CD38 gene polymorphism rs1130169 contribution to the increased gene expression and risk of colorectal cancer (pilot study)

BACKGROUND

Genetic variations in immune signaling genes may have regulatory effect on phenotypic heterogeneity of immune cells and immune functions, hence promoting tumor growth.

PURPOSE

We compared the frequencies of potentially functional CD38 gene single nucleotide polymorphisms rs1130169 (T > C) in 86 healthy controls and 90 colorectal cancer (CRC) cases to assess their association with cancer risk and CD38 gene expression.

RESULTS

The association between allele C rs1130169 and CRC risk was observed. Allele C was also significantly correlated with an increased CD38 mRNA level and CD38 positive cell percentages in peripheral blood of healthy controls that could be a possible explanation for CRC risk in C allele carriers. In peripheral blood of CRC patients CD38 mRNA and serum soluble CD38 protein levels significantly differed from those in healthy controls. Calculation of the CD38 full-length and with the third exon deletion mRNA ratio in corresponding samples showed that the mRNA isoform ratio was significantly higher in CRC cases than in controls. It suggests that alternative splicing regulates elevation of CD38 full-length mRNA level in peripheral blood of CRC patients. We also have observed higher expression levels of CD38 full-length mRNA in peripheral blood of CRC patients with lymph node metastases compared to patients without metastases.

CONCLUSION

This study indicated biological significance of rs1130169 variations that can alter differences in CRC risk by regulating CD38 gene expression.

Functional Activity of Blood Neutrophils in Patients with Stable Course and Exacerbation of Chronic Obstructive Pulmonary Disease

We performed a comparative study of the parameters of chemiluminescence of blood neutrophils in patients with different severity of chronic obstructive pulmonary disease in its different periods. The maximum values of induced and spontaneous chemiluminescence were recorded at moderate severity of the disease during exacerbation. Low levels of chemiluminescence indicators were found in severe chronic obstructive pulmonary disease in the stable phase. The values of the induction period of the chemiluminescent response in patients with moderate chronic obstructive pulmonary disease were higher than in the control group. Correlations between the values of induced chemiluminescence of neutrophils and the respiration function parameter FEV1 were established, which may indicate the influence of multidirectional changes in the functional activity of systemic neutrophils on the development and worsening of airway obstruction in chronic obstructive pulmonary disease patients.

Cognitive Impairments in Patients with Bronchial Asthma

The course of bronchial asthma can be accompanied by cognitive impairments. However, the relationship between cognitive dysfunction and asthma has not been fully revealed, nor has it been fully established what causes cognitive impairments in patients with asthma. There is an opinion that transient hypoxia and persistent systemic inflammation with insufficient control of bronchial asthma can be accompanied by neurotoxicity in relation to the hippocampus and indirectly lead to deterioration of cognitive functions. Comorbid conditions, such as obesity, allergic rhinitis, and depressive states can increase cognitive dysfunction in asthmatics. The review considers the pathophysiology of cognitive dysfunction in patients with bronchial asthma, as well as the impact of comorbid conditions on the cognitive status. This information will allow systematizing the available knowledge about the state of cognitive functions in asthma for timely detection and correction of their impairments and, ultimately, optimization of the management of these patients.

Periostin as a Biomarker of Allergic Inflammation in Atopic Bronchial Asthma and Allergic Rhinitis (a Pilot Study)

The involvement of periostin in Th2-dependent allergic inflammation has been documented. However, the significance of periostin as a biomarker of local allergic inflammation in the nasal mucosa (NM) of patients with atopic bronchial asthma (BA) and allergic rhinitis (AR) is yet to be determined. The aim of the study was to determine the presence of periostin and evaluate its role as a non-invasive marker of allergic inflammation in the nasal secretions of children with atopic BA and AR.

Materials and Methods

In 43 patients aged 4-17 years with atopic BA and AR, the NM was examined using nasal video-endoscopy and (if indicated) computed tomography; the amount of periostin in the nasal secretion was determined by the enzyme immunoassay.

Results

Exacerbation of AR was accompanied by a statistically significant increase in the level of periostin in the nasal secretion: up to 0.84 [0.06; 48.79] ng/mg, whereas in remission, that was 0.13 [0.00; 0.36] ng/mg; p=0.04. This value increased progressively as the severity of AR increased from 0.16 [0.00; 0.36] ng/mg in the mild course to 0.20 [0.00; 9.03] ng/mg in AR of moderate severity, and to 10.70 [0.56; 769.20] ng/mg in most severe cases; p=0.048. Hypertrophy or polyposis of the nasal and/or paranasal mucosa was detected in 34.9% (15/43) of the examined patients. The concentration of periostin in the nasal secretion was lower in children without NM hypertrophy: 0.18 [0.001; 4.30] ng/mg vs 0.78 [0.13; 162.10] ng/mg in patients with NM hypertrophy; the differences were close to statistically significant: p=0.051. The level of nasal periostin depended on the clinical form of hypertrophy in the sinonasal mucosa, reaching 0.17 [0.00; 0.32] ng/mg in children with polyposis hyperplasia of NM and 21.6 [10.70; 1516.80] ng/mg - with hypertrophy of the NM in the medial surface of the concha; p=0.02.

Conclusion

Exacerbation and increased severity of AR in patients with atopic BA are accompanied by an increased level of periostin in the nasal secretion. This allows us to consider the level of nasal periostin as a biomarker of local allergic inflammation in the NM of patients with atopic BA combined with AR. Hypertrophic changes in the sinonasal mucosa are generally accompanied by an increased level of nasal periostin; specifically, this level significantly depends on the clinical form of mucous membrane hypertrophy and requires additional studies.

Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma

The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.

The Relationship Between Indicators of Nasal Respiratory Function and Spirometric Parameters in Children With Bronchial Asthma

Introduction: The relationship between objective indicators of nasal obstruction and airflow limitation in children with bronchial asthma (BA) and allergic rhinitis (AR) has not yet been studied. Objective: To study the relationship between objective parameters of nasal obstruction and airflow limitation, determined using the methods of anterior active rhinomanometry (AARM) and spirometry in children with BA and AR. Materials and Methods: Eighty eight children and adolescents with BA and AR, boys-65.9% (58/88), were examined. The median age was 11.09 [10.42; 11.76] years. To determine airflow limitation, the following spirometric parameters were evaluated: forced vital capacity of the lungs (FVC), forced expiratory volume in 1 s (FEV1), the ratio of FEV1/FVC, and maximum expiratory flow at the point 25% of the flow-volume loop (MEF25). Data were recorded both in absolute values and in relative units (% pred). Nasal respiratory function was determined by AARM based on the total nasal airflow (TNAF) in absolute (Pa/cm3/s) and relative units (RTNAF, % pred). Results: In the general cohort and in boys but not in girls, a statistically significant direct correlation was found between TNAF (Pa/cm3/s) and absolute spirometry parameters of bronchial patency-all had p < 0.01. Also, RTNAF and relative MEF25 values (% pred) in the general cohort were R = 0.22, p = 0.04, and in boys, R = 0.28, p = 0.03. In girls, there was no statistically significant correlation between nasal respiratory function and spirometric parameters, all p > 0.05. Additional analysis of literature was conducted to ascertain that the identified gender differences were not occasional. Conclusion: The significant positive correlation of absolute values of AARM and spirometric parameters in children with BA and AR was established, which apparently reflects the physical development of children. Of all the relative indicators of spirometry, only MEF25 (% pred), which indirectly reflects the patency of small bronchi, had a distinct direct correlation with RTNAF. These patterns are clearly expressed in boys with BA. In girls with this disease, however, the relationship between nasal respiratory function and spirometric indicators seems to be more complex and requires further study.

[Fatal severe community-acquired pneumonia: risk factors, clinical characteristics and medical errors of hospital patients]

Community-acquired pneumonia (CAP) is the most common disease and potentially life-threatening infection in the worldwide. In the Nizhny Novgorod region, no analysis of the causes of mortality and medical errors of severe CAP patients.

AIM

To analyze the patients structure who died severe CAP in hospitals of the Nizhny Novgorod region, to identify the leading risk factors, to assess the clinical characteristics of fatal severe CAP and medical errors according to medical records of patients from 20152016.

MATERIALS AND METHODS

This was a retrospective study of medical records of 139 patients with fatal severe CAP from medical organizations of the Nizhny Novgorod region. The 72 patients died in 2015. The mortality rate from pneumonia was 67 cases in 2016.

RESULTS

The key predictors of the fatal severe CAP in patients of the Nizhny Novgorod region identified: socio-demographic status (men of working age, unemployed, smoking, alcohol and drug dependence), late treatment and hospitalization, tachypnea, hypotension, tachycardia, confusion, leukocytosis or leukopenia, thrombocytopenia, anemia, hyperglycemia, bilateral lung damage, pleural effusion, acute respiratory failure. The leading medical errors in fatal CAP were incorrect assessment of the severity of the patients condition, untimely CAP, non-monitoring of SpO2 on the first day of hospitalization, late transfer of patients to the intensive care unit, there was no influenza therapy, inadequate starting antibacterial therapy.

CONCLUSION

The main ways to avoid or minimize medical errors and reduce the mortality of patients with TVP is strict adherence to clinical recommendations, active preventive measures, diagnosis and treatment of chronic diseases.

The Relationship Between Bronchial Patency and Parameters of ECG Supraventricular Component in Children With Bronchial Asthma

Background: Uncontrolled asthma (BA) can be complicated by cardiac conduction disturbances and arrhythmias. It is typical mainly for adult asthmatics patients. In asthmatics children the effect of bronchoconstriction on cardiac conduction, including the supraventricular component of the ECG, is currently under discussion. The objective of the research is to analyze ECG parameters of the atrial complex and atrioventricular conduction and to assess their relationship with spirometric indicators in children with BA. Methods: Hundred three patients with BA from the age of 6-17 years were examined. The spirometric parameters were evaluated, including the Tiffeneau index (TI): FEV1/FVC (%), according to the level of which the patient groups were distinguished. Group 1 (G1): with TI more than 85%, (n = 15); Group 2 (G2): with TI from 85 to 75%, (n = 40); Group 3 (G3): with TI <75%, (n = 48). The ECG parameters that characterize supraventricular conduction, including the PQ interval (sec) and the sPQ segment (sec), were analyzed. We had calculated relative PQ (rPQ) by the formula rPQ=PQ/PQmed, where PQ is the patient's PQ, PQmed are the median PQ values of healthy children of age selected. Results: The duration of the PQ in groups G1 and G2 was 0.13 (0.11; 0.14) s; and 0.13 (0.12; 0.14) s, respectively, which is statistically significantly less than in patients of groups G3-0.14 (0.13; 0.15] s, p = 0.01. The duration of the sPQ segment in children of groups G1 and G2 was also generally shorter than in patients of groups G3, and amounted, respectively, to 0.05 (0.04; 0.06) s, 0.04 (0.04; 0.05) s, and 0.06 (0.04; 0.07) s, p = 0.02. The rPQ increased progressively as TI decreased and amounted in G1 to 92.9 (85.7; 106.3) %, in G2 100.0 (92.9; 103.0) %, and in G3 104 (100.0; 107.7) %, p = 0.009. A statistically significant negative correlation between IT and PQ-r = -0.23, p = 0.02; with sPQ-r = -0.20, p = 0.045; and with rPQ-r = -0.25, p = 0.01 was revealed. Conclusion: A decrease in TI in asthmatics children is associated with a prolongation of the PQ. This may indicate a slowdown in supraventricular conduction in patients with uncontrolled asthma and, thus, be considered as a risk for the formation of subsequent supraventricular arrhythmias.

Dependence of Anterior Active Rhinomanometry Indices on Nasal Obstructive Disorders in Children with Atopic Bronchial Asthma Complicated by Nasal Symptoms

BACKGROUND

Atopic bronchial asthma (BA) in children is associated with upper airways pathology (UAP). Among them, a combination of allergic rhinitis (AR) and nasal obstructive disorders (NOD), including hypertrophy of the pharyngeal tonsil (HPT) and anomalies of the intranasal structures (AINS), is abundant. In such patients, anterior active rhinomanometry (AARM) is an important method of examining nasal patency. However, NOD can influence the AARM parameters in children with BA and nasal symptoms, and this effect must be taken into account in clinical practice. Study goal was to elucidate the effect of NOD on rhinomanometric parameters in this group of patients.

METHODS

Total of 66 children with BA and AR were examined with AARM, rhinovideoendoscopy, spirometry, and standard clinical tests allowing revealing the structure of comorbid pathologies. In order to avoid the influence of anthropometric parameters of children and their age on AARM parameters, a special index of reduced total nasal airflow was used.

RESULTS

It has been established that NOD, especially HPT, have a significant negative impact on the indices of anterior active rhinomanometry during the periods of both AR remission and AR exacerbation. The effect of AINS is much weaker and was remarkable only in combination with HPT.

[The levels of soluble CD95 antigen and CD95+ mononuclear cells in patients with chronic obstructive lung diseases]

The levels of soluble CD95 (sCD95) antigen and CD95+ mononuclear cells were studied in the peripheral blood, induced sputum (IS), expired air condensate (EAC) of patients with chronic obstructive pulmonary disease (COPD). There was an increase in the relative count of CD95+ mononuclear cells and a reduction in the level of sCD95 antigen in the peripheral blood of patients with severe COPD. The elevated levels of sCD95 antigen and CD95+ mononuclear cells were revealed in IS and EAC in moderate COPD.

[Significance of biochemical parameters of saliva in the diagnosis of chronic obstructive pulmonary disease at exacerbation]

The levels of calcium, magnesium and iron were examined on an automated biochemical analyzer in saliva and blood serum of 102 patients with chronic obstructive disease of lungs (CODL) and of 20 healthy subjects. Reliably reduced levels of magnesium and iron in saliva as well as low permeability of the hematosalivary barrier (HSB) for magnesium and its high permeability for iron were detected in group 2 and 3 of patients. The dynamic level of iron in saliva reached the normal value, whereas, a stable salivary deficiency was typical of magnesium. The above tests of levels of magnesium and iron in saliva and the determination of the distribution factor for the above cations can be used in evaluating a severity of bronchial obstruction and therapy efficiency in patients with CODL.

[Metabolism of proinflammatory cytokine (interleukin-1 beta) and oxidant activity of neutrophils in various forms of chronic bronchitis]

AIM

To study content of interleukin-1 beta (IL-1 beta) and free radical oxidation in neutrophils of blood, saliva and bronchoalveolar lavage (BAL) in chronic bronchitis for prediction of obstructive defects.

MATERIAL AND METHODS

Enzyme immunoassay was used to measure IL-1 beta in the blood, saliva, BAL of 49 males with chronic bronchitis aged 39-72 years. Functional ability of the neutrophils to generate free oxygen radicals was assessed by luminol-dependent chemiluminescence.

RESULTS

Patients with chronic obstructive bronchitis exhibited excessive accumulation of IL-1 beta in the blood and BAL, enhanced activity of hematosalivary barrier for IL-1 beta and production of active oxygen radicals by systemic and tissue neutrophils.

CONCLUSION

Elevated concentration of systemic and tissue IL-1 beta, activation of free radical oxidation by blood neutrophils and BAL, enhancement of hematosalivary barrier for IL-1 beta can be considered as prognostically unfavourable factors of bronchial obstruction in patients with chronic bronchitis.