Cell-free tumour DNA as a diagnostic and prognostic biomarker in non-small cell lung carcinoma

More than 1 million people dies worldwide due to lung cancer which is the first most incident cancer in males and the third in females. Only early diagnosis makes possible to achieve long-lasting remission or even cure the disease. Unfortunately, no tumour marker to achieve this goal has been identified, yet. One of putative lung cancer markers is free circulating tumor DNA. Its concentration seems to be related to cancer burden. Moreover, it can be subjected to mutational status analysis allowing for introduction of targeted treatment. This led to the idea of liquid biopsy which can substitute for a standard biopsy not feasible in certain clinical circumstances. Assessment of cell free tumour DNA can also inform about progression/recurrence of cancer and may have a prognostic value. Therefore, the aim of this article is to review on free circulating DNA as a potential marker in lung cancer

Obstructive sleep apnea syndrome and hypothyroidism — merely concurrence or causal association?

The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients

Zespół obturacyjnego bezdechu sennego i niedoczynność tarczycy — przypadkowa zbieżność czy związek przyczynowo-skutkowy?

  Częstość występowania zespołu obturacyjnego bezdechu sennego (OBS) waha się od 4 do 7% u mężczyzn i od 2 do 5% u kobiet. Jest on przyczyną wielu poważnych następstw, takich jak: wypadki drogowe, powikłania sercowo-naczyniowe, a rosnąca zachorowalność i śmiertelność, sprawiają, że staje się jednym z głównych problemów zdrowotnych. Oprócz otyłości (głównego czynnika ryzyka dla OBS) ujawnieniu tego fenotypu sprzyja niedoczynność tarczycy. Mimo że wydaje się ona uznanym czynnikiem ryzyka OBS, niektórzy autorzy sugerują brak klinicznie istotnego związku. Zaobserwowano jednak zwiększoną częstość występowania niedoczynności tarczycy u pacjentów z OBS, ale dane epidemiologiczne są ograniczone. Zdecydowanie mniej wiadomo o subklinicznej niedoczynności tarczycy u pacjentów z OBS. Jeśli jawna i subkliniczna niedoczynność tarczycy w tej grupie pacjentów jest co najmniej tak samo częsta, jak w populacji ogólnej, zasadne wydaje się badanie pacjentów w kierunku niedoczynności tarczycy, ponieważ skuteczne leczenie może zmniejszyć zaburzenia oddychania podczas snu. Niestety, ten korzystny efekt stwierdzono tylko w kilku badaniach na niewielkiej liczbie pacjentów z niedoczynnością tarczycy. Mimo braku międzynarodowych wytycznych oraz dużych, wieloośrodkowych badań, autorzy niniejszej pracy uważają jednak, że przesiewowe badania TSH mogą się okazać korzystne dla sporej grupy pacjentów z OBS.

The role of microRNAs in pathophysiology and diagnostics of metabolic complications in obstructive sleep apnea patients

Obstructive sleep apnea (OSA) is one of the most common sleep disorders, which is characterized by recurrent apneas and/or hypopneas occurring during sleep due to upper airway obstruction. Among a variety of health consequences, OSA patients are particularly susceptible to developing metabolic complications, such as metabolic syndrome and diabetes mellitus type 2. MicroRNAs (miRNAs) as epigenetic modulators are promising particles in both understanding the pathophysiology of OSA and the prediction of OSA complications. This review describes the role of miRNAs in the development of OSA-associated metabolic complications. Moreover, it summarizes the usefulness of miRNAs as biomarkers in predicting the aforementioned OSA complications

Cell-Free Tumour DNA as a Diagnostic and Prognostic Biomarker in Non-small Cell Lung Carcinoma

More than 1 million people dies worldwide due to lung cancer which is the first most incident cancer in males and the third in females. Only early diagnosis makes possible to achieve long-lasting remission or even cure the disease. Unfortunately, no tumour marker to achieve this goal has been identified, yet. One of putative lung cancer markers is free circulating tumor DNA. Its concentration seems to be related to cancer burden. Moreover, it can be subjected to mutational status analysis allowing for introduction of targeted treatment. This led to the idea of liquid biopsy which can substitute for a standard biopsy not feasible in certain clinical circumstances. Assessment of cell free tumour DNA can also inform about progression/recurrence of cancer and may have a prognostic value. Therefore, the aim of this article is to review on free circulating DNA as a potential marker in lung cancer

Zespół obturacyjnego bezdechu sennego i niedoczynność tarczycy—Przypadkowa zbieżność czy związek przyczynowo-skutkowy?

Częstość występowania zespołu obturacyjnego bezdechu sennego (OBS) waha się od 4 do 7% u mężczyzn i od 2 do 5% u kobiet. Jest on przyczyną wielu poważnych następstw, takich jak: wypadki drogowe, powikłania sercowo-naczyniowe, a rosnąca zachorowalność i śmiertelność, sprawiają, że staje się jednym z głównych problemów zdrowotnych. Oprócz otyłości (głównego czynnika ryzyka dla OBS) ujawnieniu tego fenotypu sprzyja niedoczynność tarczycy. Mimo że wydaje się ona uznanym czynnikiem ryzyka OBS, niektórzy autorzy sugerują brak klinicznie istotnego związku. Zaobserwowano jednak zwiększoną częstość występowania niedoczynności tarczycy u pacjentów z OBS, ale dane epidemiologiczne są ograniczone. Zdecydowanie mniej wiadomo o subklinicznej niedoczynności tarczycy u pacjentów z OBS. Jeśli jawna i subkliniczna niedoczynność tarczycy w tej grupie pacjentów jest co najmniej tak samo częsta, jak w populacji ogólnej, zasadne wydaje się badanie pacjentów w kierunku niedoczynności tarczycy, ponieważ skuteczne leczenie może zmniejszyć zaburzenia oddychania podczas snu. Niestety, ten korzystny efekt stwierdzono tylko w kilku badaniach na niewielkiej liczbie pacjentów z niedoczynnością tarczycy. Mimo braku międzynarodowych wytycznych oraz dużych, wieloośrodkowych badań, autorzy niniejszej pracy uważają jednak, że przesiewowe badania TSH mogą się okazać korzystne dla sporej grupy pacjentów z OBS

Obstructive Sleep Apnea Syndrome and Hypothyroidism—Merely Concurrence or Causal Association?

The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients

The Role of Brain-Derived Neurotrophic Factor in Immune-Related Diseases: A Narrative Review

Brain-derived neurotrophic factor (BDNF) is a neurotrophin regulating synaptic plasticity, neuronal excitability, and nociception. It seems to be one of the key molecules in interactions between the central nervous system and immune-related diseases, i.e., diseases with an inflammatory background of unknown etiology, such as inflammatory bowel diseases or rheumatoid arthritis. Studies show that BDNF levels might change in the tissues and serum of patients during the course of these conditions, e.g., affecting cell survival and modulating pain severity and signaling pathways involving different neurotransmitters. Immune-related conditions often feature psychiatric comorbidities, such as sleep disorders (e.g., insomnia) and symptoms of depression/anxiety; BDNF may be related as well to them as it seems to exert an influence on sleep structure; studies also show that patients with psychiatric disorders have decreased BDNF levels, which increase after treatment. BDNF also has a vital role in nociception, particularly in chronic pain, hyperalgesia, and allodynia, participating in the formation of central hypersensitization. In this review, we summarize the current knowledge on BDNF’s function in immune-related diseases, sleep, and pain. We also discuss how BDNF is affected by treatment and what consequences these changes might have beyond the nervous system

Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets

Obstructive sleep apnea is a chronic condition characterized by recurrent episodes of apneas or hypopneas during sleep leading to intermittent hypoxemia and arousals. The prevalence of the sleep disordered breathing is estimated that almost 50% of men and 24% of women suffer from moderate to severe form of the disorder. Snoring, collapse of upper airways and intermittent hypoxia are main causes of smoldering systemic inflammation in patients suffering from obstructive sleep apnea. The systematic inflammation is considered one of the key mechanisms leading to significant cardiovascular complications. Blood platelets, formerly not even recognized as cells, are currently gaining attention as crucial players in the immune continuum. Platelet surface is endowed with receptors characteristic for cells classically belonging to the immune system, which enables them to recognize pathogens, immune complexes, and interact in a homo- and heterotypic aggregates. Platelets participate in the process of transcellular production of bioactive lipids by delivering both specific enzymes and substrate molecules. Despite their lack of nucleus, platelets synthetize proteins in a stimuli-dependent manner. Atherosclerosis and consequent cardiovascular complications result from disruption in homeostasis of both of the platelet roles: blood coagulation and inflammatory processes modulation. Platelet parameters, routinely evaluated as a part of complete blood count test, were proposed as markers of cardiovascular comorbidity in patients with obstructive sleep apnea. Platelets were found to be excessively activated in this group of patients, especially in obese subjects. Persistent activation results in enhanced spontaneous aggregability and change in cytokine production. Platelet-lymphocyte ratio was suggested as an independent marker for cardiovascular disease in obstructive sleep apnea syndrome and continuous positive air pressure therapy was found to have an impact on platelet parameters and phenotype. In this literature review we summarize the current knowledge on the subject of platelets involvement in obstructive sleep apnea syndrome and consider the possible pathways in which they contribute to cardiovascular comorbidity