Anti-HDV seroprevalance among patients with previous HBV infection.

OBJECTIVE: This prospective study aimed to determine the prevalence of anti-HDV seropositivity among subjects who had previous hepatitis B virus (HBV) infection. METHODS: Subjects who were admitted to the gastroenterology inpatient clinic of our hospital between August 2016 and July 2017 were screened for previous HBV infection. The subjects who had HBV serology compatible with resolved HBV infection were recruited in the study, and the seroprevalance of anti-HDV was studied. Participants answered a short questionnaire regarding their family history of chronic hepatitis B (CHB) and chronic hepatitis D (CHD) infection and risk factors for transmission. Subjects who were anti-HDV positive were recalled for a control visit, and HBV-DNA and HDV-RNA were assayed in the blood samples of the responders. RESULTS: Among 554 subjects who had previous HBV infection, 53 (9.6%) were anti-HDV positive. The mean age was 63.1±15.4 years in the anti-HDV-positive group and 65.9±15.6 years in the anti-HDV-negative group (p=0.19). The most common risk factor for both groups was dental procedures (89% vs 80%, p=0.33). Anti-Hbc IgG, anti-Hbs, and anti-HBeAg seropositivity did not differ between the anti-HDV-positive and -negative groups (for all, p>0.05). Although HDV-RNA was not detectable in all studied samples, only one subject had detectable HBV-DNA in the anti-HDV-positive group. CONCLUSION: This study highlighted the prevalence of anti-HDV among subjects who had resolved HBV infection. Long-term follow-up studies, including after the resolution of both infections, are needed to explore HBV-HDV interactions and the behavioral patterns of these viruses.

Rosuvastatin Lowers Systemic Inflammatory Response in Coronary Artery Bypass Graft Accompanied by Cardiopulmonary Bypass Surgery: A Randomized Controlled Study.

PURPOSE: Cardiopulmonary bypass (CPB) is commonly associated with a systemic inflammatory response that may lead to severe complications. Classic signs of systemic inflammatory response syndrome are complement activation and changes in cytokine and acute phase reactant levels. The effects of rosuvastatin after CPB on interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-18 (IL-18) and High Sensitivity C-Reactive Protein (hs-CRP) levels were investigated. METHODS: Thirty-seven male and thirteen female patients (total=50) aged 42 to 78 years, who had coronary bypass surgery due to coronary artery disease were randomly divided into two groups. The 25 patients in the control group were administered placebos. The 25 in the treatment group were administered 20 mg rosuvastatin tablets daily between preoperative day 7 and postoperative day 28. Blood samples were taken at six time points; before induction of anesthesia (T1), during CPB (T2), five minutes after removal of cross clamp (T3), after protamine infusion (T4), postoperative day three (T5) and postoperative day 28 (T6). Data points were expressed as mean ± standard deviation (SD). RESULTS: Rosuvastatin lowered IL-6 levels at T4, T5 and T6 time points (T4, T5, T6 p < 0.05), and elevated IL-10 levels at T3 and T4 (T3, T4 p < 0.05). IL-18 levels were also elevated at multiple time points. Rosuvastatin also lowered hs-CRP levels and cholesterol levels at T6 (p < 0.05). CONCLUSION: Administering 20 mg/day of rosuvastatin between preoperative day 7 and postoperative day 28 may result in fewer complications in certain (especially intraoperative) cases of systemic inflammatory response caused by the CPB technique used in coronary bypass surgery.

Serum adiponectin, anemia and left ventricular dimensions in patients with cardiac cachexia.

OBJECTIVES: Our study aims to determine the role of serum adiponectin in chronic heart failure (CHF) and cardiac cachexia (CC). METHODS: Ninety consecutive patients were included in the study. Patients were divided into three groups: 30 CHF patients with CC, 30 CHF patients without CC, and 30 healthy individuals. Adiponectin levels were measured through human ELISA kits. RESULTS: Levels of serum adiponectin were significantly higher in the CHF patients with cachexia in comparison with the other groups (CHF with CC: 58.4 ± 15.5 ng/ml vs. CHF without CC: 24 ± 6.7 ng/ml and controls: 7.7 ± 3.4 ng/ml; p = 0.001). Serum adiponectin was negatively correlated with BMI, high-sensitivity C-reactive protein, and hemoglobin (r = -0.37, p = 0.02; r = -0.29, p = 0.02; r = -0.18, p = 0.03, respectively) in the CHF patients with cachexia. Additionally, serum adiponectin levels were positively correlated with B-type natriuretic protein levels, left ventricle end-diastolic and end-systolic diameters (r = 0.36, p = 0.02; r = 0.46, p = 0.01; r = 0.49, p = 0.006, respectively) in the CHF patients with cachexia. CONCLUSION: Our findings suggest that adiponectin may play a critical role in the pathogenesis of cardiac remodeling and anemia in CC.

The effects of intra-operative amiodarone loading on the systemic inflammatory response syndrome induced by cardiopulmonary bypass.

OBJECTIVE: Cardiopulmonary bypass (CPB) leads to systemic inflammatory response syndrome (SIRS). In vitro studies showed that amiodarone blocked cytokine production. The aim of this study was to evaluate the effect of intra-operative amiodarone loading on SIRS. METHODS: This prospective randomized study included 24 patients who underwent on-pump coronary artery surgery. The patients were classified into control (n=12) and amiodarone (n=12) groups. Plasma levels of the pro-inflammatory (C-reactive protein - CRP, interleukin-6 - IL-6) and the anti-inflammatory markers (interleukin-10 - IL-10) were measured before the induction of anesthesia, 5 minutes after aortic declamping, after protamine administration and 24 hours after the CPB. The myocardial lactate production was calculated before CPB and 5 minutes after aortic declamping. Statistical analyses were performed using Mann-Whitney U, Fischer's exact and ANOVA tests. RESULTS: In both groups, the IL-6 levels significantly increased after declamping (91.18+/-16.27 pg/ml and 86.37+/-14.66 pg/ml, p<0.01) and reached peak values after infusion of protamine (329.07+/-32.24 pg/ml and 354.31+/-29.61 pg/ml, p<0.01). The highest values of IL-10 were detected after infusion of protamine in the control and amiodarone groups (265.58+/-85.63 pg/ml, p<0.01 and 287.44+/-65.26 pg/ml, p<0.01). Amiodarone did not have any significant effect on release of cytokines. The CRP levels were significantly elevated in both groups at 24th hour after CPB, but no significant difference was found between the groups. Compared with pre-CPB values, lactate production increased significantly in two groups after aortic declamping. However there was no significant difference between the groups. CONCLUSION: The results indicate that intraoperative loading of amiodarone, which is used for atrial fibrillation prophylaxis, does not seem to alter inflammatory response during CPB.

Adiponectin levels in coronary artery ectasia.

Etiopathogenesis of coronary artery ectasia (CAE), which is defined as abnormal dilatation of a segment of the coronary artery to 1.5 times of an adjacent normal coronary artery segment, is unclear. However, it is speculated that CAE develops in the atherosclerosis process through degeneration of coronary artery media layer. Our objective in this study is to compare levels of adiponectin between cases with CAE and normal coronary anatomy, and to examine whether adiponectin plays a role in CAE etiopathogenesis. The study registered a total of 66 cases, consisting of CAE cases (group 1, n = 36) and cases with normal coronary anatomy (group 2, n = 30). Taking coronary artery diameters of the control group cases as the reference, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. Serum adiponectin levels were 4.31 +/- 2.02 microg/ml in group 1 and 6.73 +/- 4.0 microg/ml in group 2 (P = 0.02). High-sensitivity C-reactive protein was 4.8 +/- 3.8 mg/l in group 1 and 3.6 +/- 3.4 mg/l in group 2 (P > 0.05). There was a negative correlation between ectatic coronary artery diameter and plasma adiponectin level (P = 0.03; r = -0.339). It was known that adiponectin levels dropped in atherosclerotic heart disease. In this study we found low plasma adiponectin levels in acquired CAE, attributed to atherosclerosis. Therefore, we think that adiponectin might be playing a role in etiopathogenesis and progression of CAE. This in turn may indicate that hypo-adiponectinemia may be useful in revealing a realized risk in CAE. However, larger, randomized, multicenter studies are required to examine the role of adiponectin in the development of CAE.

Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis and Behçet's disease.

Rheumatoid arthritis (RA) is associated with progressive joint destruction and disability. Early diagnosis of RA is important, since early and aggressive treatments lead to a better outcome. Circulating autoantibodies are a serological hallmark of systemic rheumatic diseases. More recently, antibodies directed to a cyclic citrullinated peptide, anti-CCP antibodies, have been established as specific diagnostic and prognostic tools for RA. The aims of this study were to assess the diagnostic and radiological prognostic value of the anti-CCP antibody in Turkish patients with RA (n = 97) and those with Behçet's disease (BD) (n = 46). The study also included 35 healthy controls. Anti-CCP antibodies were measured by ELISA, and radiological damage was evaluated by using modified Larsen scoring. In the RA group, sensitivity and specificity were 80.4% and 93.5% for rheumatoid factor (RF), and 74.2% and 97.8% for anti-CCP antibody, respectively. RF was positive in 3 BD patients (6.5%) and in one of the controls (2.9%). In contrast, anti-CCP antibodies were detected in one BD patient (2.2%), but not in the control subjects. Deformed joint counts and radiographic scores were higher in anti-CCP antibody-positive RA patients (n = 72) than those in anti-CCP antibody-negative patients (n = 25) (p < 0.05). Moreover, anti-CCP antibody titer correlated with deformed joint count (r = 0.224, p < 0.05) and radiographic score (r = 0.308, p < 0.05). This study indicates the diagnostic and prognostic utility of anti-CCP antibodies in Turkish patients with RA. Importantly, anti-CCP antibodies are not associated with BD.

Atopic dermatitis and Valpha24+ natural killer T cells.

OBJECTIVE: Atopic dermatitis is a chronic inflammatory skin disease associated with cutaneous hyperreactivity to environmental triggers and is often the first step in the atopic march that results in asthma and allergic rhinitis. Helper T cells and their cytokines, in addition to IgE and eosinophils, play a major role in the pathogenesis of atopic dermatitis. Natural killer T (NKT) cells may play a role in atopic dermatitis status. METHODS: The authors examined the percentage of Valpha24+CD161+ NKT cells and CD3+CD16+ CD56+ NKT cells in peripheral blood from 23 patients with atopic dermatitis aged 8 to 35 years (mean, 21.77+/-2.88 years) and 30 healthy controls aged 18 to 32 years (mean, 24.32+/-2.44 years) by using flow cytometric analysis. The mean percentages of Valpha24+CD161+ NKT cell subtypes in the atopic dermatitis group and the healthy group were 0.29%+/-0.02% and 0.42%+/-0.05%, respectively (P<.001). RESULTS: Percentages of Valpha24+CD161+ NKT cell subtypes are significantly lower in patients with atopic dermatitis than healthy individuals. On the other hand, the CD3+CD16+CD56+ NKT cell subtype does not differ between the groups. CONCLUSIONS: The reduction of Valpha24+CD161+ NKT cells subtypes may be involved in the immunopathogenesis of atopic dermatitis.

Serum interleukin-2 and neopterin levels as useful markers for treatment of active pulmonary tuberculosis.

Macrophages and T cells are responsible for the main immune response to tuberculosis by secreting many cytokines and other substances. The aim of this study was to determine the effects of multidrug treatment on serum levels of interleukin-2 (IL-2), secreted by activated T cells, and of neopterin, secreted by macrophages and monocytes, in patients with pulmonary tuberculosis. The study included 30 patients with active pulmonary tuberculosis, confirmed by the detection of acid-fast bacilli in direct sputum smears and/or sputum cultures. The serum levels of IL-2 and neopterin were measured before and during the treatment and compared with 15 patients with inactive pulmonary tuberculosis and 15 healthy controls. Serum IL-2 and neopterin levels were higher in patients with active tuberculosis (164.53 +/- 58.91 pg/ml and 69.54 +/- 29.42 nmol/l, respectively) than those in inactive tuberculosis (95.43 +/- 31.17 pg/ml and 10.71 +/- 1.78 nmol/l) or controls (79.20 +/- 14.81 pg/ml and 9.50 +/- 2.27 nmol/l) (p < 0.001 for each parameter). No significant differences were found in IL-2 and neopterin levels between inactive tuberculosis and control subjects. The IL-2 levels remained elevated in active tuberculosis at 2nd month of treatment (p < 0.001) and decreased to the control levels after 4th month. Neopterin levels were significantly higher in active tuberculosis than those in inactive tuberculosis or controls at the 2nd and 4th months of treatment. These findings indicate that measurements of serum IL-2 and neopterin levels are useful in following up the treatment and immune response to tuberculosis.