Pancreatitis-Associated Protein Does Not Predict Disease Relapse in Inflammatory Bowel Disease Patients

Background

The pancreatitis-associated protein (PAP) is increased in the serum of active inflammatory bowel disease (IBD) patients and its levels seem to be correlated with disease activity. Our aim was to evaluate the usefulness of serum and fecal PAP measurements to predict relapse in patients with inactive IBD.

Materials and Methods

We undertook a 12-month prospective study that included 66 Crohn''s disease (CD) and 74 ulcerative colitis (UC) patients. At inclusion, patients were in clinical remission, defined by a Harvey-Bradshaw (HB) Index≤4 (CD) or a partial Mayo Score (MS)<3 (UC), along with a normal serum C reactive protein (CRP) and fecal calprotectin. Patients were followed every 3 months. Blood and stool samples were collected and a clinical evaluation was performed at each visit. Serum PAP and CRP levels as well as fecal concentrations of PAP and calprotectin were assessed.

Results

Active CD patients had an increased mean serum PAP at the diagnosis of the flare (104.1 ng/ml) and 3 months prior to activity (22.68 ng/ml) compared with patients in remission (13.26 ng/ml), p<0.05. No significant change in serum PAP levels in UC and fecal PAP levels in CD and UC were detected during disease activity. In CD, serum PAP was a poor diagnostic predictor of disease activity, with an AUC of 0.69. In patients in remission, fecal PAP was barely detectable in UC compared with CD patients.

Conclusion

Serum PAP is increased only in active CD patients, but this marker does not predict disease activity. Inactive UC patients have marked low levels of PAP in fecal samples compared with CD patients.     

C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study.

OBJECTIVE--To test the hypothesis that minor chronic insults such as smoking, chronic bronchitis, and two persistent bacterial infections may be associated with increases in C reactive protein concentration within the normal range and that variations in the C reactive protein concentration in turn may be associated with levels of cardiovascular risk factors and chronic coronary heart disease. DESIGN--Population based cross sectional study. SETTING--General practices in Merton, Sutton, and Wandsworth. SUBJECTS--A random sample of 388 men aged 50-69 years from general practice registers. 612 men were invited to attend and 413 attended, of whom 25 non-white men were excluded. The first 303 of the remaining 388 men had full risk factor profiles determined. INTERVENTIONS--Measurements of serum C reactive protein concentrations by in house enzyme linked immunosorbent assay (ELISA); other determinations by standard methods. Coronary heart disease was sought by the Rose angina questionnaire and Minnesota coded electrocardiograms. MAIN OUTCOME MEASURES--Serum C reactive protein concentrations, cardiovascular risk factor levels, and the presence of coronary heart disease. RESULTS--Increasing age, smoking, symptoms of chronic bronchitis, Helicobacter pylori and Chlamydia pneumoniae infections, and body mass index were all associated with raised concentrations of C reactive protein. C Reactive protein concentration was associated with raised serum fibrinogen, sialic acid, total cholesterol, triglyceride, glucose, and apolipoprotein B values. C Reactive protein concentration was negatively associated with high density lipoprotein cholesterol concentration. There was a weaker positive relation with low density lipoprotein cholesterol concentration and no relation with apolipoprotein A I value. C Reactive protein concentration was also strongly associated with coronary heart disease. CONCLUSION--The body''s response to inflammation may play an important part in influencing the progression of atherosclerosis. The association of C reactive protein concentration with coronary heart disease needs testing in prospective studies.     

Serum C‐reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice

Cardiovascular disease is the most common cause of morbidity and mortality globally. Epidemiological studies using high‐sensitivity assays for serum C‐reactive protein have shown a consistent association between cardiovascular disease risk and serum C‐reactive protein concentrations. C‐reactive protein is a biomarker for inflammation, and has been established in clinical practice as an independent risk factor for cardiovascular disease events. There is evidence that serum C‐reactive protein is an excellent biomarker of cardiovascular disease and is also an independent and strong predictor of adverse cardiovascular events. Further characterization of the impact and influence of lifestyle exposures and genetic variation on the C‐reactive protein response to cardiovascular disease events may have implications for the therapeutic approaches to reduce cardiovascular disease events. This review summarizes the studies that have examined the association between serum C‐reactive protein and the risk of cardiovascular disease. We also discuss the impact of independent factors and C‐reactive protein genetic polymorphisms on baseline plasma C‐reactive protein levels.     

Circulating Level of Neutrophil Extracellular Traps Is Not a Useful Biomarker for Assessing Disease Activity in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of life-threatening disorders, and frequently affects the kidneys. This study investigated whether the circulating neutrophil extracellular traps (NETs) levels were associated with disease activity of AAV. We collected serum samples from 34 patients with AAV in active stage and 62 patients with AAV in remission. Cell free DNA in serum was quantified using the Quant-iT PicoGreen assay. NETs associated MPO-DNA complexes, citrullinated-histone H3-DNA (cit-H3-DNA) complexes and the concentration of deoxyribonuclease I (DNase I) were quantified using ELISA. The activity of DNase I was quantified using radial enzyme-diffusion method. Associations between circulating levels of NETs with clinico-pathological parameters were analyzed. Serum levels of NETs in active AAV patients were significantly higher than those in healthy controls, and the level of cell free DNA correlated with C-reactive protein (CRP). However, no correlation was found between MPO-DNA complexes or cit-H3-DNA complexes level and CRP. Also there was no significant correlation between NETs level and initial serum creatinine, estimated glomerular filtration rate (eGFR), crescents formation or Birmingham Vasculitis Activity Score (BVAS). Furthermore, there was no significant difference of serum levels of cell free DNA or MPO-DNA complexes between active stage and remission of AAV. In conclusion, circulating levels of NETs cannot be used as a biomarker to assess disease activity in AAV patients.     

Identification of HBsAg determinants in immune complexes from hepatitis B virus-associated vasculitis

Circulating immune complexes were characterized from 25 sera obtained from five patients with polyarteritis nodosa and three with cutaneous venulitis associated with hepatitis B virus infection. Complexes were isolated by polyethylene glycol and conglutinin-anticonglutinin precipitation methods and were analyzed for HBsAg and anti-HBsAg. Low pH was used to dissociate the complexes, and components were separated into antigen and antibody fractions by using immobilized protein A. In this study, three observations were significant: 1) complexes were frequent and quantitatively more in cutaneous venulitis than in polyarteritis; 2) the levels of HBsAg in the antigen fractions of polyarteritis were greater and correlated with the clinical improvement of the disease; the serum levels of HbsAg remained the same throughout the course of the disease; and 3) complexes from polyarteritis were not completely dissociable at pH 2.6 compared with those from patients with cutaneous venulitis and chronic active hepatitis. The antigen fractions electrophoresed in polyacrylamide gel with SDS demonstrated 6 to 10 protein bands with m.w. ranging between 17,000 and 120,000 daltons. To precisely define the polypeptide antigen moiety involved in the immune complex formation, a transfer blotting technique was used employing human anti-HBsAg globulin as probe. Polypeptides with m.w. 97,000, 49,000, and 23,000 were found to form complexes in both groups of patients.     

Study of the Serum Copper Levels in Patients with Major Depressive Disorder

Copper may be involved in the pathophysiology of depression. Clinical data on this issue are very limited and not conclusive. The purpose of the study was to determine the copper concentration in the serum of patients with major depressive disorder and to discuss its potential clinical usefulness as a biomarker of the disease. A case–control clinical study included 69 patients with current depressive episode, 45 patients in remission and 50 healthy volunteers. Cu concentration was measured by electrothermal atomic absorption spectrometry (ETAAS). The mean serum copper level in depressed patients was slightly lower (by 11 %; not statistically significant) than in the control group. Furthermore, there was no significant difference in Cu²⁺ concentration between depressive episode and remission, nor between remission and control group. In the remission group were observed significant correlations between copper levels and the average number of relapses over the past years or time of remission. There was no correlation between serum copper and severity of depression, as measured by HDRS and MADRS. The obtained results showed no significant differences between the copper concentration in the blood serum of patients (both with current depressive episode and in remission) and healthy volunteers, as well as the lack of correlations between the copper level in the active stage of the disease and clinical features of the population. Our study is the first conducted on such a large population of patients, so the results may be particularly important and reliable source of knowledge about the potential role of copper in depression.     

Serum levels of autoantibodies against monomeric C-reactive protein are correlated with disease activity in systemic lupus erythematosus

This study was performed to investigate the relation between IgG autoantibodies against human C-reactive protein (anti-CRP) and disease activity measures in serial serum samples from 10 patients with systemic lupus erythematosus (SLE), of whom four had active kidney involvement during the study period. The presence of anti-CRP was analysed by enzyme-linked immunosorbent assay. The cut-off for positive anti-CRP test was set at the 95th centile of 100 healthy blood donor sera. Specificity of the anti-CRP antibody binding was evaluated by preincubating patient sera with either native or monomeric CRP. Disease activity was determined by the SLE disease activity index (SLEDAI), serum levels of CRP, anti-DNA antibodies, complement components and blood cell counts. Of 50 serum samples, 20 (40%) contained antibodies reactive with monomeric CRP, and 7 of 10 patients were positive on at least one occasion during the study. All patients with active lupus nephritis were positive for anti-CRP at flare. Frequent correlations between anti-CRP levels and disease activity measures were observed in anti-CRP-positive individuals. Accumulated anti-CRP data from all patients were positively correlated with SLEDAI scores and anti-DNA antibody levels, whereas significant inverse relationships were noted for complement factors C1q, C3 and C4, and for lymphocyte counts. This study confirms the high prevalence of anti-CRP autoantibodies in SLE and that the antibody levels are correlated with clinical and laboratory disease activity measures. This indicates that anti-CRP antibodies might have biological functions of pathogenetic interest in SLE. Further prospective clinical studies and experimental studies on effects mediated by anti-CRP antibodies are warranted.     

Paget's disease of bone: early and late responses to three different modes of treatment with aminohydroxypropylidene bisphosphonate (APD).

Early and late responses to treatment with either oral (600 mg/day) or intravenous (20 mg/day) (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (aminohydroxypropylidene bisphosphonate; APD) were studied in 142 patients with Paget''s disease of bone who had not previously been treated with bisphosphonate. The efficacy of three therapeutic regimens was compared: (a) oral aminohydroxypropylidene bisphosphonate given continuously until six months after the serum alkaline phosphatase activity had returned to normal (long term); (b) oral aminohydroxypropylidene bisphosphonate given until urinary hydroxyproline excretion had returned to normal (short term); (c) intravenous aminohydroxypropylidene bisphosphonate for 10 days. With either oral or intravenous treatment the decrease in urinary hydroxyproline excretion was rapid and always preceded the fall in serum alkaline phosphatase activity. Normal urinary hydroxyproline excretion is essential for return of the serum alkaline phosphatase activity to normal. Complete biochemical remission, defined as return of the serum alkaline phosphatase activity to normal, was obtained in 129 patients (91%). The median duration of remission as assessed by actuarial analysis was 2.7 years. This study found no difference in the long term among the three modes of treatment, suggesting that for most patients with Paget''s disease a short course of intravenous aminohydroxypropylidene bisphosphonate will produce longlasting, complete remission without need for maintenance treatment.     

Comparison between penicillamine and sulphasalazine in rheumatoid arthritis: Leeds-Birmingham trial.

Sulphasalazine was first formulated by Svartz in the early 1940s, specifically for use as a remission inducing drug in rheumatoid arthritis. After the publication of an unfavourable trial, however, the drug was restricted to patients with ulcerative colitis. In the late 1970s sulphasalazine was re-examined in rheumatoid arthritis and favourable results reported in "open" trials. A double blind controlled trial was therefore conducted comparing enteric coated sulphasalazine and D-penicillamine in patients with active rheumatoid arthritis. A total of 63 patients were recruited in two centres; 31 were treated with sulphasalazine and 32 received penicillamine. After 16 weeks'' treatment both drugs had produced significant improvements in clinical score, pain score measured on a visual analogue scale, grip strength, Ritchie articular index, erythrocyte sedimentation rate, and serum C reactive protein concentration. Nausea was the major side effect in the sulphasalazine treated group. No potentially dangerous effects of sulphasalazine were encountered in contrast with those seen in the penicillamine group. The results suggest that sulphasalazine is an effective and safe drug capable of producing remissions in active rheumatoid arthritis. They also lend confidence to the use of preliminary "open" trials as a means of screening for remission inducing drugs in rheumatoid arthritis.     

地奥司明对前列腺增生伴前列腺炎患者HSP, CRP及PSA的影响

目的:探讨地奥斯明对前列腺增生伴前列腺炎患者血清热休克蛋白(HSP)、C反应蛋白(CRP)及血清PSA水平的影响。方法:选取已确诊为前列腺增生伴前列腺炎的患者39例,随机分为实验组及对照组。对照组19例,予普适泰片治疗;实验组20例,予地奥司明治疗。28天为一个治疗疗程。比较两组患者治疗前后热休克蛋白、C反应蛋白及血清PSA水平的变化。结果:实验组总有效率(95.0%)高于对照组(78.9%),差异具有统计学意义(P0.05);与对照组比较,实验组热休克蛋白、C反应蛋白及血清PSA水平较低(P0.05),慢性前列腺炎评分(NIH-CPSI)评分较低(P0.05),不良反应发生率(10.0%)低于对照组(31.6%),差异存在统计学意义(P0.05)。结论:地奥司明片可以明显改善男性前列腺增生伴前列腺炎患者的排尿困难及尿频尿急等症状,有效降低患者热休克蛋白、C反应蛋白及血清PSA水平。     

Plasma myeloperoxidase activity as a criterion of therapeutic effectiveness for patients with cardiovascular diseases

A significant increase in the myeloperoxidase (MPO) activity has been found in plasma of patients with stable angina and with acute coronary syndrome (ACS) in comparison with the control group. MPO concentration was significantly increased in plasma of ACS patients. Reduced MPO activity in the treated ACS patients correlated with a favorable outcome of the disease. Generally, changes in plasma MPO concentration coincided with changes in lactoferrin concentration thus confirming the role of neutrophil degranulation in the increase of plasma concentrations of these proteins. The increase in MPO activity was obviously determined by modification of the MPO protein caused by reactive oxygen species and halogen in the molar ratio of 1: 25 and 1: 50. The decrease in plasma MPO activity may be associated with increased plasma concentrations of the physiological inhibitor of its activity, ceruloplasmin, and also with modification of the MPO protein with reactive oxygen species and halogen at their molar ratio of 1: 100 and higher. Thus, MPO activity may be used for evaluation of effectiveness of the treatment of cardiovascular diseases.     

血清免疫炎症相关蛋白复合物、25-羟维生素D、脂肪细胞因子与炎症性肠病患者疾病活动性和肠道菌群的相关性研究

摘要 目的：探讨血清免疫炎症相关蛋白复合物（IIRPCs）、25-羟维生素D[25（OH）D]、脂肪细胞因子（Chemerin）与炎症性肠病（IBD）患者疾病活动性和肠道菌群的相关性。方法：选取2020年12月～2021年12月我院收治的150例IBD患者,其中溃疡性结肠炎（UC）组65例、克罗恩病（CD）组85例,另取同期健康体检者70例作为对照组,检测并比较三组血清IIRPCs、25（OH）D、Chemerin水平。此外,UC组和CD组患者分别根据克罗恩病活动指数（CDAI）和溃疡性结肠炎的改良梅奥（Mayo）评分分为活动期组、缓解期组,分别比较UC组和CD组患者活动期组与缓解期组间的血清IIRPCs、25（OH）D、Chemerin水平、肠道菌群差异,并作相关性分析。结果：IBD患者的血清IIRPCs、Chemerin水平高于对照组,而25（OH）D水平低于对照组（P＜0.05）;UC组血清IIRPCs、Chemerin水平高于CD组,25（OH）D水平低于CD组（P＜0.05）。活动期UC、CD患者的血清IIRPCs、Chemerin水平以及肠球菌、肠杆菌、酵母菌、拟杆菌数量均高于缓解期UC、CD患者,而血清25（OH）D水平以及双歧杆菌、乳酸杆菌数量均低于缓解期UC、CD患者（P＜0.05）。Pearsonn相关性分析结果显示,UC、CD患者的血清IIRPCs、Chemerin水平与肠球菌、肠杆菌、酵母菌、拟杆菌数量呈正相关,与双歧杆菌、乳酸杆菌数量呈负相关（P＜0.05）;UC、CD患者的血清25（OH）D水平与肠球菌、肠杆菌、酵母菌、拟杆菌数量呈负相关,与双歧杆菌、乳酸杆菌数量呈正相关（P＜0.05）。结论：血清IIRPCs、25（OH）D、Chemerin与IBD患者的疾病活动性、肠道菌群有关,检测上述指标对评估IBD患者病情程度有一定价值。     

Hormonal changes in patients with haematological malignancies

Levels of immunologically reactive insulin (IRI), growth hormone (GH), thyroxine, cortisol and ACTH in sera of patients with various haematological malignancies were determined. IRI and GH levels were increased in 80% of the patients regardless of the type of disease. IRI was more elevated in relapse than in remission. Cytostatic treatment returned IRI serum levels to normal. Thyroxine, ACTH and cortisol in serum were higher in only two percent of the patient with haematological malignancies.     

"Normal" acute phase response in systemic sclerosis.

An Italian woman with classic active progressive systemic sclerosis had a normal serum concentration of C reactive protein (less than 6 mg/1). During an infection with Staphylococcus aureus, however, the concentration rose to 250 mg/1. This was unexpected, since in scleroderma the acute phase response to infection (a brisk rise in serum concentrations of various proteins, including C reactive) has been thought to be defective. This patient is evidence that the acute phase response does occur in systemic sclerosis and that probably it is the nature of the primary disease that masks the response in some cases.     

血清Visfatin、PRDX1水平与克罗恩病患者活动度指标和肠道菌群的相关性分析

摘要 目的：分析血清内脂素（Visfatin）、过氧化物还原蛋白1（PRDX1）水平与克罗恩病（CD）患者活动度指标和肠道菌群的相关性。方法：选取2019年4月~2022年12月期间联勤保障部队第九一〇医院收治的146例CD患者，根据简化克罗恩病疾病活动指数（CDAI）将所有CD患者分为中重度活动组（n=36）、轻度活动组（n=49）、缓解期组（n=61）。对比三组血清Visfatin、PRDX1、C反应蛋白（CRP）水平、血沉（ESR）、肠道菌群数量。采用Pearson相关性分析血清Visfatin、PRDX1与 CDAI、 CRP、ESR和肠道菌群数量的相关性。结果：中重度活动组、轻度活动组的血清Visfatin、PRDX1水平高于缓解期组，且中重度活动组血清Visfatin、PRDX1水平高于轻度活动组（P<0.05）。中重度活动组、轻度活动组的CRP、ESR高于缓解期组，且中重度活动组CRP、ESR高于轻度活动组（P<0.05）。中重度活动组、轻度活动组的肠球菌、大肠杆菌高于缓解期组，且中重度活动组的肠球菌、大肠杆菌高于轻度活动组（P<0.05），中重度活动组、轻度活动组的双歧杆菌、类杆菌低于缓解期组，且中重度活动组的双歧杆菌、类杆菌低于轻度活动组（P<0.05）。Pearson相关性分析显示，血清Visfatin、PRDX1、 CRP水平与 肠球菌、大肠杆菌菌群数量、CDAI、ESR呈正相关，而与双歧杆菌、类杆菌菌群数量呈负相关（P<0.05）。结论：CD患者的血清Visfatin、PRDX1升高，可导致疾病进展，肠道菌群紊乱加重。     

Platelet factor-4 is an indicator of blood count recovery in acute myeloid leukemia patients in complete remission

To investigate whether serum biomarkers can be used to indicate the responsiveness of acute myeloid leukemia to remission induction chemotherapy, we performed MALDI-TOF protein profile analysis of patient sera. The resulting spectra revealed a protein (or peptide) peak at m/z 7764 that varied in intensity; its intensity was much higher in samples from patients in complete remission than in those from patients with resistant disease or in samples taken prior to treatment (at the time of diagnosis). Using fractionation, trypsin digestion, MS/MS, and protein molecular weight analyses, we identified the m/z 7764 protein as platelet factor-4 (PF4). This identification was confirmed by a magnetic bead-based MALDI immunoassay. Statistical comparison of PF4 levels and platelet counts in patient sera revealed a significant positive correlation between the two variables. This study demonstrates that PF4 protein levels are a good indicator for the recovery of blood count in the complete remission of acute myeloid leukemia. The linear positive correlation curve indicates that blood count recovery of platelets to >100,000/mm(3) is equivalent to a serum PF4 recovery level of >2.492 microg/ml.     

Soluble interleukin-2 receptor serum level is a useful marker of hidradenitis suppurativa clinical staging

Hidradenitis suppurativa (HS) is a recurrent, debilitating suppurative skin disease. The major challenge is the choice of optimal treatment. Assessment of treatment effectiveness is currently associated with clinical observations of disease activity based on Hurley’s or Sartorius’ grading system. Detailed examination of patients with HS and evaluation of disease severity is frequently time-consuming and undoubtedly subjective. With regard to these factors, there is a need for laboratory findings that will help resolve the problem. The aim of this study was to determine the usefulness of soluble interleukin-2 receptor (sIL-2R) serum concentration as a marker of HS clinical staging and comparative analysis with the commonly conducted laboratory measurements, including white blood cell count, C-reactive protein and erythrocyte sedimentation rate. The statistical analysis of all these laboratory parameters conducted within a group of 54 individuals with HS revealed that sIL-2R serum level seems to be the most sensitive measurement for evaluation of disease stage. Moreover, the existence of strong dependences between sIL-2R serum concentration and Hurley’s HS grading system were demonstrated. In conclusion, we believe that sIL-2R serum level could be used as a valuable marker for disease staging in patients with HS.     

The differentiation factor in the bone marrow and blood serum of healthy subjects and in acute leukemia

The factor of differentiation--i.e. systemic morphogen of connective tissue (SMCT)--have been discovered in bone marrow and blood serum of healthy humans. SMCT calls forth the differentiation of mesodermal cell types in early embryonic amphibian cells. These cell types are the following: notochords, muscles, mesothelium, blood cells, mesenchyme. Under the influence of the punctates of bone marrow the frequency of muscle and blood cell appearance is not constant, which might be the consequence of the individual variability of SMCT. Under the influence of bone marrow and blood serum in patients with acute lymphoblastic, monoblastic and myelomonoblastic leukemia the embryonic cells differentiate only into atypical epidermis, which proves the absence of the SMCT activity in the sources used. In some cases under the influence of bone marrow from patients having the same disease the early embryonic cells differentiate into mesodermal cell types, which normally appear under the low concentration of SMCT. This was observed however only in those cases when bone marrow or blood serum have been taken from patients in the state of remission. In patients with remission the correlation is observed between the activity of factor of differentiation in bone marrow and that of blood serum.     

Serum soluble IL-2 receptor as a marker of lymphocyte activation in some autoimmune diseases. Effect of immunosuppressive therapy

Our experience regarding serum soluble interleukin-2 receptor (sIL-2R) measurement as a marker of lymphocyte activation consists of patients with autoimmune disease: 37 with systemic lupus erythematosus (SLE), 23 with autoimmune hepatitis (AIH), 74 with inflammatory bowel disease and six with Wegener's granulomatosis (WG). The influence of immunosuppressive therapy has also been assessed. Serum sIL-2R in SLE is significantly higher than in healthy controls and good correlation is found between sIL-2R and disease activity. Severity of kidney inflammation in lupus nephritis can be reflected by the increased excretion of sIL-2R. It was found that sIL-2R level significantly falls when the disease becomes clinically inactive after immunosuppressive therapy, but in many cases (up to 50%) it does not reach normal levels. The last finding suggests that lymphocyte activation may still be present even though the disease is considered inactive under clinical criteria and support the need of prolonged immunosuppression after the first signs of remission. In AIH the serum levels of sIL-2R are elevated in all patients with active disease; all cases with "highly active" disease have significantly higher concentrations than patients with "mild activity". A good correlation has been demonstrated between elevated serum sIL-2R values and anti-asialoglycoprotein receptor (ASGPR) titer (the specific marker of AIH). The follow-up study showed a significant decrease of both sIL-2R levels and anti-ASGPR titer after 3-9 month immunosuppressive therapy. The findings support that sIL-2R and anti-ASGPR titer could serve as reliable humoral markers for disease-specific activity. Compared with inactive ulcerative colitis (UC) and Crohn's disease (CD), significantly higher levels of sIL-2R were present in the serum of patients with active disease, and in inactive disease than in healthy age-matched controls. Methotrexate (MTX) therapy of patients with refractory UC resulted in sIL-2R decrease at the end of therapeutic period (20 i.m. injections of once a week 25 mg), good responders showing > 50% decrease even at 5-7 weeks of treatment. Serum sIL-2R is elevated in all six patients with WG. Contrary to anti-neutrophil cytoplasmic antibodies (ANCA), sIL-2R remains elevated above cut-off for normal range, despite clinical improvement following immunosuppressive treatment. The last observation suggests that serum sIL-2R is not a good measure of the disease activity and argue for the need of longer immunosuppressive therapy just after the first days of clinical remission.     

The early treatment results of well differentiated thyroid cancer and its dependence on chosen factors

INTRODUCTION: The aim of the study was to estimate the influence of a thyroid remnants' volume, postsurgical concentration of thyroglobulin and radioiodine dose on the early treatment efficacy of well differentiated thyroid cancer. MATERIAL AND METHODS: We retrospectively analyzed 91 patients (76 females, 15 men) with well differentiated thyroid cancer. RESULTS: Histological classification revealed 68.1% (62/91) papillary thyroid cancers, 25.3% (23/91) follicular thyroid cancers, and 6.6% (6/91) oxyphilic thyroid cancers. Among the group, 74 (81.3%) patients reached the remission criteria and the remaining 17 patients (18.7%) showed biochemical and morphological evidence of metastatic disease. The remission was obtained in 100% of patients in stage I of the disease, 68.4% - in stage II, 78.6% - in stage III and 33.3% in stage IV. The total radioiodine dose used in patients with remission, did not differ from the dose used in patients without remission. We did not observe the influence of remnant's volume on treatment efficacy, however larger remants required higher dose of radioiodine to obtain the remission. Patients with remission had lower postsurgical thyroglobulin concentration than patients without remission. (22.2 vs. 103.3 ng/ml; p = 0.00025). CONCLUSIONS: Early treatment results of well differentiated thyroid cancer depend on the clinical stage, and postoperative serum thyroglobulin level measured after endogenous TSH stimulation. Early treatment results are not dependent on age, sex, histological type of thyroid cancer, the dose of radioiodine used in brackets of 60-150 mCi and additional diseases. Total thyroidectomy is equally efficient as near total.