Joanna Iłżecka

Interleukin‐1β converting enzyme/Caspase‐1 (ICE/Caspase‐1) and soluble APO‐1/Fas/CD 95 receptor in amyotrophic lateral sclerosis patients

Objectives – The aim of the study was to investigate the role of ICE/ Caspase‐1 and soluble APO‐1/Fas/CD 95 receptor in amyotrophic lateral sclerosis patients. Material and methods– The apoptosis parameters were measured by enzyme‐linked immunosorbent assay (ELISA) in serum and cerebrospinal fluid from 25 amyotrophic lateral sclerosis and 15 control patients. Results– There has been shown a significant increase of ICE/Caspase‐1 level in serum, and significant decrease of this parameter in cerebrospinal fluid from amyotrophic lateral sclerosis patients. Soluble APO‐1/Fas/CD 95 level in amyotrophic lateral sclerosis patients did not differ from the control group. There was no significant correlation between clinical status, duration of amyotrophic lateral sclerosis, and levels of ICE/Caspase‐1 and soluble APO‐1/Fas/CD 95. Conclusion– Our study suggests that ICE/Caspase‐1 may play a role in neurodegeneration in ALS. Due to ethical difficulties we cannot include patients suffering from progressive neurological diseases, who are a more appropriate control group for the amyotrophic lateral sclerosis patients. Therefore we are limited in drawing conclusions from the research.

Serum bilirubin concentration in patients with amyotrophic lateral sclerosis

Oxidative stress plays probably an important role in the etiopathogenesis of amyotrophic lateral sclerosis (ALS). It is known that bilirubin (BR) is an endogenous antioxidant. The aim of this study was to evaluate serum BR concentration in ALS patients. BR was determined by automated analyzer in the serum from 30 ALS and 26 healthy control group people. The study showed that serum BR concentration is significantly decreased in ALS patients with a long duration of ALS compared with patients with a short duration (P<0.05), and it is also significantly decreased in ALS patients with a moderate clinical state compared with control group patients (P<0.05). There was no significant difference in BR concentration between the groups of patients classified according to their age and sex, the clinical state, and the type of ALS onset (P>0.05). Results suggest a possibility of endogenous antioxidant system dysfunction in later phase of ALS. A decrease in BR concentration might diminish its protective effect against oxidative injury and could accelerate motor neuron degeneration.

Increased Serum Levels of Endogenous Protectant Secretory Leukocyte Protease Inhibitor in Acute Ischemic Stroke Patients

Background: Activated leukocytes and their mediators may participate in ischemic brain injury. Secretory leukocyte protease inhibitor (SLPI) plays an important role in regulating the activity of the proteases, and may limit tissue damage. The aim of this study was to evaluate the changes in SLPI level in ischemic stroke patients. Methods: The study comprised 20 patients with ischemic stroke and 20 controls. SLPI levels were measured in serum using enzyme-linked immunosorbent assay on the 1st, 5th and 12th day after stroke onset. Results: SLPI was increased in the whole group of ischemic stroke patients compared with controls. It was also significantly increased on the 1st, 5th and 12th day after stroke in patients with larger brain tissue damage involving one or more lobe of the brain and in patients with more severe clinical status compared to controls (p < 0.05). A significant correlation between SLPI and the extent of brain tissue damage was observed on the 12th day after ischemic stroke onset (p < 0.05). Conclusions: Our results suggest that SLPI takes part in the anti-inflammatory reaction after ischemic stroke. Endogenous SLPI may have a neuroprotective effect, and could be a prototype therapeutic approach for ischemic stroke.

Serumska razina za neuron specifične enolaze kao biljeg ishemijsko-reperfuzijskog oštećenja u bolesnika podvrgnutih karotidnoj endarterektomiji

In patients with atherosclerotic stenosis of the extracranial segment of internal carotid artery, surgical intervention is an effective method to prevent cerebral ischemic stroke. However, this surgical procedure may cause vascular brain damage. The aim of the study was to investigate consequential brain ischemia-reperfusion injury by measuring the cerebral specific marker, neuron-specific (NSE), in serum of patients having undergone internal carotid endarterectomy (CEA). The study involved 25 patients that underwent CEA due to internal carotid artery stenosis. Blood samples were obtained from each patient on three occasions: within 24 h prior to surgery, 12 h after surgery, and 48 h after surgery. Serum NSE levels were measured by a commercially available enzyme-linked immunosorbent assay. The study showed that serum NSE level was statistically significantly increased 48 h after CEA as compared with the level 12 h after surgery and the level before surgery (p<0.05). Difference in serum NSE between the level before surgery and 12 h after CEA was not statistically significant (p>0.05). Data from our study showed CEA to affect serum NSE in patients with significant internal carotid artery stenosis. Thus, serum NSE may be used as a biochemical marker of brain ischemia-reperfusion injury following CEA.

Neurocognitive dysfunctions and functional state of patients after internal carotid endarterectomy

Introduction. Carotid endarterectomy (CEA) is a method of treatment of carotid stenosis, which significantly reduces the risk of ischemic stroke. This procedure may affect the patient’s neurocognitive functioning. The aim of the study was to evaluate the occurrence of neurocognitive disorders and to determine the functional status of the patients undergoing CEA. Material and methods. The study group consisted of 102 people who underwent CEA. Studies were performed preoperatively and repeated on the fourth postoperative day. The following scales were used: the Mini-Mental State Examination (MMSE), Activities of Daily Living Scale (ADL), Instrumental Activities of Daily Living (IADL) and the Hamilton Depression Rating Scale (HAM-D). Results. The average number of points obtained by patients in the MMSE, both before and after surgery is 26 points to 30 that may be obtained, which shows a subtle cognitive impairment. Almost every patient showed fitness both in terms of basic (ADL), as well as complex (IADL) activities before and after surgery. Conclusions. Low or average level of cognitive performance is observed in most subjects, both before and after CEA. There are many different factors that can affect the cognitive functions. The functional status of patients stood without significant changes.

Effect of carotid endarterectomy on brain damage markers

Carotid endarterectomy (CEA) is a recommended treatment in the prevention of ischemic stroke. However, this procedure may cause neurological complications caused by cerebrovascular damage. While YKL‐40 is a proinflammatory protein, neurofilament light polypeptide (NEFL) and brain lipid‐binding protein (FABP7) are structural components of the brain. The aim of the study was to investigate YKL‐40, NEFL, and FABP7 in the serum of patients undergoing CEA.

Jakość życia chorych na chorobę Alzheimera / The life quality of the people suffering from Alzheimer’s disease

Abstract Introduction. Alzheimer’s disease is characterized by progressive dementia process. There’s no medicine available to hinder that process. In case, the ill individual is unable to diagnose early symptoms of the disease, they call a doctor in the moment when a neurotic atrophy is irreversible. The patient is gradually losing self-reliance in everyday activities, the ability to take care of themselves, loses touch with the reality and surrounding world, begins to experience distressing symptoms and becomes isolated from the society. All these factors affect the life quality of an individual suffering from Alzheimer’s disease. Aim. The present article provides an analysis of literature on the quality of life in people suffering from Alzheimer’s disease.

Serum glial fibrillary acidic protein as a marker of brain damage in patients after carotid endarterectomy

Introduction. Surgical treatment of the extracranial section of internal carotid artery stenosis is an effective method of preventing cerebral ischaemic stroke. However, this surgical procedure may cause vascular brain damage. The aim of the study was to measure glial fibrillary acidic protein (GFAP) as a marker of brain damage in the serum of patients that underwent internal carotid endarterectomy (CEA). Material and methods. This study involved 25 participants who underwent CEA because of internal carotid artery stenosis. Blood samples were taken from each patient at three different times; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum GFAP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results. The study showed that serum GFAP levels were not statistically different between all the three measurements (p > 0.05). There was also no statistical significant difference in serum GFAP levels between symptomatic and asymptomatic patients (p > 0.05). There was no statistically significant correlation in serum GFAP level 12 and 48 hours after the surgery with the clamping time (p > 0.05). There was also no significant correlation in the serum GFAP levels with the velocity of blood flow in the internal carotid artery before CEA and after surgery (p > 0.05). Conclusions. The study revealed that CEA does not change serum GFAP levels. Thus, GFAP cannot be a biochemical marker of brain damage after this surgery.

Serum microtubule associated protein tau and myelin basic protein as the potential markers of brain ischaemia-reperfusion injury in patients undergoing carotid endarterectomy

Introduction. In the prevention of ischaemic stroke the recommended surgical procedure is carotid endarterectomy (CEA). However, surgical treatment of atherosclerotic stenosis may cause neurological complications. The aim of the study was to investigate consequential brain ischaemia-reperfusion injury by measuring the cerebral specific markers, the microtubule associated protein tau (MAPt) and myelin basic protein (MBP) in the serum of patients that underwent CEA. Material and methods. This study involved 25 participants who underwent CEA due to internal carotid artery stenosis. Blood samples were taken from each patient at three different intervals; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum MAPt and MBP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results. The study showed that serum MAPt and MBP levels were statistically significantly decreased 12 hours after CEA compared to the level before the surgery (p l 0.05), but MAPt and MBP levels were normalized 48 hours after CEA. There was statistically significant correlation in serum MAPt levels with the velocity of blood flow in the internal carotid artery 12 and 48 hours after CEA (p l 0.05). Conclusions. Data from our study showed that CEA affects serum neuromarkers levels, such as MAPt and MBP, in patients with significant internal carotid artery stenosis. MAPt and MBP levels showed characteristic time curve in patients who underwent CEA and did not experience any neurological deficit in perioperative period. Possible alterations of this time curve may potentially be an index of a neurological event occurrence.

Wczesna rehabilitacja pacjentów po udarze niedokrwiennym mózgu

Introduction. Ischemic stroke is caused by stopping or decreasing arterial perfusion. Strokes are a major cause of serious and chronic invalidity which affects the total costs borne by society. Treatment of ischemic stroke involves therapy that leads to improvement in brain perfusion in the area of ischemia, and reduces the consequences. Early rehabilitation of patients plays important role in the therapeutic management. There are different methods of rehabilitation that are adjusted to patient’s general health state, extent of stroke and physical efficiency. Aim of the study. Presentation of different methods of rehabilitation patients after ischemic stroke and their impact of improving the patient’s daily functioning. Short description of state of knowledge. Nowadays, medical rehabilitation has specialist equipment that produced good results in restoring patients efficiency. The aim of the rehabilitation is to improve motor function in the upper and lower limbs, decrease of aphasia, improve the competence of respiratory muscles, decrease pharynx and larynx muscle paresis, limit or remove the pain and improve the patient’s general feeling. Conclusion. The continuity of rehabilitation is important in the prevention of recurrence of stroke. It also plays an important role in the prevention of pseudostroke syndrome where there is no new focal lesions or changes, but manifests in the intensification of paresis, occurrence of subsequent complications and deterioration of the patient’s functional status.