Selenium levels in patients with autoimmune thyroiditis and controls in lower Austria.

Autoimmune thyroiditis (AIT) is one of the most common autoimmune diseases; genetic as well as environmental factors contribute to its pathogenesis. The thyroid is the organ with the highest selenium content per unit weight. Selenium status appears to have an impact on the development of thyroid pathologies. We investigated a possible difference of selenium serum levels as a marker of nutritional selenium supply between patients with AIT in central Lower Austria and a matched group of healthy persons living in the same region. Selenium serum levels in the patients with AIT were 98.0 ± 15.6 µg/l. A significant difference to the matched group of normal persons, whose selenium serum levels were 103.2 ± 12.4 µg/l, could not be detected by the t-test (p>0.05). We considered the serum selenium levels to be indicators of selenium supply (by alimentation). A serum level of 120-160 µg/l of selenium represents the normal range. According to this, most patients and control persons showed mild to moderate selenium deficiency (80-120 µg/l selenium). Although our data present slightly higher selenium levels in normal persons than in patients with AIT, this weak and statistically insignificant trend is not sufficient to support the conclusion of a link between inadequate selenium supply and autoimmune thyroid disease.

[Control of wound healing after glaucoma surgery. Effect and inhibition of the growth factor TGF-beta]. / Steuerung der Wundheilung nach Glaukomchirurgie Wirkung und Hemmung des Wachstumsfaktors TGF-beta.

The main problem of the surgical failure after trabeculectomy is postoperative scarring of the filtering bleb. The treatment with anti-metabolites such as 5-fluorouracil and mitomycin C to prevent scarring shows many toxic side-effects and causes patient stress. In the search for therapeutic alternatives, the focus of current research concentrates on the pathophysiological interaction between growth factors and their role in the induction of scarring. Among the growth factors, TGF-beta 2 represents an important stimulant of scarring with a key regulatory function. The TGF-beta 2 concentration in the aqueous humor of primary open angle glaucoma is significantly elevated. In vitro and in vivo studies have demonstrated promising inhibition of scarring after subconjunctival application of human monoclonal anti-TGF-beta 2 antibody, which appears to be a safe and well tolerated therapeutic approach. Currently, several prospective studies are investigating the role of anti-TGF-beta 2 antibody as an alternative to conventional long term inhibition of scarring.

Prognostic value of serum 5-S-cysteinyldopa for monitoring human metastatic melanoma during immunochemotherapy.

The melanin metabolite 5-S-cysteinyldopa (5-S-CD) has been reported to be helpful in detecting occult melanoma metastases and as a prognostic marker in B16 melanoma-bearing mice. The goal of our study was to analyze the significance of the serum 5-S-CD level for the biochemical detection of metastases in human malignant melanoma (MM) and for monitoring the progression or the immunochemotherapeutically induced regression of MM. From 11 patients with metastatic MM observed between 1991 and 1995, serum samples were collected before and after each cycle of immunotherapy or immunochemotherapy. Samples were analyzed for 5-S-CD by automated high performance liquid chromatography with electrochemical detection. Cycles of immunochemotherapy consisted of human interleukin 2 and IFN-alpha (four patients) or of human interleukin 2, IFN-alpha, and dacarbazine (seven patients). Serum value of 5-S-CD in our normal controls was 1.9 +/- 0.6 ng/ml. All patients with metastatic MM showed 5-S-CD serum levels above the upper normal limit of 3.2 ng/ml (10 nM) and ranged from 2.3-fold (4.3 +/- 3.9 ng/ml) of the normal control values in early stages of metastases to more than 50-fold (94.3 +/- 220.3 ng/ml) of the normal control values in advanced stages of the disease. In 28 of 41 (68%) immunochemotherapeutical cycles, a decrease of 5-S-CD was seen during therapy, and in 13 cycles (31.7%), an increase was seen. Patients with more than 68% decreasing cycles (defined as responders; n = 5) showed significantly longer survival times (P = 0.008) than patients with less than 68% decreasing cycles (nonresponders; n = 6). High levels of 5-S-CD were also observed in metastasizing amelanotic melanoma. Serum 5-S-CD is a useful marker for monitoring the clinical course of MM patients, for discriminating between responders and nonresponders to immunochemotherapy, and as a prognostic factor concerning survival time and death risk.