MMP-9/BDNF ratio predicts more severe COVID-19 outcomes

COVID-19 clinically manifests from asymptomatic to the critical range. Immune response provokes the pro-inflammatory interactions, which lead to the cytokines, reactive oxygen/nitrogen species, peptidases, and arachidonic acid metabolites enlargement and activation of coagulation components. Matrix metalloproteinases (MMPs) contribute to tissue destruction in the development of COVID-19. Due to the endothelial, systemic course of the disease, VEGF A participates actively in COVID-19 development, while neurotrophic and metabolic effects of BDNF recommends for the prediction of complications in COVID-19 patients. Searching for a marker that would improve and simplify the ranking in COVID-19, the study intended to evaluate the relationship of MMP-9 with VEGF A, BDNF, and MMP-8 with the COVID-19 severity. Upon admission to the hospital and before the therapy administration, 77 patients were classified into a mild, moderate, severe, or critical group. Due to the inflammatory stage in COVID-19, a comparison between groups showed related differences in leukocytes, neutrophils, lymphocytes, and platelets counts as anticipated. Only in seriously ill patients, there is a significant increase in the serum concentration of MMP-9, MMP-8, and VEGF A, while BDNF values did not show significant variations between groups. However, all those parameters positively correlated with each other. The ratio of MMP-9/BDNF markedly decreased in the severe and critically patients compared to the mild group. Testing the capability of this ratio to predict the COVID-19 stage by ROC curves, we found the MMP-9/BDNF could be a suitable marker for differentiating stages I/II (AUC 0.7597), stage I/III (AUC 0.9011), and stage I/IV (AUC 0.7727). Presented data describe for the first time the high-level systemic MMP-9/BDNF ratio in patients with COVID-19. This parameter could contribute to a more precise determination of the phase of the disease.

Eosinophil Cationic Protein in Patients with Differentiated Thyroid Cancer Treated with Radioactive Iodine 131

Published data indicate the involvement of eosinophil granulocytes and eosinophil cationic protein (ECP) in tumor defense. The aim of this study was to analyze serum ECP concentrations in patients with differentiated thyroid cancer (DTC) before, 3 days and 7 days after radioactive iodine (131-I) therapy. Association of ECP concentrations with histological type of tumor, stage of disease and/or levels of selected T-helper 2 (Th2) cytokines was examined. The study population included 17 DTC patients and 10 control subjects. ECP was measured by fluoroimmunoassay (FIA). Th2 (cytokines interleukin 4 (IL-4), interleukin 5 (IL-5), and interleukin 13 (IL-13)) were determined by enzyme-linked immunosorbent assays (ELISA). We found that ECP values in DTC patients before radioactive iodine therapy were approximately two-fold higher than in the controls, but the difference was statistically significant only if the patients with DTC and associated Hashimoto thyroiditis (HT) were included. There was no correlation between the serum concentrations of IL-5 and ECP. Radioactive iodine therapy led to a decrease in serum ECP level which did not follow the decline in serum protein levels. Additional studies are needed to determine the significance of these findings.

Transforming Growth Factor Beta 1 (TGF-β1) in Thyroid Cancer Patients: a View from the Peripheral Blood

Transforming growth factor beta (TGF-β) plays an important role in many pathophysiological conditions, including cancer. The level of TGF-β in patients with differentiated thyroid cancer (DTC) has not been examined so far. The aim of this study was to measure TGF-β concentration in serum samples and in PHA-stimulated whole blood culture in vitro and to analyze possible associations of TGF-β1 levels with leukocyte, lymphocyte and platelets counts, the histological type of thyroid cancer, and stage of disease. TGF-β1 was measured in 22 DTC patients and 20 healthy controls using the duoSet ELISA Development kit for human TGF-β1. The concentration of TGF-β1 in serum samples from both groups correlated positively with the platelet counts. There was no statistically significant difference in the serum concentrations of TGF-β1 between DTC patients and control subjects, but PHA stimulated whole blood cultures of DTC patients produced less TGF-β1 than those from controls. Additional studies are needed to determine the significance of these in vitro findings.

(18)F-FDG PET scanning of abdominal aortic aneurysms and correlation with molecular characteristics: a systematic review

Purpose

The purpose of this study is to give an overview of studies investigating the role of fludeoxyglucose F18 (¹⁸F-FDG) positron emission tomography (PET) scanning in patients with aortic aneurysms with a focus on molecular characteristics of the aneurysm wall.

Methods

MEDLINE, EMBASE, and the Cochrane database were searched for relevant articles. After inclusion and exclusion, we selected 18 relevant articles reporting on ¹⁸F-FDG PET scanning of aortic aneurysms.

Results

The sample size of studies is limited, and there are no standardized imaging protocols and quantification methods. ¹⁸F-FDG PET scanning was shown to display molecular characteristics of the aortic wall. Different studies showed contradictory findings of aortic ¹⁸F-FDG uptake in aneurysm patients compared to controls.

Conclusions

Non-invasively determining molecular characteristics of aortic wall weakening might lead to better rupture and growth prediction. This might influence the decision of the surgeon between conservative and surgical treatment of aneurysms. To date, there is conflicted evidence regarding the use of ¹⁸F-FDG PET scanning to predict aneurysm rupture and growth. The role of ¹⁸F-FDG PET scanning in rupture risk prediction needs to be further investigated, and standardized imaging protocols and quantification methods need to be implemented.

Electronic supplementary material

The online version of this article (doi:10.1186/s13550-015-0153-8) contains supplementary material, which is available to authorized users.

Cytokine production in patients with papillary thyroid cancer and associated autoimmune Hashimoto thyroiditis

Hashimoto thyroiditis (HT) is the most frequent thyroid autoimmune disease, while papillary thyroid cancer (PTC) is one of the most common endocrine malignancies. A few patients with HT also develop PTC. The aim of this study was to analyze cytokine profiles in patients with PTC accompanied with autoimmune HT in comparison with those in patients with PTC alone or HT alone and healthy subjects. Cytokine levels were determined in supernatants obtained from phytohemagglutinin (PHA)-stimulated whole blood cultures in vitro. The concentrations of selected cytokines: Th1-interferon gamma (IFN-γ); Th2-interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 6 (IL-6), interleukin 10 (IL-10) and interleukin 13 (IL-13); Th9-interleukin 9 (IL-9); and Th17-interleukin 17 (IL-17A) were measured using multiplex cytokine detection systems for human Th1/Th2/Th9/Th17/Th22. We found that PTC patients with HT produced significantly higher concentrations of IL-4, IL-6, IL-9, IL-13 and IFN-γ than PTC patients without HT. In conclusion, autoimmune HT affects the cytokine profile of patients with PTC by stimulating secretion of Th1/Th2/Th9 types of cytokines. Th1/Th2 cytokine ratios in PTC patients with associated autoimmune HT indicate a marked shift toward Th2 immunity.

Severe saddle nose deformity reconstructed with rib cartilage

Augmenting the nasal dorsum is often a difficult task, because of the irregularities that might be visible under the thin dorsal nasal skin. Saddle noses are especially difficult to correct because of the need to provide strong structural support to the nose while at the same time achieving an aesthetic dorsum. Stable reconstruction of the cartilaginous septum is the critical challenge in the operative treatment of such deformities with both functional and morphological implications. Treatment depends on the degree of saddling. Autologous cartilage is widely recognized to be the standard against which other materials must be judged. It is the most acceptable and reliable long-term graft. We present a case of unusually severe posttraumatic saddle nose resolved with a single rather large costal cartilaginous graft and a columellar strut. Classic extended spreader grafts could not be used due to the lack of bony and cartilaginous support of the nasal pyramid and, thus, no possibility of stabilization. A normal nasal dorsum, as well as breathing improvement, were achieved and the patient was extremely satisfied with the result. We had no complications except a slight asymmetry of the nostrils. Graft resorbtion or displacement was not observed on the 14-months follow-up.

Quantitative real time-polymerase chain reaction method in Bcr-Abl translocation diagnostics

PURPOSE

The quantitative real-time polymerase chain reaction (qRT-PCR) is used in the detection of molecular events involved in leukemogenesis, such as the Bcr-Abl gene translocation, the most important factor in the pathogenesis of chronic myeloid leukaemia (CML). The main aim of our study was to test the reproducibility, specificity and sensitivity of the qRT-PCR in the detection of Bcr-Abl gene translocation.

METHODS

In complementary (c)DNA, isolated from K562 Bcr-Abl positive cell line, we performed qRT-PCR analysis with Bcr-Abl specific primers. For qRT-PCR analysis, we used serial dilutions of the newly synthesized cDNA in order to establish the detection threshold of this method.

RESULTS

Using the specific primers for the Bcr-Abl translocation, we obtained the specific translocation product in cDNA sample of K562 human erythroid leukemia cell line. qRT- PCR showed significant sensitivity with the detection threshold for the Bcr-Abl fluorescent signal, which enabled the precise detection that was accurate within a 10-fold dilution range, and a dynamic range of 5 orders of magnitude.

CONCLUSION

The results of our study showed that the application of the qRT-PCR is the optimal method for the detection of Bcr-Abl gene translocation, characterized by high reproducibility, specificity and sensitivity.

Late recurrence of malignant melanoma mimicking ovarian malignancy

BACKGROUND

Malignant melanoma (MM) is an extremely malignant tumor with an unpredictable profile of spread and variable periods of remission.

CASE

We describe an unusual case of malignant melanoma metastatic to the omentum occurring seven years after diagnosis and treatment of cutaneous malignant melanoma in the patient's arm. She received surgery and chemoimmunotherapy. To date, nine months after detection of malignant melanoma metastatic to the omentum, the patient is alive with no clinical and radiological metastatic disease.

CONCLUSIONS

The diagnosis of omentum malignant melanoma in a living patient is uncommon, thus very few individuals and referral centers can build up an adequate experience of handling this disease. Optimal management has been a challenge and a subject of debate and has not yet been established.

Safety and effectiveness of leflunomide in the treatment of patients with active rheumatoid arthritis. Results of a randomized, placebo-controlled, phase II study

OBJECTIVE

To assess the safety and effectiveness of leflunomide versus placebo in patients with active rheumatoid arthritis (RA) treated for 6 months.

METHODS

Four hundred two patients were randomly assigned to receive placebo or leflunomide at 5 mg, 10 mg, or 25 mg daily. A washout period of 6-12 weeks from prior second-line therapy was required.

RESULTS

Statistically significant improvement in primary and secondary outcome measures, as well as by responder analyses, occurred in the 10-mg and 25-mg dosage groups compared to placebo. Twenty-one patients (7.0%) in the active treatment groups withdrew due to adverse events (AEs). The incidence of AEs was higher with leflunomide than with placebo. Gastrointestinal symptoms, weight loss, allergic reactions, skin rash, and reversible alopecia were more common in the 10-mg and 25-mg dosage groups. The incidence of infections was similar between the treatment and placebo groups; no opportunistic infections were seen. Transient elevations in liver function studies were noted in a small number of patients.

CONCLUSION

Leflunomide is effective in daily doses of 10 mg and 25 mg in patients with active RA. Improved efficacy at the 25-mg dose was associated with a higher incidence of AEs. Randomized, placebo-controlled trials using daily doses of 10 mg and 20 mg are under way in the US and Europe to confirm these positive results.