Cytokine regulation of the acute-phase protein levels in multiple myeloma.

BACKGROUND: Interleukin (IL) 6 has an important role in the regulation of acute-phase proteins (APPs) during an acute-phase response. We studied IL-6 and other cytokines to determine if they regulate serum APP levels in the same way under the condition of the aberrant, long-lasting 'acute-phase response' that occurs in patients with chronic inflammation and cancer. METHODS: Serum levels of nine positive APPs [CRP, SAA, C1-INH, Bf, C5, C8, C9, alpha 1-acidic glycoprotein (AGP) and haptoglobin] and two negative APPs [transferrin and alpha 2-HS glycoprotein (AHSG)] were measured using immunochemical methods in 59 multiple myeloma patients and in 72 healthy control subjects. Serum IL-6 and tumour necrosis factor (TNF) alpha levels were determined by bioassays. RESULTS: IL-6 was negatively correlated with five out of nine (C1-INH, C8, C9, AGP and haptoglobin) positive APPs but positively correlated with C-reactive protein (CRP). When patients with high and low IL-6 serum concentration were compared, CRP levels were higher, AGP and haptoglobin levels were lower in the high- than in the low-L-6 group, whereas no significant difference between the two groups was found in levels of the other positive and negative APPs. TNF-alpha levels were negatively correlated with transferrin and AHSG levels. No difference in the levels of positive APPs was observed between patients with low and high TNF-alpha serum concentration. By contrast, levels of both transferrin and AHSG were significantly lower in the high- than in the low-TNF-alpha group. CONCLUSIONS: These findings indicate that, except for regulation of the negative APPs by TNF-alpha, the mechanism of APP regulation is different under the conditions of the short-term and the chronic, long-lasting 'acute-phase reaction'.

Lipoprotein(a) concentration and phenotypes in primary biliary cirrhosis.

We studied a selected group of 39 female patients suffering from primary biliary cirrhosis (PBC). This disease is characterized by typical lipoprotein alterations and elevated concentrations of serum cholesterol. Despite the increased concentration of atherogenic lipoproteins, enhanced atherogenesis is not characteristic of PBC. Serum total cholesterol, triglycerides, HDL2 and HDL3-cholesterol concentrations were measured by enzymatic methods or in combination with precipitation procedures. Apolipoproteins were determined by using immunonephelometric methods. ELISA sandwich method was used for lipoprotein(a) determinations. Apoprotein(a) phenotyping (isoforms) was performed by Western blotting with specific antibodies. The concentrations of serum lipids, lipoproteins and apoproteins (AI, AII and B) were found in the range of earlier investigations. The serum lipoprotein(a) concentration did not differ between the PBC patients and control subjects (10.0/0.1-54/, median 2.55 vs. 11.5/0-75/, median 5.2 mg/dl). In the advanced stages of PBC we found a higher number of patients with low lipoprotein concentration (lower than 1 mg/dl). In patients with shorter durations and milder histological alterations high HDL2 cholesterol subfractions has been detected (stage I = 0.42 +/- 0.18, stage II = 0.53 +/- 0.29 and stage III = 0.62 +/- 0.41 vs. stage IV = 0.26 +/- 0.15 mmol/l, P < 0.05). Despite the elevation of atherogenic lipoproteins, high HDL2-cholesterol and normal lipoprotein(a) concentrations may be one of the reasons why patients with advanced PBC are not placed at increased risk for atherosclerosis.

[Distribution of apolipoprotein A I and B in the blood according to age and gender, as well as their relation to blood cholesterol levels in the Hungarian blood donor population]. / Véradó populációban mért plazma apolipoprotein A I és B koncentráció értékek életkor és nem szerinti megoszlása, valamint kapcsolatuk a plazma cholesterin értékekkel.

In this study we assessed the plasma CHOL, HDL cholesterol (HDL-C), apoprotein A I, apoprotein B levels and the polymorphic isoforms of apoprotein A I in Hungarian blood donors (n = 202, average age: 37.5 year). The mean values are presented for age and sex groups, and the data are compared to the international measurements. The mean CHOL concentration was 5.7 +/- 1.1 mmol/l. The CHOL level correlated with age and no significant association was observed with sex. The level of HDL-C showed no correlation with the age and--in opposite to the international data--there were no significant sex differences (women: 1.42 +/- 0.45, men: 1.34 +/- 0.44 mmol/l), which may be explained by the relative high HDL-C concentration of Hungarian men. Both apo A I and apo B showed an increase with advancing age. The only difference between the sexes was found in apoprotein A I levels, i. e. it was higher in women than in men (women: 156.3 +/- 23.6, men: 143.8 +/- 26.8 mg/dl). In contrary with the results from other countries, the apoprotein B concentrations in men did not differ from that measured in women (women: 72.1 +/- 17.4, men: 69 +/- 15.8 mg/dl). In relation to the age, in the fifth decade the CHOL, the HDL-C and the apo B levels were higher in women than in men.(ABSTRACT TRUNCATED AT 250 WORDS)

[Cholesterol elimination in the urinary tract]. / Cholesterinabgänge aus den Harnwegen.

The case of a 50-year-old female patient who had been passing "calculi" containing cholesterol for 10 years is presented. Previously, abdominal surgical interventions had been carried out several times and therefore a fistula between the digestive and urogenital system was suspected. This, however, could not be confirmed either by radiological or laboratory techniques. A II/a type of hyperlipoproteinemia was found in the serum, but its correlation to the calculi could be excluded.