Proinflammatory cytokines Il-6 and TNF-α and the development of inflammation in obese subjects.

BACKGROUND: The development of obesity and related disorders, e.g., type II diabetes (T2D), hypertension, and metabolic disturbances is strongly related to increased levels in proinflammatory cytokines (IL-1, IL-6, and TNF-α). Both IL-6 and TNF-α are secreted by adipocytes and their concentration correlates with the percentage and distribution of fat tissue in the body. Both cytokines are the main factors responsible for the induction of acute phase proteins production (e.g., CRP) and to inflammatory state. OBJECTIVE: To compare of TNF-α and IL-6 concentrations in serum from obese subjects with those in subjects with normal BMI and to analyze the relation between TNF-α, IL-6, BMI and the inflammatory state as measured by the level of CRP. MATERIAL AND METHODS: The study included 80 obese subject (54 males and 26 females) BMI >25 kg/m⊃2. A control group consisted of 53 healthy subjects (24 males and 29 females) with BMI <25 kg/m⊃2. To determine the blood plasma concentration of IL-6 and TNF, commercial ELISA assay kits were used. RESULTS: The concentration of IL-6 was lower in the control compared with the obese patients, but a significance difference concerned only female subjects (P = 0.001). TNF-α concentration was significantly higher in all obese subjects (P<0.001). A higher level of this cytokine was also found in patients with obesity suffering from T2DM. A positive correlation was present between IL-6 and TNF-α concentrations. Only did the IL-6 level correlate with the concentration of CRP in serum. CONCLUSIONS: The study confirmed that increased inflammatory cytokines lead to the persistence of inflammation in obese subjects. However, some other factors, such as gender, may contribute to the development of obesity-related inflammatory states.

Frequency of distribution of inflammatory cytokines IL-1, IL-6 and TNF-alpha gene polymorphism in patients with obstructive sleep apnea.

Obesity is one of the most commonly identified factors for the obstructive sleep apnea syndrome (OSAS). Adipose tissue is the source of many cytokines, among them there are IL-6, IL-1, and TNF-alpha. The level of inflammatory cytokines increases in people with OSAS and obesity. The aim of this study was to evaluate the distribution of genotypes in inflammatory cytokine genes in people with obesity-related OSAS. The examined group consisted of 102 person with obesity related-OSAS and 77 normal weight person without OSAS. Genotyping of DNA sequence variation was carried out by restriction enzyme (IL-1: Taq I, IL-6: Lwe I, TNF-alpha: Nco I) analysis of PCR amplified DNA. The study revealed a significant correlation between polymorphism located in the promoter region of inflammatory cytokine genes and obesity-related OSAS.

Frequency of distribution of leptin receptor gene polymorphism in obstructive sleep apnea patients.

Leptin is an adipocyte-derived hormone regulating energy homeostasis and body weight. Leptin concentration is increased in patients with the obstructive sleep apnea syndrome (OSAS). Leptin receptor (LEPR) is a single transmembrane protein belonging to the superfamily of cytokine receptors related by a structure to the hemopoietin receptor family. The aim of the present study was to evaluate the frequency of distribution of leptin receptor gene polymorphism GLN223ARG in OSAS patients compared with healthy controls. The examined group included 179 subjects: 102 OSAS patients (74 men and 28 women) and 77 non-apneic controls (39 men and 38 women). Genomic DNA was isolated with the use of a column method and genotyping of DNA sequence variation was carried out by restriction enzyme analysis of PCR-amplified DNA. The results revealed a significant correlation between the polymorphism of LEPR and OSAS. Carriers of Arg allele in homozygotic genotype Arg/Arg and heterozygotic genotype Gln/Arg were more often obese and developed OSAS than the group of carriers of homozygotic Gln/Gln genotype. This tendency was observed in the whole examined population and in the group of obese women. We also found the highest levels of total cholesterol, LDL, HDL, and triglycerides in the group of homozygotic Arg/Arg genotype carriers, lower in heterozygotic Gln/Arg genotype carriers, and the lowest in the group of persons carring homozygotic Gln/Gln genotype. The presence of Arg allel seems linked to a higher risk of obesity and higher lipid levels in OSAS patients. OSAS may have a strong genetic basis due to the effects from a variety of genes including those for leptin receptor.

Transurethral microwave thermotherapy: first experiences in Poland.

OBJECTIVE: To present early experiences in Poland with high-energy transurethral microwave thermotherapy (HeTUMT), considered as a serious alternative to surgery in managing benign prostatic hypertrophy (BPH). PATIENTS AND METHODS: Sixty-one patients were treated in two centres using a commercial TUMT system. The patients were assessed at 5-6 weeks, 3 and 6 months after treatment, evaluating subjective complaints, the International Prostate Symptom Score (IPSS), urinary flow rate and postvoid residual volume. RESULTS: A complete follow-up was available in 44 patients; most had symptomatic improvement 3 months after HeTUMT but it was slightly less pronounced after 6 months. The improvement in objective variables increased up to 6 months after HeTUMT. There was > or = 50% improvement in subjective complaints in 43% of the patients, in urinary flow rate in 25% and in residual urine in half. Two patients required re-treatment for a urethral stricture and ineffective HeTUMT. CONCLUSIONS: HeTUMT may be a useful treatment for BPH but the outcome for an individual patient seems to be unpredictable. The indications for TUMT should be reviewed individually for each patient.

Microwave thermotherapy in patients with chronic urinary retention.

PURPOSE: To evaluate the efficacy of high-energy transurethral microwave thermotherapy (TUMT) in the treatment of chronic urinary retention (CUR) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: In this prospective cohort study, 29 patients with CUR due to BPH underwent high-energy TUMT. Prior to treatment and during a 12-week follow-up, the following parameters were determined: quality of life (QOL) score, peak flow rate (Qmax) by uroflowmetry, and postvoid residual urine (PVR). In those with treatment failure (PVR > 150 mL or urinary retention), pressure-flow studies were performed and compared to pre-TUMT urodynamics. RESULTS: Of the 29 patients, 21 (72%) regained the ability to void spontaneously at 5 weeks. The actuarial median time for spontaneous voiding to be restored was 3.5 weeks (95% confidence interval [CI] 2.9-4.8 weeks). Mean QOL score at 12 weeks post-TUMT (2.2; 95% CI 1.5-2.7) was lower than that at 1 week (4.6; 95% CI 3.9-5.8) by 51% (p < 0.0005). Further, a 55% increase in mean Qmax (p < .0005) determined by uroflowmetry was observed by 12 weeks vs. 1 week after high-energy TUMT. TUMT failed in 8 patients due to a hypocontractile detrusor. CONCLUSIONS: We concluded that high-energy TUMT is a potentially useful option for patient with CUR who are not candidates for prostatectomy.

[Preliminary clinical evaluation of systemic chemotherapy of invasive cancer of the bladder by the CMV protocol]. / Wstepna kliniczna ocena chemioterapii ukladowej, wg schematu CMV, w naciekajacym raku pecherza moczowego.

The authors discuss the results of preliminary clinical trials with chemotherapy with CMV (cisplatin, methotrexate, vinblastine) in the group of 17 patients with the infiltrating cancer of the bladder. Chemotherapy was used as an element of the radical treatment (in 7 patients, i.e. 41.2%) or as ++palliative treatment (in 10 patients, i.e. 58.8%). Objective response to the treatment was noted in 73.3% of the treated patients, including 13.3% of the complete recovery, and 60.0% of partial improvement. In the remaining 26.7% of patients (including all patients with distant metastases) no response to therapy was achieved. Complications of therapy are discussed. Systemic chemotherapy with CMV regimen proved efficient in the infiltrating cancer of the bladder.