Long term follow up of biomarkers of podocyte damage and renal function in patients with and without preeclampsia / Seguimento de longo prazo com biomarcadores de dano podocitário e função renal em pacientes com e sem pré-eclâmpsia

ABSTRACT Introduction: preeclampsia can be associated with future renal disease. Objectives: To measure changes in renal function overtime in patients with preeclampsia. Methods: urine and serum samples from eleven patients with preeclampsia and eight patients with a normal pregnancy were obtained during pregnancy, postpartum, and 3 years after delivery. Urine podocalyxin, protein, and serum creatinine were measured. Results: after 3 years, there were no significant differences in urinary podocalyxin in patients with or without preeclampsia: 4.34 ng/mg [2.69, 8.99] vs. 7.66 ng/mg [2.35, 13], p = 0.77. The same applied to urinary protein excretion: 81.5 mg/g [60.6, 105.5] vs. 43.2 mg/g [20.9, 139.3] p = 0.23. Serum creatinine was 0.86 mg/dL [0.7, 0.9] vs. 0.8 mg/dL [0.68, 1] p = 0.74 in those with and without preeclampsia. In normal patients, urinary podocalyxin decreased from 54.4 ng/mg [34.2, 76.9] during pregnancy to 7.66 ng/mg [2.35, 13] three years after pregnancy, p = 0.01. Proteinuria decreased from 123.5 mg/g [65.9, 194.8] to 43.2 mg/g [20.9, 139.3], p = 0.12. In preeclampsia patients, urinary podocalyxin decreased from 97.5 ng/mg [64.9, 318.4] during pregnancy to 37.1 ng/mg within one week post-partum [21.3, 100.4] p = 0.05 and 4.34 ng/mg [2.69, 8.99] three years after, p = 0.003. Proteinuria was 757.2 mg/g [268.4, 5031.7] during pregnancy vs. 757.2 mg/g [288.2, 2917] postpartum, p = 0.09 vs. 81.5 mg/g [60.6, 105.5] three years later, p = 0.01. Two patients still had proteinuria after 3 years. Conclusions: in preeclampsia patients, postpartum urinary podocalyxin decreased before proteinuria. After three years, serum creatinine, urinary podocalyxin, and protein tended to normalize, although some patients still had proteinuria.

RESUMO Introdução: a pré-eclâmpsia pode estar associada à doença renal no futuro. Objetivos: medir mudanças na função renal ao longo do tempo em pacientes com pré-eclâmpsia. Métodos: amostras de urina e soro de onze pacientes com pré-eclâmpsia e oito pacientes com gravidez normal foram obtidas durante a gravidez, pós-parto e 3 anos após o parto. Medimos podocalixina na urina, proteína e creatinina sérica. Resultados: após 3 anos, não houve diferenças significativas na podocalixina urinária em pacientes com ou sem pré-eclâmpsia: 4,34 ng/mg [2,69, 8,99] versus 7,66 ng/mg [2,35, 13], p = 0,77. O mesmo se aplicou à excreção urinária de proteínas: 81,5 mg/g [60,6, 105,5] vs. 43,2 mg/g [20,9, 139,3] p = 0,23. A creatinina sérica foi de 0,86 mg/dL [0,7, 0,9] vs. 0,8 mg/dL [0,68, 1] p = 0,74 naqueles com e sem pré-eclâmpsia. Em pacientes normais, a podocalixina urinária diminuiu de 54,4 ng/mg [34,2, 76,9] durante a gestação para 7,66 ng/mg [2,35, 13] três anos após a gravidez, p = 0,01. A proteinúria diminuiu de 123,5 mg/g [65,9, 194,8] para 43,2 mg/g [20,9, 139,3], p = 0,12. Em pacientes com pré-eclâmpsia, a podocalixina urinária diminuiu de 97,5 ng/mg [64,9, 318,4] durante a gravidez para 37,1 ng/mg em uma semana de pós-parto [21,3, 100,4] p = 0,05 e 4,34 ng/mg [2,69, 8,99] três anos depois, p = 0,003. A proteinúria foi de 757,2 mg/g [268.4, 5031.7] durante a gravidez vs. 757,2 mg/g [288.2, 2917] pós-parto, p = 0.09 vs. 81.5 mg/g [60.6, 105.5] três anos depois, p = 0.01. Dois pacientes ainda apresentavam proteinúria após 3 anos. Conclusões: em pacientes com pré-eclâmpsia, a podocalixina urinária pós-parto diminuiu antes da proteinúria. Após três anos, a creatinina sérica, a podocalixina urinária e a proteína tenderam a se normalizar, embora alguns pacientes ainda tivessem proteinúria.

Changes of Plasma Interleukin-1 Receptor Antagonist, Interleukin-8 and other Serologic Markers during Chemotherapy in Patients with Active Pulmonary Tuberculosis

BACKGROUND: The human immune response to Mycobacterium tuberculosis is mediated by macrophages and T-lymphocytes. The alveolar macrophage phagocyting mycobacterium produces interleukin (IL) -1 as an inflammatory mediator, and IL-8 as a cytokine for leukocyte recruitment and granuloma formation. Interleukin-1 receptor antagonist (IL-1ra) is an internal antagonist of IL-1. METHODS: Plasma levels of IL-1ra and IL-8 and other serologic markers were measured in 18 patients with active tuberculosis before treatment and after 2 months and 6 months of treatment. RESULTS: During treatment with antituberculous medication, patients showed significant changes in hemoglobin, hematocrit, white blood cells (WBC), platelet, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ferritin and plasma IL-1ra. After 2 months of treatment, ESR and CRP diminished significantly; after 6 months, hemoglobin increased while WBC, platelet, ESR, CRP and ferritin decreased significantly compared to their pre-treatment levels. There were two groups: patients with delayed therapeutic responses, and patients with early responses. At each point of observation, the former group of patients showed lower body weight and lower levels of hemoglobin and hematocrit, and higher levels of WBC, platelet, ESR, IL-8 and IL-1ra than the latter group. During the course of the treatment, we observed considerable differences in body weight, body mass index, hemoglobin, hematocrit, WBC and platelet counts, ESR, CRP and ferritin in both the early-response and delayed-response groups. CONCLUSION: We believe that the plasma concentrations of IL-1ra and IL-8, which showed different peaks during the course of treatment, reflected their different functions and patterns of secretion. Moreover the concentrations did not seem as sensitive as other inflammatory markers to evaluate disease activity during antituberculosis treatment. However, IL-1ra can be considered a marker for disease activity and response to treatment.

Assessment of joint damage from analysis of released bone sialoprotein into synovial fluid of rheumatoid arthritis patients

Bone sialoprotein [BSP] was quantified in synovial fluids and sera from rheumatoid arthritis [RA] patients to elucidate whether its release from bone relates to the degree of joint tissue destruction. BSP levels were determined by immunoassays of knee synovial fluids and of sera from 60 RA patients who were classified into 4 groups on the basis of radiographic knee joint tissue damage. Serum levels were compared with 15 matched healthy subjects as a control group. Synovial fluid concentrations of BSP increased with increasing degree of knee joint damage [F=13.5 and P<0.001]. Serum concentrations of BSP were increased above normal [t=5.9 and P<0.001]. but did not relate to the degree of joint damage [F=0.02 and P>0.05]. From these results we concluded that quantification of BSP in the synovial fluid can be useful as a mean for assessing the degree of tissue damage at the molecular level in patients with RA

Efficacy of serum sialoglycoproteins as a biomarker of the disease activity & treatment monitoring in patients with base tongue malignancy.

Serum levels of sialoglycoprotein constituents i.e., sialic acid, seromucoid hexoses, and mucoid proteins were determined in 34 patients with base tongue malignancy and 15 controls matched for age and sex. All three constituents were found to be significantly raised; however, only sialic acid levels increased with the severity of the disease. More than 92 per cent of the patients in each clinical stage showed abnormal values of hexoses and mucoid proteins in seromucoids. Electrophoretic separation showed a split in alpha-2-glycoprotein at pretreatment time in 67.6 per cent of the patients. On administration of radiotherapy, all three fractions decreased while alpha-2- split disappeared in 61.8 per cent patients and gamma glycoprotein peak emerged at the end of the protocol with a parallel decrease in these three constituents. It may be concluded from the data that serum sialoglycoproteins can be useful to monitor therapy in base tongue malignancy patients.