Cartilage oligomeric matrix protein as a non-invasive biomarker for diagnosis of hepatocellular carcinoma in patients with liver cirrhosis.

Aim: The current study purposed to evaluate serum COMP (Cartilage oligomeric matrix protein) as a diagnostic marker for HCC in patients with cirrhosis and to correlate it with other parameters of disease progression. Background: COMP is known to promote fibrosis in various tissues. Emerging evidence shows that COMP plays critical roles in tumor development. It can serve as a fibrosis and cancer biomarkers. Methods: The study included 24 subjects who serve as the healthy control, 24 cirrhotic patients without HCC, and 24 HCC patients with cirrhosis. All participants were subjected to liver function tests, AFP, calculation of fibrotic indices (APRI and FIB-4), and serum COMP by ELISA. Results: COMP was significantly increased in cirrhotic patients when compared to healthy controls and in HCC patients when compared to cirrhotic patients and healthy controls. A significant positive correlation was observed between COMP and APRI and FIB-4 in cirrhotic and HCC patients. Based on receiver operating characteristic (ROC) curve analysis, COMP had an area under curve (AUC) of 0.943 with 87.5% sensitivity and 79.2% specificity for diagnosis of HCC in cirrhotic patients. In combination with AFP, the sensitivity was increased to 100%. Conclusion: COMP might act as a promising non-invasive biomarker for HCC either alone or in combination with AFP. It was correlated with the degree of fibrosis and associated with advanced cancer staging.

Parathormone enhances eryptosis in patients with end stage renal disease treated by hemodialysis.

INTRODUCTION: Parathormone (PTH) and phosphorus, which are considered as uremic toxins, are associated with reduced red cell survival, yet with unproven mechanism. We aimed to assess the relation between PTH and phosphorus levels and eryptosis in patients with CKD5d treated by hemodialysis. METHODS: In a cohort of 85 patients with CKD5d treated by conventional hemodialysis, the percent of annexin V-binding RBCs was assessed by flow cytometry to indicate the percent of eryptotic RBCs. FINDINGS: The median percent of annexin V-binding RBCs was 2.3 (1.4-4.7)%. On linear regression analysis, PTH was independently associated with the percent of annexin V-binding RBCs (ß = 0.003; 95% CI: 0.002-0.004; p < 0.001). The percent of annexin V-binding RBCs differed significantly in patients with low PTH (<150 pg/mL; 27/85, 31.8%), target PTH (150-600 pg/mL; 32/85, 37.6%), and high PTH (>600 pg/mL; 26/85, 30.6%) groups (1.24 [0.65-1.85]; 2.46 [1.73-4.05]; and 4.82 [3.45-5.61]%, respectively; p < 0.001). Considering the tertiles of the percent of annexin V binding RBCs, PTH increased significantly from 85 (50.6-273) in the 1st to 298.3 (172.8-606.8) in the 2nd and 827.6 (357.4-1171.3) pg/mL in the 3rd tertiles (p < 0.001). Phosphorus and calcium levels as well as the CaxPh product were similar among the three tertiles (p > 0.05). DISCUSSION: Patients with CKD5d express high rates of eryptosis. PTH excess in those patients may result in further eryptosis enhancement, and this represents a potential pathogenic mechanism linking hyperparathyroidism with the anemia of CKD.

Association of Thyroid Peroxidase Gene Polymorphisms and Serum Anti- TPO Levels in Egyptian Patients with Autoimmune Hypothyroidism.

BACKGROUND: Thyroid peroxidase (TPO) gene mutation leads to a change in enzyme built structure resulting in the anti-TPO autoantibodies production that may cause thyroid destruction. AIM: To evaluate the association of three single nucleotide polymorphisms (SNPs) of the TPO gene and anti-TPO levels in Egyptian patients with autoimmune hypothyroidism and correlate them with the disease severity. METHODS: Two hundred patients with newly discovered autoimmune hypothyroidism were included in the study (100 with subclinical hypothyroidism and 100 of them with overt hypothyroidism) and 100 healthy individuals as a control group were genotyped by PCR-REFLP. RESULTS: The TT genotype of rs2071400 C/T and the T allele were significantly more frequent in patients with subclinical hypothyroidism and overt hypothyroidism than in the control group. But there were no significant differences in the TT genotype and T allele between subclinical and overt hypothyroidism patients. As regards TPO rs732609 A/C polymorphism, the CC genotype of rs732609 A/C and the C allele were significantly increased in patients with subclinical hypothyroidism and overt hypothyroidism than in controls. There was a significant difference in the CC genotype and C allele between subclinical and overt hypothyroidism patients. Concerning TPO rs1126797 C/T polymorphism, there were no significant differences of genotype or allele frequencies between patients groups and control group. CONCLUSION: We found an association of rs2071400 C/T and rs732609A/C polymorphisms with autoimmune hypothyroidism and correlated anti-TPO levels with different genotypes in hypothyroid patients. Also, we found an association of rs732609A/C polymorphism with the disease severity.