Serum cystatin C as a reliable biomarker for assessment of renal function in bilharzial patients with chronic renal failure

Objectives: Serum cystatin C [cys C] has been proposed as a simple, accurate and rapid endogenous marker of glomerular filtration rate [GFR] in search and clinical practice. However, there are conflicting reports regarding the superiority of cys C over serum creatinine [CL], with a few studies suggesting no significant difference. The aim‘ of the present study was to evaluate serum cys C as an indicator of renal function before and after hemodialysis in chronic renal failure patients with and without bilharzial infections and to correlate their levels with serum creatinine

Patients and Methods: The study was conducted on 47 patients. They were classified into 36 chronic renal failure patients [Group 1] divided into 23 and 13 uremic patients without and with bilharzial infections, respectively and 11 control subjects [Group II]. All uremic patients treated with hemodialysis. Cys C was assayed using a sandwich enzyme immunoassay and creatinine was assayed using a kinetic technique

Results: Serum creatinine and cys C levels of the two subgroups of CRF [with and without bilharziasis] showed significantly increase compared to the corresponding levels of the control group [p<0.05]. The rise of both markers did not differ from each other between the two subgroups of CRF [p>0.05]. After hemodialysis, the levels of serum cys C were markedly decreased. There was a significant positive correlation between cys C and creatinine in CRF with bilharzial infection only

Conclusion: Results demonstrated that there is justification to use cys C as the future marker of GFR in clinical uses

Tumor associated antigens and angiogenic cytokines in the early diagnosis of endometriosis and assessment the severity of the disease

Objective: To investigate the ability of a group of serum and peritoneal fluid (PF) markers to diagnose, non-surgically, endometriosis and to assess the severity of the disease

Patients and Methods: Serum and PF samples were obtained from 55 women while undergoing laparoscopy for pelvic pain, and infertility. Concentrations of two tumor associated antigens [CEA, CA125] and two angiogenic cytokines [TNF-alpha, IL-8] were measured in serum and PF and levels were compared among women who were allocated to groups according to their post-surgical diagnosis. Fourty patients were diagnosed with endometriosis who were subgrouped according to disease severity into endometriosis, stages I, II, III and IV. Based on laparoscopic findings the other 15 women were considered as control group

Results: Serum and PF CEA, CA125, IL-8 and TNF-alpha levels were significantly elevated in patients with endometriosis. The concentrations of these markers increase with increased severity of the disease. Serum CEA and PF IL-8 showed the highest prevalence of abnormally elevated values in all stages of endometriosis. The rise of CEA is attributed to the associated phenomenon of inflammation and adhesions with active endometriosis whereas the rise of IL-8 is related to its angiogenic activity required for survival and maintenance of endometriotic implants within the peritoneal cavity

Conclusion: Serum CEA and PF IL-8 are the best non-surgical markers for discriminating patients with and without endometriosis with high degrees of sensitivity, specificity and accuracy. Their measurement are clinically valuable in the early diagnosis of endometriosis, assessment the severity of the disease and monitoring therapy

clinical value of circulatin g levels of osteoprotegerin and receptor activator of NF-KB ligand [RANKL] in renal osteodystrophy

Objectives: Osteoprotegerin [OPG] is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF-KB ligand [RANKL]. OPG and RANKL have been shown to be important regulators of osteoclastogenesis. Thus the aim of this study was to investigate the relationship between the OPG-RANKL system and bone mineral metabolism in male patients with chronic renal failure [CRF]

Patients and Methods: Serum OPG, RANKL, Osteocalcin, ICTP and cystatin C [a new marker of glomerular filtration rate] levels were measured in 40 chronic hemodialysis male patients as well as 32 healthy controls mate for age and sex. Their lumbar-spine bone mineral density [LS-BMD] was measured y dual energy x-ray absorptiometry [DEXA]

Results: Serum OPG, RANKL and cystatin C levels were significantly increased in patients with CRF. Serum OPG was positively correlated to serum RANKL and cystatin C. Positive conelation existed between serum RANKL and each of cystatin C and ICTP. LS-BMD was significantly lower in patients with CRF than in controls and inversely correlated to levels of OPG. RANKL and cystatin C in CRF group

Conclusion: These results demonstrate that OPG/RANKL system is involved in the pathogenesis and regulation of bone turnover in renal osteodystrophy. Determinations of circulating osteoprotegerin and receptor activator of nuclear factor-KB ligand are useful markers to assess turnover renal osteopathies

Fetal gender determination in early pregnancy using real-time PCR of fetal DNA in maternal plasma

Objective: To detect fetal gender and fetal DNA concentration in maternal plasma during early gestational ages with qualitative and quantitative real-time PCR of the sex determinating region Y [SRY] gene, fetal gender was confirmed by ultrasonography and fetal outcome

Patients and Methods: Maternal plasma was obtained from 25 pregnant women during 4th - 12th weeks of gestational ages. Fetal male gender was detected in copies/ml by qualitative and quantitative real-timc PCR. [3D] ultrasound was done at 24-28 weeks of gestation months of pregnancy

Results: Fifteen out of 25 pregnant women [60%] were bearing male fetus and 10 women [40%] were bearing female fetus with sensitivity 100% and specificity 100%. The concentration of the sex determining region gene [SRY] was increased with gestational weeks

Conclusion: To the best of our knowledge this work demonstrates for the first time that real time PCR is a very reliable technique for determination of fetal sex as early as four weeks of gestation

clinical value of assaying circulating maternal serum inhibin A and activin A levels in preeclampsia

Objective: To evaluate the clinical value of measuring circulating levels of maternal serum inhibin A and activin A in preeclamptic pregnant women in the third trimester for the assessment of the severity of preeclampsia and to correlate their levels to fetal outcome

Patients and Methods: Ninety women primigravidas in the third trimester [30-40 w] were selected. They comprised thirty normal pregnant women [controls], 30 mild preeclamptic and 30 severe preeclamptic groups. Maternal serum inhibin A and activin A levels were measured using specific enzyme linked immunosorbent assay [ELISA]

Results: Serum inhibin A and activin A levels showed significant increase in the preeclamptic patients when compared to the control group. This increase was more pronounced in the severe preeclamptic patients. Significant positive correlation was found between both serum inhibin A and activin A levels and the birth weight in control group. On the other hand, signihcant negative correlation was found between both serum inhibin A and activin A levels and birth weight in mild and severe preeclamptic patients. In preeclamptic patient, it was found that serum inhibin A at a cut off level of 105 pg/ml showed sensitivity of 66.67%, specificity of 80%, positive predictive value of 76.92% and a negative predictive value of 70.59% with an accuracy of 73.33%. 0n the other hand, serum activin A at a cut off level of 20 ng/ml showed corresponding value of 90%, 70%, 75% 87.5%, respectively with an accuracy of 80%

Conclusion: Serum inhibin A and activin A levels were well correlated with the severity of preeclampsia. Both parameters can be used as biomarkers for diagnosis and assessment of the severity of preeclampsia as well as prediction of fetal outcome Preeclampsia

Measurement of markers of apobtosis and oxidative stress in maternal blood, cord blood and amniotic fluid in cases of premature rupture of membranes

Objective: to determine markers of apoptosis and oxidative stress in maternal blood, cord blood and amniotic fluid in cases of premature rupture of membrane at labor [PROM], preterm premature rupture of membranes [P-PROM] compared with laboring women with intact membranes

Subjects and Methods: antiapoptotic gene Bcl-2, nitrite/nitrate and lipid peroxidation [malondialdehyde MDA] were determined in amniochorion, maternal and cord leucocytes, plasma and amniotic fluid from gestational age-matched groups of women at labor. Samples were collected from the three groups of women [PROM, P-PROM and women with intact membrane as control group]

Results: maternal blood leucocytes and amniotic fluid Bcl-2 protein levels showed no significant differences between PROM and controls. However, there was a significant decrease of cord blood leucocytes Bcl-2 in cases of PROM and P-PROM. The decrease was more pronounced in the latter when compared to the former. Maternal, cord plasma and amniotic fluid MDA levels were significantly elevated in PROM and P-PROM compared to control values. The mean fold rise were 1.2, 1.9% respectively for maternal plasma, 1.2, 1.7% respectively for cord plasma and 2.5% for amniotic fluid. Matemal, cord plasma and amniotic fluid nitrite/nitrate levels were significantly elevated in PROM and P-PROM compared to control values. The mean fold rise were 1.3, 1.6% for maternal plasma and 1.2, 1.3% for cord plasma and 1.44% for amniotic fluid, respectively. Apoptotic cells was positively correlated with nitrite/nitrate while negative correlations, existed between Bcl-2 and nitrite/nitrate, MDA and apoptotic cells

Conclusion: enhanced oxidative stress [increased MDA], inflammation process [increased NO] and decreased antiapoptotic Bcl-2 are the characteristic features associated with P-PROM and PROM and may play causative role by affecting membrane integrity

New approaches in psychoimmunology

This review article sheds lights on the highly sophisticated advancement in molecular biology in relation to psychiatric disorders. Brain neuropathological abnormalities, electrophysiological studies and biological markers of schizophrenia and depression are elaborated

Serum prolactin and thyroid stimulating hormone levels and polytomography in cases of secondary amenorrhea without galactorrhea

Serum prolactin [PRL] and thyroid stimulating hormone [TSH] were determined in 50 patients, presenting with secondary amenorrhea without galactorrhea, as well as 20 women with normal menstrual function as control. There was a significant increase of serum PRL in amenorrheic patients [42.09 +/- 9.63 ng/ml], when compared to that of control [11.1 +/- 4.9 ng/ml] at P < 0.0025. Serum PRL also showed a significant positive correlation to body weight and duration of the complaint in the amenorrheic group. Serum TSH values in both amenorrheic and control groups did not show any significant difference [P > 0.05]. Plain X-ray confirmed the presence of pituitary macro-adenoma in one out of ten hyperprolactinemic patients. When radiological examination was again performed using hypocycloidal polytomography, two further microadenomata were discovered. In the present study, the incidence of hyperprolactinemia and pituitary adenoma in non-galactorrheic amenorrheic patients was 20% and 6 respectively. Thirty percent of hyperprolactinemic patients had pituitary adenoma. In conclusion, serum PRL determination is essential in the diagnostic work-up of amenorrhea, even without galactorrhea. A combination of hyperproclactinemia and positive hypocycloidal polytomography of the sella turcica is specific for the diagnosis of prolactinoma