The erythrosense as a real-time biomarker to reveal the presence of enhanced red blood cell aggregability in atherothrombosis.

Both anemia and inflammation might be present in individuals with atherothrombosis. We have evaluated the eventual influence of these 2 variables on the degree of erythrocyte adhesiveness/aggregation in the peripheral blood of 583 women and 402 men with various atherothrombotic risk factors and vascular events. It turned out that both anemia and inflammation (highly sensitive C-reactive protein concentrations) influence the degree of cell adhesiveness/aggregation and that there is no interaction between them. Thus, the degree of erythrocyte adhesiveness/aggregation might have the diagnostic advantage of being enhanced in individuals with atherothrombosis who have inflammation and no anemia as well as those who have anemia and no inflammation. These findings might help to turn a phenomenon of hemorheological relevance into a diagnostic tool for the detection of individuals at risk of an acute ischemic event.

Clinical and laboratory characteristics of patients with atherothrombotic risk factors presenting with low concentrations of highly sensitive C-reactive protein.

AIMS: To clarify whether individuals with low concentrations of highly sensitive C-reactive protein (hs-CRP) are free of atherothrombotic risk factors or low-grade inflammation. METHODS AND RESULTS: This cross-sectional study included 1266 individuals with risk factors (diabetes, hypertension, hyperlipidemia, smoking, obesity). Eighty percent of women and the same percentage of men with a low concentration (0.8 +/- 0.4 mg/l) of hs-CRP had at least one atherothrombotic risk factor. About one-fourth of the females and a one-third of the males with a low concentration of hs-CRP had at least one laboratory marker of chronic inflammation (erythrocyte sedimentation rate (ESR), white blood cell count (WBCC) or fibrinogen concentration) in the upper 75th percentile. CONCLUSION: Individuals presenting with low concentrations of hs-CRP are not necessarily free of atherothrombotic risk factors. One-fourth of the females and a third of the males in this group presented laboratory evidence of a low-grade inflammation as detected by increased erythrocyte sedimentation rate, white blood cell count or fibrinogen concentration.

The appearance of aggregated erythrocytes in the peripheral blood of individuals with insulin resistance.

BACKGROUND: Insulin resistance is associated with low-grade inflammatory response. The probability that the acute-phase response is associated with enhanced erythrocyte adhesiveness/aggregation was not explored. METHODS: The degree of erythrocyte adhesiveness/aggregation was evaluated by using a simple slide test. The insulin resistance was evaluated by insulin and glucose concentrations after a night of fasting. The inflammatory response was evaluated by variables of acute-phase response. RESULTS: A significant correlation (r = -0.2, p = 0.02) was noted between insulin resistance expressed as the HOMA index and the degree of erythrocyte adhesiveness/aggregation. This was probably due to the concomitant acute-phase response and the presence of increased amounts of inflammation-sensitive proteins that were found to correlate significantly with the degree of erythrocyte adhesiveness/aggregation. In the multiple linear regression analysis, erythrocyte sedimentation rate and fibrinogen concentration but not HOMA index were found to correlate significantly (p < 0.0001 and p = 0.0007 respectively) with the degree of red blood cell adhesiveness/aggregation. CONCLUSIONS: Insulin resistance is associated with an enhanced degree of erythrocyte adhesiveness/aggregation and this is related to the presence of enhanced inflammation-sensitive plasma proteins that are part of the acute-phase response. These findings might have hemorheological consequences and might contribute to the pathophysiology of the insulin-resistance syndrome.

Inflammation at a glance: erythrocyte adhesiveness/aggregation test to reveal the presence of inflammation in people with atherothrombosis.

The erythrocyte adhesiveness/aggregation test is a new biomarker to detect low-grade inflammation in patients with atherothrombosis. In a group of 30 individuals with an acute ischemic event, the variability of EAAT during a follow-up period was similar to those obtained for other commonly used markers of the acute phase response, suggesting the potential clinical use of this novel marker.

The erythrocyte adhesiveness/aggregation test (EAAT). A new biomarker to reveal the presence of low grade subclinical smoldering inflammation in individuals with atherosclerotic risk factors.

BACKGROUND: Multiple acute phase proteins and atherosclerotic risk factors increase the aggregability of erythrocytes. METHODS AND RESULTS: We used a simple slide test and image analysis to determine the degree of erythrocyte adhesiveness/aggregation in the peripheral blood of 222 women and 221 men with no, one, two or more atherosclerotic risk factors. The degree of erythrocyte adhesiveness/aggregation correlated significantly with the concentration of commonly used variables of the acute phase response. We also showed that individuals with low erythrocyte adhesiveness/aggregation tend to be younger and to have fewer risk factors for atherosclerosis, including diabetes mellitus, hypertension, hyperlipidemia and smoking. CONCLUSIONS: The association between increased erythrocyte adhesiveness/aggregation, higher concentrations of acute phase proteins, and increased atherosclerotic risk factors points to a possible clinical applicability of the erythrocyte adhesiveness/aggregation test (EAAT) to reveal the presence of both low-grade subclinical smoldering inflammation and morbid biology in individuals with risk factors for atherosclerosis.

Superiority of a functional leukocyte adhesiveness/aggregation test over the white blood cell count to discriminate between mild and significant inflammatory response in patients with acute bacterial infections.

Electronic cell counters may underestimate the white blood cell count (WBCC) in the presence of aggregated leukocytes. In the present study we focused on the possibility of using a functional, as opposed to an anatomic, count to circumvent this eventual underestimation. A model of bacterial infection was used because of the importance of leukocytosis in the physician's clinical decision-making process. There were 35 patients with low C-reactive protein (CRP) concentrations (0.5-4.9 mg/dL), 45 with intermediate (5-9.9 mg/dL), and 120 with relatively high (>10 mg/dL) CRP concentrations. A significant (P=0.008) difference was noted between the state of leukocyte adhesiveness/aggregation in the peripheral blood of individuals with low CRP concentrations (3.5%+/-4.3%) and those with high CRP concentrations (7.4%+/-8%), while there was no significant difference in the respective number of WBCs per cubic millimeter (cmm) (11,600 +/- 5,500 and 14,000 +/- 7,200, respectively). We raise the possibility that a functional test might be superior over an anatomic count in patients with acute bacterial infection and a significant acute phase response.