Serum neopterin in dilated cardiomyopathy

RIA was used to measure the level of neopterine and beta 2-microglobulin in the sera of 43 patients with a verified diagnosis of dilated cardiomyopathy (DCMP). In DCMP patients, the mean level of neopterine was 11.25 +/- 1.05 nM/l and was significantly higher than in donors (5.6 +/- 0.5 nM/l). The concentration of neopterine exceeding 9 nM/l was discovered in 55% of DCMP patients. The rise of neopterine concentration was particularly marked in patients with inflammatory reaction in the myocardium according to endomyocardial biopsy. In that patients' group, the mean level of neopterine was 12.9 +/- 2.02 nM/l while the rise of its concentration over 9 nM/l was recorded in 9 (81%) of 11 patients examined. The correlation was established between the rise of the concentration of neopterine and beta 2-microglobulin. In patients with the concentration of neopterine over 9 nM/l, the mean level of beta 2-microglobulin constituted 3.33 +/- 0.32 mg/l and in patients with the normal concentration of neopterine, it amounted to 1.91 +/- 0.18 mg/l. The growth of the concentration of beta 2-microglobulin in the groups of patients under comparison was seen in 79 and 14% of cases, respectively. It is concluded that neopterine measurements are advisable in the laboratory diagnosis of myocarditis in DCMP patients. Potential mechanisms of the rise of neopterine formation are discussed from the standpoint of hyperinterferonemia.     

儿童乙型病毒性肝炎病毒携带者血清新蝶呤水平分析

目的研究儿童乙型病毒性肝炎病毒(HBV)携带者血清新蝶呤水平变化及其与HBV复制的关系。方法采用酶联免疫吸附试验(ELISA)法和实时荧光定量PCR法分别检测150例儿童HBV携带者和60名健康儿童的血清新蝶呤水平、HBV DNA载量。结果慢性HBV携带者血清新蝶呤水平明显高于非活动性HBsAg携带者和健康儿童,差异有统计学意义(均P0.05);非活动性HBsAg携带者和健康儿童的血清新蝶呤水平差异无统计学意义(P0.05);血清新蝶呤水平与HBV DNA载量在统计学上无显著相关性(r=0.131,P0.05)。结论在儿童HBV携带者中,慢性HBV携带者比非活动性HBsAg携带者体内更容易引起细胞免疫激活,慢性HBV携带者在随访监测中更应被关注,其血清新蝶呤水平升高能提示病毒复制,但不反映病毒复制活跃程度。     

Serum HBV-DNA (hepatitis B virus DNA) in acute and chronic hepatitis B infection

HBV DNA was measured in the sera of 69 patients with hepatitis B virus infections. Sixteen patients had acute hepatitis B, 24 had chronic active hepatitis (CAH), 6 had chronic persistent hepatitis (CPH), 5 had cirrhosis without CAH and 18 were asymptomatic HBsAg carriers. In patients with acute hepatitis B who recovered, HBV DNA was present in the serum transiently early in the illness. HBV DNA persisted in the serum in the two patients who developed chronic hepatitis. Sera of 23 of 24 patients with CAH were persistently positive for HBV DNA. There was no relationship between the quantity of HBV DNA in the serum and the histological intensity of activity. Thirteen of the 24 patients with CAH had histological evidence of cirrhosis in addition to CAH and HBV DNA was detected in the sera of all 13. The sera of 2 of 6 patients with CPH were positive for HBV DNA. In one it was positive only where there was clinical evidence of reactivation of HBV infection. The other patient subsequently developed CAH. Sera of 5 patients with established HBsAg positive cirrhosis but without evidence of CAH were negative for HBV DNA. Two of these patients had hepatocellular carcinoma. Sera of 18 asymptomatic anti-HBe positive carriers with normal ALT were negative for HBV DNA. HBeAg and HBV DNA were not always found in the serum together. In acute hepatitis 5 patients with HBV DNA in the serum were HBeAg positive, but in 6 patients the sera were HBeAg positive inthe absenceof HBV DNA.     

Serum procollagen type III peptide in chronic hepatitis B

The clinical significance of serum procollagen type III peptide, a marker of active fibrogenesis, was evaluated in 110 hepatitis B surface antigen positive patients with chronic hepatitis (32 chronic persistent hepatitis, 60 chronic active hepatitis, and 18 active cirrhosis), selected on the basis of active viral replication and biochemical activity, including 54 cases treated with interferon-α. At presentation the procollagen type III peptide level serum was above normal in 48 (44%) of the 110 patients and the median value was significantly higher than that of healthy carriers with normal transaminases and histology (P<0.000005). Semiquantitative histological evaluation showed a significant correlation between serum procollagen type III peptide levels and necrosis/inflammation in the subgroup of patients with chronic active hepatitis, but no relationship with the score of fibrosis. Among patients treated with interferon-α and with increased fibrogenic activity (indicated by high pretreatment serum levels of procollagen type III peptide), peptide levels were significantly decreased when pretreatment levels were compared with those at 12 months after therapy withdrawal, both in responders to interferon (P=0.022) and non-responders (P=0.012). However, serum procollagen type III peptide levels normalized in 75% of responders to interferon with sustained serological and histological remission of liver disease, but in only 21% of non-responders (P=0.02). These results obtained in a well-defined population suggest that serum procollage type III peptide is a better marker of active fibrogenesis and inflammation than an indicator of the extent of fibrosis, and that interferon may reduce active liver fibrogenesis in chronic hepatitis B indenpendently of its effect on viral replication. However, a consistent proportion (56%) of our chronic hepatitis B patients had normal serum procollagen type III peptide levels at presentation, thus precluding the clinical use of this marker both for diagnosis of liver injury and for monitoring the therapeutic response to interferon.     

乙型肝炎病毒感染者血清抗核抗体的研究

目的探讨乙型肝炎(简称乙肝)病毒(HBV)感染者血清抗核抗体(ANA)特征及其与临床的相关性。方法收集慢性乙肝(CHB)、乙肝后肝硬化(LC)、肝癌(HCC)患者共376例,采用酶联免疫吸附试验检测ANA。结果 (1)376例患者中ANA阳性99例(26.3%),其中CHB组58例,占21.0%(58/276),LC组20例,占38.5%(20/52),HCC组21例,占43.7%(21/48);健康对照组ANA阳性2例,占3.0%(2/66)。3组均明显高于健康对照组;LC、HCC与CHB组比较,差异有统计学意义(P<0.01);LC组与HCC组比较,差异无统计学意义(P>0.05)。(2)CHB、LC和HCC组ANA以低滴度(1/100)为主,分别为72.4%(42/58)、65.0%(13/20)和71.4%(15/21)。(3)ANA滴度1/100和大于或等于1/320的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、HBV-DNA各指标比较,差异无统计学意义(P>0.05)。结论 HBV感染者出现的自身抗体以ANA为主,HCC组阳性率最高。70.7%的HBV感染者ANA为低滴度阳性,对其滴度的高低与肝细胞损伤及HBV-DNA复制率无明显相关。     

社区乙型肝炎患者血清流行病学调查分析

目的 探讨分析济南市城区人口乙型肝炎血清流行病学特征,为有效控制乙肝提供科学依据,以制订切实可行的社区护理干预措施.方法 对26765份血样均采用酶联免疫吸附法检测乙型肝炎病毒血清标志物,严格按照试剂盒说明书进行操作,采用SPSS 13.0统计软件对数据进行分析.结果 HBsAg阳性率为7.39%,其中男性阳性率8.81%,女性阳性率5.54%,二者比较差异有统计学意义(P<0.01).≤20岁年龄组阳性率均明显低于其他各年龄组(P<0.05),男性人群21～30岁年龄组HBsAg阳性率显著低于41～50岁年龄组(P<0.05).各职业间HBsAg阳性率比较差异无统计学意义.结论 对各类乙肝易感人群接种乙肝疫苗,广泛开展针对乙型肝炎相关知识的社区健康教育,全方位的护理干预,是控制和降低乙型肝炎发病率的关键措施.     

社区乙型肝炎患者血清流行病学调查分析

目的探讨分析济南市城区人口乙型肝炎血清流行病学特征，为有效控制乙肝提供科学依据，以制订切实可行的社区护理干预措施。方法对26765份血样均采用酶联免疫吸附法检测乙型肝炎病毒血清标志物，严格按照试剂盒说明书进行操作，采用SPSS 13．0统计软件对数据进行分析。结果HBsAg阳性率为7．39％，其中男性阳性率8．81％，女性阳性率5．54％，二者比较差异有统计学意义（P〈0．01）。≤20岁年龄组阳性率均明显低于其他各年龄组（P〈0．05），男性人群21～30岁年龄组HBsAg阳性率显著低于41～50岁年龄组（P〈0．05）。各职业间HBsAg阳性率比较差异无统计学意义。结论对各类乙肝易感人群接种乙肝疫苗，广泛开展针对乙型肝炎相关知识的社区健康教育，全方位的护理干预，是控制和降低乙型肝炎发病率的关键措施。     

TTV superinfection on acute hepatitis B]

TT virus(TTV) was recently reported as candidate for a new hepatitis virus from post transfusion hepatitis of unknown etiology. In the present study, influence of TTV superinfection on acute hepatitis B was analyzed. TTV DNA was detected in sera from 10 of 44(23%) patients with acute hepatitis B, but prevalence was comparable with normal blood donor. It was unlikely that TTV superinfection affected clinical course of acute hepatitis B. In cases of TTV superinfection on hepatitis B, T. Bil and ALT values were higher than in cases of non-superinfected patients. Furthermore, HCC was appearanced in a patient of recover from acute hepatitis B.     

The serum neopterin level in acute rheumatic fever]

Acute rheumatic fever (ARF) is a systemic inflammatory disease etiologically related to infection with group A streptococcus characterized by a broad spectrum of disorders of cellular and humoral immunity. To estimate the activity of the immunopathological process and to forecast myocardial derangement in ARF patients, measurements were made of neopterin in the serum of ARF patients. Nine men with ARF serving in the armed forces were examined. The control group comprised 24 donors. The reference group included 13 patients with dilated cardiomyopathy and 14 with chronic myocarditis. The mean level of neopterin in ARF patients was equal to 14.5 +/- 12.2 nM/l and was significantly higher than in the donors (5.0 +/- 2.0 nM/l). In patients with dilated cardiomyopathy and chronic myocarditis, it was 9 +/- 6 and 16 +/- 11 nM/l, respectively. On more careful clinical analysis the highest level of neopterin was recorded in 3 patients with impairment of the valvular apparatus of the heart. That level was observable during the whole period of the follow-up of the patients. In other patients, no impairment of the valves was detected, whereas the concentration of neopterin fell to normal. Therefore, the rise of the level of neopterin was described for the first time in patients with ARF. Besides, a relationship was found between the high level of neopterin and impairment of the valvular apparatus of the heart.     

Serum level and prognostic value of neopterin in patients after ischemic stroke

Background

We hypothesized that serum level of neopterin is significantly predictive of prognostic outcome in patients after acute ischemic stroke (IS).

Methods

Between November 2008 and May 2010, serum levels of neopterin were prospectively collected at 48 h after acute IS in 157 patients.

Results

Serum neopterin levels were substantially higher in patients with severe neurological impairment [National institutes of Health Stroke Scale (NIHSS) score ≥ 12] than in those with NIHSS < 12 (p < 0.008). Furthermore, Spearman's test showed a strongly positive correlation between neopterin level and NIHSS (p = 0.003). Multiple logistic regression analysis demonstrated that serum neopterin level was strongly and independently predictive of NIHSS ≥ 12 (p = 0.002) at 48 h after acute IS and 90-day major adverse clinical outcome (defined as NIHSS ≥ 12, recurrent stroke or death) (p = 0.003).

Conclusion

Serum level of neopterin was notably increased after acute IS. This biomarker was strongly and independently predictive of 90-day unfavorable clinical outcome in patients after acute IS.     

Serum cytokine levels in patients with chronic hepatitis B according to lamivudine therapy

Background: Cytokines are known to play critical roles in the pathogenesis of chronic hepatitis B (CHB). However, the relationship between cytokines and treatment responses to drugs for CHB is not clearly defined yet. We measured the serum cytokine levels of interleukin (IL)‐1α, IL‐1β, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10, vascular endothelial growth factor, interferon‐γ, tumor necrosis factor‐ (TNF‐α), macrophage/monocyte chemotactic protein 1, and epidermal growth factor to elucidate the cytokine expression pattern according to the patients' responses to lamivudine. Methods: Fifty‐eight specimens from 27 CHB patients and 98 specimens from healthy individuals were tested for 12 kinds of cytokines. The patients were grouped as: before treatment, ongoing treatment, duringmaintaining remission, and patients with viral breakthrough owing to resistance against lamivudine. The Evidence Investigator (Randox, Antrim, UK), a protein chip analyzer, was used to quantify serum cytokines. Results: Among 12 cytokines, IL‐6, IL‐8, IL‐10, and TNF‐α were significantly elevated in patients with resistance against lamivudine compared with patients maintaining response. IL‐8, IL‐10, and TNF‐α levels also weak to moderate correlated with ALT and HBV‐DNA concentrations. Conclusions: Serum cytokine levels would reflect the pathological differences of the individual treatment phases and may become useful indices in monitoring the treatment response of CHB. J. Clin. Lab. Anal. 25:414–421, 2011. © 2011 Wiley Periodicals, Inc.     

Serum paraoxonase and arylesterase activities in various forms of hepatitis B virus infection

The aim of this study was to determine and evaluate the activity of paraoxonase and arylesterase enzymes in various clinical forms of hepatitis B infection and to investigate the correlation between these parameters and chronic disease course/fibrosis. Overall, 40 patients diagnosed as hepatitis B carriers (CIHBV), 40 chronic active hepatitis B (CAHBV) patients, and 40 healthy adults (control group) between 18 and 65 years of age were enrolled the study. Serum paraoxonase and arylesterase activities were measured spectrophotometrically. Their activities were significantly lower in patients with CAHBV compared with CIHBV patients or with control group patients (P<0.001). There was a negative correlation between alanine aminotransferase levels and the activity of paraoxonase and arylesterase (r = -0.38, P = 0.001 and r = -0.28, P = 0.002, respectively). A statistically significant negative correlation was found between arylesterase activity in the sera of CAHBV patients and HBV DNA levels (ρ = -0.33, P = 0.03). On the contrary, no correlation was found between paraoxonase levels and HBV DNA levels (P>0.05). The histology activity index of CAHBV patients did not correlate with paraoxonase and arylesterase activities (P>0.05). In light of these findings, it may be assumed that during the progression of an inactive hepatitis B carrier to being actively infected, reduced paraoxonase and arylesterase activities may be observed.     

Serum levels of neopterin and interleukin-2 receptor in women with severe preeclampsia

Preeclampsia continues to be a major cause of maternal and perinatal mortality and morbidity worldwide. The etiopathogenesis of preeclampsia is not fully understood. Neopterin and interleukin-2 (IL-2) production reflects cellular immunity. Our purpose was to determine the levels of neopterin and interleukin-2 receptor (IL-2R) in pregnant women with severe preeclampsia, and assess the implications of these findings in the pathophysiology of preeclampsia. Fourteen women with preeclampsia were compared with 14 healthy pregnant women. Serum levels of neopterin were measured by an enzyme-linked immunoassay (ELISA), and IL-2R levels were determined by an immunoassay method with an Immulite analyzer. The levels of neopterin and IL-2R were significantly higher in the preeclamptic subjects than in normotensive women (P<0.05). There was a significant correlation between neopterin and IL-2R. We found that serum neopterin and IL-2R levels are increased in women with severe preeclampsia. The results of this study suggest that a T-helper 1 (Th1) type immune mechanism is involved in the pathogenesis of preeclampsia.     

Serum markers for predicting significant necroinflammatory activity in patients with chronic hepatitis B

Objectives

The aim of this study was to determine the serum markers that predict significant inflammation in patients with chronic hepatitis B (CHB).

Design and methods

Between October 2005 and June 2009, 384 subjects with CHB were enrolled.

Results

Multiple logistic regression analysis identified the ALT, hyaluronic acid (HA) and procollagen III N-terminal peptide (PIIINP) as independent predictors of significant inflammation (grade ≥ 3). We constructed a formula for predicting significant inflammation. A significant inflammation (SI) score = 1.773 × ALT score + 1.599 × PIIINP score + 0.677 × HA score − 1.962. The area under receiver operating characteristic curve of the SI score was 0.831. The sensitivity, specificity, positive predictive value and negative predictive value of the SI score were 79.5%, 70.8%, 76.8% and 74.3%, respectively.

Conclusions

A simple scoring system including ALT, PIIINP and HA is an accurate non-invasive predictor of significant inflammatory activities in patients with CHB.     

Serum pregnancy-associated alpha 2-glycoprotein levels in the evolution of hepatitis B virus infection

Serum pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) levels were evaluated in a follow-up study of patients with hepatitis B virus (HBV) infection and compared with biochemical and virological parameters. In a study of 25 patients with acute hepatitis, an association was found between high alpha 2-PAG values, ALT levels, and HBsAg in 20 patients (80%) (P less than 0.05), 18 recovered completely, and 2 had a protracted course. In five patients serum alpha 2-PAG levels were similar to those in the control group. On the other hand, eight (100%) chronic persistent HBV patients showed high levels of alpha 2-PAG (P less than 0.05) during the study period, and these levels correlated well with inflammatory activity and failure of HBsAg elimination. There were no significant differences in alpha 2-PAG values between asymptomatic HBsAg carriers and controls. Serial analysis of alpha 2-PAG, in correlation with viral markers, biochemical parameters, and histological data, would contribute to the ability to predict the final outcome of HBV infection.