Pregnancy-Associated Plasma Protein A (PAPP-A) Concentration in Population of Healthy Young People: Interactions with Tobacco Smoke and Anti-oxidative Status.

Pregnancy-associated plasma protein A (PAPP-A) is a high-molecular zinc-binding metalloproteinase that was first detected in the serum of pregnant women. It can also be detected in men and non-pregnant women. Recently, a growing interest in determining the concentration of PAPP-A as a marker of oxidative stress and atherosclerotic processes has been observed. Among the factors that could potentially influence the PAPP-A formation is the exposure to tobacco smoke. Some components of tobacco smoke have an immediate effect on the body and also direct influence on the cardiovascular system. The aim of this study was to evaluate the relation between PAPP-A concentration and either passive or active exposure to tobacco smoke in the population of medicine students (n = 152). The relation between PAPP-A concentration and chosen markers of inflammatory response and anti-oxidative processes was analyzed. The samples of serum, urine, and saliva were collected and main nicotine metabolites in urine samples were determined using ELISA technique. Comparison of the PAPP-A concentrations in the study group revealed that in the group of active smokers, the concentration of the protein was significantly higher than in the group of passive smokers (p = .04) and the group of not-exposed students (p = .006). PAPP-A concentration showed significant positive correlation with the values of FRAP and main nicotine metabolites. The evident influence of both active and passive tobacco smoke exposure on PAPP-A levels in the studied population of young people who in general are not included in the group of high-risk cardiovascular incidents, shows how important early prevention of anti-health behaviors is.

Association of rs 3807337 polymorphism of CALD1 gene with diabetic nephropathy occurrence in type 1 diabetes - preliminary results of a family-based study.

INTRODUCTION: The worldwide growing burden of diabetes and end-stage renal disease due to diabetic nephropathy has become the reason for research looking for a single marker of chronic kidney disease development and progression that can be found in the early stages of the disease, when preventive action delaying the destructive process could be performed. The aim of the study was to investigate the influence of rs3807337 polymorphism of the caldesmon 1 (CALD1) gene located on the long arm of chromosome 7 encoding for protein that is connected with physiological kidney function on development of diabetic nephropathy. MATERIAL AND METHODS: There was an association study of rs3807337 polymorphism of the CALD1 gene in parent-offspring trios by PCRRFLP method. Ninety-nine subjects: 33 patients with diabetic nephropathy due to type 1 diabetes and 66 of their biological parents, were examined. The mode of alleles transmission from heterozygous parents to affected offspring was determined using the transmission disequilibrium test. RESULTS: The allele G of rs3807337 polymorphism of the CALD1 gene was transmitted to affected offspring significantly more often than expected for no association. CONCLUSIONS: The obtained results suggest that the genetic variability of the CALD1 gene may influence the development of diabetic nephropathy in type 1 diabetes, but further studies involving larger studied groups of patients are needed. (Endokrynol Pol 2017; 68 (1): 13-17).

Conduction disturbances after transcatheter aortic valve implantation procedures - predictors and management.

Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients' state and long term-survival. The most relevant and common are His' bundle branch blocks, atrioventricular blocks, and need for permanent pacemaker implantation. With the frequency at 10% to even 50%, conduction abnormalities are among the most important TAVI-related adverse events. Risk factors for conduction disturbances include age, anatomy of the heart, periprocedural factors, type of implanted valve, and comorbidities. Severity of occurring complications varies; therefore selection of a proper treatment approach is required. Considered as the most effective management, permanent pacemaker implantation turned out to negatively influence both recovery and survival. Moreover, there is no expert consensus on use of resynchronization therapy after TAVI. In this paper, the authors present a comprehensive analysis of the most common conduction disturbances accompanying TAVI, factors related to their occurrence, and treatment approach.

Determination of advanced glycation end-products and antibodies against them (anti-CML and anti-CEL) in the serum of Graves' orbitopathy patients before and after methylprednisolone treatment.

INTRODUCTION: The glycation process is a non-enzymatic modification of proteins occurring due to the reactions of reductive carbohydrates. The glycated residues lose their biological functions, and their removal process is ineffective. They accumulate, and as a result they cause an immunological response. The aim of this study was a determination of the concentrations of advanced glycation end-products and antibodies against carboxymethyl lysine (anti-CML) and carboxyethyl lysine (anti-CEL) in the sera of Graves' orbitopathy patients. MATERIAL AND METHODS: The study group were patients from the Division of Endocrinology of the Medical University of Silesia (n = 25) suffering from Graves' orbitopathy. The concentration of AGE-peptides using flow spectrofluorimetry method, and anti-CML and anti-CEL IgG antibodies using immunoenzymatic technique (ELISA), were measured in patients sera before and after methylprednisolone treatment. RESULTS: In sera of the study group the concentrations of AGE-peptides and anti-CML were significantly lower before and after treatment in comparison to the control group (p < 0.05). Mean values of anti-CEL concentrations were comparable (at both phases of treatment) with the value observed in the control group. After treatment the concentrations of AGE-peptides and anti-CEL significantly decreased (p < 0.05); however, the concentration of anti-CML was also lower but the observed change was not significant (p > 0.05). CONCLUSIONS: In the course of Graves' orbitopathy the glycation process is disturbed. The treatment modifies significantly the process by lowering the concentration of advanced glycation end-products and suppressing the immune response to them. (Endokrynol Pol 2016; 67 (4): 383-389).

Ipsilateral shoulder pain after thoracic surgery procedures under general and regional anesthesia - a retrospective observational study.

BACKGROUND: Ipsilateral shoulder pain (ISP) is a common complication of mixed etiology after thoracic surgery (its prevalence is estimated in the literature at between 42% and 97%). It is severe and resistant to treatment (patients complain of pain despite effective epidural analgesia at the surgical site). AIM OF THE STUDY: The aim of this retrospective, observational study was to evaluate the prevalence of ISP in patients operated on in our facility and to determine the risk factors for ISP development. MATERIAL AND METHODS: 68 patients after thoracotomy or videothoracoscopy (video-assisted thoracic surgery - VATS) conducted under general and regional anesthesia were enrolled in the study and divided into two groups: group I without ISP and group II with postoperative ISP. We recorded age, sex, BMI, duration of surgery, type of surgery, type of regional anesthesia, and, in patients with epidural anesthesia, level of catheter placement. RESULTS: Statistically significant differences between the groups were obtained for BMI (24.67 and 27.68, respectively; p = 0.049), type of surgery (24% for thoracotomy and 0% for VATS, p = 0.026), and level of epidural catheter placement (4.35% for catheters placed at the level of Th5 or higher and 40.47% for catheters placed below Th5; p = 0.003). CONCLUSIONS: The prevalence of ISP in our medical center amounts to 24% of thoracotomy patients. The fact that the difference in ISP prevalence was significantly related to the level of epidural catheter placement is consistent with the theory that ISP is related to phrenic nerve innervation. Moreover, epidural catheter placement is a modifiable factor, which can be used to reduce the prevalence of post-thoracotomy ISP.

[Evaluation of the influence of exposure to tobacco smoke on the concentration of the pregnancy-associated plasma protein A in the population of healthy men and non-pregnant women]. / Ocena wplywu dymu tytoniowego na stezenie osoczowego bialka ciazowego typu A w populacji zdrowych mezczyzn i kobiet nieciezarnych.

The chemical variety of tobacco smoke components induces a multidirectional, not yet fully understood effects on living organisms, including both those actively and passively exposed. The chemical compounds present in tobacco smoke, due to its heterogeneous structure and properties undergo different biotransformation processes. Some components of tobacco smoke (for example, carbon monoxide) have an immediate effect on the body, in this case due to the formation of carboxyhemoglobin, and nicotine contained in the tobacco smoke also has direct influence on the cardiovascular system. Additionally, lifestyle imposed by the highly developed society, including a sedentary lifestyle and unhealthy diet cause, that we are exposed to the factors associated with the formation of the so-called lifestyle diseases, like atherosclerosis and cancer. Pregnancy-Associated-PlasmaProtein A (PAPP-A) is a high-molecular zinc-binding metalloproteinase that was first detected in the serum of pregnant women as a protein produced by trophoblasts of properly developing fetus. In the blood of pregnant women PAPP-A exists as heterotetrameric complex (htPAPP-A) consisting of two subunits of PAPP-A. It can also be detected in men and women who are not pregnant but this time labeled PAPP-A is present as a homodimer (dPAPP-A, "free PAPP-A") consisting of two identical subunits devoid of proMBP protein. Recently a growing interest in determining the concentration of PAPP-A as a marker of oxidative stress and atherosclerotic processes is observed, because the increased levels of PAPP-Awere detected in people with a history of cardiovascular incident. PAPP-A is present on the early stages of atherosclerotic plaque instability when it is still possible to prevent a myocardial damage. The influence of smoking and exposure to tobacco smoke on concentrations of PAPP-A is not completely understood. The aim of this study was to determine the concentration of PAPP-A levels in the population of healthy young men and non-pregnant women. In the study author's questionnaire was used to assess exposure to tobacco smoke including knowledge of exposure to selected environmental xenobiotics, unhealthy habits and everyday diet. The study group consisted of 169 students of the first and second year students of the Faculty of Medicine and Department of Medicine and Dentistry, and the second year of Emergency Medicine in Zabrze, Medical University of Silesia. Blood samples were obtained from 153 students. For the determination of protein PAPP-A ELISA method was used. Mean PAPP-A concentration in the study group was 11.52 [ng/ml]. There was a statistically significant difference in the concentration of PAPP-A regarding gender (women 14.6 [ng/ml] vs. men 20.39 [ng/ml]; p = 0.014). In the study group of smoking students average concentration of PAPP-A was lower in comparison with non-smoking students (regardless of gender). Passive exposure to tobacco smoke also affects the levels of PAPP-A in the tested population of young people.