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Daria Pašalić
Editor-in-Chief
Department of Medical Chemistry, Biochemistry and Clinical Chemistry
Zagreb University School of Medicine
Šalata ul 2.
10 000 Zagreb, Croatia
Phone +385 (1) 4590 205; +385 (1) 4566 940
E-mail: dariapasalic [at] gmail [dot] com

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P13-1

Pancirov D1, Radišić Biljak V2, Stjepanović G3, Čepelak I4. P13-1: Hematologic markers of anemia and C-reactive protein (CRP) in patients with stable chronic obstructive pulmonary disease. Biochemia Medica 2009;19(Suppl 1):S168-S169.
1Department for biochemistry and hematology diagnostics, Dr. Ivo Pedišić General hospital, Sisak, Croatia
2Sunce IHC, International Health Centre, Zagreb, Croatia
3Department for pulmology, Dr. Ivo Pedišić General hospital, Sisak, Croatia
4Department of Medical Biochemistry and Haematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
Corresponding author:laboratorij [at] obs [dot] hr
 
Abstract
 
Introduction: The goal of this investigation was to determine the value of hematologic markers of anemia and CRP in patients with stable chronic obstructive pulmonary disease, in purpose to define the relative portion of anemia, degree of systemic inflammation, and occasional correlation of cited data in these patients.
Material and methods: The investigation included 109 patients with COPD (forced expiratory volume in 1 sec. of expiration, FEV1 = 41 ± 14%) and 51 healthy examinee (FEV1 = 106 ± 15%). In accordance with GOLD guidelines, the patients were divided in three subgroups: II, III, IV, and according WHO criteria for anemia (Htc < 0.36 L/L for females, and < 0.39 L/L for males) in two subgroups: with and without anemia. Concentration of CRP in serum was determined by immunoturbidimetric method with analyzer Dimension Xpand Plus (Siemens Healthcare Diagnostics), and hematologic markers were determined by a method of flow cytometry by Cell Dyn 3200 analyzer (Abbott Diagnostics).
Results: Anemia was present in 21% of patients with COPD. Significant difference for RBC, hemoglobin and hematocrit between total number of patients and controls does not exist, as well as between all the subgroups according to GOLD guidelines and controls. Concentration of CRP is statisticaly significantly higher in a group of all COPD patients (P < 0.001), all the subgroups according to GOLD guidelines (II, III, IV: P < 0.001), and subgroups with and without anemia (P < 0.001) in correlation with controls. ROC analysis showed good diagnostic effectiveness of CRP.
Conclusion: CRP concentration is significantly elevated in all investigated subgroups of COPD examinees in relation with the controls, pointing to continual presence of inflammation. Anemia is present in 21% of patients, that mostly belong to GOLD subgroup III.
P13-2
Radišić Biljak V1, Đurić K1, Čepelak I2, Žanić Grubišić T2, Pancirov D3, Sorić J1. P13-2:C-reactive protein in stable chronic obstructive pulmonary disease. Biochemia Medica 2009;19(Suppl 1):S169-S170.
1Sunce IHC, International Health Centre, Zagreb, Croatia
2Department of Medical Biochemistry and Haematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
3Department for biochemistry and hematology diagnostics, Dr. Ivo Pedišić General hospital, Sisak, Croatia
Corresponding author:vanja [dot] radisic [at] gmail [dot] com
 
Abstract
 
Background: Systemic inflammation is very important feature of the chronic obstructive pulmonary disease (COPD). We studied serum concentration of C-reactive protein (CRP) in patients with different stages of COPD and we compared it with concentration of CRP in healthy controls.
Materials and methods: Concentration of CRP was determined in sera of COPD patients (FEV1 = 41 ± 14%), N = 109; and in healthy controls (FEV1 = 106 ± 15%), N = 51. Patients were divided into three subgroups (II, III, IV) according to GOLD guidelines. Concentration of CRP was determined with immunoturbidimetric method on Dimension Xpand Plus analyzer (Siemens Healthcare Diagnostics, USA).
Results: Concentration of CRP was increased in COPD patients (median 13.78 mg/L, IQR = 8.44-44.46) compared with healthy controls (median 7.70 mg/L, IQR = 3.36-9.34), P < 0.001. Specificity and sensitivity of selected marker was analysed by the receiver operating characteristics curve. CRP showed very good diagnostic accuracy in COPD patients (AUC = 0.808, 95% CI = 0.739-0.866, P = 0.001). For cut-off value of 11.86 mg/L for CRP concentration, specificity was 94%, and sensitivity was 60%. Concentration of CRP in subgroups were as follows: subgroup II – median 12.98 mg/L, IQR = 8.35-27.67; subgroup III – median 12.73 mg/L, IQR = 7.65-60.07; subgroup IV – median 23.18 mg/L, IQR = 11.21-39.17. There was no significant difference in CRP concentration between subgroups of patients with COPD.
Conclusion: The proposed cut-off value for CRP concentration might be used as biochemical parameter who would be of assistance in distinguishing patients with COPD, however, could not be used for grading severity of disease in patients with COPD.
P13-3
Rumora L, Grdić Rajković M, Puclin G, Posavac K, Čepelak I, Žanić Grubišić T. P13-3:Protein thiol oxidation and paraoxonase 1 activity in patients with chronic obstructive pulmonary disease. Biochemia Medica 2009;19(Suppl 1):S170-S171.
Department of Medical Biochemistry and Haematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
Corresponding author:tihana_zanic [at] yahoo [dot] co [dot] uk
 
Abstract
 
Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by chronic local and systemic inflammation, and increased oxidative stress. Cigarette smoking is the major etiological factor responsible for COPD. Reactive oxygen species, generated by cigarette smoke and by activated lung and peripheral blood cells, may disturb redox balance through oxidation of plasma proteins. Paraoxonase 1 (PON1) is an HDL-associated enzyme with three cysteine residues in positions 41, 284 and 353; C41 and C353 form a disulfide bond while C284 is free. The enzyme has both antiatherogenic and antioxidative properties.
Materials and methods: The study was carried out on 107 COPD patients (32 smokers, 28 ex-smokers, 47 non-smokers) and 45 healthy volunteers (16 smokers, 13 ex-smokers, 16 non-smokers). Serum protein thiols were measured by a spectrophotometric method using 5,5’-dithiobis-(2-nitrobenzoic acid) (DTNB). Paraoxonase activity of PON1 was assayed by monitoring the release of p-nitrophenol from paraoxon in the absence (basal PON1 activity) or in the presence of NaCl (salt-stimulated PON1 activity).
Results: Proteins thiol concentration was significantly decreased in COPD patients compared with healthy individuals, and this reduction of free sulfhydryl groups was not dependent on smoking status or disease severity (GOLD grade). In addition, both basal and salt-stimulated PON1 activity were also significantly lower in COPD patients.
Conclusion: The decrease in protein thiols observed in COPD patients suggests the increased oxidative stress in those individuals which may explain in part the reduction in PON1 paraoxonase activity.
P13-4
Šegulja D, Zovko V, Alpeza-Viman I. P13-4: Determination of procalcitonin in pulmonary patients. Biochemia Medica 2009;19(Suppl 1):S171-S172.
University hospital for lung diseases Jordanovac, Zagreb, Croatia
Corresponding author:dragana [dot] segulja [at] gmail [dot] com
 
Abstract
 
Aim: Aim of the study was to evaluate diagnostic value of procalcitonin concentration in serum in relation to other inflammation markers (CRP, fibrinogen, WBC count, erythrocyte sedimentation rate) among patients treated in Clinic for lung diseases Jordanovac. Microbiological processing is taken into account.
Patients and methods: Testing included 40 patients (17 women and 23 men) with the most frequently diagnosed diseases in our institution (55% malignant diseases, 12% pneumonia, 5%, tuberculosis, 2% sarcoidosis, autoimmune diseases, other). CRP concentration was measured by a latex immunoturbidity method on instrument Hitachi 912. Erythrocyte sedimentation rate was determined on instrument Sedi 15, and procalcitonin concentration was measured by method Enzyme-Linked Fluorescent Assay-ELFA (miniVIDAS bioMérieux). Test linearity for PCT is 0.05-200 ug/L. According to the manufacturer, risk for the development of sepsis and/or septic shock can be excluded in patients with PCT concentration < 0.5 ug/L.
Results: All patients had elevated concentrations of CRP and sedimentation rate regardless of diagnosis. Microbiological tests were done in 31 patients. 15 patients had positive findings. Most of them had procalcitonin concentration < 0.5 ug/L with a colonization, localized infection or M. tuberculosis infection. PCT concentrations > 2.0 ug/L were found with severe bacterial and fungal infections and in one case of sterile hemoculture with radiological findings which indicated to pneumonia. One patient had extremely high PCT (42.73 ug/L) but there wasn’t enough clinical data to support this finding.
Conclusion: CRP has proven to be sensitive marker inflammation. Although our investigation suggests that the PCT is more specific marker for systemic inflammation, it is necessary to do additional tests on a large sample for relevant assessment of its diagnostic value in pulmonary patients.
P13-5
Somborac A1, Ostojić S2, Detel D2, Pancirov D3, Varljen J2, Čepelak I1. P13-5: Dipeptidyl peptidase IV activity in patients with chronic obstructive pulmonary disease. Biochemia Medica 2009;19(Suppl 1):S172-S173.
1Department of Medical Biochemistry and Haematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
2Department of Chemistry and Biochemistry, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
3Department for biochemistry and hematology diagnostics, Dr. Ivo Pedišić General hospital, Sisak, Croatia
Corresponding author:icepelak [at] yahoo [dot] com
 
Abstract
 
Background: Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease with the progressive course. It is characterised by airflow limitation and abnormal inflammatory response of lungs to noxious particles and gases. Inflammation is associated with the infiltration of immune cells which release pro-inflammatory mediators into the lung. Dipeptidyl peptidase IV (DPP IV) is specific serine exopeptidase which selectively removes X-Pro dipeptide from different pro-inflammatory neuropeptides, chemokines, cytokines and other biomolecules. Thus DPP IV contributes to their functional activation or inactivation. In this work we examined DPP IV activity in sera of COPD patients and possible correlation with progression of the disease.
Materials and methods: We obtained serum from patients with stable COPD (GOLD stages II to IV; N = 110) and healthy volunteers (N = 91). DPP IV activity was determined using the spectrophotometric method with the glicyl-prolyl-p-nitroanilid as substrate.
Results: DPP IV activity in sera from COPD patients is significantly reduced comparing to healthy controls (P < 0.001). However, there were no significant differences in DPP IV activity between different stages of disease (GOLD classification).
Conclusions: Decreased activity of DPP IV found in COPD patients might be involved in attenuated proteolytic cleavage of pro-inflammatory mediators released by immune cells, thus contributing to the development of local and systemic inflammation in COPD.