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Sharaf MS, Othman AA, Abdel-Ghaffar AE, Ali DM, Eid MM. Crusted scabies in a rabbit model: a severe skin disease or more? Parasit Vectors 2023; 16:413. [PMID: 37964301 PMCID: PMC10647032 DOI: 10.1186/s13071-023-05995-8] [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: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Around 200-300 million people are estimated to be affected by scabies annually worldwide. However, the mechanisms by which this disease may affect the general condition of the host are not entirely clear. The aim of the present study was to evaluate the systemic changes that may accompany crusted scabies in both treated and non-treated experimental animals. METHODS Male New Zealand rabbits were infected with Sarcoptes scabiei var. cuniculi and divided into the following three groups: control, ivermectin-treated, and fluralaner-treated. Several methods were used to evaluate the systemic changes, including histopathological examination of the liver, kidney, heart, and spleen, as well as the measurement of serum biochemical parameters and immunological parameters. RESULTS Several definite structural and functional changes at the systemic level were revealed, as evidenced by the observed histopathological changes in the tissue sections of internal organs and the highly significant increases in markers of systemic inflammation, serum procalcitonin, and oxidative stress markers. Abnormalities in the liver and renal function results, as well as in the serum lipid profile, were also noted. Additionally, a disorganized immune response was noted, evidenced by a mixed type 1 and type 2 helper T cell response. Although there was notable clinical and parasitological cure in the ivermectin-treated group, the histopathological, biochemical, and immunological markers indicated incomplete resolution. In contrast, the fluralaner-treated group exhibited a nearly complete resolution of changes in these parameters. CONCLUSIONS We conclude that crusted scabies is a systemic syndrome that can affect several organs besides the skin. Inflammation, oxidative stress, and possibly bacterial infections, are all implicated as underlying mechanisms of tissue damage due to the disease. We recommend that fluralaner, a promising scabicidal agent, should be studied for possible human use, and especially for control programs.
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Affiliation(s)
| | - Ahmad Ali Othman
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Dareen Mohamed Ali
- Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Mahmoud Eid
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Gürünlüoglu K, Zararsiz G, Aslan M, Akbas S, Tekin M, Gürünlüoglu S, Bag HG, Cin ES, Macit B, Demircan M. Investigation of Serum Interleukin 6, High-Sensitivity C-Reactive Protein and White Blood Cell Levels during the Diagnosis and Treatment of Paediatric Appendicitis Patients Before and during the COVID-19 Pandemic. Afr J Paediatr Surg 2023; 20:130-137. [PMID: 36960509 DOI: 10.4103/ajps.ajps_128_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and Methods A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.
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Affiliation(s)
- Kubilay Gürünlüoglu
- Department of Paediatric Surgery, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Gökmen Zararsiz
- Department of Bioistatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkiye
| | - Mehmet Aslan
- Department of Paediatrics, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Sedat Akbas
- Department of Anaesthesiology, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Mehmet Tekin
- Department of Paediatrics, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Semra Gürünlüoglu
- Department of Pathology, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Harika Gözükara Bag
- Department of Biostatics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Ecem Serbest Cin
- Department of Paediatric Surgery, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Bengü Macit
- Department of Paediatrics, Faculty of Medicine, Inonu University, Malatya, Turkiye
| | - Mehmet Demircan
- Department of Paediatric Surgery, Faculty of Medicine, Inonu University, Malatya, Turkiye
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Ozdemir K, Citaker S, Diker S, Keser I, Kurukahvecioglu O, Uyar Gocun P, Gulbahar O. Does Venipuncture Increase Lymphedema by Triggering Inflammation or Infection? An Experimental Rabbit Ear Lymphedema Model Study. Lymphat Res Biol 2023; 21:34-41. [PMID: 35687408 DOI: 10.1089/lrb.2021.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Recent guidelines recommend avoiding venipuncture to prevent lymphedema for breast cancer patients. This study investigated whether single or multiple sterile venipuncture procedures develop a systemic inflammation or infection and increase lymphedema in the rabbit ear lymphedema model. Methods and Results: Eighteen New Zealand white female rabbits were included. The right ear lymphedema model was created by surgical procedure; then, rabbits were divided into three randomized groups. Single and multiple venipuncture procedures were applied at least the 60th day after surgery for Group I and II, respectively. Group III was a control group. C-reactive protein (CRP) and procalcitonin (PCT) levels were analyzed to determine inflammation and infection. Ear thickness measurements were applied using a vernier caliper to assess the differences in lymphedema between the ears. All rabbits were euthanized on the 90th day after surgery. Histopathological analysis was performed to evaluate lymphedema by measuring tissue thicknesses. Ear thickness measurements showed that ear lymphedema was developed and maintained with surgical operation in all groups (p < 0.05). There was no difference in the ear thickness measurements between and within-groups results (p > 0.05). CRP and PCT levels were below the lower detection levels in all groups. According to the differences of histopathological ear distances, there were significant differences within-groups for all groups (p < 0.05), and no differences were identified between groups (p > 0.05). Conclusion: This experimental study demonstrated that single or multiple sterile venipuncture procedures did not trigger infection or inflammation and did not exacerbate ear lymphedema in the rabbit ear lymphedema model.
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Affiliation(s)
- Kadirhan Ozdemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| | - Seyit Citaker
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Seyda Diker
- Laboratory Animal Breeding and Experimental Research Center, Gazi University, Ankara, Turkey
| | - Ilke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | | | - Pinar Uyar Gocun
- Department of Medical Pathology, and Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Gulbahar
- Department of Medical Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
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Jin Y, Yu X, Hu S, Liu L, Wang B, Feng Y, Li Y, Xiong B, Wang L. Efficacy of electroacupuncture combined with intravenous patient-controlled analgesia after cesarean delivery: a randomized clinical trial. Am J Obstet Gynecol MFM 2023; 5:100826. [PMID: 36464237 DOI: 10.1016/j.ajogmf.2022.100826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Electroacupuncture is a nonpharmacologic intervention for analgesia that is widely recognized as therapy for pain. However, the clinical efficacy of electroacupuncture combined with patient-controlled intravenous analgesia for postoperative analgesia after cesarean delivery remains unclear. OBJECTIVE This study aimed to assess the efficacy of electroacupuncture + patient-controlled intravenous analgesia for postoperative analgesia after cesarean delivery, determine the optimal frequency for the best analgesic effect, and explore the underlying mechanism of action. STUDY DESIGN This single-center, randomized, single-blinded, sham acupuncture controlled clinical trial was conducted at a tertiary university hospital in China. Female patients who underwent cesarean delivery and received fentanyl as patient-controlled intravenous analgesia for postoperative analgesia were enrolled. Patients were after surgery randomized to receive 2 Hz electroacupuncture treatment (n=53), 20/100 Hz electroacupuncture treatment (n=53), or sham electroacupuncture treatment (n=52) (controls). The 2 electroacupuncture groups received electroacupuncture treatment at 2 or 20/100 Hz at the ST36 and SP6 points, whereas, in the sham electroacupuncture group, sham electroacupuncture was performed at nonmeridian points with nonenergized electroacupuncture instruments. Of note, 4 electroacupuncture treatments were performed in all groups at 6, 12, 24, and 48 hours after surgery. The primary outcome was the number of analgesic pump compressions at 48 hours after surgery. The secondary outcomes included number of analgesic pump compressions at 6, 12, and 24 hours after surgery; pain scores at 6, 12, 24, and 48 hours after surgery; fentanyl consumption at 48 hours after surgery; interleukin 6 and procalcitonin levels at 12 and 48 hours after surgery; and time to first exhaust. RESULTS Overall, 174 primigravida women were included in the intention-to-treat analysis. The number of analgesic pump compressions and pain scores at all 4 time points and fentanyl consumption at 48 hours after surgery were significantly lower in the electroacupuncture treatment groups than in the sham electroacupuncture group (P<.001). CONCLUSION Electroacupuncture + patient-controlled intravenous analgesia had a significantly better analgesic effect than sham electroacupuncture + patient-controlled intravenous analgesia within 48 hours after surgery. Thus, electroacupuncture can be considered safe and effective and may improve the efficacy of patient-controlled intravenous analgesia for pain management after cesarean delivery. Electroacupuncture can be recommended as a routine complementary therapy for pain control after cesarean delivery.
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Affiliation(s)
- Ying Jin
- Department of Rehabilitation in Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Drs Jin and Xiong); Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Jiangsu, China (Drs Jin and Liu); Key Laboratory of Pulsed Power Translational Medicine of Zhejiang Province, Hangzhou, China (Drs Jin and Li)
| | - Xiaoshuai Yu
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (Dr Yu)
| | - Shen Hu
- Department of Obstetrics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Drs Hu, Feng, and L Wang)
| | - Lanying Liu
- Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Jiangsu, China (Drs Jin and Liu)
| | - Bin Wang
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Dr B Wang)
| | - Yuanling Feng
- Department of Obstetrics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Drs Hu, Feng, and L Wang)
| | - Yubo Li
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou, China (Dr Li); Key Laboratory of Pulsed Power Translational Medicine of Zhejiang Province, Hangzhou, China (Drs Jin and Li)
| | - Bing Xiong
- Department of Rehabilitation in Traditional Chinese Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Drs Jin and Xiong).
| | - Liquan Wang
- Department of Obstetrics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, China (Drs Hu, Feng, and L Wang).
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Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases. Diagnostics (Basel) 2022; 12:diagnostics12041011. [PMID: 35454059 PMCID: PMC9032964 DOI: 10.3390/diagnostics12041011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Despite great advances in medicine, numerous available laboratory markers, and radiological imaging, the diagnosis of acute appendicitis (AA) in some cases still remains controversial and challenging for clinicians. Because of that, clinicians are still looking for an ideal marker that would be specific to AA. The red blood cell distribution width (RDW) has been recently investigated in several studies as a potential biomarker for AA. The aim of this systematic review and meta-analysis was to systematically summarize and compare all relevant data on RDW as a diagnostic biomarker for AA. Methods: This systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Scopus, Web of Science, and Excerpta Medica database—EMBASE) were systematically searched for relevant comparative studies by two independent researches using keywords ((red cell distribution width) OR rdw) AND (appendicitis). An independent assessment of the methodological quality was performed by two authors using the Downs and Black scale. RevMan 5.4 software was used to perform the meta-analysis. Results: Fifteen studies were included in the final meta-analysis; the majority of the studies was retrospective. Nine studies compared the RDW values between AA and non-AA; four studies compared the same between AA and healthy controls, while two studies compared the RDW values among all three groups. The estimated heterogeneity among the studies for all outcome was statistically significant (I2 = 92−99%, p < 0.00001). The pooling the data demonstrated no statistically significant difference in the RDW values (weighted mean difference (WMD) = 0.03, 95% CI = (−0.46, 0.52), p = 0.91) between AA and healthy controls as well as between AA and non-AA cases (WMD = 0.23, 95%CI = (−0.19, 0.65), p = 0.28). A separate subanalysis was performed to evaluate the utility of this biomarker for the pediatric age group. Pooling the data demonstrated no significant difference among the AA and non-AA groups in terms of the RDW values (WMD = 0.99, 95% CI = (−0.35, 2.33), p = 0.15). Conclusion: The RDW value difference demonstrated no statistically significant difference in AA versus healthy individuals and AA versus non-AA individuals. At the moment, there is no evidence of RDW utility in diagnostic testing of AA. Further research with prospective, multicenter studies and studies targeting special patient groups with a large sample size are needed in this field.
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The potential role of interleukin-6, endotoxin and C-reactive protein as standard biomarkers for acute appendicitis in adults. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh200723026d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. Acute appendicitis (AA) is by far the most frequent
urgent condition in abdominal surgery and numerous biomarkers may help the
physician to diagnose and even predict the severity of the disease. The
objective of the paper was to determine the accuracy of C-reactive protein
(CRP), interleukin-6 (IL-6) and endotoxin and compare it with the diagnostic
value of Alvarado score (AS) in adults surgically treated for AA. Methods.
Sixty-seven patients were diagnosed with AA using AS. Prior to surgery serum
levels of inflammatory biomarkers were determined and together with AS were
respectively compared to the results of histopathological analysis of
specimens. The patients were divided into three group according to the
histopathological assessment. Results. The univariate analysis revealed
that the increase of CRP level by one unit increases the probability of
complicated AA (CoAA) occurence by 1% (1.00 to 1.02, p < 0.05). ROC curve
analysis has revealed that CRP has better capacity to predict supurative AA
(SAAs)/CoAAs than catarrhal AA (CAA), with the cut-of value 19.45. Increase
of AS value by one unit produced 2.98 fold increase of the probability of
CoAA occurrence (1.60 to 5.57, p < 0.001), while positive AS value increases
the probability of CoAA occurrence 24.67 times (4.94 to 123.12; p < 0.001).
ROC curve analysis was demonstrated that AS may better predict CoAAs than
CAAs/SAAs, with the cut-off value 8.50. Conclusion. AS and CRP should be
routinely used combined as powerful tools for diagnosis and prediction of
complicated AA.
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Antić J, Jokić R, Bukarica S, Lukić I, Dobrijević D, Rakić G, Pajić M, Trajković V, Milenković M. Predictive Value of Red Blood Cell Distribution Width, Mean Platelet Volume and Platelet Distribution Width in Children with Acute Appendicitis. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111041. [PMID: 34828754 PMCID: PMC8619955 DOI: 10.3390/children8111041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Acute appendicitis in pediatric patients is one of the most common surgical emergencies, but the early diagnosis still remains challenging. The aim of this study was to determine the predictive value of Red blood cell distribution width (RDW), Mean platelet volume (MPV) and Platelet distribution width (PDW) in children with acute appendicitis. Materials and Methods: This study was a retrospective assessment of laboratory findings (RDW, MPV, PDW) of patients who underwent surgical treatment for acute appendicitis from January 2019 to December 2020. Result: During this period, 223 appendectomies were performed at our Institute. In 107 (43%) cases appendicitis was uncomplicated, while in 116 (46.6%) it was complicated. WBC and RDW/MPV ratio were significant parameters for the diagnosis of acute appendicitis with cut-off values of 12.86 (susceptibility: 66.3%; specificity: 73.2%) and 1.64 (susceptibility: 59.8%; specificity: 71.9%), respectively. WBC and RDW/RBC ratio were independent variables for the diagnosis of complicated appendicitis. The cut-off values were 15.05 for WBC (sensitivity: 60.5%; specificity: 70.7%) and 2.5 for RDW/RBC ratio (sensitivity: 72%; specificity: 52.8%). Conclusions: WBC is an important predictor of appendicitis and complicated appendicitis. RDW, MPV and PDW alone have no diagnostic value in pediatric acute appendicitis or predicting the degree of appendix inflammation. However, the RDW/MPV ratio can be an important predictor of appendix inflammation, with higher values in patients with more severe appendix inflammation. RDW/RBC ratio may be an important predictor of complicated appendicitis.
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Affiliation(s)
- Jelena Antić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Correspondence: ; Tel.: +381-64-129-78-52
| | - Radoica Jokić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Svetlana Bukarica
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Ivana Lukić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Dejan Dobrijević
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Goran Rakić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Miloš Pajić
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Veličko Trajković
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Marina Milenković
- Institute for Child and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia; (R.J.); (S.B.); (I.L.); (D.D.); (G.R.); (M.P.); (V.T.); (M.M.)
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
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Liu F, Zhang X, Du W, Du J, Chi Y, Sun B, Song Z, Shi J. Diagnosis values of IL-6 and IL-8 levels in serum and bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in chronic obstructive pulmonary disease. J Investig Med 2021; 69:1344-1349. [PMID: 34127514 DOI: 10.1136/jim-2021-001857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 11/04/2022]
Abstract
Among immunologically normal hosts, patients with chronic obstructive pulmonary disease (COPD) are considered to be at high risk of invasive pulmonary aspergillosis (IPA), and early diagnosis and treatment are the key to improving the prognosis of patients. Here we aimed to evaluate whether interleukin (IL)-6 and IL-8 might be used in the detection and diagnosis of IPA in patients with COPD. We prospectively collected 106 patients with COPD and divided them into non-IPA (n=74), probable/possible IPA (n=26) and proven IPA (n=6). Platelia Aspergillus kit was used to detect galactomannan in bronchoalveolar lavage fluid (BALF), and serum and ELISA kit was used to detect IL-6 and IL-8 levels. Diagnostic efficiency of IL-6, IL-8 and galactomannan in serum and BALF was evaluated by receiver operating characteristic curve. Compared with the non-IPA group, the proven/probable IPA group showed significantly elevated levels of IL-6 and IL-8 in both serum and BALF, which were positively correlated with galactomannan levels. The sensitivity and specificity of IL-6 for diagnosing IPA were 74.32% and 81.25% (cut-off at 92.82 pg/mL, area under the curve (AUC)=0.8366) in serum and 68.92% and 71.88% (cut-off at 229.4 pg/mL, AUC=0.7694) in BALF. The sensitivity and specificity of IL-8 for diagnosing IPA were 83.78% and 81.25% (cut-off at 93.46 pg/mL, AUC=0.8756) in serum and 85.14% and 75.00% (cut-off at 325.4 pg/mL, AUC=0.8252) in BALF. The elevated levels of IL-6 and IL-8 in patients with IPA with COPD could be used as auxiliary indicators to diagnose IPA in addition to galactomannan.
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Affiliation(s)
- Fang Liu
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xin Zhang
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Wenxiu Du
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Junfeng Du
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Yumin Chi
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Baohua Sun
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Zhan Song
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Jian Shi
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
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