RESUMO
BACKGROUND: The balanced activity of matrix metalloproteinases and their tissue inhibitors is an important, albeit still not completely understood, determinant of extracellular matrix homeostasis, a factor involved in the pathogenesis of acute pancreatitis (AP). AIMS: The aim of this study was to compare serum concentrations of matrix metalloproteinase 9 (MMP-9) and its tissue inhibitor (TIMP-1) in patients with AP of various severity and to investigate their relationship with prognostic indicators of AP severity, e.g., polymorphonuclear leukocyte elastase (PMN-E). PATIENTS AND METHODS: The study included 37 patients with mild (n = 18) or severe AP (n = 19) and 15 healthy controls. Serum concentrations of MMP-9 and TIMP-1 were determined on admission (day 1) and on days 2, 3, 5 and 10. RESULTS: Throughout the study period, the serum MMP-9 concentration in patients with severe AP was significantly higher than those in individuals with mild AP and in healthy controls. In turn, the serum MMP-9 concentrations in persons with mild AP did not differ significantly from those of the controls. The serum TIMP-1 concentrations in both groups were significantly higher than in the controls. Beginning from the 2(nd) day of hospital stay, the serum TIMP-1 concentration in patients with severe AP was significantly higher than in individuals with mild AP. There were significant correlations between: MMP-9 and PMN-E, TIMP-1 and PMN-E, and MMP-9 and TIMP-1. CONCLUSION: A disturbed balance between MMP-9 and TIMP-1 observed during the early stages of severe AP suggests that endogenous TIMP-1 is unable to prevent excessive activation and release of MMP-9. MMP-9 may represent a new marker of AP severity.
Assuntos
Metaloproteinase 9 da Matriz/sangue , Pancreatite/diagnóstico , Pancreatite/metabolismo , Inibidor Tecidual de Metaloproteinase-1/sangue , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
It has been suggested that interleukin 6 (IL-6) plays a potential role in the growth and progression of tumors, including esophageal cancer (EC). The aim of the study was to compare clinical significance of serum IL-6 with classic tumor markers - carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC-Ag) - in EC patients in relation to its histological types - squamous cell carcinoma of esophagus (ESCC) and adenocarcinoma (AD) of esophagus. The study included 53 EC patients and 90 healthy subjects. Serum IL-6 and CEA levels were determined using immunoenzyme assays, while SCC-Ag - chemiluminescent assay. The diagnostic criteria and prognostic values for markers were defined. The levels of all proteins tested in EC, ESCC, and AD were higher than in healthy subjects. The percentage of elevated results was substantially higher for IL-6 (86%) than for CEA (30%) and SCC-Ag (24%) in EC, similarly as in ESCC (87%, 23%, and 33%) and AD (87%, 39%, and 13%, respectively) patients. Concentrations of IL-6 depended on distant metastases and patients' survival in EC and were significantly higher in ESCC patients with more advanced tumor stage and nodal metastases. The IL-6 area under receiver operating characteristic curve (0.92) was larger than for CEA (0.84) and SCC-Ag (0.62) in EC, likewise in ESCC (0.92, 0.87, 0.77) and AD (0.91, 0.79, 0.57, respectively). Our findings indicate better usefulness of IL-6 than classic tumor markers in the diagnosis of EC, especially in patients with ESCC.
Assuntos
Adenocarcinoma/sangue , Adenocarcinoma/patologia , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/sangue , Neoplasias Esofágicas/patologia , Interleucina-6/sangue , Adenocarcinoma/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias/sangue , Área Sob a Curva , Antígeno Carcinoembrionário/sangue , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Esofágicas/diagnóstico , Feminino , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Curva ROC , Serpinas/sangueRESUMO
BACKGROUND: The response of asthmatics to exercise differs from that of healthy subjects, and the mechanisms responsible for exercise-induced bronchoconstriction (EIB) remain to be elucidated. OBJECTIVES: The aim of this study was to evaluate changes in RANTES levels in exhaled breath condensate (EBC) following intensive exercise in allergic asthmatics. METHODS: The study was conducted in a group of 19 asthmatics (11 with EIB and 8 without EIB) and 7 healthy volunteers. Changes in the concentrations of RANTES in EBC induced during the 24 h after intensive exercise were determined. Moreover, these measurements were tested for possible correlations with the results of other tests commonly associated with asthma as well as with changes in airway inflammation after exercise. RESULTS: In contrast to asthmatic patients without EIB and healthy controls, in asthmatics with EIB RANTES concentrations were statistically significantly increased in EBC collected during the first 24 h after an exercise test. There was a statistically significant correlation between the maximum increase in RANTES concentrations in EBC after exercise and either baseline exhaled nitric oxide (F(ENO)) or bronchial hyperreactivity to histamine and an increase in serum eosinophil cationic protein or F(ENO) 24 h after exercise in the EIB asthmatics. CONCLUSIONS: The increase in RANTES in asthmatic airways, promoting the migration and activation of inflammatory cells including eosinophils, may play an important role in the upregulation of airway inflammation after EIB in asthmatic patients.
Assuntos
Asma Induzida por Exercício/metabolismo , Broncoconstrição , Quimiocina CCL5/metabolismo , Adulto , Asma Induzida por Exercício/fisiopatologia , Testes Respiratórios , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Infertility affects approximately 186 million people worldwide and 8-12% of couples of reproductive age. Therefore, a comprehensive diagnostic evaluation of infertility is crucial to achieving improvements in targeted prevention and treatment outcomes. The aim of this review is to explore the biochemistry of infertility in order to properly diagnose and treat infertile couples. Recent studies indicate that routine measurement of biochemical parameters reflecting thyroid dysfunction, immunological disorders, autoimmune mechanisms, insulin resistance and malabsorption of selected micro- and macronutrients are required to assess infertility. Due to the complexity of this approach, algorithmic protocols that integrate these biochemical parameters in a dynamic test environment are necessary to provide a more comprehensive diagnostic assessment and more effective treatment strategy for infertile couples.
Assuntos
Infertilidade Feminina , Doenças da Glândula Tireoide , Feminino , HumanosRESUMO
BACKGROUND: There is increasing evidence that exercise-induced bronchoconstriction (EIB) is associated with eosinophilic airway inflammation. In the pathogenesis of EIB the role of chemokines - responsible for promoting the migration and activation of inflammatory cells - as well as blood platelets, a potential source of those chemokines, remains unclear. METHODS: The study was conducted in a group of 19 asthmatics (11 with EIB, 8 without EIB) and 8 healthy volunteers. Changes in the plasma concentrations of RANTES and beta-thromboglobulin (beta-TG) induced by intensive exercise were determined. Moreover, the possible correlation of these measurements with the results of other tests used in the diagnosis of asthma as well as laboratory tests commonly associated with asthma were investigated. RESULTS: A comparison of the concentrations of beta-TG in all groups studied at rest did not reveal any significant differences. In all groups studied, 30 min after exercise elevated beta-TG concentrations were observed; the most significant increase was revealed in asthmatics with EIB. The baseline concentrations of RANTES before exercise in both groups of asthmatics were significantly higher in comparison to the group of healthy volunteers. After exercise, in the group of patients with EIB, a significant increase in RANTES concentrations was observed. These changes correlated with an increase in other markers of airway inflammation 24 h after exercise. CONCLUSIONS: We suggest that platelet activation, resulting in elevated RANTES release, could be one of the factors responsible for the increase of airway inflammation observed in consequence of EIB in asthmatics.
Assuntos
Asma/imunologia , Broncoconstrição/imunologia , Quimiocina CCL5/sangue , Exercício Físico , beta-Tromboglobulina/análise , Adulto , Asma/sangue , Feminino , Humanos , Masculino , Ativação PlaquetáriaRESUMO
Background: Chronic hepatitis C is a major public health problem around the world. In monitoring treatment efficacy, although costly and labour-intensive methods of molecular biology are often used, much cheaper and technically easier serological methods evaluating the concentration of HCV core antigen in serum are available. We evaluated HCVcAg quantification as a possible assessment of the treatment efficacy instead of HCV RNA quantification.Methods: We collected 514 serum samples from treated HCV infected patients. Quantitative evaluation of HCV RNA and HCVcAg was carried out before treatment, at the end of treatment, and at least 12 weeks following treatment termination. HCV RNA was determined by automated assay (Roche COBAS) and HCVcAg quantitation with ARCHITECT ci8200 analyser.Results: There was a significant correlation between HCVcAg and HCV RNA concentrations at baseline and follow-up visits, but not at the end of treatment. Among samples collected before the treatment, at the end of treatment and follow-up visit, concordance of HCV RNA and HCVcAg reached level of 98.1%, 98.9% and 98.7%, respectively. Diagnostic sensitivity, specificity, positive and negative predictive values of HCVcAg detection were >97%.Conclusions: HCVcAg measurement could be an alternative for determining HCV treatment efficacy after chemotherapy and could be an option in the diagnosis of HCV infection.
Assuntos
Antivirais/uso terapêutico , Hepacivirus/efeitos dos fármacos , Antígenos da Hepatite C/genética , Hepatite C Crônica/tratamento farmacológico , RNA Viral/genética , Proteínas do Core Viral/genética , Adulto , Feminino , Hepacivirus/genética , Hepacivirus/crescimento & desenvolvimento , Antígenos da Hepatite C/sangue , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/antagonistas & inibidores , RNA Viral/sangue , Resultado do Tratamento , Proteínas do Core Viral/sangue , Carga Viral/efeitos dos fármacos , Replicação Viral/efeitos dos fármacosRESUMO
BACKGROUND: Increased serum tryptase has been linked to the severity of the reaction after Hymenoptera stings. The aim of the study was to measure basal tryptase levels in patients with Hymenoptera venom allergy and investigate the possible correlation between these levels and the severity of sting reaction. METHODS: One hundred nine patients were included in the study. Sixty-three were wasp venom-allergic and 46 were honey bee venom-allergic. Basal serum tryptase levels were measured by UniCAP. RESULTS: Basal serum tryptase levels were elevated in 12 (11%) of the 109 patients. Levels were 5.14 pg/L (3.62-5.84), 5.3 microg/L (2.94-6.54), 5.18 microg/L (3.71-6.25), and 6.98 microg/L (4.78-12.6), for patients with sting reactions of grade I, II, III and IV (as classified by Mueller), respectively. Basal serum tryptase levels correlated significantly with the sting reaction severity (r = 0.2752; P = .004) and with age (r = 0.2906; P = .002). Sting reaction severity also correlated with age (r = 0.3654; P = .001). CONCLUSIONS: Basal serum tryptase levels were found to be elevated in 11% of venom allergic patients and correlated significantly with both sting reaction severity and age.
Assuntos
Abelhas/imunologia , Hipersensibilidade Imediata/sangue , Mordeduras e Picadas de Insetos/imunologia , Triptases/sangue , Vespas/imunologia , Adulto , Fatores Etários , Animais , Estudos Transversais , Feminino , Humanos , Hipersensibilidade Imediata/imunologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Testes CutâneosRESUMO
Granulocyte-macrophage-colony stimulating factor (GM-CSF) belongs to the group of glycoproteins called colony-stimulating factors (CSFs). It has been shown that the activity of CSFs is not limited to the hematopoietic cells but can also affect the proliferation of colon carcinoma cell lines. The purpose of this investigation was to compare the serum level of GM-CSF in colorectal cancer patients to a control group, to assess the level of GM-CSF in relation to the level of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9), and to define the sensitivity, the specificity and the predictive values of GM-CSF in colorectal cancer. In this study, the serum level of tumour markers was measured in 30 patients with colorectal cancer and in 20 healthy subjects. GM-CSF was assayed using ELISA system, CEA and CA 19-9 were measured by MEIA. The serum levels of CEA, CA 19-9 and GM-CSF were higher in the patients with colorectal cancer than in the control group. The sensitivities of CEA (63%) and CA 19-9 (56%) were lower than the GM-CSF sensitivity (80%). The specificities of tumour markers were 70% (CEA, GM-CSF) and 75% for CA 19-9. The GM-CSF predictive v values were higher than the CEA and CA 19-9 values. These results suggest that GM-CSF may be useful as tumour marker in colorectal cancer, but further studies are needed.
Assuntos
Neoplasias Colorretais/sangue , Fator Estimulador de Colônias de Granulócitos e Macrófagos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Antígeno Carcinoembrionário/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
GM-CSF is a hematopoietic growth factor. In vitro it stimulates the proliferation of myeloid progenitors and formation of granulocyte and macrophage colonies. It was found that GM-CSF in vitro is also stimulated the function of mature granulocytes, but we have no information about such influence in vivo. The purpose of this investigation was the evaluation in vivo of the GM-CSF effect on phagocytosis, bactericidal activity, and lysosome enzyme activities in granulocytes. GM-CSF was injected into mice subcutaneously during 5 consecutive days in the dose of 1 microgram/kg/d. The examination of the percent of cell phagocytizing bacteria (Staphylococcus aureus), NBT test, bactericidal activity and activation of acid phosphatase, alkaline phosphatase, peroxidase and esterase was performed every day and an evident increase of the tested parameters was found. These results prove in vivo activation of granulocytes by GM-CSF.
Assuntos
Fator Estimulador de Colônias de Granulócitos e Macrófagos/imunologia , Granulócitos/imunologia , Fagocitose/fisiologia , Staphylococcus aureus/imunologia , Fosfatase Ácida/metabolismo , Fosfatase Alcalina/metabolismo , Animais , Esterases/metabolismo , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Granulócitos/enzimologia , Injeções Subcutâneas , Ativação de Macrófagos/fisiologia , Masculino , Camundongos , Peroxidase/metabolismo , Fagocitose/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacosRESUMO
Stem Cell Factor (SCF) can stimulate the growth and development of primitive multipotential and unipotential hematopoietic stem cells, either alone or in combination with other cytokines such as Granulocyte-Macrophage Colony Stimulating factor (GM-CSF) and Granulocyte-CSF (G-CSF). It was found that these cytokines can also stimulate the function of granulocytes but there is no information concerning SCF influence on the function of these mature cells. SCF was injected into mice subcutaneously during 5 consecutive days in a dose of 1 microgram/kg/d. An examination of the percentage of phagocytic granulocytes and NBT test was performed. The activity of acid phosphatase (AcP), alkaline phosphatase (AP), peroxidase (MPO) and esterase were determined by cytochemistry methods. On the basis of obtained results we can conclude that SCF evidently increases all tested parameters connected with the metabolism of phagocytosis.
Assuntos
Granulócitos/efeitos dos fármacos , Granulócitos/metabolismo , Fatores de Crescimento de Células Hematopoéticas/administração & dosagem , Fatores de Crescimento de Células Hematopoéticas/metabolismo , Fagocitose/fisiologia , Fosfatase Ácida/metabolismo , Fosfatase Alcalina/metabolismo , Animais , Esterases/metabolismo , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos e Macrófagos/administração & dosagem , Masculino , Camundongos , Peroxidase/metabolismoRESUMO
Interleukin-3 is a multipotential hematopoietic growth factor, which like other colony stimulating factors (CSFs) is effective "in vitro" stimulation of the mature cells function. It was found that IL-3 synergistically with GM-CSF and G-CSF stimulated the proliferation of the granulocytes. Therefore the purpose of this investigation was the evaluation "in vivo" of the influence of IL-3 on the phagocytosis, bactericidal activity, and enzyme activities of granulocytes. IL-3 was injected into mice subcutaneously during 5 days in dose 1 microgram/kg/d. The examination of the percent of cells phagocytizing bacteria (Staphylococcus aureus), NBT test and bactericidal activity, were performed every day and evident increase of the tested parameters was found. Additionally the enzyme activities in primary granules were measured and showed on increase of acid phosphatase and peroxidase activity.
Assuntos
Granulócitos/imunologia , Interleucina-3/imunologia , Fagocitose/imunologia , Staphylococcus aureus/imunologia , Fosfatase Ácida/metabolismo , Animais , Granulócitos/enzimologia , Interleucina-3/farmacologia , Masculino , Camundongos , Peroxidase/metabolismo , Staphylococcus aureus/efeitos dos fármacosRESUMO
Several circulating tumour markers for non-small-cell lung cancer (NSCLC) have been identified. Recent studies have focused on a new family of markers--hematopoietic growth factors. Some clinical investigations have shown cell surface receptors for interleukin 3 (IL-3) in lung cancer cells and autologous production of IL-3 in various human cell lines derived from NSCLC. The purpose of this investigation was to compare serum levels of IL-3 in non-small-cell lung cancer with a control group, to assess pre- and post treatment levels of IL-3 in relation to levels of commonly accepted tumour markers such as carcino-embryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1), and to define the diagnostic sensitivity and specificity of IL-3 in NSCLC. In this study, the serum level of tumour markers was measured in 34 patients with NSCLC and in 20 healthy subjects. Serum samples were drawn before surgery and 10, 30, 90, 180 and 270 days after surgery. IL-3 and CEA were assayed using ELISA system and CYFRA 21-1 was measured by radioimmunoassay (RIA). Preoperative level of IL-3 was significantly increased in cancer patients relative to the control group. Concentrations of tumour markers were decreased after surgery and then increased (IL-3 and CEA) during chemio- or radiotherapy. The diagnostic sensitivity of IL-3 was 44% and the diagnostic specificity--85%. This investigation is one of the first studies assessing serum levels of IL-3 in the cancer patients. These results suggest that IL-3 may be useful in diagnostics of NSCLC, but this subject needs further studies.
Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Interleucina-3/sangue , Neoplasias Pulmonares/diagnóstico , Adulto , Idoso , Antígenos de Neoplasias/sangue , Antígeno Carcinoembrionário/sangue , Carcinoma Pulmonar de Células não Pequenas/terapia , Terapia Combinada , Feminino , Humanos , Queratina-19 , Queratinas , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To compare the expression level of the most relevant angiogenesis-related genes in the eutopic endometrium of women with and without endometriosis. STUDY DESIGN: 32 regularly menstruating patients (18 with endometriosis and 14 controls) underwent surgery in the proliferative phase of the cycle. Eutopic endometrium was collected by the use of aspirating biopsy prior to laparoscopy. Only patients with advanced (stage III and IV) histopathologically confirmed ovarian endometriosis were studied. Real-time PCR gene arrays were applied to examine the expression of 84 human angiogenesis-connected genes. Western-blot and enzyme-linked immunosorbent assays (ELISA) were used to confirm the expression of selected proteins. RESULTS: We found significantly higher levels of AKT1 (p=0.003), TYMP (p=0.02), JAG1 (p=0.007), LAMA5 (p=0.005) and TIMP-1 (p=0.03) in eutopic endometrium of patients with endometriosis as compared with controls. By the use of Western blot we found clearly positive expression of AKT1 whereas ELISA assays confirmed expression of AKT1, TYMP, JAG1, LAMA5 and TIMP1. CONCLUSION: Changes in the expression of selected genes might lead to or be a consequence of an early defect in the physiological activity of proliferative endometrium ultimately resulting in its overgrowth outside the uterine cavity.
Assuntos
Endometriose/genética , Endométrio/metabolismo , Fase Folicular/genética , Neovascularização Patológica/genética , Neovascularização Fisiológica/genética , Doenças Ovarianas/genética , RNA Mensageiro/análise , Adulto , Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Estudos de Casos e Controles , Endometriose/metabolismo , Endométrio/irrigação sanguínea , Ensaio de Imunoadsorção Enzimática , Feminino , Fase Folicular/metabolismo , Perfilação da Expressão Gênica , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Proteína Jagged-1 , Laminina/genética , Laminina/metabolismo , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Neovascularização Patológica/metabolismo , Doenças Ovarianas/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Proteínas Serrate-Jagged , Timidina Fosforilase/genética , Timidina Fosforilase/metabolismo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Adulto JovemRESUMO
PURPOSE: The matrix metalloproteinases, tissue inhibitors of metalloproteinases and angiogenesis contribute to growth and spread of cancer. We investigated the correlation between pretreatment serum levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) and vascular endothelial growth factor A (VEGF-A), and clinicopathologic features and survival in patients with esophageal cancer (EC). MATERIAL/METHODS: Serum TIMP-1 and VEGF-A were measured by enzyme-linked immunosorbent assay (ELISA) in 89 patients with EC, and 30 healthy controls. RESULTS: Serum TIMP-1 and VEGF-A levels were significantly higher in patients with esophageal carcinoma than in the control group (p=0.001 and p<0.001, respectively). High levels of TIMP-1 were associated with histological type (p<0.001), tumor depth (p<0.001), stage (p<0.001) and lymph node metastases (p=0.001). Subgroup analysis showed that tumor size (p<0.001), tumor depth (p<0.001), stage (p<0.001), lymph node metastases (p=0.002), distant metastases (p=0.009) and resectability (p=0.003), were correlated with an elevated level of VEGF-A. Patients with elevated levels of TIMP-1 and VEGF-A had a significantly lower overall survival (p=0.02 and p=0.048, respectively), and disease-free survival (TIMP-1, p<0.001). CONCLUSION: High serum levels of TIMP-1 and VEGF-A were found to be associated with tumor progression and unfavorable prognosis in patients with EC.
Assuntos
Adenocarcinoma/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Esofágicas/metabolismo , Inibidor Tecidual de Metaloproteinase-1/sangue , Fator A de Crescimento do Endotélio Vascular/sangue , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/secundário , Intervalo Livre de Doença , Ensaio de Imunoadsorção Enzimática , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Feminino , Seguimentos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , PrognósticoRESUMO
PURPOSE: The most important index of renal function is estimated glomerular filtration rate (eGFR) which can be calculated from creatinine or cystatin C concentration in serum. There is uncertainty, which formula is best suited to assess renal function in morbidly obese patients. The aim of this study was to evaluate eGFR in patients with morbid obesity using formulas: Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Grubb, Le Bricon, Hoek, Larsson, and to compare the obtained results. MATERIAL AND METHODS: In 40 morbidly obese patients, serum concentration of cystatin C and creatinine were assayed. Values of eGFR were calculated using the above-mentioned formulas. RESULTS: The mean value of eGFR ranged from 85.9 to 111.1 ml/min/1.73 m², depending on the formula. The biggest difference between the obtained values was 29% (Grubb vs. Hoek p<0.01). After calculation of eGFR from creatinine concentration (MDRD), 7 patients were qualified to the 2nd and 3rd stage of chronic renal disease, while application of Hoek's formula, based on cystatin C concentration, allotted 27 patients to 2nd and 3rd stage of chronic renal disease. Le Bricon formula gave eGFR values, that correlated best with albuminuria. CONCLUSION: eGFR calculated using Le Bricon formula based on the cystatin C concentration was significantly lower than eGFR calculated from creatinine concentration and was more closely associated with albuminuria. Relying only on creatinine concentration to estimate glomerular filtration rate can lead to underestimation of renal malfunction in obese patients.
Assuntos
Creatinina/sangue , Cistatina C/sangue , Testes de Função Renal/métodos , Modelos Biológicos , Obesidade Mórbida/metabolismo , Insuficiência Renal Crônica/metabolismo , Adulto , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Taxa de Filtração Glomerular , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Fatores de RiscoRESUMO
BACKGROUND: Matrix metalloproteinase 2 (MMP-2) is able to degrade type IV collagen and its activity is mostly regulated by tissue inhibitor of matrix metalloproteinase 2 (TIMP-2). These proteins might play a role in tumor progression, including gastric cancer (GC). METHODS: The study included 108 individuals, GC patients and healthy subjects. Serum levels of all analyzed markers were evaluated by the immunological methods, while immunohistochemistry was used to assess the expression of these proteins in GC, interstitial inflammatory cells and normal tissues. RESULTS: The percentage of positive reactions of MMP-2 and TIMP-2 was higher in GC and inflammatory cells compared to normal tissue, while serum levels of these proteins were statistically lower in GC patients in comparison to healthy subjects. There was a significant positive correlation between TIMP-2 immunoreactivity in inflammatory cells and the presence of lymph node metastasis. Area under ROC curve (AUC) for TIMP-2 was higher than MMP-2, while serum MMP-2 was an independent prognostic factor of GC patients' survival. CONCLUSION: Our findings suggest that TIMP-2 seems to be a predictor of tumor progression, especially for nodal involvement, whereas serum MMP-2 might be useful as an independent prognostic factor of patients' survival.
Assuntos
Gastrite/metabolismo , Metaloproteinase 2 da Matriz/metabolismo , Neoplasias Gástricas/metabolismo , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/metabolismo , Feminino , Gastrite/mortalidade , Gastrite/patologia , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Metaloproteinase 2 da Matriz/sangue , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Curva ROC , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/secundário , Inibidor Tecidual de Metaloproteinase-2/sangue , Adulto JovemRESUMO
PURPOSE: Clinical relevance of relations among blood pressure (BP), inflammation, endothelial dysfunction and sympathetic activation is unknown. Study aimed, whether in patients with diagnosed and treated essential arterial hypertension (HTN) biomarkers of inflammation (hs-C-reactive protein, hs-CRP), endothelial dysfunction (endothelin-1, ET-1), and sympathetic nervous system modulation (epinephrine, E and norepinephrine, NE) could be related to BP values. MATERIAL AND METHODS: In 62 patients with diagnosed and treated HTN (mean time of disease 5±3.2 years), serum hs-CRP and ET-1 as well as plasma E and NE concentrations were measured. 24-hour ambulatory blood pressure measurement device (ABPM) was used to estimate efficacy of treatment. RESULTS: A positive correlation between epinephrine and norepinephrine concentrations was found (r=0.246, p=0.05), however such a statistically significant correlation neither to hs-CRP, nor ET-1 were found. Patients with the highest hs-CRP and NE concentrations had the highest systolic (SBP) and diastolic (DBP) blood pressure values. Similar relation was found in subgroup of patients with suboptimal blood pressure values (SPB l 130mmHg, DBP l 80mmHg). In a group of optimal treated patients, elevated levels of ET-1 and NE related to increased blood pressure values. ROC analysis identified ET-1 as statistically significant to diagnose elevated blood pressure: 0.665 (95% Confidence interval 0.512 to 0.796). CONCLUSIONS: In patients with diagnosed and treated arterial hypertension, there are relations among measurements of hs-CRP, ET-1, NE and blood pressure values in spite of treatment, which may improve understanding of mechanisms involving inflammation, endothelial dysfunction and sympathetic nerve activation and may identify patients with refractory hypertension.
Assuntos
Pressão Sanguínea , Endotélio Vascular/fisiopatologia , Hipertensão/imunologia , Mediadores da Inflamação/sangue , Inflamação Neurogênica/etiologia , Adulto , Biomarcadores/sangue , Feminino , Humanos , Hipertensão/sangue , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To assess low-grade, systemic inflammation and antioxidant status as additional factors contributing to pathophysiology of essential arterial hypertension (HTN) and compare them with traditional risk factors, like abnormal lipids profile, considering their potential diagnostic usefulness. MATERIAL AND METHODS: Serum high-sensitivity C-reactive protein (hs-CRP) concentrations and total antioxidant status (TAS) were measured in 143 subjects - 71 patients with diagnosed HTN and in 72 healthy controls. RESULTS: In hypertensive patients, as compared to healthy control group, the median hs-CRP concentration was higher (2.0 mg/L, 25%; 75% quartile range: 0.1; 27.1 vs 0.4 mg/L, 25%; 75% quartile range: 0.0; 4.6, respectively, p<0.001) and TAS concentration lower (1.4 mmol/L, 25%; 75% quartile range: 1.0; 2.1 vs 1.5 mmol/L, 25%; 75% quartile range: 0.5; 1.8, respectively, p=0.048). Hypertensives had higher low-density lipoprotein cholesterol concentration (LDL-C) as well as triglycerides concentration (TG) and lower high-density lipoprotein cholesterol concentration (HDL-C). Higher diagnostic sensitivity was found for hs-CRP (87%) and for TAS (89%). According to the global linear regression analysis, age, gender, hs-CRP, TAS and HDL-C were the only parameters influencing the occurrence of HTN. ROC analysis identified hs-CRP, HDL-C and TG as statistically significant to diagnose HTN (0.839; 0.816 and 0.855, respectively). Moreover, in ROC analysis there were no differences in hs-CRP and TAS in females and males. CONCLUSIONS: These results indicate that low-grade, systemic inflammation measured by hs-CRP as well as antioxidant status assessed by TAS, in the presence of traditional risk factors, are significant factors contributing to pathophysiology and diagnosis of essential arterial hypertension.
Assuntos
Antioxidantes/análise , Proteína C-Reativa/análise , Dislipidemias/sangue , Hipertensão/sangue , Adulto , Fatores Etários , Pressão Sanguínea/fisiologia , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Creatinina/sangue , Ecocardiografia , Eletrocardiografia , Eletrocardiografia Ambulatorial , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue , Adulto JovemRESUMO
PURPOSE: Incidence of pancreatic exocrine insufficiency in biliary pathology is estimated for about 30%. The objective was to assess pancreatic exocrine function in biliary tract pathology (cholelithiasis, strictures) before and after endoscopic treatment. PATIENTS AND METHODS: Twenty-eight patients with choledocholithiasis and its complications (19F/9M; aging 31-90 years, median: 69 years) were evaluated. Fecal elastase 1 concentration was measured using ELISA, before, early, and 6-8 weeks after endoscopic treatment. The inflammatory response of pancreas to the treatment was also assessed. RESULTS: Initial fecal elastase 1 concentration in patients (median 454 microg/g) was not significantly different as compared to the control (median 357 microg/g). Nine patients (32%) had low fecal elastase 1 concentration (below 250 microg/g) and out of them 6 had the concentration below 200 microg/g, suggesting impairment of exocrine pancreatic function. Endoscopic treatment was successful in 82% of patients. Pancreatic inflammatory response was noted only in one patient. After 6-8 weeks fecal elastase 1 concentration in the whole group of patients did not significantly change in comparison to the initial level. However, out of 9 patients with initially low fecal elastase 1 concentration (median 191 microg/g) at least in 6 pancreatic function improved (median 310 microg/g), P < 0.001. CONCLUSION: One third of the patients with biliary pathology had a low fecal elastase 1 concentrations, suggesting pancreatic dysfunction. In at least 2/3 of these patients successful endoscopic treatment of biliary pathology resulted in the significant increase of fecal elastase 1 concentration. Therefore, an additional positive effect of such treatment in some patients, could be an improvement of the exocrine pancreatic dysfunction.
Assuntos
Sistema Biliar/patologia , Endoscopia/métodos , Pâncreas Exócrino/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alanina Transaminase/metabolismo , Fosfatase Alcalina/metabolismo , Aspartato Aminotransferases/metabolismo , Ductos Biliares/patologia , Bilirrubina/metabolismo , Feminino , Humanos , Litíase , Masculino , Pessoa de Meia-Idade , Elastase Pancreática/sangue , Elastase Pancreática/metabolismo , alfa-Amilases/metabolismoRESUMO
Lung cancer is biologically and clinically classified as non-small-cell lung cancer (NSCLC) or small cell lung cancer (SCLC). NSCLC is accounting for about 80% of lung cancers. Serum tumour markers may be helpful in diagnostic of this cancer and in monitoring of the tumour growth or tumour volume reduction. Recent studies have focused on a new family of markers--hematopoietic cytokines, defined also hematopoietic growth factors (HGFs). It has been shown that the actions of HGFs are not limited to hematopoietic cells but can also affect the proliferation of nonhematopoietic cells. Some clinical investigations have shown cell surface receptors for macrophage--colony stimulating factor (M-CSF) in cancer cells and autologous production of M-CSF in various human cell lines derived from cancer. The purpose of this investigation was to compare serum levels of M-CSF in NSCLC patients to a control group, to assess pre- and post treatment levels of M-CSF in relation to levels of commonly accepted tumour markers such as carcinoembryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1), and to define the diagnostic sensitivity of G-CSF in NSCLC. In this study, the serum levels of tumour markers were measured in 34 patients with NSCLC and in 20 healthy subjects. Serum samples were drawn before surgery and 10, 30, 90, 180 and 270 days after surgery. M-CSF and CEA were assayed using ELISA system and CYFRA 21-1 was measured by radioimmunoassay (RIA). The serum level of M-CSF was significantly increased in cancer patients relative to the control group on the 10th day after operation. Concentrations of CYFRA 21-1 were decreased on the 10th day, CEA on the 30th day and M-CSF on the 90th day after surgery. The diagnostic sensitivity of M-CSF was 55%, CEA--62% and CYFRA 21-1-51%. The diagnostic sensitivity and the serum level of M-CSF were related to the stage of NSCLC. These results suggest that M-CSF may be useful in diagnostic and monitoring of NSCLC, but it needs further studies.