肺癌患者血清淀粉样蛋白A(SAA)水平及临床意义

正近年来,我国肺癌发病率和死亡率大幅增长,严重威胁人群健康及生命安全,多数患者就诊时已处于中晚期,临床治疗效果较差,预后不良。血清淀粉样蛋白A(SAA)是一种与血浆高密度脂蛋白(HDL)相结合的急性相蛋白,主要来源于脂肪细胞、肝脏细胞及肿瘤细胞[1]。SAA被认为是与机体炎症反应相关的蛋白。最近研究表明,SAA在恶性肿瘤的发生发展过程中,尤其是在肿瘤的侵袭或转移过程中起到重要作用[2]。研究发现,SAA能够抑制肿瘤细     

老年脑梗死患者血清P-选择素及淀粉样蛋白A与颈动脉粥样硬化相关性

颈动脉粥样硬化性狭窄已成为老年脑梗死独立危险因素,血清P-选择素(P-selectin,Ps)作为血小板活化的标志及炎症反应的介质,在介导动脉粥样硬化形成、发展的各个时期中发挥了主要作用[1].血清淀粉样蛋白A(SAA)为急性炎症反应时的一种主要时相蛋白,研究发现其在糖尿病患者的肾血管病变过程中发挥重要作用[2].最近研究表明,Ps和SAA与冠状动脉硬化发病密切相关[3].本研究对合并颈动脉狭窄的老年脑梗死患者的Ps和SAA进行检测,分析其与颈动脉粥样硬化的关系.     

血清淀粉样蛋白A与动脉粥样硬化关系的研究进展

以动脉粥样硬化(AS)为病理基础的冠心病是当今危害人们生命健康的重要疾病。由细胞因子介导的炎症反应可能在AS过程中扮演着重要的角色。血清淀粉样蛋白A(SAA)是一种急性时相蛋白,在急性反应期水平上升极快,并引起所有急性期反应蛋白总量的急剧增加,这种特性使得SAA成为目前最敏感的炎症标志物之一。SAA的血浆浓度变化是否与AS的病变程度相关?1SAA的分子结构、基因表达及代谢SAA主要来源于肝脏,肝细胞是SAA合成部位。人类的某些正常或异常组织中的上皮细胞也能表达某些类型的SAA〔1〕。SAA主要由白细胞介素(IL)-1、IL-6和肿瘤…     

慢性阻塞性肺疾病患者血清淀粉样蛋白A水平变化及其与C-反应蛋白和白细胞介素-6的相关性

目的观察慢性阻塞性肺疾病(COPD)患者急性加重期及缓解期血清淀粉样蛋白A(SAA)的变化及其与炎症标志物C反应蛋白(CRP)和白细胞介素(IL)-6的相关性。方法选择COPD急性加重期患者86例,健康对照组72例,分别测定COPD患者急性加重期、缓解期及健康对照者血清SAA、CRP、IL-6水平。结果 COPD组急性加重期及缓解期血清SAA、CRP、IL-6水平均明显高于健康对照组(P均0.01);COPD组急性加重期血清SAA、CRP、IL-6水平均明显高于缓解期(P均0.01);AECOPD合并呼吸衰竭组血清SAA、CRP、IL-6水平均明显高于单一AECOPD组(P均0.01);COPD组急性加重期血清SAA分别与CRP、IL-6呈正相关(r=0.317、0.406,P均0.01)。结论血清SAA可以作为一种炎症标志物用于AECOPD患者的早期诊断,对患者病情的严重程度有一定的评估作用;血清SAA与CRP、IL-6联合测定对预测AECOPD的严重性和观察疗效有一定的价值。     

血清淀粉样物质A是慢性阻塞性肺疾病急性加重的生物标记物

背景和目的:通过蛋白质组学筛选出来的血清淀粉样物质A(Serum amyloid A,SAA)有可能成为COPD急性加重(AECOPD)的一个新的生物标记物.SAA是一种急性相蛋白,与C反应蛋白一样,由炎症介质如白细胞介素-6、白细胞介素-8和肿瘤坏死因子-所诱导,在AECOPD时急性升高.     

血清淀粉样蛋白A与呼吸系统疾病的研究进展

<正>血清淀粉样蛋白A(serum amyloid A,SAA)是一个非常敏感的急性时相蛋白(acute phase protein,APP)。研究发现在许多炎症性疾病,血浆SAA水平显著升高。以往研究证实SAA是淀粉样蛋白A(amyloid A,AA)的前体[1],但SAA的生物学功能仍不十分清楚。近年来研究发现SAA是一个炎症标志物,特异性及敏感性均高于C-反应蛋白(C-re-     

肺癌患者的血清淀粉样A

有学者报告恶性肿瘤时血清淀粉样 A 蛋白(SAA)升高,可作为诊断肿瘤的一个标记;另有学者报道,SAA 浓度升高与各种实体瘤的远位转移呈正相关。SAA 在体内的作用尚不清楚。体外实验表明 SAA 可抑制鼠脾细胞对抗体的反应,亦可抑制人周围血淋巴细胞(PBL)对 T 细胞依赖性抗原的反应,这大概是通过T 细胞～巨噬细胞相互作用介导的,说明 SAA 在癌患者的免疫抑制中起一定作用。作者对肺癌患者作前瞻性研究,在确定肺癌诊断时测定 SAA 浓度,并考核其与周围血淋巴细胞数,对有丝分裂原(如 PHA、ConA)的反应、肿瘤扩散情况和生存期的关系。     

急性冠脉综合症患者血清淀粉样蛋白A升高预示早期死亡率升高

已证明C-反应蛋白(CRP)升高与不稳定冠脉综合征预后不良有关;但是另一个急性期蛋白——淀粉样蛋白A(SAA)与不稳定冠脉综合征预后的关系,其报道是有矛盾的。作者研究了SAA单独或与心脏特异性肌钙蛋白T(cTnT)快速定性试验结合,预测不稳定型心绞痛或无Q波型心肌梗死14天死亡率的价值。登记进入心肌梗死溶栓试验11A(TIMI11A)的、症状发生在一周内的、不稳定型心绞痛病人或无Q波型心肌梗死(NQMI)病人,登记时即取血标本,测定SAA和cTnT快速定性试验。除外下列病例:进展性Q波型心梗、在随机分配病例之前24小时内进行了溶栓治疗、在2个…     

NLRP3炎症小体在动脉粥样硬化中的作用机制和靶向炎症治疗的研究进展

动脉粥样硬化(As)是由一系列复杂因素引起的病理过程,包括内皮功能障碍、动脉血管壁中脂质沉积、巨噬细胞浸润、平滑肌细胞功能失调、泡沫细胞形成等,炎症反应在这一过程中发挥了重要的作用。NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体是炎症细胞的传导器,其激活后介导炎症反应,激活下游的白细胞介素18、白细胞介素1β,从而参与As的发生和发展。因此,针对NLRP3炎症小体和下游炎症因子的特异性抑制剂是目前临床药物研究的潜在靶点,有望成为治疗As的一种新的治疗措施。文章对NLRP3炎症小体的结构和激活机制及与As的关系进行了讨论,同时对靶向NLRP3炎症小体和下游炎症因子的药物进行了介绍。     

稳定和不稳定心绞痛中C-反应蛋白的产生和冠脉事件的危险

炎症是动脉粥样硬化病变的重要特征之一,不稳定型心绞痛急性期反应产物,C-反应蛋白(CRP)增加与病情预后不良相关。该文观察了稳定型心绞痛和不稳定型心绞痛患者急性期反应产物C-反应蛋白和血清淀粉样白蛋白(SAA)的存在及可能的临床意义。 方法 采用一种新的超敏感免疫分析法,对2121例门诊心绞痛者(1030例不稳定,     

Diagnostische Wege und Irrwege der akuten thorakalen Aortendissektion

Despite significant improvements in the surgical therapy of acute aortic dissection (AAD), mortality rates in the initial phase remain unacceptably high. Early diagnosis and therapy are essential to improving prognosis in these patients. A prerequisite of prompt and correct diagnosis is"thinking of it". Delayed or incorrect diagnosis can often have catastrophic results.The reported acute chest and back pain of a tearing, stabbing nature combined with the physiognomy of Marfan syndrome often arouse the clinical suspicion of AAD, prompting immediate imaging of the thoracic aorta and therapy. For less clear cases, additional hints drawn from the patient history and special findings from the medical examination are presented schematically in a diagnostic pathway. As an innovative form of diagnosis, preventive echocardiographic screening in high risk groups is discussed.To heighten awareness of AAD and the importance of its correct diagnosis, the poster campaign "Thinking of it can save lives" has been initiated. The poster depicts AAD schematically, indicates Marfan syndrome as a risk factor for AAD in young people and illustrates a CT scan as the most frequently performed imaging technique with high sensitivity and specificity.     

Inflammatory markers and in-hospital mortality in acute ischaemic stroke

BACKGROUND: There is substantial evidence that cerebral ischaemia triggers an inflammatory response. We examined the short-term prognostic value on mortality of C-reactive protein (CRP), interleukin-6 (IL-6) and serum amyloid A (SAA) in patients with ischaemic stroke. METHODS: We recruited 203 consecutive patients, under the age of 66 years (mean age=54.2+/-8.1 years, men=132) who admitted to the Neurology Department with the diagnosis of non-haemorrhagic stroke. Patients in atrial fibrillation or with evidence of inflammatory or malignant disease were excluded. The diagnosis was confirmed with a computed tomography or magnetic resonance imaging of the brain within 24h of admission. CRP, IL-6 and SAA levels were determined within 12h from admission. RESULTS: Fourteen (6.9%) patients died during hospitalization. Serum concentrations of CRP, IL-6 and SAA were significantly higher in patients who died compared with those who survived and were independently associated with early death, after adjusting for various confounding factors. For one unit increase in IL-6, CRP and SAA there was an 18%, 14% and 9% higher risk of dying during hospitalization, respectively. Comparisons of the areas under the ROC curve showed that IL-6 had the best predictive ability. Age-adjusted cut-off point analysis showed that IL-6 levels >13 pg/ml were the optimal point that discriminated those who died from the rest of the patients (sensitivity=85% and specificity=93%). CONCLUSIONS: We demonstrated that in-hospital mortality in ischaemic stroke is associated with an exacerbation of inflammatory response as it is reflected by the higher serum levels of IL-6, CRP and SAA. From the inflammatory markers high IL-6 levels had the strongest independent predictive value for in-hospital mortality.     

Acute aortic dissection: Epidemiology and outcomes

Background

Little epidemiological information on acute aortic dissection (AAD) is available in the literature. The objective of the present study was to determine the incidence and mortality rates of AAD in the general population and to analyze its clinical features.

Methods

Data from the Emilia-Romagna regional database of hospital admissions was analyzed. Urgent admissions with the diagnosis of dissection of the aorta, dissection of the thoracic aorta and dissection of the thoracoabdominal aorta were selected.

Results

Between January 2000 and December 2008, 1499 Emilia-Romagna residents were hospitalized with a diagnosis of AAD. The patients were divided into three groups: Group A, 617 patients (41.2%) surgically treated for type A AAD; Group B, 93 complicated patients (6.2%) with type B AAD treated by endovascular stent-grafting and Group C, 789 patients (52.6%) suffering from any type of AAD medically treated. The overall annual incidence rate was 4.7%/100,000 people and was higher for men than for women (6.7% vs 2.9%).Two hundred ninety-six patients (19.8%) were 80 years of age or older.The overall in-hospital mortality rate was 27.7%, with mortality rates of 21.1%, 26.9% and 33% in Groups A, B and C, respectively.

Conclusion

The incidence of AAD is not negligible and a notable rate of patients is ultra-octogenarian. A large number of patients with AAD had no surgery or interventional treatment. The results of surgical treatment for patients with type A dissection are acceptable but the results obtained in patients with complicated type B dissection who were treated with an endoprosthesis are dismal.     

Serum amyloid A – an indicator of inflammation in ankylosing spondylitis

Biological markers of inflammation are useful for the diagnosis and monitoring of inflammatory rheumatic diseases. The present study tested, whether serum amyloid A (SAA) could be used as a marker of inflammatory disease activity in ankylosing spondylitis (AS). In 72 patients with AS, the two valuable surrogate markers of disease activity, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and an established clinical activity score (Bath Ankylosing Spondylitis Disease Activity Index, BASDAI) were correlated to the serum levels of SAA. It was found that SAA correlates well with ESR, CRP, and BASDAI. Because of its strong correlation, SAA seems to be an additional very useful disease activity marker. When used in diagnosis, and especially in monitoring of inflammation, further studies are required. Another interesting point of view is the described role of plasma SAA as a precursor of Amyloid A (AA) protein in secondary amyloidosis, a known complication in AS. In all probability, high circulating SAA levels are a predisposing indicator of disease activity. Received: 24 April 1999 / Accepted: 22 November 1999     

Amyloid precursors and amyloidosis in inflammatory arthritis

Recent data demonstrating the multifunctional role of serum amyloid A (SAA) in the pathogenesis of amyloidosis have yielded important insights into this potentially fatal consequence of chronic inflammation. SAA has been shown to participate in chemotaxis, cellular adhesion, cytokine production, and metalloproteinase secretion and is thus integrally involved in the disease process. In addition to its production by the liver as part of the acute phase response, SAA is also expressed by several pathologic tissues such atherosclerotic plaques, rheumatoid synovitis and in the brains of patients with Alzheimer disease. Its constitutive production in normal tissue suggests a role for SAA in host defense and tissue turnover. Many pathways are involved in the regulation of SAA, and as more becomes known about these, potential therapeutic targets may be identified. However, the prevention of secondary amyloidosis is best achieved by early and adequate treatment of patients with chronic inflammatory disorders. Suppression of the acute phase response and normalization of SAA levels are likely to significantly impact on the incidence of amyloidosis in inflammatory arthritis.     

血清淀粉样蛋白A的研究进展

血清淀粉样蛋白A(SAA)是一个非常敏感的急性相反应物。不管是在健康人还是在患有冠状动脉疾病的人群中,SAA、C反应蛋白等炎症反应物均能预测心血管事件发生的危险几率。     

Long‐term follow‐up study of porcine anti‐human thymocyte immunoglobulin therapy combined with cyclosporine for severe aplastic anemia

Immunosuppressive therapy with antithymocyte immunoglobulin (ATG) and cyclosporine A is the first treatment option for severe aplastic anemia (SAA) patients without transplantation. Horse ATG is not marketed in China. Because the price of porcine ATG (pATG) is only about one‐third of the price of rabbit ATG (rATG), long‐term follow‐up studies of pATG's efficacy will help provide valuable insights into the treatment of SAA. Retrospective studies were performed to analyze the clinical information of 102 SAA patients treated with pATG and cyclosporine A from 1999 to 2014 in Peking Union Medical College Hospital. The median age was 29 years old (range 12–72). Median follow‐up time was 59.6 months (0.2–176.8). The overall response rate was 74.5% (CR 42.1%, PR 32.4%). The recurrence rate was 9.9%. The mortality rate was 16.7%. The median survival time has not been reached, and the 5‐year survival rate was 81.8%. Other hematologic abnormalities were observed in 7.8% of patients, including symptomatic PNH, MDS, and AML. Multivariate analysis revealed there was no significant effect on survival by factors such as gender, age, severity of disease, treatment time, and PNH clone (P > 0.05). These data have indicated pATG therapy combined with cyclosporine A has significant long‐term efficacy and high overall survival in SAA.     

Expression and function of serum amyloid A, a major acute-phase protein, in normal and disease states

Serum amyloid A (SAA), the precursor protein in inflammation-associated reactive amyloidosis (AA-type), is an acute phase reactant whose level in the blood increases in response to various insults. It is expressed in the liver, but its physiological role is not well understood. Recently, a broader view of SAA expression and function has been emerging. Expression studies show local production of SAA proteins in histologically normal, atherosclerotic, Alzheimer, inflammatory, and tumor tissues. Binding sites in the SAA protein for high density lipoproteins, calcium, laminin, and heparin/heparan-sulfate were described. Adhesion motifs were identified and new functions, affecting cell adhesion, migration, proliferation and aggregation have been described. These findings emphasize the importance of SAA in various physiological and pathological processes, including inflammation, atherosclerosis, thrombosis, AA-amyloidosis, rheumatoid arthritis, and neoplasia. In addition, recent experiments suggest that SAA may play a "housekeeping" role in normal human tissues.     

新型生物标记物在冠状动脉粥样硬化性心脏病中的研究进展

冠心病及其并发症是人类死亡的首要致病因素,故对其防治措施的研究受到了学术界广泛的关注。大量研究表明冠心病发病的主要病理过程为脂质代谢平衡的破坏和炎症反应的激活。若能对冠心病发病过程中的相关蛋白表达的变化规律进行归纳总结,将为临床诊断冠心病提供有效的方法。新型生物标记物的发现对冠心病的防治具有重要意义。近年新发现大量与心血管疾病密切相关的生物标记物,如枯草溶菌素转化酶9、Sortilin等血脂相关新型生物标记物通过调节体内氧化低密度脂蛋白胆固醇水平参与冠心病的发生发展;可溶性尿激酶型纤溶酶原激活受体等炎症标记物通过多种途径影响冠心病的病理生理过程。因此,本文主要综述血脂、炎症等相关新型生物标记物在冠心病中的研究进展,以期为心血管疾病的临床诊断、治疗和预后评估提供新的参考和思路。     

Psoriasis: The visible killer

Psoriasis is a common chronic inflammatory disease associated with serious comorbidities. In recent years, increased mortality due to cardiovascular disease (myocardial infarction and stroke) has been documented in patients with severe psoriasis. Patients with psoriasis have a higher prevalence of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and obesity, but it has been suggested that the chronic inflammatory nature of psoriasis is also a contributing and potentially an independent risk factor for the development of cardiovascular disease.The authors highlight the need for early identification and treatment of psoriasis‐related comorbidities and cardiovascular disease, as well as effective treatment of psoriasis, in order to reduce the underlying systemic inflammation, and also the importance of a multidisciplinary approach of severe psoriasis patients to optimize the diagnosis, monitoring and treatment of various comorbidities, so as to prevent cardiovascular events.