Macrophage-inhibitory cytokine-1 (mic-1) in differential diagnosis of dyspnea--a pilot study.

BACKGROUND: Macrophage inhibitory cytokine-1 (MIC-1) has recently been associated with markers of heart function. AIM: This study sought to verify the relationship between markers of heart function (New York Heart Association classification (NYHA)): left ventricle ejection fraction (LVEF), N terminal prohormone of natriuretic peptide B type (NT-proBNP) and MIC-1. Furthermore, the assessment of the usefulness of these markers for differential diagnosis of the myocardial form of dyspnea was explored. METHODS: 124 patients (65 women and 59 men) were examined for dyspnea without signs of acute coronary syndrome. All patients underwent echocardiography (calculation of left ventricle ejection fraction-LVEF), and serum NT-proBNP, proguanylin as well as MIC-1 were determined. 21 healthy individuals were defined as the control group. RESULTS AND DISCUSSION: Patients were divided into two groups: A--individuals with non-cardiogenic form of dyspnea, n=77 and B--individuals with cardiogenic ethiology of dyspnea, n=47. Significant differences between MIC-1 values in individuals with cardiogenic dyspnea (median 2189.6 ng/L) and non-cardiogenic dyspnea (median 232.1 ng/L) were shown. MIC-1 correlated with age, proguanylin, NT-proBNP and negatively with LVEF (P<0.05). The median values of MIC-1 were closely associated with the NYHA classification (P<0.05). Division of the group under study according to the cause of dyspnea revealed a significant difference in MIC-1 (P<0.01). The cut-off of MIC-1>444.5 ng/L showed 100% sensitivity and 89.3% specificity for diagnosing cardiogenic dyspnea. After adjustment for age, gender and NT-proBNP, MIC-1 levels were significantly associated with the cardiogenic type of dyspnea (P<0.05). We also tested the difference in MIC-1 level among the subgroup with the cardiac form of dyspnea (10 individuals suffered from hypertension and 37 patients had no sign of hypertension). Individuals with and without hypertension had no significant difference in MIC-1 level. CONCLUSION: MIC-1 is a new diagnostic marker in the differential diagnosis of dyspnea.

Urinary clusterin concentrations--a possible marker of nephropathy? Pilot study.

BACKGROUND: Clusterin is a glycoprotein which participates in a number of pathophysiological processes in the organism. Information about clusterin use in the diagnosis of nephropathy and the differential diagnosis of proteinuria has been published recently. AIM: Search for correlations between urinary clusterin concentration and other renal function markers. Evaluation of urinary clusterin measurement use in the differential diagnosis of nephropathy. METHODS: Urea, creatinine, IgG, transferin, Na, K in serum and 24-hour collected urine were measured in a sample of 82 individuals. Cystatin C in sera was also measured as were GMT, alpha-1 microglobulin, albumin, total protein in urine. In all probands urinary clusterin was assayed (ELISA). RESULTS: Urinary clusterin values correlated with urinary total protein concentrations (r = 0.28; p = 0.018), total protein/creatinine index (r = 0.26; p = 0.02). No correlation was found between urine clusterin concentration and glomerular filtration rate, age, urine GMT/creatinine, alpha-1-microglobulin, urine albumin and albumin/creatinine ratio or Na, K fractional excretions. We found no urinary clusterin differences by sex of probands. No evidence of any relationship between urine clusterin and presence of defect of renal function, number of risk factors (chi(2) = 16.0; DF = 15; p = 0.38), albumin/creatinine index (chi(2) = 0.76; DF = 3; p = 0,86), total protein/creatinine (chi(2) = 6.5; DF = 3; p = 0.09), GMT/creatinine (chi(2) = 2.3; DF = 3; p = 0.51), high urinary alpha-1-microglobulin (chi(2) = 4.1; DF = 3; p = 0.25) or decreased of GFR (chi(2) = 1.3; DF = 3; p = 0.74). CONCLUSIONS: A positive correlation exists between urinary clusterin and urinary total protein and total protein/ creatinine index. Urinary clusterin measurement with ELISA test does not offer any advantage over routinely used parameters for nephropathy diagnosis and the differential diagnosis of proteinuria type.

Evaluation of urine N1,N12-Diacetylspermine as potential tumor marker for urinary bladder cancer.

BACKGROUND: N1,N12-diacetylspermine, a diacetylpolyamine which was recently identified in urine, appeared to be a useful tumor marker for a number of cancers. No valid data on urine diacetylspermine concentration in patients with urinary bladder cancer exist. AIM: Evaluation of urine N1,N12-diacetylspermine concentrations in individuals with urinary bladder cancer. METHODS: Urine samples were used from 36 patients with urothelial tumors of the urinary bladder and from 30 patients with benign urological diseases. Urine was collected before cystoscopy. Enzyme-linked immunoabsorbent assays (ELISA) were performed for diacetylspermine from urine. RESULTS: Urine diacetylspermine did not differentiate in individuals with urinary bladder cancer from controls (medians 171.5 vs 143.8, p = 0.64). Its efficacy for urinary bladder cancer detection was not shown. CONCLUSIONS: Urine N1,N12-diacetylspermine is probably not a useful marker for urinary bladder cancer.