Nociceptin/orphanin and substance P concentrations in critically III patients with sepsis

Sepsis is estimated to affect eighteen million people worldwide each year and kill 1, 400 people each day. Sepsis affects about 700, 000 people annually in the United States alone. The neuropeptide nociceptin/orphanin [N/OFQ] and substance P [SP] are two neuropathies involved in control of pain pathways. They have been implicated in neural, immune, inflammatory process and cardiovascular system function. In this study we evaluated the N/OFQ plasma levels and SP serum levels in critically ill patients with severe sepsis. Blood samples were collected from twenty patients with the diagnosis of severe sepsis. They were admitted in the intensive care unit. Plasma N/OFQ concentrations were determined by radio immunoassay. SP in the serum was evaluated by enzyme-linked immunoassay. Samples were collected within twenty four hours of diagnosis of sepsis in all cases. Another set of samples were collected in nine patients before death [non-survivors] and eleven patient upon recovery from severe sepsis [survivors]. The results revealed significant high levels of N/OFQ in patients with severe sepsis [non-survivors] compared with the other group of survivors [p<0.031]. The levels were significantly high in cases near death [non-survivors] compared to the survivors [p<0.012] near recovery. SP levels were significantly high in sepsis non-survivors compared to survivors [p<0.001] and significantly elevated in non-survivors before death compared to survivors near recovery [p<0.001]. Plasma N/OFQ and Serum SP, concentrations were increased in critically ill patients with sepsis and more elevated in patients who subsequently died. These two neuropeptides represent an important item for further studies to confirm their prognostic value as predictive indicators of lethal outcome or recovery. Also this study invites more work to determine the neuroendocrine system critical role in the pathogenesis of sepsis

New biochemical marker in acute coronary syndromes: diagnostic and prognostic implications of plasma angiogenin

Acute coronary syndrome [ACS] represents a life threatening manifestation of atherosclerosis usually precipitated by acute thrombosis, induced by a ruptured or eroded atherosclerotic plaque, with or without concomitant vasoconstriction. Angiogenesis is a complex biological process that has precise coordination of multiple steps. Angiogenin is a potent angiogenic growth factor related to endothelial cell proliferation. This work tried to asses angiogenin as biochemical marker contributing to the pathophysiology of ACS and its prognostic value in adverse events of ACS. This study included 23 patients of ACS. Ten patients were in disease controls group and another twelve as healthy controls. The results revealed markedly elevated angiogenin levels in acute coronary syndrome compared to the controls [Disease group and healthy control group] p<0.0001. No significant difference in angiogenin levels between the disease control and the healthy controls. Angiogenin was high in those patients with adverse outcomes. Plasma angiogenin levels were significantly increased in ACS. Angiogenin may be involved in the pathogenesis of ACS and may have prognostic value to predict adverse events

Effect of hepatitis-C viral infection on platelets

This study was conducted on 35 patients with established chronic liver diseases due to hepatitis C. Their ages ranged from 20 to 60 years. A full clinical assessment, ultrasound, complete blond picture including platelet number and functions, liver function tests [SGOT, SGPT, serum albumin, serum bilirubin and prothrombin time and concentration] were applied for every patient. Hepatitis markers for B and C and PCR for HCV and, lastly, liver biopsy were also detected. They were classified into three groups [according to their platelet number]: Group I [12 patients] with platelet count 151-350,000/mm3, group II [13 patients] with platelet count 80-140,000/mm3, and group III [10 patients] with platelet count 25-79,000/mm3. The three groups were statistically compared regarding platelet number, platelet aggregation, liver function tests, histopathological study and correlation between platelet number and aggregation. The results revealed a direct correlation between liver span and platelet number and platelet aggregation. Inverse correlations were noticed between spleen size and portal vein diameter and platelet count and aggregation. Direct correlations were present between platelet number, aggregation and liver function tests [prothrombin time, SGPT, S. Bilirubin, OT/PT ratio and albumin], but there was no correlation with SGOT