Selected angiogenic factors in plasma of patients with lower limb symptomatic peripheral arterial disease: preliminary report.

AIM: The number of people suffering from atherosclerosis-related complications such as peripheral arterial disease (PAD) ­ including lower limbs PAD increases. Hypoxia and ischemia stimulate angiogenesis ­ a postnatal multistage process in which new blood vessels form and the Vascular Endothelial Growth Factor (VEGF-A) is the key proangiogenic factor whereas its soluble receptors type 1 and type 2 (sVEGFR-1, sVEGFR-2) are regarded as inhibitory factors. The aim of this study was to assess the concentrations of VEGF-A, sVEGFR-1 and sVEGFR-2 in plasma of patients with symptomatic lower extremity PAD compared with selected clinical parameters (Ankle-Brachial Index, distance in walking test) and severity of PAD (according to the Fontaine classification). METHODS: The study group included 46 patients suffering from symptomatic PAD with Fontaine class IIa-IV without any history of neoplastic disease. The control group consisted of 30 healthy non-smoking volunteers. The following parameters were determined: plasma concentrations of VEGF-A, its soluble receptors (sVEGFR-1, sVEGFR-2) using the ELISA method also VEGF-A and sVEGFR-1 quotient was calculated on the basis of mean concentrations in homogenous units (pg/mL). RESULTS: The study group revealed a statistically significant higher level of VEGF-A concentration when compared with the control group and statistically significant lower concentration of sVEGFR-2 in the study group. In the study group a statistically significant negative correlation between VEGF-A concentrations and the length of irrelative distance in walking test was observed. In the group of PAD a significantly higher VEGF-A/sVEGFR-1 ratio in comparison with the control group was obtained. Within the group of patient suffering from PAD there was noticed an increasing VEGF-A/sVEGFR-1 ratio in subsequent subgroups according to the Fontaine classification. CONCLUSION: The plasma concentrations of VEGF-A correlated with increased clinical symptoms of PAD in the walking test. The plasma VEGF-A/sVEGFR-1 ratio may be used as a useful ischemic marker in patients with PAD which should be tested and finally verified in large group of patients.

[Serine protease inhibitors in plasma of patients with ulcerative colitis]. / Inhibitory proteaz serynowych w osoczu chorych na wrzodziejace zapalenie jelita grubego (WZJG).

UNLABELLED: Serine protease inhibitors (serpins) are the important factors regulating hemostasis and inflammatory mediators activity. The aim of this study was to determine relationships between plasma serine protease inhibitors activities and the course of ulcerative colitis (uc). PATIENTS AND METHODS: 42 patients with uc, 21 in active and 21 in inactive disease phase, and 26 healthy persons (control group) were studied. In all investigated persons activities of alpha 1-proteinase inhibitor (alpha 1-PI), alpha 2-macroglobulin (alpha 2-M), alpha 2-antiplasmin (alpha 2-AP), antithrombin III (ATIII) and plasminogen activator inhibitor type 1 (PAI-1) were determined. RESULTS: Patients with uc had higher level of alpha 1-PI than control group. In patients with active uc lower alpha 2-M activity was found than in patients with us remission. Alpha 2-M activity below 100% had 58% sensitivity and 71% specificity, and predictive value (odds ratio = 6.25) for histologic appearance of active uc. The correlation between alpha 2-M value and uc activity and time of symptoms duration before the study start was found. Patients with inflammatory process beyond sigmoid had lower alpha 2-AP activity than patients with less extended inflammatory process. CONCLUSIONS: Inflammatory process in large bowel changed the level of plasma serine protease inhibitors activities, what was a result of acute phase reaction (alpha 1-PI) and inhibitors consumption in inflammatory processes (alpha 2-M, alpha 2-AP).

[Pulmonary hypertension during the course of liver cirrhosis--presentation of two cases]. / Nadcisnienie plucne w przebiegu marskosci watroby--prezentacja dwóch przypadków.

Two patients with liver cirrhosis and clinical and autopsy features of pulmonary hypertension are presented. Others than liver's pathology secondary causes of hypertension in pulmonary circulation were not found. In both patients pulmonary hypertension had an influence on clinical course of basic disease. Taking this complication into consideration in the explanation of pathomechanisms of symptoms allowed us better to understand the clinical manifestation of liver disease in observed in our clinic cirrhotic patients.