High values of soluble cytokeratin 18 in breast carcinomas may have different meanings

We have investigated the cellular and serum CK18 in 26 non-treated primary ductal invasive breast carcinomas. The soluble CK18 (TPS) was detected by chemiluminescent assay, and the cellular CK18 and PCNA expression by immunocytochemistry. Flow-cytometry was used to estimate the amount of DNA in malignant cells. There was a significant correlation between soluble CK18 and the pre-menopausal status (p < 0.05), characterized in our group by a PCNA estimated low proliferation index. We have also found a significant correlation between soluble CK18 and the DNA index (p < 0.01). The intracellular CK18 has correlated with the PCNA expression (p < 0.05), while no correlation could be found between cellular and serum CK18. The values of soluble CK18 may offer information about the treatment-induced cell death, if monitored, while isolated measurements should be interpreted cautiously. Elevated levels of serum CK18 in non-treated carcinomas may rather reflect a high tumor turn-over or perhaps a more intensive tumor cell killing.     

HDL-cholesterol--active or passive participant in the pathogenesis of atherosclerosis? (II)

It is known that high sanguin levels of cholesterol and LDL-cholesterol (LDLc) have an important role in the pathogenesis of atherosclerosis. The treatment of hypercholesterolemia with statins and/or with fibrates have had beneficial effects on coronary heart disease and on other localization of atherosclerosis. The decreased of cholesterol and LDL-cholesterol is the most important effect of this treatment. The epidemiological studies have revealed that the treatment with statins and/or with fibrates produce an increase of HDL-cholesterol (HDLc), which is also very important in the regression of atherosclerosis. We tried in this review to explain the mechanisms of the increase of HDL-cholesterol, in concordance with the data from literature.     

Importance of mild dyslipidemias determining the cardio-vascular risk factors

The aim of our study was to correlate "medium" dyslipidemias with cardio-vascular diseases, especially essential hypertension (EHT). We selected 488 cases using randomization, from a population of hypertensive people. About 210 cases benefited by lipidograms and risk assessment, using special diagrams. When cholesterol was 200-250 mg/dl, 72% of cases had EHT and over 300 mg/dl, 57% had EHT. Comparing LDL chol with EHT, we obtained that arterial tension over 160 mmHg is correlated with LDL over 190 mg/dl on 12%, when LDL was less than 190 mg/dl but more than 150 mg/dl, we found EHT on 16% cases. EHT was very strong correlated with HDL < 40 mg/dl, 88%. On 5% of cases the only one dyslipidemia was marked by low HDL chol and all this cases had EHT. A particular risk was represented by the dyslipidemia with low HDL chol and high triglycerides (28% of cases). We concluded that the highest prevalence was for medium hypercholesterolemia with/or low HDL chol and, the same time, extreme values had comparable prevalences with medium values.     

Evaluation of simvastatin antioxidant effects

3-Hydroxy-3-methyl-coenzyme A reductase (HMG-CoA reductase) which transforms 3-hydroxy-3-methylglutaril-coenzyme A (HMG-CoA) in mevalonate, is the rate limiting enzyme in cholesterol biosynthesis. In our study, from HMG-CoA reductase's known inhibitors, we used simvastatin (ZOCOR), which is a semi synthetic derivative of the second generation. The study was performed on 25 subjects (12 men and 12 women) aged 33-67 yo, with hypercholesterolemia, which have received simvastatin, 10 mg daily for 8 months. Under treatment with simvastatin we obtained a significant decrease of total cholesterol (p < 0.0001) and an improvement of enzymatic antioxidant parameters: superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT). In conclusion, simvastatin therapy determines a significant decrease in SOD, GPx, CAT, and an increase in CAT/SOD and GPx/SOD ratios.     

Oxidative stress and immune response in eumenorrheic underweight patients

Malnutrition is known to induce a state of immunodeficiency and a predisposition to death from infectious diseases. During fasting or starvation, it appears that oxidative stress is decreased. The goal of our study was to assess the interrelation between nutritional factors, oxidative stress and immune response. The malondialdehyde (MDA)-marker of lipid peroxidation, white blood cell count, differential count and hormonal status (FSH, LH, and cortisol) were followed in eumenorrheic underweight patients. MDA was significantly lower and lymphocyte count was significantly increased in eumenorrheic underweight patients as compared to normal weight patients. Gonadal and adrenal axes were found normal in eumenorrheic underweight patients. Body mass index was positively correlated with MDA and negatively correlated with lymphocyte count. Low levels of lipid peroxidation and non-suppressed immune function in underweight patients may be explained by an increased sensitivity to leptin but further studies are requested.     

PURPLE (atrophie blanche): clinical, histological and immunological study of twelve patients

Objectives To investigate clinical, serologic, histopathologic and immunopathologic markers of PURPLE (painful purpuric ulcers with reticular pattern of lower extremities) or atrophie blanche. Design Twelve consecutive patients affected with idiopathic PURPLE were studied in the period 1992–1996. Patients with systemic diseases correlated to PURPLE were excluded from the study. Subjects All twelve patients were hospitalized at the Istituto Dermopatico Immacolata in Rome. Results Various and dishomogeneous immunological alterations were detected. Circulating immune complexes, increased serum levels of anticardiolipin and antinuclear antibodies, reduced serum complement levels, and deposition of immunoreactants in dermal vessels, were found in a limited number of patients. The results were not statistically significant. All the patients showed very similar histopathological aspects, characterized by microvascular thromboses, endothelial swelling and segmental hyalinization of small dermal vessels. Conclusion PURPLE is a thrombogenic vasculopathy in which unspecified immunological and laboratory changes are present. The recently suggested pathogenetic role of anticardiolipin and protein C deficiency in the disorder is not confirmed by this study.