Decreased levels of alpha-1-acid glycoprotein are related to the mortality of septic patients in the emergency department

OBJECTIVE: To determine the validity of alpha-1-acid glycoprotein as a novel biomarker for mortality in patients with severe sepsis. METHODS: We prospectively included patients with severe sepsis or septic shock at the emergency department at a single tertiary referral teaching hospital. All of the patients were enrolled within the first 24 hours of emergency department admission, and clinical data and blood samples were obtained. As the primary outcome, we investigated the association of serum levels of alpha-1-acid glycoprotein and 96-hour mortality with logistic regression analysis and generalized estimating equations adjusted for age, sex, shock status and Acute Physiology and Chronic Health Evaluation II score. RESULTS: Patients with septic shock had lower alpha-1-acid glycoprotein levels at the time of emergency department admission compared to patients without shock (respectively, 149.1 ±42.7 vs. 189.8 ±68.6; p = 0.005). Similarly, non-survivors in the first 96 hours were also characterized by lower levels of alpha-1-acid glycoprotein at the time of emergency department admission compared to survivors (respectively, 132.18 ±50.2 vs. 179.8 ±61.4; p = 0.01). In an adjusted analysis, alpha-1-acid glycoprotein levels ≤120 mg/dL were significantly associated with 96-hour mortality (odds ratio = 14.37; 95% confidence interval = 1.58 to 130.21). CONCLUSION: Septic shock patients exhibited lower circulating alpha-1-acid glycoprotein levels than patients without shock. Alpha-1-acid glycoprotein levels were independently associated with 96-hour mortality in individuals with severe sepsis. .

Effect of temozolomide treatment on the adenine nucleotide hydrolysis in blood serum of rats with implanted gliomas

Objective: Adenine nucleotides and adenosine have many important functions in the physiological and pathological conditions. The measurement of these nucleotides in serum may be an auxiliary tool in the identification of cellular damage in many pathological conditions. The aim of this study is to examine the effect of chemotherapy treatment on nucleotide hydrolysis in the serum of rats following glioma implantation. Methods: C6 glioma cells were injected in the right striatum of 60 day-old Wistar rats, and 20 days after the induction of gliomas, blood serum samples were prepared for measurement of ATP and AMP hydrolysis. Results: The pathological analysis showed that the malignant gliomas induced by C6 injection and treated with temozolomide exhibited a reduction in malignant characteristics. The results demonstrated that the rats that underwent temozolomide treatment had a significant decrease (p<0.05) in blood serum hydrolysis of ATP and AMP when compared with the glioma group. None of the animals included in this study presented significant alterations in the activities of the serum enzymes alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. Conclusion: The decrease in the enzymatic hydrolysis of the ATP and AMP is probably related to the diminished malignant characteristics caused by temozolomide treatment on the gliomas in vivo.