Macrophage-derived chemokine CCL22 and regulatory T cells in ovarian cancer patients

The study was undertaken to evaluate macrophage-derived chemokine (CCL22) levels in the peritoneal fluid (PF) and plasma of patients with ovarian cancer (n = 93) in relation to regulatory T cells (Tregs; n = 75). The peritoneal fluid CCL22 concentrations were significantly higher in epithelial ovarian cancer (EOC) patients than in patients with benign tumors-serous cystadenoma (n = 32). There was no difference in plasma levels of CCL22 in EOC patients compared with the non-cancer and healthy volunteers (n = 10). There were no significant differences in the plasma and PF CCL22 levels based on tumor grade. However, women with stage IV FIGO (International Federation of Gynecologists and Obstetricians) had significantly higher plasma CCL22 levels than patients with stages I and III. Women with stage I FIGO had significantly higher PF CCL22 levels than patients with stages II and III. Women with endometrioid cystadenocarcinoma had higher PF CCL22 levels than women with undifferentiated carcinoma. The percentage of tumor-infiltrating Tregs (11.06 %) was significantly higher compared to PF (3.05 %) and peripheral blood (PB) (2.01 %). Moreover, the percentage of Tregs was higher in the PF than in the PB of EOC patients. There were no significant differences in the PB, PF, and tumor-infiltrating Tregs percentage based on tumor stage, grade, or histology. Elevated levels of CCL22 found in the ascites could create a chemokine gradient aiding in Treg cells migration. Increased Tregs percentage in the local microenvironment of ovarian cancer might be an important mechanism of immunosuppression.

Dendritic cell subsets in the peritoneal fluid and peripheral blood of women suffering from ovarian cancer

BACKGROUND

Evaluation of immature myeloid and lymphoid dendritic cells (DCs) in the peritoneal fluid (PF) and peripheral blood (PB) mononuclears of women with ovarian carcinoma (n = 47) and benign ovarian tumors (n = 37).

METHODS

Mononuclear cells were isolated from PF and PB, stained with monoclonal antibodies (mAbs) against DC antigens (anti-BDCA-1, anti-BDCA-2), and estimated using flow cytometry.

RESULTS

The percentage of PF myeloid DC (MDC) in mononuclears was significantly lower in patients with ovarian cancer in comparison to the group of nonmalignant ovarian tumors (0.65% and 6.95%). The percentage of PF lymphoid DCs (LDCs) was higher in patients with ovarian cancer than in the reference group (0.64% and 0.09%). The percentage of PB MDCs and LDCs did not differ significantly between studied groups. In women suffering from ovarian cancer the percentage of both MDCs and LDCs was higher in the PF than in the PB. In the reference group the percentage of MDCs was higher but that of LDCs was lower in the PF than in the PB. In women with ovarian cancer, PF MDCs/LDCs ratio was lower in comparison to patients with serous cystadenoma. In PB the ratio of MDCs to LDCs did not differ significantly between studied groups.

CONCLUSIONS

We concluded that MDCs population may be affected by the presence of malignant disease. LDC subsets may have influence on the local immune response in the PF of women with malignant tumors of the ovary. (c) 2008 Clinical Cytometry Society.

Myeloid and lymphoid dendritic cells in the peritoneal fluid of women with ovarian cancer

PURPOSE

The aim of the study was to estimate the myeloid and lymphoid subpopulation of dendritic cells (DCs) in the peritoneal fluid (PF) of women with ovarian tumors.

MATERIAL AND METHODS

We studied 34 patients with serous cystadenocarcinoma and 29 women with serous cystadenoma. Dendritic cells were isolated from peritoneal fluid, stained with monoclonal antibodies anti-BDCA-1 and anti-BDCA-2 and estimated using flow cytometry.

RESULTS

Peritoneal fluid myeloid DCs constituted 0.59% of mononuclear cells in patients with ovarian cancer and 7.2% in women with serous cystadenoma. Lymphoid DCs constituted 0.39% of PF mononuclears in women with ovarian cancer and 0.07% in patients with serous cystadenoma. The percentage of lymphoid DCs was higher in patients with ovarian cancer than in women with serous cystadenoma. The BDCA-1/BDCA-2 DCs ratio in peritoneal fluid of patients with serous cystadenoma was significantly higher in comparison to ovarian cancer.

CONCLUSIONS

Decreased BDCA-1/BDCA-2 DCs ratio in patients with ovarian cancer may favour Th2 lymphocyte differentiation and/or induction of immunological tolerance.

[Peritoneal fluid and plasma 4-hydroxynonenal and malonyldialdehyde concentrations in infertile women]

OBJECTIVES

To investigate the possible role of oxidative stress in the pathogenesis of female infertility, we examined the peritoneal fluid (PF) and plasma lipid peroxides levels in infertile women.

MATERIALS AND METHODS

4-hydroxynonenal (4-HNE) and malonyldialdehyde (MDA) concentrations were measured in peritoneal fluid and plasma samples obtained from: 10 infertile women with minimal and mild endometriosis, 24 patients with unexplained infertility, 11 women with PCOS and 14 patients with tubal infertility.

RESULTS

PF lipid peroxides level was significantly higher in women with idiopathic infertility compared to other groups. Plasma 4-HNE and MDA concentrations did not differ significantly between the infertile groups. No significant difference or relationship was observed between peritoneal fluid and plasma lipid peroxides levels.

CONCLUSIONS

Increased free radicals activity in the peritoneal fluid environment may be the factor responsible for some cases of "unexplained infertility".

[Expression of the survivin gene in the scar endometriosis and in normal human endometrium]

The survivin gene encoding a novel inhibitor of apoptosis protein (IAP) is located on chromosome (17q25). It is expressed during development and in human cancer in vivo. Endometriosis in cicatrix after cesarean section represents the only localization of endometriotic implant which etiology is known. It is believed that during the surgical procedure when the uterine cavity is open there is a high risk of decidualized endometrium implantation. The aim of the study was to estimate the expression of the survivin mRNA in the scar endometriosis after cesarean section (n = 6) and perineum endometriosis (n = 2) and in normal human endometrium (n = 12, reference group) using reverse transcribed-polymerase chain reaction (RT-PCR).

METHODS

Total cellular RNA was isolated from the tissues using TriReagent according to the manufacturer's protocol. Total cellular mRNA was transcribed into cDNA with reverse transcriptase (RT) then the survivin gene fragment (430 bp) was amplified with PCR using specific primers. The products of the PCR reaction were separated on 2% agarose gel. The survivin gene was expressed in 4 of 6 cases of scar endometriosis after cesarean section and in 2/2 cases of perineum endometriosis. In all cases of normal endometrium we found the expression of survivin with a peak in the late proliferative phase. The antiapoptosis function of this gene product may play an important role in the endometriotic implant growth promotion.

Peritoneal fluid leptin concentration in infertile patients

Leptin may play a role in the regulation of menstrual cycle acting either directly on ovaries or at the level of the hypothalamic-pituitary axis. Peritoneal fluid is a biologically active environment that influences ovarian function but, on the other hand, concentration of many substances in peritoneal fluid can reflect the functional status of ovaries. In our study, we estimated leptin concentration in peritoneal fluid in relation to serum leptin concentration in infertile patients. A study group consisted of 31 infertile patients that underwent laparoscopy. In 15 patients, laparoscopy did not solve the problem and they were grouped as unexplained infertility, in eight patients we found endometriosis and eight patients were diagnosed as polycystic ovary syndrome (PCOS). We found significantly higher peritoneal fluid leptin concentrations in patients with unexplained infertility and endometriosis compared to those with PCOS. The plasma leptin concentration did not differ between the groups studied. There was no correlation between peritoneal fluid and plasma leptin concentrations in any patient group. Taking into account our results, the role of leptin in reproduction should be emphasized but further investigation is needed to determine its mechanism of action.

[Lipid peroxides, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) in peritoneal fluid from infertile women with minimal and mild endometriosis]

OBJECTIVES

To assess the concentrations of tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma) and lipid peroxides (the marker of free radicals activity) in peritoneal fluid (PF) of infertile women with minimal and mild endometriosis.

MATERIALS AND METHODS

19 women were studied, including 9 infertile women with minimal or mild endometriosis and 10 patients with tubal occlusion (the reference group). Lipid peroxides (malonyldialdehyde and 4-hydroxynonenal), TNF-alpha and IFN-gamma concentrations were measured in the PF using commercially available kits.

RESULTS

Concentration of IFN-gamma was detectable in PF of 7 (77.8%) women with endometriosis and in PF from 3 (30%) patients with tubal occlusion. Neither TNF-alpha or lipid peroxides PF concentration differed significantly (p < 0.05) between the groups. In the group with endometriosis we have found a positive correlation (R = 0.77, p = 0.04) between the concentrations of TNF-alpha and IFN-gamma.

CONCLUSIONS

Our results suggest that oxidative stress in the PF doesn't appear to play a role in endometriosis-associated infertility.

[Concentrations of MMP-1, TIMP-1, MMP-1/TIMP-1 and I CTP complexes in follicular fluid as related to fertilization rate in women treated with in-vitro fertilization]

OBJECTIVES

Metalloproteinases and their inhibitors appear to control connective tissue remodelling during follicular rupture. The aim of the study was to establish if oocytes fertilisation rate after ovulation induction depends on the concentrations of MMP-1, its inhibitor TIMP-1, MMP-1/TIMP-1 complex and I CTP in follicular fluid (FF).

MATERIAL AND METHODS

FF were collected from 37 infertile patients undergoing ovulation induction using either short or long protocol. FF was obtained 36 hours after administration of hCG (Pregnyl). The level of MMP-1, TIMP-1, MMP-1/TIMP-1 complex were measured using ELISA kits and I CTP, E2, FSH, LH, using RIA assay kits.

RESULTS

Statistically significant (p < 0.05) difference was found in TIMP-1, E2, and FSH concentration, being higher in the group with more than 75% fertilisation rate: TIMP-1 728.8 + 100.1 ng/ml vs 666.3 + 94.5 ng/ml; E2 477.3 +/- 160.0 ng/ml vs 368.0 +/- 190.0 ng/ml and FSH 7.27 +/- 1.45 mIU/ml vs 6.24 +/- 1.6 mIU/ml.

CONCLUSIONS

Statistically significant increase in TIMP-1 concentration observed among patients with fertilisation rate above 75% indicates an important role of this substance in ovulation process.

Total antioxidant status of peritoneal fluid in infertile women

OBJECTIVE

To determine whether impairment of the antioxidant systems of peritoneal fluid might be a factor responsible for infertility.

STUDY DESIGN

Total antioxidant status was measured in peritoneal fluid obtained from 18 infertile women suffering from minimal or mild endometriosis, 23 patients with unexplained infertility, 12 women with tubal infertility and 13 fertile women.

RESULTS

Total antioxidant status was significantly lower in peritoneal fluid from women with unexplained infertility (0.49+/-0.21 mmol/l) compared to both fertile patients (0.67+/-0.24 mmol/l, P=0.02) and women with tubal infertility (0.76+/-0.26 mmol/l, P=0.001). Peritoneal fluid total antioxidant status did not differ significantly between patients with endometriosis (0.61+/-0.2 mmol/l), tubal infertility and the fertile group (P>0.05).

CONCLUSIONS

Our results suggest that low antioxidant status in peritoneal fluid may play a role in the pathogenesis of infertility.

[Expression of the survivin gene in normal and hyperplastic endometrium]

OBJECTIVE

Surviving a novel anti-apoptotic gene is expressed during fetal development and in numerous human cancers.

MATERIAL AND METHODS

We analyzed the expression of surviving in human normal endometrium: proliferative n = 8, secretive n = 4 cases and hyperplastic endometrium 6 cases.

RESULTS

RT-PCR revealed surviving expression in all cases of normal and hyperplastic endometrium. The highest expression of surviving gene was observed in hyperplastic endometrium and in the late proliferative phase.

[Serum C-reactive protein concentration in women after hysterectomy without peritoneal suturing]

OBJECTIVES

To assess the postoperative concentration of C-reactive protein (CRP) in serum from patients after hysterectomy with and without peritoneal suturing.

MATERIALS AND METHODS

13 women after total abdominal hysterectomy and bilateral salpingooophorectomy were studied, including 8 women with nonclosed peritoneum and 5 patients after peritoneal suturing. Concentration of CRP was measured in serum obtained before, 8, 16, 48 and 192 hours after surgery, using a commercially available ELISA kit (Eurogenetics).

RESULTS

The serum concentration of CRP did not differ significantly (p < 0.05) between the groups.

CONCLUSIONS

Our results suggest that nonclosure of the peritoneum layer doesn't affect the serum C-reactive protein concentration.

[Glutathione peroxidase concentration in the peritoneal fluid from infertile women]

OBJECTIVES

To assess the concentration of Plasma Glutathione Peroxidase (plGPx) in the peritoneal fluid (PF) of patients with unexplained infertility and infertile women with minimal and mild endometriosis.

MATERIALS AND METHODS

33 women were studied, including 8 infertile women with minimal or mild endometriosis, 15 patients with unexplained infertility and 10 patients with tubal occlusion (a reference group). Concentration of plGPx was measured in the PF using a commercially available ELISA kit (Oxis Inc.).

RESULTS

The plGPx concentration was significantly (p = 0.04) lower in PF from women with unexplained infertility (846 +/- 177 ng/ml) compared to the reference group (1023 +/- 238 ng/ml), but did not differ significantly (p = 0.25) between women with endometriosis (918 +/- 81 ng/ml) and patients with tubal infertility.

CONCLUSIONS

Our results suggest that low peritoneal plGPx concentration may play a role in the pathogenesis of infertility.

[Total antioxidant status and activity of an extracellular superoxide dismutase in peritoneal fluid and plasma from women with unexplained infertility]

OBJECTIVES

To evaluate the activity of an extracellular superoxide dismutase (EC SOD) and total antioxidant status in peritoneal fluid (PF) and plasma from women with unexplained infertility (UI).

MATERIALS AND METHODS

PF and plasma samples were collected from 10 women with UI and 10 patients with tubal infertility (reference group). TAS was measured using Randox diagnostic reagent system. The activity of EC SOD was estimated using Calbiochem assay kit.

RESULTS

TAS was significantly lower in PF from women with UI. Plasma TAS did not differ significantly between the groups. Peritoneal TAS was significantly lower compared to plasma TAS and there was a positive correlation between PF and plasma total antioxidant status. Activity of EC SOD did not differ significantly between the groups in either PF and plasma samples.

CONCLUSIONS

These data demonstrate that low antioxidant status of PF but not that of blood may be responsible for idiopathic infertility. The activity of EC SOD doesn't appear to play a role in UI.

[Histopathological verification of the cervical pap smears based on material of the obstetrical-gynecological department of the provincial hospital in Kielce]

The results of the cervical Pap. smear taken before cold knife conization and the histopathological results of the cones removed in 336 women, were compared. In cytological examination we found 10.8% (13/120) false negative results, which did not confirm of the existence the precancerous lesion within cervical epithelium. The mild dysplasia according to Pap. smears was established among 15.9% (15/94) of women with CIN III and CIN II diagnosed pathologically. In part of the women the histopathological results of the postoperative specimens and bioptic cervical material were compared. Clinical value and correlation between histopathological and cytological results in the estimation of CIN (cervical intraepithelial neoplasia) were discussed with particular regard to CIN I according to Bethesda system.

[Malonyldialdehyde and total antioxidant status in the peritoneal fluid of infertile women]

OBJECTIVE

To estimate the concentration of malonyldialdehyde (MDA) and total antioxidant status in the peritoneal fluid (PF) of patients with unexplained infertility (UI) and infertile women with minimal and mild endometriosis.

MATERIALS AND METHODS

PF was obtained during laparoscopy from 8 women with UI, 12 infertile women with endometriosis (I degree and II degrees rAFS) and 10 women with benign noninflammatory ovarian tumours. All laparoscopies were performed in the follicular phase of the cycle. MDA concentration was measured according to Ledwozyw method, TAS was measured spectrophotometrically using RANDOX diagnostic reagent system.

RESULTS

We found significantly higher concentration of MDA in PF from both patients with UI (p = 0.03) and with endometriosis (p = 0.046) compared to the control group. TAS was significantly (p = 0.027) higher in PF of women with UI but did not differ significantly (p = 0.49) between patients with endometriosis and controls.

CONCLUSIONS

Our results show that an imbalance between lipid peroxides and the antioxidant system in PF environment may be one of the main factors responsible for the UI. In the group with endometriosis a marginally significant difference in MDA levels, no significant differences in TAS and data from the literature, suggest that accelerated lipid peroxidation in PF doesn't appear to play a role in the endometriosis associated infertility.

[The concentration of interleukin-2 and interleukin-2 soluble receptors in peritoneal fluid of patients with unexplained infertility]

OBJECTIVES

We measured the concentration of interleukin-2 (IL-2) and interleukin-2 soluble receptor (sIL-2R) in peritoneal fluid (PF) of patients with unexplained infertility.

MATERIALS AND METHODS

PF was obtained during laparoscopy from 7 women with unexplained infertility (UI) and 11 women with benign noninflammatory ovarian tumors. All laparoscopies were performed in follicular phase of the cycle. IL-2 and sIL-2R concentrations were measured in PF supernate stored in -70 degrees C until analysis using ELISA method (ENDOGEN).

RESULTS

We found significantly (p = 0.009) lower concentration of sIL-2R in PF from patients with UI (303.844 U/ml) than in reference group (556.385 U/ml). The level of IL-2 was not detectable in 2 cases from women with UI and 5 cases from reference group. The concentration of IL-2 in PF did not differ (p = 0.135) between patients with UI (2.346 pg/ml) and those from reference group (1.064 pg/ml).

CONCLUSIONS

The concentration of sIL-2R in PF of patients with UI was lower than in those from reference group. This may be the factor responsible for insufficient local immunosuppression, affecting reproduction.

[Multiple myeloma nephropathy as a cause of renal failure--diagnostic difficulties and prospects for treatment]

We describe two patients admitted to our hospital because of renal failure. We diagnosed multiple myeloma in both. One patient had high peripheral blood eosinophilia, that normalized during therapy. The patients were treated with melphalan and prednisone, hemodialysis and one patient with recombinant human erythropoietin. Both patients responded to that treatment: after 7 months the number of plasma cell in bone marrow decreased from 65 to 10% in the first patient, and from 38 to 4% in the second patient. They returned to work and were on maintenance hemodialysis 2 times weekly. The patients have been observed for 21 months.

Regression of left ventricular hypertrophy in hypertensive patients after 1 year of treatment with rilmenidine: a double-blind, randomized, controlled (versus nifedipine) study

OBJECTIVE

To assess the effect of 1-year treatment with rilmenidine, an oxazoline compound that exerts its antihypertensive effects through binding to imidazoline receptors in the brainstem, on left ventricular hypertrophy (LVH) secondary to essential, mild-to-moderate hypertension [supine diastolic blood pressure (DBP)95-115 mmHg].

METHODS

We performed a double-blind, randomized, controlled (versus slow-release nifedipine) trial. Adjustment of treatment took place every month (M) between inclusion (MO) and an evaluation after 6 months (M6), then during M9 and after 1 year (M12) to achieve supine DBP values < or = 90 mmHg. Patients were dropped from our study if they had DBP> 95mmHg during two consecutive visits or DBP>115 mmHg on one occasion. The daily dosage of rilmenidine was 1 mg, and could be increased to 2 mg/day. The daily dosage of slow-release nifedipine was started from the beginning at the maximum dosage of 40 mg/day, so that there was no true adjustment of treatment despite the allocation of patients to a different unit in the case of DBP> 95 mmHg. The primary criterion was the change in left ventricular mass index (LVMI, g/m2), assessed by echocardiography, between MO and M12 for patients who completed the trial.

RESULTS

After a 1-month placebo run-in period, 76 patients were selected and 73 were included (35 treated with rilmenidine and 38 treated with nifedipine). Fifteen patients withdrew from the study and two completed the study with a major deviation from protocol, leaving 56 patients (24 treated with rilmenidine and 32 treated with nifedipine) for a per-protocol analysis. Baseline demographic characteristics and history of arterial hypertension for the rilmenidine and nifedipine groups were similar, for included patients and for those taken into account for the per-protocol analysis. Between MO and M12, DBP in members of the per-protocol population was adequately controlled for those in the rilmenidine group (102.7+/-4.6 versus 88.5+/-7.1 mmHg, respectively) and for those in the nifedipine group (102.7+/-5.1 versus 85.6+/-79 mmHg, respectively). During MO, LVMI of patients in the rilmenidine group (176.9+/-41.3 g/m2) was slightly higher than that of patients in the nifedipine group (172.6+/-35.1 g/m2). During M12, LVMI was observed to have decreased both for patients in the rilmenidine group (to 154.8+/-40.2 g/m2, a decrease of 22.1+/-23.3 g/m2, P< 0.001) and for those in the nifedipine group (to 145.6+/-36.4 g/m2, a decrease of 26.9+/-29.5 g/m2, P< 0.001) but the difference between these two groups was not significant (P= 0.5).

CONCLUSION

One-year treatment with a daily dosage of 1 or 2 mg rilmenidine achieves a significant reduction of left ventricular mass, which is not statistically different than that occurring with a daily dosage of 40 mg of slow-release nifedipine.

Solitary neurofibroma of the mandible: case report and review of the literature

A case is presented of a neurofibroma of the mandible without recurrence 6 years after surgery. Search for neurofibromatosis was negative. Eradication of the tumor was explained by the extent of the operation that was performed.

Duration of effect of single daily dose methyldopa therapy

1 Methyldopa has a short plasma half-life, but longer duration of antihypertensive effect. A single bedtime dose of methyldopa has been recommended to improve compliance and decrease side effects. 2 This double-blind crossover study was designed to determine the duration of antihypertensive effect of methyldopa by comparing hourly supine and standing blood pressures, throughout the day during placebo, single morning dose, and single evening dose methyldopa therapy in 10 patients. The major side effects, drowsiness and dry mouth were assessed by visual analogue scale. Exercise blood pressures were measured 6, 12, 18 and 24 h after the dose. 3 The antihypertensive effect of methyldopa peaked after 6-9 h and declined thereafter with a half-life of approximately 10 h. Little antihypertensive effect remained 24-26 h after the dose. The time course of the reduction in blood pressure during exercise and of the major side effects paralleled the antihypertensive effects. 4 The results suggest that the duration of antihypertensive effect of methyldopa is long enough to permit twice daily dosing, but that single daily dosing cannot be recommended for most patients. The study illustrates the importance of knowing the time of the last methyldopa dose when assessing blood pressure measurements in patients taking the drug.

The effects of desmethylimipramine on the pharmacological actions of alpha methyldopa in man

The effect of pretreatment with the tricyclic antidepressant desmethylimipramine (DMI) 75 mg daily for 3 days on the action of oral methyldopa 750 mg was investigated in a double blind crossover design in volunteers. DMI pretreatment caused a small but not significant increase in supine systolic and diastolic blood pressure and heart rate. However, the effects of methyldopa on lying and standing blood pressure and heart rate were not markedly altered by pretreatment. In particular, the fall in standing blood pressure after methyldopa was present with and without DMI and the sedative action of methyldopa was similar. DMI alone reduced saliva production. No evidence was found that tricyclic antidepressant drugs significantly modify the hypotensive effect of methyldopa in man.

Sympathetic nervous function and renin activity in hypertensives on long term drug treatment with propranolol, methyldopa or bendrofluazide

Plasma noradrenaline and plasma renin activity were measured as indices of sympathetic activity and renin angiotensin system in similar groups of hypertensive patients receiving either propranolol, bendrofluazide or methyldopa. Plasma renin activity was similar in the propranolol and methyldopa groups and significantly lower (p less than 0.01) in both these groups than the diuretic treated subjects. Plasma noradrenaline was significantly lower (p less than 0.01) on methyldopa than either propranolol or bendrofluazide. These different effects on the renin angiotensin system and the sympathetic nervous system of these drugs may be relevant in the choice of long term therapy in hypertension.