Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions.

Platelet size has been demonstrated to reflect platelet activity and seems to be a useful predictive and prognostic biomarker of cardiovascular events. It is associated with a variety of prothrombotic and proinflammatory diseases. The aim is a review of literature reports concerning changes in the mean platelet volume (MPV) and its possible role as a biomarker in inflammatory processes and neoplastic diseases. PubMed database was searched for sources using the following keywords: platelet activation, platelet count, mean platelet volume and: inflammation, cancer/tumor, cardiovascular diseases, myocardial infarction, diabetes, lupus disease, rheumatoid arthritis, tuberculosis, ulcerative colitis, renal disease, pulmonary disease, influencing factors, age, gender, genetic factors, oral contraceptives, smoking, lifestyle, methods, standardization, and hematological analyzer. Preference was given to the sources which were published within the past 20 years. Increased MPV was observed in cardiovascular diseases, cerebral stroke, respiratory diseases, chronic renal failure, intestine diseases, rheumatoid diseases, diabetes, and various cancers. Decreased MPV was noted in tuberculosis during disease exacerbation, ulcerative colitis, SLE in adult, and different neoplastic diseases. The study of MPV can provide important information on the course and prognosis in many inflammatory conditions. Therefore, from the clinical point of view, it would be interesting to establish an MPV cut-off value indicating the intensity of inflammatory process, presence of the disease, increased risk of disease development, increased risk of thrombotic complications, increased risk of death, and patient's response on applied treatment. Nevertheless, this aspect of MPV evaluation allowing its use in clinical practice is limited and requires further studies.

Differences in Monocyte Subsets and Monocyte-Platelet Aggregates in Acute Myocardial Infarction-PreliminaryResults.

BACKGROUND: Monocyte-platelet interaction may favor the development of a proatherogenic monocyte phenotype. It is still uncertain which of the 3 monocyte subpopulations interact with platelets to form monocyte-platelet aggregates (MPAs) in acute myocardial infarctions. The aim of our study was to evaluate the monocyte subsets, the percentage of MPAs and the involvement of monocyte subsets in MPA formation among patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), and compared to patients with stable angina (SA). METHODS: Monocyte subsets and MPAs formation were measured in blood collected in 3.2% sodium citrate tubes by means of flow cytometry. RESULTS: Classical, intermediate and nonclassical monocyte percentages were statistically different when comparing patients with STEMI and NSTEMI. Moreover, classical and intermediate monocytes were statistically different when comparing the STEMI and SA group; however, only the classical monocyte subset was found to be higher in the acute myocardial infarction group compared to the SA group. The percentage of MPAs was significantly higher in STEMI (50.1%) compared to NSTEMI (22.9%). We found no differences in the involvement of monocyte subsets in MPA formation between patients with STEMI and NSTEMI and in comparison with the SA group. CONCLUSIONS: These findings suggest that the increase in circulating levels of classical monocytes in patients with STEMI as compared to NSTEMI reflects the severity of the acute event. The increased percentage of MPAs may favor the development of STEMI compared to NSTEMI.

The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes.

INTRODUCTION: Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/ß-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease. MATERIALS AND METHODS: The study group included 93 patients categorized into 3 subgroups depending on the severity of signs and symptoms of ACS. PLT, MPV, LPLT, and WBC were determined on hematological analyzer, IL-6 and ß-TG were measured using the ELISA method. RESULTS: In the whole group of ACS patients WBC, CRP, IL-6, MPV, and ß-TG were significantly higher as compared to controls. Analyzing the inflammation and platelet biomarkers depending on the severity of signs and symptoms in comparison to controls, statistically significant differences for above-mentioned parameters were also found. There were no significant differences between the advancement of coronary artery changes and inflammation as well as platelet parameters, except for CRP concentrations. The AUCs for all inflammation parameters tested were similar, however the highest AUCs showed WBC and CRP. Among platelet parameters the highest AUC revealed ß-TG. CONCLUSION: Markers of inflammation and platelet activation may be associated to myocardial ischemia and myocardial injury. WBC, CRP and IL-6 as inflammation parameters and MPV and ß-TG as platelet biomarkers may be useful indicators of the presence of coronary artery disease.

CXCL9, CXCL10, CXCL11, and their receptor (CXCR3) in neuroinflammation and neurodegeneration.

The aim of this review is to present data from the available literature concerning CXCL9, CXCL10 and CXCL11, as well as their receptor 3 (CXCR3) in selected diseases of the central nervous system (CNS), such as tickborne encephalitis (TBE), neuroborreliosis (NB), Alzheimer's disease (AD), and multiple sclerosis (MS). CXCL9, CXCL10, and CXCL11 lack glutamic acid-leucine-arginine (ELR), and are unique, because they are more closely related to each other than to any other chemokine. The aforementioned chemokines are especially involved in Th1-type response and in various diseases, as their expression correlates with the tissue infiltration of T cells. Their production is strongly induced by interferon gamma (IFN-υ), the most typical Th1 cytokine. They act by binding to the CXC3 receptor. Knowledge about the action mechanism of CXCR3 and its ligands may be useful in the treatment of CNS diseases. However, data in the literature concerning the evaluation of CXCL9, CXCL10, CXCL11, and their receptor with the use of the enzyme-linked immunosorbent assay (ELISA) method is limited.

The isoform A of reticulon-4 (Nogo-A) in cerebrospinal fluid of primary brain tumor patients: influencing factors.

BACKGROUND: The influence of isoform A of reticulon-4 (Nogo-A), also known as neurite outgrowth inhibitor, on primary brain tumor development was reported. Therefore the aim was the evaluation of Nogo-A concentrations in cerebrospinal fluid (CSF) and serum of brain tumor patients compared with non-tumoral individuals. RESULTS: All serum results, except for two cases, obtained both in brain tumors and non-tumoral individuals, were below the lower limit of ELISA detection. Cerebrospinal fluid Nogo-A concentrations were significantly lower in primary brain tumor patients compared to non-tumoral individuals. The univariate linear regression analysis found that if white blood cell count increases by 1 × 103/µL, the mean cerebrospinal fluid Nogo-A concentration value decreases 1.12 times. In the model of multiple linear regression analysis predictor variables influencing cerebrospinal fluid Nogo-A concentrations included: diagnosis, sex, and sodium level. The mean cerebrospinal fluid Nogo-A concentration value was 1.9 times higher for women in comparison to men. In the astrocytic brain tumor group higher sodium level occurs with lower cerebrospinal fluid Nogo-A concentrations. We found the opposite situation in non-tumoral individuals. CONCLUSIONS: Univariate linear regression analysis revealed, that cerebrospinal fluid Nogo-A concentrations change in relation to white blood cell count. In the created model of multiple linear regression analysis we found, that within predictor variables influencing CSF Nogo-A concentrations were diagnosis, sex, and sodium level. Results may be relevant to the search for cerebrospinal fluid biomarkers and potential therapeutic targets in primary brain tumor patients. MATERIALS AND METHODS: Nogo-A concentrations were tested by means of enzyme-linked immunosorbent assay (ELISA).

CXCL9 concentrations in cerebrospinal fluid and serum of patients with tick-borne encephalitis.

INTRODUCTION: The aim of our current study was to evaluate cerebrospinal fluid (CSF) and serum CXCL9 concentrations and diagnostic usefulness of this molecule in tick-borne encephalitis (TBE). The study included TBE patients in the acute phase (TBE I) and after 2 weeks of follow-up (TBE II). The control group consisted of patients investigated for suspected central nervous system (CNS) infection, but with normal CSF findings. MATERIAL AND METHODS: Concentrations of CXCL9 were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: Cerebrospinal fluid and serum concentrations of CXCL9 in patients with TBE were significantly higher than in controls (p < 0.001). This alteration was also observed in the case of the CXCL9 index (ICXCL9; CSF CXCL9 concentration divided by serum CXCL9 concentration) (p < 0.001); moreover, ICXCL9 significantly decreased after 2 weeks (p < 0.001). This is the first study to evaluate the CSF and serum levels of CXCL9 in subjects with TBE. CONCLUSIONS: CXCL9 is a ligand for CXCR3, which was found on all Th1 memory lymphocytes present in the peripheral blood; therefore the elevated concentrations of CXCL9 in TBE patients as compared to the controls might indicate that this chemokine perhaps takes part in the trafficking of Th1 cells into the CNS. The results presented here support the hypothesis that CXCL9 may play a role in TBE. However, further studies are required to determine whether this protein might be used as a potential tool for the diagnosis and monitoring of inflammation in TBE.

[Difficulties in classifying body cavity fluids into transudate/ exudate depending on the various diagnostic criteria]. / Trudnosci w klasyfikacji plynów z jam ciala na przesiek/wysiek na podstawie róznych kryteriów diagnostycznych.

Disease processes may impair the production and reabsorption of fluid from in the body cavities, which results in its excessive accumulation. AIM: The aim of the study was the evaluation of difficulties regarding the classification of fluids from the body cavities into transudate/exudate observing the following: Light's criteria, total fluid protein concentration, and total protein ratio (TP ratio) and lactate dehydrogenase ratio (LDH ratio). MATERIALS AND METHODS: Retrospective analysis was conducted on pleural (N=314), peritoneal (N=114) and pericardial (N=10) fluids, which were tested for the total protein concentration and LDH activity both in fluid and serum and calculated on TP ratio and LDH ratio. RESULTS: Based on the total protein concentration, 278 fluids from pleural cavity were classified as an exudate; 36 as a transudate. Applying the Light's criteria 240 fluids were classified as an exudate; the remaining 74 fluids were classified as a transudate. Based on TP and LDH ratios, 229 fluids from pleural cavity were classified as an exudate; 85 as a transudate. Depending on the total protein concentration, 35 fluids from the peritoneal cavity were classified as an exudate; 79 as a transudate. Applying the Light's criteria 54 fluids were classified as an exudate; the remaining 60 fluids were classified as a transudate. Based on TP and LDH ratios, 22 fluids from peritoneal cavity were classified as an exudate; 92 as a transudate. Analysis of pericardial fluids, depending on the total protein concentration classified 9 of them as an exudate and 1 as a transudate. The same results were obtained by applying Light's criteria. Based on TP and LDH ratios, 7 fluids from pericardial cavity were classified as an exudate; 3 - as a transudate. CONCLUSIONS: Applying the Light's criteria or the total protein concentration in differential diagnostics of fluids from the body cavities resulted in qualification more of them as an exudates as compared to the analysis of the same fluids depending on the TP and LDH ratios. It can be assumed that some of the transudative/exudative fluids were incorrectly classified. Performed analysis suggest that more adequate criteria of the classification of fluids from the body cavities into transudate/exudate are of great importance.

Markers of inflammation and influence of nitric oxide on platelet activation in the course of ulcerative colitis.

Ulcerative colitis is a non-specific inflammatory bowel disease of unknown etiology. We investigated whether severe form of ulcerative colitis may lead to increased number of platelets, changes in platelet parameters and their activation. To address our objectives, we measured concentrations of nitric oxide and markers of inflammation. We found increased number of low-volume platelets in a group of affected patients. However, their activity was not as high as expected. In addition to that we observed eight times higher concentration of nitric oxide in patients suffering from ulcerative colitis than in healthy individuals. Besides, severe form of the disease manifested itself with increased concentrations of interleukine 6, matrix metalloproteinase-9 and neopterin. Based on the results we propose that high amounts of nitric oxide inhibit platelet activation in severe form of ulcerative colitis. Moreover, our observations regarding interleukine 6, matrix metalloproteinase-9 and neopterin suggest that they may become useful markers of active form of ulcerative colitis.

Multiple sclerosis - etiology and diagnostic potential.

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS) damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPSM), primary progressive multiple sclerosis (PPMS), and progressive-relapsing multiple sclerosis (RPMS). Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald's diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

Lectin adhesion proteins (P-, L- and E-selectins) as biomarkers in colorectal cancer.

CONTEXT: Selectins probably participate in the interactions between platelets and other inflammatory cells in cancer invasion and metastasis formation. We assessed a potential relationship of P-, L- and E-selectin in colorectal cancer (CRC) patients in relation to tumour advancement according to TNM classification, and tumour location. MATERIALS AND METHODS: The study group was composed of 53 CRC patients and 25 healthy subjects. Plasma levels of soluble P-, L- and E-selectins were measured using the immunoenzymatic method with Quantikine kits (R&D Systems, Minneapolis, MN). RESULTS: The mean levels of all selectins were significantly higher in CRC patients compared to healthy controls. The highest level of sP-selectin was observed in patients with metastases to the liver (stage IV), and was significantly higher than in patients without metastases (stage I/II) and with lymph node metastases (stage III), p = .02. The highest levels of sL- and sE-selectin were observed in patients with lymph node metastasis. We also found sP-selectin to be the best predictor of CRC. CONCLUSION: Our finding show possible involvement of tested selectins in CRC advancement and forming metastasis. Among sL- and E- selectins, P-selectin plays an important role in the progression of CRC and could be an attractive biomarker with clinical significance.

Serum soluble CD40L concentration depending on the stage of multiple myeloma and its correlation with selected angiogenic cytokines.

INTRODUCTION    Little is known about the CD40L-CD40 pathway in hematologic malignancies, especially in multiple myeloma (MM). OBJECTIVES    The aim of the current study was to evaluate serum soluble CD40 ligand (sCD40L) concentrations in patients with newly diagnosed MM prior to treatment at different stages of disease, compared with healthy controls. To assess the clinical significance of sCD40L, we assessed correlations between the levels of sCD40L and those of angiogenic cytokines: interleukin 6 (IL-6), soluble receptor of IL-6 (sIL-6R), tumor necrosis factor α (TNF-α), soluble vascular cell adhesion molecule 1 (sVCAM-1), and platelet-derived growth factor AB (PDGF-AB), as well as with well-established biomarkers of MM activity (lactate dehydrogenase activity and percentage of bone marrow plasma cells) and with a marker of platelet activation (ß-thromboglobulin). PATIENTS AND METHODS    The study group consisted of 41 patients with newly diagnosed MM; the control group consisted of 30 healthy subjects. The level of sCD40L was determined using an enzyme-linked immunosorbent assay. RESULTS    The level of sCD40L was significantly higher in patients with MM than in controls and increased with the stage of the disease. Moreover, it significantly correlated with the levels of IL-6, sIL-6R, sVCAM-1, PDGF-AB, as well as the levels of MM activity markers and ß-thromboglobulin. CONCLUSIONS    Our findings indicate that increased serum sCD40L levels may be related to angiogenesis in patients with MM. This protein has potential clinical usefulness in MM and may be considered as an additional prognostic marker. The correlation of sCD40L with ß-thromboglobulin may indicate that in patients with MM sCD40L derives from activated platelets.

Application of the Bead-Based Technique in Neurodegeneration: A Literature Review.

BACKGROUND: Alzheimer's disease (AD) is the most common disease causing neurodegeneration. The lower concentration of ß-amyloid 1-42 (Aß1-42) together with increased levels of total tau protein (T-tau) and phosphorylated tau protein (P-tau) in the cerebrospinal fluid (CSF) make a panel of well-established biomarkers in AD diagnosis. Addition of novel biomarkers to the gold standard biomarker panel might improve the diagnostic accuracy of neurodegeneration. This goal might be reached by the use of multiplexing, which is a simultaneous measurement of multiple analytes in a single sample volume and within a single cycle or run. OBJECTIVE/METHODS: Therefore the aim of the current review was to present, according to our best knowledge, available data concerning the evaluation of concentrations and diagnostic accuracy of well-established biomarkers in AD as well as novel biomarkers analyzed with the use of the bead-based technique. Additionally we discuss the utilization of the bead-based technique as compared to the conventional ELISA method. RESULTS: Literature data indicate that the bead-based technique revealed diagnostic sensitivity, specificity and coefficients of variation at the levels similar to ELISA. Moreover, an addition of novel biomarkers (tested by means of the bead-based technique) to the gold standard biomarker panel improved the diagnostic accuracy of neurodegeneration. CONCLUSION: Review of literature data shows that the combined analysis of classical CSF biomarkers with novel biomarkers might increase the specificity and sensitivity of performed tests. However, we concluded that the replacement of conventional ELISA with the bead-based technique requires new reference intervals for Aß1-42, T-tau and P-tau concentrations.

Effect of nonsurgical periodontal treatment in conjunction with either systemic administration of amoxicillin and metronidazole or additional photodynamic therapy on the concentration of matrix metalloproteinases 8 and 9 in gingival crevicular fluid in patients with aggressive periodontitis.

BACKGROUND: To evaluate in patients with aggressive periodontitis (AgP) the effect of nonsurgical periodontal treatment in conjunction with either additional administration of systemic antibiotics (AB) or application of photodynamic therapy (PDT) on the gingival crevicular fluid (GCF) concentration of matrix metalloproteinases 8 and 9 (MMP-8 and -9). METHODS: Thirty-six patients with AgP were included in the study. Patients were randomly assigned to treatment with either scaling and root planing (SRP) followed by systemic administration of AB (e.g. Amoxicillin + Metronidazole) or SRP + PDT. The analysis of MMP-8 and -9 GCF concentrations was performed at baseline and at 3 and 6 months after treatment. Nonparametric U-Mann-Whitney test was used for comparison between groups. Changes from baseline to 3 and 6 months were analyzed with the Friedman's ANOVA test with Kendall's index of consistency. RESULTS: In the AB group, patients showed a statistically significant (p = 0.01) decrease of MMP-8 GCF level at both 3 and 6 months post treatment. In the PDT group, the change of MMP-8 GCF level was not statistically significant. Both groups showed at 3 and 6 months a decrease in MMP-9 levels. However, this change did not reach statistical significance. CONCLUSIONS: Within the limits of the present study, it may be suggested that in patients with AgP, nonsurgical periodontal therapy in conjunction with adjunctive systemic administration of amoxicilin and metronidazole is more effective in reducing GCF MMP-8 levels compared to the adjunctive use of PDT.

sVCAM-1 concentration and carotid IMT values in patients with acute myocardial infarction--Atherosclerotic markers of the presence, progress and prognosis.

PURPOSE: Vascular cell adhesion molecule 1 (VCAM-1) plays a role in the adhesion and migration of leukocytes from blood to arterial intima and correlate with the development of atherosclerosis. The aim of the study was to establish whether soluble VCAM-1 (sVCAM-1) may act as an independent risk factor of coronary artery disease occurrence and whether it may reflect a degree of its advancement, if sVCAM-1 has a potential relation with intima-media thickness measurement (IMT), if sVCAM-1 may be useful as a predictor of further cardiovascular events. MATERIAL AND METHODS: The study group was composed of 78 patients who were consecutively hospitalized in 2010-2011 due to myocardial infarction (MI). Selected clinical and biochemical risk factors were assessed, sVCAM-1 concentrations and IMT were measured. RESULTS: Concentrations of sVCAM-1 were significantly higher in the study group as compared to the healthy controls. No significant dependence between sVCAM-1 concentration and the value of IMT in carotid arteries was found. There were no significantly statistical differences between the advancement of coronary artery changes and sVCAM-1 concentration. During the follow-up that lasted from 2 to 4 years (average period - 2.8 years), 4 patients died in the study group (5.1%). sVCAM-1 concentrations (but not IMT values) were significantly statistically higher in the group of patients who died (2248.5±443.5 vs. 990.2±433.6, p=0.0003). CONCLUSIONS: sVCAM-1 concentrations are useful indicators of the presence of atherosclerosis in coronary arteries, but not its advancement. sVCAM-1 (but not IMT) can be a predictive indicator of an increased risk of death during follow-up in patients after myocardial infarction.

Does thrombopoiesis in multiple myeloma patients depend on the stage of the disease?

PURPOSE: Infiltration of the bone marrow by neoplastic plasmocytes in multiple myeloma (MM) patients might impair megakaryocytopoiesis. The aim of the study was to evaluate stage-dependent platelet count (PLT) and thrombopoietin (TPO) concentration in comparison to the control group. We also wanted to establish whether TPO might be recognized as a marker of the stage of the disease. MATERIAL/METHODS: The study group consisted of 41 patients (mean age 67.7) with newly diagnosed MM prior to treatment and categorized according to the Durie and Salmon diagnostic classification. The control group consisted of 30 healthy subjects (mean age 65.5). PLT, WBC, RBC and Hb were measured with the use of the haematological analyser. TPO was assayed with the use of ELISA and albumin with the use of the immunonephelometry method. The number of plasma cells in the bone marrow was evaluated in bone marrow smears under light microscopy. RESULTS: PLT was not statistically different as compared the control groups, but was stage-dependent. Thrombocytopenia was observed in the III stage of MM. TPO median was significantly higher in study group than in healthy subjects and it was increasing considerably with the stage of the disease. TPO concentration was negatively correlated with albumin and PLT. AUC for TPO was 0.9764. The number of plasma cells in the bone marrow was considerably increasing with the stage of the disease. CONCLUSIONS: PLT and TPO in MM patients were stage-dependent. Elevated TPO concentration in MM patients might be an unfavourable marker of the stage of the disease.

Multifunctional CD40L: pro- and anti-neoplastic activity.

The CD40 ligand is a type I transmembrane protein that belongs to a tumor necrosis factor (TNF) superfamily. It is present not only on the surface of activated CD4+ T cells, B cells, blood platelets, monocytes, and natural killer (NK) cells but also on cancer cells. The receptor for ligand is constitutively expressed on cells, TNF family protein: CD40. The role of the CD40/CD40L pathway in the induction of body immunity, in inflammation, or in hemostasis has been well documented, whereas its involvement in neoplastic disease is still under investigation. CD40L ligand may potentiate apoptosis of tumor cells by activation of nuclear factor-κB (NF-κB), AP-1, CD95, or caspase-depended pathways and stimulate host immunity to defend against cancer. Although CD40L has a major contribution to anti-cancer activity, many reports point at its ambivalent nature. CD40L enhance release of strongly pro-angiogenic factor, vascular endothelial growth factor (VEGF), and activator of coagulation, TF, the level of which is correlated with tumor metastasis. CD40L involvement in the inhibition of tumor progression has led to the emergence of not only therapy using recombinant forms of the ligand and vaccines in the treatment of cancer but also therapy consisting of inhibiting platelets-main source of CD40L. This article is a review of studies on the ambivalent role of CD40L in neoplastic diseases.

IgE antibodies in toxoplasmosis.

Toxoplasmosis is a worldwide infection caused by the intracellular parasite Toxoplasma gondii. At least a third of the world human population is infected with the parasite, making it one of the most successful parasitic infections. Primary maternal infection may cause health-threatening sequelae for the fetus, or even cause death of the uterus. Reactivation of a latent infection in immune deficiency conditions such as AIDS and organ transplantation can cause fatal toxoplasmic encephalitis. Toxoplasmosis is a major cause of chorioretinitis, especially in individuals with impaired immune systems. In the acute phase, directly after invading the body, T. gondii begins to multiply rapidly. In the majority of cases acquired toxoplasmosis is asymptomatic. In the second week of infection, specific IgM antibodies are present in the blood. IgE antibodies appear at the same time, slightly preceding specific IgA antibodies. The concentration of IgE can be one of the parameters used for diagnosing an infection with T. gondii. Laboratory diagnosis, i.e. IgE and serologic assays, plays the main role in the diagnosis of congenital infection and assists in the confirmatory diagnosis of toxoplasmic encephalitis and ocular toxoplasmosis. This article is a review of IgE in toxoplasmosis.

Potential role of soluble CD40 ligand as inflammatory biomarker in colorectal cancer patients.

Platelet activation observed in cancer patients is associated with the release of various cytokines, including P-selectin and CD40 ligand (CD40L). We analyzed the plasma levels of sCD40L in association with adhesion molecules (sP-selectin and sVCAM-1) to check the hypothesis of a possible involvement in cancer progression.Blood samples were obtained from 59 patients with different stages of colorectal cancer (CRC) and 29 age and gender-matched control subjects. Plasma sCD40L, sP-selectin, and sVCAM-1 concentrations were measured with quantitative sandwich enzyme-linked immunoassay.All patients with CRC had significantly higher levels of sCD40L (p<0.001), sP-selectin (p<0.02), and sVCAM-1 (p<0.03), as compared to healthy subjects. The level of sCD40L significantly correlated with sP-selectin (p<0.05) in patients with distant metastases to the liver. We also observed a high negative correlation between sP-selectin and platelets count (p<0.02) in patients with lymph node metastasis. The receiver-operator curve for CRC patients indicated that the area under the curve for sCD40L was 0.915, which may indicate its high efficiency as an inflammatory marker.In our study, the sCD40L correlated with sP-selectin in patients with advanced stage of CRC, which might indicate its possible participation in metastasis formation.

The effect of perioperative immunonutrition on the phagocytic activity of blood platelets in advanced gastric cancer patients.

BACKGROUND AND AIMS: Perioperative immunonutrition can influence the phagocytic activity of platelets in advanced gastric cancer. METHODS: 51 patients with stage IV gastric cancer divided into four groups depending on the clinical status and 40 normal donors were analyzed. Patients of groups I and II underwent palliative gastrectomy. Patients of groups III and IV had exploratory laparotomy. Perioperative immunonutrition was administered as follows: group I--TPN, II--oral arginine, peripheral TPN, III--TPN preoperatively, and IV--without nutrition. The phagocytic activity of blood platelets was determined before and after nutritional therapy and was assessed by measuring the fraction of phagocytic thrombocytes (%phag) and the phagocytic index (Ixphag). RESULTS: The percentage of phagocytizing platelets and the phagocytic index prior to and after the surgery amounted to the following: group I--1.136-1.237, P = NS, and 1.007-1.1, P = NS, respectively, II--1.111-1.25, P < 0.05, and 1.011-1.083, P < 0.05, III--1.112-1.186, P = NS, and 0.962-1.042, P = NS, and IV--1.085-0.96, P = NS, and 1.023-1.04, P = NS. CONCLUSIONS: The phagocytic activity of platelets in patients with advanced gastric cancer is significantly impaired. Perioperative immunonutrition with oral arginine-rich diet can partially improve the phagocytic activity of blood platelets. This trial is registered with Clinicaltrials.gov--NCT01704664.