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Sadeghi F, Sarkady F, Zsóri KS, Szegedi I, Orbán-Kálmándi R, Székely EG, Vasas N, Berényi E, Csiba L, Bagoly Z, Shemirani AH. High Neutrophil-Lymphocyte Ratio and Low Lymphocyte-Monocyte Ratio Combination after Thrombolysis Is a Potential Predictor of Poor Functional Outcome of Acute Ischemic Stroke. J Pers Med 2022; 12:1221. [PMID: 35893315 PMCID: PMC9332832 DOI: 10.3390/jpm12081221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: Ischemic stroke is one of the leading causes of death and disability. An inflammatory response is observed in multiple stages of cerebral ischemia, particularly in the acute phase. Recent publications revealed that the neutrophil−lymphocyte ratio (NLR) and lymphocyte−monocyte ratio (LMR) may be used to predict long-term prognosis in acute ischemic stroke (AIS) after thrombolysis. To test whether there is a relationship between the combination of these parameters and long-term prognosis, we analyzed the NLR−LMR combination in AIS patients treated with intravenous recombinant tissue plasminogen activator (rtPA); (2) Methods: The study included 285 adults with a diagnosis of AIS and rtPA treatment within a 4.5 h time window. Blood samples were obtained at admission and 24 h after thrombolysis to calculate pre- and post-thrombolysis NLR and LMR. Clinical data, including NIHSS was registered on admission and day 1. The long-term outcome was defined 90 days post-event by the modified Rankin Scale (mRS). Therapy-associated intracranial hemorrhage (ICH) was classified according to ECASS II. Receiver operating characteristic curve (ROC) analysis was performed to determine optimal cutoffs of NLR and LMR as predictors of therapy outcomes; (3) Results: Patients were stratified by cutoffs of 5.73 for NLR and 2.08 for LMR. The multivariate logistic regression model, including all possible confounders, displayed no significant association between NLR or LMR with 3-months functional prognosis. The combination of high NLR−low LMR vs. low NRL−high LMR as obtained 24 h after thrombolysis was found to be an independent predictor of poor 3-months functional outcome (mRS ≥ 2; OR 3.407, 95% CI 1.449 to 8.011, p = 0.005). The proportion of patients between low NLR−high LMR and high NLR−low LMR groups from admission to day 1 showed no significant change in the good outcome group. On the other hand, in the poor outcome group (mRS ≥ 2), low NLR−high LMR and high NLR−low LMR groups displayed a significant shift in patient proportions from 67% and 21% at admission (p = 0.001) to 36% and 49% at 24 h after thrombolysis (p < 0.001), respectively; (4) Conclusions: Our study demonstrated for the first time that a high NLR−low LMR combination as observed at 24 h after thrombolysis can serve as an independent predictor of 3-months poor outcome in AIS patients. This simple and readily available data may help clinicians to improve the prognostic estimation of patients and may provide guidance in selecting patients for personalized and intensified care post-thrombolysis.
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Affiliation(s)
- Farzaneh Sadeghi
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
| | - Ferenc Sarkady
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
| | - Katalin S. Zsóri
- Central Pharmacy, Szent Borbála Hospital, 2800 Tatabánya, Hungary;
| | - István Szegedi
- Doctoral School of Neuroscience, Department of Neurology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (I.S.); (N.V.)
| | - Rita Orbán-Kálmándi
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
| | - Edina G. Székely
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
| | - Nikolett Vasas
- Doctoral School of Neuroscience, Department of Neurology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (I.S.); (N.V.)
| | - Ervin Berényi
- Department of Radiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (E.B.); (L.C.)
| | - László Csiba
- Department of Radiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (E.B.); (L.C.)
- ELKH-DE Cerebrovascular and Neurodegenerative Research Group, 4032 Debrecen, Hungary
| | - Zsuzsa Bagoly
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
- ELKH-DE Cerebrovascular and Neurodegenerative Research Group, 4032 Debrecen, Hungary
| | - Amir H. Shemirani
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.S.); (F.S.); (R.O.-K.); (E.G.S.); (Z.B.)
- Central Laboratory, Szent Borbála Hospital, 2800 Tatabanya, Hungary
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Kovács S, Csiki Z, Zsóri KS, Bereczky Z, Shemirani AH. Characteristics of platelet count and size and diagnostic accuracy of mean platelet volume in patients with venous thromboembolism. A systematic review and meta-analysis. Platelets 2017; 30:139-147. [DOI: 10.1080/09537104.2017.1414175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Sándor Kovács
- Department of Research Methodology and Statistics, Institute of Sectorial Economics and Methodology, Faculty of Economics and Business, Debrecen University, Debrecen, Hungary, Hungary
| | - Zoltán Csiki
- Department of Medicine, Debrecen University, Debrecen, Hungary, Hungary
| | - Katalin S Zsóri
- Central Pharmacy, Erzsébet hospital, Sátoraljaújhely, Hungary, Hungary
| | - Zsuzsanna Bereczky
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Hungary
| | - Amir H. Shemirani
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Hungary
- Central Laboratory, Erzsébet hospital, Sátoraljaújhely, Hungary, Hungary
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Shemirani AH. Influence of preanalytical factors on the mean platelet volume. Eur Arch Otorhinolaryngol 2016; 273:4039. [PMID: 27098614 DOI: 10.1007/s00405-016-4045-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Amir H Shemirani
- Central Laboratory, Erszébet Hospital, Mártírok utja 9, Sátoraljaújhely, Hungary. .,MTA-DE Vascular Biology, Thrombosis and Hemostasis Research Group, Hungarian Academy of Sciences, Debrecen, Hungary.
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Homoródi N, Kovács EG, Leé S, Katona É, Shemirani AH, Haramura G, Balogh L, Bereczky Z, Szőke G, Péterfy H, Kiss RG, Édes I, Muszbek L. The lack of aspirin resistance in patients with coronary artery disease. J Transl Med 2016; 14:74. [PMID: 26980433 PMCID: PMC4793490 DOI: 10.1186/s12967-016-0827-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 03/02/2016] [Indexed: 12/19/2022] Open
Abstract
Background Aspirin resistance established by different laboratory methods is still a debated problem. Using COX1 specific methods no aspirin resistance was detected among healthy volunteers. Here we tested the effect of chronic aspirin treatment on platelets from patients with stable coronary artery disease. The expression of COX2 mRNA in platelets and its influences on the effect of aspirin was also investigated. Methods One hundred and forty four patients were enrolled in the study. The direct measurement of COX1 acetylation was carried out by monoclonal antibodies specific to acetylated and non-acetylated COX1 (acCOX1 and nacCOX1) using Western blotting technique. Arachidonic acid (AA) induced TXB2 production by platelets was measured by competitive immunoassay. AA induced platelet aggregation, ATP secretion and VerifyNow Aspirin Assay were also performed. COX2 and COX1 mRNA expression in platelets were measured in 56 patients by RT-qPCR. Results In 138 patients only acCOX1 was detected, in the remaining six patients nacCOX1 disappeared after a compliance period. AA induced TXB2 production by platelets was very low in all patients including the 6 patients after compliance. AA induced platelet aggregation, secretion and with a few exceptions the VerifyNow Assay also demonstrated the effect of aspirin. Smoking, diabetes mellitus and inflammatory conditions did not influence the results. The very low amount of COX2 mRNA detected in 39 % of the investigated platelets did not influence the effect of aspirin. Conclusions No aspirin resistance was detected among patients with stable coronary artery disease. COX2 expression in platelets did not influence the effect of aspirin.
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Affiliation(s)
- Nóra Homoródi
- Institute of Cardiology and Heart Surgery, University of Debrecen, 22 Móricz Zsigmond Krt., 4032, Debrecen, Hungary
| | - Emese G Kovács
- Institute of Cardiology and Heart Surgery, University of Debrecen, 22 Móricz Zsigmond Krt., 4032, Debrecen, Hungary.,Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary
| | - Sarolta Leé
- Department of Cardiology, Military Hospital, 44 Róbert Károly Krt., 1134, Budapest, Hungary
| | - Éva Katona
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary
| | - Amir H Shemirani
- Vascular Biology, Thrombosis and Hemostasis Research Group of the Hungarian Academy of Science, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary
| | - Gizella Haramura
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary
| | - László Balogh
- Institute of Cardiology and Heart Surgery, University of Debrecen, 22 Móricz Zsigmond Krt., 4032, Debrecen, Hungary
| | - Zsuzsanna Bereczky
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary
| | - Gabriella Szőke
- Diagnosticum Co., Research Laboratory, 126 Attila u., 1046, Budapest, Hungary
| | - Hajna Péterfy
- Diagnosticum Co., Research Laboratory, 126 Attila u., 1046, Budapest, Hungary
| | - Róbert G Kiss
- Department of Cardiology, Military Hospital, 44 Róbert Károly Krt., 1134, Budapest, Hungary
| | - István Édes
- Institute of Cardiology and Heart Surgery, University of Debrecen, 22 Móricz Zsigmond Krt., 4032, Debrecen, Hungary
| | - László Muszbek
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary. .,Vascular Biology, Thrombosis and Hemostasis Research Group of the Hungarian Academy of Science, University of Debrecen, 98 Nagyerdei Krt., 4032, Debrecen, Hungary.
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Katona É, Muszbek L, Devreese K, Kovács KB, Bereczky Z, Jonkers M, Shemirani AH, Mondelaers V, Ermens AAM. Factor XIII deficiency: complete phenotypic characterization of two cases with novel causative mutations. Haemophilia 2013; 20:114-20. [PMID: 24118344 DOI: 10.1111/hae.12267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2013] [Indexed: 11/29/2022]
Abstract
Coagulation factor XIII (FXIII) exists as heterotetramer (FXIII-A₂B₂) in the plasma and as dimer (FXIII-A₂) in cells. Activated FXIII mechanically stabilizes fibrin and protects it from fibrinolysis by cross-linking fibrin chains and α₂-plasmin inhibitor to fibrin. FXIII is essential to maintaining haemostasis, and its deficiency causes severe bleeding diathesis. Due to improper laboratory practices, FXIII deficiency is considered the most under-diagnosed bleeding disorder. The aim of this study was to demonstrate in two cases how FXIII deficiency is properly diagnosed and classified, and to compare results of laboratory analysis and clinical symptoms. FXIII activity from plasma and platelets was measured by a modified ammonia release assay, while FXIII-A₂B₂, FXIII-A and FXIII-B antigens were determined by ELISA. The exon-intron boundaries and the promoter region of F13A1 gene were amplified by PCR and the amplified products were analysed by direct fluorescent sequencing. FXIII-A mRNA in platelets was determined by RT-qPCR. Two children with severe bleeding symptoms were investigated. In both cases FXIII activity and FXIII-A antigen were undetectable in the plasma and platelet lysate. In the plasma no FXIII-A₂B₂ antigen was found, while FXIII-B antigen was >30% in both cases. Proband1 was a compound heterozygote possessing a known missense mutation (c.980G>A, p.Arg326Gln) and a novel splice-site mutation (c.1112+2T>C). Proband2 was homozygote for a novel single nucleotide deletion (c.212delA) leading to early stop codon. The discovered mutations explain the severity of clinical symptoms and the laboratory data. Methods precise in the low activity/antigen range are required to draw valid conclusion on phenotype-genotype relationship.
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Affiliation(s)
- É Katona
- Clinical Research Center, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary
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Csiki Z, Garai I, Shemirani AH, Papp G, Zsori KS, Andras C, Zeher M. The effect of metoprolol alone and combined metoprolol-felodipin on the digital microcirculation of patients with primary Raynaud's syndrome. Microvasc Res 2011; 82:84-7. [PMID: 21515290 DOI: 10.1016/j.mvr.2011.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 04/08/2011] [Accepted: 04/09/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Calcium channel inhibitors have beneficial impact on microcirculation, but beta-blocker effect is controversial. Clinicians still do not agree on beta-blocker combination with other treatments in the management of impaired microcirculation. The aim of the present study was to describe the effects of beta-blocker metoprolol monotherapy and combined with calcium channel inhibitor felodipin on digital microcirculation in primary Raynaud's syndrome. METHODS We enrolled in this study 46 patients suffering from both hypertension and primary Raynaud's syndrome. Fifteen patients were treated with beta-blocker monotherapy (metoprolol), 13 received combined beta-blocker and calcium channel blocker therapy (felodipin and metoprolol), while 18 patients without any medications served as controls. Measurement of digital microcirculation was carried out with laser Doppler scanner. RESULTS AND CONCLUSIONS Our investigation concludes that the concurrent administration of beta-blockers with calcium channel inhibitors positively reduces symptoms in patients suffering from Raynaud's syndrome.
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Affiliation(s)
- Zoltan Csiki
- Division of Clinical Immunology, 3rd Department of Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
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Abstract
Factor XIII (FXIII) is a protransglutaminase that, after activation, cross-links fibrin chains and several plasma proteins, most importantly alpha (2) plasmin inhibitor, to fibrin. FXIII strengthens the fibrin clot by covalent bonds and protects fibrin from the prompt elimination by the fibrinolytic system. In the last two decades, FXIII has emerged as a key regulator of fibrinolysis. FXIII is also present in platelets, monocytes, and macrophages, but this cellular form does not contribute significantly to maintaining hemostasis. FXIII deficiency is a life-threatening bleeding diathesis whose clinical consequences are well studied. In contrast, the involvement of FXIII in thrombotic disorders and its association with the risk of such diseases are less clear. This review gives an account of the data accumulated mainly in the last decade on the association of FXIII with atherothrombotic diseases and presents conclusions and hypotheses drawn from these data as well as exposing the limitations of the published studies and our knowledge on this topic. The involvement of FXIII in atherogenesis, its role in coronary artery disease, atherothrombotic ischemic stroke, and peripheral artery disease are discussed, with particular reference to the association of FXIII levels and polymorphisms with the risk of these diseases.
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Affiliation(s)
- László Muszbek
- University of Debrecen, Medical and Health Science Center, Debrecen, Hungary.
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Bereczky Z, Balogh E, Katona E, Czuriga I, Kárpáti L, Shemirani AH, Edes I, Muszbek L. Decreased factor XIII levels in factor XIII A subunit Leu34 homozygous patients with coronary artery disease. Thromb Res 2008; 121:469-76. [PMID: 17597187 DOI: 10.1016/j.thromres.2007.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 05/09/2007] [Accepted: 05/22/2007] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The effect of factor XIII A subunit (FXIII-A) Val34Leu polymorphism on the risk of coronary artery disease (CAD) has been extensively studied. In this study we investigated how FXIII-A Val34Leu genotypes influence plasma factor XIII levels in patients with coronary sclerosis (CS) and myocardial infarction (MI) and how fibrinogen level modulates this effect. PATIENTS AND METHODS 955 consecutive patients admitted for coronary angiography were categorized according to the presence or absence of significant CS and the history of MI. The frequency of FXIII-A Val34Leu polymorphism, fibrinogen, FXIII activity and antigen levels were determined. RESULTS AND CONCLUSIONS CS or MI decreased FXIII levels in patients homozygous for FXIII-A Leu34 allele, but not in heterozygous or wild type patients. In the subgroup of patients with CS, but without the history of MI no significant effect was detected, which suggests that MI has a more prominent role. The specific activity of plasma FXIII was independent of FXIII-A Val34Leu genotype. FXIII and fibrinogen levels significantly correlated in CS+ and MI+ patients. In MI+ patients of Leu/Val or Leu/Leu genotypes and with fibrinogen levels in the lowest quartile, FXIII levels were lower than in the same patient groups, but with higher fibrinogen level. The low-scale continuous activation of blood coagulation in CAD patients could lead to parallel FXIII and fibrinogen consumption. As the same amount of thrombin activates more Leu34 FXIII than Val34 FXIII, increased FXIII consumption might be responsible for the decreased FXIII levels in Leu34 homozygous CAD patients.
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Affiliation(s)
- Zsuzsanna Bereczky
- Clinical Research Center, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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Tarnai I, Csordás M, Sükei E, Shemirani AH, Káplár M, Góth L. Effect of C111T polymorphism in exon 9 of the catalase gene on blood catalase activity in different types of diabetes mellitus. Free Radic Res 2007; 41:806-11. [PMID: 17577741 DOI: 10.1080/10715760701381778] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hydrogen peroxide plays a major role in the pathomechanism of diabetes mellitus and its main regulator is enzyme catalase. The blood catalase and the C111T polymorphism in exon 9 was examined in type 1, type 2 and gestational diabetes mellitus. Compared to the control group (104.7 +/- 18.5 MU/l) significantly decreased (p < 0.001) blood catalase activities were detected in type 2 (71.2 +/- 14.6 MU/l), gestational (68.5 +/- 12.2 MU/l) diabetes mellitus and without change in type 1 (102.5 +/- 26.9 MU/l). The blood catalase decreased (p = 0.043) with age for type 2 diabetics and did not change (p>0.063) for type 1, gestational diabetic patients and controls. Blood catalase showed a weak association with hemoglobin A1c for type 1 diabetic patients (r = 0.181, increasing). The mutant T allele was increased in type 1 and gestational diabetes mellitus, and CT+TT genotypes showed decreased blood catalase activity for type 1 and increased activities for type 2 diabetic patients. The C111T polymorphism may implicate a very weak effect on blood catalase activity in different types of diabetes mellitus.
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MESH Headings
- Adult
- Catalase/blood
- Catalase/genetics
- Cytosine
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/enzymology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/enzymology
- Diabetes Mellitus, Type 2/genetics
- Diabetes, Gestational/blood
- Diabetes, Gestational/enzymology
- Diabetes, Gestational/genetics
- Exons
- Female
- Glycated Hemoglobin/metabolism
- Humans
- Male
- Polymorphism, Single Nucleotide
- Pregnancy
- Reference Values
- Thymine
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Affiliation(s)
- I Tarnai
- Department of Clinical Analytical Chemistry, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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Shemirani AH, Haramura G, Bagoly Z, Muszbek L. The combined effect of fibrin formation and factor XIII A subunit Val34Leu polymorphism on the activation of factor XIII in whole plasma. Biochimica et Biophysica Acta (BBA) - Proteins and Proteomics 2006; 1764:1420-3. [PMID: 16920044 DOI: 10.1016/j.bbapap.2006.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Revised: 06/20/2006] [Accepted: 06/21/2006] [Indexed: 12/01/2022]
Abstract
The first step in the activation of blood coagulation factor XIII (FXIII) is the proteolytic cleavage of the potentially active A subunit (FXIII-A) by thrombin at Arg37-Gly38. Both fibrin formation and FXIII-A Val34Leu polymorphism influence the rate of proteolytic activation of purified factor XIII, however their relative importance and interaction in determining the time of onset and the rate of FXIII activation in whole plasma have not yet been explored. In the present study it was shown that in plasma, fibrin formation preceded the truncation of FXIII-A by thrombin, the activation process took place exclusively on the surface of newly formed fibrin and activated FXIII remained associated with the fibrin clot. The time of fibrin formation closely correlated with the time of FXIII activation, while there was no significant relationship between the time of FXIII activation and FXIII-A Val34Leu genotype. However, in the case of Leu34 variant the lag phase between fibrin formation and FXIII-A truncation was significantly shorter than in the case of Val34 variant. The results suggest that in whole plasma the onset of FXIII activation is determined by fibrin formation, while the rate of activation is modulated by Val34Leu polymorphism.
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Affiliation(s)
- Amir H Shemirani
- Clinical Research Center, Medical and Health Science Center, University of Debrecen, 4012 Debrecen, PO Box 40, Hungary
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Shemirani AH, Muszbek L. Rapid detection of the factor XIII Val34Leu (163 G-->T) polymorphism by real-time PCR using fluorescence resonance energy transfer detection and melting curve analysis. Clin Chem Lab Med 2005; 42:877-9. [PMID: 15387436 DOI: 10.1515/cclm.2004.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Val34Leu polymorphism in the A subunit of blood coagulation factor XIII (FXIII-A) is located in the activation peptide, just three amino acids upstream of the thrombin cleavage site. The Val-->Leu replacement accelerates the rate of the proteolytic activation of FXIII and it seems to provide protection against myocardial infarction. Methods available for the assessment of the FXIII-A Val34Leu polymorphism are rather time-consuming, laborious and not easily applicable for large-scale studies. In this study a new method based on real-time PCR with fluorescence resonance energy transfer (FRET) detection and melting curve analysis was developed. The rapid, simple method was adapted to the widely used real-time PCR instrument, LightCycler (Roche Diagnostics). The results showed 100% coincidence with those obtained by the traditional PCR-restriction fragment length polymorphism (RFLP) assay and fluorescent DNA sequencing. Using this method, an allele frequency of 24.2% was obtained (n=113), which well agrees with the allele frequency obtained by PCR-RFLP on a different group of the same ethnic Hungarian population (25.9%).
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Affiliation(s)
- Amir H Shemirani
- Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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