Advantage of salivary cortisol measurements in the diagnosis of glucocorticoid related disorders.

OBJECTIVE: Salivary cortisol in the assessment of glucocorticoid related disorders. DESIGN-METHODS: Serum and salivary cortisol were measured in 189 patients (22 Cushing's syndrome, 67 pseudo-Cushing, 11 Addison's disease, 89 controls) at 8:00 and 24:00 h. RESULTS: Serum and salivary cortisol correlated in the whole study population (r=0.62, p=0.000). Morning serum and saliva cortisol in Addison's disease were lower than in controls (6.74+/-1.69 vs 22.58+/-1.78 microg/dL, and 0.15+/-0.25 vs 0.67+/-0.12 microg/dL) (p<0.001). Morning serum cortisol was similar in controls and patients with Cushing's syndrome or pseudo-Cushing (22.58+/-1.78 vs 13.96+/-6.02 vs 16.13+/-1.69 microg/dL). Morning serum and salivary cortisol at 8:00 had the same sensitivity to distinguish patients with Addison's disease from healthy controls. 24:00 am serum cortisol in controls (2.61+/-0.20 microg/dL) was lower than in the pseudo-Cushing group (6.53+/-0.77 microg/dL, p<0.001) and in Cushing's syndrome (10.90+/-2.36 microg/dL, p=0.003). 24:00 am salivary cortisol in controls (0.0025+/-0.001 microg/dL) was lower than in patients with Cushing's syndrome (0.58+/-0.11 microg/dL, p<0.001) and those higher than in patient with pseudo-Cushing (0.10+/-0.06 microg/dL, p=0.001). Both salivary cortisol and serum cortisol presented high specificity (82% and 100%) to detect Cushing's syndrome but salivary cortisol higher sensitivity (saliva 88% and serum 50%). CONCLUSION: Morning salivary cortisol is as good as serum as screening test for patients with Addison's disease and nighttime salivary cortisol is more adequate than serum in the screening of Cushing's syndrome.

Serum proteolytic activities and antiproteases in human colorectal carcinoma.

Some proteolytic enzymes, trypsin, cathepsin B, cathepsin D, collagenase, elastase and their inhibitors, API and AMG, in serum of patients with colorectal carcinoma have been evaluated. Twenty patients belonged to stage B of colorectal carcinoma, twenty two patients to stage D (Astler and Coller classification) and a control group of thirty healthy volunteers were evaluated. Except in cathepsin D, patients exhibit higher enzymatic activities than healthy subjects, and both groups have all the proteolytic activities assayed in serum. Patients with disseminated disease have increased cathepsin B and collagenase levels, with a decrease of trypsin activity, showing an increment in API and AMG in sera. However, only the API values were significantly higher in patients with metastases. The coexistence of proteolytic activities in human sera together with their inhibitors is considered as well as the origin of these, tumoral and/or reactive, increments. Cathepsin B levels are raised in colorectal neoplasms and contribute to the destruction of the extracellular matrix and the proliferation of tumoral cells. There is evidence that a relation between collagenase like activity and tumor invasiveness exists. Cathepsin B and collagenase increases agree with the tumoral mass. On the other hand, trypsin decrease in metastatic carcinoma is probably related to the increment of their inhibitors, API and AMG, acute phase reactant proteins.

[McArdle's disease. Apropos of a case]. / Enfermedad de McArdle. A propósito de un caso.

McArdle's disease (glycogenosis type V) is a metabolic disorder of hydrocarbons, inherited with autosomic recessive pattern. Biochemically is defined by a myophosphorylase deficiency; clinically it is characterized by exercise intolerance, due to the impossibility of providing energetic substrate to the muscle, myalgias and stiffness. We present a case report of a patient with McArdle's disease and we comment the diagnostic procedures and current therapeutic options.

Peroxisome enzyme modification and oxidative stress in rat by hypolipidemic and antiinflammatory drugs.

Changes in the activities of two peroxisomal enzymes (catalase and thiolase), some parameters related to oxidative situations, such as conjugated dienes, zinc, iron, copper and superoxide dismutase after the administration of two known peroxisome proliferators (clofibrate and acetylsalicylic acid), and two drugs pharmacologically related to the former (probucol and diflunisal) have been studied in male Wistar rats. Administration of the drugs was made by p.o. for 15 days. After the treatment the rats were killed, their livers and brains were taken out, and their blood was collected. Peroxisomes were purified by differential centrifugation followed by ultracentrifugation. Total RNA was also extracted and the acyl CoA oxidase mRNA expression was studied. Clofibrate was inactive on both enzymes studied in liver and diflunisal in brain. However, the acyl CoA oxidase mRNA expression increased by clofibrate treatment. Results are justified by the liposolubility and protein-binding properties of the drugs. Otherwise, the present results show the existence of an increased lipid peroxidation, lower value of superoxide dismutase, and variable results for zinc, copper and iron trace elements. These data evidence an oxidative stress situation in plasma of rats treated with these drugs, probably as a consequence of an increase in some beta-oxidation enzymes, which brings about an overproduction of H2O2.

[Metal ions in the insulin-receptor interaction in human erythrocytes]. / Iones metálicos en la interacción insulina-receptor en hematíes humanos.

The kinetics of insulin binding to its receptors on human erythrocytes suggests the existence of two types of receptors exhibiting negative cooperativity upon the binding of the hormone. Solubilized and purified receptors were associated to Zn++ or Cu++. The addition of these ions to erythrocytes or to purified insulin receptors from human erythrocytes resulted in an increase of specific insulin binding. Dialysis of solubilized or purified receptors against chelating agents such as EDTA or 1, 10-phenanthroline resulted in a decrease in specific binding of insulin. With the readdition of Zn++ or Cu++ to the medium an increase in specific binding was observed, and values much higher than those of the original preparations were obtained. Dialysis of purified receptors against chelating agents resulted in a decrease in the content of Zn++ and Cu++. These results suggest the possible involvement of a metal ion associated to the receptor in the formation of the insulin-receptor complex.

Insulin-receptor interactions. Possible involvement of metals.

Addition of Zn2+ or Cu2+ ions to plasma membrane preparations or to purified insulin receptors from rat liver resulted in an increase of specific insulin binding; no effect was observed with the addition of Fe3+, Ca2+ or Na+. Dialysis of membrane preparations, or of purified receptors, against chelating agents such as zincon (2-carboxy-2'-hydroxy-5'-sulfoformazyl-benzene) or 1,10-phenantroline resulted in a decrease in specific binding of insulin. With the readdition of Zn2+ or Cu2+ to the medium an increase in specific binding was observed, and values much higher than those of the original preparations were obtained; the addition of Ca2+, Fe3+ or Na+ to dialyzed preparations did not cause any effect on the specific binding. Dialysis of purified receptors against chelating agents resulted in a decrease in the content of Zn2+ and Cu2+. Zincon has been found to be a competitive inhibitor of insulin interfering with the specific binding to the receptor, and noncompetitive with the nonspecific binding. These results suggest the possible involvement of a metal ion present in the receptor in the formation of the insulin-receptor complex.