血清高敏C反应蛋白浓度与高血压病的相关性研究

目的　探讨血清高敏C 反应蛋白浓度与高血压病的关系。方法　对开滦集团公司2 2 0 9名离休职工健康查体 ,检测血清高敏C 反应蛋白浓度及其他生化指标 ,比较高血压组和正常血压组及不同血压水平组间血清高敏C 反应蛋白浓度的差异。结果　 2 2 0 9人中符合研究目的且资料完整的共计 2 16 9人 ,其中确诊高血压病患者 12 0 5例。高血压组、正常血压组血清高敏C 反应蛋白浓度分别为 (1 97± 1 84 )mg/L和 (1 0 8± 1 2 4 )mg/L(P <0 0 0 1)。收缩压、舒张压水平随血清高敏C 反应蛋白浓度增加而增高 (P <0 0 0 1)。非吸烟组、糖尿病组、超重及肥胖组血清高敏C 反应蛋白浓度分别为 (1 87± 1 4 3)mg/L、(2 0 9± 1 85 )mg/L和 (1 5 8± 1 6 1)mg/L ,均高于吸烟组、非糖尿病组、非超重及肥胖组的 (1 33± 1 10 )mg/L、(1 2 3± 1 4 0 )mg/L、(0 82± 1 0 6 )mg/L (P <0 0 0 1)。结论　血清高敏C 反应蛋白浓度与高血压病相关 ,炎症反应可能参与了高血压病的发生。     

C-反应蛋白水平测定在呼吸系统感染性疾病中的临床意义

目的　探讨血清C 反应蛋白水平在呼吸系统感染性疾病中的临床意义。方法　采用速率放射比浊法测定入院前接受过抗生素或退热药治疗的呼吸系统感染性疾病的患者血清CRP水平及感染控制前、后的血清CRP水平 ;采用电阻抗检测法行白细胞计数 ;腋测法测量体温。结果　入院前接受过抗生素或退热药治疗的呼吸系统感染性疾病的患者血清CRP阳性率为 89% ,WBC阳性率为 2 5 % ,T阳性率为 48%。感染控制前CRP水平为 ( 4 7.2 2± 30 .0 7)mg/L和感染控制后CRP水平为 ( 7.75± 1.34)mg/L ,(P <0 .0 1) ,而WBC感染控制前为 ( 8.16± 2 .91)和感染控制后为 ( 5 .96± 1.96 ) ,(P >0 .0 5 ) ,感染控制前体温为 ( 36 .87± 0 .87)℃和感染控制后体温为 ( 36 .5 6±0 .41)℃ ,(P <0 .0 1) ,但体温在入院时阳性率仅达 48%。结论　血清CRP水平是一种反映呼吸系统感染性疾病的敏感可靠指标 ,不受抗生素和退热药的影响。     

中国肝病患者血清铜蓝蛋白水平的研究

目的　探讨我国不同肝病患者血清铜蓝蛋白 (CP)水平交叉程度 ,为肝豆状核变性(WD)的诊断和鉴别诊断提供科学的依据。方法　测定 90 5例正常人、WD及其他各种肝病患者血清CP水平 ,采用SPSS12统计软件进行统计分析。结果　WD患者血清CP平均为 (93 9± 98 1)mg/L ,与其他各组相比差异有非常显著性 ,72 7%的患者低于 10 0mg/L ,其中 4 2 9%的患者低于 5 0mg/L ,但是也有 9 1%的患者其血清CP正常 ,其中 3例高于 4 0 0mg/L ,最高达 5 0 1mg/L。 6 8%的非WD患者血清CP低于正常 ,最低为 2 8mg/L。急性肝炎患者血清CP平均为 (398 4± 15 1 3)mg/L ,显著高于其他各组。重型肝炎患者血清CP平均为 (2 96 5± 10 6 5 )mg/L ,显著低于其他各组 ,其中18 8%的患者低于正常。结论　WD患者CP水平显著低于正常人和其他肝病患者 ,但是与其他肝病有一定程度的交叉 ,单凭CP水平不足以确诊或排除WD。     

超敏C-反应蛋白和C-反应蛋白的测定对SARS的诊断价值

目的　研究血清超敏C -反应蛋白 (hs -CRP )和C -反应蛋白 (CRP)对严重急性呼吸综合征 (SARS)的诊断价值。方法　SARS病人 2 0例、细菌性肺炎病人 2 0例、健康对照 2 0例 ,血清hs -CRP和CRP采用胶乳免疫比浊法全自动定量测定。结果　hs -CRP和CRP测定结果分别为 :健康对照组 (0 6 9± 0 6 2 )mg/L和 (4 4± 0 9)mg/L、细菌性肺炎组 (10 79± 1 36 )mg/L和 (98 0± 2 8 9)mg/L、SARS组 (3 16± 3 72 )mg/L和 (11 0± 9 6 )mg/L。三组间差异均有显著意义 (P <0 0 1)。结论　SARS病人和细菌性肺炎病人早期血清hs -CRP和CRP均升高 ,但细菌性肺炎病人升高更加显著 ,比SARS组分别增加 2 4倍和 7 9倍 ,对SARS与细菌性性肺炎的鉴别诊断有重要意义     

2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

目的　探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。　方法　检测DN患者血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。　结果　早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相     

胃癌与免疫复合物

癌症患者血中免疫复合物(IC)可作为阻抑因子而降低患者的免疫机能。作者应用3.5%多乙烯乙二醇(PEG)沉淀法测定了72例胃癌患者血清IC,同时测定了癌胚抗原(CEA)、免疫抑制酸性蛋白(IAP)、植物血凝素(PHA)·纯蛋白衍生物(PPD)皮内反应、PHA·刀豆素A(Con A)淋巴细胞转化等免疫指标,以分析与IC水平之间的关系。正常人IC值为0.479±0.06,胃癌患者的IC值随病情进展逐步增高,Ⅱ期胃癌为0.525±0.074,Ⅲ期为0.563±0.115,Ⅳ期为0.569±0.111,复发性胃癌为0.609±0.095(P<0.01)。 58例患者测定了IgA、IgG、IgM,43例测定了     

原发性高血压患者血清Ⅰ型和Ⅲ型前胶原水平及药物干预研究

目的　测定血清 型和 型前胶原 (procollagen,PC)水平 ,评价高血压患者心肌纤维化程度 ,并分析使用抑平舒 (Cilazapril)或波依定 (Felodipine)抗高血压治疗对二者的影响。方法　 4 9例原发性高血压患者分为两组 :抑平舒治疗组 (n=2 2 )和波依定治疗组 (n=2 7) ,2 3例未经治疗的高血压患者作为实验对照组 ,2 0名同龄健康者为正常对照组 ,采用放射免疫分析法测定其血清 PC 、PC 水平 ,用超声测量其左心室解剖参数 ,计算左心室质量指数(L VMI)。结果　高血压实验对照组 L VMI、血清 PC 、PC 水平较正常对照组显著升高 (L VMI:110 .0 7± 19.31对 83.73± 15 .5 0 ,PC :12 0 .96± 2 4 .4 2对 71.6 3± 17.80 ,PC :95 .92± 9.75对 6 7.90± 9.37,P<0 .0 1)。高血压患者中未经治疗者 L VMI、血清 PCI水平显著高于经抑平舒或波依定治疗 6个月的患者 (L VMI:110 .0 7± 19.31对 96 .95± 2 1.92 ,110 .0 7± 19.31对 98.5 1± 19.2 5 ;PC :12 0 .96± 2 4 .4 2对 80 .5 1± 19.6 6 ,12 0 .96± 2 4 .4 2对93.0 5± 19.6 1,P<0 .0 1) ,血清 PCI水平抑平舒治疗组低于波依定治疗组 (80 .5 1± 19.6 6对 93.0 5± 19.6 1,P<0 .0 5 ) ,而血清 PC 水平高血压患者三组间均无差异。结论　 1.血清 PC 和 PC 浓度可以?     

C反应蛋白增高在心房颤动中的意义

目的 :探讨C反应蛋白 (CRP)增高在心房颤动 (房颤 )发病中的意义。方法 :应用免疫比浊法测定 96例诊断为房颤患者血清CRP水平 ,与对照组比较 ,并对房颤按持续时间、病因不同分设亚组 ,进行统计学分析。结果 :房颤组、对照组血清CRP水平分别为 (4 .30± 2 .87)、(1.15± 0 .90 )mg L ,两组相比P <0 .0 5。器质性、孤立性房颤者CRP水平分别为 (5 .0 6± 1.92 )、(4 .37± 1.32 )mg L ,均高于对照组 ,P <0 .0 5。持续性、永久性房颤者CRP水平分别为 (5 .6 0± 1.80 )、(5 .0 0± 1.6 0 )mg L ,均高于阵发性房颤 [(3.30± 1.2 0 )mg L],P <0 .0 5。结论 :CRP增高反映的炎症状态可能促进房颤发生 ,以及呈持续性发作。     

2型糖尿病动脉粥样硬化与巨细胞病毒感染及内皮素、肿瘤坏死因子的相关性研究

目的　 (1)从流行病学的角度观察人类巨细胞病毒 (HCMV)与 2型糖尿病 (T2 DM)动脉粥样硬化 (AS)的关系 ;(2 )了解血浆内皮素 (ET)、血清肿瘤坏死因子 (TNF- α)在 T2 DM AS发生、发展中的作用及 HCMV感染与 ET、TNF- α的关系。　方法　采用酶联免疫吸附法测定 T2 DM中有 AS患者 2 1例 ,无明显 AS患者 4 7例及正常对照组 2 0例血清 HCMV抗体 Ig M和 Ig G。用放免法测定血清 TNF- α和血浆 ET的浓度。　结果　 (1) T2 DM患者的 HCMV感染率 [阳性率 Ig G为 93% (6 3/ 6 8)、Ig M为 4 6 %(31/ 6 8) ]高于正常人群 [阳性率 Ig G为 80 % (16 / 2 0 )、Ig M为 10 % (2 / 2 0 ) ],检测抗 HCMV- Ig M(抗 Ig M作为活动性感染或潜伏感染活化指标 )更有意义 (P<0 .0 1)。T2 DM患者 ET的浓度 (6 8.6 8± 17.12 ) ng/L 和 TNF- α的浓度 (1.79± 0 .4 3) μg/ L,也高于正常人 [(49.0 4± 14 .36 ) ng/ L、(1.32± 0 .4 1) μg/ L,P均 <0 .0 0 1]。 (2 ) T2 DM伴有 AS患者中 ,活动性或潜伏感染活化 HCMV感染率 (Ig M阳性率 5 7% )和血浆 ET[(86 .77± 15 .19) ng/ L]、血清 TNF- α[(2 .0 1± 0 .4 5 ) μg/ L]的水平高于不伴有 AS的 T2 DM患者 [Ig M阳性率 4 0 % ,ET为 (6 0 .5 9± 10 .4 9) ng/ L,TNF- α为 (1.6 8     

溶栓治疗对老年急性心肌梗死患者血清Ⅲ型前胶原末端肽 …

目的　观察溶栓与非溶栓治疗对老年急性心肌梗死 (AMI)患者血清Ⅲ型前胶原水平及左心功能的影响。　方法　将 38例AMI患者分为静脉溶栓组 (2 1例 )和非溶栓组 (17例 ) ,应用放射免疫法测定血清Ⅲ型前胶原末端肽 (PⅢP)含量 ,采用彩色Doppler超声心动图仪测量左室结构及舒缩功能参数。　结果　溶栓组患者在溶栓开始后 1、2、4、6周血清PⅢP含量分别为 (94 35± 11 32 )、(92 2 6± 10 18)、(89 2 4± 8 92 )和 (86 44± 7 98) μg/L ,较同期非溶栓组患者PⅢP(12 4 30± 9 77)、(12 7 6 0± 11 87)、(10 9 80± 10 96 )和 (96 2 0± 9 17) μg/L明显降低 (P <0 0 5或P <0 0 1) ;溶栓未再通组血清PⅢP含量显著高于再通组 (P <0 0 5或P <0 0 1)。血清PⅢP含量与左室重塑 (LVRM)程度有良好的相关性 (r=0 375 1,P <0 0 5 ) ,与左室舒缩功能呈负相关 (r =- 0 485 7,P <0 0 5 ;r =- 0 45 6 8,P <0 0 5 )。　结论　早期实施静脉溶栓治疗能降低血清PⅢP水平 ,减少LVRM发生 ,改善左心功能。     

Increased TNF-alpha, IL-1 beta and IL-6 levels in the bronchoalveolar lavage fluid with the upregulation of their mRNA in macrophages lavaged from patients with active pulmonary tuberculosis.

SETTING: We hypothesized that patients with active pulmonary tuberculosis (TB) have tubercular pneumonitis and that alveolar macrophages at these sites release proinflammatory cytokines, resulting in high levels of cytokines in alveolar epithelial lining fluid. OBJECTIVE: To measure cytokine levels in bronchoalveolar lavage fluid (BALF) and to confirm the source of any cytokines by examination of alveolar macrophage cytokine mRNA. DESIGN: Seventeen active pulmonary TB patients and 15 healthy controls were prospectively studied. Bronchoalveolar lavage (BAL) was performed, proinflammatory cytokine levels were determined and alveolar macrophages isolated from BALF were prepared for RNA extraction and Northern blot analysis. RESULTS: Compared with healthy controls, TNF-alpha, IL-1 beta and IL-6 in BALF were all significantly higher in patients with active pulmonary TB, 298.7 +/- 85.9 vs. 8.9 +/- 2.7 (P = 0.0001); 164.4 +/- 67.5 vs. 8.9 +/- 2.7 (P = 0.003); 969.2 +/- 214.2 vs. 86.4 +/- 17.0 (mean +/- SE pg/ml) (P = 0.0001), respectively. Only TNF-alpha and IL-6 levels were significantly higher in sera of active pulmonary TB patients, 92.3 +/- 28.7 vs. 3.5 +/- 1.2; 15.2 +/- 5.4 vs. 2.1 +/- 2.1, respectively. Northern blot analysis revealed increased gene expression of these alveolar macrophage cytokines in patients with active pulmonary TB compared healthy controls. CONCLUSION: Significantly higher levels of TNF-alpha, IL-1 beta and IL-6 were found in BALF from patients with active pulmonary TB, and were released by alveolar macrophages in the TB lesions.     

Diagnostic significance of carcinoembryonic antigen measurement in bronchial lavage fluids in bronchial carcinoma

Using monoclonal antibody against CEA, we have measured carcino-embryonic antigen in bronchial lavage fluids and sera in 36 pts with bronchial carcinoma. Simultaneously, 28 pts and 36 pts were performed with bronchial brush biopsy and cytological examination respectively. There were 25 cases with other pulmonary diseases such as TB and pneumonia as control. CEA levels of lavage fluids, sera in malignant group and control were 42.2 +/- 44.9; 12.8 +/- 23.6; and 8 +/- 11.6; 1.6 +/- 2.4 (ng/ml) respectively. CEA lavage was adjusted with albumin concentration in each case. The results showed: (1) 83.3% of malignant patients were greater than 10 ng/ml in lavage fluids and 16% in non-malignant group. Positive rate was higher than controls (P less than 0.01). (2) CEA level of lavage fluids was higher than that of sera in malignancy (P less than 0.01). (3) There were 16 patients with negative bronchial brush biopsy in malignant group but they were 93.7% positive for CEA measurement of lavage fluids. It is reasonable to consider that CEA measurement in bronchial lavage fluid is an important technique for the supplementary of bronchogenic carcinoma.     

The relationship between serum IAP and peripheral K cells in patients with subacute thyroiditis

In a previous study, we showed that the percentage of peripheral K cells of patients with subacute thyroiditis (SAT), determined by a plaque-forming cell technique, was significantly lower than that of normal controls, and that ther sera from SAT significantly inhibited the activity of K cells in normal lymphocytes, suggesting that in the sera of SAT there is some factor which inhibits K cell activity. In this study, we investigated the relationship between K cells and the serum immunosuppressive acidic protein (IAP), the sex difference in percentage of K cells, and the absolute count of K cells in patients with SAT. In normal controls, there was a sex difference in the percentage of K cells in total lymphocytes; the percentage was significantly lower in women (mean +/- S.D., 5.0 +/- 2.0%; n = 12; p less than 0.01) than in men (8.4 +/- 2.9%; n = 20). However, there was no sex difference in the absolute count of peripheral K cells. In the acute phase of SAT, the percentages of K cells wee 2.4 +/- 1.8%; 2.4 +/- 1.9% and 2.7 +/- 1.0% in 19 patients, 16 females and 3 males, respectively, which were significantly lower than 6.8 +/- 3.0%, 5.0 +/- 2.0% and 8.4 +/- 2.9% in 25 controls, 12 females and 13 males, respectively. The absolute counts of K cells in the acute phase of SAT were 56 +/- 45/mm3 and 58 +/- 48/mm3 in 13 patients including 11 females, respectively, which were significantly lower than 165 +/- 63/mm3 and 153 +/- 73/mm3 in 12 patients including 5 female controls, respectively. It was observed that serum IAP values in SAT were correlated negatively with the percentage of K cells and positively with the inhibition rate of SAT sera on K cells from normal subjects. Moreover, purified IAP showed a dose-related inhibition on the K cells from the control subjects. These results suggest that IAP in the sera of SAT seems to be one of the factors which inhibits the activity of K cells.     

Decline in beta-2 microglobulin levels after antitubercular therapy in tubercular patients with HIV infection

BACKGROUND: Infection with Mycobacterium tuberculosis results in a state of immune activation, more so, when there is concomitant HIV infection. Beta-2 microglobulin (B2M) is a useful marker to study the state of immune activation among the HIV infected. Objective. To study the modulation of B2M levels among patients with HIV/TB coinfection, to correlate it with the CD4 count and also to study the change in these levels after four weeks of therapy. MATERIAL AND METHODS: Twelve patients with HIV infection and having concomitant TB diagnosed on the basis of positive acid fast bacilli were studied both at baseline and then at four weeks. Fourteen HIV infected individuals who had no overt opportunistic infection at the time of the study were also studied along with fourteen age and sex matched healthy volunteers. CD4 counts were performed using a flowcytometer. B2M was measured using a commercially available ELISA kit. RESULTS: B2M levels in HIV/TB coinfected patients were 1.62+/-0.45 mg/L (range 1-2.7 mg/L) and were significantly higher (p<0.0002) when compared with healthy controls, whose levels were 0.74+/-0.05 mg/L (range 0.48-81 mg/L). The levels in HIV infected individuals free of opportunistic infections were 1.2+/-0.16 mg/L (range 0.78-1.92 mg/L) and were significantly lower than the levels in HIV/TB coinfected (p<0.017), but significantly higher than the levels in healthy controls (p<0.01). Four weeks of antitubercular therapy resulted in a decline in B2M to 1.08+/-0.26 mg/L (range 0.8-1.74 mg/L) and was statistically significant (p<0.012). There was no correlation between the CD4 counts and the pre-treatment levels of B2M among these patients. CONCLUSION: Patients with HIV/TB coinfection had significantly higher levels of B2M than individuals with HIV infection without associated opportunistic infection and healthy controls. Four weeks of anti-tuberculous therapy resulted in a significant decline in these levels.     

肺结核患者肺灌洗液细胞分泌γ干扰素和白细胞介素12的 …

目的 探讨肺结核患者支气管肺泡灌洗液和细胞分泌细胞因子水平的变化及其对临床表现的影响。方法 分别对１０名健康志愿者、１０例肺结核患者健侧肺、１０例轻症初治和１０例迁廷不愈的肺结核患者病变肺局部进行了支气管泡灌洗、获取肺泡巨噬细胞（ＡＭ）和淋巴细胞,用双抗体夹心酶联免疫吸附法分别测定了经脂多糖刺激ＡＭ培养上清液中白细胞介素１２（ＩＬ－１２）和经植物血凝素刺激的淋巴细胞培养上清液中的γ干扰素（ＩＦＮ－     

A comparative study of immunosuppressive acidic protein (IAP), CA 125 and acute-phase proteins as parameters for ovarian cancer monitoring

The serum concentrations of immunosuppressive acidic protein (IAP), CA 125, alpha-1-antitrypsin (AL-1-AT), C-reactive protein (CRP) and ceruloplasmin (COP) were determined in 63 patients with ovarian carcinoma (mean age 56.9 +/- 11.1 years). The threshold value of IAP was 640 micrograms/ml (means + 2SD), of CA 125 35 U/ml, of AL-1-AT 4 mg/ml, of CRP 12 micrograms/ml, and of COP 600 ng/ml. Eighty-three analyses of the patients with ovarian cancer coincided with tumor progression and 124 samples with remission. In women with progressive ovarian carcinoma the median IAP serum concentrations (799.3 +/- 292 micrograms/ml) were significantly increased as compared to the values of the healthy control group (48 volunteers, mean age 37.8 +/- 13.8 years; IAP 452.0 +/- 146.0 micrograms/ml). The median serum concentrations of IAP (799.3 +/- 292.2 micrograms/ml), CA 125 (933.8 +/- 1442.1 U/ml). AL-1-AT (3.8 +/- 8.7 mg/ml), CRP (31 +/- 39 micrograms/ml) were significantly elevated with progression as compared to remission (IAP 511.8 +/- 111.9 micrograms/ml, CA 125 18.4 +/- 14.4 U/ml, AL-1-AT 2.8 +/- 4.1 mg/ml, CRP 13 +/- 11 micrograms/ml). This was not the case with COP (509 +/- 761 vs. 466 +/- 106 ng/ml). A correlation between increased serum values and confirmed tumor progression was encountered in 65.1% of the patients for IAP, in 80.7% for CA 125 and in 34.9% for CRP and AL-1-AT. 98.8% false negative serum values were found for COP. Seven out of 16 and 4 out of 16 CA 125 negative samples showed right positive IAP and right positive CRP and AL-1-AT values, respectively. 88.7% of the IAP values, 92.7% of the CA 125 values, 71% of the AL-1-AT values, 93.5% of the CRP and 100% of the COP values were right negative. Our results indicate that the simultaneous determination of CA 125 and IAP enhance the efficiency of tumor monitoring in patients with ovarian cancer.     

Patients with pulmonary tuberculosis are frequently positive for anti-cyclic citrullinated peptide antibodies, but their sera also react with unmodified arginine-containing peptide

OBJECTIVE: The anti-cyclic citrullinated peptide (anti-CCP) enzyme-linked immunosorbent assay (ELISA) has high sensitivity and specificity for rheumatoid arthritis (RA). However, detection of anti-CCP in patients with active pulmonary tuberculosis (TB) has recently been reported. To determine whether this activity was specific for the citrullinated residue, the specificity of anti-CCP-positive sera for CCP versus that for unmodified arginine-containing peptide (CAP) was examined in patients with TB and compared with that in patients with RA. METHODS: Anti-CCP and anti-CAP in sera from patients with pulmonary TB (n = 49), RA patients (n = 36), and controls (n = 18) were tested by ELISA. Sera were available at diagnosis from most TB patients. All TB patients were treated with a combination of 2-4 antibiotics for at least 6 months, and sera were collected over time. RESULTS: Anti-CCP was found in 37% of TB patients and in 43% of RA patients. CAP reactivity was more common in TB than in RA. High anti-CCP:anti-CAP ratios (>2.0) were seen far more commonly in anti-CCP-positive RA patients than in anti-CCP-positive TB patients (94% versus 22%). Anti-CCP was inhibited by CCP peptide in sera from RA patients, but not in sera from TB patients. A slight increase in anti-CCP was common after initiating treatment for TB, although the anti-CCP level decreased after 1-2 months. CONCLUSION: Anti-CCP is frequently present in patients with active TB. However, many anti-CCP-positive TB sera also reacted with CAP, and anti-CCP:anti-CAP ratios in TB sera were low. Anti-CCP:anti-CAP ratios should be useful clinically for distinguishing CCP-specific reactivity seen in RA from reactivity with both CCP and CAP frequently seen in pulmonary TB.     

Positive anti-cyclic citrullinated proteins and rheumatoid factor during active lung tuberculosis

OBJECTIVES: To determine the prevalence of anti-cyclic citrullinated proteins (anti-CCP) and IgM rheumatoid factor (RF) in sera of patients with TB compared with healthy controls. PATIENTS AND METHODS: 47 consecutive patients with recently diagnosed active pulmonary TB and 39 healthy controls were studied. Data were collected by questionnaire on clinical features of the disease, duration of symptoms, fever, cough, arthralgia, myalgia, sicca symptoms. Serum samples were collected from patients before starting treatment for TB and frozen at -20 degrees C. Anti-CCP and IgM RF were evaluated by ELISA. RESULTS: The mean (SD) duration of TB related symptoms was 4.4 (1.7) months, 73% had fever, 94% a cough. Rheumatic symptoms were relatively rare: arthralgia (4%), myalgias (4%), eye and mouth dryness (2% and 9%, respectively). Mean (SD) levels of anti-CCP were significantly increased in patients with TB compared with controls: 44.9 (51) IU v 20 (7.3) IU (p = 0.002). Serum levels >40 U were found in 15/47 (32%) patients compared with 1/39 (2.6%) controls (p = 0.002). Mean (SD) serum levels of IgM RF were significantly increased in patients with TB: 17.8 (19) v 4.3 (5) (p<0.0001). IgM RF was positive (>6 IU) in 29/47 (62%) patients v 1/39 (2.6%) controls (p<0.0001). CONCLUSIONS: A significant proportion of patients with active TB have an increased titre of anti-CCP and IgM RF.     

Training depletes muscle glutathione in patients with chronic obstructive pulmonary disease and low body mass index

BACKGROUND: A physiological increase in muscle glutathione after training is not seen in patients with chronic obstructive pulmonary disease (COPD), indicating abnormal peripheral muscle adaptations to exercise. OBJECTIVE: We hypothesized that oxidative stress is primarily associated with low body mass index (BMI). METHODS: Eleven patients with preserved BMI (BMI(N): 28.2 +/- 1.2 kg.m(-2)), 9 patients with low BMI (BMI(L): 19.7 +/- 0.60 kg.m(-2)) and 5 age-matched controls (26.5 +/- 0.9 kg.m(-2)) were studied before and after 8 weeks of high-intensity endurance training. Reduced glutathione (GSH) and gamma-glutamyl cysteine synthase heavy-subunit chain mRNA expression (gammaGCS-HS mRNA) were measured in the vastus lateralis. RESULTS: After training, exercise capacity increased (DeltaVO(2)PEAK, 13 +/- 5.2%; 10 +/- 5.6% and 15 +/- 4.3% in BMI(L), BMI(N) and controls, respectively; p < 0.05 each). GSH levels decreased in BMI(L) (from 5.2 +/- 0.7 to 3.7 +/- 0.8 nmol/mg protein, DeltaGSH -1.5 +/- 0.7 nmol/mg protein, p < 0.05); no changes were seen in BMI(N) (from 5.4 +/- 0.7 to 6.7 +/- 0.9 nmol/mg protein, DeltaGSH 1.3 +/- 0.9 nmol/mg protein), whereas GSH markedly increased in controls (from 4.6 +/- 1 to 8.7 +/- 0.4 nmol/mg protein, DeltaGSH 4.1 +/- 1 nmol/mg protein, p < 0.01). DeltaGSH in BMI(L) was different from DeltaGSH in BMI(N) and controls (p < 0.05, each). Consistent changes were observed in gammaGCS-HS mRNA expression. CONCLUSIONS: GSH depletion after training in BMI(L) may suggest that oxidative stress plays a key role in muscle wasting in COPD patients.     

Hypercalcaemia in Greek patients with tuberculosis before the initiation of anti-tuberculosis treatment

Hypercalcaemia has been known to occur in association with granulomatous diseases. The aim of this study was to ascertain the incidence of hypercalcaemia and determine the prevalence of symptoms associated with it in Greek patients with newly-diagnosed tuberculosis (TB), before the initiation of anti-tuberculosis treatment. We prospectively evaluated all patients with newly-diagnosed TB presenting, either as inpatients or as outpatients, to our hospital, during a 3-year period. We evaluated 88 patients with TB (50 males and 38 females), aged between 23 and 89 years (mean age+/-SD: 46.4+/-19 years), and 65 age- and sex-matched controls with chronic obstructive pulmonary disease (36 males and 29 females), aged between 28 and 88 years (mean age+/-SD: 47.2+/-18 years). Among TB patients, 56 had pulmonary TB, 20 had pleural TB without evidence of pulmonary parenchyma involvement, eight had pulmonary and pleural TB, and four had disseminated disease. The mean (+/-SD) albumin-adjusted serum calcium concentration and the mean ionized calcium concentration were significantly higher in the TB group (2.49+/-0.21 mmol l(-1) and 1.27+/-0.02 mmol l(-1) respectively) than in the control group (2.36+/-0.11 mmol l(-1) and 1.19+/-0.02 mmol l(-1), P<0.05). In the TB group no correlation between type of disease and albumin-adjusted or ionized calcium concentration was seen. Hypercalcaemia was detected in 22 patients with TB (25%) but only three showed symptoms associated with it. We conclude that, although hypercalcaemia is a common laboratory finding among Greek patients with TB before anti-TB chemotherapy, it is usually asymtomatic.