Daniel Justo

Red blood cell adhesiveness/aggregation, C-reactive protein, fibrinogen, and erythrocyte sedimentation rate in healthy adults and in those with atherosclerotic risk factors

fl ammation in patients with atherosclerosis, 1 we questioned whether its presence in relatively high concentrations is associated with increased red blood cell (RBC) adhesiveness/aggregation. Such an association might be relevant regarding the poorer prognosis that is observed in affected patients due to the unfavorable hemorheologic profi le that might exist in the presence of enhanced RBC adhesiveness/aggregation. 2 The purpose of the present study was to confi rm the existence of enhanced RBC adhesiveness/aggregation in adults with atherosclerotic risk factors and increased concentrations of hs-CRP. x7fx7fx7f All the enrolled patients gave their consent for participation in this study, which was approved by the local ethics committee. We included subjects with atherosclerotic risk factors, including hypertension, diabetes mellitus, hyperlipidemia, and smoking, as well as apparently healthy institutional personnel who had no known risk factors. We excluded subjects who had underlying infl ammatory conditions (e.g., arthritis, infl ammatory bowel disease, and so on), those who had any infectious and/or infl ammatory condition such as tissue ischemia and/or infarction, and patients who had undergone any invasive procedure 6 months before study recruitment. Subjects who were on any steroidal or nonsteroidal anti-in fl ammatory medication (except for low doses [325 mg] of aspirin) were also excluded. The erythrocyte adhesiveness/aggregation test was performed by using a simple slide test. 3 In brief, venous blood was obtained from the antecubital vein into a plastic syringe containing sodium citrate 3.8% (0.25 ml citrate and 0.75 ml whole blood). The blood was mixed gently and 1 drop was applied to a glass slide kept at an angle of 30°, thus leaving a fi ne fi lm of blood on the slide. The slides were then analyzed by an image analyzer (INFLAMET, Infl amet Ltd., Tel Aviv, Israel). 4 A variable we labeled “vacuum radius” describes the space (micrometers) that is created between the aggregatedcells; the larger the space, the more intense the degree of erythrocyte adhesiveness/aggregation. 5 The RBC was performed by using the Coulter STKS autoanalyzer (Beckman Coulter, Nyon, Switzerland), the erythrocyte sedimentation rate (ESR) by Westergen’s method, and quantitative fi brinogen by Clauss’ methods using a Sysmex 6000 autoanalyzer (Sysmex Corporation, Hyaga, Japan), whereas hsCRP was determined by using the Boering BNII nephelometer (DADE Boering, Marburg, Germany), as

The erythrocyte adhesiveness/aggregation test (EAAT): A new biomarker to reveal the presence of low grade subclinical smoldering inflammation in individuals with atherosclerotic risk factors

BACKGROUNDnMultiple acute phase proteins and atherosclerotic risk factors increase the aggregability of erythrocytes.nnnMETHODS AND RESULTSnWe used a simple slide test and image analysis to determine the degree of erythrocyte adhesiveness/aggregation in the peripheral blood of 222 women and 221 men with no, one, two or more atherosclerotic risk factors. The degree of erythrocyte adhesiveness/aggregation correlated significantly with the concentration of commonly used variables of the acute phase response. We also showed that individuals with low erythrocyte adhesiveness/aggregation tend to be younger and to have fewer risk factors for atherosclerosis, including diabetes mellitus, hypertension, hyperlipidemia and smoking.nnnCONCLUSIONSnThe association between increased erythrocyte adhesiveness/aggregation, higher concentrations of acute phase proteins, and increased atherosclerotic risk factors points to a possible clinical applicability of the erythrocyte adhesiveness/aggregation test (EAAT) to reveal the presence of both low-grade subclinical smoldering inflammation and morbid biology in individuals with risk factors for atherosclerosis.

Comparative Analysis Between Dextran Sulfate Adsorption and Direct Adsorption of Lipoproteins in their Capability to Reduce Erythrocyte Adhesiveness/Aggregation in the Peripheral Blood

Abstract: The purpose of this study was to compare the degree of erythrocyte adhesiveness/aggregation (EAA) reduction of two low‐density lipoprotein (LDL) apheretic procedures, namely direct adsorption of lipoproteins (DALI) and dextran sulfate adsorption (DSA). A significant (Pu2003<u20030.001) reduction of EAA was noted in six hypercholesterolemic patients who underwent a total of 40 apheretic sessions and no difference was noted in the degree of EAA reduction by the two techniques. Thus, being a real‐time and point‐of‐care test, the erythrocyte adhesiveness/aggregation test can be applied in relevant situations of acute ischemia, where therapeutic LDL apheresis could improve the hemorheology of individuals with increased concentrations of cholesterol and inflammatory sensitive proteins.

The appearance of aggregated erythrocytes in the peripheral blood of individuals with insulin resistance

Insulin resistance is associated with low‐grade inflammatory response. The probability that the acute‐phase response is associated with enhanced erythrocyte adhesiveness/aggregation was not explored.

Capillary and venous leukocyte adhesiveness/aggregation to differentiate between viral and bacterial infection.

Abstract.Background: A simple capilary leukocyte adhesiveness/aggregation test (CAPLAAT) might be helpful in determining the intensity of inflammation in acute viral and bacterial infections.nPatientsand Methods: We included 30 patients with acute bacterial infections, 14 with viral infectiona as well as 48 healthy controls. The leukocyte adhesiveness/aggregation test (LAAT) test was performed using a simple slide test and image analysis.nResults: The CAPLAAT had a similar discrimination power between bacterial and viral infections as both the white blood cell count (WBC) and the erythrocyte sedimentation rate (ESR). It was more sensitive than the WBC and the ESR (77%, 68% and 66%, respectively) for the detection of bacterial infections and had a comparable negative predictive value. By analyzing the size distribution of the aggregated leukocytes, we found that a venous leukocyte adhesiveness/aggregation test (VLAAT) of four cells and more had the best positive predictive value (94%) and specificity (95%) for diagnosis of an acute bacterial infection (from all the acute phase response variables examined).nConclusion: The CAPLAAT might be attractive for the detection of inflammation and for the assessment of its severity at points of care where the services of a clinical laboratory are not available around the clock.

2P-0389 The appearance of aggregated erythrocytes in the peripheral blood of individuals with insulin resistance

BACKGROUNDnInsulin resistance is associated with low-grade inflammatory response. The probability that the acute-phase response is associated with enhanced erythrocyte adhesiveness/aggregation was not explored.nnnMETHODSnThe degree of erythrocyte adhesiveness/aggregation was evaluated by using a simple slide test. The insulin resistance was evaluated by insulin and glucose concentrations after a night of fasting. The inflammatory response was evaluated by variables of acute-phase response.nnnRESULTSnA significant correlation (r = -0.2, p = 0.02) was noted between insulin resistance expressed as the HOMA index and the degree of erythrocyte adhesiveness/aggregation. This was probably due to the concomitant acute-phase response and the presence of increased amounts of inflammation-sensitive proteins that were found to correlate significantly with the degree of erythrocyte adhesiveness/aggregation. In the multiple linear regression analysis, erythrocyte sedimentation rate and fibrinogen concentration but not HOMA index were found to correlate significantly (p < 0.0001 and p = 0.0007 respectively) with the degree of red blood cell adhesiveness/aggregation.nnnCONCLUSIONSnInsulin resistance is associated with an enhanced degree of erythrocyte adhesiveness/aggregation and this is related to the presence of enhanced inflammation-sensitive plasma proteins that are part of the acute-phase response. These findings might have hemorheological consequences and might contribute to the pathophysiology of the insulin-resistance syndrome.