Single, very low dose (0.03 mg) of recombinant human thyrotropin (rhTSH) effectively increases radioiodine uptake in the I-131 treatment of large nontoxic multinodular goiter.

BACKGROUND: Radioiodine therapy (RIT) in patients with large nontoxic multinodular goiter (MNG) recently becomes more common method in comparison to surgery (especially in elderly patients and with contraindications because of severe chronic diseases other systems). Repeatedly low thyroid radioactive iodine uptake (RAIU) decreases effectiveness of RIT or makes it impossible. The recombinant human thyrotropin can increase RAIU and improve the results of RIT. THE AIM OF THE STUDY: was to assess the influence of a single very low dose (0.03 mg) of rhTSH on RAIU and thyroid function in euthyroid (MNG-EU) and subclinical hyperthyroid (MNG-SC) patients with a large multinodular goiter. MATERIAL AND METHODS: 40 patients (14 male, 26 female, age 57-80 yr) with large non-toxic MNG over 80 grams and with baseline RAIU < 40% were included into the double-blind randomized study and divided into two groups: rhTSH-group and control group. First group received the single intramuscular injection of 0.03 mg rhTSH and the second received placebo. The RAIU were measured 24 and 48 hours after the rhTSH and then all the patients were administered therapeutic doses of I-131. TSH and free thyroxine levels were measured at 1st and 2nd day after the injection of rhTSH and later, at 4 and 8 weeks after the RIT. RESULTS: The mean RAIU increased significantly from 30.44 ± 7.4% to 77.22 ± 8.7% (p < 0.001). There were no statistically significant differences in RAIU between euthyroid (MNG-EU) and subclinically hyperthyroid (MNG-SC) patients. The peak of serum TSH was noticed 24 hours after rhTSH injection and in MNG-EU patients it has remained within normal range, similarly as fT4. In the MNG-SC group the administration of rhTSH resulted in a significant increase in the TSH values after 24 hours, whose mean level slightly exceeded the upper limit of the normal range with normalization at 48 hours. 8 weeks after the RIT, the TSH and fT4 levels did not exceed the normal range and did not differ in a statistically significant way. CONCLUSIONS: Even the single very low dose of rhTSH increases the values of RAIU in significant way, in euthyroid and subclinically hyperthyroid patients. The administration of rhTSH is well-tolerated. Neoadjuvant administration of a low dose (0.03 mg) of rhTSH before I-131 seems to be an optimal method of management which may increase the effectiveness of RIT and decrease the exposure of the patients to absorbed doses of ionizing radiation.

Parathyroid gland function after radioiodine ((131)I) therapy for toxic and non-toxic goitre.

INTRODUCTION: The therapeutic effect of radioactive iodine ((131)I) on benign goitre consists of the emission of tissue-destructive beta-radiation. Since the range of beta (131)I radiation in tissue can reach 2.4 mm, it can affect the adjacent parathyroid glands. The purpose of this paper is to assess parathyroid function in patients with toxic and non-toxic goitres, up to five years following (131)I therapy. MATERIAL AND METHODS: The study sample consisted of 325 patients with benign goitres (220 with toxic nodular goitre (TNG), 25 with non-toxic nodular goitre (NTNG), and 80 with Graves' disease (GD) treated with (131)I. The therapeutic activity of (131)I for each patient was calculated using Marinelli's formula. The serum levels of fT3, fT4, TSH, iPTH and Ca(2+), Ca and phosphates were determined one week before (131)I administration, as well as every two months up to a year following the therapy, and then after three and five years post-treatment. RESULTS: After two months following the administration of (131)I, all the treated patients showed a statistically significant above normal increase in iPTH concentrations (amounting to a value almost twice the norm in patients with TNG), which remained stable up to ten months after treatment, to return to normal level in the following months. In all the patients, Ca(2+), Ca, phosphates concentration remained within normal range throughout the course of the study. The concentrations of fT3 and fT4 quickly returned to normal after (131)I administration, and remained within normal range until the completion of the study. CONCLUSION: Radioiodine treatment of benign thyroid disorders results in transient (up to ten months after (131)I administration) hyperparathyroidism. The condition does not influence the level of calcium and phosphates concentration in any significant way.

Iodine isotope ¹³¹I therapy for toxic nodular goitre: treatment efficacy parameters.

BACKGROUND: When planning radioactive iodine therapy, it frequently happens, both in Poland and world-wide, that inadequate attention is paid to such easily measurable parameter sas: 1) the serum concentration of thyrotropin (TSH) before administering radioiodine, which is a key factor for extranodular(non-autonomous) iodine uptake of the thyroid gland, 2) thyroid gland iodine uptake, and 3) the effective half-life of 131I (Teff.). The aim of the study is to evaluate the impact of the above factors on the efficacy of 131I treatment in hyperthyroid patients. METHODS: The material consisted of 4140 patients: 2190 with autonomous toxic nodules (ATN) and 1950 with toxic multinodular goitres (TMG). The patients were prepared for treatment in such a way that the concentration of TSH did not exceed 0.1 mU/land Teff.< 5 days. The therapeutic activity of 131I was calculated using Marinelli's formula. The selection of absorbed dose value was determined by the degree of suppression of extranodulart issue. Monitoring was performed every eight weeks. RESULTS: At one year after 131I administration showed that a euthyroid status was achieved in 94%, hypothyroidism was seen observed in 3%, while persistence or recurrence of hyperthyroidism in 3% of ATN patients and, respectively, 89%, 4% and 7% of TMG patients. CONCLUSIONS: Patients with toxic nodular goitre who are to be treated with radioiodine should have the lowest possible serum concentration of TSH. The suppression of extranodular determines the optimal value of absorbed dose for Marinelli's formula.

Bone scan in metabolic bone diseases. Review.

Metabolic bone disease encompasses a number of disorders that tend to present a generalized involvement of the whole skeleton. The disorders are mostly related to increased bone turnover and increased uptake of radiolabelled diphosphonate. Skeletal uptake of 99mTc-labelled diphosphonate depends primarily upon osteoblastic activity, and to a lesser extent, skeletal vascularity. A bone scan image therefore presents a functional display of total skeletal metabolism and has valuable role to play in the assessment of patients with metabolic bone disorders. However, the bone scan appearances in metabolic bone disease are often non-specific, and their recognition depends on increased tracer uptake throughout the whole skeleton. It is the presence of local lesions, as in metastatic disease, that makes a bone scan appearance obviously abnormal. In the early stages, there will be difficulty in evaluating the bone scans from many patients with metabolic bone disease. However, in the more severe cases scan appearances can be quite striking and virtually diagnostic.

The influence of non-radioactive iodine (127I) on the outcome of radioiodine (131I) therapy in patients with Graves' disease and toxic nodular goitre.

BACKGROUND: The aim of the study was to achieve an effective target dose in the thyroid by increasing the effective half-life (Teff) of (131)I by use of iodide ((127)I) two days after (131)I therapy in patients with hyperthyroidism with low Teff. MATERIAL AND METHODS: The study was carried out in two groups. Group A - 41 patients, and Group B - 14 patients, all the patients were with hyperthyroidism with Teff less than 3 days qualified for (131)I therapy. Only group A patients received 600 µg of iodide a day for 3 days, two days after (131)I therapy. Radioiodine uptake (RAIU) after 24 and 48 hours, thyroid scintiscan and ultrasonography were done before and after 12 months of (131)I therapy. RESULTS: In group A a significant increase was seen in the Teff (5 days on average) resulting in an increase in the energy target dose by 28% and 37%, in patients with Graves' disease (GD) and toxic nodular goitre (TNG), respectively. After one year of therapy 50% of GD and 93% of TNG patients achieved euthyroidism; 28% of GD and 3% of TNG patients were in hypothyroidism. In Group B, all the patients had radioiodine treatment failure and received a second therapeutic dose of (131)I. CONCLUSIONS: Administration of (127)I after (131)I treatment can lead to an increase in its effective half-life. This will also increase the absorbed energy dose in thyroid tissue, thereby improving therapeutic outcome without administration of a higher or second dose of (131)I. This may minimize whole-body exposure to radiation and reduces the cost of treatment.

[Application scintigraphy in evaluation of salivary gland function]. / Zastosowanie scyntygrafii w badaniu funkcji gruczolów slinowych.

The salivary glands belong to the exocrine glands. There are tree main pairs of salivary glands: parotid, submandibular, sublingual. Several modalities are used for salivary gland imaging, such as sonography, computer tomography and magnetic resonance imaging. The aim of these methods is mainly to present morphological impairment. Parenchymal function and excretion function of all salivary glands can be quantified by scintigraphy. After single intravenous injection of 99mTc-pertechnetate sequential images are acquired up to 25-40 minutes. Usually about fifteen minutes postinjection 3 ml of lemon juice are administered intraorally as sialogogue. Salivary scintigraphy can estimate the severity of salivary gland involvement and function disorders, which may not be accurately reflected by the morphological damage. The clinical impact of scintigraphy has been reported in multiple salivary glands diseases, such as Sjogren's syndrome, sialolithiasis with or without parenchymal damage, iatrogenic irradiation of the salivary glands for therapy of head and neck tumors or radioiodine treatment of thyroid cancer. No other method can give so much information about function of salivary glands. Scintigraphy is noninvasive examination, easy to perform, reproducible and well-tolerated by the patient.

[The usefulness of nicotinamide in radioiodine therapy in patients with toxic and nontoxic large goitres]. / Uzytecznosc nikotnamidu w radiojodoterapii chorych z wolem nadczynny oraz dutymn wolem normoczynnym.

Nicotinamide (niacin) is very useful substance in treatment of many kinds of diseases. For the decades the main indications for application of niacin were lipid disorders. There are studies confirming that niacin increases thyroid radiosensitivity to 1-131. The radioiodine therapy is common method of treatment of hyperthyroidism (Graves' disease, toxic nodular goitre), large euthyroid goitre and differentiated thyroid cancer. In some studies with Wistar rats there is shown that niacin potentiates the effect of 1-131 by increasing thyroid blood flow, what results better effects of radioiodine treatment. Moreover niacin in therapeutic doses decreases serum thyroid hormone levels (mainly total thyroxine and thyroxine-binding globuline). In case of large goitre, when the calculated radioisotope dose exceeds ambulatory limits, the patient must be hospitalized. There are patients with low radioiodine uptake and radiosensitivity of thyroid, radiosensitizers can be utilized for this purpose. Recently obtained results of studies are showing that niacin can be used as radiosensitizer. It is making possible ambulatory treatment of patients with large goitres and low radioiodine sensitive thyroid. The radioiodine therapy with niacin could become shorter, less expensive and more safety for patients.

[Analysis of serum levels of ghrelin and obestatin in children and adolescents with autoimmune thyroid diseases]. / Analiza stezenia ghreliny i obestatyny w surowicy krwi u dzieci i mlodziezy w schorzeniach autoimmunologicznych tarczycy.

INTRODUCTION: Thyroid disease is leading to a change of weight - in hyperthyroidism body mass is reduced, but in hypothyroidism it is increased. Recently researches suggest that many new bioactive substances, like ghrelin and obestatin, play a role in regulation of body mass. These closely related hormones have different effects- ghrelin increases, but obestatin decreases the appetite. The aim of the study was to evaluate ghrelin and obestatin levels in young patients with untreated Graves' disease, subclinical Hashimoto' thyroiditis and in children with nodular goiter in the euthyroid clinical state. MATERIAL AND METHODS: The study group formed 78 patients of the Outpatient Endocrinology of the 2nd Department of Children's Disease (Medical University in Bialystok) and Outpatient Endocrinology IHC in Warsaw suffering from Graves' disease (29 girls and 2 boys; aged from 6 to 21 - mean 15,2 yrs) and Hashimoto's thyroiditis (29 girls and 3 boys; aged from 9 to 18 - mean 14,5 yrs). The control group consisted of children with nodular goiter (euthyroid) - 13 girls and 2 boys; aged from 9 to 18 - mean 14,8 yrs. In all patients, ghrelin and obestatin levels were analyzed by RIA's method (Phoenix Pharmaceuticals, USA). RESULTS: In children and adolescents with hyperthyroidism in Graves' disease we found lower levels of ghrelin compared to the group of children with nodular goiter and with subclinical hypothyroidism in Hashimoto's thyroiditis (123+/-23 vs. 151+/-45; vs. 140+/-36 pg/ml, p<0,02, ns). On the other hand obestatin levels were lower in children with untreated subclinical hypothyroidism in Hashimoto's thyroiditis compared to a group with nodular goiter or Hashimoto's thyroiditis in euthyroidism (203,28+/-59 vs. 222.49+/-49; 267.24+/-70 pg/ml, p<0.03, p<0.02). In a group of untreated hyperthyroidism in Graves' disease we found correlations between ghrelin and fT3 (r=-0.36, p<0,4) and fT4 levels (r=- 0.45, p<0.01). CONCLUSIONS: In conclusion, we suggested that disturbances in thyroid hormones in thyroid diseases have an essential effect on changes of hormones controlled appetite: ghrelin (in hyperthyroidism) and obestatin (in hypothyroidism).

[Nitric oxide in supernatants of leukocytes and the serum of patients with B-CLL]. / Tlenek azotu w nadsaczach hodowli leukocytów i surowicy krwi u pacjentów z przewlekla bialaczka limfatyczna B-komórkowa (pbl-B).

Progression of B-cell chronic lymphocytic leukemia (B-CLL) is linked to an abnormal immune system in the host. Recent studies have suggested that polymorphonuclear neutrophils (PMN) play a role in the malignancy process through release of a wide range of mediators, involving nitric oxide (NO). The aim of this study was to examine NO production by PMN and, for comparison of peripheral blood mononuclear cell (PBMC) confronted with the expression and concentration of inducible NO synthase (iNOS) in these cells derived from patients with B-CLL. Results obtained were analyzed according to Rai' staging systems. Our results have shown impaired production of NO by human neutrophils and mononuclear cells. Furthermore, higher expression of iNOS detected by western blot as well as increased concentrations iNOS estimated by ELISA in these cells were observed. We also found higher expression and concentration of iNOS in PMN and PBMC patients in III stage in comparison with patients in I stage of the disease. Additionally we demonstrated a lower production of superoxide anion by neutrophils of patients with B-CLL. Results obtained suggest that impaired NO production, despite of enhanced expression of iNOS, may have a favorable effect on anti-tumor response in patients with B-cell chronic lymphocytic leukemia.

[Estimation of L-selectin expression on neutrophils and level of soluble L-selectin form in serum of patient with chronic myelogenic leukemia]. / Ocena ekspresji L-selektyny na neutrofilach oraz rozpuszczalnej formy sL-selektyny w surowicy krwi u chorych na przewlekla bialaczke szpikowa.

The aim of this study was the estimation of L-selectin expression on PMN and concentration of sL-selectin in patients serum with chronic myelogenic leukemia. The results indicate the increased expression of L-selectin on isolated neutrophils from peripheral blood of patients with chronic myelogenic leukemia. A concentration of sL-selectin was also increased in patients serum with chronic myelogenic leukemia. High concentration of L-selectin on PMN makes binding neoplastic cells easier. Increased level of sL-selectin might activate of the adhesion process in patients with chronic myelogenic leukemia. High expression of L-selectin on PMN may be a response to higher levels of TNF-alpha in serum blood patients with chronic myelogenic leukemia.

[Brain perfusion disturbances in patients with vertigo -- a study with SPECT]. / Zaburzenia perfuzji mózgowej u pacjentów z zawrotami glowy -- badania technika SPECT.

BACKGROUND AND PURPOSE: The aim of our study was to evaluate brain perfusion in patients with vertigo using the SPECT technique. METHODS: The study involved a group of 32 patients and was performed in the Neurological Department of the Medical University in Bialystok. Patients with vertigo of peripheral origin like middle ear pathology were excluded from the study. Tomographic pictures were taken with Nucline X-Ring camera after administration of Tc99m-ECD. Perfusion maps were estimated by qualitative and semi-quantitative methods. RESULTS: In 8 patients (25%) perfusion maps were normal in the hemispheres, cerebellum and subcortical structures. In 10 patients (31.2%) there was a substantial decrease in perfusion in the left temporal region, in 8 patients (25%) -- hypoperfusion was seen in the right temporal region. In 4 patients (12.5%) there was a substantial decrease in perfusion in the cerebellum, in two persons -- in the frontal lobes. CONCLUSIONS: The results obtained so far confirm the major role of ischemia in etiology of the central origin vertigo and balance disturbances. It involves not only the brainstem and cerebellar structures, but the temporal lobes as well. The test has also proved that the qualitative and semi-quantitative methods of assessing brain perfusion with a SPECT are satisfactory in diagnostics of vertigo.

TNF family molecules in the serum of patients with B-cell chronic lymphocytic leukemia (B-CLL).

Tumor necrosis factor (TNF) superfamily, involving membrane receptors and ligands are important for the growth and survival of leukemic B cells. In the present study levels of TNF-alpha, sTNFRp55, sTNFRp75 and sCD40 and sCD40L in the serum of patients with B-CLL before and after treatment were measured. In sera of patients before treatment increased concentrations of sCD40 and decreased concentrations of sCD40L were shown. Increased concentrations of TNF-alpha and sTNFRp75 and lack of changes in sTNFRp55 concentrations were also found. Results obtained suggest that the relationships between examined soluble form of TNF family proteins may influence the development of B-cell chronic lymphocytic leukemia. The used therapy with 2CdA and CMC led to a favorable effect for host through changes in the relations between sCD40 and sCD40L. It was also found that sCD40 and sCD40L serum concentrations, which are dependent on the clinical stage and used therapy, are more sensitive tumor markers than TNF-alpha and its soluble receptor in patients with B-CLL treated with 2CdA and CMC.

[Estimation of level of soluble form PECAM-1, ICAM-2 and TNF-alpha, IL-18 in serum patients with chronic myelogenic leukemia]. / Ocena stezenia rozpuszczalnych form PECAM-1 i ICAM-2 i stezenia TNF-alpha i IL-18 w surowicy krwi pacjentów z przewlekla bialaczka, szpikowa.

The aim of this study was to estimate sPECAM-1, sICAM-2 and TNF-alpha and IL-18 concentrations in serum patients with chronic myelogenic leukemia. The results indicate of increased level sPECAM-1, sICAM-2 and TNF-alpha, IL-18 concentrations in serum patients with chronic myelogenic leukemia. Elevation levels of sPECAM-1 and sICAM-2 may lead to inhibit of making myelogenic leukemia cells infiltrations through the block of surface their receptors in patients with CML. High concentration of TNF-alpha and 11-18 in blood serum may indicate high expression of sPECAM-1 by activated specific enzymes responsible for releasing sPECAM-1.

[Subclinical hyperthyrodism, diagnosis and radioiodine therapy]. / Subkliniczna nadczynnosc tarczycy, diagnostyka i leczenie radioizotopowe.

Subclinical hyperthyroidism is a state of increased thyroid function with few or no clinical definitive signs or symptoms of hyperthyroidism. It is characterised by a decrease of serum (TSH) concentration below 0.1 mU/L, when serum levels of total and free thyroxin and triiodothyronin concentration are within normal reference ranges. It is not a rare finding and rates between 0.02% and 11.3% have been reported in different groups. The clinical diagnosis of subclinical hyperthyroidism is very difficult in the absence of the typical symptoms of hyperthyroidism. Therefore the diagnostic evaluation is important, especially with the use of radioisotope scan. In nuclear medicine department we can confirm the provisional diagnosis by the use of thyroid scan. Recent studies reported the effects of subclinical hyperthyroidism on cardiovascular system, skeletal system, cognitive function, on quality of life and life expectancy especially in the elderly patient. Treatment is indicated in the presence of palpitation, or atrial fibrillation, in postmenopausal osteoporosis in women not on hormone replacement therapy, and in elderly patients in whom surgery is contraindicated. According to the opinions of European clinicians and clinician members of the American Thyroid Association, the majority recommend radical treatment for these patients. Radioiodine therapy is considered to be the treatment of choice in most of the patients with nodular goiter.

Apoptosis: its pathophysiology and monitoring. The role of apoptosis in the radioiodine therapy of hyperthyroidism.

The review aims to give an up to date understanding of the mechanisms of apoptosis (programmed cell death), the methods of detecting apoptosis, in particular with regard to imaging such changes non-invasively. Radioiodine (I-131) is a gamma and beta emitting radionuclide and is commonplace in the treatment of hyperthyroidism. I-131 therapy relies on the destruction of thyroid tissue by beta radiation, and such destruction is proposed to be partly as a result of apoptosis. The review undertakes to explore and provoke research into the mechanisms of thyroid cell destruction by I-131, and whether such changes are able to be detected or monitored. Current knowledge concerning apoptosis in the thyroid gland in diseased states (including cancer) are described. The clinical significance of monitoring and modifying apoptosis are emphasized. Furthermore, overt and late destruction of thyroid tissue following I-131 therapy requires elaboration, and the relevance of detecting and modifying thyroid cell apoptosis following I-131 are questioned.

[Blood levels of the adhesion molecules ICAM-1 and VCAM-1 in patients with chronic myeloid leukemia during remission and exacerbation]. / Badanie zmian stezen czasteczek adhezyjnych ICAM-1 oraz VCAM-1 w okresie zaostrzenia i remisji u chorych na przewlekla bialaczke szpikowa.

A change in ICAM-1 and VCAM-1 concentrations is most likely to occur during the course of chronic myleoid leukemia (CML). The purpose of our study was to examine concentrations of these adhesion molecules in blood plasma, culture supernatant and isolated, broken granulocytes in 20 patients (45-65 years old) with CML in exacerbation and during the remission of the disease and in 10 healthy control subjects. The concentration assay of substances mentioned above was made using ready immunoenzymatic sets of ELISA type. The examinations were carried out on the cultures of cells stimulated and nonstimulated with mitogen--Neupogen of Roche with a the dose of 1 mu/4 ml of culture. Mitogen was added to activate granulocytes and to induce blastic transformation. A significant increase in of plasma ICAM-1 concentration was found in CML exacerbation and remission. The difference between the concentrations of the adhesion molecules with mitogen stimulated and nonstimulated cultures were observed. A significant increase in ICAM-1 and VCAM-1 concentration could suggest a higher secretory function of granulocytes. The values of ICAM-1 were increased in culture supernatants and broken granulocytes before and after adding mitogen in comparison to control groups. The difference in concentration we observed could be characteristic for leukaemic cells.

[Interleukin-6 and interleukin-12 blood levels in patients with chronic B-cell lymphocytic leukemia]. / Stezenia interleukin 6 i 12 we krwi u chorych na przewlekla bialaczke limfatyczna B-komórkowa.

B-cell chronic lymphatic leukaemia (B-CLL) is characterized by proliferation and accumulation of small B-lymphocytes, which are monoclonal in organ. The changes in IL-6 and IL-12 concentrations usually occur during the course of B-CLL. IL-6 and IL-12 seem to be positive kinetic regulators of stem cells. Therefore the purpose of our study was to examine the changes in concentrations of IL-6 and IL-12 in blood plasma, culture supernatant and isolated and broken lymphocytes from patients with B-CLL. The study was performed in I (n = 12) and III (n = 12) stage of disease according to Rai's classification--20 males and 4 females (aged 45-65) and in 12 healthy volunteers blood donors 35-55 years old. The study was approved by the local ethics committee. The measurement of concentrations of IL-6 was performed using the IL-6 immunoenzyme set of ELISA, R&D Systems Europe (UK) in plasma, culture supernatant and broken leukaemic cells. The results showed a significant increase in IL-6 and IL-12 concentration in blood plasma, culture supernatant and inside of the lymphocytes at I and III stage of B-CLL with regard to control groups. An increase of IL-6 and IL-12 concentrations in blood plasma and culture supernatant may suggest higher secretions by lymphocytes these interleukins during the course of B-CLL. An increase of IL-12 in broken leukaemic cells could be characteristic for the biochemistry of malignant lymphocytes.

[Study of interleukins and their soluble receptors in B-cell chronic lymphatic leukemia]. / Badania stezen interleukin i ich rozpuszczalnych receptorów w przewleklej bialaczce limfatycznej B-komórkowej.

The purpose of our study was to examine concentrations of IL-1 beta, IL-1 beta R, IL-6 and IL-6R in blood plasma, culture supernatant and isolated broken lymphocytes in 20 patients with CLL, at I and III stage of the disease according to Rai's classification and in 10 healthy control subjects. The studies were carried out on the cultures of cells nonstimulated and stimulated with mitogene. A significant increase in IL-1 beta and IL-6 concentrations were found in all study groups during the course of B-CLL. The values of IL-1 beta R and IL-6R were increased in blood plasma at I and III stage of CLL and decreased in culture supernatants and broken lymphocytes before and after stimulation in comparison to control groups. In all cases studied parameters were higher after stimulation. In conclusion, significant increase of IL-1 beta and IL-6 concentrations during CLL may advocacy of higher synthesis and excretions of interleukins--stimulatores of cell proliferation by leukaemic lymphocytes. Increased IL-1 beta R and IL-6R concentrations in blood plasma during CLL, seems to be one of the mechanisms restricted access of IL-1 beta and IL-6 to their surface receptors. An increase of IL-1 beta and IL-6 concentrations and decrease of IL-1 beta R and IL-6R volues suggest survival of autoregulation mechanisms defended against autocrine excreted interleukins. The volues of concentrations of IL-1 beta and IL-1 beta R positively correlated with progress of disease. Such correlation was not found with respect to concentrations of IL-6 and IL-6R.

The value of estimating serum aproptotic marker concentrations in monitoring and prognosis of 131I--therapy in Graves' disease. Preliminary report.

BACKGROUND: The effect of radioiodine (131I) in Graves' disease (GD) is probably due to the direct physical destruction of thyrocytes by beta radiation, and by the indirect action through stimulation of apoptosis in these cells. The aim of our study was to investigate the changes in serum concentrations of sFas and sFasL as stimulators of apoptosis, and Bcl-2 as an inhibitor of apoptosis in patients with GD following 131I administration. MATERIAL AND METHODS: The study was performed on 30 patients with GD (29 female and 1 male aged 25-45). All patients were euthyroid (biochemical and clinical) prior to radioiodine therapy. The target absorbed dose ranged between 90 and 160 Gy. We assessed markers of apoptosis and hormone concentrations (fT3, fT4 and TSH) in the following manner: before 131I administration, then two weeks, one month, two, three, four, and five months after 131I administration. RESULTS: After four months, the concentrations of sFas and sFasL rose by 50% and decreased during the next month. Pretherapeutic concentrations of Bcl-2 were elevated, and peaked two weeks after ingestion, showing a gradual decrease with time. We found a significant increase in serum TSH, and a decrease of fT3 and fT4 concentrations by the end of the third month of radioiodine therapy. CONCLUSIONS: Decreases in serum levels of sFas and sFasL and increases of Bcl-2 are regarded as characteristic for GD patients before radioiodine therapy. Radioiodine therapy reverses the ratio of estimated markers after four months. The concentrations of hormones reflect actual thyroid function, whereas concentrations of markers of apoptosis may suggest morphological changes.

[Effect of cytostatic therapy on IL-1beta and L-selectin concentrations, synthesis, accumulation and excretion in patients with acute myeloid leukaemia]. / Próba oceny wplywu leczenia cytostatykami na procesy syntezy, magazynowania oraz wydzielania interleukiny-1beta oraz selektyny L u chorych na ostra bialaczke szpikowa.

The etiology and pathogenesis of the majority of diseases that make up the acute leukemias is unknown. A change in IL-1beta and L selectin concentrations is most likely to occur in the course of subtype M2 of acute myeloid leukaemia (AML). The purpose of our study was to examine the change in concentrations of these molecules mentioned above in blood plasma, culture supernatant and isolated, broken granulocytes in AML patients in both exacerbation and remission of the disease and in healthy control group. Cytokine concentration assay was performed by means of ready immunoenzymatic sets of ELISA type. The examinations were carried out in leukaemic leukocyte cultures Neupogen--stimulated or nonstimulated. Mitogen was added to activate granulocytes and to provoke blastic transformation. A significant increase in IL-1beta concentration was found in AML--exacerbation and remission of the disease in blood plasma, culture supernatant and isolated, broken granulocytes. In all cases L-selectin concentrations were increased in exacerbation and decrease in remission of AML after typical chemotherapy in comparison to controls. A significant increase between the concentrations of cytokines were observed in cultures Neupogen--stimulated and non-stimulated.