The importance of some angiogenic markers in spontaneous abortion.

AIM: In this study, the authors aimed to determine the serum levels of vascular endothelial growth factor (VEGF), angiopoietin-l (ang-1) and angiopoietin-2 (ang-2) factors as indicators of placental angiogenesis and vasculogenesis in abortion cases. Materials and Meth- ods: This study was conducted in 40 women who were pregnant for 7-20 weeks and diagnosed with an incipient abortion and 40 pregnant healthy women with similar ages, gestational weeks, and body mass index (BMI) values. Serum VEGF, ang-1, and ang-2 levels were measured with ELISA methods. RESULTS: The authors found that the serum VEGF levels were higher and ang-1 levels were significantly lower in pregnant women whose pregnancies failed with abortion, compared to control group. There was no significani difference in terms of ang-2 levels between groups. CONCLUSION: A strong relationship was found between VEGF and ang-I early pregnancy loss, and significant changes of these factors may also be associated with the physiopathology of abortion incipience. Evaluating these factors may be benefical for prediction and designing of treatment modalities on spontaneous abortion.

The protective effect of aprotinin and alpha-tocopherol on ischemia-reperfusion injury of the rat liver.

BACKGROUND: Liver injury caused by ischemia-reperfusion (I/R) processes is a complication of hepatic resection surgery and transplantation, particularly using grafts from marginal donors. Despite improvements in organ preservation and advances in surgical techniques, I/R injury remains a significant clinical problem. In this study, we investigated whether aprotinin provided protection against the adverse effects of I/R injury in liver tissue. METHODS: Forty rats were randomized into four groups (n = 10): group I: (control group) I/R + no medication; group II: sham-operated group + no medication or I/R; group III: I/R + aprotinin; group IV: I/R + alpha-tocopherol. Malondialdehyde (MDA) was measured in the liver tissue and superoxide dismutase (SOD), catalase (CAT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactate dehydrogenase (LDH) in rat serum. RESULTS: Administration of aprotinin and alpha-tocopherol before I/R resulted in significant reductions of MDA levels compared to the I/R alone group (group I; P = .01 and P < .01, respectively). Administration of aprotinin or alpha-tocopherol prior to I/R resulted in significant increases in SOD and CAT levels compared with the I/R group (P < .05 each). Compared to the I/R group, significant decreases in plasma AST, ALT, and LDH levels were observed both in the aprotinin and in the alpha-tocopherol group (P < .05). Histological evaluation revealed the injury grade to be relatively lower among groups III and IV compared to group I. DISCUSSION: In conclusion, rat hepatic structures in aprotinin and alpha-tocopherol administered groups were well protected. Therefore, aprotinin may provide protection against the adverse effects of I/R injury in liver transplantation.

Increased plasma adrenomedullin in patients undergoing percutaneous transluminal coronary angioplasty.

OBJECTIVES: Adrenomedullin (ADM) production and secretion have been reported in endothelial cells. The present study was designed to assess whether coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) affect plasma ADM levels. DESIGN AND METHODS: We measured plasma concentrations of ADM using a specific radioimmunoassay method in patients undergoing coronary angiography or PTCA before and after a 5-minute procedure. Patients were divided into three groups; group I: normal coronary angiography group (11 males, 10 females; mean age 55.90 +/- 11.03 yrs), group II: coronary artery disease (CAD), only coronary angiography performed (14 males, 8 females; mean age 60.95 +/- 9.80 yrs), group III: PTCA performed in patients with CAD (35 males, 11 females; mean age 55.89 +/- 10.41 yrs). RESULTS: The plasma ADM levels and left ventricular end diastolic pressures measured before the procedure were similar in the three groups (p > 0.05). Plasma ADM levels were 13.98 +/- 2.26, 15.59 +/- 6.70, 17.15 +/- 8.47 pg/ml respectively. ADM levels measured after CA showed no significant difference in group I (13.75 +/- 1.75 pg/ml) or group II (16.50 +/- 7.18 pg/ml) (p > 0.05). A marked elevation was observed in group III with ADM levels of 27.31 +/- 12.27 pg/ml after PTCA (p < 0.01). The ADM levels observed in group III after PTCA were significantly higher than those of group I and group II after coronary angiography (p < 0.001). CONCLUSION: The results of our study show an increase of ADM after PTCA but not after coronary angiography in patients with or without CAD. We think that the increase of ADM levels may be due to cardiac secretion from endothelial and smooth muscle cells following balloon injury.

Carnitine and antioxidants levels in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a heterogeneous disorder with a spectrum of clinical severity ranging from mild arthritis to a crippling joint disease with involvement of internal organs. Carnitine is essential for muscle energy production and is required for the transport of long chain fatty acids and the acyl coenzyme A derivatives across the inner mitochondrial membrane. The levels of malondialdehyde (MDA), an index of lipid peroxidation, and the antioxidants copper-zinc superoxide dismutase (CuZnSOD), glutathione (GSH), ceruloplasmin (CP), catalase (CAT), and carnitine were assessed in 42 patients with RA and 24 control subjects. While plasma carnitine and erythrocyte CuZnSOD levels were significantly lower in the patients with RA compared with the control group (p<0.01 and p<0.001, respectively), the CAT level was not different from controls (p>0.05). Plasma MDA, CP, and erythrocyte GSH levels were significantly higher than in the control group (p<0.001, p<0.001 and p<0.01, respectively). MDA levels showed a positive correlation with CP and GSH levels (r=0.716, p<0.001 and r=0.492, p<0.01, respectively). However, MDA, GSH, and CP demonstrated a negative correlation with carnitine (r=-0.719, p<0.001; r=-0.559, p<0.01, and r=-0.635, p<0.001, respectively) in the patient group but not in controls. There was also a significant positive correlation between CP and GSH levels (r=0.561, p<0.01). However, neither CuZnSOD nor CAT levels demonstrated correlation withcarnitine, MDA, GSH, or CP levels. It was interesting that CAT activity was not altered and CuZnSOD activity decreased when compared with the control group. These results suggest that while CP, MDA and GSH levels increased, carnitine and CuZnSOD levels decreased, but CAT activity was unchanged.

Sialic acid, transketolase and Na+, K+, ATPase in patients with rheumatoid arthritis.

We studied transketolase activity of red blood cell hemolysates, and Na+, K+, ATPase activity and sialic acid concentration in red blood cell membranes from 52 patients with rheumatoid arthritis and 24 control subjects. Decreased red blood cell membrane Na+, K+, ATPase activity and sialic acid concentration and decreased transketolase in red blood cell hemolysates were observed in rheumatoid arthritis patients compared with control subjects (p < 0.001). Erythrocyte sedimentation rate and C-reactive protein values were increased in rheumatoid arthritis patients compared with control subjects (p < 0.0001). Significant correlations between sialic acid and Na+, K+, ATPase (r = 0.65, p < 0.001) and between sialic acid and transketolase (r = 0.58, p < 0.001) were observed. Erythrocyte sedimentation rate and C-reactive protein levels did not correlate with Na+, K+, ATPase activity or with sialic acid or transketolase in rheumatoid arthritis patients. These data show that decreases in Na+, K+, ATPase, and transketolase activities and sialic acid concentration are present in rheumatoid arthritis patients, and that the decrease in Na+, K+, ATPase and transketolase activities in rheumatoid arthritis might be due to decreased sialic acid.

An enzymatic method for the determination of free fatty acids in serum/plasma.

Estimation of serum free fatty acids (FFA) in serum based on the formation of inorganic phosphate has been simplified by eliminating complex stages. The principle of the present method is based on breakdown of pyrophosphate, formed by thioesterification of free fatty acids with ATP and CoA with the aid of acyl-CoA synthetase (EC 6.2.1.3) to inorganic phosphate. This is measured using the reaction with molybdate. The reaction equations are as follows: [formula: see text] The recovery of free fatty acids was 96%. The interferences of citrate, phosphatidylserine, succinate, ascorbic acid and lecithin were between 0.5 and 2%. The correlation between the new enzymatic and the classic enzymatic method was 0.966. The lower detection limit was 0.018 mmol/l. The method was linear between 0.02 and 2.0 mmol/l. The within-assay and between-assay imprecision (CV) of control sera was 5.5% and 8%, respectively.

Glutathione and nitric oxide concentrations in glutamine-infused rabbits with intestinal ischaemia/reperfusion.

Intestinal ischaemia/reperfusion causes formation of reactive oxygen intermediates which lead to mucosal cell injury. Glutathione, a scavenger of reactive oxygen intermediates, protects tissues from reactive oxygen intermediate-mediated cell injury. Nitric oxide is a lipophilic gas and its synthesis is stimulated by ischaemic conditions. In this experimental study, we aimed to investigate the role of i. v. L-glutamine infusion on mucosal tissue glutathione and serum nitric oxide concentrations in intestinal ischaemia/reperfusion. External jugular vein of albino rabbits was cannulated with catheter and infused with normal saline at 4 ml/h. After 3 days, they were randomly divided into two main groups. Group 1 (n = 30) received i. v. normal saline alone, group 2 (n = 30) received normal saline + 205 mmol/l glutamine at 4 ml/h for 24 hours. Next, mucosal glutathione and serum nitric oxide concentrations were measured after 0, 30, 60 min of ischaemia/60 min of reperfusion. Basal glutathione concentrations were similar in normal saline alone and normal saline + 205 mmol/l glutamine infusion groups (p > 0.05). At 30 and 60 min of ischaemia/60 min of reperfusion, glutathione concentrations were significantly lower in normal saline-infused rabbits compared to the normal saline + 205 mmol/l glutamine-infused rabbits (p < 0.05). In addition, serum nitric oxide concentrations were found to be significantly increased in rabbits 30 and 60 min after ischaemia/reperfusion when compared to mean basal nitric oxide concentrations obtained from control animals. However, the normal saline + 205 mmol/l glutamine group had lower serum nitric oxide concentrations than did the normal saline alone group. In conclusion, this study revealed that intestinal mucosal glutathione concentrations were significantly higher in glutamine-receiving rabbits than in non-receiving ones. Additionally, it was shown that nitric oxide concentrations increased in ischaemia both in normal saline alone and normal saline + 205 mmol/l glutamine receiving groups, while this increase in nitric oxide was more prominent in the normal saline alone group (p < 0.01). These findings show that glutamine supplementation may protect the small intestine from ischaemia/reperfusion injury and may play a regulatory role in the biosynthesis of nitric oxide.

Reduced lecithin: cholesterol acyltransferase (LCAT) and Na+, K+, ATPase activity in diabetic patients.

OBJECTIVE: To investigate the plasma concentrations of lecithin:cholesterol acyltransferase (LCAT EC 2.3.1.43) and erythrocyte membrane Na+, K+, ATPase and the correlation of these parameters in diabetes mellitus. DESIGN AND METHODS: Na+, K+, ATPase was measured with spectrophotometric method and LCAT with radioactive method in 19 patients with insulin-dependent diabetes mellitus (IDDM), in 20 with non-insulin-dependent diabetes mellitus (NIDDM) and in 20 healthy volunteers as the control group. RESULTS: Compared with the control group, plasma LCAT concentrations were found to be decreased in both of the patient groups (p < 0.01 for both). Erythrocyte membrane Na+, K+, ATPase activities were higher in the controls than both in the NIDDM and IDDM groups (p < 0.01 and p < 0.001, respectively). There were significant correlations between LCAT and Na+, K+, ATPase in IDDM (r = 0.82, p < 0.001) and in NIDDM (r = 0.74, p < 0.001). In order to investigate the effect of cholesterol (C) and lysophosphatidylcholine (LPC) on Na+, K+, ATPase activity, this enzyme's activity was determined in erythrocyte membranes obtained from diabetic subjects after in vitro incubation with increasing concentrations of LPC and C (2-10 microM). Enzymatic activity was significantly reduced by in vitro C at increasing concentrations but significantly increased by in vitro LPC at increasing concentrations. CONCLUSIONS: From these data, it is to be concluded that the decrease in Na+, K+, ATPase activity in diabetes might be due to decreased LCAT concentrations and that may explain the development of atherosclerosis in diabetics.