Evaluation of Ischemia-Modified Albumin in Patients with Inflammatory Bowel Disease.

BACKGROUND: Inflammatory bowel disease (IBD) is considered a chronic gastrointestinal inflammatory disease with unknown etiology. Oxidative stress has been demonstrated to play a critical role in the pathophysiology of IBD. We aimed to investigate the effect of the ischemia-modified albumin (IMA) and CRP levels on the pathophysiology and activities of IBD and its subgroups. METHODS: The study included 39 patients with Crohn's disease (CD) and 41 patients with ulcerative colitis (UC). Thirty-three healthy volunteers participated in the study as the control group. The IMA concentrations were determined by colorimetric method. RESULTS: IMA levels were significantly higher in IBD than in the controls (p = 0.02). In the subgroups of IBD, IMA levels were significantly lower in the control group and CD group than in UC (p < 0.001 and p < 0.001, respectively) while IMA levels were significant higher in the UC when compared with the CD group (p < 0.001). C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were significantly higher in the CD group compared to the control group (p < 0.01 and p < 0.02, respectively). CONCLUSIONS: Higher IMA level, which is a marker of oxidative stress in diseases with inflammation, indicates that inflammation and oxidative stress are related in the pathogenesis of IBD.

C-reactive protein but not hepcidin, NGAL and transferrin determines the ESA resistance in hemodialysis patients.

BACKGROUND: Erythropoiesis-stimulating agents (ESA) are commonly used for the treatment of anemia in hemodialysis (HD) patients, however, 5-10% of these patients have resistance to ESA treatment. Hepcidin and neutrophil-gelatinase associated lipocalin (NGAL) are induced by inflammation and these proteins may take role in ESA resistance. Herein, we aimed to investigate the effects of serum hepcidin, NGAL, transferrin and C-reactive protein (CRP) levels on ESA resistance in HD patients. METHODS: A total of 63 chronic HD patients (6.0 ± 17 years, M/F:44/19) and 20 healthy controls (6.0 ± 4 years, M/F:14/6) were enrolled. ESA resistance index (ERI) was calculated as weekly ESA dose (IU)/body weight (kg)/hemoglobin level (g/dL). Patients on ESA treatment were divided into two groups depending on the median ERI value as low and high ERI groups. RESULTS: Serum ferritin, hepcidin and NGAL levels were significantly higher in HD patients compared with controls. Serum transferrin levels were lower in high ESA index group compared with patients without ESA treatment and healthy controls. ERI was significantly correlated with serum CRP levels (r = 0.55, p < 0.001). In HD patients, serum hepcidin levels were associated with ferritin (r = 0.55, p < 0.01) and creatinine (r = 0.27, p = 0.03). Dose of ESA was significantly associated with serum CRP (r = 0.34, p = 0.02), total protein (r = -0.34, p = 0.01), transferrin (r = -0.28, p = 0.04) and ferritin (r = 0.31, p = 0.02). In linear regression analysis to predict ERI, age, gender, serum CRP, hepcidin, NGAL, albumin, ferritin and BMI were included (Model R = 0.62, R(2) =0 .38, p = 0.02). Serum CRP was the only significant factor predicting ERI. CONCLUSION: CRP was the only predictor of ESA resistance index in HD patients. Hepcidin, NGAL and transferrin were not found to be markers of ESA resistance.

The role of pentraxin 3 as diagnostic value in classification of patients with heart failure.

OBJECTIVE: Pentraxin 3 (PTX3) is a new inflammatory marker that is the prototype of the long pentraxin group, while C-reactive protein (CRP) is the short pentraxin group. The aim of the present study was to investigate the clinical significance of plasma PTX3 and CRP levels in heart failure (HF). MATERIALS AND METHODS: The study included 22 male and 37 female patients with HF, and 23 healthy volunteers as the control group. Patients were divided into 4 groups (class I, II, III and IV) according to New York Heart Association functional class. RESULTS: Plasma PTX3 and CRP levels were significantly elevated in HF patients compared to healthy controls. Comparing PTX3 levels in patient groups, statistically significant difference was found between class-I and class-II, class-III and class-IV patients (p=0.009, p=0.001, p<0.001, respectively). There was a positive correlation between PTX3 and CRP levels (r=0.369, p=0.004). In receiver-operating characteristic (ROC) curves, area under the curve (AUC) values for PTX3 and CRP were 0.928 (p=0.001) and 0.834 (p=0.001), respectively. CONCLUSIONS: Plasma PTX3 levels are elevated in HF and might be used as diagnostic value in classification of patients with HF. It is still debated whether inflammation may be just a cause or a consequence of the disease. Therefore further work is needed to better understand in large populations of patients with HF.