Production of three inflammatory markers : Biochemical and clinical evaluation

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In patients with inflammatory conditions such as infection, cytokines induce the production of C-reactive protein (CRP) and serum amyloid A protein (SAA) in hepatic cells. Procalcitonin (PCT) is a new type of inflammatory marker that is specifically induced by bacterial infection, sepsis and lethal multiple organ failure, but not by viral infection, autoimmune diseases, tumors or surgical stress.We determined levels of PCT, CRP and SAA in patients with various inflammatory diseases. Among the patients with inflammatory disease who had a high CRP level (CRP> 20000μg/dl), the PCT level was elevated only in those patients with severe bacterial infection. These results suggest that determining the PCT level may be useful in the differential diagnosis of severe bacterial infection. The patients who had a low CRP level (CRP< 150μg/dl), had a PCT level within the normal range. The patients with autoimmune disease, viral infection, and fungal infection did not have an elevated PCT level.The CR … More P concentration in CSF in bacterial meningitis was much higher than in viral meningitis, but CRP in CSF was also high in bacterial infection other than meningitis. On the other hand, SAA concentration in CSF in these patients with any meningitis are significantly higher than the reference values of SAA.In this study we have examined the effects of some immunosuppressive drugs and cytokines on the production of CRP and SAA by human hepatoma cells (HepG2). A corticosteroid prednisolone did not enhance the production of CRP by HepG2 cells but enhanced that of SAA, which indicate that prednisolon had no direct effect on the CRP production. Some immunosuppressants other than corticosteroids suppressed the SAA production but had no effect on the CRP production. IL-1β induced both CRP and SAA production but only in the co-presence of IL-6. A cytokine IL-6 induced the CRP production in the presence of IL-1β, but did not affect the constitutive production of SAA.Then we have examined the cytokine production by monocytes stimulated by lipopolysaccharide. Prednisolone inhibited the production of IL-1α, IL-1β, IL-6 and TNFα. Less