Serum YKL-40 Levels, Leukocyte Profiles, and Acute Exacerbations of Advanced COPD.

Little information exists on YKL-40-a key protein in tissue remodeling-and complete blood count (CBC) parameters during acute exacerbations of advanced chronic obstructive pulmonary disease (COPD). This pilot exploratory study (August 2020-January 2021) investigated the connection between serum YKL-40 levels and CBC profile in sex- and age-matched individuals with severe COPD (GOLD stage III, n = 23, median age = 66 years, 65.21% males) and very severe COPD (GOLD stage IV, n = 24, median age = 66.5 years, 74.81% males). The measured parameters were serum YKL-40, absolute leukocyte count (ALLC), absolute neutrophil count (ANC), neutrophil percentage, absolute lymphocyte count (ALC), lymphocyte percentage, neutrophil-to-lymphocyte ratio (NLR), absolute eosinophil count (AEC), eosinophil percentage, absolute monocyte count (AMC), monocyte percentage, absolute basophil count (ABC), basophil percentage, hemoglobin levels, and hematocrit concentrations. No significant inter-group differences were observed. However, high YKL-40 subjects (n = 23)-as stratified via median YKL-40 (3934.5 pg/mL)-showed significantly increased neutrophil percentage and NLR but significantly lower lymphocyte-, eosinophil-, and basophil-related parameters compared to low YKL-40 patients (n = 24). These results reveal multidimensional, YKL-40-associated changes in leukocyte profile of patients with advanced COPD during acute exacerbations, with potential implications for personalized treatment.

Serum YKL-40 Levels in Patients with Asthma or COPD: A Pilot Study.

Background and Objectives: Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are not only common obstructive respiratory conditions but also major causes of morbidity and mortality worldwide. There is, however, a surprising lack of blood-based biomarkers for separating between these pulmonary disorders. The aim of this study was to assess the practical relevance of using serum YKL-40, single or combined, for this purpose. Materials and Methods: Subjects included Romanian patients with BA (n = 24) or COPD (n = 27). YKL-40, fibrinogen, pre-treatment C-reactive protein (CRP), post-treatment CRP, erythrocyte sedimentation rate, interleukin 6 (IL-6), procalcitonin (PCT), absolute neutrophil count, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, absolute eosinophil count, and eosinophil percentage were measured and compared between these patients. Results: This is the first study investigating the clinical significance of serum YKL-40 in delineating between COPD and BA in Caucasian populations. Only fibrinogen and YKL-40 levels were different between COPD and BA, with the measured values being significantly elevated. These patients exhibited distinct inflammatory profiles. Using the upper quartiles of these variables for the pooled study population (YKL-40: 5100 pg/mL; fibrinogen: 552 mg/dL) as cut-off values, subjects were classified into high or low groups. High YKL-40 adults revealed significantly increased PCT levels. High fibrinogen subjects, by contrast, showed significantly elevated IL-6 concentrations and pre-treatment CRP levels. Low YKL-40 and fibrinogen patients showed the absence of COPD. Conclusions: Combined use of serum YKL-40 and fibrinogen may be useful for identifying the absence of COPD.

Mannose-binding lectin 2 gene polymorphisms and predisposition to allergic bronchial asthma in a western Romanian children population: an observational study.

OBJECTIVES: To analyse: (1) the associations between different mannose-binding lectin 2 (MBL2) genotypes and susceptibility to bronchial asthma (BA) in Romanian children; and (2) the correlations between several patient sociodemographic variables and MBL2 polymorphisms. METHODS: This prospective observational case-control study included paediatric patients with symptomatic BA and healthy controls. Participants were genotyped for two MBL2 single-nucleotide polymorphisms (SNPs): exon 1 codon 54 A/B variant rs1800450, and -550 promoter H/L variant rs11003125 (GenBank accession). Associations between MBL2 genotypes and susceptibility to BA were determined by calculated odds ratios, and Kendall Tau's correlations were used to investigate the associations between sociodemographic variables and SNPs. RESULTS: Among 59 patients with BA and 65 healthy controls, associations between MBL2 polymorphisms and susceptibility to BA were not found to be statistically significant. Statistically significant weak positive correlations were found between age at diagnosis and A/B genotype, and between the smoking status of biologically male and female parents. A statistically significant weak inverse association was found between male parent smoking status and family history of BA. CONCLUSION: These results may help guide future research into paediatric BA in Romania and Eastern Europe. Due to study limitations, the results require validation in future large-scale studies.

Clinical Relevance of Plasma Concentrations of MBL in Accordance with IgE Levels in Children Diagnosed with Bronchial Asthma.

Background and objectives: Bronchial asthma is a heterogeneous, multifactorial pulmonary disease characterized by variable airway obstruction caused by chronic inflammation. Our study investigates the clinical relevance of MBL plasma levels in accordance with IgE values in children who attended a pediatric consult for respiratory symptoms with bronchial asthma. Materials and Methods: The study population consists of patients <18-years-old and included 43 patients with bronchial asthma and 64 age-matched healthy subjects as a control group. We used the ELISA Human MBL Immunoassay kit and the electrochemiluminescence immunoassay (ECLIA) kit for IgE determination. Results: Our results show significantly different distributions of patients in the bronchial asthma group and control group. The measured values were within the normal range for most controls, while the bronchial asthma patients displayed higher values of plasma MBL and IgE levels. We observed a wider heterogeneity in MBL concentrations in bronchial asthma patients when compared to the healthy age-matched controls. Our results also suggest a potential clinical usefulness of plasma MBL concentrations in accordance with IgE and eosinophil cells levels in the diagnosis of bronchial asthma, and our results may suggest a prognostic role of MBL in the evolution of asthmatic disease; however, further studies are necessary to confirm these findings. Conclusions:We can say that plasma MBL concentrations present a relative diagnostic role for bronchial asthma in pediatric patients and may suggest a more severe disease progression; however, further studies are needed to elucidate the role played by MBL in the determination and evolution of this disease.

Genetic Polymorphism of MBL 2 in Patients with Allergic Bronchial Asthma.

Mannose-binding lectin (MBL) belongs to a family of glycoproteins called lectins or collectins, which possess many of the functional features of immunoglobulins. Mannose-binding lectin is a very important component of the innate immune system, which recognizes distinct pathogens and activates the classical path of the complement-fixation method. In humans, the serum levels of collectins vary widely, and their variability is correlated with susceptibility and resistance to infection and other diseases. Recent studys show that MBL gene polymorphism is involved in the pathogenesis of many diseases, including infectious and allergic illnesses. Our study aims to determine the role of MBL polymorphism in children diagnosed with allergic bronchial asthma, especially in acute episodes. We conclude that MBL2 gene polymorphism is associated with atopy, allergic diseases and acute respiratory tract infections with MBL deficiency in early childhood. In terms of genetic polymorphism, most of the studied alleles were type A, these being the most frequently present in the studied groups, while alleles B, C or D have been explored to a lesser extent. Studies are also required for adult patients with allergic and atopic conditions, because so far, most of the research has been done on pediatric population only.

Inflammation: predictive factor for negative evolution of prostate diseases.

The most frequent prostate diseases depending on age are prostatitis in young men, benign prostate hypertrophy in men over 50 years old, and prostate cancer (PCa) in elderly patients. The purpose of our study is to evaluate the role of inflammation in the progression of prostate diseases. We used clinical and paraclinical techniques for the positive diagnosis [serum prostate-specific antigen (PSA) determination, we performed transrectal ultrasound to asses the prostate volume and prostate biopsy or transurethral resection of the prostate, where it was imposed]. The prostate tissue specimens were analyzed histopathologically and immunohistochemically. Our results show that PCa patients with higher inflammation rates had a higher Gleason score in both the castration-resistant prostate cancer (CRPC) group and the castration-sensitive group. We have noticed that patients with high inflammation grade also had a much higher International Prostate Symptom Score (IPSS). In conclusion, we can say that in our study, inflammation played an important role in the evolution of benign and malignant prostate diseases; its presence has influenced directly the severity of symptoms, and the aggressiveness of the diseases.

Clinical Significance of Measuring Global Hydroxymethylation of White Blood Cell DNA in Prostate Cancer: Comparison to PSA in a Pilot Exploratory Study.

This is the first study investigating the clinical relevance of 5-hydroxymethylcytosine (5hmC) in genomic DNA from white blood cells (WBC) in the context of prostate cancer (PCa) and other prostate pathologies. Using an enzyme-linked immunosorbent assay, we identified significantly different distributions of patients with low and elevated 5hmC content in WBC DNA across controls and patients with prostate cancer (PCa), atypical small acinar proliferation (ASAP), and benign prostatic hyperplasia (BPH). The measured values were within the normal range for most PCa patients, while the latter category was predominant for ASAP. We observed a wider heterogeneity in 5hmC content in all of the prostate pathologies analyzed when compared to the healthy age-matched controls. When compared to blood levels of prostate-specific antigen (PSA), this 5hmC-based biomarker had a lower performance in PCa detection than the use of a PSA cut-off of 2.5 nanograms per milliliter (ng/mL). Above this threshold, however, it delineated almost three quarters of PCa patients from controls and patients with other prostate pathologies. Overall, genome-wide 5hmC content of WBC DNA appears to be applicable for detecting non-cancerous prostate diseases, rather than PCa. Our results also suggest a potential clinical usefulness of complementing PSA as a PCa marker by the addition of a set of hydroxymethylation markers in the blood, but further studies are necessary to confirm these findings.