Association of leptin receptor Gln223Arg genetic polymorphism with obesity and non-alcoholic fatty liver disease

Aim of investigation. Investigation of association of leptin receptor (LEPR) gene Gln223Arg polymorphism with obesity and non-alcoholic fatty liver disease (NAFLD).Material and methods. Overall 107 patients with NAFLD, 81 patient with alcoholic liver disease (ALD) and 117 patients without liver diseases (control group) were investigated. Obesity criterion was body the body mass index (BMI) ≥30,0. Cholesterol and triglycerides serum levels were estimated by enzyme colorimetric method, leptin concentration — by immunoenzyme method. Genotyping for LEPR Gln223Arg gene polymorphism was carried out by allele — specific polymerase chain reaction.Results. In control group and ALD patients no correlation of obesity with LEPR Gln223Arg gene polymorphism was revealed. In NAFLD patients without obesity Arg223Arg genotype, as well as 223Arg allele, was less frequent, than in control group — 3 times (P<0,05) and 1,5 times (P<0,05) respectively. Frequency of this genotype / allele was also significantly less in NAFLD group without obesity, than in those with obesity. Mean serum cholesterol level at NAFLD was higher, than at ALD (Р <0,05), and in Gln223Gln genotype carriers this parameter was highest in comparison to that parameter in other groups. At NAFLD patients 223Arg variant was less frequent (49,5%), than 223Gln variant, in contrast to other groups. Allelic frequency of 223Gln in women with NAFLD was 1,5 times higher (P<0,05) , than in women with ALD, and 1,3 times higher (P<0,05), than in women of control group. Frequency of Gln223Gln genotype in women with NAFLD was higher than that in women with ALD 1,5 times (Р<0,01), in women of control group — 1,3 times (Р<0,05) and in men with NAFLD — 3 times (Р=0,05) respectively.Conclusions. Carriage of 223Gln variant of LEPR Gln223Arg gene polymorphism can promote increase of cholesterol level and development of non-alcoholic fatty liver disease in absence of obesity as well, is especial in women

СIRCULATING SECRETORY IMMUNOGLOBULINA IN SEPTIC DISORDERS

Insufficiency of local immunity can play an important role in pathogenesis of sepsis, including septic (acute) infectious endocarditis (IE). The paper presents data on secretory immunoglobulin A (sIgA) contents in blood serum of patients with sepsis (26 women and 32 men), acute (11 women and 23 men) and subacute (7 women and 13 men) IE, depending on localization of the infection site (angiogenic or non-angiogenic), outcome of the disease and carriage of glutathione-S-transferase P1 gene variants (GSTP1Ile105Val). A control group consisted of 25 women and 24 men without hypertension and ischemic heart disease and lacking evidence of focal and systemic infection, was examined. Laboratory studies were performed with еnzyme immunoassay and allele-specific polymerase chain reaction. We have found that, despite large individual variability of serum sIgA concentration in sepsis and infectious endocarditis, the majority of patients had a significant (on average, 4-fold) IgA increase against controls, in both men and women, especially in acute IE (a mean of 5-fold over control values). Subacute infectious endocarditis is associated with lesser sIgA in circulation than acute IE and sepsis, which may be used for early differential diagnosis of these conditions. There were no gender differences in sIgA contents. In sepsis with non-angiogenic source of infection, the sIgA levels were higher than in angiogenic infection. There was no association of sIgA level with survival (mortality), which excludes this index from predictive markers in sepsis and IE. Carriage of heterozygous GSTP1Ile105Val genotype increases the risk of sepsis and IE development, regardless of clinical course, and homozygous genotype GSTP1Ile105Ile is associated with higher contents of circulating immunoglobulin than in carriers of GSTP1Val105Val genotype. Thus, a wide range of individual variability in of circulating sIgA levels in patients with sepsis and infective endocarditis may be connected with location of infection source and genetic factors

Случай трофобластической опухоли плацентарной площадки, дебютировавшей легочным кровотечением

Placental site trophoblastic tumor (PSTT) is the 3rd most frequently encountered gestational trophoblastic tumor after destructive cystic mole and choriocarcinoma. Currently, according to the literature, just over 600 cases are described in the world. The low incidence of this tumor, the non-specific clinical picture and the lack of changes in the overall clinical analysis pose significant challenges for clinicians in terms of reliable preoperative diagnosis. Clinical observation is made of a 34-year-old patient with PSTT manifested by hemoptysis due to bilateral metastatic lung injury. The diagnosis was verified histologically using immunohistochemical methods of investigation after an open biopsy of pulmonary tissue (lung resection). Then the patient underwent courses of adjuvant chemotherapy, surgical intervention on the opposite lung to remove the remaining tumor deposits Chemotherapy after the second surgery was continued. The patient at the time of writing (within 1 year and 6 months after the first lung operation) is alive, hysterectomy was not performed, clinical and radiological signs of tumor progression are absent.Трофобластическая опухоль плацентарной площадки (ТОПП) – 3-е по частоте встречаемости гестационное трофобластическое новообразование после деструирующего пузырного заноса и хорионкарциномы. В настоящее время по данным литературы в мире описано немногим более 600 случаев. Низкая частота встречаемости данной опухоли, неспецифичность клинической картины и отсутствие изменений в общих клинических анализах представляют значительные сложности для клиницистов в плане достоверной дооперационной диагностики. Приводится клиническое наблюдение пациентки 34 лет, у которой ТОПП манифестировала появлением кровохарканья вследствие двустороннего метастатического поражения легких. Диагноз верифицирован гистологически с использованием иммуногистохимических методов исследования после выполнения открытой биопсии легочной ткани (резекция легкого). Пациентка получала курсы адъювантной химиотерапии, выполнено хирургическое вмешательство на противоположном легком по удалению оставшихся депозитов опухоли. Химиотерапия после 2-й операции была продолжена. На момент написания статьи (в течение 1 года 6 мес. после 1-й операции на легких) пациентка жива, гистерэктомия не проводилась, клинические и рентгенологические признаки прогрессирования опухоли отсутствуют

Клинико-функциональные предикторы неконтролируемого течения бронхиальной астмы

The purpose of our work was to describe clinical and functional predictors of uncontrolled asthma. Methods. Two hundred and eighty patients with mild to severe asthma have been selected in 2009 – 2011. A comprehensive examination was performed at baseline and 5 years later. The odds ratio and confidence intervals for potential causative factors of uncontrolled asthma were calculated. Results. Inadequate asthma therapy, smoking and upper airway diseases were significant factors in patients with moderate asthma. Age > 60 years, comorbid ischaemic heart disease (IHD) and hypertension, and inadequate asthma therapy were statistically significant predictors of asthma control in patients with severe asthma. In 5 years of follow-up, prevalence of IHD and hypertension has increased. Conclusion. Poor asthma control is unusual in patients with asthma. Potential reasons of uncontrolled asthma course were determined.Бронхиальная астма (БА) является одним из самых распространенных заболеваний. Однако у большей части больных, несмотря на наличие схем лечения, контролируемого течения БА достичь не удается. Целью данного исследования явилось выявление основных клинико-функциональных предикторов неконтролируемого течения БА. Материалы и методы. В 2009–2011 гг. набрана группа пациентов с БА (n = 280) различной степени тяжести. У всех больных проводилось полное клинико-функциональное обследование – в 2009–2011 гг. и в динамике через 5 лет. Также выполнялись развернутый и биохимический анализы крови, определение цитокинового профиля и артериальной ригидности; исследование функции внешнего дыхания с помощью спирометрии и бодиплетизмографии. Анализировались показатели работы сердечно-сосудистой системы по данным электрокардиографии, эхокардиографии, проводилась неинвазивная артериография. Оценивались эластические и функциональные свойства аорты во время анализа характеристик пульсовой волны. Результаты. С помощью расчета значений отношения шансов и доверительного интервала выявлены возможные причины неконтролируемого течения БА в зависимости от тяжести. Выявлена значительная роль неадекватной базисной терапии, курения и ЛОР-патологии у больных среднетяжелой БА. Показано, что наиболее значимыми статистически значимыми причинами, влияющими на достижение контроля над БА тяжелого течения, являются возраст старше 60 лет, сопутствующие ишемическая болезнь сердца (ИБС) и гипертоническая болезнь (ГБ), а также неадекватная базисная терапия. Помимо этого, в динамике через 5 лет отмечается рост заболеваемости ГБ и присоединение ИБС различных форм. Заключение. У больных БА установлены низкий уровень контроля и возможные связанные с этим причины

Metal-exchange reaction between cadmium tetraphenylporphyrinates and copper(II) in dimethylformamide

The metal-exchange reaction of cadmium 5,10,15,20-tetraphenylporphyrinate (CdTPP) and cadmium 2-bromo-5,10,15,20-tetraphenylporphyrinate (CdTPPBr) with copper acetate (Cu(OAc)(2)) in dimethylformamide was studied spectrophotometrically. The kinetic parameters of the metal-exchange reaction were determined. A possible stoichiometric reaction mechanism was proposed