Interleukin-6 as an independent predictor of future cardiovascular events in high-risk Japanese patients: comparison with C-reactive protein

Inflammation is associated with the development of atherosclerotic vascular lesions and some inflammatory parameters are used as cardiovascular (CV) risk markers. The present study was designed to assess the predictive power of interleukin (IL)-6 for future CV events. In 121 Japanese patients with multiple CV risk factors and/or disease, serum concentrations of IL-6 and high sensitive C-reactive protein (hs-CRP) were measured. During follow-up periods (mean, 2.9 years) after the baseline assessment, 50 patients newly experienced CV events such as stroke/transient ischemic attack (n=10), heart failure hospitalization (n=6), acute coronary syndrome (n=7), and revascularization for coronary artery disease (n=15) and peripheral arterial disease (n=12). The serum level of IL-6, but not hs-CRP, was significantly higher in patients who had CV events than in event-free subjects (3.9±2.6 and 3.0±2.2 pg/mL, P=0.04). When the patients were divided into three groups by tertiles of basal levels of IL-6 (<1.85, 1.85-3.77, and ≥3.77 pg/mL), cumulative event-free rates by the Kaplan-Meier method were decreased according to the increase in basal IL-6 levels (65%, 50%, and 19% in the lowest, middle, and highest tertiles of IL-6, respectively; log-rank test, P=0.002). By univariate Cox regression analysis, previous CV disease, creatinine clearance, and serum IL-6 levels were significantly associated with CV events during follow-up. Among these possible predictors, the highest tertile of IL-6 was only an independent determinant for the morbidity in the multivariate analysis (hazard ratio 2.80 vs. lowest tertile, P=0.006). These findings indicate that IL-6 is a powerful independent predictor of future CV events in high-risk Japanese patients, suggesting its predictive value is superior to that of hs-CRP.     

C反应蛋白与动脉粥样硬化

人类C反应蛋白 (C reactiveprotein ,CRP)是在感染和组织损伤时血浆浓度快速、急剧升高的主要的急性期蛋白。CRP可以激活补体和加强吞噬细胞的吞噬而起调理作用 ,从而清除入侵机体的病原微生物和损伤、坏死、凋亡的组织细胞 ,在机体的天然免疫过程中发挥重要的保护作用。关于CRP的研究已经有 70多年的历史 ,传统观点认为CRP是一种非特异的炎症标志物 ,但近十年的研究揭示了CRP直接参与了炎症与动脉粥样硬化等心血管疾病 ,并且是心血管疾病最强有力的预示因子与危险因子     

一种定量检测人血清高敏C反应蛋白的化学发光免疫方法

旨在建立一种可定量检测人血清高敏CRP的化学发光检测方法 (High-sensitivity C-reactive protein quantifiable chemiluminescent immunoassay,hs-CRP CLIA)。首先利用亲和层析和离子交换层析技术从肝硬化病人腹水中纯化出高纯度的天然CRP作为免疫原制备了22株CRP单克隆抗体 (单抗),其中13株单抗在磷酸胆碱配体捕获ELISA中呈阳性,然后利用方正滴定法筛选出单抗10C5和10C11建立了hs-CRP CLIA。试剂盒评估结果显示：该方法对血清中干扰物质IgG、血红蛋白、甘油三酯等无非特异性反应;该方法检测灵敏度高,在0.04~20.38 mg/L范围内定量检测人血清CRP标准品呈良好线性关系 (R2＞0.993);该方法准确性高、可重复性好,平均回收率为99％,批内差为4.2％~5.8％,批间差为9.0％~11.5％;该方法与进口商品化高敏CRP ELISA试剂盒平行比较检测90份血清标本,结果显示两者有良好的可比性 (r=0.968)。综上,建立的hs-CRP CLIA是一种准确、可靠、可定量的高灵敏C反应蛋白检测方法,该方法的临床应用,有利于改善我国心脏病风险评估及肠炎性疾病预后判断。     

C反应蛋白与动脉粥样硬化

C反应蛋白（C-reactiveprotein,CRP）是人类非特异性急性期蛋白,是判断组织损伤和炎症反应的敏感指标之一。CRP的表达水平与动脉粥样硬化（atherosclerosis,AS）和心血管疾病的发生具有冠著的相关性。但是关于CRP是否是AS的独立危险因素并参与AS的发病机制,目前尚存在很大争议。新近的研究发现,CRP与某些特定的配体结合后,五聚体结构CRP可分离形成单体结构CRP。这一发现为研究CRP蛋白与AS的相互关系提供了新的线索,对CRP及其单体结构的深入研究,将有可能帮助人们找到治疗心血管疾病的有效方法。就炎性反应标志物CRP及其单体（monomeric CRP,mCRP）与动脉粥样硬化的相关研究进展进行综述,以探讨分析CRP在AS中的作用。     

C-反应蛋白对脂肪细胞脂联素表达的影响

通过体外培养脂肪细胞,研究C-反应蛋白（CRP）对大鼠脂肪细胞脂联素蛋白分泌及mRNA基因表达的影响。取大鼠附睾脂肪垫培养脂肪细胞。用0、10、50ug／mL的CRP刺激脂肪细胞6h,提取细胞RNA,用实时荧光定量RT-PCR技术检测脂联素mRNA表达的变化;收集细胞培养液,运用Western blot技术检测脂联素蛋白分泌的变化。结果显示0、10、50ug／mL的CRP对大鼠脂肪细胞脂联素mRNA表达的影响无差异（P〉0．05）。50、10ug／mL的CRP均可减少大鼠脂肪细胞培养液中脂联素蛋白的分泌量（P〈0．05）。CRP可呈剂量依赖性的降低脂肪细胞脂联素蛋白分泌的水平。而各组CRP未能影响脂肪细胞脂联素mRNA的表达。CRP对脂肪细胞脂联素基因表达和蛋白分泌的研究可以揭示转录后的控制决定了CRP对脂联素的影响。     

Synthetic peptides from C-reactive protein containing tuftsin-related sequences

Peptides containing Lys-Pro-Arg or Thr-Lys-Arg segments corresponding to various regions of human C-reactive protein were synthesized. The peptides prepared were composed of amino acid residues, 37–58, 51–58, 173–187 and 181–187 of C-reactive protein. The relationship between C-reactive protein, its synthetic fragments and tuftsin (Thr-Lys-Pro-Arg) was investigated in binding studies, enhancement of phagocytosis and change in cyclic nucleotide levels of mouse macrophages. The peptides AA 51–58 and 181–187 did enhance macrophage phagocytosis capacity to a similar extent to that of tuftsin. They showed however only negligible binding to the cells. The effect of C-reactive protein and the synthetic peptides on metabolic activity of neutrophils was also investigated. It was shown that the peptides inhibited to some degree superoxide production, lysozyme release and Vitamin B₁₂ binding protein release from neutrophils in the absence and presence of the stimulants, PMA or Con A. Comparable activity with tuftsin was not found.     

Study of the spontaneous dissociation of rabbit C-reactive protein

C-Reactive protein (CRP) is composed of five identical noncovalently linked monomers and characterized as an important acute-phase protein. The CRP subunit obtained by denaturing treatments, which is termed modified CRP, has also been widely studied. In the current work, we found that there exists some degree of natural dissociation of CRP in stock solution. This dissociation is critically dependent on the absence of Ca²⁺. Low pH could enhance the dissociation of CRP, while ionic strength has little effect. Anilinonaphthalenesulfonate (ANS) fluorescence detections indicate that the exposure of hydrophobic surface increases during the dissociation. Acidic pH conditions also induce an increase in ANS fluorescence. This suggests that hydrophobic interactions between CRP subunits may contribute to the study of its pentameric structure. Surface plasmon resonance experiments indicate that monomeric CRP does not specifically bind to phosphatidylcholine-containing membrane as native CRP does. Electron microscopy shows that monomeric CRP binds to negatively charged lipid through electrostatic forces, and such lipid may induce the dissociation of CRP due to the acidic pH in the diffuse double layer near the membrane.     

Ethnic groups and high sensitivity C-reactive protein in Israel

Abstract

High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic risk and outcome. hs-CRP is influenced by various modifiable and non-modifiable factors. We studied the relationship between ethnic background and hs-CRP level, among the Jewish population in Israel. A total of 3659 men and 2180 women were divided into two ethnic groups (Ashkenazi and Sephardic Jews), based on the knowledge of Jewish immigration patterns throughout the centuries. Mean hs-CRP levels were calculated for each group and were adjusted for various factors known to influence hs-CRP. Sephardic Jews were found to have higher adjusted mean hs-CRP levels (2.0 mg l^?1 for men and 3.9 mg l^?1 for women) compared with Ashkenazi Jews (1.5 mg l^?1 for men and 2.9 mg l^?1 for women). Ethnic background emerged as an independent significant predictor of hs-CRP levels. We demonstrated that ethnicity is an important factor when considering hs-CRP as a marker of atherothrombotic risk.     

Expression of membrane-associated C-reactive protein by human monocytes: indications for a selectin-like activity participating in adhesion

We have shown previously that rat liver macrophages (Kupffer cells) express a membrane-bound form of C-reactive protein (mCRP) on their surface which is identical to a galactose-specific particle receptor activity. We now establish the presence of mCRP on human monocyte-macrophages using immunocytochemistry with an anti-neoCRP specific monocloncal antibody and RNA-RNAin situ hybridization to demonstrate the presence of CRP-specific mRNA. Concomitant with mCRP expression, cells exhibit galactose-dependent uptake of particles coated with lactosylated bovine serum albumin. Adhesion experiments on fibronectin-coated surfaces that mCRP on human blood monocytes may act as a selectin-like adhesion molecule, mediating initial carbohydrate-specific contacts which are followed by peptide-specific recognition via integrin receptors.     

Ethnic groups and high sensitivity C-reactive protein in Israel

High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic risk and outcome. hs-CRP is influenced by various modifiable and non-modifiable factors. We studied the relationship between ethnic background and hs-CRP level, among the Jewish population in Israel. A total of 3659 men and 2180 women were divided into two ethnic groups (Ashkenazi and Sephardic Jews), based on the knowledge of Jewish immigration patterns throughout the centuries. Mean hs-CRP levels were calculated for each group and were adjusted for various factors known to influence hs-CRP. Sephardic Jews were found to have higher adjusted mean hs-CRP levels (2.0 mg l^-1 for men and 3.9 mg l^-1 for women) compared with Ashkenazi Jews (1.5 mg l^-1 for men and 2.9 mg l^-1 for women). Ethnic background emerged as an independent significant predictor of hs-CRP levels. We demonstrated that ethnicity is an important factor when considering hs-CRP as a marker of atherothrombotic risk.     

C-反应蛋白——关联心血管疾病与炎症的重要分子

炎症在心血管疾病（cardiovascular disease,CVD）的各个阶段中均发挥着重要作用。C-反应蛋白（C-reactive protein,CRP）是一种典型的人类急性期蛋白,由5个相同的亚基构成,在临床上被广泛用作炎症的非特异性标识物。近年的研究显示,CRP不仅是CVD发病风险的灵敏标识,而且直接参与调控与CVD相关的炎症过程。基于对已有研究发现的回顾和分析,文章指出CRP的单体形式（monomeric CRP, mCRP）是调控局部炎症过程的主要CRP异构体。     

应用C-反应蛋白区别急性失代偿性心力衰竭与肺炎

目的研究通过测定入院时C-反应蛋白（CRP）水平和CRP速度来鉴别急性失代偿性心力衰竭（ADHF）与肺炎的功效。方法回顾性研究三级医院两年的ADHF与肺炎患者的病例资料。住院时已经用抗生素治疗的患者除外。CRP作为诊断标志物的有效性通过ROC来评估。结果 72例ADHF和50例肺炎患者被纳入研究。ADHF患者入院时平均CRP水平为（13.5±13.5）mg/L,而肺炎患者为（127±84）mg/L（P〈0.001）。CRP增加大于等于0.56 mg/（L·h）时诊断肺炎。入院时CRP水平和CRP升高作为区别肺炎与ADHF的标记物时的敏感度是0.96,特异性为0.972。结论本研究强调生物标志物的动态特性,证实了急性期反复测量CRP的有效性,它将为临床医生提供有价值的工具来建立正确的诊断及减少不必要的抗生素使用。     

阿维菌素中毒患者血清C反应蛋白的浓度变化及意义

目的探讨口服阿维菌素中毒患者血清C反应蛋白浓度变化与病情严重程度及预后的关系。方法将39例口服阿维菌素中毒患者分为轻度中毒组和中重度中毒组,42例健康体检者为对照组。轻、中重度中毒组患者分别于入院时及入院第3、5天检测血清C反应蛋白浓度,并进行组间比较。结果中毒组血清CRP水平明显高于对照组,差异有统计学意义（P〈0.05）;轻度中毒组血清CRP水平在入院时及入院第3、5天变化较小,各时点血清CRP水平比较无显著统计学意义（P〉0.05）;中重度中毒组血清CRP水平在入院时即显著升高,入院第3天达最高值,各时点血清CRP水平比较差异有统计学意义（P〈0.05）。结论血清C反应蛋白浓度可作为判断口服阿维菌素中毒患者病情严重程度及预后的敏感指标。     

Effects of interleukin-2 (IL-2) on human plasma lipid,lipoprotein, and C-reactive protein

Six patients with confirmed malignant disease received four consecutive weekly cycles of human recombinant interleukin-2 (IL-2) 4 days/week, continuous iv. infusion, 3 × 10⁶ U/m²/day. Plasma cholesterol decreased a mean of 7% within 24 hours after IL-2 infusion and decreased by 33% within 4 days. Plasma cholesterol was significantly lower than baseline concentration by day 21 (–21%), and day 25 (–41%) was significantly lower than day 21. Decreased plasma cholesterol was the result of decreased HDL and LDL cholesterol concentrations. Plasma triglyceride demonstrated a mean increase of 46% after 4 days of therapy and remained greater than baseline concentrations at all time points analyzed. Apolipoprotein AI and AII decreased concomitantly with HDL-cholesterol concentrations, whereas apolipoprotein B after an initial mean decrease of 17% during the first cycle was not significantly different from baseline during the fourth cycle. Apolipoprotein E and Lp(a) were not significantly affected by IL-2 treatment. Plasma C-reactive protein (CRP) increased by 79% within 24 hours of therapy, increased by 254% on day 4, then decreased to baseline concentrations by day 21 after 3 days off of IL-2. Day 25 CRP was elevated compared to both baseline and day 21 concentrations. IL-2 induced plasma lipoprotein changes may be due in part to the induction of interferon gamma.     

Carbohydrate ligands of human C-reactive protein: Binding of neoglycoproteins containing galactose-6-phosphate and galactose-terminated disaccharide

Binding of carbohydrate ligand by human C-reactive protein (CRP), in both native form and structurally deviated form (neoCRP or mCRP), was investigated using galactose-6-phosphate (Gal6P)- and Galβ3GalNAc-containing bovine serum albumin (BSA) derivatives. To this end, we synthesized glycosides of Gal6P and Galβ3GalNAc that can potentially generate a terminal aldehyde group. ω-Aldehydo glycosides were then conjugated to BSA via reductive amination. Using these neoglycoproteins, we showed that: (1) Gal6P-BSA and Galβ3GalNAc-BSA bound to both forms of CRP, the former with or without calcium and the latter only in the absence of calcium; (2) phosphate-containing ligands can be bound with or without calcium, but the binding is much stronger in the presence of calcium than in the absence, underscoring the importance of direct coordination of phosphate to two calcium ions observed in the X-ray structure of phosphorylcholine (PC)–CRP complex; (3) cross-inhibition studies further corroborated the hypothesis that binding sites of PC and sugar are contiguous; (4) while PC-BSA bound to the native CRP over a wide pH range of 4.5 to 9, all the carbohydrate ligands and protamine-BSA (poly-cation-based ligand) exhibited optimal binding at around pH 6 to 6.5; and (5) ligand-binding conformation of mCRP appears to be more fragile than that of the native CRP in the acidic media (pH < 6).     

Quantitative measurements of C-reactive protein using silicon nanowire arrays

A silicon nanowire-based sensor for biological application showed highly desirable electrical responses to either pH changes or receptor-ligand interactions such as protein disease markers, viruses, and DNA hybridization. Furthermore, because the silicon nanowire can display results in real-time, it may possess superior characteristics for biosensing than those demonstrated in previously studied methods. However, despite its promising potential and advantages, certain process-related limitations of the device, due to its size and material characteristics, need to be addressed. In this article, we suggest possible solutions. We fabricated silicon nanowire using a top-down and low cost micromachining method, and evaluate the sensing of molecules after transfer and surface modifications. Our newly designed method can be used to attach highly ordered nanowires to various substrates, to form a nanowire array device, which needs to follow a series of repetitive steps in conventional fabrication technology based on a vapor-liquid-solid (VLS) method. For evaluation, we demonstrated that our newly fabricated silicon nanowire arrays could detect pH changes as well as streptavidin-biotin binding events. As well as the initial proof-of-principle studies, C-reactive protein binding was measured: electrical signals were changed in a linear fashion with the concentration (1 fM to 1 nM) in PBS containing 1.37 mM of salts. Finally, to address the effects of Debye length, silicon nanowires coupled with antigen proteins underwent electrical signal changes as the salt concentration changed.     

Cardiac glycosides induce resistance to tubulin-dependent anticancer drugs in androgen-independent human prostate cancer

Due to high prevalence and mortality and the lack of effective therapies, prostate cancer is one of the most crucial health problems in men. Drug resistance aggravates the situation, not only in human prostate cancer but also in other cancers. In this study, we report for the first time that cardiac glycosides (e.g. ouabain and digitoxin) induced resistance of human prostate cancer cells (PC-3) in vitro to tubulin-binding anticancer drugs, such as paclitaxel, colchicine, vincristine and vinblastine. Cardiac glycosides exhibited amazing ability to reverse the G2/M arrest of the cell cycle and cell apoptosis induced by tubulin-binding agents. However, neither ionomycin (a Ca(2+) ionophore) nor veratridine (a Na(+) ionophore) mimicked the preventive action of cardiac glycosides, indicating that elevation of the intracellular Ca(2+) concentration and Na(+) accumulation were not involved in the cardiac glycoside action. Furthermore, cardiac glycosides showed little influence on the effects induced by actinomycin D, anisomycin and doxorubicin, suggesting selectivity for microtubule-targeted anticancer drugs. Using in situ immunofluorescent detection of mitotic spindles, our data showed that cardiac glycosides diminished paclitaxel-induced accumulation of microtubule spindles; however, in a non-cell assay system, cardiac glycosides had little influence on colchicine- and paclitaxel-induced microtubule dynamics. Using an isotope-labeled assay method, we found that ouabain modestly but significantly inhibited the transport of [(14)C]paclitaxel from the cytosol into the nucleus. It is suggested that cardiac glycosides inhibit the G2/M arrest induced by tubulin-binding anticancer drugs via an indirect blockade on microtubule function. The decline in transport of these drugs into the nucleus may partly explain the action of cardiac glycosides.