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Wei S, Shen Z, Yin Y, Cong Z, Zeng Z, Zhu X. Advances of presepsin in sepsis-associated ARDS. Postgrad Med J 2024; 100:209-218. [PMID: 38147883 DOI: 10.1093/postmj/qgad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/30/2023] [Accepted: 12/02/2023] [Indexed: 12/28/2023]
Abstract
This article reviews the correlation between presepsin and sepsis and the resulting acute respiratory distress syndrome (ARDS). ARDS is a severe complication of sepsis. Despite the successful application of protective mechanical ventilation, restrictive fluid therapy, and neuromuscular blockade, which have effectively reduced the morbidity and mortality associated with ARDS, the mortality rate among patients with sepsis-associated ARDS remains notably high. The challenge lies in the prediction of ARDS onset and the timely implementation of intervention strategies. Recent studies have demonstrated significant variations in presepsin (PSEP) levels between patients with sepsis and those without, particularly in the context of ARDS. Moreover, these studies have revealed substantially elevated PSEP levels in patients with sepsis-associated ARDS compared to those with nonsepsis-associated ARDS. Consequently, PSEP emerges as a valuable biomarker for identifying patients with an increased risk of sepsis-associated ARDS and to predict in-hospital mortality.
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Affiliation(s)
- Senhao Wei
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
- Graduate School of Peking University Health Science Center, Peking University Health Science Center, Beijing 100191, China
| | - Ziyuan Shen
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
- Graduate School of Peking University Health Science Center, Peking University Health Science Center, Beijing 100191, China
| | - Yiyuan Yin
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Zhukai Cong
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Zhaojin Zeng
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
- Graduate School of Peking University Health Science Center, Peking University Health Science Center, Beijing 100191, China
| | - Xi Zhu
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
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Bizzoca D, Piazzolla A, Moretti L, Vicenti G, Moretti B, Solarino G. Physiologic postoperative presepsin kinetics following primary cementless total hip arthroplasty: A prospective observational study. World J Orthop 2023; 14:547-553. [PMID: 37485426 PMCID: PMC10359746 DOI: 10.5312/wjo.v14.i7.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/09/2023] [Accepted: 06/12/2023] [Indexed: 07/17/2023] Open
Abstract
BACKGROUND Presepsin is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in diagnosing and managing periprosthetic joint infections.
AIM To define the normal postoperative presepsin plasmatic curve, in patients undergoing primary cementless total hip arthroplasty (THA).
METHODS Patients undergoing primary cementless THA at our Institute were recruited. Inclusion criteria were: Primary osteoarthritis of the hip; urinary catheter time of permanence < 24 h; peripheral venous cannulation time of permanence < 24 h; no postoperative homologous blood transfusion administration and hospital stay ≤ 8 d. Exclusion criteria were: The presence of other articular prosthetic replacement or bone fixation devices; chronic inflammatory diseases; chronic kidney diseases; history of recurrent infections or malignant neoplasms; previous surgery in the preceding 12 mo; diabetes mellitus; immunosuppressive drug or corticosteroid assumption. All the patients received the same antibiotic prophylaxis. All the THA were performed by the same surgical and anaesthesia team; total operative time was defined as the time taken from skin incision to completion of skin closure. At enrollment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS) and C-reactive protein 24 h before arthroplasty and at 24, 48, 72 and 96 h postoperatively and at 3, 6 and 12-mo follow-up.
RESULTS A total of 96 patients (51 female; 45 male; mean age = 65.74 ± 5.58) were recruited. The mean PS values were: 137.54 pg/mL at baseline, 192.08 pg/mL at 24 h post-op; 254.85 pg/mL at 48 h post-op; 259 pg/mL at 72 h post-op; 248.6 pg/mL at 96-h post-op; 140.52 pg/mL at 3-mo follow-up; 135.55 pg/mL at 6-mo follow-up and 130.11 pg/mL at 12-mo follow-up. In two patients (2.08%) a soft-tissue infection was observed; in these patients, higher levels (> 350 pg/mL) were recorded at 3-mo follow-up.
CONCLUSION The dosage of plasmatic PS concentration is highly recommended in patients undergoing THA before surgery to exclude the presence of an unknown infection. The PS plasmatic concentration should be also assessed at 72 h post-operatively, evaluate the maximum postoperative PS value, and at 96 h post-operatively when a decrease of presepsin should be found. The lack of a presepsin decrease at 96 h post-operatively could be a predictive factor of infection.
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Affiliation(s)
- Davide Bizzoca
- DAI Neuroscienze, Organi di Senso e Apparato Locomotore, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
| | - Andrea Piazzolla
- DAI Neuroscienze, Organi di Senso e Apparato Locomotore, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
| | - Lorenzo Moretti
- DAI Neuroscienze, Organi di Senso e Apparato Locomotore, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
| | | | - Biagio Moretti
- Di BraiN, University of Bari "Aldo Moro", Bari 70124, Italy
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Vrancianu CO, Serban B, Gheorghe-Barbu I, Czobor Barbu I, Cristian RE, Chifiriuc MC, Cirstoiu C. The Challenge of Periprosthetic Joint Infection Diagnosis: From Current Methods to Emerging Biomarkers. Int J Mol Sci 2023; 24:ijms24054320. [PMID: 36901750 PMCID: PMC10002145 DOI: 10.3390/ijms24054320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Due to the increase in the life span and mobility at older ages, the number of implanted prosthetic joints is constantly increasing. However, the number of periprosthetic joint infections (PJIs), one of the most severe complications after total joint arthroplasty, also shows an increasing trend. PJI has an incidence of 1-2% in the case of primary arthroplasties and up to 4% in the case of revision operations. The development of efficient protocols for managing periprosthetic infections can lead to the establishment of preventive measures and effective diagnostic methods based on the results obtained after the laboratory tests. In this review, we will briefly present the current methods used in PJI diagnosis and the current and emerging synovial biomarkers used for the prognosis, prophylaxis, and early diagnosis of periprosthetic infections. We will discuss treatment failure that may result from patient factors, microbiological factors, or factors related to errors during diagnosis.
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Affiliation(s)
- Corneliu Ovidiu Vrancianu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Bogdan Serban
- University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence: (B.S.); (I.G.-B.)
| | - Irina Gheorghe-Barbu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
- Correspondence: (B.S.); (I.G.-B.)
| | - Ilda Czobor Barbu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Roxana Elena Cristian
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
- Romanian Academy, 010071 Bucharest, Romania
| | - Catalin Cirstoiu
- University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Solarino G, Bizzoca D, Moretti L, Vicenti G, Piazzolla A, Moretti B. What's New in the Diagnosis of Periprosthetic Joint Infections: Focus on Synovial Fluid Biomarkers. Trop Med Infect Dis 2022; 7:355. [PMID: 36355897 PMCID: PMC9692966 DOI: 10.3390/tropicalmed7110355] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 08/10/2023] Open
Abstract
Periprosthetic joint infections are some of the leading causes of revision prosthetic surgery, accounting for 25% of failed total knee replacements and 15% of failed total hip replacements. The search for a biomarker that, together with clinical and radiological findings, could improve the management of such patients is currently a significant challenge for orthopaedic surgeons. Synovial fluid is a viscous and mucinous substance produced by the synovium, a specialized connective tissue that lines diarthrodial joints. Synovial fluid is an ultrafiltrate of plasma but also contains proteins secreted from the surrounding tissues, including the articular cartilage and synovium. Therefore, synovial fluid represents a source of disease-related proteins that could be used as potential biomarkers in several articular diseases. Based on these findings, the study of synovial fluid has been gaining increasing importance in recent years. This review aims to assess the accuracy and the limitations of the most promising synovial fluid biomarkers-i.e., Alpha-Defensin, Leukocyte Esterase, C-Reactive Protein, Interleukin-6, Calprotectin, Presepsin and Neopterin-in the diagnosis of PJI. Special attention will be given to emerging synovial biomarkers, which could soon be important in diagnosing PJIs.
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Affiliation(s)
- Giuseppe Solarino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Davide Bizzoca
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
- AOU Consorziale Policlinico di Bari, UOSD Spinal Surgery and Scoliosis Deformity Centre, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Lorenzo Moretti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Giovanni Vicenti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Andrea Piazzolla
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
- AOU Consorziale Policlinico di Bari, UOSD Spinal Surgery and Scoliosis Deformity Centre, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Biagio Moretti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”-AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
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The Usefulness of Synovial Fluid Proteome Analysis in Orthopaedics: Focus on Osteoarthritis and Periprosthetic Joint Infections. J Funct Morphol Kinesiol 2022; 7:jfmk7040097. [PMID: 36412759 PMCID: PMC9680387 DOI: 10.3390/jfmk7040097] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 12/14/2022] Open
Abstract
Synovial fluid (SF) is a viscous and mucinous substance produced by the synovium, a specialized connective tissue that lines diarthrodial joints. SF represents a source of disease-related proteins that could be used as potential biomarkers in several articular diseases. Based on these findings the study of SF has been gaining increasing importance, in recent years. This review aims to summarize the usefulness of synovial fluid in orthopaedics research and clinical practice, mainly focusing on osteoarthritis (OA) and periprosthetic joint infections (PJIs). Proteomics of the SF has shown the up-regulation of several components of the classic complement pathway in OA samples, including C1, C2, C3, C4A, C4B, C5, and C4 C4BPA, thus depicting that complement is involved in the pathogenesis of OA. Moreover, proteomics has demonstrated that some pro-inflammatory cytokines, namely IL-6, IL-8, and IL-18, have a role in OA. Several SF proteins have been studied to improve the diagnosis of PJIs, including alpha-defensin (Alpha-D), leukocyte esterase (LE), c-reactive protein (CRP), interleukin-6 (IL-6), calprotectin and presepsin. The limits and potentials of these SF biomarkers will be discussed.
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Delva ML, Samuel LT, Acuña AJ, Kamath AF. Presepsin as a diagnostic biomarker of peri-prosthetic joint infection: a review of the literature. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2022; 33:695-700. [PMID: 35262776 DOI: 10.1007/s00590-022-03232-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION While presepsin has shown promise as a sepsis biomarker, it has only recently been considered in the field of orthopedic surgery. Therefore, the present review evaluates the role of presepsin in total joint arthroplasty (TJA) as well as its diagnostic and prognostic value in diagnosing PJI. METHODS Utilizing 4 online databases, we thoroughly searched the literature for articles evaluating the role of presepsin in TJA as well as its prognostic and diagnostic value for PJI. RESULTS Studies evaluating perioperative presepsin trends in primary TJA demonstrated that its natural course is similar to C-Reactive Protein (CRP). The area under (AUC) the receiver operating characteristic curves values for serum presepsin ranged from 0.86 to 0.926. These values were higher than the AUCs for CRP in each of their respective studies. However, synovial presepsin demonstrated a lower AUC (0.41). Prognostically, presepsin demonstrated potential in terms of infection monitoring following revision TJA for PJI. CONCLUSION Although the data remains limited, presepsin may serve as a potential biomarker to evaluate the natural inflammatory response following TJA as well as to help diagnose PJI. The present review serves to set the foundation for future study into serum presepsin in larger patient cohorts. Further study is needed to evaluate how this biomarker compares to other laboratory values traditionally used for PJI diagnosis.
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Affiliation(s)
- Mona Lisa Delva
- School of Medicine, Case Western Reserve University, Health Education Campus, 9501 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Linsen T Samuel
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA
| | - Alexander J Acuña
- School of Medicine, Case Western Reserve University, Health Education Campus, 9501 Euclid Avenue, Cleveland, OH, 44106, USA
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA
| | - Atul F Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA.
- Center for Hip Preservation, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail code A40, Cleveland, OH, 44195, USA.
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Kusnierova P, Bystronova I, Walder P, Hlubek R, Vsiansky F, Stejskal D. Alpha-defensins determination in different types of synovial fluid and parallel collected serum samples by ELISA. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 165:367-374. [PMID: 33899825 DOI: 10.5507/bp.2021.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/07/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS The study aims were to verify the serum (S) and synovial fluid (SF) reference intervals (RIs) for human neutrophil defensins (HNP1-3); measure S and SF defensin concentrations in different types of SF, including non-inflammatory, inflammatory non-pyogenic, inflammatory pyogenic, and hemorrhagic; and to compare the HNP1-3 concentrations in SF and S with those of other inflammatory biomarkers. METHODS SF and S samples were collected from 92 patients. HNP1-3 concentrations were determined using enzyme-linked immunosorbent assays; glucose, lactate, interleukin-6, and procalcitonin using an automatic analyzer; and presepsin using a Pathfast system. There were 61 non-inflammatory, 11 inflammatory non-pyogenic, 11 inflammatory pyogenic, and 9 hemorrhagic SF. Non-inflammatory SF was divided into non-inflammatory normal and non-inflammatory osteoarthritis. The former was used to estimate the HNP1-3 RI in SF and S. RESULTS The estimated HNP1-3 RIs of SF and S were 12.47-437.42 mg/L and 5.45-44.75 µg/L, respectively. HNP1-3 differed significantly between S and SF and individual groups of SF (P<0.001 and P=0.001, respectively). There were significant relationships between SF HNP1-3 and S HNP1-3 (P<0.001), S C-reactive protein (P<0.001), and S interleukin-6 (P=0.007), and between SF HNP1-3 and SF C-reactive protein (P=0.004) and SF interleukin-6 (P<0.001). The highest kappa coefficient was between SF HNP1-3 and SF interleukin-6 (κ=0.507). CONCLUSIONS We validated the SF HNP1-3 diagnostic kit and demonstrated that SF and S HNP1-3 are promising biomarkers for distinguishing inflammatory from non-inflammatory joint diseases.
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Affiliation(s)
- Pavlina Kusnierova
- Institute of Laboratory Diagnostics, Department of Clinical Biochemistry, University Hospital Ostrava, Czech Republic
| | - Iveta Bystronova
- Institute of Laboratory Diagnostics, Department of Clinical Biochemistry, University Hospital Ostrava, Czech Republic.,Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Pavel Walder
- Orthopedic Department, University Hospital Ostrava, Czech Republic
| | - Rudolf Hlubek
- Orthopedic Department, University Hospital Ostrava, Czech Republic
| | - Frantisek Vsiansky
- Institute of Laboratory Diagnostics, Department of Clinical Biochemistry, University Hospital Ostrava, Czech Republic
| | - David Stejskal
- Institute of Laboratory Diagnostics, Department of Clinical Biochemistry, University Hospital Ostrava, Czech Republic
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Imagama T, Seki K, Seki T, Tokushige A, Matsuki Y, Yamazaki K, Nakashima D, Okazaki T, Hirata K, Yamamoto M, Tanaka H, Sakai T. Synovial fluid presepsin as a novel biomarker for the rapid differential diagnosis of native joint septic arthritis from crystal arthritis. Int J Infect Dis 2020; 102:472-477. [PMID: 33278715 DOI: 10.1016/j.ijid.2020.10.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate whether presepsin can be used as a novel biomarker to differentiate between native joint septic arthritis (NJSA) and crystal arthritis (CA). METHODS This study included 75 patients diagnosed with either NJSA (n = 21) or CA (n = 54). Presepsin in synovial fluid and blood, C-reactive protein, and procalcitonin were measured and compared between the NJSA and CA groups. Receiver operating characteristic (ROC) curve analyses were performed to differentiate between the two groups. RESULTS Synovial fluid and blood presepsin were significantly higher in the NJSA group than in the CA group (p < 0.0001 and p < 0.01, respectively). The area under the ROC curve for synovial fluid presepsin in the NJSA group compared with the CA group was 0.93 (sensitivity 85.7%, specificity 85.2%, positive predictive value 69.2%, negative predictive value 93.9%, positive likelihood ratio 5.79, negative likelihood ratio 0.17). Among the tests, synovial fluid presepsin was the most accurate. CONCLUSIONS Measurement of synovial fluid presepsin is reliable for the early diagnosis of NJSA, and synovial fluid presepsin could be used as a novel biomarker for differentiating between NJSA and CA.
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Affiliation(s)
- Takashi Imagama
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan.
| | - Kazushige Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Toshihiro Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Atsunori Tokushige
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Yuta Matsuki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Kazuhiro Yamazaki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Daisuke Nakashima
- Department of Orthopedic Surgery, St. Hill Hospital, 3-7-18, Imamurakita, Ube 755-0155, Japan
| | - Tomoya Okazaki
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Kenji Hirata
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Manabu Yamamoto
- Department of Orthopedic Surgery, Tokuyama Central Hospital, 1-1, Koda, Shunan, 745-8522, Japan
| | - Hiroshi Tanaka
- Department of Orthopedic Surgery, Yamaguchi Prefectural Grand Medical Center, 10077, Osaki, Hofu, 747-8511, Japan
| | - Takashi Sakai
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan
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Lyu S, Ding R, Liu P, OuYang H, Feng Y, Rao Y, Yang S. LC-MS Analysis of Serum for the Metabolomic Investigation of the Effects of Pulchinenoside b4 Administration in Monosodium Urate Crystal-Induced Gouty Arthritis Rat Model. Molecules 2019; 24:molecules24173161. [PMID: 31480258 PMCID: PMC6749452 DOI: 10.3390/molecules24173161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/18/2019] [Accepted: 08/28/2019] [Indexed: 02/07/2023] Open
Abstract
Gouty arthritis (GA) is commonly caused by deposition of monosodium urate (MSU) crystals within the joint capsule, bursa, cartilage, bone, or other periarticular tissues after chronic hyperuricemia. Clinically, GA is characterized by acute episodes of joint inflammation, which is most frequently encountered in the major joints, and also has a significant impact on quality of life. Pulchinenoside b4(P-b4) has a wide range of biological activities, including antitumor, anti-inflammatory, antiviral and immunomodulatory activities. Currently, the anti-GA activity and metabolomic profiles after being treated by P-b4 have not been reported. In this paper, for the first time, we have performed a non-targeted metabolomics analysis of serum obtained from an MSU crystal-induced GA rat model intervened by P-b4, using ultra-performance liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry. In this study, the main pharmacodynamics of different dosing methods and dosages of P-b4 was firstly investigated. Results have shown that P-b4 possesses high anti-inflammatory activity. These results demonstrated changes in serum metabolites with 32 potential biomarkers. Arachidonic acid, sphingolipid, and glycerophospholipid metabolism are considered to be the most relevant metabolic pathway with P-b4 treatment effect in this study. Moreover, the changes of metabolites and the self-extinction of model effects within 24 h reveals important information for GA diagnostic criteria: The regression of clinical symptoms or the decline of some biochemical indicators cannot be regarded as the end point of GA treatment. Furthermore, our research group plans to conduct further metabolomics research on the clinical course of GA.
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Affiliation(s)
- Shang Lyu
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
| | - Ruowen Ding
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China
| | - Peng Liu
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China
| | - Hui OuYang
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China
- State Key Laboratory of Innovative Drug and Efficient Energy-Saving Pharmaceutical Equipment, Nanchang 330006, China
| | - Yulin Feng
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
- State Key Laboratory of Innovative Drug and Efficient Energy-Saving Pharmaceutical Equipment, Nanchang 330006, China.
| | - Yi Rao
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
| | - Shilin Yang
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China
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