Factors associated to hypermanganesemia in patients receiving home parenteral nutrition

BACKGROUND: Home parenteral nutrition (HPN) patients often present hypermanganesamia. AIM: To examine which factors may be associated to hypermanganesemia in HPN patients. METHODS: Plasma manganese (Mn), liver function tests, C-reactive protein concentrations, erythrocyte sedimentation rate (ESR), tumor necrosis factor-alpha (TNF- alpha), interleukin-6, soluble receptors of interleukin-2, and blood neopterin concentrations were determined in 21 HPN patients and 10 healthy controls. Brain magnetic resonance imaging (MRI) and careful neurologic clinical examination were performed in 11 patients. RESULTS: Mn concentration was higher in HPN patients than controls (1.96+/-1.1 vs 0.81+/- 0.4 microg/L;P<0.001) and positively correlated to the amount of parenteral nutrition (PN) supply, transaminases and alkaline phosphatase (r=0.53, P<0.0001) concentrations, as well as to ESR (r=0.61, P<0.0001), TNF- alpha and blood neopterin. The amount of calories provided by PN was positively correlated to inflammatory markers and liver parameters. All patients investigated by MRI showed hyperintense basal ganglia on T1-weighted images suggesting brain Mn deposition. Only one had slight clinical extrapyramidal symptoms. CONCLUSION: In HPN patients, sustained inflammation may facilitate hypermanganesemia through 1. cholestatic liver disease and thereby decreased Mn biliary excretion, 2. high nutritional requirements (responsible for increased Mn supply), and/or 3. modified Mn metabolism or body distribution. Neurologic complications appeared marginal whereas Mn brain deposition seems frequent.     

妊高征患者血清新喋呤、白介素2及可溶性受体的变化与意义

目的:通过观察妊高征患者血清新喋呤、白介素2及可溶性受体(sIL-2R) 水平的变化, 探讨妊高征患者细胞免疫功能的变化及意义。方法: 采用酶联免疫吸附分析法与放射免疫分析法测定28例妊高征(轻、中度12例, 重度16例)和30例正常孕妇的血清新喋呤、白介素2和sIL-2R水平; 比较二组间新喋呤、白介素2和sIL-2R水平的差异; 观察新喋呤、白介素2和sIL-2R水平与妊高征病情的关系。结果: 妊高征患者血清新喋呤、白介素2和sIL-2R水平显著高于对照组(t'=4 543, P<0 .001; t=2. 946, P<0. 01; t'=2 .251, P<0. 05); 重度妊高征患者新喋呤水平显著高于轻、中度患者(t'=2 .913,P<0 .01), 重度妊高征患者与轻、中度患者组比较白介素2和sIL-2R均无显著性差异(t=0 .888, P>0 .2; t=0. 444, P>0 .5)。结论: 妊高征患者血清新喋呤、白介素2及可溶性受体水平显著增高, 新喋呤水平随妊高征病情加重而增高, 提示细胞免疫活性增强可能与妊高征的发生和发病有关。     

The relationship between nutritional status and serum soluble interleukin-2 receptor concentrations in patients with Crohn's disease treated with elemental diet

Serum soluble interleukin-2 receptor concentrations (sIL-2R) were measured and correlated with indices of disease activity and nutrition in 13 patients with active Crohn's disease treated with an elemental diet. The initial serum sIL-2R concentrations were raised, 1121 +/- 181 U/ml (mean +/- SEM) compared to controls, 177 +/- 22.9 U/ml (n = 18) (p < 0.001). Four weeks' treatment resulted in significant improvement in disease activity (Harvey-Bradshaw index) and 4-day faecal (111)Indium-leucocyte excretion. Serum sIL-2R concentrations did not change significantly after treatment, 789 +/- 79.8 U/ml (p > 0.05). Serum sIL-2R concentrations were inversely correlated with albumin, pre-albumin, creatinine-height index and total body potassium. Only those patients with markedly elevated sIL-2R concentrations (>800 U/ml) and severe nutritional depletion prior to treatment, showed significant reductions in sIL-2R levels with elemental dietary treatment. These results demonstrate an association between nutritional impairment and immune activation in Crohn's disease.     

妊娠期肝内胆汁淤积症细胞免疫与辅助T细胞亚群功能的研究

目的:通过观察妊娠期肝内胆汁淤积症(ICP)患者血清新喋呤、可溶性白介素2受体(sIL-2R)、辅助T细胞1型(白介素2)与2型细胞因子(白介素10)的变化,探讨细胞免疫功能与辅助T细胞亚群功能变化与ICP的关系。方法:采用酶联免疫吸附分析法和放射免疫分析法测定30例ICP患者和30例正常孕妇血清新喋呤、可溶性白介素2受体(sIL-2R)、白介素2(IL-2)与IL-10浓度,比较二组间差异。结果:与对照组比较,ICP患者血清新喋呤和sIL-2R水平显著增高(P<0·001,P<0·05),IL-2、IL-10与IL-2/IL-10比值均无显著性差异(P>0·5,P>0·2,P>0·05)。结论:ICP患者血清新喋呤和sIL-2R水平显著增高,提示细胞免疫活性增强,但辅助T细胞亚群功能无显著漂移。     

Primary school children from northeast Thailand are not at risk of selenium deficiency

Selenium has important roles as an antioxidant, in thyroid hormone metabolism, redox reactions, reproduction and immune function, but information on the selenium status of Thai children is limited. We have assessed the selenium status of 515 northeast Thai children (259 males; 256 females) aged 6 to 13 years from 10 rural schools in Ubon Ratchthani province. Serum selenium (n=515) was analyzed by Graphite Furnace Atomic Absorption Spectrophotometry and dietary selenium intake by Hydride Generation Absorption Spectrophotometry from one-day duplicate diet composites, from 80 (40 females; 40 males) randomly selected children. Inter-relationships between serum selenium and selenium intakes, and other biochemical micronutrient indices were also examined. Mean (SD) serum selenium was 1.46 (0.24) micro mol/L. Concentrations were not affected by infection or haemoglobinopathies, but were dependent on school (P< 0.001), sex (P=0.038), and age group (P=0.003), with serum zinc as a significant covariate. None of the children had serum selenium concentrations indicative of clinical selenium deficiency (i.e. <0.1 micro mol/L). Significant correlations existed between serum selenium and serum zinc (r= 0.216; P < 0.001), serum retinol (r = 0.273; P < 0.001), urinary iodine (r = -0.110; P = 0.014), haemoglobin (r = 0.298; P <0.001), and haematocrit (r = 0.303; P< 0.001). Mean (SD) dietary selenium intake was 46 (22) micro g/d. Children with low serum selenium concentrations had a lower mean selenium intake than those with high serum selenium concentrations (38 +/- 17 vs.51 +/- 24 micro g/d; P< 0.010). In conclusion, there appears to be no risk of selenium deficiency among these northeast Thai children.     

Selenium status prior to and during one month total parenteral nutrition in gastroenterological patients: A randomised study of two dosages of Se supplementation

13 consecutive adult gastroenterological patients with non-malignant disease who were candidates for total parenteral nutrition (TPN), and who had mild protein-energy malnutrition (82 +/- 3% of ideal body weight, serum albumin 32 +/- 2 g/l, mean +/- SEM) were found to have, prior to TPN, a Selenium level 50% less than controls (p < 0.001) as assayed by Se and glutathione peroxidase (GSHPx) in plasma and erythrocytes. Compared with other trace metals and minerals, eg, Mn, Zn and Cu, depletion of Selenium was the most marked in this population. Patients were randomised to be supplemented with either 100 or 200 mug/d of sodium-selenite, equal to 32 mug (0.4 mumol) or 64 mug (0.8 mumol) of selenium, in two cross-over periods of TPN, each of two weeks. In this short term study, significant increases in the four measurements of Se status (p < 0.05) were seen in all patients, but there was no difference between those receiving the high or low dose of the element. GSHPx in plasma was normalised within 1 month whereas the increase seen in the erythrocyte pool was consistent with a 4-month half-life. Pooled Se values for patients and controls showed logarithmic correlations between Se and GSHPx in erythrocytes (p < 0.001) and plasma (p < 0.01). Changes in GSHPx provided further evidence of Se depletion in our patients. This study suggests that malnourished gastroenterological patients receiving TPN require Se supplements and that 100 mug (0.4 mumol)/d of sodium-selenite is adequate for most patients since there was no additional benefit from the higher dose of 200 mug (0.8 mumol).     

Glutathione, glutathione peroxidase, and selenium status in HIV-positive and HIV-negative adolescents and young adults

BACKGROUND: Antioxidant nutrient deficiencies may hasten the progression of HIV disease by impairing antioxidant defenses. OBJECTIVE: The objective of the study was to determine whether HIV infection is associated with poor selenium status and low antioxidant protection by glutathione and glutathione peroxidase (GPX). DESIGN: In a cross-sectional study of 365 HIV-positive and HIV-negative adolescents and young adults, we examined the relation of plasma selenium, whole-blood glutathione, and whole-blood GPX to HIV status, disease severity, immune activation, and oxidative damage. RESULTS: Selenium deficiency (plasma selenium < 0.070 microg/mL) was not seen in any subjects, and plasma selenium in 244 HIV-positive subjects (0.120 +/- 0.0013 microg/mL) did not differ significantly (P = 0.071) from that in 121 HIV-negative subjects (0.125 +/- 0.0020 microg/mL) . However, multiple regression analysis after adjustment for covariates showed a significant (P = 0.002) negative association between HIV-associated immune activation (plasma neopterin) and plasma selenium concentrations. GPX activity was highest in HIV-positive subjects taking antiretroviral therapy (median: 14.2; 25th, 75th percentiles: 11.1, 18.7 U/mL; n = 130), intermediate in HIV-positive subjects not taking antiretroviral therapy (11.8; 9.4, 15.1 U/mL; n = 114), and lowest in HIV-negative subjects (10.6; 8.6, 12.7 U/mL; n = 121; P < 0.05 for all comparisons). GPX was also positively associated with malondialdehyde, a marker of oxidative damage. CONCLUSIONS: Subjects had adequate selenium status, although HIV-related immune activation was associated with lower plasma selenium concentrations. GPX activity appears to have been induced by the oxidative stress associated with HIV infection and use of antiretroviral therapy. Thus, young, well-nourished subjects can mount a compensatory antioxidant response to HIV infection.     

Selenium supplementation, soluble tumor necrosis factor-alpha receptor type 1, and C-reactive protein during psoriasis therapy with narrowband ultraviolet B

OBJECTIVE: We examined the influence of supplementation with selenomethionine on soluble tumor necrosis factor-alpha receptor type 1 (sTNF-R1) and C-reactive protein (CRP) concentrations in patients with psoriasis who were treated with narrowband ultraviolet B. METHODS: Thirty-seven patients had narrowband ultraviolet B therapy five times a week and received 200 mug of selenium daily as selenomethionine (group 1, n = 19) or placebo (group 2, n = 18) for 4 wk. Assessment, performed at baseline, after 2 and 4 wk, and 4 wk after the end of treatment included measurement of the Psoriasis Area and Severity Index (PASI) and serum concentrations of selenium (micrograms per liter), sTNF-R1 (nanograms per milliliter), and CRP (milligrams per liter). Control sera were obtained from 20 healthy volunteers. RESULTS: Baseline PASI was 12.70 +/- 5.48 (13.02 +/- 6.25 in group 1 and 12.37 +/- 4.71 in group 2), selenium concentration was 50.55 +/- 9.54 (49.05 +/- 10.38 and 52.13 +/- 8.61, respectively), sTNF-R1 concentration was 1.91 +/- 0.38 (1.96 +/- 0.37 and 1.87 +/- 0.40, respectively), and CRP concentration was 25.34 +/- 8.27 (26.12 +/- 8.42 and 24.57 +/- 7.72). In controls, selenium concentration was 48.71 +/- 9.39 (P > 0.05 versus patients), sTNF-R1 concentration was 1.48 +/- 0.30 (P < 0.05), CRP concentration was <6. The baseline sTNF-R1 level correlated to PASI value (r = 0.40, P < 0.05) and CRP concentration (r = 0.36, P > 0.05). The treatment resulted in an almost parallel decrease in PASI in both groups. At 4 wk after the end of treatment, selenium concentrations were 83.77 +/- 5.13 in group 1 and 52.12 +/- 7.54 in group 2 (P < 0.05), sTNF-R1 concentrations were 1.72 +/- 0.27 and 1.47 +/- 0.26 (P < 0.05), and CRP concentrations were 7.72 +/- 4.23 and 8.15 +/- 3.32, respectively (P > 0.05). Selenium concentration correlated inversely with CRP in group 1. CONCLUSION: The results confirm that sTNF-R1 and CRP concentrations are increated in active psoriasis and that supplementation with selenomethionine for 4 wk in safe doses is ineffacious as adjuvant therapy in patients with psoriasis.     

新生儿缺血缺氧性脑病细胞免疫功能和生长抑素检测

【目的】 探讨新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)患儿外周血生长抑素(somatostatin,SS)水平的变化及其与细胞免疫功能的关系。 【方法】 HIE新生儿50例血SS水平及T淋巴细胞亚群、IL-2、sIL-2R和IL-6分别采用放射免疫分析法、APAAP法和双抗体夹心ELISA法进行检测。并分析两者相关性。 【结果】 HIE患儿血SS水平明显高于对照组(P<0.01),其细胞免疫功能显示sIL-2R水平明显升高(P<0.01),而CD3⁺、CD4⁺百分率、CD4⁺/CD8⁺比值、IL-2及IL-6水平明显降低(P均<0.01)。HIE患儿血SS的变化与CD3⁺、CD4⁺百分率、CD4⁺/CD8⁺比值、IL-2及IL-6水平呈显著负相关(P均<0.01),与sIL-2R呈显著正相关(P<0.01)。 【结论】 HIE患儿血SS水平升高与HIE存在密切相关,且其变化与机体细胞免疫功能存在非常明显的相关性。     

急性CO中毒后迟发性脑病患者脑脊液和血清可溶性白细胞介素-2受体水平

目的　探讨急性一氧化碳中毒后迟发性脑病 (DEACMP)患者血清和脑脊液可溶性白细胞介素 2受体 (sIL 2R)的变化。方法　采用双抗体夹心ELISA法测定 31例DEACMP患者入院时、出院前的sIL 2R含量 ,并与 32例其他脑病组和 31例对照组作比较。结果　DEACMP组血清sIL 2R水平[(32 9.2 1± 16 0 .99)U/ml]明显高于对照组 [(115 .6 7± 89.5 8)U/ml],差异有显著性 (P <0 .0 5 ) ;与其他脑病组 [(36 7.5 0± 12 3.14 )U/ml]比较 ,差异无显著性 (P >0 .0 5 ) ;DEACMP组脑脊液sIL 2R水平[(5 4 .4 8± 4 3.0 4 )U/ml]略高于对照组 [(34.96± 2 2 .70 )U/ml],但明显低于其他脑病组 [(110 .2 4±76 .5 6 )U/ml],差异有显著性 (P <0 .0 5 )。DEACMP组血清sIL 2R水平入院时 [(338.34± 16 1.5 3)U/ml]与出院前 [(35 1.31± 175 .93)U/ml]比较 ,差异无显著性 (P >0 .0 5 ) ,而脑脊液sIL 2R水平出院前[(10 0 .2 6± 93.6 5 )U/ml]较入院时 [(5 2 .2 8± 4 3.31)U/ml]明显增高 ,差异有显著性 (P <0 .0 5 )。结论　本病的发生与免疫病理损伤有关 ,血清和脑脊液sIL 2R水平可以反映DEACMP患者机体的免疫状态 ,对判断病情程度及预后有一定的价值。     

Selenium deficiency in the acquired immunodeficiency syndrome

Severe protein-calorie malnutrition is common in patients with AIDS (acquired immunodeficiency syndrome). These nutritional deficits are likely to further impair immune responses and other organ functions vital for recovery from serious infectious diseases. Since selenium deficiency is known to be associated with oral candidiasis and abnormal phagocytic function in animals and depressed helper T-cell numbers in man, we evaluated both selenium status and other nutritional parameters in 12 patients with AIDS compared to 27 healthy controls. Selenium was measured by a spectrofluorometric method. The mean (+/- SD) plasma selenium level in AIDS was 0.043 +/- 0.01 microgram/ml vs 0.095 +/- 0.016 microgram/ml in controls (p less than 0.001). Whole blood selenium and red blood cell selenium levels were also significantly reduced in AIDS (p less than 0.005). The mean weight loss in AIDS patients was 35.5 +/- 21.2 pounds. Serum albumin was significantly (p less than 0.01) lower in AIDS patients compared to controls. A good correlation between serum albumin and plasma selenium was noted (r = 0.77; p less than 0.001). We conclude that selenium deficiency is a common component of the malnutrition seen in AIDS patients. Therefore, aggressive nutritional support, including attention to selenium status, should be considered an integral part of the therapy of AIDS patients.     

In vivo effects of olive oil-based lipid emulsion on lymphocyte activation in rats

Numerous studies suggest that immune function may be compromised by lipid emulsions rich in polyunsaturated fatty acids, especially linoleic acid. In our study, we compared the effect of a new olive oil-based lipid emulsion (ClinOleic(R)) containing 18% linoleic acid, and an emulsion based on soybean oil (Ivelip(R); 52% linoleic acid) on lymphocyte functions. Weaning Wistar rats (n= 24) were fed for 4 weeks on an oral diet that contained 12% of total energy as lipids from soybean oil. Then they received, during 6 days, a total parenteral nutrition (260 kcal/kg/d) in which 12% of total energy was brought by one of the two lipid emulsions. The fatty acid profile of spleen lymphocyte phospholipids reflected lipid intakes, with a higher content of oleic acid in ClinOleic(R) group and linoleic acid in Ivelip(R) group. A greater proportion of cells expressed the interleukin-2 receptor a-chain (CD25) after administration of ClinOleic(R) when compared to Ivelip(R) (55.43 +/- 3.47 vs 45.48 +/- 3.26%, P< 0.05). Moreover, the CD25 expression was positively correlated with oleic acid content of spleen lymphocyte phospholipids (r= 0.500, P< 0.018). These results show that ClinOleic(R) is able to induce, in vivo, a greater proportion of cells expressing CD25, and suggest that oleic acid could have a role in the observed effects.     

Association of elevated blood levels of pentachlorophenol (PCP) with cellular and humoral immunodeficiencies

It has long been suspected that pentachlorophenol (PCP) exerts a damaging influence on the immune system. In this study, the possible relationship between blood levels of PCP and immune function was studied in 190 patients who had been exposed for more than 6 mo to PCP-containing pesticides. The patients suffered from frequent respiratory infections and general fatigue. Lymphocyte subpopulations, in-vitro responses to mitogens, allogeneic stimulator cells, plasma neopterin, cytokines, soluble cytokine receptors, soluble adhesion molecules, and immunoglobulin autoantibodies were determined. A dose-response relationship between blood levels of PCP and cellular and humoral immune parameters was established. Blood levels of PCP were associated negatively with (a) total lymphocyte counts (p = .0002), CD4/CD8 ratios (p = .0015), and absolute counts of CD3+ (p < .0001), CD4+ (p < .0001), CD16+ (p < .0001), CD25+ (p = .0003), DR+ (p < .0001), CD8+/56+ (p = .020), and CD19+ cells (p = .092); (b) plasma levels of interleukin-2 (IL-2) (p < .0001), soluble IL-2R (p < .0001), IL-6 (p < .0001), IL-10 (p = .0039), interferon-gamma (IFN-gamma) (p < .0001), tumor necrosis factor-alpha (TNF-alpha) (p < .0001), transforming-growth factor-beta2 (p = .023), soluble IL-1 receptor antagonist (sIL-1 RA) (p < .0001), soluble intercellular adhesion molecule-1 (p = .0003); and (c) immunoglobulin (Ig) M-anti-Fab type autoantibodies (p = .0353). PCP levels were associated positively with (a) number of impaired stimulation assays per patient (p = .041); (b) number of circulating CD11b+ monocytes (p = .0015); and (c) plasma levels of neopterin (p < .0001), IL-4 (p = .020), and sIL-6R (p = .020). Compared with patients who had PCP plasma levels that were less than or equal to 10 microg/l, patients with blood levels of PCP that exceeded 10 microg/l experienced the following more often: low numbers of total blood lymphocytes (p = .054), CD3+ (p = .0014), CD4+ (p = .0001), DR+ (p = .0003), CD16+ (p = .0033), and CD25+ cells (p = .0033). In addition, the same aforementioned patients experienced the following more frequently: undetectable plasma levels of IL-2 (p = .0057), IL-6 (p = .042), IL-8 (p = .038), IL-10 (p = .0001), TNF-alpha (p = .0062), and IFN-gamma (p = .016); and impaired in-vitro responses of lymphocytes (p = .071). The authors concluded that increased blood levels of PCP were associated significantly with cellular and humoral immunodeficiencies. Recurrent respiratory infections and general fatigue could originate from PCP-associated immunosuppression.     

Utilizing selenious acid to reverse selenium deficiency in total parenteral nutrition patients

The ability of selenious acid to reverse selenium deficiency in eight adult home TPN patients was assessed. Initially, deficiency was documented by comparing both plasma selenium levels in patients (means = 0.035 micrograms/g) to those of 10 controls (means = 0.117 micrograms/g) (p less than 0.001) and by comparing erythrocyte glutathione peroxidase (GSHPx) activity, as mumol NADPH oxidized/g Hb/min, in patients (means = 8.93) to controls (means = 31.76) (p less than 0.002). Subsequently, patients added 100 micrograms/day of selenious acid to their total parenteral nutrition solutions. Postsupplementation selenium status demonstrated a mean plasma level of 0.101 micrograms/g and a mean erythrocyte GSHPx activity of 17.56. Statistically, patients' plasma selenium levels were significantly different (p less than 0.001) when compared to pretreatment levels. Additionally, there was no significant difference between the restored levels and the levels of the controls. Postsupplementation erythrocyte GSHPx activity (means = 17.56) was not significantly different from the initial patient values, although activity did double. Additionally, there existed a significant difference between the postsupplementation enzyme activity and the controls (p less than 0.03). We conclude that selenious acid is able to normalize deficient plasma levels but not deficient erythrocyte GSHPx activity.     

Selenium intake, age, gender, and smoking in relation to indices of selenium status of adults residing in a seleniferous area

Duplicate meals, serum, whole blood, and toenails were collected every 3 mo for 1 y from a group of 44 free-living adults residing in high-selenium areas of South Dakota and Wyoming to assess the relation of selenium intake to indices of selenium status. The average selenium values for the group were as follows: dietary intake, 174 +/- 91 micrograms/d (mean +/- SD), 2.33 +/- 1.08 micrograms/kg body wt; serum, 2.10 +/- 0.38 mumol/L; whole blood, 3.22 +/- 0.79 mumol/L; and toenails, 15.2 +/- 3.0 nmol/g. Selenium intake (micrograms/kg body wt) was strongly correlated (all values, P less than 0.01) with selenium concentration of serum (r = 0.63), whole blood (r = 0.62), and toenails (r = 0.59). Men and women had similar mean values of serum, whole blood, and toenail selenium despite higher selenium intakes in men. Smokers had lower tissue selenium concentrations than did nonsmokers due, at least in part, to lower selenium intake. Age was not associated with tissue selenium content. Of the variables examined selenium intake was clearly the strongest predictor of tissue selenium concentration.     

Neopterin as a marker for immune system activation in coal workers' pneumoconiosis

Coal workers' pneumoconiosis (CWP) is an occupational pulmonary disease that occurs by chronic inhalation of coal dust. Coal workers' pneumoconiosis is divided into two categories depending on the extent of the disease as simple pneumoconiosis (SP) and progressive massive fibrosis (PMF). Development of CWP is associated with the activation of the immune system. Neopterin is a predictive biochemical marker of cell-mediated immune activation and elevated levels of neopterin are detected in body fluids of patients with immune-related diseases. The present study was aimed to investigate whether increased serum, urine and bronchoalveolar lavage (BAL) fluid levels of neopterin is associated with the development and/or severity of CWP. Mean serum neopterin levels in SP and PMF patients (10.72 +/- 0.98 nmol/L; 14.08 +/- 3.86 nmol/L, respectively) were significantly higher than those of control group (5.30 +/- 0.47 nmol/L) (P < 0.05). Although urinary neopterin levels were also increased in SP and PMF patients (235.17 +/- 7.40 micromol/mol creatinine; 256.05 +/- 9.43 micromol/mol creatinine, respectively) as compared with the control group (140.00 +/- 5.43 micromol/mol creatinine) (P < 0.01), they were within the normal concentration range. No significant difference was observed between serum and urinary neopterin levels of SP and PMF patients. A correlation was observed between serum and urinary neopterin levels of all subjects (r = 0.525, P < 0.01). Bronchoalveolar lavage fluid neopterin levels were significantly higher in patients with SP and PMF (22.67 +/- 2.9 nmol/L; 41.67 +/- 8.68 nmol/L, respectively) compared with control subjects (6.264 +/- 1.74 nmol/L) (P < 0.05, P < 0.01, respectively). The levels of neopterin in BAL fluid were also significantly higher in patients with PMF than in those with SP (P < 0.05). These findings indicate that elevated serum and BAL levels of neopterin may be considered as a suitable biomarker for the assessment of CWP.     

Pyrethroids used indoors--immune status of humans exposed to pyrethroids following a pest control operation--a one year follow-up study.

A multiparametric analysis of immune components was performed in blood and serum of 61 voluntary persons before and after (1 day, 3 days, 4-6 months, 10-12 months) a professional pest control operation (PCO) using pyrethroids. Following parameters were included in the study (1) immunological parameters of the humoral defence, i.e. immunoglobulins of the classes A, G, M and E, complement components C3c and C4, acute phase proteins such as acid alpha 1-glycoprotein, haptoglobin, C-reactive protein; (2) mediators and receptors of immunity, i.e. neopterin, soluble interleukin-2 receptor (sIL-2R), soluble interleukin-6 receptor (sIL-6R), soluble tumor necrosis factor receptor (sTNF RII); (3) immunological markers of the cellular defence, i.e. white blood cell counts and lymphocyte (sub)populations such as total lymphocytes (CD2), mature lymphocytes (CD3), T-helper/inducer cells (CD4), T-suppressor/cytotoxic cells (CD8), B-cells (CD20), natural killer cells (CD56), as well as the ratio of CD4/CD8. The medians of all investigated immune components found before and for all time intervals after pyrethroid application were within the reference interval with respect to the total collective. Within this physiological range the investigated parameters showed a trend to lower values predominantly during the early phase (1 and 3 days) after PCO, partially being significant. Significant decreases were no more present in the late phase (6 to 12 month) after PCO indicating reversibility. Atopics did not differ in the immune response after PCO as compared to non-atopics. Obtained results suggest a modulation of immune components after a correct performed PCO within the physiological range towards lower values during the first days. However these immune changes are considered to be subtle and underlying compensatory mechanisms of immunoregulation.     

Low serum selenium and glutathione peroxidase activity in patients receiving short-term total parenteral nutrition

Selenium status was determined in 15 consecutive postoperative patients receiving short-term total parenteral nutrition (TPN) using both serum selenium concentration and glutathione peroxidase (GSH-Px) activity as an indicator of body selenium status. The serum selenium concentration was significantly (p less than 0.001) lower in TPN patients (0.52 +/- 0.16 mumol/l, mean +/- SD) than in age- and sex-matched controls (1.08 +/- 0.17 mumol/l). Serum selenium in TPN patients ranged from 0.28 to 0.79 mumol/l and was associated with the duration of TPN. The lowest selenium values was found in patients who had received TPN over 3 weeks (0.35 +/- 0.06 mumol/l) as compared to patients receiving TPN for 1-3 weeks (0.61 +/- 0.13 mumol/l; p less than 0.01). Serum GSH-Px activity in TPN patients was also low (116 +/- 21 U/l) and ranged from 75 to 159 U/l. A significant positive correlation was found between serum selenium and GSH-Px activity (r = 0.520; p less than 0.05) whereas serum selenium and GSH-Px activity did not correlate significantly with liver function tests and body mass index. This study suggests that also short-term TPN patients may be at risk of selenium deficiency.     

Trace element nutrition status and dietary intake of children with phenylketonuria

The trace element status (copper, iron, zinc, manganese, chromium, and selenium) of 20 dietetically treated phenylketonuric (PKU) children was assessed. Significantly higher intakes of copper (p = 0.002) and iron (p = 0.005) were noted in PKU children compared with their siblings. No significant differences were found for zinc, manganese, or chromium. Intake of selenium was significantly lower (p = 0.0001) in PKU children (8.4 +/- 3.9 micrograms/d) than in siblings (41.6 +/- 9.4 micrograms/d). Plasma and urine selenium and erythrocyte glutathione peroxidase activity (GSHpx) were significantly lower (p = 0.001) in PKU children (0.38 +/- 0.11 mumol/L, 58.0 +/- 34.5 nmol/d, and 14.2 +/- 5.5 U/g Hb, respectively) than in siblings (0.82 +/- 0.15 mumol/L, 165.2 +/- 49.4 nmol/d, and 22.7 +/- 5.2 U/g Hb, respectively). No differences were found in plasma and urine concentrations of other elements. Intake of selenium was significantly correlated with erythrocyte GSHpx (r = 0.87, p = 0.0001) and plasma selenium (r = 0.71, p = 0.0001) for the combined groups. The need and possible procedures, including dietary manipulation, for increasing selenium intake in PKU subjects are discussed.     

Conjugated linoleic acids exhibit a strong fat-to-lean partitioning effect, reduce serum VLDL lipids and redistribute tissue lipids in food-restricted rats

Effects of conjugated linoleic acids (CLA) on a series of metabolic events are expected to depend on the feeding regimen and levels of energy ingested. This study was the first examining the mode of action of CLA on body composition, tissue lipids, lipoproteins and hepatic enzymes in situations of enhanced fat store mobilization. Two groups of male growing Sprague-Dawley rats were fed for 3 wk a diet containing 0 (control group) or 3 g/100 g of a CLA mixture at the expense of sunflower oil, and were then subjected to a weight-loss feeding regimen for another 18 d. Rats fed the CLA-fortified diet gained 11% less weight than the control rats (P<0.05). Rats fed the high CLA diet had less body fat (1.47+/-0.16 vs. 1.07+/-0.09 g/100g, P<0.05) and a higher lean deposition (25.6+/-0.2 vs. 28.4+/-0.3 g/100 g, P<0.05) than control rats. CLA-fed rats had a 41% lower cholesterol concentration in liver than the control rats (P<0.05). Some differences in glycerophospholipid subclass profile of liver and erythrocyte membrane were observed; the hepatic concentrations of phosphatidylethanolamine (4.76+/-0.46 vs. 6.86+/-0.99 micromol/g, P = 0.07) and phosphatidylcholine (12.9+/-0.5 vs. 15.3+/-1.2 micromol/g, P = 0.09) tended to be greater and the level of phosphatidylcholine in erythrocyte membranes was significantly greater (1.40+/-0.12 vs. 1.83 +/-0.16 micromol/g, P<0.05) in the CLA-treated group than in the control group. The activities of catalase and ornithine decarboxylase in liver did not differ between the groups. Further, CLA-treated rats had significantly lower serum concentrations of VLDL lipids than control rats, whereas concentrations of LDL and HDL lipids were unaffected. The results indicate that a high dose of a CLA mixture is a strong repartitioning agent and a modulator of lipid metabolism under conditions of enhanced fat store mobilization in rats.