Soluble as an apoptotic marker in myocardial infarction, the outcome and its relation to high risk, clinical features

This study was designed to detect the impact of apoptosis on prognosis and clinical outcome in patients with myocardial infarction [MI] and its relation to the other risk factors for coronary artery disease. Forty patients [22 males, 18 females] with mean age 53.88 +/- 1.39 years diagnosed as MI on the basis of electrocardiographic and enzymatic changes in addition to the clinical symptoms and signs. Twenty-two patients were smokers. Fifteen healthy volunteers were chosen as a control group. Patients group was classified according to infarct size [expensive MI 62.5%, localized MI 37.5%], presence or absence of heart failure [MI with HF 67.5%, MI without HF 32.5%], presence or absence of diabetes mellitus [DM] [MI with DM 46.5%, MI without DM 52.5%], presence or absence of hypertension [HTN] [MI with HTN 47.5%, MI without HTN 52.5%]. For every participant, history and clinical examination paying special attention to vital signs and cardiopulmonary examination, as well as resting electrocardiogram [ECG] looking for the changes of MI were done. In addition, the following laboratory investigations: Serum sugar, total cholesterol, triglycerides, soluble Apo-1/Fas, homocysteine and nitric oxide [NO] concentrations in serum were assessed. It was concluded that soluble Fas as a marker of myocardial apoptosis is strongly associated with and may be a major determinant of unfavorable early symptomatic post- infarction HF and is related to the size of MI. Homocysteine acts as an independent risk factor for atherosclerotic cardiovascular events and the decreased level of NO is associated with increased risk for development of atherosclerosis, HTN and symptomatic left ventricular [LV] dysfunction

Thyroid and pancreatic islet cell antibodies in chronic hepatitis c [HCV] infection with and without diabetes

The prevalence and the clinical relevance of thyroid and pancreatic beta cell immunity in HCV +ve patients with and without diabetes before interferon [IFN-alpha] therapy remain controversial. So, the aim of the present study was : 1-To determine the prevalence of organ specific Pancreatic beta cell and thyroid autoantibodies and organ non-specific antibodies [Anti Neutrophil Cytoplasmic Antibodies [ANCA], Anti Smooth Muscle Antibodies [ASMA] and Liver Kidney Microsomal Antibodies [LKMA] in HCV+ve patients with and without diabetes. 2- To evaluate whether autoimmune beta cell damage could be involved in the development of diabetes in HCV +ve patients. 3- To assess the clinical value and the relationship between such autoantibodies. Research design and Methods: The evidence of clinical autoimmune diseases and the presence of autoantibodies were assessed in 56 HCV+ve patients before INF-alpha therapy. Autoantibodies to Islet Cells [ICA], Thyroglobulin [TGAs]. Thyroid Peroxidase [TPAs] were tested by ELISA and immunometric assay, in addition to ANCA, ASMA and LKMA were tested by ELISA and immunoflorescence assay in 30 patients with diabetes [Group I], 26 patients without diabetes [Group II], in addition to 14 sex and age matched controls. Correlating these antibodies with age, sex, body mass index [BMI], presence of liver cirrhosis and its staging. It was found that age, BMI, family history of diabetes, and insulin levels were significantly higher in the diabetic group than in non diabetic HCV+ve patients. None of the 56 patients studied showed evidence of clinical autoimmune diseases. However, 5.4% of patients were positive for ICA[3/56], 10.7% [6/56] were positive for TGAs, 8.9% [5/56] were positive for TPAs. The coexistence of ICA and thyroid antibodies were found in only 3.6% of patients [2/56]. Furthermore, 71.4% of patients [40/56] were positive for ANCA, 35. 7% [20 /56] were positive for ASMA, 12.5% [7/56] were positive for LKMA. The frequencies of these autoantibodies were not significantly different in the presence- or absence of diabetes or when compared with controls except in ANCA +ve group in which antibodies were significantly higher [p<0.05] in the diabetic group. Moreover, ICA +ve patients were all diabetics. The ICA, TGAs and TPAs were more frequent among HCV+ ve female patients although most of our patients [75%,] were men. The presence of liver cirrhosis or / is staging according to Child Pugh score had no relation to the presence of such antibodies. Our study indicated a low prevalence of beta cell immunity and thyroid autoantibodies in HCV +ve patients. The level of such autoantibodies whether organ specific or non organ specific had no relation to the presence of diabetes or liver cirrhosis complicating or associated with HCV infection. Old age, high BMI, and family history of diabetes are risk factors for diabetes in HCV patients. Furthermore, the role of NCV in the development of diabetes was unlikely to be mediated by autoimmune mechanism. However, hyperinsulinemia and insulin resistance may play a role

Viral hepatitis in malignant lymphoma

This study included 25 newly diagnosed non-Hodgkin's lymphoma [NHL] patients who fulfilled the criteria for inclusion in the study. Hepatitis profile was done for NHL patients at the time of diagnosis and after three months of chemotherapy and for ten healthy persons who were selected as a control group. In addition to the routine lab investigations, lactate dehydrogenase [LDH], B2 microglobulin and hepatitis markers were done before each cycle of chemotherapy. The study revealed a high percentage of NCV infection in patients with NHL [36%] in comparison with the control group [10%]. Patients with positive serological markers were liable to hepatic dysfunction and hepatitis reactivation during and after the end of chemotherapy. The presence of the hepatitis infection did not affect the response to chemotherapy in this group of patients. However 3/5 of the relapsed patients were HCV +ve. The results of serum gamma transferase [GGT] before treatment with chemotherapy in patients who were positive and negative to HCV showed very highly significant difference

Soluble fas as an apoptotic marker in myocardial infarction: the outcome and its relation to high risk clinical features

In myocardial infarction [MI], activation of soluble fas which is a widely expressed cell surface receptor can induce apoptosis in cardiac myocytes. Apoptosis contributes to myocardiocyte loss in cardiac disease and may be a major determinant for the development of early symptomatic heart failure [HF] but the precise role of apoptosis in the development of cardiac dysfunction need to be established. To detect the impact of apoptosis on prognosis and clinical outcome in patients with myocardial infarction and its relation to the other risk factors for coronary artery disease. Forty patients [22males, 18 females] with mean age 53.88"1.39 years diagnosed as MI on the bases of electrocardiographic and enzymatic changes in addition to the clinical symptoms and signs.Twenty two out of them were smoker. Fifteen healthy volunteers, age and sex matched with the patients as control group has been enrolled in this study. Patient group were classified according to: A- Infarct size [extensive MI 62.5%, localized MT 37.5%]. B- Presence or absence of heart failure [Ml with HF 67.5%, MI without HF 32.5%]. C- Presence or absence of DM [Ml with DM 47.5%, MI without DM 52.5%]. D- Presence or absence of hypertension [Ml with hypertension 47.5%, Ml without hypertension 52.5%]. For every participant, history and clinical examination paying especial attention to vital signs and cardiopulmonary examination, resting electrocardiogram [ECG] looking for the changes of MI and the following laboratory investigation: blood sugar, total choleserol, triglycerides, nitric oxide [NO], Apo-l/fas, and homocysteine concentrations in serum were measured. The serum levels of fas, nitric oxide [NO] and homocysteine are significantly higher in the patients than in the controls [p<0.001]. As regard serum levels of soluble fas in patients with MI, there were significantly higher values in patients with extensive lesion and in those associated with HF when compared to patients with localized lesion and patients not associated with HF respectively [p<0.001]. Serum level of NO was significantly higher in normotensive patients with MI than in hypertensive patients with MI [p<0.001]. Also the serum level of NO was significantly higher in patients with extensive MI than in patients with localizes MI [p<0.001] and significantly higher in patients with compensated heart than in patients with symptomatic HF [p<0.001]. Serum level of homocysteine is significantly higher in normotensive patients with MI and in non diabetic patients with MI when compared to MI patients associated with hypertension or diabetes mellitus [p<0.05, <0.001 respectively]