Evidence for negative effects of elevated intra-abdominal pressure on pulmonary mechanics and oxidative stress.

OBJECTIVE: To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy. MATERIALS AND METHODS: Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery. RESULTS: Peak inspiratory pressure, ETCO2, and pCO2 values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2 values in LC group. In BALF samples, total oxidant status (TOS), arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group. CONCLUSIONS: Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy.

Investigation of Bisphenol A as an endocrine disruptor, total thiol, malondialdehyde, and C-reactive protein levels in chronic obstructive pulmonary disease.

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a common health problem and it is associated with oxidant/antioxidant imbalance and systemic inflammation. Bisphenol A (BPA) is an endocrine disruptor agent, exerting a wide variety of metabolic effects. Also, BPA is related with oxidative stress, decreased antioxidant enzymes, and inflammation. The aim of this study is to investigate the relationships between COPD and serum BPA, C-reactive protein (CRP), malondialdehyde (MDA), and total thiol levels. PATIENTS AND METHODS: This study was enrolled at 83 subjects that they were divided into two groups: control (n=33), COPD (n=50). The serum BPA, CRP, MDA, and total thiol levels were analyzed. RESULTS: The CRP and BPA levels were significantly higher in the COPD patients than control subjects. The total thiol levels were significantly lower in COPD cases than the controls. There is no different between groups for MDA. Also, there had a linear relationship between BPA and CRP in correlation analysis. CONCLUSIONS: COPD is associated with high serum BPA, CRP and low total thiol levels in comparison with healthy individuals. It is suggested that BPA might have a role in the etiopathogenesis of COPD.

Sclerostin and Dkk-1 in patients with ankylosing spondylitis.

OBJECTIVE: To determine the serum Dickkopf-related protein 1 (Dkk-1) and sclerostin levels, and their relationship to structural damage and disease activity in patients with ankylosing spondylitis (AS), as well as to compare the serum Dkk-1 and sclerostin levels in patients receiving and not receiving anti-TNF-a treatment. MATERIALS AND METHOds: This cross-sectional study included 44 AS patients and 41 healthy age- and gender- -matched controls. Demographic data, disease activity parameters, and Bath Ankylosing Spondylitis Radiologic Index (BASRI) scores were recorded. Serum Dkk-1 and sclerostin levels were measured using commercially available ELISA. RESULTS: Serum Dkk-1 levels were lower (P > 0.05) and sclerostin levels were significantly lower (P < 0.05) in the AS patients than in the controls. Dkk-1 and sclerostin levels were similar in the patients that did and didn't receive anti-TNF-a treatment, and in the patients with active and inactive disease (P > 0.05). There wasn't a correlation between serum Dkk-1 or sclerostin levels, and disease activity indices (P > 0.05). BASRI scores did not correlate with serum Dkk-1 or sclerostin levels (P > 0.05). DISCUSSIOn: Sclerostin expression is impaired in AS, but this is not the case for Dkk-1. The lack of an association between Dkk-1 or sclerostin levels, and anti-TNF-a treatment, disease activity indices, and radiological damage might indicate that neither the Dkk-1 nor sclerostin level induce inflammation and radiological damage in AS patients. Pathologic bone formation in AS might be due to molecular dysfunction of sclerostin and Dkk-1 at the cellular level.