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Introduction: Oxidative stress could play a role in the development of preeclampsia. Ischemia modified albumin (IMA) is a oxidatively modified form of albumin., Objective: To evaluate the levels of salivary and serum IMA and IMA: albumin ratio (IMAR) in preeclampsia and with its severity and investigate their correlation with the fetal birth weight., Methods: This case control study was conducted on 50 preeclamptic (32 mild and 18 severe cases) and 50 normal pregnant controls. Blood and saliva were obtained to measure albumin, IMA and IMAR was calculated., Results: serum and salivary IMA and IMAR were significantly increased in preeclampsia. Although the increase in serum was in accordance with the severity, it was not so in the saliva. Yet, salivary IMAR showed significant difference between controls and mild preeclampsia. There was a negative correlation between IMA and albumin in both serum and saliva. A weak negative correlation was seen between the serum IMAR and fetal birth weight (r = -0.293; p < 0.05), but not with salivary IMAR., Conclusion: This study is an evidence for involvement of oxidative stress in the pathogenesis of preeclampsia, which is reflected in serum and saliva. Salivary IMAR could be a better marker for early prediction of preeclampsia.

The underlying causes and mechanisms of pre-eclampsia (PE), its exact etiology remains unclear and poorly understood. Hypoxia, ischemia, and oxidative stress induced by free radicals have been associated with development of PE. Ischemia-modified albumin (IMA) is a chemically modified albumin due to oxidative stress. IMA, a serum biomarker of hypoxia, ischemia, and oxidative free radicals is a potential biomarker for PE. The aim of the current proposal was to study serum IMA as a diagnostic biomarker of pre-eclampsia (PE) in pregnant females and to evaluate the correlation between serum IMA and different markers of pre-eclampsia (BP, urinary protein, LFT, KFT, serum total protein & uric acid).A total of 60 pregnant women aged between 21 and 35 years were recruited (30 PE cases and 30 normal pregnancy). Serum IMA was measured by spectrophotometric method developed by Bar-Or D. BP and biochemical parameters (urinary protein, LFT, KFT, serum total protein & uric acid) were also assayed and compared between two groups. Correlation analysis was done for analyzing the relationship between serum IMA and biochemical parameters.The mean serum IMA was significantly higher in normotensive pregnant females (0.93 ABSU) than PE cases (0.71 ABSU). Kidney function and liver function parameters were more deranged in PE cases than in controls. Serum IMA was positively correlated with serum creatinine (r=0.322), serum uric acid (r=0.54) and urinary protein (0.376) whereas negatively correlated with total serum bilirubin (r=−0.515) and serum albumin (r=−0.380).Elevated serum IMA concentrations in normotensive pregnant controls as compared to PE cases suggest that apart from ongoing ischemia and oxidative stress in placenta IMA values are influenced by many other mechanisms in pregnancy. [ABSTRACT FROM AUTHOR]

Background: Respiratory distress syndrome is a critical respiratory illness that affects premature newborns and can lead to very severe, unfavorable consequences as a result of hypoxia, Aim: To assess the relationship between Ischemia Modified Albumin (IMA) and the prognosis of RDS in preterm patients, Patients and methods: This was prospective case control study performed on 90 newborn infants in the NICU of Al-Zahra University Hospital, Faculty of Medicine for Girls, and Tala General Hospital in Menoufia governorate from November 2020 to November 2021. Patients were divided into two groups: Preterm group (n=45, GA=36 weeks) and full term group (n=45, GA>36 weeks). They followed up by clinical examination and laboratory investigational study until their outcome either discharge either death. Results: IMA was significantly higher among patients who needed mechanical ventilation. Duration of mechanical ventilation correlated positively with IMA levels, with statistical significance difference. Increased IMA levels were associated with an increased total hospital stay duration. Regarding outcome, IMA levels were significantly higher among patients who died, with a statistically significant difference. At a cut-off value equal to 222.8, IMA had 100% sensitivity and 98.3% specificity to predict a poor outcome for pre-term infants with respiratory distress, Conclusion: Ischemia-modified albumin could be used as a diagnostic modality for respiratory distress syndrome among premature neonates with high reliability and reproducibility. It could also be utilized as a predictor of disease outcome. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine dynamic thiol-disulphide homeostasis (TDH) parameters and ischemia modified albumin (IMA) levels in calves with neonatal diarrhea and compare with healthy controls. A total of 50 calves were included in the study. There were 25 calves in both diarrhea and healthy groups. Serum native thiol, total thiol, disulfide and IMA levels were measured using new methods. Native thiol (P=0.025) and total thiol (P=0.041) values decreased significantly in calves with neonatal diarrhea compared to the healthy control group. Disulphide (P= 0.133), disulphide/native thiol ratio (P=0.001) and IMA (P=0.0018) parameters were lower in healthy group, and the difference between the two groups was significant for the parameters other than disulphide. This study shows that TDH is impaired in neonatal calf diarrhea and IMA levels are increased due to oxidative stress. [ABSTRACT FROM AUTHOR]

Background: Children are significantly more likely to be malnourished due to their special nutritional needs for growth. Ischemia Modified Albumin (IMA) is a new marker of ischemia that occurs when serum albumin comes in contact with the heart's ischemic tissues. IMA has been used to measure several acute conditions but has never been used to measure acute malnutrition in children. This study aims to examine albumin and IMA in malnourished children to see if they can be used as markers of malnutrition in children. Materials and Methods: 84 children were examined (41 boys and 43 girls, mean age (SD): 6.18 (3.89); range: 0.92-16.75 years) who were referred to the hospital from 20 October to May 20, 2020. A physician performed nutrition examinations on children. BMI of less than 18.5 was considered malnourished children. The hypothesis of the normality of variables was accepted with the Kolmogorov-Smirnov test. To study the difference in variables means at groups, the T-test and Phi-Correlation were used. The ANCOVA was used to study the relationship between variables and Albumin and IMA values at different levels. Results: The amount of albumin in the study group ranged from 4.10 to 5.15 (mean ± SD 4.82± 0.17), and the IMA range in the study group was 0.56 to 1.25 (mean ± SD 0.74± 0.13). The amount of albumin in the control group ranged from 4.19 to 5.19 (mean ± SD 4.83± 0.18), and the IMA range in the control group was 0.44 to 1.11 (mean ± SD 0.67± 0.13). No significant difference was observed between the albumin values (p-value = 0.752) between malnourished and healthy children. However, the IMA level in malnourished children was significantly higher (p-value = 0.19) than in healthy children. Conclusions: Although albumin was not significantly different between the two groups, the IMA of malnourished children was significantly higher than that of healthy children. This result means that IMA can be used as a marker for malnutrition in children. This study is a preliminary study showing that IMA can be used as a malnutrition marker in children with malnutrition and we believe that it will contribute to the literature. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate to usability of ischemia modified albumin (IMA) and IMA/albumin ratio (IMAR) values in the follow-up of ALF patients. King College criteria (KCC) and Model for End-Stage Liver Disease (MELD) score are the most commonly used criteria in the follow-up of patients with acute liver failure (ALF). However, these criteria cannot always predict prognosis and the need for liver transplantation (LT). Materials and Methods: IMA and IMAR values of 23 ALF patients and 43 healthy volunteers were measured. Then IMA and IMAR values were compared with KCC and MELD score to predict LT requirement and prognosis in ALF patients. Results: IMA and IMAR values were significantly higher in ALF patients compared healthy volunteers (p=0.001, p=0.001; respectively). IMA and IMAR values predicted LT requirement in ALF patients such as KCC and MELD (=30) score (p=0.006, p=0.04, p=0.001, p=0.03; respectively). IMA values were found to better than KCC in predicting mortality (p=0.008, p=0.02; respectively). MELD (=30) score failed to predict mortality (p=0.44). Conclusion: IMA and IMAR values can be used as diagnostic biomarkers in ALF patients. IMA is a better prognostic biomarker in the follow-up of ALF patients. [ABSTRACT FROM AUTHOR]

Background/Aim: Oxidative stress is known to increase in patients receiving anesthesia before undergoing surgery. Since newborns are more sensitive to oxygen-free radicals, the effects and characteristics of anesthesia methods that are used for pregnant women require analysis. This study aimed to evaluate the effects of spinal and general anesthesia on oxidative stress by investigating thiol disulfide and ischemia modified albumin (IMA) concentrations in the cord blood of patients undergoing cesarean section (Csection) via spinal or general anesthesia. Methods: This cross-sectional prospective study included 60 patients who were indicated for elective cesarean section. Patients with chronic disease, pregnancy complications and/or required emergency cesareans were not included. Group 1 (n = 30) underwent general anesthesia, and Group 2 (n = 30) underwent spinal anesthesia during their C-sections. Thiol-disulfide levels were evaluated concurrently in all blood samples taken from the umbilical artery remaining on the placental side. Results: The mean age (SD) of the mothers was 30.6 (4.4) years and the mean gestational age (SD) was 39.0 (0.9) weeks. Gestational age, birth weight, and first and fifth min Apgar scores of the two groups were similar. The mean (SD) native thiol (362.4 [63.8]; 323.2 [45.8]), total thiol (409.6 [70.2]; 363.5 [46.1]), and disulfide values (23.6 (5.4); 20.2 (4.3)) were significantly higher in group 1 than group 2, while the median (interquartile range [IQR]) values of IMA (0.89 (0.85-max 0.92); 0.85 (min 0.82-max 0.879) were significantly higher in group 2 than group 1 (P < 0.05). Conclusions: As general anesthesia may cause a higher degree of oxidative stress, selecting the appropriate anesthetic technique may be especially important for risky pregnancies in which increased oxidative stress in the mother and baby may be critical for the outcome. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the role of oxidative stress in endometriosis patients by determining dynamic thiol/disulfide homeostasis and ischemia modified albumin (IMA) levels. Patients and Methods: This prospective case-controlled study was conducted at a tertiary gynecology clinic in Istanbul, Turkey. 86 patients previously diagnosed with endometriosis and persistent endometriomas were included in the study group. 60 patients who visited the clinic during the study period for routine gynecological control were included in the control group. Thiol/disulfide parameters and IMA levels were determined from the serum samples. Results: When the thiol/disulfide parameters were compared between the study and the control group no significant difference was observed (p=0.49). Mean disulfide level in the control group was 18.58 ± 5.73 µmol/L and in the study group was 18.61 ± 7.37 µmol/L. Levels were statistically similar in both groups (p=0.98). In addition, there were no differences between the groups in terms of IMA and albumin levels. Conclusion: The results of this study revealed no significant difference in the dynamic thiol/disulfide homeostasis among the endometriosis patients. Although, it has been accepted as a potential oxidative stress marker in other chronic inflammatory diseases, its use in determining the systemic oxidative stress level in endometriosis patients is limited. [ABSTRACT FROM AUTHOR]

Aim: Seborrheic dermatitis (SD) is a commonly seen chronic inflammatory skin disease that occurs as scaly reddish-brown itchy patches on sebaceous, gland-rich areas of the scalp, face, and trunk. The relation between SD disease and serum IMA (Ischemia modified albumin) levels remains unknown. To investigate the potential role of serum IMA and corrected IMA levels in SD disease. Materials and Methods: Thirty-seven participants who were diagnosed with SD disease and sixty-two healthy subjects (control group) were enrolled in the study. Venous blood samples were collected from each participant, and serum IMA was measured spectrophotometrically using the albumin cobalt binding test. Results: The serum IMA and corrected IMA levels were statistically significant between the groups, and the levels of IMA and corrected IMA were measured as SD patients group 0.70, 0.70 and control group 0.52, 0.51 ABSU (absorbance units), respectively (p < 0.05). Moreover, serum IMA and corrected IMA levels were statistically significant between male and female groups in terms of gender as 0.75 and 0.69 ABSU, respectively (p < 0.05). Serum albumin levels, age, and BMI (body mass index) were statistically insignificant between these groups. Conclusion: Our results show increased serum IMA and corrected IMA levels in patients with SD. Evaluation of IMA and corrected IMA levels in SD disease may contribute to diagnosis and prognosis. Further and comprehensive studies are needed. [ABSTRACT FROM AUTHOR]

Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients. Thirty-four patients on maintenance hemodialysis were included. Prehemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0.268, P<0.05), CRP and IMA (r=0.452, P=0.007), parathormone and IMA (r=0.436, P=0.010), There was a negative correlation between albumin and IMA (r= -0.338, P=0.05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation P<0.05, R=0.506, out of four two variables added statistically significant to the prediction, PTH (P=0.006), CRP (P=0.029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function. [ABSTRACT FROM AUTHOR]

Objectives: The thiol-disulphide (TDH) homeostasis was investigated in a number of disorders. The aim of the present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia-modified albumin. Materials and Methods: A total of 146 participants who were admitted to the emergency department and who consisted of 69 patients and 77 healthy volunteers were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Thiol/disulphide levels were examined using a brand-new method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in the computer system. Results: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03). Conclusion: Total thiol and native thiol levels decrease in obstructive jaundice pathogenesis. Thiol-disulphide homeostasis may be a new biomarker of oxidative stress in obstructive jaundice. [ABSTRACT FROM AUTHOR]

Background: Acute cholecystitis (AC) is caused by chemical and bacterial inflammation of the gallbladder. The use of Tokyo guidelines is recommended in determining the diagnosis of AC and its clinical severity. In the early stages of AC, many cytokines are secreted due to the local inflammatory cell activation, leading to exacerbation of inflammation and organ failure. Ischemia modified albumin (IMA) is a type of albumin that occurs in ischemia and oxidation and is used as a marker of hypoperfusion and oxidative stress. This study aims to investigate the effectiveness of ischemia modified albumin, C-reactive protein (CRP), and some other inflammation parameters in predicting the severity of the AC on admittance. Methods: Forty-two patients diagnosed with AC and 30 healthy individuals in the control group were included in the study. The severity assessment of the patients was performed based on the revised Tokyo guidelines (TG 13). The patients were divided into 3 groups according to severity of the disease. Blood samples were taken from the subjects on admittance. Serum IMA levels were studied using an ELISA kit. SPSS 22.00 package program was used for statistical analysis. Results: Thirty (71.4%) of the participants were in the mild group, while 12 (28.6%) were in the moderate group. There were no patients in the severe group. Leukocyte, CRP, and IMA values in the patient group were higher than those of the control group (p > 0.05). According to the Tokyo classification, a significant difference was found between the groups with mild and moderate grades in terms of CRP and IMA values (p < 0.001 and p < 0.05, respectively). When the cutoff value of IMA was 84 ng/mL, the sensitivity was found to be 76% and specificity was determined to be 40% (AUC: 0.665, p = 0.017, 95% Confidence Interval). Conclusions: It is considered that IMA could be useful in predicting the clinical severity of TG13-based acute cholecystitis and, therefore, could be used in the management of treatment by the clinician such as medical treatment, early surgery, and interval surgery. [ABSTRACT FROM AUTHOR]

Serum ischemia-modified albumin (IMA) is higher in patients with cerebral infarction (CI). In this study, we aimed at studying the association between IMA and CI. Patients with CI were divided to severe stenosis group and mild stenosis group according to the stenosis of vertebrobasilar artery. Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) were used for diagnosis. Cobalt-combined with Albumin test was used to determine the serum IMA levels. Serum IMA levels in patients with CI and healthy volunteers were compared by t test. Receiver operating characteristic (ROC) curve was performed for evaluating the diagnostic efficiency of serum IMA for CI. The correlation between IMA level and the National Institute of Health Stroke Scale(NIHSS) score after treatment was analyzed. Serum IMA levels in patients with CI was increased compared to healthy volunteers(P <.05). Patients in severe stenosis group had a higher serum IMA level than mild stenosis group(P <.05). Serum IMA level at admission was associated with NIHSS score on the 7th day after treatment(P <.05). Serum IMA level was correlated with vertebrobasilar artery stenosis and short-term prognosis in patients with acute CI. [ABSTRACT FROM AUTHOR]

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In the general population Thyroid dysfunctions are common after DM as the most well-known situation to influence the endocrine system. Diabetic patients are at increased danger of thyroid sickness, particularly persons with poor glycaemic control. Ischemia Modified Albumin IMAis novel marker of oxidative stress and tissue ischemia . The pathophysiological occasions of ischemia, including free oxygen radicals and hypoxia, bring about a conformational change of albumin in the N-terminus. The study included 120 subjects, divided into four groups; the first group included 30 patients type2 diabetes mellitus T2DM with newly diagnosed hyperthyroidism HprT, the second group includes 30 patients T2DMwith newly diagnosed hypothyroidism HpoT, the third group included 30 patients diagnosed with T2DM, and the fourth group included 30 healthy control subjects. The concentration of (fasting blood glucose FBG, Glycated hemoglobin HbA1c,Total cholesterol TC, Triglyceride TG,high density lipoprotein HDL, Free Triiodothyronin FT3,Free Thyroxin FT4 and thyroid-stimulating hormone TSH). The results show high significant differences in level of IMA between all studied groups that including diabetic patient with newlydiagnosed hyperthyroidism, diabetic patient with newlydiagnosed hypothyroidism, DM only, and control group [(2.60±1.11), (2.41±1.23), (2.57±5.50), (2.10±0.61)] respectively. Conclusion: Biomarkers IMA could be helpful early diagnosis in monitoring T2DM with newlydiagnosed thyroiddisorders. [ABSTRACT FROM AUTHOR]

Non-ST elevated myocardial infarction (NSTEMI)) diagnosis is difficult when the electrocardiography (ECG) normal and troponin parameters are slightly higher than the normal reference range. This study aimed to assess the IMA (ischemia modified albumin), MDA (malondialdehyde), SOD (superoxide dismutase), and catalase in patients with NSTEMI. The present study included 55 patients with NSTEMI and 55 healthy subjects prospectively. IMA, MDA, SOD, and catalase levels were measured from venous blood obtained from each patient within twelve hours after the onset of symptoms. Differences between the two groups were evaluated with Student's unpaired t -test for parameters with a normal distribution. IMA (3.14 ± 0.06 vs. 1.49 ± 0.03) and MDA (3.14 ± 0.06 vs. 1.49 ± 0.03) were higher, and SOD (1.10 ± 0.03 vs. 2.31 ± 0.02) and catalase (0.54 ± 0.02) vs. 0.22 ± 0.02) were lower in NSTEMI patients than control subjects. There was a significant correlation among IMA, MDA, SOD and catalase. Our data reveal that levels of MDA and IMA were increased, and SOD and catalase levels were decreased significantly in patients with NSTEMI. Blood concentrations of oxidant and antioxidant parameters could assess the oxidative state in patients with NSTEMI. [ABSTRACT FROM AUTHOR]

Background: Acute coronary syndrome (ACS) can be classified to ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. The challenging in acute coronary syndrome remains, as it does not detect the myocardial ischemia by cardiac troponin and creatine kinase-MB. Pro brain-type natriuretic peptide (pro-BNP) was released when the heart need to hard works, which leads of retention fluid and expansion of veins and arteries. Therefore, this hormone release in the response of the changes of pressure in the heart especially for patients with ACS, which be benefit to use as an indicator to evaluate health problem that related with heart. Ischemia modified albumin (IMA) is a form of human serum albumin in which the N-terminal amino acids have been modified by ischemia as the result of acidosis, damaging occurs by free radicals, fatty acids releasing, exposures to free copper and iron, and disturbance of calcium pump. The aim of this study was to estimate the brain natriuretic peptide (Pro-BNP) and Ischemia Modified Albumin (IMA) Levels as early diagnostic markers and correlated with conventional cardiac markers at admission to the emergency department in Acute Coronary Syndrome Patients with ST segment elevation myocardial infarction (STEMI) and Non ST segment elevation myocardial infarction (NSTEMI). Methods: Eighty ACS patients who arrived at the emergency department ED within 6h of clinical symptoms divided to STEMI and NSTEMI, and another 40 of noncardiac chest pain patients (NCCP) as control were enrolled in this study. pro-BNP was measured using a Cobas e 411 Roche, Germany, and IMA was measured using enzymelinked immunosorbent assay (ELISA) kits. Tukey HSD Post hoc ANONA test and One-way ANOVA were used to compare differences of mean between groups. Pearson Correlation was calculated to assess the relation between the biomarkers of this study. Receiver Operating Characteristics (ROC) curve was calculated to estimate the sensitivity and specificity for the use of pro-BNP and IMA as biomarker in the diagnosis and discriminatory ability of ACS. Results: pro-BNP and Ischemia modified albumin were significantly higher in acute coronary syndrome patients (STEMI & NSTEMI) compared to NCCP as controls (1359.82±995.00 and 2698.22±1604.69 vs 180.07±90.24) (p<0.01) for pro-BNP and (96.79±16.03 and 86.00±15.14 vs. 69.42±10.65) for IMA. There were a significant differences in mean of each pr0-BNP and IMA values between two categories of acute coronary syndrome were seen (p<0.01). The correlation of IMA with CK-MB in NSTEMI patients was peak negative (r=-0.41, p<0.01). Receiver operator characteristics (ROC) curve was calculated to define the optimal cut-off values for the use of each pro-BNP and IMA as biomarkers in early diagnostic and distinguish of patients with STEMI and NSTEMI at admission to ED within 6h of clinical signs. ROC curve revealed to the optimal cutoff value for pro-BNP in STEMI was 231 pg/ml and NSTEMI was 400 pg/ml with sensitivity of 85% and 87.5% and specificity of 82.5% and 87.5% with area under curve AUC of 91.9% and 95.7%. The optimal cutoff value for IMA in STEMI was 89 U/ml and NSTEMI was 80.9 U/ml with sensitivity of 85% and 82.5% and specificity of 90.0% and 75.0% with AUC of 88% and 87.5%. Conclusions: We conclude pro-BNP together with IMA assay as promising biochemical markers for the early diagnosis of ACS, and complement together as a good discriminator between STEMI patients and NSTEMI patients. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the potential early diagnostic value of ischemia modified albumin (IMA) and D-dimer in testicular torsion.Material and Methods: A total of 42 prepubertal Wistar-Hannover rats (26-30 days old, weighing 75-125 grams) were used in the study. They were randomly divided into 2 groups as torsion (21 rats) and control (21 rats). Both torsion and control groups were subdivided into three subgroups as 30th, 120th and 240th minutes. Intraperitoneal injection of 70 mg/kg ketamine (Ketalar, Pfizer, Istanbul, Turkey) plus 10 mg/kg of xylazine (Rompun, Bayer, Istanbul, Turkey) were used for general anesthesia. In the control group, scrotal incision was made and the left testis gently extracted. Then, intracardiac blood and testicular tissue were obtained at 30th, 120th and 240th minutes. In torsion group, testicular ischemia was achieved by rotating left testis 720° clockwise and maintained by fixing the testis. Blood and testicular samples were obtained at 30th, 120th and 240th minutes. All animals were sacrificed after completion of the study.Results: There was a statistically significant difference between the IMA and D-dimer levels at 30th, 120th and 240th minutes of torsion group when compared with the control group (p = .001). When compared in terms of pathological changes at 30th, 120th and 240th minutes, significant difference was found for all 3 periods (p = 0.039, p = 0.014, p = 0.03, respectively). The D-dimer and IMA estimated torsion with reasonable accuracy [Area under the curve (AUC)= 0.771 (p = 0.003, 95% confidental interval: 0.620-0.922) and AUC = 0.706 (95% confidental interval: 0.549-0.863, p = 0.022), respectively.Conclusion: The elevated D-dimer and IMA serum levels observed in the experimental testicular torsion modelseem to have a potential role as a serum marker in the early diagnosis of testicular torsion. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the alterations in thiol/disulphide homeostasis and ischemia-modified albumin (IMA) levels in patients with different subtypes of age-related cataract by comparing these values with control cases. Material and Method: Totally 198 eyes of 99 consecutive patients diagnosed with age-related cataract and 188 eyes of 94 control cases were included in the study. In cataract group disease subtypes were recorded as nuclear cataract, cortical cataract, posterior subcapsular cataract or mixed cataract. Results: Native thiol and total thiol levels were significantly lower in cataract group while disulphide, disulphide/native thiol and disulphide/total thiol ratios were significantly higher. IMA and adjusted IMA levels were also significantly higher in cataract group. When patients with different subtypes of cataract were analyzed; there was not any significant difference between patients with different subtypes of cataract regarding the thiol/disulphide homeostasis parameters or adjusted IMA levels. Conclusion: Serum dynamic thiol/disulphide homeostasis is altered in age-related cataract patients in the favor of oxidative stress and there was a significant increase in serum IMA and adjusted IMA levels in cataract patients. However, we did not determine any significant difference in dynamic thiol/disulphide homeostasis parameters or IMA levels between patients with different subtypes of cataract. Since age-related cataract is a common disease that can only be treated with surgery; to prevent or slow down its development is critical. The parameters of dynamic thiol/disulphide homeostasis or IMA may be regarded as new targets for the new treatment modalities in cataract. [ABSTRACT FROM AUTHOR]

Aim: Glaucoma is an optic neuropathy causing progressive impairment of visual functions. We aimed to assess the alterations in thiol–disulfide homeostasis and serum ischemia modified albumin (IMA) levels, which are the determinants of antioxidant status, in patients with primary open-angle glaucoma (POAG). Material and Method: A total of 140 eyes from 70 patients with POAG and 174 eyes of 87 healthy, control cases were included in the study. All study participants underwent a complete ophthalmic evaluation. Alterations in serum thiol–disulfide homeostasis and IMA levels were measured in all participants. Results: IMA levels were significantly higher in glaucoma group (p:0.001). Native thiol, Total thiol and Native/Total thiol ratio were significantly decreased while Disulfide, Disulfide/Native thiol, and Disulfide/Total thiol ratios were significantly higher in glaucoma group (p:0.001). There was no significant difference regarding central corneal thickness (CCT), iridocorneal angle, albumin, IMA and adjusted IMA levels in patients with different stages of glaucoma. In correlation analysis, there was a negative correlation between Native thiol, Total thiol and Native/Total thiol ratio and disease period, number of daily drops required and stage of the disease in glaucoma patients. There was also a positive correlation between Disulfide, Disulfide/Native thiol and Disulfide/Total thiol levels and the disease activity. Conclusion: In patients with POAG, thiol–disulfide homeostasis is disturbed in the favor of pro-oxidant molecules and IMA levels are increased, indicating the presence of augmented oxidative stress. In that aspect, systemic and local anti-oxidant treatments may be new targets in glaucoma treatment. Larger, prospective studies about the role of anti-oxidants in prevention and treatment of POAG are warranted. [ABSTRACT FROM AUTHOR]

Aim: Hyperbilirubinemia causes oxidative stress. Method: We evaluated three oxidative stress markers in hyperbilirubinemic neonates (native/total thiol levels, serum ferroxidase activity and ischemia modified albumin (IMA), comparing these levels to levels in a control group to determine which indicators were the most sensitive. Results: Serum from 124 term infants (67 with pathologic jaundice and 57 controls) were evaluated. Native/total thiol ratio was significantly lower (p:0.021) while disulfide levels were significantly higher (p:0.001) in the jaundiced group. There was no significant difference in ferroxidase (p:0.603) or IMA (p:0.251) levels. Conclusion: Altered thiol/disulfide homeostasis in the favor of disulfide indicates augmented oxidative stress in jaundiced term infants. The lack of alteration in ferroxidase or IMA levels suggests these latter alterations take more time or more severe oxidative stress to become altered or are not as sensitive as the thiol/disulfide ratio to detect oxidative stress states. [ABSTRACT FROM AUTHOR]

Aim: The cardiovascular system is susceptible to thyroid hormones. Many studies show that hypothyroidism is associated with increased cardiovascular risk, functional abnormalities, atherosclerosis, and increased arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AI) are regarded as indexes of arterial stiffness. Oxidative free radicals that occur during ischemic events cause certain chemical changes in the albumin molecules. The ischemia-modified albumin (IMA) has been suggested as an indicator of oxidative stress. Evaluation of oxidative stress markers and parameters of arterial stiffness can shed light on the mechanism of increased cardiovascular risk in patients with hypothyroidism. Material and Methods: For this study, PWV, AI measurements, and IMA levels of 20 untreated patients with overt hypothyroidism (OH), 21 untreated patients with subclinical hypothyroidism (SH), and 30 healthy controls (control-CNT) were evaluated. Patients and the healthy controls' gender, age, weight, height, body mass index, waist circumference, smoking habit and blood biochemical results were recorded. Results: PWV was found to be increased in patients with overt hypothyroidism; however, there was no difference in between subclinical hypothyroidism and control group(p=0,881). Also, PWV had a significant positive correlation with; age, BMI, waist circumference, blood glucose, uric acid, pulse pressure and systolic and diastolic blood pressures. IMA levels were not different in between the groups. Conclusion: Hence the increased CV risk in patients with hypothyroidism is a multifactorial state; the interplay of many factors determines it. Future studies with larger sample sizes are needed to evaluate the possible relationship among IMA levels, arterial stiffness parameters and cardiovascular risk factors in patients with hypothyroidism. [ABSTRACT FROM AUTHOR]

Introduction: Behçet's disease (BD) is a complex multisystemic inflammatory disorder which is characterized by recurrent attacks of acute inflammation. As there is no universally recognized pathognomonic laboratory marker of BD, its diagnosis is still based on clinical findings. Aim: To evaluate the role of calprotectin and ischemia modified albumin (IMA) as biomarkers in the assessment of disease activity of BD. Material and methods: A total of 93 patients with BD and 62 age- and gender-matched healthy controls were included in the study. Disease activity was assessed with the BD Current Activity Form (BDCAF) score. Serum levels of calprotectin, high-sensitivity C-reactive protein (hsCRP) and IMA were measured in the patient and control groups. Results: Serum levels of calprotectin, IMA and hsCRP in patients with BD were higher than those of the healthy control group (p < 0.001 for all). No correlations between calprotectin and IMA, hsCRP, erythrocyte sedimentation rate, CRP, or BDCAF score were found. Conclusions: As the calprotectin level are increased in BD patients, it could be a candidate biomarker which plays a role in BD pathogenesis. [ABSTRACT FROM AUTHOR]

Background and Purpose: Stroke is one of the leading causes of mortality and long-term disability. Prompt diagnosis and treatment of stroke are crucial for a better outcome. A blood test, which serves as a biomarker in rural areas will help in immediately transferring patients to a hospital for thrombolytic therapy. The aim of the present study was to examine the role of ischemia modified albumin (IMA) as a screening biomarker in acute ischaemic stroke. Materials and Methods: Serum samples were collected from 50 patients with acute ischaemic stroke within one, 24, 48, 72 and 144 h of time of admission for IMA. We compared patients' 1st-hour value with age- and sex-matched controls by independent sample t test. p value < 0.05 was considered significant. Results: The serum IMA levels of patients 1st hour (108 ± 8.9) were significantly higher than those of the controls (79 ± 6.3) p < 0.05. The IMA levels showed a steady decline at 1 h (108 ± 8.9), 24 h (94 ± 4.2), 48 h (82 ± 6.1), 72 h (77 ± 5.6) and 144 h (76 ± 3.8) of admission in patients. Conclusion: We observed that serum IMA was significantly higher in stroke patients as compared to controls. IMA was elevated in the acute phase of stroke and had a gradual graded decline over 1 week. We concluded that IMA may be a sensitive and rapid biomarker for screening of early ischaemic stroke in rural settings. [ABSTRACT FROM AUTHOR]

Aim: "Ischemia modified albumin" (IMA) was investigated as a possible biomarker in several diseases such as vascular disorders. We aimed to reveal the possible value of IMA in predicting the development of contrast induced nephropathy (CIN) after coronary angiography in patients with stable angina pectoris. Material and Methods: 106 patients underwent coronary angiography with a diagnosis of stable angina pectoris were included in our study. Basic demographic and clinical findings and laboratory values were recorded and analyzed. Serum creatinine (SCre) levels were also measured 48 hours after coronary angiography and recorded. Amount of contrast agent (CA) given during coronary angiography was recorded. The patients were divided into 2 groups: CIN positive and CIN negative groups. Results: CIN was developed in 14 patients (13%); and IMA levels were similar in CIN positive and negative groups (p>0.05). SCre (both measurements before and after CA administration) was not correlated with IMA levels. There was no association between drug usage and development of CIN (p>0.05). Comorbidities were not associated with the development of CIN (p>0.05) with the exception of hypertension (HT). Presence of hypertension (p=0.0393) and female gender (p=0.0199) was associated with development of CIN. Mean age was 61.3 and 52.3 in CIN positive and negative groups, respectively (p>0.05). Conclusion: Any specific biomarker indicating CIN is not available yet. Most frequently used marker is the measurement of SCre 24-48 hours after administration of CA. We found IMA levels not to be a predictor for the development of CIN. Further investigations will clearly determine the importance of IMA as a biomarker in renal failure developed after CA administration. [ABSTRACT FROM AUTHOR]

The role of oxidative stress in the pathogenesis of phenylketonuria (PKU)-associated disorders has been implicated. Ischemia modified albumin (IMA) is a modified form of serum albumin, which is produced under the conditions of oxidative stress. The aim of this study was to measure the serum level of IMA in the PKU patients and to investigate its ability in predicting the status of oxidative stress in these patients. Fifty treated-PKU patients and fifty age- and sex-matched healthy subjects were included in the study. The blood samples were obtained and the serum level of phenylalanine (Phe) was measured using reverse phase HPLC method. The levels of IMA, malondialdehyde (MDA), gamma-glutamyl transferase (GGT) activity, and uric acid (UA) were determined using colorimetric methods. The levels of serum Phe, IMA, and MDA were significantly higher (p < 0.001) and the level of UA (p < 0.05) was lower in the PKU patients compared to control group. Serum IMA level was positively correlated with MDA (r = 0.585, p < 0.001) and UA (r = 0.6, p < 0.001). An inverse relationship was observed between the serum level of IMA and Phe (r = − 0.410, p < 0. 01). Results of the present study suggest that serum IMA level could be used as a novel marker for the evaluation of oxidative stress in the PKU patients. [ABSTRACT FROM AUTHOR]

Purpose: Oxidative stress has been implicated in several disorders, including acute pancreatitis (AP). Ischemia-modified albumin (IMA), which reflects the ability to bind cobalt, has been found to be elevated in conditions of oxidative stress and tissue hypoxia. This study examined IMA and adjusted IMA levels in patients with AP, and examined the associations of IMA and adjusted IMA levels to the severity of AP. Patients and methods: A total of 42 consecutive patients with AP and 43 age- and sexmatched control subjects were enrolled. Serum samples were obtained from patients with AP on admission as well as 48-72 hours after hospitalization, and from the controls, at the time of enrollment. Adjusted IMA was calculated by multiplying the IMA value of each patient with the ratio of the patient's albumin value and the median albumin value of the study population. The severity of AP was assessed according to the modified Atlanta classification, and the patients were divided into 2 groups: mild AP and severe AP. Results: The serum IMA and adjusted IMA values of patients with AP on admission and those of the controls did not differ (p=0.86 and p=0.99, respectively). The second measurements of IMA and adjusted IMA in the AP group were higher than the first measurements of both the AP group and controls (for all, p<0.01). Among the IMA measurements, only adjusted IMA on admission had the ability to predict the severity of AP. Severe AP was correlated with albumin, and the area under the curve of adjusted IMA values on admission was 0.746 for differentiating patients with severe AP from mild AP with statistical significance (p=0.005). Conclusion: It was shown that IMA and adjusted IMA levels rise with the progression of AP. Lower levels of adjusted IMA predict the severity of AP. Further studies with serial measurements of IMA are warranted to explore the indicative role of IMA in the course of AP. [ABSTRACT FROM AUTHOR]

Aim: In cases with acute ischemia, albumin's binding capacity for transition metals decreases and the resulting albumin is defined as ischemia modified albumin (IMA). In this study, we aimed to investigate the relationship between IMA and clinical follow-up in patients with acute renal failure (ARF). Material and Methods: Levels of IMA were measured in 51(23 male, 28 female) patients with ARF. Venous blood samples were drawn from patients for biochemical tests and put in plain tubes containing the gel. Results: Mean age of male and female patients was 65.39±15.28 and 70.11±15.25, respectively. The IMA levels in 25.5% of the patients were within the normal range (<400 ABSU), while the IMA levels were higher (>400 ABSU) in 75.5% of the patients. The survival rates of patients in IMA <400 ABSU group for 12 and 24 months were 66.7% and for 30 and 32 months it was 33.3%; while the survival rates of patients in IMA ≥400 ABSU group for 12 months were 85.8%, for 24 months were 61.3%, and for 30 and 32 months were 30.6%. No significant difference was determined among survival rates of IMA groups (p=0.719). Conclusion: The comparison between the groups having normal or higher IMA values did not show any significant differences in terms of survival. However, in our study the proportion of patients who needed dialysis during treatment were significantly higher in higher IMA group(IMA≥400 ABSU). Therefore, we believe that higher IMA levels may indicate a necessity for dialysis in patients with ARF. [ABSTRACT FROM AUTHOR]

Ischemia modified albumin is a novel marker of ischemia generated due to hypooxygenation and increased hydroxyl free radicals in low pH. The molecule has been licenced for clinical use as an early marker for acute coronary syndrome in cardiology. Since presence of ischemia might have serious and sometimes devastating effects in perinatology, various researches have evaluated its value in different clinical conditions. This narrative review aims to summarize the literature concerning the value of IMA in perinatology and guide for further research. [ABSTRACT FROM AUTHOR]

The article discusses a study which assessed the serum ischemia modified albumin (IMA) and plasma CoQ10 levels in obese children with metabolic syndrome. Topics covered include the correlation between insulin resistance and lipid profile in obese children with and without metabolic syndrome (MS), and the possibility that obese children have oxidative damage, lipid peroxidation and cardiometabolic risk.

Objective: Nasal polyps (NP) are a chronic inflammatory disease of the nasal mucosa; their etiology is suspected to involve oxidative stress. Growth differentiation factor-15 (GDF-15), brain natriuretic peptide (BNP), and ischemia-modified albumin (IMA) are biomarkers used especially in the early diagnosis and follow-up of cardiovascular diseases. The aim of this study was to assess levels of serum GDF-15, BNP, and IMA in patients with NP and to compare them with those of healthy subjects.Methods: This was a prospective study enrolling 41 patients with NP and 48 healthy controls, all aged 18-65 years and referred to the Department of Otorhinolaryngology, Head and Neck Surgery, between January 2014 and February 2015. After a 12-h fast, venous blood (3mL) was drawn and centrifuged (3000rpm, 10min) to collect serum. Blood samples were drawn before endoscopic sinus surgery in the NP group. Serum GDF-15, BNP, and IMA levels were measured.Results: GDF-15, BNP, and IMA levels of patients with NP were statistically significantly higher than in controls and GDF-15 values were higher than the normal upper limit. GDF-15, BNP, and IMA levels were significantly correlated in both groups.Conclusions: As GDF-15 is a marker of chronic inflammation and oxidative stress, our finding of increased serum GDF-15 in patients with NP supports the hypothesis that its pathogenesis involves chronic inflammation and oxidative stress. [ABSTRACT FROM AUTHOR]

BACKGROUND: Videothoracoscopic surgery leads to general organ hypoperfusion by reducing mean arterial pressure, systemic vascular resistance, and end-diastolic volume index. Oxidative stress occurs as a result of hypoperfusion. Evaluation of the short-term effects of videothoracoscopic sympathectomy on serum ischemia-modified albumin (IMA), malondialdehyde (MDA), and nitric oxide (NO) levels in patients with primary hyperhidrosis was aimed. METHODS: Twenty-six patients who underwent videothoracoscopic surgery were contributed in this study. Venous blood samples were obtained from these patients 1 h before and after the surgery. IMA, MDA, and NO levels were measured in serum samples by colorimetric methods. Albumin concentrations were also measured for each sample, and albumin-adjusted IMA levels were calculated. RESULTS: Postoperative IMA, albumin-adjusted IMA, and MDA values were significantly higher compared to the preoperative values (P = 0.003, 0.027, 0.018, respectively). However, postoperative NO levels were lower than the preoperative values (P = 0.002). There was no significant difference between pre- and postoperative albumin concentrations, and there was no significant correlation between the parameters tested. CONCLUSIONS: We can conclude that elevation in MDA and IMA levels after videothoracoscopic surgery was caused by increased oxidative stress due to minimal ischemia-reperfusion injury after the infusion of CO2 during the surgical process. Videothoracoscopic sympathectomy operation causes a decrease in NO production, and this should be taken in consideration when evaluating nitrosative stress in videothoracoscopic surgery. [ABSTRACT FROM AUTHOR]

Aim: The aim was to evaluate the role of high sensitivity troponin T and ischemia modified albumin (IMA) and in the early diagnosis of acute coronary syndrome (ACS). Materials and Methods: This was a cross-sectional study that comprised of 120 individuals of which 75 were cases and 45 healthy controls. On the basis of clinical history and 12-lead electrocardiogram, initial diagnosis of ACS was made in the cases. High sensitive cardiac troponin T (hs-cTnT) and IMA were measured in all the individuals. Results: Levels of IMA were significantly higher in patients of ACS as compared to those in control group (means: 101.83 [95% confidence interval (CI): 91.96-111.70] vs. 41.11 [95% CI: 38.55-43.67]). By taking the cut-off as >65.23 U/mL for IMA, which was obtained from receiver operating characteristic (ROC) curve, the sensitivity was 91.3%, specificity was 81.1%, positive predictive value (PPV) was 74.4%, and negative predictive value (NPV) was 93.9%. Positive likelihood ratio was 4.83 while negative likelihood ratio was 0.11, whereas the corresponding values in case of hs-cTnT were 95.6% (95% CI: 85.2-99.5), 61.3% (95% CI: 49.5-72.6), 59.7%, 95.8%, 2.47 and 0.07 by taking cut-off as >14 pg/mL. The area under the ROC curves (AUC) of IMA and hs-cTnT at 0-6 h were 0.932 (95% CI: 0.87-0.97, P < 0.001) and 0.797 (95% CI: 0.71-0.86, P < 0.001), respectively. The logistic model combining the two markers yielded sensitivity, specificity, PPV, and NPV of 95.7%, 81.1%, 88.6%, and 92.5% respectively. Conclusion: hs-cTnT and IMA may be useful tools for risk stratification of ACS and can be used together with better accuracy in the early diagnosis of ACS. [ABSTRACT FROM AUTHOR]

Objective: Pre-eclampsia is associated with ischemia and increased oxidative stress, which may lead to modification of plasma albumin to ischemia modified albumin (IMA). Methods: IMA levels were estimated in cord blood of 30 newborns born to pre-eclamptic mothers and compared with 30 normal newborns. IMA was estimated colorimetrically and the results were compared statistically. Results: The levels of IMA were found to be significantly higher ( p < 0.001) in newborns born to pre-eclamptic mothers (0.835 ± 0.02 ABSU) as compared to those born to normal mothers (0.325 ± 0.01 ABSU). Conclusion: IMA may act as a marker of ischemia and oxidative stress in newborns delivered to pre-eclamptic mothers. [ABSTRACT FROM AUTHOR]

Objective: Ischemia modified albumin (IMA) is a marker that is considered as an oxidative stress biomarker. In this study we investigated the IMA levels, an oxidative stress marker, in obesity that leads to free radical formation, in children. Material and Method: Fifty obese and fifty normal weighted children as a control were included in the study. Blood samples were collected for biochemical parameters and serum IMA values. Results: Serum IMA levels were significantly higher in obese group than non-obese group (p<0.001). Median and minimum-maximum IMA values of obese and control groups were 930 (min: 673-max 1332) and 864 (min:496-max:1068) respectively. Conclusion: IMA may be used as an important marker to show oxidative stress in childhood obesity. [ABSTRACT FROM AUTHOR]

Background: Acute pulmonary embolism (PE) is a life-threatening and a relatively common cardiovascular pathology. Although the pathogenesis of PE is well defined, there is no ideal diagnostic biochemical marker. Previous studies showed an increased ischemia modified albumin (IMA) levels in acute PE; however, the relationship between IMA and right ventricular (RV) dysfunction has not been examined. The aim of this study was to evaluate the diagnostic value of IMA and the relationship with RV dysfunction in acute PE. Materials and Methods: A total of 145 patients (70 females) with suspected acute PE was enrolled to the study. Eighty-nine patients were diagnosed with acute PE via computed tomographic pulmonary angiography. Sixty-five patients with similar demographic and clinical characteristics were assigned to the control group. All patients were evaluated for RV dysfunction using transthoracic echocardiography. Results: Serum IMA levels were significantly increased in acute PE compared with control group (0.41 ± 0.06 vs. 0.34 ± 0.11, P = 0.001). There was no relationship between serum IMA levels and RV dysfunction. IMA levels were positively correlated with shock index and heart rate. Receiver operating curve analysis demonstrated that serum IMA levels higher than 0.4 put the diagnosis at sensitivity of 53.85% and at specificity of 85.96%. Conclusions: Although IMA levels are increased in patients with acute PE, it failed to predict RV dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: Subclinical Hypothyroidism (sHT) is characterized by normal serum free thyroxine concentrations with elevated serum thyroid-stimulating hormone concentrations. It has been associated with atherosclerotic cardiovascular disease. The present study was conducted to determine the significance of Ischemia modified albumin (IMA) as a novel marker of atherosclerosis in sHT patients with normal lipid profile. Materials and Method: 50 subclinical hypothyroidism (Isolated TSH elevation) patients of either sex > 18 years and 50 age and sex matched euthyroid controls were subjected to lipid profile, Thyroid profile (T3, T4, TSH) & IMA (marker of Atherosclerosis) estimations. Results: It was observed that sHT patients had normal lipid profile along with normal T3 and T4 levels. Increase in TSH (26.87 ± 1.63) levels were observed in sHT patients compared to controls (p < 0.05). IMA which was expressed in Absorption Units (ABSU) was higher in sHT (0.46 ± 0.06 ABSU) compared to the controls (0.32 ± 0.026) (p<0.05). Conclusion: IMA elevation with progression of sHT signifies atherosclerotic burden before the onset of dyslipidemia. This study might be helpful to plan for better optimizing levothyroxine therapy and avoid the possible future cardiovascular disease in sHT patients. [ABSTRACT FROM AUTHOR]

Myocardial ischemia produces free radicals that catalyze a series of oxidative reactions that damage healthy tissues. The N-terminal sequence of albumin is one of the proteins modified by these highly reactive oxygen species and forms the ischemia modified albumin (IMA). This study involves investigations undertaken in different study groups to assess the levels of IMA. Mean serum IMA levels (U/mL) in patients with ST-segment elevated myocardial infarction (92.1 ± 10.6), non-ST-segment elevated myocardial infarction (87.3 ± 5.95) and unstable angina (UA) (88.9 ± 6.16) were significantly higher than non-cardiac chest pain (77.9 ± 6.69) and also healthy subjects (54.7 ± 17.2) ( p < 0.001). IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this biomarker for early detection of myocardial ischemia. These data indicate a possible role of the IMA test in the early triage of patients with chest pain. [ABSTRACT FROM AUTHOR]

Background: It is well known that mucosal changes and alterations in liver function occur in the experimental obstructive jaundice model. Aims: We aimed to evaluate the effect of resveratrol on obstructive jaundice-induced changes in the small bowel mucosa and liver using ischaemia-modified albumin as a marker of oxidative damage. Study Design: Animal experimentation. Methods: The study used a rodent experimental model of obstructive jaundice, including a sham group (1), a control group (2), and a study group (3). Wistar albino rats were used. Jaundice was produced by ligation of the bile duct in Groups 2 and 3. In Group 3, resveratrol was administered intraperitoneally for 14 days. Results: In terms of the structure and the size of the mucosal villi, significant thickening and blunting were detected in Group 2 compared with Group 1. These changes were significantly less noticeable in Group 3 compared with Group 2. Levels of ischaemia-modified albumin were significantly higher in Group 2 compared with those in Group 1, and they were significantly decreased in Group 3 compared with Group 2. Conclusion: Resveratrol administration to obstructive jaundiced rats reduced the organic effects of obstructive jaundice on small bowel mucosa and liver oxidative stress. We believe that this reduction might attenuate bacterial translocation and systemic effects of secreted cytokines. [ABSTRACT FROM AUTHOR]

Objective: The aim of this cross-sectional study was to determine the oxidant and antioxidant status and a novel ischemia marker - ischemia modified albumin - in the cord blood of smoker and non-smoker pregnants. Methods: This study was performed on 30 smoker and 60 non-smoker pregnant women. Malondialdehyde (MDA), vitamin A and E, total antioxidant capacity (TAC) and ischemia modified albumin (IMA) levels and superoxide dismutase activities (SOD) were determined in the cord blood of the contributors. Results: In the cord blood of the smoker women compared to the non-smokers; MDA (µmol/L) levels increased (5.17 ± 0.25, 3.60 ± 0.06, p = 0.000), IMA (ABSU) levels increased (0.913 ± 0.02, 0.830 ± 0.01, p = 0.050), SOD (U/ml) activities decreased (8.22 ± 0.14, 8.63 ± 0.14, p = 0.045), Vit A(µg/L) (339.06 ± 17.52, 454.91 ± 16.56, p = 0.000) and Vit E (mg/L) levels decreased (2.8 ± 0.15, 7.58 ± 0.38, p = 0.000) and TAC (Mm Trolox) levels decreased (3.25 ± 0.15, 4.08 ± 0.09, p = 0.000), and these differences were statistically significant. We found moderate and strong positive correlations between smoking status and IMA (r = 0.325, p = 0.002) and smoking status and MDA levels (r = 0.636, p = 0.000). Smoking status presented weak, moderate and strong negative correlations with SOD activities, TAC, Vit A and Vit E levels, respectively ( r = −0.237, p = 0.024), ( r = −0.420, p = 0.000), ( r = −0.443, p=0.000), (r = −0.795, p = 0.000). Conclusion: It was determined that smoking cigarette during gestation disturbed the balance between the oxidant and antioxidant system and caused oxidative stress. Increased IMA levels in cord blood of smoker pregnants suggests that smoking during pregnancy causes fetal ischemia. [ABSTRACT FROM AUTHOR]

Abstract: Background: Ischemia modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress. This study reports on the levels and clinical significance of IMA in patients with β-thalassemia major. Methods: Blood specimens were collected from 166 subjects (101 β-thalassemia major patients and 65 healthy controls). Serum levels of IMA, ferritin, malondialdehyde (MDA), ferroxidase, transaminases, total protein, and albumin were determined using conventional methods. Results: Serum levels of IMA (ABSU) were significantly higher in patients than in controls (0.725±0.155 vs 0.554±0.154, p=0.000). Similarly, higher levels were also observed for ferritin, MDA, ferroxidase, and transaminases. No significant differences were observed between patients and controls with respect to total protein and albumin. Spearman univariate analysis demonstrated significant correlation between IMA and ferritin, MDA, ferroxidase, and transaminases. Multiple linear regression analysis revealed significant association of IMA with ferritin and ferroxidase after adjusting for the other variables (r=0.343, p=0.002; r=0.228, p=0.029 respectively). MDA however, correlated significantly with ferritin only (r=0.654, p=0.000). Conclusion: Our findings suggest that increased levels of IMA in thalassemic patients are likely to be a result of iron-induced oxidative stress and hence its potential significance as a new marker of oxidative stress in such patients. [Copyright &y& Elsevier]

Abstract: Objective : The aim of this study was to evaluate the effect of HD on ischemia modified albumin (IMA) and protein carbonyl groups in order to investigate the role of IMA as a marker of protein oxidation. Design and methods : This study was conducted with 23 chronic hemodialysis patients. The serum IMA levels and protein carbonyl groups were measured immediately before hemodialysis (pre-HD) and after the end of hemodialysis (post-HD). Results : IMA concentrations were significantly higher in post-HD than those of the pre-HD and carbonyl protein concentrations were higher in post-HD in comparison with pre-HD. A significant correlation was observed between IMA and carbonyl protein levels. Conclusions : The increase of IMA levels and protein carbonyl groups post-HD could be attributed to the increase of oxidative stress associated with HD, and IMA appears to be an important biomarker for assessing protein oxidation after HD. [Copyright &y& Elsevier]

Abstract: Objective: Menopause is associated with weight gain and an increase of cardiovascular risk. The aim of the present study was to estimate serum ischemia-modified albumin (IMA) levels in postmenopausal women and evaluate their association with body mass index (BMI) and coronary artery disease (CAD). Methods: The study included 130 non-smoker postmenopausal women aged 43–80: 40 with BMI 26–32kg/m2 (Group A), 60 with BMI 21–25kg/m2 (Group B), and 30 with documented CAD and BMI 23–29kg/m2 (Group C). Serum IMA, albumin, hsCRP and NT-proBNP, glucose and insulin were measured. Homeostasis assessment model score (HOMA) and Quantitative insulin sensitivity index (QUICKI) were co-estimated. Results: Serum IMA and IMA to albumin ratio were significantly elevated in Group A as compared to Group B (p <0.001) and similar to those of Group C. hsCRP and NT-proBNP did not differ between Groups A and B while they were lower in comparison to Group C (p <0.001). Glucose, insulin and HOMA were elevated in Group A compared to Group B (p <0.001) while QUICKI was lower (p <0.001). In Group A, IMA was positively correlated with BMI, hsCRP, insulin, HOMA and negatively with QUICKI. In postmenopausal women, multivariable regression analysis revealed that obesity was the strongest significant determinant of circulating IMA levels (p <0.001) contributing, therefore, to the elevated serum IMA concentration. Conclusions: Postmenopausal obesity is associated with elevated serum IMA possibly due to obesity associated oxidative stress. IMA measurement could provide an assessment of atherosclerotic burden in postmenopausal women. Further clinical evaluation is under investigation. [Copyright &y& Elsevier]

Abstract: Owing to their higher risk for cardiac death or ischemic complications, patients with acute coronary syndrome (ACS) must be identified from other causes of chest pain. Patients with acute coronary syndrome are divided into categories based on their electrocardiogram; those with new ST-segment elevation and those who present with ST-segment depression. The subgroups of patients with ST-segment elevation are candidates for immediate reperfusion, while fibrinolysis appears harmful for those with non-ST elevation myocardial infarction. There is increasing evidence to encourage appropriate risk stratification before deciding on a management strategy (invasive or conservative) for each patient. The TIMI, GRACE or PURSUIT risk models are recommended as useful for decisions regarding therapeutic options. Cardiac biomarkers are useful additions to these clinical tools to correctly risk stratify ACS patients. Cardiac troponin is the biomarker of choice to detect myocardial necrosis and is central to the universal definition of myocardial infarction. The introduction of troponin assays with a lower limit of detection will allow for earlier diagnosis of patients who present with chest pain. Analytical and clinical validations of these new assays are currently in progress. The question is whether the lower detection limit of the troponin assays will be able to indicate myocardial ischemia in the absence of myocardial necrosis. Previous to the development of ultrasensitive cardiac troponin assays free fatty acids unbound to albumin and ischemia modified albumin were proposed as biochemical markers of ischemia. Advances in our knowledge of the pathogenesis of acute coronary thrombosis have stimulated the development of new biomarkers. Markers of left ventricular performance (N-terminal pro-brain natriuretic peptide) and inflammation (e.g. C-reactive protein) are generally recognized as risk indicators. Studies suggest that using a number of biomarkers clinicians can risk stratify patients over a broad range of short and long term cardiac events. Nevertheless, it is still under debate as to which biomarker combination is best preferred for risk prediction. This review will focus on recent practice guidelines for the management of patients with ACS as well as current advances in cardiac biomarkers, their integration into clinical care and their diagnostic, prognostic and therapeutic utility. [Copyright &y& Elsevier]

Abstract: We report on the use of zeolites to limit the effects of reactive oxygen species (ROS) on human albumin under in vitro conditions. Zeolites of different structure type, channel size, channel polarity, and charge-compensating cation were screened for the elimination of ROS, notably HO , resulting from the Fenton reaction. A test based on ischemia-modified albumin (IMA) was used as a marker to monitor the activity of HO after co-exposure of human serum to these zeolites. Two commercial zeolites, faujasite (FAU 13×, channel opening 0.74×0.74nm with Na+ as charge-compensating cation) and ferrierite (FER, channel opening 0.54×0.42nm with H+ as charge-compensating cation), were found to reduce IMA formation by more than 65% due to removal of HO relative to reference values. It was established that partial ion exchange of the zeolites’ respective charge-compensating cation vs. Fe3+ implicated in the Fenton reaction plays a major role in HO deactivation process. Moreover, our results show that no saturation of the respective zeolite active sites occurred. This is possible only when ROS are actively converted to water molecules within the zeolite void system, which generates H+ ion transport. Because zeolites cannot be administered in blood, their use in medicine should be limited to extra corporeal circuits. Zeolites could be of use during cardiopulmonary bypass or hemodialysis procedures. [Copyright &y& Elsevier]

Ischemia modified albumin (IMA), as measured using the albumin cobalt binding test, is currently the most promising biomarker for early detection of ischemia before the onset of irreversible cardiac injury. This paper reviews the information available on IMA, including its pathophysiology, analysis, clinical applications and future perspectives. The data provided was identified by a search of MEDLINE using the terms IMA, biomarkers and ischemia. IMA may be useful to cover the complete diagnostic window of patients presenting with acute coronary syndromes (ACS) in the Emergency Department, along with the electrocardiogram and cardiac troponins. Preliminary data regarding the significance of IMA in the prognosis of either ACS or following revascularization need further study. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate ischemia-modified albumin levels (IMA) in polycystic ovary syndrome (PCOS) cases with and without insulin resistance and the correlation of IMA with carotid intima media thickness, homocysteine, and high-sensitivity C-reactive protein levels. Significantly higher levels of IMA in young lean PCOS cases, more relevant in insulin resistant cases, indicates chronic hypoxia and oxidative stress which might play a role in the metabolic consequences in PCOS. [Copyright &y& Elsevier]