• 제목/요약/키워드: Inflammatory markers

검색결과 388건 처리시간 0.026초

유아기 급성폐손상 병태생리 연구를 위한 어린 토끼 실험모델 (Young Rabbit Model for Pathophysiologic Study of Acute Lung Injury in Early Childhood)

  • 권영민;최석철;박종원;김양원;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • 제36권8호
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    • pp.545-558
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    • 2003
  • 급성 폐 손상을 초래하는 성인호흡곤란증후군(ARDS)은 높은 치사율 때문에 많은 임상의들의 관심과 연구대상이 되어왔다. 그동안 선행 연구자들의 지속적인 노력에도 불구하고 유아 및 소아그룹의 ARDS에 관한 병태생리학적 규명은 여전히 미흡한 실정이다. 본 연구는 어린 토끼(생후 약 8주)를 실험적 내독소성 급성폐손상 모델로 사용하여 유소아 그룹의 급성폐손상 병태생리의 시간적 진행양상을 규명하기 위해 전향적으로 계획되었다. 대상 및 방법: 연구목적에 따라 실험용 토끼를 대조군(n=8)과 실험적 급성폐손상을 위한 내독소 투여군으로 나눈 후, 검체의 채취시간에 따라 내독소 투여군을 다시 3, 6, 12 및 24시간 군으로 아그룹화하였다(시간대별 각 군의 n=8). 토끼의 귀정맥을 통해 대장균 내독소(Escherichia coli serotype O55. B5)를 0.50 mg/kg 투여한 후, 각 군별로 혈액 및 기관지폐포 세척액을 채취하여 백혈구계의 동태, 면역학적 인자들, 단백질 농도를 측정하였고, 폐의 병리조직학적 소견도 함께 관찰하였다. 결과: 내독소 투여군들에서 3시간 및 6시간대에 혈액 내 호중구, 림프구, 단 구, 그리고 호산구 수 감소에 기인한 총 백혈구 수의 유의한 감소가 있는 반면, 12시간 및 24시간 때 호중구 수 증가에 기인한 총 백혈구수의 증가가 있었다(p <0.05). Tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) 및 interleukin-1 ${\beta}$ (IL-1 ${\beta}$ )의 혈중농도는 대부분의 시간대에 내독소 투여군들이 대조군보다 유의하게 높았다(p <0.05). Superoxide dismutase (SOD) 농도는 3시간 및 6시간 때에는 내독소 투여군들이 대조군보다 높았으나(p<0.05) 12시간 때에는 오히려 낮았다(p <0.05). 기관지폐포 세척액 내 총 백혈구 수와 단백질 농도는 내독소 투여군들이 전 시간대에 걸쳐 대조군보다 유의하게 높았다(p<0.05). 내독소 투여군들의 경우 기관지폐포 세척액의 출혈성 경향을 보였다. 내독소 투여군들은 페간질 및 실질조직 내 주로 림프구와 단구로 구성된 염증성 세포들의 심한 침윤, 폐포 내 약간의 호중구 격절, 그리고 간질의 비후와 같은 폐 손상 징후를 보였다. 이러한 현상은 내독소 투여 6시간대에 가장 심하였으나 시간경과에 따라 조금씩 호전되었다. 내독소 투여군들의 면역학적 표식자들(TNF-${\alpha}$, IL-1${\beta}$, SOD)과 기괸지폐포 세척액 변수들 간에 여러 시간대에 걸쳐 유의한 양 혹은 음의 상관관계를 보였다(p<0.05). 결론: 내독소는 어린 토끼에 있어 급격하고 치명적인 급성염증성 폐손상을 일으키며 그 병태생리학적 진행이 6시간대까지는 시간의존성으로 격심해지고 이후부터 완화되는 경향을 보였다. 이러한 내독소 기인성 급성폐손상의 발생과 진행에는 혈액학적, 면역학적, 생화학적 변수들이 복합적으로 관여하였으며, 어린 토끼는 혈액 내 투여된 내독소에 대해 매우 민감하고 신속한 반응을 보임으로써 향후 유아 및 소아그룹 연구를 위한 실험동물모델로서의 이용 가능성을 보여주었다.

기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화 (The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma)

  • 김태연;윤형규;최영미;이숙영;권순석;김영균;김관형;문화식;박성학;송정섭
    • Tuberculosis and Respiratory Diseases
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    • 제48권6호
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    • pp.922-931
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    • 2000
  • 배경 및 목적 : 기관지천식의 중요한 특징적인 병인인 기도의 만성염증 상태와 증상의 변화를 판단하는 객관적인 지표로서 여러 가지 방법이 시도되고 있는데 최근에는 비침습적이고 비교적 간단한 유도객담 검사로 침습적인 기관지 조직 검사나 기관지폐포세척술을 대신하려는 경향이 있다. 저자들은 기관지천식 환자의 유도객담에서 호산구, eosinophil cationic protein(ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating factor(GM-CSF), 그리고, nitric oxide(NO)의 유도체를 측정하고, 객담내 NO 및 호산구와 관계가 있다고 알려진 cytokine들의 농도가 증상 및 기도의 염증상태를 반영하는 지표로서 이용될 수 있는지를 알아보고자 하였다. 방법 : 기관지천식 환자 30명을 대상으로 2주간 경구용 프레드니솔론 30mg을 투여하고, 약제 투여 전후로 1초간 노력성 호기량($FEV_1$과 혈중 총 호산구수, 그리고 유도객담 검사를 시행하여 객담내 호산구 비율과 ECP, IL-3, IL-5, GM-CSF, 그리고, NO 유도체를 측정하였다. 결과 : 대상환자중 남자는 13a여(43.3%), 여자는 17명(56.7%)이었고 연령분포는 19세부터 64세까지였으며 평균연령은 41.8세였다. 30명중 2명은 두 번째 검사시 객담이 채취되지 않았고, 3명은 두 번째 방문을 하지 않았다. 프레드니솔론 투여후 평균 1초당 노력성 호기량(% of predicted value)은 78.1$\pm$27.2%에서 90.3$\pm$18.3%로 개선되었고(P<0.001), 유도객담내 평균 호산구비율은 56.1$\pm$27.2%에서 29.6$\pm$21.3%로 (P<0.001), 객담내 평균 ECP 농도는 $134.5\pm68.1{\mu}\;g/L$에서 $41.5\pm42.4\;{\mu}g/L$로 유의하게 감소하였고(P<0.001), 평균 혈중 총 호산구수는 425.7$\pm$265.9에서 287.7$\pm$294.7로 감소하는 경향을 보였지만 통계적으로 유의하지 않았다. 유도객담내 NO 유도체의 평균 농도는 프레드니솔론 투여 전호로 유의한 차이가 없었으며($70.4\pm44.6\;{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) 평균 eotaxin 농도는 27.7$\pm$12.8 pg/ml에서 21.7$\pm$8.7 pg/ml로 감소하는 경향을 보였다. IL-3, IL-5, CSF는 대부분의 경우에서 측정되지 않았다. 치료전의 1초당 노력성 호기량과 객담내 ECP의 농도 사이에 의미있는 역상관관계가 있었고(r=0.369, P<0.05). 결론 : 유도객담내에서 측정 가능한 여러 인자중 eotaxin 및 ECP가 치료에 따른 기도염증 상태의 변화를 반영하는 지표로 이용될수 있을 것으로 생각된다. 그 외 유도객담내 호산구비율 측정도 치료에 따른 증상이나 염증의 변화를 손쉽게 관찰할수 있는 간단한 방법으로 생각되지만 유도객담에서 Griess reagent를 이용한 NO 유도체의 측정은 기관지천식의 증상이나 염증상태의 변화를 반영하는 지표로서 유용하지 않을 것으로 생각된다.

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Correlation of the Beta-Trace Protein and Inflammatory Cytokines with Magnetic Resonance Imaging in Chronic Subdural Hematomas : A Prospective Study

  • Park, Ki-Su;Park, Seong-Hyun;Hwang, Sung-Kyoo;Kim, Chaekyung;Hwang, Jeong-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제57권4호
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    • pp.235-241
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    • 2015
  • Objective : Magnetic resonance imaging (MRI) of chronic subdural hematoma (CSDH) detects various patterns, which can be attributed to many factors. The purpose of this study was to measure the level of interleukin-6 (IL-6), interleukin-8 (IL-8), and highly specific protein [beta-trace protein (${\beta}TP$)] for cerebrospinal fluid (CSF) in CSDHs, and correlate the levels of these markers with the MRI findings. Methods : Thirty one patients, treated surgically for CSDH, were divided on the basis of MRI findings into hyperintense and non-hyperintense groups. The concentrations of IL-6, IL-8, and ${\beta}TP$ in the subdural fluid and serum were measured. The ${\beta}TP$ was considered to indicate an admixture of CSF to the subdural fluid if ${\beta}TP$ in the subdural fluid $({\beta}TP_{SF})/{\beta}TP$ in the serum $({\beta}TP_{SER})>2$. Results : The mean concentrations of IL-6 and IL-8 of the hyperintense group (n=17) of T1-WI MRI were $3975.1{\pm}1040.8pg/mL$ and $6873.2{\pm}6365.4pg/mL$, whereas them of the non-hyperintense group (n=14) were $2173.5{\pm}1042.1pg/mL$ and $2851.2{\pm}6267.5pg/mL$ (p<0.001 and p=0.004). The mean concentrations of ${\beta}TP_{SF}$ and the ratio of ${\beta}TP_{SF}/{\beta}TP_{SER}$ of the hyperintense group (n=13) of T2-WI MRI were $7.3{\pm}2.9mg/L$ and $12.6{\pm}5.4$, whereas them of the non-hyperintense group (n=18) were $4.3{\pm}2.3mg/L$ and $7.5{\pm}3.9$ (p=0.011 and p=0.011). Conclusion : The hyperintense group on T1-WI MRI of CSDHs exhibited higher concentrations of IL-6 and IL-8 than non-hyperintense group. And, the hyperintese group on T2-WI MRI exhibited higher concentrations of ${\beta}TP_{SF}$ and the ratio of ${\beta}TP_{SF}/{\beta}TP_{SER}$ than non-hyperintense group. These findings appear to be associated with rebleeding and CSF admixture in the CSDHs.

길경(桔梗)발효 추출물의 알레르기성 소양행동 억제효과연구 (Anti-pruritic Effect of Ethanol Extracts from Platycodon grandiflorum and its fermented production in Scratching Behavior Mouse Models)

  • 하미애;김진우;이신우;전현식;조영손;신용욱
    • 대한본초학회지
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    • 제29권6호
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    • pp.165-173
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    • 2014
  • Objectives : Platycodon Root is frequently used in traditional medicine to treat inflammatory diseases of the throat. The purpose of this study was to characterize the effect of the EtOH extract of fermented Platycodon grandiflorum on the ameliorative effects on the Antipruritic Effect of atopic dermatitis mouse model induced by compound 48/80 and ovalbumin (OVA)-induced allergic responses in mice. Methods : In the present study, we examined the anti allergic effect of Platycodon grandiflorum (PR) and its fermented production (FPR) in several mouse model. We measured acute ear edema in a mouse model caused by TPA and consecutively histological change of Ear tissue was observed by hematoxylin and eosin (H&E) staining. and also Scratching behaviors by compound 48/80 was investigated. The levels of allergic mediators such as immunoglobulin (Ig) E, and anti-oxidant markers such as SOD and MDA in the sera of OVA induced allergic mice were measured by enzyme-linked immunosorbent assay. Results : FPR inhibited compoud 48/80-induced scratching behavior in mice, as well as acetic acid-induced writhing in mice. The anti-scratching behavioral effect of FPR was more potent than PR. FPR extract significantly decreased the serum levels of IgE and MDA compared with those of OVA control group. Conclusions : These results indicate that Anti allergic effect of Platycodon grandiflorum is enhanced by fermentation with Saccharomyces cerevisae and FPR may be useful for protection from the itching reactions, which are IgE-mediated representative skin allergic diseases.

월경주기에 따른 치은열구액 내 염증지표의 변화: 예비 연구 (Influence of Menstrual Cycle on Inflammatory Markers in Gingival Crevicular Fluid : Pilot Study)

  • 박후섭;황수정;조민정;김도경;양선연
    • 치위생과학회지
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    • 제12권1호
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    • pp.71-77
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    • 2012
  • 본 연구는 월경주기에 따른 치주조직의 변화에 관한 예비연구로, 건강한 치주조직을 가지고 있고 월경주기가 일정한 20대 여성 7명과 남성 3명을 대상으로 4주간 8회 추구조사를 하였다. 시진상 치주조직의 상태는 건강하므로 치은열구액 내 바이오마커의 변화를 기준 변수로 하여, 상악전치부 치은열구액 내 MMP-9과 MMP-8, IL-$1{\beta}$의 농도를 측정하여 비모수 검정방법으로 분석하였다. 그 결과, 1. 여성대상자에서 월경시기, 배란추정시기에 각 염증지표들이 상승하는 추세를 보였으나 변화정도는 유의하지 않았다. 2. 성별에 따른 각 염증지표들의 차이는 유의하지 않았으며, MMP-9, MMP-8의 농도는 차이가 없었으나 IL-$1{\beta}$의 농도가 남성에서 유의하게 높았다(p=0.03). 3. 검사시점별 각 염증지표들의 상관관계는 강하거나 상당한 강한 양적 선형관계를 나타내었고 배란추정 시기와 월경시기에 상관계수가 더 높게 나타났다. 4. MMP-8과 IL-$1{\beta}$의 관계는 모든 검사시점에서 유의하였으나 MMP-9의 경우, MMP-8과 IL-$1{\beta}$의 상관관계가 유의하지 않은 시점도 있었다. 따라서, 여성대상자도 월경주기에 따른 변화정도가 남성대상자와 유의한 차이가 없으므로 치주병 위험요인에 따른 치주조직 변화의 추구조사에 참여할 수 있는 근거가 마련되었다. 또한 검사지표 중에 MMP-8이 모든 시점에서 다른 지표와 유의하고 강한 상관관계를 나타내어 대표 바이오마커로 적합할 것으로 사료되었다.

Circulating Levels of Adipocytokines as Potential Biomarkers for Early Detection of Colorectal Carcinoma in Egyptian Patients

  • Zekri, Abdel-Rahman N;Bakr, Yasser Mabrouk;Ezzat, Maali Mohamed;Zakaria, Mohamed Serag Eldeen;Elbaz, Tamer Mahmoud
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.6923-6928
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    • 2015
  • Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.

Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus

  • Mohan, Mahendra;Jhingran, Rajesh;Bains, Vivek Kumar;Gupta, Vivek;Madan, Rohit;Rizvi, Iram;Mani, Kanchan
    • Journal of Periodontal and Implant Science
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    • 제44권4호
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    • pp.158-168
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    • 2014
  • Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

Development and Characterization of an Anti-Acne Gel Containing Siamese Crocodile (Crocodylus siamensis) Leukocyte Extract

  • Phupiewkham, Weeraya;Lu, Qiumin;Payoungkiattikun, Wisarut;Temsiripong, Threeranan;Jangpromma, Nisachon;Lai, Ren;Klaynongsruang, Sompong
    • Journal of Microbiology and Biotechnology
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    • 제28권5호
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    • pp.707-717
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    • 2018
  • Leukocytes are reportedly the first line of the innate immune defense and essential for the control of common bacterial infections. Therefore, in this work, the antibacterial activity of crocodile leukocyte extract against Propionibacterium acnes was evaluated, and we also characterized the related activity of skin infection. The leukocyte extract showed the minimum inhibitory concentration to be $100{\mu}g/ml$ to P. acnes. SEM imaging demonstrated that the leukocyte extract adversely affected P. acnes cell permeability in a concentration-dependent manner. Furthermore, the crocodile leukocyte extract could significantly reduce proinflammatory markers and decrease inflammatory signs in infected mouse ears. The crude leukocyte extract was further purified using FPLC and RP-HPLC. The resulting fraction F5 was indicated as the anti-acne peptide-containing fraction. The molecular mass of the peptide contained in F5 was calculated to be 4,790.5 Da. N-Terminal sequencing revealed the amino acid sequence as GPEPVPAIYQ, which displays similarities to immunoglobulin A and leucine-rich repeat neuronal protein. This is the first reported amino acid sequence of a crocodile leukocyte extract that possesses anti-acne activity. To attempt to use it in a prototype cosmetic, an anti-acne gel containing crude crocodile leukocyte extract was formulated, resulting in seven gel formulations (G1, G2, G3, G4, G5, G6, and G7). The formulations G5, G6, and G7 exhibited 2-fold higher anti-acne activity than G1-G4. Investigation of accelerating stability studies of anti-acne gel formulations G5, G6, and G7 demonstrated that a low storage temperature ($4^{\circ}C$) is suitable for maintaining the physical properties and biological activity of the anti-acne gel products.

Vasa Vasorum Densities in Human Carotid Atherosclerosis Is Associated with Plaque Development and Vulnerability

  • Joo, Sung-Pil;Lee, Seung-Won;Cho, Yong-Hwan;Kim, You-Sub;Seo, Bo-Ra;Kim, Hyung-Seok;Kim, Tae-Sun
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.178-187
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    • 2020
  • Objective : The extensive vasa vasorum network functions as a conduit for the entry of inflammatory cells or factors that promote the progression of angiogenesis and plaque formation. Therefore, we investigated the correlation between the carotid vasa vasorum activities and carotid plaque vulnerability using indocyanine green video angiography (ICG-VA) during carotid endarterectomy (CEA). Methods : Sixty-nine patients who underwent CEA were enrolled prospectively from September 2015 to December 2017. During CEA, a bolus of ICG was injected intravenously before and after resecting the atheroma. Additionally, we performed immunohistochemistry using CD68 (a surface marker of macrophages), CD117 (a surface marker of mast cells), and CD4 and CD8 (surface markers of T-cells) antibodies to analyze the resected plaque specimens. Results : The density of active vasa vasorum was observed in all patients using ICG-VA. The vasa vasorum externa (VVE) and interna (VVI) were seen in 11 (16%) and 57 patients (82.6%), respectively. Macroscopically, the VVE-type patterns were strongly associated with preoperative angiographic instability (81.8%, p=0.005) and carotid plaque vulnerability (90.9%, p=0.017). In contrast, the VVI-type patterns were weakly associated with angiographic instability (31.6%) and plaque vulnerability (49.1%). CD68-stained macrophages and CD117-stained mast cells were observed more frequently in unstable plaques than in stable plaques (p<0.0001, p=0.002, respectively). Conclusion : The early appearance of VVE, along with the presence of many microvessel channels that provided nutrients to the developing and expanding atheroma during ICG-VA, was strongly associated with unstable carotid plaques. The degree of infiltration of macrophages and mast cells is possibly related to the formation of unstable plaques.

Serum Cathepsin B to Cystatin C Ratio as a Potential Marker for the Diagnosis of Cholangiocarcinoma

  • Monsouvanh, Ammala;Proungvitaya, Tanakorn;Limpaiboon, Temduang;Wongkham, Chaisiri;Wongkham, Sopit;Luvira, Vor;Proungvitaya, Siriporn
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9511-9515
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    • 2014
  • Cholangiocarcinoma (CCA) is a cancer of the bile duct epithelial cells. The highest incidence rate of CCA with a poor prognosis and poor response to chemotherapy is found in Southeast Asian countries, especially in northeastern Thailand and Lao PDR. Cathepsin B is a lysosomal cysteine protease which is regulated by cysteine proteinase inhibitors such as cystatin C. Elevation of cathepsin B levels in biological fluid has been observed in patients with inflammatory diseases and many cancers. We aimed to investigate the serum cathepsin B and cystatin C levels of CCA patients to evaluate the feasibility of using cathepsin B and cystatin C as markers for the diagnosis of CCA. Fifty-six sera from CCA patients, 17 with benign biliary diseases (BBD) and 13 from controls were collected and the cathepsin B and cystatin C levels were determined. In addition, cathepsin B expression was investigated immunohistochemically for 9 matched-pairs of cancerous and adjacent tissues of CCA patients. Serum cathepsin B, but not cystatin C, was significantly higher in CCA and BBD patient groups compared to that in the control group. Consistently, all cancerous tissues strongly expressed cathepsin B while adjacent tissues were negative in 7 out of 9 cases. In contrast, serum cystatin C levels were comparable between CCA and control groups, although serum cystatin C levels in the BBD group was higher than that in the control or CCA groups. When the serum cathepsin B to cystatin C ratio was calculated, that of the CCA group was significantly higher than that of the control group, and, although statistically not significant, the ratio of CCA group showed a trend to be higher than that of the BBD group. Thus, the cathepsin B to cystatin C ratio might be used as an alternative marker for aiding diagnosis of CCA.