Comparison of prognostic values of high-sensitivity cardiac troponin T and N-terminal prohormone brain natriuretic peptide to assess mortality in elderly inpatients.

BACKGROUND: Studies have shown that increases in low-level high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in the elderly population lead to high risk of adverse clinical outcomes, such as mortality. In this study, associations between the two biomarkers and long-term mortality in elderly patients hospitalized for medical conditions other than acute cardiovascular events were investigated. A comparison of the predictive value of hs-cTnT and NT-proBNP for all-cause mortality was conducted. METHODS: A cohort of 715 elderly inpatients free of acute cardiovascular events was initially recruited. Based on tertiles of baseline hs-cTnT and NT-proBNP levels, the elderly were arranged into low, middle, and high groups. The mortality of each group was observed and the predictive values of hs-cTnT and NT-proBNP compared. Additionally, all-cause mortality was analyzed for hs-cTnT and NT-proBNP combined. RESULTS: There were 135 (18.9%) all-cause mortality cases identified during follow-up (median 47 months). The upper tertile of hs-cTnT was significantly associated with an increased risk of mortality (HR 3.29, 95% CI 1.85-5.85), even after adjustment for potential confounders. However, there were no significant differences observed in mortality rates among the three NT-proBNP groups after adjustment for potential confounders (HR 1.77, 95% CI 0.83-3.17). Compared to NT-proBNP, hs-cTnT was a better predictor of mortality, as area under curves for hs-cTnT and NT-proBNP at 60 months were 0.712 (95% CI 0.616-0.809) and 0.585 (95% CI 0.483-0.6871), respectively. Also, the combination of the two cardiac biomarkers did not render a better predictive value for mortality than hs-cTnT alone. CONCLUSION: Unlike hs-cTnT, baseline NT-proBNP levels failed to show an independent association with all-cause mortality in hospitalized elderly without acute cardiovascular events. hs-cTnT provided significant prognostic value for mortality in the study cohort.

Selenious-ß-lactoglobulin induces the apoptosis of human lung cancer A549 cells via an intrinsic mitochondrial pathway.

In this study, the cytotoxic activity of selenious-ß-lactoglobulin (Se-ß-Lg) and the anticancer mechanism were investigated in human lung cancer A549 cells in vitro. MTT assay showed that Se-ß-Lg at 200 µg/mL exhibited a significant suppression effect on A549 cells and the maximum inhibition rate reached 90% after 72 h treatment. Flow cytometry analysis revealed that 200 µg/mL of Se-ß-Lg induced cell cycle arrest at G0/G1 phase. Cell apoptosis was induced via the generation of reactive oxygen species (ROS) and the decrease of mitochondrial membrane potential (ΔΨm) in a time-dependent manner. Furthermore, Se-ß-Lg suppressed the expression of Bcl-2 and improved the level of Bax, leading to the release of cytochrome c and a higher expression of caspase-3 in A549 cells. In summary, Se-ß-Lg could induce apoptosis in A549 cells via an intrinsic mitochondrial pathway and it might serve as a potential therapeutic agent for human lung cancer.

High-sensitivity cardiac troponin T in geriatric inpatients.

BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is detectable in elderly patients without clinical diagnosed cardiovascular disease. Elevated hs-cTnT levels predict increased cardiovascular risks and poor prognosis. The aim of this study was to determine the distribution and associated factors of hs-cTnT in geriatric inpatients without acute coronary syndrome (ACS). METHODS: Hs-cTnT was measured with a highly sensitive assay in 679 geriatric inpatients without ACS. Patients were further divided into 3 groups according to the tertile of hs-cTnT levels and single and multiple variable analyses were performed to assess the association of hs-cTnT to cardiovascular risk factors, biochemical measurements and echocardiographic abnormalities. RESULTS: Hs-cTnT was detectable (≥3ng/L) in 98.4% of the subjects and 52.0% of the subjects had hs-cTnT levels ≥14ng/L, which is at the 99th percentile Upper Reference Limit (URL). The levels of hs-cTnT were independently associated with N-terminal pro-brain natriuretic peptide (NT-proBNP), male gender, older age, estimated glomerular filtration rate (eGFR), left ventricular mass index (LVMI), diabetes mellitus (DM) and left ventricular ejection fraction (LVEF). There were no significant differences in hs-cTnT levels between geriatrics patients with stable coronary artery disease (SCAD) and those without SCAD. CONCLUSION: Hs-cTnT elevation caused by non-ischemic acute conditions was very common in geriatric hospitalized patients. Due to increases in baseline hs-cTnT in the elderly, detection of a rise and/or fall in hs-cTnT levels is essential for determining a diagnosis of ACS or AMI in geriatric patients. Further studies are needed to establish age-specific 99th percentile values of hs-cTnT for elderly individuals.

CXCL12-CXCR4 Axis Promotes Proliferation, Migration, Invasion, and Metastasis of Ovarian Cancer.

The CXCL12-CXCR4 chemokine axis may play a very important role in ovarian cancer cells proliferation, migration, invasion, and peritoneal metastasis in vitro and in vivo. In this study, transfected SKOV3-CXCR4, transfected vector SKOV3-negative, nontransfected SKOV3 ovarian cancer cells, and human peritoneal mesothelial cells (HPMCs) were cultivated in vitro, and the proliferation, migration, and invasion of these ovarian cancer cells were investigated with or without the influence of the CXCL12-CXCR4 axis. Nude mice models of ovarian cancer were created by injection of ovarian cancer cells into the peritoneal cavity for investigation of ovarian cancer cells metastasis. Our results demonstrated that in the SKOV3-CXCR4 group, the cell number of proliferation, migration, or penetration through the Matrigel membrane treated with CXCL12 was significantly (p < 0.05) greater than those treated with CXCR4 antibody or CXCR4 antagonist AMD 3100 in a concentration-dependent manner. In the SKOV3-negative and the nontransfected SKOV3 groups, no significant (p > 0.05) differences existed in the cell number of proliferation, migration, or penetration. Coculture of HPMCs and SKOV3-CXCR4 had significantly (p < 0.05) higher migration and invasion rates than the SKOV3-CXCR4-only group. In nude mice seeded with ovarian cancer cells, the tumor weight in the nude mice injected with SKOV3-CXCR4 cells was significantly (p < 0.05) greater than in the group injected with the SKOV3-negative or nontransfected SKOV3 cells. Taken together, our results show that the CXCL12-CXCR4 chemokine axis can significantly promote the proliferation, migration, invasion, and peritoneal metastasis of ovarian cancer cells, and interference with this axis may serve as a new therapeutic target in treating ovarian cancers.

[Relationship between chemokine axis CXCL12-CXCR4 and epithelial ovarian cancer].

OBJECTIVE: To explore the relationship between chemokine axis CXCL12-CXCR4 and the pathogenesis and severity of epithelial ovarian cancer. METHODS: SKOV3 transfected with plasmid, SKOV3 transfected with vector and SKOV3 were cultured in vitro. Methyl thiazolyl tetrazolium (MTT) was used to analyze the effects of different concentrations of CXCL12 on the proliferation, migration and invasion of three cell lines and examine the inhibition of neutralizing CXCR4 antibody or antagonist AMD3100. And the load and weight of acquired tumor were determined at different concentrations of CXCL12. RESULTS: CXCL12 could promote the proliferation, migration and invasion of SKOV3/CXCR4 cells in a dose-dependent fashion (P < 0.05). The effect on CXCL12 tumorigenesis could be inhibited by neutralizing CXCR4 antibody or antagonist AMD3100 (P < 0.05). Significant differences existed in the mean survival time, load and weight of metastatic tumors among the three nude mice. CONCLUSION: A close correlation exists between chemokine axis CXCL12-CXCR4 and the pathogenesis, metastasis of epithelial ovarian cancer. The above axis may be an important pathogenic factor of epithelial ovarian cancer. And the antibody of CXCL12-CXCR4 is probably effective in its management.