Mycobacterium tuberculosis complex in atherosclerosis.

In recent years, the results of some studies have revealed the possible potential role of several infectious agents in the inflammatory mechanism of atherosclerosis. The detection of specific antibodies against microorganisms such as and as well as Chlamydia pneumoniae and cytomegalovirus as well as antibodies directed to heat shock proteins in the sera of atherosclerotic patients and the presence of genomic material in atheromatous plaques all provide evidence supporting the presumptive role of infectious agents in atherosclerosis. There are some findings that can be accepted as clues for the possible involvement of Mycobacterium tuberculosis in atherosclerosis. These consist of the presence of high levels of mycobacterial heat shock protein 65 in atherosclerotic patients, and in animal studies, the detection of atherosclerotic changes in the vascular wall of animals vaccinated with recombinant heat shock protein 65, and Mycobacterium tuberculosis containing heat shock protein 65. The probable proatherogenic effect of the specific immune response to BCG-associated heat shock protein was also suggested. The mycobacterium cell wall contains a phospholipid, phosphatidylinositol, which was shown to have a procoagulant effect similar to that of a cytomegalovirus possessing phosphatidylserine, another phospholipid showing a procoagulant effect. These data suggest that Mycobacterium tuberculosis may also be involved in the pathogenesis of atherosclerosis.</p

Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism

Objective: Right ventricular dysfunction (RVD) with myocardial damage may lead to fatal complications in patients with acute pulmonary embolism (PE). Cytoplasmic heart-type fatty acid-binding protein (HFABP) and the N-terminal fragment of its prohormone (NT-proBNP) are sensitive and specific biomarkers of myocardial damage. We evaluated RVD and cardiac biomarkers for myocardial damage and short-term mortality in patients with acute PE. Methods: We analyzed 41 patients (24 females, 17 males) with confirmed acute PE prospective. Three groups (massive, submassive, and nonmassive) of patients were defined, based on systemic systolic blood pressure measured on admission and RVD by transthoracic echocardiography (TTE). Also, systolic (s) and mean (m) pulmonary artery pressures (PAPs) were recorded by TTE, and plasma concentrations of cardiac troponin T (cTn-T), NT-proBNP, and HFABP were evaluated 6 month follow-up. Results: Seventeen (41.5%) patients experienced a complicated clinical course in the 6-month follow-up for the combined end-point, including at least one of the following: death (n=12, 29.3%; 3 PE-related), chronic PE (n=4, 9.8%), pulmonary hypertension (n=2, 4.9%), and recurrent PE (n=1, 2.4%). Multivariate hazard ratio analysis revealed HFABP, NT-proBNP, and PAPs as the 6-month mortality predictors (HR 1.02, 95% CI 1.01- 1.05; HR 1.01, 95% CI 1.01-1.04; and HR 1.02, 95% CI 1.02-1.05, respectively). Conclusion: HFABP, NT-proBNP, and PAPs measured on admission may be useful for short-term risk stratification and in the prediction of 6-month PE-related mortality in patients with acute PE. © 2016 by Turkish Society of Cardiology

The relationship between visceral adipose tissue and intima-media thickness in patients with kidney disease

Introduction: Increase in visceral adipose tissue (VAT) is associated with cardiovascular risk. However, the relationship between atherosclerosis and VAT has not yet been adequately studied in chronic kidney disease (CKD). The aim of this study was to assess the relationship among VAT, adipokines, and atherosclerosis in patients with CKD.Materials and methods: 45 healthy control, 53 predialysis patients, and 52 hemodialysis patients have been enrolled in the study. Intima media thickness (IMT) of the carotid artery, and VAT measurements were evaluated via ultrasonography.Results: IMT (p:0.002), VAT (p:0.021), adiponectin (plt;0.001) and pentraxin-3 (p:0.003) were higher in predialysis patients than healthy controls. The values of IMT (plt;0.001), VAT (p:0.0014), adiponectin (p:0.005), pentraxin-3 (p: lt;0.001), C reactive protein (CRP) (p:0.009), triglyceride (p: lt;0.001) and parathyroid hormone (PTH) (plt;0.001), were higher in hemodialysis patients than healthy controls. VAT was positively correlated with CRP(r: 0, 23 p: 0.005), IMT (r: 0.347 plt;0.001), body mass index (BMI) (r: 0.33 plt;0.001), and negatively correlated with creatinine clearance (R: -0.245 p: 0.003). VAT is independently related with adiponectin (ß:-0.213 p: 0.008), BMI (ß: 0.369, Plt;0.001), and CRP (ß:0.164, P:0.032) in multiple regression analysis. IMT was positively correlated with VAT (r: 0.347 plt;0.001), CRP (r: 0.186 p: 0.022), age (r: 0.333 plt;0.001), BMI (r: 0.444 plt;0.001) in all participants.Conclusion: These findings show that VAT is a strong risk factor for atherosclerosis in patients with CKD. However IMT was not correlated with adiponectin, pentraxin-3, and leptin in patients with CKD. Also sonographic measurement of VAT could be useful to stratify the risk of cardiovascular disease in patients with CKD

The effect of modern cupper ıntra uterin device (IUD) on serum iron and total iron binding capacity (TIBC)

Bakırlı RİA takılan 20 vakada, uygulama öncesi ve uygulamadan 12 ay sonra serum demir ve total demir bağlama kapasitesi tayin edilerek, RİA ile anemi riski ilişkisi araştırıldı. RİA grubunda 2 vakada sınırda demir azlığı (% 10) ve 1 vakada bariz demir eksikliği (% 5) tespit edilirken, kontrol grubunda sadece bir vakada (% 7.69) bariz demir eksikliği tespit edildi. Ancak RİA ve kontrol gruplarının başlangıç ve 12 ay sonraki serum demir ve TDBK değerleri arasında istatistiksel olarak önemli bir fark görülmedi.In copper IUD inserted 20 women, the association of IUD and risk of anemia has been investigated by measurements of serum iron and total iron binding capacity (TIBC) before and after 12 months of insertion. In IUD group 2 cases of borderline iron deficiency (10 %) and one case (5 %) of evident iron deficiency have been found whereas in the control group only one case was evidently iron deficient (7.69 %). Serum iron and TIBC values of both groups were statistically significant

Mycobacterium tuberculosis complex DNA does not exist in atheromatous plaques

The possible potential role of several infectious agents in atherosclerosis has been shown. Several infectious agents DNA in atheromatous plaques have been displayed by PCR. In patients with atheromas antibody levels against Hsp65 were higher. Vaccination of mice with recombinant Hsp65 and Hsp65-rich M. tuberculosis resulted in formation of atheromatous plaques. We attempted to detect M. tuberculosis DNA in atherosclerotic plaque samples by PCR. In endarterectomy tissue samples obtained from patients during coronary artery bypass graft surgery DNA was prepared by proteinase-K digestion, phenol/chloroform extraction and ethanol precipitation. After amplification with M.tuberculosis complex IS6110 region specific primers, the products were analyzed on electrophoresis. M. tuberculosis DNA was negative in all tissue samples. More data on etiological studies with mycobacteriaceae will be yield information on atherosclerosis pathogenesis

Serum calcitonin gene-related peptide levels in women with polycystic ovary syndrome

Purpose: Calcitonin gene-related peptide (CGRP) is an amino acid neuropeptide with widespread expression. It has potent effects on lipid and energy metabolism. It induces insulin resistance. This study was planned to determine CGRP levels in women with polycystic ovary syndrome (PCOS). Methods: Forty-seven women with PCOS and 34 healthy controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, postprandial and fasting glucose, insulin and other hormones (gonadotropins, androgens) and CGRP levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. Results: Waist measurements, postprandial and fasting glucose and fasting insulin levels and free androgen index and HOMA-IR were significantly higher in subjects with PCOS. However, the women with PCOS had considerably lower high-density lipoprotein cholesterol levels than healthy subjects. Serum CGRP levels were higher in study subjects than in controls, although it was statistically insignificant. Conclusions: Serum CGRP level was not related with insulin resistance, ovarian hyperandrogenism and dyslipidemia in abdominally obese women with PCOS. These outcomes propose that CGRP may not play a pivotal role in the pathogenesis of PCOS. © 2012 Springer-Verlag Berlin Heidelberg

Immunohistochemical detection and distribution of cornifin α and vitamin D receptor expression in vaginal epithelium treated with vitamin D 3

Objective: In growth and differentation of keratinizing stratified squamous epithelium, 1.25-dihydroxyvitamin D3 has an important role. Cornifin α as a marker of vaginal epithelial differentiation distribution in vagina epithelium has not been studied. We examined distribution of VDR and cornifin α in vagina epithelium in ovariectomized and treated vitamin D rats. Materials and Methods: Bilateral ovariectomies were performed in 20 mature non-pregnant Wistar female rats. All the animals were divided into 2 groups; control group I untreated and group II i.m. 0.025 μg 1.25-dihydroxyvitamin D3 injected for three days of a week for 2 weeks. In 15 days after the last injection, vaginas were removed and processed for immunohistochemistry. Results: Recorded epithelial differentiation, 1.25-dihydroxyvitamin D 3 receptor and cornifin α expression in vaginal epithelium of control and vitamin D3 treated rats. In treated animals, vaginal epithelium changed into highly-stratified keratinizing layers. Cornifin α and 1.25-dihydroxyvitamin D3 receptor as a marker of squamous differentiation is present in ovariectomized rats treated with 1.25-dihydroxyvitamin D3. In contrast, cornifin α and 1.25-dihydroxyvitamin D3 receptor were absent in all layers of vaginal epithelium in control group. Discussion: The results indicate that 1.25-dihydroxyvitamin D3 induced proliferation of vaginal epithelium which was consistent with the cornifin α expression. We demonstrated for the first time that 1.25-dihydroxyvitamin D3 up-regulated 1.25-dihydroxyvitamin D3 receptor expression in vaginal epithelium