Clopidogrel responsiveness in chronic kidney disease patients with acute coronary syndrome

Objective: Cardiovascular diseases are the leading cause of death in patients with chronic kidney disease (CKD). There is conflicting evidence about effect of CKD on clopidogrel responsiveness. We aimed to evaluate the clopidogrel responsiveness in CKD patients with acute coronary syndrome (ACS). Methods: A total of 101 patients; 55 with moderate to severe CKD and 46 with normal renal function or mild CKD, hospitalized with ACS were included in our study. Multiplate test was used to determine clopidogrel responsiveness. Platelet aggregation results were presented as aggregation unit (AU)*min and values over 470 AU*min were accepted as clopidogrel low responders. Results: The 101 patients (mean age 64.76±8.67 years; 61 [60.4%] male) were grouped into the two study groups as follows: group 1; 55 patients with eGFR<60 ml/min/1.73 m2 and group 2; 46 patients with eGFR>60 ml/min/1.73 m2. 35 patients (34.7%) of the study population were found to have low response to clopidogrel (16 [34.8%] patients in group 1 and 18 [33.3%] patients in group 2, p=0.879) . There was no significant difference between group 1 and 2 for Multiplate test results (414.67±281.21 vs 421.56±316.19 AU*min, p=0.909). Clopidogrel low responsiveness were independently related to Multiplate test results of aspirin responsiveness (OR=1.004, CI 1.002–1.007, p=0.001) and hemoglobin (OR=0.727, CI 0.571–0.925, p=0.010). Multiplate results were also independently related to Multiplate test results of aspirin responsiveness (β=0.402, p<0.0001) and hemoglobin (β=-0.251, p=0.007). Conclusion: Platelet response to clopidogrel does not differ between patients with eGFR < 60 ml/min/1.73 m2 and eGFR>60 ml/min/1.73 m2

Razine pentraksina 3 dobro su povezane s težinom bolesti kod prijma u bolesnika s COVID-19

Pentraxin 3 (PTX3), a long pentraxin, is not only released from dendritic cells and neutrophils but also from epithelial and endothelial cells such as alveolar epithelium. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) initially activates the innate immune system, causing a complex immune response. Clinical and experimental studies suggest that PTX3, a locally and systemically secreted marker, can be used as a predictor of the severity and mortality in respiratory infections. In the current study, serum PTX3 levels in patients hospitalized with COVID-19 were found to be significantly increased at admission and showed significant association with the disease severity.Pentraksin 3 (PTX3), dugi pentraksin, ne oslobađa se samo iz dendritičnih stanica i neutrofila, nego i iz epitelnih i endotelnih stanica poput alveolarnog epitela. Teški akutni respiracijski sindrom koronavirus-2 (SARS-CoV-2) u početku aktivira urođeni imuni sustav uzrokujući složen imuni odgovor. Klinička i eksperimentalna istraživanja ukazuju na to da se PTX3, lokalno i sistemski izlučeni biljeg, može koristiti kao prediktor težine i smrtnosti kod respiracijskih infekcija. U ovom istraživanju utvrđeno je da su razine PTX3 u serumu bolesnika hospitaliziranih s COVID-19 bile značajno povišene kod prijma i značajno povezane s težinom bolesti

Discoidin domain receptor 1 as a promising biomarker for high-grade gliomas

Background: Two fundamental challenges in the current therapeutic approach for central nervous system tumors are the tumor heterogeneity and the absence of specific treatments and biomarkers that selectively target the tumor tissue. Therefore, we aimed to investigate the potential relationship between discoidin domain receptor 1 (DDR1) expression and the prognosis and characteristics of glioma patients. Materials and Methods: Tissue and serum samples from 34 brain tumor patients were evaluated for DDR1 messenger ribonucleic acid levels in comparison to 10 samples from the control group, and Kaplan-Meier survival analysis has performed. Results: DDR1 expression was observed in both tissue and serum samples of the patient and control groups. DDR1 expression levels in tissue and serum samples from patients were higher in comparison to the control group, although not statistically significant (P > 0.05). A significant correlation between tumor size and DDR1 serum measurements at the level of 0.370 was reported (r = 0.370; P = 0.034). The levels of DDR1 in serum showed a positive correlation with the increasing size of tumor. The results of the 5-year survival analysis depending on the DDR1 tissue levels showed a significantly higher survival rate (P = 0.041) for patients who have DDR1 tissue levels above cutoff value. Conclusions: DDR1 expression was significantly higher among brain tumor tissues and serum samples and its levels showed a positive correlation with the increased size of tumor. This study can be a starting point, since it investigated and indicated, for the first time, that DDR1 can be a novel therapeutic and prognostic target for aggressive high-grade gliomas

The role of h-FABP and Myoglobin in Determining Disease Severity and Prognosis in STEMI

Introduction:Acute coronary syndrome (ACS) remains as a single biggest cause of death worldwide. Heart-type fatty acid -binding protein (h-FABP) and myoglobin are small proteins present in the myocyte cytosol. In cases of myocardial damage, they can freely pass into the bloodstream. Thus, they might be useful in the diagnosis of ACS. The aim of this prospective study was to search the relationship between h-FABP and myoglobin levels and disease severity and mortality.Methods:One hundred-fourty-nine male patients with ST-elevation myocardial infarction consitututed our study population. Two groups occurred according to low (<23) and high (≥23) SYNTAX score as group 1 and group 2. Blood specimens were taken for h-FABP and myoglobin analysis at hospital admission and at 12 h. Patients underwent coronary angiography for diagnosis and treatment, and the SYNTAX score was calculated. Participants were followed up for 72 months, and cardiovascular mortality rates were recorded.Results:H-FABP at admission and h-FABP level at 12th h were lower in group 1 than in group 2 (p<0.001). We did not find significant differences between the myoglobin levels measured at the time of hospital entrance and at the 12th h in both groups. During 72-month follow-up, 123 patients survived and the survivors had a lower SYNTAX score, and a lower h-FABP level at admission. In the univariate analysi, h-FABP levels at admission and at 12 h were found to be independent predictors of coronary artery disease (CAD) severity. However, h-FABP levels did not predict mortality.Conclusion:In patients with ACS, measuring h-FABP levels at admission and in the late period (12th hour) are helpful, not only in the diagnosis but also severity and seriousness of CAD

Cytokine Contents in Chronic Lymphocytic Leukemia: Association with ZAP70 Expression

Objective: Chronic lymphocytic leukemia (CLL) is a disease that shows varying clinical progression, and expression of the protein tyrosine kinase ZAP70 has been described as a very valuable prognostic factor. Patients with ZAP70 positivity are characterized by worse clinical course and significantly shorter progression-free and overall survival. In this study, intracytoplasmic interferon gamma (IFN-γ) and interleukin-4 (IL-4) content of T, B, and CLL cells in CLL patients and their correlations with Rai staging and ZAP70 positivity were investigated. Materials and Methods: CLL patients newly diagnosed or in followup at the İstanbul University İstanbul Medical Faculty Hematology Department were included in this study. These patients were classified according to Rai staging and ZAP70 expression. IL-4, IFN-γ, and ZAP70 expressions in peripheral blood T, B, and CLL cells were measured by four-color flow cytometry. Results: There was a statistically significant correlation between advanced disease and ZAP70 positivity. IL-4-secreting T cells were significantly increased; however, IFN-γ secretion was significantly decreased in CLL patients compared to healthy individuals, whereas IL-4-secreting B cells were significantly diminished in contrast to T cells. Conclusion: These findings suggest damage in the cellular immunity and that IL-4 might lead to many complications and may be important in disease progression

Cytokine Contents in Chronic Lymphocytic Leukemia: Association with ZAP70 Expression

Objective: Chronic lymphocytic leukemia (CLL) is a disease that shows varying clinical progression, and expression of the protein tyrosine kinase ZAP70 has been described as a very valuable prognostic factor. Patients with ZAP70 positivity are characterized by worse clinical course and significantly shorter progression-free and overall survival. In this study, intracytoplasmic interferon gamma (IFN-&#947;) and interleukin-4 (IL-4) content of T, B, and CLL cells in CLL patients and their correlations with Rai staging and ZAP70 positivity were investigated. Materials and Methods: CLL patients newly diagnosed or in followup at the İstanbul University İstanbul Medical Faculty Hematology Department were included in this study. These patients were classified according to Rai staging and ZAP70 expression. IL-4, IFN-&#947;, and ZAP70 expressions in peripheral blood T, B, and CLL cells were measured by four-color flow cytometry. Results: There was a statistically significant correlation between advanced disease and ZAP70 positivity. IL-4-secreting T cells were significantly increased; however, IFN-&#947; secretion was significantly decreased in CLL patients compared to healthy individuals, whereas IL-4-secreting B cells were significantly diminished in contrast to T cells. Conclusion: These findings suggest damage in the cellular immunity and that IL-4 might lead to many complications and may be important in disease progression

Is interleukin 17F (7488 A/G) responsible for the pathogenesis of breast and gastrointestinal cancers in Turkish patients

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