Plasma Adiponectin Levels and Relations With Cytokines in Children With Acute Rheumatic Fever
Condition: Acute Rheumatic Fever
MeSH terms: Rheumatic Fever; Rheumatic Diseases; Fever
Study type: Observational [Patient Registry]

Summary: 
      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.
    

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.
    

Observational model: Case-Crossover
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        acute rheumatic fever and by comparing results with that of healthy