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AIM:To evaluate the high sensitivity C-reactive protein (hsCRP), Fetuin-A and matrix γ-carboxyglutamate protein (MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration (ARMD) in comparison to healthy controls.METHODS: The subjects were 40 patients with choroidal neovascularization (CNV) having a mean age of 70.9±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slit-lamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hsCRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay (ELISA) technique.RESULTS:hsCRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P=0.02)] and Fetuin-A levels (50.27±5.04 vs 44.99±10.28 ng/mL, P=0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups (P=0.08). There was not a significant correlation between MGP with Fetuin-A and hsCRP among the patients (P=0.7, P=0.9 respectively). A significant negative correlation of hsCRP with Fetuin-A was observed in both case and control groups (P=0.004, r=-0.33 and P=0.001, r=-0.54, respectively).CONCLUSION: Although our study shows that serum hsCRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.

Introduction: Vascular calcification is a common complication in the chronic kidney disease (CKD) patients and the leading cause of morbidity and mortality in this patient. The aim of the present study was to evaluate a possible correlation between vitamin D receptor (VDR) gene FokI and ApaI polymorphisms with the expression of calcification biomarkers such as Fetuin-A and intact Parathormone hormone (iPTH) in hemodialysis patients (HD). Methods: In this cross-sectional study, serums were obtained from 46 stable chronic HD patients. The serum levels of iPTH, Fetuin-A, vit D, calcium, phosphorus and VDR genotyping were determined by standard methods. Results: The serum levels of Fetuin-A, calcium did not differ between males and females but significant differences in iPTH and vitamin D levels was found in the study patients [(336.8±139 pg/dl) vs. (414.7±111.8 pg/dl) p=0.04 and (24.5±7.6 ng/ml) vs.(19.9±4.8 ng/ml) p=0.02 respectively]. A Significant correlations were found between serum Phosphorus and levels of serum calcium (r = –0.4; p = 0.002), vitamin D (r = –0.5; p = 0.001) and iPTH (r = 0.4; p = 0.001). iPTH level in FokI polymorphism, were different between genotype groups in study patient (p=0.02). There was a significant positive correlation between Vitamin D and iPTH levels in patients with aa genotype (p=0.02, r=0.4). Conclusion: These findings suggest that FokI (rs2228570) polymorphism in exon 2 of the VDR gene may play a role in iPTH levels. Fetuin-A deficiency or high level of iPTH and its association with VDR gene polymorphisms may be useful to identify the high-risk group susceptible to renal failure and atherosclerosis. Although VDR gene FokI and ApaI polymorphisms could affect the levels of Fetuin-A and vitamin D, their direct role on atherosclerosis needs further studies in the future., Journal of Analytical Research in Clinical Medicine; EISSN 2345 - 4970

Background & Aims: Rheumatoid Arthritis (RA) is one of the common autoimmune diseases with unknown etiology. It has been suggested that antioxidant supplements may play a role in inflammation perpetuating process. This study examined the influence of combined antioxidant supplementation on serum asymmetric dimethylarginine (ADMA), vascular endothelial growth factor (VEGF) levels and high-sensitivity C-reactive protein (hs-CRP) as inflammatory markers in RA patients. Materials & Methods: A three-month pre-post study was conducted on 40 female RA patients receiving one Selenplus capsule (Selenium 50μg, Zinc 8 mg, vitamin A 400 μg, vitamin C 125 mg and vitamin E 40 mg) daily. 5 ml venous blood samples were taken from all the participants before and after the administration period. The serum levels of ADMA, VEGF and high-sensitivity C-reactive protein (hs-CRP) were measured by standard methods. Results: 39 out of 40 patients completed the study. In comparison with the baseline, we did not find any significant differences between serum ADMA and VEGF values before and after the intervention. The 3-month use of SelenPlus supplementation resulted in decreasing hs-CRP level (p< 0.003). Conclusion: The combined antioxidant supplements for 3 months decreased serum hs-CRP levels in RA patients that may be helpful in RA treatment. The hs-CRP reduction may due to the anti-inflammatory effects of Zinc and Selenium in SelenPlus supplement. Published under a Creative Commons Attribution Non-Commercial Share Alike License.

CONTEXT AND OBJECTIVE: Red grape seed extract (RGSE) contains oligomeric proanthocyanidin complexes as a class of flavonoids. These compounds are potent antioxidants and exert many health-promoting effects. This study aimed to determine the effects of RGSE on serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apo-AI) levels and paraoxonase (PON) activity in patients with mild to moderate hyperlipidemia (MMH). DESIGN AND SETTINGS: A randomized double-blind placebo-controlled clinical trial was conducted at Shahid-Modarres Hospital (Tehran, Iran) and Tabriz University of Medical Sciences. Seventy MMH patients were randomly assigned to receive treatment (200 mg/day of RGSE) or placebo for eight weeks. RESULTS: Significant elevation in serum levels of apo-AI (P = 0.001), HDL-C (P = 0.001) and PON activity (P = 0.001) and marked decreases in concentrations of TC (P = 0.015), TG (P = 0.011) and LDL-C (P = 0.014) were found in the cases. PON activity was significantly correlated with apo-AI (r = 0.270; P < 0.01) and HDL-C (r = 0.45; P < 0.001). Significant differences between the RGSE and control groups (before and after treatment) for TC (P = 0.001), TG (P = 0.001), PON (P = 0.03), apo-AI (P = 0.001) and LDL-C (P = 0.002) were seen. CONCLUSION: It is possible that RGSE increases PON activity mostly through increasing HDL-C and apo-AI levels in MMH patients. It may thus have potential beneficial effects in preventing oxidative stress and atherosclerosis in these patients. RESUMO: CONTEXTO E OBJETIVO: Extrato de semente de uva vermelha (RGSE) contém complexos de proantocianidinas oligoméricas como classe de flavonoides. Estes compostos são antioxidantes potentes e exercem muitos efeitos de promoção da saúde. Este estudo visou determinar os efeitos de RGSE nos níveis séricos de triglicérides (TG), colesterol total (TC), colesterol de lipoproteína alta-densidade (HDL-C), colesterol de lipoproteína baixa-densidade (LDL-C), apolipoproteína AI (apo-AI) e atividade de paraoxonase (PON) em pacientes com hiperlipidemia leve a moderada (MMH). DESENHO E LOCAL: Estudo clínico randomizado duplo-cego controlado com placebo, realizado no Hospital Shahid-Modarres (Teerã, Irã) e na Universidade de Ciências Médicas de Tabriz. Setenta pacientes com MMH foram aleatoriamente designados para receber tratamento (200 mg/dia de RGSE) ou placebo durante oito semanas. RESULTADOS: Elevação significativa nos níveis séricos de apo-AI (P = 0,001), HDL-C (P = 0,001) e atividade de PON (P = 0,001) e diminuição marcada nas concentrações de TC (P = 0,015), TG (P = 0,011) e LDL-C (P = 0,014) foram encontradas nos casos. Atividade de PON mostrou correlação significativa com apo-AI (r = 0,270; P < 0,01) e HDL-C (r = 0,45; P < 0,001). Diferenças significativas entre os grupos RGSE e controle (antes e após tratamento) para TC (P = 0,001), TG (P = 0,001), PON (P = 0,03), apo-AI (P = 0,001) e LDL-C (P = 0,002) foram observadas. CONCLUSÃO: É possível que RGSE aumente atividade de PON principalmente através da elevação dos níveis de HDL-C e apo-AI em pacientes MMH. Ele pode, assim, ter efeitos benéficos potenciais na prevenção de estresse oxidativo e aterosclerose nesses pacientes.

Osteoarthritis (OA) is characterized by progressive cartilage degradation and secondary inflammation of the synovial membrane. Studies have shown that mud therapy may influence serum levels of several cytokines involved in the pathogenesis of OA and chondrocyte metabolism. The main targets of our research were to make use of Lake Urmia mud for topical gel formulation, evaluation of the possible therapeutic effects of this gel on symptoms of patients with knee OA and the evaluation of serum tumor necrosis factor-alpha (TNF-alpha) level after mud therapy in comparison with the application of a placebo.Fifty (50) patients suffering from knee OA participated in this study and randomized into two groups: case group and control group. Patients in the case group received mud therapy and the placebo was applied to patients in the control group. Three (3) parameters including pain, morning stiffness, and joint functionality were assessed in all patients. Visual analogue scale and Western Ontario McMaster Osteoarthritis index (WOMAC) were the employed scales for pain assessment. Functional capacity was evaluated by using WOMAC functional capacity and WOMAC global index. All the mentioned steps were done before and after treatment. Blood samples, in both groups, were collected for measuring tumor necrosis factor (TNF)-alpha serum level.All the differences (for three parameters), in the case group, were statistically significant. TNF-alpha serum level reduction in both groups were detected: 19.41% in the case group and 1.76% in the control group.Mud therapy using formulated gel is an effective method in knee OA treatment and pain reduction. Further studies may be needed for the evaluation of possible synergism between pharmacological treatment and mud therapy.

BACKGROUND: Inflammation is recognized in up to 50% of chronic kidney disease (CKD) patients, being a common feature of advanced renal disease and crucial mediator of vascular calcification which may be relevant in CKD. This study was aimed at evaluating the role of Growth arrest–specific 6 (Plasma GAS-6) and mineral metabolism abnormalities in hemodialysis patients. METHODS: We enrolled a total of 92 adults including 46 (28 males and 18 females) clinically stable hemodialysis patients (HD) and 46 (23 males and 23 females) patients with normal kidney as control group. Plasma GAS-6, interleukin 6 (IL-6), and high sensitivity C-reactive protein (hsCRP) concentration and biochemical alteration were quantified; as biochemical factors, GAS-6, interleukin 6(IL-6), and high-sensitivity C-reactive protein (hsCRP) levels were determined by standard methods. RESULTS: Levels of GAS-6 were significantly increased in hemodialysis (HD) patients compared with normal controls (P < 0.001). In HD patients, IL-6, and hsCRP levels were increased compared with controls (P < 0.001). The levels of GAS-6 were directly associated with IL-6 (r = 0.560, P < 0.001) in HD patients. No significant correlation was found between hsCRP and GAS-6 levels in HD patients (r = 0.05, P = 0.742). Multiple regression analysis demonstrated that serum P was independently associated with hsCRP and GAS-6 independently associated with IL-6. CONCLUSIONS: Elevated serum P and GAS-6 might play a role in the development of inflammation in CKD patients. Although our study shows that GAS-6 is directly associated with IL-6 and phosphor with hsCRP, their direct role in vascular calcification and type of their relationships need further studies in the future., Journal of Analytical Research in Clinical Medicine; EISSN

Introduction: Oxidation of low-density lipoprotein (LDL) is believed to be a key factor in the development of atherosclerosis. Oxidative modification of LDL is associated with increased uptake of these particles by the macrophage receptors located in the arterial wall which in turns would lead to accumulation of lipids within the cytoplasm of the cell and formation of the foam cells, a perquisite step in the development of the atherosclerotic plaque. The aim of the present study was to evaluate the association between serum Ferritin and oxidized low-density lipoprotein in coronary artery disease (CAD) patients. Methods: The study group consisted of 160 males [mean age (47±7) years] with suspected CAD and no history of renal, liver and diabetic disorders undergoing coronary angiography. Oxidized LDL and Ferritin levels were measured by ELISA methods. Results: Results obtained from the study revealed that the mean serum Ferritin concentration in our study population was 149.77+119.93 ng/ml and that of OX-LDL was 8.86+5.67 IU/L. Serum Ferritin levels were significantly correlated with both OX-LDL concentrations (p=0.001, r=0.24) and CAD SCORE (p=0.005, r=0.208) in study patients group; however no correlation was detected between OX-LDL and CAD SCORE (p>0.9). Conclusion: The present study is the first to report serum Ferritin levels is associated with circulating OX-LDL level in patients with CAD. The correlation of CAD SCORE with Ferritin levels in these patients is indicative of the importance of this parameter in predicating CAD. These results suggest that measurement of OX- LDL and Ferritin could be of great assistance in predicating premature CHD., Journal of Cardiovascular and Thoracic Research; ISSN 2008-6830