Time-Course of Changes in Inflammatory Response after Whole-Body Cryotherapy Multi Exposures following Severe Exercise

The objectives of the present investigation was to analyze the effect of two different recovery modalities on classical markers of exercise-induced muscle damage (EIMD) and inflammation obtained after a simulated trail running race. Endurance trained males (n = 11) completed two experimental trials separated by 1 month in a randomized crossover design; one trial involved passive recovery (PAS), the other a specific whole body cryotherapy (WBC) for 96 h post-exercise (repeated each day). For each trial, subjects performed a 48 min running treadmill exercise followed by PAS or WBC. The Interleukin (IL) -1 (IL-1), IL-6, IL-10, tumor necrosis factor alpha (TNF-α), protein C-reactive (CRP) and white blood cells count were measured at rest, immediately post-exercise, and at 24, 48, 72, 96 h in post-exercise recovery. A significant time effect was observed to characterize an inflammatory state (Pre vs. Post) following the exercise bout in all conditions (p<0.05). Indeed, IL-1β (Post 1 h) and CRP (Post 24 h) levels decreased and IL-1ra (Post 1 h) increased following WBC when compared to PAS. In WBC condition (p<0.05), TNF-α, IL-10 and IL-6 remain unchanged compared to PAS condition. Overall, the results indicated that the WBC was effective in reducing the inflammatory process. These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Object. Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. The C-reactive protein (CRP) constitutes a highly sensitive inflammatory marker. The association of elevated systemic CRP and coronary vasospasm has been well established. Additionally, elevation of the serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between elevated CRP levels in the serum and CSF and the development of vasospasm in patients with aSAH. Methods. A total of 41 adult patients in whom aSAH was diagnosed were included in the study. Their demographics, the admitting Glasgow Coma Scale (GCS) score, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum and CSF CRP measurements were obtained on Days 0, 1, 2, 3, 5, 7, and 9. All patients underwent either surgical or endovascular treatment within 48 hours of their admission. The outcome was evaluated using the Glasgow Outcome Scale and the modified Rankin Scale. Results. The CRP levels in serum and CSF peaked on the 3rd postadmission day, and the CRP levels in CSF were always higher than the serum levels. Patients with lower admission GCS scores and higher Hunt and Hess and Fisher grades had statistically significantly higher levels of CRP in serum and CSF. Patients with angiographic vasospasm had higher CRP measurements in serum and CSF, in a statistically significant fashion (p < 0.0001). Additionally, patients with higher CRP levels in serum and CSF had less favorable outcome in this cohort. Conclusions. Patients with aSAH who had high Hunt and Hess and Fisher grades and low GCS scores showed elevated CRP levels in their CSF and serum. Furthermore, patients developing angiographically proven vasospasm demonstrated significantly elevated CRP levels in serum and CSF, and increased CRP measurements were strongly associated with poor clinical outcome in this cohort. (DOI: 10.3171/2009.2.FOCUS08311

Inflammasome Proteins as Biomarkers of Injury and Disease

The inflammasome is a multi-protein complex of the innate immune response that activates caspase-1 after infections, tissue injury, or disease. Once active caspase-1 cleaves the pro-inflammatory cytokines pro-IL-1β and pro-IL-18 into their respective mature forms, IL-1β and IL-18. Inflammasome proteins such as caspase-1, NOD-like receptor protein-1 (NLRP1), NLRP3, or apoptosis-associated speck-like protein containing a CARD (ASC) can be used as biomarkers of tissue injury and disease. For instance, higher levels of inflammasome proteins are present in the cerebrospinal fluid of patients with traumatic brain injury who present poor outcomes after trauma. Hence, the inflammasome after brain injury can be used as a tool to prognosticate outcomes after brain trauma. Similarly, in rodent models of multiple sclerosis, animals that do not respond to the classic interferon (IFN)-β treatment do not present an NLRP3 inflammasome-dependent disease. Thus, the inflammasome in multiple sclerosis can be used as a prognostic tool to identify responders to IFN-β treatment. In the same manner, patients taking finasteride for male pattern baldness who do not respond to treatment correlate with higher levels of caspase-1 in hair follicles. Moreover, the inflammasome can also be used as a biomarker of disease progression in diabetes and atherosclerosis, as well as a biomarker of tissue injury in inflammatory bowel disease and semen quality in patients with male infertility after spinal cord injury. Therefore, the inflammasome, a receptor of the innate immune response, is a useful biomarker in a variety of diseases and tissue injury