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Evaluation of Serum Troponin and Cytokines as Predictors of Ischaemic Heart Disease in Diabetic Patients

Mohamed Talaat Abdel-Aziz, Dawlat El-Miligy, Hanan Abdel-Aziz, Yasser Nassar, Amina El-Ansary, Amr El-Meligi*
*Departments, Faculty of Medicine, Cairo University

Biochimica Clinica: 2002; 26(4): 345-351 [Article in english]

ABSTRACT. The present study aims to evaluate the importance of the determination of serum levels of troponin I, vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF - b) and tumor necrosis factor alpha (TNF - a) as predictors of ischemic heart diseases in high risk diabetic patient group susceptible to myocardial vascular occlusion. Subjects and Methods: The study was performed on 40 subjects classified into three groups: two groups of type 2 diabetes mellitus patients (the first with recent myocardial infarction and the other with ischemic heart disease), in addition to healthy controls. All members of the study were subjected to thorough clinical and ECG examinations; in addition to the estimation of levels of plasma glucose and serum creatine kinase (CK), CK-MB, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), troponin I, VEGF, TGF - b and TNF - a. Results: A significant increase was present in enzymatic activity of CK, CK-MB, AST, and LDH and in troponin I levels in the infarction group compared to both control and ischemic groups. In the latter two groups, troponin I was detectable in 0 and 54% of the subjects respectively. The results of the study showed significant elevation in serum VEGF, TGF - b and TNF - a in cases of myocardiac ischemia compared to control group. The elevations of these parameters were not significant in acute myocardial infarction group compared to controls as the samples were taken directly after admission to the hospital. Conclusion: Serum troponin I seems to be an extremely sensitive marker of myocardial infarction. On the contrary, the change in serum VEGF, TGF - b and TNF - a seem to be insignificant in the very early stage of myocardial infarction which indicate relatively slow induction of these growth factors in response to ischemia and hypoxia. VEGF could also be responsible for the compensatory stage of ischemic patients most probably due to its angiogenic effect and collateral formation which play a role in the protection from vascular occlusion. On the other hand the elevated levels of TNF - a and TGF - b could play a role in the pathogenesis of the ischemic changes.

Effect of Inducers of Heme Oxygenase-1 on Eicosanoids, cAMP and cGMP levels in Rat Endothelial Cells

*M.T.Abdel-Aziz, M.F. Al-Asmar, H. Atta, O. Shaker, H.H. Fouad, H. Hosni, N. Kamal, L. Rashed
*Department of Medical Biochemistry, Faculty of Medicine, Cairo UniversityDepartment of Medical Biochemistry, Faculty of Medicine, Ain Shams University, Egypt

Biochimica Clinica: 2002; 26(4): 352-357 [Article in english]

ABSTRACT. The present study was carried out to compare the effects of heme oxygenase -1 gene transfer into rat endothelial cells on cell proliferation, and on levels of cGMP, cAMP, PGI2 and TXB2. The transduced cells exhibited enhanced ability to express HO-1 mRNA as detected by RT- PCR. The proliferation of the transduced cells significantly increased compared to non-transduced cells. The cGMP and cAMP levels in transduced cells increased by 6.29 and 1.25 folds respectively, compared to non-transduced cells. Furthermore, the levels of PGI2 and TXB2 in transduced cells were decreased by 17.67 and 8.52 folds, respectively, relative to that in non-transduced cells. In this study, induction of HO-1 gene by injurious stimuli such as snake venom metalloproteinase with disintegrin like activity (SVMP), endotoxin (lipopolysaccharide, LPS) and H2O2 was studied in relation to cell proliferaion as well as levels of cGMP, cAMP, PGI2 and TXB2. SVMP increased the levels of cGMP and cAMP by 8.88 and 9.37 folds respectively, in transduced cells compared to non-transduced cells. Furthermore, SVMP decreased the levels of PGI2 and TXB2 by 26.85 and 13.95 folds respectively, in transduced cells compared to non-transduced cells. LPS increased the levels of cGMP and cAMP by 8.88 and 4.68 folds respectively, in transduced cells. LPS decreased the levels of PGI2 and TXB2 by 53.02 and 27.77 respectively, in transduced cells as compared to non-transduced cells. H2O2 increased the levels of cGMP and cAMP by 47.77 and 6.25 folds, respectively, in transduced cells. Furthermore, H2O2 decreased the levels of PGI2 and TXB2 by 183.3 and 2.52 folds respectively, in transduced cells as compared to non-transduced cells. Moreover, H2O2 decreased cell proliferation significantly in both transduced and non-transduced cells. SVMP and LPS had no effect on cell proliferation in both transduced and non-transduced cells. Although, SVMP, LPS and H2O2 had no effects on PGI2, cGMP and cAMP levels in non transduced cells, these injurious agents had an enhancing effect on TXB2 levels in these cells (increase by 2.66, 1.38 and 1.83 folds, respectively).

Chromosomal translocations in acute lymphoblastic leukemia

Mohammed Talat Abdel Aziz*, Hany Hussein, Dawlat El-Meligy, Hanan Hassan Fouad, Nagwa Kamal, Iman Sidhom
*Medical Biochemistry Department, Faculty of Medicine, Cairo University

Biochimica Clinica: 2002; 26(4): 358-363 [Article in english]

ABSTRACT. In this study, RT - PCR was used to identify chimeric transcripts encoded by the major risk - stratifying translocations of pediatric acute lymphoblastic leukemia (ALL). This assay identifies all types of BCR - ABL transcripts encoded by the t (9; 22), all described variants of the E2A - PBX1 transcripts encoded by the t (1; 19), the MLL - AF4 transcripts encoded by the t(4;11) and all variants of TEL - AML1 encoded by the t(12;21). Also, This study points out bone marrow immuno- phenotyping and clinical features associated with these translocations as well as their initial response to therapy. Application of this molecular technique to the analysis of 70 leukemic patients resulted in the detection of t(12;21) in 18 patients (25.7%) and t(9;22) in 2 patients (2.8 %). However, neither t(1;19) nor t(4;11) were detected. The 18 patients who were positive for t(12;21) had their age ranging between 1 and 10 years with a peak between 2 and 4 years. The 18 positive patients were B-lineage ALL (9 C-ALL and 9 Pre-B). Their total leukocytic counts (TLC) had a median of 9 x 109 /L and only one of the 18 patients had organomegaly. None of the cases showed CNS infiltration. As regards the response to induction therapy, all positive patients achieved complete remission (CR) following induction therapy while none showed slow response to therapy. All of the 18 patients did not show recurrence after 2 years follow up. On the other hand, one of the 2 positive cases for t (9; 22) had an age >10 years. Both were Pre-B ALL and had a median TLC of 51 x 109/l. Following induction therapy, one patient achieved CR, while the other one was resistant. Both t(9,22) showed recurrence within 2 years follow up. In conclusion, in this study TEL-AML1 positive patients showed features for good prognosis and achieved complete response to induction therapy , whereas, cases with t (9; 22) showed weaker response to therapy and bad prognosis. On the other hand , t(1,19) and t(4,11) are rare variants among Egyptian ALL cases. Thus, this technique should be justified for accurately risk stratifying pediatric ALL patients.

Peptidi natriuretici del sistema ANP/BNP: basi biochimiche e metodi di analisi

Erika Zambelli, Elio F De Palo*
*Sezione di Biochimica Clinica del Dipartimento di Scienze Medico Diagnostiche e Terapia Speciale - Universitą degli Studi di Padova

Biochimica Clinica: 2002; 26(4): 364-383 [Article in italiano]

ABSTRACT. The present review describes the recent literature results published on the topic of the family of natriuretic hormone peptides. These hormones are characterised by two main groups, namely ANP and BNP which are strictly related to the heart renal axis and represent an important hormonal function in homeostasis of the haemodinamic and blood pressure. The clinical biochemistry laboratory is interested in an analytical approach and also in the biochemical function of these hormones. It is well known that the peptide/protein hormones are synthesised in the different endocrine glands as precursors namely pro-hormones. BNP and ANP are also synthesised as pro hormones and the metabolism of these precursors originates the known fragments. This review describes these fragments from the molecular point of view. Recent works have described a possible role of these hormonal compounds and this aspect also stimulates the clinical biochemist to investigate and improve the study to recognise their potential role. The analyses of these fragments are fundamental and of great help in understanding the various applications in patho-physiology. The present review describes the main analytical aspects and techniques suitable for the analyses in body fluids (plasma and urine) with and/or without sample treatment.

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