Brain-derived neurotrophic factor and ciliary neurotrophic factor in maternal plasma and umbilical cord blood from pre-eclamptic and physiological pregnancies.

The aim of the study was to investigate the circulating levels of ciliary neurotrophic factor (CNTF) and brain-derived neurotrophic factor (BDNF) in maternal serum and umbilical cord blood from respective pregnancies in pre-eclampsia (PE) cases and a control cohort. A total of 12 pre-eclampsia cases and 34 healthy controls were enrolled and the maternal peripheral blood - umbilical cord blood duos, were examined for BDNF and CNTF levels. BNDF levels were significantly higher in umbilical cord blood from pre-eclamptic pregnancies; there was also significant difference between maternal plasma and umbilical cord blood levels of BDNF (p < 0.001) in the controls. The CNTF levels in umbilical cord blood (CNTF-UCB) were significantly higher in PE cases than in the controls (p = 0.03). Significant differences were observed in expression of BDNF and CNTF proteins in maternal peripheral blood and umbilical cord blood between pre-eclampsia cases and healthy controls.

Circulating levels of B-cell activating factor in paediatric patients with malignancy with or without cancer-related cachexia.

BACKGROUND: Cancer-related cachexia is a multifactorial syndrome characterised by progressive loss of body weight and it affects a large proportion of patients with advanced cancer. Cachexia is associated with reduced treatment tolerance, response to therapy, quality of life and duration of survival, whereas some of its mechanisms are shared across the whole continuum of diseases in the population, either cancer-related or non-cancer related e.g. systemic inflammation, increased lipolysis, insulin resistance and reduced physical performance. However, so far there has been only little effort to utilise the integrative physiology of adipose tissue to achieve therapeutic gain. B cell-activating factor (BAFF) is a novel member of the TNF ligand superfamily, is mainly produced by myeloid cells and has recently been shown to participate in B-cell survival and B- and T-cell maturation, but also in adipogenesis. Therefore, it represents an elegant candidate molecule linking the immune system and adipose tissue metabolism, both being involved deeply in the pathogenesis of cachexia. Moreover, it has been described very recently that BAFF directly influences secretion of IL-6 and IL-10. MATERIAL AND METHODS: In this study, pre-treatment circulating levels of BAFF were investigated in a cohort of 83 paediatric patients with malignancy (0-18 y) with or without cancer-related cachexia using ELISA-based methodology. RESULTS: Apart from logical significant associations of BAFF circulating levels with disease severity in B-lineage malignancies (ALL or B-cell lymphomas), we observed significant elevation of BAFF in adolescent patients with Ewing sarcoma and rhabdomyosarcoma, compared to the circulating levels appropriate for given age. CONCLUSION: To the best of our knowledge, this is so far the first study focusing on BAFF in paediatric malignancies with or without cancer-related cachexia. More research into whether BAFF can represent a useful circulating biomarker for detection and monitoring of the cancer-related cachexia is imperative.

Big endothelin in chronic heart failure: marker of disease severity or genetic determination?

The first objective of the study was to compare the levels of big endothelin and endothelin-1 and other noninvasive parameters used for evaluation of disease severity in patients with stable chronic heart failure (CHF). Endothelin-1 and big endothelin plasma concentrations were measured in 124 chronic heart failure patients. The second objective of the study was to prove an association between endothelin-1 and big endothelin plasma levels and two frequent polymorphisms in the endothelin-1 coding gene (6p21-23) -3A/-4A and G (8002) A in patients with chronic heart failure. Thirdly, we tried to associate other noninvasive parameters of CHF, especially cardiothoracic index (CTI), NYHA classification, signs of pulmonary congestion (PC) and ejection fraction (EF) with determined genotypes of the two ET-1 polymorphic variants. There were significant differences between big endothelin levels in NYHA II versus IV (P<0.001) and NYHA III versus IV (P<0.001) and endothelin-1 in NYHA II versus IV (P<0.001) and NYHA III versus IV (P<0.001). No associations between plasma levels of endothelin-1 and big endothelin and polymorphisms G (8002) A and -3A/-4A in gene coding endothelin-1 were found. In patients with CHF with CTI above 60% the number of carriers of genotypes with ET-1 8002A (AA and AG genotypes) increases. Concerning on the -3A/-4A ET-1 polymorphism, we observed a significant difference in genotype distribution as well as in allelic frequency in the group of patients with CTI above 60% between patients without and with pulmonary congestion. The allelic frequency of 3A allele is twice elevated in the patients with pulmonary congestion (37.8 vs. 78.1%, respectively).

[Physical training in patients with chornic heart failure: haemodynamics, effects]. / Telesný trénink u pacientu s chronickým srdecním selháním: hemodynamika, pusobky.

UNLABELLED: The objective of the investigation is to assess the safety and contribution of physical training in patients with chronic heart failure and to assess the effect of training on central haemodynamics, left ventricular function evaluated by echocardiography and humoral substances. PATIENTS AND METHODS: Patients with cardiac failure NYHA II and III incl. 17 on t he background of IHD and 21 on the background of dilatation cardiomyopathy. All patients had the ejection fraction below 40% and pVO2 below 20 ml/kg/min. They were divided into groups enagaged in training (T) and controls (K). Before training and after its termination the patients were subjected to clinical examination, basic laboratory tests, echocardiography amd dextrolateral catheterization at rest and during ergometry and levels of humoral agents were assessed. The training was pursued three times per week for a period of two months on a bicycle ergometer. RESULTS: Before training there were no statistically significant differences between the groups. After training the groups did not differ in echocardiographic and haemodynamic parameters. In the training group there was as compared with the onset of the experiment a decline of the maximal median pressure (123.6 +/- 11.9 vs. 113 +/- 10.2 mm Hg, p < 0.04) the maximal pulse rate (112.5 +/- 18.7 vs. 108.4 +/- 20.1 p <0.02). In the control group, on the other hand there was an increase of big endothelin (52.2 +/- 4 9.1 vs. 88.0 +/- 76.7 pg/ml, p < 0.04) and an increase of pulmonary vascular resistance (102.8 +/- 71.7 vs. 149.2 +/- 69.5 dyn.s/cm5, p < 0.002). CONCLUSION: Physical training was well tolertaed by patients, it led to a subjective improvement of their conditionn, to a reduction of the chronotropic response to a load and thus to more economical cardiac activity.

[Big endothelin and chronic heart failure]. / Big endotelin a chronické srdecní selhání.

In a group of 124 patients the authors investigated the importance of assessment of plasma levels of big endothelin and endothelin 1 in patients with chronic heart failure as compared with other currently used non-invasive parameters. A six fold increase of plasma levels of both substances was found in patients in functional class NYHA IV as compared with patients in class NYHA II-III. But even patients in the milder stage of NYHA had twice as high values as compared with the standard of the healthy population. Similarly patients with interstitial pulmonary oedema had a twice as high level of both parameters as compared with patients who had a normal finding on X-ray or merely a redistribution of the pulmonary vascularization. The sensitivity of assessment of plasma levels is such that this examination could become part of the basic diagnosis.

Visfatin is secreted into the breast milk and is correlated with weight changes of the infant after the birth.

INTRODUCTION: Visfatin is a recently identified adipokine with numerous metabolic and immunoregulatory properties that has been implicated in the regulation of the white adipose tissue (WAT) and significant changes in visfatin levels were reported during pregnancy. The aim of the study was to investigate dynamics of visfatin levels in maternal serum and human breast milk during a 180-d period after the delivery. MATERIALS AND METHODS: : Breast milk and venous blood samples were obtained from 24 healthy lactating women with uncomplicated, physiological pregnancy and appropriate-for-gestational age neonates and serum-milk sample duos were collected at the time of birth, at the 1-3, 12-14, 28-30, 88-90 and 178-180 postpartum. RESULTS: Our study demonstrates that (1) visfatin is abundantly secreted into breast milk in humans, reaching approx. 100× higher concentrations compared to maternal serum; (2) visfatin concentrations in maternal serum show significant variations after the delivery and (3) visfatin concentration in colostrum could be used for prediction of the subsequent weight development (less/more severe weight loss during first 3 days after the birth) of the infant. DISCUSSION: Our data suggest that visfatin could play an important role in regulation of adiposity of the infant after the birth.