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

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.

The Serum Levels of Resistin and Its Relationship with Other Proinflammatory Cytokines in Patients with Alzheimer's Disease.

OBJECTIVE: The present study aims to analyze the levels of resistin, tumor necrosis factor alpha (TNF-α), interleukin (IL)-1ß, IL-6, IL-18, and C-reactive protein (CRP) in patients with Alzheimer's disease (AD) and also investigate a potential relationship between resistin levels and TNF-α, IL-1ß, IL-6, IL-18, and CRP levels in patients with AD. METHODS: The study included fifty patients with AD and 30 healthy controls with normal cognitive functions. The serum resistin, TNF-α, IL-1ß, IL-6, IL-18, and CRP levels were assessed. We performed a Mini-Mental State Examination (MMSE) to evaluate the general cognitive performance. RESULTS: The mean serum resistin, IL-1ß, IL-18, and TNF-α levels were significantly higher in patients with AD compared with the controls (p=0.026, p=0.002, p=0.003, and p=0.038, respectively). The IL-6 and CRP levels did not differ between the groups (p=0.874 and p=0.941). The resistin levels were positively correlated with the levels of CRP and IL-18 (r=0.526, p＜0.001; r=0.402, p=0.004, respectively). MMSE scores and inflammatory markers were not correlated (p＞0.05 for all). CONCLUSION: Serum resistin levels were significantly increased and correlated with some inflammatory markers in AD patients, suggesting that resistin might play a role in the inflammatory process of AD.

Determination of in vitro activities of polymyxin B and rifampin in combination with ampicillin/sulbactam or cefoperazone/sulbactam against multidrug-resistant Acinetobacter baumannii by the E-test and checkerboard methods.

The aim of this study was to investigate the in vitro activities of polymyxin B (PB) and rifampin (RIF) in combination with ampicillin/sulbactam (AS) or cefoperazone/sulbactam (CS) against 20 multidrug-resistant Acinetobacter baumannii (MDR-AB) isolates by the checkerboard and E-test methods. Fractional inhibitory concentration index (FICI) values were defined as synergy, FICI ≤ 0.5; additivity, 0.5 < FICI ≤ 1.0, indifference, 1.0 < FICI < 4.0; and antagonism, FICI ≥ 4. Synergistic interaction was detected only for the RIF + AS and RIF + CS combinations. While the most frequently detected interaction type for PB + AS or PB + CS combinations was indifference, some showed antagonistic interactions. The detection rate of synergy was significantly higher by the checkerboard than by the E-test method, and the detection rate of indifference was significantly higher by the E-test than by the checkerboard method for RIF + AS combination (P ≤ 0.0001). In addition, no statistically significant difference was detected between the checkerboard and E-test methods for the detection rates of interaction types for any of the other combinations (P > 0.05), except for PB + CS combination for the detection of additivity (P = 0.018). Owing to the high percentage of synergistic interactions between RIF and AS, we considered this combination as an effective therapeutic option for MDR-AB infections.

Distribution of genes encoding resistance to macrolides, lincosamides and streptogramins among clinical staphylococcal isolates in a Turkish university hospital.

This study investigated the prevalence of genes encoding resistance to macrolides, lincosamides and streptogramins (MLS(B)) among staphylococci in a series of 301 erythromycin-resistant clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci (CoNS). Erythromycin-resistance phenotypes were determined according to Clinical and Laboratory Standards Institute guidelines and specific resistance genes erm(A), erm(B), erm(C), msr(A) and msr(B) were identified using polymerase chain reaction. Two hundred of 301 (66.5%) erythromycin-resistant staphylococcal isolates exhibited resistance to MLS(B) antibiotics. Of these, 127 (63.5%) exhibited a cMLS(B) resistance phenotype (resistant to both erythromycin and clindamycin), whereas 73 (36.5%) expressed the iMLS(B) resistance phenotype (resistant to erythromycin and susceptible to clindamycin). The most prevalent resistance determinants were erm(A) (62%) among S. aureus and erm(C) (30%) among CoNS isolates. Combinations of resistance mechanisms were rarely seen, and occurred most often in oxacillin-resistant isolates. The results of the present study support the idea that there are geographical differences in the prevalence of erythromycin resistance mechanisms among staphylococci, therefore local surveillance studies are important tools for guiding therapy and in the promotion of judicious use of antimicrobial agents.

Macrolide-lincosamide-streptogramin B resistance phenotypes in clinical staphylococcal isolates.

The prevalence of macrolide-lincosamide-streptogramin B (MLSB) resistance as well as the MLSB resistance phenotypes were investigated by the double-disk diffusion test among 532 clinical staphylococci isolates in a Turkish university hospital. The activity of other antimicrobials, including trimethoprim/sulfamethoxazole, telithromycin, quinupristin/dalfopristin, linezolid, gentamicin, chloramphenicol, ciprofloxacin and vancomycin, was also evaluated. Of 532 isolates, 38.5% were resistant to MLSB antibiotics; 63.9% of the resistant isolates exhibited a constitutive phenotype (cMLSB) whereas 36.1% expressed an inducible resistance phenotype (iMLSB). MLSB resistance was more prevalent among coagulase-negative staphylococci (CoNS) strains. Oxacillin-resistant strains exhibited significantly higher MLSB resistance rates compared with oxacillin-susceptible strains (P<0.0001). The most frequently detected resistance phenotype among the total staphylococcal isolates was the constitutive type and this phenotype was more frequently encountered among oxacillin-resistant strains. With the exception of the fully active agents such as vancomycin, linezolid and quinupristin/dalfopristin, the most effective antibiotics were telithromycin and chloramphenicol among all isolates. Susceptibility rates to other antibiotics tested were higher among isolates without MLS(B) resistance than isolates with MLSB resistance. The detection of a considerable rate (43.5%) of iMLSB resistance among erythromycin-resistant/clindamycin-susceptible strains suggests that the true percentage of clindamycin resistance may be underestimated if testing for inducible resistance is not performed.

[The role of anti-cyclic citrullinated peptide (anti-CCP) antibodies in serologic diagnosis and evaluation of disease activity in rheumatoid arthritis]. / Romatoid artritin serolojik tanisinda ve hastalik aktivitesinin degerlendirilmesinde anti-CCP (cyclic citrullinated peptide) antikorlarinin rolü.

Anti-cyclic citrullinated peptide (anti-CCP) antibodies are used as highly specific and sensitive markers in the diagnosis of rheumatoid arthritis (RA), in recent years. The aim of this prospective and cross-sectional study was to measure the levels of anti-CCP and rheumatoid factor (RF) in patients with RA and osteoarthritis, and healthy volunteers to evaluate the specificity and possible diagnostic value of anti-CCP and RF, as well as their correlations with parameters of disease activity. Thirty-four patients with RA (mean age: 53.8 +/- 8.6; 29 female), 32 patients with osteoarthritis (mean age: 53.1 +/- 8.1; 26 female) and 32 healthy controls (mean age: 49.6 +/- 6.7; 24 female) were evaluated between July 2004-July 2005. RA diagnosis was done on the basis of criteria recommended by American College of Rheumatology (ACR). Clinical parameters, including disease activity score (DAS28) and health assessment questionnaire (HAQ) indices for physical capacity were detected for RA patients. As a result, 25 (73.5%) of the patients with RA were found positive for anti-CCP (mean value: 74.6 +/- 64.9 RU/ml), while 24 (70.6%) were positive for RF (mean value: 62.6 +/- 84.8 IU/ml). Serum levels of anti-CCP and RF showed statistically significant increase in patients with RA in comparison with osteoarthritis patients (all were negative for anti-CCP; 6.2% were positive for RF) and healthy controls (all were negative for anti-CCP anf RF) (p < 0.001). Twenty-two of the RA patients (64.7%) yielded positive results for both anti-CCP and RF, while seven (20.6%) were negative for both of the parameters. The sensitivity and specificity of anti-CCP reactivity for RA patients diagnosed based on ACR criteria were detected as 73.5% and 100%, respectively; the corresponding results for RF were 70.6% sensitivity and 96.8% specificity. The mean DAS28 and HAQ scores of RA patients with anti-CCP and RF were higher than the patients without anti-CCP and RF, however these differences were not statistically significant (p > 0.05). Furthermore, a correlation between serum anti-CCP levels and HAQ score was determined, while there was no correlation between DAS28 and anti-CCP levels. In conclusion, antibodies against CCP were thought to be more specific than RF for RA, and the determination of anti-CCP in addition to RF could be helpful in serological diagnosis and monitorization of patients with RA.

Distribution of hepatitis B virus (HBV) genotypes among HBV carriers in Isparta.

BACKGROUND: The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Isparta, Southwest of Turkey, as well as the clinical features and transmission route for patients with HBV infections. METHODS: Patients (n = 135) with HBV infection were included in the study. Epidemiological and clinical data were obtained. HBV genotypes were determined with a preS2 epitope ELISA kit. RESULTS: Although the HBV transmission route remained unidentified in 51.1% of the patients, blood contact was determined as the most common probable transmission route (38.5%). One hundred twenty-four (91.8%) of 135 samples, could be genotyped. One hundred fifteen (85.1%) were genotyped as type D/E, six (4.4%) were genotyped as type A, two (1.4%) were genotyped as type C, and one (0.7%) were genotyped as type F. CONCLUSION: Genotype D/E is determined as the predominant HBV genotype circulating in Isparta, Southwest of Turkey. No relationship between genotypes and disease severity and transmission route has been detected.

Pathogenicity of Blastocystis hominis, a clinical reevaluation.

Blastocystis (B.) hominis was considered to be a member of normal intestinal flora in the past, but in recent years it has been accepted as a very controversial pathogenic protozoan. In this study, 52 individuals whose stool examination revealed B. hominis were evaluated for clinical symptoms. Metronidazole was administered for 2 weeks to the patients infected with B. hominis. After 2 weeks of treatment they were called for a follow-up stool examination. No other bacteriological and parasitological agents were found during stool examination of these patients. The frequency rate of intestinal symptoms was 88.4% in the B. hominis cases. Abdominal pain was the most frequent symptom (76.9%). Diarrhea and distention followed at a rate of 50.0% and 32.6%. Intestinal symptoms may be seen frequently together with the presence of B. hominis and this protozoan may be regarded as an intestinal pathogen, especially when other agents are eliminated.

Adenosine deaminase activity in serum of patients with hepatitis -- a useful tool in monitoring clinical status.

BACKGROUND AND PURPOSE: The evaluation of adenosine deaminase (ADA) activity in sera of patients with hepatitis should be considered a useful tool in the monitoring of their clinical status. In this study, we aimed to determine the relationship between viral load, transaminase levels, and serum ADA levels in hepatitis B virus (HBV)- and hepatitis C virus (HCV)-infected patients. METHODS: Seventy three patients with hepatitis B, 71 patients with hepatitis C and 40 healthy individuals were included. Patients with HBV and HCV infections were classified into 3 groups according to viral load. Serum ADA levels were investigated by colorimetric assays. RESULTS: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ADA levels of HBV- and HCV-infected patients were higher than those of the control group. These differences were statistically significant for the levels of all enzymes in HCV-infected patients (p<0.05), and all except AST (p>0.05) in HBV-infected patients. ADA levels of HBV-infected patients with high viral loads were higher than those in HBV-infected patients with intermediate and low viral loads, and the difference was detectably significant between patients with high and intermediate viral loads. Evaluation of HCV-infected patients according to viral load showed no statistically significant relationship between viral load and serum ADA, ALT, and AST levels (p>0.05). HBV- and HCV-infected patients with high ALT and AST levels showed statistically significantly higher levels of ADA than patients with normal ALT and AST levels (p<0.001). CONCLUSIONS: We suggest that serum ADA levels are associated more with the level of serum transaminases than viral load in HBV- and HCV-infected patients. In the treatment of patients with hepatitis, serum ADA levels should be considered a useful tool for the monitoring of liver condition.

Lipid peroxidation level and antioxidant enzyme activities in the blood of patients with acute and chronic fascioliasis.

OBJECTIVE: In this study, we investigated the relationship between fascioliasis and serum malondialdehyde (MDA) levels, superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) activities. We also investigated whether there are significant differences in MDA levels and antioxidant enzymatic activities between acute and chronic fascioliasis. METHODS: Forty fascioliasis patients who were diagnosed by ES-ELISA positivity were included in this study. The patients were classified as 18 with acute and 22 with chronic fascioliasis. RESULTS: In patients with fascioliasis, levels of MDA were statistically higher and erythrocyte SOD and GPx activities were statistically lower than in healthy controls. MDA levels were found to be higher in patients with acute fascioliasis than in patients with chronic fascioliasis although MDA levels were significantly higher in patients with chronic fascioliasis than in controls. There was no statistically significant difference between the two groups for the antioxidant enzyme activities. CONCLUSION: The results of this study may indicate that fascioliasis produces specific effects on the antioxidant defense mechanisms due to its inflammatory character. Our results also allow us to suggest that oxidative stress has an important role in the pathogenesis of fascioliasis and the persistence of this oxidative stress can be one of the underlying factors in the pathogenesis of the chronic disease.

Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids.

This study compared the BACTEC blood culture system (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md) with conventional culture methods for recovery and time to detection of significant isolates from normally sterile body fluids. A total of 412 specimens were included in the study. Half of the specimens were inoculated directly into the automated blood culture system. The remaining specimens were centrifuged at 3000 rpm for 10 min and were inoculated onto conventional media. Clinically significant microorganisms were isolated from 41 specimens (10%) by both culture systems; however, for 62 specimens (14.9%), growth was detected only with the BACTEC system. No isolates were detected with only conventional culture methods. A significant difference was noted between the blood culture system and routine culture methods for recovery of pathogenic microorganisms that were from sterile body fluids. The most frequently isolated microorganisms recovered only with the blood culture system were gram-positive cocci; gram-negative bacilli were the most frequently isolated microorganisms that were recovered with both culture methods. Streptococcus pneumoniae, Streptococcus viridans, Aeromonas hydrophila, and Brucella were recovered only with the blood culture system. Furthermore, the mean time to detection of significant pathogens was significantly less with the blood culture system than with conventional media. The BACTEC blood culture system was found to improve the yield of clinically significant isolates from normally sterile body fluids with reduced time to detection; it may be advantageous for isolation of fastidious microorganisms, such as Brucella and S pneumoniae, especially from cerebrospinal and synovial fluid specimens.

Eosinophil cationic protein in patients with fascioliasis: its probable effects on symptoms and signs.

Eosinophilia is 1 of the most common signs of fascioliasis especially during acute stage. In this study, our aim was to determine eosinophil cationic protein (ECP) in the sera of patients with fascioliasis and to investigate the likely relation between ECP and symptoms and signs of fascioliasis. Presence of high liver enzyme levels, eosinophilia, abdominal pain or urticaria was not found to be significantly associated with ECP positivity (p>0.05), but statistical analyses revealed that ECP positivity was significantly related to weight loss status of patients (p<0.005). In conclusion, ECP may be 1 of the likely causes of the symptoms and signs of fascioliasis.

The demonstration of serum interleukin 6-8, tumor necrosis factor-alpha, complement, and immunoglobulin levels in Behçet's disease with ocular involvement.

PURPOSE: To investigate whether there are alterations in the humoral immune system in patients with Behçet's disease (BD) with ocular involvement. METHODS: Twenty-four BD patients with active uveitis and without any other manifestations of the disease were included in Group I-a. The same patients were reassessed during the convalescence period and assigned to Group I-c. Moreover, 24 age- and sex-matched healthy controls (Group II) were included in the study. Serum levels of immunoglobulin (Ig) A, IgM, complement (C) 3, C4, interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-alpha) in Groups I-a, I-c, and II were measured and compared. RESULTS: IgA, C3, C4, IL-6, IL-8, and TNF-alpha levels were higher in Group I-a than in Groups I-c and II. CONCLUSIONS: IgA-, C3-, C4-, IL6-, IL8-, and TNF-alpha-mediated mechanisms might be responsible for ocular lesions in BD.

Tissue parasites in patients with chronic urticaria.

Chronic urticaria is an important diagnostic and therapeutic problem. We aimed to investigate the sero-prevalence of tissue parasites causing toxocariasis and fasciolosis in patients with chronic urticaria. All cases were analyzed for antibodies against Toxocara canis and Fasciola hepatica by modified (homemade) ELISA. The excretory/secretory products of Toxocara and Fasciola were used as antigens (ES-ELISA) in the test. In this study, the highest toxocariasis seropositivity (29.0%) rate and the highest fasciolosis seropositivity (14.5%) rate were found in patients with chronic urticaria. Fasciolosis seropositivity and total seropositivity of toxocariasis and fasciolosis in patients with chronic urticaria was significantly higher than in healthy controls (p<0.05). Toxocariasis seropositivity in patients with chronic urticaria was not significantly higher than that in healthy controls (p>0.05). We suggest that parasitic infections should be considered as an important cause of chronic urticaria. Serological methods should be used to expose the diagnosis of tissue parasites in such cases.

Serum Levels of IL-4, IL-10, IL-12, IL-13 and IFN-gamma in Behçet's disease.

Behçet's disease (BD) is an inflammatory disease of unknown etiology. Although its pathogenesis is not fully understood, recent studies have suggested that immunological abnormalities and neutrophil hyperfunction may be involved in its etiology and pathophysiology. The immune system in BD can be characterized as a divergent cytokine production profile of the mixed Th1/Th2 cell type. In this study, we investigated the levels of interleukin (IL)-4, IL-10, IL-12, IL-13 and interferon-g in the sera of patients with BD, in comparison with recurrent aphthous stomatitis and healthy controls, to determine the Th1/Th2 profile of the disease. The levels of IL-4, IL-10 and IL-13 were found to be high in active BD patients, and IL-12 and interferon-gamma levels were lower in active BD patients than in inactive BD, recurrent aphthous stomatitis, and control patients.

Pansclerotic morphea treated with UVA: a case report.

We present an 8-year-old girl with pansclerotic morphea of childhood, a rare, severe variant of localized scleroderma. Various systemic agents and PUVA are used in the treatment of this disease. We used UVA therapy in the treatment of this case.

Antimicrobial activity and chemical composition of some essential oils.

In this study the composition and antimicrobial properties of essential oils obtained from Origanum onites, Mentha piperita, Juniperus exalsa, Chrysanthemum indicum, Lavandula hybrida, Rosa damascena, Echinophora tenuifolia, Foeniculum vulgare were examined. To evaluate the in vitro antibacterial activities of these eight aromatic extracts; their in vitro antimicrobial activities were determined by disk diffusion testing, according to the NCCLS criteria. Escherichia coli (ATTC 25922), Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATTC 27853 were used as standard test bacterial strains. Origanum onites recorded antimicrobial activity against all test bacteria, and was strongest against Staphylococcus aureus. For Rosa damascena, Mentha piperita and Lavandula hybrida antimicrobial activity was recorded only to Staphylococcus aureus. Juniperus exalsa, and Chrysanthemum indicum exhibited antibacterial activities against both Staphylococcus aureus and Escherichia coli. We also examined the in vitro antimicrobial activities of some components of the essential oils and found some components with antimicrobial activity.