Elevated plasma pentraxin-3 in polycystic ovary syndrome is associated with hyperandrogenism: a case-control study

Background Pentraxin 3 (PTX3) - a crucial humoral innate immunity component – is related to obesity and cardiovascular complications in women who suffer from polycystic ovary syndrome (PCOS). However, the circulating PTX3 level in PCOS is still debated. In this study, we aimed to evaluate PTX3 plasma levels in PCOS women of childbearing age, and find possible endocrine/metabolic factors that could affect this level. Methods A total of 360 women were enrolled: 120 PCOS women and 240 body mass index (BMI) matched normally ovulating women. Blood samples were collected on the third day of natural menstrual cycle or from the bleeding after progesterone withdrawal. The PTX3 concentration was measured by immunoassay. Results The PTX3 plasma level was significantly higher in PCOS women compared to controls. There was a positive correlation between PTX3 plasma level and PCOS diagnosis, overweight, cycle length, serum LH to FSH ratio, estradiol, total testosterone (TT) on the third day of menstrual cycle, antral follicle count (AFC), as well as uric acid. Multivariant linear regression analysis indicated that participants’ serum PTX3 levels were proportional to the circulating TT level, existence of PCOS, basal estradiol level and AFC. Conclusions Overall, the circulating PTX3 level was elevated in PCOS women and significantly associated with the presence of hyperandrogenism. This study provided the basis for further in-depth researches regarding PTX3 role in PCOS pathophysiology.

The role of Pentraxin3 in plasma and bronchoalveolar lavage fluid in COPD patients with invasive pulmonary aspergillosis

BACKGROUND The use of galactomannan testing in plasma and bronchoalveolar lavage fluid (BALF) has improved diagnosis of invasive pulmonary aspergillosis(IPA) in COPD patients; However, the high false positive rate leads to overdiagnosis. This study aimed to investigate the diagnostic value of PTX3 in COPD patients with invasive pulmonary aspergillosis. METHODS A total of 165 patients initially suspected of COPD with invasive pulmonary aspergillosis were included in the study. Among these, 35 cases were proven or probable to be invasive pulmonary aspergillosis (35 plasma samples and 28 BALF samples). The remaining 130 cases were non-aspergillosis controls(130 plasma samples and 83 BALF samples). PTX3 levels and GM were measured by enzyme-linked immunosorbent assay. Results Median plasma and BLAF PTX3 level was significantly higher in COPD patients with invasive pulmonary aspergillosis compared with non-aspergillosis patients (3.74 [2.57–5.61]ng/ml vs 1.29[0.62–2.88] ng/ml,P < 0.001; 3.88[2.28–8.29]ng/ml vs 1.58[0.85–2.13]ng/ml, P < 0.001). When the plasma GM/PTX3 and BALF GM/PTX3 assays were used for patients included in the study, the sensitivity/specificity value were 60%/77.1%/78.6%/89.3%, 73.8%/69.2%/80.7%/77.1%, respectively. Thus, The sensitivity of PTX3 in plasma and BLAF was higher than that of GM. However, There was no significant difference in the specificity of PTX3 and GM between the IPA group and non-aspergillosis group. When PTX3 and GM were both positive in plasma or BLAF, the specificity for the diagnosis of pulmonary aspergillosis can reach more than 90%. Conclusions BALF and plasma PTX3 measurements were significantly higher among patients with IPA. The sensitivity of PTX3 was superior to GM in the diagnosis of IPA in COPD patients. The combination of GM and PTX3 is beneficial to the diagnosis of IPA in COPD patients.

Investigation of IgG anti-oxLDL antibody levels and HDL and LDL subclasses in patients with ST-segment elevation acute myocardial infarction

IntroductionDyslipidemia, inflammation and immunological processes play a key role in the development of atherosclerosis. This study investigates the relationship of different phenotypes of low-density lipoprotein (LDL) and high-density lipoprotein (HDL), human antibodies G classes against oxLDL (IgG anti-oxLDL antibodies) and inflammatory marker pentraxin-3 (PTX3) in patients with ST-segment elevation acute myocardial infarction (STEMI). Among STEMI patients with different Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score, we analyzed predictive abilities of these biomarkers to assess disease outcome.Material and methodsIn 69 STEMI, 21 patients with stable angina pectoris (AP) and 67 healthy controls, IgG anti-oxLDL antibodies and PTX3 were determined by ELISA. Gradient gel electrophoresis was used for lipoprotein subclasses separation.ResultsWe found significantly lower HDL and LDL diameters (p<0.001 and p<0.001, respectively) and higher PTX3 concentration (p<0.001) in patients than in controls. Control subjects with small-sized HDL and LDL B phenotype had significantly higher IgG anti-oxLDL antibody levels (p=0.015), whereas STEMI patients with the same profile had higher PTX3 concentration (p=0.005). STEMI patients with intermediate SYNTAX score had lower levels of IgG anti-oxLDL antibodies (p=0.008). Multivariate logistic regression analysis showed that smaller LDL diameter was an independent predictor of intermediate SYNTAX score (OR=0.370; p=0.019).ConclusionsSmaller LDL and HDL particles are associated with elevated IgG anti-oxLDL antibodies in healthy subjects, but with increased PTX3 level in STEMI patients. In addition, we found that smaller LDL size was independent predictor of higher SYNTAX score. Further studies are needed to expand our preliminary observations.

Increased Pentraxin 3 Levels Correlate With IVIG Responsiveness and Coronary Artery Aneurysm Formation in Kawasaki Disease

Kawasaki disease (KD) is a febrile disease of childhood characterized by systemic vasculitis that can lead to coronary artery lesions (CAL). This was a prospective cohort study to determine the levels of the pentraxin 3 (PTX3), soluble CD24-Subtype (Presepsin) and N-terminal pro-brain natriuretic peptide (NT-pro BNP) in consecutive KD patients. From January 2013 to March 2015, all patients with KD admitted to Aichi Medical University Hospital who provided consent had their plasma saved before IVIG administration. In total, 97 cases were registered. 22 cases of incomplete KD were excluded from the outcome analysis. The total 75 cases were used for statistical analyses. A PTX3 threshold of &gt;7.92 ng/ml provided a specificity of 88.5 %, a sensitivity of 94.4 %, and a likelihood ratio as high as 15.92 for the diagnosis of KD compared with febrile non-KD controls. Although an echocardiographic diagnosis of CAL in the early course of the disease was confirmed in 24 cases, it was not in the remaining 51 cases. Neither NT-proBNP nor Presepsin had statistical significance for the prediction of the echocardiographic CAL diagnosis. Only PTX3 was significantly predictive of the echocardiographic CAL diagnosis (p=0.01). The PTX3 level was significantly higher in the intravenous immunoglobulin (IVIG) non-responders (45.9±7.45) than in the IVIG responders (17.0 ± 1.46 ng/ml) (p&lt; 0.001). The PTX3 level also correlated with the number of IVIG treatment courses needed to resolve fever (R² =0.64). Persistent CAL (pCAL) formation was observed in three cases; one of aneurysm only and two aneurysms with dilatations. The patients with pCAL had significantly higher PTX3 levels (85 ± 8.4 ng/ml) than patients without pCAL (22 ± 2.2 ng/ml) (p&lt; 0.0001). In terms of pCAL prediction, the area under the curve (AUC) of receiver operating characteristic ROC curve of PTX3 was 0.99, and it was significantly greater than that of Presepsin (0.67) or NT-proBNP (0.75). PTX3 is a soluble pattern recognition molecule that acts as a main component of the innate immune system. These data suggest that PTX3 can be utilized as a definitive biomarker for the prediction of IVIG resistance and subsequent CAL formation in patients with KD.

Elevated ovarian pentraxin 3 in polycystic ovary syndrome

Purpose Pentraxin 3 (PTX3) plays a crucial role in cumulus expansion and fertilization. The ovarian PTX3 level in polycystic ovary syndrome (PCOS) remains uncertain. In the present study, we investigated the follicular PTX3 levels and found the influence of reproductive hormones on ovarian PTX3 concentration. Methods This study was based on 204 healthy-weight women (102 PCOS and 102 normal ovulating subjects) undergoing in vitro fertilization (IVF). Follicular fluid (FF) was collected during oocyte retrieval. The PTX3 levels and other hormone levels in FF samples were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The PTX3 level in the follicle was significantly higher in the healthy-weight PCOS women than controls. Positive correlations were found between ovarian PTX3 level and the existence of PCOS, cycle length, basal LH to FSH ratio and TT in serum, antral follicle count, and ovarian insulin and androgen level, and inverse correlations with the basal serum PRL and ovarian SHBG. In multivariant linear regression analysis, the presence of PCOS diagnosis, participants’ basal LH to FSH ratio, and ovarian androstenedione level were the main predictors of ovarian PTX3 level among the enrolled subjects. Conclusion Elevated ovarian PTX3 level supports the low-grade chronic inflammatory state in the follicles of PCOS. The existence of PCOS, disturbed pituitary gland, and ovarian hyperandrogenism might also be related to this state of low-grade chronic inflammation and could be a subject of further study.

Pentraxin 3 is more accurate than C-reactive protein for Takayasu arteritis activity assessment: A systematic review and meta-analysis

Aims Whether the circulating levels of pentraxin 3 (PTX3), an acute phase reactant (APR), are higher in active Takayasu arteritis (TAK), and if so, whether PTX3 is more accurate than C-reactive protein (CRP) in TAK activity assessment has been investigated in this study. Study design Research works such as PubMed, Embase, ScienceDirect, Cochrane Library, and two Chinese literature databases (CNKI and WanFang) were searched for studies conducted till August 30th, 2019. Two investigators searched the studies independently, who evaluated the quality of the study using the Newcastle–Ottawa scale (NOS) and extracted data. Pooled standard mean difference (SMD) and diagnostic indexes, with a 95% confidence interval (CI), were calculated using a random-effect model. Results Totally, 8 studies involving 473 TAK (208 active and 265 inactive TAK) patients and 252 healthy controls were eventually included in the meta-analysis. PTX3 level in the blood in active TAK patients were found to be higher than that in dormant TAK with pooled SMD of 0.761 (95% CI = 0.38–1.14, p<0.0001; I2 = 68%, p of Q test = 0.003). And there was no publication bias. Among the 8 studies, 5 studies identified active TAK with both PTX3 and CRP. The pooled sensitivity, specificity, and AUC values of PTX3 in active TAK diagnosis were higher than those of CRP (0.78 [95% CI = 0.65–0.87] vs. 0.66 [95% CI = 0.53–0.77], p = 0.012; 0.85 [95% CI = 0.77–0.90] vs. 0.77 [95% CI = 0.56–0.90], p = 0.033; 0.88 [95% CI = 0.85–0.90] vs. 0.75 [95% CI = 0.71–0.79], p < 0.0001). It showed potential publication bias using Egger’s test (p of PTX3 = 0.031 and p of CRP = 0.047). Conclusions PTX3 might be better than CRP in the assessment of TAK activity. Yet, it should be cautious before clinical use for moderate heterogeneity and potential publication bias of the meta-analysis.

ELEVATED SERUM PENTRAXIN-3 LEVELS IS POSITIVELY CORRELATED TO DISEASE SEVERITY AND COAGULOPATHY IN COVID-19 PATIENTS

BACKGROUND Coronavirus disease 2019 (COVID-19) is highly contagious and deadly and is associated with coagulopathy. Pentraxin-3(PTX3) participates in innate resistance to infections and plays a role in thrombogenesis. PURPOSE The present study aimed to investigate the role of PTX3 in coagulopathy in patients with COVID-19. METHODS A retrospective study including thirty-nine COVID-19 patients enrolled in Hunan, China were performed. The patients were classified into the D-dimer_L (D-dimer?1mg/L) and D-dimer_H (D-dimer?1mg/L) groups basing on the plasma D-dimer levels on admission. Serum PTX3 levels were detected by enzyme-linked immunosorbent assays and compared between those two groups, and then linear regression models were applied to analyze the association between PTX3 and D-dimer. RESULTS Our results showed that serum PTX3 levels (median values, 10.21 vs 3.36, P < 0.001), chest computerized tomography scores (median values, 10.0 vs 9.0, P < 0.05), and length of stay (16.0±4.2 vs 10.7±3.6, P = 0.001) in the D-dimer_H group were significantly higher than that in D-dimer_L group. The coefficient of determination for PTX3 was 0.651 (P < 0.001) in the D-dimer_H group. CONCLUSION Serum level of PTX3 was positively correlated with disease severity and coagulopathy. Detection of serum PTX3 level could assist to identify severer patients on admission and may be a potential therapeutic target for coagulopathy in patients with COVID-19.

The Roles of Pentraxin-3 to Predict In-Hospital and Three Months Major Adverse Cardiac Event in Acute Myocardial Infarction

Background: Pentraxin-3 (PTX3) was a useful marker for localized vascular inflammation and damage in the cardiovascular system. Recent studies have shown that plasma PTX3 is elevated in patients with myocardial infarction; however, its prognostic value still remains unclear. Aims: This study aimed to investigate the relationship between PTX3 and in-hospital and three months of a major adverse cardiac event (MACE) in acute ST-elevation and non-ST-elevation myocardial infarction patients. Methods: This cohort study conducted from September 1st, 2018 to October 31st, 2019 in Dr. Moewardi Hospital. A 144 patient were observed during hospitalization and 130 survived patient were follow up for three months. The admission PTX3 was compared between the patient with and without MACE. Higher levels of PTX3 were defined as concentrations greater than the optimal cut-off value derived from the Receiver Operating Characteristic (ROC) curve. Results: Among patients, 43.75% was anterior STEMI, 35.42% was inferior STEMI, and 20.38% was NSTEMI with median PTX3 level was 8.16 (0.21-69.35) ng/mL. The in-hospital MACE occurred in 52% of patients, while three months of MACE occurred in 17% patient. Patients with MACE had a higher level of PTX3 compared without MACE (p<0.001) during hospitalization, but not in three months follow up (p=0.408). Multivariate analysis also shown PTX3 was as a predictor of in-hospital MACE (OR 1.127; p=0.001), along with heart rate (OR 1.025; p=0.015). There are different of in-hospital MACE between the patient with high (≥8.247 ng/mL) and low (<8.225 ng/mL) PTX3 level with a hazard ratio (HR) 2.142 (95%CI 1.315-3.487; p=0.002), but the result did not similar after three months follow up (p=0.373). Conclusion: The PTX3 can be used as a predictor of in-hospital MACE but not for three months follow up.

P4612Elevated pentraxin-3 level is associated with impaired post procedural myocardial perfusion assessed by quantitative blush evaluator in patients with acute STEMI undergoing primary PCI

Background Long Pentraxin-3 (PTX3) has been known as an emerging cardiac biomarker and has potential diagnostic and prognostic value in coronary heart disease. Whether plasma PTX3 level is associated with post procedural myocardial perfusion assessed by quantitative blush evaluator (QuBE) in acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is unknown. Purpose This study sought to evaluate the association between plasma PTX3 level and post procedural myocardial perfusion assessed by QuBE in patients with acute STEMI undergoing primary PCI. Methods We enrolled 217 patients with acute STEMI who underwent primary PCI (men=191, women=26). Post procedural myocardial perfusion was evaluated using QuBE. PTX3 level was measured at admission by an ELISA method. We used 0.33 ng/mL for PTX3 level as a cut off point for future worse clinical outcome as shown by previous study. Impairment of myocardial perfusion was defined as QuBE <9 arbitrary unit as also shown by previous studies. Results Plasma PTX3 level had an inverse correlation with QuBE score (r=−0.64, p<0.001). Patients in elevated PTX3 group (≥0.33 ng/mL; N=80) had lower median QuBE score compared with lower PTX3 group (<0.33ng/mL; N=137), with QuBE score (8.6 arbitrary unit vs. 15.1 arbitrary unit, P<0.001). Multivariate logistic analysis showed that plasma PTX3 level ≥0.33 ng/mL (OR=7.65, p<0.001) along with Diabetes Mellitus (OR=2.30, p=0.04), and Killip class II-IV (OR=2.57, p=0.04) were independent predictors of impaired myocardial perfusion, as shown by QuBE score <9 arbitrary unit. Analysis between PTX3 and low QuBE score Variables Multivariate OR (95% CI) P value PTX3 ≥0.33 ng/mL 7.65 (3.37–17.36) <0.001 Diabetes Mellitus 2.30 (1.01–5.23) 0.04 Hypertension 1.15 (0.47–2.82) 0.75 Killip class II-IV 2.57 (1.04–6.35) 0.04 IRA LAD 3.79 (1.64–8.78) 0.002 Thrombus grade 4 & 5 3.36 (1.06–11.98) 0.04 Post PPCI TIMI flow <3 5.29 (2.09–13.36) 0.001 PTX3, pentraxin-3; QuBE, quantitative blush evaluator; IRA, infarct related artery. Conclusions Patients with acute STEMI with high plasma PTX3 level were associated with reduced myocardial perfusion after primary PCI shown by low QuBE score. Elevated PTX3 level may be used as a marker for persistent impairment of myocardial perfusion after primary PCI in STEMI

Pentraxin Level is the Key to Determine Primary Percutaneous Coronary Intervention (PCI) or Fibrinolysis

<P>Aims: To examine if pentraxin can help identify patients benefitting most from primary Percutaneous Coronary Intervention (PCI) vs. fibrinolysis. </P><P> Methods: Patients with acute ST-Elevation Myocardial Infarction (STEMI) were consecutively recruited from a community center without PCI and a tertiary center with PCI facilities. Left ventricular ejection fraction (LVEF) was determined echocardiographically at baseline and 5 days after the index admission; the difference between two measurements was considered as the magnitude of improvement. We used regression models to test the hypothesis that the magnitude of the advantage of PCI over fibrinolysis in preserving LVEF 5 days after STEMI is modified by pentraxin 3 (PTX3). </P><P> Results: The functional advantage (LVEF) of the PCI over fibrinolysis has been determined by PTX3. LVEF was attenuated and even reversed as PTX3 level increased. The primary PCI of the participants with less than 7 ng.ml-1 PTX3 level, achieved a clinically significant increase in the LVEF as compared to fibrinolysis. At lower levels of PTX3, PCI shows a conspicuous advantage over fibrinolysis in terms of the probability of developing an LVEF <40%. </P><P> Conclusion: We demonstrated not only the functional advantage of PCI over fibrinolysis performed within the recommended time frames but also the relative advantage of its relevance to the baseline PTX3 levels. PTX3 can play a role in determining the choice of best therapy. More than 75% of patients with STEMI who have PTX3 levels ≤7 ng.ml-1 imply the need of PCI.</P>