C-reactive protein is directly related to plasminogen activator inhibitor type 1 (PAI-1) levels in diabetic subjects with the 4G allele at position -675 of the PAI-1 gene

HOMA-IR as a Predictor of PAI-1 Levels in Women with Severe Obesity

BACKGROUND

Obesity is a chronic inflammatory disorder that increases the risk of cardiovascular diseases (CVDs). Given the high CVD mortality rate among individuals with obesity, early screening should be considered. Plasminogen activator inhibitor (PAI-1), a cytokine that links obesity and CVDs, represents a promising biomarker. However, PAI-1 is not part of the clinical routine due to its high cost. Therefore, it is necessary to find good predictors that would allow an indirect assessment of PAI-1.

METHODS

This study enrolled 47 women with severe obesity (SO). The obtained anthropometric measurements included weight, height, neck (NC), waist (WC), and hip circumference (HC). Blood samples were collected to analyse glucose and lipid profiles, C-reactive protein, liver markers, adiponectin, and PAI-1 (determined by ELISA immunoassay). Homeostasis model assessment-adiponectin (HOMA-AD), homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), triglyceride-glucose index (TyG), and atherogenic index of plasma (AIP) were calculated. The women were grouped according to PAI-1 levels. The data were analysed using IBM SPSS Statistics, version 21. The significance level for the analysis was set at 5%.

RESULTS

Women with SO who have higher levels of PAI-1 have lower values of high-density lipoprotein cholesterol (HDL) (p = 0.037) and QUICKI (0.020) and higher values of HOMA-AD (0.046) and HOMA-IR (0.037). HOMA-IR was demonstrated to be a good predictor of PAI-1 in this sample (B = 0.2791; p = 0.017).

CONCLUSIONS

HOMA-IR could be used as a predictor of PAI-1 levels, pointing out the relevance of assessing glycaemic parameters for the prevention of CVDs in women with SO.

A Smartphone-Based Colorimetric Reader for Human C-Reactive Protein Immunoassay

A smartphone-based colorimetric reader (SBCR), comprising a Samsung Galaxy SIII mini, a gadget (iPAD mini, iPAD4, or iPhone 5s) and a custom-made dark hood and base holder assembly, is used for human C-reactive protein (CRP) immunoassay. A 96-well microtiter plate (MTP) is positioned on the gadget's screensaver to provide white light-based bottom illumination only in the specific regions corresponding to the well's bottom. The images captured by the smartphone's back camera are analyzed by a novel image processing algorithm. Based on one-step kinetics-based human C-reactive protein immunoassay (IA), SBCR is evaluated and compared with a commercial MTP reader (MTPR). For analysis of CRP spiked in diluted human whole blood and plasma as well as CRP in clinical plasma samples, SBCR exhibits the same precision, dynamic range, detection limit, and sensitivity as MTPR for the developed IA (DIA). Considering its compactness, low cost, advanced features and a remarkable computing power, SBCR is an ideal point-of-care (POC) colorimetric detection device for the next-generation of cost-effective POC testing (POCT).

Surface plasmon resonance-based immunoassay for human C-reactive protein

A rapid and highly-sensitive surface plasmon resonance (SPR)-based immunoassay (IA) has been developed and validated for detecting human C-reactive protein (CRP), a specific biomarker for inflammatory and metabolic disorders, and infections.

Magnetic chemiluminescent immunoassay for human C-reactive protein on the centrifugal microfluidics platform

Schematic of the LabDisk-based hCRP MCIA. The antibody-coated dynabeads are sequentially transported through the immunoassay buffers by magnetic actuation. Finally the chemiluminescence signal is acquired from a detection cavity.

Failure to lyse venous thrombi because of elevated plasminogen activator Inhibitor 1 (PAI-1) and 4G polymorphism of its promotor genome (The PAI-1/4G Syndrome)

Plasminogen activator Inhibitor 1 (PAI-1) inhibits plasminogen activators leading to decreased fibrinolysis and increased risk of thromboembolic disease (TED). Shifts in PAI-1 promoter genome from normal 5G>5G to 4G>5G or 4G>4G alleles are associated with overexpression of PAI-1. In this study patients with residual venous thrombi were observed to have increased PAI-1 levels and more frequent shifts to 4G alleles. Of the 26, 20 (76.9%) patients with unresolved thrombus had elevated PAI-1 values. 4G genomic shifts were found in 92.9% patients studied. Normal PAI-1 levels were found in 5 patients with 4G polymorphisms. Thus, PAI-1 is often elevated among patients with residual thrombus, with an unexpectedly high prevalence of the 4G polymorphism of the promoter genome. Patients with persistent thrombus should be considered at risk of having constituently increased PAI-1 due to genomic changes in the PAI-1 promoter genome. Hypotheses are proposed to explain those with normal PAI-1, despite having 4G polymorphisms.

C-reactive protein and venous thromboembolism: causal or casual association?

The plasma concentration of C-reactive protein (CRP), the first acute-phase protein to be identified, increases dramatically following tissue injury or inflammation. Although the physiological role of CRP is still not fully known, it has been suggested that concentrations might increase as part of the acute-phase response for facilitating non-specific immune functions, defense against bacterial pathogens, clearance of apoptotic and necrotic cells to prevent immunization against autoantigens and acceleration of the repair process. In agreement with the evidence that inflammation plays a pivotal role in the pathogenesis of atherosclerosis, CRP concentrations have been associated with cardiovascular disease, and measurement of CRP has therefore been proposed as a valuable aid to predict and stratify the risk of myocardial infarction and stroke. Recently, some clinical and biological evidence in support of the hypothesis that CRP might be also involved in the onset of venous thrombosis have emerged. Native and monomeric CRP exert several prothrombotic activities, including activation of blood coagulation, impairment of the endogenous fibrinolytic capacity, and stimulation or enhancement of platelet adhesiveness and responsiveness. Epidemiological investigations have also shown that CRP concentrations are associated with increased risk of venous thromboembolism and, even more interestingly, that statins might be effective in reducing the risk of this pathology. Although there is increasing emphasis that CRP might not only be a marker but also an active player in the development of venous thrombosis, further evidence is needed to establish which event comes first--thrombosis or inflammation.