Bogdan Cylwik

Relationship between serum acute-phase proteins and high disease activity in patients with rheumatoid arthritis

PURPOSE The aim of this study was to assess the relationship between serum acute-phase proteins and high disease activity evaluated by activity score (DAS28) in patients with rheumatoid arthritis. MATERIAL/METHODS Studies were carried out on 27 females with RA and 32 control women. Acute-phase proteins were divided into 4 fractions as follows: alpha1-globulins represented by alpha1-acid glycoprotein (AGP) and alpha1-antitrypsin (AAT); alpha2-globulins - haptoglobin (Hp); beta-globulins - complement C3 (C3) and total transferrin (Tf); gamma-globulins - C reactive protein (CRP), rheumatoid factor (RF) and immunoglobulin G (IgG), and determined by immunoturbidimetric methods. RESULTS The serum levels of acute-phase proteins changed in RA patients. On account of the alterations of concentration, acute-phase proteins are placed in the downgrade scale as follows: CRP, Hp, AGP, C3, AAT and Tf. None of the acute-phase proteins correlated with the RF and the majority of them were closely related to ESR. Almost all of the acute-phase proteins (without C3) were closely related to RA activity (based on DAS28) and their places in the downgrade scale were as follows: CRP, Tf, AGP, Hp and AAT. The degree of disability evaluated by Health Assessment Questionnaire has affected on the concentrations of AGP, Tf and CRP. Serum AGP, AAT and RF levels significantly correlated with the patients age. No correlations were observed between IgG, TP levels, and clinical data. CONCLUSIONS Among the entire panel, the CRP and AGP appeared to be the most useful biochemical markers for evaluation of the disease activity of patients with RA.

The effect of the severity of liver cirrhosis on the level of lipids and lipoproteins

The effect of severity of liver cirrhosis, an alcoholic and non-alcoholic genesis, on the results of serum lipids and lipoproteins was evaluated. Serum cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-Ch), and low-density lipoprotein cholesterol (LDL-Ch) were measured in the sera of 59 patients suffering from alcoholic cirrhosis and 34 patients with non-alcoholic cirrhosis. The level of serum triglycerides depends on the severity of liver damage in alcoholic liver cirrhosis, being the highest in Child-Pugh score B. The severity of liver damage significantly affects the HDL-Ch and LDL-Ch levels in cirrhosis of non-alcoholic origin, reaching the highest value for LDL-Ch and the lowest for HDL-Ch in score C. It should not be generalized that the levels of lipids and lipoproteins in liver cirrhosis progressively diminished with the deterioration of liver function. The serum HDL-Ch and LDL-Ch may be considered as markers of severity of liver damage in non-alcoholic cirrhosis, but the triglycerides only in disease of alcoholic origin.

Total and Free Serum Sialic Acid Concentration in Liver Diseases

Background. The objective of this study was to compare the levels of total (TSA) and free (FSA) sialic acid in acute and chronic liver diseases. Materials and Methods. The serum TSA and FSA levels were determined in 278 patients suffering from acute and chronic liver diseases of different etiologies. TSA was estimated by enzymatic method and FSA by the thiobarbituric method modified by Skoza and Mohos. Results. There were no significant differences in the serum TSA concentration between liver diseases of different etiologies, although in most of the liver diseases the mean TSA level was significantly lower than that in the control group. In contrast to TSA, the concentration of FSA appears to differ between liver diseases. In toxic hepatitis it was higher than that in nonalcoholic cirrhosis. However, neither of them differs between alcoholic and nonalcoholic cirrhosis or between liver tumors and tumors with cirrhosis. Conclusions. We conclude that the changes in concentrations of TSA and FSA during the same liver diseases indicate significant disturbances in sialylation of serum glycoproteins.

Sialic acid level reflects the disturbances of glycosylation and acute‑phase reaction in rheumatic diseases

In the rheumatic diseases, the changes in the carbohydrate part of serum glycoproteins occur and these abnormalities can be monitored by serum level of total and free sialic acid. The aim of this study was to evaluate the total and free sialic acid level as a marker of inflammation activity (TSA) and the changes in glycosylation of blood glycoproteins (FSA) in rheumatoid arthritis (RA), systemic sclerosis (SSc) and systemic lupus erythematosus (SLE). Studies were carried out in 50 patients with RA, 24 with SLE and 32 with SSc. TSA concentration was measured with an enzymatic, colorimetric method and FSA with a thiobarbituric method. The serum levels of TSA in RA and SLE patients were significantly increased compared to controls and in RA patients were higher than that in SSc patients. The mean serum level of FSA in RA patients was significantly higher, but in SSc patients significantly lower than that in the controls, and in RA patients was significantly higher than in SLE and in SSc patients. All acute-phase proteins were changed: Positive acute-phase proteins were elevated, and the negative protein was decreased. The positive acute-phase proteins positively correlated with the levels of TSA and FSA in RA and SSc patients. In SLE patients, TSA positively correlated with haptoglobin and α1-antitrypsin. In RA patients, there was the positive correlation of TSA and FSA with DAS 28. The changes in the serum levels of TSA and FSA in the course of rheumatic diseases could reflect the abnormalities in glycosylation/sialylation patterns of glycoproteins induced by acute-phase response.

Serum total and free sialic acid in patients with chronic liver disease

Sialic acid (SA) is a derivative of neuraminic acid attached to the carbohydrate chains of glycoproteins and glycolipids. The attachment of SA to carbohydrate chains takes place in the liver. Therefore, it has been hypothesized that liver function influences serum SA concentrations. Variations in serum total SA (TSA) concentrations in chronic liver diseases such as cirrhosis, hepatoma, viral hepatitis and fatty liver were reported previously, but there are differences in published results (1–3). Additionally, post-translational glycosylation (sialylation) of proteins in the liver is affected by chronic alcohol abuse (4–6). These perturbations cause the release of the free form of SA (FSA) and increase its concentration in the sera of alcoholics (7). This study compares serum TSA and FSA concentrations in patients suffering from cirrhosis and viral hepatitis. The test group consisted of 79 patients (27 females and 52 males) (mean age: 55 years; range: 20–84). The patients were divided into three subgroups: alcoholic cirrhosis – 31 patients (12 females and 19 males), non-alcoholic cirrhosis – 24 patients (9 females and 15 males) and chronic viral hepatitis C – 24 patients (10 females and 14 males). Causes of non-alcoholic liver cirrhosis were hepatitis B (7 cases) and C virus (3 cases), biliary obstruction (5 cases), autoimmune hepatitis (5 cases) and steatohepatitis (4 cases). Diagnosis was on the basis of physical and clinical examination (abdominal ultrasound, microscopic analysis of liver biopsy samples in selected cases), serological testing whepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV)x and biochemical evidence of liver damage. The control group consisted of 49 healthy subjects recruited from

Serum Sialic Acids Levels According to the Severity of Liver Cirrhosis

The sialylation of serum proteins and lipids changes in liver diseases of different etiologies and could change the total sialic acid (TSA), lipid‐bound SA (LSA), and free SA (FSA) levels in the sera. However, little is known of the relationship of serum SAs concentrations and the severity of liver disease. Therefore, the aim of this study was to investigate the SAs concentrations (TSA, LSA, and FSA) in liver cirrhosis in relation with the severity of liver disease.

N-Latex CDT Results in Liver Diseases

AIMS The aim of this study was to test whether liver diseases of alcoholic and non-alcoholic origin cause false-positive carbohydrate-deficient transferrin (CDT) results when the particle-enhanced immunonephelometry for CDT assays is used and to assess the effect of liver disease severity on N-Latex CDT results. METHODS Blood was sampled from 245 newly admitted patients suffering from liver diseases: alcoholic and non-alcoholic cirrhosis (AC), chronic viral (B and C) and non-viral hepatitis, toxic and autoimmune hepatitis (AIH), hepatocellular carcinoma and primary biliary cirrhosis (PBC). CDT was determined by particle-enhanced imunononephelometry using the N-Latex CDT test. RESULTS There were significant differences in %CDT levels between liver diseases of various etiologies. The %CDT level in AC was higher than that in chronic hepatitis (non-viral and viral C). In turn, the %CDT level in chronic hepatitis C was lower than that in toxic hepatitis. The frequency of false-positive %CDT results in liver diseases of non-alcoholic origin was 13/146, and was highest in AIH (4/14). There were no CDT-positive results in PBC and chronic hepatitis B. The frequency of CDT-positive results in alcoholic liver diseases was 24/59 in cirrhosis and 10/34 in hepatitis. Serum levels of %CDT in cirrhotic patients are correlated with the severity of the disease assessed by the Child-Pugh score. CONCLUSION We concluded that the liver diseases affect the relative but not absolute values of CDT when using the assay with the monoclonal antibodies directed against CDT. The CDT results from N-Latex CDT test reflect the severity of liver dysfunction.

The diagnostic power of direct carbohydrate-deficient transferrin immunoassay in alcoholics. Absolute or relative values?

The objective of this study was to compare the diagnostic power of direct carbohydrate-deficient transferrin (CDT) immunoassay in alcohol abuse expressed in relative units with the diagnostic power of the results expressed in absolute units. Serum CDT was determined in 127 alcoholics using N Latex CDT direct immunonephelometric assay (Siemens Healthcare Diagnostics, Marburg, Germany). The diagnostic sensitivity, specificity, negative and positive predictive value, and also the positive and negative likelihood ratios do not differ between results expressed in relative or absolute units independently of cutoff chosen. Finally, the area under the receiver operating characteristic (ROC) curves for N Latex CDT test expressed in absolute units does not differ from the area for results expressed in relative units. We conclude that the diagnostic usefulness of N Latex immunonephelometric assay using the relative or absolute values is the same.

Hyaluronic acid concentration in liver diseases

The aim of this study was to evaluate the effect of liver diseases of different etiologies and clinical severity of liver cirrhosis on the serum level of hyaluronic acid. The results were compared with noninvasive markers of liver fibrosis: APRI, GAPRI, HAPRI, FIB-4 and Forn’s index. Serum samples were obtained from 20 healthy volunteers and patients suffering from alcoholic cirrhosis (AC)—57 patients, non-alcoholic cirrhosis (NAC)—30 and toxic hepatitis (HT)—22. Cirrhotic patients were classified according to Child–Pugh score. Hyaluronic acid concentration was measured by the immunochemical method. Non-patented indicators were calculated using special formulas. The mean serum hyaluronic acid concentration was significantly higher in AC, NAC and HT group in comparison with the control group. There were significant differences in the serum hyaluronic acid levels between liver diseases, and in AC they were significantly higher than those in NAC and HT group. The serum hyaluronic acid level differs significantly due to the severity of cirrhosis and was the highest in Child–Pugh class C. The sensitivity, specificity, accuracy, positive and negative predictive values and the area under the ROC curve for hyaluronic acid and all non-patented algorithms were high and similar to each other. We conclude that the concentration of hyaluronic acid changes in liver diseases and is affected by the severity of liver cirrhosis. Serum hyaluronic acid should be considered as a good marker for noninvasive diagnosis of liver damage, but the combination of markers is more useful.

The effect of intragastric ammonia production on titratable gastric acid output in Helicobacter pylori-infected patients with chronic gastritis.

The purpose of this study was to assess whether intragastric neutralization of HCl by ammonia in Helicobacter pylori-infected patients could meaningfully affect the titratable acid output as a measure of gastric acid secretion in a relation to the severity of infection. In 79 patients with different degrees of Helicobacter pylori infection and chronic gastritis, the basal acid output (BAO) and maximal acid output (MAO) after pentagastrin (6 μg/kg s.c.) was estimated. Cl− and NH4+ contents in these fractions were also assayed. H+/Cl− ratio in the MAO fraction was diminished in markedly infected patients (68.1 ± 3.9%, vs 84.1 ± 3.3% in noninfected patients; P < 0.005). Ammonium content was maximal in patients with marked infection (0.912 ± 0.086 vs 0.149 ± 0.034 mmol/hr in MAO [P < 0.001] and 0.475 ± 0.063 vs 0.105 ± 0.016 mmol/hr in BAO of noninfected patients [P < 0.001]), with intermediate values in mild and moderate infection. The NH4+/(H+ + NH4+) ratio reached 27.01 ± 7.34% in the BAO of moderately infected patients, vs 10.22 ± 3.81% in noninfected patients (P = 0.05), and 7.25 ± 1.06% in the MAO of markedly infected patients, vs 1.14 ± 0.33% in noninfected patients (P < 0.001). The intragastric ammonia production affects the titratable acid output in Helicobacter pylori-infected patients dependent on the severity of infection. Therefore this factor should be taken into consideration in the evaluation of gastric secretory function in Helicobacter pylori-infected patients.