Primary Sjögren syndrome (pSS) is a systemic autoimmune disorder that affects various systems in the body, resulting in symptoms such as dry eyes and mouth, pain, and fatigue. Inflammation plays a critical role in pSS and its associated complications, with chronic inflammation being a common occurrence in patients with pSS. This review of the literature highlights inflammatory markers that could serve as indicators to predict disease progression in pSS. Laboratory markers are frequently and significantly increased in pSS patients, including erythrocyte sedimentation rate, C-reactive protein, complement proteins, S100 proteins, cytokines (IFNs, CD40 ligand, soluble CD25, rheumatoid factors, interleukins, and TNF-α), and chemokines (CXCL13, CXCL10, CCL2, CXCL11, and CCL25). These inflammatory markers can be used as prognostic indicators for disease progression in pSS. In conclusion, the results from the studies reported in this review indicate that high levels of inflammatory markers may serve as markers for disease progression of pSS, which, in turn, may be valuable in predicting disease outcome.

The objective of this study was to investigate the prevalence of vitamin D deficiency or insufficiency and its association with inflammatory markers and type 2 diabetes. We conducted our research at Qingdao Endocrine and Diabetes Hospital, where serum 25-hydroxyvitamin D3 levels were determined for 2,806 individuals with type 2 diabetes aged 30 and older between January 2018 and December 2019. Medical records were analyzed, and data on health, blood lipids, HbA1c, and inflammation were collected. Our results revealed a high prevalence of vitamin D deficiency in the population. Among male and female patients, median serum 25(OH)D3 levels were 22.46 and 19.00 ng/mL, respectively. More than 60% of female patients had vitamin D deficiency, with over 80% having levels below 30 ng/mL. We observed a favorable connection between high-density lipoprotein cholesterol and 25(OH)D3, while triglycerides and HbA1c showed negative correlations. As 25(OH)D3 levels increased, inflammatory markers such as hypersensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), white blood cell count, neutrophil count, and monocyte count decreased (trend test, p < 0.05), although peripheral blood lymphocytes initially increased and then decreased. After controlling for age and gender, multiple linear regression analysis indicated negative correlations between ESR, hsCRP, and white blood cell count with 25(OH)D3 (p < 0.05). In conclusion, our study demonstrates that individuals with type 2 diabetes often exhibit vitamin D deficiency or insufficiency, which is associated with elevated levels of inflammatory markers in the blood.

BACKGROUND: Craniosynostosis (CS) is a group of skull malformations manifested by congenital absence or premature closure of cranial sutures. Reconstructive surgery in the second half of life is traditional approach for CS. The issues of surgical stress response after reconstructive surgery for CS in children are still unclear.
OBJECTIVE: To evaluate clinical and laboratory parameters in children undergoing traumatic reconstructive surgery for CS.
METHODS: Inclusion criteria were CS, reconstructive surgery, age <24 months, no comorbidities and available laboratory diagnostic protocol including complete blood count, biochemical blood test with analysis of C-reactive protein, procalcitonin, ferritin and presepsin. The study included 32 patients (24 (75%) boys and 8 (25%) girls) aged 10.29±4.99 months after surgery between October 2021 and June 2022. Non-syndromic and syndromic forms of CS were observed in 25 (78.1%) and 7 (21.9%) cases, respectively.
RESULTS: There were no infectious complications. We analyzed postoperative clinical data, fever, clinical and biochemical markers of inflammation.
CONCLUSIONS: Early postoperative period after reconstructive surgery for CS in children is accompanied by significant increase of inflammatory markers (C-reactive protein, procalcitonin, ferritin). However, these findings do not indicate infectious complications. This is a manifestation of nonspecific systemic reaction. Severity of systemic inflammatory response syndrome with increase in acute phase proteins indicates highly traumatic reconstructive surgery for CS in children. Analysis of serum presepsin allows for differential diagnosis between infectious complication and uncomplicated course of early postoperative period.
Краниосиностозами (КС) называется группа пороков развития костей свода и основания черепа, проявляющихся врожденным отсутствием или преждевременным закрытием черепных швов. Традиционным методом коррекции КС во втором полугодии жизни являются реконструктивные операции. Вопросы хирургического стресс-ответа после реконструктивных операций при КС у детей остаются неизученными.
UNASSIGNED: В настоящем проспективном исследовании была осуществлена оценка клинических и лабораторных показателей воспаления у детей, перенесших травматичные реконструктивные операции по поводу КС.
UNASSIGNED: Критериями включения в исследование были наличие КС, проведение реконструктивной операции, возраст пациента менее 24 мес, отсутствие сопутствующей соматической патологии, а также выполнение протокола лабораторной диагностики, включавшей исследование общего анализа крови, биохимического анализа крови с исследованием С-реактивного белка (СРБ), прокальцитонина (ПКТ), ферритина (ФТ) и пресепсина (ПСП). В исследование были включены 32 пациента (24 (75%) мальчика; и 8 (25%) девочек) в возрасте 10,29±4,99 мес, оперированные в период с октября 2021 г. по июнь 2022 г. в ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н.Н. Бурденко» Минздрава России. Несиндромальные формы КС были представлены 25 (78,1%) наблюдениями, и в 7 (21,9%) наблюдениях отмечались синдромальные формы.
UNASSIGNED: В исследуемой группе пациентов не отмечалось инфекционных осложнений. Представлена динамика клинической картины послеоперационного периода с анализом лихорадки, динамики клинических и биохимических маркеров воспаления.
UNASSIGNED: Естественное течение раннего послеоперационного периода после реконструктивных операций у детей сопровождается выраженным повышением уровня биохимических маркеров воспаления (СРБ, ПКТ, ФТ), что, однако, не свидетельствует об инфекционном осложнении, а является проявлением неспецифической системной реакции организма. Выраженность синдрома системного воспалительного ответа в виде повышения белков острой фазы воспаления свидетельствует о высокой травматичности реконструктивных операций при КС у детей. Исследование уровня ПСП в крови позволяет провести дифференциальную диагностику между инфекционным осложнением и неосложненным течением раннего послеоперационного периода.

OBJECTIVE: This study aimed to investigate the predictive power of serum systemic inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER), and C-reactive protein (CRP) levels for distinguishing uncomplicated and complicated acute appendicitis in adult patients admitted to the emergency department (ED).
METHODS: This retrospective, cross-sectional, observational, and single-center study enrolled 212 consecutive adult patients with acute appendicitis who were admitted to the ED of our tertiary care university hospital between January 1, 2019 and December 31 2021. Patients were divided into two groups (Group I, uncomplicated acute appendicitis; Group II, complicated appendicitis) according to their surgical findings and histopathological examination. Systemic inflammatory markers measured on admission were compared among patients to identify factors associated with complicated acute appendicitis.
RESULTS: A total of 132 patients, 83 male (62.9%) and 49 female (37.1%), were included in the study. The mean age was 34.7±13.40 years. Based on the histopathological examination, the number of patients in Group I was 103 (78.03%) and 29 (21.96%) in Group II. Laboratory findings on admission revealed no significant differences between Groups I and II patients in terms of mean serum NLR, MER, and CRP values (p=0.096, p=0.248, and p=0.297, respectively). However, the mean serum PLR in Group II patients was statistically significantly higher than those in Group I (p=0.032). The mean serum monocyte and monocyte fraction (%) values were significantly lower, and the mean serum neutrophil fraction (%) value was higher in Group II patients compared to those with Group I. Receiving operator characteristic (ROC) analysis identified a serum PLR cutoff value of ≥133.73 for distinguishing uncomplicated and complicated acute appendicitis in adult patients, with 60% sensitivity and 58.4% specificity. In addition, ROC analysis revealed a cutoff monocyte fraction (%) level of ≤6, with 72% sensitivity and 64% specificity, for distinguishing uncomplicated and complicated acute appendicitis in adult patients.
CONCLUSIONS: Our findings indicate that the mean serum NLR, MER, and CRP values measured on admission to ED in adult patients with acute appendicitis could not predict complicated acute appendicitis. However, mean serum PLR and neutrophil and monocyte counts can be useful in distinguishing complicated cases.

Objectives: It is difficult to capture the severity of synovial inflammation on imaging. Herein we hypothesize that diffusion tensor imaging (DTI) derived metrics may delineate the aggregation of the inflammatory cells and expression of inflammatory cytokines and dynamic contrast-enhanced (DCE) imaging may provide information regarding vascularity in the inflamed synovium. Patients and methods: Patients with knee arthritis (>3-months duration) underwent conventional (T2-weighted fast spin echo and spin echo T1-weighted images) as well as DTI and DCE MRI and thereafter arthroscopic guided synovial biopsy. DCE and DTI metrics were extracted from the masks of the segments of the inflamed synovium which enhanced on post-contrast T1-weighted MRI. These metrics were correlated with immunohistochemistry (IHC) parameters of inflammation on synovium. Statistical analysis: Pearson’s correlation was performed to study the relationship between DTI- and DCE-derived metrics, IHC parameters, and post-contrast signal intensity. Linear regression model was used to predict the values of IHC parameters using various DTI and DCE derived metrics as predictors. Results: There were 80 patients (52 male) with mean age 39.78 years and mean disease duration 19.82 months. Nineteen patients had tuberculosis and the rest had chronic undifferentiated monoarthritis (n = 31), undifferentiated spondyloarthropathy (n = 14), rheumatoid arthritis (n = 6), osteoarthritis (n = 4), reactive arthritis (n = 3), ankylosing spondylitis (n = 2), and juvenile idiopathic arthritis (n = 1). Fractional anisotropy (FA), a metric of DTI, had significant correlation with number of immune cells (r = 0.87, p < 0.01) infiltrating into the synovium and cytokines (IL-1β, r = 0.55, p < 0.01; TNF-α, r = 0.42, p < 0.01) in all patients and also in each group of patients and adhesion molecule expressed on these cells in all patients (CD54, r = 0.51, p < 0.01). DCE parameters significantly correlated with CD34 (blood flow, r = 0.78, p < 0.01; blood volume, r = 0.76, p < 0.01) in each group of patients, a marker of neo-angiogenesis. FA was the best predictor of infiltrating inflammatory cells, adhesion molecule and proinflammatory cytokines. Amongst the DCE parameters, blood volume, was best predictor of CD34. Conclusion: DTI and DCE metrics capture cellular and molecular markers of synovial inflammation in patients with chronic inflammatory arthritis.

UNASSIGNED: To determine whether peripheral blood leukocyte numbers and serum markers of inflammation can be used to predict which patients with primary uveal melanoma will develop metastasis.
UNASSIGNED: Retrospective study.
UNASSIGNED: Medical records of patients with uveal melanoma (UM) who received treatment for primary UM between February 1992 and December 2020 at the Erasmus University Medical Center (Rotterdam, The Netherlands) and the Rotterdam Eye Hospital (Rotterdam, The Netherlands) were reviewed.
UNASSIGNED: Inclusion criteria were the presence of a melanoma of the choroid or ciliary body and the availability of data from peripheral blood samples taken before treatment of the melanoma. Data including patient demographics, C-reactive protein (CRP) levels; erythrocyte sedimentation rate (ESR); number of leukocytes, neutrophils, monocytes, and lymphocytes; and histopathologic findings were obtained from medical records. Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated.
UNASSIGNED: Metastasis-free survival.
UNASSIGNED: Of the 807 patients with UM, serum and leukocyte data were available for 183 of them at the time of primary tumor treatment. In the total group, no correlation was found between ESR before treatment; the number of leukocytes; percentages of neutrophils, monocytes, and lymphocytes; or NLR or LMR values and any of the clinical characteristics or metastasis-free survival. Among patients who underwent enucleation, those with negative BAP1 findings showed significantly lower numbers of leukocytes (P < 0.05). In the entire cohort, a significant association was found between high CRP levels and longer metastasis-free survival (MFS; P = 0.049).
UNASSIGNED: The total blood leukocyte number was related to loss of BAP1 staining in patients who underwent enucleation, with lower leukocyte counts correlating with absent BAP1 staining. Higher CRP levels were associated with a longer MFS in the entire cohort. Neither the NLR nor the LMR is a good predictor for metastasis developing in patients with UM.

Babesia rossi causes severe morbidity and mortality in dogs in sub-Saharan Africa, and the complications associated with this disease are likely caused by an unfocused, excessive inflammatory response. During this experimental B. rossi study we investigated inflammatory marker and cytokine kinetics during infection and after treatment. We aimed to determine whether infectious dose and treatment would influence the progression of the inflammatory response and clinical disease. Six healthy male beagle dogs formed the study population, one was used to raise the infectious inoculum, three were administered a high B. rossi infectious dose (HD group) and two a low infectious dose (LD group). Clinical examination, complete blood count (CBC) and C-reactive protein (CRP) were determined daily. Cytokines were quantified on stored plasma collected during the study, using a canine specific cytokine magnetic bead panel (Milliplex©). The experiment was terminated and treatment administered when predetermined experimental or humane endpoints were reached. Parasitemia occurred on day 1 and 3 in the HD and LD groups respectively. The rate of increase in parasitemia in the HD group was significantly faster than that seen in the LD group. Significant differences were found in heart rate, blood pressure, interferon gamma (INFγ), keratinocyte chemoattractant (KC), INFγ-induced protein 10 (IP10), granulocyte-macrophage colony-stimulating factor (GM-CSF), monocyte chemoattractant protein 1 (MCP1), tumor necrosis factor alpha (TNFα), interleukin 2 (IL-2), IL-6, IL-7, IL-8, IL-10 IL-15, IL-18, CRP, neutrophils and monocytes between groups at multiple time points during the course of the infection. Our findings suggest that the initiation of inflammation occurs before the onset of clinical disease in B. rossi infection and infectious dose influences the onset of the inflammatory response. Treatment enhances the inflammatory response in the immediate post-treatment period which may contribute to disease associated complications. Finally, we found that there is an imbalance in pro/anti-inflammatory cytokine concentrations during infection which may promote parasite replication.

OBJECTIVE: Airborne Low Intensity Multi frequency Ultrasound (ALIMFUS) uses thermal and non thermal principal of ultrasound to facilitate transportation of drugs into the cells and it\'s metabolism. This is randomized, multi-center, Double Blind, Interventional, Placebo Controlled Study to evaluate efficacy and safety of ALIMFUS as an Add-on therapy to Oral Hypoglycemic Agent (OHA) in Type 2 DM.
METHODS: Total 103/186 subjects completed the study and received 10 min either ALIMFUS therapy on alternate day for 90 days or placebo. Baseline and end of the study Lab parameters like HbA1c, blood sugars, Lipid Profile, Serum Hs-CRP, Serum Interleukin-6, Serum TNF-α, Serum homocysteine, Serum Vitamin D, Serum Leptin, Serum Adiponectin and Quality of Life score were assessed.
RESULTS: At the end of study ALIMFUS group achieved greater (0.77 ± 1.13 vs 0.48 ± 0.79) but non-significant reduction in HbA1c. More subjects in ALIMFUS group (30.76% vs 27.45%) achieved HbA1c < 7%. Significant reduction in fasting and postprandial glucose noted in both groups whose baseline HbA1c was ≥8%. Significant reduction in lipid profile noted in ALIMFUS group compared to placebo. Insulin, adiponectin, CRP and homocysteine and quality of life were significantly better in ALMFUS group compared to baseline; but non-significant compared to placebo. No adverse events were associated with ALIMFUS.
CONCLUSIONS: Thus, ALIMFUS could be novel technology in diabetes management for patient unable to achieve glycemic targets on combination therapy. However further exploratory long term studies are required to demonstrate its effective role as add-on therapy in diabetes management.

Acute kidney injury (AKI) is one of the most severe complications of SARS-CoV-2 infection. In a retrospective study, we aimed to describe the influence of COVID-19-related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID-19-designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID-19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin-6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d-dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacement therapy (RRT). Compared with AKI at admission, hospital-acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy.

OBJECTIVE: To assess the ratio of levels of peripheral markers of inflammation and biomarkers of endothelial dysfunction (ED) with the severity of depression in middle-aged patients with cerebral microangiopathy.
METHODS: In an observational study of outpatients (n=262, 42.1% of men, 57.9% of women, average age 54.2±7 years), the severity of depressive disorders was assessed with HADS. Levels of peripheral markers of endothelial inflammation (C-reactive protein (CRP), monocytic chemoattractant protein-1 (MCP-1)) and ED biomarkers (endothelin-1, endothelial NO synthase, vascular endothelial growth factor, desquamated endotheliocytes, S100 protein, von Willebrand factor, fibrinogen) were determined by enzyme immunoassay. The initial sample of patients is divided into two groups: with clinical (n=146) and subclinical (n=116) depression. Based on the indicators of the ED biomarkers, a factor analysis was performed to calculate the integrative indicator of endothelial function (IIEF).
RESULTS: Patients with clinically defined depression compared with patients with subclinical depression had an increased level of peripheral markers of inflammation (CRP 6.11 vs 2.03 mg/L; p<0.05; MCP-1 2.02 vs 0.66 ng/ml; p<0.05). The severity of depression was directly correlated with the level of peripheral markers of inflammation (CRP, r=0.85, p<0.05; MCP-1, r=0.8, p<0.05, respectively). Patients with clinically expressed depression were characterized by a lower IIEF compared with patients with subclinical depression (0.12±0.04 vs 1.14±0.3; p<0.05, respectively). Odds ratios adjusted for age, obesity, type 2 diabetes mellitus were as follows: 1.5; 95% CI (1.3-1.8), p<0.001 for CRP; 1.67; 95% CI (0.63-2.85), p<0.001 for MCP-1; 1.21; 95% CI (1.19-1.35), p<0.001 for IIEF.
CONCLUSIONS: Pro-inflammatory ED contributes to the development of depression in middle-aged patients with cerebral microangiopathy associated with arterial hypertension. The severity of depression depends on the degree of ED. The association between the degree of ED, the pro-inflammatory activity of the endothelium and the severity of depression is relatively independent of age, obesity, type 2 diabetes mellitus.
UNASSIGNED: Оценить, как соотносятся уровни периферических маркеров воспаления и эндотелиальной дисфункции с выраженностью депрессии у пациентов среднего возраста с церебральной микроангиопатией.
UNASSIGNED: В обсервационном исследовании у амбулаторных пациентов (n=262, 42,1% мужчин, 57,9% женщин, средний возраст 54,2±7 лет) оценивали выраженность депрессивных расстройств с помощью Госпитальной шкалы депрессии. Уровни периферических маркеров эндотелиального воспаления (С-реактивный белок (СРБ), моноцитарный хемоаттрактантный протеин-1 (МСР-1)) и эндотелиальной дисфункции (эндотелин-1, активность эндотелиальной NO-синтазы, фактор роста эндотелия сосудов, количество десквамированных эндотелиоцитов, белок S100, фактор фон Виллебранда, фибриноген) определяли иммуноферментным методом. Исходная выборка пациентов разделена на две группы с клинической (n=146) и субклинической (n=116) депрессией. На основании показателей исследуемых биомаркеров эндотелиальной дисфункции проведен факторный анализ для расчета интегративного показателя эндотелиальной функции (ИПЭФ).
UNASSIGNED: Пациенты с клинически очерченной депрессией по сравнению с пациентами с субклинической депрессией имели повышенный уровень периферических маркеров воспаления (СРБ 6,11 против 2,03 мг/л; p<0,05; МСР-1 2,02 против 0,66 нг/мл; p<0,05). Тяжесть депрессии прямо коррелировала с уровнем периферических маркеров воспаления (СРБ, r=0,85, p<0,05; МСР-1, r=0,8, p<0,05 соответственно). Пациенты с клинически выраженной депрессией характеризовались меньшим ИПЭФ по сравнению с пациентами с субклинической депрессией (0,12±0,04 против 1,14±0,3 усл. ед. соответственно; p<0,05). Отношение шансов развития депрессии с учетом поправки на возраст, ожирение, сахарный диабет 2-го типа в зависимости от уровня периферических маркеров воспаления и ИПЭФ составило: СРБ OR 1,5; 95% ДИ (1,3—1,8), p<0,001; МСР-1 OR 1,67; 95% ДИ (0,63—2,85), p<0,001; ИПЭФ OR 1,21; 95% ДИ (1,19—1,35), p<0,001. Депрессия у пациентов среднего возраста с церебральной микроангиопатией, ассоциированной с артериальной гипертензией, формируется на фоне провоспалительной дисфункции эндотелия. Тяжесть депрессии зависит от степени дисфункции эндотелия. Ассоциация между степенью эндотелиальной дисфункции, провоспалительной активностью эндотелия и выраженностью депрессии относительно независима от возраста, ожирения, наличия сахарного диабета 2-го типа.