De nombreuses études ont contribué à dévoiler les mécanismes à la base de l’athérosclérose. Cette maladie est médiée par un important déséquilibre homéostatique, qui entraine une inflammation vasculaire contribuant à sa progression. Plusieurs équipes de recherche ont axé leurs investigations sur l’étude d’importants biomarqueurs inflammatoires telle que la protéine C-réactive (CRP). Considérée comme facteur de risque de maladies cardiovasculaires, cette dernière participe aussi aux différents stades du développement de l’athérosclérose. Notre étude révèle pour la toute première fois un processus d’auto-induction de l’expression de la CRP régit par les CE vasculaires. Ce mécanisme représente une nouvelle cible thérapeutique potentielle pour la prévention de l’athérosclérose. L’estrogène (E2) est une hormone féminine qui possède un rôle athéroprotecteur via entre autres, la modulation de la réponse inflammatoire. Ainsi, nous avons cherché à déterminer si elle avait un effet bénéfique sur le profil athérogénique de la CRP exprimée par les cellules endothéliales (CE). En effet, nos travaux ont démontré que l’E2 a la capacité de moduler le rétrocontrôle positif de l’expression de la CRP, contribuant à diminuer également le profil inflammatoire de cette dernière. De plus, nous avons établi que l’E2 restitue une importante voie pro-angiogénique impliquant la réponse migratoire des CE au VEGF, en contrant l’effet d’inhibition de la CRP. Cette nouvelle découverte nous a permis d’éclaircir un important mécanisme de guérison vasculaire de cette hormone dans un contexte inflammatoire. Ainsi, ces données contribuent à mieux comprendre la production endogène de la CRP par les CE vasculaires et l’activité cardioprotectrice de l’E2. / Numerous studies have contributed to reveal the mechanisms underlying cardiovascular diseases such as atherosclerosis. This disease is mediated by an important homeostatic imbalance, which causes vascular inflammation contributing to its progression. Several research groups have focused their studies on inflammatory biomarkers such as C-reactive protein (CRP). Considered as a risk factor for cardiovascular diseases, it also participates in various stages of atherosclerosis development. Our study shows for the first time a process of self-induction of the CRP expression regulated by vascular EC. This mechanism represents a new potential therapeutic target for the prevention of atherosclerosis formation. Estrogen (E2) is a female hormone which has an atheroprotective role through various vascular regulation mechanisms including modulation of the inflammatory response. Thus, we sought to determine whether it had a beneficial effect on atherogenic profile of CRP expressed by endothelial cells (EC). Indeed, our work has demonstrated for the first time that E2 has the ability to modulate the CRP expression positive feedback identified in our study, which also helps to reduce the inflammatory profile of the latter. In addition, we determined that E2 restores an important proangiogenic response involving migration of vascular EC to VEGF, by countering the inhibition effect of CRP. This new discovery has enabled us to clarify an important vascular healing mechanism of this hormone in an inflammatory context. Thus, these data provide further advances that contribute to a better understanding of the endogenous CRP production by vascular EC and the cardioprotective activity of E2.

Introduction: In Africa, it is estimated that cardiovascular disease (CVD) will affect approximately 1.3 million people per annum over the following 20 years. C-reactive protein (CRP) is a predictor of CVD risk and certain CRP gene polymorphisms can result in altered CRP concentrations. The distribution of CRP gene polymorphisms is ethnic-specific and extrapolating information from other populations to the black South African population, reported to harbour considerable genetic variation, should be avoided. This highlights the fact that genetic research among black South Africans is necessary. Objectives: The main aim of this dissertation was to determine the association between various polymorphisms (reported and novel [single nucleotide polymorphisms (SNPs)] within the CRP gene with CRP concentrations [measured as high sensitivity (hs)-CRP concentrations] in a black South African population undergoing an epidemiological transition. Interactions between specific CRP polymorphisms and certain environmental factors on hs-CRP concentrations were also investigated. Methods: This cross-sectional study (n=1,588) was nested within the Prospective Urban and Rural Epidemiological (PURE) study. Genotyping was performed using Illumina VeraCode technology on the BeadXpress® platform. Hs-CRP concentrations were measured by the use of a sequential multiple analyser computer (SMAC) through a particle-enhanced immunoturbidometric assay. Results: All the SNPs adhered to the assumptions of Hardy-Weinberg equilibrium, although the distribution of several SNPs differed from that reported in other population groups. Three SNPs (rs3093058, rs3093062 and rs3093068) were associated with a significant (p ≤ 0.05) increase in CRP concentrations. Five SNPs (rs1205, rs1341665, rs2794520, rs7553007 and rs2027471) were associated with a significant (p ≤ 0.05) decrease in CRP concentrations. This difference in effect was most probably due to changes in gene function brought about by the localisation of these SNPs in the CRP gene. Men and urban individuals were more likely to present with significant associations between the SNPs investigated and CRP concentrations. The difference in the prevalence of the alleles associated with higher CRP concentrations in this population compared to non-African populations could possibly explain the increased CRP concentrations that are observed in the black South African population. Gene-gender (rs1205, rs1341665 and rs2027474) as well as gene-environmental (rs3093068) interactions were also observed. Conclusions: CRP concentrations are in themselves a complex trait and there are many factors at play that influence their expression. Numerous factors (both genetic and environmental) are involved and no single factor acting alone is likely to have enough of an influence to be used as a clinical diagnostic test of CRP concentrations. These results provide valuable information on the regulation of CRP in a black South African population as well as contribute to the literature of CRP on a global level. / Thesis (MSc (Nutrition))--North-West University, Potchefstroom Campus, 2013.

Introduction: In Africa, it is estimated that cardiovascular disease (CVD) will affect approximately 1.3 million people per annum over the following 20 years. C-reactive protein (CRP) is a predictor of CVD risk and certain CRP gene polymorphisms can result in altered CRP concentrations. The distribution of CRP gene polymorphisms is ethnic-specific and extrapolating information from other populations to the black South African population, reported to harbour considerable genetic variation, should be avoided. This highlights the fact that genetic research among black South Africans is necessary. Objectives: The main aim of this dissertation was to determine the association between various polymorphisms (reported and novel [single nucleotide polymorphisms (SNPs)] within the CRP gene with CRP concentrations [measured as high sensitivity (hs)-CRP concentrations] in a black South African population undergoing an epidemiological transition. Interactions between specific CRP polymorphisms and certain environmental factors on hs-CRP concentrations were also investigated. Methods: This cross-sectional study (n=1,588) was nested within the Prospective Urban and Rural Epidemiological (PURE) study. Genotyping was performed using Illumina VeraCode technology on the BeadXpress® platform. Hs-CRP concentrations were measured by the use of a sequential multiple analyser computer (SMAC) through a particle-enhanced immunoturbidometric assay. Results: All the SNPs adhered to the assumptions of Hardy-Weinberg equilibrium, although the distribution of several SNPs differed from that reported in other population groups. Three SNPs (rs3093058, rs3093062 and rs3093068) were associated with a significant (p ≤ 0.05) increase in CRP concentrations. Five SNPs (rs1205, rs1341665, rs2794520, rs7553007 and rs2027471) were associated with a significant (p ≤ 0.05) decrease in CRP concentrations. This difference in effect was most probably due to changes in gene function brought about by the localisation of these SNPs in the CRP gene. Men and urban individuals were more likely to present with significant associations between the SNPs investigated and CRP concentrations. The difference in the prevalence of the alleles associated with higher CRP concentrations in this population compared to non-African populations could possibly explain the increased CRP concentrations that are observed in the black South African population. Gene-gender (rs1205, rs1341665 and rs2027474) as well as gene-environmental (rs3093068) interactions were also observed. Conclusions: CRP concentrations are in themselves a complex trait and there are many factors at play that influence their expression. Numerous factors (both genetic and environmental) are involved and no single factor acting alone is likely to have enough of an influence to be used as a clinical diagnostic test of CRP concentrations. These results provide valuable information on the regulation of CRP in a black South African population as well as contribute to the literature of CRP on a global level. / Thesis (MSc (Nutrition))--North-West University, Potchefstroom Campus, 2013.

Background: Obesity-related diseases are arising as a major problem among children. inflammation has recently been identified to play an important role in the relationship between obesity.- as well as stunting-related diseases. Objectives: The aim of this study was to assess the association between serum tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations and a variety of cardiometabolic and anthropometric indices of children in a township outside Potchefstroom, South Africa. Methods: Blood samples of 115 girls and 78 boys (mean age 15.6 ± 1.35) in the Physical Activity in the Young (PLAY) study were cross-sectionally analysed. Trained fieldworkers collected the demographic, Tanner growth stage and habitual physical activity information. Physiologists measured the children’s blood pressure. Anthropometric measurements were taken by. trained post-graduate students with level 1 or 2 qualifications in anthropometrics. A standard test battery was administered by trained postgraduate students in Human Movement Science to assess muscular strength. flexibility and endurance of the children. Blood samples were collected, centrifuged and stored frozen until further analyses. Results: Stunted girls had a significantly higher serum TNF-α concentration than the non-stunted girls (p=0.03). The factor analyses showed that the inflammatory. status clustered with the height for age-z-scores (HAZ) scores and the waist-hip-ratio (WHR). The HAZ-score of the over-fat boys (- 1.46) was significantly smaller than the lean boys (- 1.14, p=0.0 1). whereas the over-fat girls had a trend for a smaller HAZ-score (-1.07) than the lean girls (-0.89). No significant differences were found between the over-fat and the lean children-s inflammatory status. TNF-α and CRP levels tended to be higher in the over-fat children than in lean children. The girls' scrum IL-6 and CRP concentrations correlated significantly with their body mass index (BMI) and WHR (p<0.05 )and their TNF-α and IL-6 concentrations correlated significantly with their WHR (p<0.01 and p<0.05, respectively). Conclusion: In comparison to the non-stunted girls, stunted girls had a statistically significantly higher TNF-α concentration. Unusual fat distribution that is found in over-fat and stunted children may be associated with low-grade inflammation in children. More research is needed on these associations with markers of inflammation in a long-term longitudinal study. / Thesis (M.Sc. (Nutrition))--North-West University, Potchefstroom Campus, 2007.

Infection is a leading cause of death in hemodialysis patients, partly due to dysfunctional immunity. Frequent dialysis therapy improves patient outcomes and quality of life. We hypothesize that extended home hemodialysis (EHHD) also improves immune function compared to conventional in-hospital hemodialysis (CHD); therefore, we designed a prospective matching-cohort clinical study to assess serum inflammatory markers and the functional capacity of monocyte-derived dendritic cells (MDDCs) and T-lymphocytes. Serum CRP was decreased in EHHD patients suggesting that extended dialysis may decrease inflammatory solute/cytokine levels. Compared to controls, MDDCs from hemodialysis patients had similar endocytic capacity, expression of co-stimulatory molecules, and T-cell activation capacity. However, CHD was associated with the highest expression of CD83 and CD40. Activated T-cells in CHD patients also produced significantly more immunosuppressive IL-10 compared to EHHD patients and controls. Therefore, EHHD may improve immune function by decreasing inflammation, MDDC pre-activation, and synthesis of immunosuppressive cytokines.

Despite major advances in the treatment and prevention of atherosclerosis the last several decades, cardiovascular disease still accounts for the majority of deaths in Sweden. With the population getting older, more obese and with rising numbers of diabetics, the cardiovascular disease burden may increase further in the future. The focus in cardiovascular disease has shifted with time from calcification and narrowing of arteries to the biological processes within the atherosclerotic plaque. C-reactive protein (CRP) has emerged as one of many proteins that reflect a low grade systemic inflammation and is suitable for analysis as it is more stable and easily measured than most other inflammatory markers. Several large prospective studies have shown that CRP is not only an inflammatory marker, but even a predictive marker for cardiovascular disease. C-reactive protein is associated with several other risk factors for cardiovascular disease including obesity and the metabolic syndrome. Our study of twenty healthy men during a two week endurance cross country skiing tour demonstrated a decline in already low baseline CRP levels immediately after the tour and six weeks later. In a study of 200 obese individuals with impaired glucose tolerance randomised to a counselling session at their health care centre or a one month stay at a wellness centre, we found decreased levels of CRP in subjects admitted to the wellness centre. The effect remained at one, but not after three years of follow-up. In a prospective, nested, case-referent study with 308 ischemic strokes, 61 intracerebral haemorrhages and 735 matched referents, CRP was associated with ischemic stroke in both uni- and multivariate analyses. No association was found with intracerebral haemorrhages. When classifying ischemic stroke according to TOAST criteria, CRP was associated with small vessel disease. The CRP 1444 (CC/CT vs. TT) polymorphism was associated with plasma levels of CRP, but neither with ischemic stroke nor with intracerebral haemorrhage. A study on 129 patients with atrial fibrillation was used to evaluate whether inflammation sensitive fibrinolytic variables adjusted for CRP could predict recurrence of atrial fibrillation after electrical cardioversion. In multivariate iv models, lower PAI-1 mass was associated with sinus rhythm even after adjusting for CRP and markers of the metabolic syndrome. In conclusion, lifestyle intervention can be used to reduce CRP levels, but it remains a challenge to maintain this effect. CRP is a marker of ischemic stroke, but there are no significant associations between the CRP1444 polymorphism and any stroke subtype, suggesting that the CRP relationship with ischemic stroke is not causal. The fibrinolytic variable, PAI-1, is associated with the risk of recurrence of atrial fibrillation after electrical cardioversion after adjustment for CRP. Our findings suggest a pathophysiological link between atrial fibrillation and PAI-1, but the relation to inflammation remains unclear.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2009. / Härtill 4 uppsatser.

O possível envolvimento da inflamação na carcinogênese colorretal tem potenciais implicações prognósticas, preventivas e terapêuticas. Foi investigado, através de imunoistoquímica, se a proteína C reativa (PCR) é expressa em adenocarcinoma retal primário humano, e avaliada sua relação com achados clínico-patológicos. Acúmulo celular de PCR foi observado em 65 (71%) de 91 pacientes com adenocarcinoma de reto e em todos os 22 controles (p<0,01). Nenhuma diferença significativa foi observada referente aos fatores clínico-patológicos ou taxas de sobrevida, mas uma correlação linear entre a proporção de positividade da PCR e o estágio de Dukes-Turnbull foi observada (p=0,005). Estes dados sugerem que a PCR pode desempenhar um papel na carcinogênese retal, mas parece não afetar o prognóstico. Estudos adicionais são necessários em amostras populacionais maiores. / The possible involvement of inflammation on colorectal carcinogenesis has potential prognostic, preventive and therapeutic implications. We investigated immunohistochemically whether C-reactive protein (CRP) is expressed in human primary rectal adenocarcinoma and assessed its relationship with clinicopathological findings. Cell accumulation of CRP was observed in 65 (71%) out of 91 patients with adenocarcinoma of the rectum and in all 22 control cases (p<0.01). No significant difference was observed with regard to clinicopathological features or survival rates, but a linear correlation between the positivity proportion of CRP and Dukes-Turnbull stage (p=0.005) was observed. These data suggest that CRP might play a role in rectal carcionogenesis, but seems to not affect prognosis. Additional studies are warranted in larger population samples.

Fundamentação: O acidente vascular cerebral (AVC) é uma das principais causas de morte em todo o mundo e a maioria dos sobreviventes permanece com alguma sequela neurológica após o evento agudo. O presente estudo objetiva investigar a associação de alguns biomarcadores sanguíneos com as escalas de AVC, bem como avaliar a capacidade dos biomarcadores selecionados na predição de desfechos neurológicos durante o tempo de acompanhamento. Material e Métodos: Incluímos nesse estudo 60 pacientes com AVC agudo admitidos na unidade neurovascular da emergência ou na unidade de medicina intensiva do Hospital de Clínicas de Porto Alegre, nas primeiras 24 horas do início dos sintomas. Foram coletas amostras sanguíneas nas primeiras 24 horas, no terceiro e no quinto dias após o AVC para dosagem de enolase neurônio específica (ENS), proteína S100ß (S100ß), interleucina 6 (IL-6), proteína C reativa (PCR) e fator neurotrófico derivado do cérebro (BDNF). A gravidade do AVC e o grau de dependência funcional dos pacientes após o AVC foram mensurados através das escalas do National Institutes of Health Stroke Scale (NIHSS) e modified Rankin Scale (mRS) nos três momentos das coletas sanguíneas e na alta hospitalar. Resultados: Os níveis séricos de S100ß, IL-6 e PCR mostraram-se o melhor painel de biomarcadores após o AVC nesse estudo. Quando os pacientes foram subdivididos em dois grupos para a avaliação de desfechos neurológicos, usando as escalas do NIHSS (NIHSS ≤ 6 e NHISS > 6) e mRS (mRS ≤ 3 e mRS > 3), ambas as escalas apresentaram boa associação entre as concentrações de S100ß e de IL-6 em todas as medidas e as escalas de AVC para bom prognóstico (NIHSS ≤ 6 e mRS ≤ 3) na alta hospitalar. Dentre os biomarcadores selecionados para o estudo, foram os três citados acima que apresentaram as melhores correlações com as escalas de AVC e com o prognóstico pós AVC durante o tempo de acompanhamento. Conclusão: Os biomarcadores séricos podem ser úteis na avaliação da gravidade e do prognóstico após o AVC. A associação de S100ß, IL-6 e PCR parece acrescentar pouco às escalas validadas de AVC na capacidade de predizer desfechos após o evento agudo. / Background and Purpose: Stroke is an important cause of death worldwide, and the majority of stroke survivors suffer from some form of residual disability. This study aimed to investigate the association of blood biomarkers with stroke scales and their predictive value after acute stroke at the time of admission until hospital discharge. Design and Methods: We investigated 60 patients with acute stroke who were admitted within 24 h of event onset at the intensive care unit or neurovascular emergency unit of Clínicas Hospital. All patients provided venous blood samples for the measurement of neuron-specific enolase (NSE), S100ß protein (S100ß), interleukin-6 (IL-6), C-reactive protein (CRP) and brain-derived neurotrophic factor (BDNF) within 24 h of the acute event, on the third day and on the fifth day after the stroke. Neurological stroke severity and global disability were determined with the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at the same three times of blood collection and at the time of hospital discharge. Results: The serum levels of the S100ß protein, IL-6 and CRP seem to constitute the best panel of biomarkers after acute stroke in this study. When patients were subdivided into two groups according to the NIHSS (NIHSS ≤ 6 and NIHSS > 6) and mRS (mRS ≤ 3 and mRS > 3) scores, which were used as neurological outcome measures, both neurologic scores for good outcome (NIHSS ≤ 6 and mRS ≤ 3) at hospital discharge were significantly related to the S100ß protein and IL-6 levels at all of the measured time points. Among the analyzed blood markers, S100ß, IL-6 and PCR levels significanttly correlated with the stroke scales and prognostic value. Conclusion: Blood biomarkers may be useful in acute stroke either by suggesting stroke severity or providing a prognostic value. The addition of the S100ß protein, IL-6 and CRP to previously validated stroke scales slightly improves the ability of these scales to predict outcome.

Submitted by Simone Souza (simonecgsouza@hotmail.com) on 2018-08-30T16:47:23Z No. of bitstreams: 1 DISS_2013_ Silvana de Faria Moreira Teixeira.pdf: 1279237 bytes, checksum: 063915a03b12b72c03db3ab8c08b48e6 (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2018-10-03T17:44:35Z (GMT) No. of bitstreams: 1 DISS_2013_ Silvana de Faria Moreira Teixeira.pdf: 1279237 bytes, checksum: 063915a03b12b72c03db3ab8c08b48e6 (MD5) / Made available in DSpace on 2018-10-03T17:44:35Z (GMT). No. of bitstreams: 1 DISS_2013_ Silvana de Faria Moreira Teixeira.pdf: 1279237 bytes, checksum: 063915a03b12b72c03db3ab8c08b48e6 (MD5) Previous issue date: 2013-11-12 / A doença periodontal é um agravo da saúde de etiologia infecciosa e natureza inflamatória, caracterizada pela destruição dos tecidos de suporte do dente por meio da ação direta de bactérias e ação do hospedeiro. Estudos vêm demonstrando a relação entre doença periodontal e o surgimento ou progressão de algumas doenças sistêmicas, entre as quais as cardiovasculares. Objetivo: Analisar a associação entre doença periodontal, hipertensão arterial, Síndrome Metabólica e demais variáveis laboratoriais de interesse. Métodos: Estudo observacional, de corte transversal, em amostra de 177 adultos e idosos que compareceram no setor de triagem de quatro Centros de Especialidades Odontológica (CEOs) da Secretaria Municipal de Saúde de Cuiabá no período de setembro a dezembro de 2012. Foram aplicados inquéritos, realizadas medidas antropométricas, da pressão arterial, exame clínico periodontal e exames laboratoriais de sangue e urina. O critério para diagnóstico de hipertensão arterial adotado foi: média de duas medidas da PAS ≥ 140mmHg e/ou PAD ≥90mmHg, ou uso de anti-hipertensivo oral; da síndrome metabólica segundo a “I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica” e NCEP-ATP III e diagnóstico da doença periodontal utilizando o Índice Periodontal Comunitário. Resultados: Observou-se prevalência da Doença Periodontal de 72,3%, Hipertensão Arterial de 40,6% e Síndrome Metabólica de 33,3% . A renda per capita de até ½ salário mínimo mostrou-se associada com a Doença Periodontal (p=0,026) sob análise bivariada. Não foi observada associação entre Doença Periodontal e Síndrome Metabólica (RP=0,98, IC95%=0,80-1,19 e p=0,812). Circunferência da cintura aumentada, HDL-colesterol baixo e hipertensão arterial apresentaram maior relação com Doença Periodontal, mas sem significância estatística. Entre as variáveis laboratoriais apenas os níveis elevados de Proteína C-reativa ultrassensível apresentaram associação significativa com a Doença Periodontal tanto sob analise bivariada quanto múltipla (RP=1,22; IC 95%=1,02-1,47 e p=0,030). Conclusões: Níveis elevados da Proteína C-reativa ultrassensível mostraram associação significativa com a Doença Periodontal. Sugerese a realização de estudos longitudinais mais amplos, de base populacional para avaliar as relações entre Doença Periodontal e as variáveis analisadas. / Periodontal disease is a worsening of the health of infectious etiology and inflammatory nature, characterized by destruction of the supporting tissues of the tooth through the direct action of bacteria, and action of the host. Studies have shown a relationship between periodontal disease and the onset or progression of some systemic diseases, including the cardiovascular. Objective: To analyze the association between periodontal disease, hypertension, metabolic syndrome and other laboratory variables of interest. Methods: An observational cross-sectional study in a sample of 177 adults and seniors who were attended at the sector screening of the four centers of dental specialties (CEO) of the Cuiaba’s Municipal Health from September to December 2012. Were administered surveys, conducted anthropometric measurements, blood pressure, clinical examination and laboratory tests of blood and urine. The criterion for diagnosis of hypertension adopted was: mean of two measurements of SBP ≥ 140 mmHg and / or DBP≥ 90 mmHg, or use of oral antihypertensive, metabolic syndrome according to " First Brazilian Guideline for Diagnosis and Treatment of Metabolic Syndrome " and NCEP - ATP III and periodontal diagnosis using the Community Periodontal Index. Results: The prevalence of periodontal disease was 72.3 %, Hypertension 40.6% and Metabolic Syndrome 33.3%. The per capita income of up to ½ minimum wage was associated with periodontal disease (p=0.026) in bivariate analysis . There was no association between periodontal disease and Metabolic Syndrome (PR= 0.98, 95% CI= 0.80- 1.19, p= 0.812). Increased waist circumference, low HDL cholesterol and hypertension had a higher relation with periodontal disease , but without statistical significance. Among the laboratory variables only high levels of ultrasensitive Creactive protein were significantly associated with periodontal disease both in bivariate analysis as multiple (PR= 1.22, 95% CI = 1.02-1.47, p = 0.030). Conclusions: High levels of ultrasensitive C-reactive protein were significantly associated with periodontal disease. It is suggested to carry out longitudinal studies broader, population-based to assess the relationship between periodontal disease and the variables analyzed.