Clinical Diagnostic Value of Dkk-1 Level in Ankylosing Spondylitis: Comparison of Test Systems Based on Aptamers and Antibodies.

In ankylosing spondylitis, the pathological metabolism of the bone tissue is regulated by various proteins; of these, Dkk-1 protein, an antagonist of the Wnt-signaling pathway, is of particular interest. We compared the methods of Dkk-1 detection in the blood serum of patients with ankylosing spondylitis (conventional ELISA and aptamer/antibody assay) and analyzed the relationship between Dkk-1 level and structural progression of ankylosing spondylitis and secondary osteoporosis. Dkk-1 levels in patients were significantly increased and depended on the stage of the disease, but not on the presence/absence of osteoporosis. Thus, Dkk-1 is a potential serum marker of progression of ankylosing spondylitis reflecting a tendency to structural progression of the disease before the appearance of radiographic changes. The results obtained by both methods practically coincided, which suggests good prospects for applying DNA aptamer-based test system.

[Analysis of the course and outcomes of pregnancy in patients with advanced stages chronic kidney disease].

BACKGROUND: Pregnancy in patients with advanced chronic kidney disease (CKD) is associated with a high risk of adverse outcomes for the mother and the fetus, but data on the characteristics of the course of pregnancy in these women is limited. AIM: To analyse of the course and outcomes of pregnancy in patients with CKD stages 3a4. MATERIALS AND METHODS: Thirty five pregnant women with CKD stages 34 were included: 3a 12 (34.3%) patients, stage 3b 10 (28.6%), stage 4 13 (37.1%). RESULTS: Proteinuria, serum creatinine, blood pressure in dynamics, the presence of a physiological response were investigated. Pregnancy management included blood pressure correction, antianemic, antiplatelet, anticoagulant therapy, prevention and treatment of urinary infection, correction of metabolic disorders. All pregnant women had proteinuria of varying severity, which increased towards the end of pregnancy. Seventeen (51.5%) patients had hypertension, successfully corrected with antihypertensive drugs. The average delivery term was 34.6 weeks. Preeclampsia developed in 14 (42.4%) cases, an inverse relationship was found between the presence of a physiological response and preeclampsia (p=0.009; rs=-0.463). All children were born alive and viable. After delivery in patients with CKD 3a creatinine values returned to the pre-gestational level, in patients with grade 3b and 4 progression of CKD was noted. CONCLUSION: A favorable pregnancy outcome in women with late stages of CKD is possible with constant monitoring by a multidisciplinary team of doctors with mandatory monitoring of renal function, proteinuria, blood pressure, coagulation, markers of preeclampsia and indicators of fetal health. It was proposed to consider the physiological response of the kidneys to pregnancy as a predictor of a favorable outcome.

[Effects of High-Dose Statin Therapy on Cognitive Functions and Quality of Life in Very High Cardiovascular Risk Patients].

AIM: To investigate the effects of intensive lipid-lowering therapy on cognitive functions and quality of life in patients (pts) with very high cardiovascular risk. MATERIAL AND METHODS: In 93 pts (58 men, 63.2±9.5 years old with history of clinically evident cardiovascular disease and fasting low-density lipoprotein cholesterol (LDL-C) >1.8 mmol/l or non-high-density lipoprotein cholesterol (non-HDL-C) >2.6 mmol/l the mental status and quality of life were assessed before and after 6 months of therapy with atorvastatin 80 mg/day. The Montreal Cognitive Assessment (MoCA) scale and Questionnaire SF-36 (russian version) were used to evaluate cognitive functions and quality of life. RESULTS: 59 (63%) pts had cognitive dysfunction (less than 26 scores by MoCA scale). We observed significant difference in cognitive status between pts ≥65 and.

[Alirocoumab: new perspectives of lipid-lowering therapy]. / Alirokumab: novye perspektivy lipidsnizhaiushchei terapii.

Alirocoumab (Praluent) is a fully human monoclonal antibody against proprotein covertase subtilisin/kexin type 9 (PCSK9). The data of ODYSSEY Phases II and III clinical trials demonstrate the high efficacy of alirocoumab in lowering the level of low-density lipoprotein (LDL) cholesterol in patients with primary hypercholesterolemia, with a considerable advantage over control groups (placebo, ezetimibe or modified statin therapy) in both monotherapy and combination therapy with statins and other lipid-lowering agents. Alirocoumab provides additional lipid-lowering effects against other atherogenic fractions of cholesterol, including non-high-density lipoprotein cholesterol, apolipoprotein B and lipoprotein (a). The agent show high safety and good tolerability and it can be considered as the drug of choice for patients who have not reached their target LDL cholesterol levels after statin therapy and have statin intolerance and familial heterozygous hypercholesterolemia. There are now the preliminary results of a secondary analysis of data from the ODYSSEY LONG TERM study, suggesting that alirocoumab therapy may be accompanied by a lower risk of cardiovascular events. The final results will be provided after the data of a study of cardiovascular outcomes after therapy with alirocoumab versus placebo (ODYSSEY OUTCOMES) are published.