Oxidized Alpha-1-Antitrypsin as a Potential Biomarker Associated with Onset and Severity of Chronic Obstructive Pulmonary Disease in Adult Population.

Oxidative stress could reduce inhibitor activity of the alpha-1-antitrypsin (A1AT). Oxidative-modified A1AT (oxidized alpha-1-antitrypsin, OxyA1AT) significantly loses ability to protect the lungs from neutrophil elastase. We aimed to investigate OxyA1AT as a potential biomarker associated with onset and severity of chronic obstructive pulmonary disease (COPD) in adult population. The study included 65 patients with COPD (33 smokers and 32 no-smokers) and 46 healthy participants (17 smokers and 29 no-smokers). Determination of OxyA1AT in serum was based on the difference between the inhibitory activities of normal and oxidized A1AT against trypsin and elastase. The level of OxyA1AT was significantly increased in the group of COPD smokers compared to healthy no-smokers (p = 0.030) and COPD no-smokers (p = 0.009). The highest level of OxyA1AT was found in group of smokers with severe and very severe COPD in comparison to the following: no-smokers with the same stage of disease (p = 0.038), smokers with moderate COPD (p = 0.022), and the healthy control group, regardless of the smoking status (control no-smokers p = 0.001 and control smokers p = 0.034). In conclusion, serum level of OxyA1AT would be potentially good biomarker for the assessment of harmful effect of smoking to the onset and severity of COPD. Also, clinical significance of OxyA1AT as prognostic biomarker could be useful in assessing the effectiveness of antioxidant therapy for COPD and emphysema. Suitable and inexpensive laboratory method for determination of OxyA1AT is additional benefit for the introduction of OxyA1AT into routine clinical practice for diagnosis and monitoring of COPD.

Association of the methionine sulfoxide reductase A rs10903323 gene polymorphism with functional activity and oxidative modification of alpha-1-antitrypsin in COPD patients.

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is multi-factorial disorder which results from environmental influences and genetic factors. We aimed to investigate whether methionine sulfoxide reductase A (MSRA) rs10903323 gene polymorphism is associated with COPD development and severity in Serbian adult population. METHODS: The study included 155 patients with COPD and 134 healthy volunteers. Genotyping was determined performing home-made polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The difference between the inhibitory activities of normal and oxidized Alpha-1-Antitrypsin (A1AT) against elastase and trypsin was used for determination of Oxidized Alpha-1-Antitrypsin (OxyA1AT) (expressed as % and g/L). Functional activity of A1AT was presented as a specific inhibitor activity to elastase (SIA-Elastase, kU/g). RESULTS: Frequencies of the genotypes AA, AG and GG were 80.0%, 20.0%, 0% in COPD patients and 80.5%, 18.5% and 1.5% in the control group, and there was no significant difference in genotype or allele distributions between groups. Serum level of A1AT (g/L) and OxyA1AT was significantly higher in COPD patients than in the control group, but functional activity of A1AT (SIA-Elastase) was significantly lower in COPD patients than in the control group. In COPD group, increased level of OxyA1AT was present in G allele carriers who were smokers relative to G allele carriers who were not smokers. In the smoker group of patients with severe and very severe COPD (GOLD3+4), significant increase in OxyA1AT level was present in G allele carriers compared to AA homozygotes. CONCLUSION: These findings suggest that MSRA rs10903323 gene polymorphism is probably not a risk for COPD by itself but could represent a COPD modifier, since minor, G allele, is associated with an increased level of oxidized A1AT, indicating impaired ability of MSRA to repair oxidized A1AT in COPD-smokers, and in severe form of COPD.

Histomorphometric evaluation of implant design as a key factor in peri-implant bone response: a preliminary study in a dog model.

AIM: Primary implant stability as the establishment of a direct bone-to-implant contact (BIC) plays a major role in long-term successful implant osseointegration. Numerous factors influencing this initial stability have been studied. This preliminary in vivo study on a dog lower jaw aimed to investigate the hypothesis that primary implant stability in low density bone may be influenced by implant design. METHODS: The authors compared two different implant designs with regard to their immediate quantitative relation to host bone (BIC% and gap area, GA%). The screw-shaped implants, manufactured by Or-Vit (Castelmaggiore-Bologna, Italy), exhibited similar microroughness surface and two different thread pitches: ''narrow-pitch'' implants (NP) and ''wide-pitch'' implants (WP) with a 0.5 mm and 1.5 mm thread pitch respectively. Implants were placed in dog jaw after complete osseous healing of the extractive sockets, according to a delayed implantation procedure. Five hours after surgery the animal was sacrificed. Radiographic, histological, morphometric and ultrastructural analysis were performed. RESULTS: An inverse relation existed among the two parameters BIC and GA: GA, as a region with high osteogenetic potentiality, appeared wider in WP implants; BIC, as the expression of primary mechanical stability, was higher in NP implants. CONCLUSION: Based on this results, we could assume that NP implants might be the clinical choice in case of immediate loading.This single case study might be considered a starting point for further long term in vivo investigations aiming to establish the implant design that best favours osseointegration at different bone quality sites.

Proinflammatory cytokines (IL-1beta and TNF-alpha) and chemokines (IL-8 and MIP-1alpha) as markers of peri-implant tissue condition.

Analysis of peri-implant crevicular fluid (PICF) offers a non-invasive means of studying the host response in peri-implant disease and may provide an early indication of patients at risk for active disease. This study examined the PICF levels of interleukin-1beta (IL-1beta), tumour necrosis factor alpha (TNF-alpha), interleukin-8 (IL-8) and macrophage inflammatory protein-1alpha (MIP-1alpha) in patients with non-manifesting inflammation, early and late stages of mucositis. The study group comprised 90 adult healthy volunteers with endosseal titanium implants inserted. Samples were taken from peri-implant sulcus using a filter paper technique. Implant tissues were categorized clinically as healthy, early mucositis or advanced mucositis. Clinical manifestations were determined by: gingival index and bleeding on probing, plaque index and radiographic analyses. Cytokine concentrations were assesed using commercially available enzyme-linked immunosorbent assay kits. Patients from the control group (healthy patients) have significantly lower concentrations of IL-1beta, TNF-alpha, IL-8 and MIP-1alpha in PICF compared with both groups with mucositis. Positive correlation was noted in the control group between IL-1beta and TNF-alpha and between MIP-1alpha and IL-8 in the group with early mucositis. The results suggest that cytokines could be prognostic markers of implant failure.

[The importance of the transfer factor test in the diagnosis of pulmonary emphysema]. / Znacaj testa transfer faktora u dijagnostici emfizema pluca.

Physical examination, X-ray and lung function studies were performed in a group of 29 patients with chronic obstructive lung diseases. According to the diffusing capacity, patients were divided into two subgroups: one with normal and the other with decreased lung transfer-factor. Comparing the parameters of pulmonary function significantly more severe obstructive ventilatory insufficiency and greater lung hyperinflation were found in the subgroup of patients with decreased diffusing capacity. In this subgroup the collapsing type of flow-volume loop and X-ray signs of emphysema were present more frequently than in patients with normal lung diffusing capacity.

Two-component transdental implants.

Transdental implantation is a procedure of tooth stabilization in maxillary and/or mandibular bone. Indications for use of these implants are root fractures, chronic periapical inflammations and periodontal disease. Transdental implants have been used in the Clinic for Maxillofacial Surgery since 1977. In the period of 20 years of treatment 490 two-component transdental implants have been inserted and failure rate was 9% (43). Considering our experience and that of other authors we can conclude that with proper indications and sophisticated surgical technique the use of this type of implants has favorable survival rate.

Prosthetic reconstruction of facial defects.

A seven-year experience in prosthetic reconstruction of facial defects is presented. Surgical-prosthetic treatment was performed in 25 patients. Facial defect associated with organ loss of the midface was found in 4 (16%) patients. Isolated facial or midfacial organ defects were found in 21 (84%) patients, and dominant eye loss in 11 (44%) patients. All patients were managed by facial prostheses made of rigid acrylate and soft silicon. To obtain retention and stability of facial prostheses, eye glasses were most frequently used in 32% patients, and modern methods of retention with implants in 26%. The use of implants improved prosthetic reconstruction in terms of stability and retention.

Implants in management of gunshot injuries of teeth, facial bones and jaws.

The use of implants in management of gunshot injuries of teeth, face and jaws presents novelty that is manifested in primary surgical treatment, reduction and fixation of bone fragments and teeth, replacement of lost parts of bone tissues as well as preparation for definitive prosthetic management. At the Clinic for Maxillofacial Surgery of the MMA 173 implants of different types and purposes have been placed in the period 1991-1997, in rehabilitation of the patients injured during the civil war. Although this number of placed implants is significant, the conclusive estimate about benefit of using implants may be obtained only after a longer period of time. Early results are satisfactory.