KDM3A, a Novel Blood-Based Biomarker in Colorectal Carcinogenesis

Colorectal cancer (CRC) is one of the leading causes of cancer-linked deaths globally. The determination of biomarkers is important in the prognosis and treatment of CRC. Previous studies emphasized the relationship between hypoxia and CRC in humans, and there is strong evidence that this process is strongly related to HIF-1. KDM3A is a histone demethylase that could directly bind to HIF-1α, a subunit of HIF-1. This study aimed to reveal whether the expression level of the KDM3A gene could be used as a predictor of CRC. The expression levels of HIF-1α, KDM3A, and Epithelial-Mesenchymal Transition (EMT) genes were evaluated by qRT-PCR in leukocyte samples of 50 CRC patients in different stages and 50 healthy controls. HIF-1α and KDM3A expression levels were significantly higher in the CRC group, compared to the controls. Slug and ZEB-1 genes, the mesenchymal markers, showed the same significance pattern between groups. We acquired 0.664 AUC with 54% sensitivity and 85.4% specificity for separating controls from CRC patients by using the KDM3A expression levels in ROC analysis. This data support that KDM3A could be a novel supplementary biomarker in diagnosis of CRC, which could be noninvasively detected in circulation.

P–534 A novel heterozygous mutation in the luteinizing hormone/choriogonadotropin receptor (LHCGR) gene in a patient with ‘genuine’ empty follicle syndrome

Study question

Whether empty follicle syndrome (EFS) in a patient has a genetic basis.

Summary answer

Our findings would expand the mutational spectrum of LHCGR, in patients with GEFS

What is known already

The LHCGR gene (OMIM #52790) is located on chromosome 2p21 has 11 exons The LHCGRs present in gonadal cells; granulosa, theca and luteal cells in women and Leydig cells in menandplays a critical role in male sexual differentiation, female ovarian development and fertility (folliculogenesis, ovulation, corpus luteum formation and progesterone secretion)

Inactivating mutations in males can lead to Leydig cell hypoplasia, which causes disorders in sexual development (MIM #238 320). Phenotype of women is less severe and variable and has no effect on the secondary sex characteristics, but it could cause amenorrhoea and infertility Study design, size, duration: In the context of clinical genetics, Next Generation Sequencing libraries were prepared in line with the manufacturer’s orders using QIASeq™ Targeted DNA Custom Panel (Qiagen) targeting exons and 20 bp exon-intron boundaries of selected genes (AR, BMP15, CATSPER1, CFTR, CYP21A2, FSHB, FSHR, HESX1, LHB, LHCGR, NR5A1, POU1F1, SRY, ZP1). The variant detected in NGS analysis was further confirmed using Sanger sequencing (MiSeq, Illumina, San Diego, CA).

Participants/materials, setting, methods

A 27 years old Turkish women with 6 year history of primary unexplained infertility underwent controlled ovarian hyperstimulation and IVF with an antagonist protocole in Ankara City Hospital. Although normal follicular development, E2 levels, and bioavailable β-hCG plasma levels, no oocytes or cumulus-corona complexes were retrieved by follicular aspiration.

Main results and the role of chance

A novel heterozygous mutation on Exon 5 of LHCGR (NM_000233.4):c.453C>G (p.Phe151Leu). This variant has not been reported in GnomAD database and is a novel variant as per controlled from ClinVar and HGMD mutation databases

Also coagulation tests were done Patient was heterozygote for the prothrombin mutation (FXIII) and homozygote for MTHFR C677T mutation. The patient has normal pubertal development and female karyotype (46,XX). Gonadotropin and E2 levels were normal, nor any history of anosmia, primary amenorrhoea, polycystic ovaries, hyperandrogenism, systemic disorder, or neurologic defect.

According to ACMG 2015 and HGMD detected variant was classified as unknown clinical significance (VUS) variant In 22nd World Congress COGI in 2015 we have presented another recurrent GEFS case with compound heterozygous frameshift mutations in exon 5 and 11 of LHCGRgene(c.1764_1765insT) and (c.430G>T, p.V144F) who developed premature ovarian failure at the end The different types of LHCGR mutations would lead to the different functional effects and clinical phenotypes in different ages; primary amenorrhea with high levels of LH, poor ovarian response (Poesidon group1), GEFS and secondary amenorrhea (premature ovarian failure) GEFS may be a gradual biological occurrence related to ovarian ageing. Long term follow up is important, since some clinical manifestations appear later in life.

Limitations, reasons for caution

LH resistance in females were always found due to their effected brothers and only 10 GEFS cases of 46, XX females with LHCGR gene defect reported in literature.

Patient was heterozygous for indicated mutation; therefore segregation study should be done in family members and in vitro studies should be performed.

Wider implications of the findings: Screening for mutations in the LHCGR gene in Poseidon group 1 and in patients GEFS especially the recurrent ones will provide valuable information and time for clinical management, corresponding treatment and give the opportunity of wise and cost effective counseling of patients about their future reproductive choices.

Trial registration number

it is a case report

Identification of a new class of potent aldose reductase inhibitors: Design, microwave-assisted synthesis, in vitro and in silico evaluation of 2-pyrazolines

Aldose reductase (AR) acts as a multi-disease target for the design and development of therapeutic agents for the management of diabetic complications as well as non-diabetic diseases. In the search for potent AR inhibitors, the microwave-assisted synthesis of twenty new compounds with a 1,3-diaryl-5-(4-fluorophenyl)-2-pyrazoline moiety as a common fragment in their structure (1-20) was carried out efficiently. Compounds 1-20 were subjected to in vitro studies, which were conducted to assess their AR inhibitory effects and cytotoxicity towards L929 mouse fibroblast (normal) cells. Among these compounds, 1-(3-bromophenyl)-3-(4-piperidinophenyl)-5-(4-fluorophenyl)-2-pyrazoline (20) was identified as the most promising AR inhibitor with an IC₅₀ value of 0.160 ± 0.005 μM exerting competitive inhibition with a K_i value of 0.019 ± 0.001 μM as compared to epalrestat (IC₅₀ = 0.279 ± 0.001 μM; K_i = 0.801 ± 0.023 μM) and quercetin (IC₅₀ = 4.120 ± 0.123 μM; K_i = 6.082 ± 0.272 μM). Compound 20 displayed cytotoxicity towards L929 cells with an IC₅₀ value of 18.75 ± 1.06 μM highlighting its safety as an AR inhibitor. Molecular docking studies suggested that π-π stacking interactions occurred between the m-bromophenyl moiety of compound 20 and Trp21. Based on in silico pharmacokinetic studies, compound 20 was found to possess favorable oral bioavailability and drug-like properties. It can be concluded that compound 20 is a potential orally bioavailable AR inhibitor for the management of diabetic complications as well as non-diabetic diseases.

The impact of laparoscopic sleeve gastrectomy on plasma obestatin and ghrelin levels

OBJECTIVE

To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on the levels of obestatin and ghrelin hormones and body mass index (BMI) in morbidly obese patients.

PATIENTS AND METHODS

The study included 30 morbidly obese patients who had LSG. Five cc blood samples were taken from the patients preoperatively and at postoperative months 3 and 6. After serum extraction, the levels of obestatin and ghrelin hormones and the levels of fasting insulin and glucose were studied using the enzyme-linked immunosorbent assay (ELISA) method. The homeostatic model assessment of insulin resistance (HOMA-IR) score was calculated. Preoperative and postoperative 3- and 6-month BMI were calculated. Kruskal-Wallis Analysis of Variance, Bonferroni-Dunn Test, Spearman's correlation test, and Pearson's correlation test were used for statistical analysis.

RESULTS

BMI of the patients were statistically significantly reduced at postoperative months 3 and 6 compared to preoperative values, and at postoperative month 3 compared to month 6 values (p < 0.001). Ghrelin values were higher at postoperative month 6 compared to the preoperative and postoperative month 3 values (p < 0.001). Obestatin values of the patients were lower at postoperative month 6 compared to the preoperative and postoperative month3 values (p < 0.001). Insulin and glucose values were statistically significantly lower at postoperative months 3 and 6 compared to preoperative values (p < 0.001), whereas there was no difference between months 3 and 6. HOMA-IR score was significantly lower at postoperative month 3 compared to preoperative values (p < 0.001).

CONCLUSIONS

LSG enables effective weight loss and glucose regulation in obese patients. LSG has also effects on obestatin and ghrelin hormones, which are coded by the same gene and have opposing effects, and the associated mechanisms of which are still controversial. Obestatin produces a feeling of satiety, whereas ghrelin initiates eating by producing a feeling of hunger. The patients were observed to have increased ghrelin and reduced obestatin postoperatively due to a negative energy balance.

Factors affecting recurrence after surgery for ovarian mature cystic teratoma

We aimed to evaluate the risk factors for recurrence of surgically managed ovarian mature cystic teratoma (MCT). A total of 178 women with MCT managed surgically at our clinic were included in this retrospective study. The cases were followed for a minimum of 34 months. Risk factors recorded were age, gravidity, diameter of MCT, tumour markers, bilaterality, operation time and recurrence time. One hundred forty-one women (79.2%) underwent laparoscopy and the other thirty-seven patients (20.8%) underwent laparotomy. The mean age of patients with cyst recurrence was significantly lower than that of patients without recurrence (p = 0.02). There was a significantly lower median gravidity and parity in this group. The capacity of younger age, lower gravidity and parity in predicting the recurrence of ovarian MCT was analysed using receiver operating characteristic curve analysis. The cut-off value of age, number of gravidity and parity was 26, 1 and 0, respectively. In conclusion, younger age and lower gravidity and parity were predictive of recurrence due to a more conservative approach in young and nulliparous patients. Therefore, we suggest regular follow-up visits during the postoperative period, especially for younger patients and those with lower numbers of gravidity and parity.

The clinical significance of endometrial fluid collection in asymptomatic postmenopausal women

OBJECTIVE

This study assessed the clinical significance of endometrial fluid collection (EFC) in asymptomatic postmenopausal women.

MATERIALS AND METHODS

A total of 564 postmenopausal females were enrolled into this retrospective study, of whom 141, with EFC, comprised the study group; the remaining 423 postmenopausal women (the three consecutive patients) who had been admitted to the menopause outpatient clinic for their routine annual check formed the control group. Data, including age, gravidity, parity, body mass index, hypertension, diabetes mellitus, menopause duration, endometrial thickness and histopathological endometrium results, were compared between groups using the SPSS for Windows software package (version 15.0; SPSS Inc., Chicago, IL, USA).

RESULTS

There were no significant group differences in gravidity, parity, body mass index, rates of hypertension and diabetes mellitus, endometrial thickness or histopathological endometrium results. However, there were group differences in age (62.0 ± 7.6 vs. 57.2 ± 8.9 years, p < 0.001) and menopause duration (13.4 ± 7.8 vs. 7.9 ± 5.4 years, p < 0.001).

CONCLUSION

The results indicate that EFC in asymptomatic postmenopausal women is a benign condition, influenced by older age and commensurately longer menopause duration due to a lack of hormonal stimulation. The presence of EFC by itself does not affect the decision to provide further evaluation; that is determined by the presence of confirmed risk factors (e.g. thickened endometrial stripe). However, further studies are needed to assess any long-term prognostic impact of this finding.

Increased serum nitric oxide and malondialdehyde levels in patients with acute intestinal amebiasis

OBJECTIVE

To determine the level of oxygen-nitrogen stress parameters in the pathogenesis of amebiasis.

METHODS

Twenty-four acute intestinal amebiasis patients and 20 healthy controls were enrolled in the present study. Serum malondialdehyde and nitric oxide levels were determined spectrophotometrically.

RESULTS

Serum malondialdehyde and nitric oxide levels were significantly higher in acute intestinal amebiasis patients than healthy controls (P<0.001).

CONCLUSIONS

These results suggest that oxidative and nitrosative stress may play a major role in tissue damage in acute intestinal amebiasis patients. Also these parameters can be used to supplement the conventional microscopic method for reliable diagnosis of intestinal amebiasis.

The clinical manifestations and survival of systemic lupus erythematosus patients in Turkey: report from two centers

Background

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Survival has become longer as a result of better treatment modalities and better supportive care. There is no information on survival of SLE patients in Turkey. We evaluated clinical features and survival in SLE patients in two rheumatology departments.

Methods

All SLE patients being followed up by the Department of Rheumatology, Trakya University Medical Faculty, and the Department of Rheumatology, Marmara University Medical Faculty, over the 1996–2012 period were included. Patients were diagnosed with SLE if they fulfilled at least four American College of Rheumatology (ACR) criteria. The clinical and laboratory features, mortality data were obtained from medical charts.

Results

We had 428 SLE patients, and women (399 patients, 93.2%) far outnumbered men (29 patients, 6.8%). The mean age at the time of SLE diagnosis was 40.3 ± 12.4 years. The most frequent clinical manifestations were arthritis (76.9%) and photosensitivity (70.1%). Renal disease was present in 32.9% of patients and neurological involvement in 12.9% of patients. After a median follow-up of 60 months, 19 patients died. The most frequent causes of death were ischemic heart disease, chronic renal failure and sepsis. The rate of five-year survival was 96%; 10-year survival, 92%; and 15-year survival, 88.8%. Multivariate Cox analysis showed that serositis at the time of diagnosis, SLE disease activity index (SLEDAI) score 6, and autoimmune hemolytic anemia were independent prognostic factors.

Conclusions

Data from two centers in Northwestern Turkey show that the mortality rate for SLE is similar to the rate in Western countries.

Diagnostic value of thiols, paraoxonase 1, arylesterase and oxidative balance in colorectal cancer in human

Oxidative stress has been shown to play an important role in carcinogenesis. We hypothesize that serum oxidative and anti-oxidative factors work together to influence colon and rectal cancer through an oxidative balance mechanism. Total thiol (Ttl) is considered a plasma antioxidant and high density lipoprotein (HDL)- dependent paraoxonase l (PON1) is known as a free radical scavenger. This study was undertaken to determine the activity of PON1, arylesterase (ARE) and Ttl levels and oxidative balance in colorectal cancer (CRC) patients and healthy subjects.Paraoxonase and arylesterase activities of the HDL-dependent PON1 enzyme and the level of Ttl, total oxidant status (TOS) ,total antioxidant status (TAS) in forty patients with CRC (19 female, 21 male; mean age, 56.5 ± 2.1) and thirty-nine age and sex matched healthy persons (22 female, 17 male; mean age 56 ± 1.7) were studied.PON1 and ARE activities were significantly lower in patients with CRC compared to controls (p<0.001 for each), whereas oxidant parameters (TOS and OSI) were significantly higher in CRC patients (p<0.001 for each). However, TAS and Ttl significantly decreased in patients with CRC (p=0.03 and p<0.0001, respectively). According to the ROC curve analysis, Ttl was superior to other parameters in terms of diagnostic sensitivity and specificity which were 97.5% and 92.3%, respectively, and the AUC 0.97 in CRC patients. Decreased Ttl and HDL-dependent PON 1 enzyme activities and high TOS levels imply an imbalance of the free radical system which enhances the support the hypothesis that CRC is associated with excess reactive oxygen species.These findings show that of serum oxidative imbalance was associated with an increased risk of CRC. To our knowledge, this is the first report demonstrating lower serum PON1, ARE activities in CRC patients. The mechanism behind this association needs further elucidation.

Effects of erdosteine on cyclosporin-A-induced nephrotoxicity

AIM

In cyclosporin-A (CsA)-induced toxicity, oxidative stress has been implicated as a potential responsible mechanism. Therefore, we aimed to investigate the protective role of erdosteine against CsA-induced nephrotoxicity in terms of tissue oxidant/antioxidant parameters and light microscopy in rats.

MATERIALS AND METHODS

Wistar albino rats were randomly separated into four groups. Group 1 rats treated with sodium chloride served as the control, group 2 rats were treated with CsA, group 3 with CsA plus erdosteine, and group 4 with erdosteine alone. Animals were killed and blood samples were analyzed for blood urea nitrogen (BUN), serum creatinine (Cr), uric acid (UA), total protein (TP), and albumin (ALB) levels. Kidney sections were analyzed for malondialdehyde (MDA) and nitric oxide (NO) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities, as well as for histopathological changes.

RESULTS

In the CsA group, MDA, GSH-Px, BUN, and Cr levels were increased. The TP and ALB levels were decreased. These changes had been improved by erdosteine administration. Other biochemical parameters did not show any significant change.

CONCLUSION

These results indicate that erdosteine produces a protective mechanism against CsA-induced nephrotoxicity and suggest a role of oxidative stress in pathogenesis.