Stężenie rezystyny w surowicy u dzieci z cukrzycą typu 1 — negatywna relacja z masą tłuszczową ciała

Introduction: Insulin is one of the major factors regulating adipose tissue function. On the other hand, adipocytes secrete adipocytokines that may influence insulin synthesis and action, and are involved in blood glucose regulation. In type 1 diabetes mellitus (t1DM), beta cells function is replaced with exogenous insulin therapy. This raises a question concerning the impact of t1DM on adipose tissue secretory function. The aim of this study was to evaluate one of the adipocytokines, resistin, serum concentrations in relation to body fat mass in children with t1DM.Material and methods: The study comprised 75 children with t1DM and a control group of 20 healthy coevals. All children had estimated serum resistin concentrations, glycated haemoglobin levels, growth and body weight measurements, and bioelectrical impedance analysis in order to establish body composition.Results: Resistin serum concentrations were significantly lower in children with t1DM vs. controls (median values: 343 vs. 590 pg/mL; mean values ± SD: 577 ± 561 vs. 861 ± 628 pg/mL; p < 0.001), and they negatively correlated with body fat mass (p = 0.022) and age (p = 0.022) in the t1DM group, but not in the control group. Disease duration, glycated haemoglobin levels and insulin dosage revealed no direct statistical relation to resistin levels.Conclusions: Diminished serum resistin concentrations and a negative correlation between resistin levels and body fat mass in children with type 1 diabetes seem to result from broken physiological adipo-insular regulations, independent of disease duration, its metabolic control and insulin supply. (Endokrynol Pol 2014; 65 (5): 342–347)Wstęp: Insulina jest jednym z głównych czynników regulujących funkcje tkanki tłuszczowej. Z drugiej strony, adipocyty wydzielają adipocytokiny, które mogą wpływać na sekrecję i działanie insuliny oraz brać udział w regulacji stężenia glukozy we krwi. W cukrzycy typu 1 sekrecja insuliny przez komórki beta zostaje zastąpiona przez egzogenną insulinoterapię. Powstaje pytanie o wpływ tej choroby na czynność sekrecyjną tkanki tłuszczowej. Celem pracy była ocena stężenia jednej z adipocytokin, rezystyny, w surowicy dzieci z cukrzycą typu 1, oraz związku oznaczonej rezystynemii z masą tkanki tłuszczowej.Materiał i metody: Badaniami objęto 75 dzieci z cukrzycą typu 1, oraz grupę kontrolną 20 zdrowych dzieci. U wszystkich wykonano oznaczenia stężenia rezystyny w surowicy, poziomu hemoglobiny glikowanej, pomiary wzrostu i masy ciała, oraz badanie impedancji bioelektrycznej celem oceny składu ciała.Wyniki: Stężenia rezystyny w surowicy były niższe u dzieci z cukrzycą typu 1 niż w grupie kontrolnej (mediana: 343 vs. 590 pg/ml, średnia ± SD: 577 ± 561 vs. 861 ± 628 pg/ml, p < 0,001) oraz korelowały ujemnie z masą tkanki tłuszczowej (p = 0,022) oraz wiekiem (p = 0,022) w grupie dzieci z cukrzycą, ale nie w grupie kontrolnej. Czas trwania choroby, poziom hemoglobiny glikowanej i dawkowanie insuliny nie wykazały bezpośredniego związku statystycznego ze stężeniami rezystyny.Wnioski: Obniżone stężenie rezystyny w surowicy oraz ujemna korelacja między stężeniami rezystyny i masą tłuszczową ciała u dzieci z cukrzycą typu 1 wydają się wynikać z przerwania fizjologicznych regulacji adipo-insularnych, niezależnie od czasu trwania choroby, jej kontroli metabolicznej i podaży insuliny. (Endokrynol Pol 2014; 65 (5): 342–347

Influence of opioid peptides on human neutrophil apoptosis and activation in vitro.

BACKGROUND: It has been shown that cells of the immune system release opioid peptides and possess receptors for them. The concentrations of opioid peptides in the peripheral circulation rapidly increase during inflammation and acute stress response. AIMS: The effect of opioid peptides Met-enkephalin (M-ENK) and beta-endorphin (beta-END) on the oxidative metabolism of normal human neutrophils and their death by apoptosis in vitro was investigated. METHODS: Isolated from peripheral blood, neutrophils were incubated in the presence or absence of 10(-6) to 10(-10) M of M-ENK and beta-END for 12 and 18 h. Apoptosis of neutrophils was determined in vitro by flow cytometric analysis of cellular DNA content and Annexin V-FITC protein binding to the cell surface. The MTT-reduction assay was employed to estimate the oxidative metabolism of neutrophils. RESULTS: Treatment with M-ENK caused a significant increase in apoptotic cells after 18 h of culture: *0 M (control) versus 10(-10) M, p < or = 0.02; **10(-10) M versus 10(-10) M, p < or = 0.02. Treatment with beta-END caused a significant increase in apoptotic cells after 12 h of culture: 0 M versus 10(-8) M, p < or = 0.03; **0 M versus 10(-10) M, p < or = 0.04. We found the significant increase in MTT reduction by neutrophils in the presence of M-ENK and beta-END both before and after the culture. However, the ability of neutrophils to reduce the MTT salt to formazan decreased significantly after the culture. CONCLUSIONS: We observed that the in vitro effect of opioid peptides on the neutrophil survival and their functional state was time and dose dependent. The presence of antioxidants in the culture medium modifies neutrophil survival

The connections of the endopiriform nucleus with the insular claustrum in the rat and rabbit

The connections between two parts of the claustrum in the rat and rabbit were studied using the highly fluorescent lipophilic carbocyanine dye (DiI). After the application of DiI crystal into the endopiriform nucleus, labeled fibers in the insular claustrum were observed in its part directly neighboring the insular cortex and capsula externa. Additionally, numerous projections into the piriform, insular and entorhinal cortices were present. The presence of connections between the endopiriform nucleus and insular claustrum suggests its role concerned with the processes taking part in the allocortical regions as well as in the limbic system

Galectin-3: a potential biomarker for diagnostics of heart failure

Heart failure is a dysfunction with varied ethology; one of possible causes is anticancer treatment with anthracyclines. Rapid diagnosis is important because the disease is associated with high mortality and morbidity. The only biomarkers fully approved for diagnostics of heart failure are natriuretic peptides. They are secreted by ventricular muscle cells in response to volume and pressure overload. However, their concentration can be influenced by other factors, such as age or gender. A potential marker, not affected by these issues might be galectin-3. Current studies showed that galectin can play particularly significant role in myocardial fibrosis and inflammation. Elevated galectin-3 concentration has been observed in such cardiovascular diseases as heart failure,  atherosclerosis, stroke and myocardial infarction. The review summarizes results of studies which indicate the role of galectin-3 in inducing fibrosis and cardiac remodelling (processes which influence disease progression and prognosis) and showed its potential diagnostic value.Heart failure is a dysfunction with varied ethology; one of possible causes is anticancer treatment with anthracyclines. Rapid diagnosis is important because the disease is associated with high mortality and morbidity. The only biomarkers fully approved for diagnostics of heart failure are natriuretic peptides. They are secreted by ventricular muscle cells in response to volume and pressure overload. However, their concentration can be influenced by other factors, such as age or gender. A potential marker, not affected by these issues might be galectin-3. Current studies showed that galectin can play particularly significant role in myocardial fibrosis and inflammation. Elevated galectin-3 concentration has been observed in such cardiovascular diseases as heart failure,  atherosclerosis, stroke and myocardial infarction. The review summarizes results of studies which indicate the role of galectin-3 in inducing fibrosis and cardiac remodelling (processes which influence disease progression and prognosis) and showed its potential diagnostic value

Awareness of oral health prophylaxis in pregnant women

Introduction: During pregnancy, changes in the oral cavity occur due to fluctuations in hormone levels and changes in eating habits and hygiene. Objectives: To evaluate pregnant women’s awareness of oral health prophylaxis. Material and Methods: An anonymous questionnaire was completed by 341 pregnant women from Malopolskie Voivodeship. The statistical analysis was carried out in the R program (v. 3.4.3); a p-value <0.05 was considered significant. Results: Over half of the respondents did not receive oral hygiene instruction and did not take part in any prophylactic program. The main sources of oral health knowledge were the internet (66.3%), dentist (43.1%) and gynaecologist (17.9%). Respondents willingly followed the advice of healthcare workers. Approximately 32% of the surveyed women were aware of the most appropriate period for dental treatment (second trimester). Over half of the women admitted that they would receive dental care more often if more procedures were reimbursed. Approximately 71% of the women were aware of the increased susceptibility to tooth decay during pregnancy. The relationship between the presence of caries in parents and that in children was known by 42.1% of respondents, but 45% admitted they did not know how to take care of their child’s teeth properly. Conclusions: Women with a higher education level had better knowledge in the area of oral health. However, most of the respondents need to increase their knowledge in this area. Prophylactic programs should be broadly propagated, and healthcare workers should deliver essential information in daily practice

Multiple brain abscesses caused by citrobacter koseri in a preterm neonate : case report

Background: Brain abscesses are very rarely diagnosed in neonates, but if present, they are associated with a high risk of severe complications and mortality. In neonates, brain abscesses can be detected on transfontanelle ultrasonography, in which they appear as hyperechogenic lesions surrounded by a hypoechogenic border. Case Report: We present a female neonate, born in the 28th week of gestation, with birth weight of 950 grams, who was born in an ambulance by spontaneous vaginal vertex delivery. No signs of infection were present until the 35th day of hospitalization, when a sudden and serious deterioration in the patient's condition was observed due to late-onset sepsis. Cranial US, performed on the 40th day of life, revealed hyperechogenic lesions with a hypoechogenic halo in the right frontal lobe, which could correspond to brain abscesses. These lesions were caused by Citrobacter koseri septicaemia, identified by transfontanelle ultrasonography, and confirmed on magnetic resonance imaging. The patient recovered and was discharged on the 91th day of life (39 PCA) with a recommendation of permanent neurological surveillance. Conclusions: Ultrasonography of the central nervous system can reveal inflammatory changes and developing brain abscesses. In neonates, magnetic resonance imaging should be performed as the method of choice for confirming brain abscesses

Epicutaneous immunization with ovalbumin and CpG induces TH1/TH17 cytokines, which regulate IgE and IgG2a production

Background: Subcutaneous allergen-specific immunotherapy is a standard route for the immunotherapy of allergic diseases. It modulates the course of allergy and can generate long-term remission. However, subcutaneous allergen-specific immunotherapy can also induce anaphylaxis in some patients, and therefore additional routes of administration should be investigated to improve the safety and tolerability of immunotherapy. Objective: We sought to determine whether epicutaneous treatment with antigen in the presence of a Toll-like receptor 9 agonist can suppress TH2-mediated responses in an antigenspecific manner. Methods: Epicutaneous immunization was performed by applying a skin patch soaked with ovalbumin (OVA) plus CpG, and its suppressor activity was determined by using the mouse model of atopic dermatitis. Finally, adoptive cell transfers were implemented to characterize the regulatory cells that are induced by epicutaneous immunization. Results: Epicutaneous immunization with OVA and CpG reduces the production of OVA-specific IgE and increases the synthesis of OVA-specific IgG2a antibodies in an antigen-specific manner. Moreover, eosinophil peroxidase activity in the skin and production of IL-4, IL-5, IL-10, and IL-13 are suppressed. The observed reduction of IgE synthesis is transferable with T-cell receptor (TCR) ab1CD41CD252 cells, whereas IgG2a production is dependent on both TCRab1 and TCRgd1 T cells. Further experiments show that the described phenomenon is myeloid differentiation primary response 88, IFN-g, and IL-17A dependent. Finally, the results suggest that epicutaneous immunization with OVA and CpG decreases the synthesis of OVA-specific IgE and skin eosinophil peroxidase activity in mice with ongoing skin allergy. Conclusion: Epicutaneous application of protein antigen in the presence of adjuvant could be an attractive needle-free and self-administered immunotherapy for allergic diseases

Metabolic syndrome and type 2 diabetes in 16-years-old boy - case report

Zespół metaboliczny jest silnym determinantem cukrzycy typu 2 oraz czynnikiem ryzyka miażdżycowych chorób układu sercowo-naczyniowego. Podstawowe kryteria rozpoznawania zespołu metabolicznego u dorosłych obejmują: otyłość brzuszną, dyslipidemię, nieprawidłową tolerancję węglowodanów i nadciśnienie tętnicze. W populacji polskiej częstość otyłości oraz zespołu metabolicznego stale wzrasta. Autorzy opisują przypadek 16-letniego chłopca przyjętego do szpitala z powodu przypadkowo ambulatoryjnie stwierdzonej nieprawidłowej glikemii na czczo. Wywiad rodzinny był dodatni w kierunku otyłości, cukrzycy typu 2, nadciśnienia tętniczego, dyslipidemii i choroby niedokrwiennej serca. W badaniu przedmiotowym stwierdzono otyłość brzuszną (BMI 32,9; WHR > 1), cechy acanthosis nigricans oraz podwyższone wartości ciśnienia tętniczego. W badaniach dodatkowych stwierdzono: wartości glikemii między 156 a 296 mg/dl, HbA1c - 10,7%, dyslipidemię oraz podwyższone wartości aminotransferaz. W badaniu ultrasonograficznym jamy brzusznej wykazano cechy stłuszczenia wątroby. Z tego względu u chłopca wprowadzono intensywne leczenie farmakologiczne, przeprowadzono edukację dietetyczną i diabetologiczną, a także ustalono zmiany w stylu życia. Po 6-miesięcznej terapii chłopca ponownie przyjęto do Kliniki w celu wykonania badań kontrolnych. Wyniki badań laboratoryjnych uległy poprawie, mimo że nie nastąpiło obniżenie masy ciała. Zespół metaboliczny należy rozpoznawać jak najwcześniej, ponieważ istnieje wówczas możliwość zastosowania leczenia, by zapobiec rozwojowi cukrzycy typu 2 i jej powikłaniom. Zatem badanie dzieci z nadwagą i otyłością w kierunku zespołu metabolicznego jest konieczne, szczególnie w przypadku stwierdzenia tego zespołu chorobowego w najbliższej rodzinie pacjenta.The metabolic syndrome is associated with increased risk of type 2 diabetes mellitus and atherosclerotic cardiovascular disease. Criteria of metabolic syndrome in adults include central obesity, dyslipidemia, impaired glucose tolerance and hypertension. The incidence of obesity, as well as metabolic syndrome, in population of Poland is increasing. Authors describe the case of 16-year-old boy admitted to the hospital because of accidentally diagnosed impaired fasting glucose. Family history appeared to be positive in terms of obesity, type 2 diabetes mellitus, hypertension, dyslipidemia and ischemic heart disease. Physical examination revealed abdominal obesity (BMI 32.9; WHR > 1), acanthosis nigricans, and elevated blood pressure. The main laboratory findings were as follows: blood glucose levels between 156 and 296 mg/dl; HbA1c - 10.7%, dyslipidemia, and elevated liver enzymes activity. Ultrasound of the abdomen showed signs of fatty liver. Intensive pharmacological treatment, as well as dietetic and diabetic education were performed and modification of the lifestyle was ordered. The boy was readmitted to the hospital after 6 month therapy to perform the control tests. Laboratory findings improved significantly, despite of the weight stability. Metabolic syndrome should be diagnosed early, when effective treatment may prevent the development of type 2 diabetes mellitus and its complications. It is advised to perform tests for elements of metabolic syndrome in overweight and obese children, especially in those with a positive family history

Criss-cross heart, dextrocardia and transposition of the great arteries — comprehensive management of a complex cardiovascular defect and rare morphology

The criss-cross heart congenital defect (CHD) concomitant with transposition of the great arteries has an incidence of less than 0.1% of all inherited heart anatomy abnormalities. It derives from the anomaly of cardiac rotation around its long axis after ventricular septation, and results in an atypical relation between the ventricles and the atria. Furthermore, such patients may also present with ventricular septal defect (VSD), large vessel malposition, double outflow and/or right ventricular hypoplasia (RV), pulmonary artery stenosis (PA), and tricuspid valve hypoplasia. A 7-month-old patient after a transcatheter pulmonary balloon valvuloplasty and a surgical unilateral modified Blalock-Taussig (BT) shunt was admitted to the paediatric cardiac surgery department for further treatment. CHD had been diagnosed prenatally and confirmed after birth. Echocardiographic study revealed dextrocardia and a criss-cross heart pathology with discordant atrioventricular (AV) and ventriculoarterial relations. Intracardiac pathology was concomitant with transposition of the great arteries [aorta originating from the RV, and PA from above the VSD], subvalvular and valvular pulmonary stenosis (gradient RV/PA approx. 90 mm Hg), and unobstructed BT shunt. Systemic cyanosis was not observed, and the child’s mental and physical development was undisturbed. After diagnostic catheterisation, the patient was referred for further surgery. Using extracorporeal circulation, a bidirectional Glenn anastomosis was performed, and the BT shunt as well as the PA were closed and dissected. The postoperative course was uncomplicated. More than 90% of criss-cross heart co-occur with levocardia and the concomitance with the AV-related transposition of the great arteries and dextrocardia, to the best of our knowledge, is the second described report in the literature. Thus, the diagnosis of a rare congenital heart defect should be always considered, especially in prenatal diagnostics, and precisely defined during qualification for further surgical treatment.The criss-cross heart congenital defect (CHD) concomitant with transposition of the great arteries has an incidence of less than 0.1% of all inherited heart anatomy abnormalities. It derives from the anomaly of cardiac rotation around its long axis after ventricular septation, and results in an atypical relation between the ventricles and the atria. Furthermore, such patients may also present with ventricular septal defect (VSD), large vessel malposition, double outflow and/or right ventricular hypoplasia (RV), pulmonary artery stenosis (PA), and tricuspid valve hypoplasia. A 7-month-old patient after a transcatheter pulmonary balloon valvuloplasty and a surgical unilateral modified Blalock-Taussig (BT) shunt was admitted to the paediatric cardiac surgery department for further treatment. CHD had been diagnosed prenatally and confirmed after birth. Echocardiographic study revealed dextrocardia and a criss-cross heart pathology with discordant atrioventricular (AV) and ventriculoarterial relations. Intracardiac pathology was concomitant with transposition of the great arteries [aorta originating from the RV, and PA from above the VSD], subvalvular and valvular pulmonary stenosis (gradient RV/PA approx. 90 mm Hg), and unobstructed BT shunt. Systemic cyanosis was not observed, and the child’s mental and physical development was undisturbed. After diagnostic catheterisation, the patient was referred for further surgery. Using extracorporeal circulation, a bidirectional Glenn anastomosis was performed, and the BT shunt as well as the PA were closed and dissected. The postoperative course was uncomplicated. More than 90% of criss-cross heart co-occur with levocardia and the concomitance with the AV-related transposition of the great arteries and dextrocardia, to the best of our knowledge, is the second described report in the literature. Thus, the diagnosis of a rare congenital heart defect should be always considered, especially in prenatal diagnostics, and precisely defined during qualification for further surgical treatment