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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.
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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.
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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.
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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.
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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.
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Humans , Psoriasis , Monocytes , Biomarkers , Cross-Sectional Studies , Cholesterol, HDLABSTRACT
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.
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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.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Urticaria/blood , Serum Amyloid A Protein/analysis , Reference Values , Severity of Illness Index , C-Reactive Protein/analysis , Biomarkers/blood , Case-Control Studies , Chronic Disease , Prospective Studies , Statistics, NonparametricABSTRACT
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.
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Humans , Male , Female , Adult , Middle Aged , Aged , Serum Amyloid A Protein/analysis , Amyloidosis/diagnosis , Argentina , Immunohistochemistry , Prospective Studies , Cohort StudiesABSTRACT
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.
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Objective To explore the association between serum amyloid A (SAA) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus(T2DM).Methods A total of 148 diabetic subjects were divided into three groups according to C1MT:normal IMT group,IMT incrassation group and arteriosclerosis group.Levels of SAA,25-hydroxyvitamin D [25 (OH) D],brachial-ankle artery pulse wave velocity (baPWV),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1 c),triglyceride (TG),total cholesterol (TC),body mass index (BMI) and blood presure were measured in all groups.The relationship between SAA,CIMT,25 (OH)D,baPWV and other factors was also analyzed.Results Compared to the normal IMT group,levels of FPG,HbA1 c,TC,BMI,SAA and ba-PWV were significantly higher in IMT incrassation group and arteriosclerosis group,while HDL-C and 25 (OH)D were lower.In arteriosclerosis group,levels of BMI,FPG,HbA1 c,SAA and ba-PWV were higher than those in IMT incrassation group,while 25 (OH) D was lower.Pearson correlation analysis showed that the level of SAA was positively correlated with baPWV,BMI,TC,course of disease and IMT,while it was negatively correlated with HDL-C and 25 (OH)D.Logistic regression analysis of IMT showed that smoking,obesity,high levels of HbAlc,FPG,TC,SAA,low levels of HDL-C and 25 (OH)D may contribute to higher levels of IMT.Conclusions SAA was closely related to carotid atherosclerosis.Further prospective studies will be helpful to explore the influence of SAA on diabetic macroangiopathy.
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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.
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@#AIM:To investigate the clinical value of serum amyloid A(SAA)in the diagnosis of infectious endophthalmitis. <p>METHODS:A total of 270 patients admitted to the Eye Hospital of Wenzhou Medical University from June 2016 to March 2019 were collected, including 116 patients with infectious endophthalmitis as the experimental group and 154 non-infectious patients as the control group. The levels of SAA was detected by colloidal gold immunochromatography. Variables were compared and diagnostic value was measured by using receiver operating characteristic(ROC)curve.<p>RESULTS:The median levels of SAA in experimental group and control group were 14.98mg/L and 2.56mg/L, respectively,the difference between the two groups was statistically significant(<i>P</i><0.001); the median levels of CRP and WBC had statistic difference between two groups, respectively(<i>P</i><0.001). The area under the ROC curve of SAA, CRP and WBC for diagnosis of infectious endophthalmitis were 0.772, 0.638 and 0.618 respectively. The optimal cut-off value corresponding to the maximum value of Youden index was 6.975mg/L by SAA, the sensitivity was 63.79% and the specificity was 84.42%.<p>CONCLUSION: SAA combined with CRP and WBC can improve the diagnostic efficacy of infective endophthalmitis. SAA can provide useful reference information for the assistant diagnosis of infectious endophthalmitis, which is worthy of clinical application.
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Objective To value different stages of chronic obstructive pulmonary disease (COPD) patients with the detection of the levels of serum thymic stromal lymphopoietin (TSLP),serum amyloid A (SAA),and C-reactive protein (CRP).Methods A total of 33 patients with COPD during and after hospitalization and 16 healthy controls were enrolled in the study from the 3rd affiliated hospital of SYSU.Differences and correlations of the level of serum TSLP,SAA and CRP were analyzed to value the veracity of those factors in different stages of COPD.Results The levels of CRP and SAA were higher in acute exacerbation of COPD (AECOPD) group than stable COPD group,TSLP was lower in the AECOPD group than the healthy control group (P ＜ 0.05).CRP had a positive correlation with SAA (correlation r =0.546,P =0.000),CRP [area under curve (AUC) =0.797] and SAA (AUC =0.815),and they were statistically significant in identity of different stages of COPD (P ＜ 0.05).Conclusions Serum TSLP level is decreased in acute exacerbation phase of COPD.CRP and SAA are increased in AECOPD.SAA is more confident in identity of different phases of COPD.
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Objective To investigate the neutrophil extracellular traps (NETs) formation and their molecular mechanisms induced by serum amyloid A (SAA) in rheumatoid arthritis (RA).Methods Neutrophils were isolated from peripheral blood of RA and healthy volunteers.① Neutrophils were cultured in vitro,the formation of NETs was observed and their percentage was calculated.② Neutrophils were cultured in vitro,divided into six groups:control,SAA,[SAA+anti-Toll like receptro4 (TLR4)-Ab],LPS,(LPS+anti-TLR4-Ab) and anti-TLR4-Ab.Appropriate stimulation was conducted for each group.NETs formation and their percentages were investigated.The concentration of DNA in supernatant was detected by fluorescent staining.F test and t test were used for statistical analysis.Results ① The purification of isolated neutrophils was higher than 95％.The network which was collocated with the spreading neutrophils nucleus and neutrophil elastase under the microscope,was NETs.In the RA group,the formation of NETs induced by SAA was significantly more than control [(19.1±0.8) vs (7.4±0.5),t=12.30,P＜0.05].② However,after pretreated with anti-TLR4 antibody,NETs formation was significantly less than the SAA group [(5.7±0.4) vs (14.7±1.1),t=7.825,P＜0.05].Moreover,the fluorescence intensity of DNA in supernatant was significantly higher in SAA group than that of anti-TLR4-Ab pretreatment group [(18.7 ±0.7) vs (12.9±0.8),t=5.552,P＜0.05].The concentration of DNA in supernatant of SAA group was higher than that of anti-TLR4-Ab pretreatment group [(36.9±1.3) μg/ml and (16.3±0.6) μ,g/ml,t=14.41,P＜0.05].Conclusion SAA can induce the formation of NETs from neutrophils by binding to TLR4 in RA.
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Objective To investigate the clinical values of serum amyloid A (SAA) and hypersensitivity C reactive protein(hs-CRP) in the diagnosis of postoperative infection in patients with ovarian tumor.Methods Clinical data of 679 patients with ovarian tumor were retrospectively analyzed.According to the development of postoperative infection or not,all patients were assigned into infection group(n =45) or non-infection group(n =634).The primary outcomes indicators were SAA,hs-CRP,C reactive protein(CRP) and white blood cell.Results Compared with the non-infection group,the infection group got a significantly higher levels of SAA [(104.73 ± 34.74) mg/L vs.(6.12 ±0.74) mg/L,t =25.546,P =0.000] and hs-CRP [(142.35 ± 43.84) mg/L vs.(18.45 ± 5.39) mg/L,t =24.595,P =0.000] and white blood cell [(11.48 ± 3.59) × 109/L vs.(7.49 ± 2.83) × 109/L,t =6.305,P =0.000] and CRP [(32.58 ± 10.48) mg/L vs.(16.34 ± 8.47) mg/L,t =8.496,P =0.000].The area under the Receiver Operating Characteristic of SAA,hs-CRP,white blood cell and CRP were 0.879 (95％ confidence interval:0.825 ～ 0.920,P =0.000),0.858(95％ confidence interval:0.792 ～0.925,P =0.000),0.737(95％ confidence interval:0.658 ～0.817,P =0.000) and 0.767 (95 ％ confidence interval:0.713 ～ 0.822,P =0.000).Z tests showed that the areas under the curve of SAA and hs-CRP in the diagnosis of postoperative infection in patients with ovarian tumor were higher than white blood cells and CRP(all P ＜ 0.05).Conclusion SAA and hs-CRP have better diagnostic values in the postoperative infection of ovarian tumor,and it is worth to be popularized.
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Objective To analyze serum amyloid protein A (SAA) subtype and amino acid mutation sequence of the renal biopsy specimens from patients with renal amyloidosis secondary to ankylosing spondylitis (AS) by laser microdissection combined with mass spectometry.Methods Kidney biopsy formalin-preserved paraffin-embedded (FFPE) specimen slices were stained by Congo red,the positive areas of Congo red staining were selected by microdissection,after trypsin hydrolysis and filtration,peptide samples were subjected to liquid chromatography tandem mass spectrometry.Analysis softwares were used to evaluate the results,and the patient's amino acid sequence of SAA protein was compared to mutant amino acid sequence reported by literature or deduced from mutant SAA gene to determine whether there was a variation.Results SAA1 and SAA2 proteins with high abundance were identified by mass spectrometry,serum amyloid P and apolipoprotein E were also detected.No variation of SAA1 and SAA2 protein was detected.Conclusions The SAA1 and SAA2 proteins in AA amyloidosis secondary to ASwere identified for the first time,which enriched the pathogenesis of amyloidosis secondary to AS and provided a new method for the accurate classification of AA amyloidosis.
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Fundamento: la proteína amiloide A sérica es producida en respuesta a la liberación de citoquinas por parte de monocitos y macrófagos, después de un estímulo de fase aguda como es la infección. Objetivo: determinar los niveles séricos de amiloide A y su asociación con pacientes diagnosticados con periodontitis crónica. Métodos: se realizó un estudio observacional de corte transversal, el universo estuvo constituido por 80 pacientes con periodontitis crónica y 28 personas sin periodontitis como grupo control. El diagnóstico de periodontitis crónica se basó en criterios definidos con anterioridad. Todos los participantes respondieron un cuestionario relacionado con características sociodemográficas. Para calcular los niveles de amiloide A sérico se realizó una prueba de ensayo enzimático. Resultados: los niveles de amiloide A sérico patológicos se asociaron con la periodontitis (p=0,002) y se correlacionaron de manera significativa con mayor edad (r=2,42; p=0,01); sin embargo, la regresión logística ajustada por edad mostró asociación estadística significativa solo con periodontitis (OR=5,6; intervalo de confianza del 95 % 1,7-19). Conclusiones: la probabilidad de presentar niveles patológicos de amiloide A sérico en pacientes con periodontitis crónica es seis veces la de los pacientes sin periodontitis, lo cual podría ser un factor de riesgo para enfermedades cardiovasculares.
Background: serum amyloid A protein is produced in response to the cytokines released by monocytes and macrophages after an acute-phase stimulus such as infection. Objective: to determine the serum levels of amyloid A protein and its association with patients diagnosed with chronic periodontal disease. Methods: a cross-sectional observational study was conducted. The universe was composed of 80 patients with chronic periodontitis and 28 people without periodontal affections as a control group. Diagnosis of chronic periodontal disease was based on criteria stated previously. All the participants answered a questionnaire related to sociodemographic characteristics. A clinical enzymatic trial was carried out to calculate the levels of pathological serum amyloid A. Results: pathological levels of serum amyloid A were associated with periodontitis (p=0,002) and were correlated significantly with older age (r=2, 42; p=0, 01). Nevertheless, logistic regression adjusted by age showed remarkable statistical association only with periodontal disease (OR=5, 6; interval from 95 % 1, 7-19). Conclusions: probability of presenting pathological levels of serum amyloid A in patients with chronical periodontal disease is six times the one of the patients without this affection. That could me a risk factor for cardiovascular diseases.
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Objective To explore the clinical application value of serum amyloid A (SAA),C-reactive protein (CRP) and SAA/CRP in early diagnosis of hand-foot-mouth disease (HFMD).Methods The serum levels of SAA and CRP were detected in 873 children with HFMD who were admitted in Hangzhou Children's Hospital from April to December in 2015.And 487 healthy children were enrolled as healthy control group.SAA was measured by nephelometry assay,and CRP was measured by immunoturbidimetry.Variables were compared using Mann-Whitney U test and diagnostic value was measured by using receiver operating characteristic (ROC) curve.Results The median levels of SAA in HFMD group and control group were 330.5 and 4.0 mg/L,respectively,which was statistically different (Z=-29.02,P＜0.01);the median levels of CRP were 10.0 and 1.0 mg/L,respectively,with statistical difference (Z =23.79,P＜ 0.01);and the median SAA/CRP were 23.06 and 2.40,respectively,with statistical difference (Z=-24.79,P＜0.01).In ROC curve comparison,the area under the curve of SAA (0.980) was higher than those of SAA/CRP ratio (0.911) and CRP (0.899) for diagnosing HFMD.When using 10.30 mg/L as the cut off value for SAA according to the ROC curve,the sensitivity was 91.6％ and the specificity was 96.6％.Conclusions Joint detection of SAA and CRP can improve the efficiency in the early diagnosis of HFMD.SAA can provide useful auxiliary information for the diagnosis of HFMD,which is worthy of extensive clinical application.
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Objective To explore whether serum amyloid A (SAA) can induce the formation of neutrophil extracellular traps(NETs)in neutrophils in vitro. Methods A stable method for inducing NETs formation in vitro was established, in-cluding isolation of peripheral blood neutrophils, cell culture, and NETs formation and observation. The neutrophils were iso-lated from peripheral blood of healthy volunteers. And cells were cultured in vitro and classified into three groups:negative control (NC) group, SAA group and lipopolysaccharide (LPS) group. Following the distinct stimulation in three groups, NETs formation was observed and its percentage was calculated. The concentration of hinstone (h) 3 in supernatant was detected by ELISA. Results The purification and vitality of isolated neutrophils were both more than 95%. The nuclei of neutrophils lost their shape and spread, NETs formation was found. More NETs formation was found in SAA group than that in NC group (P < 0.05). Moreover, the concentration of h3 in supernatant was significantly higher in SAA group than that in NC group (P<0.05). Conclusion SAA can induce the formation of NETs in vitro.
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Objective To evaluate the clinical value of SAA by detecting their expression levels in patients with lung cancer and the analysis of the relativity of SAA for early diagnosis.Methods There are 243 cases specimens obtained from lung cancer patients who were newly diagnosed and without any treatment in Zhejiang Cancer Hospital from April 2014 to June 2015.The 243 lung cancer individuals were 147 male, and 96 female, their ages ranged from 29 to 85 years, with an average age of 63 years.The distribution of pathological type was as follows:95 patients were adenocarcinoma, 102 patients were squamous carcinoma, and 46 patients were small cell carcinoma.The distribution of TNM staging systems was as follows: 59 patients in stage 1and stage 2, 54 patients in stage 3, and 130 patients in stage 4.While 179 cases physical examination as the control.There were 94 individuals male, and 85 individuals female.Their ages ranged from 26 to 86 years, with an average age of 61 years.By using latex enhanced immune turbidimetric method, serum SAA concentrations in patients with lung cancer and healthy controls were checked on the Hitachi-7600 automated chemistry analyzer ( Hitachi ).The comparisons of all analyses values between healthy controls and lung cancer were estimated by two independent samples nonparametric tests ( Mann-Whitney U).The association between SAA and lung cancer prognostic factors such as age, smoking status and metastasis, was evaluated by spearman correlation and multivariate analysis.Results The median and interquartile spacing of SAA concentration was 42.36 mg/L (9.35, 74.22) in lung cancer patients.While 24 mg/L ( 3.25, 21.45 ).The median level of SAA in lung cancer patients (42.36 mg/L) were significantly higher than in healthy controls (11.24 mg/L), and difference reached statistically significant (Z=-2.403,P=0.006).Nevertheless, there was no significant difference in SAA concentrations among the different pathological types(Z=-1.013, P=0.339), ages (Z=0.578, P=0.458) and gender(Z=0.726, P=0.246) of lung cancer patients.While the level of SAA in has smoking status (Z=-2.282, P=0.013) and distant metastasis (Z=-2.138, P=0.017) of lung cancer was higher.By drawing ROC curve, the cut off value of SAA in distinguishing lung cancer with healthy control was 14.48 mg/L.Meanwhile, the AUC was 0.811, the accuracy is 89.12% and the sensitivity was 88.73%.Serum concentration was positively related with smoking status ( r =0.331, P =0.018 ) and distant metastasis ( r =0.372, P=0.015 ) by Spearman correlation analysis .Conclusion Serum SAA concentrations may contribute to the auxiliary diagnosis of lung cancer, evaluate the clinical stage and distant metastases of lung cancer.