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Huang C, Lu J, Yang J, Wang Z, Hang D, Fu Z. Associations of serum cystatin C concentrations with total mortality and mortality of 12 site-specific cancers. Front Mol Biosci 2024; 11:1209349. [PMID: 38725873 PMCID: PMC11079135 DOI: 10.3389/fmolb.2024.1209349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
Purpose Cystatin C (CysC), beyond its biomarker role of renal function, has been implicated in various physical and pathological activities. However, the impact of serum CysC on cancer mortality in a general population remains unknown. We aimed to examine the associations of serum CysC concentrations with total mortality and mortality of 12 site-specific cancers. Methods We included 241,008 participants of the UK Biobank cohort with CysC measurements who had normal creatinine-based estimated glomerular filtration rates and were free of cancer and renal diseases at baseline (2006-2010). Death information was obtained from the National Health Service death records through 28 February 2021. Multivariable Cox proportional hazards models were used to compute hazard ratios (HR) per one standard deviation increase in log-transformed CysC concentrations and 95% confidence intervals (95% CI) for mortality. Results Over a median follow-up of 12.1 (interquartile range, 11.3-12.8) years, 5,744 cancer deaths occurred. We observed a positive association between serum CysC concentrations and total cancer mortality (HR = 1.16, 95% CI: 1.12-1.20). Specifically, participants with higher serum CysC concentrations had increased mortality due to lung cancer (HR = 1.12, 95% CI: 1.05-1.20), blood cancer (HR = 1.29, 95% CI: 1.16-1.44), brain cancer (HR = 1.19, 95% CI: 1.04-1.36), esophageal cancer (HR = 1.20, 95% CI: 1.05-1.37), breast cancer (HR = 1.18, 95% CI: 1.03-1.36), and liver cancer (HR = 1.49, 95% CI: 1.31-1.69). Conclusion Our findings indicate that higher CysC concentrations are associated with increased mortality due to lung, blood, brain, esophageal, breast, and liver cancers. Future studies are necessary to clarify underlying mechanisms.
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Affiliation(s)
- Changzhi Huang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiayi Lu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jing Yang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhenling Wang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dong Hang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Zan Fu
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Huang H, Zhang Y, Gui L, Zhang L, Cai M, Sheng Y. Proteomic analyses reveal cystatin c is a promising biomarker for evaluation of systemic lupus erythematosus. Clin Proteomics 2023; 20:43. [PMID: 37853350 PMCID: PMC10583312 DOI: 10.1186/s12014-023-09434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 10/04/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organ involvement, especially the kidneys. However, the underlying mechanism remains unclear, and accurate biomarkers are still lacking. This study aimed to identify biomarkers to assess organ damage and disease activity in patients with SLE using quantitative proteomics. METHODS Proteomic analysis was performed using mass spectrometry in 15 patients with SLE and 15 age-matched healthy controls. Proteomic profiles were compared in four main subtypes: SLE with proteinuria (SLE-PN), SLE without proteinuria (SLE-non-PN), SLE with anti-dsDNA positivity (SLE-DP), and SLE with anti-dsDNA negativity (SLE-non-DP). Gene ontology biological process analysis revealed differentially expressed protein networks. Cystatin C (CysC) levels were measured in 200 patients with SLE using an immunoturbidimetric assay. Clinical and laboratory data were collected to assess their correlation with serum CysC levels. RESULTS Proteomic analysis showed that upregulated proteins in both the SLE-PN and SLE-DP groups were mainly mapped to neutrophil activation networks. Moreover, CysC from neutrophil activation networks was upregulated in both the SLE-PN and SLE-DP groups. The associations of serum CysC level with proteinuria, anti-dsDNA positivity, lower complement C3 levels, and SLE disease activity index score in patients with SLE were further validated in a large independent cohort. CONCLUSIONS Neutrophil activation is more prominent in SLE with proteinuria and anti-dsDNA positivity, and CysC is a promising marker for monitoring organ damage and disease activity in SLE.
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Affiliation(s)
- He Huang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yukun Zhang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lan Gui
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Li Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Minglong Cai
- Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Yujun Sheng
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.
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Pedük Ş, Sarıkaya S, Tekin M. Breast cancer risk coordinators: Artificial intelligence-based density measurement and Mullerian-inhibiting substance. Ir J Med Sci 2023; 192:1601-1606. [PMID: 36229588 DOI: 10.1007/s11845-022-03187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/04/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Due to its increasing prevalence, breast cancer has become a serious public health problem. In addition to the models used to identify individuals at risk, the search for fast and accurate tools has continued for years. AIMS In our study, we aimed to examine the correlation of mammographic density measurement and serum Mullerian-inhibiting substance (MIS) levels with an effective model such as Gail. METHODS Of the women whose serum MIS levels were measured in the last 1 year, 214 participants who applied for routine breast examination were included in the study. The age range was between 40 and 60. Exclusion criteria were determined as pathological mammographic findings, active breast symptom, and thoracic radiotherapy history. Mammographic density measurement (PD) was performed with the artificial intelligence-based Deep-LIBRA software. The relationship of these two parameters with the lifetime risk of developing breast cancer was examined. RESULTS The correlation between PD and GRP was remarkable (p < 0.01 cc:0.35). A positive correlation was observed between serum MIS levels and increased breast cancer, but it was not possible to prove this statistically (p = 0.056). It was thought that this situation was caused by perimenopausal patients. Because when the menopause group was excluded, the correlation between MIS levels and GRP decreased (p = 0.12 cc:0.17). CONCLUSIONS PD measurement can be considered as a promising method for the determination of individuals at risk for breast cancer in a large group of patients, but we think that serum MIS levels are not suitable for risk assessment in perimenopausal patients.
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Affiliation(s)
- Şevki Pedük
- Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Surgical Oncology, Emek District Namık Kemal Street N: 54, 34785, Sancaktepe, Turkey.
| | - Sevcan Sarıkaya
- Konya City Hospital - Gynecology and Obstetrics, Karatay, Turkey
| | - Mustafa Tekin
- Aksaray University Training and Research Hospital - Gynecology and Obstetrics, Aksaray, Turkey
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Association between Cystatin C and Cardiac Function in Acute Myocardial Infarction Patients: A Real-World Analysis. DISEASE MARKERS 2022; 2022:7267937. [PMID: 35502303 PMCID: PMC9056268 DOI: 10.1155/2022/7267937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 12/17/2022]
Abstract
Background. Acute myocardial infarction (AMI), as well as its long-term and short-term complications, is known to present with high morbidity and mortality. Cardiac function deterioration and ventricular remodelling after AMI are known to be correlated to worse long-term outcomes. However, the underlying mechanism remains elusive and there is a shortage of serum prediction markers. This study investigates the relationship between in-hospital Cystatin C (CysC) and cardiac function and subsequent prognosis among AMI patients. Research Design and Methods. We measured admission CysC and cardiac function parameters, including ejection fraction (EF) and pro-BNP value in 5956 patients diagnosed with AMI. Simple and multiregression analyses were performed to investigate the correlation between CysC and cardiac function in AMI patients. Major adverse cardiovascular events (MACE), cardiovascular, and all-cause mortality were documented, and 351 participants with high cystatin (≥1.09 mg/L) and 714 low cystatin (<1.09 mg/L) were investigated for survival analysis during a 48-month follow-up. Results. 5956 patients with AMI were enrolled in the initial observational analysis, and 1065 patients of the whole cohort were included in the follow-up survival analysis. The admission CysC level was found to be significantly positively correlated to the pro-BNP level (
, 95% CI 4758 to 5265,
) and negatively correlated to the EF value (
, 95% CI -3.503 to -1.605,
). Kaplan-Meier survival analysis revealed significantly increased MACE incidence (
, 95% CI 1.400 to 3.755,
), cardiovascular mortality (
, 95% CI 1.694 to 5.371,
), and all-cause mortality (
, 95% CI 2.010 to 5.835,
) in high-admission CysC cohort with AMI at the end of 4-year follow-up. Conclusions. Admission CysC is negatively correlated with cardiac function in AMI patients and acts as a novel predictor for MACE incidence in the whole population. Further studies are needed to investigate the specific mechanism of CysC in the cardiac function deterioration among AMI patients.
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Lu S, Li S. Association between preoperative serum Cystatin-C levels and postsurgical oncological prognosis in patients with PRCC: A retrospective cohort study. Cancer Med 2022; 11:4112-4121. [PMID: 35384340 DOI: 10.1002/cam4.4731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Cystatin-C (Cys-C) is a predictor of several malignancies. However, whether Cys-C levels predict prognosis in patients with papillary renal cell carcinoma (PRCC) remains uncertain. The aim of this study was to assess the correlation between Cys-C and clinical outcomes in patients with PRCC. METHODS The medical records of 137 patients with PRCC who underwent surgery at our institution from January 2008 to December 2020 were retrospectively analyzed. Data were divided into two subgroups based on cutoff values and the relationship between the Cys-C group and their clinical outcomes was assessed. RESULTS By the last follow-up, 62 patients had died of various causes, 53 of whom died from PRCC. Sixty patients suffered recurrence or metastasis during follow-up. Based on the cutoff value, the patients were divided into two groups: low Cys-C group (Cys-C < 1.25 mg/L, n = 92) and high Cys-C group (Cys-C ≥ 1.25 mg/L, n = 45). Pathological classification and serum Cys-C levels were shown to be independent prognostic factors affecting clinical outcomes, according to multivariate Cox regression analysis (p < 0.05). After adjusting the Cox proportional hazards model, the risk of death was elevated in the high Cys-C group. The results of the area under the curve for time-dependent receiver operating characteristics analysis indicated that Cys-C is a stable and reliable prognostic biomarker for predicting survival in patients with PRCC. Forest plots, constructed to better reflect the comparison of hazard ratios between the two groups, confirmed that Cys-C levels were significantly associated with worsening overall survival. CONCLUSION This study is the first to examine the relationship between preoperative serum Cys-C levels and prognostic overall survival in patients with PRCC. Cys-C may be a useful biomarker for preoperative screening of high-risk patients who may require adjuvant therapy.
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Affiliation(s)
- Shiyang Lu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Shijie Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, PR China
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Cwiklinski K, Drysdale O, López Corrales J, Corripio-Miyar Y, De Marco Verissimo C, Jewhurst H, Smith D, Lalor R, McNeilly TN, Dalton JP. Targeting Secreted Protease/Anti-Protease Balance as a Vaccine Strategy against the Helminth Fasciola hepatica. Vaccines (Basel) 2022; 10:vaccines10020155. [PMID: 35214614 PMCID: PMC8878381 DOI: 10.3390/vaccines10020155] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
The liver fluke Fasciola hepatica is an economically important global pathogen of humans and their livestock. To facilitate host invasion and migration, F. hepatica secretes an abundance of cathepsin peptidases but prevents excessive damage to both parasite and host tissues by co-secreting regulatory peptidase inhibitors, cystatins/stefins and Kunitz-type inhibitors. Here, we report a vaccine strategy aimed at disrupting the parasite’s protease/anti-protease balance by targeting these key inhibitors. Our vaccine cocktail containing three recombinant stefins (rFhStf-1, rFhStf-2, rFhStf-3) and a Kunitz-type inhibitor (rFhKT1) formulated in adjuvant Montanide 61VG was assessed in two independent sheep trials. While fluke burden was not reduced in either trial, in Trial 1 the vaccinated animals showed significantly greater weight gain (p < 0.05) relative to the non-vaccinated control group. In both trials we observed a significant reduction in egg viability (36–42%). Multivariate regression analyses showed vaccination and increased levels of IgG2 antibodies specific for the F. hepatica peptidase inhibitors were positive indicators for increased weight gain and levels of haemoglobin within the normal range at 16 weeks post-infection (wpi; p < 0.05). These studies point to the potential of targeting peptidase inhibitors as vaccine cocktails for fasciolosis control in sheep.
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Affiliation(s)
- Krystyna Cwiklinski
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
- Correspondence:
| | - Orla Drysdale
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
| | - Jesús López Corrales
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
| | - Yolanda Corripio-Miyar
- Moredun Research Institute, Pentland Science Park, Penicuik, Midlothian EH26 0PZ, UK; (Y.C.-M.); (T.N.M.)
| | - Carolina De Marco Verissimo
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
| | - Heather Jewhurst
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
| | - David Smith
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
- Moredun Research Institute, Pentland Science Park, Penicuik, Midlothian EH26 0PZ, UK; (Y.C.-M.); (T.N.M.)
| | - Richard Lalor
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
| | - Tom N. McNeilly
- Moredun Research Institute, Pentland Science Park, Penicuik, Midlothian EH26 0PZ, UK; (Y.C.-M.); (T.N.M.)
| | - John P. Dalton
- Molecular Parasitology Laboratory, Centre for One Health, Ryan Institute, National University of Ireland Galway, H91 DK59 Galway, Ireland; (J.L.C.); (C.D.M.V.); (H.J.); (R.L.); (J.P.D.)
- School of Biological Sciences, Medical Biology Centre, Queen’s University Belfast, Belfast BT9 5DL, UK; (O.D.); (D.S.)
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Ding L, Liu Z, Wang J. Role of cystatin C in urogenital malignancy. Front Endocrinol (Lausanne) 2022; 13:1082871. [PMID: 36589819 PMCID: PMC9794607 DOI: 10.3389/fendo.2022.1082871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Urogenital malignancy accounts for one of the major causes of cancer-related deaths globally. Numerous studies have investigated novel molecular markers in the blood circulation, tumor tissue, or urine in order to assist in the clinical identification of tumors at early stages, predict the response of therapeutic strategies, and give accurate prognosis assessment. As an endogenous inhibitor of lysosomal cysteine proteinases, cystatin C plays an integral role in diverse processes. A substantial number of studies have indicated that it may be such a potential promising biomarker. Therefore, this review was intended to provide a detailed overview of the role of cystatin C in urogenital malignancy.
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Affiliation(s)
- Li Ding
- Department of Urology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zijie Liu
- Department of Urology, Wuxi No.2 People’s Hospital, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Junqi Wang
- Department of Urology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- *Correspondence: Junqi Wang,
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Cystatin C and cystatin SN as possible soluble tumor markers in malignant uveal melanoma. Radiol Oncol 2021; 56:83-91. [PMID: 34957724 PMCID: PMC8884861 DOI: 10.2478/raon-2021-0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background The aim of the study was to determine the concentration of endogenous cystatin C and cystatin SN, as potential tumor biomarkers, in the serum and biological fluids of the eye in both healthy controls and patients with uveal melanoma. Patients and methods The concentration of both cystatins was determined in the intraocular fluid (IOF), tear fluid, and serum of patients with uveal melanoma and compared to baseline measurements in IOF, tears, serum, cerebral spinal fluid, saliva and urine of healthy controls. Results The concentration of cystatin C in all the biological matrices obtained from healthy controls significantly exceeded the concentration of cystatin SN and was independent of gender. Cystatin C concentrations in the tear fluid of patients with uveal melanoma (both the eye with the malignancy, as well as the contralateral, non-affected eye), were significantly greater than cystatin C concentrations in the tear fluid of healthy controls and was independent of tumor size. The concentration of cystatin SN in IOF of patients with uveal melanoma was significantly less than the corresponding concentration of cystatin SN in healthy controls. Conclusions The ratio of cystatins (CysC:CysSN) in both the serum and tear fluid, as well as the concentration of cystatin SN in IOF, would appear to strongly suggest the presence of uveal melanoma. It is further suggested that multiple diagnostic criteria be utilized if a patient is suspected of having uveal melanoma, such as determination of the cystatin C and cystatin SN concentrations in serum, tears, and IOF, ocular fundus and ultrasound imaging, and biopsy with histopathological evaluation.
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