The NETest liquid biopsy is diagnostic for gastric neuroendocrine tumors: observations on the blood-based identification of microscopic and macroscopic residual diseaseOK

Background

NETest, a novel multi-gene liquid biopsy has utility in neuroendocrine tumor (NET) diagnosis and identification of residual disease. We independently assessed utility of the NETest to diagnose gastric neuroendocrine neoplasms (GNENs) and identify micro- and macroscopic residual disease.

Methods

Cohorts comprised histologically confirmed GNENs at biopsy, n = 46; GNETs Type 1: 42 (32 NET G1, 10 NET G2), a GNET Type 3: 1 well-differentiated NET G3, neuroendocrine carcinomas (NECs) (n = 3), and controls (n = 63). Disease status at sampling was assessed by gastroscopy, histology (resection margin [R] positivity of polypectomy or biopsy), EUS, CT or MRI, and/or ⁶⁸Ga-DOTA-TATE PET/CT. Groups included image- (gastroscopy, EUS, and anatomical and/or functional imaging) positive or image negative disease. NETest assay by PCR (spotted plates, normal cut-off: 20). Data: mean ± SD.

Results

Disease extent: Image-negative (n = 30) (21 R0, 9 R1); Image-positive, n = 16.

Diagnosis: NETest was increased in GNETs (23 ± 11) vs. controls (7 ± 4, p < 0.0001). In histology-positive, the NETest accuracy was 100% (25/25).

Microscopic disease: In image-negative but R1, NETest was elevated in 100% (9/9; 28 ± 9). Levels were elevated vs. controls (7 ± 4, p < 0.0001), or R0 (16 ± 11, p = 0.02). Eight of 21 R0, exhibited positive NETest.

Macroscopic disease: Gastric lesions were multiple: 38%, single: 62%, submucosal: 13%, or ulcerated: 13%. Lesions size was ≤5 mm (50%), > 5–9.9 mm (17%), 10–19.9 mm (17%), ≥20 mm (17%) [≥10 mm: 34%). The NETest accuracy was 100% (16/16). Levels (28 ± 7) were higher than controls (7 ± 4, p < 0.0001) or R0 (16 ± 11, p = 0.002) but not to R1 (28 ± 9, p = 0.5).

Conclusions

NETest is diagnostic for gastric NETs. Elevated levels identify both microscopic and macroscopic residual disease. In histology/image-negative disease, elevated NETest may reflect early evidence of increased neuroendocrine gene expression of hypergastrinemia-induced neoplastic transformation of enterochromaffin-like (ECL) cells to tumor status. A sensitive liquid biopsy has utility in the management and surveillance of gastric NET disease.

ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation

ENETS consensus recommendations for the standards of care in neuroendocrine neoplasms (NEN) concerning follow-up and documentation are considered in this review. The documentation of patients with NEN should include the most relevant data characterizing an individual patient from the first contact with his/her physician/hospital until his/her last presentation during follow-up. It is advocated that follow-up occurs in specialized NEN centers with regular NEN tumor boards with expert panels. The follow-up should be in accordance with the ENETS consensus guidelines from 2011 and 2016, the present and coming WHO classification and ENETS/UICC recommendations for TNM staging. The recommendations for follow-up in patients with thymic, bronchopulmonary and gastroenteropancreatic NEN are given in Table 1. However, it should be stressed that evidence-based studies for follow-up are largely missing.

Changes in lipid metabolism in women with age-related macular degeneration

Age-related macular degeneration (AMD) is one of the leading causes of visual loss among people aged 65 and older. At present the origin of AMD still remains unknown. The objective was to evaluate the chosen lipid and lipoprotein concentrations in blood of patients with AMD. Sixty women aged 55-71 (mean age 65.1+/-5.7) were treated in the outpatient ophthalmological clinic for more than two years because of AMD. We evaluated total serum cholesterol (TCH), triglycerides (TG), HDL-cholesterol (HDL), LDL-cholesterol (LDL), lipoprotein (a) (Lp(a)), apolipoprotein AI (Apo AI) and apolipoprotein B (Apo B) by direct spectrophotometry (Human and Randox standard kits, USA). We found a significant increase of TCH, LDL and TG (224.36+/-41.67 mg/dl, 159.02+/-39.66 mg/dl and 120.92+/-42.64 mg/dl), and a significant decrease of HDL (38.68+/-6.36 mg/dl) in the AMD patients when compared with the control group. We have not found a significant difference in the average TG level between the studied groups. The concentration of Apo B was markedly increased (164.66+/-46.46 mg/dl) and Apo AI concentration was markedly decreased (128.9+/-17.01 mg/dl) in the AMD patients when compared with the control group. There was no significant difference in the concentration of the Lp(a) between the two groups. The results of our present study could point to the fact that changes in the lipid metabolism could be one of the very important risk factors involved in the pathogenesis of AMD.

Serum concentrations of adiponectin and resistin in hyperthyroid Graves' disease patients

This study was undertaken to determine whether serum adiponectin and resistin levels are influenced by hyperthyroidism and autoimmune factors and to find out whether their levels are dependent on the presence of ophthalmopathy. We measured serum concentrations of adiponectin and resistin in 76 patients (63 women, 13 men) with Graves' disease (GD) and compared them with levels of the control group which consisted of 30 healthy subjects. Patients were separated into two groups according to the presence or the absence of thyroid-associated ophthalmopathy (TAO). TAO (-) group consisted of 26 subjects without eye signs of GD and TAO (+) group included 50 subjects with ophthalmopathy. The latter group was further divided into 2 subgroups: with active TAO [26 patients, clinical activity score (CAS)> or =4] and with inactive TAO (24 patients, CAS<4). Groups did not differ in age, sex, body mass index (kg/m2) and smoking habits. Compared with euthyroid subjects, hyperthyroid GD patients had elevated mean serum adiponectin concentrations (19.96+/-4.97 microg/ml vs 15.01+/-3.99 microg/ml, p<0.001). However we did not observe any disparity between the TAO (-) and TAO (+) groups (20.60+/-5.06 microg/ml vs 19.63+/-4.94 microg/ml, p=ns). Comparing patients with a CAS> or =4 and patients with a CAS<4, we found similar mean serum concentrations of adiponectin (20.04+/-5.01 microg/ml vs 18.74+/-4.83 microg/ml, p=ns). Serum levels of resistin did not differ between the hyperthyroid patients and control subjects (13.11+/-4.26 ng/ml vs 12.82+/-4.75 ng/ml, p=ns). Serum resistin levels did not differ between TAO (+) and TAO (-) groups nor in patients with active and inactive TAO. Serum adiponectin correlated significantly with free T4 (FT4), free T3 (FT3), and TSH-R antibodies (TRAb) in GD patients (r=0.40, 0.41, and 0.37, respectively; p<0.001 for each). Serum resistin levels were not correlated with thyroid hormones and thyroid antibodies. The variables that in simple linear regression analyses were found to be correlated with serum adiponectin were then used in multiple regression analysis. In a model including adiponectin as dependent variable and FT4, FT3 and TRAb levels as independent variables, FT3 and TRAb remained as parameters independently related to adiponectin level (R2=0.35, p<0.001).

CONCLUSIONS

Elevated serum adiponectin levels in GD patients are related to the degree of hyperthyroidism and autoimmune process. The presence and activity of ophthalmopathy is not a modifier of serum adiponectin and resistin.

TGF-beta1 mRNA expression in liver biopsy specimens and TGF-beta1 serum levels in patients with chronic hepatitis C before and after antiviral therapy

BACKGROUND AND OBJECTIVE

Transforming growth factor (TGF)-beta1 is the best-characterized profibrogenic cytokine. TGF-beta1 increases the production of extracellular matrix proteins and their receptors and inhibits the synthesis of matrix degrading proteolytic enzymes. We undertook this study to simultaneously evaluate the effect of interferon alpha 2b plus ribavirin therapy on TGF-beta1 daily serum levels and on mRNA TGF-beta1 expression in liver biopsy specimens from 60 patients with chronic hepatitis C.

METHODS

Serum levels of TGF-beta1 were measured by ELISA. The levels of the RNAs in liver biopsy specimens were measured by quantitative reverse transcriptase polymerase chain reaction. After treatment, patients were divided into two groups: 34 responders [undetectable hepatitis C virus (HCV)-RNA, normal ALT levels, decrease in histology activity index compared with pretreatment liver biopsy] and 26 non-responders (detectable HCV-RNA, elevated ALT levels, no decrease in the histology activity index).

RESULTS AND DISCUSSION

In patients with hepatitis C, the 'responders' to the antiviral treatment showed significant decreases in both mean daily serum TGF-beta1 levels and mRNA TGF-beta1 expression in the liver biopsy specimens. The 'non-responders' serum TGF-beta1 concentrations did not change significantly, but the mRNA TGF-beta1 expression did.

CONCLUSION

Both serum TGF-beta1 concentration and mRNA TGF-beta1 expression in liver biopsy specimens may be useful as prognostic markers in patients with hepatitis C undergoing antiviral therapy.

Circadian rhythm of androstendione and free testosterone in asthmatic women with postmenopausal hormone therapy

OBJECTIVE

of this study was to assess daily rhythm of androstendione (delta4alpha) and free testosterone (FT) levels in postmenopausal asthmatic women before and after hormonal replacement therapy and the influence of inhaled glucocorticosteroids (GC).

METHODS

54 asthmatic and 20 healthy postmenopausal women (aged 48-59) before and after 6 months of estrogen plus progestin therapy (EPT) were studied. Hormone concentrations in serum (delta4alpha and FT) were assessed with the use of RIA method. Statistical analysis of the circadian rhythm was performed with the use of cosinor test according to Halberg et al

RESULTS

Cosinor analysis of delta4alpha and FT secretion during the day showed existence of daily rhythm in three studied groups before as well as after postmenopausal hormone therapy (HT). A statistically significant decrease of circadian concentrations of delta4alpha and FT in groups of patients treated with GC was observed. Changes in amplitude of delta4alpha and FT rhythm between studied groups were not observed. However, displacement of rhythm acrophase of studied hormones in asthmatic women in comparison to control group before and after HT was shown. No significant differences in circadian values of delta4alpha and FT concentrations before HT use compared to values after HT were shown.

CONCLUSIONS

Postmenopausal asthmatic women show diminished circadian concentrations of androstendione and free testosterone in serum caused among other things by inhalative GC. Postmenopausal hormone therapy did not influence any changes in function of studied endocrine organs.

Serum adiponectin in women with polycystic ovarian syndrome and its relation to clinical, metabolic and endocrine parameters

Several studies have demonstrated that low levels of serum adiponectin are present in obesity, insulin resistance, hypertension and hyperlipidemias. The aim of our study was to determine whether serum adiponectin level is different between patients with polycystic ovarian syndrome (PCOS) and control subjects. We also investigated relationships between various cardiovascular risk factors, levels of serum adiponectin and other hormones, such as androstendione, testosterone, estradiol, DHEAS, sex hormone binding globulin (SHBG), and leptin. We also analysed the correlation between serum adiponectin and free androgen index. Ninety-one women with clinical diagnosed PCOS and 53 healthy control subjects, carefully matched by body mass index (BMI) and age, were enrolled in the study. The fasting blood samples were obtained and all participants underwent an oral 75 g glucose tolerance test. The prevalences of impaired glucose tolerance (IGT), hypertension and hypertriglyceridemia were higher in the PCOS group. PCOS women had increased androgen concentrations and higher free androgen index and decreased level of serum SHBG. Lower serum adiponectin concentrations were observed among cases than in controls (median 13.7 microg/ml vs 17.8 microg/ml, p<0.001) despite being matched by BMI. In the PCOS group adiponectin levels correlated significantly with: BMI (r=-0.32, p=0.002), waist circumference (r=-0.32, p=0.003), waist-to-hip ratio (WHR, r=-0.38, p=0.001), triglycerides (r=-0.31, p=0.007), SHBG (r=0.30, p=0.003) and free androgen index (r=-0.29, p=0.02). In contrast, the adiponectin level does not appear to be related to total testosterone, DHEAS and leptin levels. The adiponectin and SHBG levels were found to be decreased in PCOS women with IGT compared to PCOS women with normal glucose tolerance, but after adjustment by BMI or WHR, the differences were no longer statistically significant. To exclude a possible confounding effect due to a higher prevalence of IGT in the PCOS group, this comparison was repeated for the subgroup of 58 PCOS women and 48 control women after excluding those with IGT. Neither adiponectin nor SHBG were significantly different between those subgroups. Multiple regression analysis revealed that serum adiponectin concentrations were best predicted by WHR, free androgen index and presence of IGT when all patients were considered. In PCOS subjects, the only independent predictor of adiponectin concentrations was glucose tolerance status.

CONCLUSIONS

Lower adiponectin levels were observed in PCOS group than in control women, and these differences were probably due to higher prevalence of IGT in these cases.

The relationship between bone metabolism, melatonin and other hormones in sham-operated and pinealectomized rats

OBJECTIVE

The influence of pinealectomy and long-term melatonin (MEL) administration on circadian oscillations of selected biochemical markers of bone metabolism [serum alkaline phosphatase (ALP) activity, carboxyterminal propeptide type I procollagen (PICP) and carboxyterminal telopeptide type I collagen (ICTP) concentrations as well as urinary excretion of hydroxyproline (HYP) and Ca] and possible involvement of circadian secretion of IGF-I, parathyroid, thyroid, adrenal cortex and gonads function in this mechanism was evaluated.

METHODS

Studies were performed in 192 adult male Wistar rats weighing 145 +/- 9 g which were subjected to pinealectomy or sham operation. In half of the animals from each group MEL (Sigma, USA) in a dose of 50 mg/100 g b.w. was administered intraperitonealy (daily between 17.00 and 18.00 h for a 4-week period). Material for studies (blood and urine) was collected every 3 hours during a day. Hormones, PICP and ICTP concentrations were determined with the use of RIA methods. whereas ALP, HYP and Ca values - spectrophotormetrically.

RESULTS

The study has shown that pinealectomy had an inducing, while exogenous MEL a suppressing effect upon the level of investigated biochemical markers of bone metabolism. Furthermore, substantial changes in the values of amplitude and phase of their circadian oscillations were shown. Distinct, dependent on the time of day disturbances in circadian fluctuations of PICP, ICTP, HYP and Ca showing generally negative correlation with changes in endogenous MEL concentrations and positive with IGF-I and corticosterone (B) levels were found. In addition, changes in circadian oscillations of ALP and PICP correlated negatively with daily oscillations of calciotropic hormones and B. However, ICTP, HYP and Ca concentrations correlated positively with circadian fluctuations of B and FT3 (the latter only in sham operated rats receiving MEL).

CONCLUSIONS

This study showed that both pinealectomy and long-term MEL administration influence the circadian rhythm of bone metabolism and that an important role in the mechanism of this dependence is played by the changes of endogenous MEL levels. Secondary changes in circadian oscillations of calciotropic hormones, IGF-I and corticosterone concentrations, caused by pinealectomy and long-term MEL administration result in altered bone metabolism rhythm.

Influence of lighting conditions on daily rhythm of bone metabolism in rats and possible involvement of melatonin and other hormones in this process

OBJECTIVE

To evaluate the influence of lighting conditions on daily fluctuations of biochemical markers of bone and mineral metabolism such as the activity of serum alkaline phosphatase (ALP), the concentration of carboxyterminal propeptide of type I procollagen (PICP), cross-linked carboxyterminal telopeptide of type I collagen (ICTP) and inorganic phosphorus (iP) as well as urinary excretion of hydroxyproline (HYP) and calcium (Ca). In addition, possible involvement of daily secretion of melatonin (MEL), GH/IGF-I axis activity and parathyroid, thyroid, adrenocortical and gonadal function in this process.

METHODS

Three series of 48 adult male Wistar rats weighing 180 +/- 10 g were conditioned to different lighting conditions for 4 weeks: 1. control group (LD 12:12 h, light on from 7.00 to 19.00); 2. short-day group (LD 0.5:23.5 h, light on from 7.00 to 7.30); 3. long-day group (LD 23.5:0.5 h, light on from 19.30 to 19.00). The blood was obtained by decapitation. Material for studies was collected every 3 hours during a day. The concentration of hormones, PICP and ICTP was determined with the use of RIA method, whereas ALP, iP, HYP and Ca levels were estimated spectrophotometrically.

RESULTS

A significant influence of different lighting conditions on the daily profile of investigated markers of bone metabolism in rats was confirmed. Thus a short day was found to have an inducing effect upon the level of these markers, while a long day showed a suppressing effect. Furthermore, substantial changes in the values of amplitude and phase of their daily rhythms were found. Also some distinct anomalies in daily oscillations of ALP, PICP, ICTP, HYP and Ca were found which were dependent on the time of the day and showed a negative correlation with the changes in endogenous MEL concentrations. Moreover, ICTP, HYP and Ca concentrations correlated positively with daily fluctuations of IGF-I and triiodothyronine.

CONCLUSIONS

Lighting conditions can influence daily fluctuations of studied bone metabolism markers in rats, and in the mechanism of this dependence the changes in endogenous MEL concentrations seem to play an important role. Secondary changes in daily IGF-I and triiodothyronine oscillations, caused by short- and long-day conditions, result in altered daily bone resorption rhythmicity.

Dynamic pattern of IGF-I and chosen biochemical markers of bone metabolism in a rat model of postmenopausal osteoporosis

OBJECTIVE

To assess the relationship between the dynamic pattern of IGF-I levels and chosen biochemical markers of bone metabolism in ovariectomized rats - a model of postmenopausal osteoporosis.

METHODS

Six-month-old rats were randomized to sham operation (control group) or ovariectomy. Serum levels of insulin-like growth factor (IGF-I) and chosen biochemical markers of bone metabolism (alkaline phosphatase - ALP, carboxyterminal propeptide of type I procollagen - PICP, cross-linked carboxyterminal telopeptide of type I collagen - ICTP in serum as well as urinary excretion of hydroxyproline - HYP and total calcium - Ca) were measured before (group 0) and 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 and 28 weeks after the operation.

RESULTS

In a model of experimental osteoporosis induced by ovariectomy in female rats a distinct tendency to decrease the IGF-I concentrations was shown. Differences were significant in relation to the control group in a period from 2 to 28 weeks after operation. Ovariectomy stimulated the values of studied markers of bone metabolism; it was more intensified in regard to resorption markers. Significant ICTP and HYP concentrations' changes, in relation to the control group, were shown in the some period and total calcium - from 2 to 16 weeks after ovariectomy. However, the values of studied markers of bone formation were generally changing to a slight degree. Significant differences of ALP activity, in relation to the control group, were observed only at 8 and 20 weeks, while those of PICP concentrations were found at in 4, 8 and 12 weeks after the operation. The alterations in the levels of IGF-I correlated significantly and negatively with the changes in ALP activity as well as in PICP, ICTP, HYP and Ca concentrations both in ovariectomized and control rats. This relation was more expressed in the ovariectomized group.

CONCLUSIONS

Our findings suggest that secondary changes in IGF-I concentration, due to the deficiency of sex hormones, results in altered bone metabolism in ovariectomized rats.

Circadian serum levels of dehydroepiandrosterone sulphate in postmenopausal asthmatic women before and after long-term hormone replacement

OBJECTIVE

To assess mean 24-h serum concentrations of dehydroepianrosterone (DHEAS) in postmenopausal women with asthma before and after hormone replacement therapy (HRT).

METHODS

Studies were performed in 55 asthmatic and 20 healthy postmenopausal women aged 48-60 before HRT and after 6 months of transdermal 17b-estradiol (E2) and medroxyprogesterone acetate treatment (cyclical method). Serum DHEAS concentrations were assessed with the use of RIA method.

RESULTS

In the group of postmenopausal asthmatic women treated with glucocorticoids the mean 24 h DHEAS serum levels were lower than in a similar group not treated with glucocorticoids and a control group of healthy postmenopausal women. However, in both groups of asthmatic women (e.g. glucocorticoid treated and untreated) a significant increase of mean daily DHEAS levels after 6 months of HRT was observed. The hormone concentrations did not change in control group.

CONCLUSIONS

Postmenopausal asthmatic women show diminished circadian dehydroepiandrosterone sulphate serum concentrations irrespective whether they were treated with glucocorticoids or not. However, after 6 months of hormonal replacement therapy in these groups increased levels of DHEA were found.

Influence of pinealectomy and long-term melatonin administration on GH-IGF-I axis function in male rats

BACKGROUND

A relationship between circadian GH-IGF-I axis activity and pineal gland function in rats is not sufficiently elucidated, particularly in the aspect of melatonin (MEL) participation with relation to a possible mechanism of these dependencies.

OBJECTIVE

Influence of pinealectomy and long-term MEL administration on circadian GH-IGF-I axis function in male rats was evaluated. An attempt was also made to determine whether the effect of exogenous MEL is dependent on the pineal gland presence.

METHODS

Studies were performed in 192 sexually mature male Wistar rats, which were subjected to pinealectomy or sham operation. In half of the animals from each group MEL (Sigma, USA) in dose of 50 microg/ 100g b.m. was administrated intraperitoneally (daily between 5 and 6 pm during a 4-week period). Blood for RIA assays of MEL, GH and IGF-I concentrations was collected every 3 hours during a day-beginning at 8 am (rats killed by decapitation).

RESULTS

Significant influence of pinealectomy and exogenous MEL on a daily profile of endogenous MEL in rats was confirmed. Distinct, dependent on the time of the day anomalies in circadian oscillations of GH and IGF-I showing positive correlation with changes in endogenous MEL concentrations were also shown. GH rhythm was suppressed in a group of rats with removed pineal gland; after pinealectomy distinct decrease and after MEL use - distinct increase of GH and IGF-I concentrations during the day were observed. It had influenced mean daily concentrations and values of amplitude of circadian GH and IGF-I oscillations in all studied groups of animals. In rats with preserved pineal gland the effect of exogenous MEL action was more intensified.

CONCLUSIONS

Pineal gland can influence circadian function of GH-IGF-I axis, and in mechanism of this dependence, changes in endogenous MEL concentrations seem to play an important role. Administration of MEL in rats after pinealectomy only partly prevents changes of GH-IGF-I axis function caused by gland removal, which can indicate participation of other pineal gland substances in generating disturbances. Influence of exogenous MEL on GH-IGF-I axis function during the day is dependent on the presence of pineal gland, which can be connected with indirect and/or direct influence of administrated hormone on this gland.

Influence of adjuvant chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil on plasma melatonin and chosen hormones in breast cancer premenopausal patients

OBJECTIVE

To investigate the effect of chemotherapy on levels of melatonin in patients with breast cancer.

BACKGROUND

In light of reports on the possible oncostatic role of melatonin in breast cancer patients, it is essential to know the influence of adjuvant chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) on plasma melatonin concentration as well as on its contributing factors, e.g. current hormonal state of the organism. The combination therapy is one of the oldest, safest and most commonly prescribed adjuvant treatments.

METHOD

Twenty-four breast cancer patients on CMF chemotherapy were studied along with a control group of 16 healthy pre-menopausal women.

RESULTS

Plasma melatonin concentration (determined by RIA method) in breast cancer patients prior to treatment did not differ significantly from that of healthy women, but it was significantly increased after the initial cycle of CMF, and significantly increased as compared to a group of healthy women. We did not notice any significant interactions between plasma melatonin and growth hormone, prolactin, estradiol, progesterone, cortisol and met-enkephalin concentrations in all studied groups.

CONCLUSION

The possible oncostatic action of melatonin warrants further investigation to elucidate whether the induced increase of blood melatonin concentration is essential to successful CMF chemotherapy.

Assessment of the relationship between dynamic pattern of nighttime levels of melatonin and chosen biochemical markers of bone metabolism in a rat model of postmenopausal osteoporosis

BACKGROUND

Lately, there have been suggestions that bone mass changes occurring in postmenopausal women may remain related to melatonin.

OBJECTIVE

To assess the relationship between the dynamic pattern of nighttime levels of melatonin and chosen biochemical markers of bone metabolism in ovariectomized rats--a model of postmenopausal osteoporosis.

METHODS

Mature Wistar female rats were either ovariectomozed or underwent a sham operation. Following this they were killed at 02:00AM at weekly intervals for 8 weeks after surgery. Serum levels of MEL at death related to the chosen biochemical markers of bone formation (alkaline phosphatase--ALP; carboxyterminal propeptide of type I procollagen--PICP, both in serum) and resorption (cross-linked carboxyterminal telopeptide of type I collagen--ICTP in serum; hydroxyproline--HYP and total calcium--Ca, both excreted in urine).

RESULTS

In all ovariectomized rats changes of examined indices of bone tissue metabolism were found to be dynamic and statistically significant relative to the control group; however the changes were more pronounced regarding resorption markers. Following ovariectomy, the increase in ALP and PICP values was found to begin at the 4th and the 1st week, while that in ICTP, HYP and Ca at the 2nd, the 1st and the 1st week, respectively. The ALP and PICP values remained at a similar level until the end of observation, whereas ICTP, HYP and Ca gradually decreased. MEL levels were decreased during the 2nd week following surgery and slightly increased 2 weeks later. The serum MEL levels in the ovariectomized group were significantly and negatively correlated with serum ICTP and both urinary HYP and Ca levels.

CONCLUSION

Our findings in rats seem to corroborate the concept of secondary changes in MEL levels co-participating in the development of bone mass changes characteristic for postmenopausal osteoporosis.

Assessment of the relationship between circadian variations of salivary melatonin levels and type I collagen metabolism in postmenopausal obese women

BACKGROUND

Few experimental and clinical studies show that melatonin (MEL) can play a significant part to modulate circadian bone metabolism. On this basis it was suggested that MEL secretion which altered during 24-h in obese women could be of importance to regulate bony mass defect after menopause.

OBJECTIVE

The aim of the study was to prove if there were any connection between changes in 24-h profile of serum MEL levels and circadian metabolism of type I collagen in postmenopausal women with visceral obesity.

METHODS

The relationship of 24-h profile of salivary MEL and circadian metabolism of type I collagen (as assessed by measuring saliva concentrations of carboxyterminal propeptide of type I procollagen--PICP and cross-linked carboxyterminal telopeptide of type I collagen--ICTP) was investigated in 26 women with visceral obesity (33.5 < BMI < 42.1 kg/m(2)) and 18 healthy volunteers with correct body mass (21 < BMI < 24.5 kg/m(2); 0.73 < WHR < 0.76). The specimens were collected at subjects' home at 3 h intervals during a 24 h span. The age range of all subjects was 52-60 years.

RESULTS

In all the obese women studied a tendency to suppress circadian levels of tested biochemical markers of bone metabolism was observed (especially regarding ICTP); those alterations were accompanied by substantial increment in MEL concentrations during the day. Significant and negative correlation was found between values of acrophase MEL and PICP rhythms and both amplitude and acrophase of MEL and ICTP rhythms.

CONCLUSION

Our results confirm hypothesis that alterations in MEL concentrations might have a protective effect against postmenopausal loss of bone mass.

Plasma transforming growth factor beta1 in breast cancer patients treated with CMF chemotherapy

BACKGROUND

In early breast cancer patients the transformed epithelial cells are thought to be sensitive to transforming growth factor beta1 (TGFbeta1)-mediated growth arrest. TGFbeta1 may therefore act as an anti-tumour promoter. However, in advanced breast cancer resistance to such TGFbeta1 action develops. Neoplastic cells produce TGFbeta1, which may enhance tumour invasion and metastasis, mainly by intensifying angiogenesis, which is an immunosuppressive action. In the light of the potential role of TGFbeta1 in breast cancer pathogenesis, an understanding of the effect of applied therapeutic methods on plasma TGFbeta1 concentration is essential.

OBJECTIVE

To investigate the effect of adjuvant chemotherapy on plasma transforming growth factor beta1 (TGFbeta1) concentration in breast cancer patients with metastases to axillary lymph nodes.

METHOD

Fifteen stage II breast cancer patients on adjuvant chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) were studied along with 15 healthy premenopausal women.

RESULTS

Plasma TGFbeta1 concentration (determined by the ELISA method) in the breast cancer patients did not differ significantly from that of the healthy women. Adjuvant CMF chemotherapy significantly decreased plasma TGFbeta1 concentration in those pre-menopausal breast cancer women with metastases to axillary lymph nodes.

CONCLUSION

The possible pathogenic action of this growth factor in stage II breast cancer disease warrants further investigation to elucidate whether the induced decrease of blood TGFbeta1 concentration is essential to successful chemotherapy.