Lipoprotein(a) plasma concentrations, apolipoprotein (a) polymorphism and family history of coronary heart disease in patients with essential hypertension.

AIM: The purpose of the study was to investigate lipoprotein (a) (Lp(a)) levels and apolipoprotein (a) (apo(a)) phenotypes, and their relationship with a family history of coronary heart disease (CHD) in patients with essential hypertension (EH). METHODS: One hundred and eight newly diagnosed patients with mild to moderate EH and 159 controls were studied. Lp(a) levels were determined with an ELISA method. Apo(a) isoforms were identified by a capillary immunoblotting technique. RESULTS: Lp(a) levels and frequency distribution of apo(a) isoforms did not show significant differences between patients and controls. Lp(a) levels in hypertensives with a family history of CHD were significantly higher than in those without a family history of CHD (P < 0.01). Hypertensives with a family history of CHD showed significantly different frequencies of apo(a) isoforms to those without a family history of CHD (P < 0.05). In EH patients with a family history of CHD, apo(a) isoforms of low molecular weight (MW) had a higher prevalence (62.6%), while in hypertensives without a family history of CHD, apo(a) isoforms of high MW were prevalent (81.6%); the difference between the two subgroups was significant (P < 0.001). Multivariate analysis showed that both Lp(a) levels and apo(a) isoforms of low MW are significant variables in distinguishing between the subgroups. CONCLUSIONS: Lp(a) levels and apo(a) phenotypes do not differ between hypertensives and controls. High Lp(a) levels and apo(a) isoforms of low MW are strongly associated with a family history of CHD in hypertensives. The quantification of Lp(a) levels and the characterization of apo(a) phenotypes may be used for assessment of familial predisposition to CHD in hypertensives.

In vivo and in vitro HeNe laser effects on phagocyte functions.

The goal of this work was to evaluate the effect of helium-neon (HeNe) laser irradiation on immunocompetent cells. We used the in vivo skin window method and in vitro granulocyte function tests. The study of cellular migration showed a marked decrease in vitro and in vivo in a dose-independent manner. Superoxide release was not modified by laser irradiation. The granulocyte's aggregation, when using PHA and PMA, presented a reduction that was statistically very significant, not as a subordinate dose. An increase of the release of ATP was demonstrated only at 4 joules and precedes granulocyte aggregation. When using Ca2+ ionophore A23187 as stimulus, laser irradiation at 1, 2 or 4J did not show any modification of granulocyte aggregation. The monoclonal antibody 60.1, which identifies a membrane antigen fundamental for aggregation and chemotaxis, is expressed in normal amounts on granulocyte membranes both before and after irradiation with a HeNe laser. In fact, Laser irradiation preferentially attacks the area of the cellular centrosome that determines a modification of cellular morphology. The electron microscope and immunofluorescence study with a monoclonal antibody have pointed out a disorganization of the microtubules. The alteration of some of the granulocyte functions is correlated to the damage in the centrioles. The granulocyte mitochondrial system and surface membrane remain intact, and this explains the normal production and release of free radicals. Further experiments are necessary to evaluate the clinical application of lasers in various diseases with immunophagocytic pathogenesis.

Skin involvement in hemopathies: specific cutaneous manifestations of acute nonlymphoid leukemias and non-Hodgkin lymphomas.

The course of a hemopathy may be characterized by the appearance of cutaneous lesions. In such cases a correct histological investigation is needed, especially when the lesions have an aspecific appearance. It is important, therefore, to recognize the cases characterized by cutaneous involvement of typical systemic disease cells. Lymphomas and leukemias are the hemopathies which more frequently present specific and nonspecific cutaneous manifestations (with an approximate incidence of 3-40 and 6-50%, respectively). In the period 1977-1983 we examined 337 patients affected with acute nonlymphoblastic leukemia and 243 patients affected with non-Hodgkin lymphoma, in order to verify the incidence of specific cutaneous manifestations.

In vitro fibroblast and dermis fibroblast activation by laser irradiation at low energy. An electron microscopic study.

The effects of laser irradiations have been estimated both from the clinical point of view (rate of reduction of the ulcerated area) and in ultrastructural terms. The modification produced by laser in human fibroblasts in culture have also been investigated. Under our clinical and experimental conditions, laser stimulates the secretion of fibroblasts, both in vivo and in vitro, for reasons that are still the object of research. After irradiation the formation of periodic collagen fibrils is not observed, so that complete ' restitutio ad integrum' of the dermal matrix does not occur.

Insulin receptors in psoriasis.

We have demonstrated how in psoriasis, irrespective of any diabetic family history, there exists a state of hyperinsulinism with a decreased resistance to insulin, which is aggravated by obesity. Since reviewing the latest studies concerning diabetes at the receptor level, we have carried out a comparative study dealing with insulin receptors in lymphocytes in homogeneous groups of normal, obese, and psoriatics of normal weight and overweight. We have also made a comparison regarding the behaviour of the receptors in these various metabolic states.

Insulinogenic indexes in psoriasis.

We have earlier demonstrated that in psoriasis there exists a reduced tolerance to carbohydrates in association with hyperinsulinism. To pursue this problem further, we felt it worthwhile to deal with the results of the oral glucose tolerance test performed on 78 subjects (divided into homogenous groups of normal, obese and psoriatic groups, both with and without diabetic genetic history and obesity) with determinations of both blood glucose and blood insulin levels. We have calculated the insulinogenic indexes by using the techniques elaborated by various authors (I/G, delta I/delta G, AI/AG) and we have then carried out a statistical evaluation both of these indexes and of the ratio between the various indexes employing not only the usual techniques but also that of correlation and simple and multiple regression. We have done this in order to evaluate which of these indexes is better suited to demonstrate the physiopathological mechanism concerning the relationship between insulin hypersecretion and reduced carbohydrate tolerance in the various pathological conditions which we have dealt with.

[Serum insulin binding activity and diabetic retinopathy]. / Attività insulino-legante serica e retinopatia diabetica.

Radiochemical evaluation of serum insulin-binding activity in diabetics shows that there are no correlations between this behaviour and diabetic retinopathy. High values are mainly encountered in insulin-dependent diabetics; its nil or poor inhibition, owing to the effect of preincubation of the serum with high concentrations of unlabelled insulinic antigen, suggests that the phenomenon is connected above all to the presence of aspecific serous factors that "bind" the labelled hormone.

Psoriasis and insulin secretion. Preliminary results.

We have studied psoriatic subjects with normal weight and with overweight without inherited diabetic familiarity. The results seem to indicate the existence in psoriasis of an endogenous insulin-resistence. In this prospective the hypothesis that psoriasis carries a diabetogen risk is suggested.