Serum levels of soluble P-selectin are increased and associated with disease activity in patients with Behçet's syndrome.

Behçet's syndrome (BS) is a relapsing, chronic, inflammatory disease characterized by endothelial dysfunction, atherothromboembogenesis, and leukocytoclastic vasculitis with complex immunologic molecular interactions. Generalized derangements of the lymphocyte and neutrophil populations, activated monocytes, and increased PMNLs motility with upregulated cell surface molecules such as ICAM-1, VCAM-1, and E-selectin, which are found on the endothelial cells, leukocytes, and platelets, have all been demonstrated during the course of BS. Our aim is to investigate the association of serum concentrations of soluble P-selectin in patients with BS, and to evaluate whether disease activity has an effect on their blood levels. This multicenter study included 31 patients with BS (15 men and 16 women) and 20 age- and sex-matched healthy control volunteers (11 men and nine women). Neutrophil count, erythrocyte sedimentation rate, and acute-phase reactants as well as soluble P-selectin levels were determined. The mean age and sex distributions were similar (P > .05) between BS patients (35 years) and control volunteers (36 years). Serum levels of soluble P-selectin in patients with BS (399 +/- 72 ng/mL) were significantly (P < .001) higher when compared with control subjects (164 +/- 40 ng/mL). In addition, active BS patients (453 +/- 37 ng/mL) had significantly (P < .001) elevated levels of soluble P-selectin than those in inactive period (341 +/- 52 ng/mL). This study clearly demonstrated that serum soluble P-selectin levels are increased in BS patients when compared with control subjects, suggesting a modulator role for soluble P-selectin during the course of platelet activation and therefore, atherothrombogenesis formation in BS, especially in active disease.

Plasma endothelin-1, homocysteine and serum nitric oxide values in patients with left-to-right shunt.

BACKGROUND: This study aimed to evaluate the effect of pulmonary blood flow and pulmonary hypertension on plasma endothelin-1, homocysteine and serum nitric oxide levels in patients with left-to-right shunt lesions with pulmonary hypertension and also with normal pulmonary arterial pressure. METHODS AND RESULTS: Plasma endothelin-1, homocysteine and nitric oxide levels were measured in 44 patients (Group 1) with left-to-right shunt and normal pulmonary arterial pressure (Qp/Qs: 2.1), 65 patients (Group 2) with left-to-right shunt and pulmonary hypertension (Qp/Qs: 2.4), 20 healthy control subjects (Group 3), and 17 post-operative patients (Group 4). Plasma endothelin-1 and serum nitric oxide levels were significantly higher in Group 2 than in groups 1, 3, and 4 (p<0.001). Plasma homocysteine levels were significantly higher in Group 2 than in Groups 1 and 4 (p<0.001 and p<0.01, respectively). CONCLUSIONS: The increase in serum nitric oxide levels in patients with left-to-right shunt and pulmonary hypertension may be attributed to the compensatory mechanism. However, this increase does not improve pulmonary hypertension because of increased endothelin-1 and homocysteine levels. In the light of present study, we conclude that vascular changes caused by increased homocysteine and endothelin-1 may provoke pulmonary hypertension in patients with left-to-right shunt.

[Determination of allergen-specific IgE in patients with atopy or allergy symptoms]. / Atopi veya alerjili olgularda alerjen-spesifik IgE düzeyleri.

OBJECTIVES: We investigated the role of specific IgE assay in the diagnosis in patients found to be atopic or allergic by history and physical examination. PATIENTS AND METHODS: Serum specific IgE levels were measured by the chemiluminescent assay in 143 adults (58 females, 85 males; mean age 34.3 years; range 16 to 62 years) and in 113 children (62 girls, 51 boys; mean age 10.2 years; range 5 to 16 years) with rhinitis, asthma, or dermatitis. The results were analyzed in six groups depending on the specific IgE level (no specific IgE, very low, low, moderate, high, and very high levels). The specific IgE threshold for a negative or positive result was accepted as 0.70 IU/ml. Allergen-specific IgE antibodies were sought for 35 allergens in adults, and for 19 allergens in children. RESULTS: Specific IgE levels were positive (>0.70 IU/ml) in 92 adults (64.34%) and in 50 children (44.25%). Hypersensitivity to individual allergens ranged between 20.08% and 41.96% in adults, and between 17.70% and 28.32% in children. Fourteen adults and eight children showed sensitivity to a single allergen; the remaining patients were sensitive to at least two allergens. CONCLUSION: Detection of sensitivity to allergens is complementary to findings obtained by history and physical examination and may help to reveal allergic etiology in patients presenting with a similar symptom profile.