Serial changes in the serum levels of leptin, homocysteine, galectin-3, total phospholipids and hexosamines among patients undergoing coronary artery bypass grafting

AbstractBackgroundCoronary artery disease (CAD) is the most common cardiovascular disorder in adults. This study was performed to elucidate the role of active leptin, homocysteine, galectin-3, total phospholipids, total, bound, free hexosamines, free-to-bound hexosamines ratio in the pathogenesis of chronic myocardial ischemia and studying the effect of coronary artery bypass grafting (CABG) on their serum levels.MethodsA prospective case control study was carried out on 100 ischemic heart disease male patients undergoing elective CABG and 25 healthy males. Serum levels of total phospholipids, total and free hexosamines, were estimated using spectrophotometric methods, while, serum levels of active leptin, homocysteine and galectin-3 were estimated using ELISA assay kit.ResultsSignificant higher serum active leptin, homocysteine, galectin-3, free hexosamines and free to bound hexosamines ratio levels preoperatively when compared with the control group (p < 0.01 for all) with significant lowering of their serum levels following CABG (p < 0.01 for all) except for active leptin. Significant lower serum total phospholipids, total and bound hexosamines levels preoperatively when compared with the control group (p < 0.01 for all) with significant elevations in their serum levels following CABG (p < 0.01 for all).ConclusionsHigh active leptin, homocysteine, galectin-3, free and free to bound hexosamines ratio and low total phospholipids, total and bound hexosamines play an important role in the pathogenesis of myocardial ischemia. The serum levels of homocysteine, galectin-3, hexosamines and total phospholipids, but not active leptin are significantly lowered following CABG

Clinical and genetic assessment of pediatric patients with Gaucher’s disease in Upper Egypt

Background: Gaucher’s disease (GD) is an autosomal recessive genetic disorder that results from pathogenic mutations of GBA gene encoding the enzyme glucocerebrosidase (acid b-glucosidase). Of the approximately 300 mutations associated with GD, 4 accounts for the majority of mutations seen in GD patients: N370S, L444P, 84 GG and IVS2+1.Aim: Establishing and providing, clinical and molecular backgrounds of pediatric patients with GD in Upper Egypt.Subjects and methods: The present study is a cross sectional study, carried out on 26 pediatric patients with GD. They were recruited from the pediatric outpatient clinics and inpatients Pediatric departments of Assiut and Qena University hospitals, Upper Egypt. Clinical evaluation and mutation analysis using commercially available strip assay kit after PCR amplification of the target gene were done for all included GD patients.Results: Consanguinity between patients’ parents was present in 73.1% of the included patients. 76.9% of included patients were of type 1 GD, while 23.1% were of type 3 GD and none of our patients was classified as type 2 GD. The main frequent clinical presentations of GD in this study were hepatosplenomegaly (88.5%); pallor (76.9%); abdominal distension (61.5%) and musculoskeletal involvement (37.1%). Neurological abnormalities of type 3 GD included in this study were squint, seizures and delayed mental development. Five different genotypes were detected, homozygous for the mutation L444P, homozygous for the mutation N370S, heterozygous for the mutations N370S and rec Ncil, heterozygous for IVS2 +1 and rec NciI, heterozygous for L444P and IVS2 +1. Conclusions: Non-neuropathic type 1 and type 3 GD were the only clinical types found in the present study. The most common mutant alleles found in this study were L444P and N370S

Increased circulating ANG II and TNF-α represents important risk factors in obese Saudi adults with hypertension irrespective of diabetic status and BMI

Central adiposity is a significant determinant of obesity-related hypertension risk, which may arise due to the pathogenic inflammatory nature of the abdominal fat depot. However, the influence of pro-inflammatory adipokines on blood pressure in the obese hypertensive phenotype has not been well established in Saudi subjects. As such, our study investigated whether inflammatory factors may represent useful biomarkers to delineate hypertension risk in a Saudi cohort with and without hypertension and/or diabetes mellitus type 2 (DMT2). Subjects were subdivided into four groups: healthy lean controls (age: 47.9±5.1 yr; BMI: 22.9±2.1 Kg/m2), non-hypertensive obese (age: 46.1±5.0 yr; BMI: 33.7±4.2 Kg/m2), hypertensive obese (age: 48.6±6.1 yr; BMI: 36.5±7.7 Kg/m2) and hypertensive obese with DMT2 (age: 50.8±6.0 yr; BMI: 35.3±6.7 Kg/m2). Anthropometric data were collected from all subjects and fasting blood samples were utilized for biochemical analysis. Serum angiotensin II (ANG II) levels were elevated in hypertensive obese (p<0.05) and hypertensive obese with DMT2 (p<0.001) compared with normotensive controls. Systolic blood pressure was positively associated with BMI (p<0.001), glucose (p<0.001), insulin (p<0.05), HOMA-IR (p<0.001), leptin (p<0.01), TNF-α (p<0.001) and ANG II (p<0.05). Associations between ANG II and TNF-α with systolic blood pressure remained significant after controlling for BMI. Additionally CRP (p<0.05), leptin (p<0.001) and leptin/adiponectin ratio (p<0.001) were also significantly associated with the hypertension phenotype. In conclusion our data suggests that circulating pro-inflammatory adipokines, particularly ANG II and, TNF-α, represent important factors associated with a hypertension phenotype and may directly contribute to predicting and exacerbating hypertension risk

Expression Profiles of P53, Caspase-3 And Bcl-2 in Patients Undergoing Congenital Heart Corrective surgery: Combined Effects Of Anesthesia And Surgery

Background:&nbsp;Apoptosis is a physiological programmed cell death necessary for &nbsp;&nbsp;development and cellular homeostasis. Dysregulation of apoptosis pathways leads to a number of diseases such as cancer, autoimmune and immunodeficiency diseases, and neuro-degenerative disorders. &nbsp; Patients and methods: The current study included 56 patients (29 males and 27 females), undergoing corrective heart surgery operations, categorized into 3 groups: group A included 23 patients with atrial septal defect (ASD); group B included 15 patients with ventricular septal defect (VSD); and group C included 15 patients with fallot tetralogy. Biochemical assays of apoptotic (P53 &nbsp;and caspase 3) and antiapoptotic markers (Bcl-2)&nbsp;using &nbsp;colorimetric and ELISA assay kits were performed to all included patients twice, preoperative and 24 hours postoperative. &nbsp;Results:&nbsp;No statistical significant difference was found in the preoperative levels of Bcl-2, Caspase-3 and P53 between the three groups. While significant difference was found when comparing the preoperative and postoperative levels of the previous markers in the same group and between groups (p˂0.05 for all). Conclusion: Both apoptotic and antiapoptotic pathways are activated during congenital heart corrective surgeries. Degree of markers increase is directly related to duration of anesthesia exposure. Key words:&nbsp;P53; caspase-3; Bcl-2; congenital heart corrective surgery; Apotosis

Measuring the Systemic Inflammatory Response to On- and Off-Pump Coronary Artery Bypass Graft (CABG) Surgeries Using the Tryptophan/Kynurenine Pathway

Background: Cardiac surgeries induce many inflammatory responses with remarkable clinical implications. Tryptophan (Trp) is a precursor for serotonin, melatonin and kynurenine (Kyn). Plasma kynurenic acid (Kyna) and Kyn concentrations are thought to be related to the severity of inflammation. Plasma Trp/Kyn ratio is used to measure inflammatory cytokine activity. Methods: We performed the current longitudinal study in a tertiary care center and included 62 patients divided into two groups; group A (on-pump CABG patients) and group B (off-pump CABG patients). Plasma Trp and Kyn were measured using the high-performance liquid chromatography (HPLC) technique. Serum interlukin-6 (IL-6) and white blood cells (WBCs) were measured using ELISA and routine blood count, respectively. Results: The present study revealed that the intraoperative levels of plasma Kyn, IL-6 and WBCs were significantly increased while the plasma Trp/Kyn ratio was significantly decreased in both the groups; however, the changes were more significant in the on-pump CABG group. Moreover, the levels in both the groups returned to preoperative levels 72 h postoperative. Our study has shown that WBCs is positively correlated with IL-6, but has negative correlation with Trp/Kyn ratio. Conclusions: Kyn and Trp/Kyn ratio might be utilized as markers of the severity of inflammation in major surgery. In addition, off-pump CABG might be more preferable than on-pump CABG regarding stress and release of inflammatory markers

Partial Correlation Using Systolic BP, Diastolic BP, TNF-α and Angiotensin II as Dependent Variables Controlled for BMI.

<p>Spearman's correlation coefficient with corresponding p-value (p<0.05 is significant).</p

Correlation between systolic blood pressure and ANG II (r = 0.17, p<0.05) (A); TNF-α (r = 0.2, p<0.001) (B) in the entire group studied.

<p>Correlation between systolic blood pressure and ANG II (r = 0.17, p<0.05) (A); TNF-α (r = 0.2, p<0.001) (B) in the entire group studied.</p

Correlation between ANG II and TNF-α (r = 0.32, p<0.001) in the entire group studied.

<p>Correlation between ANG II and TNF-α (r = 0.32, p<0.001) in the entire group studied.</p