Time to Change Our Viewpoints to Assess Renal Risks in Patients with Solitary Kidneys beyond Traditional Approaches?

Solitary functioning kidney (SFK) can be defined as the absence or hypofunction of a kidney due to acquired or congenital reasons. A congenital solitary functioning kidney (cSFK) is more common than is an acquired one (aSFK) and is characterized by the anatomical absence (agenesis) or hypofunction (hypoplasia; hypodysplasia) of one kidney from birth. Among the acquired causes, the most important is nephrectomy (Nx) (due to the donor, trauma or mass resection). Patients with SFK are at risk for the development of chronic kidney disease (CKD) in the long term. This risk potential is also significantly affected by hypertension. The relationship between hypertension and subclinical chronic inflammation is a connection that has not yet been fully clarified pathogenetically, but there are many studies highlighting this association. In recent years, studies examining different fibrosis and inflammation biomarkers in terms of the evaluation and prediction of renal risks have become increasingly popular in the literature. Oxidative stress is known to play an important role in homocysteine-induced endothelial dysfunction and has been associated with hypertension. In our study, we aimed to investigate the relationship between ambulatory blood pressure monitoring (ABPM) and urinary/serum fibrosis and inflammatory markers in patients with SFK. We prospectively investigated the relationship between ABPM results and soluble urokinase plasminogen activator receptor (suPAR), procollagen type III N-terminal peptide (PIIINP), homocysteine and other variables in 85 patients with SFK and compared them between cSFK and aSFK groups. In the etiology of SFK, a congenital or acquired origin may differ in terms of the significance of biomarkers. In particular, the serum homocysteine level may be associated with different clinical outcomes in patients with cSFK and aSFK.

Relationship between serum Betatrophin, GPIHBP1, and LDL subfractions in patients with gestational diabetes mellitus.

OBJECTIVES: Gestational diabetes mellitus (GDM) leads to changes in the lipid metabolism. In this study, we aimed to compare serum levels of LDL subfractions, betatrophin, and glycosylphosphatidylinositol-anchored high-density lipoprotein binding protein 1 (GPIHBP1) between patients with GDM and healthy pregnant women. DESIGN AND METHODS: We designed a prospective case-control study with 41 pregnant women. Subjects were divided into two groups: GDM and control. Betatrophin and GPIHBP1 levels were measured by ELISA method. Lipoprint LDL subfraction kit was used to perform LDL subfraction analysis electrophoretically. RESULTS: Serum levels of LDL6 subfraction, betatrophin, and GPIHBP1 were found to be higher in GDM group compared to the controls (p < 0.001). The mean LDL size were also found larger in GDM group. A positive correlation was found between betatrophin and GPIHBP1 levels (rho = 0.96, p < 0.001). CONCLUSIONS: Our findings suggest that betatrophin, and GPIHBP1 levels were found to be increased in GDM. This maybe the result of adaptive mechanisms in response to insulin resistance, but also this relationship should be evaluated for their effects on impaired lipid metabolism and lipoprotein lipase metabolism. There is a need for further prospective studies with larger samples to fully elucidate the mechanisms of this relationship both in pregnant patients and the other patient groups.

New Biomarkers (Endocan, Interleukin-17, and Thrombospondin-4) for the Diagnosis, Assessment of Severity, and Follow-Up of Peripheral Arterial Disease.

The present study evaluated the use of endocan, interleukin-17 (IL-17), and thrombospondin-4 (TSP-4) blood levels as potential biomarkers for the diagnosis and follow-up of peripheral arterial disease (PAD). Patients with PAD (Rutherford categories I, II, and III) who were admitted between March 2020 and March 2022 for cardiovascular surgery or outpatient clinic follow-up were included. The patients (n = 60) were divided into 2 groups: medical treatment (n = 30) and surgical treatment (n = 30). In addition, a control group (n = 30) was created for comparison. Endocan, IL-17, and TSP-4 blood levels were measured at the time of diagnosis and at the first month after treatment. Endocan and IL-17 values were found to be significantly higher in both groups that underwent medical (259.7 ± 46 pg/mL, 63.7 ± 16.6 pg/mL) and surgical (290.3 ± 84.5 pg/mL, 66.4 ± 19.6 pg/mL) treatment than the control group (187.4 ± 34.5 pg/mL, 56.5 ± 7.2 pg/mL P < .001). Tsp-4 value was found to be significantly higher only in the surgical treatment group (15 ± 4.3 ng/mL) than the control group (12.9 ± 1.4 ng/mL P < .05). The decreases in endocan, IL-17, and TSP-4 levels at the first month of treatment in both groups were also significant (P < .001). A combination of classical and these new biomarkers could be included in PAD screening, early diagnosis, severity determination, and follow-up protocols in order to provide effective assessment in clinical practice.

Comparison of orexin-A and neurofilament light chain levels in patients with relapsing-remitting multiple sclerosis: a pilot study.

Background and purpose: Multiple sclerosis is an autoimmune disease of the central nervous system, with myelin degeneration and Relapsing-Remitting Multiple Sclerosis (RRMS) as the most common type. The aim of this study was to determine the levels of Neurofilament Light Chain (NFL) and Orexin-A (OXA) in patients with RRMS and compare it with healthy control subjects' data. Methods: In this case-control study of 61 subjects, serum and cerebrospinal fluid samples were collected from 23 RRMS patients and 38 healthy control subjects. NFL and OXA levels were determined in cerebrospinal fluid and serum samples using enzyme-linked immunosorbent assay kits. Self-reported questionnaires were also administered to evaluate fatigue severity and impact. Receiver operating characteristic curve analysis was used to determine the optimal cut-off value of NFL and OXA. Results: The NFL and OXA concentrations in cerebro-spinal fluid of RRMS patients were significantly higher than those of the control group (p < 0.001), but no sig-nificant difference was found in the serum concentrations (p = 0.842, p = 0.597, respectively). The cut-off values were found to be 1.194 ng/ml for NFL and 77.81 pg/ml for OXA in cerebrospinal fluid. A positive correlation was found between the Expanded Disability Status Scale and Epworth Sleepiness Scale in RRMS patients (ρ = 0.49, p = 0.045). Conclusion: These results suggest that increased levels of both NFL and OXA in cerebrospinal fluid reflect neuronal destruction in RRMS. Further research of neurodegeneration should focus on neuropeptides to determine the possible roles in RRMS pathogenesis.

Changes in Tears Monocyte Chemoattractant Protein-1 Level After External Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction.

BACKGROUND: The authors aimed to define tears monocyte chemoattractant protein-1 (MCP-1) changes after external dacryocystorhinostomy surgery. MATERIALS AND METHODS: Tears samples were collected with a Schirmer strip and stored in Eppendorf tubes at -80°C. At the end of the study, the papers were cut into small pieces and incubated with phosphate-buffered saline solution. Monocyte chemoattractant protein-1 levels were determined by using an enzyme-linked immunosorbent assays kit. RESULTS: The MCP-1 levels were 498.66±101.35, 576.40±149.78, 422.53±85.94, and 436.96±81.38 ng/L before surgery, in the first week, the first, and third months after surgery, respectively. Its level significantly increased in the first week compared with the preoperative level ( P <0.001). There was a prominent decrease in the postoperative first month ( P <0.001). In the third postoperative month, the mean MCP-1 level was not significantly increased compared with the postoperative first month ( P =0.196). CONCLUSION: The tears MCP-1 level was significantly decreased after external dacryocystorhinostomy surgery.

Comparison of trace element (selenium, iron), electrolyte (calcium, sodium), and physical activity levels in COVID-19 patients before and after the treatment.

OBJECTIVE: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), a worldwide health problem, is the cause of 2019 coronavirus disease. This study aimed to compare the trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of COVID-19 patients before and after COVID-19 treatment. METHOD: This prospective study was conducted in patients diagnosed with COVID-19 (n = 15). Trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of the patients were compared before and after the treatment. RESULT: Most of patients had selenium deficiency (86.7 %), iron deficiency (73.3 %), calcium deficiency (66.7 %) and sodium deficiency (46.7 %) before COVID-19 treatment. The most important improvements were seen in iron deficiency (from 73.3 % to 26.7 %) and sodium deficiency (from 46.7 % to 13.3 %) after the treatment. Selenium, iron, calcium, and sodium levels of the patients were significantly higher after the treatment (p < 0.05). The patients had low physical activity before and after COVID-19 treatment. In addition, no statistically significant difference was found in the comparison of physical activity levels (p > 0.05). CONCLUSION: This study indicated that selenium, iron, calcium, and sodium levels and deficiencies might improve after treating patients with COVID-19. However, the results of this study showed that the physical activity levels of COVID-19 patients might remain stable and low throughout the treatment process.

The role of antioxidant vitamins and selenium in patients with obstructive sleep apnea.

PURPOSE: Obstructive sleep apnea (OSA) is a disorder characterized by recurrent episodes of obstruction of the upper respiratory tract during sleep often accompanied by oxygen desaturations. Antioxidant defense mechanisms are important to prevent OSA-associated diseases and decrease mortality. We aimed to determine the levels of selenium and vitamins A, C, and E in patients with OSA but without any comorbidities and compare the results with a control group, theorizing that the findings may be helpful to understand the antioxidant mechanisms in the pathogenesis of OSA and associated diseases. METHODS: We designed a case-control study with 146 subjects. Subjects were categorized into four groups by apnea-hypopnea index (AHI) scores: control (n = 32; AHI < 5), mild OSA (n = 32; 5 ≤ AHI < 15), moderate OSA (n = 34; 15 ≤ AHI < 30), and severe OSA (n = 48; AHI ≥ 30) groups. Serum levels of selenium were measured by atomic absorption spectrometer. Vitamin A, C, and E levels were measured by high-performance liquid chromatography and ultraviolet (HPLC-UV) detector. RESULTS: After adjusting for age, BMI, and gender, serum selenium and vitamin A levels were found to be higher in patients with OSA compared with controls (ANCOVA, p < 0.008, and p = 0.014 respectively), and levels of these markers increased with the severity of the disease. AHI was positively correlated with selenium (r = 0.289; p < 0.001), and vitamin A levels (r = 0.276; p < 0.001). CONCLUSION: These results demonstrated that antioxidant response with increased vitamin A, and selenium concentrations, may be important defense mechanisms in patients with OSA patients who do not have other comorbidities. Antioxidant nutrients or supplements may be implemented as a complementary treatment of OSA to support antioxidant defense.

Chitotriosidase levels in healthy elderly subjects.

Chitotriosidase (CHIT) belongs to the family of glycosylhydrolases and is highly homologous to chitinases from lower organisms. The enzyme CHIT is of interest for clinical reasons, because it is selectively expressed in chronically activated tissue macrophages. In most ethnic groups, approximately 6% of all individuals are homozygous for CHIT deficiency. Pathological tissue macrophages in several disease conditions massively express CHIT. A shared feature of such cells in the different conditions is the accumulation of lipid material in the lysosomal apparatus. Serum CHIT activity is significantly increased in individuals suffering from atherosclerosis disease and is related to the severity of the atherosclerotic lesion, suggesting a possible role as atherosclerotic extent marker. Our objective is to determine the levels of serum CHIT activity in healthy elderly subjects. Healthy 90 (between 65-94 years old) elderly people and 69 (between 20-44 years old) young people were chosen. Serum CHIT enzymatic activity was determined with the flurometric enzyme activity assay using artificial 4-MU substrate. We found CHIT activity 270 +/- 21 (nmol/mL/h) (values are mean +/- SD) in elderly people and 136 +/- 17 in young people. There are statistical differences between elderly and young subjects.

Age-related paraoxonase activity changes in Turkish population.

Paraoxonase1 (PON1) is a high-density lipoprotein (HDL)-associated enzyme capable of hydrolyzing diverse substrates from organophosphate (OP) toxins to oxidized phospholipids. As such, it has been linked with both the prevention of OP poisoning and inhibition of atherosclerosis initiated by oxidatively modified low-density lipoprotein (LDL). The aim of this study was to investigate, with aging, the activity of PON1 associated with HDL and partially responsible for its antiatherogenic activity. The study involved 187 individuals (67 males and 120 females) divided into three groups according to their ages, young (n = 49; 20-44 years, mean age = 30.12 +/- 6.6 years), middle aged (n = 25; 45-64 years, mean age = 52 +/- 5.6 years), and elderly subjects (n = 113; 65-95 years, mean age = 78.94 +/- 6.2 years). Interestingly, serum total cholesterol and LDL-cholesterol levels significantly decreased with age (P < 0.05). The elderly aged group had also significantly lower body mass index than the middle aged group (P < 0.05). Serum paraoxonase activity and HDL cholesterol levels remained unchanged with age. The prevalence of phenotype AA, AB, and BB in our subjects' group was 40.6%, 45.9%, and 13.5%, respectively.

Mitochondrial DNA alterations in aging.

During the aging process, the increase of mitochondrial DNA (mtDNA) alterations has been reported. In this study, we investigated deletions/insertions in the approximately 2.4-kb region (from 14680 to 578 bp) of mtDNA covering D-loop region. A total of 96 individuals (ages between 20 and 94 years) were screened in this study. Genomic DNA was purified from whole blood samples. The 2.4-kb region of mtDNA was amplified with PCR and visualized by agarose gel electrophoresis. The sequence of the amplicon was confirmed in one sample by sequencing. We detected mtDNA deletions in only two cases (ages 26 and 30 years) at this resolution. As a result, there is no increase in the major deletions/insertions in the analyzed mtDNA region with aging. Complete sequencing of this region is needed to detect any age-dependent changes.