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Cytomegalovirus and Epstein-Barr virus reactivation in the intensive care unit.

The purpose of this work was to evaluate the reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in immunocompetent patients in the intensive care unit (ICU) and to identify risk factors associated with reactivation.

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Increased serum amyloid A and its association with autoantibodies, acute phase reactants and disease activity in patients with rheumatoid arthritis.

Determination of disease activity in patients with rheumatoid arthritis (RA) has become an important component for RA management. The aim of the present study was to investigate the association between circulating levels of serum amyloid A (SAA) and disease activity in RA patients. The types of disease and the respective number of patients enrolled in the present study were as follows: RA, 88; osteoarthritis (OA), 54; systemic lupus erythematosus (SLE), 43; and other autoimmune diseases, 30, as well as 50 healthy controls (HC). SAA levels were measured using an ELISA assay and western blot analysis was used to detect serum SAA levels. The correlations between SAA levels and disease activity score for 28 joints (DAS28), erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP), respectively, were evaluated; in addition, the presence and absence of rheumatoid factor (RF) and anti‑cyclic citrullinated peptide antibody (anti‑CCP) were detected in respect to SAA levels. The results of the present study demonstrated that serum levels of SAA in RA patients were significantly increased compared to those of the OA, SLE, others and HC patients (P<0.05). SAA levels were found to be positively correlated with DAS28, ESR and CRP levels (R2=0.6174, 0.4422 and 0.3919, respectively). In addition, anti‑CCP was not correlated with DAS28 (R2=0.0154). Furthermore, increased SAA levels were detected in patients with positive anti‑CCP compared with those in anti‑CCP negative subjects (P<0.01). In conclusion, the results of the present study provided further evidence for possible roles of SAA in RA, which indicated that it may be a useful biomarker for assessing disease severity and may provide additional information about disease activity.

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Increased circulating T‑helper 22 cells in patients with dilated cardiomyopathy.

Recently, the newly determined interleukin (IL)‑22‑producing T-helper (Th) 22 cell has been implicated to be involved in the pathogenesis of autoimmune diseases. However, its role in the pathogenesis of dilated cardiomyopathy (DCM) has yet to be elucidated. A total of 30 patients with DCM and 30 healthy controls were enrolled in the present study. The levels of Th22, Th17 and Th1 cells in the peripheral blood were analyzed by flow cytometry. Levels of plasma IL‑22 and autoantibody adenine nucleotide translocator (ANT) were assessed using the ELISA. The key transcription factor of Th22, aryl hydrocarbon receptor (AHR), was assessed using quantitative polymerase chain reaction. Additionally, clinical data on the brain natriuretic peptide (BNP), C‑reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were collected. In comparison with those in the control group, significantly elevated levels of Th22, Th17 and Th1 cells were detected in patients with DCM (all P<0.01). Similarly, elevated mRNA levels of peripheral AHR were detected in patients with DCM. The percentage of Th22 cells was higher in ANT‑positive compared with ANT‑negative patients with DCM. The levels of BNP and CRP, but not ESR, showed a significant positive correlation with those of Th22 cells. With regard to the concentrations of plasma IL‑22, no statistical difference was found between patients with DCM and the healthy controls, nor did it demonstrate a statistical correlation with the percentage of Th22 cells. In conclusion, the present study showed that patients with DCM, particularly those of the ANT autoantibody positive subjects, exhibit elevated levels of peripheral Th22 cells, indicating that a Th22 immune response may be implicated in the pathogenesis of DCM.

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[Relationships among Oxidative Stress Markers, Life Style Factors and Biochemical Findings.].

In many studies, oxidative stress markers have been employed to serve as a measure of a disease process or to reflect oxidative status. These oxidative stress markers must have some degree of predictive validity, but full substantiation of this relation is still lacking. This paper presents data on levels of three biomarkers, oxidized low-density lipoproteins (LDL), carbonyl, and 8-hydroxy-2'-deoxyguanosine (8-OHdG), and a number of life style factors associated with oxidative stress in healthy adults.

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The biological role of the female sex hormone estrogen in the periodontium--studies on human periodontal ligament cells.

Several studies have addressed the association between changes in levels of the female sex hormone, estrogen, and changes in the parameters of periodontitis, but the mechanism behind estrogenic effects in the periodontium is poorly understood. There are two subtypes of estrogen receptors (ER), ERalpha and ERbeta. The objectives of the present studies were to map periodontal ligament (PDL) cell ER-subtype expression patterns and to investigate their functional importance. This information is valuable for understanding the biological role of ERs in the periodontium.

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Effect of atorvastatin on peripheral endothelial function and systemic inflammatory markers in patients with stable coronary artery disease.

Endothelial dysfunction, detectable by an impaired flow-mediated vasodilation (FMD) of the brachial artery, has been shown to be associated with increased levels of circulating proinflammatory markers. Therapeutic interventions such as lipid-lowering with statins increase FMD and decrease inflammatory markers, like soluble (s) E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) or high-sensitivity Creactive protein (hsCRP). The effect of atorvastatin therapy on both FMD and inflammatory markers in patients with stable coronary artery disease (CAD) has not been investigated.

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Comparison of procalcitonin, sCD14 and interleukin-6 values in septic patients.

The aim of the study was to investigate whether procalcitonin, soluble CD14 and interleukin-6 show advantages in predicting the outcome and specificity for bacterial infection in patients with sepsis in comparison to common C-reactive protein measurement. Laboratory parameters were measured in plasma of patients during 14 days following the diagnosis of sepsis. Patients fulfilling the ACCP/SCCM criteria for sepsis were admitted to an intensive care unit (n=35). Procalcitonin was measured with an immunoluminometric assay, and soluble CD14 and interleukin-6 were analysed by ELISA. C-reactive protein was determined nephelometrically. Measurements were performed on days 0, 1, 2, 3, 4, 7 and 14. Separating the patients into survivors (n=22) and non-survivors (n=13), it was demonstrated that non-survivors mostly exhibited, after the day of admission, increasing procalcitonin concentrations which peaked around days three and four. In contrast, the procalcitonin concentrations of survivors fell continuously to the value of 2.1 ng/ml which was reported to be important for patients prognosis. The difference between procalcitonin median values of survivors (n=22) and non-survivors (n=13) attained the level of statistical significance on day 7 and on day 14 (p=0.05). When comparing the median values of Creactive protein, soluble CD14 and interleukin-6 between survivors and non-survivors, no significant differences were detectable. In this study, plasma concentrations of soluble CD14 and interleukin-6 showed no predictive value for patients' outcome as compared with established laboratory parameters such as C-reactive protein or leukocyte count. Monitoring of procalcitonin seemed to detect severe episodes of sepsis and may improve the laboratory monitoring of septic patients.

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Interleukin-10 and interleukin-6 in lupus erythematosus and rheumatoid arthritis, correlations with acute phase proteins.

We sought to investigate the influence of interleukin-10 (IL-10) and IL-6 on the acute phase proteins (APP) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). IL-10, IL-6, Creactive protein (CRP), alpha-1-acid glycoprotein (AGP), and alpha1 antichymotrypsin (ACT) serum levels were determined in one hundred-eight patients (71 with SLE, 37 with RA). Quantification of the serum IL-10 level showed increased levels in SLE and RA patients as compared to healthy controls. Serum IL-6 level was found to be elevated in SLE and RA patients. A correlation between IL-10 and IL-6 serum level was found only in SLE. CRP and AGP serum levels were increased in RA as compared to controls, whereas in SLE only AGP was found elevated. A statistically significant correlation between IL-6 serum level and CRP, AGP and ACT was found only in RA. No correlation between IL-10 and serum level of CRP, AGP and ACT was established. Since IL-10 has a potent immunosuppressive activity, we expected it to be negatively correlated with APP levels. Surprisingly, IL-10 did not correlate with APP either in SLE or RA patients. However, the elevation of IL-10 serum levels in SLE and RA and the correlation between IL-10 and IL-6 in SLE may suggest that IL-10 may play a central role in inflammatory connective tissue diseases.

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