{"id":1186,"date":"2016-12-11T18:22:07","date_gmt":"2016-12-11T17:22:07","guid":{"rendered":"http:\/\/www.newslab.sk\/2016\/12\/11\/biochemicke-zapalove-markery\/"},"modified":"2017-10-04T14:33:26","modified_gmt":"2017-10-04T12:33:26","slug":"biochemical-and-inflammation-markers","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/biochemical-and-inflammation-markers\/","title":{"rendered":"Biochemical and Inflammation Markers"},"content":{"rendered":"<pre><span style=\"color: #ff0000;\"><strong>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf\u00a0\r\nattachment at the end of the paper.\r\n\r\n<\/strong><\/span><\/pre>\n<p><strong>Klinick\u00fd v\u00fdznam<\/strong><br \/>\nC-reakt\u00edvny prote\u00edn je ne\u0161pecifick\u00e1 reakt\u00edvna bielkovina ak\u00fatnej f\u00e1zy. Patr\u00ed medzi \u03b2-globul\u00edny. Je syntetizovan\u00fd v pe\u010deni, pri\u010dom sign\u00e1lom na synt\u00e9zu je p\u00f4sobenie cytok\u00ednov IL-6, IL-1, TNF\u03b1. M\u00e1 schopnos\u0165 aktivova\u0165 komplementov\u00fd syst\u00e9m, via\u017ee sa na fragmenty z rozpadnut\u00fdch buniek, a t\u00fdm chr\u00e1ni organizmus pred ich \u0161kodliv\u00fdm \u00fa\u010dinkom. Jeho koncentr\u00e1cia sa zvy\u0161uje pri ak\u00fatnych z\u00e1palov\u00fdch procesoch vyvolan\u00fdch bakteri\u00e1lnymi infekciami, poopera\u010dn\u00fdmi stavmi alebo po\u0161koden\u00edm tkan\u00edv. Vzostup po navoden\u00ed<br \/>\nreakcie ak\u00fatnej f\u00e1zy je r\u00fdchly \u2013 nast\u00e1va u\u017e po 6 hodin\u00e1ch. Maxim\u00e1lne hladiny dosahuje za 24 \u2013 48 hod\u00edn. Ak nenastan\u00fa komplik\u00e1cie, normaliz\u00e1cia nast\u00e1va v priebehu 4 dn\u00ed. Pri bakteri\u00e1lnych infekci\u00e1ch dosahuje CRP najvy\u0161\u0161ie hodnoty. V\u00edrusov\u00e9 infekcie nie s\u00fa sprev\u00e1dzan\u00e9 v\u00fdrazn\u00fdm vzostupom (1).<\/p>\n<p>Prokalciton\u00edn je bielkovina syntetizovan\u00e1 hlavne v pe\u010deni, v men\u0161ej miere v neuroendokrinn\u00fdch bunk\u00e1ch \u010driev a p\u013e\u00fac, v monocytoch a makrof\u00e1goch. Stimulom na jeho synt\u00e9zu s\u00fa hlavne bakt\u00e9riov\u00e9 endotox\u00edny<br \/>\n(lipopolysacharidy), ale aj cytok\u00edny \u2013 TNF-\u03b1, IL-6 (2). Je markerom \u0165a\u017eko prebiehaj\u00facich z\u00e1palov \u2013 sepsa, viacorg\u00e1nov\u00fd dysfunk\u010dn\u00fd syndr\u00f3m MODS, infekcie sprev\u00e1dzaj\u00facich pop\u00e1leniny. Pom\u00e1ha odl\u00ed\u0161i\u0165 ak\u00fatnu bakteri\u00e1lnu infekciu od in\u00fdch typov z\u00e1palu. Lok\u00e1lne bakteri\u00e1lne infekcie nesp\u00f4sobuj\u00fa jeho zv\u00fd\u0161enie. Vylu\u010duje sa obli\u010dkami, \u013eahk\u00e1 a stredne \u0165a\u017ek\u00e1 ren\u00e1lna insuficiencia nem\u00e1 vplyv na jeho hladinu (3).<\/p>\n<p><strong>PCT m\u00f4\u017ee by\u0165 zv\u00fd\u0161en\u00fd aj pri niektor\u00fdch neinfek\u010dn\u00fdch stavoch:<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>PCT m\u00f4\u017ee by\u0165 zv\u00fd\u0161en\u00fd aj pri niektor\u00fdch neinfek\u010dn\u00fdch\u00a0 stavoch:<\/p>\n<ul>\n<li>prolongovan\u00fd alebo z\u00e1va\u017en\u00fd kardiog\u00e9nny \u0161ok<\/li>\n<li>prolongovan\u00e9 z\u00e1va\u017en\u00e9 abnormality org\u00e1novej perf\u00fazii<\/li>\n<li>alobunkov\u00fd karcin\u00f3m p\u013e\u00fac a medul\u00e1rny karcin\u00f3m \u0161t\u00edtnej \u017e\u013eazy<\/li>\n<li>v\u010dase kr\u00e1tko po z\u00e1va\u017enej traume, ve\u013ek\u00fdch chirurgick\u00fdch z\u00e1krokoch, z\u00e1va\u017en\u00fdch pop\u00e1lenin\u00e1ch<\/li>\n<li>lie\u010dba, ktor\u00e1 stimuluje uvo\u013e\u0148ovanie proz\u00e1palov\u00fdch cytok\u00ednov<\/li>\n<li>novorodenci do 48 hod\u00edn<\/li>\n<\/ul>\n<p>Interleuk\u00edn-6 je cytok\u00edn so \u0161irok\u00fdm spektrom funkci\u00ed, ktor\u00fd vykazuje aktivitu v B-bunk\u00e1ch, T-bunk\u00e1ch, krvotvorn\u00fdch kme\u0148ov\u00fdch bunk\u00e1ch, hepatocytoch a mozgov\u00fdch bunk\u00e1ch. Produkcia IL-6 je vyvolan\u00e1 n\u00e1hle<br \/>\npri ak\u00fatnych z\u00e1palov\u00fdch reakci\u00e1ch spojen\u00fdch so zranen\u00edm, \u00farazom, stresom, infekciou, neopl\u00e1ziou a \u010fal\u0161\u00edmi z\u00e1va\u017en\u00fdmi stavmi. IL-6 je u\u017eito\u010dn\u00fd pri hodnoten\u00ed z\u00e1va\u017enosti SIRS (syndr\u00f3m syst\u00e9movej z\u00e1palovej<br \/>\nodpovede organizmu), sepsy a septick\u00e9ho \u0161oku. IL-6 je u\u017eito\u010dn\u00fdm v\u010dasn\u00fdm markerom na detekciu neonat\u00e1lnej sepsy. V literat\u00fare sa uv\u00e1dza, \u017ee zohr\u00e1va \u00falohu pri chronick\u00fdch z\u00e1paloch, napr\u00edklad reumatoidnej artrit\u00edde, \u010do treba bra\u0165 do \u00favahy pri hodnoten\u00ed \u00a0ak\u00fatnych z\u00e1palov\u00fdch stavov u t\u00fdchto pacientov (4).<\/p>\n<ul>\n<li>Hodnotenie z\u00e1va\u017enosti SIRS, sepsy, septick\u00e9ho \u0161oku a ur\u010denie \u010fal\u0161ej progn\u00f3zy<\/li>\n<li>Diagnostika neonat\u00e1lnej sepsy<\/li>\n<\/ul>\n<p>Preseps\u00edn (sCD14-ST) je fragment glykoprote\u00ednu CD14 a vznik\u00e1 ako v\u00fdsledok z\u00e1palovej reakcie sp\u00f4sobenej infekciou. Glykoprote\u00edn CD14 je exprimovan\u00fd na povrchu membr\u00e1ny monocytov, makrof\u00e1gov, granulo- cytov, kde sl\u00fa\u017ei ako receptor komplexov lipopolysacharidov \u00a0(LPS) a LPS via\u017eucich \u00a0prote\u00ednov (LPBP). Je lokalizovan\u00fd v bl\u00edzkosti toll-like receptora 4 (TLR4). Naviazan\u00edm \u00a0LPBP komplexu \u00a0na CD14 sa aktivuje TLR4 \u2013 \u0161pecifick\u00e1 proz\u00e1palov\u00e1 \u00a0kask\u00e1da, a t\u00fdm sa sp\u00fa\u0161\u0165a z\u00e1palov\u00e1 reakcia hostite\u013ea proti infek\u010dn\u00e9mu agens. Komplex LPS-LPBP-CD14 je uvo\u013e\u0148ovan\u00fd do cirkul\u00e1cie a vplyvom plazmatick\u00fdch prote\u00e1z \u0161tiepen\u00fd na subtyp sCD14-ST-preseps\u00edn.<br \/>\nPreseps\u00edn sl\u00fa\u017ei na diagnostiku a progn\u00f3zu sepsy a pos\u00fadenie miery z\u00e1va\u017enosti septick\u00fdch stavov. Koncentr\u00e1cie s\u00fa signifikantne vy\u0161\u0161ie u pacientov s bakteri\u00e1lnou infekciou ako u pacientov \u00a0bez infekcie (5, 6).<\/p>\n<ul>\n<li>&lt; 200 ng\/l \u00a0 Sepsa vyl\u00fa\u010den\u00e1<\/li>\n<li>&lt; 300 ng\/l \u00a0 Syst\u00e9mov\u00e1 infekcia nepravdepodobn\u00e1<\/li>\n<li>&lt; 500 ng\/l \u00a0 Syst\u00e9mov\u00e1 infekcia (sepsa) mo\u017en\u00e1<\/li>\n<li>&lt; 1 000 ng\/l Zv\u00fd\u0161en\u00e9 riziko nepriazniv\u00e9ho v\u00fdvoja<\/li>\n<li>\u2265 1 000 ng\/l Vysok\u00e9 riziko progresie (\u0165a\u017ek\u00e1 sepsa\/septick\u00fd \u0161ok) Riziko 30-d\u0148ovej \u00a0mortality ako pri APACHE \u00a0II &gt; 25<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>I<\/strong><strong>n<\/strong><strong>dik<\/strong><strong>\u00e1<\/strong><strong>c<\/strong><strong>i<\/strong><strong>a<\/strong><\/p>\n<ul>\n<li>Skor\u00e1 diagnostika sepsy<\/li>\n<li>Monitoring priebehu ochorenia<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>P<\/strong><strong>r<\/strong><strong>e<\/strong><strong>d<\/strong><strong>an<\/strong><strong>a<\/strong><strong>l<\/strong><strong>y<\/strong><strong>t<\/strong><strong>i<\/strong><strong>c<\/strong><strong>k<\/strong><strong>\u00e9 inform\u00e1cie<\/strong><\/p>\n<p>CRP, PCT, IL-6 \u2013 odber do \u0161tandardnej biochemickej \u00a0sk\u00famavky so separa\u010dn\u00fdm g\u00e9lom. Po odbere treba \u010do najsk\u00f4r doru\u010di\u0165 do laborat\u00f3ria.<br \/>\nPCT \u2013 stabilita v s\u00e9re 24 hod\u00edn, po tomto \u010dase parameter m\u00f4\u017ee by\u0165 vy\u0161etren\u00fd, len ak s\u00e9rum bolo do 24 hod\u00edn zmrazen\u00e9.<br \/>\nPreseps\u00edn \u2013 sk\u00famavka ako na KO (K-EDTA) do laborat\u00f3ria doru\u010di\u0165 vzorku do 4 hod\u00edn od odberu.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Me<\/strong><strong>t<\/strong><strong>\u00f3d<\/strong><strong>a vy\u0161etrenia<\/strong><\/p>\n<p>CRP \u2013 imunoturbidimetrick\u00e9 stanovenie<br \/>\nPCT, IL-6 \u2013 elektrochemiluminiscen\u010dn\u00e1 \u00a0imunoanal\u00fdza (ECLIA) Preseps\u00edn \u2013 chemiluminiscen\u010dn\u00e1 imunoanal\u00fdza (CLEIA)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>I<\/strong><strong>n<\/strong><strong>t<\/strong><strong>e<\/strong><strong>r<\/strong><strong>f<\/strong><strong>e<\/strong><strong>r<\/strong><strong>e<\/strong><strong>n<\/strong><strong>c<\/strong><strong>ie<\/strong><\/p>\n<p>CRP \u2013 hemol\u00fdza, siln\u00fd z\u00e1kal<br \/>\nPCT, IL-6 \u2013 siln\u00e1 hemol\u00fdza, siln\u00fd z\u00e1kal<br \/>\nPreseps\u00edn \u2013 hemol\u00fdza, z\u00e1kal<\/p>\n<p>&nbsp;<\/p>\n<p><strong>K<\/strong><strong>\u00f3<\/strong><strong>d vy\u0161etrenia<\/strong><\/p>\n<p>CRP \u2013 4571, PCT \u2013 4488, IL-6 \u2013 4474, Preseps\u00edn \u2013 44421<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Dos<\/strong><strong>t<\/strong><strong>up<\/strong><strong>nos<\/strong><strong>\u0165 vy\u0161etrenia <\/strong>Centr\u00e1lne laborat\u00f3rium Bratislava Centr\u00e1lne laborat\u00f3rium Ko\u0161ice<\/p>\n<p>&nbsp;<\/p>\n<p><strong>L<\/strong><strong>it<\/strong><strong>e<\/strong><strong>ra<\/strong><strong>t<\/strong><strong>\u00fa<\/strong><strong>ra<\/strong><\/p>\n<ol>\n<li>Masopust J. <em>K<\/em><em>li<\/em><em>nick\u00e1 biochemie <\/em><em>\u2013 po\u017eadov\u00e1n\u00ed a hodnocen\u00ed biochemick\u00fdch vy\u0161et\u0159en\u00ed<\/em>. 1. vyd. \u010c\u00e1st II. Praha: Karolinum; 1998: 493\u2013494.<\/li>\n<li>Len\u00e1rtov\u00e1 R. Prokalciton\u00edn \u2013 kvantitat\u00edvne stanoveni <em>Labor Aktuell. <\/em>04\/08, 14\u201316.<\/li>\n<li>Maruna P. <em>P<\/em><em>o<\/em><em>kalcitonin. <\/em>Praha: Triton; 2003.<\/li>\n<li><em>I<\/em><em>L<\/em><em>&#8211;<\/em><em>6 Interleuk\u00edn-6. N\u00e1vod <\/em><em>n<\/em><em>a pou\u017eitie<\/em>. Roche Diagnostics. 2010-02.<\/li>\n<li>Available from: &lt;<span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/presepsin.com\/clinical-performance.html\">http:\/\/presepsin.com\/clinical-performance.html.<\/a><\/span>&gt;.<\/li>\n<li>Available from: <span style=\"color: #000000;\">&lt;<a style=\"color: #000000;\" href=\"http:\/\/www.pathfast.eu\/index.php?option\">http:\/\/www.pathfast.eu\/index.php?option<\/a>&gt;.<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf\u00a0 attachment at the end of the paper. Klinick\u00fd v\u00fdznam C-reakt\u00edvny prote\u00edn je ne\u0161pecifick\u00e1 reakt\u00edvna bielkovina ak\u00fatnej f\u00e1zy. Patr\u00ed medzi \u03b2-globul\u00edny. Je syntetizovan\u00fd v pe\u010deni, pri\u010dom sign\u00e1lom na synt\u00e9zu je p\u00f4sobenie cytok\u00ednov IL-6, IL-1, TNF\u03b1. M\u00e1 schopnos\u0165 aktivova\u0165<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[289],"tags":[449,775,450,451,777,776],"class_list":["post-1186","post","type-post","status-publish","format-standard","hentry","category-biochemistry","tag-crp-en","tag-inflammation","tag-interleukin-6-en","tag-presepsin-en","tag-procalcitonin","tag-sepsis","typ_clanku-review-article"],"acf":{"abstrakt":"<p>Inflammation represents a general defence mechanism of the body against various harmful stimuli irritations. CRP\u2013C-reactive protein, an acute phase protein, is a significant inflammation indicator. Its concentration increases particularly in acute inflammatory processes caused by bacterial infections. Cytokine IL-6, procalcitonin and presepsin are markers used for diagnosis of severe inflammations and sepsis.<\/p>\n<p><strong>Key words: <\/strong>inflammation, sepsis, CRP, procalcitonin, interleukin-6, presepsin<\/p>\n","casopis":[{"ID":995,"post_author":"7","post_date":"2016-11-16 12:14:30","post_date_gmt":"2016-11-16 11:14:30","post_content":"<h4><strong>Biochemistry <\/strong><\/h4>\r\n<ul>\r\n \t<li>Biochemical inflammation markers<\/li>\r\n \t<li>Biochemical examinations in liver diseases<\/li>\r\n \t<li>Biochemical diagnosis in diseases of GIT<\/li>\r\n \t<li>Hypoglycemia<\/li>\r\n \t<li>Urolithiasis as a result of metabolic diseases<\/li>\r\n \t<li>Indication and application of tumor markers in clinical practice<\/li>\r\n \t<li>Monoclonal gammopathies \u2013 laboratory examinations in diagnosis and monitoring<\/li>\r\n \t<li>Hormones in diagnosis of reproductive function disorders<\/li>\r\n \t<li>Cerebrospinal fluid diagnosis of diseases affecting the nervous system<\/li>\r\n \t<li>Determining trace elements in blood serum<\/li>\r\n<\/ul>\r\n<h4><strong>Genetics<\/strong><\/h4>\r\n<ul>\r\n \t<li>Assessing the therapeutic response in patients with chronic myelocyte leukemia treated with tyrosine kinase inhibitors<\/li>\r\n \t<li>Hormones in diagnosis of reproductive functions\u2019 disorders<\/li>\r\n<\/ul>\r\n<h4><strong>Hematology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Anemias \u2013 laboratory diagnosis of the most frequently prevalent types of anemia<\/li>\r\n \t<li>Laboratory and hematological technical equipment<\/li>\r\n<\/ul>\r\n<h4><strong>Immunology <\/strong><\/h4>\r\n<ul>\r\n \t<li>Paraneoplastic neurological syndromes and in vitro diagnosis of onconeural antibodies<\/li>\r\n<\/ul>","post_title":"newslab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab","to_ping":"","pinged":"","post_modified":"2017-08-16 21:40:20","post_modified_gmt":"2017-08-16 19:40:20","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.newslab.sk\/casopis\/newslab\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"62","upload_clanok":{"ID":1187,"id":1187,"title":"vlnieskova_biochemicke_zapalove_markery","filename":"Vlnie\u0161kov\u00e1_Biochemick\u00e9_z\u00e1palov\u00e9_markery.pdf","filesize":448551,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2016\/12\/Vlnie\u0161kov\u00e1_Biochemick\u00e9_z\u00e1palov\u00e9_markery.pdf","link":"https:\/\/www.newslab.sk\/en\/biochemical-and-inflammation-markers\/vlnieskova_biochemicke_zapalove_markery\/","alt":"","author":"7","description":"","caption":"","name":"vlnieskova_biochemicke_zapalove_markery","status":"inherit","uploaded_to":1186,"date":"2016-12-11 17:13:12","modified":"2016-12-11 17:13:12","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=1186"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1186\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=1186"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=1186"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=1186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}