1
|
Ma L, Zhang C, Gao J, Jiao X, Yu Z, Zhu Y, Wang T, Ma X, Wang Y, Tang W, Zhao X, Ruan W, Wang T. Mortality prediction with adaptive feature importance recalibration for peritoneal dialysis patients. PATTERNS (NEW YORK, N.Y.) 2023; 4:100892. [PMID: 38106617 PMCID: PMC10724364 DOI: 10.1016/j.patter.2023.100892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/18/2023] [Accepted: 11/10/2023] [Indexed: 12/19/2023]
Abstract
The study aims to develop AICare, an interpretable mortality prediction model, using electronic medical records (EMR) from follow-up visits for end-stage renal disease (ESRD) patients. AICare includes a multichannel feature extraction module and an adaptive feature importance recalibration module. It integrates dynamic records and static features to perform personalized health context representation learning. The dataset encompasses 13,091 visits and demographic data of 656 peritoneal dialysis (PD) patients spanning 12 years. An additional public dataset of 4,789 visits from 1,363 hemodialysis (HD) patients is also considered. AICare outperforms traditional deep learning models in mortality prediction while retaining interpretability. It uncovers mortality-feature relationships and variations in feature importance and provides reference values. An AI-doctor interaction system is developed for visualizing patients' health trajectories and risk indicators.
Collapse
Affiliation(s)
| | | | - Junyi Gao
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Health Data Research UK, London, UK
| | | | | | | | | | - Xinyu Ma
- Peking University, Beijing, China
| | | | - Wen Tang
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Xinju Zhao
- Department of Nephrology, Peking University People’s Hospital, Beijing, China
| | - Wenjie Ruan
- Department of Computer Science, University of Exeter, Exeter, UK
| | - Tao Wang
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| |
Collapse
|
2
|
The Impact of Whole-Body Cryotherapy on Endothelium Parameters in Patients with Ankylosing Spondylitis. Antioxidants (Basel) 2023; 12:antiox12020521. [PMID: 36830079 PMCID: PMC9952202 DOI: 10.3390/antiox12020521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The aim of the study was to assess the effect of whole-body cryotherapy (WBC) with subsequent exercise training (WBC group) or exercise-only training (ET group) on endothelium inflammation parameters in patients with ankylosing spondylitis (AS). METHODS The WBC procedure lasted 3 min, and exercise training consisted of one 60 min session a day, which was the same in each group. The ET group was compared to the WBC group. Endothelium (high-sensitivity C-reactive protein (hsCRP), soluble P-Selectin, soluble vascular cell adhesion molecule-1 (sVCAM-1), neopterin), and oxidative stress (lipid hydroperoxide (LHP), protein sulfhydryl (PSH), lipofuscin, paraoxonase-1(PON-1), and albumin) parameters were estimated 1 day before and 1 day after the completion of the study. RESULTS A significant decrease in hsCRP, sP-Selectin, sVCAM-1, and neopterin concentrations was observed in the WBC group after the treatment. After the treatment, in both groups, LHP and lipofuscin levels and PON-1 activity decreased significantly. The observed drop in these parameters was higher in the WBC group compared to the ET group. Albumin concentration increased in the WBC group after treatment. CONCLUSION Procedures of WBC have a beneficial effect on endothelium parameters in AS patients; therefore, this method can be applied in the treatment of this group of patients.
Collapse
|
3
|
Ibrahim NH, El Hanafy MSED, El Brashy AWSED, Abd-Elmonem EA. Serum fibrinogen to albumin ratio in patients with ankylosing spondylitis: correlation with disease activity and severity. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [DOI: 10.1186/s43166-022-00140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The fibrinogen to albumin ratio (FAR) has risen to prominence as a novel biomarker for various conditions, including systemic inflammation. Therefore, this study aims to assess the role of FAR in ankylosing spondylitis (AS) and its correlation with disease activity, severity, and functional status of AS patients. Thirty adult patients with AS were enrolled, along with 20 healthy age- and sex-matched subjects as controls. Bath Indices were used to determine the disease activity, severity, and functional status.
Results
The patients’ mean age was 35.3 years, including 22 males (73.3%) and eight females (26.7%). The median disease duration was 10 years, ranging from 1 to 28 years. AS cases showed higher FAR than the control group (P < 0.001). Active cases were associated with significantly higher FAR when compared to cases in remission (P < 0.001). FAR showed significant positive correlations with Bath Indices including BASDAI, BASFI, and BASMI scores (P = 0.002, 0.002, < 0.001, 0.019, 0.022).
Conclusion
FAR has been increased in AS, particularly in active cases. FAR has also been associated with the impaired functional status of AS patients. FAR can represent a novel inflammatory parameter for monitoring disease activity and severity in AS.
Collapse
|
4
|
Sonsuz A, Bakkaloglu OK. Biomarkers in Liver Disease. Biomark Med 2022. [DOI: 10.2174/9789815040463122010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Symptoms and signs of liver diseases are highly variable depending on the
etiology, disease stage, and type of liver involvement. There are different types of liver
diseases; causes of liver diseases may be viral, toxic, metabolic, or autoimmune.
However, in some cases, liver disease can develop as a result of diseases of other
organs or systems. It is almost impossible to differentiate all of these solely on the basis
of clinical symptoms and findings. Furthermore, the early stages of liver disease may
be completely asymptomatic, or in some cases, the disease may progress with only
subtle and non-specific symptoms. Therefore, biomarkers have a critical role in
screening, diagnosis, staging, and evaluation of therapeutic response to treatment in
liver diseases.
Collapse
Affiliation(s)
- Abdullah Sonsuz
- Department of Internal Medicine-Gastroenterology, Cerrahpasa Medical Faculty, Istanbul
University – Cerrahpasa, Istanbul, Turkey
| | - Oguz Kagan Bakkaloglu
- Department of Internal Medicine-Gastroenterology, Cerrahpasa Medical Faculty, Istanbul
University – Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
5
|
Belinskaia DA, Voronina PA, Goncharov NV. Integrative Role of Albumin: Evolutionary, Biochemical and Pathophysiological Aspects. J EVOL BIOCHEM PHYS+ 2021; 57:1419-1448. [PMID: 34955553 PMCID: PMC8685822 DOI: 10.1134/s002209302106020x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/02/2021] [Accepted: 04/02/2021] [Indexed: 12/12/2022]
Abstract
Being one of the main proteins in the human body and many
animal species, albumin plays a crucial role in the transport of
various ions, electrically neutral molecules and in maintaining
the colloidal osmotic pressure of the blood. Albumin is able to
bind almost all known drugs, many nutraceuticals and toxic substances,
determining their pharmaco- and toxicokinetics. However, albumin
is not only the passive but also the active participant of the pharmacokinetic
and toxicokinetic processes possessing a number of enzymatic activities.
Due to the thiol group of Cys34, albumin can serve as a trap for
reactive oxygen and nitrogen species, thus participating in redox
processes. The interaction of the protein with blood cells, blood
vessels, and also with tissue cells outside the vascular bed is
of great importance. The interaction of albumin with endothelial glycocalyx
and vascular endothelial cells largely determines its integrative
role. This review provides information of a historical nature, information
on evolutionary changes, inflammatory and antioxidant properties
of albumin, on its structural and functional modifications and their significance
in the pathogenesis of some diseases.
Collapse
Affiliation(s)
- D. A. Belinskaia
- Sechenov Institute of Evolutionary
Physiology and Biochemistry of the Russian Academy of Sciences, St. Petersburg, Russia
| | - P. A. Voronina
- Sechenov Institute of Evolutionary
Physiology and Biochemistry of the Russian Academy of Sciences, St. Petersburg, Russia
| | - N. V. Goncharov
- Sechenov Institute of Evolutionary
Physiology and Biochemistry of the Russian Academy of Sciences, St. Petersburg, Russia
- Research Institute of Hygiene,
Occupational Pathology and Human Ecology, p/o Kuzmolovsky, Vsevolozhsky District, Leningrad
Region, Russia
| |
Collapse
|
6
|
Serum Albumin in Health and Disease: Esterase, Antioxidant, Transporting and Signaling Properties. Int J Mol Sci 2021; 22:ijms221910318. [PMID: 34638659 PMCID: PMC8508759 DOI: 10.3390/ijms221910318] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022] Open
Abstract
Being one of the main proteins in the human body and many animal species, albumin plays a decisive role in the transport of various ions-electrically neutral and charged molecules-and in maintaining the colloidal osmotic pressure of the blood. Albumin is able to bind to almost all known drugs, as well as many nutraceuticals and toxic substances, largely determining their pharmaco- and toxicokinetics. Albumin of humans and respective representatives in cattle and rodents have their own structural features that determine species differences in functional properties. However, albumin is not only passive, but also an active participant of pharmacokinetic and toxicokinetic processes, possessing a number of enzymatic activities. Numerous experiments have shown esterase or pseudoesterase activity of albumin towards a number of endogeneous and exogeneous esters. Due to the free thiol group of Cys34, albumin can serve as a trap for reactive oxygen and nitrogen species, thus participating in redox processes. Glycated albumin makes a significant contribution to the pathogenesis of diabetes and other diseases. The interaction of albumin with blood cells, blood vessels and tissue cells outside the vascular bed is of great importance. Interactions with endothelial glycocalyx and vascular endothelial cells largely determine the integrative role of albumin. This review considers the esterase, antioxidant, transporting and signaling properties of albumin, as well as its structural and functional modifications and their significance in the pathogenesis of certain diseases.
Collapse
|
7
|
Yu KYC, Yung S, Chau MKM, Tang CSO, Yap DYH, Tang AHN, Ying SKY, Lee CK, Chan TM. Serum syndecan-1, hyaluronan and thrombomodulin levels in patients with lupus nephritis. Rheumatology (Oxford) 2021; 60:737-750. [PMID: 32793966 DOI: 10.1093/rheumatology/keaa370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/28/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES We investigated circulating syndecan-1, HA and thrombomodulin levels in patients with biopsy-proven Class III/IV ± V LN and their clinico-pathological associations. Patients with non-renal SLE or non-lupus chronic kidney disease, and healthy subjects served as controls. METHODS Serum syndecan-1, HA and thrombomodulin levels were determined by ELISAs. RESULTS Syndecan-1, HA and thrombomodulin levels were significantly higher during active LN compared with remission (P < 0.01, for all), and correlated with the level of proteinuria, estimated glomerular filtration rate, anti-dsDNA antibodies, complement 3 and serum creatinine. Longitudinal studies showed that syndecan-1 and thrombomodulin levels increased prior to clinical renal flare by 3.6 months, while HA level increased at the time of nephritic flare, and the levels decreased in parallel with treatment response. Receiver operating characteristic curve analysis showed that syndecan-1 and thrombomodulin levels distinguished patients with active LN from healthy subjects, LN patients in remission, patients with active non-renal lupus and patients with non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.98, 0.91, 0.82 and 0.95, respectively, for syndecan-1; and area under curve of 1.00, 0.84, 0.97 and 0.79, respectively, for thrombomodulin). HA level distinguished active LN from healthy subjects, LN patients in remission and non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.82, 0.71 and 0.90, respectively) but did not distinguish between renal vs non-renal lupus. Syndecan-1 and thrombomodulin levels correlated with the severity of interstitial inflammation, while HA level correlated with chronicity grading in kidney biopsies of active LN. CONCLUSION Our findings suggest potential utility of serum syndecan-1, thrombomodulin and HA levels in clinical management, and their potential contribution to LN pathogenesis.
Collapse
Affiliation(s)
- Kelvin Y C Yu
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Susan Yung
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Mel K M Chau
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Colin S O Tang
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Desmond Y H Yap
- Department of Medicine, The University of Hong Kong, Hong Kong
| | | | - Shirley K Y Ying
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | | | - Tak Mao Chan
- Department of Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
8
|
Lee LE, Pyo JY, Ahn SS, Song JJ, Park YB, Lee SW. Fibrinogen to albumin ratio reflects the activity of antineutrophil cytoplasmic antibody-associated vasculitis. J Clin Lab Anal 2021; 35:e23731. [PMID: 33591581 PMCID: PMC8059749 DOI: 10.1002/jcla.23731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 11/11/2022] Open
Abstract
Background We investigated whether fibrinogen to albumin ratio (FAR) at diagnosis could reflect the cross‐sectional activity and predict poor outcomes in patients with antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitis (AAV). Methods This cross‐sectional study included 54 immunosuppressant drug‐naïve patients with AAV who had the results of plasma fibrinogen and serum albumin at diagnosis. Clinical and laboratory data at diagnosis were collected, and all‐cause mortality, cerebrovascular accident, cardiovascular disease, end‐stage renal disease occurrences were assessed as poor outcomes. FAR was calculated by the following equation: FAR = plasma fibrinogen (g/dl)/serum albumin (g/dl). Results The median age was 65.5 years, and 59.3% of patients were men (33 MPA, 13 GPA and 8 EGPA). FAR was significantly correlated with Birmingham vasculitis activity score (BVAS; r = 0.271), erythrocyte sedimentation rate (ESR; r = 0.668) and C‐reactive protein (CRP; r = 0.638). High BVAS was defined as BVAS ≥16, and the cut‐off of FAR at diagnosis was set as 0.118. AAV patients with FAR at diagnosis ≥0.118 had a significantly higher risk for the cross‐sectional high BVAS than those without (RR 3.361). In the univariable linear regression analysis, CRP (β = 0.383) and FAR (β = 0.297) were significantly correlated with BVAS at diagnosis. However, in the multivariable analysis, none of them was correlated with the cross‐sectional BVAS. FAR at diagnosis could not predict poor outcomes during follow‐up in AAV patients. Conclusions Fibrinogen to albumin ratio at diagnosis could reflect the cross‐sectional BVAS but could not predict poor outcomes in patients with AAV.
Collapse
Affiliation(s)
- Lucy Eunju Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Yoon Pyo
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
9
|
Ma L, Zhu D, Jiang Y, Liu Y, Ma X, Liu M, Chen X. Low triiodothyronine: A new facet of inflammation in acute ischemic stroke. Clin Chim Acta 2016; 458:63-7. [DOI: 10.1016/j.cca.2016.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 01/17/2023]
|
10
|
Malhotra R, Marcelli D, von Gersdorff G, Grassmann A, Schaller M, Bayh I, Scatizzi L, Etter M, Guinsburg A, Barth C, Marelli C, Carioni P, van der Sande F, Kooman JP, Liu E, Toffelmire T, Wang Y, Thijssen S, Usvyat LA, Kotanko P. Relationship of Neutrophil-to-Lymphocyte Ratio and Serum Albumin Levels with C-Reactive Protein in Hemodialysis Patients: Results from 2 International Cohort Studies. Nephron Clin Pract 2015; 130:263-70. [PMID: 26182958 DOI: 10.1159/000437005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/16/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM The neutrophil-to-lymphocyte ratio (NLR), defined as the neutrophil count divided by lymphocyte count, is an inexpensive and readily available parameter, which may serve as a surrogate for inflammation markers, such as C-reactive protein (CRP). The aim of this study was to determine the utility of NLR in the prediction of elevated CRP levels in hemodialysis (HD) patients. METHODS We analyzed 43,272 HD patients from 2 distinct cohorts within the Monitoring Dialysis Outcomes research collaboration in whom contemporaneous measurements of neutrophil and lymphocyte counts, serum albumin and CRP levels were available. Logistic regression was used to determine the relationship of trichotomized NLR (<2.5, 2.5-5 and >5.0) and albumin levels (<3.1, 3.1-4.0 and >4.0 g/dl) with elevated CRP levels (>10.0, >20.0 and >30.0 mg/l). Congruence of the prediction models was examined by comparing the regression parameters and by cross-validating each regression equation within the other cohort. RESULTS We found that NLR >5.0 vs. <2.5 (cohort 1: OR 2.3; p < 0.0001 and cohort 2: OR 2.0; p < 0.0001) was associated with CRP levels >10.0 mg/l. Stepwise increase in odds ratio for CRP >10.0 mg/l was observed with the combination of high NLR and low albumin levels (NLR >5.0 and albumin <3.1) (cohort 1: OR 7.6; p < 0.0001 and cohort 2: OR 11.9; p < 0.0001). Cross-validation of the 2 regression models revealed a predictive accuracy of 0.68 and 0.69 in the respective cohorts. CONCLUSION This study suggests that NLR could serve as a potential surrogate marker for CRP. Our results may add to diagnostic abilities in settings where CRP is not measured routinely in HD patients. NLR is easy to integrate into daily practice and may be used as a marker of systemic inflammation.
Collapse
Affiliation(s)
- Rakesh Malhotra
- Renal Research Institute, Mount Sinai Hospital New York, New York, N.Y., USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Precedent fluctuation of serum hs-CRP to albumin ratios and mortality risk of clinically stable hemodialysis patients. PLoS One 2015; 10:e0120266. [PMID: 25793462 PMCID: PMC4368637 DOI: 10.1371/journal.pone.0120266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/21/2015] [Indexed: 01/19/2023] Open
Abstract
Background A high sensitivity C-reactive protein to albumin ratio (hs-CRP/Alb) predicts mortality risk in patients with acute kidney injury. However, it varies dynamically. This study was conducted to evaluate whether a variation of this marker was associated with long-term outcome in clinically stable hemodialysis (HD) patients. Methods hs-CRP/Alb was checked bimonthly in 284 clinically stable HD outpatients throughout all of 2008. Based on the “slope” of trend equation derived from 5–6 hs-CRP/alb ratios for each patient, the total number of patients was divided into quartiles—Group 1: β≦ −0.13, n = 71; group 2: β>-0.13≦0.003; n = 71, group 3: β>0.003≦0.20; and group 4: β>0.20, n = 71. The observation period was from January 1, 2009 to August 31, 2012. Results Group 1+4 showed a worse long-term survival (p = 0.04) and a longer 5-year hospitalization stay than Group 2+3 (38.7±44.4 vs. 16.7±22.4 days, p<0.001). Group 1+4 were associated with older age (OR = 1.03, 95% CI = 1.01–1.05) and a high prevalence of congestive heart failure (OR = 2.02, 95% CI = 1.00–4.11). Standard deviation (SD) of hs-CRP/Alb was associated with male sex (β = 0.17, p = 0.003), higher Davies co-morbidity score (β = 0.16, p = 0.03), and baseline hs-CRP (β = 0.39, p<0.001). Patients with lower baseline and stable trend of hs-CRP/Alb had a better prognosis. By multivariate Cox proportional methods, SD of hs-CRP/alb (HR: 1.05, 95% CI: 1.01–1.08) rather than baseline hs-CRP/Alb was an independent predictive factor for long-term mortality after adjusting for sex and HD vintage. Conclusion Clinically stable HD patients with a fluctuating variation of hs-CRP/Alb are characterized by old age, and more co-morbidity, and they tend to have longer subsequent hospitalization stay and higher mortality risk.
Collapse
|
12
|
Farah R, Shurtz-Swirski R, Khamisy-Farah R. Lercanidipine effect on polymorphonuclear leukocyte-related inflammation and insulin resistance in essential hypertension patients. Cardiol Ther 2012; 1:4. [PMID: 25135158 PMCID: PMC4107444 DOI: 10.1007/s40119-012-0004-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Inflammation, insulin resistance, and oxidative stress (OS) are among the mechanisms that have been implicated in the pathogenesis of essential hypertension (EH). Peripheral polymorphonuclear leukocytes (PMNLs) are primed in EH patients, releasing uncontrolled superoxide anions contributing to OS in these patients. PMNL priming correlates with insulin resistance and PMNL intracellular calcium ([Ca(2+)]i). Recent studies have attributed additional anti-ischemic and antioxidative characteristics to the antihypertensive drug, lercanidipine, a third-generation calcium-channel blocker. The purpose of this study was to evaluate the possible nontraditional effect of 2 months of lercanidipine treatment on insulin resistance and on PMNL-related inflammation in EH patients. METHODS Non-smoking EH patients with untreated mild-to-moderate high blood pressure (BP) were included. Low-grade inflammation was reflected by PMNL apoptosis and by white blood cell (WBC) and PMNL counts. Systemic inflammation was measured by plasma fibrinogen, C-reactive protein (CRP), and transferrin and albumin levels. Fasting serum insulin levels served as a marker of insulin resistance. RESULTS Two months of lercanidipine treatment showed a significant decrease in BP, WBC, and PMNL counts, PMNL apoptosis, CRP, and serum insulin levels, and a significant increase in serum albumin levels. Rates of superoxide release from PMNLs, WBC and PMNL counts, and insulin levels positively correlated with mean arterial BP values. CONCLUSION The use of lercanidipine can be favorable in EH patients due to its combined anti-PMNL priming and anti-inflammatory effects, in addition to its antihypertensive characteristics.
Collapse
Affiliation(s)
- Raymond Farah
- Department of Internal Medicine B, Ziv Medical Center, Safed, Israel,
| | | | | |
Collapse
|
13
|
|