Soluble adhesion molecules, cytokines and cellular markers in serum in patients with acute infections

The aim of this study was to evaluate the diagnostic capacity of a number of blood components such as soluble adhesion molecules, interleukin-6 (IL-6), myeloperoxidase (MPO) and lysozyme in the distinction of acute bacterial and viral infections. Blood was taken from 115 acutely infected patients at admission before any treatment and in some cases on several consecutive days. 35 of the patients had a definite viral cause for their infection and 66 a bacterial cause. All variables were raised in patients with acute bacterial infections. Soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, lysozyme and MPO were also raised in acute viral infections, but for sE-selectin and MPO less so than in bacterial infections. Evaluation of the diagnostic power showed that for MPO and IL-6 at cut-offs of 1300 microg/l and 100 ng/l, respectively, the positive predictive value was 97% and 100% and the negative predictive value 78% and 76%, respectively, in the classification of acute bacterial infections. In the distinction between viral or bacterial causes of acute infections in otherwise healthy subjects serum measurements of MPO and IL-6 are valuable tools and should be considered as diagnostic aids in the routine setting. The soluble adhesion molecules did not offer any further information in this respect.     

原发性胆汁性肝硬化患者肝脏雌激素受体与外周血细胞因子及自身抗体的相关性研究

目的 探讨原发性胆汁性肝硬化(PBC)患者肝脏雌激素受体(ER-α)与外周血T淋巴细胞亚群细胞因子和自身抗体的相关性.方法 采取横断面研究方法,设未治疗的80例女性PBC患者为PBC组;健康对照组为10例基线匹配的健康女性志愿者;非PBC对照组为20例非自身免疫性肝病患者,ELISA法检测各组外周细胞因子:白细胞介素6(IL-6)、IL-8、IL-22、肿瘤坏死因子α(TNFα)、干扰素γ(IFNY);自身抗体:M2型抗线粒体抗体(AMA-M2)、抗-Sp100及抗-gp210水平;免疫组织化学法检测PBC组及非PBC对照组肝组织ER-α的表达,指标相关性采用Spearman相关性检验,数值资料比较采用秩和检验.结果 与健康对照组相比,PBC组和非PBC对照组的细胞因子水平显著升高;而PBC组和非PBC对照组比较,差异无统计学意义.PBC组肝组织ER-α阳性率为(50.7±8.9)％显著高于非PBC对照组(10.2±2.8)％,Z=4.82,P＜0.05,差异有统计学意义.PBC组肝组织ER-α阳性率与血清AMA-M2、抗-SP100、抗-gp210的阳性率呈正相关,相关系数r分别为0.898、0.819和0.814,P值均＜0.05,差异有统计学意义;ER-α与血清细胞因子IL-22、TNFα、IFNγ的含量也呈正相关,相关系数r分别为0.71、0.89和0.82,P＜0.05,差异有统计学意义.非PBC对照组血清AMA-M2、抗-Sp100、抗-gp210为阴性,肝组织ER-α表达与血清细胞因子水平无相关性(P＞0.05).结论 PBC患者血清细胞因子水平和ER-α阳性率显著升高,与自身抗体阳性率呈正相关,提示PBC患者肝组织高表达ER-α,可能是PBC的发病原因之一.     

Studies on serum ketone bodies in patients with hyperthyroidism

In order to investigate effects of thyroid hormone on ketone bodies metabolism, fasting levels of serum ketone bodies, serum free fatty acids (FFA), serum insulin (IRI), plasma glucagon (IRG) and plasma glucose were examined in 29 untreated patients with hyperthyroidism and 20 healthy subjects. In 21 patients the levels of serum ketone bodies were re-examined when euthyroidism was achieved after treatment. In all of healthy subjects and 17 patients changes in the levels of serum ketone bodies after oral glucose load were examined. The results were as follows: 1). Fasting levels of serum FFA and total ketone bodies (TK), acetoacetate (AcAc), 3-hydroxy-beta-butylate (3OHBA), ratio of 3OHBA to AcAc in the patients were significantly higher than those in healthy subjects. The levels of IRI, IRG or ratio of IRG to IRI in the patients were not different from those in healthy subjects. In the patients, the fasting level of TK was significantly correlated with the level of FFA. 2). After oral glucose load the levels of TK and FFA in the patients decreased gradually. 3). The fasting levels of TK and FFA in the patients decreased when euthyroidism was achieved after treatment. It was suggested that the fasting levels of serum ketone bodies in patients with hyperthyroidism elevated probably due to activated lipolysis.     

Bone remodelling in osteoporosis

Bone remodelling, a highly regulated succession of events, is the temporal sequence of osteoclastic bone resorption and osteoblastic bone formation. Bone loss with age and in osteoporotic patients is due to a desequilibrium between both processus. Bone histomorphometry was the method used to measure these events. Its shows clearly that, with age, the quantity of bone formed in one remodelling unit (so called mean wall thickness) decreases. In osteoporotic women, compared to control women of the same age the amount of bone formed is also decreased. Concordant data on this point have been obtained in different laboratories. By contrast, the cellular mechanism underlying this decreased amount of bone formed is largely controversial: a decreased osteoblast recruitment or life span or capacity to synthetise collagen have been suggested. Bone loss with age is associated with an increase in the amount of bone resorbed. This observation is the result of an indirect measurement founded on the distance between trabeculae. As the decreased bone formation, this processus is exaggerated in postmenopausal osteoporosis. The respective importance of decreased bone formation and increased bone resorption is however difficult to assess. Some osteoporotic patients have increased bone resorption surfaces compared to control women on their bone biopsy; however, it does not seem that these patients form a definite subgroup of osteoporotic patients as the extent of resorption surfaces changes with time in an untreated osteoporotic. In conclusion, the observed changes in bone remodelling in osteoporotic postmenopausal women are an exaggeration of those observed during ageing. These changes should be a basis for a coherent therapy of bone loss in osteoporotic patients.     

Bone remodelling in osteoporosis

Clinical Rheumatology - Bone remodelling, a highly regulated succession of events, is the temporal sequence of osteoclastic bone resorption and osteoblastic bone formation. Bone loss with age and...     

血清骨代谢指标及细胞因子与老年男性骨质疏松的相关性

目的探讨老年男性骨质疏松(osteoporosis,OP)患者血清骨代谢指标及细胞因子变化及意义。方法对280例老年男性体检者进行骨密度(bone mineral density,BMD)测量,检测血清Ⅰ型原胶原N-端前肽(procollagen type 1 N-terminal propeptide,P1NP)、β-胶原降解产物(β-crosslaps,β-CTX)、骨钙素(osteocalcin,OC)和白细胞介素-6 (interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及胰岛素样生长因子-1 (insulin-like growth factor-1,IGF-1)水平。应用非条件Logistic回归分析老年男性OP的相关影响因素。结果 OP组血清P1NP、β-CTX、IL-6、TNF-α及IGF-1水平均明显高于骨量减少组和正常组(P<0. 05),血清OC水平明显低于骨量减少组和正常组(P<0. 05)。相关分析显示,OP组BMD与OC呈正相关(r=0. 370,P<0. 05),与P1NP、β-CTX、IGF-1、、IL-6、TNF-α呈负相关(r=-0. 475、-0. 420、-0. 386、-0. 414、-0. 281,P<0. 05)。Logistic回归分析显示,年龄(OR=1. 702)、P1NP (OR=2. 437)、β-CTX (OR=1. 853)、IGF-1 (OR=2. 106)、IL-6 (OR=1. 614)及TNF-α(OR=1. 428)是老年男性OP的危险因素,OC是老年男性OP的保护因素(OR=0. 815)。结论骨代谢指标及细胞因子水平与老年男性OP发生密切相关。     

Aminopeptidases in the serum and urine of patients with hyperthyroidism]

In patients with hyperthyroidism the serum activities of the leucine aminopeptidase (LAP) and the alanine aminopeptidase (AAP) as well as the alanine aminopeptidase excretion in the urine were determined. A significantly increased activity of the leucine aminopeptidase in the serum and an increased excretion of alanine aminopeptidase in the urine were found. The AAP in the serum did not show a significant increase of activity. On account of the changes in the serum and in the urine before and during therapy a low-grade participation of the hepatobiliary and renal systems which are clinically not uppermost is to be assumed. Increased excretion of AAP and hyperthyroidism coincide nearly without exception in out patients. Correlation-statistical investigations make it probable to regard the increased excretion of AAP in the urine as an indirect parameter of the peripheral metabolism in hyperthyroidism.     

甲状腺机能亢进症血脂和总蛋白的变化及意义

目的探讨甲亢患者血脂和总蛋白的变化与甲状腺激素的关系及临床意义。方法用免疫化学发光技术检测71例患者和32例健康对照组血清游离T3(FT3)、游离T4(FT4),以生化仪检测甘油三酯(TG)、胆固醇(TCH)、高密度脂蛋白胆固醇(HDL-C)和总蛋白的含量。结果甲亢患者血脂含量明显低于对照组(P＜0.05),与FT3、FT4呈反比关系。总蛋白含量也明显低于对照组(P＜0.05),其变化与FT3、FT4浓度有关。结论甲亢患者血脂和总蛋白明显降低,且可作为判断甲亢病情和疗效的指标之一。     

Hyperlipidaemias and serum cytokines in patients with coronary artery disease

OBJECTIVE: The inflammatory processes as well as the lipid disturbances play an important role in the pathogenesis of atherosclerosis.The aim of the study was to evaluate the influence of the hyperlipidaemias on serum levels of tumour necrosis factor (TNF) alpha, the soluble form of TNF receptor (sTNFR) 1 and 2, Interleukin (IL)-10 in patients with stable coronary artery disease (CAD). METHODS AND RESULTS: The study group comprised 94 consecutive admissions with stable CAD: 39 patients with hypercholesterolaemia (group HC), 22 patients with mixed hyperlipidaemia (group HL) and 33 patients with normal lipids (group NL).Twenty healthy volunteers were the controls (group C). Serum TNFalpha levels were higher in all CAD groups (p < 0.001) than in healthy subjects. Mean serum concentrations of sTNFR 1 were significantly higher in group NL (p < 0.05) in comparison both to group HC and controls. IL-10 levels were higher in group HC than in controls (p < 0.5). In all CAD patients TNFalpha showed a negative correlation with HDL-cholesterol (p < 0.001) and a positive correlation with triglycerides (p < 0.00 1). Moreover, sTNFR 1 and IL-10 showed a negative (p < 0.05) and sTNFR 2 a positive correlation with LDL-cholesterol (p < 0.001). CONCLUSIONS: CAD patients are characterized by increased serum concentrations of TNFalpha. It seems likely that immune activation (TNFalpha, sTNFR 1, sTNFR 2, and IL- 10) in CAD patients is related to serum lipids levels.     

甲状腺机能亢进症患者部分骨代谢生化指标的变化及分析

目的　查明甲状腺机能亢进症患者血清骨钙素 (BGP)、碱性磷酸酶 (AL P)及尿羟脯氨酸 (HOP) ,观察其变化并进行分析。方法　以 30例甲亢患者及 15例正常人为研究对象 ,测定 BGP、AL P、尿 HOP等指标。结果　甲亢患者血清 BGP(11.18± 4.74) ng/ m l和尿 HOP(2 4.32± 11.2 1) mg/ g.Cr均高于正常对照组 (P <0 .0 5)。结论　骨吸收增加和骨形成相对降低可能为甲亢患者骨代谢异常发生的主要原因     

Relationship between cytokines and tumour markers in patients with chronic heart failure

AIMS: Serum levels of some cytokines and tumour markers are elevated in patients with chronic heart failure (HF). We aimed to investigate the relationship between circulating levels of cytokines and tumour markers in patients with HF. METHODS: We included 35 HF patients and 33 normal controls. HF patients were divided into two groups: mild HF (NYHA class I/II) (n=10) and severe HF (NYHA class III/IV) (n=25). Serum cytokine levels (TNF-alpha, IL-1 beta, IL-6, and IL-10) were measured by ELISA and tumour markers (CA 125, CA 19-9, CA 15-3, CEA and AFP) by chemiluminescent enzyme immunoassay. RESULTS: Serum levels of TNF-alpha, IL-6, and IL-10 as cytokines, and CA 125 and CA 19-9 as tumour markers were significantly higher in HF patients than in normal controls (p<0.0001 for all). Serum levels of TNF-alpha, IL-6 and IL-10 and CA 125 in the severe HF patients were significantly higher than in the mild HF patients (p<0.001 for all). Correlation analysis showed that CA 125 was positively related to TNF-alpha (r=0.624, p<0.001), IL-6 (r=0.671, p<0.001), and IL-10 (r=0.545, p<0.001) in HF. CONCLUSION: These findings show that CA 125 is markedly elevated in patients with HF, and correlates with serum TNF-alpha, IL-6 and IL-10 levels. Therefore, we speculate that among the tumour markers studied, only CA 125 is closely related to the cytokine system.     

Bone mineral density in patients with hyperthyroidism measured by dual energy X-ray absorptiometry

OBJECTIVE We assessed the changes of bone mass in patients with hyperthyroidism by measuring bone mineral density using a new method, dual energy X-ray absorptiometry. DESIGN The values of bone mineral density in patients with hyperthyroidism were compared with data obtained from the controls, and we assessed the correlation analysis between bone mineral density and several metabolic parameters. PATIENTS We studied 52 Japanese patients with hyperthyroidism (20 males, 32 females). Healthy normal subjects served to establish the mean bone mineral density In the healthy Japanese population (Shiraki et al. 1991). MEASUREMENT Bone mineral density was assessed by the measurement of lumbar vertebrae and femur by dual energy X-ray absorptiometry. The bone mineral density of vertebrae for each patient was calculated as the percentage of the mean value (% bone mineral density) obtained from an age and sex-matched control group. Blood was drawn to measure the levels of serum calcium, phosphorus, creatinine, alkaline phosphatase, free T3, free T4, TSH, TSH receptor antibody, parathyroid hormone, and serum osteocalcin. RESULTS The percentage bone mineral density of vertebrae in patients was 92.6 as compared with that of normal controls, and was inversely correlated with serum TSH receptor antibody, osteocalcin, and alkaline phosphatase. CONCLUSIONS These findings suggest that bone mineral density is decreased in patients with hyperthyroidism and that TSH receptor antibody, osteocalcin, and alkaline phosphatase are sensitive markers of bone metabolism alterations in hyperthyroidism.     

Associations between elevated pre‐treatment serum cytokines and peripheral blood cellular markers of immunosuppression in patients with lymphoma

Higher ratios of the pre‐treatment peripheral blood absolute lymphocyte (ALC) to absolute monocyte counts (AMC) are associated with improved outcomes in lymphoma. Conversely, elevated pre‐treatment serum cytokines are associated with inferior outcomes. The relationship between pre‐treatment serum cytokines and ALC/AMC ratios remains unknown. We studied twelve serum cytokines and the ALC/AMC ratios in 390 patients with untreated diffuse large B‐cell, follicular, mantle cell, T‐cell, and Hodgkin lymphoma. Different pre‐treatment serum cytokine concentrations correlated with ALC, AMC, and ALC/AMC ratios depending on the lymphoma type. In the entire cohort (n = 390) lower ALC/AMC ratios modestly correlated with higher IL‐2R (r = ?0.36), IL‐12 (r = ?0.17), IP‐10 (r = ?0.23), and MIG (r = ?0.32) concentrations (p < 0.001). Elevated IL‐2R was independently associated with suppressed ALC (OR 2.69, 95% CI 1.77–4.07, p < 0.001), elevated AMC (OR 2.05, 95% CI 1.34–3.14, p < 0.001), and suppressed ALC/AMC ratios (OR 3.51, 95% CI 2.31–5.34, p < 0.001). Both elevated IL‐2R (HR 2.27, 95% CI 1.48–3.49, p < 0.001) and suppressed ALC/AMC ratios (HR 1.53, 95% CI 1.03–2.28, p = 0.037) were independently associated with inferior overall survival. These data support the notion that elevated serum cytokines are immunosuppressive and provide further rationale to target the tumor microenvironment for therapeutic benefit.     

甲状腺功能亢进症患者血清尿酸水平变化的临床分析

目的 探讨甲状腺功能亢进（以下简称甲亢）患者血清尿酸浓度变化及临床意义.方法 测定150例甲亢患者血清尿酸浓度并对其中50例经治疗后临床痊愈停药者复查血清尿酸水平.结果 新发甲亢组患者血清尿酸浓度为（404.54±53.96）μmol/L,较正常对照组（301.19±45.48）μmol/L 显著升高（P＜0.01）.治疗好转组患者复查血清尿酸浓度为（293.15±42.45）μmol/L,较治疗前明显下降（P＜0.01）.结论 新发甲亢患者血清尿酸浓度明显升高,经治疗甲状腺功能恢复正常后血清尿酸浓度可显著下降.表明甲亢作为一种消耗性疾病,其高代谢状态可导致尿酸代谢异常,使血尿酸浓度升高.     

Bone mineral density in hyperthyroidism

OBJECTIVE: To investigate whether previous hyperthyroidism is a cause of permanent secondary osteoporosis. DESIGN AND PATIENTS: In this cross-sectional study, 164 women with untreated or previously treated overt and symptomatic hyperthyroidism were examined 0-31 years after the initial episode of hyperthyroidism and its treatment, and were compared with a control group of 79 age-matched women without previous history of hyperthyroidism. Subjects with current or previous metabolic bone disease, any antiresorptive treatment for osteoporosis or treatments and habits known to affect bone metabolism were excluded. MEASUREMENTS: The age of the first manifestation of the disease, the age at the measurement of bone mineral density (BMD) at the spine and femoral neck and the interval between diagnosis and treatment of hyperthyroidism and BMD measurement were recorded and the Z-scores and T-scores of BMD were analysed. RESULTS: Untreated hyperthyroidism and hyperthyroidism up to 3 years after its diagnosis and treatment were associated with decreased BMD. Three or more years after the first episode of the disease the mean Z-score at both skeletal sites was near zero and not different from the controls. The age at which hyperthyroidism was manifested for the first time had no effect on the final outcome. Women affected at a young age (13-30 years) had a more pronounced loss of BMD when examined untreated or early (< 3 years) after diagnosis, but a BMD significantly above zero if examined later (> 3 years). Older women (aged 51-70 years) showed a similar pattern, although the differences were not significant. Middle-aged subjects (31-50 years) had the smallest loss of BMD during the first 3 years. Analysis of T-scores of former hyperthyroid women aged > or = 51 years showed no significantly different relative risk (RR) for osteoporosis in comparison with the controls. However, the study was not powered enough to give meaningful RR results. CONCLUSIONS: Overt symptomatic hyperthyroidism is associated with decreased BMD during the first 3 years after diagnosis and treatment of the disease. After this interval, former hyperthyroid women have a Z-score near zero and not different from women without a history of the disease, apparently because of recovery of the bone density lost early during the course of the disease. Symptomatic hyperthyroidism does not seem to be a cause of long-lasting osteoporosis, and the age of the patient during the first episode is irrelevant.     

Bone mineral density and bone remodelling in Tunisian patients with ankylosing spondylitis: A cross-sectional study

Aim of the workTo assess the bone turnover markers and bone mineral density (BMD) in ankylosing spondylitis (AS) patients and to evaluate their association with clinical variables.Patients and methodsForty-seven AS patients were compared with 47 matched control. Clinical features and inflammatory parameters were assessed. C-terminal telopeptide fragments of type I collagen (CTX), alkaline phosphatases (ALP), N-terminal propeptide of type I procollagen (PINP) serum levels, and BMD of the lumbar spine and femoral neck were evaluated. The Bath AS disease activity and functional indices (BASDAI and BASFI) were assessed.ResultsMean serum levels of C-reactive protein, ALP and CTX were higher in AS patients than control (p = 0.001, p = 0.001 and p = 0.027 respectively). Osteopenia and osteoporosis were significantly more frequent in AS patients (57.4%) than control (21.3%) (p < 0.001). The PINP and ALP significantly correlated with disease duration (r = 0.33, p = 0.02 and r = 0.3, p = 0.04 respectively). BMD of the femoral neck was significantly lower in AS patients with history of coxitis than AS patients without (p = 0.02). Patients on anti-tumour necrosis factor (TNFα) therapy had higher T score (lumbar spine) compared to those not. Multivariate regression showed that CRP levels and disease activity were independently associated with low BMD and T score (lumbar) was significantly associated with anti-TNF use (p = 0.007).ConclusionsAn increase in bone turnover markers and decrease of BMD were observed in AS patients. Inflammatory activity of AS was associated to hyper bone remodelling and decrease of BMD. Anti-TNF use seems to be beneficial on AS inflammation and therefore on the BMD.     

胰岛素、胰岛素原对胰岛素抵抗状态下HepG2细胞PAI-1分泌的影响

目的研究胰岛素、胰岛素原对胰岛素抵抗状态下ＨｅｐＧ２细胞ＰＡＩ１分泌的影响。方法选择在合成ＰＡＩ１方面与肝细胞相似的ＨｅｐＧ２细胞，以高浓度胰岛素诱导胰岛素抵抗后，分别用生理浓度的胰岛素、胰岛素原刺激２４小时，以观察胰岛素抵抗状态下ＰＡＩ１活性的变化。结果基础状态下胰岛素抵抗ＨｅｐＧ２细胞与非胰岛素抵抗ＨｅｐＧ２细胞相比，ＰＡＩ１活性差异不明显；胰岛素、胰岛素原刺激后，胰岛素抵抗ＨｅｐＧ２细胞ＰＡＩ１活性明显高于非胰岛素抵抗ＨｅｐＧ２细胞。当培液中同时加入１０－４Ｍ二甲双胍后，胰岛素、胰岛素原介导的ＰＡＩ１过量分泌得到明显抑制。结论在胰岛素抵抗状态下，胰岛素、胰岛素原刺激后ＨｅｐＧ２细胞ＰＡＩ１活性明显增加，而二甲双胍可明显抑制此现象。     

Bone turnover markers in patients with leg ischemia before and after revascularization

In patients with leg ischemia bone metabolism impairment has been observed. The aim of this study was to investigate the biochemical bone metabolism markers. Elevated level of osteolysis markers was observed before and 7 days after revascularization the level of markers was unchanged.