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Vernon-Roberts A, Humphrey O, Day AS. Exploring the Diagnostic Spectrum of Children with Raised Faecal Calprotectin Levels. Children (Basel) 2024; 11:420. [PMID: 38671637 PMCID: PMC11049439 DOI: 10.3390/children11040420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Faecal calprotectin (FC) is a marker of gut inflammation. The cause and relevance of raised FC in children outside the context of established inflammatory bowel disease (IBD) have had minimal attention. This study aimed to address this by carrying out a retrospective study on children with abnormal FC tests aged 4-17 years without established IBD in the South Island, New Zealand. Abnormal FC results were stratified: 51-249 μg/g, 250-499 μg/g, and 500+ μg/g, and participants were categorised into diagnostic groups. Data were collected on symptoms and diagnostic tests. Three-hundred and ten children had abnormal index FC results, with a mean age of 12.9 years, and a 55% proportion of females. The median FC was 125 μg/g; 71% had levels 51-249 μg/g and 21% had levels 500+ μg/g. Of those with FC 500+ μg/g, 89% either had infectious diarrhoea or were diagnosed with IBD at the time of, or subsequent to, the index FC. Alarm symptoms did not delineate between groups with FC 500+ μg/g. Abnormalities in platelet levels, abdominal ultrasound, and colonoscopy were more frequent for children diagnosed with IBD. Repeat FC test levels were significantly reduced except for those subsequently diagnosed with IBD. Abnormal FC levels for the majority were below the level indicative of mucosal inflammation. Repeat FC testing could play an important role in distinguishing between diagnoses.
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Affiliation(s)
- Angharad Vernon-Roberts
- Department of Paediatrics, University of Otago Christchurch, Christchurch 8011, New Zealand;
| | - Olivia Humphrey
- Christchurch Hospital, Te Whatu Ora Waitaha Canterbury, Christchurch 8011, New Zealand
| | - Andrew S. Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch 8011, New Zealand;
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Plana E, Oto J, Herranz R, Medina P, Cana F, Miralles M. Calprotectin as a new inflammatory marker of abdominal aortic aneurysm: A pilot study. Vasc Med 2024; 29:189-199. [PMID: 38457311 DOI: 10.1177/1358863x241231494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Abdominal aortic aneurysm (AAA) is a relevant clinical problem due to the risk of rupture of progressively dilated infrarenal aorta. It is characterized by degradation of elastic fibers, extracellular matrix, and inflammation of the arterial wall. Though neutrophil infiltration is a known feature of AAA, markers of neutrophil activation are scarcely analyzed; hence, the main objective of this study. METHODS Plasma levels of main neutrophil activation markers were quantified in patients with AAA and a double control group (CTL) formed by healthy volunteers (HV) and patients with severe atherosclerosis submitted for carotid endarterectomy (CE). Calprotectin, a cytoplasmic neutrophil protein, was quantified, by Western blot, in arterial tissue samples from patients with AAA and organ donors. Colocalization of calprotectin and neutrophil elastase was assessed by immunofluorescence. RESULTS Plasma calprotectin and IL-6 were both elevated in patients with AAA compared with CTL (p ⩽ 0.0001) and a strong correlation was found between both molecules (p < 0.001). This difference was maintained when comparing with HV and CE for calprotectin but only with HV for IL-6. Calprotectin was also elevated in arterial tissue samples from patients with AAA compared with organ donors (p < 0.0001), and colocalized with neutrophils in the arterial wall. CONCLUSIONS Circulating calprotectin could be a specific AAA marker and a potential therapeutical target. Calprotectin is related to inflammation and neutrophil activation in arterial wall and independent of other atherosclerotic events.
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Affiliation(s)
- Emma Plana
- Angiology and Vascular Surgery Service, La Fe University and Polytechnic Hospital, Valencia, Spain
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Julia Oto
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Raquel Herranz
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Pilar Medina
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Fernando Cana
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Manuel Miralles
- Angiology and Vascular Surgery Service, La Fe University and Polytechnic Hospital, Valencia, Spain
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
- Department of Surgery, University of Valencia, Valencia, Spain
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Hetland G, Fagerhol MK, Mirlashari MR, Nissen-Meyer LSH, Croci S, Lonati PA, Bonacini M, Salvarani C, Marvisi C, Bodio C, Muratore F, Borghi MO, Meroni PL. Elevated NET, Calprotectin, and Neopterin Levels Discriminate between Disease Activity in COVID-19, as Evidenced by Need for Hospitalization among Patients in Northern Italy. Biomedicines 2024; 12:766. [PMID: 38672123 PMCID: PMC11048478 DOI: 10.3390/biomedicines12040766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) displays clinical heterogeneity, but little information is available for patients with mild or very early disease. We aimed to characterize biomarkers that are useful for discriminating the hospitalization risk in a COVID-19 cohort from Northern Italy during the first pandemic wave. We enrolled and followed for four weeks 76 symptomatic SARS-CoV-2 positive patients and age/sex-matched healthy controls. Patients with mild disease were discharged (n.42), and the remaining patients were hospitalized (n.34). Blood was collected before any anti-inflammatory/immunosuppressive therapy and assessed for soluble C5b-9/C5a, H3-neutrophil extracellular traps (NETs), calprotectin, and DNase plasma levels via ELISA and a panel of proinflammatory cytokines via ELLA. Calprotectin and NET levels discriminate between hospitalized and non-hospitalized patients, while DNase negatively correlates with NET levels; there are positive correlations between calprotectin and both NET and neopterin levels. Neopterin levels increase in patients at the beginning of the disease and do so more in hospitalized than non-hospitalized patients. C5a and sC5b-9, and other acute phase proteins, correlate with neopterin, calprotectin, and DNase. Both NET and neopterin levels negatively correlate with platelet count. We show that calprotectin, NETs, and neopterin are important proinflammatory parameters potentially useful for discriminating between COVID-19 patients at risk of hospitalization.
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Affiliation(s)
- Geir Hetland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, 0451 Oslo, Norway
| | - Magne Kristoffer Fagerhol
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, 0451 Oslo, Norway
| | - Mohammad Reza Mirlashari
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
| | - Lise Sofie Haug Nissen-Meyer
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.C.); (M.B.)
| | - Paola Adele Lonati
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
| | - Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.C.); (M.B.)
| | - Carlo Salvarani
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Chiara Marvisi
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Caterina Bodio
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
| | - Francesco Muratore
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Maria Orietta Borghi
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pier Luigi Meroni
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
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Shafrir A, Katz LH, Shauly-Aharonov M, Zinger A, Safadi R, Stokar J, Kalisky I. Low ALT Is Associated with IBD and Disease Activity: Results from a Nationwide Study. J Clin Med 2024; 13:1869. [PMID: 38610634 PMCID: PMC11012492 DOI: 10.3390/jcm13071869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Sarcopenia is underdiagnosed in patients with inflammatory bowel disease (IBD). Low alanine transaminase (ALT) is associated with sarcopenia. We evaluated the association between low ALT and the presence of IBD and disease activity. Methods: Data were collected from a national Israeli health insurer cohort comprising 976,615 patients. Patients with a diagnosis of IBD were compared to healthy controls. After exclusion of patients with liver disease, ALT > 40 IU/L and age < 18, a total of 233,451 patients were included in the analysis. Low ALT was defined as <10 IU/L. Results: Low ALT was more common amongst patients with IBD than in healthy controls (7.76% vs. 5.7% p < 0.001). Low ALT was found in 148 (7.9%) of the patients with CD and 69 (6.9%) of the patients with UC. For CD, low ALT was associated with increased fecal calprotectin (FC) and CRP (223.00 μg/mg [63.45-631.50] vs. 98.50 [31.98-324.00], p < 0.001, 9.10 mg/L [3.22-19.32] vs. 3.20 [1.30-8.30], p < 0.001) and decreased albumin and hemoglobin (3.90 g/dL [3.60-4.20] vs. 4.30 [4.00-4.50], p < 0.001,12.20 g/dL [11.47-13.00] vs. 13.60 [12.60-14.70], p < 0.001). For UC, low ALT was associated with higher FC and CRP (226.50 μg/mg [143.00-537.00] vs. 107.00 [40.85-499.50], p = 0.057, 4.50 mg/L [1.90-11.62] vs. 2.30 [1.00-6.20], p < 0.001) and with lower albumin and hemoglobin (4.00 g/dL [3.62-4.18] vs. 4.30 [4.10-4.40], p < 0.001, 12.40 g/dL [11.60-13.20] vs. 13.60 [12.60-14.60], p < 0.001). These findings remained consistent following multivariate regression and in a propensity score-matched cohort. Conclusions: Low ALT is more common in patients with IBD and is associated with biochemical disease activity indices.
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Affiliation(s)
- Asher Shafrir
- Meuhedet Health Medical Organization, Jerusalem District, Tel Aviv 6203854, Israel
- Institute of Gastroenterology and Hepatology, Hadassah Medical Center, Jerusalem 1200, Israel; (L.H.K.); (A.Z.); (I.K.)
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
| | - Lior H. Katz
- Institute of Gastroenterology and Hepatology, Hadassah Medical Center, Jerusalem 1200, Israel; (L.H.K.); (A.Z.); (I.K.)
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
| | - Michal Shauly-Aharonov
- Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel;
- The Jerusalem College of Technology, Jerusalem 9190401, Israel
| | - Adar Zinger
- Institute of Gastroenterology and Hepatology, Hadassah Medical Center, Jerusalem 1200, Israel; (L.H.K.); (A.Z.); (I.K.)
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
| | - Rifaat Safadi
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
- The Liver Institute, Hadassah Medical Organization, Jerusalem 91120, Israel
| | - Joshua Stokar
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
- Department of Endocrinology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Itay Kalisky
- Institute of Gastroenterology and Hepatology, Hadassah Medical Center, Jerusalem 1200, Israel; (L.H.K.); (A.Z.); (I.K.)
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel; (R.S.); (J.S.)
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Shahub S, Kumar RM, Lin KC, Banga I, Choi NK, Garcia NM, Muthukumar S, Rubin DT, Prasad S. Continuous Monitoring of CRP, IL-6, and Calprotectin in Inflammatory Bowel Disease Using a Perspiration-Based Wearable Device. Inflamm Bowel Dis 2024:izae054. [PMID: 38520737 DOI: 10.1093/ibd/izae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Indexed: 03/25/2024]
Abstract
BACKGROUND Wearable sensor devices represent a noninvasive technology to continuously track biomarkers linked to inflammatory bowel disease (IBD). We assessed the inflammatory markers associated with IBD in human perspiration. METHODS Participants with IBD were monitored for 40 to 130 minutes with a proprietary wearable sensor device used to measure C-reactive protein, interleukin-6, and calprotectin. Sensor response using electrochemical impedance spectroscopy and serum samples were measured on the same day. The Mann-Whitney test was used to analyze the relationship between active and remission IBD in serum and perspiration, classified according to endoscopic reports and serum biomarker levels. Asynchronously collected fecal calprotectin from a subset of the population was similarly analyzed. RESULTS A total of 33 subjects were enrolled. Expression of calprotectin was significantly elevated in the active cohort compared with the remission cohort in perspiration (P < .05; median = 906.69 ng/mL; active 95% confidence interval [CI], 466.0-1833 ng/mL; remission 95% CI, 328.4-950.8 ng/mL), serum (median = 1860.82 ng/mL; active 95% CI, 1705-2985 ng/mL; remission 95% CI, 870.2-1786 ng/mL), and stool (P < .05; median = 126.74 µg/g; active 95% CI, 77.08-347.1 µg/g; remission 95% CI, 5.038-190.4 µg/g). Expression of CRP in perspiration and serum was comparable between the active and remission cohorts (perspiration: P > .05; median = 970.83 pg/mL; active 95% CI, 908.7-992 pg/mL; remission 95% CI, 903.3-991.9 pg/mL; serum: median = 2.34 µg/mL; active 95% CI, 1.267-4.492 µg/mL; remission 95% CI, 1.648-4.287 µg/mL). Expression of interleukin-6 in perspiration was nonsignificant in the active cohort compared with the remission cohort and was significantly elevated in serum (perspiration: P < .05; median = 2.13 pg/mL; active 95% CI, 2.124-2.44 pg/mL; remission 95% CI, 1.661-2.451 pg/mL; serum: median = 1.15 pg/mL; active 95% CI, 1.549-3.964 pg/mL; remission 95% CI, 0.4301-1.257 pg/mL). Analysis of the linear relationship between perspiration and serum calprotectin (R2 = 0.7195), C-reactive protein (R2 = 0.615), and interleukin-6 (R2 = 0.5411) demonstrated a strong to moderate relationship across mediums. CONCLUSIONS We demonstrate the clinical utility of perspiration as a noninvasive medium for continuous measurement of inflammatory markers in IBD and find that the measures correlate with serum and stool markers across a range of disease activity.
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Affiliation(s)
- Sarah Shahub
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
| | | | - Kai-Chun Lin
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
| | - Ivneet Banga
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
| | - Natalie K Choi
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA
| | - Nicole M Garcia
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA
| | | | - David T Rubin
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA
| | - Shalini Prasad
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
- EnLiSense LLC, Allen, TX, United States
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Bjurström O, Karling P. The association between drugs and repeated treatment with budesonide in patients with microscopic colitis: a retrospective observational study. Therap Adv Gastroenterol 2024; 17:17562848241240640. [PMID: 38510459 PMCID: PMC10953108 DOI: 10.1177/17562848241240640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Background Smoking and the use of non-steroidal anti-inflammatory drugs (NSAIDs) acetylsalicylic acid (ASA), proton pump inhibitors (PPIs), serotonin reuptake inhibitors (SSRIs), and statins have been associated with microscopic colitis (MC). Objectives We investigated whether these factors were associated with repeated budesonide treatments in patients diagnosed with MC. Design Retrospective observational study. Methods All patients with a histologically verified diagnosis of MC at our clinic between the years 2006 and 2022 were identified. Baseline factors and drugs prescribed before and after diagnosis were registered. The influence of risk factors on the odds of having a prescription of oral budesonide and the odds of having a second course of budesonide was studied. Results Patients with MC (n = 183) with a mean age of 62.3 years [standard deviation (SD): 13.3 years] were followed for a median of 5 years (25th-75th percentile 4-10 years) after diagnosis. In all, 138 patients (75%) had at least one prescription of budesonide after diagnosis, and 90 patients (49%) had at least one clinical relapse treated with budesonide. Patients who had been prescribed NSAIDs within 1 year before clinical relapse had higher odds for clinical relapse [odds ratio (OR): 3.70, 95% confidence interval (CI): 1.06-12.9] but there was no increased risk for clinical relapse for the use of ASA (OR: 0.99, 95% CI: 0.39-2.90), PPIs (OR: 1.09, 95% CI: 0.45-2.63), SSRI (OR: 1.41, 95% CI: 0.82-2.44), or statins (OR: 0.83, 95% CI: 0.35-1.99). No association was seen between being a smoker and/or being prescribed NSAID, ASA, PPI, SSRI, and statins at baseline and the odds of having a prescription of oral budesonide within 1 year after diagnosis. Conclusion The risk of being prescribed a second course of budesonide is associated with receiving a prescription of NSAIDs but not with the use of ASA, PPIs, SSRIs, and statins.
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Affiliation(s)
- Oliver Bjurström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Pontus Karling
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, 901 87, Sweden
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Bourgonje AR, Bourgonje MF, Sokooti S, la Bastide-van Gemert S, Nilsen T, Hidden C, Gansevoort RT, Mulder DJ, Hillebrands JL, Bakker SJL, van Beek A, Dullaart RPF, van Goor H, Abdulle AE. Plasma calprotectin and new-onset type 2 diabetes in the general population: a prospective cohort study. J Clin Endocrinol Metab 2024:dgae130. [PMID: 38436468 DOI: 10.1210/clinem/dgae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/13/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Systemic inflammation plays a pivotal role in the development of type 2 diabetes (T2D). Here we hypothesized that circulating levels of calprotectin, a myeloid cell-derived biomarker of inflammation, is associated with the development of new-onset T2D in the general population. METHODS A total of 4,815 initially non-diabetic participants of the Prevention of Renal and Vascular ENd-stage Disease (PREVEND), a prospective population-based cohort study, were assessed for plasma levels of calprotectin at baseline. Circulating levels of calprotectin were investigated for potential associations with the risk of new-onset T2D, defined as a fasting plasma glucose level ≥7.0 mmol/l, a random plasma glucose level ≥11.1 mmol/l, a self-reported physician-based diagnosis of T2D, the use of glucose-lowering drugs, or any combinations thereof. RESULTS Median plasma calprotectin levels were 0.49 [0.35-0.69] mg/l. Plasma calprotectin levels were significantly associated with the risk of new-onset T2D (hazard ratio [HR] per doubling 1.42 [95% confidence interval: 1.22-1.66], P<0.001). The association remained independent of adjustment for age and sex (HR 1.34 [95%CI: 1.14-1.57], P<0.001), but not after further adjustment for potentially confounding factors (HR 1.11 [95% CI: 0.90-1.37], P=0.326), with adjustment for hyperlipidemia and high-sensitivity C-reactive protein explaining the loss of significance. Stratified analyses showed significant effect modification by hypertension, history of cardiovascular disease and HOMA-IR (Pinteraction≤0.001 for each), with higher HRs in individuals without hypertension, without history of cardiovascular disease and with below-median HOMA-IR. CONCLUSIONS Elevated plasma levels of calprotectin are associated with a higher risk of developing T2D in the general population and may represent a moveable inflammatory biomarker. This association, however, does not represent a direct effect, and seems dependent on hyperlipidemia and systemic inflammation.
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Affiliation(s)
- Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Martin F Bourgonje
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sara Sokooti
- Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sacha la Bastide-van Gemert
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | | | - Ron T Gansevoort
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Douwe J Mulder
- Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan-Luuk Hillebrands
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - André van Beek
- Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Amaal E Abdulle
- Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Gedük A, Polat MG, Terzi Demirsoy E, Öztaş B, Eryılmaz BH, Yenihayat EM, Albayrak H, Erol HA, Mehtap Ö, Tarkun P, Hacıhanefioğlu A. Do Alarmins Have a Role in Multiple Myeloma? Turk J Haematol 2024:0-0. [PMID: 38426298 DOI: 10.4274/tjh.galenos.2024.2023.0469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Objective Calprotectin (CLP), S100A6, and High Mobility Group Nucleosome-Binding Protein 1 (HMGN1), known as alarmins, are involved in the pathogenesis of many tumors. In this study, we aimed to inve stigate the relationship of serum CLP, S100A6, and HMGN1 levels with clinical and laboratory findings in Multiple Myeloma (MM) patients and their role in the pathogenesis of MM. Materials and Methods We measured serum CLP, S100A6, and HMGN1 levels in 55 newly diagnosed patients and 32 healthy controls (HC). Results We determined significantly decreased serum CLP, S100A6 ve HMGN1 levels in MM patients compared to HC (p=0.012, p=0.001, p=0.030, respectively). ROC analysis was used to determine a diagnostic cut-off value for serum CLP, S100A6 and HMGN1; the cut off value for CLP was <98 ng/ml (AUC = 0.663, 95% CI 0.554-0.761, p=0.009), S100A6 was <1174.5 pg/ml (AUC = 0.706, 95% CI 0.598-0.799, p=0.001), and HMGN1 was <440.18 pg/ml (AUC = 0.640, 95% CI 0.530-0.740, p:0.03). CLP level was found to be statistically significantly in light chain MM patients ( 91.58±22.57) higher than in heavy chain MM patients (79.42±15.83) (p=0.03). A negative correlation was observed between CLP and M protein, IgG, globulin, and beta 2 microglobulin (correlation coefficient: -0,361; -0,370; -0,279; -0,300, p=0,024, p=006, p=0,04, p=0,0033). Conclusion In this study, we found that serum CLP, S100A6, and HMGN1 levels were statistically lower in newly diagnosed MM patients compared to HC. These results suggest that CLP may binds to the paraprotein produced by heavy chain MM in the blood and therefore its blood levels are found to be low. Additionally, low levels of HMGN1, which is involved in DNA repair, suggest that HMGN1 may contribute to the complex genetic abnormalities found in MM.
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Affiliation(s)
- Ayfer Gedük
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Merve Gökçen Polat
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Esra Terzi Demirsoy
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Berrin Öztaş
- Kocaeli University Faculty of Medicine, Department of Biochemistry, Kocaeli, Turkey
| | - Baldan Huri Eryılmaz
- Kocaeli University Faculty of Medicine, Department of Internal Medicine, Kocaeli, Turkey
| | - Emel Merve Yenihayat
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Hayrunnisa Albayrak
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Haşim Atakan Erol
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Özgür Mehtap
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
| | - Pınar Tarkun
- Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Turkey
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9
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Zhang H, Zhang Q, Liu K, Yuan Z, Xu X, Dong J. Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID-19. Immun Inflamm Dis 2024; 12:e1212. [PMID: 38477671 DOI: 10.1002/iid3.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/22/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Patients with coronavirus disease-2019 (COVID-19) are characterized by hyperinflammation. Calprotectin (S100A8/S100A9) is a calcium- and zinc-binding protein mainly secreted by neutrophilic granulocytes or macrophages and has been suggested to be correlated with the severity and prognosis of COVID-19. AIM To thoroughly evaluate the diagnostic and prognostic utility of calprotectin in patients with COVID-19 by analyzing relevant studies. METHODS PubMed, Web of Science, and Cochrane Library were comprehensively searched from inception to August 1, 2023 to retrieve studies about the application of calprotectin in COVID-19. Useful data such as the level of calprotectin in different groups and the diagnostic efficacy of this biomarker for severe COVID-19 were extracted and aggregated by using Stata 16.0 software. RESULTS Fifteen studies were brought into this meta-analysis. First, the pooled standardized mean differences (SMDs) were used to estimate the differences in the levels of circulating calprotectin between patients with severe and non-severe COVID-19. The results showed an overall estimate of 1.84 (95% confidence interval [CI]: 1.09-2.60). Diagnostic information was extracted from 11 studies, and the pooled sensitivity and specificity of calprotectin for diagnosing severe COVID-19 were 0.75 (95% CI: 0.64-0.84) and 0.88 (95% CI: 0.79-0.94), respectively. The AUC was 0.89 and the pooled DOR was 18.44 (95% CI: 9.07-37.51). Furthermore, there was a strong correlation between elevated levels of circulating calprotectin and a higher risk of mortality outcomes in COVID-19 patients (odds ratio: 8.60, 95% CI: 2.17-34.12; p < 0.1). CONCLUSION This meta-analysis showed that calprotectin was elevated in patients with severe COVID-19, and this atypical inflammatory cytokine might serve as a useful biomarker to distinguish the severity of COVID-19 and predict the prognosis.
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Affiliation(s)
- Haoran Zhang
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Qingyu Zhang
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Kun Liu
- Graduate School of Education, Shandong Sport University, Jinan, Shandong Province, China
| | - Zenong Yuan
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Xiqiang Xu
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Jun Dong
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
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10
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Young SM, Woode RA, Williams EC, Ericsson AC, Clarke LL. Fecal dysbiosis and inflammation in intestinal-specific Cftr knockout mice on regimens preventing intestinal obstruction. Physiol Genomics 2024; 56:247-264. [PMID: 38073491 DOI: 10.1152/physiolgenomics.00077.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/08/2023] [Accepted: 12/03/2023] [Indexed: 12/26/2023] Open
Abstract
Chronic intestinal inflammation is a poorly understood manifestation of cystic fibrosis (CF), which may be refractory to ion channel CF transmembrane conductance regulator (CFTR) modulator therapy. People with CF exhibit intestinal dysbiosis, which has the potential for stimulating intestinal and systemic inflammation. CFTR is expressed in organ epithelia, leukocytes, and other tissues. Here, we investigate the contribution of intestinal epithelium-specific loss of Cftr [iCftr knockout (KO)] to dysbiosis and inflammation in mice treated with either of two antiobstructive dietary regimens necessary to maintain CF mouse models [polyethylene glycol (PEG) laxative or a liquid diet (LiqD)]. Feces collected from iCftr KO mice and their wild-type (WT) sex-matched littermates were used to measure fecal calprotectin to evaluate inflammation and to perform 16S rRNA sequencing to characterize the gut microbiome. Fecal calprotectin was elevated in iCftr KO relative to WT mice that consumed either PEG or LiqD. PEG iCftr KO mice did not show a change in α diversity versus WT mice but demonstrated a significant difference in microbial composition (β diversity) with included increases in the phylum Proteobacteria, the family Peptostreptococcaceae, four genera of Clostridia including C. innocuum, and the mucolytic genus Akkermansia. Fecal microbiome analysis of LiqD-fed iCftr KO mice showed both decreased α diversity and differences in microbial composition with increases in the Proteobacteria family Enterobacteriaceae, Firmicutes families Clostridiaceae and Peptostreptococcaceae, and enrichment of Clostridium perfringens, C. innocuum, C. difficile, mucolytic Ruminococcus gnavus, and reduction of Akkermansia. It was concluded that epithelium-specific loss of Cftr is a major driver of CF intestinal dysbiosis and inflammation with significant similarities to previous studies of pan Cftr KO mice.NEW & NOTEWORTHY Chronic intestinal inflammation is a manifestation of cystic fibrosis (CF), a disease caused by loss of the anion channel CF transmembrane conductance regulator (CFTR) that is expressed in many tissues. This study shows that intestinal epithelial cell-specific loss of CFTR [inducible Cftr knockout (KO)] in mice is sufficient to induce intestinal dysbiosis and inflammation. Experiments were performed on mice consuming two dietary regimens routinely used to prevent obstruction in CF mice.
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Affiliation(s)
- Sarah M Young
- College of Veterinary Medicine, University of Missouri Comparative Medicine Program, Columbia, Missouri, United States
| | - Rowena A Woode
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Estela C Williams
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Aaron C Ericsson
- College of Veterinary Medicine, University of Missouri Comparative Medicine Program, Columbia, Missouri, United States
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, United States
- College of Veterinary Medicine, University of Missouri Metagenomics Center, Columbia, Missouri, United States
| | - Lane L Clarke
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, United States
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11
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Swolinsky JS, Hinz RM, Markus CE, Singer E, Bachmann F, Halleck F, Kron S, Naik MG, Schmidt D, Obermeier M, Gebert P, Rauch G, Kropf S, Haase M, Budde K, Eckardt KU, Westhoff TH, Schmidt-Ott KM. Plasma NGAL levels in stable kidney transplant recipients and the risk of allograft loss. Nephrol Dial Transplant 2024; 39:483-495. [PMID: 37858309 PMCID: PMC11024820 DOI: 10.1093/ndt/gfad226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The objective of this study was to investigate the utility of neutrophil gelatinase-associated lipocalin (NGAL) and calprotectin (CPT) to predict long-term graft survival in stable kidney transplant recipients (KTR). METHODS A total of 709 stable outpatient KTR were enrolled >2 months post-transplant. The utility of plasma and urinary NGAL (pNGAL, uNGAL) and plasma and urinary CPT at enrollment to predict death-censored graft loss was evaluated during a 58-month follow-up. RESULTS Among biomarkers, pNGAL showed the best predictive ability for graft loss and was the only biomarker with an area under the curve (AUC) > 0.7 for graft loss within 5 years. Patients with graft loss within 5 years (n = 49) had a median pNGAL of 304 [interquartile range (IQR) 235-358] versus 182 (IQR 128-246) ng/mL with surviving grafts (P < .001). Time-dependent receiver operating characteristic analyses at 58 months indicated an AUC for pNGAL of 0.795, serum creatinine-based Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rate (eGFR) had an AUC of 0.866. pNGAL added to a model based on conventional risk factors for graft loss with death as competing risk (age, transplant age, presence of donor-specific antibodies, presence of proteinuria, history of delayed graft function) had a strong independent association with graft loss {subdistribution hazard ratio (sHR) for binary log-transformed pNGAL [log2(pNGAL)] 3.4, 95% confidence interval (CI) 2.24-5.15, P < .0001}. This association was substantially attenuated when eGFR was added to the model [sHR for log2(pNGAL) 1.63, 95% CI 0.92-2.88, P = .095]. Category-free net reclassification improvement of a risk model including log2(pNGAL) in addition to conventional risk factors and eGFR was 54.3% (95% CI 9.2%-99.3%) but C-statistic did not improve significantly. CONCLUSIONS pNGAL was an independent predictor of renal allograft loss in stable KTR from one transplant center but did not show consistent added value when compared with baseline predictors including the conventional marker eGFR. Future studies in larger cohorts are warranted.
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Affiliation(s)
- Jutta S Swolinsky
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Ricarda M Hinz
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Carolin E Markus
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Eugenia Singer
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Friederike Bachmann
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Fabian Halleck
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Susanne Kron
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Marcel G Naik
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin
| | - Danilo Schmidt
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | | | - Pimrapat Gebert
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology
| | - Geraldine Rauch
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology
| | - Siegfried Kropf
- Institute of Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Michael Haase
- Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
- Diaverum Renal Services, MVZ Potsdam, Potsdam, Germany
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Timm H Westhoff
- Medical Department I, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Kai M Schmidt-Ott
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
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12
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Martínez Gallego MÁ, Crespo Sánchez MG, Serrano Olmedo MG, Buño Soto A, Álvarez Casasempere S, Nozal P, Martínez-Ojinaga E, Molina Arias M, Losantos-García I, Molero-Luis M. Trends in Faecal Zonulin Concentrations in Paediatric Patients with Celiac Disease at Baseline and on a Gluten-Free Diet: Exploring Correlations with Other Faecal Biomarkers. Nutrients 2024; 16:684. [PMID: 38474812 DOI: 10.3390/nu16050684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Celiac disease (CeD) is an autoimmune condition triggered by gluten in genetically predisposed individuals, affecting all ages. Intestinal permeability (IP) is crucial in the pathogenesis of CeD and it is primarily governed by tight junctions (TJs) that uphold the intestinal barrier's integrity. The protein zonulin plays a critical role in modulating the permeability of TJs having emerged as a potential non-invasive biomarker to study IP. The importance of this study lies in providing evidence for the usefulness of a non-invasive tool in the study of IP both at baseline and in the follow-up of paediatric patients with CeD. In this single-centre prospective observational study, we explored the correlation between faecal zonulin levels and others faecal and serum biomarkers for monitoring IP in CeD within the paediatric population. We also aimed to establish reference values for faecal zonulin in the paediatric population. We found that faecal zonulin and calprotectin values are higher at the onset of CeD compared with the control population. Specifically, the zonulin levels were 347.5 ng/mL as opposed to 177.7 ng/mL in the control population (p = 0.001), while calprotectin levels were 29.8 μg/g stool compared to 13.9 μg/g stool (p = 0.029). As the duration without gluten consumption increased, a significant reduction in faecal zonulin levels was observed in patients with CeD (348.5 ng/mL vs. 157.1 ng/mL; p = 0.002), along with a decrease in the prevalence of patients with vitamin D insufficiency (88.9% vs. 77.8%). We conclude that faecal zonulin concentrations were higher in the patients with active CeD compared with healthy individuals or those following a gluten-free diet (GFD). The significant decrease in their values over the duration of the GFD suggests the potential use of zonulin as an additional tool in monitoring adherence to a GFD.
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Affiliation(s)
| | | | | | - Antonio Buño Soto
- Department of Laboratory Medicine, La Paz University Hospital, 28046 Madrid, Spain
| | | | - Pilar Nozal
- Department of Immunology, La Paz University Hospital, 28046 Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER U754), 28046 Madrid, Spain
- Complement Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
| | - Eva Martínez-Ojinaga
- Paediatric Gastroenterology and Nutrition Service, La Paz University Hospital, 28046 Madrid, Spain
| | - Manuel Molina Arias
- Paediatric Gastroenterology and Nutrition Service, La Paz University Hospital, 28046 Madrid, Spain
| | | | - Marta Molero-Luis
- Department of Laboratory Medicine, La Paz University Hospital, 28046 Madrid, Spain
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13
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Gensmyr-Singer H, Werner M, Karling P. The drug-survival of low-dose thioguanine in patients with inflammatory bowel disease: a retrospective observational study. Therap Adv Gastroenterol 2024; 17:17562848241228064. [PMID: 38384282 PMCID: PMC10880529 DOI: 10.1177/17562848241228064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/04/2024] [Indexed: 02/23/2024] Open
Abstract
Background Thiopurines are commonly used to treat inflammatory bowel disease but withdrawal due to side effects are common. Thioguanine has been suggested to be better tolerated than conventional thiopurines. Objectives We studied drug-survival of low dose of thioguanine in real-life clinical practice in comparison to conventional thiopurines. Design Retrospective observational study. Methods All patients born 1956 and later, and who at least once started thiopurine treatment between 2006 and 2022 were included. A medical chart review was performed that noted drug-survival for every thiopurine treatment attempt. The Mantel-Cox rank test was used to test differences in drug-survival for different thiopurines. Blood chemistry analysis and faecal calprotectin levels were registered for the first 5 years of treatment. Results In the study population, there was 379 initiated thiopurine treatments (210 for Crohn's disease and 169 for ulcerative colitis) in 307 patients with inflammatory bowel disease (IBD). Low-dose thioguanine (median dose 11 mg; 25-75th percentile 7-19 mg) had been initiated in 31 patients. Overall, when including all thiopurine attempts, thioguanine had the longest drug-survival [Mantel-Cox rank test: thioguanine versus azathioprine p = 0.014; thioguanine versus 6-mercaptopurine (6-MP) p < 0.001]. For second-line thiopurine treatment thioguanine had longer drug-survival than 6-MP (Mantel-Cox rank test: p = 0.006). At 60 months, 86% of the patients who started low-dose thioguanine were still on treatment compared to 42% of the patients who started 6-MP (p = 0.022). The median 6-thioguanine nucleotide levels in patients treated with thioguanine was 364 pmol/8 × 108. Patients on thioguanine treatment showed significantly lower values of median mean corpuscular volume at follow-up than patients treated with azathioprine and 6-MP. Patients treated with 6-MP showed significantly lower levels of FC in the third year of treatment compared to patient treated with azathioprine (59 versus 109 µg/g; p = 0.023), but there was no significant difference in FC levels for thioguanine compared to azathioprine (50 versus 109 µg/g; p = 0.33). Conclusion Treatment with a low dose of thioguanine is well-tolerated in patients with IBD and had a significantly higher drug-survival than conventional thiopurines.
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Affiliation(s)
| | - Mårten Werner
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Pontus Karling
- Department of Public Health and Clincal Medicine, Umeå University, Umeå S-90811, Sweden
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14
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Maroudias G, Vrachnis D, Fotiou A, Loukas N, Mantzou A, Pergialiotis V, Valsamakis G, Machairiotis N, Stavros S, Panagopoulos P, Vakas P, Kanaka-Gantenbein C, Drakakis P, Vrachnis N. Measurement of Calprotectin and PTH in the Amniotic Fluid of Early Second Trimester Pregnancies and Their Impact on Fetuses with Growth Disorders: Are Their Levels Related to Oxidative Stress? J Clin Med 2024; 13:855. [PMID: 38337548 PMCID: PMC10856459 DOI: 10.3390/jcm13030855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Background: During the early stages of human fetal development, the fetal skeleton system is chiefly made up of cartilage, which is gradually replaced by bone. Fetal bone development is mainly regulated by the parathyroid hormone parathormone (PTH) and PTH-related protein, with specific calprotectin playing a substantial role in cell adhesion and chemotaxis while exhibiting antimicrobial activity during the inflammatory osteogenesis process. The aim of our study was to measure the levels of PTH and calprotectin in early second trimester amniotic fluid and to carry out a comparison between the levels observed among normal full-term pregnancies (control group) and those of the groups of embryos exhibiting impaired or enhanced growth. Methods: For the present prospective study, we collected amniotic fluid samples from pregnancies that underwent amniocentesis at 15 to 22 weeks of gestational age during the period 2021-2023. Subsequently, we followed up on all pregnancies closely until delivery. Having recorded fetal birthweights, we then divided the neonates into three groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: In total, 64 pregnancies, including 14 SGA, 10 LGA, and 40 AGA fetuses, were included in our study. Both substances were detected in early second trimester amniotic fluid in both groups. Concentrations of calprotectin differed significantly among the three groups (p = 0.033). AGA fetuses had a lower mean value of 4.195 (2.415-6.425) IU/mL, whereas LGA fetuses had a higher mean value of 6.055 (4.887-13.950) IU/mL, while SGA fetuses had a mean value of 5.475 (3.400-9.177) IU/mL. Further analysis revealed that only LGA fetuses had significantly higher calprotectin concentrations compared to AGA fetuses (p = 0.018). PTH concentration was similar between the groups, with LGA fetuses having a mean value of 13.18 (9.51-15.52) IU/mL, while SGA fetuses had a mean value of 14.18 (9.02-16.00) IU/mL, and AGA fetuses had similar concentrations of 13.35 (9.05-15.81) IU/mL. The differences in PTH concentration among the three groups were not statistically significant (p = 0.513). Conclusions: Calprotectin values in the amniotic fluid in the early second trimester were higher in LGA fetuses compared to those in the SGA and AGA categories. LGA fetuses can possibly be in a state of low-grade chronic inflammation due to excessive fat deposition, causing oxidative stress in LGA fetuses and, eventually, the release of calprotectin. Moreover, PTH concentrations in the amniotic fluid of early second trimester pregnancies were not found to be statistically correlated with fetal growth abnormalities in either LGA or SGA fetuses. However, the early time of collection and the small number of patients in our study should be taken into account.
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Affiliation(s)
- George Maroudias
- Department of Obstetrics and Gynecology, Tzaneio General Hospital, 18536 Athens, Greece
| | - Dionysios Vrachnis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.V.); (A.F.)
| | - Alexandros Fotiou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.V.); (A.F.)
| | - Nikolaos Loukas
- Department of Obstetrics and Gynecology, Tzaneio General Hospital, 18536 Athens, Greece
| | - Aimilia Mantzou
- First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece (C.K.-G.)
| | - Vasileiοs Pergialiotis
- First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece;
| | - George Valsamakis
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528 Athens, Greece; (G.V.)
| | - Nikolaos Machairiotis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Sofoklis Stavros
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Panagiotis Vakas
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528 Athens, Greece; (G.V.)
| | - Christina Kanaka-Gantenbein
- First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece (C.K.-G.)
| | - Petros Drakakis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17, UK
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15
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Fortuny M, Sarrias MR, Torner M, Iborra I, Clos A, Ardèvol A, Bartolí R, Morillas RM, Domènech E, Masnou H. Systematic review of the role of calprotectin in cirrhosis. Eur J Clin Invest 2024; 54:e14111. [PMID: 37849372 DOI: 10.1111/eci.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Calprotectin is a calcium-binding-S100-protein synthetized mainly in neutrophils which has been demonstrated to be an accurate biomarker of the presence of these cells. Gut barrier dysfunction in patients with advanced chronic liver disease (ACLD), in addition to the lack of noninvasive tools for diagnosis and prognosis of cirrhosis decompensations, has raised interest in this biomarker. AIMS Our aim is to summarize the current evidence regarding the role of calprotectin in terms of its diagnostic and prognostic utility in ACLD. METHODS We performed a systematic search (PROSPERO registration no. CRD42023389069) of original articles published without any restrictions on the publication date until January 2023 providing information about calprotectin for the prognosis or diagnosis of ACLD and its decompensations in adult patients. RESULTS A total 227 articles were identified, and 26 observational studies finally met the inclusion criteria. In 14 studies, calprotectin was measured in ascitic fluid, all of which reported higher calprotectin values in spontaneous bacterial peritonitis, while cut-off points for its diagnosis were proposed in nine studies. Three studies reported higher faecal calprotectin levels in patients with hepatic encephalopathy and portal hypertension. Four studies evaluated faecal calprotectin and one plasma calprotectin as biomarkers for gut barrier integrity and bacterial translocation. CONCLUSIONS Calprotectin is emerging as a promising biomarker in ACLD, particularly for the management of bacterial infections and alcohol-related liver disease. Further research with better study designs should help to determine the feasibility of calprotectin measurement in routine clinical practice.
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Affiliation(s)
- Marta Fortuny
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria-Rosa Sarrias
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Maria Torner
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ignacio Iborra
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ariadna Clos
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Alba Ardèvol
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ramon Bartolí
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Rosa M Morillas
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Eugeni Domènech
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
- IBD Unit, Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Helena Masnou
- Hepatology Unit, Hospital Germans Trias i Pujol, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
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Bourgonje AR, Bourgonje MF, la Bastide‐van Gemert S, Nilsen T, Hidden C, Gansevoort RT, Bakker SJL, Mulder DJ, Dullaart RPF, Abdulle AE, van Goor H. Plasma Calprotectin Levels Associate With New-Onset Hypertension in the General Population: A Prospective Cohort Study. J Am Heart Assoc 2024; 13:e031458. [PMID: 38156449 PMCID: PMC10863804 DOI: 10.1161/jaha.123.031458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Low-grade systemic inflammation is a relevant pathogenic mechanism underlying the development of hypertension. In this study, we hypothesized that plasma calprotectin levels, as a biomarker of neutrophil-mediated inflammation, is associated with developing new-onset hypertension in the general population. METHODS AND RESULTS Plasma calprotectin levels were determined in 3524 participants who participated in the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study, a prospective population-based cohort study. Plasma calprotectin levels were studied for associations with the risk of new-onset hypertension, defined as systolic blood pressure of at least 140 mm Hg, diastolic blood pressure of at least 90 mm Hg, or the first recorded use of antihypertensives. Participants with hypertension at baseline were excluded. Median plasma calprotectin levels were 0.48 (0.34-0.66) mg/L, and median systolic blood pressure was 117 (109-126) mm Hg. Plasma calprotectin levels were significantly associated with the risk of new-onset hypertension (hazard ratio [HR], per doubling 1.30 [95% CI, 1.21-1.41]; P<0.001), also after adjustment for age and sex (HR, 1.26 [95% CI, 1.16-1.37]; P<0.001), but not after additional adjustment for potentially confounding factors, including baseline systolic blood pressure (HR, 1.00 [95% CI, 0.90-1.11]; P=0.996). Stratified analyses showed significant effect modification by sex (Pinteraction=0.023) and urinary albumin excretion (Pinteraction=0.004), with higher HRs in men (compared with women) and in individuals with higher urinary albumin excretion (>9.3 mg per 24 hours) compared with lower urinary albumin excretion (≤9.3 mg per 24 hours). CONCLUSIONS Higher plasma calprotectin levels are associated with an increased risk of new-onset hypertension in the general population. This association is dependent on baseline systolic blood pressure and is particularly prominent in men compared with women.
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Affiliation(s)
- Arno R. Bourgonje
- Department of Gastroenterology and HepatologyUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
- The Henry D. Janowitz Division of Gastroenterology, Department of MedicineIcahn School of Medicine at Mount Sinai, NYNew YorkNYUSA
| | - Martin F. Bourgonje
- Department of Pathology and Medical BiologyUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Sacha la Bastide‐van Gemert
- Department of EpidemiologyUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | | | | | - Ron T. Gansevoort
- Division of Nephrology, Department of Internal MedicineUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Stephan J. L. Bakker
- Division of Nephrology, Department of Internal MedicineUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Douwe J. Mulder
- Department of Internal Medicine, Division of Vascular MedicineUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Robin P. F. Dullaart
- Department of Internal Medicine, Division of EndocrinologyUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Amaal E. Abdulle
- Department of Internal Medicine, Division of Vascular MedicineUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
| | - Harry van Goor
- Department of Pathology and Medical BiologyUniversity of Groningen, University Medical Center GroningenGroningenthe Netherlands
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Hong L, Huang Y, Han J, Li S, Zhang L, Zhou Q, Cao X, Yu W, Guo X, Yang Y, Zhou Y, Yan W, Hong S, Jiang S, Cao Y. Pathogen-specific alterations in intestinal microbiota precede urinary tract infections in preterm infants: a longitudinal case-control study. Gut Microbes 2024; 16:2333413. [PMID: 38561312 PMCID: PMC10986765 DOI: 10.1080/19490976.2024.2333413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Urinary tract infections (UTIs) are among the most common late-onset infections in preterm infants, characterized by nonspecific symptoms and a pathogenic spectrum that diverges from that of term infants and older children, which present unique diagnostic and therapeutic challenges. Existing data on the role of gut microbiota in UTI pathogenesis in this demographic are limited. This study aims to investigate alterations in gut microbiota and fecal calprotectin levels and their association with the development of UTIs in hospitalized preterm infants. A longitudinal case-control study was conducted involving preterm infants admitted between January 2018 and October 2020. Fecal samples were collected weekly and analyzed for microbial profiles and calprotectin levels. Propensity score matching, accounting for key perinatal factors including age and antibiotic use, was utilized to match samples from UTI-diagnosed infants to those from non-UTI counterparts. Among the 151 preterm infants studied, 53 were diagnosed with a UTI, predominantly caused by Enterobacteriaceae (79.3%) and Enterococcaceae (19.0%). Infants with UTIs showed a significantly higher abundance of these families compared to non-UTI infants, for both Gram-negative and positive pathogens, respectively. Notably, there was a significant pre-UTI increase in the abundance of pathogen-specific taxa in infants later diagnosed with UTIs, offering high predictive value for early detection. Shotgun metagenomic sequencing further confirmed the dominance of specific pathogenic species pre-UTI and revealed altered virulence factor profiles associated with Klebsiella aerogenes and Escherichia coli infections. Additionally, a decline in fecal calprotectin levels was observed preceding UTI onset, particularly in cases involving Enterobacteriaceae. The observed pathogen-specific alterations in the gut microbiota preceding UTI onset offer novel insight into the UTI pathogenesis and promising early biomarkers for UTIs in preterm infants, potentially enhancing the timely management of this common infection. However, further validation in larger cohorts is essential to confirm these findings.
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Affiliation(s)
- Luyang Hong
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Yihuang Huang
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Junyan Han
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Shujuan Li
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Lan Zhang
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Qi Zhou
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Xincheng Cao
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Weiyin Yu
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Xinhui Guo
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Yi Yang
- NHC Key Laboratory of Neonatal Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Yufeng Zhou
- NHC Key Laboratory of Neonatal Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- National Children’s Medical Center, Department of Clinical Epidemiology of Children’s Hospital of Fudan University, Shanghai, China
| | - Shangyu Hong
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Siyuan Jiang
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Children’s Hospital of Fudan University, Shanghai, China
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Farghaly MAA, Ali MAM, Ramey S, Said W, Abdelkarem A, Collin M. Characteristics of fecal calprotectin as an early marker for suspected necrotizing enterocolitis in newborns exclusively fed maternal breast milk: a case-control study. Proc AMIA Symp 2023; 37:43-47. [PMID: 38174026 PMCID: PMC10761025 DOI: 10.1080/08998280.2023.2277580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/22/2023] [Indexed: 01/05/2024] Open
Abstract
Objective Numerous studies have proposed using fecal calprotectin among many biomarkers associated with necrotizing enterocolitis (NEC) diagnosis. This study aimed to evaluate fecal calprotectin as an early marker for suspected NEC (stage 1) in infants fed exclusively breast milk. Methods We collected 20 stool samples from newborns admitted to the neonatal intensive care unit at Aswan University Hospital diagnosed with stage I NEC. We compared them with 20 samples from matched healthy newborns. Fecal calprotectin level was measured by enzyme-linked immunosorbent assay. Results Fecal calprotectin level was higher in cases than in the control group (P < 0.001). Also, there was a positive correlation between fecal calprotectin and C-reactive protein in the studied cases (P = 0.001). However, there were no correlations between fecal calprotectin and sex or postnatal age. Conclusion Fecal calprotectin levels increase in newborns with stage I NEC. Although not specific, its sensitivity suggests a role as a potential biomarker in the evaluation of suspected NEC.
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Affiliation(s)
- Mohsen A. A. Farghaly
- Cleveland Clinic Children’s, Cleveland, Ohio, USA
- Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mahmoud A. M. Ali
- Faculty of Medicine, Aswan University, Aswan, Egypt
- Department of Pediatrics, Case Western Reserve University/MetroHealth System, Cleveland, Ohio, USA
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Stacey Ramey
- Department of Pediatrics, Case Western Reserve University/MetroHealth System, Cleveland, Ohio, USA
| | - Wafaa Said
- Faculty of Medicine, Aswan University, Aswan, Egypt
| | | | - Marc Collin
- Department of Pediatrics, Case Western Reserve University/MetroHealth System, Cleveland, Ohio, USA
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Bukvić F, Ivković A, Čičak H, Dukić L, Šimundić AM, Marijančević D, Pašalić D. The Association of Serum Calprotectin with Fitness Indicators and Biochemical Markers in High-Level Athletes: A Continuous Dynamic Monitoring during One Competitive Season. Sports (Basel) 2023; 11:243. [PMID: 38133110 PMCID: PMC10748013 DOI: 10.3390/sports11120243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
The objective was to determine the associations between several biochemical indicators and the dynamics of concentration change across four physical fitness phases over the period of a competitive season. Furthermore, associations between serum calprotectin and biomarkers of inflammation or muscle injury and physical indicators were examined. SUBJECTS AND METHODS Twenty professional male water polo players (median age: 28 (22-42)) were included in this study. Serum creatine kinase activity was determined by the automated photometric UV method. The concentrations of calprotectin, C-reactive protein, and myoglobin were measured using an automated immunoturbidimetric method, while an automated immunochemistry method was employed for interleukin-6, troponin I, and cortisol determination. Tests of repeated strength, maximal strength, and static strength were used to evaluate physical activity. RESULTS Serum calprotectin concentrations expressed in median and IQR were significantly different: T1: 2.92 g/mL (2.47; 3.86); T2: 2.35 g/mL (1.26; 2.87); T3: 2.27 g/mL (1.60; 3.27); and T4: 1.47 g/mL (1.04; 2.85) (p = 0.004). Cortisol concentration and CK activity showed significant changes among phases (p = 0.049 and p = 0.014, respectively). Each physical activity examined showed a significant seasonal decrease (all p values were 0.001). Calprotectin serum concentration and indicators of muscular injury, inflammation, and physical activity were found to be correlated during particular stages of the seasonal examination. CONCLUSIONS Calprotectin values determined throughout one competitive season decreased as training intensity among water polo players increased. Serum calprotectin concentrations and indicators were related to biochemical markers of inflammation and muscle damage.
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Affiliation(s)
- Frane Bukvić
- Department of Orthopedics and Trauma Surgery, University Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia; (F.B.); (A.I.)
| | - Alan Ivković
- Department of Orthopedics and Trauma Surgery, University Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia; (F.B.); (A.I.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Helena Čičak
- Department of Medical Laboratory Diagnostics, University Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia; (H.Č.); (L.D.); (A.-M.Š.)
| | - Lora Dukić
- Department of Medical Laboratory Diagnostics, University Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia; (H.Č.); (L.D.); (A.-M.Š.)
| | - Ana-Maria Šimundić
- Department of Medical Laboratory Diagnostics, University Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia; (H.Č.); (L.D.); (A.-M.Š.)
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Domagoj Marijančević
- Department of Clinical Chemistry, University Hospital Centre ‘Sestre Milosrdnice’, 10000 Zagreb, Croatia;
| | - Daria Pašalić
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Hansen AH, Mortensen JH, Rønnow SR, Karsdal MA, Leeming DJ, Sand JMB. A Serological Neoepitope Biomarker of Neutrophil Elastase-Degraded Calprotectin, Associated with Neutrophil Activity, Identifies Idiopathic Pulmonary Fibrosis and Chronic Obstructive Pulmonary Disease More Effectively Than Total Calprotectin. J Clin Med 2023; 12:7589. [PMID: 38137658 PMCID: PMC10743791 DOI: 10.3390/jcm12247589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Neutrophil activation can release neutrophil extracellular traps (NETs) in acute inflammation. NETs result in the release of human neutrophil elastase (HNE) and calprotectin, where the former can degrade the latter and generate protein fragments associated with neutrophil activity. We investigated this in chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) using the novel neoepitope biomarker CPa9-HNE, quantifying a specific HNE-mediated fragment of calprotectin in serum. CPa9-HNE was compared to total calprotectin. Initially, CPa9-HNE was measured in healthy (n = 39), COPD (n = 67), and IPF (n = 16) serum using a neoepitope-specific competitive enzyme-linked immunosorbent assay. Then, a head-to-head comparison of CPa9-HNE and total calprotectin, a non-neoepitope, was conducted in healthy (n = 19), COPD (n = 25), and IPF (n = 19) participants. CPa9-HNE levels were significantly increased in COPD (p < 0.0001) and IPF subjects (p = 0.0001) when compared to healthy participants. Additionally, CPa9-HNE distinguished IPF (p < 0.0001) and COPD (p < 0.0001) from healthy participants more effectively than total calprotectin for IPF (p = 0.0051) and COPD (p = 0.0069). Here, CPa9-HNE also distinguished IPF from COPD (p = 0.045) participants, which was not observed for total calprotectin (p = 0.98). Neutrophil activity was significantly higher, as assessed via serum CPa9-HNE, for COPD and IPF compared to healthy participants. Additionally, CPa9-HNE exceeded the ability of non-neoepitope calprotectin serum measurements to separate healthy from lung disease and even COPD from IPF participants, indicating that neutrophil activity is essential for both COPD and IPF.
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21
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Szczuko M, Komisarska P, Kikut J, Drozd A, Sochaczewska D. Calprotectin Is Associated with HETE and HODE Acids in Inflammatory Bowel Diseases. J Clin Med 2023; 12:7584. [PMID: 38137653 PMCID: PMC10744317 DOI: 10.3390/jcm12247584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Intestinal diseases are identified as autoimmune phenomena attributed to a specific virus that binds to the mucosal epithelium. The importance of precise diagnostic processes and identification is emphasized, but the multifaceted and complex etiological factors pose challenges for effective treatment. A recent supplementary study suggested a linkage between the secretion of calprotectin, a protein associated with inflammatory processes, and increased levels of hydroxyeicosatrienoic acids (HETE) and hydroxyoctadecadienoic (HODE) compounds. METHODS Sixty-two patients (average age: 14.06 ± 2.93 years) suffering from inflammatory bowel diseases were included in this study. Comparative analyses were performed to assess the concentrations of calprotectin against the levels of arachidonic acid derivatives. The calprotectin concentration was determined using the enzyme-linked immunosorbent assay (ELISA) method. The derivatives of HETE and HODE were identified through liquid chromatography. RESULTS Patients with Crohn's disease (CD) displayed higher average concentrations of fatty acid metabolites; however, no correlation with calprotectin was observed. A dependency of 12S HETE concentration relative to age was noted in the CD group, and a similar trend was also identified in ulcerative colitis (UC), with the significant metabolites being 15 HETE and 5 oxoETE. In UC patients, a positive correlation was established between the calprotectin concentration and the acids 5-HETE and 12-HETE. CONCLUSIONS These findings may be instrumental for monitoring the inflammatory states of patients and indicating a pathway for intervention. The metabolite 16RS HETE is associated with UC activity, and 15-HETE is related to the disease's duration. A relatively more significant role of HETE acids in the progression of the disease was observed in UC.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 72-009 Police, Poland (A.D.)
| | - Paulina Komisarska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 72-009 Police, Poland (A.D.)
| | - Justyna Kikut
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 72-009 Police, Poland (A.D.)
| | - Arleta Drozd
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 72-009 Police, Poland (A.D.)
| | - Diana Sochaczewska
- Department of Neonatology, Pomeranian Medical University in Szczecin, 72-009 Police, Poland;
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Sejersen K, Weitoft T, Knight A, Lysholm J, Larsson A, Rönnelid J. Serum calprotectin correlates more strongly with inflammation and disease activity in ACPA positive than ACPA negative rheumatoid arthritis. Rheumatology (Oxford) 2023:kead641. [PMID: 38048609 DOI: 10.1093/rheumatology/kead641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate performance of serum and synovial fluid levels of the granulocyte protein calprotectin as inflammatory biomarker in rheumatoid arthritis (RA) patients with knee synovitis. METHODS 76 RA patients with ongoing knee synovitis were included. Data on disease activity score with 28 joints and their subcomponents and radiological destruction of the affected knee were collected. White blood cell count, C-reactive protein, anti-citrullinated peptide antibodies (ACPA) against cyclic citrullinated peptide version 2 (anti-CCP2), IgM rheumatoid factor (RF) and calprotectin were analysed in parallel in circulation and in synovial fluid (SF). Counts of polynuclear and mononuclear cells were measured in SF. RESULTS Serum (S) calprotectin correlated stronger than SF-calprotectin with inflammatory markers and disease activity. Instead, SF-calprotectin showed a strong correlation to SF counts of white blood cells, and especially to polymorphonuclear cell counts (Spearman's rho = 0.72, p< 0.001). S-calprotectin showed markedly stronger correlation with inflammatory markers and disease activity in ACPA positive as compared with ACPA negative RA patients; a similar difference was observed for patients with and without IgM RF. CONCLUSION The particularly strong association between circulating calprotectin and inflammation in ACPA positive RA is a new argument for a specific role for polymorphonuclear granulocytes/neutrophils in this RA subset. Measurement of calprotectin in SF does not convey any additional benefit compared with measurement in the circulation in RA patients with knee synovitis.
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Affiliation(s)
- Kristina Sejersen
- Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala, Sweden
- Stockholm, Unilabs AB, Sweden
| | - Tomas Weitoft
- Department of Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Ann Knight
- Section of Rheumatology, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | | | - Anders Larsson
- Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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23
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de Paz Poves C, Barneo-Caragol C, Cillero Sánchez AI, Jimenez Mendiguchia L, Quirós Caso C, Moreno Rodríguez M, López González FJ, Prieto García MB. Evaluation of DiaSorin Liaison ® calprotectin fecal assay adapted for pleural effusion. Adv Lab Med 2023; 4:419-424. [PMID: 38106502 PMCID: PMC10724856 DOI: 10.1515/almed-2023-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/13/2023] [Indexed: 12/19/2023]
Abstract
Objectives Calprotectin (CP) is a calcium and zinc binding protein that is widely measured on faecal samples but its determination in other biological fluids might be of interest. The aim of this work was to validate the measurement of CP in pleural fluid by chemiluminescence. Methods LIAISON®XL, a fully automated chemiluminescence analyzer, was used for CP quantification on pleural fluid. A validation protocol was designed using both quality control materials provided by the manufacturer and pools of pleural fluid samples. Stability, imprecision, bias, linearity, detection capability and carry over effect were evaluated. Results CP was stable on pleural fluid at least one week, under refrigerated conditions, and four weeks at -80 °C. The observed intra- and inter-day imprecision was between 2.2 and 6.49 %, with a negative bias under 5.51 %. The linearity of the method was verified up to 2,000 ng/mL. The LoQ for the assay was 48.52 ng/mL. A statistically significant carry-over effect was observed after measuring CP concentrations above the upper limit of linearity, but given the observed magnitude, a clinically relevant impact should not be expected. Conclusions DiaSorin Liaison® calprotectin assay allows reliable measurement of CP in pleural fluid.
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Affiliation(s)
- Cristina de Paz Poves
- Laboratory of Medicine, Department of Clinical Biochemistry, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Clara Barneo-Caragol
- Laboratory of Medicine, Department of Clinical Biochemistry, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | | | - Covadonga Quirós Caso
- Laboratory of Medicine, Department of Clinical Biochemistry, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - María Moreno Rodríguez
- Department of Clinical Biochemistry, Hospital Universitario San Agustín, Avilés, Asturias, Spain
| | | | - Mᵃ Belén Prieto García
- Laboratory of Medicine, Department of Clinical Biochemistry, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Memi T, Koletsos N, Gerolymatou N, Karakosta M, Georgiadis AN, Drosos AA, Voulgari PV. Clinical, Serological, and Immunological Characteristics of Greek Patients with Polymyalgia Rheumatica and/or Giant Cell Arteritis: A Research Protocol. Mediterr J Rheumatol 2023; 34:577-580. [PMID: 38282939 PMCID: PMC10815527 DOI: 10.31138/mjr.050923.csa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/30/2024] Open
Abstract
Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA) are chronic inflammatory disorders that usually affect older people. Although the aetiology of these diseases remains unknown, genetic, environmental, and immune factors have been implicated. Specific cytokines such as the IL-6, IL-1β, IL-12, IL-17, and interferon -γ seem to play an essential role. The diagnosis of the disease is usually based on clinical manifestations and the use of histology or imaging, while disease monitoring is based on physical examination, laboratory, and imaging findings. However, there is the unmet need in identifying possible biomarkers that could help the diagnosis and the monitoring as well. The present study aims to investigate the epidemiological, clinical, and immunological characteristics of PMR and/or GCA patients in the region of northwest Greece and to evaluate the role of specific molecules associated with the pathogenesis of the diseases, giving evidence to possible future biomarkers.
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Affiliation(s)
- Tereza Memi
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Nikolaos Koletsos
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Nafsika Gerolymatou
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Maria Karakosta
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Athanasios N. Georgiadis
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Alexandros A. Drosos
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Paraskevi V. Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
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Park S, Song J, Park MA, Jang HJ, Son S, Kim DH, Kim Y. Assessing the Probiotic Effects of Pediococcus pentosaceus CACC616 in Weaned Piglets. Microorganisms 2023; 11:2890. [PMID: 38138034 PMCID: PMC10746064 DOI: 10.3390/microorganisms11122890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
During weaning, piglets experience various stressor events that disrupt their gut microbiota and immune balance, decrease growth parameters, and increase mortality rates. In this study, we assessed the efficacy of Pediococcus pentosaceus CACC616 as a probiotic supplement. We characterized this strain and evaluated its effect on improving growth performance, modulating gut microbiota composition, and reducing noxious odor components in weaned piglets compared to a non-supplementary diet (control). During the 26-day period, 40 crossbred weaned piglets were randomly assigned to pens with 20 animals each in two groups: control and treatment groups with CACC616. On day 26, the treatment group exhibited a lower feed conversion ratio (FCR) and a significant alteration in gut microbial composition, correlating with improved growth parameters and gut health (p < 0.05). The treatment group also exhibited significantly reduced digestibility- and intestinal-environment-related noxious odor components (p < 0.05). The CACC616 strain effectively reduced pathogenic genera numbers, including Campylobacter, Mogibacterium, Escherichia-Shigella, and Desulfovibrio spp., with the treatment group exhibiting lower fecal calprotectin levels than the control group (p < 0.05). Overall, this study revealed that the functional probiotic CACC616 contributes to enhanced FCR and effectively modulates weaned piglets' inflammation and intestinal microbiota.
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Affiliation(s)
- Soyeon Park
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
| | - Jeongsup Song
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
| | - Mi Ae Park
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
| | - Hyun-Jun Jang
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
| | - Seoyun Son
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
| | - Dae-Hyuk Kim
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
- Department of Molecular Biology, Institute for Molecular Biology and Genetics, Jeonbuk National University, Jeonju 54896, Republic of Korea
- Department of Bioactive Material Science, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Yangseon Kim
- Department of Research and Development, Center for Industrialization of Agricultural and Livestock Microorganisms, Jeongeup 56212, Republic of Korea; (S.P.); (J.S.); (M.A.P.); (H.-J.J.); (S.S.); (D.-H.K.)
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Hong L, Huang Y, Han J, Li S, Zhang L, Jiang S, Zhou Q, Cao X, Yu W, Yang Y, Hong S, Zhou Y, Yan W, Cao Y. Dynamics and Crosstalk between Gut Microbiota, Metabolome, and Fecal Calprotectin in Very Preterm Infants: Insights into Feeding Intolerance. Nutrients 2023; 15:4849. [PMID: 38004243 PMCID: PMC10674500 DOI: 10.3390/nu15224849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Feeding intolerance (FI) is a significant concern in the care of preterm infants, impacting their growth and development. We previously reported that FI is linked to lower fecal calprotectin (FC) levels. This study aims to explore the postnatal dynamics and interplay between microbiota, metabolic profiles, and host immunity in preterm infants with and without FI. METHODS Infants with gestational age <32 weeks or birth weight <1500 g were enrolled at the Children's Hospital of Fudan University between January 2018 and October 2020. Weekly fecal samples were analyzed for bacterial profiling, metabolome, and calprotectin levels, exploring their longitudinal development and interrelationships. RESULTS Of the 118 very preterm infants studied, 48 showed FI. These infants experienced an interrupted microbial-immune trajectory, particularly at 3-4 weeks of age, marked by a reduced bacterial abundance, alpha diversity, and FC levels. Metabolic changes in FI were pronounced between 3 and 6 weeks. Pantothenic acid and two polyamine metabolites were closely associated with bacterial abundance and FC levels and negatively correlated with the duration to attain full enteral feeding. CONCLUSIONS FI infants demonstrated compromised microbiome-immune interactions, potentially influenced by specific metabolites. This research underscored the importance of early microbial and metabolic development in the pathogenesis of FI in very preterm infants.
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Affiliation(s)
- Luyang Hong
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yihuang Huang
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Junyan Han
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Shujuan Li
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Lan Zhang
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Siyuan Jiang
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Qi Zhou
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Xincheng Cao
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Weiyin Yu
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yi Yang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China; (Y.Y.)
| | - Shangyu Hong
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai 200438, China;
| | - Yufeng Zhou
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China; (Y.Y.)
| | - Weili Yan
- Department of Clinical Epidemiology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yun Cao
- Department of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China; (Y.Y.)
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Syal G, Mishkin DS, Banty A, Lee S, Fontelera N, Hampton M, Ziring D, Fleshner PR, Melmed GY. Effectiveness of Oral Tofacitinib in Chronic Pouchitis: A Prospective, Open-Label Pilot Study. Inflamm Bowel Dis 2023:izad191. [PMID: 37898112 DOI: 10.1093/ibd/izad191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 10/30/2023]
Abstract
Oral tofacitinib can be effective in inducing response and remission in patients with chronic antibiotic refractory pouchitis. In addition to improving symptoms and quality of life, it can lead to improvement in endoscopic inflammation score and fecal calprotectin.
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Affiliation(s)
- Gaurav Syal
- Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, CA, USA
| | | | - Andrea Banty
- Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susie Lee
- Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Norma Fontelera
- Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Melissa Hampton
- Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - David Ziring
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Phillip R Fleshner
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gil Y Melmed
- Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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28
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Kudoh M, Kakiuchi T, Yoshiura M, Esaki M, Matsuo M. Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report. Medicine (Baltimore) 2023; 102:e35448. [PMID: 37904372 PMCID: PMC10615447 DOI: 10.1097/md.0000000000035448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/31/2023] [Indexed: 11/01/2023] Open
Abstract
RATIONALE Juvenile polyps (JPs) are the most common polyp type and can be observed in 1% of all preschoolers. The peak incidence is observed at ages 3 to 5 years, constituting 90% of all polyps in children. Elevated levels of fecal calprotectin (FC) are often seen in children with JPs. PATIENT CONCERNS A 15-month-old girl was referred to our hospital for blood on the stool surface persisting for 3 months. She was healthy, with no abdominal pain, diarrhea, anorexia, or weight loss and no complaints other than hematochezia. Her physical examination, vital signs and laboratory date were unremarkable. DIAGNOSIS JPs. INTERVENTION Total colonoscopy for her found 2 JPs in the sigmoid colon, which were subsequently resected endoscopically. OUTCOMES At the age of 5 years, this patient again had bloody stools. Her FC measurement at that time was 1020 mg/kg, which normalized to 42 mg/kg 3 months after her second resection. LESSONS Single or multiple solitary JPs require follow-up that fully considers the possibility of recurrence. Establishing a method for early confirmation of JP recurrence based on bloody stools, fecal occult blood testing, and FC measurement is necessary.
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Affiliation(s)
- Maika Kudoh
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Masato Yoshiura
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
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29
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Saviano A, Petruzziello C, Zanza C, Candelli M, Gabrielli M, Migneco A, Franceschi F, Ojetti V. Role of Fecal Calprotectin in Patients Presenting to the Emergency Department with Abdominal Pain with or without Diarrhea or Rectal Bleeding. Rev Recent Clin Trials 2023:RRCT-EPUB-135647. [PMID: 37921137 DOI: 10.2174/0115748871259008231006071656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Abdominal pain is a frequent reason for admission to the Emergency Department. It may be a symptom of an underlying "organic" disease or a "functional" manifestation without an underlying anatomic or physiologic alteration. The evaluation of patients with abdominal pain is a challenge for the emergency physician and the selection of patients for second-level radiological examinations or endoscopic procedures is not always easy to perform. Faecal calprotectin could be a useful diagnostic marker to distinguish between "organic" or "functional" form and its determination could be helpful to select patients for further examinations in the context of an emergency setting. MATERIALS AND METHODS This is an observational and retrospective study on 146 patients with abdominal pain and/or diarrhea (with or without rectal bleeding) admitted to the Emergency Department of Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, who collected a fecal sample to evaluate fecal calprotectin. We evaluated and correlated the level of fecal calprotectin with the final diagnosis they received. RESULTS 50/146 patients (34,24%) received a diagnosis of acute diverticulitis, in particular, 14/50 (28%) were complicated and 36/50 (72%) were uncomplicated; 4/146 (2,7%) were cholangitis, 32/146 (21,9%) were colitis, 6/146 (4,1%) gastritis, 42/146 (28,7%), Irritable bowel syndrome and 12/146 (8,2%) Inflammatory bowel disease. For the differential diagnosis between Irriable or inflammatory bowel diseses, our study showed a VPP and a VPN of 100% meanwhile for the differential diagnosis between Acute complicated and uncomplicated diverticulitis, our study showed a VPP of 40% and a VPN of 84%. CONCLUSION In the emergency setting, faecal calprotectin could be a helpful marker to select patients with abdominal pain who need second-level radiological examinations or endoscopic procedures, guiding the emergency physician in the evaluation of such a complex and wideranging symptom.
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Affiliation(s)
- Angela Saviano
- Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
| | - Carmine Petruzziello
- Department of Emergency Medicine-Ospedale San Carlo di Nancy GVM care and research, Rome
| | - Christian Zanza
- Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
| | - Marcello Candelli
- Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
| | - Maurizio Gabrielli
- Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
| | - Alessio Migneco
- Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
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30
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Nouri M, Weström B, Lavasani S. Elevated Fecal Calprotectin Accompanied by Intestinal Neutrophil Infiltration and Goblet Cell Hyperplasia in a Murine Model of Multiple Sclerosis. Int J Mol Sci 2023; 24:15367. [PMID: 37895046 PMCID: PMC10606994 DOI: 10.3390/ijms242015367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system caused by myelin-specific autoreactive T cells. We previously demonstrated intestinal barrier disruption and signs of inflammation in experimental autoimmune encephalomyelitis (EAE), a model of MS. Fecal calprotectin is a disease activity biomarker in inflammatory bowel diseases, released by neutrophils in response to inflammation. We aimed to further investigate EAE manifestations in the gastrointestinal tract and to determine whether calprotectin is a useful biomarker of intestinal inflammation in EAE. Calprotectin was analyzed in feces, cecal contents, and plasma of EAE mice. Infiltrating neutrophils and goblet cells were investigated in different parts of the gastrointestinal tract before the onset of neurological symptoms and during established disease. We found increased calprotectin levels in feces, cecal content, and plasma preceding EAE onset that further escalated during disease progression. Increased neutrophil infiltration in the intestinal tissue concomitant with IL-17 expression and myeloperoxidase activity was found to correlate well with clinical activity. Increased goblet cells in the intestine, similar to irritable bowel syndrome (IBS), were also observed. The results suggest calprotectin as a good biomarker of gastrointestinal inflammation in EAE and the potential of this model as a useful animal model for IBS.
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Affiliation(s)
- Mehrnaz Nouri
- ImmuneBiotech AB, Medicon Village, 223 63 Lund, Sweden
- Department of Biology, Lund University, 223 62 Lund, Sweden
| | - Björn Weström
- Department of Biology, Lund University, 223 62 Lund, Sweden
| | - Shahram Lavasani
- ImmuneBiotech AB, Medicon Village, 223 63 Lund, Sweden
- Department of Clinical Sciences Lund, Lund University, 221 85 Lund, Sweden
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31
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Parackova Z, Zentsova I, Bloomfield M, Klocperk A, Horvath R, Malcova H, Cebecauerova D, Sediva A. Expanded population of low-density neutrophils in juvenile idiopathic arthritis. Front Immunol 2023; 14:1229520. [PMID: 37915575 PMCID: PMC10616245 DOI: 10.3389/fimmu.2023.1229520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Juvenile idiopathic arthritis (JIA), a clinically variable disease characterized by autoimmune arthritis, affects children, and its immunopathology remains elusive. Alterations in neutrophil biology play an important role in this disease. In the present study, we aimed to explore the features of low-density neutrophils (LDNs) in patients with JIA. Methods Gene expression of peripheral blood mononuclear cells (PBMCs) from children with distinct subtypes of JIA was analyzed by NanoString Immunology panel. Presence of LDNs was ascertained by flow cytometry and the release of neutrophil-associated products were analyzed by LUMINEX. Results LDNs were detected in patients' peripheral blood mononuclear cells (PBMCs) after density gradient centrifugation. Transcriptomic analysis of JIA PBMCs revealed that genes related to neutrophil degranulation were markedly upregulated. The number of LDNs and level of their degranulation products increased in patients' PBMCs and correlated with serum calprotectin, but not with disease activity, sedimentation rate and C-reactive protein (CRP) levels. The phenotypes of LDNs varied from those of normal-density neutrophils and healthy donor LDNs. Phenotypical analysis revealed LDNs are immature and primed population with decreased suppressive capacity. A negative correlation between surface proteins CD62L, CD66b, and CD11b and the number of inflamed joints/JADAS was established. Conclusion Our results describe LDNs as primed, degranulated, immature cells with impaired suppressive activities. This work thus contributes to the increasing body of evidence that LDNs in JIA are altered and their role in the disease immunopathogenesis and possible clinical associations should be investigated further.
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Affiliation(s)
- Zuzana Parackova
- Department of Immunology, 2nd Faculty of Medicine Charles University, University Hospital in Motol, Prague, Czechia
| | - Irena Zentsova
- Department of Immunology, 2nd Faculty of Medicine Charles University, University Hospital in Motol, Prague, Czechia
| | - Marketa Bloomfield
- Department of Immunology, 2nd Faculty of Medicine Charles University, University Hospital in Motol, Prague, Czechia
| | - Adam Klocperk
- Department of Immunology, 2nd Faculty of Medicine Charles University, University Hospital in Motol, Prague, Czechia
| | - Rudolf Horvath
- Department of Paediatric and Adult Rheumatology, University Hospital in Motol, Prague, Czechia
| | - Hana Malcova
- Department of Paediatric and Adult Rheumatology, University Hospital in Motol, Prague, Czechia
| | - Dita Cebecauerova
- Department of Paediatric and Adult Rheumatology, University Hospital in Motol, Prague, Czechia
| | - Anna Sediva
- Department of Immunology, 2nd Faculty of Medicine Charles University, University Hospital in Motol, Prague, Czechia
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32
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Mellett L, Amarasinghe G, Farnsworth CW, Khader SA. Elevated Level of Circulating but Not Urine S100A8/A9 Identifies Poor COVID-19 Outcomes. ACS Infect Dis 2023; 9:1815-1820. [PMID: 37787461 PMCID: PMC10580308 DOI: 10.1021/acsinfecdis.3c00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Indexed: 10/04/2023]
Abstract
The alarmin calprotectin (S100A8/A9) is thought to drive a cytokine storm, a hallmark of severe COVID-19. Recent studies report circulating S100A8/A9 levels can distinguish COVID-19 severity but have only been conducted in non-U.S. cohorts and mainly focus on serum S100A8/A9 levels. Thus, we quantified S100A8/A9 in serum and urine samples from a hospital cohort in St. Louis, Missouri, to expand the understanding of S100A8/A9 as a prognostic biomarker for COVID-19. Elevated S100A8/A9 serum levels were observed in ICU patients (n = 49, p = 0.0370) and patients with fatal cases of COVID-19 (n = 76, p = 0.0018). We observed no correlation in the S100A8/A9 levels in matched serum and urine samples. Our results support the association of serum S100A8/A9 levels with COVID-19 severity and suggest that further investigation of urine S100A8/A9 as a COVID-19 biomarker is not warranted.
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Affiliation(s)
- Leah Mellett
- Department
of Molecular Microbiology, Washington University
in St. Louis, St. Louis, Missouri 63108, United States
- Department
of Pathology and Immunology, Washington
University School of Medicine, St. Louis, Missouri 63108, United States
| | - Gaya Amarasinghe
- Department
of Pathology and Immunology, Washington
University School of Medicine, St. Louis, Missouri 63108, United States
| | - Christopher W. Farnsworth
- Department
of Pathology and Immunology, Washington
University School of Medicine, St. Louis, Missouri 63108, United States
| | - Shabaana A. Khader
- Department
of Molecular Microbiology, Washington University
in St. Louis, St. Louis, Missouri 63108, United States
- Department
of Microbiology, University of Chicago, Chicago, Illinois 60637 United States
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33
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Cantoro L, Monterubbianesi R, Falasco G, Camastra C, Pantanella P, Allocca M, Cosintino R, Faggiani R, Danese S, Fiorino G. The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease. Diagnostics (Basel) 2023; 13:3183. [PMID: 37892004 PMCID: PMC10605540 DOI: 10.3390/diagnostics13203183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Delayed diagnosis is a challenge in the management of inflammatory bowel disease (IBD). Several studies show a significant association between diagnostic delay and disease progression to complications and surgery, especially in Crohn's disease (CD). What risk factors are associated with diagnostic delay in IBD remains unclear. In order to reduce diagnostic delay, the Red Flags Index has been developed and validated. The combination of the Red Flags Index score and non-invasive biomarkers such as fecal calprotectin seems to be highly accurate in screening patients with underlying IBD to be referred for further diagnostic workup and eventual early effective treatment strategies. Our literature review aims to obtain a comprehensive overview of the impacts of diagnostic delay in IBD on the potential risk factors associated with IBD, how diagnostic tools may be effective in reducing diagnostic delay, and future perspectives in this field.
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Affiliation(s)
- Laura Cantoro
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Rita Monterubbianesi
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Giuliano Falasco
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Caterina Camastra
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Paolo Pantanella
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Mariangela Allocca
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
| | - Rocco Cosintino
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Roberto Faggiani
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
| | - Silvio Danese
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
| | - Gionata Fiorino
- IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.C.); (G.F.)
- Department of Gastroenterology and Digestive Endoscopy and Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.A.); (S.D.)
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Barberio B, Gracie DJ, Black CJ, Ford AC. Impact of Baseline Disease Activity and Trial Duration on Efficacy of Biologics in Active Crohn's Disease: Meta-analysis. Inflamm Bowel Dis 2023; 29:1594-1601. [PMID: 36637168 DOI: 10.1093/ibd/izac263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Timings of assessment of efficacy and criteria used to define Crohn's disease (CD) activity at baseline may affect therapeutic gain of active drug over placebo in induction of remission trials in CD, but these issues have not been assessed systematically. We examined these issues in a meta-analysis. METHODS We searched the literature to June 2022 for randomized controlled trials of biologics vs placebo in active CD. We extracted clinical remission and response rates according to criteria used to define CD activity and time point of assessment, pooling them in a meta-analysis for all patients according to previous biologic exposure. We calculated the number needed to treat (NNT), with a 95% confidence interval (CI) to assess therapeutic gain of active drug over placebo according to these characteristics of trial design. RESULTS We identified 20 induction of remission trials (6754 patients). Rates of clinical remission were highest (42.6% with active drug vs 21.0% with placebo) and NNT lowest (5; 95% CI, 3-7.5) in trials using clinical and endoscopic activity to define active CD. Rates of remission were lower (26.5% with active drug, vs 18.6% with placebo) and NNT highest (12; 95% CI, 6-61) in trials using clinical activity alone. Results were similar according to previous biologic exposure. Time point of assessment seemed to have less of an effect, although the NNT was lowest in trials assessing remission rates at 9 to 12 weeks (NNT = 5.5; 95% CI, 4-8). Again, results were similar according to previous biologic exposure. CONCLUSIONS Both the criteria used to define CD activity at study entry and the time point used to confirm efficacy may be important in maximizing therapeutic gain of active drug over placebo.
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Affiliation(s)
- Brigida Barberio
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Gastroenterology Unit, University of Padova-Azienda Ospedaliera di Padova, Via Giustiniani 2, Padova 35128, Italy
| | - David J Gracie
- Leeds Gastroenterology Institute, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK
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Fedulovs A, Tzivian L, Zalizko P, Ivanova S, Bumane R, Janeviča J, Krūzmane L, Krustins E, Sokolovska J. Progression of Diabetic Kidney Disease and Gastrointestinal Symptoms in Patients with Type I Diabetes. Biomedicines 2023; 11:2679. [PMID: 37893052 PMCID: PMC10604159 DOI: 10.3390/biomedicines11102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: Little research is conducted on the link between diabetic kidney disease (DKD) progression and diabetic gastroenteropathy in type 1 diabetes (T1D). (2) Methods. We performed a cross-sectional study with 100 T1D patients; 27 of them had progressive DKD, defined as an estimated glomerular filtration rate (eGFR) decline ≥3 mL/min/year or increased albuminuria stage, over a mean follow-up time of 5.89 ± 1.73 years. A newly developed score with 17 questions on gastrointestinal (GI) symptoms was used. Faecal calprotectin was measured by ELISA. Lower GI endoscopies were performed in 21 patients. (3) Results: The gastrointestinal symptom score demonstrated high reliability (Cronbach's α = 0.78). Patients with progressive DKD had higher GI symptom scores compared to those with stable DKD (p = 0.019). The former group demonstrated more frequent bowel movement disorders (p < 0.01). The scores correlated negatively with eGFR (r = -0.335; p = 0.001), positively with albuminuria (r = 0.245; p = 0.015), Hba1c (r = 0.305; p = 0.002), and diabetes duration (r = 0.251; p = 0.012). Faecal calprotectin levels did not differ between DKD groups significantly. The most commonly reported histopathological findings of enteric mucosa were infiltration with eosinophils, lymphocytes, plasmacytes, the presence of lymphoid follicles, and lymphoid aggregates. Conclusion: The progression of DKD is positively correlated with gastrointestinal symptoms; however, more research is needed to clarify the causal relationships of the gut-kidney axis in T1D.
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Affiliation(s)
- Aleksejs Fedulovs
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
| | - Lilian Tzivian
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
| | - Polina Zalizko
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV 1002 Riga, Latvia;
| | - Santa Ivanova
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
| | - Renāte Bumane
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
| | - Jana Janeviča
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV 1002 Riga, Latvia;
| | - Lelde Krūzmane
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
| | - Eduards Krustins
- Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV 1002 Riga, Latvia;
| | - Jelizaveta Sokolovska
- Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia; (A.F.); (L.T.); (P.Z.); (S.I.); (R.B.); (J.J.); (L.K.)
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da Rocha IMG, Torrinhas R, Fonseca D, Lyra CDO, de Sousa Alves Neri JL, Balmant BD, Callado L, Charlton K, Queiroz N, Waitzberg DL. Pro-Inflammatory Diet Is Correlated with High Veillonella rogosae, Gut Inflammation and Clinical Relapse of Inflammatory Bowel Disease. Nutrients 2023; 15:4148. [PMID: 37836432 PMCID: PMC10574102 DOI: 10.3390/nu15194148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/16/2023] [Accepted: 09/17/2023] [Indexed: 10/15/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are chronic conditions arising from an intricate interplay of genetics and environmental factors, and are associated with gut dysbiosis, inflammation, and gut permeability. In this study, we investigated whether the inflammatory potential of the diet is associated with the gut microbiota profile, inflammation, and permeability in forty patients with IBD in clinical remission. The dietary inflammatory index (DII) score was used to assess the inflammatory potential of the diet. The fecal microbiota profile was analyzed using 16SrRNA (V3-V4) gene sequencing, while fecal zonulin and calprotectin levels were measured with enzyme-linked immunosorbent assays. We found a positive correlation between the DII score and elevated calprotectin levels (Rho = 0.498; p = 0.001), but not with zonulin levels. Although α- and β-diversity did not significantly differ across DII quartiles, the most pro-inflammatory diet group exhibited a higher fecal abundance of Veillonella rogosae (p = 0.026). In addition, the abundance of some specific bacteria sequences showed an exponential behavior across DII quartiles and a correlation with calprotectin or zonulin levels (p ≤ 0.050). This included a positive correlation between sq702. Veillonella rogosae and fecal calprotectin levels (Rho = 0.419, p = 0.007). DII, calprotectin, and zonulin levels were identified as significant predictors of 6-month disease relapse (p ≤ 0.050). Our findings suggest a potential relationship of a pro-inflammatory diet intake with Veillonella rogosae and calprotectin levels in IBD patients in clinical remission, which may contribute to disease relapse.
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Affiliation(s)
- Ilanna Marques Gomes da Rocha
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Raquel Torrinhas
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Danielle Fonseca
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Clelia de Oliveira Lyra
- Department of Nutrition, Universidade Federal do Rio Grande do Norte, Natal 59078-900, RN, Brazil
| | - Julianna Lys de Sousa Alves Neri
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Bianca Depieri Balmant
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Letícia Callado
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Karen Charlton
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Natalia Queiroz
- Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
| | - Dan L. Waitzberg
- Laboratory of Nutrition and Metabolic Surgery (LIM-35), Department of Gastroenterology, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo 05508-070, SP, Brazil
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Vázquez-Cuesta S, Lozano García N, Fernández AI, Olmedo M, Kestler M, Alcalá L, Marín M, Bermejo J, Díaz FFA, Muñoz P, Bouza E, Reigadas E. Microbiome profile and calprotectin levels as markers of risk of recurrent Clostridioides difficile infection. Front Cell Infect Microbiol 2023; 13:1237500. [PMID: 37780848 PMCID: PMC10534046 DOI: 10.3389/fcimb.2023.1237500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Clostridioides difficile infection (CDI) is the main cause of nosocomial diarrhoea in developed countries. Recurrent CDI (R-CDI), which affects 20%-30% of patients and significantly increases hospital stay and associated costs, is a key challenge. The main objective of this study was to explore the role of the microbiome and calprotectin levels as predictive biomarkers of R-CDI. Methods We prospectively (2019-2021) included patients with a primary episode of CDI. Clinical data and faecal samples were collected. The microbiome was analysed by sequencing the hypervariable V4 region of the 16S rRNA gene on an Illumina Miseq platform. Results We enrolled 200 patients with primary CDI, of whom 54 developed R-CDI and 146 did not. We analysed 200 primary samples and found that Fusobacterium increased in abundance, while Collinsella, Senegalimassilia, Prevotella and Ruminococcus decreased in patients with recurrent versus non-recurrent disease. Elevated calprotectin levels correlated significantly with R-CDI (p=0.01). We built a risk index for R-CDI, including as prognostic factors age, sex, immunosuppression, toxin B amplification cycle, creatinine levels and faecal calprotectin levels (overall accuracy of 79%). Discussion Calprotectin levels and abundance of microbial genera such as Fusobacterium and Prevotella in primary episodes could be useful as early markers of R-CDI. We propose a readily available model for prediction of R-CDI that can be applied at the initial CDI episode. The use of this tool could help to better tailor treatments according to the risk of R-CDI.
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Affiliation(s)
- Silvia Vázquez-Cuesta
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Biochemistry and Molecular Biology Department, Faculty of Biology, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Nuria Lozano García
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ana I. Fernández
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Olmedo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Martha Kestler
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Luis Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - Mercedes Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - Javier Bermejo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Francisco Fernández-Avilés Díaz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro de Investigación Biomédica en red de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - Elena Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
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Caproli A, Pina SD, Vezzoli M, Cavazzana I, Airò P, Brugnoni D, Franceschini F, Garrafa E, Piantoni S. Calprotectin as a biomarker in rheumatoid arthritis: the potential predictive value of response to treatment. Bioanalysis 2023; 15:1111-1113. [PMID: 37584369 DOI: 10.4155/bio-2023-0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Affiliation(s)
- Alessia Caproli
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
| | - Silvia Della Pina
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
| | - Marika Vezzoli
- Department of Molecular & Translational Medicine, University of Brescia, Brescia, 25100, Italy
| | - Ilaria Cavazzana
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
| | - Paolo Airò
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
| | - Duilio Brugnoni
- Department of Laboratory Diagnostics, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili, Brescia, 25100, Italy
| | - Franco Franceschini
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
| | - Emirena Garrafa
- Department of Molecular & Translational Medicine, University of Brescia, Brescia, 25100, Italy
- Department of Laboratory Diagnostics, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili, Brescia, 25100, Italy
| | - Silvia Piantoni
- Rheumatology & Clinical Immunology Unit, Department of Clinical & Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili & University of Brescia, Brescia, 25100, Italy
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Kapel N, Ouni H, Benahmed NA, Barbot-Trystram L. Fecal Calprotectin for the Diagnosis and Management of Inflammatory Bowel Diseases. Clin Transl Gastroenterol 2023; 14:e00617. [PMID: 37440723 PMCID: PMC10522095 DOI: 10.14309/ctg.0000000000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/13/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Calprotectin is a heterodimeric calcium- and zinc-binding protein mainly derived from the cytoplasm of neutrophils that has direct antimicrobial functions and a role in the regulation of the innate immune response. It can be found in various biological compartments, in particular, the stool, with concentrations related to the level of mucosal inflammation. The measurement of fecal calprotectin has thus been recognized as a useful surrogate marker to distinguish patients with inflammatory bowel disease from those with irritable bowel syndrome. Moreover, it allows the monitoring of intestinal inflammation with a high negative predictive value, making it possible to exclude the diagnosis of inflammatory bowel disease for symptomatic patients. It also shows high sensitivity for the identification of patients requiring additional examinations for diagnosis, such as colonoscopy, and the evaluation of therapeutic responses, providing evidence of relapse or mucosal healing, which can lead to the intensification or reduction of treatment. As calprotectin levels are a measure of mucosal inflammation, high fecal concentrations are also found in other diseases with an inflammatory component, such as infectious enteritis or colorectal cancer. Interpretation of the concentration must therefore always take into account the clinical history and symptoms specific to each patient.
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Affiliation(s)
- Nathalie Kapel
- Laboratoire de Coprologie Fonctionnelle, Laboratoire de Biologie Médicale de Référence «Exploration Biochimique des Selles (Phénotype)», AP–HP, Hôpital Universitaire Pitié Salpêtrière-Charles Foix, Paris, France
- INSERM UMR-S1139, Faculté de Pharmacie, Université de Paris Cité, Paris, France
| | - Hamza Ouni
- Laboratoire de Coprologie Fonctionnelle, Laboratoire de Biologie Médicale de Référence «Exploration Biochimique des Selles (Phénotype)», AP–HP, Hôpital Universitaire Pitié Salpêtrière-Charles Foix, Paris, France
| | - Nacer Adam Benahmed
- Laboratoire de Coprologie Fonctionnelle, Laboratoire de Biologie Médicale de Référence «Exploration Biochimique des Selles (Phénotype)», AP–HP, Hôpital Universitaire Pitié Salpêtrière-Charles Foix, Paris, France
| | - Laurence Barbot-Trystram
- Laboratoire de Coprologie Fonctionnelle, Laboratoire de Biologie Médicale de Référence «Exploration Biochimique des Selles (Phénotype)», AP–HP, Hôpital Universitaire Pitié Salpêtrière-Charles Foix, Paris, France
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Razmkhah F, Kim S, Lim S, Dania AJ, Choi J. S100A8 and S100A9 in Hematologic Malignancies: From Development to Therapy. Int J Mol Sci 2023; 24:13382. [PMID: 37686186 PMCID: PMC10488294 DOI: 10.3390/ijms241713382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
S100A8 and S100A9 are multifunctional proteins that can initiate various signaling pathways and modulate cell function both inside and outside immune cells, depending on their receptors, mediators, and molecular environment. They have been reported as dysregulated genes and proteins in a wide range of cancers, including hematologic malignancies, from diagnosis to response to therapy. The role of S100A8 and S100A9 in hematologic malignancies is highlighted due to their ability to work together or as antagonists to modify cell phenotype, including viability, differentiation, chemosensitivity, trafficking, and transcription strategies, which can lead to an oncogenic phase or reduced symptoms. In this review article, we discuss the critical roles of S100A8, S100A9, and calprotectin (heterodimer or heterotetramer forms of S100A8 and S100A9) in forming and promoting the malignant bone marrow microenvironment. We also focus on their potential roles as biomarkers and therapeutic targets in various stages of hematologic malignancies from diagnosis to treatment.
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Affiliation(s)
| | | | | | | | - Jaebok Choi
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; (F.R.); (S.K.); (S.L.); (A.-J.D.)
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von Wulffen M, Luehrmann V, Robeck S, Russo A, Fischer-Riepe L, van den Bosch M, van Lent P, Loser K, Gabrilovich DI, Hermann S, Roth J, Vogl T. S100A8/A9-alarmin promotes local myeloid-derived suppressor cell activation restricting severe autoimmune arthritis. Cell Rep 2023; 42:113006. [PMID: 37610870 DOI: 10.1016/j.celrep.2023.113006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/11/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023] Open
Abstract
Immune-suppressive effects of myeloid-derived suppressor cells (MDSCs) are well characterized during anti-tumor immunity. The complex mechanisms promoting MDSC development and their regulatory effects during autoimmune diseases are less understood. We demonstrate that the endogenous alarmin S100A8/A9 reprograms myeloid cells to a T cell suppressing phenotype during autoimmune arthritis. Treatment of myeloid precursors with S100-alarmins during differentiation induces MDSCs in a Toll-like receptor 4-dependent manner. Consequently, knockout of S100A8/A9 aggravates disease activity in collagen-induced arthritis due to a deficit of MDSCs in local lymph nodes, which could be corrected by adoptive transfer of S100-induced MDSCs. Blockade of MDSC function in vivo aggravates disease severity in arthritis. Therapeutic application of S100A8 induces MDSCs in vivo and suppresses the inflammatory phenotype of S100A9ko mice. Accordingly, the interplay of T cell-mediated autoimmunity with a defective innate immune regulation is crucial for autoimmune arthritis, which should be considered for future innovative therapeutic options.
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Affiliation(s)
- Meike von Wulffen
- Institute of Immunology, University of Münster, Münster, Germany; Interdisciplinary Center of Clinical Research (IZKF), University of Münster, Münster, Germany
| | | | - Stefanie Robeck
- Institute of Immunology, University of Münster, Münster, Germany
| | - Antonella Russo
- Institute of Immunology, University of Münster, Münster, Germany
| | | | - Martijn van den Bosch
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter van Lent
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karin Loser
- Department of Human Medicine, University of Oldenburg, Oldenburg, Germany
| | | | - Sven Hermann
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
| | - Johannes Roth
- Institute of Immunology, University of Münster, Münster, Germany; Interdisciplinary Center of Clinical Research (IZKF), University of Münster, Münster, Germany
| | - Thomas Vogl
- Institute of Immunology, University of Münster, Münster, Germany; Interdisciplinary Center of Clinical Research (IZKF), University of Münster, Münster, Germany.
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Havelka A, Larsson AO, Mårtensson J, Bell M, Hultström M, Lipcsey M, Eriksson M. Analysis of Calprotectin as an Early Marker of Infections Is Economically Advantageous in Intensive Care-Treated Patients. Biomedicines 2023; 11:2156. [PMID: 37626653 PMCID: PMC10452832 DOI: 10.3390/biomedicines11082156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023] Open
Abstract
Calprotectin is released from neutrophil granulocytes upon activation. Several studies have indicated that plasma calprotectin is an early determinant of bacterial infections, which may serve as a diagnostic tool facilitating decision making on antibiotic treatment. The study objective was to explore the health and economic implications of calprotectin as a predictive tool to initiate antimicrobial therapy in a cohort of critically ill patients. Thus, data obtained from a previously published study on calprotectin as a hypothetical early biomarker of bacterial infections in critically ill patients were evaluated regarding the potential cost-effective impact of early analysis of calprotectin on an earlier start of antibiotic treatment. Under the assumption that calprotectin is used predictively and comparators (white blood cells, procalcitonin, and C-reactive protein) are used diagnostically, a cost-effective impact of EUR 11,000-12,000 per patient would be obtained. If calprotectin would be used predictively and comparators would be used predictively for 50% of patients, it is hypothesized that cost-effectiveness would be between EUR 6000 and 7000 per patient, based on reduced stay in the ICU and general ward, respectively. Furthermore, predictive use of calprotectin seems to reduce both mortality and the length of hospital stay. This health economic analysis on the predictive use of plasma calprotectin, which facilitates clinical decision making in cases of suspected sepsis, indicates that such determination has a cost-saving and life-saving impact on the healthcare system.
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Affiliation(s)
- Aleksandra Havelka
- Department of Molecular Medicine and Surgery, Karolinska Institute, 171 76 Stockholm, Sweden;
- Gentian Diagnostics AS, 1596 Moss, Norway
| | - Anders O. Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, 751 85 Uppsala, Sweden
| | - Johan Mårtensson
- Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Max Bell
- Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Michael Hultström
- Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Medical Cell Biology, Integrative Physiology, Uppsala University, 751 23 Uppsala, Sweden
- Department of Epidemiology, McGill University, Montréal, QC H3A 0G4, Canada
- Lady Davis Institute of Medical Research, Jewish General Hospital, Montréal, QC H3T 1E2, Canada
| | - Miklós Lipcsey
- Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden
| | - Mats Eriksson
- Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, 751 85 Uppsala, Sweden
- NOVA Medical School, New University of Lisbon, 1099-085 Lisbon, Portugal
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Michailidou D, Johansson L, Kuley R, Wang T, Hermanson P, Rantapää-Dahlqvist S, Lood C. Immune complex-mediated neutrophil activation in patients with polymyalgia rheumatica. Rheumatology (Oxford) 2023; 62:2880-2886. [PMID: 36562570 PMCID: PMC10393430 DOI: 10.1093/rheumatology/keac722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Neutrophils are important in host defence. However, neutrophils are also linked to inflammation and organ damage. The purpose of this study was to assess whether markers of neutrophil activation are increased in PMR. METHODS Levels of immune complexes (IC), calprotectin and neutrophil extracellular traps (NETs) were measured in plasma of healthy individuals (n = 30) and patients with PMR (n = 60), at flare and upon treatment with glucocorticoids using ELISA. Plasma-mediated neutrophil activation was assessed in presence of an FcγRIIA inhibitory antibody (IV.3). RESULTS Plasma levels of calprotectin and NETs were elevated in PMR (P < 0.001). Mechanistically, neutrophil activation was driven by ICs, present in plasma, able to up-regulate neutrophil activation markers CD66b and CD11b (P < 0.0001) in an FcγRIIA-dependent manner (P < 0.01). Of note, circulating levels of IC correlated with plasma induced CD66b and CD11b (r = 0.51, P = 0.004, and r = 0.46, P = 0.01, respectively) and decreased after glucocorticoid therapy. In contrast to NETs, calprotectin significantly decreased after glucocorticoid therapy (P < 0.001) and was higher in PMR without overlapping GCA compared with patients with overlapping disease (P = 0.014). Interestingly, musculoskeletal involvement was associated with elevated levels of calprotectin before initiation of glucocorticoid therapy (P = 0.036). CONCLUSIONS Neutrophil activation, including NET formation, is increased in PMR, through IC-mediated engagement of FcγRIIA. Clinically, neutrophil activation is associated with musculoskeletal involvement, with calprotectin, but not NETs, being a biomarker of treatment response in PMR patients. In all, IC-mediated neutrophil activation is a central process in PMR pathogenesis identifying potential novel therapeutic targets (FcγRIIA), as well as soluble markers for disease monitoring (calprotectin).
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Affiliation(s)
- Despina Michailidou
- Division of Rheumatology, Department of Medicine,University of Washington, Seattle, WA, USA
| | - Linda Johansson
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Runa Kuley
- Division of Rheumatology, Department of Medicine,University of Washington, Seattle, WA, USA
- Center of Life Sciences, Mahindra University, Hyderabad, India
| | - Ting Wang
- Division of Rheumatology, Department of Medicine,University of Washington, Seattle, WA, USA
| | - Payton Hermanson
- Division of Rheumatology, Department of Medicine,University of Washington, Seattle, WA, USA
| | | | - Christian Lood
- Division of Rheumatology, Department of Medicine,University of Washington, Seattle, WA, USA
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Fischer JAJ, Pei LX, Elango R, Hou K, Goldfarb DM, Karakochuk CD. Is a Lower Dose of More Bioavailable Iron (18-mg Ferrous Bisglycinate) Noninferior to 60-mg Ferrous Sulfate in Increasing Ferritin Concentrations While Reducing Gut Inflammation and Enteropathogen Detection in Cambodian Women? A Randomized Controlled Noninferiority Trial. J Nutr 2023; 153:2453-2462. [PMID: 37271416 DOI: 10.1016/j.tjnut.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Global guidelines recommend untargeted iron supplementation for women in regions of anemia prevalence ≥40%, such as Cambodia. However, the potential harms of untargeted iron on the gut have not been rigorously studied in women and likely vary depending on iron dose and form. OBJECTIVES We investigated if a lower dose of a highly bioavailable iron amino acid chelate was as effective as the standard dose of iron salts in increasing ferritin concentrations and whether any differences were observed in gut inflammation or enteropathogen detection. METHODS A double-blind, randomized placebo-controlled noninferiority trial was conducted in Cambodia. Nonpregnant women (n = 480, 18-45 y) were randomly assigned to 60-mg ferrous sulfate, 18-mg ferrous bisglycinate, or placebo for 12 wk. Nonfasting blood and stool specimens were collected at baseline and 12 wk. Ferritin and fecal calprotectin were measured with an ELISA. A molecular assay was used to detect 11 enteropathogens in a random subset of n = 100 women. Generalized linear mixed-effects models were used to estimate the adjusted mean difference in ferritin concentrations at 12 wk (primary outcome), as compared with our 'a priori' noninferiority margin of 20 μg/L. RESULTS Baseline anemia and iron deficiency prevalence was low (17% and 6%, respectively). The adjusted mean difference in ferritin concentrations between the iron groups was 14.6 (95% confidence interval [CI]: 7.6, 21.6) μg/L. Mean ferritin concentration at 12 wk was higher in the ferrous sulfate (99 [95% CI: 95, 103] μg/L, P < 0.001) than in ferrous bisglycinate (84 [95% CI: 80, 88] μg/L) and placebo groups (78 [95% CI: 74, 82] μg/L). No differences in fecal calprotectin concentrations or enteropathogen detection were observed across groups at 12 wk. CONCLUSIONS Ferrous bisglycinate (18-mg) was not as effective as ferrous sulfate (60-mg) in increasing ferritin concentrations and did not differentially influence biomarkers of gut health in this predominantly iron-replete population of Cambodian women. This trial was registered at clinicaltrials.gov registry as NCT04017598.
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Affiliation(s)
- Jordie A J Fischer
- Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Lulu X Pei
- Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Rajavel Elango
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, the University of British Columbia, Vancouver, Canada
| | - Kroeun Hou
- Helen Keller International, Phnom Penh, Cambodia
| | - David M Goldfarb
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pathology and Laboratory Medicine, the University of British Columbia, Vancouver, Canada
| | - Crystal D Karakochuk
- Food, Nutrition and Health, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada.
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Wirthgen E, Weber F, Kubickova-Weber L, Schiller B, Schiller S, Radke M, Däbritz J. Identifying predictors of clinical outcomes using the projection-predictive feature selection-a proof of concept on the example of Crohn's disease. Front Pediatr 2023; 11:1170563. [PMID: 37576142 PMCID: PMC10420065 DOI: 10.3389/fped.2023.1170563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Objectives Several clinical disease activity indices (DAIs) have been developed to noninvasively assess mucosal healing in pediatric Crohn's disease (CD). However, their clinical application can be complex. Therefore, we present a new way to identify the most informative biomarkers for mucosal inflammation from current markers in use and, based on this, how to obtain an easy-to-use DAI for clinical practice. A further aim of our proof-of-concept study is to demonstrate how the performance of such a new DAI can be compared to that of existing DAIs. Methods The data of two independent study cohorts, with 167 visits from 109 children and adolescents with CD, were evaluated retrospectively. A variable selection based on a Bayesian ordinal regression model was applied to select clinical or standard laboratory parameters as predictors, using an endoscopic outcome. The predictive performance of the resulting model was compared to that of existing pediatric DAIs. Results With our proof-of-concept dataset, the resulting model included C-reactive protein (CRP) and fecal calprotectin (FC) as predictors. In general, our model performed better than the existing DAIs. To show how our Bayesian approach can be applied in practice, we developed a web application for predicting disease activity for a new CD patient or visit. Conclusions Our work serves as a proof-of-concept, showing that the statistical methods used here can identify biomarkers relevant for the prediction of a clinical outcome. In our case, a small number of biomarkers is sufficient, which, together with the web interface, facilitates the clinical application. However, the retrospective nature of our study, the rather small amount of data, and the lack of an external validation cohort do not allow us to consider our results as the establishment of a novel DAI for pediatric CD. This needs to be done with the help of a prospective study with more data and an external validation cohort in the future.
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Affiliation(s)
- Elisa Wirthgen
- Department of Pediatrics, Rostock University Medical Center, Rostock, Germany
| | - Frank Weber
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, Rostock, Germany
| | | | - Benjamin Schiller
- Department of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, Germany
| | - Sarah Schiller
- Department of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, Germany
| | - Michael Radke
- Department of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, Germany
| | - Jan Däbritz
- Department of Pediatrics, Rostock University Medical Center, Rostock, Germany
- Department of Pediatrics, Pediatric Gastroenterology, Rostock University Medical Center, Rostock, Germany
- Department of Pediatrics, Greifswald University Medical Center, Greifswald, Germany
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Mahendra J, Muralidharan J, Srinivasan S, Mahendra L, Cherian SM, Fathima L, Prakash P, Namasivayam A, Dave PH, Bedi M, Muralidharan H. Calprotectin and periostin levels in periodontitis patients with coronary artery disease. Oral Dis 2023. [PMID: 37499075 DOI: 10.1111/odi.14686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE The aim of the study was to assess the effect of non-surgical periodontal therapy (NSPT) on periodontal and cardiac parameters as well as on the expression of calprotectin and periostin levels in periodontitis patients with and without coronary artery disease (CAD). METHODS Ninety subjects were categorised into three groups: Group H: periodontally and systemically healthy subjects, Group P: stage III grade B periodontitis subjects with no associated systemic diseases and Group P + CAD: stage III grade B periodontitis subjects diagnosed with CAD. Demographic, periodontal and cardiac parameters were recorded at baseline (0 day) and on the 180th day after NSPT. Gingival crevicular fluid was collected from all participants at baseline (0 day) and after the 180th day. Calprotectin and periostin expression were reassessed. RESULTS A significant increase in the levels of calprotectin (34.05 ± 11.72) was seen at baseline in the P + CAD group, whereas on the contrary, a decreased periostin (1.59 ± 0.41) was also noted at baseline. The study also showed a significant improvement in periodontal and cardiac parameters on the 180th day following NSPT. CONCLUSION Detection of calprotectin and periostin expression in GCF samples could represent a link to the association of periodontitis and CAD.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Janani Muralidharan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Sruthi Srinivasan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, India
| | - Lubna Fathima
- Department of Periodontology, Madha Dental College, Chennai, India
| | - Prashanthi Prakash
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | | | - Pavithra H Dave
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Harini Muralidharan
- Department of Pharmacy, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Pauwels RWM, Ten Bokkel Huinink S, van der Woude CJ, Doukas M, Oudijk L, de Vries AC. Early fecal calprotectin levels at week 8 may guide therapeutic decisions on Ustekinumab therapy in patients with Crohn's disease. Scand J Gastroenterol 2023; 58:980-987. [PMID: 36970968 DOI: 10.1080/00365521.2023.2194009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/12/2023] [Accepted: 03/19/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Response evaluation after induction therapy with ustekinumab (UST) in Crohn's disease (CD) is important for decisions on maintenance therapy. We aimed to assess the potential of fecal calprotectin (FC) levels to predict endoscopic response at week 16. METHODS CD patients with FC >100 µg/g and endoscopic active disease (SES-CD> 2, Rutgeerts' score ≥ i2) at initiation of UST therapy were enrolled. FC was determined at weeks 0, 2, 4, 8 and 16 and patients underwent a colonoscopy at week 16. The primary outcome was an endoscopic response at week 16 (SES-CD score ≥50% decrease or a decrease of ≥1 points in Rutgeerts' score). The optimal cut-off levels of FC and change in FC to predict endoscopic response were determined using ROC statistics. RESULTS 59 CD patients were included. Endoscopic response was observed in 21/59 (36%) patients. The diagnostic accuracy for FC levels at week 8 to predict endoscopic response at week 16 showed a predictive value of 0.71. A decrease in FC levels ≥500 µg/g between baseline at week 8 indicates endoscopic response (PPV = 89%), whereas absence of any decrease indicates endoscopic non-response after induction (NPV = 81%). CONCLUSIONS Continuation of UST therapy without endoscopic response evaluation may be considered in patients with a decrease in FC levels of ≥500 µg/g at week 8. The decision on continuation of UST therapy or therapy optimization needs reconsideration in patients without a decrease of FC level. In all other patients, endoscopic response evaluation of induction therapy remains essential for therapeutic decisions.
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Affiliation(s)
- Renske W M Pauwels
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - M Doukas
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - L Oudijk
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Annemarie C de Vries
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
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Nowak JK, Kalla R, Satsangi J. Current and emerging biomarkers for ulcerative colitis. Expert Rev Mol Diagn 2023; 23:1107-1119. [PMID: 37933807 DOI: 10.1080/14737159.2023.2279611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Ulcerative colitis (UC) is a chronic illness requiring lifelong management that could be enhanced by personalizing care using biomarkers. AREAS COVERED The main biomarker discovery modalities are reviewed, highlighting recent results across the spectrum of applications, including diagnostics (serum anti-αvβ6 antibodies achieving an area under the curve [AUC] = 0.99; serum oncostatin M AUC = 0.94), disease activity assessment (fecal calprotectin and serum trefoil factor 3: AUC > 0.90), prognostication of the need for treatment escalation (whole blood transcriptomic panels and CLEC5A/CDH2 ratio: AUC > 0.90), prediction of treatment response, and early identification of patients with subclinical disease. The use of established biomarkers is discussed, along with new evidence regarding autoantibodies, proteins, proteomic panels, transcriptomic signatures, deoxyribonucleic acid methylation patterns, and UC-specific glycomic and metabolic disturbances. EXPERT OPINION Novel biomarkers will pave the way for optimized UC care. However, validation, simplification, and direct clinical translation of complex models may prove challenging. Currently, few candidates exist to assess key characteristics, such as UC susceptibility, histological disease activity, drug response, and long-term disease behavior. Further research will likely not only reveal new tools to tackle these issues but also contribute to understanding UC pathogenesis mechanisms.
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Affiliation(s)
- Jan K Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Rahul Kalla
- Medical Research Council Centre for Inflammation Research, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Jack Satsangi
- Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine Division, University of Oxford, Oxford, UK
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Jandel AN, Heilmann RM, Sander H, Steiner JM, Grützner N, Xenoulis PG. Serum α 1-Proteinase Inhibitor, Calprotectin, and S100A12 Concentrations in the Characterization of Pancreatitis in Dogs. Vet Sci 2023; 10:428. [PMID: 37505833 PMCID: PMC10385135 DOI: 10.3390/vetsci10070428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
Miniature Schnauzers are predisposed to develop pancreatitis, with familial hypertriglyceridemia (HTG) described as a potential risk factor. Diagnosing pancreatitis in dogs is based on the integration of serum canine-specific pancreatic lipase (cPLI) concentration, clinical presentation, and diagnostic imaging findings. However, markers of systemic inflammation and antiprotease activity have not been extensively investigated in the characterization and prognostication of pancreatitis in dogs. Serum concentrations of alpha1-proteinase inhibitor (α1PI; as a marker of systemic antiprotease response) and calprotectin and S100A12 (as markers of systemic inflammation) were measured in serum samples from 35 Miniature Schnauzers diagnosed with pancreatitis (serum cPLI concentration >400 μg/L, clinical signs, abdominal imaging findings). These markers were evaluated for possible associations with patient characteristics, clinical presentation, risk factors for pancreatitis, and outcome. The study showed that biomarkers of systemic inflammation and antiprotease activity are commonly increased in Miniature Schnauzers with pancreatitis. Whereas serum calprotectin and S100A12 concentrations were found to have limited utility in differentiating pancreatitis presentations, serum α1PI concentrations and potentially also the serum calprotectin-to-S100A12 ratio might be non-invasive surrogate markers of disease severity in dogs with pancreatitis.
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Affiliation(s)
- Annina N Jandel
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
| | - Romy M Heilmann
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Henri Sander
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
| | - Jörg M Steiner
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Niels Grützner
- Ruminant and Swine Clinic, Free University of Berlin, DE-14165 Berlin, Germany
- VetaRegio GmbH, DE-06366 Köthen, Germany
| | - Panagiotis G Xenoulis
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
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Lazic I, Stephan M, Pohlig F, Langer S, VON Eisenhart-Rothe R, Suren C. Synovial Calprotectin for Diagnosing Periprosthetic Joint Infection in Loose Hip and Knee Arthroplasties: A Prospective Cohort Study. In Vivo 2023; 37:1714-1720. [PMID: 37369505 DOI: 10.21873/invivo.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND/AIM Synovial calprotectin has been demonstrated as a promising biomarker for periprosthetic joint infections (PJI) in painful total hip (THA) and knee arthroplasties (TKA). However, its diagnostic utility has not been evaluated explicitly in cases with marked loosening or migration of the implant. Concerns have already been raised in cases with metallosis and severe periprosthetic osteolysis because wear-induced inflammation may yield false positive results. The purpose of this study was to evaluate calprotectin for the diagnosis of PJI in cases that preoperatively demonstrate moderate to severe periprosthetic osteolysis or implant migration as signs for implant loosening in THA and TKA. PATIENTS AND METHODS Thirty-three patients were included in this prospective study between February of 2019 and November of 2021. The extent of osteolysis was classified according to Engh et al., Paprosky et al., and the modern Knee Society Radiographic Evaluation and Scoring System. Synovial white blood cell count (WBC), percentage of polymorphonuclear neutrophils (PMC), serum C-reactive protein (CRP) and synovial calprotectin using a lateral-flow-assay were tested against the European Bone and Joint Infection Society (EBJIS) definition for PJI. Statistic quality criteria were calculated and compared using a binary classification test. RESULTS Ten patients were classified as confirmed infections according to the EBJIS definition (7 THA and 5 TKA). The calprotectin assay yielded a sensitivity of 0.60, a specificity of 0.61, a positive predictive value of 0.40, and a negative predictive value of 0.78. The calprotectin assay resulted in nine false positive and four false negative cases. No correlation between the extent of osteolysis and false classification by means of the calprotectin assay was observed. CONCLUSION The diagnostic accuracy of synovial calprotectin is impaired if moderate to severe signs of implant loosening are present. If PJI is unlikely, the calprotectin LFT can be applied as a further exclusion tool as the negative predictive value remains relatively high.
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Affiliation(s)
- Igor Lazic
- Technische Universität München, School of Medicine, Klinikum Rechts der Isar, Klinik für Orthopädie und Sportorthopädie, Munich, Germany;
| | - Maximilian Stephan
- Technische Universität München, School of Medicine, Klinikum Rechts der Isar, Klinik für Orthopädie und Sportorthopädie, Munich, Germany
| | - Florian Pohlig
- Technische Universität München, School of Medicine, Klinikum Rechts der Isar, Klinik für Orthopädie und Sportorthopädie, Munich, Germany
| | - Severin Langer
- Technische Universität München, School of Medicine, Klinikum Rechts der Isar, Klinik für Orthopädie und Sportorthopädie, Munich, Germany
| | - Rüdiger VON Eisenhart-Rothe
- Technische Universität München, School of Medicine, Klinikum Rechts der Isar, Klinik für Orthopädie und Sportorthopädie, Munich, Germany
| | - Christian Suren
- München Klinik Bogenhausen, Zentrum für Orthopädie, Unfallchirurgie und Sportmedizin, Munich, Germany
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