Evaluation of Serum Zonulin and Occludin Levels in Bipolar Disorder

Objective@#The etiology of bipolar disorder (BD) is still not fully understood. Little is currently known about the relationship between the interaction the gastrointestinal system and brain function and BD. Zonulin is the only known physiological modulator of tight junctions and is a biomarker for intestinal permeability (IP). Occludin is an integral transmembrane tight junction protein involved in the maintenance and assembly of such junctions. The current study aims to determine whether zonulin and occludin levels are altered in BD and whether they can serve as clinical biomarkers of disease. @*Methods@#Forty-four patients with BD and 44 healthy controls were included in this study. The Young Mania Rating Scale (YMRS) was used to determine the severity of manic symptoms, while the Hamilton Depression Rating Scale (HDRS) was used to determine the severity of depressive symptoms, and the Brief Functioning Rating Scale (FAST) to assess functionality. Venous blood samples were taken from all participants and serum zonulin and occludin levels were measured. @*Results@#The mean serum zonulin and occludin levels of the patients were significantly higher compared to the healthy control group. There was no difference between manic, depressive, and euthymic patients in terms of zonulin and occludin levels. There was no correlation between the total number of attacks, duration of disease, YMRS, HDRS, FAST scores, and zonulin and occludin levels in the patient group. The groups were divided into three according to body mass index as normal, overweight, and obese. Zonulin and occludin levels increased as body mass index increased and were highest in the obese group. @*Conclusion@#The study shows that zonulin and occludin levels in BD increase independently of the disease stage. Consideration of the role of IP in the pathogenesis of BD may be helpful in determining the appropriate treatment modality.

Novel markers in predicting Brucella sacroiliitis: The platelet large cell ratio and basal immature reticulocyte fraction

Objective: To present platelet large cell ratio (P-LCR), reticulocyte, and immature reticulocyte fraction (IRF) values as novel parameters in diagnosis and response to treatment in patients developing sacroiliitis. Methods: Sixty-eight patients with clinical symptoms and Brucella standard tube agglutination (Wright) or Brucella Coombs agglutination test titers ≥1:160 were included in the study. Two groups were established, one developing sacroiliitis and another with no sacroiliitis development. P-LCR, reticulocyte, and IRF levels were measured using a Sysmex XN-9000 device (Japan). These were then compared between the two groups. Results: Reticulocyte (P=0.037) and IRF (P=0.026) levels were significantly lower among the patients developing sacroiliitis compared to the non-sacroiliitis group, while P-LCR (P=0.003) levels were significantly higher. P-LCR had the most powerful correlation with sacroiliitis development. Significant negative correlation was observed between reticulocyte, IRF levels and sacroiliitis. Conclusions: Elevated P-LCR levels were observed as a marker of persisting inflammation in patients developing sacroiliitis, while low reticulocyte and IRF levels secondary to bone marrow involvement were detected. These three parameters emerged as highly significant markers in terms of diagnosis and reflecting responses to treatment in organ involvement such as sacroiliitis in brucellosis. These are presented as inexpensive, and easily accessible novel parameters.

effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration

Gallbladder stones are common in the Western world, and 70% to 80% of gallstones are cholesterol stones. This study investigates the effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. The gallstones of 75 patients with cholelithiasis were examined using spectrophotometry. High serum cholesterol and LDL levels were associated with high cholesterol stone rates [86.7% vs. 40.0%, P < 0.001; 75.0% vs. 48.9%, P < 0.05, respectively]. Similarly, high serum cholesterol and LDL levels were correlated with high gallbladder stone cholesterol concentrations [63.6% vs. 44.4%, P < 0.001; 62.3% vs. 46.0%, P < 0.001, respectively]. In contrast, low serum HDL levels do not seem to affect the occurrence of gallbladder cholesterol stones [60.0% vs. 58.3%, respectively, P > 0.05] or gallbladder stone cholesterol concentrations [50.8% vs. 52.4%, respectively, P > 0.05]. The relationship between cholesterol, LDL, and HDL levels and cholesterol gallstone formation is multifactorial and complex and is also dependent on other individual properties