Relationship between the clinical outcomes and the systemic inflammatory response index and systemic immune inflammation index after total knee arthroplasty.

BACKGROUND: Periprosthetic joint infection (PJI) is an extremely damaging complication that can occur after total knee arthroplasty (TKA). There is no study in the literature investigating the relationship between systemic inflammatory response index (SIRI) and systemic inflammation immune index (SII) values and prognosis and infection in patients who have undergone TKA. The aim of the study was to determine the relationship between the inflammatory index values and the rate of PJI in patients who had previously had TKA. METHODS: A total of 187 patients who underwent TKA between 2015 and 2023 years were retrospectively analyzed. RESULTS: The median value of the postoperative SII index was 1862.3 (1146.6-2630.4) in the infected group, while it was 1058.2 (605.0-1762.8) in the non-infected group (p < 0.001). In the infected group, the median value of preoperative SIRI was observed as 2.3 (1.7-3.5), while in the non-infected group it was 0.9 (0.7-1.5) (p < 0.001). The cutoff value for postoperative SIRI was observed to be 2.19, with a sensitivity value of 95%, a specificity value of 46%, the AUC value observed was 65%. The cutoff value for the postoperative SII index was observed to be 1058.96, with a sensitivity value of 100%, a specificity value of 50%. CONCLUSIONS: Our study has associated the inflammatory markers SIRI, SII, neutrophil lymphocyte ratio, and platelet lymphocyte ratio with PJI, which are easy and inexpensive to obtain. There is no widely recognized serum biomarker that can be used alone with good sensitivity and specificity. This study contributes to finding the gold standard inflammatory marker for diagnosing PJI.

FOXP3 gene polymorphisms increase the risk of systemic lupus erythematosus in a Han Chinese population.

BACKGROUND: FOXP3 is a transcription factor that regulates the development and function of Treg, playing an essential role in preventing autoimmune diseases. Variation in FOXP3 can impair the function of Treg cells, thus destroying their inhibitory capacity and leading to autoimmune diseases. This paper investigated whether the three SNPs in the FOXP3 gene (-3279 C/A, -924 A/G and -6054 del/ATT) are associated with systemic lupus erythematosus (SLE) susceptibility in the Han Chinese population. MATERIALS AND METHODS: The study cohort comprised 122 SLE patients and 268 healthy controls. Genotyping was performed by polymerase chain reaction sequence-specific primer (PCR-SSP). Furthermore, we examined the potential clinical manifestations associated with FOXP3 polymorphisms in SLE patients. RESULTS: The results showed that the -3279 (C > A) was significantly associated with the SLE risk in a homozygote (OR = 3.24, 95% CI = 1.23-8.52, p = .013, AA vs. CC), dominant (OR = 1.68, 95% CI = 1.07-2.65, p = .025, AC + AA vs. CC), recessive (OR = 2.90, 95% CI = 1.12-7.55, p = .023, AA vs. AC + CC) and allelic (OR = 1.72, 95% CI = 1.18-2.53, p = .005, A vs. C) models. In addition, -924 (A > G) was positively associated with SLE risk in the heterozygote (OR = 1.66, 95% CI = 1.04-2.66, p = .033, AG vs. AA) and dominant (OR = 1.59, 95% CI = 1.01-2.49, p = .042, AG + GG vs. AA) models, whereas -6054 (del > ATT) was not associated with SLE. Moreover, the immunological index analysis suggested that decreased complement C4 occurred more frequently in SLE patients carrying the minor allele (A) -3279 (C > A) than those not (p = .005). CONCLUSIONS: We demonstrated that -3279 (C > A) and -924 (A > G) were associated with an increased risk of SLE and the immunological index, indicating that the FOXP3 variation is potentially related to the occurrence and development of SLE.

The relationship between the systemic immune inflammatory index and computerized tomography guided coronary lesion severity in diabetic patients.

PURPOSE: The incidence of cardiovascular events is high in diabetic patients. In diabetic patients, the levels of inflammatory parameters in the circulation are increased, which is associated with poor outcome. In this study, we investigated the relationship between the systemic immune inflammatory index (SII), which is a sensitive indicator of the inflammatory response, and the severity of coronary atherosclerosis in diabetic patients. MATERIALS AND METHODS: Diabetic patients who underwent coronary computed tomography for chest pain were included in the study. The patients were divided into two groups according to their median systemic immune inflammatory index values, and the predictors of SII elevation were investigated. RESULTS: A total 210 patients were included in the study. The mean age of the patients was 52.6 ± 9.3 and 44.3% were male. In univariate analysis, HDL, triglyceride, lesion severity, and CAR were associated with high SII. In the regression analysis, lesion severity and lower HDL levels were determined as predictor of high SII. CONCLUSION: Inflammation plays an important role in the development of coronary atherosclerosis. Diabetic patients with elevated SII levels may require further investigation for significant atherosclerosis.

Novel prognostic factors after radical resection of hepatocellular carcinoma: Updating an old issue.

In this editorial, I comment on the article by Li et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2023, investigating the role of some novel prognostic factors for early survival after radical resection of liver cancer. Liver cancer is an important burden among Asian and Western populations, despite recent advances in both medicine (from virus eradication to systemic target therapies) and surgery. However, survival after proven radical surgery remains poor, with recurrences being the rule. Many prognostic scores have been developed and validated to select those patients who will best benefit from radical liver surgery, although the final general and oncological outcomes continue to be highly jeopardized. Unfortunately, no single biomarker can resolve all these issues for hepatocellular carcinoma, and it remains to be proven whether some of them maintain predictive power in the long-term follow-up. In the ongoing era of "precision" medicine, the novel prognostic markers, including immune inflammatory and nutritional indexes could be of great help in better stratify surgical candidates.

Nonspecific immune, histology and accumulation of marine worm, Urechis unicinctus in response to bisphenol A (BPA).

Bisphenol A (BPA) is one of the environmental endocrine disruptors, due to its chemical stability it exists in abundant concentrations in water and soil consequently accumulating in the food chain and causing many endocrine-related health problems. So far, studies on the effects of BPA on marine invertebrates have focused on acute toxicity, endocrine regulation, reproduction, and development. However, fewer studies have been conducted on marine benthos. The current study aimed to detect the accumulation of BPA and its impact on tissue structure, antioxidant capacity, and immune indexes in marine worm, Urechis unicinctus. U. unicinctus, as a common marine benthic animal, were exposed to different concentrations of BPA. Blood cells and intestinal tract were taken for tissue structure inspection, and supernatant of the coelomic fluid was collected for oxidative and antioxidant biomarkers. Results showed that the accumulation of BPA in muscles of U. unicinctus tended to increase with exposure time. BPA induced a rise in H2O2 and MDA content, and altered the activities of CAT, T-SOD, GST, LSZ and ACP, weaken the immune system functions. Moreover, pathological observation showed that BPA caused severe histopathology in the respiratory intestine, stomach, and midgut. These results will be helpful to understand the response mechanism of U. unicinctus under BPA exposure and provide a reference for controlling the aquaculture conditions and marine water quality of U. unicinctus.

Peripheral Inflammatory and Immune Landscape in Multiple System Atrophy: A Cross-Sectional Study.

BACKGROUND: Neuroinflammation might contribute to the pathogenesis of multiple systemic atrophy (MSA). However, specific alterations in the peripheral inflammatory and immune profiles of patients with MSA remain unclear. OBJECTIVES: To determine the peripheral inflammatory and immune profiles of patients with MSA and their potential value as biomarkers for facilitating clinical diagnosis and monitoring disease severity. METHODS: This cross-sectional study included 235, 240, and 235 patients with MSA, patients with Parkinson's disease (PD), and healthy controls (HCs), respectively. Inflammatory and immune parameters were measured in peripheral blood, differences between groups were assessed, and clusters were analyzed. Associations between the parameters and clinical characteristics of MSA were assessed using Spearman and partial correlation analyses. RESULTS: Significant differences were observed especially in monocytes, neutrophils-to-lymphocyte ratio (NLR) and neutrophils-to-lymphocyte ratio (MPV) between MSA patients and HCs (P < 0.01). Monocytes and uric acid (UA) levels were also significantly different between the MSA and PD patients (P < 0.05). The combination of NLR and MPV distinguished MSA-P patients from HCs (areas under the curve = 0.824). In addition, complement components C4 and C3 were significantly correlated with the Scale Outcomes in PD for Autonomic Symptoms and Wexner scale, whereas immunoglobulin G (IgG) was significantly correlated with scores of Unified Multiple System Atrophy Rating Scale (P < 0.05). CONCLUSIONS: In MSA patients, monocytes, NLR and MPV might serve as potential diagnostic biomarkers, whereas MLR, C3, C4, and IgG significantly correlate with disease severity. © 2023 International Parkinson and Movement Disorder Society.

Effects of maggot antimicrobial peptides on growth performance, immune function, and cecal flora of yellow-feathered broilers.

Introduction: This study investigated the effects of maggot antimicrobial peptides on growth performance, blood parameters, immune organ index, and cecum microbial diversity in yellow broilers. Methods: The addition of 100-300 mg/kg maggots antimicrobial peptides to the corn-soybean meal basal diet was evaluated. Two hundred and forty one-day-old yellow-feathered broilers were randomly divided into four groups (60 chickens in each group): basal diet group (BC group), basal diet group + 100, 200, 300 mg/kg maggots antimicrobial peptides (MDAL group, MDAM group, and MDAH group). Results: The result showed that the average daily feed intake (ADFI) of the BC group, MDAM group, and MDAH group was higher than that of the MDAL group (P > 0.05), the average daily gain of MDAM group and MDAH group was significantly higher than that of BC group and MDAL group (P < 0.05), but the feed-weight ratio (F/G) was significantly lower than that of BC group (P < 0.05). The total protein (TP) content in the MDAM group and MDAH group was significantly higher than that in the BC group (P < 0.05), and the albumin (ALB) content in the MDAH group was higher than that in the BC group (P > 0.05). The contents of IgA and IgG in the MDAH group were significantly higher than those in the BC group (P < 0.05). In contrast, the content of alanine aminotransferase (ALT) in the MDAH group was significantly lower than that in the BC group (P < 0.05). The thymus and spleen indexes of the MDAH group were significantly higher than those of the BC group (P < 0.05). 16S rDNA sequencing results showed that Bacteroidota and Bacteroides were the dominant phylum and genus of cecal microorganisms at the phylum and genus levels, respectively. Cecum microorganisms are mainly involved in biological processes such as energy production and conversion, amino acid transport and metabolism, and carbohydrate transport and metabolism. Discussion: It was concluded that adding different doses of maggot antimicrobial peptide to the basal diet could improve yellow-feathered broilers' growth and immune performance and change the cecum flora. The appropriate dose of antimicrobial peptide addition was 300 mg/kg.

Prognostic value of preoperative hematological markers in patients with glioblastoma multiforme and construction of random survival forest model.

OBJECTIVE: In recent years, an increasing number of studies have revealed that patients' preoperative inflammatory response, coagulation function, and nutritional status are all linked to the occurrence, development, angiogenesis, and metastasis of various malignant tumors. The goal of this study is to determine the relationship between preoperative peripheral blood neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), systemic immune-inflammatory index (SII), platelet to lymphocyte ratio (PLR), and platelet to fibrinogen ratio (FPR). Prognostic nutritional index (PNI) and the prognosis of glioblastoma multiforme (GBM) patients, as well as establish a forest prediction model that includes preoperative hematological markers to predict the individual GBM patient's 3-year survival status after treatment. METHODS: The clinical and hematological data of 281 GBM patients were analyzed retrospectively; overall survival (OS) was the primary endpoint. X-Tile software was used to determine the best cut-off values for NLR, SII, and PLR, and the survival analysis was carried out by the Kaplan-Meier method as well as univariate and multivariate COX regression. Afterward, we created a random forest model that predicts the individual GBM patient's 3-year survival status after treatment, and the area under the curve (AUC) is used to validate the model's effectiveness. RESULTS: The best cut-off values for NLR, SII, and PLR in GBM patients' preoperative peripheral blood were 2.12, 537.50, and 93.5 respectively. The Kaplan-Meier method revealed that preoperative GBM patients with high SII, high NLR, and high PLR had shorter overall survival, and the difference was statistically significant. In addition to clinical and pathological factors. Univariate Cox showed NLR (HR = 1.456, 95% CI: 1.286 ~ 1.649, P < 0.001) MLR (HR = 1.272, 95% CI: 1.120 ~ 1.649, P < 0.001), FPR (HR = 1.183,95% CI: 1.049 ~ 1.333, P < 0.001), SII (HR = 0.218,95% CI: 1.645 ~ 2.127, P < 0.001) is related to the prognosis and overall survival of GBM. Multivariate Cox proportional hazard regression showed that SII (HR = 1.641, 95% CI: 1.430 ~ 1.884, P < 0.001) is also related to the overall survival of patients with GBM. In the random forest prognostic model with preoperative hematologic markers, the AUC in the test set and the validation set was 0.907 and 0.900, respectively. CONCLUSION: High levels of NLR, MLR, PLR, FPR, and SII before surgery are prognostic risk factors for GBM patients. A high preoperative SII level is an independent risk factor for GBM prognosis. The random forest model that includes preoperative hematological markers has the potential to predict the individual GBM patient's 3-year survival status after treatment,and assist the clinicians for making a good clinical decision.

Circulating immune index predicting the prognosis of patients with hepatocellular carcinoma treated with lenvatinib and immunotherapy.

Background: Immune checkpoint inhibitor (ICI)-based combination therapy has opened a new avenue for the treatment of multiple malignancies including hepatocellular carcinoma (HCC). However, considering the unsatisfactory efficacy, biomarkers are urgently needed to identify the patients most likely to benefit from ICI-based combination therapy. Methods: A total of 194 patients undergoing ICI-based combination therapy for unresectable HCC were retrospectively enrolled and divided into a training cohort (n = 129) and a validation cohort (n = 65) randomly. A novel circulating immune index (CII) defined as the ratio of white blood cell count (×109/L) to lymphocyte proportion (%) was constructed and its prognostic value was determined and validated. Results: Patients with CII ≤ 43.1 reported prolonged overall survival (OS) compared to those with CII > 43.1 (median OS: 24.7 vs 15.1 months; 6-, 12-, 18-month OS: 94.2%, 76.7%, 66.1% vs 86.4%, 68.2%, 22.8%, P = 0.019), and CII was identified as an independent prognostic factor for OS (hazard ratio, 2.24; 95% confidence interval, 1.17-4.31; P = 0.015). These results were subsequently verified in the validation cohort. Additionally, patients with low CII levels had improved best radiological tumor response (complete response, partial response, stable disease, progressive disease: 3%, 36%, 50%, 11% vs 0%, 27%, 46%, 27%; P = 0.037) and disease control rate (89% vs 73%; P = 0.031) in the pooled cohort and better pathologic response (pathologic complete response, major pathologic response, partial pathologic response, no pathologic response: 20%, 44%, 28%, 8% vs 0%, 0%, 40%, 60%; P = 0.005) in the neoadjuvant cohort. Detection of lymphocyte subsets revealed that an elevated proportion of CD4+ T cells was related to better OS, while the proportion of CD8+ T cells was not. Conclusions: We constructed a novel circulating immune biomarker that was capable of predicting OS and therapeutic efficacy for HCC patients undergoing ICI and lenvatinib combination therapy.

Association between admission systemic immune-inflammation index and mortality in critically ill patients with sepsis: a retrospective cohort study based on MIMIC-IV database.

Systemic immune-inflammation index (SII) has been identified as a prognostic biomarker for various diseases. Our study aimed to investigate the association between SII and mortality risk in critically ill patients with sepsis, thus exploring possible tools for rapid screening. This retrospective cohort study was conducted using clinical data extracted from the Medical Information Mart for Intensive Care Database. The study included only patients diagnosed with sepsis admitted to the intensive care unit for the first time. We used the restricted cubic splines to explore the relationship between SII and 28-day mortality. Kaplan-Meier curve and Cox regression models were performed to evaluate the association between SII and mortality. Subgroup analysis was performed to explore the stability of the primary results. A total of 16,007 patients with sepsis were eligible in the final analysis. We found a J-shaped relationship between SII and mortality risk. The SII level associated with the lowest mortality risk was 774.46*109/L. Compared with the reference group (second SII quartile), the 28-day mortality was increased in the highest quartile and third quartile groups of SII levels; fully adjusted HRs were 1.16 (1.02 to 1.32) and 1.40 (1.23 to 1.58), respectively. However, although the lower SII (Q1 group) also showed a trend toward a higher hazard of 28-day mortality, there was no statistical difference, with a fully adjusted HR of 1.05 (0.92 to 1.21). In the population of critically ill patients with sepsis, low and high SII levels were associated with an increased risk of short-term mortality. The 28-day mortality risk was lowest at SII levels of 774.46*109/L.

Systemic inflammation and immune index predicting outcomes in patients with intracerebral hemorrhage.

OBJECT: Recent evidence has suggested that systemic inflammatory and immune index (SIRI) and systematic inflammation index (SII) could predict prognosis in stroke patients. This study aimed to determine the effects of SIRI and SII on predicting in-hospital infections and unfavorable outcomes in patients with acute intracerebral hemorrhage (ICH). METHODS: We used the data from a prospective and registry-based study recruiting ICH patients between January 2014 and September 2016 in a single comprehensive stroke center. All patients were stratified by quartiles of SIRI or SII. Logistic regression analysis was used to estimate the associations with follow-up prognosis. The receiver operating characteristics (ROC) curves were performed to examine the predictive utility of these indexes for infections and prognosis. RESULTS: Six hundred and forty spontaneous ICH patients were enrolled in this study. Compared with the lowest quartile (Q1), SIRI or SII values both showed positive correlations with increased risks for poor 1-month outcomes (adjusted ORs in Q4 was 2.162 [95% CI: 1.240-3.772] for SIRI, 1.797 [95% CI: 1.052-3.070] for SII). Additionally, a higher level of SIRI, but not SII, was independently associated with a higher risk of infections and an unfavorable 3-month prognosis. The C-statistic for the combined SIRI and ICH score was higher than SIRI or ICH score alone for predicting in-hospital infections and poor outcomes. CONCLUSION: Elevated SIRI values were associated with in-hospital infections and poor functional outcomes. It may provide a new biomarker for ICH prognosis prediction, especially in the acute stage.

The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis.

Objective: To study the predictive value of systemic immune index (SII) and systemic inflammatory response index (SIRI) in the prognosis of patients with nasopharyngeal carcinoma. Methods: Two researchers independently searched PubMed, Cochrane, Embase, and Web of Science databases (until March 18, 2022) for all studies on SII, SIRI, and prognosis in patients with nasopharyngeal carcinoma. Quality assessment of included studies was assessed using the Newcastle-Ottawa Scale (NOS). In addition, a bivariate mixed-effects model was used to explore predictive value. Results: A total of 9 studies that satisfied the requirements were included, involving, 3187 patients with nasopharyngeal carcinoma. The results of the meta-analysis showed that SII could be an independent predictor of OS (HR=1.78, 95%CI [1.44-2.20], Z=5.28, P<0.05), and SII could also be an independent predictor of PFS (HR=1.66, 95%CI [1.36-2.03], Z=4.94, P<0.05). In addition, SIRI could also serve as an independent predictor of OS (HR=2.88, 95%CI [1.97-4.19], Z=5.51, P<0.05). The ROC area was 0.63, the sensitivity was 0.68 (95%CI [0.55-0.78]), and the specificity was 0.55 (95%CI [0.47-0.62]), all of which indicated that SII had a certain predictive value for OS. Conclusion: SII and SIRI can be used as independent predictors to predict the prognosis and survival status of patients with nasopharyngeal carcinoma and have certain predictive accuracy. Therefore, SII and SIRI should be considered in studies that update survival risk assessment systems. Systematic Review Registration: https://www.ytyhdyy.com/, identifier PROSPERO (CRD42022319678).

The value of serum IL-4 to predict the survival of MDS patients.

BACKGROUND: Immune indicators are routinely used for the detection of myelodysplastic syndrome (MDS), but these are not utilized as a reference indicator to assess prognosis in MDS-related prognostic evaluation systems, such as the World Health Organizational prognostic scoring system, the international prostate symptom score, and the revised international prostate symptom score. METHODS: We examined immune indicators, including cluster of differentiation (CD)3, CD4, CD8, CD56, CD19, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-a, and interferon-γ in 155 newly diagnosed MDS patients. We also conducted a correlation analysis with clinical indices. RESULTS: IL-4 was found to be a predictor of survival in these 155 patients using the receiver operating characteristic curve, with 5.155 as the cut-off point. Patients with serum IL-4 levels ≥ 5.155 had a lower overall survival (OS) than those with IL-45.155 at diagnosis. Furthermore, multivariate analysis revealed that IL-4 levels > 5.155 were an independent predictor of OS (hazard ratio: 0.237; 95% confidence interval, 0.114-0.779; P = 0.013). In addition, serum IL-4 expression in the three different scoring systems showed significant differences in the survival of medium- to high-risk MDS patients (P = 0.014, P < 0.001, P < 0.001). CONCLUSIONS: According to our study, IL-4 levels at the time of diagnosis can predict MDS prognosis in patients as a simple index reflecting host systemic immunity.

Inflammatory Indicators in Peripheral Blood in Sudden Sensorineural Hearing Loss Patients With Different Audiogram Shapes.

Objective: A retrospective study was conducted to explore the immune-inflammatory responses in sudden sensorineural hearing Loss (SSNHL) patients with different audiogram shapes. Methods: One hundred and ten inpatients with SSNHL were assigned to 4 subgroups according to the audiogram shape and treated with systemic methylprednisolone. The numbers of white blood cells, neutrophils, lymphocytes, platelets, and monocytes were counted. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the monocyte-to-lymphocyte ratio (MLR) were calculated and statistically analyzed. Results: Neutrophil-to-lymphocyte ratio, MLR, and systemic immune index (SII) of SSNHL patients were significantly higher than the control group, while PLR was not statistically significant. There were no statistical differences in NLR, PLR, MLR, and SII among the 4 subgroups. Conclusion: Immune-inflammatory response may be a common pathogenesis in all SSNHL patients with different audiogram shapes. The predictive value of these hematologic markers needs further research in the future.

Relationship between immune indexes and prognosis in patients with sepsis: data analysis based on MIMIC-Ⅳ database / 中华危重病急救医学

Objective:To investigate the relationship between the changes of immune indexes and prognosis in patients with sepsis.Methods:Based on the hospitalization information from 2008 to 2019 in the American Medical Information Mart for Intensive Care-Ⅳ v2.0 (MIMIC-Ⅳ v2.0), the hospitalized data including CD3 count, CD4 count, CD8 count, CD4/CD8 ratio, immunoglobulins (IgA, IgG, IgM) levels and lymphocyte counts, gender, age, body mass index (BMI), sequential organ failure assessment (SOFA), and prognosis of patients with coronary heart disease, hypertension, diabetes mellitus, underlying diseases, and 28-day prognosis were collected. The immunological indexes affecting the prognosis of patients with sepsis were compared and analyzed. The receiver operator characteristic curve (ROC curve) was drawn to analyze the value of immunological indexes in predicting the 28-day prognosis of patients with sepsis.Results:A total of 33 745 patients were enrolled in the study, including 1 509 cases of sepsis and 32 236 cases without sepsis. Among the patients with sepsis, there were 1 084 cases alive and 425 cases died within 28 days. BMI (kg/m 2: 33.25±28.71 vs. 28.90±15.28) and IgA levels within 3 days and 7 days after admission in sepsis group were significantly higher than those in the non-sepsis group [within 3 days after admission: (275.01±216.96) mg/L vs. (85.99±75.76) mg/L; within 7 days after admission: (275.01±216.96) mg/L vs. (85.99±75.76) mg/L, all P < 0.05]. CD3 count, CD8 count within 3 days and 7 days after admission in sepsis group were significantly lower than that in the non-sepsis group [within 3 days after admission: CD3 counts were (1 080.74±849.23)/μL vs. (1 242.91±889.24)/μL, CD8 counts were (558.07±368.77)/μL vs. (625.07±529.66)/μL; within 7 days after admission: CD3 counts were (1 079.69±850.61)/μL vs. (1 242.48±889.23)/μL, CD8 counts were (556.70±467.23)/μL vs. (624.93±429.78)/μL, all P < 0.05]. The proportion of patients with hypertension, diabetes and coronary heart disease were significantly higher than those in the non-sepsis group [hypertension: 10.07% (152/1 509) vs. 2.47% (796/32 236), diabetes: 50.10% (756/1 509) vs.15.18% (4 895/32 236), coronary heart disease: 31.21% (471/1 509) vs. 19.19% (6 186/32 236), all P < 0.05]. In the sepsis group, the CD3 count, CD4 count and CD4/CD8 ratio in the survival group were significantly higher than those in the death group within 3 days and 7 days after admission [within 3 days after admission: CD3 counts were (1 127.20±857.14)/μL vs. (938.26±810.50)/μL, CD4 counts were (559.76±507.18)/μL vs. (338.75±267.11)/μL, CD4/CD8 ratios were 1.87±0.80 vs. 1.02±0.12; within 7 days after admission: CD3 count were (1 124.01±810.53)/μL vs. (943.78±808.21)/μL, CD4 count were (559.56±507.36)/μL vs. (341.95±266.56)/μL, CD4/CD8 ratios were 1.88±0.79 vs. 1.03±0.13, all P < 0.05]. The area under the ROC curve (AUC) of CD4/CD8 ratio within 3 days after admission in predicting the prognosis of septic patients at 28 days was 0.615 [95% confidence interval (95% CI) was 0.555-0.671], the sensitivity was 70.83%, and the specificity was 52.49%. Conclusions:Hypertension, coronary heart disease and diabetes are more likely to induce sepsis. The changes of immune indexes in patients with sepsis will occur in the early stage. Early CD4/CD8 index can predict the prognosis of patients with sepsis to a certain extent.

Boosting animal performance, immune index and antioxidant status in post-weaned bull calves through dietary augmentation of selective traditional medicinal plants.

Traditional medicinal plants (TMP) are considered valuable alternatives to hazardous synthetic chemical utilized as animal growth promoters. This study aimed to evaluate effects of dietary supplementation of seed and leaf powder (75:25) of three Bangladeshi TMP viz. Emblica officinalis Gaertn., Terminalia bellirica Gaertn. Roxb., and Terminalia chebula Retz. on growth performance, digestibility of nutrients, hematological indices, immune index and antioxidant status in post-weaned bull calves. Dietary treatments: TMP1 (basal diet = green grass + concentrate), TMP2 (basal diet + 0.5% mixture of seed and leaf (75:25) of E. officinalis Gaertn.), TMP3 (basal diet + 0.5% mixture of seed and leaf (75:25) of T. bellirica Gaertn. Roxb.), and TMP4 (basal diet + 0.5% mixture of seed and leaf (75:25) of T. chebula Retz.). Supplementation of TMP significantly (p < 0.10) improved weight gain without affecting digestibility. Hematological indices did not change much by treatment of TMP except for enhancement of monocyte (p < 0.10) and platelet percentage (p < 0.05). A reduction in IGF, enhancement (p < 0.05) of lymphocyte proliferation, and IgG were recorded in TMP2, TMP3 and TMP4 compared to TMP1. Decreasing (p < 0.05) trend of interleukins-1 and 6, and an elevation of TNF-α and antioxidant status were recorded in the TMP2, TMP3, and TMP4 in comparison to TMP1. An elevated level of total antioxidant and glutathione peroxidase activities were found in calves treated with TMP2, TMP3, and TMP4 (p < 0.05) relative to TMP1. Taken together, our results indicate that supplementation of feed with Bangladeshi TMP promoted growth and some health indices like immune-advocating efficacy of post-weaned bull calves.

Effects of oral administration of Spirulina platensis and probiotics on serum immunity indexes, colonic immune factors, fecal odor, and fecal flora in mice.

To evaluate the effects of Spirulina platensis and probiotics on growth, immunity indexes, fecal flora, and fecal odor in mice, 40 mice were randomly allotted to four groups, and each was administrated with nothing, S. platensis, probiotics, or both for 28 days, respectively. Then, many indexes were measured. The results showed that S. platensis was more effective (P < 0.001) than probiotics in improving mice's feed conversion ration (FCR). In immunity, probiotics administration increased (P < 0.042) serum IgE, IgM, IFN-γ, colonic AHR, TLR4, and NF-κB protein expression and decreased (P < 0.039) serum IL-1α, IL-21, IL-22, and colonic ARNT gene expression. However, the S. platensis showed weaker effect, which increased (P < 0.025) the serum IgE, IgM, TNF-α, and the colonic AHR and NF-κB protein expression, and decreased (P < 0.01) serum IL-21. Probiotics consumption decreased the fecal odor by decreasing (P < 0.02) fecal Escherichia coli, indole-3-acetic acid (IAA), and skatole contents, and the S. platensis decreased (P = 0.04) the IAA. These results indicated that oral administration of probiotics, S. platensis, or both of them in mice probably benefited body's immunity and reduced fecal odor. However, their mechanisms were still unclear and need further study.

Immune marker signature helps to predict survival in uveal melanoma.

The detailed molecular function of tumor microenvironment (TEM) in uveal melanoma (UVM) remains unclear. This study generated the immune index and the stromal index scores by ESTIMATE algorithm based on RNA-sequencing data with 80 UVM patients. There was no correlation between the immune stromal index and clinical parameters. The differentially expressed genes related to the immune stromal index were calculated and were described by functional annotations and protein-protein interaction network diagrams. After univariate and multivariate Cox regression analyses, there were four genes (HLA-J, MMP12, HES6, and ADAMDEC1) with significant prognostic significance. The prognostic model was constructed using these four characteristic genes, and the KM curve and tROC curve were described to show that the model had a better ability to predict survival outcomes and prognosis. The verification results in GSE62075 showed that HLA-J and HES6 were expressed differently in the cancer group than in the non-cancer group. This study indicates that the risk signature based on the immune index can be used as an indicator to evaluate the prognosis of patients with UVM.

[Acupuncture combined with Heixiaoyao powder for children with cerebral palsy and its effect on serum immune indexes and nerve growth related protein].

OBJECTIVE: To observe the efficacy of acupuncture combined with Heixiaoyao powder for children with cerebral palsy (liver-qi stagnation, spleen-kidney deficiency syndrome) and its effect on serum immune indexes and nerve growth related protein. METHODS: A total of 180 children with cerebral palsy were randomly divided into a combined group (60 cases, 2 cases dropped off), an acupuncture group (60 cases, 4 cases dropped off) and a Chinese medication group (60 cases, 5 cases dropped off). On the basis of conventional treatment, the children in the combined group were treated with acupuncture [Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Benshen (GB 13), 30 min each time, twice a day] and Heixiaoyao powder; the children in the acupuncture group were treated with acupuncture, and the children in the Chinese medication group were treated with Heixiaoyao powder, the treatment was same with the combined group. All the children were treated for 6 consecutive days and rest for 1 day, totaling for 8 weeks. The Gesell developmental schedules (GDS) and TCM symptom scores were recorded before treatment, after treatment and at 3-month, 6-month and 12-month follow-up visit; the serum immune indexes (IgA, IgG and IgM) and nerve growth related protein [myelin basic protein (MBP), high mobility group box-1 (HMGB1), neuronspecific enolase (NSE)] were detected before and after treatment. The clinical efficacy of each group was evaluated. RESULTS: The total effective rate was 91.4% (53/58) in the combined group, which was higher than 80.4% (45/56) in the acupuncture group and 78.2% (43/55) in the Chinese medication group (P<0.05). Compared before treatment, the GDS scores in the three groups were increased and the TCM symptom scores were reduced after treatment and at 3-month, 6-month and 12-month follow-up visit (P<0.05). The GDS score in the combined group was higher than that in the acupuncture group and the Chinese medication group, and the TCM symptom score was lower than that in the acupuncture group and Chinese medication group (P<0.05). After treatment, the serum levels of IgA, IgG and IgM in the combined group were increased (P<0.05), and the serum levels of MBP, HMGBl and NSE were decreased (P<0.05), and the improvements were superior to those in the acupuncture group and the Chinese medication group (P<0.05). CONCLUSION: Acupuncture combined with Heixiaoyao powder could effectively improve the development quotient in children with cerebral palsy (liver-qi stagnation, spleen-kidney deficiency syndrome), regulate the serum immune indexes and nerve growth related protein levels.

Immunological Classification of Pancreatic Carcinomas to Identify Immune Index and Provide a Strategy for Patient Stratification.

Background: Cancer immunotherapy has produced significant positive clinical effects in a variety of tumor types. However, pancreatic ductal adenocarcinoma (PDAC) is widely considered to be a "cold" cancer with poor immunogenicity. Our aim is to determine the detailed immune features of PDAC to seek new treatment strategies. Methods: The immune cell abundance of PDAC patients was evaluated with the single-sample gene set enrichment analysis (ssGSEA) using 119 immune gene signatures. Based on these data, patients were classified into different immune subtypes (ISs) according to immune gene signatures. We analyzed their response patterns to immunotherapy in the datasets, then established an immune index to reflect the different degrees of immune infiltration through linear discriminant analysis (LDA). Finally, potential prognostic markers associated with the immune index were identified based on weighted correlation network analysis (WGCNA) that was functionally validated in vitro. Results: Three ISs were identified in PDAC, of which IS3 had the best prognosis across all three cohorts. The different expressions of immune profiles among the three ISs indicated a distinct responsiveness to immunotherapies in PDAC subtypes. By calculating the immune index, we found that the IS3 represented higher immune infiltration, while IS1 represented lower immune infiltration. Among the investigated signatures, we identified ZNF185, FANCG, and CSTF2 as risk factors associated with immune index that could potentially facilitate diagnosis and could be therapeutic target markers in PDAC patients. Conclusions: Our findings identified immunologic subtypes of PDAC with distinct prognostic implications, which allowed us to establish an immune index to represent the immune infiltration in each subtype. These results show the importance of continuing investigation of immunotherapy and will allow clinical workers to personalized treatment more effectively in PDAC patients.