Summary
Serum sclerostin levels could be closely associated with serum phosphate and fibroblast growth factor-23 levels in hemodialysis patients with low intact parathyroid hormone (PTH) levels. ...Further study is required to indicate whether these close associations are present in patients with spontaneously low PTH levels without any vitamin D treatment.
Introduction
Intact parathyroid hormone (iPTH) is involved in the interaction between sclerostin and phosphate/fibroblast growth factor-23 (FGF23) in animal models. However, their relationship in patients on hemodialysis (HD) is unclear.
Methods
Data of 102 HD patients were collected regarding clinical and laboratory parameters and mineral bone disorder medications. The patients were divided into subgroups according to the iPTH level (A, <70 pg/mL; B, 70–150 pg/mL; C, 150–300 pg/mL; and D, ≥300 pg/mL).
Results
The sclerostin level was significantly and positively correlated with phosphate and log of FGF23 levels in subgroups A, B, and combined A and B. Multiple linear regression analysis in the combined A and B subgroup revealed that male sex (
t
= 3.24,
P
= 0.01; 95 % confidence interval CI 11.78 to 50.43) and phosphate level (
t
= 2.13,
P
= 0.04; 95 % CI, 1.08 to 36.91) were independent factors for serum sclerostin level. The log of serum FGF23 level (
t
= 1.90,
P
= 0.06, 95 % CI −1.85 to 63.50) appeared to be an important factor for serum sclerostin level. The frequency of patients using vitamin D treatment was not significantly different among subgroups A (93.1 %), B (88.0 %), C (85.2 %), and D (90.5 %).
Conclusion
Serum sclerostin levels were associated with serum phosphate and FGF23 levels in patients with low iPTH levels. Further study is required to indicate whether these close associations are present in patients with spontaneously low iPTH levels without vitamin D treatment.
Background. Dialysis-related amyloidosis is one of the chronic the complications of haemodialysis. We conducted an investigation of dialysis-associated amyloidosis in extremely long-term survivors. ...Methods. Twenty-one patients on haemodialysis for more than 30 years (‘30+’ group) and 13 patients on haemodialysis for 20–30 years (‘20–30’ group) at Sangenjaya Hospital were enrolled in this study. The frequencies of operations for conditions related to haemodialysis-related amyloidosis were examined. Results. The mean age at the start of haemodialysis was younger in the ‘30+’ group (29.1 ± 7.3 years) than in the ‘20–30’ group (40.5 ± 8.2 years, P = 0.0003). Eighteen (85.7%) patients had undergone surgery for CTS, six (28.6%) had undergone surgery for trigger finger and six (28.6%) had undergone surgery for cervical destructive spondyloarthropathy (DSA) at 30 years after the start of haemodialysis therapy. Patients who were over the age of 30 years at the start of dialysis therapy more frequently underwent CTS operations (100%) than those who were under 30 years of age at the start of dialysis (76.9%; P = 0.025) in the ‘30+’ group at 30 years after the start of haemodialysis. The frequencies of operations for CTS did not differ significantly between the ‘20–30’ group and the ‘30+’ group. Conclusions.Haemodialysis-associated amyloidosis was common in extremely long-term survivors. Even though the mean age at the start of haemodialysis was younger in the ‘30+’ group than in the ‘20–30’ group, the frequency of operations for CTS did not differ. This may be attributable to the recent advances in haemodialysis technologies.
Background. The prevalence of allergies is steadily increasing worldwide; however, the pathogenesis is still unclear. We hypothesized that Mycobacterium avium subsp. paratuberculosis (MAP) may ...contribute to allergy development. This organism can be present in dairy foods, it can elicit an immunomodulatory switch from a Th1 to a Th2 response, and it has been speculated that it is linked to several human autoimmune diseases. To determine the contribution, sera from 99 individuals with various atopic disorders and 45 healthy nonallergic controls were assessed for total IgE levels and successively for MAP-specific IgE by ELISA. Results. The mean total serum IgE level in allergic patients was 256±235 IU/mL, and in the healthy controls it was 62±44 IU/mL (AUC = 0.88; p<0.0001). Among the patient groups, 50 of the 99 subjects had increased IgE total level ≥ 150 IU/mL, while 49 subjects had IgE ≤ 150 IU/mL (mean level: 407±256 IU/mL versus 106±16 IU/mL; p<0.0001). Additionally, 6 out of 50 subjects (12%) with IgE ≥ 150 IU/mL and none (0%) with IgE ≤ 150 IU/mL were positive for specific MAP IgE (AUC = 0.63; p=0.03). Conclusion. The present study revealed that MAP has the ability to induce specific IgE and might contribute to the induction of allergic inflammation in genetically predisposed individuals.
Abstract Background and aims Serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) and MDA-LDL/LDL-cholesterol (LDL-c) ratio are risk factors for arteriosclerosis and cardiovascular ...disease (CVD). However, no information is available on these parameters or their associations with coronary artery calcification (CAC) in haemodialysis (HD) patients. Methods and results Fifty-seven HD patients and 26 control subjects were included in this cross-sectional study. Serum MDA-LDL concentrations and MDA-LDL/LDL-c ratios were examined. HD patients had significantly higher MDA-LDL/LDL-c ratios than the controls (105.1 ± 27.5 vs. 81.4 ± 18.9 mU/mg, P < 0.001); however, there was no significant difference in serum MDA-LDL levels between the 2 groups. CAC scores were examined only in HD patients and their possible associations with the clinical/laboratory data were analysed. Analysis of HD patients showed that MDA-LDL/LDL-c ratio has an association with presence of CVD, CAC score, HD duration, MDA-LDL, or haemoglobin A1C . In addition, the CAC score was positively correlated with serum MDA-LDL level ( P = 0.048) and MDA-LDL/LDL-c ratio ( P = 0.006). Furthermore, multivariate logistic regression analysis showed that MDA-LDL/LDL-c ratio ( β = 0.04, P = 0.003) and HD duration ( β = 0.16, P = 0.007) were independently associated with CAC score. Conclusion The MDA-LDL/LDL-c ratio of HD patients was significantly higher than that of non-HD subjects and was independently associated with the CAC score. Therefore, this ratio could be an important risk factor for CAC in HD patients.
Background. Osteoprotegerin (OPG) is a glycoprotein that inhibits osteoclast differentiation and activity. OPG-deficient mice develop severe osteoporosis and medial arterial calcification. The ...expression of OPG is detected in early atherosclerotic lesions in non-uraemic patients. We examined whether serum OPG is associated with aortic calcification in haemodialysis patients. Methods. Serum OPG was measured in 102 patients who were undergoing haemodialysis. The aortic calcification index (ACI) was assessed by computed tomography scans. Results. Serum OPG level, measured by enzyme-linked immunosorbent assay, was significantly greater in patients with higher ACI than in those with lower ACI. There was a direct relationship between ACI and serum OPG levels and a positive association between OPG and ACI (r = 0.483, P<0.0001). Multiple regression analyses indicated that serum OPG levels were independently associated with the severity of aortic calcification (P<0.0001). Conclusions. These findings show that serum OPG levels are associated with the extent of vascular calcification, suggesting that OPG may be involved in the development of vascular calcification in haemodialysis patients.
The gamma contribution to the dose received by the population in the city of São Paulo, Brazil, was evaluated. Gamma ray spectroscopy with a sodium iodide scintillation detector was chosen as the ...technique, by the easiness of use, high sensitivity and possibility of identification of an inadvertent contamination. Measurements were taken at
1
m
from the ground, outdoors (at the streets) and indoors (at commercial places). Besides the gamma spectra, the ambient dose equivalent rates were assessed. It was found that in average the indoor dose rates are 46% higher than the outdoor values. No statistically significant cluster of dose values was found in the distribution of outdoor values over the city territory, although a non-homogeneous pattern is observed. As far as the indoor sample is concerned, the statistical analysis points to different mean values, according to the category of the commerce. A final conclusion is that the ambient dose equivalent values observed are high when compared to other places of the world.
Mizoribine (MZR) is a purine antimetabolic immunosuppressant agent that has few little severe adverse events. We studied whether maintenance therapy with MZR and prednisolone (PSL) in severe ...proliferative lupus nephritis patients could improve immunity, reduce proteinuria, prevent renal relapse, and reduce steroid dose.
Long-term maintenance therapy with MZR and PSL was evaluated in ten patients with biopsy-proven proliferative lupus nephritis. Patients with severe lupus nephritis, who had proteinuria of 0.5 g or more even after treatments with plasma exchange and/or pulse methyl prednisolone, were recruited. MZR at an average dose of 140 +/- 10 (100 - 200) mg was administered two to three times/day in combination with PSL. The average period for the MZR maintenance therapy was 89.7 +/- 5.5 (70 - 126) months. Urine protein excretion, serum hemolytic complement activity (CH50), C3, serum creatinine, general and biochemical blood examinations, anti-ds-DNA antibody were collected at each monthly medical examination.
All patients were females, mean age 43.0 +/- 3.3 years. A significant decrease in proteinuria was noted two years after the combination therapy (p = 0.0016). Five patients experienced lupus nephritis relapse. Patients who did not experience relapses had their MZR combination therapy initiated earlier (p = 0.037) when compared with the patients who experienced relapses. Serum creatinine levels remained unchanged in all patients throughout treatment and follow-up, even during renal relapses. Levels of C3 and CH50 normalized as proteinuria decreased. None of the patients developed serious side effects during MZR treatment. A significant steroid-sparing effect was observed three years after initiating MZR (p = 0.0025).
From our long-term observation, maintenance therapy with low-dose PSL combined with MZR can eliminate proteinuria and have steroid-sparing effect. Early initiation of the therapy can protect against renal relapses among severe proliferative lupus nephritis patients without serious side effects.
ABSTRACT Newly-developed spectrographs with increased resolving powers, particularly those covering the near-IR range, allow the characterization of more and more absorption lines in stellar spectra. ...This includes the identification and confirmation of absorption lines and the calibration of oscillator strengths. In this study, we provide empirical values of ${{\rm log} gf}$ based on the abundances of classical Cepheids obtained with optical spectra to establish the consistency between optical and infrared abundance results. Using time series spectra of classical Cepheids obtained with WINERED spectrograph (0.97–1.35 $\mu$m, R$\sim$ 28000), we demonstrate that we can determine the stellar parameters of the observed Cepheids, including effective temperature (${T_\mathrm{eff}}$), surface gravity (${{\rm log} g}$), microturbulence ($\xi$), and metallicity (${\rm {{\mathrm{ M}}/\mathrm{ H}}}$). With the newly calibrated relations of line-depth ratios, we can achieve accuracy and precision comparable to optical studies, with uncertainties of $\sim$90 K and 0.108 dex for ${T_\mathrm{eff}}$, and ${{\rm log} g}$, respectively. Finally, we created a new atlas of absorption lines, featuring precise abundance measurements of various elements found in the atmosphere of Cepheids, including neutron-capture elements whose ${{\rm log} gf}$ values have been astrophysically calibrated.
Closing the ring: Thermally stable but reactive 3‐zinciobenzofurans and indoles were synthesized by metalative cyclization of 2‐ynyl phenols or anilines. Furthermore, a variety of extended ...π‐conjugated molecules were obtained by Pd‐catalyzed cross‐coupling reactions of these heterocycles with mono‐ or polyhalo‐substituted arenes and alkenes (R2Haln; see scheme; Bn=benzyl).
Rheumatoid arthritis is a common autoimmune disease with a complex genetic etiology. Here we identify a SNP in the promoter region of FCRL3, a member of the Fc receptor-like family, that is ...associated with susceptibility to rheumatoid arthritis (odds ratio = 2.15, P = 0.00000085). This polymorphism alters the binding affinity of nuclear factor-kappaB and regulates FCRL3 expression. We observed high FCRL3 expression on B cells and augmented autoantibody production in individuals with the disease-susceptible genotype. We also found associations between the SNP and susceptibility to autoimmune thyroid disease and systemic lupus erythematosus. FCRL3 may therefore have a pivotal role in autoimmunity.
PDF
