Prolidase could be considered a sign of inflammation associated with cigarette smoking.

Objectives: Smoking causes inflammation, thickening, and narrowing of the airways. This inflammatory process is a reaction to free radicals and oxidants. Smoking affects collagen metabolism and tissue remodeling. Prolidase enzyme hydrolyzes iminodipeptides with hydroxyproline and C terminal proline. It plays a crucial role in the metabolism of collagen and the remodeling of the matrix. The present study aims to reveal the association of prolidase with inflammation caused by smoking and to compare serum prolidase levels with oxidative-antioxidative status in healthy individuals. Methods: A total of 76 participants (38 smokers and 38 nonsmokers) were involved in the present study. Serum cotinine levels were measured to show the exposure to nicotine in tobacco smoke by using the competitive inhibition enzyme immunoassay method. Serum prolidase, total oxidant status (TOS), and total antioxidant status (TAS) were determined by the enzyme-linked immunosorbent (ELISA) method, respectively. The correlation between smoking, serum prolidase levels, TOS, and TAS was investigated. Results: TAS and serum prolidase levels of smokers were considerably lower than those in non-smokers (p < 0.001, p = 0.012 respectively). However, no differences were observed in TOS between the two groups. There was no statistically significant correlation between serum prolidase levels, TAS, and TOS. Moreover, no relationship was observed between respiratory function parameters and serum prolidase levels. Conclusion: To the best of our knowledge, the present study is the first study to demonstrate the role of prolidase in smoking-related inflammation. The results achieved in the present study suggest that smoking creates an imbalance in the oxidant-antioxidant activity. Smoking decreases prolidase levels, leading to decreased collagen turnover. Chronic pulmonary disease might be related to this decrease in collagen turnover.

Role of prolidase activity and oxidative stress biomarkers in unexplained infertility.

OBJECTIVE: Our aim was to explore the significance of serum prolidase enzyme activity and oxidative stress in women with unexplained infertility (UEI). METHODS: In this case-control study (n = 160; 86 cases; 74 controls) prolidase enzyme activity and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and vitamin E were measured in plasma using enzyme-linked immunosorbent assays. RESULTS: Prolidase enzyme activity and TAS levels were particularly higher in the patient group (P = 0.013, P = 0.001, respectively). Decreased OSI levels were detected in the patient group (P = 0.001). There was a positive relationship of prolidase with vitamin E in both patient and control groups (r = 0.892, P = 0.001, and r = 0.659, P = 0.001, respectively). A positive, but weak, relationship was identified between prolidase activity and TOS levels and also between vitamin E and TOS levels in the UEI group (r = 0.265, P = 0.049, and r = 0.288, P = 0.014, respectively). No association was found between prolidase and TOS levels or between vitamin E and TOS levels in the control group (r = 0.0097, P = 0.527, and r = 0.085, P = 0.610, respectively). CONCLUSION: Our results showed an association between serum prolidase activity and oxidative stress in UEI patients. Further studies including greater groups are required to show the role of reactive oxygen species in UEI.

Serum and placental periostin levels in women with early pregnancy loss.

OBJECTIVES: Periostin is secreted from the placenta in the embryonic period and it is emphasized that it may be involved in endometrial implantation. In this study, we aimed to investigate periostin serum levels and placental tissue expression in first trimester pregnancy losses. STUDY DESIGN: In this prospective case-control study, 30 patients who underwent dilatation and curettage with first trimester spontaneous abortion (<10 weeks of gestation) were included in the study group and 30 patients who had voluntary pregnancy termination (<10 gestational weeks) were included in the control group. Serum samples collected from the study and control groups were analyzed usingenzyme-linkedimmunosorbent assay (ELISA), and trophoblastic and decidual tissues were examined using immunohistochemical staining with streptavidin-biotin-peroxidase techniques. RESULTS: There were no significant differences between the groups in terms of age, gravida status, parity number, gestational week, and number of previous abortions. In the spontaneous abortion group, the serum level of periostin was significantly lower than in the voluntary termination group (6.56 ± 4.16 pg/mLvs. 9.51 ± 4.52 pg/mL, p = 0.03). There was no significant difference between the two groups in terms of periostin expression in decidual and trophoblastic tissue (p = 0.617, p = 0.274, p = 0.497). CONCLUSION: Periostin serum levels were significantly reduced in patients with spontaneous pregnancy loss. Periostin can be used as a predictive marker for the success of endometrial implantation.

Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester.

Objectives: Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected for the first time in pregnancy or identified during pregnancy. Mean platelet volume (MPV) is a marker of activation and function of platelet. Several studies investigated the relation between MPV and GDM. The purpose of the present study is to predict GDM in the first trimester by using MPV value.Materials and methods: Two hundred pregnant women with GDM and 200 normal pregnant women were enrolled in the study. The first trimester MPV values of GDM and control groups were compared to predict GDM in the first trimester.Results: Women with GDM had higher MPV value compared with the control group (p < .001). The area under the receiver-operator curve was 0.70 for MPV. The cutoff value of MPV was 7.38 fl with 70% sensitivity and 60% specificity. According to the ages, MPV value was higher in GDM group in the individuals who were above 28-year-old (p < .001).Conclusion: MPV can be used to predict GDM in the first trimester.

The effect of pregabalin on tourniquet-induced ischemia-reperfusion injury: a prospective randomized study

Background/aim: The aim of this study was to investigate the efficacy of pregabalin on ischemia-reperfusion injuries. Materials and methods: Fifty-four patients were randomly assigned into 2 groups. A 150-mg tablet of pregabalin was given the night before and then 1 h before the operation for patients in Group P (pregabalin group, n = 27). A placebo was given to patients in Group C (control group, n = 27) at the same times. After combined spinal-epidural anesthesia was performed, venous blood samples were taken before tourniquet inflation (t1), just before tourniquet deflation (t2), and 20 min after tourniquet deflation (t3) for the analysis of total antioxidant status (TAS), total oxidant status (TOS), catalase (CAT), and ischemia-modified albumin (IMA). Results: There was no significant difference in TAS levels between the groups for the t3 period. However, the TAS in Group P was significantly higher in the t3 period than the t2 period (mean ± SD, 0.46 ± 0.1 vs. 0.38 ± 0.2 mmol of Trolox equivalent/L, respectively; P < 0.05). The CAT level in the t3 period was significantly higher in Group P than Group C (mean ± SD, 53.04 ± 32.1 vs. 35.46 ± 17.2 µmol/ formaldehyde, respectively; P < 0.05). In the t3 period, the TOS was significantly lower in Group P than Group C (mean ± SD, 11.97 ± 5 vs. 18.29 ± 9.9 pg/mL, respectively; P < 0.05). The TOS in Group P was significantly lower in the t3 period than the t2 period (mean ± SD, 11.97 ± 5 vs. 18.98 ± 10.7 pg/mL, respectively; P < 0.0001). Conclusion: Pregabalin has no marked antioxidant activity, but it contributes to the antioxidant defense system of an organism.

Vitamin D receptor gene TaqI single nucleotide polymorphism is not associated with lead levels in maternal and umbilical cord blood.

PURPOSE: We aimed to investigate the association of vitamin D receptor (VDR) gene TaqI single nucleotide polymorphism (SNPs) with serum lead (Pb) levels in maternal and umbilical cord blood. MATERIALS AND METHODS: Eighty-one patients who lived in Konya, Turkey for the last 3 years and had delivery at Baskent University Konya Hospital in 2016 were included in this study. Venous blood samples were drawn from each volunteer immediately before giving birth to determine the maternal Pb levels and VDR SNPs. Additionally, umbilical cord blood samples were collected from the umbilical vein into tube with EDTA as an anticoagulant immediately after birth to determine Pb levels of the fetus. RESULTS: The median level of Pb in the maternal blood was 29.00 (Interquartile Range (IQR) = 16.35) µg/L and the median Pb level in the cord blood was 22.50 (IQR = 9.75) µg/L. Blood Pb level of women living in the urban area was significantly higher than in those living in the rural area (Z = 2.118; p = .034). There was a very strong positive correlation between the Pb levels in the maternal blood and in the umbilical cord blood (ρ = 0.825, p < .001, respectively). Regarding VDR SNPs, "TT", "TC", and "CC" VDR TaqI genotypes were observed in 28 (34.6%), 45 (55.5%), and eight samples (9.9%), respectively. Pb levels in maternal and cord blood were higher in women with the "CC" VDR TaqI genotype; however, there was no statistically significant difference (p > .05). CONCLUSIONS: Although women with the "CC" VDR TaqI genotype had higher maternal and cord blood Pb levels, this was statistically insignificant and therefore, VDR TaqI SNPs did not significantly affect maternal and umbilical cord blood Pb levels.

Association of Cytotoxic T Lymphocyte Antigen-4 Gene Polymorphisms with Psoriasis Vulgaris: A Case-Control Study in Turkish Population.

Psoriasis is a common, chronic, and autoimmune skin disease in which dysregulation of immune cells, particularly T cells, is thought to play an important role in the pathogenesis. Cytotoxic T lymphocyte antigen-4 (CTLA-4) expressed only on activated T cells is an immunoregulatory molecule and plays a role in the pathogenesis of autoimmune disorders. We aimed to determine whether CTLA-4 gene polymorphisms are associated with development and/or clinical features of psoriasis vulgaris (Pv). Genotyping of SNPs (-318C>T, +49A>G, and CT60A>G) in CTLA-4 gene was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 103 Pv patients and 102 controls. No statistically significant associations were detected in any of the investigated genetic models for the -318C>T polymorphism. The genotype distributions of +49A>G and CT60A>G were associated with Pv development. In haplotype analysis, while frequency of CAA haplotype was significantly higher in the control group, frequencies of CGG and CAG haplotype were significantly higher among the patients. However, all of CTLA-4 polymorphisms and haplotypes do not have an effect on severity and onset age of Pv. In conclusion, the +49A>G and CT60A>G polymorphisms may be risk factors for Pv development. Furthermore, CGG and CAG haplotypes may contribute to Pv development, while CAA haplotype may be protective against Pv.

Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases.

BACKGROUND: Ostructive sleep apnea (OSA) is an independent risk factor for the development of cardiovascular events. Platelet activation and inflammation are the mechanisms involved in the association between OSA and cardiovascular disease (CVD). The markers of platelet activation and inflammation are the mean platelet volume (MPV), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), neutrophil- lymphocyte ratio (NLR). We aimed to define the association of NLR, PLR, RDW, and MPV with the severity of disease and the presence of CVD. METHODS: This study consisted of 300 patients who were admitted to the sleep laboratory. The patients were classified according to their apnea- hypopnea index (AHI) scores as OSA negative (Group A: AHI<5), mild (Group B: AHI: 5-15), moderate (Group C: AHI=15-30), and severe OSA (Group D: AHI >30). RESULTS: There were no significant differences in the NLR, PLR, and MPV among the groups (P>.05); only RDW differed significantly (P=.04). RDW was significantly higher in patients with than without risk factors for CVD [15.6% (15.4-15.7) vs 15.3% (15.1-15.3), respectively; P=.02]. CONCLUSIONS: NLR, PLR, MPV, and RDW are widely available and easily obtained from a routinely performed hemogram. Among these laboratory parameters, only RDW can demonstrate the reverse consequences of OSA-associated comorbidities, because vascular damage due to systemic inflammation is an important underlying mechanism in these diseases. RDW might be used as a marker of the response and patient compliance with continuous positive airway pressure treatment.

Parathyroid Hormone Levels in the Prediction of Ischemic Stroke Risk.

Objective. It was examined whether PTH and 25-dihydroxyvitamin D (25(OH)D) levels, together or separately, are indicators of the risk of stroke. Materials and Methods. This prospective study was performed at two centers. In the study, 100 patients diagnosed with acute ischemic stroke and 100 control individuals in the same age range were examined. In addition to neurological examination, cranial imaging, extensive routine blood chemistry, PTH, and 25(OH)D levels were evaluated in all cases. Stroke risk factors were determined. Logistic regression was used for statistical analysis. Results. A total of 60 patients and 79 control individuals were included in the study. Different estimation models were designed in order to examine the relationship between PTH and 25(OH)D levels with stroke. According to modeling results, it was determined that the most effective predictor for risk of stroke was 25(OH)D levels, followed by hypertension and PTH levels, respectively. Conclusion. PTH and 25(OH)D levels together can make important contributions to determination of stroke risk, and further investigations are needed to understand this relationship more fully.

Is there a Real Correlation between Red Cell Distribution Width and Peripheral Arterial Disease?

BACKGROUND: Few data is available concerning the association between peripheral arterial disease (PAD) and red cell distribution width (RDW). In this study, we analyzed the relationship between RDW and atherosclerosis of the vessels other than coronary arteries in patients who had undergone digital substraction angiography (DSA). METHODS: This study included 730 patients who had undergone DSA. Patients were divided into two groups according to their angiographic images. The association between RDW and atherosclerosis of peripheral arteries was analyzed. The relationship between atherosclerosis and smoking, hypertension (HT), diabetes mellitus (DM), hs-CRP, hemoglobin, white blood cell (WBC), triglyceride, total cholesterol, HDL and LDL cholesterol levels was assessed. RESULTS: Atherosclerosis was observed more common in male and patients with older age, HT, DM and smoking (p<0.001). hs-CRP and WBC levels were both in significantly positive association with atherosclerosis (p<0.05). However, there were no significant differences in the RDW levels, hemoglobin, triglyceride, total cholesterol, LDL and HDL cholesterol levels in the groups (p>0.05). CONCLUSION: Our results seem to demonstrate that older age, male gender, HT, DM and smoking are powerful risk factors for PAD. In contrast to the previous reports, RDW levels are found not to be associated with atherosclerosis of peripheral arteries.

Aqueous Humour and Serum Levels of Nitric Oxide, Malondialdehyde and Total Antioxidant Status in Patients with Type 2 Diabetes with Proliferative Diabetic Retinopathy and Nondiabetic Senile Cataracts.

OBJECTIVES: Diabetic retinopathy is associated with enhanced oxidative stress and/or reduction of antioxidant status. Several studies have examined the oxidative agents, such as nitric oxide (NO) and malondialdehyde (MDA), in the body fluids of patients with diabetes. However, total antioxidant status (TAS) in the aqueous humour of patients with diabetes has not been determined to date. To address this issue, we analyzed the aqueous humour and serum levels of NO, MDA and TAS in patients with type 2 diabetes and nondiabetic senile cataracts. METHODS: This prospective study included 35 patients with type 2 diabetes and 35 age- and sex-matched healthy subjects in whom cataract surgery was indicated. Aqueous humour and serum MDA, NO and TAS levels were determined by spectrophotometric methods, respectively. RESULTS: The analysis of MDA levels in the serum and aqueous humour revealed no significant differences in any of the groups (p>0.05). At the level of aqueous humour, patients with type 2 diabetes had significantly increased NO levels, compared to the controls (p=0.003). The control group also presented significantly higher TAS levels than the subgroup with type 2 diabetes in serum (p=0.001). However, there were no significant differences in the TAS levels of aqueous humour and serum NO levels in the groups (p>0.05). CONCLUSIONS: Our results seem to demonstrate that the development of diabetic retinopathy is associated with high levels of aqueous humour NO and reduced serum antioxidant defenses. Therefore, inhibition of reactive oxygen species production and substitution of serum antioxidant status may be a therapeutic target for eye diseases associated with oxidative stress.

Oxidative stress and nasal polyposis: does it affect the severity of the disease?

BACKGROUND: Nasal polyposis (NP) is a chronic inflammatory disease and the waste products of this inflammation are reactive oxygen species composed of free radicals. Changes in oxidative status have already been revealed in NP. The aim of this study was to investigate the effect of oxidative status to the severity of the disease and the quality of life. METHODS: The study group included 24 patients with NP and 20 controls. The Turkish version of the Rhinosinusitis Disability Index, visual analog scale (VAS), polyp stage, computed tomography (CT) score, and the eosinophilic cationic protein (ECP) levels in nasal lavage (NAL) fluid were used to assess the severity of the disease. Malondialdehyde, nitric oxide (NO), and the total antioxidant status (TAS) levels in NAL fluids were measured representing the oxidative stress. RESULTS: NO values were correlated with nasal congestion (p = 0.031). TAS values were correlated with nasal obstruction (p = 0.039). ECP values showed correlation with all the nasal obstruction (p = 0.003), congestion (p = 0.009), rhinorrhea (p = 0.009), and VAS scores (p = 0.039). CONCLUSION: In NP, ECP levels detected in NAL fluid were significantly high and were correlated with the severity of the disease. Moreover, the severity of oxidative stress, in the forms of TAS and NO, is significantly correlated with the severity of the nasal obstruction and congestion, respectively.

A prospective clinical study of flow-mediated dilatation in burn injury.

The authors investigated endothelial function using flow-mediated dilatation (FMD) in burn patients. This study was done in burn patients with specific criteria on admission. Blood lipid profile at 1st day, high-sensitivity C-reactive protein, and FMD were assessed at 1st and 7th days, as well as at 1st and 3rd months. The highest values of high-sensitivity C-reactive protein were detected on the 7th day, which were significantly higher than those at 1st and 3rd months. The lowest value of FMD was observed on the 7th day. FMD values were higher during the 1st month compared with the 7th day. The highest value of FMD was detected in the 3rd month. It was found that FMD values measured at 7th day and 1st month were significantly lower in patients with a burn percentage of 40 or greater. Our results suggest that inflammation is more prominent on 7th day following burn. The decrease in FMD values on 7th day after injury can be attributed to endothelial damage. The increase in FMD on 3rd month after burn is attributable to effective burn treatment and gradual decrease of inflammatory mediators. The data from this study suggest that there is endothelial dysfunction and low-grade inflammation in burn patients. This condition is more prominent in patients with a burn ratio greater than 40%. Burn patients more frequently have impaired FMD, which may be indicative of arterial endothelial dysfunction and a marker for increased atherosclerosis.

Association between serum γ-glutamyltransferase levels and coronary microvascular function.

BACKGROUND: Serum γ-glutamyltransferase (GGT) level is an independent risk factor for cardiovascular (CV) disease, and there is a strong association between serum GGT levels and most CV risk factors. However, the role of the serum GGT level as an independent risk factor for coronary microvascular function remains controversial. PURPOSE: We aimed to determine whether the serum GGT level is independently and specifically associated with coronary flow reserve (CFR) impairment in normal individuals. METHODS: We examined healthy individuals who did not have any major CV risk factors (277), of whom CFR was achieved in 263 (95%). They were divided into three groups according to serum GGT levels. In each participant, CFR was measured using an Acuson Sequoia C256 Echocardiography System. RESULTS: Participants with high GGT levels had significantly impaired CFR compared with those with intermediate and low GGT levels (2.82±0.49 vs. 2.71±0.51 and 2.44±0.48 U/l; P<0.0001). After adjusting for potential confounders, including sex, BMI, blood pressure, lipids, and glucose, we found that the serum GGT and high-sensitivity C-reactive protein levels were associated independently with CFR impairment (b=-0.205, P=0.007; b=-0.172, P=0.024). We also found that the serum GGT level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve was 75% [95% confidence interval, 0.65-0.86], and the serum GGT level was significantly predictive of a low CFR (P<0.0001). CONCLUSIONS: These results support a role for the serum GGT level as an independent marker of coronary microvascular damage and inflammation in normal individuals without concomitant risk factors.

Can first-trimester screening program detect women at high risk for gestational diabetes mellitus?

This study was designed to compare first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency in pregnancies complicated by gestational diabetes mellitus and those of a control group. The study included 60 gestational diabetic and 60 control women who attended the first-trimester combined screening program for Down syndrome between 11 and 14 gestational weeks with complete follow-up data and delivered in our institution. Maternal serum free ß-human chorionic gonadotropin, pregnancy-associated plasma protein-A and fetal nuchal translucency were investigated. The combined risks, double test risks and age risks were calculated by PRISCA software version 4.0. Comparison of the results between the two groups yielded no significant differences in serum levels of free ß-human chorionic gonadotropin and fetal nuchal translucency. However, women who developed gestational diabetes mellitus had significantly lower pregnancy-associated plasma protein-A. And also, the combined risks and double test risks calculated by PRISCA software were statistically higher in gestational diabetic women than normal pregnant women. These results suggest that differences can be seen between diabetic and healthy pregnant women in first-trimester maternal serum biochemical markers of aneuploidy.

Resistin--a novel feature in the diagnosis of sepsis in premature neonates.

OBJECTIVE: To evaluate the diagnostic potential of resistin in sepsis and to compare results with C-reactive protein (CRP) in infants < 32 weeks of gestation. STUDY DESIGN: A total of 64 infants were prospectively included in the study. Blood samples were collected for basal CRP and resistin within the first hour of life. When sepsis was suspected, samples were collected for CRP and resistin before the treatment was started (pretreatment CRP and resistin). On the third day of sepsis, CRP and resistin levels were measured for evaluating the treatment response (follow-up CRP and follow-up resistin). Culture-proven septic patients were divided into groups according to early or late-onset sepsis (EOS and LOS) and gram-negative or gram-positive sepsis (GNS and GPS). RESULTS: Pretreatment and follow-up resistin levels were significantly higher than basal resistin levels in both EOS and LOS groups (p < 0.01), with a positive correlation with CRP levels. To predict the GNS and GPS area under curve, values of pretreatment CRP and resistin were 0.714 and 0.984, respectively (p = 0.039). CONCLUSION: Resistin had a superior potential to that of CRP in the diagnosis of sepsis in preterm infants. Resistin may be used as an early marker for sepsis in premature infants.

Association between serum total antioxidant status and coronary microvascular functions in patients with SLE.

Mortality from cardiovascular disease has been found to be increased in patients with systemic lupus erythematosus (SLE). Coronary flow reserve (CFR) measurement is used both to assess epicardial coronary arteries and to examine the integrity of coronary microvascular circulation. Oxidative stress, enhancing modification of plasma lipids, is also associated with atherosclerotic events in lupus patients. Impairment of CFR and TAS has been shown to be an early manifestation of coronary atherosclerosis. Forty patients with SLE and 33 healthy volunteers were included in this study. Echocardiographic examination included left ventricular myocardial velocity measurements and coronary flow reserve (CFR) measurement. Serum total antioxidant status levels (TAS) also were measured using TAS kit. Lateral myocardial early peak velocity (Em) and lateral Em/Am ratio did not differ between the groups, but lateral myocardial atrial peak velocity (Am) was significantly higher in SLE group than the control group. Baseline coronary diastolic peak flow velocity (DPFV) of left anterior descending was similar in both the groups. However, hyperemic DPFV and CFR (2.50 ± 0.42 vs. 3.09 ± 0.45, P < 0.0001) were significantly lower in the SLE group than in the control group. CFR significantly and inversely correlated with CRP and significantly correlated with TAS. Subclinical coronary microvascular dysfunction can occur in SLE patients without traditional cardiovascular risk factors, probably associated with underlying inflammation and impairment of TAS.

The goiter prevalence and urinary iodine levels among adolescents.

Endemic goiter and iodine deficiency are among the worldwide major public health problems of today. We aimed to research the goiter prevalence and the urinary iodine level of school children. In this descriptive study, 1,847 school children in Konya aged between 10 and 18 years were included. Urinary iodine level was measured. The mean value of iodine excretion in urine was 198 +/- 46.61 microg/L. In 40 students (2.2%), the urinary iodine level was < 100 microg/L. Six of these students (0.3%) had moderate iodine deficiency. Thyroid hyperplasia was found with palpation method in 128 students (6.9%). Ultrasonographically, five female students had solid nodule, and one male student had multiple nodules. In our study, no severe iodine deficiency was found. According to the results of our study, the mandatory iodization program in Konya has been conducted successfully.

Isotretinoin does not prolong QT intervals and QT dispersion in patients with severe acne: a surprising finding for a drug with numerous side effects.

BACKGROUND: Isotretinoin is a widely prescribed drug for the treatment of severe acne. Several adverse cardiac effects due to isotretinoin have been previously reported. However, no data exist on the effects of isotretinoin therapy on QT intervals. OBJECTIVE: To investigate the effects of isotretinoin therapy on QT intervals and QT dispersion, and also to see if it is related to serum lipids, homocysteine and lipoprotein (a) or not. METHODS: Forty-five patients with severe acne (mean age 21±6 years, range 14-38 years; 26 female) were included in the study. Twelve-lead surface electrocardiograms (ECGs) were acquired at three stages: before therapy and at the ends of the first and sixth months of 0.8 mg/kg/day of isotretinoin therapy. Serum levels of triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol, homocysteine and lipoprotein (a) were also measured at the day of ECG recordings. Minimum and maximum QT intervals were measured and QT dispersion was calculated. RESULTS: Mean heart rates were similar throughout the isotretinoin therapy. Serum levels of lipids, homocysteine and lipoprotein (a) all increased significantly at the end of the first month and remained significantly elevated at the end of sixth month (P is less than 0.05 for both stages). QT intervals and QT dispersion did not differ significantly throughout the six months of isotretinoin therapy (P is greater than 0.05). CONCLUSIONS: In patients with severe acne, six months of 0.8 mg/kg/day of isotretinoin therapy neither prolongs QT interval, nor increases QT dispersion. This effect is not related to blood lipids, homocysteine or lipoprotein (a) levels. Our findings indicate that from the point of polymorphic ventricular tachycardia risk, 0.8 mg/kg/day of isotretinoin therapy is a safe choice in acne treatment.

A truncating mutation in SERPINB6 is associated with autosomal-recessive nonsyndromic sensorineural hearing loss.

More than 270 million people worldwide have hearing loss that affects normal communication. Although astonishing progress has been made in the identification of more than 50 genes for deafness during the past decade, the majority of deafness genes are yet to be identified. In this study, we mapped a previously unknown autosomal-recessive nonsyndromic sensorineural hearing loss locus (DFNB91) to chromosome 6p25 in a consanguineous Turkish family. The degree of hearing loss was moderate to severe in affected individuals. We subsequently identified a nonsense mutation (p.E245X) in SERPINB6, which is located within the linkage interval for DFNB91 and encodes for an intracellular protease inhibitor. The p.E245X mutation cosegregated in the family as a completely penetrant autosomal-recessive trait and was absent in 300 Turkish controls. The mRNA expression of SERPINB6 was reduced and production of protein was absent in the peripheral leukocytes of homozygotes, suggesting that the hearing loss is due to loss of function of SERPINB6. We also demonstrated that SERPINB6 was expressed primarily in the inner ear hair cells. We propose that SERPINB6 plays an important role in the inner ear in the protection against leakage of lysosomal content during stress and that loss of this protection results in cell death and sensorineural hearing loss.