Clinical utility of paraoxonase in atherosclerotic coronary artery disease

The scope of this study was to evaluate the significance of serum paraoxonase [PON] assay in diagnosing coronary artery disease [CAD] and to investigate its reliability in determining the severity and progression of CAD. Furthermore, the diagnostic reliability of this marker was compared to that of routinely used conventional lipid parameters and apolipoproteins A1 and B. This study included 65 male patients suffering from anginal pain and were subjected to coronary angiography in addition to 20 age matched healthy males. The coronary angiography of 20 angina patients revealed normal coronary arteries and they were considered as pathological controls. The remaining 45 patients were proved to have atherosclerotic CAD, 15 of them had single vessel affected [SVD], 14 had double vessels affected [DVD] and 16 had multiple vessels affected [MVD]. Routine lipid profile, apolipoprotein A1 [apo-A1], apolipoprotein B [apoB] and serum PON were assayed in all subjects. Serum PON was assayed using a prepared solid phase competitive enzyme immunoassay. Apolipoprotein A1 [apo-A1] and apoB were assayed on the Olympus AU400 system by an immunoturbidimetric endpoint method. Routine lipid parameters were measured on the Synchron CX7 autoanalyzer. Our results showed that all angina subjects were similarly exposed to hypertension, diabetes mellitus and smoking as risk factors for CAD. Serum lipid profile did not vary significantly among the subjects suffering from chest pain. However, when compared to healthy controls, patients with anginal pain showed significantly lowered HDL-C and apo-A1 serum levels and significantly higher atherosclerotic, risk ratio. Moreover, all assayed lipid parameters failed to show any significant difference between different subgroups of CAD patients. In the present study, serum PON levels decreased progressively with the progression of CAD being significantly lower in MVD and DVD subgroups than in SVD. Serum PON levels correlated significantly with nearly all angiographic parameters. Moreover, serum PON had a diagnostic sensitivity, specificity and efficacy of 95.6%, 93.2% and 94.6%, respectively at a cut-off level of 91.0 microg/mL in detecting CAD patients when compared to controls and was proved to be the best discriminating marker for CAD using the multiple regression analysis. As regards apo-A1, the diagnostic efficacy was 67.6% at a cutoff level of 120 mg/dL and it was the second discriminating parameter that could differentiate CAD patients from healthy subjects using the multiple regression analysis and showed a significant correlation with some angiographic parameters and with PON. Finally, routine lipid profile parameters and apoB did not show any significant correlation neither with PON nor with the angiographic parameters. In conclusion, the current study revealed that serum PON was the best predictive marker for CAD risk and the best diagnostic tool for severity for atherosclerotic CAD

Assessment of nitric oxide in induced sputum of asthmatic patients and its prognostic significance in monitoring allergic inflammation

Nitric oxide [NO] plays an important role as an inflammatory mediator in the airways. However, because direct measurement of endogenous NO has been difficult in vivo, the exact pathologic role of NO in bronchial asthma has remained unclear. To study the levels of nitric oxide derivatives in induced sputum of asthmatic patients in order to assess their clinical utility as non-invasive prognostic indicator for monitoring the degree of airway inflammation in asthmatics. We examined the concentration of stable end products of NO, namely nitrite and nitrate in hypertonic saline-induced sputum in 25 patients with different grades of bronchial asthma among whom 12 patients were examined before and after anti-asthmatic medications including steroid preparations. Ten normal age and sex-matched subjects were included as controls. Patients were 14 males and 11 females aged 36.6 +/- 8.7 years. They included 11 patients with severe asthma, 7 with moderate asthma and 7 with mild asthma. Fresh expectorated sputum was treated with equal volume of dithiothreitol 0.1%, cytospinned for cell count, and the supernatant was collected for biochemical assay. Measurement of NO derivatives in induced sputum was carried out colorimetrically by using modified Griess reaction. We evaluated the relationship between levels of NO derivatives and percentages of eosinophils, epithelial shedding in induced sputum and the degree of airway obstruction measured by pulmonary functions [forced expiratory volume in one second [FEV1]/forced vital capacity [FVC]] in asthmatic patients. The concentration of NO derivatives in induced sputum was significantly higher in patients with asthma than in normal control subjects [1126 +/- 134.3 micro mol/L versus 567 +/- 98.4 micro mol/L; P <0.01]. According to asthma severity, severe and moderate asthmatic patients had higher levels of NO derivatives [1261 +/- 193.2 and 1037 +/- 156.3micro mol/L, respectively] in induced sputum as compared to mild asthmatic patients [786 +/- 89.5 micro mol/L] [P < 0.01]. Percentages of eosinophils in induced sputum were also significantly higher in asthmatic patients than controls [35.6 +/- 4.7% vs 1.3 +/- 0.2%, P<0.01]. There were significant positive correlations between NO derivatives levels and percentages of each of eosinophils and shedding epithelial cells in induced sputum in asthmatic patients [r[S]=0.58, P <0.01; r[S]=0.62, P<0.01, respectively]. A significant negative correlation was found between NO derivatives levels and the ratio of FEV1/FVC [r[S]= -0.63, P<0.01], that's to say NO derivatives levels correlated positively with the degree of airway obstruction in asthmatic patients. The levels of NO derivatives and percentages of eosinophils in induced sputum were reduced significantly in asthmatic patients following treatment with corticosteroids [P<0.05]. These findings confirmed that the level of NO derivatives was increased in the tracheobronchial secretion of asthmatic patients and was parallel with the severity of asthma. Hence, measurement of NO derivatives in induced sputum could be used as a non-invasive prognostic biochemical marker for assessing the degree of airway inflammation and monitoring the anti-inflammatory treatment response in asthmatic patients

Basic fibroblast growth factor: a novel tumor marker for the diagnosis of hepatocellular carcinoma

This study was conducted on 22 patients with HCC, 11 patients with liver cirrhosis [LC], 12 patients with chronic hepatitis [CH] and 20 healthy controls aiming to assess the diagnostic performance of basic fibroblast growth factor [bFGF] as a novel tumor marker of hepatocellular carcinoma [HCC] versus alpha-fetoprotein as a conventional serum tumor marker. The study measured bFGF by ELISA technique, alpha-fetoprotein [AFP] by a chemiluminescent immunometric assay and type III procollagen [IIIP], which represented a marker of liver fibrosis, by a radioimmunoassay technique. The results indicated that patients with HCC had significantly higher serum bFGF levels [13.6 +/- 11.5 pg/ml] than those in the normal subjects [2.2 +/- 0.8 pg/ml] as well as in patients with CH [4.2 +/- 3.3 pg/ml] and LC [8.4 +/- 6.5 pg/ml]. The serum levels of bFGF increased gradually with the progression of chronic liver disease being highest in patients with HCC. None of the liver function test findings or levels of IIIP correlated with the levels of bFGF