Metabolic syndrome and its related biochemical derangements in breast cancer patients who received neoadjuvant chemotherapy: A study from a tertiary care oncology centre from Puducherry, South India.

BACKGROUND AND AIMS: Comparison of the existence of metabolic syndrome, its components and their related biochemical complications between newly diagnosed and treated breast cancer patients. METHODS: Forty newly diagnosed untreated breast cancer patients and forty breast cancer patients who had received 7 cycles of neoadjuvant chemotherapy were recruited as group 1 and group 2 respectively. Height, weight, blood pressure, hormonal status, and tumor size were noted. The fasting blood glucose and lipid profile were estimated in AU 5811 Beckman coulter Clinical chemistry analyzer. Fasting insulin was estimated using Beckman Coulter access immunoassay system (UnicelDxI600). HbA1c assay was carried out in HPLC based ion exchange chromatography (Tosoh automated glycohemoglobin analyzer G8. Homeostasis Model Assessment 2-IR (HOMA 2-IR), HOMA-% B and HOMA-% S were calculated using an online calculator HOMA CALCULATOR [Oxford University]. Serum hsCRP and MDA were estimated by ELISA. FRAP assay was carried out manually to measure antioxidant status. RESULTS: The existence of metabolic syndrome as well as type 2 diabetes was higher in the treated group when compared to the untreated patients. However, there were no significant differences in the indices of glucose homeostasis, low grade inflammation, oxidative stress and individual components of metabolic syndrome between the two groups. The triple negative patients were more prone to develop metabolic syndrome when compared to the triple positive patients. CONCLUSION: Suitable therapeutic approaches may be planned out to address the metabolic syndrome and its related complications among breast cancer patients especially during the course of treatment.

Neutralization of the pharmacological effects of Cobra and Krait venoms by chicken egg yolk antibodies.

Five-month-old white leghorn chickens were immunized with 50 microg of Common Cobra (Naja naja) and 30 microg of Krait venoms (Bungarus caeruleus) to generate antivenom antibodies against the venom antigen. Chickens received booster doses of increasing concentrations of venom at 14 days time intervals to raise the antivenom level in egg yolk. The antivenom from immunized chicken egg yolk was extracted by polyethylene glycol (PEG) and ammonium sulphate precipitation method which was further purified by DEAE cellulose ion exchange column chromatography. A high molecular weight protein of 180 kDa was detected by electrophoretic analysis which shows the purity of antivenom generated in chicken. Antibodies generated were specific and sensitive to the venom antigen. Various pharmacological activities of Cobra and Krait venoms were carried out by both in-vivo and in-vitro methods. The neutralization of lethality, hemorrhagic, edema, PLA(2) and procoagulant activity was evaluated in assays involving pre-incubation of venom and antivenom prior to testing. The antivenom was effective in neutralizing the toxic and enzymatic activities of venom. The LD(50) of venom for 18 g of mice was found to be 10 microg for Cobra and 3 microg for Krait venoms. The median effective dose (ED(50)) of anti-Cobra venom was 4.48 mg/5LD(50) and 1.0 ml neutralized 0.127 mg of Cobra venom and the median effective dose (ED(50)) of anti-Krait venom was 3.18 mg/5LD(50) and 1.0 ml neutralized 0.051 mg of Krait venom. The results indicate that antivenom generated in chicken could be used for therapeutic purposes in case of snakebite envenomation.

Studies on pharmacological effects of Russell's viper and Saw-scaled viper venom and its neutralization by chicken egg yolk antibodies.

Antivenom antibodies were raised in 24-week-old white leghorn chickens against hemotoxic venoms of Russell's viper and Saw-scaled viper snakes. Booster injections of increasing concentrations of venom were given at 14days of time interval to raise the antivenom level in egg yolk. Antibodies were extracted from immunized chicken egg yolk by Polson et al. (Polson A., Von Wechmar M.B., Van Regenmortel M.H.V. Isolation of viral IgY antibodies from yolks of immunized hens. Immunological Communications 1980; 9:475-493.) and further purified by DEAE cellulose ion exchange column chromatography, which gave pure (180-200kDa) specific antibodies against venom. High titre of more than 1:10,000 antibodies were detected by ELISA at the 135th day of observation. The lethal toxicity and various pharmacological activities like hemorrhagic activity, phospholipase activity, edema and procoagulant activities of venom were carried out by both in vivo and in vitro methods. The effectiveness of antivenom in neutralizing these effects was carried out involving pre-incubation type experiments. The median effective dose (ED50) for Russell's viper venom was 0.96mg/2LD50/18g mice and for Saw-scaled viper venom it was 1.28mg/2LD50/18g mice. One millilitre of specific antivenom was effective in neutralizing 0.110mg of Russell's viper and 0.137mg of Saw-scaled viper venoms respectively (PD50). Antivenom was effective in neutralization assays in a dose dependent manner. The results indicate that antibodies raised in chicken could effectively neutralize the pharmacological effects induced by venoms and chickens therefore present an alternative and cheaper source of specific antibody generation.