1
|
Cerro-Pardo I, Lindholt JS, Núñez E, Roldan-Montero R, Ortega-Villanueva L, Vegas-Dominguez C, Gomez-Guerrero C, Michel JB, Blanco-Colio LM, Vázquez J, Martín-Ventura JL. Combined Immunoglobulin Free Light Chains Are Novel Predictors of Cardiovascular Events in Patients With Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2022; 63:751-758. [DOI: 10.1016/j.ejvs.2021.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022]
|
2
|
Wang W, Zhang L, Yang T, Ma S, Zhang Q, Shi P, Ding F. Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery. Ren Fail 2022; 44:1-10. [PMID: 35086423 PMCID: PMC8797736 DOI: 10.1080/0886022x.2021.2013886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives Increased polyclonal free light chains (FLCs) are found in inflammatory conditions. Inflammation is recognized in the progression of acute kidney injury (AKI). This study was aimed to determine whether polyclonal combined FLC (cFLC) was associated with prognosis of AKI patients. Methods This prospective cohort included 145 adults with hospital-acquired AKI following cardiovascular surgery between 2014 and 2016, according to the KDIGO creatinine criteria. The primary end point of the study was all-cause death during follow-up. Results The median of serum cFLC concentration in the cohort was 42.0 (31.9–60.3 mg/L) and levels of cFLC in patients with AKI stage 3 were higher than those in AKI stage 1 and stage 2. cFLC levels correlated significantly with renal function biomarkers, high sensitivity C-reactive protein (hsCRP), and sequential organ failure assessment (SOFA) score. Patients were organized into the following two groups: the low-cFLC group (cFLC <43.3 mg/L) and the high-cFLC group (cFLC ≥ 43.3 mg/L). A total of 17 (11.0%) patient deaths occurred within 90 d, 13 (18.8%) in the high-cFLC group. Kaplan–Meier analysis revealed that the two groups differed significantly with respect to 90-d survival (log-rank p = .012), and Cox regression analysis showed that an cFLC level ≥43.3 mg/L was significantly associated with a 5.0-fold increased risk of death (adjusted hazard ratio [HR], 5.95; 95% confidence interval [CI], 1.04– 33.91; p = .045) compared with an cFLC level <43.3 mg/L. Conclusions Serum cFLC levels were significantly elevated and might be an independent predictor of mortality in patients with AKI following cardiovascular surgery.
Collapse
Affiliation(s)
- Wenji Wang
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| | - Lulu Zhang
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| | - Tianye Yang
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| | - Shaojun Ma
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| | - Qi Zhang
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| | - Peng Shi
- Department of Medical Statistics, Children's Hospital; Center for Evidence-based Medicine, Fudan University, Shanghai, PR China
| | - Feng Ding
- School of Medicine, Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
| |
Collapse
|
3
|
Novel Biomarkers in Heart Failure: New Insight in Pathophysiology and Clinical Perspective. J Clin Med 2021; 10:jcm10132771. [PMID: 34202603 PMCID: PMC8268524 DOI: 10.3390/jcm10132771] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/18/2022] Open
Abstract
Heart failure (HF) is a complex clinical syndrome with a huge social burden in terms of cost, morbidity, and mortality. Brain natriuretic peptide (BNP) appears to be the gold standard in supporting the daily clinical management of patients with HF. Novel biomarkers may supplement BNP to improve the understanding of this complex disease process and, possibly, to personalize care for the different phenotypes, in order to ameliorate prognosis. In this review, we will examine some of the most promising novel biomarkers in HF. Inflammation plays a pivotal role in the genesis and progression of HF and, therefore, several candidate molecules have been investigated in recent years for diagnosis, prognosis, and therapy monitoring. Noncoding RNAs are attractive as biomarkers and their potential clinical applications may be feasible in the era of personalized medicine. Given the complex pathophysiology of HF, it is reasonable to expect that the future of biomarkers lies in the application of precision medicine, through wider testing panels and “omics” technologies, to further improve HF care delivery.
Collapse
|
4
|
Tanimura K, Sato S, Sato A, Tanabe N, Hasegawa K, Uemasu K, Hamakawa Y, Hirai T, Muro S. Low serum free light chain is associated with risk of COPD exacerbation. ERJ Open Res 2020; 6:00288-2019. [PMID: 32665945 PMCID: PMC7335835 DOI: 10.1183/23120541.00288-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 04/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background Most exacerbations of chronic obstructive pulmonary disease (COPD) are triggered by respiratory tract infections. Adaptive immunity via antibody production is important in preventing infections. Impaired antibody production is reported to be associated with an increased risk of exacerbations of COPD. In the present study, we elucidated whether reduced free light chains (FLCs), which are excessive amounts of light chains produced during antibody synthesis and can be used to estimate systemic antibody production, may be a promising biomarker to predict the risk of exacerbations of COPD. Methods We enrolled stable male patients with COPD and prospectively observed them for 2 years. At baseline, serum combined FLC (cFLC; sum of kappa and lambda values) and pulmonary function were evaluated. Exacerbation was defined as a worsening of symptoms requiring treatments with antibiotics, corticosteroids or both. Results 63 patients with stable COPD were enrolled (72.8±8.1 years, GOLD A/B/C/D=24/28/6/5), and 51 patients completed the 2-year follow-up. Serum cFLC was 31.1 mg·L−1 on average and ranged widely (1.4 to 89.9 mg·L−1). The patients with low cFLC (below the mean−sd, n=6) experienced a significantly shorter time to the first exacerbation of COPD (p<0.0001 by the log-rank test). A multivariate Cox proportional hazard model, including the COPD assessment test score, % predicted forced expiratory volume in 1 s (FEV1 % pred), and number of previous exacerbations demonstrated that low cFLC and low FEV1 % pred were independently and significantly correlated with the risk for exacerbations of COPD. Conclusion Low cFLC may be a B-cell-associated novel biomarker associated with risk of COPD exacerbation. Impaired antibody production is associated with an increased risk for exacerbations of COPD. Low serum free light chain is a novel B-cell-associated biomarker for COPD exacerbations.https://bit.ly/35cgMTC
Collapse
Affiliation(s)
- Kazuya Tanimura
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Sato
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsuyasu Sato
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoya Tanabe
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Hasegawa
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiyoshi Uemasu
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoko Hamakawa
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toyohiro Hirai
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shigeo Muro
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Dept of Respiratory Medicine, Nara Medical University, Nara, Japan
| |
Collapse
|
5
|
Perrone MA, Pieri M, Marchei M, Sergi D, Bernardini S, Romeo F. Serum free light chains in patients with ST elevation myocardial infarction (STEMI): A possible correlation with left ventricle dysfunction. Int J Cardiol 2019; 292:32-34. [PMID: 31253526 DOI: 10.1016/j.ijcard.2019.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/25/2019] [Accepted: 06/10/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Light chains are proteins produced by plasma cells, also called light chains kappa and lambda, are tied together with other proteins (heavy chains) to form the intact immunoglobulins or antibodies. Recent studies have shown a possible role of combined free light chains (cFLC) as an inflammatory marker in patients with chronic heart failure (HF). HF is a significant contributor to overall mortality in the community, but often patients with chronic HF also have chronic renal failure, which could alter the concentration of cFLC. METHODS We evaluated the FLC in patients with STEMI (n = 113), who were treated with primary angioplasty in the Cardiology Department of the University Hospital "Tor Vergata". For each patient during hospitalization we have determined blood concentration of cFLC, in addition to routine blood tests and we also performed an echocardiogram to evaluate cardiac function. RESULTS We performed cFLC serum concentration in 113 patients with STEMI and observed that the cFLC concentration correlates with Left Ventricle Ejection Fraction (LVEF). We identified that the majority of patients (97%) who had one of the two positive light chains also had a reduced systolic function (LVEF <50%). CONCLUSIONS For the first time in this paper we highlight the increase of serum free light chains concentrations in acute ischemic heart failure in patients with STEMI and without kidney failure. The cFLC could be proposed as a new biomarker for left ventricle dysfunction, further studies are required to confirm these results.
Collapse
Affiliation(s)
| | - Massimo Pieri
- Division of Clinical Biochemistry and Clinical Molecular Biology, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Marchei
- Division of Cardiology, University of Rome Tor Vergata, Rome, Italy
| | - Domenico Sergi
- Division of Cardiology, University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Division of Clinical Biochemistry and Clinical Molecular Biology, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Romeo
- Division of Cardiology, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
6
|
Alehagen U, Alexander J, Aaseth J, Larsson A. Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: a subanalysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK. JOURNAL OF INFLAMMATION-LONDON 2019; 16:5. [PMID: 30923464 PMCID: PMC6421641 DOI: 10.1186/s12950-019-0210-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/12/2019] [Indexed: 01/21/2023]
Abstract
Background Inflammation is central to the pathogenesis of many diseases. Supplementation with selenium and coenzyme Q10 has been shown to reduce cardiovascular mortality, and increase cardiac function in elderly persons with a low intake of selenium. There are indications that one of the mechanisms of this positive effect is a decrease in inflammation. Methods Osteopontin, osteoprotegerin, sTNF receptor 1, sTNF receptor 2 and the tumor necrosis factor-like weak inducer of apoptosis called TWEAK, were determined in plasma after 6 months and 42 months in 219 community-living elderly persons, of whom 119 received supplements of selenium (200 μg/day) and coenzyme Q10 (200 mg/day), and 101 received a placebo. Repeated measures of variance were used to evaluate the levels, and the results were validated through ANCOVA analyses with adjustments for important covariates. Results Significantly lower concentrations of four of the five biomarkers for inflammation were observed as a result of the intervention with the supplements. Only TWEAK did not show significant differences. Conclusion In this sub-analysis of the intervention with selenium and coenzyme Q10 or placebo in an elderly community-living population, biomarkers for inflammation were evaluated. A significantly lower concentration in four of the five biomarkers tested could be demonstrated as a result of the supplementation, indicating a robust effect on the inflammatory system. The decrease in inflammation could be one of the mechanisms behind the positive clinical results on reduced cardiovascular morbidity and mortality reported earlier as a result of the intervention. The study is small and should be regarded as hypothesis-generating, but nonetheless adds important data about mechanisms presently known to increase the risk of clinical effects such as reduced cardiovascular mortality, increased cardiac function and better health-related quality of life scoring, as previously demonstrated in the active treatment group . Trial registration The intervention study was registered at Clinicaltrials.gov, and has the identifier NCT01443780 and registered on 09/30/2011.
Collapse
Affiliation(s)
- Urban Alehagen
- 1Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Jan Alexander
- 2Norwegian Institute of Public Health, N-0403 Oslo, Norway
| | - Jan Aaseth
- 3Research Department, Innlandet Hospital Trust, Brumunddal, Norway.,4Inland Norway University of Applied Sciences, N-2411 Elverum, Norway
| | - Anders Larsson
- 5Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
| |
Collapse
|
7
|
Alehagen U, Lindahl TL, Aaseth J, Svensson E, Johansson P. Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial. PLoS One 2015; 10:e0137680. [PMID: 26375288 PMCID: PMC4574282 DOI: 10.1371/journal.pone.0137680] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/10/2015] [Indexed: 02/07/2023] Open
Abstract
Background/Objectives Inflammation and oxidative stress are central in many disease states. The major anti-oxidative enzymes contain selenium. The selenium intake in Europe is low, and supplementation with selenium and coenzyme Q10, important anti-oxidants, was evaluated in a previous study. The aim of this study was to evaluate response on the inflammatory biomarkers C-reactive protein, and sP-selectin, and their possible impact on cardiovascular mortality. Subjects/Methods 437 elderly individuals were included in the study. Clinical examination, echocardiography, electrocardiography and blood samples were drawn. The intervention time was 48 months, and median follow-up was 5.2 years. The effects on inflammation/atherosclerosis were evaluated through analyses of CRP and sP-selectin. Evaluations of the effect of the intervention was performed using repeated measures of variance. All mortality was registered, and endpoints of mortality were assessed by Kaplan-Meier plots. Results The placebo group showed a CRP level of 4.8 ng/mL at the start, and 5.1 ng/mL at the study end. The active supplementation group showed a CRP level of 4.1 ng/mL at the start, and 2.1 ng/mL at the study end. SP-selectin exhibited a level of 56.6 mg/mL at the start in the placebo group and 72.3 mg/mL at the study end, and in the active group the corresponding figures were 55.9 mg/mL and 58.0 mg/mL. A significantly smaller increase was demonstrated through repeated measurements of the two biomarkers in those on active supplementation. Active supplementation showed an effect on the CRP and sP-selectin levels, irrespective of the biomarker levels. Reduced cardiovascular mortality was demonstrated in both those with high and low levels of CRP and sP-selectin in the active supplementation group. Conclusion CRP and sP-selectin showed significant changes reflecting effects on inflammation and atherosclerosis in those given selenium and coenzyme Q10 combined. A reduced cardiovascular mortality could be demonstrated in the active group, irrespective of biomarker level. This result should be regarded as hypothesis-generating, and it is hoped it will stimulate more research in the area.
Collapse
Affiliation(s)
- Urban Alehagen
- Department of Cardiology and, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- * E-mail:
| | - Tomas L. Lindahl
- Dept. of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Dept. of Clinical Chemistry, County Council of Östergötlan, Linköping, Sweden
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust and Hedmark University College, Tromsø, Norway
| | | | - Peter Johansson
- Department of Cardiology and, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|