Biomarkers in medicine最新文献

Objective: The present study aimed to investigate whether circulating calprotectin levels were associated with the extent of lung parenchyma involvement, laboratory parameters of inflammation/organ damage, and clinical outcome in patients with SARS-CoV-2 infection.

Methods: A retrospective observational cohort study was conducted enrolling 172 adult patients with laboratory-confirmed SARS-CoV-2 infection. The extent of lung parenchyma involvement was assessed using a validated high-resolution computerized tomography (HRCT)-based stratification system. Serum calprotectin concentrations were quantified using the QUANTA Flash Circulating Calprotectin Reagents. Routine laboratory parameters were collected from clinical records. In a subset of patients who received tocilizumab (n = 56), serum samples were longitudinally collected.

Results: Circulating serum calprotectin levels were significantly associated with the extent of CT-assessed pulmonary involvement, markers of systemic inflammation, and adverse clinical outcomes (mechanical ventilation requirement and in-hospital death). A calprotectin threshold of 3.86 μg/mL showed high sensitivity for identifying patients with ≥40% lung parenchyma involvement, while a threshold of 13.73 μg/mL showed high specificity for adverse clinical outcomes. Longitudinal monitoring of calprotectin in tocilizumab-treated patients revealed that rising levels during follow-up were associated with death or tracheotomy, independent of baseline values.

Conclusion: Our findings support the clinical utility of circulating calprotectin as a complementary biomarker in COVID-19 management.

Objectives: This meta-analysis aimed to investigate the relationship between interleukin-1 receptor-associated kinase (IRAK1) gene rs1059703 and rheumatoid arthritis (RA) risk.

Methods: The pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Funnel plot with trim-and-fill analysis was used for publication bias investigation.

Results: IRAK1 gene rs1059703 was not significantly associated with RA risk under dominant genetic model (OR = 1.47, 95%CI = 0.96-2.24, p = 0.071), recessive genetic model (OR = 1.14, 95%CI = 0.92-1.40, p = 0.2258), allele genetic model (OR = 1.29, 95%CI = 0.95-1.75, p = 0.0878), and codominant genetic model (OR = 1.33, 95%CI = 0.82-2.15, p = 0.2125). Subgroup analysis also suggested that IRAK1 gene rs1059703 polymorphism was correlated with RA risk under dominant genetic model (I² = 80.9%, P_Q < 0.0001, OR = 1.77, 95%CI = 1.12-2.79, p = 0.014) and allele model (I² = 79.6%, P_Q = 0.0002, OR = 1.45, 95%CI = 1.05-2.00, p = 0.026) in Caucasian. Sensitivity analysis indicated that there was no significant change in the combined OR. No publication bias was observed.

Conclusion: A statistically significant association between IRAK1 rs1059703 and RA risk was observed in Caucasian populations, but not in Asian populations with the available power under the current sample size. The apparent Caucasian association observed in the full dataset was not sustained after restricting analyses to HWE-compliant studies, where only a single Caucasian study remained.

Aims: To develop a multibiomarker model for predicting 12-month major adverse cardiovascular events (MACE) in patients with acute heart failure (AHF) and assess incremental value.

Materials and methods: This study included 675 patients with AHF, comprising a development cohort (n = 303) and a validation cohort (n = 372). MACE comprised all-cause death or heart failure rehospitalization. Least absolute shrinkage and selection operator Cox regression and multivariable Cox regression were used for model development. Model performance was assessed using discrimination, calibration, decision curve analysis (DCA), and incremental value.

Results: The final model included monocyte-to-lymphocyte ratio (MLR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), heparin-binding protein (HBP), and soluble suppression of tumorigenicity 2 (sST2). Harrell's concordance index, the 12-month area under the time-dependent receiver operating characteristic curve (AUC), and Brier score were 0.710, 0.804, and 0.180 in the development cohort and 0.710, 0.760, and 0.203 in the validation cohort, respectively. Calibration demonstrated overall agreement between predicted and observed risks, and DCA suggested potential clinical net benefit. Adding HBP, sST2, and MLR to clinical variables and NT-proBNP increased the 12-month AUC from 0.753 to 0.824.

Conclusions: The multibiomarker model showed moderate predictive performance and may support post-discharge risk stratification in patients with AHF.

Background: Peritoneal dialysis-associated peritonitis (PDAP) remains a major cause of technique failure in peritoneal dialysis (PD) patients. Novel complete blood count-derived inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI), may provide accessible tools for early PDAP risk prediction.

Methods: In this retrospective cohort study, 302 PD patients were stratified according to incident PDAP during follow-up. Restricted cubic splines assessed nonlinear associations. Multivariable logistic regression evaluated independent associations with first-episode PDAP. Receiver operating characteristic curves assessed predictive performance.

Results: Baseline SII, SIRI, and AISI levels were significantly higher in the PDAP group than in the non-PDAP group (all p < 0.05). Higher Ln-SII (OR: 3.598; 95% CI: 2.204-5.872), Ln-SIRI (OR: 2.425; 95% CI: 1.584-3.714), and Ln-AISI (OR: 2.007; 95% CI: 1.403-2.871) were independently associated with increased PDAP risk (all p < 0.001). SII showed the highest discriminatory performance among the three markers, with an area under the curve of 0.689. A combined model incorporating SII, SIRI, and AISI achieved an AUC of 0.715.

Conclusion: Higher SII, SIRI, and AISI levels were associated with an increased risk of first-episode PDAP. A combined model demonstrates promising predictive accuracy.

Aims: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality worldwide, highlighting the need for reliable prognostic indicators. The modified Controlling Nutritional Status (mCONUT) score integrates nutritional and inflammatory parameters. This study evaluated the prognostic value of mCONUT in NSCLC and developed an mCONUT-based nomogram.

Patients and methods: This multicenter cohort study included 900 patients with NSCLC. The previously reported CRP-integrated mCONUT scoring system was applied. The prognostic performance of CONUT and mCONUT was compared using concordance index, time-dependent receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Overall survival (OS) was the primary endpoint. Secondary outcomes included short-term survival, malnutrition, and quality of life. A nomogram was constructed based on independent prognostic factors.

Results: During a median follow-up of 33.4 months, 380 deaths occurred. mCONUT showed a higher C-index than CONUT for OS prediction (0.650 vs. 0.605). A high mCONUT score was independently associated with poorer OS (HR = 1.63, 95% CI: 1.28-2.06), increased short-term mortality, an increased risk of malnutrition, and worse quality of life. The mCONUT-based nomogram showed improved discrimination (C-index = 0.727).

Conclusion: mCONUT may serve as a supplementary prognostic tool for individualized risk stratification in patients with NSCLC.

Introduction: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disorder characterized by recurrent febrile episodes and complications, including secondary amyloidosis. Protein 14-3-3η, part of a family of intracellular proteins, regulates pyrin activity, inhibiting inflammatory processes. Mutant pyrin disrupts this interaction, activating the inflammasome. Therefore, this study aimed to evaluate serum 14-3-3η levels in relation to attack status and amyloidosis in FMF patients.

Methods: A cross-sectional study was conducted with 104 FMF patients diagnosed via Tel Hashomer and PRINTO criteria and 50 healthy controls. Serum 14-3-3η levels were measured using ELISA kits, and statistical analyses were performed using SPSS version 22.0, with significance set at p < 0.05.

Results: Groups were similar in age and sex distribution. Serum 14-3-3η levels were significantly lower in FMF patients (median: 1.58 ng/mL) compared to controls (median: 2.33 ng/mL; p < 0.001). No significant differences were observed based on attack status or amyloidosis presence (p = 0.568 and 0.446, respectively).

Conclusion: Serum 14-3-3η levels are significantly reduced in FMF patients compared to healthy controls, which may indicate its role in FMF pathogenesis. However, no significant correlation was observed with disease activity or amyloidosis, thus limiting its potential use as a prognostic biomarker for disease progression or complications.

Background: Mounting research has proven that microRNAs (miRNAs) exert critical regulatory functions in the pathological progression of pediatric pneumonia.

Aims: To investigate the expression levels and clinical significance of miR-493-5p in children with severe pneumonia.

Methods: A total of 125 children diagnosed with severe pneumonia, 100 children with mild pneumonia, and 100 healthy children as normal controls were enrolled in this study. RT-qPCR was adopted to quantify serum miR-493-5p expression levels. ROC curves were plotted to assess its diagnostic efficiency; Kaplan-Meier survival analysis combined with Log-rank test evaluated 28-day prognostic value. LPS-stimulated MRC-5 human lung fibroblast cell model was constructed for in vitro functional experiments to uncover the underlying molecular mechanism of miR-493-5p.

Results: Serum miR-493-5p expression was markedly elevated in children with severe pneumonia. ROC analysis validated that serum miR-493-5p possessed satisfactory accuracy for distinguishing severe pneumonia from mild cases. miR-493-5p may target Interferon Regulatory Factor 1 (IRF1) to affect the functions and inflammatory responses of cells in the pneumonia model.

Conclusions: Serum miR-493-5p level has significant diagnostic and prognostic value in children with severe pneumonia.

Objectives: To evaluate the prognostic role of the lymphocyte-C-reactive protein ratio (LCR) in intrahepatic cholangiocarcinoma (ICC) within the TNM framework.

Methods: This study enrolled 248 resected ICC patients (low-LCR: 122; high-LCR: 126). A modified TNM (mTNM)system incorporating LCR was proposed.

Results: Low LCR was an independent prognostic factor for both overall survival (OS) and recurrence-free survival (RFS) by multivariable analysis. Median OS and RFS times were 43.2 and 12.8 months. Patients were stratified into 5 subgroups according to the mTNM staging system: group 1 (n = 67): stage I, LCR > 6000, group 2 (n = 50): stage I, LCR ≤ 6000, group 3 (n = 49): stage II, LCR > 6000, group 4 (n= 49): stage II, LCR ≤ 6000, and group 5 (n = 33): stage III with any LCR. Survival overlaps occurred between groups 2 and 3 (median OS: 49.4 vs 36.6 months; median RFS: 16.2 vs 13.8 months, p > 0.05). Similar overlaps were found for groups 4 and 5. The mTNM system showed improved discriminative ability (AUC: 0.69) over other staging systems (AUC: 0.63-0.65).

Conclusion: The mTNM system incorporating LCR provides relatively accurate survival prediction in resected ICC patients.