ST131型产NDM-1型碳青霉烯酶大肠埃希菌的耐药机制研究

目的探讨我院首株临床分离的产NDM-1型碳青霉烯酶大肠埃希菌耐药特征及其传播机制。方法用Vitek 2Compact全自动微生物分析系统进行菌株鉴定及耐药初筛;微量肉汤稀释法和E-test试纸条检测药物最低抑菌浓度(MIC);改良Hodge试验、亚胺培南-EDTA协同试验检测金属β-内酰胺酶;PCR以及测序方法检测大肠埃希菌耐药基因;多位点序列分型(MLST)技术进行序列分型;S1-PFGE、Southern印迹杂交和质粒不相容性分型方法研究携带bla_(NDM-1)质粒的特征。结果该菌对包括亚胺培南、美罗培南和厄他培南在内的β-内酰胺类抗菌药物、左氧氟沙星、庆大霉素均耐药,对阿米卡星、替加环素以及多黏菌素B敏感。改良Hodge试验、亚胺培南-EDTA协同试验阳性;PCR扩增产物测序结果经BLAST比对后显示携带bla_(NDM-1)、bla_(CTX-M-14)和qnr S基因;MLST序列分型为ST131型;bla_(NDM-1)位于大小约为100 000 bp的IncN型质粒上,且该质粒可通过接合传播。结论新出现的产NDM-1型碳青霉烯酶大肠埃希菌为ST131型,bla_(NDM-1)基因可通过质粒传播,临床应加强监测以防止耐药菌传播。     

碳青霉烯类耐药的大肠埃希菌中bla_(NDM)基因型检测及流行病学分析

目的检测上海交通大学附属瑞金医院临床分离碳青霉烯类耐药的大肠埃希菌产NDM型碳青霉烯酶的情况,研究其流行病学特征。方法收集该医院2013年11月-2015年1月临床分离的18株对亚胺培南或美罗培南药敏纸片抑菌圈直径≤19 mm的大肠埃希菌。采用聚合酶链反应(PCR)检测bla_(NDM)型碳青霉烯酶基因并对阳性产物进行测序以确定基因型别;通过质粒转移接合试验了解耐药基因是否可以通过质粒进行水平传播;应用多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)对产NDM酶的大肠埃希菌进行同源性分析。结果 18株耐碳青霉烯类大肠埃希菌中6株扩增到bla_(NDM)基因,其中4株为bla_(NDM-1),2株为bla_(NDM-5)。6株产NDM酶的大肠埃希菌中3株成功进行转移接合试验,MLST发现6株产酶菌株共分为5个ST型(ST5018,ST354,ST405,ST2967,ST156),与PFGE结果中5种不同的DNA谱型(A~E)相对应,其中2株菌株同为ST5018型且为PFGE-DNA谱型中A型的不同亚型(A1,A2)。结论本研究检出产NDM酶碳青霉烯类耐药大肠埃希菌。bla_(NDM)阳性病例多为散发,但由质粒介导的水平传播在bla_(NDM)的播散中可能起重要作用。上海地区首次检出NDM-5型碳青霉烯酶,应引起重视。     

从新生儿标本中分离3株ST1642型产NDM-5型碳青霉烯酶大肠埃希菌

目的分析新生儿科3株产NDM-5型碳青霉烯耐药大肠埃希菌的分子流行特征。方法收集2017年8—9月新生儿科病房分离的3株碳青霉烯耐药大肠埃希菌(E1、E2和E3)。采用Vitek 2 Compact系统联合K-B法、E-test法进行药物敏感性试验; PCR扩增碳青霉烯耐药基因及其他相关耐药基因; PCR技术检测质粒复制子分型;质粒接合试验探讨质粒的可接合传递性;多位点序列分析(MLST)和脉冲场凝胶电泳(PFGE)分析菌株同源性。结果 3株细菌对绝大多数β-内酰胺类药物耐药,除外氨曲南(E1、E3敏感,E2耐药),对喹诺酮类药物、复方磺胺甲噁唑耐药,对氨基糖苷类药物敏感。PCR及测序提示3株细菌均检出blaNDM-5基因,同时检出部分超广谱β-内酰胺酶基因(blaSHV、blaTEM或blaCTX-M);质粒复制子类型均为Inc X3,E1质粒接合转移试验成功; MLST提示3株细菌均为ST1642型,PFGE显示3株细菌条带一致。结论新生儿科3株碳青霉烯耐药大肠埃希菌均产NDM-5型碳青霉烯酶,同时携带超广谱β-内酰胺酶基因,MLST和PFGE提示3株细菌为同一克隆来源。     

尿液分离产ESBLs大肠埃希菌对磷霉素耐药的分子流行病学及耐药机制分析

目的探究尿液分离产超广谱β-内酰胺酶(ESBLs)大肠埃希菌对磷霉素耐药的分子流行病学特征及其耐药机制。方法收集南京大学医学院附属鼓楼医院2016年1—12月尿液分离大肠埃希菌308株,通过药敏试验筛选产ESBLs及磷霉素耐药菌株;PCR扩增ESBLs基因及磷霉素相关耐药基因;采用多位点序列分型(MLST)对菌株进行遗传相关性分析,采用接合试验验证耐药基因的转移性。结果 308株尿液分离大肠埃希菌中产ESBLs菌株168株(54.54%);产ESBLs菌株中检出磷霉素耐药菌株18株(10.71%,18/168)。其中,ESBLs耐药基因携带率分别为bla_(SHV) 88.9%(16/18)、bla_(CTX-M) 77.8%(14/18)、bla_(TEM-208) 5.6%(1/18);bla_(TEM-1b) 61.1%(11/18);fosA3基因的携带率为83.3%(15/18)。MLST分型主要为ST131(27.78%)。接合试验表明,fosA3阳性菌株的耐药性均具有可转移性。结论产ESBLs大肠埃希菌对磷霉素的耐药率仍处于较低水平。fosA3基因是造成磷霉素耐药的主要机制,该基因位于可接合的质粒上,易于水平传播,需要高度重视。     

碳青霉烯类耐药弗劳地枸橼酸杆菌中质粒介导bla_(NDM-1)基因的研究

目的研究碳青霉烯类耐药弗劳地枸橼酸杆菌中bla_(NDM-1)基因的传播特征。方法收集昆明医科大学第一附属医院2012年6月-2014年10月产NDM-1酶弗劳地枸橼酸杆菌18株,采用VITEK 2全自动鉴定药敏仪进行菌种鉴定和药敏试验;通过接合试验、脉冲场凝胶电泳(PFGE)及Southern印迹杂交试验对bla_(NDM-1)基因的水平传播机制进行研究。结果 18株细菌对青霉素类、头孢菌素类、碳青霉烯类抗生素的耐药率为100%,对其他抗生素也呈现不同程度的耐药;13株细菌接合试验成功,接合子对碳青霉烯类抗生素耐药;PFGE及Southern印迹杂交试验表明16株细菌中bla_(NDM-1)基因均位于约33.3kb大小的质粒上,剩余2株细菌的bla_(NDM-1)基因位于33.3～54.7kb大小的质粒上。结论质粒介导碳青霉烯类耐药弗劳地枸橼酸杆菌中bla_(NDM-1)基因水平转移。     

氨曲南联合头孢他啶/阿维巴坦对产新德里金属β-内酰胺酶大肠埃希菌的体外抗菌活性评估

摘要:目的评估氨曲 南联合头孢他啶/阿维巴坦对产新德里金属β-内酰胺酶(NDM)大肠埃希菌的体外抗菌活性。方法收集2018- -2020 年临床分离的碳青霉烯耐药大肠埃希菌30株,采用微量肉汤稀释法检测常规药物的敏感性,采用E-test 试验检测菌株对氨曲南和头孢他啶/阿维巴坦的最低抑菌浓度(MIC),双E-test纸条法检测氨曲南与头孢他啶/阿维巴坦之间的协同作用;酶抑制剂增强试验检测碳青霉烯酶表型;PCR扩增和测序技术检测碳青霉烯酶基因和超广谱β-内酰胺酶(ESBLs)基因;多位点序列分型(MLST)对菌株进行分子分型。结果碳青霉烯酶表 型检测结果显示,30株大肠埃希菌均为金属酶表型,基因检测结果显示携带NDM-5基因26株,携带NDM-7基因2株,携带NDM-1和NDM-9基因各1株。另外,15株携带TEM-I基因,22株携带CTX-M-I组基因( 10株携带CTX-M-I5,12株携带CTX-M-55) ,9株携带CTX-M-9组基因(均为CTX-M-27)。MLST将30株菌分为8个不同的ST型,以ST167(40% , 12/30)、ST405 (20% ,6/30)和ST410( 20% , 6/30)为主。30 株细菌仅对替加环素和多黏菌素敏感,对阿米卡星耐药率为46.7%。27 株对氨曲南耐药的菌株,在联合头孢他啶/阿维巴坦后25株细茵由耐药变为敏感,氨曲南MIC3g和MIC。分别下降至2 μg/mL和4 μg/mL。结论氨曲南联合 头孢他啶/阿维巴坦对产NDM金属酶大肠埃希菌有较强的体外协同作用，可成为一种治疗产金属酶大肠埃希菌感染的潜在药物组合。     

2株不同序列分型耐黏菌素大肠埃希菌耐药机制分析

目的探讨2株黏菌素耐药大肠埃希菌的耐药机制。方法采用Vitek 2 Compact全自动微生物鉴定药敏系统鉴定细菌及检测常见抗菌药物敏感性,并检测菌株是否产超广谱β-内酰胺酶(ESBLs);用三维试验检测菌株是否产AmpC酶;用微量肉汤稀释法测定菌株对黏菌素的最低抑菌浓度(MIC);用PCR及测序检测耐药基因;多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)分析菌株的分子分型和同源性;接合试验和S1酶切脉冲场凝胶电泳(S1-PFGE)对菌株的质粒特征进行分析。结果2株菌均对碳青霉烯类药物敏感,对黏菌素耐药,其中N408对头孢类药物耐药;PCR扩增和测序分析显示2株菌均携带mcr-1基因,且N408和N433分别携带blaCIT和blaTEM-1基因;2株菌质粒接合试验均成功,接合子均检测到mcr-1基因;MLST分析显示N408为ST453型,N433为ST8900型,PFGE显示为不同条带。S1-PFGE显示N408有2个质粒,N433有1个质粒。结论本地区已出现携带mcr-1基因黏菌素耐药大肠埃希菌,且可通过质粒在不同菌株间水平播散,应引起临床的重视,加强此类菌株的检测。     

耐碳青霉烯肠杆菌科细菌碳青霉烯酶检测与多位点序列分型分析

目的了解耐碳青霉烯肠杆菌科细菌(CRE)的耐药机制及分子流行病学特征。方法采用全自动微生物鉴定系统鉴定菌株,并进行药物敏感性试验;采用改良碳青霉烯类灭活试验(m CIM)筛查菌株碳青霉烯酶;采用聚合酶链反应(PCR)及基因测序方法检测菌株碳青霉烯酶耐药基因;采用多位点序列分型(MLST)方法对菌株进行分子分型。结果共收集到24株CRE,其中13株为肺炎克雷伯菌,11株为阴沟肠杆菌,mCIM阳性率均为100%。13株肺炎克雷伯菌中有10株携带bla_(KPC-2)基因,1株携带bla_(NDM-1)基因,1株携带bla_(NDM-4)基因,1株未检出bla_(KPC)、bla_(IMP)、bla_(VIM)、bla_(NDM)及bla_(OXA)基因;11株阴沟肠杆菌均携带bla_(NDM-1)基因。MLST结果显示13株肺炎克雷伯菌中有12株为ST11型,1株为ST571型;11株阴沟肠杆菌均为ST93型。结论研究涉及的肺炎克雷伯菌碳青霉烯类耐药的主要机制为携带bla_(KPC-2)基因,优势序列分型(ST)为ST11;阴沟肠杆菌碳青霉烯类耐药的主要机制为携带bla_(NDM-1)基因,优势ST为ST93。应及时采取有效措施防止CRE的传播。     

三株从新生儿标本中分离的ST 1642型产NDM-5型碳青霉烯酶 大肠埃希菌

摘要：目的 分析新生儿科3株产NDM-5型碳青霉烯耐药大肠埃希菌的分子流行特征。方法 收集2017年8-9月新生儿科病房分离的3株碳青霉烯耐药大肠埃希菌（E1、E2、E3），Vitek2-Compact系统联合K-B法、E-test法进行药物敏感性试验，PCR扩增碳青霉烯耐药基因及其他相关耐药基因，检测质粒复制子分型并进行质粒接合转移试验，多位点序列分析（MLST）和脉冲场凝胶电泳（PFGE）分析菌株同源性。结果 药敏结果提示3株细菌对绝大多数β内酰胺类药物耐药，除外氨曲南（E1、E3敏感，E2耐药），对多粘菌素B、氨基糖苷类药物均敏感。PCR及测序结果提示3株细菌均检到blaNDM-5基因，同时检测到部分超广谱β内酰胺酶基因（blaSHV、blaTEM或blaCTX-M）；质粒复制子类型均为IncX3，E1质粒接合转移试验成功；MLST结果提示3株细菌均为ST1642型，PFGE结果显示3株细菌条带一致。结论 新生儿科3株碳青霉烯耐药的细菌均产NDM-5型碳青霉烯酶，同时携带超广谱β内酰胺酶基因，MLST和PFGE提示3株细菌为同一克隆来源。     

碳青霉烯类耐药肠杆菌科细菌耐药基因调查

目的分析临床分离碳青霉烯类耐药肠杆菌科细菌耐药基因携带情况。方法收集2012-2014年临床分离碳青霉烯类药物耐药肠杆菌科菌株37株,采用改良Hodge试验和EDTA双纸片协同试验筛查碳青霉烯酶及金属酶表型,采用PCR法及基因测序方法调查耐药基因携带情况。结果 37株碳青霉烯类耐药肠杆菌科菌株包括肺炎克雷伯菌16株(43.2%)、大肠埃希菌6株(16.2%)、黏质沙雷菌6株(16.2%)、阴沟肠杆菌4株(10.8%)和弗劳地枸橼酸杆菌、阿斯肠杆菌、产酸克雷伯菌、成团泛菌、芳香沙雷菌各1株(各2.7%);耐药表型显示33株改良Hodge试验阳性,8株金属酶表型阳性;其中35株检出耐药基因,包括bla_(KPC)(21株)、bla_(IMP)(6株)、blaOXA-48(3株)、bla_(NDM-1)(3株)和bla_(VIM)(2株)。结论本院临床分离碳青霉烯类耐药肠杆菌科细菌以bla_(KPC)为主要耐药基因,其次为bla_(IMP)基因。     

湖南地区成人血清IgG亚类水平调查及影响因素分析

目的调查湖南地区成年人血清IgG亚类的浓度水平,探讨年龄、性别及生活方式等因素的影响。方法用免疫散射比浊法测定170例体检者血清中IgG_1、IgG_2、IgG_3、IgG_4和IgG浓度。结果血清IgG_1、IgG_2、IgG_3、IgG_4和IgG浓度分别为(7.53±0.14)g/L、3.99(3.13,5.02)g/L、0.49(0.30,0.70)g/L、0.53(0.26,0.93)g/L、12.2(10.5,14.1)g/L;血清IgG_1/IgG、IgG_2/IgG、IgG_3/IgG和IgG_4/IgG分别为(61.3±0.69)%、33.38(27.8,38.8)%、3.97(2.5,5.3)%和4.44(2.1,7.3)%。女性血清IgG_3浓度及IgG_3/IgG比值高于男性(P=0.005,0.014);不同性别间IgG_1、IgG_2、IgG_4及IgG_1/IgG、IgG_2/IgG、IgG_4/IgG的差异无统计学意义。31~40岁组血清IgG_3浓度显著高于41~50岁组(P=0.03),而年龄对血清IgG_1、IgG_2和IgG_4浓度的影响无统计学意义。重度吸烟组血清IgG_1的浓度比不吸烟组低,差异有统计学意义(P=0.023)。重度吸烟组IgG_4/IgG高于不吸烟组(P=0.018)。中/重度饮酒组血IgG_1、IgG_3浓度和IgG_3/IgG比值比不饮酒组低(P=0.05,0.004,0.015)。代谢综合征低风险组血清IgG_3和IgG_3/IgG高于高风险组(P=0.034,0.038)。结论性别和年龄对于血清IgG_3浓度的影响有显著意义。重度吸烟可能导致IgG_1的浓度降低和IgG_4/IgG比值的上升。血清IgG_1、IgG_3和IgG_3/IgG的降低与饮酒存在一定的关系。     

The SAMe-TT2R2 score and decision-making between a vitamin K antagonist or a non-vitamin K antagonist oral anticoagulant in patients with atrial fibrillation

Oral anticoagulation therapy is essential in patients with atrial fibrillation and clinicians need guidance on decision-making between the vitamin K antagonists (VKA), e.g. warfarin, or non-vitamin K antagonist oral anticoagulants. Observational studies have shown that patients who receive VKA therapy spend a significant percentage of their time with international normalized ratio values outside of the therapeutic range (time in therapeutic range, TTR <60%.) Recently, a clinical score has been developed with commonly encountered clinical features, the SAMe-TT₂R₂ score, to help decision-making with regard to whether a patient is likely to do well, or not, with a VKA. Those with a SAMe-TT₂R₂ score of 0–1 are likely to do well on a VKA, while those with a SAMe-TT₂R₂ score ≥2 are on probability going to achieve suboptimal TTR. In this article, we provide an overview of the main published retrospective and prospective studies that have validated the SAMe-TT₂R₂ score and its value for decision-making in daily clinical practice.     

Selective monitoring of vitamin D2 and D3 supplementation with a highly specific 25-hydroxyvitamin D3 immunoassay with negligible cross-reactivity to 25-hydroxyvitamin D2

Background

The effects of vitamin D₂ and D₃ supplementation on circulating concentrations of 25(OH)D₃ require reliable analytical tools for specific determination of 25(OH)D₃ and 25(OH)D₂. We have developed a highly specific 25-OH Vitamin D3 ELISA with negligible cross-reactivity towards 25(OH)D₂.

Methods

25(OH)D₃ concentrations were measured in several study participants; 1) 641 healthy men and women; 2) 39 postmenopausal women receiving 400-800 IU vitamin D₃ daily for 4 months; 3) 45 men and women with hip fracture receiving 1000 IU vitamin D₂ daily for 3 months.

Results

This 25-OH Vitamin D3 ELISA had minimal cross-reactivity to 25(OH)D₂, (0.7%), and demonstrated a high correlation (r² = 0.93) with 25(OH)D₃ determined by HPLC. 25(OH)D₃ increased by 14% in subjects receiving vitamin D₃ for 4 months (p < 0.01), whereas there was no significant change in 25(OH)D₃ levels in those receiving vitamin D₂.

Conclusions

We report that 25(OH)D₃ ELISA was used for evaluation of 25(OH)D₃ concentrations in subjects receiving vitamin D₂ and D₃ supplementation. The increase of 25(OH)D₃ in circulation with vitamin D3 supplementation and lack of increase with vitamin D₂ supplementation suggest that this assay has sufficient sensitivity and specificity to be used as a reliable measurement of nutritional vitamin D₃ status in humans.     

Circadian Variation in Circulating Platelet Aggregates

The mitochondrial F₁F_o adenosine triphosphate (ATP) synthase is one of the most thoroughly studied enzyme complexes known. Yet, a number of new observations suggesting that the enzyme is also located on the cell surface necessitate further investigation. While the mitochondrial synthase utilizes the proton gradient generated by oxidative phosphorylation to power ATP synthesis, the cell surface synthase has instead been implicated in numerous activities, including the mediation of intracellular pH, cellular response to antiangiogenic agents, and cholesterol homeostasis. Intriguingly, a common thread uniting these various models of cell surface ATP synthase functions is the apparently caveolar distribution of the enzyme. Recent studies concerning the cell surface ATP synthase manifest applications in the regulation of serum cholesterol levels, cellular proliferation and antitumor strategies. This review addresses the expression, interactions, functions, and consequences of inhibition of cell surface ATP synthase, an enzyme now displaying a shift in paradigm, as well as of location.     

Vitamin B12 deficiency: New data on an old disease

Cobalamin deficiency is a common finding. In the elderly the prevalence is 10-20%, but only 5-10% of these are clinically symptomatic. Typical clinical symptoms include macrocytic anemia, neuropsychiatric symptoms and glossitis. In many cases this triad is lacking, however. The serum cobalamin assay is the best first line test, but the results must be carefully interpreted, since a normal level does not exclude deficiency. Markers of cobalamin activity, such as serum homocysteine or methylmalonic acid may be helpful in this situation. The main cause of cobalamin deficiency is atrophic gastritis. It is either caused by an autoimmune process which leads to achlorhydria and severe intrinsic factor deficiency ("classical pernicious anemia") or by atrophic gastritis from other causes, in particular helicobacter pylori infection. In the latter cases the lack of gastric acid does not allow separation of cobalamin from proteins, but intrinsic factor, although low, is sufficient for cobalamin protection (food cobalamin malabsorption). Helicobacter pylori eradication may cure some of these patients. While in food cobalamin malabsorption syndrome small doses of oral cobalamin are effective, parenteral therapy or high oral doses are required for treatment of pernicious anemia. While almost all patients respond hematologically, only half of the patients with neurological signs, and a small minority of psychiatric patients respond to treatment. Patients with pernicious anemia and atrophic gastritis have a greatly increased long-term risk for gastric carcinoids.     

Conjunctival oxygen tension monitoring in emergency department patients

Conjunctival oxygen tension (PcjO2) was sequentially monitored in 96 medical and surgical patients admitted to the emergency department resuscitation suite during a 6-month period. There were 28 patients with cardiac arrest, 44 with major trauma, and 24 with severe medical problems. A total of 2,392 PcjO2 data points were collected in these patients. In patients with cardiac arrest, PcjO2 showed changes in physiological condition as early as or earlier than measurement of vital signs. Measurement of PcjO2 and the finding of a PcjO2 index (PcjO2/PaO2) less than .5 in normotensive multiple trauma patients allowed rapid detection of hemorrhagic hypovolemia. In critically ill medical patients, low values for PcjO2 were found with hypoxemia as well as in conditions associated with decreased cardiac output and tissue oxygen delivery. These two conditions could be distinguished by measuring PaO2 and calculating the PcjO2 index; a PcjO2 index less than .5 was associated with diminished peripheral perfusion and cardiac output, and a PcjO2 index greater than .5 indicated hypoxemia without any compromise in cardiac output. In the group of critically ill surgical and medical patients included in this study, conjunctival oxygen monitoring provided clinically useful information not available from vital signs and permitted identification of physiological instability associated with abnormalities in peripheral tissue perfusion and oxygenation as early as or earlier than conventional monitoring methods.     

Reliability of Cardiac Output Calculation by the Fick Principle and Central Venous Oxygen Saturation in Emergency Conditions

Background  For many years thermodilution has been the gold standard for determining cardiac output in the critically ill patients. Less invasive methods have recently been introduced. This study aimed at evaluating the agreement between cardiac output (CO) measured by a new Fick method, using central venous saturation (Scvo₂), and that measured by the classic thermodilution technique, in patients requiring emergent CO evaluation. Settings  Prospective clinical study in a university-affiliated, tertiary hospital, at surgical and general intensive care units. Patients and methods  Fifteen mechanically ventilated patients arriving in the emergency department in hemodynamic shock, had immediately a pulmonary artery catheter introduced under fluoroscopy upon arrival into the ICU. Cardiac output (CO) was obtained in each patient via both thermodilution and the Fick method, using oxygen consumption, SpO₂ and Scvo₂. Results  COs ranged between 2 and 2.3 (in the Fick and thermodilution methods, respectively) and 19 or 19.5 l/min (respectively). Mean thermodilution-derived CO was 6.2 ± 4.2 l/min whereas the Fick’s was 7.0 ± 4.3 l/min. There was statistical significant correlation between the two modalities of measurements, with an r ² = 0.9 (P < 0.001). Conclusions  The new method of Fick assessed emergent CO as reliably as the thermodilution, regardless of whether it was low or high. The use of Scvo₂ allows for prompt bedside calculation for most emergency patients. Avi A. Weinbroum and Philippe Biderman concurred equally to the present investigation. Weinbroum AA, Biderman P, Soffer D, Klausner JM, Szold O. Reliability of cardiac output calculation by the Fick principle and central venous oxygen saturation in emergency conditions.     

Human chorionic gonadotropin (hCG) may be a marker of systemic oxidative stress in normotensive and preeclamptic term pregnancies

Objectives:

In vitro studies on placental function have revealed interactions between levels of secretion of human chorionic gonadotropin (hCG) by trophoblastic cells and oxidative stress generated by hydrogen peroxide (H₂O₂). Here, we have examined the relationship between maternal levels of hCG and H₂O₂ in vivo in term pregnancies with and without preeclampsia.

Design and methods:

We measured serum levels of hCG and H₂O₂ in twenty preeclamptic and twenty normotensive term pregnant women (controls), using an enzymatic immunoassay and an electrochemical method, respectively.

Results:

Higher levels of serum hCG and H₂O₂ were observed in patients with preeclampsia in comparison to controls. A significant positive correlation between serum hCG concentration and H₂O₂ production was found.

Conclusion:

Our results show that: (1) systemic hCG levels are correlated with an oxidative stress state in term pregnant women with preeclampsia and (2) circulating hCG may be a monitoring tool of oxidative stress during pregnancy.     

Elimination of 14C-glycated albumin from serum of rabbit

Glycated albumin was prepared by incubation of serum from rabbits with randomly labelled ¹⁴C-glucose. The isolated glycated albumin fraction was re-infused to the same animal. ¹⁴C-labelled glucose was given to alloxan-treated rabbits. The disappearance of the radioactivity showed a rapid initial phase and a slow elimination phase, which could be acceptably described by first-order kinetics. The estimated half-life of glycated albumin was about 6 days, which is about 70% of that generally stated for albumin in the rabbit. If these findings were transferred to human conditions, the half-life of fructosamine would be in the range of 13-14 days.