Objectives: Adiponectin, a major cytokine from adipose tissue, and high sensitivity C-reactive protein (hs-CRP), well-established markers of inflammation are known to be associated with increased risk of cardiovascular disorders (CVD). Therefore the objective of our study was to evaluate the levels of these parameters and determine their correlation with glycemia to assess the cardiovascular risks in the patients with Type 2 diabetes mellitus.Methods: This study was conducted in the Department of Biochemistry, Santosh Medical College, Ghaziabad, with 25 Type 2 diabetic patients and 25 age and sex-matched controls. Ethical clearance from the institution and informed consent from the patients were taken before the study. Adiponectin was analyzed by enzyme-linked immunoadsorbent assay, and blood sugar and CRP were estimated by the kit based method.Results: Fasting blood sugar (FBS, 158.2±37.2) and hs-CRP (3.97±1.54) were significantly high, adiponectin was significantly low in the patients with diabetes compared to controls (80.52±9.72, 1.27±0.75, and 10.78±1.69, respectively, p<0.05). Adiponectin showed a negative correlation with FBS (r=−0.427) and hs-CRP (r=−0.336), but the correlation was significant only in case of FBS (p<0.05). hs-CRP positively correlated with FBS (r=0.568) and was statistically significant.Conclusion: The results of our study further support the role of adiponectin and hs-CRP as a predictive biomarker of CVD risks in the patients suffering from Type 2 diabetes.
MAS, which is currently grouped under secondary or acquired haemophagocytic lymphohistiocytosis (sHLH), is a rare and fatal disorder that results from excess activation of T-cells and macrophages. Though the pathogenesis of MAS is poorly understood, various proinflammatory cytokines like interleukins (IL-1, IL-6), tumor necrosis factor α (tNF α), interferons are thought to play significant roles. MAS is associated with various clinical features such as non-remitting fever, bleeding, cytopenias, splenomegaly, hepatic dysfunctions, increased levels of triglyceride, ferritin and decreased levels of albumin and fibrinogen. Early diagnosis and interventions are crucial to reduce mortality risk but diagnosis is not often easy due to persistence of wide range of features that overlap with other rheumatic diseases, most commonly sJIA (systemic juvenile idiopathic arthritis). Corticosteroids and cyclosporins are commonly used for MAS treatment. Intravenous immunoglobulins, biologic agents like IL-1 blockers (anakinra, canakinumab), IL-6 blockers (tocilizumab) are also frequently used. Moreover there is still the need of genetic and immunohistological study in order to understand the exact mechanism of the syndrome development and establishment of novel therapies with lesser toxicities.
Cytokine release syndrome (CRS) is a life threatening toxicity associated numerous immunotherapeutic techniques involving monoclonal antibodies, bispecific antibodies and adoptive T cell therapies. It is also referred as infusion reaction that results in release of large amount cytokines (Like IL-6, IFN-r, INF) from the target cells. Cytokines when released in excessive amounts into the circulation produces systemic symptoms like nausea, shills, fever, rashes, headache, hypotension, dyspenea etc. Most of the patients present mild to moderate symptoms which can be managed easily but some patients show life threatening symptoms. Studies have shown that immunosuppressive agents like corticosteroids and tocilizumab can reverse the toxicity of CRS, however such immunosuppression may limit the immunotherapeutic efficacy. Therefore specific precautions must be considered in such patients to present exacerbation of the complication. Thus this review is based on the overview of CRS which include etiology, mechanism and management of CRS, so that immunotherapeutic benefits can be maximized with minimum risk of complication.
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