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Arellano-Orden E, Calero Acuña C, Sánchez-López V, López Ramírez C, Otero-Candelera R, Marín-Hinojosa C, López Campos J. Cellular mechanisms involved in the pathogenesis of airway remodeling in chronic lung disease. Eur Clin Respir J 2022; 9:2097377. [PMID: 35832729 PMCID: PMC9272929 DOI: 10.1080/20018525.2022.2097377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- E. Arellano-Orden
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. Calero Acuña
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - V. Sánchez-López
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. López Ramírez
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - R. Otero-Candelera
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. Marín-Hinojosa
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jl López Campos
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Jurgens MS, Safy-Khan M, de Hair MJH, Bijlsma JWJ, Welsing PMJ, Tekstra J, Lafeber FPJG, Sasso EH, Jacobs JWG. The multi-biomarker disease activity test for assessing response to treatment strategies using methotrexate with or without prednisone in the CAMERA-II trial. Arthritis Res Ther 2020; 22:205. [PMID: 32907614 PMCID: PMC7487793 DOI: 10.1186/s13075-020-02293-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/11/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives The CAMERA-II trial compared two tight-control, treat-to-target strategies, initiating methotrexate with prednisone (MTX+pred) or MTX with placebo (MTX+plac), in early RA-patients. The multi-biomarker disease activity (MBDA) blood test objectively measures RA disease activity with a score of 1–100. In CAMERA-II, response profiles of the MBDA score, its individual biomarkers, and DAS28 were assessed. Methods We evaluated 92 patients from CAMERA-II of whom clinical data and serum for MBDA testing at baseline and ≥ 1 time-point from months 1, 2, 3, 4, 5, 6, 9, or 12 were available. Changes (∆) from baseline for DAS28 and MBDA score and comparisons of ∆DAS28 and ∆MBDA score over time within the MTX+pred versus the MTX+plac strategy were tested for significance with t tests. Changes in biomarker concentration from baseline to months 1–5 were tested with Wilcoxon signed rank test and tested for difference between treatment arms by Mann-Whitney U test. Results MBDA and DAS28 showed similar response profiles, with gradual improvement over the first 6 months in the MTX+plac group, and in the MTX+pred group faster improvement during month 1, followed by gradual improvement. The 12 MBDA biomarkers could be grouped into 4 categories of response profiles, with significant responses for 4 biomarkers during the MTX+plac strategy and 9 biomarkers during the MTX+pred strategy. Conclusions MBDA tracked treatment response in CAMERA-II similarly to DAS28. More individual MBDA biomarkers tracked treatment response to MTX+pred than to MTX+plac. Four response profiles could be observed. Trial registration CAMERA-II International Standard Randomised Controlled Trial Number: ISRCTN 70365169. Registered on 29 March 2006, retrospectively registered.
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Affiliation(s)
- M S Jurgens
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - M Safy-Khan
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
| | | | - J W J Bijlsma
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - P M J Welsing
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - J Tekstra
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - F P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - E H Sasso
- Crescendo Bioscience, Inc., South San Francisco, CA, USA
| | - J W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University of Utrecht, G02.228, PO Box 85500, 3508, GA, Utrecht, The Netherlands
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Bailey KL, Murphy PJ, Lineberry OK, Haack MR, Dickinson JD, Kalil AC. Procalcitonin predicts the severity of cystic fibrosis pulmonary exacerbations and readmissions in adult patients: a prospective cohort study. J Investig Med 2020; 68:856-863. [PMID: 31969379 DOI: 10.1136/jim-2019-001183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2019] [Indexed: 11/04/2022]
Abstract
Patients with cystic fibrosis (CF) experience multiple pulmonary exacerbations throughout their lifetime, resulting in repeated antibiotic exposure and hospital admissions. Reliable diagnostic markers to guide antibiotic treatment in patients with CF, however, are lacking. Given that the CF airway is characterized by persistent and frequent bacterial infection, our goal was to determine if procalcitonin (PCT) could be used as a severity and prognostic marker of CF exacerbation. We enrolled 40 participants at the time of diagnosis of CF pulmonary exacerbation. Inclusion criteria: age ≥19 years with exacerbation requiring antibiotics as determined by the treating physician. Exclusion criteria: antibiotics initiated more than 48 hours prior to enrollment, and pregnancy. Blood samples were collected on enrollment day and after 7-10 days of treatment. Of the 40 patients enrolled, 23 (57.5%) had detectable levels of PCT (≥0.05 ng/mL). PCT levels were significantly associated with pulmonary exacerbation scores (p=0.01) and per cent decrease in forced expiratory volume in 1 second (FEV1) (p=0.01) compared with the best in the last 12 months. Those who had worsening PCT during treatment had less improvement in FEV1 (p=0.001) and were more likely to be readmitted to the hospital sooner (p<0.0001). Likewise, those who had a detectable PCT at the time of admission were more likely to be readmitted sooner (p=0.03). PCT elevation during antibiotic treatment is associated with less improvement in FEV1 and earlier readmission. A detectable PCT level occurs only in more severe CF exacerbations. Multicenter trials are needed to confirm whether PCT may play a role in the clinical care of patients with CF.
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Affiliation(s)
- Kristina L Bailey
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA .,Int Med-Pulmonary, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Peter J Murphy
- Int Med-Pulmonary, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Olena K Lineberry
- Int Med-Pulmonary, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Matthew R Haack
- Int Med-Pulmonary, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - John D Dickinson
- Int Med-Pulmonary, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andre C Kalil
- Int Med-Infectious Disease, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Baumann R, Gube M, Markert A, Davatgarbenam S, Kossack V, Gerhards B, Kraus T, Brand P. Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:84-91. [PMID: 28176762 DOI: 10.1038/jes.2016.86] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 12/06/2016] [Indexed: 06/06/2023]
Abstract
Zinc- and copper-containing welding fumes increase systemic C-reactive protein (CRP). The aim of this study was to investigate the performance of the biomarkers serum amyloid A (SAA) and soluble vascular cell adhesion molecule-1 (VCAM-1) in this regard. Fifteen male subjects were exposed under controlled conditions to welding fumes containing either zinc, or copper, or copper and zinc for 6 h. Plasma samples were collected before, 6 and 24 h after start of exposure and biomarkers therein were measured by electrochemiluminescent assay. For each exposure, systemic concentrations of systemic SAA, but not VCAM-1, increased significantly at 24 h after exposure start compared with baseline ("copper only": P=0.0005, "zinc only": P=0.027, "copper and zinc": P=0.001). SAA showed a wider range of concentrations than did CRP and its levels increased up to 19-fold after welding fume exposure. The recognition of copper as a potential harmful component in welding fumes, also independent from zinc, deserves further consideration. SAA might represent a new sensitive biomarker for potential subclinical sterile inflammation after inhalation of copper- and/or zinc-containing welding fumes. As elevations of CRP and SAA protein have both been linked to a higher risk for cardiovascular disease, these findings might particularly be important for long-term welders.
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Affiliation(s)
- R Baumann
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - M Gube
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - A Markert
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - S Davatgarbenam
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - V Kossack
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - B Gerhards
- ISF - Welding and Joining Institute, Aachen University of Technology, Pontstraße, Germany
| | - T Kraus
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
| | - P Brand
- Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr, Germany
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Expression of the protein serum amyloid A in response to Aspergillus fumigatus in murine models of allergic airway inflammation. Rev Iberoam Micol 2015; 32:25-9. [DOI: 10.1016/j.riam.2013.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/06/2013] [Accepted: 03/18/2013] [Indexed: 11/18/2022] Open
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Ratjen F, Saiman L, Mayer-Hamblett N, Lands LC, Kloster M, Thompson V, Emmett P, Marshall B, Accurso F, Sagel S, Anstead M. Effect of azithromycin on systemic markers of inflammation in patients with cystic fibrosis uninfected with Pseudomonas aeruginosa. Chest 2013; 142:1259-1266. [PMID: 22595153 DOI: 10.1378/chest.12-0628] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND While the mechanism of action by which azithromycin exerts positive effects inpatients with cystic fibrosis remains unclear, evidence suggests that azithromycin may act as an immunomodulatory agent. We examined changes in systemic inflammatory markers in a doubleblind, randomized, controlled trial of oral azithromycin in patients 6-18 years of age with cystic fibrosis who were uninfected with Pseudomonas aeruginosa. METHODS WBC counts and differential, serum myeloperoxidase (MPO), high-sensitivity C reactive protein (hsCRP), intracellular adhesion molecule 1, IL-6, calprotectin, serum amyloid A (SAA),and granulocyte colony-stimulating factor (G-CSF) were measured at baseline and after 28 and 168 days of treatment in patients receiving either oral azithromycin or placebo. RESULTS Inflammatory markers were similar in both groups at baseline. HsCRP, MPO, SAA, calprotectin,and the absolute neutrophil count (ANC) significantly decreased from baseline today 28 in the azithromycin group compared with the placebo group ( P < .05). This treatment effect was sustained at day 168 for ANC, calprotectin, and SAA ( P < .05). Changes in hsCRP, calprotectin,and SAA at day 28 were negatively correlated with changes in FEV 1 (L) and FEV 1(% predicted), as well as both absolute and relative changes in weight ( P < .05). Except for weight (%),the associations remained significant for calprotectin; FEV 1 (L) and weight (%) remained significantly correlated with the 168-day change in hsCRP. The 168-day change in ANC was significantly correlated with changes in lung function, but not in weight; the change in G-CSF was significantly correlated with the change in weight (%) only. CONCLUSIONS In patients not infected with P aeruginosa , oral azithromycin significantly reduced neutrophil counts and serum inflammatory markers within 28 days of initiating treatment. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT00431964; URL: www.clinicaltrials.gov
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Affiliation(s)
- Felix Ratjen
- Division of Respiratory Medicine, Department of Pediatrics, and Program in Physiology and Experimental Medicine, SickKids Research Institute, The Hospital for Sick Children, and University of Toronto, Toronto, ON, Canada.
| | - Lisa Saiman
- Department of Pediatrics, Columbia University, New York, NY
| | | | - Larry C Lands
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | | | | | - Peggy Emmett
- University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
| | | | - Frank Accurso
- University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
| | - Scott Sagel
- University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
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KANOH YUHSAKU, ABE TADASHI, MASUDA NORIYUKI, AKAHOSHI TOHRU. Progression of non-small cell lung cancer: Diagnostic and prognostic utility of matrix metalloproteinase-2, C-reactive protein and serum amyloid A. Oncol Rep 2012; 29:469-73. [DOI: 10.3892/or.2012.2123] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/10/2012] [Indexed: 11/05/2022] Open
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Jeong S, Park Y, Cho Y, Kim HS. Diagnostic utilities of procalcitonin and C-reactive protein for the prediction of bacteremia determined by blood culture. Clin Chim Acta 2012; 413:1731-6. [PMID: 22759977 DOI: 10.1016/j.cca.2012.06.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 06/26/2012] [Accepted: 06/26/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND We compared the diagnostic utilities of procalcitonin (PCT) and C-reactive protein (CRP) for predicting bacteremia diagnosed by blood cultures. PCT was also evaluated as a parameter for differentiating true bacteremia from culture contamination. METHODS We analyzed a total of 3343 patients in which PCT, CRP, and blood cultures were concurrently requested for detecting bacteremia from January 2010 to December 2011. PCT concentrations were measured by the VIDAS® Brahms PCT assay, and CRP concentrations were determined by a turbidimetric assay using CA-400 analyzer. RESULTS The PCT concentrations of bacteremia cases (n=331) were significantly higher than those of non-bacteremia (n=2856) (median: 3.2 ng/ml vs. 0.4 ng/ml, P<0.0001). The correlation coefficient between the PCT and CRP concentrations was 0.51. The areas under the receiver operating characteristic curves (ROC-AUCs) of PCT and CRP for discriminating bacteremia from non-bacteremia were 0.76 and 0.64, respectively. The ROC-AUC of PCT for differentiating true bacteremia from contamination was 0.86, while that of CRP was 0.65. CONCLUSIONS PCT concentration by single testing was more useful for predicting bacteremia than CRP. PCT also exhibited diagnostic utility for ruling out blood culture contamination. Thus, PCT could be helpful in the accurate diagnosis of bacteremia.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Vasu VT, De Cruz SJ, Houghton JS, Hayakawa KA, Morrissey BM, Cross CE, Eiserich JP. Evaluation of thiol-based antioxidant therapeutics in cystic fibrosis sputum: Focus on myeloperoxidase. Free Radic Res 2011; 45:165-76. [PMID: 20954832 PMCID: PMC3018684 DOI: 10.3109/10715762.2010.521154] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Neutrophil-dependent reactions catalysed by myeloperoxidase (MPO) are thought to play important roles in the pulmonary pathobiology of cystic fibrosis (CF). Aerosolized thiol antioxidants such as glutathione (GSH) and N-acetylcysteine (NAC) are currently being utilized as therapeutics to modify CF respiratory tract oxidative processes. This study hypothesized that MPO in CF airway lining fluids may be a target of such therapeutics. MPO activity in sputum from 21 adult CF patients was found to be inversely associated with lung function (FEV(1)). In contrast, systemic inflammation (assessed by plasma C-reactive protein) was not correlated with lung function. Ex vivo studies revealed that GSH and NAC effectively scavenged N-chloramines in sputum and inhibited sputum MPO activity with potency exquisitely dependent upon MPO activity levels. Detailed kinetic analyses revealed that NAC and GSH inhibit MPO by distinct mechanisms. Activation of the key pro-inflammatory transcription factor NF-κB in cultured HBE1 cells was inhibited by GSH. The findings reveal that MPO activity and its reactive products represent useful predictors of the doses of inhaled thiol antioxidants required to ameliorate airway oxidative stress and inflammation in CF patients and provide mechanistic insight into the antioxidative/anti-inflammatory mechanisms of action of GSH and NAC when administered into the CF lung.
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Affiliation(s)
- Vihas T. Vasu
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
| | - Sharon J. De Cruz
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
| | - Jessica S. Houghton
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
| | - Keri A. Hayakawa
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
| | - Brian M. Morrissey
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
| | - Carroll E. Cross
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
- Department of Physiology and Membrane Biology, University of California, Davis, CA
| | - Jason P. Eiserich
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, Center for Comparative Respiratory Biology and Medicine, Davis, CA
- Department of Physiology and Membrane Biology, University of California, Davis, CA
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Charro N, Hood BL, Faria D, Pacheco P, Azevedo P, Lopes C, de Almeida AB, Couto FM, Conrads TP, Penque D. Serum proteomics signature of cystic fibrosis patients: a complementary 2-DE and LC-MS/MS approach. J Proteomics 2010; 74:110-26. [PMID: 20950718 DOI: 10.1016/j.jprot.2010.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 09/17/2010] [Accepted: 10/05/2010] [Indexed: 01/01/2023]
Abstract
Complementary 2D-PAGE and 'shotgun' LC-MS/MS approaches were combined to identify medium and low-abundant proteins in sera of Cystic Fibrosis (CF) patients (mild or severe pulmonary disease) in comparison with healthy CF-carrier and non-CF carrier individuals aiming to gain deeper insights into the pathogenesis of this multifactorial genetic disease. 78 differentially expressed spots were identified from 2D-PAGE proteome profiling yielding 28 identifications and postulating the existence of post-translation modifications (PTM). The 'shotgun' approach highlighted altered levels of proteins actively involved in CF: abnormal tissue/airway remodeling, protease/antiprotease imbalance, innate immune dysfunction, chronic inflammation, nutritional imbalance and Pseudomonas aeruginosa colonization. Members of the apolipoproteins family (VDBP, ApoA-I, and ApoB) presented gradually lower expression from non-CF to CF-carrier individuals and from those to CF patients, results validated by an independent assay. The multifunctional enzyme NDKB was identified only in the CF group and independently validated by WB. Its functions account for ion sensor in epithelial cells, pancreatic secretion, neutrophil-mediated inflammation and energy production, highlighting its physiological significance in the context of CF. Complementary proteomics-based approaches are reliable tools to reveal pathways and circulating proteins actively involved in a heterogeneous disease such as CF.
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Affiliation(s)
- Nuno Charro
- Laboratório de Proteómica, Departamento de Genética, INSA, I.P., Lisboa, Portugal
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Ozseker F, Buyukozturk S, Depboylu B, Yilmazbayhan D, Karayigit E, Gelincik A, Genc S, Colakoglu B, Dal M, Issever H. Serum amyloid A (SAA) in induced sputum of asthmatics: a new look to an old marker. Int Immunopharmacol 2006; 6:1569-76. [PMID: 16919829 DOI: 10.1016/j.intimp.2006.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Revised: 05/26/2006] [Accepted: 05/30/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND Some cellular and soluble markers of inflammation in induced sputum have been used for studying airway inflammation in asthma. The aim of this study was to assess the usefulness of systemic inflammation marker serum amyloid A (SAA) in blood and induced sputum to monitor the airway inflammation in asthmatic patients. METHOD Seventeen non-smokers newly diagnosed mild to moderate asthmatic patients and 10 healthy volunteers were included in this prospective parallel designed study. Inflammatory cell counts, SAA and eosinophil cationic protein (ECP) levels were measured in sera and induced sputum of both groups. All tests were repeated in the asthma group after 6 months of inhaled steroid therapy. The diagnostic accuracy and reproducibility of sputum and blood SAA were estimated. RESULTS Serum and induced sputum SAA and ECP levels, sputum eosinophils and neutrophils of untreated asthmatic patients were significantly greater compared to the control group. Sputum and sera SAA levels and sputum neutrophils remained unchanged after the 6 months of anti-inflammatory therapy, although ECP levels, sputum eosinophils and macrophages were significantly reduced. The area under the curve (AUC) for sputum SAA was found equal to AUC for sputum ECP (0.87). The reproducibility of sputum SAA was satisfactory (ICC=0.84) as well. CONCLUSION Our findings suggest that systemic inflammatory marker SAA may be used as a reliable inflammatory marker in asthma. The facts that whether it remarks an ongoing inflammation unresponsive to treatment in the airways or reflects a systemic inflammation needs to be clarified with further studies.
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Affiliation(s)
- Ferhan Ozseker
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Turkey.
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Kokubun M, Imafuku Y, Okada M, Ohguchi Y, Ashikawa T, Yamada T, Yoshida H. Serum amyloid A (SAA) concentration varies among rheumatoid arthritis patients estimated by SAA/CRP ratio. Clin Chim Acta 2005; 360:97-102. [PMID: 15932751 DOI: 10.1016/j.cccn.2005.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Revised: 04/05/2005] [Accepted: 04/05/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND C reactive protein (CRP) and serum amyloid A (SAA) are similarly sensitive indicators of inflammation, but discrepancies are recognized in several disease conditions. SAA levels are generally higher and vary more among individuals. The significance of the SAA/CRP ratio was evaluated in the estimation of SAA. METHODS Sera of out-patients with rheumatoid arthritis (RA) and healthy subjects were measured for CRP and SAA cross-sectionally and longitudinally by a highly sensitive latex agglutination turbidimetric immunoassay. The results were classified into four groups according to the CRP concentration, and the SAA/CRP ratios were calculated and evaluated. RESULTS In the cross-sectional study, CRP and SAA were shown to correlate significantly in sera of patients with RA, but not in healthy subjects. The SAA/CRP ratios were wide RA patients and tended to decrease in the range and mean values were observed depending on the concentration of CRP. In the longitudinal study, variations of the ratio among individuals were wide, but smaller and similar within individuals. The difference in magnitude of the ratios is due to the difference in SAA concentration. CONCLUSION Variations of SAA/CRP ratios were affected by SAA concentrations. The ratio should be checked in the evaluation of SAA.
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Affiliation(s)
- Masae Kokubun
- Department of Clinical Laboratory Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1247, Japan
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Mitaka C. Clinical laboratory differentiation of infectious versus non-infectious systemic inflammatory response syndrome. Clin Chim Acta 2005; 351:17-29. [PMID: 15563869 DOI: 10.1016/j.cccn.2004.08.018] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2004] [Revised: 08/25/2004] [Accepted: 08/27/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the accuracy of C-reactive protein (CRP), procalcitonin (PCT), neopterin, and endotoxin in the differential diagnosis of sepsis and non-infectious systemic inflammatory response syndrome (SIRS). METHODS A Medline database and references from identified articles were used to perform a literature search relating to the differential diagnosis of sepsis versus non-infectious SIRS. RESULTS CRP, PCT, and neopterin are released both in sepsis and in non-infectious inflammatory disease. CRP and PCT are equally effective, although not perfect, in differentiating between sepsis and non-infectious SIRS. However, CRP and PCT have different kinetics and profiles. The kinetics of CRP is slower than that of PCT, and CRP levels may not further increase during more severe stages of sepsis. On the contrary, PCT rises in proportion to the severity of sepsis and reaches its highest levels in septic shock. PCT tends to be higher in nonsurvivor than in survivor. Therefore, PCT demonstrated a closer correlation with the severity of sepsis and outcome than CRP. Unlike CRP and PCT, neopterin is increased in viral infection as well as bacterial infection, and neopterin is also a useful indicator of sepsis. Endotoxemia was detected in no more than half of patients with Gram-negative bacteremia, and Gram-negative bacteremia was detected in half of patients with endotoxemia. CONCLUSIONS The diagnostic capacity of PCT is superior to that of CRP due to the close correlation between PCT levels and the severity of sepsis and outcome. Neopterin is very useful in the diagnosis of viral infection. The endotoxin assay in combination with CRP, PCT, or neopterin may help as a diagnostic marker for Gram-negative bacterial infection.
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Affiliation(s)
- Chieko Mitaka
- Department of Critical Care Medicine, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
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Büyüköztürk S, Gelincik AA, Genç S, Koçak H, Oneriyidogan Y, Erden S, Dal M, Colakoglu B. Acute phase reactants in allergic airway disease. TOHOKU J EXP MED 2005; 204:209-13. [PMID: 15502420 DOI: 10.1620/tjem.204.209] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Acute phase reactants have been implicated for their involvement as proinflammatory molecules in various inflammatory diseases. However, little is known regarding their role in the allergic airway disease. The aim of the present study was to examine the blood concentrations of three acute-phase proteins, namely C-reactive protein (CRP), serum amyloid A (SAA) and fibrinogen in patients with allergic rhinitis and asthma. Three study groups include: non-smoker allergic rhinitis (n = 50), non-smoker asthma (n = 20), and non-allergic, non-smoker healthy control subjects (n = 20). Patients who have had recent upper or lower respiratory tract infection and trauma, any rheumatological illnesses, malignancy or obesity were excluded. Blood samples were obtained from all the patients and control subjects and were analyzed for serum CRP, SAA and plasma fibrinogen. The mean CRP and fibrinogen values in the rhinitis and asthma groups were not significantly different when compared to the control group. However, the mean SAA levels of both groups were found to be significantly higher than those of the control group (p = 0.002 for rhinitis, p = 0.02 for asthma). There was no significant correlation between the FEV(1) values and the levels of the serum markers. This study demonstrates that acute phase reactant SAA rises in patients with allergic rhinitis and patients with asthma. We therefore suggest that SAA may have a role in the inflammatory airway disease.
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Affiliation(s)
- Suna Büyüköztürk
- Department of Allergy, Istanbul University Faculty of Medicine, Turkey.
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Yamada T, Okuda Y, Takasugi K, Itoh K, Igari J. Relative serum amyloid A (SAA) values: the influence of SAA1 genotypes and corticosteroid treatment in Japanese patients with rheumatoid arthritis. Ann Rheum Dis 2001; 60:124-7. [PMID: 11156544 PMCID: PMC1753473 DOI: 10.1136/ard.60.2.124] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES (1) To determine whether serum concentration of serum amyloid A (SAA) protein is influenced by the SAA1 allele in Japanese patients with rheumatoid arthritis (RA) as previously shown in a healthy control group; and (2) to analyse what factors, based on such an allelic bias, influence the relative SAA values of those patients. METHODS SAA and C reactive protein (CRP) concentrations together with SAA1 genotypes were determined in 316 Japanese patients with RA. The relative SAA values were evaluated as an SAA/CRP ratio. RESULTS Comparison of the three SAA1 homozygote groups showed that the SAA/CRP ratio was highest in the 1.5/1.5 group (mean 9.0, p<0.01 v the other two homozygote groups) followed by the 1.3/1.3 group (mean 7.2, NS v the 1.1/1.1 group) and the 1.1/1.1 group (mean 4.0). The SAA/CRP ratio was significantly higher in patients receiving corticosteroids regardless of the presence of allele 1.5. No clear differences in the ratio between patients with or without amyloidosis were found. CONCLUSION The SAA1.5 allele and corticosteroid treatment had a positive influence on SAA concentrations in serum. These findings are important when evaluating SAA concentration in inflammatory diseases and when considering the cause or treatment of amyloidosis.
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Affiliation(s)
- T Yamada
- Department of Clinical Pathology, Juntendo University School of Medicine, Tokyo, Japan.
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16
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Abstract
Recent data demonstrating the multifunctional role of serum amyloid A (SAA) in the pathogenesis of amyloidosis have yielded important insights into this potentially fatal consequence of chronic inflammation. SAA has been shown to participate in chemotaxis, cellular adhesion, cytokine production, and metalloproteinase secretion and is thus integrally involved in the disease process. In addition to its production by the liver as part of the acute phase response, SAA is also expressed by several pathologic tissues such atherosclerotic plaques, rheumatoid synovitis and in the brains of patients with Alzheimer disease. Its constitutive production in normal tissue suggests a role for SAA in host defense and tissue turnover. Many pathways are involved in the regulation of SAA, and as more becomes known about these, potential therapeutic targets may be identified. However, the prevention of secondary amyloidosis is best achieved by early and adequate treatment of patients with chronic inflammatory disorders. Suppression of the acute phase response and normalization of SAA levels are likely to significantly impact on the incidence of amyloidosis in inflammatory arthritis.
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Affiliation(s)
- G Cunnane
- Division of Rheumatology, University of California, San Francisco, Veterans Affairs Medical Center, San Francisco, California 94121, USA.
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17
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Yamada T. Serum amyloid A (SAA): a concise review of biology, assay methods and clinical usefulness. Clin Chem Lab Med 1999; 37:381-8. [PMID: 10369107 DOI: 10.1515/cclm.1999.063] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Serum amyloid A (SAA) is a family of proteins encoded in a multigene complex. Acute phase isotypes SAA1 and SAA2 are synthesized in response to inflammatory cytokines. SAA and C-reactive protein (CRP) are now the most sensitive indicators for assessing inflammatory activity. In viral infection and kidney allograft rejection, SAA proved more useful than CRP. Development of convenient assay methods for SAA will facilitate its use in clinical laboratories.
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Affiliation(s)
- T Yamada
- Department of Clinical Pathology, Jichi Medical School, Minamikawachi, Tochigi, Japan.
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18
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Poole S, Walker D, Gaines Das RE, Gallimore JR, Pepys MB. The first international standard for serum amyloid A protein (SAA). Evaluation in an international collaborative study. J Immunol Methods 1998; 214:1-10. [PMID: 9692853 DOI: 10.1016/s0022-1759(98)00057-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An ampouled preparation of acute phase serum rich in serum amyloid A protein (SAA) was evaluated in seven laboratories in six countries for its suitability to serve as the international standard for immunoassay of SAA. A variety of different immunoassays were used. On the basis of the results reported here and with the authorization of the Expert Committee on Biological Standardization of the World Health Organization (WHO) this preparation (coded 92/680) was established as the first international standard of SAA.
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Affiliation(s)
- S Poole
- Division of Endocrinology, National Institute for Biological Standards and Control, Potters Bar, Herts, UK
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Friesen CA, Wiens LA, Burry VF, Portnoy J, Roberts CC. C-reactive protein in acute pulmonary exacerbations of patients with cystic fibrosis. Pediatr Pulmonol 1995; 20:215-9. [PMID: 8606850 DOI: 10.1002/ppul.1950200403] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
C-reactive protein (CRP) concentrations were evaluated in 9 cystic fibrosis (CF) patients with acute pulmonary exacerbations and 14 patients with acute exacerbations of asthma without any symptoms of an acute infection. CRP concentrations were serially evaluated over the course of therapy in CF patients and compared with pulmonary function tests (PFTs) and clinical scores. CF patients were treated with aerosolized bronchodilators, intravenous fluids, and chest physiotherapy for 48 hours. Intravenous antibiotic therapy was added after 48 hours. Initial CRP concentrations differed significantly between patients with CF and those with asthma. CRP concentrations were elevated in 7 of 9 CF patients versus 3 of 14 asthma patients (P < 0.02). In CF patients, CRP concentrations did not correlate with PFTs (except on day 0) or clinical scores. Frequently PFTs and clinical scores continued to improve after CRP levels had reached their lowest concentrations. CRP concentrations decreased only after the addition of antibiotic therapy.
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Affiliation(s)
- C A Friesen
- Cystic Fibrosis Center, Children's Mercy Hospital, Kansas City, Missouri, USA
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20
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Abstract
Serum amyloid A (SAA) proteins comprise a family of apolipoproteins coded for by at least three genes with allelic variation and a high degree of homology between species. The synthesis of certain members of the family is greatly increased in inflammation. However, SAA is not often used as an acute-phase marker despite being at least as sensitive as C-reactive protein. SAA proteins can be considered as apolipoproteins since they associate with plasma lipoproteins mainly within the high density range, perhaps through amphipathic alpha-helical structure. It is not known why certain subjects expressing SAA develop secondary systemic amyloidosis. There is still no specific function attributed to SAA; however, a popular hypothesis suggests that SAA may modulate metabolism of high density lipoproteins (HDL). This may impede the protective function of HDL against the development of atherosclerosis. The potential significance of the association between SAA and lipoproteins needs further evaluation.
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Affiliation(s)
- E Malle
- Philipps University, Department of Internal Medicine, Marburg/Lahn, Germany
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21
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Smith JW, McDonald TL. Production of serum amyloid A and C-reactive protein by HepG2 cells stimulated with combinations of cytokines or monocyte conditioned media: the effects of prednisolone. Clin Exp Immunol 1992; 90:293-9. [PMID: 1424289 PMCID: PMC1554599 DOI: 10.1111/j.1365-2249.1992.tb07945.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The hepatic production of the acute phase proteins in response to inflammatory cytokines, and the interaction of corticosteroids within this response, has been the subject of considerable recent research. In this study we have examined the effects of the corticosteroid prednisolone on the production of IL-1 alpha and IL-1 beta by lipopolysaccharide (LPS)-stimulated monocytes, and the ability of the monocyte conditioned media (MOCM) obtained under these conditions to induce human hepatoma HepG2 cells to produce serum amyloid A (SAA) and C-reactive protein (CRP). We also examined the production of SAA and CRP by HepG2 cells exposed to different combinations and concentrations of recombinant human (rh) IL-1 alpha, rhIL-1 beta, rhIL-6, recombinant human tumour necrosis factor-alpha (rhTNF-alpha) and prednisolone. The findings indicate: (i) prednisolone substantially inhibits the production of both IL-1 alpha and IL-1 beta by LPS-stimulated monocytes. The MOCM from prednisolone-treated monocytes induced less SAA and CRP production by HepG2 cells; (ii) IL-1 alpha and IL-1 beta both induced CRP and SAA synthesis by HepG2 cells, but only in the presence of IL-6. IL-1 beta was the more potent inducer for SAA production, but for CRP production IL-1 alpha and IL-1 beta were equivalent; (iii) prednisolone enhances the production of SAA by HepG2 cells, but does not enhance the production of CRP; (iv) TNF-alpha in the presence or absence of IL-6 and/or prednisolone did not induce the production of SAA or CRP by HepG2 cells. These findings offer a tenable solution to a disparate production of SAA compared with CRP in corticosteroid-treated cystic fibrosis (CF) patients.
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Affiliation(s)
- J W Smith
- Department of Pathology and Microbiology, University of Nebraska Medical Centre, Omaha 68198-6495
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