Serum and CSF alpha-synuclein levels do not change in COVID-19 patients with neurological symptoms.

SARS-CoV-2 infection can associate diverse neurological manifestations. Several studies have provided proof to support the theory of neurotropic involvement of SARS-CoV-2. Alpha-synuclein has been described as a native antiviral factor within neurons, and upregulation of this protein can be seen in animals that suffered other neuroinvasive infections. To assess if increased expression of this protein takes place in COVID-19 patients with neurological symptoms, we analyzed serum total alpha-synuclein levels in three groups: seven COVID-19 patients with myoclonus, Parkinsonism and/or encephalopathy; thirteen age- and sex-matched COVID-19 patients without neurological involvement and eight age- and sex-matched healthy controls. We did not find differences among them. In a subset of four patients, the change in serum alpha-synuclein before and after the onset of neurological symptoms was not significant either. Cerebrospinal fluid alpha-synuclein levels were also similar between neurological COVID-19 and healthy controls. Overall, these results cannot support the hypothesis of alpha-synuclein upregulation in humans with neurological symptoms in COVID-19. Further research taking into account a larger group of COVID-19 patients including the whole spectrum of neurological manifestations and disease severity is needed.

Diferente evolución de la esclerostina sérica respecto de otros marcadores de remodelado óseo en el primer año tras un trasplante hepático / Different development of serum sclerostincompared to other bone remodeling markersin the first year after a liver transplant

Objetivo: Nuestro estudio tiene como objetivo principal valorar la evolución de los niveles de esclerostina en pacientes con trasplante hepático, e investigar su relación con otros marcadores de remodelado óseo. Material y método: Estudio observacional prospectivo. Se incluyeron 83 pacientes con trasplante hepático. Se determinaron los valores de esclerostina, β-crosslaps, fosfatasa alcalina ósea, osteocalcina y proteína C reactiva la semana anterior al trasplante y posteriormente, a los 1, 3, 6 y 12 meses. Se determinaron basalmente la 25 hidroxi-vitamina D y la paratohormona. En cada revisión se evaluó la existencia de fracturas. La evolución de los marcadores respecto del valor basal se determinó mediante la prueba t-Student. Un valor de p inferior a 0,05 se consideró estadísticamente significativo. Resultados: 56 varones y 27 mujeres (edad media: 56,2±10,4 años). Los niveles basales de esclerostina (0,76±0,35 ng/ml) disminuyeron de forma significativa precozmente (0,55±0,22 ng/ml en el primer mes, p=0,034), tendencia que se mantuvo hasta los 12 meses (0,62±0,22 ng/ml, p=0,047). Al contrario, los niveles basales de osteocalcina (17±10,3 ng/ml) y β-crosslaps (0,44±0,3 ng/ml) se incrementaron significativamente a los largo del estudio; en el caso de la osteocalcina, hasta los 12 meses (37,27±26,84 ng/ml, p<0,01) y el β-crosslaps, hasta los 6 meses (0,62±0,34 ng/ml, p<0,01), con un descenso posterior (0,47±0,31 ng/ml, p=0,2). Conclusiones: Tras el trasplante hepático existe un descenso de los niveles de esclerostina, opuesto a la elevación de otros marcadores de remodelado, β-crosslaps y osteocalcina. Son necesarios más estudios para determinar si estos cambios tienen un impacto en la aparición de osteoporosis en pacientes sometidos a trasplante

Objetive:Our main objective was to evaluate the development of sclerostin levels in patients with liver transplantation,and to investigate their relationship with other bone remodeling markers.Material and method:Prospective observational study of 83 patients with liver transplantation. Sclerostin, β‐crosslaps,bone alkaline phosphatase, osteocalcin and C‐reactive protein values were determined the week before the transplantand subsequently, at 1, 3, 6 and 12 months. The hydroxy‐vitamin D and the paratohormone were determined basally. Ineach revision, the existence of fractures was evaluated. The development of the markers compared to the baseline valuewas determined by the t‐Student test. A p‐value less than 0.05 was considered statistically significant.Results:56 men and 27 women (mean age: 56.2±10.4 years). Baseline sclerostin levels (0.76±0.35 ng/ml) decreasedsignificantly early (0.55±0.22 ng/ml in the first month, p=0.034), a trend that remained until 12 months (0.62±0.22ng/ml, p=0.047). On the contrary, the basal levels of osteocalcin (17±10.3 ng/ml) and β‐crosslaps (0.44±0.3 ng/ml) in‐creased significantly throughout the study; in the case of osteocalcin, up to 12 months (37.27±26.84 ng/ml, p<0.01) andβ‐crosslaps, up to 6 months (0.62±0.34 ng/ml, p<0.01), with a subsequent decrease (0.47±0.31 ng/ml, p=0.2).Conclusions:There is a decrease in the levels of sclerostin after liver transplantation, as opposed to the elevation ofother markers of remodeling, β‐crosslaps and osteocalcin. More studies are needed to determine if these changes havean impact on the occurrence of osteoporosis in patients undergoing transplantation

Deficiencia de vitamina D: ¿la estamos identificando bien? / Vitamin D deficiency: are we identifying it properly?

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Regional reference values for some quantities measured with the ADVIA Centaur analyser. A model of co-operation between the in vitro diagnostic industry and clinical laboratories.

This work is a model of co-operation between the in vitro diagnostic industry and clinical laboratories for the production of reference values. Thirteen clinical laboratories having an ADVIA Centaur analyser and representing the majority of the geographical regions of Spain have shared the search for reference individuals and the production of reference values for thyrotropin, free thyroxine, free triiodothyronine, cobalamine and folate concentrations in serum. All the logistic work has been done in co-operation with the Spanish supplier of the ADVIA Centaur analyser. The reference limits produced in the virtual laboratory are derived from the blend of reference values obtained by each laboratory. The multicentre reference limits were estimated according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).