Associations between systemic inflammation and somatic depressive symptoms: Findings from the Moli-sani study.

BACKGROUND: The link between systemic inflammation and depression has been deeply investigated, but relatively few studies explored symptom-specific associations, mostly focusing on common inflammatory biomarkers like C-reactive protein (CRP) levels. METHODS: We investigated associations of low-grade inflammation with depressive symptoms assessed through a reduced version of Patient Health Questionnaire 9 (PHQ-9) in a large population-based cohort of adult Italians (N = 13 301). We built logistic regressions between each depressive symptom and composite index of systemic inflammation based on four circulating biomarkers, namely CRP, Plt, WBC, and GLR (INFLA)-score, a composite blood-based inflammation index, and with its component biomarkers, namely CRP, platelets count (Plt), white blood cells count (WBC), and granulocyte-to-lymphocyte ratio (GLR). RESULTS: We observed a strong association of the altered appetite/eating symptom with standardized INFLA-score (OR [95% CI] = 1.19 [1.12-1.26]; corrected p = 3.0 × 10-7 ), CRP (1.28 [1.20-1.36]; p = 1.9 × 10-13 ), and WBC (1.13 [1.06-1.20]; p = 2.3 × 10-3 ), and of tiredness/low energy with GLR (1.11 [1.05-1.17]; p = 9.4 × 10-3 ). These associations remained stable within nondepressed participants (PHQ-9 < 10), and after adjustment for the use of antidepressants, main chronic conditions, and lifestyle factors; while they were notably attenuated within depressed participants (PHQ-9 ≥ 10) and-for altered appetite only-by adjustment for obesity. CONCLUSIONS: This study provides a robust replication of the association previously reported between CRP and altered appetite in a large US population cohort, and supports a link between systemic inflammation, altered appetite, and tiredness. Moreover, it extends this evidence to inflammatory markers other than CRP and suggests new targets for the treatment of atypical depression.

Pre-analytic factors and initial biomarker levels in community-acquired pneumonia patients.

BACKGROUND: Blood biomarkers are increasingly used to diagnose, guide therapy in, and risk-stratify community-acquired pneumonia (CAP) patients in emergency departments (EDs). How pre-analytic factors affect these markers' initial levels in this population is unknown. METHODS: In this secondary analysis of consecutive ED patients with CAP from a large multicentre antibiotic stewardship trial, we used adjusted multivariate regression models to determine the magnitude and statistical significance of differences in mean baseline concentrations of five biomarkers (procalcitonin [PCT], C-reactive protein [CRP], white blood cells count [WBC], proadrenomedullin [ProADM], copeptin) associated with six pre-analytic factors (antibiotic or corticosteroid pretreatment, age, gender, chronic renal failure or chronic liver insufficiency). RESULTS: Of 925 CAP patients (median age 73 years, 58.8% male), 25.5% had antibiotic pretreatment, 2.4%, corticosteroid pretreatment, 22.3%, chronic renal failure, 2.4% chronic liver insufficiency. Differences associated with pre-analytic factors averaged 6.1% ± 4.6%; the three largest statistically significant changes (95% confidence interval) were: PCT, +14.2% (+2.1% to +26.4%, p = 0.02) with liver insufficiency; ProADM, +13.2% (+10.2% to +16.1%, p < 0.01) with age above median; CRP, -12.8% (-25.4% to -0.2%, p = 0.05) with steroid pretreatment. In post hoc sensitivity analyses, reclassification statistics showed that these factors did not result in significant changes of biomarker levels across clinically used cut-off ranges. CONCLUSIONS: Despite statistically significant associations of some pre-analytic factors and biomarker levels, a clinically relevant influence seems unlikely. Our observations reinforce the concept of using biomarkers in algorithms with widely-separated cut-offs and overruling criteria considering the entire clinical picture. TRIAL REGISTRATION: Identifier ISRCTN95122877.

Biomonitoring of polycyclic aromatic hydrocarbons exposure and short-time health effects in wildland firefighters during real-life fire events.

Human biomonitoring data retrieved from real-life wildland firefighting in Europe and, also, worldwide are scarce. Thus, in this study, 176 Portuguese firefighters were biomonitored pre- and post- unsimulated wildfire combating (average:12-13 h; maximum: 55 h) to evaluate the impact on the levels of urinary polycyclic aromatic hydrocarbons hydroxylated metabolites (OHPAH; quantified by high-performance liquid chromatography with fluorescence detection) and the associated short-term health effects (symptoms, and total and differentiated white blood cells). Correlations between these variables and data retrieved from the self-reported questionnaires were also investigated. Firefighters were organized into four groups according to their exposure to wildfire emissions and their smoking habits: non-smoking non-exposed (NSNExp), non-smoking exposed (NSExp), smoking non-exposed (SNExp), and smoking and exposed (SExp). The most abundant metabolites were 1-hydroxynaphthalene and 1-hydroxyacenaphthene (1OHNaph + 1OHAce) (98-99 %), followed by 2-hydroxyfluorene (2OHFlu) (0.2-1.1 %), 1-hydroxyphenanthrene (1OHPhen) (0.2-0.4 %), and 1-hydroxypyrene (1OHPy) (0.1-0.2 %); urinary 3-hydroxybenzo(a)pyrene was not detected. The exposure to wildfire emissions significantly elevated the median concentrations of each individual and total OHPAH compounds in all groups, but this effect was more pronounced in non-smoking (1.7-4.2 times; p ≤ 0.006) than in smoking firefighters (1.3-1.6 times; p ≤ 0.03). The greatest discriminant of exposure to wildfire emissions was 1OHNaph + 1OHAce (increase of 4.2 times), while for tobacco smoke it was 2OHFlu (increase of 10 times). Post-exposure, white blood cells count significantly increased ranging from 1.4 (smokers, p = 0.025) to 3.7-fold (non-smokers, p < 0.001), which was accompanied by stronger significant correlations (0.480 < r < 0.882; p < 0.04) between individual and total OHPAH and total white blood cells (and lymphocytes > monocytes > neutrophils in non-smokers), evidencing the impact of PAH released from wildfire on immune cells. This study identifies Portuguese firefighters with high levels of biomarkers of exposure to PAH and points out the importance of adopting biomonitoring schemes, that include multiple biomarkers of exposure and biomarkers of effect, and implementing mitigations strategies.

Challenging the Interpretation of White Blood Cell Counts in Patients with Sepsis Following Packed Cell Transfusion.

Critically ill patients with sepsis often require packed cell transfusions (PCT). However, PCT may affect white blood cell (WBC) counts. We conducted a population-based retrospective cohort study to trace changes in WBC count following PCT in critically ill patients with sepsis. We included 962 patients who received one unit of PCT while hospitalized in a general intensive care unit, and 994 matched patients who did not receive PCT. We calculated the mean values of WBC count for the 24 h before and 24 h after PCT. Multivariable analyses using a mixed linear regression model were performed. The mean WBC count decreased in both groups, but more in the non-PCT group (from 13.9 × 109/L to 12.2 × 109/L versus 13.9 × 109/L to 12.8 × 109/L). A linear regression model showed a mean decrease of 0.45 × 109/L in WBC count over the 24 h following the start of PCT. Every 1.0 × 109/L increase in the WBC count prior to PCT administration showed a corresponding decrease of 0.19 × 109/L in the final WBC count. In conclusion, among critically ill patients with sepsis, PCT causes only mild and clinically non-prominent changes in WBC count.

Serum Chemerin Concentration Is Associated with Proinflammatory Status in Chronic Coronary Syndrome.

BACKGROUND: Chemerin is an adipokine and a chemoattractant for leukocytes. Increased chemerin levels were observed in patients with coronary artery disease (CAD). We investigated associations between chemerin and biochemical measurements or body composition in CAD patients. METHODS: In the study, we included patients with stable CAD who had undergone percutaneous coronary intervention (PCI) in the past. All patients had routine blood tests, and their insulin and chemerin serum levels were routinely measured. Body composition was assessed with the DEXA method. RESULTS: The study group comprised 163 patients (mean age 59.8 ± years, 26% of females, n = 43). There was no significant difference in serum chemerin concentrations between patients with diabetes and the remaining ones: 306.8 ± 121 vs. 274.15 ± 109 pg/mL, p = 0.1. Chemerin correlated positively with the white blood cell (WBC) count, the neutrophil to lymphocyte ratio, hsCRP, all fractions of cholesterol, triglycerides, platelet count, fasting insulin, and c-peptide. Chemerin levels were also correlated with total fat mass but only in a subgroup with normal glucose metabolism. CONCLUSION: In patients with CAD, serum chemerin levels are correlated with inflammation markers, insulin resistance, and an unfavorable lipid profile. Correlation with fat mass is dependent on glucose metabolism status. Depending on the presence of diabetes/prediabetes, the mechanisms regulating chemerin secretion may be different.

Increased serum levels of aldehydes are associated with cardiovascular disease and cardiovascular risk factors in adults.

Previous studies have identified several genetic and environmental risk factors for cardiovascular disease (CVD), but little is known about the associations between serum aldehydes and CVD risk. Herein, we examined associations between serum levels of aldehydes and the risk of CVD and CVD subtypes among 1947 U.S. adults participating in the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Bayesian kernel machine regression (BKMR) was used to analyze the combined effect of serum aldehydes on the overall risk of CVD. We found that isopentanaldehyde concentrations were positively associated with the odds of CVD (adjusted odds ratio (aOR): 2.17; 95 % confidence interval (95 % CI): 1.36, 3.46). The result of BKMR also indicated a positive association of mixed aldehydes with CVD risk. Isopentanaldehyde had the highest posterior inclusion probabilities (PIP = 0.90). Each one-unit (ng/mL) increase in the isopentanaldehyde concentration was associated with a 25.0 mg/dL increase in triglycerides and a 0.9 × 109/L increase in white blood cell (WBC) count in the fully adjusted model. Current evidence suggests that isopentanaldehyde may increase the risk of CVD by elevating triglycerides and WBC count.

Genotoxicity and subchronic toxicological study of a novel ginsenoside derivative 25-OCH3-PPD in beagle dogs.

BACKGROUND: Ginsenosides have been widely used clinically for many years and were regarded as very safe. However, a few researches on the toxicities of these kinds of agents showed that some ginsenosides may have side-effect on the rats or dogs. So it is extremely necessary to further clarify the potential toxicity of ginsenosides. This study was carried out to investigate long-term toxicity and genotoxicity of 25-methoxydammarane-3, 12, 20-triol (25-OCH3-PPD), a new derivative of ginsenoside, in beagle dogs. METHODS: Twenty-four beagle dogs were divided randomly into four treatment groups and repeatedly orally administered with 25-OCH3-PPD capsule at 60, 120, and 240 mg/kg/day for 91 consecutive days. Ames, micronucleus, and chromosomal aberration tests were established to analyze the possible genotoxicity of 25-OCH3-PPD. RESULTS: There was no 25-OCH3-PPD-induced systemic toxicity in beagle dogs at any doses. The level of 25-OCH3-PPD at which no adverse effects were observed was found to be 240 mg/kg/day. The result of Ames test showed that there was no significant increase in the number of revertant colonies of 25-OCH3-PPD administrated groups compared to the vehicle control group. There were also no significant differences between 25-OCH3-PPD administrated groups at all dose levels and negative group in the micronucleus test and chromosomal aberration assay. CONCLUSION: The highest dose level of 25-OCH3-PPD at which no adverse effects were observed was found to be 240 mg/kg per day, and it is not a genotoxic agent either in somatic cells or germs cells. 25-OCH3-PPD is an extremely safe candidate compound for antitumor treatment.

The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes.

INTRODUCTION: Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/ß-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease. MATERIALS AND METHODS: The study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and ß-TG were measured using the ELISA method. RESULTS: In the whole group of ACS patients WBC, CRP, IL-6, MPV, and ß-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed ß-TG. CONCLUSION: Markers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and ß-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.

[White blood cells counts and parasite density in malaria in children aged 6 to 60 months in urban areas of Togo]. / Numération leucocytaire et densité parasitaire dans le paludisme simple chez les enfants âgés de 6 mois à 5 ans en milieu urbain au Togo.

Rational use of the artemisinin-based combination therapies in Togo requires laboratory parasitemia values to confirm suspected malaria. This study was conducted to determine the impact of the measured white blood cell (WBC) count on the determination of malaria parasite density among children younger than 5 years old infected with uncomplicated Plasmodium falciparum in Togo. This cross-sectional study of 267 children from four pediatric centers diagnosed malaria with both thick and thin blood smears and counted WBCs with a hematology analyzer. The parasite densities, calculated with the number of WBCs and estimated with an assumed count of 8,000/µL, were compared with the Wilcoxon matched pairs signed-rank test. The children's median age was 35 months (interquartile range [24-48]), with a sex ratio of 1.32. The median WBC value was 8,300 cells/µL (range: 1,300-24,900 cells/µL). The median parasitemia value calculated with the absolute WBC count was 35,714 (range: 139-48,860 parasites/µL) was not statistically different from that estimated with the assumed value of 8,000 cells/µL - 33 125 parasites/µL (p = 0.564). This study shows that malaria parasite density obtained by assuming 8000 cells/µL does not result in overestimations for children aged 6-59 months.

Clinical value of combined detection of PCT,CRP and WBC in diagnosis of neonatal infectious pneumonia / 国际检验医学杂志

Objective To explore the clinical value of combined detection of procalcitonin (PCT ) ,C reaction protein (CRP) and white blood cells (WBC) count in diagnosis of neonatal infectious pneumonia .Methods A total of 137 cases of neonatal infectious pneumonia ,including bacterial infection group of 72 cases and non‐bacterial infection group of 65 cases ,were selected .Another 63 healthy neonatus were enrolled as control group .Levels of PCT ,CRP and WBC were measured .Results Levels and positive rates of PCT ,CRP and WBC in bacterial infection group were significantly higher than the other two groups (P<0 .05) .The sensitivity and specificity of PCT were higher than CRP and WBC .The sensitivity of combined detection were further increased .Conclusion Diagnostic sensitivity and specificity of PCT could be higher than CRP and WBC .Combined detection of PCT ,CRP and WBC might be with important clinical value for the differential diagnosis of neonatal infectious pneumonia and observation of curative effect .

The correlation between white blood cells count of EPS and semen quality / 国际检验医学杂志

Objective To analyze the correlation between the content of visible components of EPS ,and to investigate the rela‐tionship between the main parameters of semen and EPS .Methods On the basis of white blood cell count of EPS ,the patients were divided into group A (inflammatory patients ,n=189) and group B (non‐inflammatory patients ,n=94) .The density ,(a+b) activi‐ty and survival rate of sperm were detected by CASA .Results There was no linear correlation between the number of white blood cells and lecithin bodies or red blood cells .Compared with group B ,the sperm density and (a+b) level of sperm activity and surviv‐al rates of semen were significantly decreased in group A (P<0 .05 or P<0 .01) .Conclusion The number of white blood cells of EPS could affect sperm quality of the patients .

Effect of Bidouyan Oral Liquid for the Treatment of Experimental Suppurative Maxillary Sinusitis Rabbits / 中药新药与临床药理

Objective To investigate the therapeutic effect of Bidouyan Oral Liquid(BOL) on acute suppurative max-illary sinusitis(ARMS) in rabbits.Methods Modified Hinni's method was used to inducing the ARMS rabbit models.The high and low-dosage of BOL was administered by gastric gavage and penicillin V was used for the positive medicine.The white blood cells(WBC)count,neutrophil percentage,serum C-reactive protein(CRP)level,inflammatory changes of mucosa of nasal sinuses under light microscope and bacteria culture of secretion in ARMS rabbit models were observed.Results Inflammatory changes were shown in the experimental ARMS rabbits as follows:white blood cells count and neutrophil percentage increased,mucosa of nasal sinuses congested and swollen with the exfoliation of pili.After the treatment with high-and low-dosage of BOL,the above parameters in the rabbits recovered to normal,the difference being insignificant compared with penicillin V.Conclusion BOL in clinical dose can control the general and local inflammatory reaction in ARMS rabbits.