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Introduction: Serum levels of β2-microglobulin (b2M) are significantly higher in patients with end stage renal failure undergoing hemodialysis (HD) and its accumulation accelerates Dialysis Related Amyloidosis (DRA). In HD patients low-flux dialysis, intravenous (IV) iron (administered for the treatment of anemia) affects ß2M removal during dialysis. IV iron also affects the oxidation of plasma proteins, including b2M., Aims: To examine the effect of intravenous iron therapy on ß2M levels and oxidation in HD patients treated with high-flux compared with low-flux dialyzers., Methods: Sixteen HD patients on chronic maintenance IV iron therapy were studied. Half of the patients were allocated to high-flux and half to low-flux dialysis. After five weeks, each patient was assigned to the second dialyzer. After two weeks of treatment with each dialyzer, blood samples were taken and serum levels of β2M were measured. In addition, the hematocrit and iron status were measured. Part of the samples were used to evaluate oxidized β2M., Results: A significant increase in β2M levels was found with low-flux dialysis, which further increased during dialysis with IV iron administration. High-flux dialysis therapy significantly lowered the β2M levels, with a clear decrease during the dialysis session, that was unaffected by IV iron administration. A significant decrease in β2M oxidation was found during highflux, but not low-flux dialysis., Conclusions: High-flux dialysis is more effective than lowflux in decreasing the levels and oxidation of ß2M. These observations may have significance in improving iron therapy, aimed to decrease or attenuate the appearance of DRA.

Background: Infectious diseases cause a systemic inflammatory reaction. In some cases of meningitis it is difficult to determine whether the disease is of bacterial, viral or non-infectious origin. In order to distinguish between bacterial and viral diseases the levels of various inflammatory markers are used to determine the severity of the disease and the clinical prognosis., Objective: The purpose of this study was to determine whether the levels of different markers can be used to distinguish between bacterial or viral meningitis or non-infectious neurological disease., Methods: Patients with bacterial meningitis (n= 8), viral meningitis (n= 17), non-infectious neurological diseases (n = 17) and healthy subjects (n = 15) were studied. The levels of soluble CD14 (sCD 14), interleukin-6 (IL-6), interleukin-1beta (IL-1beta) and soluble adhesion molecule-1 (sICAM-1) were determined in the blood of all participants and in spinal fluid only in patients who had clinical indication to perform lumbar puncture., Results: All the patients showed significant differences in the levels of blood and CSF markers measured compared to healthy subjects. In the blood, although some differences were significant, there was overlapping between all values of the measured markers in patient blood samples excluding IL-6, for which levels were significantly different between the bacterial and viral meningitis. Interestingly, the levels of all markers showed significant differences among all groups of patients., Conclusions: Among the blood markers examined, IL-6 can be used to distinguish between bacterial and viral diseases. However, the levels of cytokines examined in CSF, can serve to distinguish between bacterial and viral meningitis and non-infectious diseases.

Background: In hypertensive patients, the polymorphonuclear leukocytes (PMNLs) are primed, concomitantly contributing to oxidative stress and chronic low-grade inflammation. Furthermore, in the Sabra rat model of salt-induced hypertension, priming of PMNLs, oxidative stress and inflammation antecede the development of hypertension. In the present study we tested the hypothesis that PMNL priming and PMNL and white blood cells (WBC) counts are interrelated with blood pressure values. Therefore, we have evaluated the correlation between WBC and PMNL counts, PMNL priming parameters and blood pressure in untreated essential hypertension patients (EH) and age and gender healthy controls., Methods: Diastolic blood pressure (DBP), systolic blood pressure (SBP) and mean arterial pressure (MAP) values were correlated by linear regression analysis with the rates of superoxide release from separated PMNLs and with WBC and PMNL counts., Results: The rate of superoxide release from PMNLs was higher in EH patients compared to their healthy controls. The rate of superoxide release from PMNLs correlated with SBP, DBP and MAP. WBC and PMNL counts were all significantly correlated with blood pressure values., Conclusion: The results of the study offer an additional mechanism involving primed PMNLs and elevated PMNL counts in the pathogenesis of hypertension and its late cardiovascular complications.

Introduction: Oxidative stress (OS), inflammation and insulin resistance are among the mechanisms that have been recently implicated in pathogenesis of essential hypertension (EH). Peripheral polymorphonuclear leukocytes (PMNLs) are primed in EH patients, releasing uncontrolled superoxide anion contributing to OS and chronic low-grade inflammation in these patients. PMNL priming correlates with insulin resistance and with PMNL intracellular calcium ([Ca2+]i). Recent studies have attributed additional anti-oxidative characteristics to the anti-hypertensive drug Lercanidipine (Vasodip), a third generation calcium-channel blocker., Aim: To evaluate possible novel effects of two months of Lercanidipine treatment on systemic and PMNL-related inflammation and on insulin resistance in EH patients., Methods: Fifteen non-smoking EH patients with untreated mild to moderate high blood pressure (BP) and age- and gender-matched healthy controls (HC) were included in the study. Low-grade inflammation was expressed by PMNL counts and apoptosis, by plasma fibrinogen, CRP and albumin (as a negative acute phase reactant) levels. Fasting serum insulin levels served as a marker of insulin resistance., Results: Inflammation parameters and insulin levels were higher in EH compared to HC. PMNL counts, fibrinogen and insulin levels positively correlated with mean arterial blood pressure values. Two months of Lercanidipine treatment showed a significant decrease in BP, PMNL counts and apoptosis, CRP and serum insulin levels and a significant increase in serum albumin levels., Conclusion: The authors imply that the low-grade systemic inflammation and insulin resistance detected in EH patients may be attenuated by the use of Lercanidipine, adding new unknown anti-inflammatory properties to this calcium channel blocker.