系统性红斑狼疮患者血清抗核小体抗体与抗C1q抗体的检测及临床意义

目的：探讨抗核小体抗体与抗C1q抗体与系统性红斑狼疮（system lupus erythematosus，SLE）活动性的关系以及在狼疮肾（lupus ephritis，LN）患者血清的表达及临床意义。方法：采用酶联免疫吸附试验对33例LN患者血清进行检测，以43例无肾炎临床表现的SLE患者做为对照组。同时将76例SLE患者按SLEDAI评分分为SLEDAI≥10分组与SLEDAI〈10分组两组，进行抗核小体抗体，抗C1q抗体与SLE活动度相关性的分析。结果：LN患者血清中抗核小体抗体与C1q抗体浓度及阳性率显著高于SLE对照组（P〈0．01），抗dsDNA抗体，抗Sm抗体，抗nRNP抗体有较高的阳性率，与对照组比较有统计学意义（P〈0.05）。同时SLEDAI≥10分组，抗核小体抗体与抗C1q抗体浓度及阳性率显著高于SLEDAI〈10分组（P〈0、01），抗dsDNA抗体，抗Sm抗体，抗nRNP抗体在SLEDAI≥10分组中有较高的阳性率，与SLEDAI〈10分组比较有统计学意义（P〈0.05）。相关性分析表明血清中抗核小体抗体，抗C1q抗体与SLEDAI评分呈正相关。分别以LN和SLEDAI作为因变量将抗核小体抗体，抗C1q抗体，抗dsDNA抗体，抗Sm抗体，抗nRNP抗体进行Logistic回归统计分析。结果显示以LN作为因变量入选的自变量有，抗C1q抗体，抗Sm抗体（P〈0．05y，以SLEDAI作为因变量入选的自变量有抗核小体抗体．抗C1q抗体（P〈0．05）。结论：在LN患者中，存在抗核小体抗体和抗C1q抗体的高表达，抗核小体抗体及抗C1q抗体在LN疾病中起较为重要作用。抗核小体抗体，抗C1q抗体，是反映SLE患者并发肾脏损伤的重要指标，在LN诊断和判定其活动性方面有重要作用，与SLE的发生发展密切相关，能较好的反映SLE病情的活动性。     

血红素氧合酶1对尿毒症环境脐静脉内皮细胞单核细胞趋化蛋白1表达的影响

目的 体外观察尿毒症患者血清对人脐静脉内皮细胞（HUVEC）合成单核细胞趋化蛋白1(MCP-1)的影响，探讨诱导血红素氧合酶1（HO-1）高表达对调节MCP-1合成的作用。 方法 以含10％尿毒症血清的M199培养基体外培养HUVEC细胞株。采用RT-PCR法检测HUVEC MCP-1 mRNA的表达。用ELISA法检测HUVEC MCP-1蛋白的分泌。然后分别以HO-1诱导剂氯化血红素（hemin）及阻断剂原卟啉锌(ZnPP)预处理HUVEC，应用RT-PCR法和免疫组织化学法检测细胞内HO-1及MCP-1 mRNA及蛋白的表达。 结果 尿毒症血清可上调细胞MCP-1 mRNA的表达，促进MCP-1蛋白合成，MCP-1蛋白量为对照组的2.95倍。hemin诱导的HO-1高表达可下调尿毒症血清引起的MCP-1基因表达，抑制MCP-1蛋白合成，ZnPP可阻断其作用。30 μmol/L hemin可使HUVEC合成MCP-1蛋白减少34.4％，而hemin与ZnPP共同作用组的MCP-1蛋白量恢复至尿毒症血清组的98.0％。 结论 尿毒症血清可诱导HUVEC 的MCP-1高表达。促进HO-1高表达时可抑制MCP-1合成及分泌。HO-1有减轻尿毒症环境对内皮细胞功能损伤的作用。     

氟伐他汀对UUO大鼠肾间质单核细胞趋化蛋白-1表达及巨噬细胞浸润的影响

目的观察氟伐他汀对单侧输尿管梗阻大鼠肾间质单核细胞趋化蛋白-1(MCP-1)表达和巨噬细胞浸润的影响,探讨其抗纤维化机制。方法90只SD雌性大鼠随机分成假手术(SOR)组、单侧输尿管梗阻术(UUO)模型组和UUO+氟伐他汀治疗组(T-UUO,氟伐他汀20mg·kg-1·d-1)。于术后第1、4、7、10、14d分别处死各组大鼠。用HE及Masson染色动态观察肾脏病理变化,免疫组织化学法测定MCP-1、单核巨噬细胞抗原(ED-1)的表达。结果UUO模型组肾小管-间质MCP-1与ED-1表达较SOR组增加(P<0.05);在术后各时间点,T-UUO组大鼠肾小管-间质MCP-1、ED-1的表达及肾间质胶原相对面积较UUO模型组显著减少,但/仍高于SOR组(P<0.05)。结论氟伐他汀可通过降低MCP-1表达、减少单核/巨噬细胞浸润以抑制肾间质纤维化。     

雷公藤甲素对TNF-α诱导的肾系膜细胞MCP-1和ICAM-1表达干预及其机制的研究

目的：观察雷公藤甲素对TNF-α诱导的肾系膜细胞（GMC）MCP-1,ICAM-1表达的干预并探讨其作用机制。方法：把培养的GMC按刺激及干预情况分为正常对照组、TNF-α刺激组、雷公藤甲素低（5ng/ml）,中（10ng/ml）,高浓度（15ng/ml）干预组,以及吡咯烷二硫代氨基甲酸盐（PDTC）干预组（阳性对照组）、PDTC与雷公藤甲素（10ng/ml）联合干预组。TNF-α刺激干预诱导24h后,分别提取细胞上清液、细胞质、细胞核等成分,采用ELISA法检测MCP-1,ICAM-1,IκB,IκBα,ELISA结合EMSA方法检测各组NF-κB p65,以RT-realtime PCR方法检测MCP-1,ICAM-1的mRNA。结果：TNF-α刺激组MCP-1、ICAM-1的mRNA及蛋白表达、NF-κB p65分子水平较对照组显著增高（P〈0.01）;各浓度雷公藤甲素或PDTC干预后上述指标显著下降（P〈0.01）,其中PDTC与雷公藤甲素联合干预组较单用PDTC干预组MCP-1、ICAM-1更低。相关分析表明NF-κB p65与MCP-1及ICAM-1的蛋白和mRNA表达水平呈正相关。GMC经TNF-α刺激后IκB有所下降,雷公藤甲素呈剂量依赖性上调κB,TNF-α刺激后磷酸化的IκBα较正常对照组显著升高（P〈0.05）,低浓度雷公藤甲素可显著下调其水平（P〈0.05）。结论：雷公藤甲素能显著抑制GMC分泌MCP-1、ICAM-1等促炎因子的mRNA及蛋白表达,其机制可能是促进IκB表达上调,并抑制IκBα磷酸化,从而阻断细胞核NF-κB p65活化所致。     

阻断IgG-Fcγ受体结合的短肽对粒细胞与内皮细胞黏附及内皮细胞细胞间黏附分子1表达的影响

目的 观察阻断IgG-FcγR结合的短肽tg19320对粒细胞与内皮细胞黏附以及内皮细胞细胞间黏附分子1（ICAM-1）表达的影响，并探讨其作用机制。 方法 培养人脐静脉内皮细胞（HUVEC）。提纯活动期血管炎患者血清抗中性粒细胞胞质抗体（ANCA） IgG。以多肽固相合成tg19320。分离健康人新鲜外周血中性粒细胞。分别以肿瘤坏死因子α（TNF-α）、健康人IgG、ANCA IgG及ANCA IgG+tg19320处理HUVEC，用细胞直接计数法检测粒细胞与内皮细胞间的黏附率；应用Western印迹及实时定量PCR方法检测HUVEC ICAM-1蛋白和mRNA表达；ELISA检测细胞培养上清液中可溶性ICAM-1（sICAM-1）的水平；Western印迹检测HUVEC磷酸化核因子κB抑制物（p-IκB）的表达。 结果 ANCA IgG显著上调中性粒细胞与内皮细胞间的黏附率（P ＜ 0.05），但ANCA IgG+tg19320组较ANCA IgG组黏附率显著降低（P ＜ 0.05）。ANCA IgG组与健康人IgG组相比，HUVEC ICAM-1 mRNA及蛋白表达显著增加（P ＜ 0.05）。tg19320分别从mRNA和蛋白水平阻断ANCA对ICAM-1的作用（P ＜ 0.05），并显著降低ANCA IgG引起的细胞培养上清液中sICAM水平增高（P ＜ 0.05）。ANCA IgG增加HUVEC p-IκB表达，tg19320显著降低p-IκB的表达。 结论 tg19320通过抑制IκB磷酸化进而干预NF-κB活化；抑制ANCA IgG对内皮细胞与中性粒细胞间黏附的促进作用，并阻断ICAM-1上调表达。短肽tg19320对原发性小血管炎具有体外保护作用。     

氯沙坦和氟伐他汀联合治疗早期糖尿病肾病的临床观察

目的探讨氯沙坦和氟伐他汀联合治疗早期糖尿病肾病（DN）的疗效及其机制。方法40例早期DN患者随机分为4组,每组各10例：糖尿病对照组、氯沙坦治疗组、氟伐他汀治疗组、氯沙坦＋氟伐他汀治疗组;另选10例非糖尿病者为正常对照组。糖尿病对照组给予控制血糖等治疗至正常范围,各治疗组在常规治疗的基础上每日分别加服氯沙坦50mg、氟伐代汀40mg和两药联合应用,观察疗程2个月。比较各组尿白蛋白排泄率（UAER）、尿白蛋白（Alb）、血肌酐（SCr）、肌酐清除率（Ccr）、血压、血脂和尿细胞转化生长因子β1（TGF-β1）、尿单核细胞趋化蛋白（MCP-1）等指标的变化。结果各治疗组与糖尿病对照组比较UAER、Alb、尿TGF-β1、MCP-1明显下降（P〈0．05,P〈0．01）;两药联用治疗组上述指标更明显;血脂、血压比较各组无统计学差异（P〉0．05）。结论早期DN患者尿中TGF-β1、MCP-1增加,氯沙坦、氟伐代汀因降低TGF-β1、MCP-1等而减轻微量白蛋白尿及改善肾功能,该作用不依赖于降血压、降血脂效应,两药联用效果更好。     

氯沙坦对尿酸性肾病大鼠肾组织MCP-1和ICAM-1mRNA表达的影响

目的 探讨氯沙坦对尿酸性肾病大鼠血清尿酸、尿素氮、肌酐、尿蛋白以及单核细胞趋化蛋白-1（MCP-1）和细胞间黏附分子-1（ICAM-1）在肾脏中表达的影响.方法 分别给予右侧肾脏切除术后大鼠氧嗪酸钾或者联合别嘌呤醇或者联合氯沙坦灌胃8周,监测上述指标变化情况,并采用实时荧光定量PCR测定各组大鼠肾脏MCP-1和ICAM-1mRNA表达的情况.结果 别嘌呤醇和氯沙坦均有效降低血清尿酸水平（P〈0.01）,改善肾功能（P〈0.05）.肾切除联合氧嗪酸钾灌胃组大鼠肾脏组织MCP-1和ICAM-1明显高于单纯肾切除组（P〈0.01）,别嘌呤醇和氯沙坦均能减少氧嗪酸钾所致的上述基因表达的增加（P〈0.01）.结论 MCP-1和ICAM-1介导的炎症反应可能参与高尿酸血症加速肾脏病进展过程,氯沙坦可能通过抑制尿酸所致的炎症反应而延缓肾脏病的进展.     

氟伐他汀对糖尿病大鼠肾组织核因子-κB活性的影响

目的：观察氟伐他汀对实验性2型糖尿病大鼠肾组织中核因子-κB（NF-κB）活化的影响。方法：应用单侧肾切除后饮食加小剂量链脲佐菌素（STZ）方法,制备2型糖尿病肾病（DN）大鼠模型。将实验动物随机分为假手术组、2型糖尿病组及氟伐他汀治疗组（2mg·kg^-1·d^-1）。给药治疗6周后,检测各组动物血糖、血脂、血肌酐（Scr）、24h尿蛋白定量（TP／24h）等指标。采用电泳迁移率变动分析（EMSA）方法检测NF-κB活性变化,采用RT—PCR方法检测单核细胞趋化蛋白-1（MCP-1）mRNAg达水平。结果：小剂量氟伐他汀未影响血糖、血脂。治疗6周后,可明显降低2型DN大鼠肾组织中NF-κB活性,减少MCP-1 mRNA表达,并降低蛋白尿。结论：氟伐他汀对实验性2型糖尿病大鼠具有非依赖降脂的肾脏保护作用,其机制至少部分与降低肾组织中NF-κB活性,下调MCP-1基因表达有关。     

MCP-1、ICAM-1在糖尿病肾病大鼠肾脏损害中作用及厄贝沙坦干预的影响

目的：探讨MCP-1、ICAM-1在糖尿病肾病大鼠肾脏损害中作用及厄贝沙坦对二者的影响.方法：采用高糖高脂饮食合并链脲佐菌素腹腔注射的方法建立糖尿病肾病大鼠模型.将大鼠随机分为正常对照NC 组、糖尿病肾病DN组、厄贝沙坦DI组,检测各组大鼠24 h尿量、24 h尿白蛋白定量（24 h UTP）、血糖（BG）、血肌酐（Scr）、尿素氮（BUN）、肾重指数（KI）;行HE染色观察各组大鼠病理学形态,免疫组化观察MCP-1、ICAM-1蛋白的表达,RT-PCR观察MCP-1 mRNA、ICAM-1mRNA的表达.结果：与NC组比较,DN组大鼠肾脏病理改变加重,24 h尿量、24 h UTP、KI、BG、Scr、BUN、肾脏组织中MCP-1mRNA和ICAM-1mRNA及蛋白水平均显著增加,差异均有统计学意义（P＆lt;0.01）;与DN组比较,DI组大鼠BG、BUN、Scr有所改善,差异无统计学意义;肾脏病理改变减轻,其余指标明显降低,差异有统计学意义（P＆lt;0.05）.结论：MCP-1、ICAM-1在糖尿病肾病肾脏损害过程中可能起重要作用;厄贝沙坦能够减轻糖尿病肾病肾组织MCP-1、ICAM-1的表达,缓解了肾脏病理损伤.     

抗核抗体阴性的系统性红斑狼疮的探讨

目的 :探讨抗核抗体 (ANA)阴性的系统性红斑狼疮 (SLE)的特点。方法 :总结 1991年～ 1998年 85 3例住院SLE病人 ,发现ANA阴性者有 139例 ,对ANA阴性者的临床及实验室资料进行分析 ,并与ANA阳性者比较。结果 :ANA阴性者光过敏明显增加 ,肾炎、关节炎则明显减少 ,雷诺氏现象、脱发也较少 ;抗SS -A抗体较多见 ,抗ds-DNA明显少于ANA阳性者 ,抗Sm、抗核糖核蛋白抗体、类风湿因子阳性率较低。结论 :ANA阴性的SLE是SLE的一种亚类 ,其特点是皮肤光过敏多见 ,抗SS -A阳性率较高。     

p38 MAPK在LPS诱导内皮细胞表达ICAM-1中的作用

目的 研究p38丝裂原激活蛋白激酶(MAPK)信号转导通路在脂多糖(LPS)诱导人脐静脉内皮细胞(HUVEC)表达细胞间粘附分子-1(ICAM—1)中的作用。方法 脐静脉内皮细胞培养后分为两组：(1)刺激组,设不同时相点分别用LPS刺激内皮细胞;(2)预处理组,在LPS刺激前2h,用SB203580预处理内皮细胞。观察ICAM—1蛋白和mRNA表达的变化,检测内皮细胞p38MAPK活性变化。结果 LPS刺激后,内皮细胞表面ICAM—1分子在8～36h显增加,胞浆中mRNA在2h即有显增加;LPS刺激HUVEC后15min,p38MAPK活性即有升高,30～60min达高峰。p38抑制剂SB203580可显抑制LPS的诱导作用。结论 LPS可能通过激活p38MAPK信号转导通路,调节HUVEC的ICAM—1基因和蛋白表达。     

丙泊酚对过氧化氢诱导入脐静脉内皮细胞超氧化物歧化酶1表达的影响

目的 探讨丙泊酚对过氧化氢(H2O2)诱导入脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)超氧化物歧化酶1(superoxide dismutase-1,SOD1)表达的影响.方法 将体外培养24孔板中的HUVEC分为3部分:第1部分(分4组,每组6例):①正...     

睾酮对人血管内皮细胞tPA、PAI-1基因表达的影响

目的:观察睾酮对人血管内皮细胞(HUVEC)纤溶酶原激活物(tPA)及其抑制物1(PAI-1)表达的影响。方法:将体外培养的HUVEC分别与4个浓度睾酮组(3、30、3×103、3×104nmol/L)及单纯培养液对照组作用48h,RT-PCR法观察各组tPA、PAI-1 mRNA表达水平。结果:生理浓度睾酮组(3和30 nmol/L)tPA mRNA水平明显高于对照组,PAI-1 mRNA水平均明显低于对照组(P均<0.05)。3×104nmol/L睾酮组tPA、PAI-1 mRNA水平均明显降低(P<0.05)。结论:生理浓度睾酮通过促进tPA表达,抑制PAI-1合成,增强纤溶系统活性,有利于防止男性冠心病等血栓性疾病。     

The role of quick bio-intact PTH(1-84) assay during parathyroidectomy for secondary hyperparathyroidism

OBJECTIVE: The role of the quick PTH assay in surgery for secondary HPT is unclear because of overestimation of intact PTH(1-84) values due to the cross-reactivity of currently available first-generation PTH assays with non-PTH(1-84) fragments that accumulate in renal failure. In this study, we used a second-generation quick PTH immunometric assay that are claimed to detect the biologically active PTH(1-84) molecule with no cross-reactivity with PTH fragments to investigate the potential utility of the assay during parathyroidectomy for secondary HPT. MATERIAL AND METHODS: The study was performed on 18 patients (12 women, 6 men) between October 2004 and March 2005. EDTA serum samples were drawn via a peripheral venous catheter after induction of anesthesia (basal), and at 5, 10, and 30 min after excision of diseased parathyroid glands. Serum active PTH(1-84) was measured by the quick Bio-Intact PTH(1-84) assay, which is a two-site chemiluminometric assay. RESULTS: At 30 min the quick Bio-PTH(1-84) level of 16 patients was under 45 pg/mL. Four parathyroid glands were removed macroscopically from 12 of the 16 patients, and three glands were removed from the other four patients. All patients were cured of their HPT. Four enlarged parathyroid glands were removed from a patient whose Bio-Intact PTH(1-84) at 30 min had not fallen below 45 pg/mL, and no other glands were found by further exploration. At the 6 mo follow-up examination, the first-generation intact PTH level of this patient was over 45 pg/mL, but several diagnostic imaging methods did not reveal any enlarged parathyroid glands. Three enlarged parathyroid glands from the other patient, and exploration led to the identification of an ectopic parathyroid gland at the carotid bifurcation. CONCLUSIONS: The results of this prospective study show that quick Bio-Intact PTH(1-84) monitoring is a valuable new tool for use in the surgical treatment of secondary HPT. An intraoperative, quick Bio-Intact PTH(1-84) assay will be of value for the adequate prediction of surgical cure.     

Detection and Quantification of Soluble Intercellular Adhesion Molecule-1 (slCAM-1) in the Serum and Urine of Patients with Bladder Cancer

Background : A possible role for intercellular adhesion molecules in tumor progression and metastasis has been strongly suggested. To investigate the effect of soluble intercellular adhesion molecule-1 (slCAM-1) on bladder cancer, slCAM-1 serum and urinary concentrations were measured in patients with superficial or invasive bladder cancer and in patients with prostatic hypertrophy.
Methods : Serum and urine samples were obtained from 26 patients with transitional cell carcinoma of the bladder (mean age, 66.8 years) and 14 patients with benign prostatic hypertrophy (BPH; mean age, 70.5 years). Fifteen healthy volunteers served as control patients. Samples were collected before surgery and 5 days after surgery. The serum and urinary slCAM-1 levels were measured by an ELISA.
Results : The preoperative serum concentration of slCAM-1 was significantly higher in patients with invasive bladder cancer (351.8 ±158.0 ng/mL)than in the healthy controls (233.1 ±96.1 ng/mL; P<0.05) or BPH patients (224.7 ± 80.5 ng/mL; P< 0.05). In addition, serum slCAM-1 levels were significantly higher in patients with tumors greater than 3 cm in size (412.7 ± 147.6 ng/mL) than in patients with smaller tumors (246.6 ± 101.2 ng/mL; P<0.05). Urinary slCAM-1 levels in patients with invasive bladder cancer were also significantly higher than in the patients with superficial cancer prior to surgery.
Conclusion : Our results suggested that slCAM-1 may play an important role in the progression of bladder cancer, and that elevated serum slCAM-1 levels may be related to tumor size.     

化痰通络方含药血清对血管内皮生长因子诱导的脐静脉内皮细胞增殖的影响及其机制研究

目的:观察化痰通络方含药血清对血管内皮生长因子(VEGF)诱导的脐静脉内皮细胞(HUVEC)增殖的影响及其机制。方法:将20只新西兰兔随机分为化痰通络方高(HTTL-h)、中(HTTL-m)、低(HTTL-l)剂量组,雷公藤多苷组(TG组),生理盐水组(Sal组),每组4只。分离鉴定健康新生儿HUVEC,siRNA敲降VEGFR2、PLCG1以及MAPK1,并采用RT-PCR和及Western Blot检测VEGFR2、PLCG1和MAPK1 mRNA及蛋白水平的表达。MTT法检测经VEGF诱导的HUVEC增殖情况。结果:与Sal组比较,VEGF可显著促进HUVEC增殖,而TG或HTTL-l均可显著抑制VEGF诱导的HUVEC增殖;siRNA敲降VEGFR2后,VEGF则不能促进HUVEC增殖,同时TG也失去了对HUVEC增殖的抑制能力;siRNA敲降PLCG1后,VEGF依然可以显著促进HUVEC增殖,此时TG对VEGF刺激的HUVEC增殖失去了抑制效应,但HTTL-m和HTTL-l依然对VEGF刺激的HUVEC增殖具有显著抑制效应;siRNA敲降MAPK1后,VEGF也可显著促进HUVEC增殖,TG对VEGF刺激的HUVEC增殖具有抑制效应,同时HTTL-l也对VEGF刺激的HUVEC增殖具有显著抑制效应。结论:化痰通络方含药血清对VEGF诱导的HUVEC增殖具有抑制作用。TG抑制VEGF诱导的HUVEC增殖依赖于VEGFR2和PLCG1表达,而化痰通络方对VEGF刺激的HUVEC增殖的抑制效应则不依赖VEGF/VEGFR2/PLCG1/MAPK1信号通路。     

白细胞介素1β、肿瘤坏死因子α在膝关节原发性骨关节病发病中的作用

目的探讨白细胞介素１β（ＩＬ－１β）、肿瘤坏死因子α（ＴＮＦ－α）在膝关节原发性骨关节病（ＯＡ）发病中的作用。方法提取１６例ＯＡ患者（ＯＡ组）、５例对照者（非ＯＡ组）的关节液,采用酶联免疫吸附法（ＥＬＩＳＡ法）测定ＩＬ－１β,生物活性法（ＭＴＴ法）检测ＴＮＦ－α的水平。结果在ＯＡ组关节滑液中,ＩＬ－１β的水平均显著高于对照组（Ｐ＜０００１）;对照组的ＴＮＦ－α未能测出,而ＯＡ组ＴＮＦ－α的检出阳性率为２５％。其次,为进一步探讨滑液中上述细胞因子的产生来源,传代培养膝关节滑膜细胞并用脂多糖（ＬＰＳ）刺激,ＯＡ组（２０例）关节滑膜细胞自发分泌ＩＬ－１β的水平显著高于对照组（５例）,Ｐ＜００５;ＬＰＳ刺激的条件下,ＯＡ组和对照组分泌ＩＬ－１β均显著升高,尤以ＯＡ组为著（Ｐ＜０００１）;ＴＮＦ－α在ＯＡ组中仅有两例呈阳性,对照组中均为阴性。结论ＩＬ－１β和ＴＮＦ－α在骨关节病的发病中起重要作用。ＯＡ患者滑膜细胞高水平自发性分泌ＩＬ－１β可能与其炎症发生与发展密切相关,可能是关节滑液中ＩＬ－１β的主要来源,而滑膜细胞分泌ＴＮＦ－ａ可能不是关节滑液中的主要来源。     

Serum 1-84 and 7-84 parathyroid hormone concentrations and bone in patients with primary hyperparathyroidism

BACKGROUND AND AIMS: Parathyroid hormone (PTH) acts on bone as both anabolic and catabolic factor. It includes two fractions: 1-84 (cyclase activating PTH, CAP) which increases bone turnover and serum calcium, and 7-84 (cyclase inactivating PTH, CIP) acting the opposite way. The aim of this study was to establish whether bone mineral density (BMD) and turnover in patients' primary hyperparathyroidism (HPT) are dependent on CAP and CIP concentrations. PATIENTS/METHODS: Thirty-one patients with HPT and 29 appropriately matched controls were examined. Parameters of calcium-phosphate homeostasis and BMD were estimated. RESULTS: BMD of radius shaft was lower in patients with HPT as compared with controls, whereas BMD of spine and ultradistal radius were similar. Serum calcium, bone alkaline phosphatase, total PTH, 1-84 PTH, and 7-84 PTH were higher in HPT patients, whereas serum phosphate was lower and beta cross-laps similar. Both total PTH and CAP correlated significantly with BMD of radius shaft and serum calcium concentration, but not with other examined parameters. CONCLUSION: Total and 1-84 PTH are similarly associated with examined parameters in patients with HPT. Thus, determination of serum CAP concentration does not seem to have advantages over total PTH with regard to bone mineral density and bone turnover assessment in those patients.     

The clinical significance of antibody to vascular endothelial cells after renal transplantation

Abstract: Vascular endothelial cells (ECs) are considered to be a primary target for injury in allograft rejection. However, the relationship between serum antibody activity to ECs and rejection episodes has not been examined extensively in renal transplantation. Twenty-two renal transplant recipients were included in this study. Serum antibody activity to vascular endothelial cells (AECA) was measured using a cellular enzyme-linked immunosorbent assay (ELISA) in which human umbilical vein endothelial cells (HUVEC) and human glomerular endothelial cells (HGEC) were preincubated with TNF-α used as target cells. Serum samples were obtained just before transplantation and once a week during the immediate 1–3-month post-transplantation period. There was a significant correlation between the presence of AECA against HGEC and rejection episodes ( P  < 0.05). Patients with multi-episodes of rejection showed significantly higher frequencies of AECA than patients with mono-episodic rejection ( P  < 0.0005). It should be noted that patients suffering from multi-episodes of rejection revealed higher AECA titres before transplantation. These findings imply that the HGEC–ELISA could be used as a prospective, informative test to identify patients with a higher risk of acute rejection in renal transplantation.