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Zhao H, Yao Y, Zong C, Liu H, Zhang K, Song Y, Ye B, Yang J, Li Y, Song B, Xu Y, Gao Y. Serum fibrinogen/albumin ratio and early neurological deterioration in patients with recent small subcortical infarction. Ann Med 2024; 56:2396072. [PMID: 39194283 DOI: 10.1080/07853890.2024.2396072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/16/2024] [Accepted: 08/05/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Serum fibrinogen/albumin ratio (FAR) is a new inflammatory marker related to a variety of diseases, and it has been shown to be associated with stroke. This study is to investigate the relationship between serum FAR and early neurological deterioration (END) in patients with recent small subcortical infarction (RSSI). PATIENTS AND METHODS Consecutive RSSI patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2022 were enrolled. The National Institute of Health Stroke Scale (NIHSS) was utilized to evaluate the severity of the patients at admission and within seven days post-admission. END was defined as an increase of ≥2 points in NIHSS score from admission or ≥1 point in the motor item of the score within seven days post-admission. Multivariate logistic regression analysis was employed to identify risk factors for END. The correlation between FAR and END was investigated using restricted cubic spline (RCS) analysis. Subgroup analysis was used to assess stability across different populations. RESULTS A total of 766 RSSI patients were included in the analysis, with 538 males (70.24%). END occurred in 115 (15.01%) patients. Multivariate logistic regression analysis revealed that FAR (OR = 1.016, 95%CI: 1.005-1.028), PAD (OR = 1.805, 95%CI: 1.161-2.807) and age (OR = 1.028, 95%CI: 1.009-1.048) were associated with END in RSSI patients. RCS analysis indicated a linear correlation between FAR and END (p for nonlinear = .128). Subgroup analysis indicated association between FAR and END in male (OR = 1.02, 95%CI: 1.00-1.03), patients aged ≤65 years (OR = 1.02, 95%CI: 1.00-1.03) and patients without smoking history (OR = 1.02, 95%CI: 1.00-1.03). CONCLUSIONS Elevated FAR levels were associated with the occurrence of END within seven days after admission in RSSI patients, especially in men, age ≤65 years, or patients without smoking history.
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Affiliation(s)
- Haixu Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ying Yao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Ce Zong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongbing Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ke Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Song
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jing Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- National Health Council Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Sun S, Cheng Y, Li L, Zhu H, Liu C, Cao Y. A High Fibrinogen-to-Albumin Ratio on Admission is Associated with Early Neurological Deterioration Following Intravenous Thrombolysis in Patients with Acute Ischemic Stroke. J Inflamm Res 2024; 17:4151-4161. [PMID: 38952563 PMCID: PMC11216320 DOI: 10.2147/jir.s459161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024] Open
Abstract
Purpose The fibrinogen-to-albumin ratio (FAR) is a novel inflammation marker associated with various diseases. This study aimed to investigate the correlation between FAR and early neurological deterioration (END) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Patients and Methods From September 1, 2021, to March 31, 2023, continuously recruited AIS patients who received IVT within 4.5 hours were included in the study. Blood samples were collected in the emergency room before IVT. The National Institutes of Health Stroke Scale (NIHSS) score was assessed upon admission and after thrombolysis within the first 24 hours. END was defined as an increase in the NIHSS score by ≥ 4 points within 24 hours after thrombolysis. Multivariate logistic regression analysis was conducted to explore the relationship between FAR and END, and a receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of FAR for END. Results 343 participants were recruited, and 59 (17.2%) experienced END. Patients with END had higher FAR levels than those without END (P<0.001). Multivariate logistic regression analysis showed that FAR was independently associated with END, both as a continuous variable and as a tertile variable (P<0.005). After excluding patients with hemorrhagic transformation (HT), FAR remained independently associated with END (P<0.005). The area under the curve (AUC) of FAR for predicting END was 0.650 (95% CI=0.571-0.729, P<0.001), with an optimal cutoff of 72.367 mg/g, a sensitivity of 61.6%, and a specificity of 62.6%. Conclusion FAR upon admission was independently associated with END after IVT and can be an effective predictor.
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Affiliation(s)
- Shifu Sun
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, People’s Republic of China
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, the First People’s Hospital of Yancheng, Yancheng, Jiangsu Province, 224000, People’s Republic of China
| | - Yongqing Cheng
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, the First People’s Hospital of Yancheng, Yancheng, Jiangsu Province, 224000, People’s Republic of China
| | - Lei Li
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, the First People’s Hospital of Yancheng, Yancheng, Jiangsu Province, 224000, People’s Republic of China
| | - Honghong Zhu
- Department of Rheumatology and Immunology, the Yancheng Clinical College of Xuzhou Medical University, the First People’s Hospital of Yancheng, Yancheng, Jiangsu Province, 224000, People’s Republic of China
| | - Changxia Liu
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, the First People’s Hospital of Yancheng, Yancheng, Jiangsu Province, 224000, People’s Republic of China
| | - Yongjun Cao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, People’s Republic of China
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Zhou XJ, Lu K, Liu ZH, Xu MZ, Li C. U-shaped relationship found between fibrinogen-to-albumin ratio and systemic inflammation response index in osteoporotic fracture patients. Sci Rep 2024; 14:11299. [PMID: 38760436 PMCID: PMC11101643 DOI: 10.1038/s41598-024-61965-9] [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: 02/20/2024] [Accepted: 05/13/2024] [Indexed: 05/19/2024] Open
Abstract
The relationship between the Systemic Inflammatory Response Index (SIRI) and the Fibrinogen-to-albumin ratio (FAR) has not been extensively investigated. The objective of this study was to determine the independent relationship between FAR and SIRI in people with osteoporotic fractures (OPF). A cross-sectional study was conducted using retrospective data from 3431 hospitalized OPF patients. The exposure variable in this study was the baseline FAR, while the outcome variable was the SIRI. Covariates, including age, gender, BMI, and other clinical and laboratory factors, were adjusted. Cross-correlation analysis and linear regression models were applied. The generalized additive model (GAM) investigated non-linear relationships. Adjusted analysis revealed an independent negative association between FAR and SIRI in OPF patients (β = - 0.114, p = 0.00064, 95% CI - 0.180, - 0.049). A substantial U-shaped association between FAR and SIRI was shown using GAM analysis (p < 0.001). FAR and SIRI indicated a negative association for FAR below 6.344% and a positive correlation for FAR over 6.344%. The results of our study revealed a U-shaped relationship between SIRI and FAR. The lowest conceivable FAR for a bone-loose inflammatory disease might be 6.344%, suggesting that this has particular significance for the medical diagnosis and therapy of persons with OPF. Consequently, the term "inflammatory trough" is proposed. These results offer fresh perspectives on controlling inflammation in individuals with OPF and preventing inflammatory osteoporosis.
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Affiliation(s)
- Xiao-Jie Zhou
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Ke Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Zhou-Hang Liu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Min-Zhe Xu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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Chen X, Xu X, Li Y, Liu F, Zhang B, Zuo L. Association between fibrinogen-to-albumin ratio and functional prognosis of 3 months in patients with acute ischemic stroke after intravenous thrombolysis. Brain Behav 2024; 14:e3364. [PMID: 38376013 PMCID: PMC10757894 DOI: 10.1002/brb3.3364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The presence of high fibrinogen and low albumin levels in serum is associated with a negative prognosis in acute ischemic stroke (AIS). Fibrinogen-to-albumin ratio (FAR), a new inflammatory biomarker, may provide better prognostic insights in patients with AIS than separate evaluation of fibrinogen or albumin. The objective of this investigation is to examine the correlation between FAR and 3-month functional prognosis after intravenous thrombolysis (IVT) in AIS patients. METHODS The retrospective study recruited AIS patients who received IVT from June 2014 to December 2021. The 3-month functional prognosis was assessed using the Modified Rankin Scale (mRS). A mRS score of ≤2 indicated a good outcome, whereas a mRS score of >2 suggested a poor outcome. RESULTS A total of 591 AIS patients who underwent IVT were included and 147 patients (24.9 %) had a poor outcome. Among the 102 pairs of patients after propensity score matching, there was a significant association between FAR and 3-month prognosis (adjusted OR, 1.19; 95% CI, 1.03-1.38; p = .020). The optimal FAR cutoff value was found to be 7.57, and even after stratifying patients based on this value, we still observed a significant correlation between high FAR level and poor outcome (adjusted OR, 2.08; 95% CI, 1.28-3.40; p = .003). CONCLUSIONS FAR may serve as a prospective biomarker of predicting 3-month prognosis in AIS patients after IVT.
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Affiliation(s)
- Xinxin Chen
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
| | - Xiahong Xu
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
| | - Ying Li
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
| | - Feifeng Liu
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
| | - Bei Zhang
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
| | - Lian Zuo
- Department of NeurologySchool of MedicineShanghai East HospitalTongji UniversityShanghaiChina
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Wang Y, Bai L, Li X, Yi F, Hou H. Fibrinogen-to-Albumin Ratio and Clinical Outcomes in Patients With Large Artery Atherosclerosis Stroke. J Am Heart Assoc 2023; 12:e030837. [PMID: 38063159 PMCID: PMC10863775 DOI: 10.1161/jaha.123.030837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND A high fibrinogen-to-albumin ratio (FAR), a novel inflammatory marker, is considered to be a prognostic marker in vascular diseases. However, the association of FAR with large artery atherosclerosis (LAA) stroke is still unknown. This study was conducted to evaluate the association between FAR levels and clinical outcomes in patients with acute LAA stroke. METHODS AND RESULTS A total of 809 patients within 72 hours of LAA stroke were included and followed up to 1 year. FAR was calculated as fibrinogen (g/L)/albumin (g/L). The associations of FAR with clinical outcomes were assessed by multivariate Cox regression or logistic regression analysis. Clinical outcomes included stroke recurrence, all-cause death, poor functional outcome (modified Rankin Scale score 3-6), and dependence (modified Rankin Scale score 3-5). Among the 809 patients with acute LAA stroke, the median FAR was 0.075 (interquartile range, 0.064-0.087). At 1 year, 103 (12.7%) patients had stroke recurrence, 105 (13.0%) had poor functional outcome, 76 (9.8%) had dependence, and 29 (3.6%) had died. After adjusting for all confounding risk factors, a high FAR level was associated with stroke recurrence (hazard ratio, 2.57 [95% CI, 1.32-5.02]), poor functional outcome (odds ratio, 3.30 [95% CI, 1.57-6.94]), and dependence (odds ratio, 3.49 [95% CI, 1.49-8.19]). CONCLUSIONS A high FAR level was associated with an increased risk of stroke recurrence, poor functional outcome, and dependence in patients with acute LAA stroke.
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Affiliation(s)
- Yafei Wang
- Department of NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
- Key Laboratory of Hebei NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Lin Bai
- Department of NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
- Key Laboratory of Hebei NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Xiaohui Li
- Department of NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
- Key Laboratory of Hebei NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Fei Yi
- Department of NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
- Key Laboratory of Hebei NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Huiqing Hou
- Department of NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
- Key Laboratory of Hebei NeurologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
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Ban J, Pan X, Yang L, Jia Z, Zhen R, Zhang X, Chen S. Correlation Between Fibrinogen/Albumin and Diabetic Peripheral Neuropathy. Diabetes Metab Syndr Obes 2023; 16:2991-3005. [PMID: 37790261 PMCID: PMC10543934 DOI: 10.2147/dmso.s427510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/16/2023] [Indexed: 10/05/2023] Open
Abstract
Purpose This study aimed to examine the correlation between fibrinogen/albumin (FAR) and diabetic peripheral neuropathy (DPN). Patients and Methods A total of 342 patients were included and categorized into either the DPN group or the Non-DPN (NDPN) group based on their DPN status. The FAR index was determined by calculating the ratio of fibrinogen (FIB) to serum albumin (ALB), multiplied by 100. The participants were then divided into a High-FAR group and a Low-FAR group using the median FAR value as the threshold. Neurophysiological data were collected from the participants, which included motor conduction velocity (MCV) and sensory conduction velocity (SCV). Results The DPN group displayed higher FAR levels [(DPN vs NDPN:6.72 (5.89,7.74) vs 5.94±1.14], in addition to slower SCV and MCV data compared to the NDPN group. The high FAR group had a higher prevalence of DPN (78.9% vs 55.6%) (P<0.05). There was a negative correlation between FAR and NCV, including bilateral median nerve SCV, left ulnar nerve SCV, bilateral median nerve MCV, bilateral common peroneal nerve MCV, bilateral tibial nerve MCV, and left ulnar nerve MCV. FAR was revealed to be an independent risk factor for the development of DPN in patients and demonstrated a greater predictive value for DPN development in Type 2 diabetes mellitus (T2DM) compared with FIB, HbA1c. Conclusion The results suggest that monitoring FAR levels in patients with T2DM could identify those at higher risk for developing DPN, making the FAR index a valuable predictor of DPN development. Furthermore, since FAR has an inverse relationship with NCV, it stands to reason that high FAR levels may indicate nerve damage and slower conduction velocities. Thus, managing FAR could prove beneficial in both preventing and delaying the onset of DPN in T2DM patients.
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Affiliation(s)
- Jiangli Ban
- Graduate School of Hebei North University, Zhangjiakou, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Xiaoyu Pan
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Liqun Yang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Zhuoya Jia
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Ruoxi Zhen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Xueqing Zhang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Shuchun Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China
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Zhang JJ, Sánchez Vidaña DI, Chan JNM, Hui ESK, Lau KK, Wang X, Lau BWM, Fong KNK. Biomarkers for prognostic functional recovery poststroke: A narrative review. Front Cell Dev Biol 2023; 10:1062807. [PMID: 36699006 PMCID: PMC9868572 DOI: 10.3389/fcell.2022.1062807] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Background and objective: Prediction of poststroke recovery can be expressed by prognostic biomarkers that are related to the pathophysiology of stroke at the cellular and molecular level as well as to the brain structural and functional reserve after stroke at the systems neuroscience level. This study aimed to review potential biomarkers that can predict poststroke functional recovery. Methods: A narrative review was conducted to qualitatively summarize the current evidence on biomarkers used to predict poststroke functional recovery. Results: Neurophysiological measurements and neuroimaging of the brain and a wide diversity of molecules had been used as prognostic biomarkers to predict stroke recovery. Neurophysiological studies using resting-state electroencephalography (EEG) revealed an interhemispheric asymmetry, driven by an increase in low-frequency oscillation and a decrease in high-frequency oscillation in the ipsilesional hemisphere relative to the contralesional side, which was indicative of individual recovery potential. The magnitude of somatosensory evoked potentials and event-related desynchronization elicited by movement in task-related EEG was positively associated with the quantity of recovery. Besides, transcranial magnetic stimulation (TMS) studies revealed the potential values of using motor-evoked potentials (MEP) and TMS-evoked EEG potentials from the ipsilesional motor cortex as prognostic biomarkers. Brain structures measured using magnetic resonance imaging (MRI) have been implicated in stroke outcome prediction. Specifically, the damage to the corticospinal tract (CST) and anatomical motor connections disrupted by stroke lesion predicted motor recovery. In addition, a wide variety of molecular, genetic, and epigenetic biomarkers, including hemostasis, inflammation, tissue remodeling, apoptosis, oxidative stress, infection, metabolism, brain-derived, neuroendocrine, and cardiac biomarkers, etc., were associated with poor functional outcomes after stroke. However, challenges such as mixed evidence and analytical concerns such as specificity and sensitivity have to be addressed before including molecular biomarkers in routine clinical practice. Conclusion: Potential biomarkers with prognostic values for the prediction of functional recovery after stroke have been identified; however, a multimodal approach of biomarkers for prognostic prediction has rarely been studied in the literature. Future studies may incorporate a combination of multiple biomarkers from big data and develop algorithms using data mining methods to predict the recovery potential of patients after stroke in a more precise way.
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Affiliation(s)
- Jack Jiaqi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | | | - Jackie Ngai-Man Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Edward S. K. Hui
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Xin Wang
- Department of Rehabilitation Medicine, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Benson W. M. Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kenneth N. K. Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Study of Albumin Oxidation in COVID-19 Pneumonia Patients: Possible Mechanisms and Consequences. Int J Mol Sci 2022; 23:ijms231710103. [PMID: 36077496 PMCID: PMC9456270 DOI: 10.3390/ijms231710103] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
Oxidative stress induced by neutrophils and hypoxia in COVID-19 pneumonia leads to albumin modification. This may result in elevated levels of advanced oxidation protein products (AOPPs) and advanced lipoxidation end-products (ALEs) that trigger oxidative bursts of neutrophils and thus participate in cytokine storms, accelerating endothelial lung cell injury, leading to respiratory distress. In this study, sixty-six hospitalized COVID-19 patients with respiratory symptoms were studied. AOPPs-HSA was produced in vitro by treating human serum albumin (HSA) with chloramine T. The interaction of malondialdehyde with HSA was studied using time-resolved fluorescence spectroscopy. The findings revealed a significantly elevated level of AOPPs in COVID-19 pneumonia patients on admission to the hospital and one week later as long as they were in the acute phase of infection when compared with values recorded for the same patients 6- and 12-months post-infection. Significant negative correlations of albumin and positive correlations of AOPPs with, e.g., procalcitonin, D-dimers, lactate dehydrogenase, aspartate transaminase, and radiological scores of computed tomography (HRCT), were observed. The AOPPs/albumin ratio was found to be strongly correlated with D-dimers. We suggest that oxidized albumin could be involved in COVID-19 pathophysiology. Some possible clinical consequences of the modification of albumin are also discussed.
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