Aim: Inflammatory reactions accompanying ischemia increase the cytokine synthesis what leads to the increase in serum ceruloplasmin (Cp) concentration and activity. The aim of the study was to evaluate the association between serum Cp oxidase concentration and activity and the grade of lower extremity ischemia. Moreover, the correlation of Cp concentration and activity with the levels of interleukin 6 (IL-6), C-reacting protein (CRP), and a-1-acid glycoprotein (AGP) in serum was studied.
Methods: Two groups of patients were examined: 15 patients with moderate (MI) and 32 patients with critical ischemia (CI) of the lower extremities. Cp oxidase activity was measured spectrophotometrically, after incubation with o-dianisidine. The concentration of IL-6 was measured with the ELISA method, and Cp, CRP and AGP concentration by rocket immunoelectrophoresis.
Results: Significant increase in Cp oxidase concentration and activity was observed in patients with critical limb ischemia (median: 164.8 U/L), especially in patients with necrotic changes (median: 216.6 U/L). Cp oxidase activity was dependent on its concentration in patients with critical limb ischemia with necrotic changes (r=0.56; P<0.01). In patients with critical limb ischemia, the increase in Cp concentration and activity correlated significantly with CRP concentration (r=0.46; P=0.0007) (r=0.62; P=0.0001), respectively.
Conclusion: Concentration and the oxidase activity of Cp depend of the degree of lower extremity ischemia and correlates with the major markers of inflammation, such as CRP. Critical limb ischemia induces the inflammatory reaction triggering the increase in IL-6 and of acute phase protein production. These processes lead to the increase in Cp oxidase activity dependent of Cp and CRP concentration.