The impact of anti-endothelial cell antibodies (AECAs) on the development of blood vessel damage in patients with systemic lupus erythematosus: the preliminary study.

Vascular injury represents one of the most frequent lesions in systemic lupus erythematosus (SLE). The aim of the study was to assess the influence of anti-endothelial cell antibodies (AECAs) on the development of endothelial cell (EC) activation, dysfunction and subsequent vasculitis in women with SLE. Fifty six women with SLE were divided into 2 subgroups, i.e. subjects with positive AECAs (+) and those with negative AECAs (-). The control group consisted of 25 healthy women. Clinical characteristics, routine laboratory tests and circulating markers of EC activation/dysfunction, i.e. monocyte-chemotactic protein-1 (MCP-1), soluble E- and P-selectin, vascular and intercellular adhesion molecule-1 (sVCAM-1, sICAM-1), von Willebrand factor (vWF), pentraxin 3 (the marker of vasculitis) the indicator of procoagulant activity i.e. prothrombin fragment 1 + 2 (F1 + 2) were detected using ELISA and compared between patients with AECA (+), AECA (-) and control subgroups. Serum concentrations of AECAs in AECA(+), AECA(-) and control groups were 4.58 ± 2.97, 0.92 ± 0.50 and 0.72 ± 0.28 AU/ml, respectively (p < 0.001). The study showed significant increases in EC activation markers, i.e. MCP-1, sE-selectin, sVCAM-1 and F1 + 2 in SLE AECA(+) compared to SLE AECA(-) and control groups. However, the indicator of vasculitis (PTX3) was significantly lower in SLE AECA(+). Moreover, multivariate analysis of variance showed a positive correlation between AECAs and sE-selectin and sVCAM-1 levels, but not with PTX3. AECAs were involved in the initial stages of vascular damage in SLE, i.e. in EC activation and dysfunction. However, they did not play a role in the development of vasculitis.

Demyelinating polyneuropathy and lymphoplasmacytic lymphoma coexisting in 36-year-old man: A case report.

BACKGROUND: Lymphoplasmacytic lymphoma is a rare non-Hodgkin's lymphoma, occurring mostly in the elderly. It develops slowly and leads to malignant proliferation of lymphoid line cells in the bone marrow, lymph nodes and spleen. It may also affect nerve roots and meninges; some patients develop sensorimotor polyneuropathy which may precede general symptoms of lymphoma. CASE SUMMARY: We present a case of a 36-year-old man diagnosed in 2012 with chronic inflammatory demyelinating polyneuropathy (CIDP), then he was hospitalized in 2019 due to progressive symptoms of heart failure and significant weight loss over the previous four months. Based on clinical and laboratory findings a diagnosis of lymphoplasmacytic lymphoma was suspected and confirmed by bone marrow flow cytometry. There was no improvement in the results of laboratory tests and the patient's condition after immediate implementation of chemotherapy. Patient died on the fifth day of treatment. CONCLUSION: While CIDP and malignant disease co-occurrence is rare, it should be suspected and investigated in patients with atypical neuropathy symptoms.

Interdependencies among Selected Pro-Inflammatory Markers of Endothelial Dysfunction, C-Peptide, Anti-Inflammatory Interleukin-10 and Glucose Metabolism Disturbance in Obese Women.

BACKGROUND: Currently increasing importance is attributed to the inflammatory process as a crucial factor responsible for the progressive damage to vascular walls and progression of atherosclerosis in obese people. We have studied the relationship between clinical and biochemical parameters and C-peptide and anti-inflammatory IL-10, as well as selected markers of inflammation and endothelial dysfunction such as: CCL2, CRP, sICAM-1, sVCAM-1 and E-selectin in obese women with various degree of glucose metabolism disturbance. MATERIAL AND METHODS: The studied group consisted of 61 obese women, and 20 normal weight, healthy volunteers. Obese patients were spited in subgroups based on the degree of glucose metabolism disorder. Serum samples were analyzed using ELISA kits. RESULTS: Increased concentrations of sICAM-1, sVCAM-1, E-selectin, CCL2 and CRP were found in all obese groups compared to the normal weight subjects. In patients with Type 2 diabetes mellitus (T2DM) parameters characterizing the degree of obesity significantly positively correlated with levels of CRP and CCL2. Significant relationships were found between levels of glucose and sICAM-1and also E-selectin and HOMA-IR. C-peptide levels are positively associated with CCL2, E-selectin, triglycerides levels, and inversely with IL-10 levels in newly diagnosed T2DM group (p<0.05). Concentrations of IL-10 correlated negatively with E-selectin, CCL2, C-peptide levels, and HOMA-IR in T2DM group (p<0.05). CONCLUSION: Disturbed lipid and carbohydrate metabolism are manifested by enhanced inflammation and endothelial dysfunction in patients with simply obesity. These disturbances are associates with an increase of adhesion molecules. The results suggest the probable active participation of higher concentrations of C-peptide in the intensification of inflammatory and atherogenic processes in obese patients with type 2 diabetes. In patients with obesity and type 2 diabetes, altered serum concentrations of Il-10 seems to be dependent on the degree of insulin resistance and proinflammatory status.

[Description of the case of Cogan syndrome]. / Opis przypadku zespolu Cogana.

Cogan syndrome is a persistent disease with the autoimmunologic background connected with vasculitis. It can be diagnosed by symptoms such as interstitial keratitis, optic nerve dysfunction and nervus acusticus dysfunction with subsequent hearing impairment or deafness. In its course, such systemic symptoms frequently occur: exhaustion, weight loss and joint pain. Due to the rare occurrence of Cogan syndrome and vast obstacles in diagnosing it, the case of34 years old patient with Cogan syndrome is discussed.

[Development of systemic lupus erythematosus after thymectomy performed in a patient with myasthenia gravis]. / Rozwój tocznia rumieniowatego ukladowego po wykonanej tymektomii u chorej z nuzliwoscia miesni prazkowanych.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, with not fully understood, complex origin. Several factors are suspected of involvement in the development of the disease. Genetic predisposition, environmental factors, some drugs, estrogens, cigarette smoking and ultra violet radiation seems to be the most important among them. The case of a patient with myasthenia gravis (MG) followed by thymectomy and lupus erythematosus (SLE) diagnosed one year later presented in this study.

Is chronic inflammation a possible cause of obesity-related depression?

Adult obesity has been associated with depression, especially in women. Whether depression leads to obesity or obesity causes depression is unclear. Chronic inflammation is observed in obesity and depression. In 63 obese women without additional diseases depression level was assessed with the Beck's questionnaire. After evaluation of depression level study group was divided into groups according to the mood status (A--without depression, B-mild depression, and C--severe depression), and serum concentration of TNF-alpha, sTNFs, leptin, and IL-6 were measured by ELISA. No differences in age, body mass, BMI, and body composition were observed in study groups. We did not observe differences of serum concentrations of TNF-alpha, sTNFRs, leptin, and IL-6 between subgroup A and subgroups B and C. It seems that circulating adipokines did not exert influence on depression levels in obese women.

Depression in obese persons before starting complex group weight-reduction programme.

BACKGROUND: The aim of the present study was to assess the prevalence of depression in subjects before starting a weight-reduction programme. METHODS: The study group involved 173 obese subjects aged 47.0 +/- 16.5 years, body mass index (BMI) 36.1 +/- 6.3, weight 96.2 +/- 18.3 kg. The body weight and height were measured and BMI was calculated. Beck's Depression Inventory (BDI) was used for the evaluation of depressive symptoms. RESULTS: Severe depression was diagnosed in 84 subjects (mean BMI 37.5 +/- 6.3, mean weight 98.1 +/- 17.6 kg, age 48.7 +/- 16.0, 22.2 +/- 1.6 points), mild depression was diagnosed in 65 subjects (mean BMI 34.7 +/- 4.8, mean weight 95.3 +/- 18.1 kg, age 45.9 +/- 16.6; 10.8 +/- 2.0 points), and 24 subjects (mean BMI 35.0 +/- 8.7, mean weight 92.2 +/- 21.1 kg, age 44.0 +/- 17.5, 6.5 +/- 0.5 points) did not have depression. We observed differences in BMI between subjects without depression and severe depression (p < 0.05) and between mild and severe depression. We did not observe differences of age and body mass between these subgroups. Correlations between weight, BMI and BDI score were found in all subjects. CONCLUSION: Depression often accompanies obesity. The depression levels increased in morbidly obese persons in comparison to moderately obese patients.

The effect of weight reduction on plasma concentrations of ghrelin and insulin-like growth factor 1 in obese women.

INTRODUCTION: The aim of the present study was to examine how weight loss treatment modulates plasma concentrations of ghrelin and insulin-like growth factor 1 (IGF-1) in obese women and to determine whether there is any association with possible changes in plasma concentrations of these hormones after weight loss. MATERIAL AND METHODS: The study group consisted of 22 obese women without additional disease (age 40.6 +/- 12.9 years; BMI 37.2 +/- 4.6 kg/m(2)). All subjects participated in a 3-month weight reduction program. The measurements were performed at baseline and after weight loss. Plasma concentration of ghrelin and IGF-1 were measured by enzyme - linked immunosorbent assay (ELISA) kit. Serum concentrations of insulin were measured by radioimmunoassay (RIA). Body composition was determined by bioelectrical impedance analysis using a Bodystat analyser. RESULTS: The mean weight loss was 9.3 +/- 4.1 kg (9.7 +/- 4.3%). Following weight loss, plasma ghrelin and IGF-1 concentrations increased significantly (63.5 +/- 13.0 vs. 72.8 +/- 15.1 pg/ml; p < 0.01; 126.9 +/- 67.0 vs. 170.5 +/- 83.3 ng/ml p < 0.01, respectively) and serum insulin concentrations decreased significantly (17.5 +/- 8.5 vs. 14.8 +/- 10.4 mIU/ml p< 0.05). We observed a significant positive correlation between the increase of ghrelin and decrease of body fat percentage after weight loss (r = 0.44, p = 0.03). There are no correlations between change of ghrelin and IGF-1concentrations and between changes of insulin and IGF 1 concentrations. CONCLUSION: Plasma concentrations of ghrelin and IGF-1 increased after weight loss. However, it seems there is no association between serum concentrations of ghrelin and IGF-1 in obese women.

The effect of weight loss on inflammation in obese women with polycystic ovary syndrome.

INTRODUCTION: The aim of the present study was to evaluate the effect of modest weight reduction on serum concentrations of tumour necrosis factor alpha (TNF-alpha), TNF soluble receptors (sTNFRs) and interleukin-6 (IL-6) in obese women with polycystic ovary syndrome (PCOS). MATERIAL AND METHODS: The study group consisted of 15 obese women with PCOS (mean age 28.5 +/- 7.7 years). Serum concentrations of TNF-alpha, sTNFRs and IL-6, insulin, FSH, LH, DHEAS, androstendione, total and free testosterone, cortisol, 17OH-progesterone, oestradiol and sex hormone binding globulin (SHBG), glucose, total cholesterol, HDL cholesterol and triglycerides were measured before treatment and after 10% weight loss. All patients were advised to follow a 1000-1200 kcal diet with a limited intake of simple carbohydrate and animal fats and to exercise regularly (30 min, 3 times a week). Body composition was measured by bioimpedance. Serum concentrations of TNF-alpha, sTNFRs and IL-6 were determined by enzyme linked immunosorbent assay (ELISA). Plasma insulin, FSH, LH, DHEAS, androstendione, total and free testosterone, cortisol, 17OH-progesterone, oestradiol and SHBG were measured by a commercial RIA. Blood glucose, total cholesterol, HDL cholesterol and triglycerides were measured by an enzymatic procedure. RESULTS: We observed no differences in serum concentrations of TNF-alpha, sTNFRs or IL-6 after treatment. CONCLUSIONS: It seems that more than a modest weight reduction is necessary to obtain a decrease in serum concentrations of proinflammatory cytokines and an improvement in ovarian function in obese women with polycystic ovary syndrome.

Plasma orexin and ghrelin response to the oral glucose tolerance test in obese women.

INTRODUCTION: The aim of the present study was to examine the response of plasma orexin and ghrelin to the oral glucose tolerance test (OGTT) in obese women without additional disease. MATERIAL AND METHODS: The study group comprised 15 obese women aged 30.4+/-9.7 years of mean BMI 34.7+/-3.8 kg/m(2). The measurements were performed after an overnight fast and 30, 60 and 120 minutes after the oral administration of 75 grams of glucose. Serum concentrations of ghrelin and orexin A were measured by an enzyme-linked immunosorbent assay (ELISA) kit. Serum concentrations of insulin were measured by radioimmunoassay (RIA). Plasma glucose was determined by an enzymatic procedure. Body composition was determined by impedance analysis using Bodystat. RESULTS: We observed no significant differences between serum concentrations of ghrelin and orexin during OGTT. No correlations were found between serum ghrelin and orexin concentrations and serum insulin and glucose concentrations in any of the measurements. CONCLUSION: Oral glucose administration did not change serum concentrations of ghrelin and orexin A in obese women without additional disease.

Serum concentration of visfatin in obese women.

The aim of the present study was to determine serum concentrations of visfatin in obese women in comparison to normal-weight controls. Study subjects were 21 obese women without additional disease (age, 29.0+/-4.9 years; body mass index, 37.1+/-6.1 kg/m2) and 16 healthy, normal-weight women (age, 29.9+/-5.4 years; body mass index, 22.5+/-1.7 kg/m2). Body composition was measured by bioimpedance. Serum concentrations of visfatin were assayed with an enzyme-linked immunosorbent assay kit (Phoenix Pharmaceuticals, Burlingame, CA). Insulin was determined by radioimmunoassay and glucose by colorimetric method. Serum concentration of visfatin was significantly higher in obese women when compared to controls. Positive correlations between serum concentrations of visfatin and insulin in the obese group were found. In the control group, we observed positive correlations between serum concentrations of visfatin and glucose. In conclusion, the observed increase of visfatin in obesity may be a counterregulation preventing further glucose increase.

[The effect of weight loss on serum concentration of interleukine-6 (IL-6) and insulin resistance]. / Wplyw redukcji masy ciala na stezenie interleukiny-6 (IL-6) i insulinoopornosc.

INTRODUCTION: Interleukine-6 (IL-6) is one of the cytokines, excreting by adipocytes, which increases in obesity. These cytokines participate in very complicated mechanisms of developing insulin resistance that accompany obesity. The aim of the study was to: 1) evaluate the influence of weight loss on insulin resistance and serum concentration of IL-6, 2) evaluate the hypothetical association between serum concentration of IL-6 and the improvement of insulin sensitivity in obese women after weight loss. MATERIAL AND METHODS: The study involved 27 obese women (age 40.3 +/- 11.1 year; BMI 37.4 +/- 5.2 kg/m(2)) with insulin resistance diagnosed using HOMA index, without concomitant diseases and without any medication. All the patients participated in complex weight reduction treatment (diet, physical activity and psychotherapy). Before and after weight reduction therapy weight and height were measured, body composition was determined using bioimpedance analysis. Serum concentration of glucose was determined by enzymatic procedure, serum concentration of insulin was measured by radioimmunoassay, serum concentration of IL-6 was measured by ELISA. HOMA index was calculated with formula. RESULTS: The mean weight loss after 3-month was 9.2 +/- 4.5 kg (approximately 10% of initial weight). After weight reduction significant decreases in HOMA index, insulin and IL-6 concentrations was observed. However, no correlations between changes in insulin concentrations, HOMA index and decrease of IL-6 concentration were showed. We observed significant correlations between DeltaHOMA and DeltaBMI (r = 0.48; p = 0.012) and Delta percentage fat mass (r = 0.39; p < 0.05). CONCLUSIONS: A moderate weight loss improves insulin sensitivity and decreases serum concentrations of IL-6. However improvement of insulin sensitivity is the effect of fat mass reduction and does not change serum concentration of IL-6.