Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen? / Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

In der Diagnostik von Infektionen und inflammatorischen Prozessen ist das C-reaktive Protein (CRP) einer der meistverwendeten Parameter, unter anderem aufgrund der geringen Kosten und der schnellen Verfügbarkeit. Im Zuge der letzten Jahre gewannen jedoch andere Entzündungsparameter, wie zum Beispiel das Interleukin 6 (IL-6) oder Procalcitonin (PCT), zunehmend an Bedeutung. Obwohl diese Parameter im klinischen Alltag noch nicht überall etabliert sind, besitzen sie doch wesentliche Vorteile in der Diagnostik und im Verlaufsmonitoring von entzündlichen Erkrankungen. Beispielsweise ist die Erkennung entzündlicher Komplikationen auf Intensivstationen durch erhöhte IL-6 Spiegel 24 bis 48 Stunden vor einer Erhöhung des CRP möglich. Die deutliche Überlegenheit von PCT gegenüber CRP in der Diagnostik von bakteriellen Infektionen und Sepsis begründet sich in der höheren Spezifität des PCT für bakterielle Infektionen. Der PCT-Verlauf ermöglicht daher eine bessere Beurteilung des Therapieerfolges und Krankheitsverlaufs des Patienten und liefert Hinweise auf eine gegebenenfalls erforderliche Therapieumstellung. Daraus ergibt sich die Frage, ob die Messung des CRP-Spiegels durch IL-6 und/oder PCT ersetzt werden kann. In dieser Übersichtsarbeit wird die derzeitige Bedeutung von CRP im Verhältnis zu den neueren Entzündungsparametern in der Diagnostik von bakteriellen Infektionen, im therapeutischen Monitoring und in seiner Aussagekraft bezüglich der Prognose des Patienten auf Intensivstationen dargestellt.C-reactive protein (CRP) currently constitutes one of the most widely used parameters for the diagnosis of infections and inflammatory processes, due to simple methods and low costs. However, in recent years, other parameters, such as interleukin 6 (IL-6) and procalcitonin (PCT), have gained in importance. Although these parameters are presently not established everywhere in clinical routine, they provide significant advantages in the diagnosis and monitoring of inflammatory diseases. For instance, in intensive care, the increase in IL-6 levels may indicate inflammatory complications 24 to 48 h prior to the increase in circulating CRP levels. In contrast to CRP, PCT shows a higher specificity for bacterial infections, which facilitates the diagnosis of bacterial infections and sepsis. Therefore, PCT values provide a better evaluation of prognosis and therapeutic success and of a necessary change in therapy. These points raise the question whether CRP levels should at least in part be replaced by PCT and/or IL-6. Thus, this review seeks to examine the value of CRP in relation to PCT and IL-6 in the diagnosis of bacterial infections, in therapeutic monitoring, and regarding prognosis in critical care patients

Reading list: 15 recommended reads on colonial histories, colonial legacies

In this reading list, we recommend fifteen books previously reviewed on the LSE RB blog that critically explore the histories of imperialism, discuss the life and works of people who have contested colonialism and seek to better understand the legacies of empire in the present. If you would like to add to this list, please add your recommendations in the comments below

Genes from Chagas Susceptibility Loci That Are Differentially Expressed in T. cruzi-Resistant Mice Are Candidates Accounting for Impaired Immunity

Variation between inbred mice of susceptibility to experimental Trypanosoma cruzi infection has frequently been described, but the immunogenetic background is poorly understood. The outcross of the susceptible parental mouse strains C57BL/6 (B6) and DBA/2 (D2), B6D2F1 (F1) mice, is highly resistant to this parasite. In the present study we show by quantitative PCR that the increase of tissue parasitism during the early phase of infection is comparable up to day 11 between susceptible B6 and resistant F1 mice. A reduction of splenic parasite burdens occurs thereafter in both strains but is comparatively retarded in susceptible mice. Splenic microarchitecture is progressively disrupted with loss of follicles and B lymphocytes in B6 mice, but not in F1 mice. By genotyping of additional backcross offspring we corroborate our earlier findings that susceptibility maps to three loci on Chromosomes 5, 13 and 17. Analysis of gene expression of spleen cells from infected B6 and F1 mice with microarrays identifies about 0.3% of transcripts that are differentially expressed. Assuming that differential susceptibility is mediated by altered gene expression, we propose that the following differentially expressed transcripts from these loci are strong candidates for the observed phenotypic variation: H2-Eα, H2-D1, Ng23, Msh5 and Tubb5 from Chromosome 17; and Cxcl11, Bmp2k and Spp1 from Chromosome 5. Our results indicate that innate mechanisms are not of primary relevance to resistance of F1 mice to T. cruzi infection, and that differential susceptibility to experimental infection with this protozoan pathogen is not paralleled by extensive variation of the transcriptome

Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen?/Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

In der Diagnostik von Infektionen und inflammatorischen Prozessen ist das C-reaktive Protein (CRP) einer der meistverwendeten Parameter, unter anderem aufgrund der geringen Kosten und der schnellen Verfügbarkeit. Im Zuge der letzten Jahre gewannen jedoch andere Entzündungsparameter, wie zum Beispiel das Interleukin 6 (IL-6) oder Procalcitonin (PCT), zunehmend an Bedeutung. Obwohl diese Parameter im klinischen Alltag noch nicht überall etabliert sind, besitzen sie doch wesentliche Vorteile in der Diagnostik und im Verlaufsmonitoring von entzündlichen Erkrankungen. Beispielsweise ist die Erkennung entzündlicher Komplikationen auf Intensivstationen durch erhöhte IL-6 Spiegel 24 bis 48 Stunden vor einer Erhöhung des CRP möglich. Die deutliche Überlegenheit von PCT gegenüber CRP in der Diagnostik von bakteriellen Infektionen und Sepsis begründet sich in der höheren Spezifität des PCT für bakterielle Infektionen. Der PCT-Verlauf ermöglicht daher eine bessere Beurteilung des Therapieerfolges und Krankheitsverlaufs des Patienten und liefert Hinweise auf eine gegebenenfalls erforderliche Therapieumstellung. Daraus ergibt sich die Frage, ob die Messung des CRP-Spiegels durch IL-6 und/oder PCT ersetzt werden kann. In dieser Übersichtsarbeit wird die derzeitige Bedeutung von CRP im Verhältnis zu den neueren Entzündungsparametern in der Diagnostik von bakteriellen Infektionen, im therapeutischen Monitoring und in seiner Aussagekraft bezüglich der Prognose des Patienten auf Intensivstationen dargestellt.C-reactive protein (CRP) currently constitutes one of the most widely used parameters for the diagnosis of infections and inflammatory processes, due to simple methods and low costs. However, in recent years, other parameters, such as interleukin 6 (IL-6) and procalcitonin (PCT), have gained in importance. Although these parameters are presently not established everywhere in clinical routine, they provide significant advantages in the diagnosis and monitoring of inflammatory diseases. For instance, in intensive care, the increase in IL-6 levels may indicate inflammatory complications 24 to 48 h prior to the increase in circulating CRP levels. In contrast to CRP, PCT shows a higher specificity for bacterial infections, which facilitates the diagnosis of bacterial infections and sepsis. Therefore, PCT values provide a better evaluation of prognosis and therapeutic success and of a necessary change in therapy. These points raise the question whether CRP levels should at least in part be replaced by PCT and/or IL-6. Thus, this review seeks to examine the value of CRP in relation to PCT and IL-6 in the diagnosis of bacterial infections, in therapeutic monitoring, and regarding prognosis in critical care patients

Editorial Introduction. Intersex: cultural and social perspectives

Intersex has been a topic of much discussion in courses on sex and gender in the academy. Much of this discourse has centred on the nature of intersex and how far it challenges the categories of sex and gender. As Emi Koyama and Lisa Weasel pointed out in 2002, this form of academic appropriation risks diverting attention from important social justice issues towards trivial or reductive theorising about social construction. Academic enquiries into the oppression of people with intersex variations may only sometimes be helpful in bringing hegemonic forces of body normativity, prejudice and sex/gender norms into question. Some scholarship on intersex has attempted to include the experiences of intersex people to a greater extent. This research has been empirical (for instance Kessler 1998; Preves 2003; Karkazis 2008; Davis 2015; 2015a; Monro, Crocetti and Yeadon-Lee 2019; Crocetti et al. 2020), autoethnographic or informed by personal experience (Holmes 2009; Morland 2009; Davis 2015; Rubin 2017; Carpenter 2018, 2020; Malatino 2019) and archival (Griffiths 2018; Dreger 1998). Rather than focusing on what intersex people are, this growing body of work has examined the challenges that intersex people face, which include systematic oppression, discrimination and human rights violations (Ghattas 2013; FRA 2015; Carpenter 2016; Crocetti et al. 2020). The emerging field of interdisciplinary intersex studies, therefore, can be characterised by the co-constitution of knowledge with the individuals and communities it seeks to study, as intersex activists (both academics and non-academics) are important authors in the field. This special issue of Culture, Health & Sexuality brings together some of this work and introduces interdisciplinary intersex studies to a wider audience. This editorial provides an overview of intersex issues, paying homage to the activists and academics who have forged the development of this field

Bordetella pertussis filamentous hemagglutinin itself does not trigger anti-inflammatory interleukin-10 production by human dendritic cells.

peer reviewedFilamentous hemagglutinin (FHA) is an important adhesin of the whooping cough agent Bordetella pertussis and is contained in most acellular pertussis vaccines. Recently, FHA was proposed to exert an immunomodulatory activity through induction of tolerogenic IL-10 secretion from dendritic cells. We have re-evaluated the cytokine-inducing activity of FHA, placing specific emphasis on the role of the residual endotoxin contamination of FHA preparations. We show that endotoxin depletion did not affect the capacity of FHA to bind primary human monocyte-derived dendritic cells, while it abrogated the capacity of FHA to elicit TNF-alpha and IL-10 secretion and strongly reduced its capacity to trigger IL-6 production. The levels of cytokines induced by the different FHA preparations correlated with their residual contents of B. pertussis endotoxin. Moreover, FHA failed to trigger cytokine secretion in the presence of antibodies that block TLR2 and/or TLR4 signaling. The TLR2 signaling capacity appeared to be linked to the presence of endotoxin-associated components in FHA preparations and not to the FHA protein itself. These results show that the endotoxin-depleted FHA protein does not induce cytokine release from human dendritic cells

Correction to:Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey (European Journal of Pediatrics, (2022), 181, 8, (3163-3172), 10.1007/s00431-022-04467-y)

In the original published version of the above article, the following names under "the ESPNICIVMFT group" were presented incorrectly and are now corrected as shown below: Luregn J Schlapbach Fabrizio Chiusolo and is affiliated to "Pediatric Intensive Care, Bambino Gesù Children’s Hospital, Rome, Italy" Stavroula Ilia The original article has been corrected.</p