High-sensitivity C-reactive protein (hs-CRP) in systemic lupus erythematosus patients without cardiac involvement; relation to disease activity, damage and intima-media thickness

Gheita, Tamer A.; El‐Gazzar, Iman I.; Azkalany, Ghada S.; El-Fishawy, Hussein S.; ElFaramawy, Amr

doi:10.1016/j.ejr.2012.08.002

Cited by 13 publications

(6 citation statements)

References 30 publications

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“…Serum hs-CRP levels are known to be higher in patients with SLE than in healthy controls [ 19 ] and are correlated with cardiovascular risk factors in patients with SLE [ 20 ]. One study showed an association of this measure with a disease activity score [ 21 ], but another suggested that such an association only appeared after excluding patients with measurable interferon (IFN)-α and CRP gene polymorphisms [ 22 ]. Our data are consistent with a reported meta-analysis showing the benefit of probiotic supplementation in reducing hs-CRP levels in other patient populations, such as those with rheumatoid arthritis [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Gut Microbiota and Systemic Inflammation after Synbiotic Supplementation in Patients with Systemic Lupus Erythematosus: A Randomized, Double-Blind, Placebo-Controlled Trial

Widhani

Djauzi

Suyatna

et al. 2022

Cells

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Gut dysbiosis has a role in the pathogenesis of lupus. Synbiotic supplementation may restore the balance of gut microbiota. This study investigated whether synbiotics could improve gut microbiota and systemic inflammation in lupus patients. This randomized, double-blind, placebo-controlled trial was conducted in adult systemic lupus erythematosus (SLE) patients. Subjects were randomized to receive either synbiotics or a placebo. Fecal microbiota, hs-CRP, IL-6, and IL-17 were measured at baseline and after 60 days. Patients who fulfilled the inclusion criteria were randomized into synbiotic (n = 23) and placebo groups (n = 23). In the synbiotic group, hs-CRP was not significantly increased (1.8 [0.9; 4.85] vs. 2.1 [0.9; 4.25] mg/L; pre vs. post; p = 0.23), whereas in the placebo group hs-CRP was increased significantly (1.75 [0.4; 4.45] vs. 3.75 [0.58; 7.05] mg/L; pre vs. post; p = 0.005). In the synbiotic group, IL-6 decreased significantly (8.76 [6.62; 11.39] vs. 6.59 [4.96; 8.01]; pre vs. post; p = 0.02), while there was no significant change in IL-17 level. In the placebo group, there was no significant change in IL-6 and IL-17. Synbiotic supplementation increased the Firmicutes:Bacteroidetes ratio (0.05 ± 0.60 vs. −0.08 ± 0.63, synbiotic vs. placebo p = 0.48) and butyrate metabolism (p = 0.037) and decreased amino sugar and nucleotide sugar metabolism (p = 0.040). There was improvement in the SLE disease activity index 2K (SLEDAI-2K) score in the synbiotic group (14 [9; 16] vs. 8 [2; 12]; pre vs. post; p < 0.001), while no change in the placebo group (9 [8; 18.25] vs. 9 [5.5; 15]; pre vs. post; p = 0.31). Synbiotic supplementation could reduce systemic inflammation and SLE disease activity and alter the composition and functions of gut microbiota.

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Section: Discussionmentioning

confidence: 99%

Changes in Gut Microbiota and Systemic Inflammation after Synbiotic Supplementation in Patients with Systemic Lupus Erythematosus: A Randomized, Double-Blind, Placebo-Controlled Trial

Widhani

Djauzi

Suyatna

et al. 2022

Cells

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“…It should be mentioned that the discordance between ESR and CRP levels during SLE flares led to the impression of low CRP levels in these patients. However, CRP baseline levels seem actually to be higher in SLE patients than in the general population, 42,43 being a possible determinant of the increased cardiovascular risk. We need to underline the fact that CRP is one of the predictors of elevated cardiovascular risk in apparently healthy subjects.…”

Section: C-reactive Protein and Erythrocyte Sedimentation Rate Discordance In Patients With Systemic Lupus Erythematosusmentioning

confidence: 94%

“…45 In patients with SLE, CRP was also positively correlated with traditional cardiovascular risk factors such as body weight or hypertension, and inversely correlated with the presence of antimalarial treatment. 46 Moreover, in SLE patients without known cardiac pathology, CRP levels were correlated with intima-media thickness, 43 a well-known marker of subclinical vascular disease and increased cardiovascular risk.…”

Section: C-reactive Protein and Erythrocyte Sedimentation Rate Discordance In Patients With Systemic Lupus Erythematosusmentioning

confidence: 99%

Is there still a place for erythrocyte sedimentation rate and C-reactive protein in systemic lupus erythematosus?

Dima

Opriş

Jurcuţ³

et al. 2016

Lupus

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The inflammatory response during systemic lupus erythematosus (SLE) flares is known to be atypical, characterized by a disproportionately lower C-reactive protein (CRP) elevation when compared with erythrocyte sedimentation rate (ESR). Thus, in these patients, the analysis of inflammatory markers might be challenging in daily clinical practice. Clinicians need frequently to distinguish lupus reactivations and infectious conditions, and the significance of ESR and CRP seems to be different. Even though a non-specific marker of inflammation, ESR utility in SLE should not be neglected and it appears to be a useful biomarker for SLE activity assessment. Describing a specific cut-off for ESR in SLE is important for patients' follow-up, and levels up to 25-30 mm/h have been proposed as an upper limit of the normal range. Regarding CRP, even though higher baseline levels are described in SLE when compared with controls, including in remission periods, its response during flares seems to be incomplete and not always correlated with disease activity; while CRP values greater than 10 mg/l could be indicative for severe flares, when there is no serositis or arthritis, higher CRP levels above 50-60 mg/l may be associated with infection.

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“…38 CRP is a highly sensitive marker that has been used to detect low levels of chronic inflammation. 39 Our results suggest that LCBE exhibits antiinflammatory activity, which was evidenced by the decrease in the CRP and IL-6 levels in the serum of LCBE-supplemented rats. The inhibitory effects of LCBE against LPS-induced liver inflammation may be associated with the reduction of ROS levels and GSH depletion, which is consistent with a previous report.…”

Section: Groupsmentioning

confidence: 51%

Lonicera caerulea berry extract suppresses lipopolysaccharide-induced inflammation via Toll-like receptor and oxidative stress-associated mitogen-activated protein kinase signaling

Wang

Zhu

et al. 2016

Food Funct.

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The protective effects of Lonicera caerulea berry extract (LCBE) against hepatic inflammation and the underlying mechanisms were investigated in a rat model of lipopolysaccharide (LPS)-induced chronic liver inflammation. Male Sprague-Dawley rats were injected with LPS (200 μg per kg bw) with or without LCBE co-administration (50, 100 and 200 mg per kg bw intragastrically once daily) for 4 weeks. We found that LCBE supplementation inhibited the increase in Toll-like receptor (TLR)2 and TLR4 expression induced by LPS, while preventing glutathione depletion and reactive oxidative species generation and abrogating increases in C-reactive protein and interleukin-6 levels, restoring alanine and aspartate aminotransferase activities, and blocking the phosphorylation of p38 and c-Jun N-terminal kinase mitogen-activated protein kinases (MAPKs). The protective effects of LCBE against liver damage caused by LPS were dose-dependent. These results demonstrate that LCBE suppresses liver inflammation caused by LPS via inhibition of TLR and MAPK signaling and oxidative stress pathways, and suggest that LCBE treatment can potentially prevent chronic liver injury.

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High-sensitivity C-reactive protein (hs-CRP) in systemic lupus erythematosus patients without cardiac involvement; relation to disease activity, damage and intima-media thickness

Cited by 13 publications

References 30 publications

Changes in Gut Microbiota and Systemic Inflammation after Synbiotic Supplementation in Patients with Systemic Lupus Erythematosus: A Randomized, Double-Blind, Placebo-Controlled Trial

Changes in Gut Microbiota and Systemic Inflammation after Synbiotic Supplementation in Patients with Systemic Lupus Erythematosus: A Randomized, Double-Blind, Placebo-Controlled Trial

Is there still a place for erythrocyte sedimentation rate and C-reactive protein in systemic lupus erythematosus?

Lonicera caerulea berry extract suppresses lipopolysaccharide-induced inflammation via Toll-like receptor and oxidative stress-associated mitogen-activated protein kinase signaling

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