Acute Phase Response and its Effect on Short Term Outcome of Bangladeshi patients after On-Pump Cardiac Surgery

Background: Throughout any surgical procedure, the immune system is generally activated as a physiological response to the surgical trauma. Cardiopulmonary bypass can trigger the inflammatory response in three ways: direct contact activation of the immune system due to exposer of blood to foreign surfaces, ischaemia-reperfusion injury to vital organs as a result of aortic cross clamping, and splanchnic hypoperfusion. Objective: The aim of the study was to observe the acute phase response variables in Bangladeshi patients and to assess the acute phase response and morbidity of the patients after prolonged bypass surgery.Methods:This cross sectional study was conducted in the Department of Cardiac Surgery, BSMMU from January 2009 to December 2010. Fifty patients were selected for the study and were divided into 2 groups on the basis of cardiopulmonary bypass time. Group I was cardiopulmonary bypass time less than 90 minutes and Group II was more than 90 minutes. Data were stored and analyzed with standard computer software (SPSS-15). P < 0.05 was considered statistically significant.Results:The mean duration of cardiopulmonary bypass (CPB) time (55.76�.8 in group I, 131�.35 in group II; P<0.001) and Aortic cross clamp time (28.48�31 in group I, 83.48�.99 in group II; P<0.001) was higher in group II than group I. Analysis of outcome variables showed that mean postoperative ventilation time was 6.24�20 in group I and 9.16�33 in group II. There was significant difference in the ventilation time between two groups (P<0.001). This study showed that there is a definite relationship of wound infection with the prolonged cardiopulmonary bypass time (P<0.001) and also persistently rising CRP increases the chance of wound infection.Conclusions:We may conclude that prolonged cardiopulmonary bypass time is associated with increased acute phase response and morbidity of Bangladeshi patients.

Acute phase proteins in serum and cerebrospinal fluid in healthy cattle: possible use for assessment of neurological diseases / Proteínas de fase aguda no soro e no líquido cefalorraquidiano de bovinos hígidos: possíveis usos na avaliação de doenças neurológicas

Use of acute-phase proteins (APPs) for assessment of health and disease in animals has increased greatly within the last decade. The objective was to determine the normal concentration of APPs in the serum and cerebrospinal fluid (CSF) of healthy cattle by polyacrylamide gel electrophoresis. Fifty crossbred animals (350±70kg of BW and 18±1.2 months of age), 25 heifers and 25 steers were used. CSF samples were collected from atlanto-occipital (AO) site and blood samples were obtained from the jugular vein. CSF and serum protein electrophoresis were performed by means of sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Thirty-seven proteins with molecular weights ranging from 7 and 37kDa were identified in CSF of all animals. These eight were nominally identified with immunoglobulin A and G, celuloplasmin, transferrin, albumin, α1-antitripsin, acidic glycoprotein, and haptoglobin. All protein fractions in CSF did not differ between heifers and steers. In sera, 34 proteins with molecular weights between 7 and 244kDa were identified in heifers and steers. Similar proteins were nominally identified in the sera, but only the CSF presented α1-antitripsin. The serum values of acidic glycoprotein and immunoglobulin G were significantly higher in steers compared with heifers. In conclusion, measurement of CSF acute phase protein concentrations can be useful in diagnosing and monitoring the progression of bovine neurological diseases, perhaps even to guide therapeutic procedures. The CSF electrophoretic profile of healthy cattle does not change depending on gender.(AU)

O uso de proteínas de fase aguda (PFAs) para a avaliação da saúde e da doença em animais de produção tem aumentado consideravelmente na última década. O objetivo deste estudo foi determinar a concentração normal de PAFs no soro e no líquido cefalorraquidiano (LCR) de bovinos sadios por meio da eletroforese em gel de poliacrilamida. Foram avaliados cinquenta animais mestiços (350±70kg de PV e 18±1,2 meses de idade), 25 novilhas e 25 novilhos. As amostras de LCR foram colhidas no espaço atlanto-occipital (AO) e as amostras de sangue obtidas da veia jugular. As PAFs do soro e do LCR foram determinadas através da eletroforese em gel poliacrilamida. Trinta e sete proteínas com pesos moleculares que variaram entre 7 e 37kDa foram identificadas no LCR de todos os animais, independente do sexo. Estas oito proteínas foram nominalmente identificadas como imunoglobulina A e G, ceruloplasmina, transferrina, albumina, α1-antitripsina, glicoproteína ácida, e haptoglobina. As frações de proteínas presentes no LCR não diferiram entre novilhas e novilhos. No soro de machos e fêmeas, 34 proteínas com pesos moleculares entre 7 e 244 kDa foram identificadas. As proteínas do soro foram similarmente identificadas, entretanto a α1-antitripsina foi identificada somente no LCR. Os valores séricos de glicoproteína ácida e imunoglobulina G foram significativamente mais elevados nas novilhas em comparação aos novilhos. Em conclusão, a determinação das concentrações de proteínas de fase aguda presentes do LCR pode ser útil no diagnóstico e monitoramento da progressão de doenças neurológicas bovinas, talvez possa ainda direcionar procedimentos terapêuticos. O perfil eletroforético do LCR de bovinos hígidos não se altera em função do sexo.(AU)

Cinética da proteína total, fibrinogênio e ceruloplasmina em cordeiros Santa Inês durante os primeiros cinco meses de vida / Kinetics of total protein, fibrinogen, and ceruloplasmin in Santa Inês lambs during the first five months of life

Objetivou-se estudar a cinética da proteína total, fibrinogênio e ceruloplasmina durante os primeiros cinco meses de vida, em cordeiros saudáveis da raça Santa Inês, no município de São Gonçalo dos Campos, Bahia, Brasil. Amostras de sangue foram colhidas de 22 animais, ao longo de onze momentos: logo após o parto (T0), 12 (T1), 24 (T2), 48 horas (T3), sete (T4), 15 (T5), 30 (T6), 60 (T7), 90 (T8), 120 (T9) e 150 dias de vida (T10). A proteína total e o fibrinogênio plasmáticos foram analisados por meio de refratômetro clínico e pela técnica de desnaturação pelo calor, respectivamente, enquanto que a determinação da ceruloplasmina sérica se baseou em sua atividade oxidásica. Para análise estatística utilizou-se o programa SPSS versão 18; os dados com distribuição não paramétrica foram submetidos ao teste de Friedman para avaliar o efeito do tempo, enquanto que as comparações múltiplas pelo teste de Wilcoxon permitiram a identificação das diferenças entre os momentos, adotando-se nível de significância de 5% (p<0,05). A proteína total apresentou o menor valor no T0 diferindo estatisticamente dos demais tempos, com pico às 12 horas (T1), porém estabilizando-se até o final do experimento. O fibrinogênio não apresentou diferença estatística entre os tempos. De T1 (12h) a T3 (48h) constatou-se baixos valores de ceruloplasmina, muito embora às 24 horas (T2) tenha diferido estatisticamente (p<0,05), em relação ao T0. A partir do sétimo dia (T4) a concentração desta proteína aumentou significativamente, atingindo pico nos tempos T8 (90 dias) e T9 (120 dias). Foi possível estabelecer a cinética das proteínas estudadas, identificar os principais momentos com alterações e sugerir os fatores associados com as mudanças observadas.

The objective was to study the kinetics of the total protein, fibrinogen, and ceruloplasmin during the first five months of life in healthy lambs Santa Inês, in São Gonçalo dos Campos, Bahia, Brazil. Blood samples were collected from 22 animals, over eleven times: immediately after birth (T0), 12 (T1), 24 (T2), 48 hours (T3), seven (T4), 15 (T5), 30 (T6), 60 (T7), 90 (T8) 120 (T9), and 150 days of age (T10). The total protein and plasma fibrinogen were analyzed by means of a clinical refractometer and the heat denaturation technique, respectively, while the determination of serum ceruloplasmin was based on its oxidase activity. For statistical analysis, the SPSS version 18 program was used; the non-parametric data were submitted to the Friedman test to evaluate the effect of time, whereas the multiple comparisons by the Wilcoxon test allowed the identification of the differences between the moments, adopting a significance level of 5% (P < 0.05). The total protein presented the lowest value at T0 differing statistically from the other times, with a peak at 12 hours (T1), but stabilizing until the end of the experiment. Fibrinogen is not able to differentiate between the times. Between T1 (12h) and T3 (48h), low values of ceruloplasmin were observed, although at 24 hours (T2) it differed statistically (p <0.05) in relation to T0. On the seventh day (T4) the concentration of this protein increased significantly, reaching a peak at T8 (90 days) and T9 (120 days). It was possible to establish the kinetics of the proteins studied, to identify the main moments with alterations and to suggest the factors associated with the observed changes.

Serum levels of proteins and acute-phase proteins in captive emus (Dromaius novaehllandieae) of different ages / Teores séricos de proteínas, inclusive proteínas de fase aguda, em emus (Dromaius novaehollandiae) de diferentes faixas etárias e criados em cativeiro

Protein electrophoresis is a relatively simple technique that allows separating serum protein fractions, and provides important information in the investigation and diagnosis of several diseases. This study determined the levels of acute-phase proteins in the serum of healthy, captive emus (Dromaius novaehollandiae). Animals were divided into two groups (n=11 in each) based on age, with 1-year-old and 4-year-old emus. Acute-phase proteins were separated by SDS-PAGE. Ceruloplasmin, transferrin, albumin, haptoglobin, acidic glycoprotein, IgA, and IgG were detected in the serum of all animals. Protein profiles varied significantly with age (P<0.05). Individuals in the 4-year-old emus group had higher values of ceruloplasmin, transferrin, albumin, haptoglobin, and acidic glycoprotein, compared with the group with 1-year-old animals, showing the role of age in the protein profile of this species. Reference values for acute-phase proteins in healthy emus may be useful in the evaluation of health status and in the diagnosis of diseases affecting the species.(AU)

A eletroforese de proteínas é um método relativamente simples, que permite a separação das proteínas do plasma em frações. Sua interpretação fornece informações importantes para a investigação e o diagnóstico de inúmeras doenças. O objetivo deste estudo foi o de determinar a concentração das proteínas de fase aguda no soro de emus (Dromaius novaehollandiae) hígidos e criados em cativeiro. As aves foram separadas em dois grupos: grupo 1: (n=11), aves com um ano de idade; grupo 2: (n=11), aves com quatro anos de idade. As proteínas de fase aguda foram separadas por eletroforese em gel de poliacrilamida (SDS-PAGE). Identificaram-se as proteínas ceruloplasmina, transferrina, albumina, IgG, haptoglobina, glicoproteína ácida, IgA e IgG no soro de todos os emus. Houve diferença (P<0.05) entre os traçados eletroforéticos em função da faixa etária. As aves do grupo 2 apresentaram valores superiores de ceruloplasmina, transferrina, albumina, haptoglobina e glicoproteína ácida quando comparadas às aves do grupo 1. Conclui-se que o perfil eletroforético de emus sofre alterações conforme a idade analisada. O estabelecimento de valores de referência para as proteínas de fase aguda de emus hígidos poderá auxiliar estudos futuros na avaliação da saúde assim como no diagnóstico de doenças em emus.(AU)

Proteinograma sérico e do líquido peritoneal de equinos submetidos à orquiectomia / Serum and peritoneal protein profile of horses subjected to orchiectomy

Avaliou-se a resposta de fase aguda através da determinação da concentração das proteínas de fase aguda (PFAs) no soro sanguíneo e no líquido peritoneal de dez equinos submetidos à orquiectomia. Foram colhidas amostras de sangue e líquido peritoneal antes do procedimento de orquiectomia (T0) e diariamente, até o sexto dia (T1-T6) pós-operatório. As PFAs foram separadas por eletroforese em gel de poliacrilamida contendo SDS-PAGE, e suas concentrações determinadas por densitometria computadorizada. Foram identificadas no soro e no líquido peritoneal, no pré e pós-operatório, as proteínas ceruloplasmina, transferrina, albumina, haptoglobina e α1-glicoproteína ácida. No pós-operatório, verificaram-se alterações nas concentrações séricas e peritoneais das PFAs, as quais foram associadas à resposta inflamatória desencadeada pelo trauma cirúrgico. A orquiectomia desencadeia reação inflamatória em equinos e o proteinograma pode ser utilizado para diagnosticar e monitorar complicações pós-operatórias.

The acute phase response was evaluated by determining the concentration of acute phase proteins (APP) in blood serum and peritoneal fluid in ten equines submitted to orchiectomy blood and peritoneal fluid samples were collected before the orchiectomy procedure (T0) and daily until the sixth postoperative day (T1-T6). The APPs were separated by electrophoresis on polyacrylamide gel containing SDS - PAGE and their concentrations were determined by computerized densitometry. There were identified in serum and peritoneal fluid, during pre and postoperative period, the acute phase proteins: ceruloplasmin, transferrin, albumin, haptoglobin and α1-acid glycoprotein. Postoperatively, there were changes in serum and peritoneal APPs, which were associated with the inflammatory response induced by surgical trauma. The orchiectomy triggers inflammatory reaction in equines and the proteinogram can be used to diagnose and monitor the postoperative complications.

Biomarkers for acute-phase response and coagulation/fibrinolysis in patients with chronic urticaria: a correlation study / 中华皮肤科杂志

Objective To evaluate the relationship of acute-phase response and coagulation/fibrinolysis with chronic urticaria (CU).Methods Fifty-three patients with CU and twenty-five healthy human controls were enrolled in this study.Venous blood samples were collected from all of these subjects.Then,enzyme-linked immunosorbent assay was carried out to measure the serum levels of interleukin-6 (IL-6) and amyloid protein A (AA),and immunoturbidimetry to determine the levels of serum high sensitive C-reactive protein (Hs-CRP) and plasma D-dimer.The patients with CU were classified into three groups according to the severity of clinical symptoms.The levels of serum IL-6 and plasma D-dimer were given in mean ± standard deviation,and those of serum AA and Hs-CRP in mean (25th percentile,75th percentile).Rank sum test and t test were performed to compare these parameters between the patients and controls,and Spearman rank correlation analysis was conducted to study the relationship among these parameters as well as between these parameters and symptom severity in these patients.Results The levels of serum IL-6,serum AA and plasma D-dimer were (10.70 ± 4.94) ng/L,4.92 (8.22,12.51) μg/L,and (222.32 ± 163.69) μg/L respectively in the patients with CU,significantly higher than those in the healthy controls ((7.49 ± 3.41) ng/L,2.11 (1.21,2.83) μg/L,(104.72 ± 43.12) μg/L,respectively,all P＜ 0.05),while no significant differences were observed between the patients and controls in the level of serum HsCRP (0.30 (0.10,1.40) mg/L vs.0.30 (0.10,0.55) mg/L,P ＞ 0.05).In patients with CU,the levels of serum IL-6 were unrelated to those of serum Hs-CRP,serum AA,or plasma D-dimer (all P ＞ 0.05),whereas a positive correlation was observed between the levels of serum Hs-CRP and AA (r =0.67,P ＜ 0.01),serum Hs-CRP and plasma D-dimer (r =0.49,P ＜ 0.01),serum AA and plasma D-dimer (r =0.38,P ＜ 0.01).Further more,the levels of serum Hs-CRP,AA and plasma D-dimer were significantly correlated with symptom severity in patients with CU (r =0.63,0.62,0.47,respectively,all P ＜ 0.01).Conclusions Acute-phase response coexists with the activation of coagulation system in patients with CU,suggesting a potential association between acute-phase response and coagulation system activation.

Redução transitória nos níveis séricos de retinol em crianças com pneumonia e resposta de fase aguda / Transient decreased retinol serum levels in children with pneumonia and acute phase response

OBJETIVO: Comparar os níveis séricos de retinol em crianças pré-escolares durante um episódio de pneumonia e 45 dias após a resolução da infecção. MÉTODOS: O estudo foi conduzido com crianças pré-escolares sem infecção (grupo controle, n = 9) ou com pneumonia (n = 12), após a hospitalização (fase 1) e 45 dias após a alta (fase 2). A avaliação nutricional incluiu antropometria, questionário alimentar e exames laboratoriais, incluindo os níveis urinários e séricos de retinol. Aplicou-se o teste pareado de Student ou de Mann-Whitney. RESULTADOS: Não houve diferença na ingestão alimentar. Documentaram-se menores valores de hemoglobina sanguínea e dos níveis séricos de sódio e albumina durante a fase 1, além de maiores valores da proteína C reativa. Não houve mudança no retinol urinário, enquanto os níveis séricos aumentaram após a recuperação da pneumonia. CONCLUSÕES: Durante a pneumonia, as crianças apresentam redução transitória nos níveis séricos de vitamina A, um epifenômeno da resposta de fase aguda.

OBJECTIVE: To compare serum retinol levels in preschool children during an episode of pneumonia and 45 days after the resolution of the infection. METHODS: The study was conducted with preschool children without any infection (control group, n = 9) or children hospitalized for pneumonia (n = 12), who were evaluated soon after hospitalization (phase 1) and 45 days later (phase 2). Nutritional assessment included anthropometric measurements, a food questionnaire, and laboratory blood routine examination, including urinary and serum retinol levels. Paired Student t or Mann-Whitney tests were used as required. RESULTS: Food intake was similar between groups. Blood hemoglobin and serum sodium and albumin decreased during phase 1, while there were higher C-reactive protein serum values. Urinary retinol levels remained unchanged whereas serum retinol increased significantly after pneumonia recovery. CONCLUSIONS: During the course of pneumonia, children had transient decrease in serum levels of vitamin A, an epiphenomenon of the acute phase response.

Inflammation and acute phase response.

Inflammation caused by infection takes place by the cooperative cascade of cytokines and leukocytes. Tumor necrosis factor, interlukin-1, and interlukin-6 play important roles as proinflammatory cytokines to mediate local inflammation and activate other inflammatory cells e.g. neutrophils, monocytes, and macrophages. At least 15 different low molecular weight cytokine are secreted by activated leukocytes and are responsible for triggering acute phase response in the form of fever, leukocytosis, increased secretion of adreno corticotropic hormones, and production of acute phase proteins. Acute phase proteins are produced in liver under the influence of cytokines, which through blood stream passes to the site of inflammation and kill the pathogens by opsonization and activating complement pathways. The changes in the concentrations of positive acute-phase proteins and negative acute-phase proteins are due to the changes in their production by liver. Three of the best known acute phase proteins are C-reactive protein, serum anyloid A, and haptoglobin. Some disease states are casually related to acute phase proteins. C-reactive protein mediated compliment activation has a key role in some forms of tissue alteration such as cardiac infarction. Elevated S amyloid A levels are seen in chronic arthritis and tuberculosis. Other acute phase proteins show more moderate rise, usually less than fivefold.

Application of detection of C-reactive protein, serum glucose concentration and APACHE Ⅱ grade in systemic inflammatory response syndrome / 中国综合临床

Objective To study the value of detection of C- reactive protein(CRP), serum glucose concen-tration and APACHE Ⅱ grade for estimating inflammation, pathogenetic condition and prognosis of systemic inflam-matory response syndrome (SIRS) patients.Methods 50 SIRS patients in ICU were selected and were divided into S1 and S2 subgroup according to SIRS diagnosis standard, and 18 patients developed MOBS.30 patients without SIRS, were selected as control group.Detection of CRP, serum glucose concentration and APACHE Ⅱ grade were per-formed.Results CRP(76.19±11.98 mg/L vs.14.04±5.70 mg/L) ,serum glucose concentration(7.10±1.30 mmol/L vs.5.32±1.09 mmol/L) and APACHE Ⅱ grade (20.06±6.39 vs.7.90±3.54) of SIRS group were higher than that of non-SIRs group (P<0.01).CRP, serum glucose concentration and APACHE Ⅱ grade all are higher in group S2 than that of group S1 (91.25±9.89 mg/L vs.62.29±10.38 mg/L,8.32±2.40 mmol/L vs.7.10±1.69 mmol/L,26.72±5.14 vs.18.37±5.70).MOBS incidence and case fatality in S2 subgroup (12/15 and 6/35) were higher than that of S1 subgroup(10/15 and 3/35 ) (P<0.01 ).Conclusion CRP, serum glucose concentration and APACHE Ⅱ grade are increased in SIRS patients and with their increasing, MOBS incidence and case fatality were also increasing.CRP, serum glucose concentration and APACHE Ⅱ grade are significant factors in estimating SIRS patients pathogenetic condition and their prognosis.

Haptoglobin study in myasthenia gravis / Estudo sobre a haptoglobina na miastenia grave

OBJECTIVE: A cross-sectional study of haptoglobin (Hp) in myasthenia gravis (MG) was designed, with the objective to identify its values and correlate them with different disease status. METHOD: 46 patients were enrolled in the study, all having disease severity established according to the quantitative myasthenia gravis strength scores (QMGSS). Based on the functional scale determined by Myasthenia Gravis Foundation of America (MGFA) recommendations, patients were classified as having: complete stable remission (CSR; n=10); minimal manifestations-0 (MM0; n=6), minimal manifestations-1 (MM1; n=4); pharmacological remission (PR; n=6). Two other groups participated: thymomatous patients (T; n=10) and patients without imunosuppression or thymectomy, until the assessment for Hp (WIT; n=10). Hp dosage was done by immunonephelometry, blindly to clinical data. Student's t-test, Anova test and linear regression were employed for statistical analyses. RESULTS: Statistically significant differences occurred between CSR+MM0xWIT groups (86.62x157.57, p<0.001) and PR+MM1xWIT groups (73.93x157.57, p<0.001). Linear regression showed correlation between Hp levels and QMGSS (r=0.759, p<0.001). CONCLUSION: Our results suggest that Hp may be useful in clinical practice as a disease severity marker in MG.

OBJECTIVO: Desenhou-se estudo transversal sobre a haptoglobina (Hp) na miastenia grave (MG) com o objetivo de identificar seus valores e correlacioná-los a diferentes condições na doença. MÉTODO: 46 pacientes foram incluídos, todos tendo a gravidade da doença estabelecida segundo escores internacionais (QMGSS). Os pacientes tiveram seu estado funcional determinado de acordo com a Myasthenia Gravis Foundation of América (MGFA) e classificados em: remissão completa estável (CSR; n=10); mínima manifestação-0 (MM0; n=6), mínima manifestação-1 (MM1; n=4); remissão farmacológica (PR; n=6). Dois outros grupos participaram: pacientes timomatosos (T; n=10) e pacientes sem imunossupressão ou timectomia, até o momento da inclusão no estudo (WIT; n=10). A dosagem de Hp foi realizada por imunonefelometria, de modo cego quanto à clínica. As análises estatísticas incluíram o teste de Student, Anova e regressão linear. RESULTADOS: Observou-se diferença significativa entre os grupos CSR+MM0xWIT (86,62x157,57, p<0,001) e entre PR+MM1xWIT (73,93x157,57, p<0,001). A regressão linear mostrou correlação positiva entre os valores de Hp e os escores QMGSS (r=0,759, p<0,001). CONCLUSÃO: O estudo sugere que valores altos de Hp se correlacionaram a maior gravidade da MG.

Effects of low-dose recombinant human growth hormone on acute phase response in patients with abdominal sepsis / 肠外与肠内营养

Objective: To examine the effects of recombinant human growth hormone on the acute phase response in abdominal sepsis patients.Methods: Prospective unblinded trial was made with each patient serving as his/her own control.Eighteen abdominal sepsis patients were enrolled ranging in age from 24 to 60 yrs.All patients received 10 U/d of GH 48 hrs after performing drainage and for 7days.Results: Serum concentration of constitutive proteins,acute phase protein and cytokines were measured before and 1,3,5 and 7 days after GH administration.GH notablely increased serum constitutive protein levels(prealbumin,transferrin,fibronectin) and decreased serum acute phase protein level(CRP).Cytokine TNF-?,IL-1? and IL-6 had significant change after GH administration,but the changes were not relative to the change of acute phase response.Conclusion: Low-dose rhGH effectively modulated the acute phase response by attenuating production of the hepatic acute phase protein and increasing the synthesis of constitutive proteins.

Serum C-reactive protein levels in subjects with impaired fasting glycemia and its clinical significance / 中国实用内科杂志

Objective To investigate the levels of serum C-reactive protein in subjects with impaired fasting glycemia and its significance.Methods From Mar.to Sep.2005,according to oral 75 g glucose tolerance test(OGTT)in the patients in the First Hospital Affiliated to China Medical University,there are 30 subjects with normal glucose tolerance(NGT),28 cases with impaired fasting glycemia(IFG).CRP was detected with ELISA.Results (1)Serum CRP in the subjects with impaired fasting glycemia was significantly higher than those in normal subjects( P

The metabolic response to traumatic brain injury and implications for nutritional support / 肠外与肠内营养

The metabolic response to traumatic brain injury includes hypermetabolism, hypercatabolism, hyperglycemia, acute phase response and immunosuppression, which are mediated mainly by hypothalamus pituitary adrenal axis and cytokines. Sufficient nutritional support and appropriate metabolic intervention are believed clinically to play an important role on the mitigation of secondary brain damage, reduction of septic rate and improvement of patient′s outcomes.

Serum C-reactive protein levels in subjects with varying glucose tolerances and effect of acarbose intervention / 中华内分泌代谢杂志

Objective To investigate the difference of serum C-reactive protein (CRP) concentrations in subjects with various glucose tolerances and the change of serum CRP concentrations in cases of impaired glucose tolerance (IGT) treated with acarbose. Methods A total of 154 subjects participated in the study and according to oral 75 g glucose tolerance test (OGTT), among them there were 44 subjects with normal glucose tolerance (NGT), 89 cases with IGT and 21 cases with type 2 diabetes (DM). Sixty IGT subjects were recruited into randomized, double-blind, placebo-controlled study. The IGT subjects received either 150 mg acarbose daily or placebo for 16 weeks. The serum CRP concentration was detected with immunoscattering assay. Results (1) The serumCRPconcentration〔median(25%, 75%)〕 was 4.60(4.10-5.25)mg/L in NGT subjects, 5.25(4.50-6.00)mg/L in IGT subjects, 5.70(5.20-7.50)mg/L in type 2 DM patients (F=157.00, P0.05). Conclusion (1) The serum CRP concentration is gradually increased with the worsening of glucose tolerence; (2) The serum CRP concentration is positively correlated with OGTT 2 h blood glucose, HbA 1C , TC, TG; (3) The serum CRP concentration is decreased in IGT subjects treated with acarbose following the improvement of hyperglycemia.

Induction of hepatic acute phase reactants by conditioned medium from lipopolysaccharide treated human dermal fibroblasts / 第二军医大学学报

To test the hypothesis that dermal fibroblasts (DF) are an important source of cytokines which elicit major changes in hepatic synthesis of acute phase reactants(APRs). Metkods: Condi-tioned medium(CM) from human DF challenged with bacterial lipopolysaccharide (I,PS) was collected andIL-10 and IL-6 levels were measured- The ability of DF conditioned medium(fLPS) and dexamethasone(Dex) to mediate an hepatic acute phase response was tested on rat hepatoma H4 cells- Various concentra-tions and combinations of CM (?LPS), recombinant IL-6 (rhIL-6) and Dex were tested for their abilitiesto stimulate albumin, Q,-acid glycoprotein (AGP), a,-antitrypsin (AT) and transferrin mRNA synthesis.Results: LPS stimulated IL-6 production by DF and Dex inhibited this producti0n. IL-6 and CM+LPS in-hibited the production of albumin mRNA,while the expression of AT and AGP 0ccurred 0nly with CM+LPS+Dex. However,IL-6 alone had an inhibitory effect 0n albumin and transferrin mRNA producti0n.Dex maximized the effects 0f lL-6 and CM, and was essential f0r AGP gene expression. C0nclusion: (l)LPS-treated human DF can secrete IL-6, but not IL-101 (2)DF may als0 pr0duce other cyt0kines whichmodulate hepatic pr0tein synthesis during the acute phase response l (3) Dex inhibits IL-6 production byDF, but enhances its ability to stimulate the acute phase response.