Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis

Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis The aim of this prospective control study was a quantitative evaluation of the activity of rheumatoid arthritis (RA) in certain time intervals, using articular indexes (set of 28 sensitive and 28 swollen joints), laboratory parameters (Hb, Hct, Er, Le and Plt) and acute phase reactants (ESR, RF, CRP); to determine which of the acute phase reactants is the most useful biochemical marker for the evaluation of disease activity in RA; to quantify the therapeutical and laboratory differences in certain time intervals in the group with and without immunomodulatory therapy with Methotrexate. Sixty patients with RA were included, 27 of who were treated with non-steroid antiinflammatory drugs (NSAIDs) and Methotrexate (MTX). The control group consisted of 33 patients treated only with NSAIDs because of irregular controls. In the first group of patients the disease activity was estimated at four time intervals, and in the control group of patients at three time intervals following the scores of the articular indexes, blood cell counts, ESR and CRP in every patient. In the first group of patients decreased activity of RA was found upon every following control with a consecutive decrease in mean values of the scores of articular indexes with statistically significant differences at the four time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of Hb, Er, Plt, ESR, (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (there were great standard deviations). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of articular indexes with an increse at every following control (in favour of progression of the disease). There were no statistically significant differences considering blood cell counts, ESR and CRP (in favour of permanently active disease). In conclusion, CRP is the most useful marker for the prospective follow-up of patients with RA.

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Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183138 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1009

Author(s):

Pawan Kumar Vishwakarma ◽

Umesh Saroj

Keyword(s):

Rheumatoid Arthritis ◽

Combination Therapy ◽

Acute Phase ◽

Uttar Pradesh ◽

Acute Phase Reactant ◽

Joint Space ◽

Chronic Inflammatory Disease ◽

Radiological Progression ◽

Acute Phase Reactants ◽

Phase Reactant

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010. Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.

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is hypoalbuminemia a new biomarker in severe pneumonia associated with coronavirus disease 2019?

10.22541/au.161371941.17843430/v1 ◽

2021 ◽

Author(s):

Yavuz Otal ◽

GAMZE AVCIOĞLU ◽

Fadime Gullu Haydar

Keyword(s):

Acute Phase ◽

Severe Pneumonia ◽

Acute Phase Reactant ◽

Healthy Control Group ◽

Control Group ◽

City Hospital ◽

Acute Phase Reactants ◽

Neutrophil Lymphocyte Ratio ◽

Phase Reactant ◽

Healthy Control

Objective: In the present study, the importance of albumin level in severe pneumonia due to covid 19 was investigated. Design: This was a retrospective study. Setting:Emergency Department of Ankara City Hospital, between 1 september 2020 and 1 february May 2021. Subjects: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose the relation between hypoalbuminemia and other acute phase reactants was compared in severe pneumonia due to Covid-19. Main outcome measures: The data of 122 patients diagnosed with pneumonia due to Covid 19 and 60 healthy control group were retrospectively analyzed in statistical terms in computer medium. The cases were divided into 3 groups as Healthy Control Group, Intubated Group, and Non-Intubated Group. The lung tomography of patients diagnosed with Covid 19 pneumonia was examined one-by-one. The RT-PCR (Real-Time Polymerized Chance Reaction) test results were recorded from the system. The albumin, WBC (White Blood Cell), N/L (Neutrophil/Lymphocyte Ratio), CRP (C-Reactive Protein) levels, who are acute phase reactant levels, of the patients were compared with the Control Group. Also, the two groups who were intubated and not intubated were also compared. Results: When all the data were examined, it was found that the albumin levels were lower at statistically significant levels in all 3 study groups (p<0.01). The other acute phase reactants, N/L ratio and CRP levels were significantly higher (p<0.05). Hypoalbuminemia was found to be significantly lower as a result of the comparisons of the two groups that were intubated and not intubated (p=0.02), and no differences were detected in terms of other parameters (p>0.05). Conclusion: Serum albumin levels may be lower in severe Covid 19 pneumonia. Hypoalbuminemia can be a biomarker indicating the severity of the disease as an acute phase reactant.

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Acute-phase behavior of factor VIII procoagulant and other acute-phase reactants in rabbits

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1989.257.1.r49 ◽

1989 ◽

Vol 257 (1) ◽

pp. R49-R56

Author(s):

D. A. Noe ◽

P. A. Murphy ◽

W. R. Bell ◽

J. N. Siegel

Keyword(s):

Factor Viii ◽

Acute Phase ◽

Interleukin 1 ◽

Plasma Concentrations ◽

Acute Phase Reactant ◽

Acute Phase Reactants ◽

Reactive Protein ◽

Phase Reactant ◽

The Mean ◽

Laboratory Models

We measured the plasma concentrations of factor VIII procoagulant (FVIII:C) in rabbits in two laboratory models of inflammation and after injections of purified homologous interleukin 1 (IL-1). The mean FVIII:C activities 2-4 days following the intramuscular injection of turpentine were significantly elevated, as were the concentrations of fibrinogen and C-reactive protein (CRP). By contrast, rabbits given 50 ng of bacterial lipopolysaccharide intravenously developed increased levels of FVIII:C but not of fibrinogen or CRP. We then studied plasma levels of FVIII:C, fibrinogen, and CRP after injections of either form of purified rabbit IL-1. If the rabbits' temperatures were monitored, FVIII:C levels increased in a log dose-related manner. This effect was not seen unless the rabbits were restrained and was seen in restrained rabbits even if the temperatures were not monitored. Fibrinogen and CRP levels did not change after IL-1 injections. These findings demonstrate that FVIII:C is an acute-phase reactant as judged by its response to turpentine inflammation or endotoxin injections, and to injections of IL-1 in restrained rabbits. FVIII:C appears to be a more sensitive acute-phase reactant than either fibrinogen or CRP. Neither of the latter proteins responded to low-dose endotoxin injections nor to either form of purified homologous IL-1. The doses of IL-1 given did cause fever, neutrophil leukocytosis, and hypoferremia.

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Association Between Sharp's Radiographic Index and Acute Phase Reactants in Rheumatoid Arthritis

Journal of Medical Biochemistry ◽

10.2478/v10011-008-0025-0 ◽

2008 ◽

Vol 27 (4) ◽

pp. 447-453

Author(s):

Irena Kafeđiska ◽

Dejan Spasovski ◽

Todor Gruev ◽

Nada Marina ◽

Mane Grličkov ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Acute Phase ◽

Time Intervals ◽

Acute Phase Reactants ◽

Disease Evolution ◽

Course Of Disease ◽

Mean Values ◽

Early Ra ◽

Number Of Patients

Association Between Sharp's Radiographic Index and Acute Phase Reactants in Rheumatoid ArthritisThe aim of this study was to evaluate the activity of rheumatoid arthritis (RA) by hand radiography (Sharp's radiographic index), and assessment of acute phase reactants - erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF), and to determine their value as prognostic markers for disease outcome in patients with early RA treated with disease modifying antirheumatic drugs (DMARDs)-Methotrexate (MTH); to register and quantify clinical, radiographic and laboratorial differences in certain time intervals in a group of patients treated with immunomodulation therapy with MTH; to determine which of the acute phase reactants would be the most useful marker for evaluation of disease activity in long-term follow-up in RA patients; to select high-risk groups with aggressive course of disease, in order to emphasize the necessity of early and aggressive treatment. Thirty patients with early RA (disease evolution up to 1 year) were evaluated in several time intervals. The score of the Sharp's index showed greater radiographic progression of the joint damage of hands in time intervals between 0-time and 12 months (p=0.0167) and between 0-time and 18 months (p=0.0089). Statistical analysis showed differences in values of CRP in four time intervals (p=0.00002). Considering CRP, there were statistically significant differences among mean values in four time intervals (p=0.0428) (standard deviations showed greater variations). There were no statistically significant differences among mean values of RF in four time intervals (p=0.573). At 0-time in 3 (10%) patients progression of the Sharp's index was found, after 6 months in 13 (39%) patients, while after 12 and 18 months progression of the Sharp's index was found in an identical number of patients, 15 (50%). In most patients high values of CRP and RF were found. Progression of the radiographic damage is especially expressed in patients with high values of ESR, CRP, RF and existence of previous erosions of hands, which are predictors for aggressive course of disease. CRP is the most useful marker for the evaluation of RA activity in the long-term followup of RA patients.

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PROTEIN C ACTS AS AN ACUTE PHASE REACTANT IN EQUINE LAMINITIS

10.1055/s-0038-1643183 ◽

1987 ◽

Author(s):

K W Prasse ◽

J N Moore ◽

A Duncan

Keyword(s):

Acute Phase ◽

Protein C ◽

Coagulation Factors ◽

Acute Phase Reactant ◽

Normal Range ◽

Microvascular Damage ◽

Acute Phase Reactants ◽

Intravascular Thrombosis ◽

Phase Reactant ◽

Equine Colic

Equine Colic Syndrome is a disease of horses whose complications include laminatis.This term describes a situation where microvascular damage to the hoof causes degeneration of the interphalangeal laminae,leading to lameness. Vascular studies have suggested that microthrombosis involving the delicate vessels in the hoof,coupled with changes in the platelet count, coagulation factors & elevated FDP's implicate DIC as a potential etiology. Limited test capability in the horse has limited further evaluation of this hypothesis. We have developed an assay for equine protein C activity,our normal range being 70-60% (Mean+/- 2SD). We studied 12 horses with the disease for 5 consecutive days,drawing 1 blood sample per day. Our expectation was that protein C levels would decrease.if DIC was significant,as would be expected in humans. No significant decrease was noted in any horse. However there was a significant increase in the protein C levels beyond the upper limit of the normal range in 10 of the 12 horses by the third day. Five of the 10 horses maintained this elevation beyond the 5th day. Thus protein C changes were more consistent with an acute phase reactant response,rather than reflecting the decrease we anicipated,if the equine DIC parallels human DIC. We are measuring other acute phase reactants to see if equine protein C parallels those. Since our assay is still being evaluated,more data needs to be obtained in this and other equine disease states before any definative role for protein C in equine pathology can be determined. In our laminitis horses,we are devolping assays for antithrombin III and plasminogen which should allow us to evaluate the disease state more completley for any involement of elements of intravascular thrombosis and fibrinolysis in the equine colic syndrome.

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Acute phase reactant, Pentraxin 3, as a novel marker for the diagnosis of rheumatoid arthritis

Clinica Chimica Acta ◽

10.1016/j.cca.2018.01.035 ◽

2018 ◽

Vol 480 ◽

pp. 65-70 ◽

Cited By ~ 5

Author(s):

A. Sharma ◽

R. Khan ◽

N. Gupta ◽

A. Sharma ◽

M.S. Zaheer ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Acute Phase ◽

Acute Phase Reactant ◽

Pentraxin 3 ◽

Phase Reactant

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Murine serum glycoprotein gp70 behaves as an acute phase reactant.

Journal of Experimental Medicine ◽

10.1084/jem.155.2.345 ◽

1982 ◽

Vol 155 (2) ◽

pp. 345-357 ◽

Cited By ~ 38

Author(s):

I Hara ◽

S Izui ◽

F J Dixon

Keyword(s):

T Cells ◽

Acute Phase ◽

Viral Genome ◽

Lipid A ◽

Acute Phase Reactant ◽

Acute Phase Reactants ◽

Single Intraperitoneal Injection ◽

Phase Reactant ◽

Immunohistochemical Studies ◽

Parenchymal Cells

A single intraperitoneal injection of bacterial lipopolysaccharide (LPS) or its lipid A component induced high levels of glycoprotein, gp70, in sera of several strains of mice within 24 h. This serum gp70 response induced by LPS was independent of the activation of B cells and the presence of T cells. However, serological and immunohistochemical studies demonstrated the production of gp70 by hepatic parenchymal cells and its subsequent release into the circulating blood. The expression of gp70 in the serum was enhanced not only by LPS but also other inducers of acute phase reactants (APR) such as turpentine oil or polyriboinosinic-polyribocytidylic acid. Further, the serum gp70 response was kinetically identical to those of APR. These results strongly suggest that (a) the liver may be the major source for serum gp70, (b) serum gp70 behaves like an APR, (c) its expression may be controlled by a mechanism similar to that for other APR, and (d) this glycoprotein apparently behaves as a normal host constituent and not a product of a viral genome.

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Searching for methods to predict septic complications in surgical patients

Kazan medical journal ◽

10.17750/kmj2015-294 ◽

2015 ◽

Vol 96 (3) ◽

pp. 294-297

Author(s):

T Z Zakiev ◽

S R Tuysin ◽

A R Gil’fanov ◽

R D Sagdiev ◽

I V Zakieva

Keyword(s):

Acute Phase ◽

Albumin Level ◽

Main Group ◽

Water Soluble ◽

Control Group ◽

Study Group ◽

C Reactive Protein ◽

Acute Phase Reactants ◽

Reactive Protein ◽

Cell Counts

Aim. To assess the significance of acute stage reactants as the marker for purulent complications in surgical patients.Methods. We analyzed the results of treatment of 228 patients with purulent and inflammatory diseases of soft tissues, treated in 2011-2014. Acute phase reactants: C-reactive protein, albumin and fibrinogen were measured starting from the day of admission and surgical treatment and during the next 7 days. The control group (112 patients) included patients whowere treated conventionally by gauze bandage with water-soluble ointments and antiseptic solutions and broad-spectrum antibiotics. In the study group (116 patients) topical treatment of wounds was performed using «Poliderm» bandages.Results. Application of the «Poliderm» combined dressing reduced the wounds clearance term from 4.3±0.5 to 3.2±0.4 days, active inflammation term from 8.8±1.3 to 6.4±0.7 days, epithelialization of the wound from 10.1±0.8 to 8.4±0.6 days. C-reactive protein level was 87.3±4.3 g/l at the day of admission and decreased by day 7 to 34.13±1.2 g/l, compared to 51.83±3.6 g/l on the 7th day in the control group. Albumin level was 42.73±3.7 g/l in the study group with further decrease to 40.33±1.7 g/l on the 2nd and subsequent increase up to 45.13±1.3 g/l on the day 7. Patients of the control group had albumin level decreased on the 2nd and 3rd days with further increase up to 41.73±2.1 g/l on the day 7. At the treatment start, leukocyte intoxication index was 5.923±0.4 in the main group and 5.873±0.3 in the control group. On the 2nd day, this parameter decreased to 5.12 in the main group and to 5.41 in the control group.Conclusion. Measuring the levels of acute phase reactants (C-reactive protein, albumin, etc.) allows to assess the clinical course of a purulent and inflammatory disease, to register the good treatment effect on the 1-2nd day of treatment, even before the significant clinical changes, changes in the body temperature, white blood cell counts, erythrocyte sedimentation rate.

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Glycoprotein biosynthesis during the acute-phase response to inflammation

Canadian Journal of Biochemistry and Cell Biology ◽

10.1139/o83-133 ◽

1983 ◽

Vol 61 (9) ◽

pp. 1041-1048 ◽

Cited By ~ 36

Author(s):

J. C. Jamieson ◽

H. A. Kaplan ◽

B. M. R. N. J. Woloski ◽

M. Hellman ◽

K. Ham

Keyword(s):

Acute Phase ◽

Acute Phase Response ◽

Elevated Serum ◽

Serum Cortisol ◽

Serum Levels ◽

Acute Phase Reactant ◽

Phase Response ◽

Acute Phase Reactants ◽

Acid Glycoprotein ◽

Phase Reactant

Inflammation results in an increase in the levels of a variety of glycoproteins in serum. The glycoproteins that respond in this way are usually referred to as acute-phase reactants. Studies on the acute-phase response of rat α1-acid glycoprotein showed that there was an increase in the liver levels of this glycoprotein at 12 h after turpentine inflammation. This was followed by increased serum levels at 48–72 h after inflammation, suggesting a precursor–product relationship between liver and serum α1-acid glycoprotein. Incorporation studies coupled with measurements of synthesis rates of α1-acid glycoprotein showed that increased synthesis was responsible for the acute-phase response of this protein to inflammation. These studies also showed that albumin was a negative acute-phase reactant. The acute-phase response of α1-acid glycoprotein was accompanied by increased liver pools of UDP–N-acetylglucosamine (UDP–GlcNAc) and UDP–N-acetylgalactosamine (UDP–GalNAc) and increased liver activities of glucosamine-6-phosphate synthase and UDP–GlcNAc 2-epimerase. Activities of galactosyl and sialyl transferases in liver were also elevated and serum sialyl transferase was increased substantially in inflammation, suggesting that it may also be an acute-phase reactant. Liver activities of β-N-acetylhexosaminidase and β-galactosidase declined by about 50% at 24 h after inflammation; there was evidence that serum levels of these enzymes increased at 24–72 h after inflammation, suggesting that the lysosomal glycosidases may be released from liver during inflammation. Inflammation resulted in elevated serum Cortisol, insulin, and adrenocorticotropic hormone and induced increased glycogenosis; liver cAMP levels were also increased during inflammation. Preliminary studies are presented to show that leukocyte-derived factors may be involved in the acute-phase response of α1-acid glycoprotein to inflammation.

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Improved specificity of serum albumin determination and estimation of "acute phase reactants" by use of the bromcresol green reaction.

Clinical Chemistry ◽

10.1093/clinchem/22.5.616 ◽

1976 ◽

Vol 22 (5) ◽

pp. 616-622 ◽

Cited By ~ 119

Author(s):

J E Gustafsson

Keyword(s):

Serum Albumin ◽

Cellulose Acetate ◽

Acute Phase ◽

Acute Phase Reactant ◽

Serum Samples ◽

Acute Phase Reactants ◽

Slow Reaction ◽

Phase Reactant ◽

Control Serum ◽

Bromcresol Green

Abstract The reaction of serum samples with bromcresol green proceeds in two steps. Albumin is responsible for the faster (less than 1 min) reaction; the slower (30-min) reaction is a measure of "acute phase reactant(s)" in serum. Serum is simply mixed with bromcresol green reagent and the absorbance is measured twice, immediately and at 60 min. Albumin concentrations, determined from the absorbance at 0 min, correlate well with those determined by Laurell "rocket" immunoelectrophoresis; r = 0.95 with no certain deviation from unity for the slope and with a negligible difference at zero concentration. The slow reaction was expressed as deltaA% = 100 (deltaAs/deltaAv) where deltaAs and delta Av are the changes in absorbance between 60 and 0 min for the sample and a commercial control serum, respectively. The value for deltaA% correlates well with the percentage of alpha2-fraction as determined by electrophoresis on cellulose acetate, as well as with orosomucoid and ceruloplasmin, all of which are acute phase reactant(s). Whether these proteins or other acute phase reactant(s) actually cause the slow reaction has not yet been established.

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