Association between Urinary Levels of Interleukin-6, Interleukin-10 and Tumor Necrosis Factor-Alpha with Glomerular and Tubular Damage Indicators in Patients with Type 2 Diabetes.

BACKGROUND: This study investigated the association between urinary levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α) with estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio (uACR), and urinary neutrophil gelatinase-associated lipocalin (uNGAL) in patients with type 2 diabetes (T2D). METHODS: Urinary concentrations of IL-6, IL-10, TNF-α, ACR, and NGAL were measured in 121 patients with T2D. RESULTS: Urinary IL-6 and TNF-α increased 45.5% and 49.4% in the highest uACR quartile compared to lowest quartile. Urinary IL-10 levels decreased 40.9% in the highest uACR quartile compared to the lowest quartile. Urinary IL-6 and TNF-α were 75.3% and 81.6%, higher in the highest uNGAL quartile compared to the lowest quartile. Urinary IL-10 concentration was 69.8% lower in patients from the highest uNGAL quartile compared to lowest quartile. CONCLUSIONS: Urinary IL-6, IL-10, and TNF-α were associated with indicators of glomerular and tubular injuries in patients with T2D.

Evaluation of the In Vitro Interference of Hemoglobin, Lipids, and Bilirubin on the Measurement of Plasma Advanced Oxidation Protein Products.

BACKGROUND: The pre-analytical phase is the most vulnerable and contributes to the majority of errors in laboratory assays. Therefore, the aim of this study was to evaluate in vitro interference of hemoglobin, lipids, and bilirubin on measurement of plasma advanced oxidation protein products (AOPPs). METHODS: AOPPs were measured in a sample spiked with increasing concentrations of hemoglobin, Intralipid® 20% or bilirubin. Then, the relative deviation of the result from the nonspiked baseline value was calculated. RESULTS: We found that all interferents analyzed influenced AOPPs baseline value significantly. Hemoglobin produced a non-linear negative bias, with a maximum decrease of 21.1%. Otherwise, lipids and bilirubin produced a positive bias, ranging from 20.0 to 90.9%, and 12.1 to 33.2%, respectively. CONCLUSIONS: The addition of interferents produced a significant bias in the measurement of AOPPs and in different degrees at the majority of concentrations added.

Cholinesterase of rats experimentally infected by Cryptococcus neoformans: Relationship between inflammatory response and pathological findings.

The aim of this study was to assess the role of the acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) as biomarkers of inflammation and tissue injury on rats experimentally infected by Cryptococcus neoformans. For this purpose, 20 male rats were divided into two groups: 10 animals representing the uninfected control group (Group A) and 10 C. neoformans var. grubii infected animals (Group B). Blood and brain samples were collected on days 10 (A10 and B10), and 30 (A30 and B30) post-infection (PI) for hematological analyses; AChE (in lymphocytes and brain) and seric BChE activity; interleukins (IL-1, IL-6, and IL-10); nitrite/nitrate (NOx) levels; and markers of protein oxidation (AOPP) and lipid peroxidation (TBARS). As a result, when animals of Group A were compared to animals of Group B, it was observed leukocytosis (P<0.05) on day 10 PI; AChE activity increase (P<0.05) in lymphocytes (day 30 PI) and in brain (days 10 and 30 PI); BChE activity decrease (P<0.05) on day 10 PI; IL-1 and IL-6 increase (P<0.01) in both periods, while IL-10 had reduced levels (P<0.01) in the same periods; NOx levels increased (P<0.05) significantly on days 10 and 30 PI, while AOPP and TBARS levels increased significantly on day 30 PI; as well as pneumonia on infected rats. Therefore, based on the results obtained, it was possible to conclude that AChE and BChE behavior lead to a proinflammatory reaction evidenced by the enhancement of IL-1, IL-6, and NOx throughout the experiment associated with reduction on IL-10 levels, and cellular damage.

Iron metabolism in hamsters experimentally infected with Leptospira interrogans serovar Pomona: influence on disease pathogenesis.

The aim of this study was to analyze the classic iron markers associated to the storage process in hamsters experimentally infected by Leptospira interrogans serovar Pomona. Four groups with six hamsters each were used; two were negative controls (C7 and C14) and two were composed by infected animals (T7 and T14). Blood samples were collected on the seventh (C7 and T7) and fourteenth days (C14 and T14) post-inoculation. Iron availability was determined in sera samples through the assessment of iron, ferritin, transferrin, and iron binding capacity, whereas the bone marrow was also evaluated for the presence of iron by Pearl's reaction. Additionally, the total antioxidant capacity (TAC) and total oxidant status (TOS) were assessed, along with hepcidin and IL-6 levels. Based on the results, it was possible to observe the onset of an anemic profile, predominantly hemolytic and regenerative. Also, The other parameters showed an increase in seric iron (P<0.01) and ferritin (P<0.01), and a positive Pearl's reaction in T7 and T14, when compared with the control groups. Transferrin levels decreased (P<0.05) in animals of T14 with saturation index. TAC was increased in both periods (P<0.01), while TOS was increased only on T14 (P<0.05). Hepcidin and IL-6 were increased on T7 and T14 (P<0.01). Therefore, it was observed that the serum profile from infected animals showed a strong hemolytic pattern, with some demonstration of ferric tissue sequestration when the infection tended to become chronic. The results show that iron metabolism is activated in hamsters infected by L. interrogans serovar Pomona.

Prognostic value of red blood cell distribution width in prediction of in-hospital mortality in patients with acute myocardial infarction.

BACKGROUND: Red blood cell indices may add important prognostic information to risk stratification scores, such as Global Registry of Acute Coronary Events (GRACE) risk score. However, the incremental predictive value of red blood cell distribution width (RDW) on this score has not been assessed. Therefore, the aim of this study was to assess whether the RDW has additional prognostic value on the GRACE risk score in prediction of in-hospital mortality in patients with acute myocardial infarction (AMI). METHODS: A historic cohort was investigated at the University Hospital in Santa Maria city, Brazil. The laboratory database and medical registry were used to identify patients with AMI. A total of 109 patients were eligible for the present study. Cox regression models were calculated including GRACE risk score variables plus RDW. Moreover, measures of discrimination and calibration were also calculated. The primary outcome evaluated was all-cause in-hospital mortality. RESULTS: When included in a predictive model based on the GRACE risk score, RDW became an independent predictor of in-hospital mortality (HR 1.358, 95% CI 1.04 - 1.77; p = 0.023). The addition of RDW to the original model showed adequate calibration (Hosmer-Lemeshow p-value 0.174) and produced a slight improvement in its discriminatory power (AUC 0.769, 95% CI 0.677 - 0.847; p = < 0.0001). CONCLUSIONS: We suggest that RDW might provide additional information over the GRACE risk score in patients with AMI.

Relationship between testicular lesion and hormone levels in male rats infected with Trypanosoma evansi.

The aim of this study was to evaluate the relationship between testicular lesions and hormone levels in rats experimentally infected with Trypanosoma evansi. For that, the measurement of reproductive hormones, histopathology and biomarkers of cellular injury were carried out in twenty-four animals, which were divided into two groups with 12 animals each. Group A was the negative control, or uninfected, while group B was composed by animals infected with T. evansi. Both groups were divided again into two other subgroups (n=6), from which serum and testicular fragments were collected on days 5 (A1 and B1) and 15 (A2 and B2) post-infection (PI). The morphological analysis showed increased alterations of head and tail of sperm in infected rats when compared with those of the control group. A significant reduction (P<0.01) in the levels of LH, FSH, testosterone and estradiol, associated with an increase in cortisol, was observed in serum of group B when compared with negative control. Additionally, NOx, lipid peroxidation and protein oxidation were enhanced in testicles, indicating the occurrence of cellular lesion. On histopathology, it was possible to observe testicular degeneration, among other disorders in infected animals. Therefore, based on these results, it is possible to conclude that the experimental infection with T. evansi caused changes in the levels of the main hormones of male rats associated with cellular injury.

Influence of toxoplasmosis on acetylcholinesterase activity, nitric oxide levels and cellular lesion on the brain of mice.

The objective of this study was to investigate the activity of acetylcholinesterase (AChE), nitrite/nitrate (NOx) levels, as well as the biomarkers of cellular damage in the brain of mice experimentally infected with Toxoplasma gondii. Sixty mice were divided into two experiments: in experiment I the mice were infected with T. gondii/RH strain, while in experiment II they were infected with T. gondii, strains VEG and ME-49. Our evaluations were carried out on brain homogenized samples, assessing the AChE and glutathione reductase (GR) activities, and NOx, TBARS and AOPP levels in all the infected animals, compared with the control group. In both experiments, I and II, it was observed an increase in the activity of AChE and GR, as well as in the levels of NOx in the brain of infected mice with T. gondii. TBARS levels were increased in mice infected with the three different strains, RH, ME-49, and VEG. AOPP concentration was increased only in mice infected with the RH strain. Animals infected with the strains VEG and ME-49 showed histological lesions, associated with the presence of the parasite in the brain. Therefore, the infection by T. gondii is able to interfere in cholinesterase activity and NO levels, in association with oxidative stress and histological lesion.

Neospora caninum and Toxoplasma gondii: relationship between hepatic lesions, cytological and biochemical analysis of the cavitary liquid during the acute phase of the diseases in experimental models.

The objective of this study was to evaluate the pathogenesis of ascites in mice infected with Toxoplasma gondii and gerbils infected with Neospora caninum during the acute phase disease. For that, 12 gerbils [Experiment I: not infected/control (n=6) and infected (n=6)] and 12 mice [Experiment II: control (n=6) and infected (n=6)] were used. Infected gerbils and mice showed marked ascites on days 5-7 post-infection (PI), while the not-infected animals had not ascites. Peritoneal liquid was collected from the all mice with uninfected animals receiving 1.5mL of saline solution into their abdominal cavity, allowing the recovery of cavity liquid. As a result, it was possible to observe differences in physics, chemistry and cytological analysis of the fluid cavity of animals infected with N. caninum and T. gondii, when they were compared with uninfected animals, as well as between animals experimentally infected. Additionally both, N. caninum and T gondii, caused an increase in the levels of nitric oxide (NOx-nitrate/nitrite), protein oxidation (AOPP) and lipid peroxidation (TBARS), while serum total protein and albumin were reduced in infected gerbils and mice. Gerbils infected with N. caninum showed multiple large cells with multilobulated nucleus, lytic necrosis and abundant amount of eosinophilic cytoplasm into the hepatic parenchyma. By the other hand, mice infected with T. gondii developed myriad foci of lytic necrosis combined with tachyzoites and cysts containing bradyzoites in liver. Both experimental models for N. caninum and T. gondii showed inflammatory foci and tachyzoites the peritoneum, which could be a major cause of ascites. Toxoplasmosis and neosporosis were able to cause clinical signs in experimental models with similar alterations in peritoneal fluid; however the toxoplasmosis histological changes were much more evident. Therefore, the pathogenesis of ascites appears to be directly related to liver damage, which strongly suggests alteration in the normal production of proteins as observed in this study, along with peritonitis.

Serum levels of LH, FSH, estradiol and progesterone in female rats experimentally infected by Trypanosoma evansi.

The goal of this study was to evaluate reproductive hormones in sera samples of female rats experimentally infected by Trypanosoma evansi during different phases of the estrous cycle. For that, 64 animals were divided into two groups: 24 rats for the control group (uninfected), and 40 animals were infected by T. evansi. These groups were divided into subgroups according to the time of infection (days 5 and 15 post-infection; PI) and the phase of the estrous cycle (proestrus, estrus, metestrus and diestrus). Serum was collected at days 5 and 15 PI and the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone and estradiol were assessed by enzyme immunoassay technique. The concentration of nitrite/nitrate (NOx), advanced oxidation protein products (AOPP), and thiobarbituric acid reactive substances (TBARS) were measured in ovaries and uteruses in these same periods. Infected females showed significant decrease (P<0.05) of LH, FSH, estradiol and progesterone in different periods and phases of the estrous cycle when compared to uninfected rats. In addition, it was observed an increase in the concentration of NOx, AOPP, and TBARS in the ovaries, which is indicative of cell damage. Therefore, our experimental study showed that T. evansi infection in female rats may cause changes in LH, FSH, estradiol, and progesterone levels regardless of the time of infection or phase of the estrous cycle.

Increased cytokine and nitric oxide levels in serum of dogs experimentally infected with Rangelia vitalii.

This study aimed to measure the levels of interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), and nitrite/nitrate (NO x ) in serum of dogs experimentally infected with Rangelia vitalii. Twelve female mongrel dogs were divided into 2 groups; group A (uninfected controls) composed by healthy dogs (n=5) and group B consisting of dogs inoculated with R. vitalii (n=7). Animals were monitored by blood smear examinations, which showed intraerythrocytic forms of the parasite on day 5 post-infection (PI). Blood samples were collected through the jugular vein on days 0, 10, and 20 PI to determine the serum levels of IFN-γ, TNF-α, IL-1, IL-6, and NO x . Cytokines were assessed by ELISA quantitative sandwich technique, and NO x was measured by the modified Griess method. Cytokine levels (IFN-γ, TNF-α, IL-1, and IL-6) were increased (P<0.01) in serum of infected animals. Serum levels of NO x were also increased on days 10 PI (P<0.01) and 20 PI (P<0.05) in infected animals. Therefore, the infection with R. vitalii causes an increase in proinflammatory cytokines and nitric oxide content. These alterations may be associated with host immune protection against the parasite.

Diabetic nephropathy: traditional to proteomic markers.

Diabetic nephropathy (DN) is one of the major microvascular complications of diabetes and it is defined as a rise in the urinary albumin excretion (UAE) rate and abnormal renal function. Currently, changes in albuminuria are considered a hallmark of onset or progression of DN. However, some patients with diabetes have advanced renal pathological changes and progressive kidney function decline even if urinary albumin levels are in the normal range, indicating that albuminuria is not the perfect marker for the early detection of DN. The present article provides an overview of the literature reporting some relevant biomarkers that have been found to be associated with DN and that potentially may be used to predict the onset and/or monitor the progression of nephropathy. In particular, biomarkers of renal damage, inflammation, and oxidative stress may be useful tools for detection at an early stage or prediction of DN. Proteomic-based biomarker discovery represents a novel strategy to improve diagnosis, prognosis and treatment of DN; however, proteomics-based approaches are not yet available in most of the clinical chemistry laboratories. The use of a panel with a combination of biomarkers instead of urinary albumin alone seems to be an interesting approach for early detection of DN, including markers of glomerular damage (e.g., albumin), tubular damage (e.g., NAG and KIM-1), inflammation (e.g., TNF-α) and oxidative stress (e.g., 8-OHdG) because these mechanisms contribute to the development and outcomes of this disease.

Plasma malondialdehyde levels and risk factors for the development of chronic complications in type 2 diabetic patients on insulin therapy.

BACKGROUND: We assessed plasma malondialdehyde (MDA) levels as a biomarker of lipid peroxidation in type 2 diabetic patients on insulin therapy. Associations among MDA levels and some risk factors for the development of chronic complications of diabetes were also evaluated. METHODS: MDA, fasting glucose, fructosamine, urinary albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, creatinine, uric acid, serum albumin, lactate, high sensitive C reactive protein (hsCRP), and vitamin E were measured in 53 type 2 diabetic patients and 26 healthy subjects. RESULTS: MDA levels were higher in type 2 diabetes insulin users (12.8 +/- 3.0 micromol/L) and type 2 diabetes no insulin users (10.3 +/- 2.1 micromol/L) compared to control subjects (8.2 +/- 2.1 micromol/L). Fasting glucose, fructosamine, urinary albumin, and hsCRP were higher in all type 2 diabetic patients compared to controls. Significant correlations were observed between MDA and fasting glucose (r = 0.685, p < 0.001), fructosamine (r = 0.526, p < 0.001), urinary albumin (r = 0.516, p < 0.001), and the duration of type 2 diabetes (r = 0.401, p = 0.005). CONCLUSIONS: MDA levels increased in type 2 diabetes, especially in patients on insulin therapy. Chronic hyperglycemia and other biomarkers, such as urinary albumin, were correlated with MDA levels, suggesting the involvement of lipid peroxidation in the pathogenesis of diabetes complications.

Nitric oxide level, protein oxidation and antioxidant enzymes in rats infected by Trypanosoma evansi.

The aim of this study was to evaluate the nitric oxide (NO()) level, protein oxidation and antioxidant enzymes in rats infected with Trypanosoma evansi and establish the association of NO() levels with the degree of parasitemia. Thirty-six male rats (Wistar) were divided into two groups with 18 animals each. Group A was not infected while Group B was intraperitoneally infected, receiving 7.5×10(6) trypomastigotes per animal. Each group was divided into three subgroups with 6 rats each and blood was collected during different periods post-infection (PI), as follows: day 5 (A(5) and B(5)), day 15 (A(15) and B(15)) and day 30 PI (A(30) and B(30)). Blood samples were collected by cardiac puncture to estimate the levels of nitrites/nitrates (NO(x)) and advanced oxidation protein products (AOPP) in serum, and superoxide dismutase (SOD) and catalase (CAT) activities in blood. On days 15 and 30 PI NO(x) and AOPP levels were increased in serum of rats infected. Rodents infected with T. evansi showed a significant increase in SOD (days 5 and 15 PI) and CAT (day 30 PI) activities. Based on the physiological role of NO(), we can conclude that its increased concentration is related to an inflammatory response against the parasite, once a redox imbalance was observed during infection.

Hba(1c) as a tool for the diagnosis of type 2 diabetes: comparison with fasting glucose.

BACKGROUND: Glycated hemoglobin (HbA(1c)) has been proposed for the diagnosis of diabetes. However, several countries have not incorporated its use for this purpose yet and there is no consensus on a suitable cut-off point of HbA(1c) for the diagnosis of diabetes. Thus, the aim of this study was to evaluate the diagnostic characteristics of HbA(1c) and fasting plasma glucose (FPG) for the assessment of type 2 diabetes. METHODS: FPG, HbA(1c), and creatinine levels were assessed in 47 patients with type 2 diabetes and 46 healthy controls. RESULTS: The areas under the curve for HbA(1c) > or = 6.5% and FPG > or = 7.0 mmol/L were 0.97 and 0.92, respectively. HbA(1c). has a slightly higher ability to discriminate type 2 diabetes compared with FPG. The association between HbA(1c) and type 2 diabetes was independent of gender, age, hypertension, smoking, and body mass index. CONCLUSIONS: HbA(1c) was able to be used for the diagnosis of type 2 diabetes.