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1.
Incorporation of dynamic segmented neutrophil-to-monocyte ratio with leukocyte count for sepsis risk stratification.
Fang, WF, Chen, YM, Wang, YH, Huang, CH, Hung, KY, Fang, YT, Chang, YC, Lin, CY, Chang, YT, Chen, HC, et al
Scientific reports. 2019;(1):19756
Abstract
The association between sepsis and segmented neutrophil-to-monocyte (SeMo) ratio is unclear. We postulated that an increase in dynamic SeMo ratio measurement can be applied in risk stratification. This retrospective study included 727 consecutive sepsis patients in medical intensive care units (ICUs), including a subpopulation of 153 patients. According to the leukocyte (white blood cell, WBC) count on day 3 (normal range, between 4,000/µL and 12,000/µL) and delta SeMo (value of SeMo ratio on day 3 minus value of SeMo ratio on day 1; normal delta SeMo, <7), patients were grouped into 3 (delta SeMo & WBC tool). The survival lines separated significantly with hazard ratios of 1.854 (1.342-2.560) for the delta SeMo or WBC abnormal group and 2.860 (1.849-4.439) for the delta SeMo and WBC abnormal group compared to the delta SeMo and WBC normal group. Delta SeMo & WBC tool and delta sequential organ failure assessment (SOFA) tool performed better than the other tools (delta SeMo, delta WBC, day 3 WBC, and day 1 WBC). Severity in delta SeMo & WBC tool and delta SeMo tool reflected the immune dysfunction score, cytokine expression, and human leukocyte antigen D-related monocyte expression on day 1 and day 3. There was correspondence between delta SOFA and delta WBC and between delta SeMo and delta cytokine expression. Incorporation of dynamic SeMo ratio with WBC count provides risk stratification for sepsis patients admitted in the ICU.
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2.
Non-Celiac Gluten Sensitivity in patients with severe abdominal pain and bloating: The accuracy of ALCAT 5.
Di Stefano, M, Pesatori, EV, Manfredi, GF, De Amici, M, Grandi, G, Gabriele, A, Iozzi, D, Di Fede, G
Clinical nutrition ESPEN. 2018;:127-131
Abstract
BACKGROUND AND AIMS Non-Celiac Gluten Sensitivity (NCGS) is a recently proposed clinical condition causing both intestinal and extra-intestinal symptoms, without gastrointestinal lesions, which improve on avoiding gluten intake, in the absence of celiac disease and wheat allergy. The prevalence of this condition is still a matter of debate, in part due to the very recent introduction of an accepted diagnostic test, a double-blind, placebo controlled gluten challenge. However, this is a lengthy and cumbersome procedure, theoretically burdened by a significant reduction of patient compliance. ALCAT 5 is an automated in vitro test evaluating the toxic effect of gluten on neutrophils by the exposure of these cells to a gluten-containing extract of gluten-containing cereals. The test is very simple to perform, the results are rapidly obtained, and might represent, if sufficiently accurate, a promising alternative to diagnose gluten intolerance. The aim of this study was the comparison of ALCAT 5 results with those of a double-blind, placebo-controlled, gluten challenge, in a group of patients with clinically-suspected NCGS. METHODS Twenty-five patients (M/F 3/22, mean age 32 ± 4 yrs) with severe functional abdominal pain and bloating, who had previously undergone the ALCAT 5 test, were enrolled. All the subjects reported their symptoms on a gluten-containing diet and considered gluten the causal agent. Following the Salerno Experts' Criteria, they underwent a double-blind, placebo controlled trial with gluten vs placebo. A mean value during gluten ingestion >30% of the value during placebo was considered as indicative of gluten sensitivity. RESULTS After blinded administration of gluten, 13 out of 25 (52%) patients showed an increase in the severity of abdominal pain, and 11 out of 25 (44%) showed an increase in the severity of abdominal bloating. Considering these two symptoms together, in 16 patients out of 25 (64%), blinded gluten administration induced an increase of abdominal pain and/or bloating. The ALCAT 5 test proved to be positive in 20 and negative in 5 patients. In sixteen patients out of 25 the result of ALCAT 5 agreed with the double-blind trial (64%). In particular, both tests were positive in 14 patients and negative in 2. CONCLUSIONS In this subgroup of patients, ALCAT 5 could be used to support the clinical suspicion of the presence of NCGS and to address these patients to a blinded gluten challenge.
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3.
Activation of polymorphonuclear leukocytes and increased plasma vasoconstrictors in vasospastic and nonvasospastic angina.
Figueras, J, Garcia-Dorado, D, Agulló, L, Cortadellas, J, Padilla, F, Domingo, E, Galard, R
The Canadian journal of cardiology. 2011;(5):601-5
Abstract
BACKGROUND The cause of coronary vasoconstriction in patients with angina at rest, nonsignificant coronary stenosis, and endothelial dysfunction remains unknown. Our objective was to investigate the association between enhanced coronary vasoconstriction and increased circulating levels of vasoconstrictor agents. METHODS Plasma levels of big endothelin-1, serotonin, and superoxide produced by polymorphonuclear leukocytes were measured in 38 patients with stable angina at rest without significant coronary artery stenosis-23 with nonvasospastic angina and 15 with vasospastic angina-and were compared with 10 patients with stable coronary disease and 20 age-matched controls. RESULTS Patients with angina at rest showed higher big endothelin-1 (1.28 vs 0.72 fmol/mL, P < 0.001), serotonin (18.0 vs 9.1 ng/mL, P = 0.002), and superoxide produced by polymorphonuclear leukocytes (177 vs 67 nmol/10 × E8 × minutes, P = 0.001) than did controls. Serotonin and superoxide produced by polymorphonuclear leukocytes were also higher than in coronary disease patients (5.4 ng/mL, P = 0.001, and 97 nmol/10 x E8 x minutes, P = 0.005), and big endothelin-1 levels tended to be higher (0.99 fmol/mL, P = 0.073). Moreover, there were no significant differences in these 3 parameters between patients with vasospastic and nonvasospastic angina, and among the latter, between patients with a positive and those with a negative exercise stress test. CONCLUSION Systemic plasma levels of agents with the potential to produce coronary vasoconstriction are increased in patients with stable vasospastic or nonvasospastic angina and, hence, may contribute to their angina, increased coronary tone, and impaired vasodilatory capacity. Furthermore, they may establish a mechanistic link between the 2 conditions.
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4.
Comparison of neutrophil functions in aggressive and chronic periodontitis.
Ryder, MI
Periodontology 2000. 2010;:124-37
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5.
Effect of dietary supplementation with increasing doses of docosahexaenoic acid on neutrophil lipid composition and leukotriene production in human healthy volunteers.
Stanke-Labesque, F, Molière, P, Bessard, J, Laville, M, Véricel, E, Lagarde, M
The British journal of nutrition. 2008;(4):829-33
Abstract
n-3 PUFA supplementation helps in the prevention or treatment of inflammatory diseases and CVD. However, many supplementations reported sofar are either a combination of n-3 PUFA or used large daily amounts of n-3 PUFA dosages. The present study investigated the influence of increasing dose intake of DHA on the fatty acid composition of phospholipids in neutrophils and on their capability to produce leukotrienes(LT) B4 and B5 in vitro. Twelve healthy volunteers were supplemented with increasing daily doses of DHA (200, 400, 800 and 1600 mg, each dose in TAG containing DHA as the only PUFA and for a 2-week period). At the end of each supplementation period, neutrophil fatty acid composition,and LTB4 and LTB5 production were determined by GC and liquid chromatography-tandem MS, respectively. The DHA/arachidonic acid ratio increased in a dose-dependent manner with respect to the increasing doses of DHA supplementation and was significantly different from baseline after supplementation with either 400, 800 or 1600 mg DHA. The LTB5/LTB4 ratio was significantly increased compared to baseline after supplementation with 800 and 1600 mg DHA. LTB5/LTB4 and DHA/arachidonic acid ratios were correlated (r 0.531, P<0.0001). The present data suggest that both changes in neutrophil lipid composition and LT production occurred with daily supplementation with 800 and 1600 mg DHA. The clinical benefits associated with these doses of DHA in inflammatory diseases remain to be investigated.
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6.
Oxidative stress and inflammation due to peripheral polymorphonuclear leukocytes after coronary angiography vs percutaneous coronary intervention.
Farah, R, Shurtz-Swirski, R, Bolotin, Y, Brezins, M
Minerva cardioangiologica. 2008;(2):189-95
Abstract
AIM: Percutaneous coronary intervention (PCI) as an invasive procedure includes inflation of a balloon and/or implantation of an endovascular prosthesis (stent) in an atherosclerotic coronary vessel at a level where the plaque narrows its cross-sectional area by more than 75%. Various reports have demonstrated that balloon inflation or stent implantation trigger inflammation and subsequent growth of smooth muscle cells. Both oxidative stress (OS) and inflammation parameters worsen, increasing the risk of complications. The polymorphonuclear leukocyte (PMNL) is one of the inflammatory cells releasing reactive oxygen species contributing to OS, inflammation and endothelial injury. The aim of this study was to study the contribution of PMNLs during coronary intervention. METHODS Patients enrolled in this study were randomized into two groups, namely nine patients undergoing PCI procedure, compared to 11 undergoing diagnostic coronary angiography. PMNLs were separated from patient blood, before and following PCI. PMNL priming was measured by rate of superoxide release from PMNLs and flow cytometry analysis of CD11b levels. PMNL-related inflammation was estimated by white blood cells (WBC) and PMNL count. Systemic inflammation was monitored by C-reactive protein (CRP) and fibrinogen. RESULTS Tested patients were divided into patients undergoing PCI procedure, compared to those undergoing diagnostic coronary angiography; already at time ''0'', OS and inflammation parameters were higher in the PCI group of patients. OS parameters decreased significantly following PCI procedure. PCI itself induces increased OS and inflammation. Significant positive correlation was found between serum creatine phosphokinase and rate of superoxide release from PMNLs, indicating correlation between PMNL priming and the severity of cardiac disease. Systemic inflammation parameters, such as fibrinogen and CRP, showed significant decrease in the PCI group after the procedure, while those related to PMNLs did not. CONCLUSION PMNL contribution to OS and inflammation is lower in patients undergoing diagnostic coronary angiography, compared to the PCI group. This research adds new facet to evaluation of cardiac patients whether they will undergo PCI procedure or diagnostic coronary angiography.
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7.
Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients.
Asfour, IA, El Shazly, S, Fayek, MH, Hegab, HM, Raouf, S, Moussa, MA
Biological trace element research. 2006;(1):19-32
Abstract
The present study was undertaken to explore the effect of the administration of high doses of sodium selenite on apoptosis in polymorphonuclear leukocytes in patients with non-Hodgkin's lymphoma. Thirty patients with newly diagnosed non-Hodgkin's lymphoma were randomly divided into two groups. Group I was treated with chemotherapy and group II received 0.2 mg/kg/d sodium selenite in addition to chemotherapy. Flow cytometry was used for the monitoring of apoptosis on peripheral blood neutrophils at the time of diagnosis and after treatment in both groups of patients. Sodium selenite administration resulted in a significant reduction in neutrophils apoptosis (82+/-10% vs 32+/-18%, p<0.05) and this was associated with significant reduction in infection rate following chemotherapy (67% vs 20%, p<0.05). Also, significant improvement in cardiac ejection fraction was observed (62+/-4% vs 69+/-5% p<0.05). It is concluded that sodium selenite administration at the dosage chosen acts as a cytoprotective agent, alleviating side effects and immunosuppressive effects of cytotoxic chemotherapeutic agents.
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8.
No effect of fluid intake on neutrophil responses to prolonged cycling.
Bishop, NC, Scanlon, GA, Walsh, NP, McCallum, LJ, Walker, GJ
Journal of sports sciences. 2004;(11-12):1091-8
Abstract
Ingesting carbohydrate beverages during prolonged exercise is associated with fewer numbers of circulating neutrophils and attenuated neutrophil functional responses, yet there is little information about the effect of fluid intake alone on immune responses to prolonged exercise. The aim of this study was to examine the influence of regular fluid ingestion compared with no fluid ingestion on plasma cortisol, circulating neutrophil and lipopolysaccharide (LPS)-stimulated neutrophil degranulation responses to prolonged cycling. In a randomized design, nine recreationally active males cycled for 2 h at 65% VO2max on two occasions with either fluid ingestion (lemon-flavoured water, fluid trial) before and during the exercise, or with no fluid intake at all (no fluid trial). Venous blood samples were obtained at rest, immediately after exercise and 1 h after exercise. Immediately after exercise, the plasma cortisol concentration was significantly higher in the no fluid trial than in the fluid trial (592 +/- 62 vs 670 +/- 63 nmol x l(-1), P < 0.05). Circulating numbers of neutrophils increased 4.5-fold (P < 0.01) and LPS-stimulated elastase release per neutrophil decreased 34 +/- 7% (P < 0.01) immediately after exercise; there were no differences between trials. These results suggest that in ambient environmental conditions, fluid ingestion alone has a negligible effect on circulating neutrophil and LPS-stimulated neutrophil degranulation responses to prolonged exercise.
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9.
Effects of carvedilol on oxidative stress in polymorphonuclear and mononuclear cells in patients with essential hypertension.
Yasunari, K, Maeda, K, Nakamura, M, Watanabe, T, Yoshikawa, J, Asada, A
The American journal of medicine. 2004;(7):460-5
Abstract
PURPOSE To compare the effects of carvedilol and propranolol on oxidative stress in leukocytes and C-reactive protein levels in patients with hypertension. METHODS Sixty hypertensive patients were randomly assigned to carvedilol (20 mg; n = 30) or propranolol (60 mg; n = 30) for 6 months. Thirty normotensive subjects who were given placebo served as controls. Oxidative stress in polymorphonuclear cells and mononuclear cells were measured by gated flow cytometry. C-reactive protein levels were measured by immunonephelometric assay. RESULTS Oxidative stress in polymorphonuclear cells and mononuclear cells was increased significantly in hypertensive patients compared with in normotensive controls. After 6 months of treatment, carvedilol decreased oxidative stress significantly in polymorphonuclear cells by a mean of 45 arbitrary units (95% confidence interval [CI]: 32 to 59 arbitrary units; P <0.001) and propranolol decreased oxidative stress significantly by 20 arbitrary units (95% CI: 7 to 33 arbitrary units; P <0.003; P = 0.001 for difference between treatments). Carvedilol also decreased oxidative stress significantly in mononuclear cells by 23 arbitrary units (95% CI: 15 to 31 arbitrary units; P <0.001), whereas propranolol decreased oxidative stress by 2 arbitrary units (95% CI: 7 to 12 arbitrary units; P = 0.62; P = 0.002 for difference between treatments). Carvedilol decreased C-reactive protein levels significantly by a median of 0.073 mg/dL (interquartile range, 0.034 to 0.112 mg/dL; P <0.001), whereas propranolol decreased levels by 0.012 mg/dL (interquartile range, 0.009 to 0.032 mg/dL; P = 0.26; P = 0.003 for difference between treatments). CONCLUSION These findings suggest that carvedilol inhibits oxidative stress in polymorphonuclear and mononuclear cells, as well as lowers C-reactive protein levels, to a greater extent than does propranolol in hypertensive patients.
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10.
Development of a wound dressing targeting neutrophil function.
Nygren, H, Malmberg, P, Sahlin, H
World journal of surgery. 2004;(3):337-42
Abstract
Earlier studies show that neutrophils are virtually unable to kill Staphylococcus aureus in vitro. However, upon addition of 10 mM N-acetylcysteine (NAC) or reduced glutathione (GSH) the neutrophil bacterial killing ability becomes excellent. We want to exploit this phenomenon to develop a wound dressing material that will improve neutrophil function. To study the mechanisms behind the downregulation of neutrophil elimination of bacteria, we used different markers for neutrophil function on surface-adhering neutrophils in contact with S. aureus with or without addition of the antioxidants NAC or GSH. Analysis by scanning electron microscopy showed cell shrinkage and numerous cytoplasmic processes on surface-adhering neutrophils exposed to S. aureus. In cells exposed to S. aureus and GSH, the cells were of normal size and the cytoplasm was spread as in normal attachment. Staining for intracellular GSH, a hallmark of oxidative stress, showed little difference between the experimental groups, indicating that the cells were not damaged by traditional oxidative stress. The H(2)O(2) production of neutrophils, measured by Amplex red, was correlated to bacterial exposure and was not affected by the addition of scavengers. The intracellular and extracellular production of ROS was measured by luminol-amplified chemiluminescence. The apparent ROS-production was mostly intracellular and decreased in the presence of scavengers. However, extracellular production of ROS was not affected by the addition of NAC. The production of nitric oxide (NO) was measured spectrophotometrically as the production of nitrate apparently decreased in the presence of scavengers, probably as a result of interference with the reagents in the test system. In conclusion, differences between leukocytes that were able to eliminate S. aureus and those that were not were mainly seen in the morphology of the cells and in cell viability. The morphological findings point to a difference in NO signaling in the absence and presence of ROS scavengers.