IL-6 and IGFII in normal ovulatory; anovulatory pcos and controlled ovarian hyperstimulation cycles

Cytokine interleukin-6 [IL-6] and insulin like growth factor II [IGF-II] are polyfunctional regulatory peptides. They have a wide variety of biological activities including ovulation regulation of gonadal steroid secretion by the ovaries, corpus luteum function and embryo implantation. To investigate their role in normal ovulation, polycystic ovary syndrome [PCOS] and controlled ovarian hyperstimulation [COH] this study is conducted. Department of Obstetrics and Gynecology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt. Sixty women were included in this study from 3 groups of patients; 20 women in each group. First group includes women with normal ovulatory cycle and a second group includes women with anovulatory PCOS cycle and a third group of women prepared for assisted reproduction by [ICSI]. Three blood samples from each women were obtained at day 3 of the cycle day 12 or day of ovum pick up and day 22 of the cycle. Follicular Fluid [FF]collected at the day of ovum pick up from women undergoing [ICSI]. Blood and FFsamples were assayed for IL-6 and IGF-II as well as E2, FSH, LH and P, using [ELISA] technique. The mean values of IL-6 level in the early follicular phase in normal ovulatory, PCOS and COH groups were 12.93 +/- 0.77, 101.99 +/- 32.04 and 12.86 +/- 0.88 [pg/ml], respectively. There is highly significant increase in PCOS group in comparison to normal ovulatory and COH groups. IL-6 significantly increased in patients with increased number of follicles than those of low number of follicles in COH group. The mean values of IL-6 in late follicular phase were 11.4 +/- 0.88, 99.7 +/- 4.0, 27.3 +/- 8.0 in the three groups, respectively. The level is only significanlly increased in those patients with COH than the level in early follicular phase inside each group. The mean values of IL-6 in the mid luteal phase were 176.6 +/- 29.7 and 68.7 +/- 52.3 [pg/ml] in normal ovulatory and PCOS groups. There was highly significant increase in the ovulatory than the anvulatory cycle. There was a significant increase of IL-6 in FF at the time of ovum pick up over the serum samples taken at the same time. The mean values of IGF-II level in late follicular phase were 589.97 +/- 22.58, 466.4 +/.- 41.74 and 770.7 +/- 79.38 [ng/ml] in normal ovulatory, PCOS and COH group, respectively. The increase of IGF-II in cases of COH than normal ovulatory cycle shows its significant role in steroidogenesis which is important for the elevated E2 level in this group. IL-6 may be an early predictor for the ovarian responce and the development of ovarian Hyper stimulation syndrome [OHSS] with the othor hormonal and US parameters. IL-6 may be taken in consideration as a maker for corpus luteum function in conjunction with progesterone in day 22. The elevation of IL-6 in day 3 in PCOS patients than in the normal ovulatory cycle may partially explain the increased liability to OHSS in these patients. The significant reduction in IGF-II in cases of PCOS may play a role in anovulation

Tumor necrosis factor alpha, interleukin-10 and nitric oxide in patients with type 1 diabetes mellitus and their association with glycemic control an dsome complications of the disease

Type-1 diabetes mellitus is a disease that results from autoimmune destruction of insulin producing beta-cells. The autoimmune response against beta-cells is believed to result from a disorder of immune regulation. According to this concept tumor necrosis factor alpha [TNF-alpha], interleukin-10 [IL-10], nitric oxide [NO], urinary albumin excretion rate [UAER] and HbAIc in addition to serum glucose, kidney and liver function tests as well as lipogram were studied in sixty eight type-1 diabetic patients. Twelve healthy subjects were included as a control group According to disease duration patients were classified into three groups: group I [30 cases] patients with disease duration less than 5 years, group II [22 cases] patients with disease duration 5-10 years and group III [16 cases] patients with disease duration > 10 years. Also patients were classified according to UAER into 3 groups: group A [30 cases] normoalbuminuric patients UAER < 20 micro g/min. group B [35 cases] microalbuminuric patients UAER 20-200 micro g/min. group C [3 cases] macroalbuminuric patients UAER > 200 micro g/min. According to HbAIc levels, patients were classified into controlled group [HbALc < 6%] 20 patients and uncontrolled group [HbAIc > 6%] 48 patients. In whole patients group mean values of HbAIc, TNF-alpha and UAER showed significant elevations compared to controls [P <0.001, 0.001 and 0.05 respectively], while IL-10 revealed significant reduction. [P < 0.001]: NO mean value showed statistically insignificant elevation. Mean values of HbAIc in groups I, II, III, A, B revealed significant elevations compared to controls [P < 0.001 for all] also in group III versus group I [P < 0.05] and in group B versus A [P<0.05]. TNF-alpha showed significant elevation in groups I, II, III in comparison with controls [P < 0.001 for all]. While mean value of IL-10 showed significant reduction in groups I, III compared to controls [P < 0.01, P < 0.001 respectively] also in group III versus group I, II [P < 0.01 for both]. NO and UAER showed significant elevations in group III compared to controls [P < 0.05 and P < 0.01 respectively]. NO levels showed significant elevation in groups I and III compared to group II [P < 0.05 for both]. UAER in group III revealed significant elevation versus groups I and ii [P < 0.01, P < 0.001 respectively]. In normoalbuminuric and microalbuminuric groups [A, B] TNF-alpha showed significant elevation compared to controls [P < 0.001 for both]. IL-10 mean value showed significant reduction in groups A and B compared to controls [P < 0.001 for both]. NO levels revealed no significant differences. In uncontrolled group, level of IL-10 was significantly low, while UAER was significantly high [p < 0.05 for both]. TNF-alpha and NO showed no signifigant difference between controlled and uncontrolled groups. Positive correlations were found between TNF-alpha and serum glucose and HbAIc, also negative correlations were found between IL-10 and serum glucose, HBAIc, cholesterol, triglycerides and LDL-c. NO showed positive correlation with UAER level. From this study we concluded that increased TNF-a [proinflammatory cytokine of Th1] and decreased IL-10 levels [type 2 cytokine of Th2] may play a role in the pathogenesis of type-1 diabetes mellitus. TNF-alpha and IL-10 may be a predictor of glycemic control. Increased NO level may play a role in the pathogenesis and complications of diabetes

Soluble adhesion molecules for prediction of cardiac dysfunction in chronic renal failure patients

Beside cell-bound adhesion molecules, which are of fundamental importance to a large number of physiological and pathological processes, soluble forms of adhesion molecules have been detected in the circulating blood in recent years. Circulating soluble adhesion molecules appear to be biologically active, and raised levels have been reported in a variety of disorders. In the present study, we measure the serum levels of the soluble [s] molecules included vascular cell adhesion molecule 1 [sVCAM- 1] and sE-selectin in 26 patients on chronic hemodialysis [HD], 16 undialyzed patients with chronic renal failure [CRF], and 10 healthy controls having a similar mean and distribution of ages. The presence of hypoalbuminemia, inflammation [C-reactive protein,CRP] and dyslipidemia were assessed together with echocardiographic evaluation of cardiac dimensions, systolic and diastolic function in all studied groups. sVCAM-1 was found to be elevated in patients with chronic hemodialysis and undialyzed CRF [P < 0.001 each] compared with the controls but levels did not differ between both groups of patients. sE-selectin was also raised in both groups of CRF patients compared with controls [P < 0.001 each] with higher significant level in the undialyzed group [P < 0.05] compared with HD group. Both adhesion molecules are correlated positively to each other [r = 816, P<0.001]. The presence of hypoalbuminemia, inflammation, dyslipidemia together with left ventricular hypertrophy [LVH] and low ratio of E/A peak early LV filling velocity [E] /peak atrial filling velocity [A] by echocardiography were associated with higher sVCAM-1 and sE-selectin than in CRF patients without these findings. Both sVCAM and sE-selectin correlated significantly positive with CRP [P<0.01, P<0.001 respectively], left ventricular mass index [LVMI] [P<0.001, P<0.05 respectively], and significantly negative with high-density lipoprotein [HDL] [P<0.001 each], serum albumin levels [P<0.001 each] and with E/A ratio [P<0.001 each]. Elevated serum concentrations of soluble adhesion molecules [sVCAM-l and sE-selectin] are found in undialyzed and chronic hemodialysis patients who are malnourished inflamed, dyslipidemic and have echo findings of cardiac diastolic dysfunction and LVH