Serum calprotectin and ischemia modified albumin levels as markers of disease activity in Behçet's disease

Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease

BACKGROUND/AIMS

The achievement of endoscopic remission is an important therapeutic goal in the treatment of inflammatory bowel diseases (IBD). We aimed to evaluate the role of fecal calprotectin (FCP) and ischemia-modified albumin (IMA) as biomarkers for evaluating IBD disease activity.

METHODS

A total of 48 patients with IBD (20 with ulcerative colitis and 28 with Crohn's disease) were included in this study. FCP and serum C-reactive protein levels, erythrocyte sedimentation rate, and IMA were measured in patients with IBD and compared with endoscopic findings.

RESULTS

Elevated FCP and serum IMA levels were significantly associated with endoscopic non-mucosal healing. The correlation between FCP and IMA was not significant. Analysis of the receiver operating characteristic curve showed that both FCP and IMA had diagnostic value in predicting non-mucosal healing. When the Ln(FCP)+IMA/10 value was calculated using both factors, the predictive value for non-mucosal healing increased; however, no significant difference was observed.

CONCLUSIONS

IMA could be a candidate serum biomarker for predicting endoscopic mucosal healing in IBD.

Finding the Needle in the Haystack: Serological and Urinary Biomarkers in Behçet's Disease: A Systematic Review

Urinary and serological markers play an essential role in the diagnostic process of autoimmune diseases. However, to date, specific and reliable biomarkers for diagnosing Behçet's disease (BD) are still lacking, negatively affecting the management of these patients. To analyze the currently available literature on serological and urinary BD biomarkers investigated in the last 25 years, we performed a systematic literature review using the Population, Intervention, Comparison, and Outcomes (PICO) strategy. One hundred eleven studies met the eligibility criteria (6301 BD patients, 5163 controls). Most of them were retrospective, while five (5%) were prospective. One hundred ten studies (99%) investigated serological biomarkers and only two (2%) focused on urinary biomarkers. One hundred three studies (93%) explored the diagnostic potential of the biomolecules, whereas sixty-two (56%) tested their effect on disease activity monitoring. Most articles reported an increase in inflammatory markers and pro-oxidant molecules, with a decrease in antioxidants. Promising results have been shown by the omics sciences, offering a more holistic approach. Despite the vast number of investigated markers, existing evidence indicates a persistent gap in BD diagnostic/prognostic indices. While new steps have been taken in the direction of pathogenesis and disease monitoring, international efforts for the search of a diagnostic marker for BD are still needed.

Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients

Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients. Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured. Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value. Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.

Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients

Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients. Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured. Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value. Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.

Ischemia-Modified Albumin—A Potential New Marker of Oxidative Stress in Dermatological Diseases

There is growing evidence that oxidative stress is involved in the pathogenesis of numerous conditions, including dermatological diseases. Various markers are available to assess oxidative stress, but none of these can be considered the ideal marker. Recent studies have shown that ischemia-modified albumin (IMA) is not only an indicator of ischemia, but also a marker of oxidative stress. We have conducted a narrative review to evaluate the role of IMA in dermatological diseases. We have identified 24 original articles that evaluated IMA in skin disorders (psoriasis, acne vulgaris, hidradenitis suppurativa, urticaria, vitiligo and Behcet’s disease) and hair disorders (alopecia areata, androgenetic alopecia and telogen effluvium). The results of the studies analyzed reveal that IMA may be considered a new marker of oxidative stress in dermatological diseases and offer new insights into the pathogenesis of these disorders and the theoretical basis for the development of new, effective, targeted therapies. To the best of our knowledge, this is the first review that gathers up data on the role of IMA in dermatological diseases.

The significance of α-defensins 1-3 in Behcet’s disease: a case-control study among Egyptian patients

Background

Behcet’s disease (BD) is associated with uveitis, oral ulcers, genital ulcers and arthritis. Enhanced activity of innate immunity components, such as neutrophils, natural killer (NK) cells and endothelial cells, is a prominent feature of BD. The aim of this study was to clarify the significance of α-defensins 1-3 in BD and detect their correlation with disease activity, severity and oral ulcer activity.

Results

Significant differences were found between Behcet’s patients and controls as regards serum α-defensins 1-3 (median 10.1, IQR 4–45 μg/ml versus median 7.4, IQR 0.6–13.2 μg/ml, p = 0.001) and salivary α-defensins 1-3 (median 17.4, IQR 5.7–44 μg/ml versus median 8.6, IQR 3.3–11 μg/ml, p < 0.001). Receiver operating characteristic (ROC) showed a fair area under curve (AUC) (AUC = 0.743), with sensitivity of 40% and specificity 100% at cutoff value of 17.3 μg/ml for serum α-defensins 1-3, while salivary α-defensins 1-3 showed excellent AUC (AUC = 0.936), with sensitivity of 93.3% and specificity of 86.7% at cutoff value of 9.8 μg/ml. The levels of serum and salivary α-defensins 1-3 > cutoff value were significantly higher in active severe Behcet’s patients with active oral ulcers (p < 0.001).

Conclusion

α-Defensins 1-3 may be involved in the pathogenesis of BD and could be valuable markers in the determination of disease activity, severity and oral ulcer activity.

Ischemia-modified albumin as a possible marker of oxidative stress in patients with telogen effluvium

BACKGROUND

Telogen effluvium is the most common form of non-scarring alopecia characterized by diffuse hair loss. Ischemia-modified albumin is a marker of oxidative stress and inflammation.

OBJECTIVE

The aim of this study was to compare the levels of ischemia-modified albumin of telogen effluvium patients with healthy controls.

METHODS

Ninety-one patients diagnosed with telogen effluvium and 35 healthy volunteers were included in the study. Serum ischemia-modified albumin level was determined by a fast-colorimetric method, and albumin cobalt binding test. The results were evaluated statistically.

RESULTS

There was no statistically significant difference between the serum albumin values of patient and control groups (p=0.739). Serum ischemia-modified albumin values were significantly higher in the patients with telogen effluvium than healthy controls (p<0.001).

STUDY LIMITATIONS

Body mass index values of the patient and control groups could not be calculated.

CONCLUSIONS

To the best of the authors' knowledge, this is the first clinical study to investigate the role of oxidative stress in the pathogenesis of telogen effluvium using ischemia-modified albumin as a biomarker. Based on the results of the present study, it can be considered that oxidative stress plays an important role in the pathogenesis of telogen effluvium. There is a need for further studies to support the results of this study, to demonstrate the possible effects of oxidative stress, and to investigate the other oxidative stress markers in the pathogenesis of telogen effluvium.