Serum amyloid A in children and adolescents: association with overweight and carotid intima-media thickness

ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.

Effects of Xixin Decoction （洗心汤） on the Diversity of Intestinal Flora and Levels of Aβ1-42，LPS，SAA，and ACH in Brain and Intestinal Tissues of Rapidly Aging Model Mice / 中医杂志

ObjectiveTo observe the possible mechanism of Xixin Decoction （洗心汤， XXD） in the prevention and treatment of Alzheimer 's disease（AD）. MethodsFifty rapid aging model mice （SAMP8） were randomly divided into model group， probiotic group， high-， moderate- and low-dose group of XXD， with 10 mice in each group. Another 10 homologous anti-rapid aging mice （SAMR1） were set as control group. After 10 weeks of feeding， the control group and the model group were given 10 ml·kg-1·d-1 of distilled water by gavage， while the probiotic group （0.39 g·kg-1·d-1）， the high-dose group of XXD （5.08 g·kg-1·d-1）， the moderate-dose group of XXD （2.54 g·kg-1·d-1）， and the low-dose group of XXD （1.27 g·kg-1·d-1） were given corresponding drugs or decoctions by gavage， once a day in all groups. After 10 weeks of intragastric administration， Morris water maze was used to detect the spatial learning and memory ability of mice in each group. HE staining was used to observe the pathological changes of hippocampal CA3 region and colon. The levels of β-amyloid 1-42 （Aβ1-42）， lipopolysaccharide （LPS）， serum amyloid A （SAA） and acetylcholine （ACH） in hippocampus and colon were detected by ELISA.The diversity of intestinal flora in mouse feces was detected by 16S rRNA sequencing. ResultsCompared to those in the control group， the levels of Aβ1-42，LPS， SAA increased， while the level of ACH decreased in the model group （P＜0.05 or P＜0.01）. Compared to those in the model group， the escape latency period of the probiotic group was significantly shortened on the 2nd and 5th days， while the escape latency period was shortened， and the residence time in the target platform quadrant increased in the high-dose XXD group during the 2nd to 5th days； the escape latency period was shortened significantly in the moderate-dose XXD group on the 5th day （P＜0.05 or P＜0.01）. Compared to those in the model group， the hippocampal neuron cells in the high- and moderate-dose XXD groups were arranged more closely， with decreased levels of SAA， Aβ1-42 and LPS， increased ACH level， Simpson and Shannon index （P＜0.05 or P＜0.01）； the arrangement of hippocampal neuron cells in the probiotic group and the low-dose XXD group was relatively loose； the proportions of Bacteroidetes and Prevotella were significantly reduced in the probiotic group and the high-dose XXD group， while that of Firmicutes and Lactobacillus significantly increased （P＜0.05 or P＜0.01）. Compared to those in the probiotic group and the high-dose XXD group， the number of goblet cells in the moderate-dose XXD group decreased， and the number of glands in the low-dose XXD group decreased with atrophy. The high-dose XXD group had decreased Aβ1-42 level in the hippocampus， increased ACH level in thehippocampus and colon tissue， and decreased SAA in the colon tissue than the moderate- and low-dose XXD groups （P＜0.05 or P＜0.01）； moreover， the SAA level in the hippocampus was significantly higher in the low-dose XXD group than the high- and moderate-dose groups （P＜0.01）. ConclusionXXD can improve the spatial learning and memory ability of SAMP8， reduce the production and deposition of LPS， SAA and Aβ1-42 in brain and intestine， and increase the content of ACH. The mechanism of its prevention and treatment of AD maybe related to regulating intestinal microecology， affecting flora diversity and improving inflammatory response.

The level and significance of CD64 index, matrix metalloproteinase-9 and serum amyloid A in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae infection / 中国医师杂志

Objective:To investigate the level and significance of CD64 index, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae (CRE) infection.Methods:A total of 61 patients with severe CRE infection who were admitted to the neurosurgery department of Kashgar First People′s Hospital from January 2019 to January 2022 were selected as the CRE group, and 100 patients with severe carbapenem sensitive Enterobacteriaceae (CSE) infection were selected as the CSE group. The difference in clinical data between the two groups was compared, and the difference in clinical data between the dead and surviving patients in the CRE group was compared. The value of CD64 index, MMP-9 and SAA in differential diagnosis of CRE was analyzed. Logistic regression was used to analyze the influencing factors of prognosis in patients with CRE infection.Results:The age, hypertension, lung disease, liver and kidney disease, comorbidities≥2, antibiotic use≥2 combinations, antibiotic use time>10 days, proportion of carbapenem use, CD64 index, MMP-9, and SAA of the CRE group patients were significantly higher than those of the CSE group patients (all P<0.05). The area under the receiver operating characteristic (ROC) curve for CD64 index, MMP-9, and SAA differential diagnosis of CRE was 0.857, 0.701, and 0.655, respectively (all P<0.05). In the CRE group, the age , the score of Acute Physiological and Chronic Health Status Ⅱ (APACHE Ⅱ) score at admission, diabetes, liver and kidney diseases, comorbidities≥2, the proportion of carbapenems, CD64 index, MMP-9 and SAA of dead patients were significantly higher than those of survivors (all P<0.05). Logistic regression analysis showed that age, APACHE Ⅱ score at admission, comorbidities≥2, CD64 index, MMP-9, and SAA were influencing factors for the prognosis of severe CRE patients (all P<0.05). Conclusions:The peripheral blood CD64 index, MMP-9, and SAA have certain application value in the diagnosis of neurological severe CRE infection, and are also influencing factors for the prognosis of CRE infected patients.

The serum levels of FCGBP, SAA1, CXCL10 in children with mycoplasma pneumoniae pneumonia and their relationship with prognosis / 中国医师杂志

Objective:To investigate the serum levels and clinical significance of Fc fragment of the IgG-binding protein (FCGBP), serum amyloid protein A1 (SAA1), and CXC chemokine ligand 10 (CXCL10) in children with mycoplasma pneumoniae pneumonia (MPP) and their relationship with prognosis.Methods:A prospective study was conducted on 122 children with MPP admitted to the department of pediatrics of the 970th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from January 2019 to December 2021. According to the severity and prognosis of MPP, they were divided into mild and severe groups, good prognosis group, and poor prognosis group. Forty healthy children who underwent physical examination during the same period were set as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of FCGBP, SAA1, and CXCL10 in each subject, and to compare the differences in serum levels of FCGBP, SAA1, and CXCL10 among different groups. Multivariate logistic regression analysis was used to investigate the influencing factors of poor prognosis in MPP patients. The diagnostic value of individual and combined detection of serum procalcitonin (PCT), FCGBP, SAA1, and CXCL10 for poor prognosis in MPP children by analyzing the receiver operating characteristic (ROC) curve.Results:The levels of serum FCGBP [(115.68±10.57)ng/ml, (78.41±6.73)ng/ml, (12.55±3.25)ng/ml], SAA1 [(34.18±3.72)mg/L, (25.54±2.63)mg/L, (6.74±0.82)mg/L], and CXCL10 [(714.26±55.64)ng/L, (353.74±42.67)ng/L, (106.25±12.92)ng/L] in the severe MPP group were significant higher than those in the mild MPP group and the control group, with statistical significance (all P<0.05). The white blood cell (WBC), neutrophil percentage, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), PCT, lactate dehydrogenase (LDH), D-dimer (D-D), FCGBP, SAA1, CXCL10 of the children in the poor prognosis group were significantly higher than those in the good prognosis group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that increased PCT ( OR=1.603, 95% CI: 1.190-2.160), FCGBP ( OR=1.757, 95% CI: 1.115-2.770), SAA1 ( OR=1.900, 95% CI: 1.327-2.720) and CXCL10 ( OR=1.704, 95% CI: 1.212-2.397) were independent risk factors for poor prognosis of MPP children (all P<0.05). The combined detection of serum PCT, FCGBP, SAA1, and CXCL10 had a significantly higher diagnostic value for the risk of poor prognosis in children with MPP than a single indicator. Conclusions:The elevated levels of serum FCGBP, SAA1, and CXCL10 in children with MPP are associated with the severity of MPP and are independent risk factors for poor prognosis in MPP patients.

Correlation between sputum culture results and serum levels of C-reactive protein, amyloid A and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective:To investigate the correlation between sputum culture results and serum levels of C-reactive protein, amyloid A, and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 131 older adult patients with AECOPD who received treatment in the Affiliated Hospital of Shaoxing University between January 2019 and January 2021 were retrospectively analyzed. According to sputum culture results, these patients were divided into a sputum culture positive group ( n = 52) and a sputum culture negative group ( n = 79). The sputum of patients was collected aseptically for isolation and identification of pathogens. The general data [age, gender, history of smoking, underlying diseases (hypertension, diabetes mellitus, coronary heart disease), albumin level, mechanical ventilation, method of sputum suction, duration of antibiotics medication, length of hospital stay] were recorded for each group. The risk factors for positive sputum culture were analyzed using binary logistic regression techniques. The efficiency of serum levels of C-reactive protein, amyloid A, and procalcitonin for predicting positive sputum culture was analyzed using the receiver operating characteristic curve. Results:There were 67 strains of pathogens isolated from 52 older adult patients with positive sputum culture of AECOPD. The main pathogens were Gram-negative bacteria (67.16%) [Klebsiella pneumonia (31.34%)], followed by Gram-positive bacteria (25.37%) and fungi (7.47%). Logistic regression analysis showed that mechanical ventilation ( OR = 2.75, P = 0.020), usage of broad-spectrum antibiotics ( OR = 2.95, P = 0.012), serum C-reactive protein level ≥ 20.96 mg/L ( OR = 2.44, P = 0.007), serum amyloid A level ≥ 18.03 mg/L ( OR = 2.67, P = 0.016) and serum procalcitonin level ≥ 2.08 μg/L ( OR = 2.51, P = 0.013) were independent risk factors of positive sputum culture in older adult patients with AECOPD. The receiver operating characteristic curve analysis showed that the area under the receiver operating characteristic curve depicting serum levels of C-reactive protein, amyloid A, and procalcitonin in combination for predicting AECOPD was 0.896, which is of predictive efficiency for positive sputum culture ( P < 0.05). Conclusion:The sputum culture pathogens in older adult patients with AECOPD are mainly Gram-negative bacteria. Increased serum levels of C-reactive protein, amyloid A, and procalcitonin are independent risk factors for Gram-positive bacteria. Combined detection of serum levels of C-reactive protein, amyloid A, and procalcitonin is highly efficient in the diagnosis of AECOPD and can be used to evaluate the sputum culture results in older adult patients with AECOPD.

Diagnóstico de amiloidosis renal AA mediante espectrometría de masas en un paciente con proceso inflamatorio crónico grave abdominal

Introducción la amiloidosis es una enfermedad rara, producto del plegamiento y depósito normal de proteínas en tejidos y órganos. Esta enfermedad puede tener un compromiso renal que se manifiesta con síndrome nefrótico y deterioro de la función renal y su etiología puede estar asociada a amiloidosis con compromiso sistémico, siendo la amiloidosis AL y la amiloidosis AA las más frecuentes, esta última está asociada a inflamación crónica grave de origen infecciosa o autoinmune. Para el diagnóstico es fundamental el estudio sistémico multidisciplinario (hematológico, cardiaco, autoinmune, infeccioso y neoplásico), y cuando hay compromiso renal: la biopsia con estudio completo de microscopía de luz, tinciones especiales incluyendo rojo congo, inmunofluorescencia y microscopía electrónica. Cuando no se logra establecer la causa, la espectrometría de masas es una ayuda crucial para el diagnóstico específico. Objetivo se presenta el caso de un paciente con un proceso inflamatorio crónico grave abdominal que evolucionó a síndrome nefrótico por amiloidosis AA, donde la espectrometría de masas ayudó a aclarar el diagnóstico. Presentación del caso se presenta el caso de un paciente con un proceso inflamatorio crónico grave abdominal que evolucionó a síndrome nefrótico por amiloidosis AA, donde la espectrometría de masas ayudó a aclarar el diagnóstico Discusión y conclusiones se considera que la espectrometría de masas es un estudio diagnóstico muy importante para establecer el diagnóstico etiológico de la amiloidosis cuando otros métodos no han logrado establecerlo.

Introduction Amyloidosis is a rare disease, resulting from the accumulation and deposition of insoluble proteins in tissues or organs. This disease may involve the kidney, resulting in nephrotic syndrome and renal failure. The amyloidosis has been associated with systemic involvement, with AL amyloidosis and AA amyloidosis being the most common. The last is associated with various inflammatory disorders as chronic infections and autoimmune diseases. A multidisciplinary approach is required to the diagnosis (hematologic, cardiac, autoimmune, infectious, neoplastic) and in cases of renal involvement, a kidney biopsy with complete study of light microscopy, special stains including congo red, immunofluorescence, electron microscopy is essential for diagnosis. In cases where the cause cannot be stablished, mass spectrometry is practical tool to the identification of the correct type of amyloidosis. Purpose Here, we present a patient with a chronic and severe abdominal inflammatory process that progressed to a nephrotic syndrome due to AA amyloidosis, in which mass spectrometry helped to clarify the diagnosis. Case presentation Here, we present a patient with a chronic and severe abdominal inflammatory process that progressed to a nephrotic syndrome due to AA amyloidosis, in which mass spectrometry helped to clarify the diagnosis Discussion and conclusion Mass spectrometry is considered a useful diagnostic test to confirm the etiology of amyloidosis, especially if other methods are insufficient to establish it.

Predictive value of serum amyloid A/albumin level in activity and prognosis of systemic lupus erythematosus / 中国医师杂志

Objective:To investigate the predictive value of serum amyloid A/albumin (SAA/ALB) in the activity and prognosis of systemic lupus erythematosus (SLE).Methods:97 SLE patients initially diagnosed in Jincheng People′s Hospital from January 2018 to December 2020 were selected. According to whether the SLE disease activity index (SLE-DAI) was ≥5, SLE patients were divided into active and stable periods. The clinical data of active and stable SLE patients were compared. The independent influencing factors of active SLE were analyzed by logistic regression. The predictive value of SAA, ALB, SAA/ALB on active SLE and severe active SLE was analyzed by receiver operating characteristic(ROC) curve; Kaplan Meier survival curve was used to analyze the prognosis of patients with different SAA/ALB.Results:There were 97 SLE patients, including 64 in active phase and 33 in stable phase.Compared with the stable phase, the SLE-DAI, alanine aminotransferase (ALT) and α-Hydroxybutyrate dehydrogenase (α- HBDH), lactate dehydrogenase (LDH), SAA, SAA/ALB≥0.52 mg/g, urinary microalbumin/creatinine (ACR) in SLE patients of active phase were all higher, while the ALB, albumin/globulin (A/G) and complement (C3) levels were all lower, with statistically significant difference (all P<0.05). LDH, SAA/ALB ≥0.52 mg/g, A/G≥1.18 and C3≥0.60 g/L were all independent influencing factors of active SLE, and the OR were 1.321, 1.401, 0.744 and 0.663 respectively (all P<0.05). The area under the curve (AUC) of SAA and SAA/ALB in predicting active SLE were 0.755 and 0.861, respectively. AUC SAA/ALB>AUC SAA, with statistically significant difference ( P<0.05). The AUC of ALB in predicting stable SLE was 0.743. The AUC of SAA and SAA/ALB in predicting severe active SLE were 0.699 and 0.746, respectively. AUC SAA/ALB>AUC SAA, with statistically significant difference ( P<0.05). The AUC of ALB in predicting non severe active SLE was 0.671. Among the 64 active SLE patients, 21 had poor prognosis. The AUC of poor prognosis predicted by SAA/ALB was 0.736, and the best cut-off value was 0.78 mg/g. There was significant difference in the duration of remission between the high and low SAA/ALB groups (χ 2=6.507, P<0.05). Conclusions:SAA/ALB ≥0.52 mg/g was an independent factor for active SLE. SAA/ALB had a high predictive value for active SLE, severe active SLE and poor prognosis.

Value of serum amyloid protein dynamic changes on evaluating condition and prognosis of patients with viral and mycoplasma community-acquired pneumonia / 中华危重病急救医学

Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.

Progress of serum amyloid A in diagnosis and treatment of neonatal infectious diseases / 国际儿科学杂志

Neonatal infection related diseases are the main causes of neonatal death and disability.Traditional inflammatory factors, such as peripheral blood leucocyte count, C-reactive protein and procalcitonin play an important role in indicating neonatal infectious diseases.However, its sensitivity, specificity and effectiveness still need to be improved.Many studies have shown that the expression of serum amyloid A(SAA)increase significantly in various infectious diseases of neonates, and it has received more and more attention as a new type of infection-related indicator.This article reviews the research progress on the structural characteristics of serum amyloid A, detection methods and its clinical application in various neonatal infectious diseases, follow-up of disease changes, guidance of antibiotic use and evaluation of prognosis.

Serum amyloid A 3 deficiency improves cognitive impairment and attenuates tau pathology in mouse model of Alzheimer′s disease / 中国药科大学学报

@#To explore the effects of serum amyloid A (SAA) on the cognitive function and tau phosphorylation in Alzheimer''s disease (AD), two mouse models of AD were constructed: one is the APP/PS1 double transgenic mice mated with the Saa3 knockout (Saa3-/-) mice, and the other involves intracerebroventricular (ICV) injection of streptozotocin (STZ) into WT and Saa3-/- mice.The expression of Saa3 in mouse brain was evaluated using immunofluorescence staining.The body weight of STZ injection mice during modeling was measured.The motor coordination and balance, spontaneous exploratory activity, and anxiety level of these mice were assessed by Rotarod test, open field, and elevated plus maze, respectively.Spatial reference learning and memory were evaluated by Morris water maze.Western blot was used to detect the phosphorylation level of tau protein in mouse brain tissue.The results showed that the expression of Saa3 was increased in the brain of AD mice.The Saa3 gene deletion had no significant effect on motor coordination, balance and spontaneous exploratory activity in these mice, yet with alleviated anxiety level of AD model mice.Saa3 deficiency improved the impairment of learning and memory function of intracerebroventricular STZ injection mice and APP/PS1 mice. Deletion of Saa3 relieved the hyperphosphorylation of tau protein at specific sites in the brain of AD mice. The difference between the groups was statistically significant (P < 0.05). These results suggest that Saa3 is associated with cognitive function and tau pathology in AD, and that the inhibition of SAA may be a new strategy for the treatment of AD.

Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis

Abstract Background Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. Objectives To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. Methods This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. Results Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). Study limitations This was a single-center study with relatively limited numbers of patients and controls. Conclusions The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

Evaluation of factors for predicting risk of uveitis recurrence in Behcets disease patients

This study aimed to investigate the predictive factors for uveitis recurrence (UR) risk in Behcet's disease (BD) patients. BD patients (n=164) with a history of uveitis were recruited, and demographic data, clinical features, and laboratory tests were recorded. Uveitis was defined as anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis referring to the "International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease". In total, there were 70 UR patients and 94 non-UR patients. Compared to non-UR patients, UR patients appeared to be older and presented with increased uveitis occurrence rate and times within 3 months, oral ulcers occurrence rate, as well as higher concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and serum amyloid A (SAA). Multivariate logistic model disclosed that uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA independently predicted higher risk of UR. Furthermore, receiver operating characteristic curve analysis showed that the combination of uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA exhibited a high predictive value for UR risk with an area under the curve of 0.983 (95%CI: 0.969−0.998). In conclusion, uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA might be potential predictive factors for UR risk in BD patients, which can help in prevention and management of the disease.

Effect of serum amyloid A on microglial migration and its mechanism / 中国药科大学学报

@#To investigate the effect of serum amyloid A (SAA) on microglial migration and its mechanism,the migration ability of SAA-induced primary microglia and murine N9 microglia,and the effect of formyl peptide receptor 2 (FPR2) antagonist and TLR2 neutralizing antibody on SAA-induced migration of N9 microglia were all examined by Transwell assay. The expression changes of FPR2 and Toll-like receptor 2 (TLR2) in N9 microglia after SAA stimulation were detected by real-time PCR. The effect of SAA on the expression of downstream signaling pathway kinases in N9 microglia was detected by Western blot. The effect of signaling pathway inhibitors on SAA-induced N9 microglial migration was examined by Transwell assay. The results showed that SAA promoted the migration of primary microglia and N9 microglia in a concentration-dependent manner. FPR2 antagonist and TLR2 neutralizing antibody inhibited SAA-induced N9 cell migration. SAA promoted increased mRNA transcript levels of FPR2 and TLR2 in N9 microglia,and stimulated the activation of mitogen-activated protein kinases (MAPKs) and nuclear factor κB (NF-κB) signaling pathways in N9 microglia,as shown by increased extracellular regulated protein kinase (ERK),p38 and c-Jun N-terminal kinase (JNK) phosphorylation levels and decreased IκBα expression levels. Inhibitors of p38,JNK,and NF-κB signaling pathways inhibited SAA-induced migration of N9 microglia. The difference between the groups was statistically significant (P<0.05). These results indicate that SAA activates downstream p38,JNK,and NF-κB signaling pathways by acting on FPR2 and TLR2,thereby inducing microglia migration.

Expressions of multiple inflammation markers in the patients with 2019 novel coronavirus pneumonia and their clinical values / 中华检验医学杂志

Objective@#To explore the Expressions of multiple inflammation markers in the patients with 2019 novel coronavirus pneumonia (COVID-19) and their clinical values, and to provide theoretical basis for clinical diagnosis and treatment.@*Methods@#A total of 164 patients, diagnosed with COVID-19 and admitted to Guangzhou Eighth People's Hospital from January to February 2020, were selected as the research group and divided into three groups (ordinary, severe, and critically severe pneumonia) according to the disease severity. Meandwhile 66 non-infected patients during the same period were selected as negative control group. The expressions of WBC, LYM, CRP, SAA, and PCT were retrospective studied and compared between groups. The diagnostic values of WBC, CRP, SAA and the combination of these three markers in all patients with COVID-19 and in different severity groups were analyzed by ROC curve.@*Results@#Compared with control group (WBC count :8.13(6.51,9.42)×109/L, LYM count:2.00(1.28,2.43)×109/L), WBC count [4.94(4.05, 6.67) ×109/L] and LYM count [1.33(0.94, 1.96) ×109/L] of COVID-19 patients were significantly reduced (Z=-7.435, P<0.01; Z=-4.906, P<0.01) . Compared with the control group [CRP: 1.36 (0.57~5.67) mg/ml; SAA:[4.98 (4.80~15.75) mg/mL], CRP [7.93 (2.45~23.98) mg/ml] and SAA [34.13 (4.83~198.40) mg/ml] were increased in research group (Z=-5.72, P<0.01; Z=-4.166, P<0.01) . PCT in the control group and the research group were 0.100 0(0.030 6~0.100 0)ng/ml and 0.044 5(0.031 6~0.077 0)ng/ml, respectively. There was no statistical difference between two groups (Z=-1.451, P=0.147) . The areas under the ROC curve (AUC) of WBC, CRP and SAA in patients with COVID-19 were 0.814, 0.742, 0.673, respectively (P<0.01), while the AUC of the combination of three indexes for COVID-19 diagnosis was 0.882, with 83.33%(55/66) specificity and 84.76% (139/164) sensitivity, P<0.01.The AUCs of WBC, CRP, and SAA for predicting severe and critically severe COVID-19 were 0.799, 0.779, and 0.886 , respectively (P<0.01), and the AUC of the combination of three indexes for the diagnosis of severe and critically severe COVID-19 was 0.924, with 78.67% (118/150) specificity and 14/14 sensitivity (P<0.01).@*Conclusion@#Combining detection of WBC, CRP and SAA can improve the specificity and sensitivity of COVID-19 diagnosis, with a high diagnostic value for severe and critically severe COVID-19.

Analysis of clinical characteristics of new coronavirus pneumonia patients in secondary epidemic areas / 中华危重病急救医学

Objective@#Understand the clinical characteristics of confirmed pneumonia patients infected with new corona virus in secondary epidemic areas and guide the diagnosis and treatment of novel pneumonia in secondary epidemic areas and provide a reference for clinical prevention and control of the epidemic situation.@*Methods@#The clinical data of 33 patients admitted with pneumonia caused by a novel coronavirus in the Second Affiliated Hospital of Wenzhou Medical University from January 15 to February 1, 2020, were retrospectively reviewed. At the onset of the disease, we analyzed the primary symptoms such as fever, cough, fatigue, chest tightness, chest pain and also a significant blood test results of the patients. According to the patient's contact history, it was divided into the direct infection group of the main epidemic area and the indirect contact infection group of the main epidemic areas. The difference between clinical manifestations among the two groups was analyzed.@*Results@#The main clinical symptoms of patients with novel coronavirus pneumonia in the secondary epidemic area were respiratory tract and systemic symptoms. After grouping according to the presence and absence of direct contact in the main epidemic area, there was no significant difference in baseline data between the two groups, and there was no significant difference in symptoms and signs between the two groups (P < 0.05). Some patients had serum amyloid protein (SAP) increased abnormall.@*Conclusions@#The respiratory tract and systemic symptoms are the primary symptoms of the patients with the new type of coronavirus pneumonia in the secondary epidemic area, which are not typical. The abnormal increase of serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment.

Serum amyloid A and muscle activity biomarkers in horses submitted to equestrian show jumping / Biomarcadores de amilóide sérica A e de atividade muscular em cavalos submetidos a salto equestre

The aim of this study was to evaluate the serum amyloid A (SAA) and biomarkers of muscle activity of horses submitted to show jumping activity. To do this, the variables SAA, glucose, lactate and the biomarkers creatine kinase (CK) and aspartate amino transferase (AST) were evaluated in 10 horses submitted to the show jumping exercise in a tournament for beginners. The evaluations occurred before exercise (T0), immediately after (T1), 30 minutes (T2), 60 minutes (T3) and 24 hours after the end (T4). Data were evaluated using analysis of variance for repeated measures. The statistical software SAEG 9.1 was used to verify the level of significance between the moments for P<0.05. Glucose presented a difference between the moments T0 (97.7±13.3mg/dL) and T1 (79.7±14.1mg/dL). Lactate presented elevation in T1 (15.3±6.1mmol/L) compared to the others T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) and T4 (5.1±1.6mmol/L). The CK showed a significant difference between T0 (82.8±51.2U/L) and T1 (140.1±58.5U/L) and between T4 (74.4±43.1U/L) with T1 (140.1±58.5U/L). The AST presented no difference between moments. The show jumping activity with one-meter obstacles did not induce changes in the SAA protein between the moments.(AU)

O objetivo deste estudo foi avaliar a amilóide sérica A (SAA) e biomarcadores de atividade muscular de equinos submetidos a atividade de salto, ou hipismo clássico. Para tanto, foram avaliadas as variáveis SAA, glicose, lactato e os biomarcadores creatina quinase (CK) e aspartatoaminotransferase (AST) em 10 equinos submetidos ao exercício de saltos em torneio para iniciantes. As avaliações ocorreram antes do exercício (T0), imediatamente após (T1), 30 minutos (T2), 60 minutos (T3) e 24 horas após o término (T4). Os dados foram avaliados utilizando análise de variância para medidas repetidas. O software estatístico SAEG 9.1 foi utilizado para verificar o nível de significância entre os momentos para P<0,05. A glicose diferenciou-se entre os momentos T0 (97.7±13.3mg/dL) e T1 (79.7±14.1mg/dL). O lactado apresentou elevação comparada com o momento T1(15.3±6.1mmol/L) e os demais T0 (3.8±0.8mmol/L), T2 (6.5±3.9mmol/L), T3 (5.3±2.2mmol/L) e T4 (5.1±1.6mmol/L). A CK mostrou diferença significativa entre T0 (82.8±51.2U/L) e T1 (140.1±58.5U/L) e entre T4 (74.4±43.1U/L) com T1 (140.1±58.5U/L). A AST não apresentou diferença entre os momentos. A atividade de hipismo clássico com obstáculos de um metro não induziu alterações na proteína SAA entre os momentos.(AU)

Serum amyloid A levels in acute and chronic urticaria

Abstract: Background: Serum amyloid A is an acute-phase protein. There is no available data regarding serum amyloid A levels in patients with acute and chronic urticaria (CU). Objective: To investigate the association between serum amyloid A and urticaria. Methods: This was a case-control study of 81 patients who visited our Hospital between June and December 2016 with a diagnosis of urticaria. Eighty healthy controls (HC) who visited for routine health examination and physical checkups were recruited. Serum amyloid A and C-reactive protein levels were measured by automated methods. Results: Serum amyloid A and C-reactive protein levels were significantly higher in AU (Serum amyloid A: 207.1 (6.7-439.0) mg/L; C-reactive protein: 16.0 (0.2-90.0) mg/L) and CU (Serum amyloid A: 6.5 (2.5-35.8) mg/L; C-reactive protein: 1.0 (0.1-16.0) mg/L) compared with HC (Serum amyloid A: 5.04 (2.0-9.1) mg/L; C-reactive protein: 1.2 (0.1-5.6) mg/L), and in AU compared with CU (all P<0.05). There were no differences between the CU and HC group. In CU, Serum amyloid A levels in those with moderate/severe urticaria (median, 16.4 (9.7-35.8) mg/L) were higher than in those with mild urticaria (median, 5.7 (2.5-9.5) mg/L) and HC (all P<0.05). Serum amyloid A and C-reactive protein levels exceeded the normal lab range in 90.7% and 72.1% patients with AU compared with 28.9% and 13.2% patients with CU, respectively. Significant positive correlations were found between serum amyloid A and C-reactive protein (r = 0.562, P < 0.001). Study limitations: There was no comparison between active disease and remission. Conclusion: There was an association between serum amyloid A levels and urticaria. Higher serum amyloid A levels were associated with AU and more severe CU. Serum amyloid A may help to identify CU patients earlier.

Amiloidosis AA: Estudio de cohorte en una institución / AA amyloidosis. A single institution cohort study

La amiloidosis AA causa principalmente disfunción renal, lo que lleva a un elevado riesgo de mortalidad a mediano plazo. Existe escasa información epidemiológica sobre la amiloidosis AA en Argentina, por lo que el objetivo de este trabajo fue describir las características epidemiológicas de esta enfermedad en un hospital de tercer nivel en nuestro país. Se realizó una cohorte prospectiva de todos los pacientes consecutivos con evidencia de amiloidosis AA, por inmunohistoquímica de tejidos, incluidos en el Registro Institucional de Amiloidosis del Hospital Italiano de Buenos Aires, desde el 01/04/2012 hasta el 31/12/2017. De los 121 pacientes del registro, se incluyeron 18 con AA para el análisis. Del total incluido, 50% (9) eran mujeres, con una mediana de edad de 53.5 (rango intercuartil, RII 46-61) años. El 88.9% (16) presentó compromiso renal, todos tuvieron proteinuria, y 6 requirieron diálisis. Seis tuvieron infiltración amiloide del aparato digestivo. La latencia entre la aparición de la enfermedad subyacente y el diagnóstico de AA tuvo una mediana de 27 (RII 8-35) años. La enfermedad subyacente fue de origen inflamatorio en 6 casos. En el 50% (9) de los enfermos la causa de amiloidosis AA fue desconocida. En el restante 50% esas causas se asemejan a las de países desarrollados. A su vez, nuestros resultados resaltan la importancia de su diagnóstico diferencial para identificar el tratamiento o seguimiento más adecuado según el cuadro que presente cada paciente.

There is limited epidemiological information on AA amyloidosis in Argentina, so the objective of this study was to describe the epidemiological characteristics of this disease in a tertiary hospital in our country. We designed a prospective clinical cohort of all consecutive patients with AA amyloidosis confirmed by immunohistochemistry in tissue from the Institutional Registry of Amyloidosis of the Hospital Italiano de Buenos Aires, in the period 04/01/2012- 12/31/2017. Of the 121 patients in the registry, 18 were included with AA for the analysis. Of the total included, 50% (9) were female, with a median age of 53.5 (interquartile range, RII 46-61) years. The 88.9% (16) of cohort presented renal compromise, all had proteinuria, and 6 required dialysis. Six had amyloid infiltration of the digestive system. The latency between the onset of the underlying disease and the diagnosis of AA had a median of 27 (RII 8-35) years. The underlying disease was of inflammatory origin in 6 cases. In 50% (9) of the patients the cause of AA amyloidosis was unknown. In the remaining 50%, these causes resemble those observed in developed countries. Furthermore, our results highlight the importance of their differential diagnosis to identify the most appropriate treatment or follow-up according to the situation presented by each patient.

Effect of SSA1 on biological behavior of gastric cancer cells and its application in diagnosis of gastric cancer / 医学研究生学报

Objective Currently, there is a lack of clinical precise methods in the early diagnosis of gastric cancer. The article aimed to investigate the effect of serum amyloid A1 (SAA1) on the biological behavior of gastric cancer cells and its role in the early diagnosis of gastric cancer. Methods We collected 82 specimens of gastric cancer patients and 30 specimens of healthy controls. Cultured human gastric cancer SGC-7901 cells were randomly divided into SAA1-siRNA group, NC-siRNA group and blank control group. SAA1-siRNA, NC-siRNA and transfection reagent were transfected into the SGC-7901, and the expression of SAA1 protein in each group was detected by western blot 48 h later. Cell viability in each group was detected by CCK8 and cell invasion ability was measured by Transwell chamber. The ROC curve was used to analyze the efficacy of SAA1 in the diagnosis of gastric cancer. The expression of SAA1 was detected by ELISA, and the correlation between SAA1 and clinicopathological factors was analyzed. Results The SAA1 protein expression in SAA1-siRNA group [(1.12±0.12)μg] was significantly lower than those in NC-siRNA group[(1.97±0.13)μg] and blank control group[(2.09±0.28)μg] (P<0.05). The cell viability of CCK8 assay showed that the cell viability of SAA1-siRNA group(52.44±12.30) was significantly lower than those of NC-siRNA group(77.16±7.70) and blank control group (97.78±11.80). Transwell test results showed that the migration ability of SAA1-siRNA group(22.21±6.53) was significantly lower than those of NC-siRNA group(52.02±4.29) and blank control group(54.10±5.40)(P<0.05). The expression of SAA1 in patients with gastric cancer was (50.03 ± 20.89μg / mL) significantly higher than those of healthy controls (24.06 ± 10.72μg / mL), and the difference was statistically significant (P <0.05). ROC curve analysis showed that the AUC of SAA1 diagnosis of gastric cancer was 0.791 (95% CI: 0.701~0.880), the detection threshold was 31.97μg, and the diagnostic sensitivity and specificity were 0.659 and 0.833, respectively. There was no significant correlation between the expression of SAA1 and gender, age and tumor metastasis of gastric cancer (P> 0.05), while it was correlated with tumor maximum diameter and invasion degree, and increased with tumor invasion degree (P< 0.05). Conclusion The expression of SAA1 in gastric cancer patients increases significantly, which can be used as a new potential marker for the diagnosis of gastric cancer.

Serum amyloid A protein in identification of disease activity and infection for systemic-onset juvenile idiopathic arthritis / 中华全科医师杂志

We retrospectively analyzed 126 children with juvenile idiopathic arthritis (JIA)admitted from January to December 2017,including 65 cases of systemic-onset JIA (SoJIA) and 61 cases of other types of JIA.The value of serum amyloid A protein (SAA) in the identification of the disease activity and infection in children with SoJIA was assessed.The area under the ROC curve of SAA in identification of disease activation of SoJIA patients was 0.934,which was not significantly different with other types of JIA.With the cut-off value of 68.32 mg/L the sensitivity and specificity for diagnosis of SoJIA activity were 0.913 and 0.892 respectively.In SoJIA patients the SAA was closely correlated with ESR and CRP (r=0.721 and 0.699,P＜0.001).The SAA level was significantly higher in the disease active stage than that in stable stage,in the stable stage with infection than that in the stable stage without infection of SoJIA patients.There were also significant differences in platelet and CRP between active disease with infection and active disease without infection.SAA is expected to be used for assessing disease activity of SoJIA,if combined with platelet and CRP,it may be of value in the identification of the complicating infection.