Altered serum levels of neprilysin in heart failure patients with reduced ejection fraction.

OBJECTIVE: In addition to the recent success of neprilysin inhibition in treatment of heart failure, elevated soluble neprilysin (sNEP) in circulation has been suggested to be a prognostic biomarker in heart failure with a reduced ejection fraction (HFrEF). However, the diagnostic performance of sNEP is nebulous and its levels in HFrEF have not been compared with controls. For the purpose of this study, we determined the role of sNEP levels as a biomarker in routine ambulatory care of HFrEF patients, when compared to the control subjects. METHODS: Ambulant patients with chronic HFrEF (n = 18) were included. Apparently healthy volunteers - hospital physicians (n = 9) were included as the controls. Besides standard diagnostic tools (echocardiographic examination and laboratory biochemical diagnostic tests including NT-proBNP assessment), we analysed serum levels of neprilysin with a commercially available human soluble neprilysin ultrasensitive ELISA kit (Aviscera Bioscience, USA). RESULTS: Concentrations of sNEP were significantly reduced in HFrEF patients (average ± S.E.M.=1038 ± 464 pg/ml) when compared to the controls (1947 ± 613 pg/ml; p < 0.05). Two of eighteen HFrEF samples were below, while two of ten control samples were above the detection limit of the immunoassay. We documented a lack of significant correlation between sNEP and left ventricular ejection fraction (LVEF) and other echocardiographic features as well as NT-proBNP. However, sNEP significantly negatively correlated to serum natrium levels (Spearman r = ‒0.6112, p < 0.05) and to systolic blood pressure (Spearman r = ‒0.4746, p < 0.05) in HFrEF. CONCLUSION: Levels of sNEP were significantly reduced in HFrEF, when compared to the controls, with absent correlations to relevant HF-related features (e.g. LVEF). These findings might contribute to clarification of the diagnostic value of sNEP in HF (Tab. 2, Fig. 2, Ref. 30) Keywords: soluble neprilysin, heart failure, reduced ejection fraction, pharmacotherapy.

Gastric secretory investigation of recurrent ulcer after surgery for duodenal ulcer.

The results of gastric secretory studies in 192 cases of recurrent ulcer after surgery for duodenal ulcer were analyzed and compared with the secretory data collected in a control group of 74 duodenal ulcer patients who had undergone various forms of gastric surgery, but who did not develop a recurrent ulcer (controls). The patients studied comprised 46 cases of recurrent ulcer after partial gastrectomy, 10 cases of recurrent ulcer after partial gastrectomy and bilateral truncal vagotomy, 56 cases of recurrent ulcer after truncal vagotomy and drainage, 52 cases of recurrent ulcer after highly selective vagotomy, and finally 28 cases in which the recurrent ulcer led to the diagnosis of the Zollinger-Ellison syndrome. The entire study was based upon an analysis of the basal acid output, the response to maximal stimulation by pentagastrin or by histalog and by insulin in the case of previous vagotomy, and finally on an assessment of basal serum gastrin. The analysis has suggested minimal secretory levels with discriminative values useful for the postoperative diagnosis of recurrent ulcer and for an assessment of the completeness of vagotomy (ratio PAO Insulin/PAO pentagastrin or histalog). Moreover, an analysis of various elements of the sequential basal pentagastrin-insulin test permitted us to approach the pathophysiological mechanism responsible for ulcer recurrence, and to identify suitable criteria for selection of the best treatment.

[Effectiveness of live influenza vaccines obtained by strain recombination and passages]. / Effektivnost' zhivykh grippoznykh vaktsin, poluchennykh putem rekombinatsii i passazhei shtammov.

A comparative study of the immunizing activity of strain variants derived from one epidemic influenza virus A/USSR/77 (H1N1) by using different attenuation methods was carried out. Serial passages in chick embryos preserved the biological activity of the virus better than genetic recombination which was manifested by a significant superiority of the passaged virus over the reassortant in the capacity of replicating in the upper respiratory tracts of the vaccinees, of inducing immune responses and creating the protection of the portals of entry of infection. The problem of optimal preservation of biological potentials of influenza virus in the process of attenuation is discussed.

[Results of a study of the effectiveness of simultaneous immunization against influenza with live and inactivated vaccines (1980-1983)]. / Itogi izucheniia éffektivnosti odnovremennoi immunizatsii protiv grippa zhivoi i inaktivirovannoi vaktsinami (1980-1983 gg.).

A comparative evaluation of immunological and epidemiological effectiveness of commercial live and killed vaccine preparations used simultaneously or separately was first carried out in simultaneous field trials of various methods of influenza vaccine prevention in a human population of 10,449 subjects. The advantage of simultaneous immunization was confirmed by immunological parameters and protective effect in the period of influenza A epidemic of 1983. The correlation of immunological and epidemiological effectiveness of influenza vaccines in joint or separate administration is discussed.

[Immunological effectiveness of a method for simultaneous immunization against influenza using live and inactivated vaccines]. / Immunologicheskaia éffektivnost' sposoba odnovremennoi immunizatsii protiv grippa zhivoi i inaktivirovannoi vaktsinami.

A significant increase in immunological effectiveness of simultaneous immunization with a killed and live influenza vaccine as compared with separate use of these preparations has been demonstrated. The simultaneous immunization better protected the upper respiratory tracts of the vaccinated volunteers, inhibiting reproduction of the challenge influenza virus with residual virulence. A live vaccine from the "old" influenza A/6/50 (H1N1) was found to produce a protective effect on the current influenza A/1977 (H1N1) virus with residual virulence.