Plasma Adiponectin Levels and Relations With Cytokines in Children With Acute Rheumatic Fever

We aimed to investigate if adiponectin facilitates diagnosis of ARF by analyzing adiponectin levels in acute and convalescent periods of the acute rheumatic fever and by comparing results with that of healthy control group; also by comparatively examining levels of adiponectin in ARF cases who had different clinical findings at presentation. In addition, we aimed to investigate its role in the pathogenesis of ARF by evaluating correlations with cytokines such as TNF-α, IL-6 and IL-8 and acute phase reactants.

Study Overview

• Status: Completed
• Conditions: Acute Rheumatic Fever

Detailed Description

Totally, 33 children (age range: 5 - 17 years; 15 male and 18 female) were enrolled to the study who were diagnosed as ARF at the Pediatric Cardiology Department, Medical Faculty, Eskişehir Osmangazi University. The study protocol was approved by Ethics Committee of Medical Faculty, Eskişehir Osmangazi University (Decision No. 41 dated June 4, 2008). Parents of study participants were informed about the aim and the method of the study and written consents were obtained.

For the study subjects, diagnosis of ARF was made according to the Modified Jones criteria (4) and appropriate treatment was started. Patients were divided into three groups by clinical findings. Group 1 included patients with only chorea, while patients with arthritis and carditis were involved in Group 2 and patients with only carditis were included in the Group 3. A group with only arthritis was not established since the patients with isolated arthritis are usually followed up at primary and secondary healthcare facilities rather than referring those patients to our tertiary healthcare center.

Venous Blood Sampling Following tests were analyzed using venous blood samples drawn from patients and healthy control subjects; complete blood count, ESR, nephelometric CRP and immune turbidimetric hsCRP, total cholesterol, triglyceride, LDL-C and HDL-C levels by enzymatic coloxrimetric method and FSH and LH and total testosterone (for male subjects) and estradiol (for female subjects)levels by chemoluminescent assey. Plasma and serum samples were drawn for adiponectin, TNF-α, IL-6 and IL-8. Blood samples were drawn for analyzing acute phase reactants at Day 2nd , 5th , 10th and 15th days and at 8 week in order to evaluate response to the treatment, while blood samples were simultaneously drawn for analyzing adiponectin, TNF-α, IL-6 and IL-8 levels.

Plasma Adiponectin Measurement Venous blood samples were added into the centrifuge tubes with EDTA, they were centrifuged at 3000 rpm, 4 °C for 15 minutes and the resultant plasma samples were stored at -80 °C. Plasma samples were diluted (1:300) as directed by the instruction for use of the kit, before the analysis was conducted. Samples taken for plasma adiponectin levels were analyzed using Human Adiponectin ELISA, High Sensitivity kit (BioVendor Research and Diagnostic Products, Modrice, Czech Republic) with enzyme-linked immunosorbent assay (ELISA) method. Absorbance was read at 450 nm. Results were expressed as ng/ml and converted into µg/ml via dividing them by 1000.

Serum TNF-α, IL-6 and IL-8 Measurements The venous blood samples were added into centrifuge tubes not containing anticoagulant for measuring serum TNF-α, IL-6 and IL-8 levels. Samples were centrifuged at 3000 rpm, 4 °C for 15 minutes and the resultant serum samples were stored at -80 °C. Samples taken for measuring serum TNF-, IL-6 and IL-8 levels were analyzed with ELISA method using Human TNF-α ELISA, Human IL-6 ELISA, Human IL-8/NAP-1 ELISA kits (Bender MedSystems, Vienna, Austria). Absorbance was read at 450 nm. Results were expressed as pg/ml.

• Study Type: Observational
• Enrollment (Actual): 87

Contacts and Locations

Study Locations

• Turkey
  • Odunpazarı
    • Eskisehir, Odunpazarı, Turkey, 26480
      • Eskisehir Osmangazi Universty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year to 13 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

acute rheumatic fever and by comparing results with that of healthy

Description

For the study subjects, diagnosis of ARF was made according to the Modified Jones criteria (4) and appropriate treatment was started. Patients were divided into three groups by clinical findings. Group 1 included patients with only chorea, while patients with arthritis and carditis were involved in Group 2 and patients with only carditis were included in the Group 3. A group with only arthritis was not established since the patients with isolated arthritis are usually followed up at primary and secondary healthcare facilities rather than referring those patients to our tertiary healthcare center.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Crossover
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change from baseline adiponectin and cytokin levels at 2 months in the acute rheumatic fever	2 months

Collaborators and Investigators

• Sponsor: Eskisehir Osmangazi University

Publications and helpful links

General Publications

• Ouchi N, Walsh K. Adiponectin as an anti-inflammatory factor. Clin Chim Acta. 2007 May 1;380(1-2):24-30. doi: 10.1016/j.cca.2007.01.026. Epub 2007 Feb 2.

Study record dates

Study Major Dates

• Study Start: July 1, 2008
• Primary Completion (Actual): August 1, 2010

Study Registration Dates

• First Submitted: June 19, 2013
• First Submitted That Met QC Criteria: June 22, 2013
• First Posted (Estimate): June 26, 2013

Study Record Updates

• Last Update Posted (Estimate): June 26, 2013
• Last Update Submitted That Met QC Criteria: June 22, 2013
• Last Verified: June 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections; Joint Diseases; Musculoskeletal Diseases; Connective Tissue Diseases; Arthritis; Bacterial Infections; Bacterial Infections and Mycoses; Streptococcal Infections; Gram-Positive Bacterial Infections; Body Temperature Changes; Rheumatic Diseases; Fever; Rheumatic Fever
• Other Study ID Numbers: EskisehirOU 4.6.2008/41