Primer osteoartritli hastalarda sinovyal sıvı ve plazmanın koagülasyon, fibrinolitik sistem ve galektin-3 yönünden incelenmesi

Enflamasyon ve koagülasyon artritte prognozu ağırlaştıran sebepler arasındadır. Fakat her ikisinin de nedeni ve mekanizması henüz anlaşılmış değildir. Ayrıca OA’nın, RA’dan farklı olarak, enflamatuvar hastalık olup olmadığı da netlik kazanmamış henüz araştırma safhasındadır. Bu çalışmada; çalışma grubuna aldığımız POA’lı olgu (n=20) ve kontrol (n=20) grubunda, sinovyal sıvı ve plazmada; galektin-3 ile birlikte enflamasyon belirteçleri, bazı koagülasyon faktörleri ve fibrinolitik sistem parametreleri incelenmiştir. POA’lı olguların sinovyal sıvısı ve plazmasındaki galektin-3 değerleri kontrol grubuna göre ileri derecede anlamlı bir artış göstermiştir (p<0,001). Bu artış sinovyal sıvıda dramatik derecede olmuştur. POA’lı olguların sinovyal sıvısındaki ortalama galektin-3 değerleri 14,20 ±1.33 ng/ml iken, kontrol grubunda bu değerler 3.31±1,71 ng/ml’dir. POA’lı olguların kandaki CRP değerleri ile bir saatlik sedimantasyon hızı da sırasıyla (p<0,005) ve (p<0,001) olarak galektin-3 gibi ileri derecede anlamlı artış göstermiştir. POA’lı olguların plazma ve sinovyal sıvısındaki protein C değerleri ise yukarıdaki enflamasyon belirteçlerinin aksine hem plazmada hem de sinovyal sıvıda anlamlı olarak azalmıştır (p<0,001). Çalışmamızda ekstrensek ve entrensek sistem faktörlerinde de artışlar tespit ettik. Rutin tarama testi olan PT ve APTT testleri de bu bulguları desteklemektedir. Bunun yanısıra POA’lı olguların fibrinojen değerleri hem plazmada hem sinovyal sıvıda ileri derece anlamlı (p<0,001) artış gösterirken, plazminojen değerleri plazmada değişmemiş sinovyal sıvıda ileri derecede artmıştır. Benzer şekilde D-dimer değerleri de hem plazmada hem de sinovyal sıvıda ileri derecede anlamlı artış göstermiştir (p<0,001). Sonuçlarımız, çalışma grubumuza giren POA’lı olgularda enflamatuvar yanıt olduğunu, koagülasyon faktörlerindeki artığın, bu olguların sinovyal sıvılarında pıhtı oluşumunu desteklediğini, koagülasyon sisteminde kontrolün azaldıını, fibrinolitik sistemin hızlandığını, bunun nedeninin de enflamasyon olabileceğini düşündürmüştür. SUMMARY Inflammation and coagulation are among the factors that worsen the prognosis in arthritis.However the reasons and the mechanisms of action are still not well understood. Moreover,it is still not certain if OA is an inflammatory disease or not.Therefore, in the present study, we investigated galectin-3 and inflammation, coagulation and fibrinolytic system markers both in synovial fluid and in plasma in the experimental group with POA (n=20) and in control group (n=20). In POA group, Galectin-3 increased significantly both in synovial fluid and in plasma compared with the control group (p<0,001). Blood CRP levels and one hour sedimentation rates increased significantly when compared with the controls (p<0,005 and p<0,001 respectively).Moreover, plasma and synovial fluid Protein C levels decreased significantly when compared with the control group (p<0,001). On the other hand we found elevations in the intrinsic and extrinsic factors. PT and APTT levels supports these findings (p<0,001). Furthermore fibrinogen levels in the POA group increased significantly both in the plasma and in the synovial fluid (p<0,001).On the other hand, plasminogen levels were found to be increased significantly in the synovial fluid and remained constant in plasma. Moreover, D-Dimer levels increased significantly both in plasma and in synovial fluid (p<0,001). Based on our results we suggest that, in patients with POA, there is an inflammatory response and the increase in the coagulation factors induces the clot formation in their synovial fluid. Consequently, inflammation may be the reason for the decrease in the control of coagulation and the increase in fibrinolytic system

Primer osteoartritli hastalarda sinovyal sıvı ve plazmanın koagülasyon, fibrinolitik sistem ve galektin-3 yönünden incelenmesi

ÖZETEnflamasyon ve koagülasyon artritte prognozu ağırlaştıran sebepler arasındadır. Fakather ikisinin de nedeni ve mekanizması henüz anlaşılmış değildir. Ayrıca OA’nın, RA’danfarklı olarak, enflamatuvar hastalık olup olmadığı da netlik kazanmamış henüz araştırmasafhasındadır. Bu çalışmada; çalışma grubuna aldığımız POA’lı olgu (n=20) ve kontrol(n=20) grubunda, sinovyal sıvı ve plazmada; galektin-3 ile birlikte enflamasyon belirteçleri,bazı koagülasyon faktörleri ve fibrinolitik sistem parametreleri incelenmiştir.POA’lı olguların sinovyal sıvısı ve plazmasındaki galektin-3 değerleri kontrol grubunagöre ileri derecede anlamlı bir artış göstermiştir (p<0,001). Bu artış sinovyal sıvıda dramatikderecede olmuştur. POA’lı olguların sinovyal sıvısındaki ortalama galektin-3 değerleri14,20 ±1.33 ng/ml iken, kontrol grubunda bu değerler 3.31±1,71 ng/ml’dir.POA’lı olguların kandaki CRP değerleri ile bir saatlik sedimantasyon hızı da sırasıyla(p<0,005) ve (p<0,001) olarak galektin-3 gibi ileri derecede anlamlı artış göstermiştir.POA’lı olguların plazma ve sinovyal sıvısındaki protein C değerleri ise yukarıdakienflamasyon belirteçlerinin aksine hem plazmada hem de sinovyal sıvıda anlamlı olarakazalmıştır (p<0,001).Çalışmamızda ekstrensek ve entrensek sistem faktörlerinde de artışlar tespit ettik. Rutintarama testi olan PT ve APTT testleri de bu bulguları desteklemektedir.Bunun yanısıra POA’lı olguların fibrinojen değerleri hem plazmada hem sinovyal sıvıdaileri derece anlamlı (p<0,001) artış gösterirken, plazminojen değerleri plazmada değişmemişsinovyal sıvıda ileri derecede artmıştır. Benzer şekilde D-dimer değerleri de hem plazmadahem de sinovyal sıvıda ileri derecede anlamlı artış göstermiştir (p<0,001).Sonuçlarımız, çalışma grubumuza giren POA’lı olgularda enflamatuvar yanıt olduğunu,koagülasyon faktörlerindeki artığın, bu olguların sinovyal sıvılarında pıhtı oluşumunudesteklediğini, koagülasyon sisteminde kontrolün azaldıını, fibrinolitik sistemin hızlandığını,bunun nedeninin de enflamasyon olabileceğini düşündürmüştür.SUMMARY Inflammation and coagulation are among the factors that worsen the prognosis in arthritis.However the reasons and the mechanisms of action are still not well understood. Moreover,it is still not certain if OA is an inflammatory disease or not.Therefore, in the present study, we investigated galectin-3 and inflammation, coagulation and fibrinolytic system markers both in synovial fluid and in plasma in the experimental group with POA (n=20) and in control group (n=20). In POA group, Galectin-3 increased significantly both in synovial fluid and in plasma compared with the control group (p<0,001). Blood CRP levels and one hour sedimentation rates increased significantly when compared with the controls (p<0,005 and p<0,001 respectively).Moreover, plasma and synovial fluid Protein C levels decreased significantly when compared with the control group (p<0,001). On the other hand we found elevations in the intrinsic and extrinsic factors. PT and APTT levels supports these findings (p<0,001). Furthermore fibrinogen levels in the POA group increased significantly both in the plasma and in the synovial fluid (p<0,001).On the other hand, plasminogen levels were found to be increased significantly in the synovial fluid and remained constant in plasma. Moreover, D-Dimer levels increased significantly both in plasma and in synovial fluid (p<0,001). Based on our results we suggest that, in patients with POA, there is an inflammatory response and the increase in the coagulation factors induces the clot formation in their synovial fluid. Consequently, inflammation may be the reason for the decrease in the control of coagulation and the increase in fibrinolytic system

Investigation of Inflammatory and Hemostatic Parameters in Female Patients Undergoing Total Knee Arthroplasty Surgery

Tendency to hypercoagulation is a common phenomenon in primary osteoarthritis patients (POA) undergoing total knee arthroplasty (TKA) surgery, but the clinical implications of this condition are not clear. Therefore we aimed to evaluate the inflammatory and coagulation parameters in the patient group and find a possible explanation for the tendency to hypercoagulation occurring in plasma and synovia of inflamed joints. Of the evaluated factors involved in inflammation and coagulation, galectin-3, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, FVIIa:C, FXII:C, and platelet count increased, whereas tissue factor (TF) activity in synovia, PT, APTT and FVII:C in plasma and synovia were decreased. In conclusion, activation of inflammation and tendency to hypercoagulation is observed in preoperative plasma and synovia of patients undergoing TKA surgery

Morphine attenuates neurotoxic effects of MPTP in zebrafish embryos by regulating oxidant/antioxidant balance and acetylcholinesterase activity

Parkinson's disease (PD) is one of the most common neurodegenerative diseases due to the loss of dopaminergic neurons in the midbrain in the substantia nigra. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxic agent causing disruptions in mitochondria of dopaminergic neurons leading to impaired oxidant-antioxidant balance. Both zebrafish and zebrafish embryos are sensitive to MPTP. In zebrafish embryos, MPTP decreases the dopaminergic cells in the diencephalon by damaging dopaminergic neurons. Morphine is an opioid pain killer and a strong analgesic that is used to treat chronic pain. Until today morphine has been shown to regulate the survival or death of neurons and both protective and destructive effects of morphine have been reported in the central nervous system. This study aimed to evaluate the effects of morphine in MPTP-exposed zebrafish embryos. Developmental parameters were monitored and documented daily during embryonic development. Locomotor activity of zebrafish embryos at 96 h postfertilization (hpf) was determined. Acetylcholinesterase (AChE) activity and oxidant-antioxidant parameters were analyzed by biochemical methods. RT-PCR was used to evaluate bdnf, dj1, lrrk and pink1 expressions. Morphine treatment improved mortality and hatching rates, locomotor activity, AChE, and antioxidant enzyme activities as well as the expressions of bdnf, dj1, lrrk and pink1 in a dose-dependent manner that were altered by MPTP. Increased lipid peroxidation supports the role of morphine to induce autophagy to prevent PD-related pathologies. Our study provided important data on the possible molecular mechanism of the therapeutic effects of morphine in PD

Increased serum sialic acid levels in primary Osteoarthritis and inactive rheumatoid arthritis

ALTURFAN, A.A., USLU, E., ALTURFAN, E.E., HATEMI, G., FRESKO, I. and KOKOGLU, E. Increased Serum Sialic Acid Levels in Primary Osteoarthritis and Inactive Rheumatoid Arthritis. Tohoku J. Exp. Med., 2007, 213 (3), 241-248 - Accumulation of oxidized proteins and impaired antioxidant system have been shown to be associated with arthritis. Serum sialic acid (SA) is known as a parameter of inflammation. In the present study, to explore the potential role of SA in arthritis, we measured serum SA levels, plasma protein oxidation, and antioxidant status in patients with primary osteoarthritis (POA) and inactive rheumatoid arthritis (RA). Inactive RA (iRA) was defined upon the American College of Rheumatology criteria for clinical remission of RA. A total of 40 patients (20 POA patients, including 4 male subjects, and 20 iRA female patients) and 20 healthy female subjects were included in this study. SA, antioxidants, and protein oxidation levels were determined spectrophotometrically in serum or plasma samples. Serum SA levels were significantly increased in POA (3.34 +/- 0.37 mM, p < 0.0001) and 1RA (3.11 +/- 0.47 mM, p < 0.05), compared with healthy controls (2.41 +/- 0.16 mM). Plasma total antioxidant activity, plasma superoxide dismutase activity and serum reduced glutathione levels were significantly decreased in patients with POA and those with iRA, whereas plasma carbonyl content and serum total protein were increased in those patients. Moreover, plasma total thiol levels were significantly increased in iRA and decreased in POA. Thus, increased SA and protein oxidation levels are associated with the decreased antioxidant levels in POA and iRA patients. These results suggest that SA may be considered as a potent defense molecule against oxidative damage in arthritis. Antioxidant therapy may halt or ameliorate the progression of arthritis. - osteoarthritis; rheumatoid arthritis; oxidative stress; antioxidants; sialic acid (c) 2007 Tohoku University Medical Press

Caprylic acid ameliorates rotenone induced inflammation and oxidative stress in the gut-brain axis in Zebrafish

Background Dysfunction of the gastrointestinal tract (GIT) is one of the most common non-motor symptom of Parkinson's Disease (PD). Pathological processes causing PD were suggested to initiate in the enteric nervous system (ENS) and proceed to the central nervous system (CNS). There are studies showing that low-carbohydrate ketogenic diets can improve motor symptoms of PD. Caprylic acid (C8) is the principal fatty acid component of the medium-chain triglycerides in the ketogenic diets. In this study, we aimed to evaluate the effects of caprylic acid, in neurotoxin exposed zebrafish focusing on the relationship between intestinal and brain oxidative stress and inflammation. Methods Adult zebrafish were exposed to rotenone (5 mu g/L) (R group) and caprylic acid (20 and 60 mg/mL) (L + HDCA and R + HDCA groups) for 30 days. At the end of 30 days locomotor activities were determined. Levels of lipid peroxidation (LPO), nitric oxide, glutathione and superoxide dismutase and glutathione S-transferase activities were determined by spectrophotometric methods and gene expressions of tnf alpha, il1, il6, il21, ifn gamma and bdnf were evaluated by RT-PCR in the brain and intestinal tissues of zebrafish. Results Caprylic acid ameliorated LPO, NO, SOD and the expressions of tnf alpha, il1, il6, il21, ifn gamma and bdnf in brain and intestines. Locomotor activities were only ameliorated in high dose R + HDCA group. Conclusions Caprylic acid ameliorated the neurotoxin-induced oxidative stress and inflammation both in the brain and intestines and enhanced locomotor activity in zebrafish