Thrombomodulin levels in insulin-dependent diabetic patients with microalbuminuria.

Thrombomodulin (TM) plays an important role in the regulation of blood coagulation at the endothelial surface. TM is also present in plasma, where an increase of its level seems to reflect endothelial damage. Since microalbuminuria is associated with an increased atherothrombotic risk and is considered an expression of widespread vascular damage, we evaluated plasma thrombomodulin levels, blood pressure, and plasma lipid values in Type 1 diabetic patients with micro- and normoalbuminuria. Thrombomodulin was measured in 12 microalbuminuric (albumin excretion rate 20-200 micrograms min-1 in 2 of 3 overnight urine collections) and in 12 normoalbuminuric (albumin excretion rate < 20 micrograms min-1) Type 1 diabetic patients matched for age, sex, body mass index, smoking habits, diabetes duration, and glycated haemoglobin. Mean thrombomodulin was significantly higher in micro- than in normalbuminuric group (59.34 +/- 3.58 vs 43.56 +/- 3.52 ng ml-1 p < 0.01). Systolic and diastolic blood pressure were significantly higher in micro- than in normoalbuminuric group (p < 0.05). There was a positive correlation between plasma thrombomodulin and albumin excretion rate (p = 0.013, r = 0.49), and between thrombomodulin and diastolic blood pressure (p = 0.023, r = 0.46) in diabetic patients as a whole but not in the individual groups. These findings suggest the presence of an endothelial injury in microalbuminuric patients.

Prothrombin fragment 1 + 2 and antithrombin III-thrombin complex in microalbuminuric type 2 diabetic patients.

In microalbuminuria there is an increased cardiovascular risk not fully explained by the excess of conventional risk factors. To investigate whether or not microalbuminuria is associated with haemostatic abnormalities in Type 2 diabetic patients, we measured the prothrombin fragment 1 + 2, a marker of thrombin generation, and the thrombin-antithrombin complex, a marker of thrombin neutralization. Plasma levels of prothrombin fragment 1 + 2 and thrombin-antithrombin complex were assayed in 17 microalbuminuric patients (albumin excretion rate, AER 20-200 micrograms min-1) and in 17 comparable normoalbuminuric (AER < 20 micrograms min-1) Type 2 diabetic patients. Plasma prothrombin fragment 1 + 2 was significantly higher in microalbuminuric than in normoalbuminuric patients (1.09 +/- 0.06 vs 0.86 +/- 0.04 nM, p = 0.003). Individual values of F1 + 2 were above the upper limit of the normal range in 8/17 microalbuminuric and in none of the normoalbuminuric Type 2 diabetic patients. Plasma thrombin-antithrombin complex values were not significantly different in the two groups and were not correlated with AER. These results suggest that microalbuminuria is associated with a prethrombotic state and a relatively defective thrombin neutralization. Coagulation abnormalities might be part of the cardiovascular risk in microalbuminuric patients.

[Sero-epidemiological studies on diffusion of viral hepatitis "A" and "B" in Turin (Italy) (author's transl)]. / Ricerche sieroepidemiologiche sulla diffusione delle epatiti "A" e "B" in Torino.

The age-prevalence of antibodies directed against the hepatitis viruses A (anti-HAV) and B (anti-HBs and anti-HBc) has been studied in an open sample of population of Turin (Italy), made up by 680 persons. Is has been shown that all three types of antibodies are present at birth, thast they progressively decrease and than again raise, from 6-10 years of age, up to 70-75%, 35% and about 40% in adults, respectively for anti-HAV, anti-HBs and anti-HBc. A further peak over 97% after 40 years for anti-HAV likely means a past higher spreading of the virus. The conclusion is drawn that, for both hepatitis A and B, the percentage of positive and the time of appearance of active humoral immunity after the loss of maternal antibodies are typical medium level of hygienic conditions. The comparison of anti-HBs and anti-HBc behaviour has shown that the latter is more frequent and at least as persistent as the former, and that it should not therefore be obligatory considered ia a marker of viral replication.

[Rubella epidemic of 1977 in Turin. Virological studies]. / L'epidemia di rosolia del 1977 a Torino. Ricerche virologiche.

During the outbreak of rubella in Turin in 1977, 1,041 newborns, whose mother's pregnancy coincided with the epidemic, were studied for the elimination of rubella virus through inoculation in primary cultures of African green monkey kidney cells. Additional 10 embryos or fetuses of therapeutic abortion from women with rubella early in pregnancy were studied through cultivation of material of abortion and inoculation in monkey cells. Only one strain was isolated, from the placenta of an embryo whose mother suffered rubella in the 2nd month of pregnancy. The hypothesis is proposed of a particularly benignity, from a teratogenic point of view, of the virus involved in the outbreak.