scholarly journals The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mahmoud Ganjifard ◽  
Samaneh Kouzegaran ◽  
Reza Abdi ◽  
Mohsen Naseri ◽  
Elahe Allahyari ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Inflammatory Cytokines ◽  
Lower Limb ◽  
Venous Blood ◽  
Repeated Measure ◽  
Controlled Clinical Trial ◽  
Ischemic Reperfusion ◽  
Tnf Α ◽  
Lower Limb Surgery ◽  
Hs Crp

Background and Objective. The injuries caused by reperfusion of blood can lead to significant adverse effects after surgery. This study aimed to compare the effects of spinal and general anesthesia on inflammatory cytokines following changes in ischemic reperfusion due to tourniquet in lower limb surgeries. Methods. In this randomized controlled clinical trial, 34 patients with lower limb surgery admitted at the orthopedic ward of Imam Reza Hospital, Birjand, Iran, were selected by the available sampling method. They were randomly divided into two groups as follows: general anesthesia (n = 17) and spinal anesthesia (n = 17). Venous blood samples were taken from the patients of both groups at baseline (before the use of tourniquet) and 12 and 24 hours after reperfusion. Interleukin-6 (IL-6), tumor necrotizing factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and ferritin were measured and recorded. The data were analyzed using independent t-test, chi-square, and repeated measure at the significant level of 0.05. Results. The results showed that hs-CRP and IL-6 significantly increased during the study ( p < 0.001 ); however, the mean changes of TNF-α and ferritin were not significant during the study. Moreover, none of the inflammatory cytokines indicated significant differences between these two study groups ( p < 0.05 ). Conclusion. According to the results, the use of tourniquet can lead to inflammation, and the inflammation is similar in both groups.

scholarly journals Safety and Efficacy of the Combination of BCc1 and Hep-S Nanochelating-Based Medicines in Hospitalized COVID-19 Adult Patients: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

2021 ◽  
Author(s):  
Maryam Hafizi ◽  
Somayeh Kalanaky ◽  
Saideh Fakharzadeh ◽  
Atefeh Fakharian ◽  
Somayeh Lookzadeh ◽  
...  
Keyword(s):  
Treatment Group ◽  
Inflammatory Cytokines ◽  
Clinical Symptoms ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Reduce Mortality Rate ◽  
Tnf Α

Abstract Background: The mortality and morbidity of COVID‐19 disease as well as the lack of a proper medication has forced researchers and clinicians to employ urgent efficient technologies to overcome this current pandemic. In the severe forms of COVID-19, the patients develop a cytokine storm syndrome (CSS) where pro-inflammatory cytokines such as IL-6 and TNF-α play a key role in the development of this serious process. The efficiency of nanomedicines - as efficient immunomodulators - that are synthesized based on nanochelating technology have been proved in the previous studies. In the present study, the therapeutic effect of the combination of BCc1 and Hep-S nanomedicines on hospitalized COVID-19 patients was evaluated.Method: Laboratory-confirmed moderate COVID-19 patients at Masih Daneshvari Hospital were enrolled to participate in a randomized, double-blind, placebo-controlled study in two separate groups: combination of BCc1 and Hep-S (N=62) (treatment) or placebo (N=60) (placebo). The primary outcome of the study was evaluating the safety of the nanomedicines combination and its effect on the number of deceased patients, while the secondary outcome was decrease in inflammatory cytokines.Results: The evaluation of blood biochemical indices as well as clinical symptoms showed that adding the combination of BCc1 and Hep-S nanomedicines to the standard protocol of the treatment caused no adverse effects. The results analysis revealed that 28-day consumption of the nanomedicines led to a significant decrease in the mean level of IL-6 cytokine of the patients in the treatment group (p < 0.05). In addition, the patients in the treatment group had lower TNF-α levels compared to those in the control (p > 0.05) and they also showed less need for oxygen therapy. Finally, the number of the deceased patients in the treatment group was 30% lower than that of the control (p > 0.05).Conclusion: The combination of BCc1 and Hep-S, as safe nanomedicines, inhibits IL-6 as a highly important and well-known cytokine in COVID-19 pathophysiology, and presents a promising view for immunomodulation that can manage CSS and reduce mortality rate in COVID19 patients.Trial registration IRCTID, IRCT20170731035423N2. Registered 12 Jun 2020, http://www.irct.ir/ IRCT20170731035423N2.

scholarly journals Comparing the Effects of Pre-loading with Gelatine 4% Plasma Volume Expander and 6% Hydroxyethyl Starch Solution Before Spinal Anaesthesia for Lower Limb Orthopaedic Surgery

2020 ◽  
Vol 27 (6) ◽  
pp. 68-78
Author(s):  
Nur Dyana Md Nizar ◽  
Shamsul Kamalrujan Hassan ◽  
Rhendra Hardy Mohamad Zaini ◽  
Mohamad Hasyizan Hassan ◽  
Wan Mohd Nazaruddin Wan Hassan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Venous Blood ◽  
Acid Base Balance ◽  
Acid Base ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
Base Balance

Background: Hypotension is a common complication following spinal anaesthesia. The administration of intravenous fluids prior to spinal anaesthesia, known as pre-loading, has been used to offset the hypotension effect; however, the ideal fluid for pre-loading is still a matter of debate. The objective of this study was to compare the effects of Gelaspan 4% and Volulyte 6% as pre-loading fluids. Methods: A total of 93 patients with American Society of Anaesthesiologists (ASA) physical status I or II having lower limb orthopaedic surgery under spinal anaesthesia were randomised into two groups that received either Volulyte (n = 47) or Gelaspan (n = 46). Before the spinal anaesthesia, these patients were pre-loaded with 500 mL of the fluid of their respective group. Blood samples were taken before pre-loading and again after spinal anaesthesia and sent for venous blood gas and electrolyte level measurement. Baseline and intraoperative records of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and the requirement of ephedrine to treat hypotension were also recorded. Results: Both fluids could not prevent significant reductions in SBP (P = 0.011), DBP (P = 0.002) and MAP (P = 0.001). There was also significant reduction in HR over time (P < 0.001). There was no significant difference in terms of ephedrine usage between both groups. Neither Volulyte 6% nor Gelaspan 4% caused significant changes in acid-base status. Conclusion: The use of 500 mL of either Gelaspan 4% or Volulyte 6% as pre-loading fluids did not significantly prevent the incidence of post-spinal anaesthesia hypotension following orthopaedic lower limb surgery; however, both were useful in the maintenance normal acid-base balance.

scholarly journals Effects of cinnamon supplementation on expression of systemic inflammation factors, NF-kB and Sirtuin-1 (SIRT1) in type 2 diabetes: a randomized, double blind, and controlled clinical trial

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Mina Davari ◽  
Reza Hashemi ◽  
Parvin Mirmiran ◽  
Mehdi Hedayati ◽  
Shamim Sahranavard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Sirtuin 1 ◽  
Controlled Clinical Trial ◽  
Group Comparison ◽  
Double Blind ◽  
Tnf Α ◽  
Significant Difference ◽  
Hs Crp

Abstract Background and objectives NF-kB, SIRT1 and systemic inflammation factors including hs-CRP, IL-6 and TNF-α accelerate atherosclerosis pathogenesis. Our purpose was to evaluate the effect of daily supplementation of three-gram cinnamon on plasma levels of NF-kB, SIRT, hs-CRP, IL-6 and TNF-α among type 2 diabetes patients. Subjects and methods A randomized, double blind, and controlled clinical trial was performed with 44 adult patients who were 25 to 70 years old with type 2 diabetes, randomized to two intervention (n = 22) and control (n = 22) groups differing by daily three grams cinnamon supplementation and placebo for 8 weeks, respectively. The plasma levels of NF-kB, SIRT, hs-CRP, IL-6 and TNF-α were measured by ELISA assay at the beginning and end of the study. Results After 8-week intervention, 39 subjects (n = 20 in the cinnamon and n = 19 in the placebo groups) ended up the trial. It was not observed significant difference in levels of hs-CRP (P = 0.29), TNF-α (P = 0.27), IL-6 (P = 0.52), and Sirtuin-1 (P = 0.51) in between group comparison. While, the result showed significant difference in levels of NF-kB (P = 0.02) between groups. As well as, in among group comparison, there was not observed significant differences except in hs-CRP (P = 0.008) in placebo group. Conclusions This study elucidated that cinnamon supplementation has no beneficial effects in reduction of NF-kB, SIRT1, hs-CRP, IL-6 and TNF-α levels in type 2 diabetes patients which have a considerable role in development of atherogenesis.

Neuraxial and Combined Neuraxial/General Anesthesia Compared to General Anesthesia for Major Truncal and Lower Limb Surgery

2017 ◽  
Vol 125 (6) ◽  
pp. 1931-1945 ◽  
Author(s):  
Lauren M. Smith ◽  
Crispiana Cozowicz ◽  
Yoshiaki Uda ◽  
Stavros G. Memtsoudis ◽  
Michael J. Barrington
Keyword(s):  
General Anesthesia ◽  
Lower Limb ◽  
Lower Limb Surgery

Spinal and general anesthesia produces differential effects on oxidative stress and inflammatory cytokines in orthopedic patients

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Peter A. Aremu ◽  
Abayomi M. Ajayi ◽  
Benneth Ben-Azu ◽  
Olayinka T. Orewole ◽  
Solomon Umukoro
Keyword(s):  
Oxidative Stress ◽  
General Anesthesia ◽  
Inflammatory Cytokines ◽  
Orthopedic Surgery ◽  
Interleukin 6 ◽  
Surgical Stress ◽  
Oxidative Stress Biomarkers ◽  
Differential Effects ◽  
Stress Biomarkers ◽  
Tnf Α

AbstractObjectivesThe contribution of anesthetic procedure to surgical stress and postoperative complications has been attributed to increased oxidative stress and release of inflammatory cytokines. Thus, the levels of oxidative stress biomarkers and inflammatory cytokines in patients with general anesthesia (GA) and spinal anesthesia (SA) that underwent open reduction and internal fixation (ORIF) in orthopedic surgery at Federal Teaching Hospital, Ido-Ekiti, Ekiti state, Nigeria were investigated.MethodsForty patients were randomly distributed into two groups (n = 20) namely GA and SA. Blood samples were collected before and after surgery for estimation of glucose, oxidative stress biomarkers (malondialdehyde [MDA], glutathione, catalase and nitrile) and inflammatory cytokines (tumor necrosis factor-α [TNF-α] and interleukin-6) levels.ResultsThe post-operative blood glucose level was higher than the pre-operative value (p<0.5) in the two groups. There were significant (p<0.05) changes in MDA concentration and catalase activity in patients with GA in the post-operative stage relative to preoperative phase. There were no significant differences in glutathione, nitrite and interleukin-6 contents between the two groups. The patients with SA had higher levels of TNF-α in the post-operative stage.ConclusionsThese findings suggest that anesthesia has differential effects on oxidative stress and inflammatory cytokines in patients with ORIF orthopedic surgery.

scholarly journals Correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases in gingival crevicular fluid with peri-implantitis

2019 ◽  
Vol 17 ◽  
pp. 205873921984554
Author(s):  
Zhiming Song ◽  
Paul Weigl ◽  
Bi Wang
Keyword(s):  
Oxidative Stress ◽  
Matrix Metalloproteinases ◽  
Inflammatory Cytokines ◽  
Gingival Crevicular Fluid ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Probing Depth ◽  
Tnf Α ◽  
Hs Crp ◽  
Crevicular Fluid

This study aimed to analyze the correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases (MMPs) in gingival crevicular fluid (GCF) with peri-implantitis (PI). Forty patients receiving dental implantation were enrolled. There were 52 implants, which were divided into PI group (42 implants) and health implant (HI) group (10 implants). Fifty-two healthy teeth (HT) with the same names with affected teeth in the patients were selected as the control group. The periodontal status was recorded. The GCF was collected and quantified. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), MMP-13, and MMP-8 were detected using enzyme-linked immunosorbent assay (ELISA). Results showed that the probing depth, sulcus bleeding index, GCF volume, and TNF-α, IL-6, hs-CRP, MMP-8, and MMP-13 levels in GCF in PI group were significantly higher than HI and HT groups, respectively ( P < 0.01 or P < 0.05). The SOD and GSH-Px levels in PI group were significantly lower than HI and HT groups, respectively ( P < 0.05). Excepting hs-CRP, there was no significant difference of each index between HI and HT groups ( P > 0.05). In conclusion, TNF-α, IL-6, hs-CRP, SOD, GSH-Px, MMP-8, and MMP-13 are involved in the occurrence of PI, and they may be used as auxiliary indicators to evaluate the degree of PI. In addition, the clinical periodontal index probing depth and sulcus bleeding index are positively correlated with GCF volume, hs-CRP, MMP-8, and MMP-13.

Dietary patterns in relation to inflammation in shift workers

2019 ◽  
pp. jramc-2018-001119
Author(s):  
Reihane Khorasaniha ◽  
F Siassi ◽  
F Khajehnasiri ◽  
M Qorbani ◽  
G Sotoudeh
Keyword(s):  
Dietary Intake ◽  
Inflammatory Cytokines ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Fast Food ◽  
Serum Concentrations ◽  
Cross Sectional ◽  
Shift Workers ◽  
Tnf Α ◽  
Hs Crp

IntroductionRotational shift work has a considerable effect on immune function and cause inflammation. In addition, it may lead to unhealthy dietary intake. No earlier study has examined the association between dietary patterns and inflammation in rotational shift workers. Therefore, this study was conducted to investigate the association between dietary patterns and circulating proinflammatory cytokines among shift workers.MethodsThis cross-sectional study was conducted among 257 male shift workers. Dietary intake of participants was examined using the semiquantitative Food Frequency Questionnaire. Serum concentrations of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (hs-CRP) were measured using suitable commercial kits.ResultsThree main dietary patterns included green vegetables, yellow vegetables and cruciferous vegetables (VEG), liquid oils and mayonnaise, fast food and eggs (LFE), as well as tea and coffee, refined grains and spice (TRS). Subjects with the highest adherence to VEG dietary pattern had a significantly lower concentration of IL-6 (p<0.01) and TNF-α (p<0.001) as compared with those with the lowest adherence. On the other hand, a significant negative association was found between LFE dietary pattern and serum concentrations of IL-6 (p=0.01) and TNF-α (p=0.02). However, no significant association was found between adherence to VEG (p=0.34) or LFE (p=0.99) dietary patterns and levels of hs-CRP and between adherence to TRS dietary pattern and any of the inflammatory cytokines.ConclusionAdherence to VEG and LFE dietary patterns was inversely and directly associated to serum IL-6 and TNF-α concentrations in shift workers, respectively. However, no significant association was found between adherence to these two dietary patterns and serum hs-CRP concentrations and between TRS dietary pattern and any of the inflammatory cytokines.

scholarly journals Inflammatory Cytokines, Adipocytokines, and Th17/Treg Balance in Patients with Nonalcoholic Fatty Liver Disease following Administration of Dahuang Zhechong Pills

2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Xiaohua Duan ◽  
Jianlin Lv ◽  
Hebei Jiang ◽  
Kefei Zheng ◽  
Yulin Chen
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Inflammatory Cytokines ◽  
Fatty Liver Disease ◽  
Test Group ◽  
Control Group ◽  
Nonalcoholic Fatty Liver ◽  
Expression Levels ◽  
Tnf Α ◽  
Hs Crp

Objectives. The occurrence and development of nonalcoholic fatty liver disease (NAFLD) is related to lipid peroxidation, imbalance of inflammatory response factors, and immune function disorder. This study was conducted with the purpose of investigating the expression levels of inflammatory cytokines and adipocytokines and Th17/Treg balance in NAFLD patients treated with Dahuang Zhechong pills (DHZCPs). Methods. The study recruited 100 NAFLD patients who were then arranged into the test group and control group. Patients in the test group were treated with DHZCPs, while patients in the control group were untreated. Peripheral TH17 and Treg cells were detected by flow cytometry, and peripheral IL-17, IL-10, hs-CRP, and TNF-α expression levels were determined by enzyme-linked immunosorbent assay (ELISA) methods. The concentrations of ghrelin, leptin, and adiponectin were quantitatively examined. Results. The levels of TC, TG, ALT, and AST were declined but the level of HDL-C was increased in NAFLD patients treated with DHZCPs compared with untreated patients ( P < 0.05 ). The ratio of Th17/Treg in NAFLD patients treated with DHZCPs was (1.52 ± 0.21), which was significantly lower than (2.39 ± 0.45) of untreated patients ( P < 0.05 ). The levels of IL-17, hs-CRP, and TNF-α were lower, but the level of IL-10 was higher in NAFLD patients treated with DHZCPs than that in untreated patients ( P < 0.05 ). The expression levels of ghrelin and adiponectin in NAFLD patients treated with DHZCPs were evidently higher than those in untreated patients ( P < 0.01 ), and the expression level of leptin in NAFLD patients treated with DHZCPs was evidently lower than that in untreated patients ( P < 0.01 ). Conclusions. Administration of DHZCPs regulates the immune function of NAFLD patients by keeping Th17/Treg balance and affecting the levels of inflammatory cytokines and adipocytokines.

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