RETRACTED: Serum amyloid A protein in the course of infectious mononucleosis

Abstract

Background:Serum amyloid A (SAA) protein is a major acute phase protein. Increased concentrations have been reported in many inflammatory diseases. In bacterial infections, high levels correlate with those of C-reactive protein (CRP). In viral infections, where CRP changes are weaker, SAA is of value for establishing early diagnosis, monitoring the severity, and the evolution of the disease.Objective:Evaluation of SAA as a marker for diagnosis of infectious mononucleosis, including severe forms.Material and methods:A total of 31 patients with non-complicated and severe, complicated infectious mononucleosis were examined. SAA and CRP were measured by immuniturbidimetric assays at the day of admission and 4.97 ± 1.35 days later.Results:SAA increases significantly than those in a control group, without correlation with the etiologic agent. It decreases when full recovery appears. In the subgroup of subjects with complications, we observed significant increased SAA when Epstein-Barr virus /EBV/ was the etiologic agent, in the course of bacterial and viral secondary infection. SAA is higher than CRP in non-complicated group. In cases of bacterial superinfections, both increase simultaneously and treatment have to be adapted. Second, serum sample for CRP is normal in patients without full recovery where SAA stay increased.Conclusion:In viral infections, high SAA concentrations are indicative for early diagnosis, severe course of the diseases, effect of the treatment, early recovery, and disease outcome. When SAA and CRP increase simultaneously, bacterial co-infection is suspected, and relevant antibiotic treatments have to be initiated.

Distribution of serum amyloid A and establishment of reference intervals in healthy adults

“…2 The elevated SAA is closely related to inflammation-mediated diseases, such as liver diseases, autoimmune diseases, metabolism-related diseases, amyloidosis, and tumors. [3][4][5][6] Besides, in acute-phase reactions such as acute inflammation and trauma, the concentration of SAA in the blood can be rapidly increased by approximately 1000-fold within 5-6 hours under the stimulation of IL-1, IL-6, and TNF-α. 7,8 Therefore, SAA has important clinical value in the diagnoses, progression, and prognoses of diseases associated with inflammation.…”

“…Although both SAA and C‐reactive protein (CRP) are acute‐phase proteins, the detection of SAA is more conclusive than the detection of CRP in patients with viral infections, severe acute pancreatitis, and rejection reactions to kidney transplants . The elevated SAA is closely related to inflammation‐mediated diseases, such as liver diseases, autoimmune diseases, metabolism‐related diseases, amyloidosis, and tumors . Besides, in acute‐phase reactions such as acute inflammation and trauma, the concentration of SAA in the blood can be rapidly increased by approximately 1000‐fold within 5‐6 hours under the stimulation of IL‐1, IL‐6, and TNF‐α .…”

Novel biomarkers for the prediction of COVID-19 progression a retrospective, multi-center cohort study

“…Serum amyloid A (SAA) is an acute-phase protein during infection and inflammation [ 21 , 22 ]. Emerging evidence showed that SAA could be a potential marker for virus infection, such as Epstein-Barr virus [ 23 ], cytomegalovirus infection [ 24 ], hepatitis C virus [ 25 ], as well as influenza infection [ 26 ]. These aforementioned data have suggested that SAA could be an important biomarker in virus infection.…”

Acute phase protein response to viral infection and vaccination

“…Higher blood levels of CRP can be used to differentiate between bacterial and viral gastrointestinal infection [98,99] and therefore avoiding unnecessary antibiotic therapy. Combined high levels of both CRP and SAA are indicative of bacterial infection in cases on infectious mononucleosis, while elevated SAA (only) points to a viral infection [100]. In addition to the identification of a bacterial or viral origin of a disease the determination of CRP concentrations has been shown to distinguish between viral (dengue) and protozoan (malaria)-infected patients with very similar clinical signs [101].…”