ABSTRACT
Proteins of S100 group, produced by phagocytes represent endogenous activators of innate immune responses. Role of these proteins in the etiopathogenesis of cholelithiasis remains unknown. The studies aimed at the morphometric evaluation of S100A8 and S100A9 protein expression in gallbladder mucosa in patients with acute and chronic calculous cholecystitis (n = 71). The presence of proteins was detected by immunohistochemistry while quantitative analysis employed the spatial visualization technique. We found the immunopositive expression of the two studied S100 proteins in neutrophils and monocytes/macrophages of the gallbladder's wall and a higher expression in acute cholecystitis. Quantitative study revealed higher immunoexpression of S100A9 over S100A8 in both studied groups of patients. Moreover, a reciprocal linear relationship between the expression of the studied proteins and a positive correlation between expression of either S100A8 or S100A9 and inflammatory activity (grading) in the gallbladder wall were found. The expression of S100A8 protein in the chronic cholecystitis group and in older patients correlated with leukocytosis, which suggests the role of S100A8 particularly at the chronic stage of cholecystitis. The obtained results indicated close relationship between S100A8 and S100A9 proteins in their proinflammatory functions. The increased expression of only one of them can be recognized as a useful index of local inflammatory activity in calculous cholecystitis.
Subject(s)
Acalculous Cholecystitis/metabolism , Calgranulin A/metabolism , Calgranulin B/metabolism , Gallbladder/metabolism , Acalculous Cholecystitis/diagnosis , Adult , Calgranulin A/genetics , Calgranulin B/genetics , Case-Control Studies , Female , Gallbladder/pathology , Humans , Macrophages/metabolism , Male , Middle Aged , Mucous Membrane/metabolism , Mucous Membrane/pathology , Neutrophils/metabolismABSTRACT
Nephrotic syndrome (NS) is an essential clinical problem in the elderly. It may be difficult to recognize NS in the elderly because its symptoms are frequently missed with congestive heart failure or venous insufficiency. Glomerular diseases are not most common in elderly population but they play important role in renal pathology in this group of patients. Many structural and functional changes occur in the kidney with an increasing age. These changes may make, at least in part, the interpretation of renal lesions difficult. Glomerular pathology in this group of patients may be secondary to neoplastic diseases, and, therefore before the kidney biopsy screening for malignancies should be performed. The occurrence of particular forms of glomerular diseases differs between the older and young population. The most common forms of primary glomerular diseases in elderly are membranous nephropathy and focal-segmental glomerulosclerosis, whereas diabetic nephropathy and amyloidosis are common causes of secondary nephropathies. Kidney biopsy in the elderly gives valuable information, just as it is in the other age groups. It is a reasonably safe procedure, although associated with an increased risk of bleedings, when compared to younger population.
Subject(s)
Kidney/pathology , Nephrotic Syndrome/etiology , Nephrotic Syndrome/pathology , Aged , Biopsy, Needle , Humans , Neoplasms/complicationsABSTRACT
Nephrotic syndrome (NS) in elderly may increase mortality. The severity of NS determines its management. In the milder forms, with serum albumin concentrations greater than 2.5 mg/dl, significant sodium retention, volume expansion and hypertension patients should be treated with diuretics and hypertensive agents alone. Hypercholesterolemia needs to be treated in patients with NS because this is an important contributor to progressive loss of renal function and increased morbidity and mortality from cardiovascular disease in patients with renal insufficiency Statins decrease proteinuria and have antinflammatory action. Patients with severe NS will likely require immunosuppressive agents to significantly reduce heavy proteinuria. Elderly individuals should receive an appropriate immunosuppressive therapy to induce remission of NS and reduce the risk of progressive loss of renal function. However, since side effects of the used drugs and infectious complications occur more frequently in elderly, careful monitoring of therapy should be carried out.
