Whole Grain Consumption and Inflammatory Markers: A Systematic Literature Review of Randomized Control Trials

Whole grain foods are rich in nutrients, dietary fibre, a range of antioxidants, and phytochemicals, and may have potential to act in an anti-inflammatory manner, which could help impact chronic disease risk. This systematic literature review aimed to examine the specific effects of whole grains on selected inflammatory markers from human clinical trials in adults. As per the Preferred Reporting Items for Systematic Reviews (PRISMA) protocol, the online databases MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched from inception through to 31 August 2021. Randomized control trials (RCTs) ≥ 4 weeks in duration, reporting ≥1 of the following: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor (TNF), were included. A total of 31 RCTs were included, of which 16 studies recruited overweight/obese individuals, 12 had pre-existing conditions, two were in a healthy population, and one study included participants with prostate cancer. Of these 31 RCTs, three included studies with two intervention arms. A total of 32 individual studies measured CRP (10/32 were significant), 18 individual studies measured IL-6 (2/18 were significant), and 13 individual studies measured TNF (5/13 were significant). Most often, the overweight/obese population and those with pre-existing conditions showed significant reductions in inflammatory markers, mainly CRP (34% of studies). Overall, consumption of whole grain foods had a significant effect in reducing at least one inflammatory marker as demonstrated in 12/31 RCTs.

Effect of Non-surgical Periodontal Therapy on Levels of Inflammatory Markers in Gingival Crevicular Fluid and Serum of Patients With Breast Cancer and Periodontitis.

Purpose: studies have demonstrated the positive impact of non-surgical periodontal therapy (NSPT) on the control of local and systemic infection/inflammation in normosystemic and systemically compromised patients, represented by the improvement of periodontal clinical parameters and reduction in the levels of inflammatory markers in the gingival crevicular fluid (GCF), saliva and serum. This study aimed to evaluate periodontal clinical parameters and inflammatory mediators in GCF and serum, before and after NSPT, in patients with periodontitis and breast cancer, before chemotherapy. Methods: seventeen women with histopathological diagnosis of invasive ductal carcinoma and periodontitis were submitted to the evaluation of clinical periodontal parameters (plaque index – PI, bleeding on probing – BOP, probing depth – PD, clinical attachment level – CAL) and submitted to scaling and root planing (SRP), at an interval of 24 hours. At the beginning of the study (baseline), before NSPT, samples of tumor microenvironment fluid (TM), GCF and peripheral blood (serum) were collected for the determination of inflammatory markers IL-1β, TNF-α, TGF-β and IL-17, using the LUMINEX methodology. Seven days after SRP, new GCF and serum samples were obtained and analyzed.Results: TGF-β levels were significantly decreased in GCF and serum (p<0.05), while IL-17 concentrations were statistically reduced in GCF (p<0.05). Conclusion: NSPT decreased local and systemic inflammatory markers and may be an important tool in the multidisciplinary approach of women with breast cancer and periodontitis before chemotherapy.

The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample

Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70–90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (β = 0.16, p = 0.02; β = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness.

What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

Purpose: To investigate the role of inflammatory markers in predicting the spontaneous passage of ureteral stones. Methods: We retrospectively reviewed 279 patients with ureteral stones sized 4–10 mm that were managed conservatively. The patients were divided into two groups: Group 1 consisted of 137 patients who passed the stone spontaneously; Group 2 comprised 142 patients without spontaneous stone passage. The groups were compared using the Mann-Whitney U and chi-square tests. In addition, univariate and multivariate analyses were performed to identify the significance of the parameters. Results: The mean age of the patients was 41.2 years. The patients in Group 1 had a significantly lower mean stone size, white blood cell count and neutrophil count. In addition, stone location, presence of hydronephrosis and history of urolithiasis were significantly different between the groups. Neutrophil percentage, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were insignificantly lower in Group 1. In a multivariate analysis, stone size, distal location and hydronephrosis status significantly predicted the spontaneous stone passage. However, inflammatory markers including white blood cell count, neutrophil count and neutrophil-to-lymphocyte ratio could not determine the likelihood of spontaneous stone passage. Conclusion: Our results suggest that inflammatory markers are no meaningful parameters for the prediction of spontaneous stone passage.

Fatigue Is Common in Immunoglobulin G Subclass Deficiency and Correlates With Inflammatory Response and Need for Immunoglobulin Replacement Therapy

PurposeIndividuals with immunoglobulin G deficiency (IgGsd) often complain of fatigue. The correlation between systemic inflammation and fatigue is unknown. In this study perceived quality of life (QoL) and fatigue in individuals with IgGsd, on and off immunoglobulin replacement therapy (IgRT) were correlated to inflammatory markers in plasma to identify the subgroup that benefits from IgRT.MethodThirty-five IgGsd-patients were sampled on three occasions: at baseline, after being on IgRT for at least 18 months, and 18 months after discontinuation of IgRT. Short form 36, EQ-5D-5L visual analogue scale and fatigue impact scale questionnaires were used for evaluation of QoL and fatigue. Furthermore, a panel of 92 inflammatory markers were analysed in plasma. Thirty-two gender- and age-matched healthy individuals were included as controls and sampled on one occasion.ResultsQoL was lower and perceived fatigue higher in IgGsd compared to the controls. Severe fatigue and low QoL were associated with the need to restart IgRT (which is considered in IgGsd-individuals with a high burden of infections in Sweden). Twenty-five inflammatory factors were dysregulated in IgGsd and the plasma protein patterns were similar regardless of whether IgRT was ongoing or not. Enrichment analysis indicated IL-10 signalling as the most affected pathway. Severe fatigue was associated with decreased levels of the neurotrophic factors VEGFA and CSF-1.ConclusionFatigue is a major contributory factor to impaired health-related QoL in IgGsd and is related to the need for IgRT. Low-grade systemic inflammation is a potential driver of fatigue. In addition to the burden of infections, we suggest the degree of fatigue should be considered when the decision to introduce IgRT is made.

Do partnership dissolutions and living alone affect systemic chronic inflammation? A cohort study of Danish adults

BackgroundPartnership breakups and living alone are associated with several adverse health outcomes. The aim of this study, carried out in Denmark, is to investigate whether accumulated numbers of divorces/partnership breakups or years lived alone across 26 years of adult life are associated with levels of inflammation, and if vulnerability with regards to gender or educational level can be identified.Methods4835 participants from the Copenhagen Aging and Midlife Biobank (CAMB) aged 48–62 years were included. Data on accumulated numbers of partnership breakups and years living alone were retrieved from a national standardised annual register. Inflammatory markers interleukin 6 (IL-6) and high sensitivity C-reactive protein (hsCRP) were measured in blood samples. Multivariate linear regression analyses were adjusted for age, educational level, early major life events, body mass index, chronic diseases, medicinal intake affecting inflammation, acute inflammation and personality scores.ResultsFor men, an association was found between an increasing number of partnership breakups or number of years living alone and higher levels of inflammatory markers. No such association was found for women, and no evidence of partnership breakups and educational level having a joint effect was found for either gender.ConclusionThe findings suggest a strong association between years lived alone or accumulated number of partnership breakups and low-grade inflammation for middle-aged men, but not for women. Among those of either sex with a lower level of education, no specific vulnerability to accumulated years lived alone or number of breakups was identified.

Inflammation and mortality in COVID-19 hospitalized patients with and without type 2 diabetes

Background The aim of this study was to determine the relationship of inflammation with mortality in COVID-19 hospitalized patients and to assess if the relationship differed by strata of type 2 diabetes status. We hypothesized that the association of inflammation with mortality was different by type 2 diabetes status. Methods A case-control (died-survived) study of 538 COVID-19 hospitalized patients, stratified by diabetes status, was conducted at Columbia University Irving Medical Center. We quantified the levels of eight cytokines and chemokines in serum, including interferon(IFN)-α2, IFN-γ, Interleukin(IL)-1α, IL-1β, IL-6, IL-8/CXCL8, IFNγ-induced protein 10 (IP10)/CXCL10 and tumor necrosis factor α (TNF-α) using immunoassays. Logistic regression models were used to model the relationships of log-transformed inflammatory markers (or their principal components) and mortality. Results In multiple logistic regression models, higher serum levels of IL-6 (adjusted odds ratio (aOR):1.74, 95% confidence intervals (CI): (1.48, 2.06)), IL-8 (aOR: 1.75 (1.41, 2.19)) and IP10 (aOR: 1.36 (1.24, 1.51)), were significantly associated with mortality. This association was also seen in second principal component (PC) with loadings reflecting similarities among these three markers (aOR: 1.88 (1.54-2.31)). Significant positive association of these same inflammatory markers with mortality was also observed within each strata of diabetes. Conclusions We show that mortality in COVID19 patients is associated with elevated serum levels of innate inflammatory cytokine IL-6 and inflammatory chemokines IL-8 and IP10. This relationship is consistent across strata of diabetes, suggesting interventions targeting these innate immune pathways could potentially also benefit patients with diabetes.