ◽  
Vol 36 (8) ◽  
pp. 1606-1610 ◽  
Author(s):  
CYNTHIA S. CROWSON ◽  
MAHBOOB U. RAHMAN ◽  
ERIC L. MATTESON
Keyword(s):  
Clinical Trials ◽  
Disease Activity ◽  
Randomized Clinical Trials ◽  
Clinical Disease ◽  
C Reactive Protein ◽  
Clinical Disease Activity ◽  
Reactive Protein ◽  
Activity Assessment ◽  
Erythrocyte Sedimentation ◽  
Disease Activity Assessment

Objective.To assess clinical utility of measurements of C-reactive protein (CRP) versus Westergren erythrocyte sedimentation rate (ESR) in evaluating patients with rheumatoid arthritis (RA).Methods.Data from 3 randomized clinical trials of golimumab involving 1247 patients with RA in which ESR and CRP were obtained at baseline and Week 24, along with standard measures of clinical disease activity [swollen and tender joint counts, global disease activity assessment, composite Disease Activity Scores (DAS) and Clinical Disease Activity Index (CDAI)], were utilized.Result.Both ESR and CRP were significant predictors of swollen joint count (p < 0.001 for each). Only 4.5% of patients with no swollen joints had elevated CRP and normal ESR, but 15.2% had elevated ESR and normal CRP. ESR and CRP correlated significantly (Pearson r = 0.59, p < 0.001) with each other. DAS-ESR and DAS-CRP were highly correlated (r = 0.96, p < 0.001) with each other, although DAS-ESR values were slightly lower than the DAS-CRP values at the upper end of the range (DAS > 8). Both ESR and CRP were significantly associated with CDAI (p < 0.001 for each).Conclusion.It is not necessary to obtain both ESR and CRP measures for clinical disease activity assessment in clinical trials of RA. Neither test adds significantly to clinical measures of disease activity including joint counts and global assessments. Where available, the CRP alone may be preferred for disease activity assessment as a simple, validated, reproducible, non age-dependent test.

scholarly journals 4311 Inflammatory biomarkers of cognitive dysfunction in pediatric obesity: associations between Executive Function, C-Reactive Protein, Interleukin 6, and Tumor Necrosis Factor alpha

2020 ◽  
Vol 4 (s1) ◽  
pp. 97-97
Author(s):  
Kathryn Prendergast ◽  
Caroline Keller ◽  
Shima Dowla ◽  
Marissa Gowey
Keyword(s):  
Executive Function ◽  
Chronic Disease ◽  
Tumor Necrosis Factor ◽  
Pediatric Obesity ◽  
Inflammatory Markers ◽  
Tumor Necrosis ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Necrosis Factor

OBJECTIVES/GOALS: Executive function (EF) deficits lead to poorer adherence and weight loss in obesity treatment. Conversely, untreated obesity leads to both EF impairments and risk of chronic disease. EF deficits in children with obesity have begun to be associated with biomarkers of chronic disease risk such as glucose and cortisol. Elevated pro-inflammatory biomarkers, such as C-Reactive Protein (CRP), Interleukin 6 (IL-6), and Tumor Necrosis Factor a (TNFa), indicate risk for obesity-associated chronic disease and may represent another candidate biomarker of EF deficits in pediatric obesity. These inflammatory markers tend to be elevated in obesity but have yet to be examined in association with EF in pediatric obesity. This represents an opportunity to identify potential biomarkers of EF which may serve as novel treatment targets that could improve outcomes and chronic disease prevention. Thus, the present study aims to explore associations between EF and blood serum CRP, IL-6, and TNFa. METHODS/STUDY POPULATION: Treatment-seeking children aged 8-12 years with BMI>95th percentile were recruited from a pediatric weight management clinic and attended baseline assessments for a family-based behavioral intervention program for pediatric obesity. Demographics and medical history were assessed via parent questionnaire. Height and weight were measured by research staff and converted to zBMI. Child performance-based EF was assessed via the NIH Toolbox Cognitive Battery iPad application. Blood draws, assays, and Dual-energy X-ray Absorptiometry (DXA; measuring adiposity) were conducted by trained research personnel. Pearson’s correlations were conducted to explore associations between EF (NIH Toolbox Cognitive Battery, fully corrected T-scores) and CRP, IL-6, and TNFa. RESULTS/ANTICIPATED RESULTS: Children (n = 12) were primarily female (76.5%) and African American (64.7%). Correlation coefficients between inflammatory markers and EF were highly variable (r = −0.39 to 0.52). CRP showed small, negative associations with Cognitive Flexibility (r = −0.39) and Inhibitory Control (r = −0.34). IL-6 also demonstrated a small, negative association with Inhibitory Control (r = −0.37). TNFa was positively and moderately associated with working memory (r = 0.53). Remaining associations were weak (−0.3<r<0.3). DISCUSSION/SIGNIFICANCE OF IMPACT: Signals of higher inflammation, measured via CRP and IL-6, in association with EF deficits were identified in a small sample of children with obesity, as hypothesized. However, signals in the opposite direction were identified as well, measured via TNFa. CRP and IL-6 may represent candidate biomarkers of executive dysfunction in obesity that warrant further domain and biomarker-specific research, with potential long-term implications for improving pediatric obesity treatment.

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