Estimation of monocyte‐chemoattractantprotein‐1 (Mcp‐1) level in patients with lupus nephritis

Aim: To evaluate the use of non‐invasive estimation of CP‐1 in urine as a good indicator for lupus nephritis activity. Methods: The study was conducted on 30 patients with systemic lupus erythematosus (SLE) (group I): 15 of these patients were selected without renal involvement (group I [A]), and the other 15 were selected with evidence of renal involvement (group I [B]). Further 10 age‐ and sex‐matched healthy subjects were taken as a control group (group II). The SLE disease activity index (SLEDAI) was applied. Laboratory investigations done for the studied group of patients included: renal function tests (antinuclear antibody) titer, (anti‐double‐stranded DNA) titer, and monocyte chemotactic protein 1 (MCP‐1) level in serum and urine samples. Results: Serum MCP‐1 was significantly higher in SLE patients with nephritis than in the control group, while no significant difference was found between SLE patients without nephritis and the control group. Urinary MCP‐1 in patients with active lupus nephritis (LN) were significantly higher than both patients with inactive LN and control the group. Urinary MCP‐1 in SLE patients with nephritis was significantly higher than both group I (A) and group II. Urinary MCP‐1 correlated positively with proteinuria, and negatively with creatinine clearance and hemoglobin; thus, urinary MCP‐1 correlates with the severity of nephritis. Conclusion: Urinary and not serum MCP‐1 is a useful invasive technique for the assessment of renal disease activity in patients with LN.     

Impact of low‐level BK polyomavirus viremia on intermediate‐term renal allograft function

Background

BK polyomavirus (BKPyV)‐associated nephropathy (PyVAN) is a significant cause of premature renal transplant failure. High‐level BKPyV viremia is predictive for PyVAN; however, low‐level BKPyV viremia does not necessarily exclude the presence of PyVAN. As data are limited regarding whether or not low‐level BKPyV viremia has an effect on intermediate‐term graft outcome, this study analyzes the impact of low‐level BKPyV viremia on intermediate‐term graft function and outcome compared with high‐level viremia and non‐viremic patients.

Methods

All renal transplant patients received follow‐up examinations at the Department of Nephrology, University Hospital Essen. Patients were screened for BKPyV viremia and stratified into three groups according to their maximum BKPyV load in serum (low‐level viremia, high‐level viremia, and no viremia).

Results

In 142 of 213 (67%) patients, BKPyV was never detected in serum; 42 of 213 (20%) patients were found positive for low‐level viremia (≤10⁴ copies/mL); and 29 of 213 (13%) patients showed high‐level viremia (>10⁴ copies/mL). No significant differences regarding transplant function and graft failure were observed between patients without BKPyV viremia (delta estimated glomerular filtration rate [eGFR] +0.1 mL/min [month 1 vs last visit at month 44]) and patients with low‐level BKPyV viremia (delta eGFR ?1.7 mL/min). In patients with high‐level viremia, transplant function was significantly restricted (delta eGFR ?6.5 mL/min) compared with low‐level viremia until the last visit at 44 ± 9.7 months after transplantation. Although the graft function and graft loss were worse in the high‐level viremia group compared with no viremia (eGFR 37 vs 45 mL/min), the difference was not significant.

Conclusions

High‐level viremia was associated with impaired graft function. In contrast, low‐level BKPyV viremia had no significant impact on intermediate‐term graft function.     

Multi‐component molecular‐level body composition reference methods: evolving concepts and future directions

Excess adiposity is the main phenotypic feature that defines human obesity and that plays a pathophysiological role in most chronic diseases. Measuring the amount of fat mass present is thus a central aspect of studying obesity at the individual and population levels. Nevertheless, a consensus is lacking among investigators on a single accepted ‘reference’ approach for quantifying fat mass in vivo. While the research community generally relies on the multi‐component body volume class of ‘reference’ models for quantifying fat mass, no definable guide discerns among different applied equations for partitioning the four (fat, water, protein and mineral mass) or more quantified components, standardizes ‘adjustment’ or measurement system approaches for model‐required labelled water dilution volumes and bone mineral mass estimates, or firmly establishes the body temperature at which model physical properties are assumed. The resulting differing reference strategies for quantifying body composition in vivo leads to small, but under some circumstances, important differences in the amount of measured body fat. Recent technological advances highlight opportunities to expand model applications to new subject groups and measured components such as total body protein. The current report reviews the historical evolution of multi‐component body volume‐based methods in the context of prevailing uncertainties and future potential.     

Prognostic impact of intensive statin therapy on N‐terminal pro‐BNP level in non‐ST‐segment elevation acute myocardial infarction patients

Objective

This study explored the impact of intensive daily dosing of atorvastatin on in‐hospital N‐terminal pro‐B‐type natriuretic peptide level, left ventricular systolic function and incidence of major adverse cardiac events in non‐ST‐segment elevation myocardial infarction patients.

Background

Several studies showed that early initiation of statin therapy in acute coronary syndrome patients has a favorable prognostic impact.

Methods

Hundred statin naive patients were prospectively enrolled. Once eligible, patients were randomly assigned to receive either a moderate daily dose that is, 20 mg (Group A) or an intensified daily dose that is, 80 mg (Group B) of atorvastatin, in addition to an equally divided loading dose given 24 and 12 h before coronary angiography (80 mg each). N‐terminal pro‐B‐type natriuretic peptide levels were recorded before and after coronary intervention. Collected data after 3 months included; N‐terminal pro‐B‐type natriuretic peptide levels, left ventricle systolic function and major adverse cardiac events.

Results

Mean age of the study cohort was 55 ± 10 years, 68% being males. There was no significant difference between both groups concerning procedural data. Group B patients showed a significantly lower N‐terminal pro‐B‐type natriuretic peptide levels at both sampling occasions, i.e., after coronary intervention and 3 months later (P < 0.001). After 3 months, the same group showed higher left ventricle ejection fraction (P < 0.05), with no significant difference between both groups regarding incidence of major adverse cardiac events.

Conclusion

Intensive atorvastatin therapy in non‐ST‐segment elevation myocardial infarction patients undergoing percutaneous coronary intervention is associated with; lower in‐hospital N‐terminal pro BNP level and higher LVEF after 3 months.

     

Maternal and early‐life area‐level characteristics and childhood adiposity: A systematic review

There is a cross‐sectional evidence that physical and social environments are linked to childhood adiposity. Evidence is scarce for the role of preconception, pregnancy, and early‐life area‐level characteristics in shaping childhood adiposity. We aimed to systematically review evidence for associations between physical and social environmental conditions experienced in these periods and childhood adiposity. Published literature was identified from the CINAHL, Embase, MEDLINE, and PsycINFO databases. Longitudinal studies linking an area‐level environmental exposure in the preconception, pregnancy, or early‐life (less than 1 year) periods and a measure of adiposity between the ages of 2 and 12 years were examined. Eight studies in the United States, Denmark, South Korea, United Kingdom, and Canada satisfied the inclusion criteria. Storm‐induced maternal stress, nitrogen oxides exposure, traffic noise, and proximity were associated with greater childhood adiposity. Frequent neighbourhood disturbances were associated with lower adiposity, while particulate matter exposure was associated with both higher and lower adiposity in childhood. Area‐level characteristics may play a role in the ongoing obesity epidemic. There is a limited evidence of longitudinal associations between preconception, pregnancy, and early‐life area‐level characteristics with childhood adiposity. Numerous factors that appear important in cross‐sectional research have yet to be assessed longitudinally, both individually and in combination.