Effect of perindopril and bisoprolol on IL-2, INF-γ, hs-CRP and T-cell stimulation and correlations with blood pressure in mild and moderate hypertension.

INTRODUCTION: Cardiovascular disease is the leading global cause of death. Its development is largely determined by lifestyle and cardiovascular risk factors, among which arterial hypertension (HT) plays a key role. Available data indicate a significant role of inflammation in the pathophysiology of HT. OBJECTIVES: The aim of this study was to assess concentrations of mediators of inflammation in patients with mild and moderate HT and its modulation with antihypertensive treatment. MATERIALS AND METHODS: 56 subjects: 17 with first- and 20 with second-grade HT, and 19 healthy subjects constituting a control group. Antihypertensive therapy: in first-grade HT, perindopril 5 mg daily, and in second-grade HT, bisoprolol (5 mg daily) additionally were ordered. Before and after a 4-week treatment, interleukine-2, interferon-γ, and high-sensitivity C-reactive protein serum concentrations were assessed. RESULTS: hs-CRP concentration was higher in hypertensive patients, and the difference was statistically significant in patients with second-grade HT compared to the control group (1.42 mg/L vs. 2.55 mg/L; p = 0.003). Antihypertensive treatment was associated with hs-CRP decrease. IL-2 concentration was 14.8% (p = 0.005) higher in first- and 22.2% (p = 0.002) higher in second-grade HT compared to the controls. Treatment significantly reduced concentration of IL-2. IFN-γ concentrations, compared to the control group, were higher by 19.6% (p < 0.001) and 39.9% (p < 0.001) in 1st and 2nd grade HT, respectively. CONCLUSION: Increased values of blood pressure were accompanied by higher concentrations of cytokines and hs-CRP. Reversal of adverse T-cell stimulation was observed after 4-week therapy.
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Cancer related fatigue syndrome in neoplastic diseases.

Fatigue is one of the most important factors which has a considerable influence on treatment and the life quality of oncological patients. The fatigue syndrome is often diagnosed during cancer treatment and this syndrome is not related to the physical effort. Cancer related fatigue is a patient's subjective, psychologically, physically and emotionally based feeling. It is disproportionate to patient's daily activity. The pathogenesis of this syndrome remains still unknown. However, on the basis of various questionnaires, it is possible to test the disease's complex nature. Cancer related fatigue causes deterioration of patient's life along with lower motivation to struggle with the disease. It is thought that the factor which increases the incidence of cancer related fatigue is a long-term use of drugs such as opioids, benzodiazepine, and medicines containing codeine, tranquilizers, anxiolytics and antidepressants. On the basis of the results, one can choose an appropriate treatment method for cancer related fatigue such as rehabilitation, psychotherapy or public assistance. A great number of patients consider excessive fatigue a typical concomitant symptom in neoplastic disease; therefore, they do not report it. It is of a paramount importance to make patients aware of the fact that cancer related fatigue is a serious disease which can be treated.