The End of the Road for Prostate Specific Antigen Testing?

Many candidate biomarkers for diagnosis of prostate cancer have been investigated; but prostate-specific antigen (PSA) testing remains the frontline test for both mass screening and individual clinical testing. Although the PSA test is cost-effective; analytically reliable; and flexibly high throughput; it has a very weak correlation with prostate malignancy. This has resulted in over-diagnosis and over-treatment of patients leading to costly economic; social; and psychological impacts. PSA testing lacks the ability to molecularly characterize prostate diseases and define aggressiveness and lethality; which are necessary to influence choice of treatment. Therefore; newer molecular tests are beginning to replace the PSA tests. The prostate cancer antigen 3 test has shown superiority and is now widely used. The recently reported sarcosine urine test; the already delineated TMPRSS2: ETS fusion genes; the glutathione-S-transferase P1 serum marker; and enhancer of zeste homolog 2 biomarker may also help improve diagnosis and prognostication of prostate cancer. The analytical trend is toward a multiplex testing format using molecular and/or proteomic techniques that are reliable; accurate; reproducible; and ensure rapid quantitation. Therefore; validation of these newer biomarkers and their assays are necessary for both large-scale clinical trials and clinical utility

Natural products research networks in sub-Saharan Africa

Networking is a means of calibrating the quality of work that a group of people is undertaking; fostering international collaboration; pooling of available resources to provide quality training and research in various scientific disciplines and ensuring rapid worldwide dissemination of research information. Several networks involved in research and development of medicinal plants exist in the various sub-regions of the African Region. However; this paper discusses only six such networks of African researchers which share certain common characteristics. These networks aim to foster research on natural products and their sustainable use in human health; and the dissemination of information on research into natural products among others. They also aim to enhance research training capabilities of institutions through national and Regional activities; promote collaboration and research partnerships and mentoring of young researchers in the advancement of natural products research and support the principles of biodiversity conservation. However; these networks have many challenges; mostly financial. A suggestion has been made for the African Network of Drug and Diagnostics Innovation to consider the involvement of other existing networks in its structure for synergizing the efforts to create health products

Towards sustainable local production of traditional medicines in the African Region

The majority of the population in the WHO African Region and other developing countries; particularly rural dwellers use plant-based traditional medicines for health care. Most developing countries are endowed with vast resources of medicinal and aromatic plants; which have been used over centuries for the treatment of diseases. The global resurgence of interest in herbal medicines has created a large market for plant derived remediesthat developing countries could exploit to their advantage; provided they could be produced with acceptable quality and safety specifications. This article highlights the current limitations of traditional medicinal productsin the Member States; the essential requirements for the local production of traditional medicines; the status of local production in WHO African Region; approaches to sourcing plant raw materials as well as challenges. Methods for value addition; processing and product improvement for the commercial utilization of medicinal plants are indicated

Calcium; Inorganic Phosphates; Alkaline and Acid Phosphatase Activities in Breast Cancer Patients in Calabar; Nigeria

Background: Breast cancer is the commonest malignancy of women in Nigeria. Change in serum levels of some biochemical parameters could assist diagnosis and follow-up of breast cancer. Objective: To determine serum levels of calcium; inorganic phosphates; alkaline phosphatase (ALP) and acid phosphatase (ACP) activities in patients with breast cancer; and change in the serum levels over time. Methods: Total serum calcium and inorganic phosphates; and serum ALP and ACP activities were determined in 25women with breast cancer and 25 age-matched controls using colorimetric and enzymatic methods; over 6 months with bimonthly analysis. Results: The serum calcium level; increases in serum calcium levels; ALP and ACP activities in the study group with time (p0.05); whereas no significant increase was observed in the control group.Conclusion: Breast cancer patients have higher calcium levels and higher ALP and ACP activities. The increase in the levelsof these parameters with the levelsofthese parameters with time shows that they could be of importance in monitoring treatment and disease progress in a resource-poor setting

Value of P53 protein as a tumor marker in patients with transitional cell bladder cancer

Objective: The aim of this work is to determine the value of P53 as a biochemical marker in patients with bladder cancer. Patients and Methods: This study was conducted on 30 patients with transitional cell carcinoma (TCC) of different grades and 10 healthy men as a control group who had been admitted to the Urology Department; Benha Faculty of Medicine between August 1999 and November 2001. The mean age of the patients was 56.3 years (range 38-80 years). They were evaluated by history taking; clinical examination; laboratory investigations; radiological examination and cysto-scopy-guided biopsies. P53 was determined in the serum preoperatively and postoperatively after 21 days and 6 months; as well as in the tissue specimens taken by transurethral resection or by radical cystectomy. Results: The mean serum P53 value in the control group was 10.0 + 1.83 Pg/ml. In the patients with grade-1 tumors it was 25.6 + 4.8 Pg/ml compared to 44.8 + 14.73 Pg/ml and 131.1 + 15.28 Pg/ml for grade-2 and grade-3 tumors; respectively (P 0.05). In tumors larger than 2 cm the mean serum P53 value was 87.54 + 10.81 Pg/ml; while in tumors less than 2 cm it was 32.91 + 2.32 Pg/ml (P 0.05). The mean serum P53 value in a single tumor was 27.8 + 7.1 Pg/ml compared to 102.3 + 20.4 Pg/ml in multiple tumors (P 0.05). On follow-up after 21 days the mean serum P53 value was 14.0 + 2.71 Pg/ml in grade-1 tumors; 17.0 + 3.79 Pg in grade-2 and 55.3 + 12.4 Pg/ml in grade-3 tumors (P 0.05). Eleven patients developed recurrence; their mean serum P53 was 125.6 + 13.46 Pg/ml preoperatively and significantly decreased to 59.9 + 18.2 Pg/ml postoperatively; but then rose again to 91.5 + 20.1 Pg/ml. The mean P53 in the tissues of the control group was 11.3 + 2.31 Pg/ml; while the tissues of the cancer patients showed values of 29.8 + 4.42 Pg/ml; 46.6 + 11.08 and 140.2 + 14.85 Pg/ml for grade-1; grade-2 and grade-3 tumors; respectively (P 0.05). Conclusion: P53 seems to be a promising tumor marker for transitional cell bladder cancer and a valuable tool for identifying subgroups of patients that may have a poor prognosis

Serum transforming growth factor Beta1 and prostate specific antigen as markers for localized and metastatic prostate cancer

Objectives: To assess any additional benefits of the estimation of serum TGF Beta1 over serum PSA for differentiating localized from metastatic prostatic carcinoma. Patients and Methods: Forty-seven prostate cancer patients (23 with and 24 without metastases) and ten controls were included in the study. Serum PSA was estimated using the chemiluminescent immunometric assay; and serum TGF Beta1 was assessed using the enzyme immunoassay.Results: The mean serum PSA in the localized and metastatic disease groups were significantly higher than that in the control group (p0.001; p0.001 respectively); while the mean serum TGF Beta1 in the metastatic disease group only was significantly higher than in the control: group (p0.01). The mean serum PSA and TGF Beta1 in the metastatic disease group were significantly higher than the values in the localized disease group (p0.001; p0.001 respectively). Serum PSA was directly correlated with Gleason score in both patient groups (localized group: r