Analysis of Reference Ranges of Total Serum Protein in Namibia: Clinical Implications

Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats?

Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.

Evaluation of a potential prognostic parameter for the inflammatory status in COVID‐19 patients: The inflammatory protein ratio

C‐reactive protein (CRP), fibrinogen, and d‐dimer are determined in the human plasma of 2745 hospitalized patients with and without coronavirus disease 2019 (COVID‐19) by automated‐latex enhanced immunoassay and immuno‐turbidimetric assay. SARS‐COV‐2 RNA qualitative test, real time polymerase chain reaction (RT‐PCR) based, is performed in nasopharyngeal swabs to confirm those with SARS‐COV‐2 positivity. Furthermore, serum proteins are separated and quantified in all the patients by serum protein electrophoresis (SPE).

A new SPE parameter, inflammatory protein ratio (IPR), is elaborated for the first time by a mathematical equation that considers the albumin, α1‐globulin, and α2‐globulin. IPR normal reference range (10.7%–28.3%) is calculated considering the normal reference range of albumin, α1‐globulin, and α2‐globulin obtained for controls. Analysis of variance (ANOVA), Pearson's, Kruskal–Wallis, and Spearman's tests application show that IPR significantly correlates with direct proportionality with d‐dimer, CRP, and fibrinogen. Significant (p < 0.001) increase of these parameters, IPR included, is detected in COVID‐19 patients only. Our results show that IPR is more specific for monitoring inflammatory status thanks to its correlation with the only three serum proteins involved in inflammation: albumin, α1‐globulin, and α2‐globulin. Furthermore, IPR can simplify the interpretation of SPE results about inflammatory status, being of unique value compared to the six‐serum protein classes separately presented in the typical SPE clinical reports.