Study on Intravenous Zoledronic Acid Treatment in Thalassemia-Induced Osteoporosis.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3764-3764
Author(s):  
Zaher Otrock ◽  
Sami Azar ◽  
Adlette Inati ◽  
Suzane Koussa ◽  
Rami Mahfouz ◽  
...  

Abstract Background: Beta-thalassemia is an inherited disorder of hemoglobin synthesis with many associated morbidities. Osteoporosis is an important cause of morbidity in these patients. Bisphosphonates are potent inhibitors of osteoclast activity and have been recently used for the treatment of osteoporosis in beta-thalassemia. Several studies have indicated that the vitamin D receptor (VDR) gene has a role in the regulation of bone mineral density (BMD) and bone metabolism, but the results are very controversial. The aim of this study is to assess the effectiveness and safety of zoledronic acid in Lebanese thalassemics with osteoporosis. Methods: We studied 23 patients with beta-thalassaemia major (14 patients) and intermedia (9 patients). Thirteen patients were male and 10 were female, with a mean (+/− standard deviation) age of 25 +/− 9 years. All patients had severe osteoporosis and were receiving calcium and vitamin D supplements prior to and during the study. Zoledronic acid was given i.v. at a dose of 4 mg every 3 months over 12 months. The effects were monitored by assessing pain score, analgesic score and performance score. The BMD of the hip and lumbar spine, osteocalcin, bony alkaline phosphatase and pyrrolidine crosslinks were also measured. To gain more insight into the genetic basis of osteoporosis in thalassemia and to correlate this with the response to zoledronic acid, we analysed the polymorphism of the VDR gene in three polymorphic sites (Bsm I, Taq I and Apa I) using restriction enzymes digestion. Results: We have given two doses of zoledronic acid uptil now. The most common adverse event was joint pain in 12 patients (52.2%) lasting for 1–3 days and responding to analgesics. Four patients had perioral numbness and five had fever. These adverse events were markedly reduced after the 2nd dose; only two patients had joint pain. No patients discontinued the study until now. The pain scores, analgesic score and performance score were all improved compared to baseline values. The difference in pain index score was significant (p=0.004), and the reduction in the number of painful sites was slightly significant (p=0.097). There was significant difference in the baseline z score of the spine between transfusion dependent patients (15 patients) and transfusion non-dependent patients (8 patients) (p = 0.042). The distributions of VDR alleles in Bsm I polymorphism were 30.4% for BB, 52.3% for Bb, and 17.3% for bb; in the Apa I polymorphism 17.4% for AA, 47.8% for Aa, and 34.8% for aa; in Taq I polymorphism 30.4% for TT, 52.3% for Tt, and 17.3% for tt. We found no significant differences in baseline BMD between the three groups of Bsm I polymorphism at all sites. Apa I was not associated with significant differences in BMD. The BMD of the Ward’s triangle was higher in patients with the Tt-genotype compared with individuals with the tt-genotype and the difference was almost significant (p=0.089, ANOVA). Conclusions: In Lebanese thalassemics with osteoporosis zoledronic acid (a dose of 4 mg) is well tolerated and the clinical response is quite impressive. However, the response to treatment needs to be assessed by follow-up BMDs and blood bone markers.

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Toptaş ◽  
Ali Metin Kafadar ◽  
Canan Cacina ◽  
Saime Turan ◽  
Leman Melis Yurdum ◽  
...  

Objective. It has been stated that brain cancers are an increasingly serious issue in many parts of the world. The aim of our study was to determine a possible relationship between Vitamin D receptor (VDR) gene polymorphisms and the risk of glioma and meningioma.Methods. We investigated the VDR Taq-I and VDR Fok-I gene polymorphisms in 100 brain cancer patients (including 44 meningioma cases and 56 glioma cases) and 122 age-matched healthy control subjects. This study was performed by polymerase chain reaction-based restriction fragment length polymorphism (RF LP).Results. VDR Fok-I ff genotype was significantly increased in meningioma patients (15.9%) compared with controls (2.5%), and carriers of Fok-I ff genotype had a 6.47-fold increased risk for meningioma cases. There was no significant difference between patients and controls for VDR Taq-I genotypes and alleles.Conclusions. We suggest that VDR Fok-I genotypes might affect the development of meningioma.


2018 ◽  
Vol 76 (11) ◽  
pp. 760-766 ◽  
Author(s):  
Ana Carolina R. de Oliveira ◽  
Carolina A. Magalhães ◽  
Cristina M. G. Loures ◽  
Vanessa G. Fraga ◽  
Leonardo C. de Souza ◽  
...  

ABSTRACT Elderly people are at a high risk of developing vitamin D (VitD) deficiency due to both decreased intake and cutaneous synthesis. Most of the biological actions of VitD are mediated by the vitamin D receptor (VDR), which is present in neurons and glial cells of the hippocampus, and in the cortex and subcortical nuclei, essential areas for cognition. It is known that VDR gene polymorphisms may decrease the VDR affinity for VitD. Objective: The present study aimed to investigate the influence of VitD levels on cognitive decline in patients with dementia due to Alzheimer's disease (AD, n = 32) and mild cognitive impairment (MCI, n = 15) compared to cognitively healthy elderly (n = 24). We also evaluated the association of VDR gene polymorphisms with cognitive disturbance. Methods: Four polymorphisms on the VDR gene were studied, namely, BsmI, ApaI, FokI and TaqI, by polymerase chain reaction-restriction fragment length polymorphism. Serum levels of 25-hydroxy vitamin D (25(OH)D) were determined by high performance liquid chromatography. Results: No significant difference in 25(OH)D levels or genotypic/allelic frequencies was observed between the groups. Deficiency of 25(OH)D was more frequently observed in women. The AA/AG genotypes of the BsmI polymorphism was associated with sufficient 25(OH)D levels, while the GG genotype of this same polymorphism was associated to insufficient levels in the cognitively-impaired group (individuals with AD or MCI). Conclusions: The data obtained do not confirm the relationship between reductions of VitD levels, polymorphisms in the VDR gene, and altered cognitive function in this sample. However, the data indicate that BsmI polymorphism in the VDR gene is associated with the VitD levels in individuals with cognitive decline.


Author(s):  
Thais Walverde Siqueira ◽  
Edward Araujo Júnior ◽  
Rosiane Mattar ◽  
Silvia Daher

Objective To evaluate the relationship between vitamin D receptor (VDR) gene polymorphism (FokI [rs10735810]) and serum vitamin D concentration in gestational diabetes mellitus (GDM). Methods A prospective case-control study that recruited healthy pregnant women (control group) (n = 78) and women with GDM (GDM group) (n = 79), with no other comorbidities. Peripheral blood samples were collected in the 3rd trimester of gestation, and all of the pregnant women were followed-up until the end of the pregnancy and the postpartum period. Serum vitamin D concentrations were measured by high-performance liquid chromatography (HPLC). For genomic polymorphism analysis, the genomic DNA was extracted by the dodecyltrimethylammonium bromide/cetyltrimethylammonium bromide (DTAB/CTAB) method, and genotyping was performed by the polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP) technique, using the restriction enzyme FokI. The Student-t, Mann-Whitney, chi-squared, and Fischer exact tests were used for the analysis of the results. Results There was no significant difference between the pregnant women in the control and GDM groups regarding serum vitamin D levels (17.60 ± 8.89 ng/mL versus 23.60 ± 10.68 ng/mL; p = 0.1). Also, no significant difference was detected between the FokI genotypic frequency when the 2 groups were compared with each other (p = 0.41). Conclusion There was no association between the FokI polymorphism and the development of GDM, nor was there any change in serum vitamin D levels in patients with GDM.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1437-1437
Author(s):  
Ralph Schwiebert ◽  
Sharon Barrans ◽  
Jan Taylor ◽  
Andrew S Jack ◽  
Cathy H Burton

Abstract Introduction A challenge in the management of classical Hodgkin lymphoma (CHL) is selecting treatment which will maximise success while minimising treatment side effects. The international Response Adapted Therapy in Hodgkin Lymphoma (RATHL) trial (NCT00678327) demonstrated that treatment may be successfully adapted based on positron emission tomography (PET-CT) scan results after 2 cycles (PET2) of ABVD chemotherapy in advanced CHL. This approach however delays risk stratification meaning some patients may be over or under treated and therefore a baseline predictor is highly desirable. A gene expression-based model performed on RNA from formalin-fixed paraffin-embedded tissue (FFPET) biopsies on the Nanostring platform (Scott et al, J Clin Oncol 2013; 31:692-700) has been published. In addition Steidl et al used gene expression profiling (GEP) to correlate tumour-associated macrophages with survival in CHL (Steidl et al, NEJM 2010; 10:875-885). In order to explore whether GEP at baseline could be used in combination with PET2 results to predict outcome, these published gene signatures were explored on the DASL platform in a series of CHL cases and correlated with PET2 response. Recently, PD-1 ligand (PD-L1) on the cell surface of Reed-Sternberg cells (the hallmark cells of CHL) has been demonstrated to co-opt the PD-1 pathway allowing immune evasion (Green et al, Blood 2010;116:3268-77). Therefore this was also performed by immunohistochemistry (IHC) and GEP as well as assessment of EBV status. Methods 50 patients with CHL were identified, with at least 2 years of follow up, diagnosed between 2008 and 2013. Deauville scores at PET2 were determined. IHC consistent with CHL, including: CD3, CD19, CD20, CD30, CD79, BOB-1, OCT-2, MUM1 and TARC was performed on 3mm FFPET lymph node sections, and reported by two independent observers. Latent Epstein-Barr virus (EBV) infection was determined by IHC for LMP-1 expression and in-situ hybridisation using fluorescein-labelled peptide nucleic acid probes (Dako, K5201). PD-L1 expression was determined by IHC using a rabbit monoclonal antibody (Cell Signaling Technology, E1L3N, #13684). Three to five 5mm sections of FFPET were used for RNA extraction using the Ambion RecoverAll™ kit standard protocol. GEP was quantified using Illumina's whole genome cDNA-mediated annealing, selection, extension, and ligation Assay (WG-DASL). 61 genes of interest were analysed for significance in the difference in gene expression between groups and included genes from the two recently reported GEP predictor tools in CHL (Steidl et al, 2010, Scott et al 2013) as well as PD-1 and PD-L1. The Mann-Whitney test was used to assess the significance in the difference between means (significant if p<0.05). Results A statistically significant difference in EBV status was found between PET negative (Deauville scores 1-3) and PET positive (Deauville scores 4-5) groups (Fisher's exact test: P-Value = 0.028). All patients who were EBV positive had a negative PET2 scan. GEP using WG-DASL revealed that only 2 genes of those reported in recent predictor models (Steidl et al 2010, Scott et al 2013) were expressed at significantly different levels between PET negative and PET positive patients (GLUL, RNF144B), both with increased expression in the PET2 positive group. There was no significant difference between PD-L1 expression and PET scores, CD274 gene expression and outcome. Assessment as to whether samples would cluster into groups according to PET positivity or PD-L1 expression status by unsupervised cluster analysis using four recently reported B cell lymphoma gene signatures (Monti et al, Blood 2005; 5:1851-61, Care et al, PloS one 2013; 2: e55895) was performed, but no significant grouping was found. Conclusion GEP on the DASL platform was not able to predict PET response. The original models were trained on outcome and therefore retraining of the GEP model based on PET response is likely to be required. EBV status was found to be predictive of PET response but this could not be correlated with other biomarkers to predict outcome. Although PD-1 and PD-L1 targeted therapy has shown exciting results in patients with CHL, PD-L1 IHC expression and CD274 gene expression, did not correlate with PET2 response or outcome. Baseline biomarkers capable of identifying patients likely to benefit from targeted treatment needs to be further investigated in proposed clinical trials. Disclosures No relevant conflicts of interest to declare.


2019 ◽  
Vol 57 (5) ◽  
pp. 697-706 ◽  
Author(s):  
Chenbin Li ◽  
Mingting Peng ◽  
Dongsheng Xu ◽  
Hong Lu ◽  
Wenbin Zhou ◽  
...  

Abstract Background Flow cytometric enumeration of lymphocyte subsets in peripheral blood can provide important information about immune status. Commutable reference materials (RM) are crucial for maintaining accurate and comparable measurement results over time and space. Commutability assessment of RMs for lymphocyte subsets enumeration has not been reported elsewhere. Methods Lymphocyte subsets were measured in triplicate on 56 patient samples and eight RMs using two measuring systems commonly used in laboratories (FACS Canto II and Cytomics FC500). The first step was to determine the suitability of RMs and comparability of different systems with patient samples. After the requirements of suitability and comparability were met, the second step was to assess commutability following regression approach and difference in bias approach. Results Two RMs were not measurable on FC500 system for CD3-CD16/56+ and CD3-CD19+ percentages. The results of comparability showed no significant difference in the two systems. Eight RMs for CD3+CD4+ cell count, six RMs for CD3+ and CD3+CD8+ percentages, five RMs for CD3-CD16/56+ percentage, and three RMs for CD3-CD19+ percentage were commutable using the two approaches. For CD3+, CD3+CD8+ and CD3-CD19+ percentages, the results of regression approach showed that one RM was non-commutable for each parameter, while the other approach showed that the RM was commutable. Conclusions The suitability of RM and comparability of different measuring systems are prerequisites for assessing commutability. This study indicated that different approaches led to different results. The difference in bias approach is recommended for criteria relating to medical requirements and performance characteristics of measuring systems in use.


Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Vani Chandrashekar

Hb A1c measurement is subject to interference by hemoglobin traits and this is dependent on the method used for determination. In this paper we studied the difference between Hb A1c measured by HPLC in hemoglobin traits and normal chromatograms. We also studied the correlation of Hb A1c with age. Hemoglobin analysis was carried out by high performance liquid chromatography. Spearman’s rank correlation was used to study correlation between A1c levels and age. Mann-WhitneyUtest was used to study the difference in Hb A1c between patients with normal hemoglobin and hemoglobin traits. A total of 431 patients were studied. There was positive correlation with age in patients with normal chromatograms only. No correlation was seen in Hb E trait or beta thalassemia trait. No significant difference in Hb A1c of patients with normal chromatograms and patients with hemoglobin traits was seen. There is no interference by abnormal hemoglobin in the detection of A1c by high performance liquid chromatography. This method cannot be used for detection of A1c in compound heterozygous and homozygous disorders.


2021 ◽  
Vol 10 (8) ◽  
pp. 1728
Author(s):  
Simon Rauch ◽  
Michiel Jan van Veelen ◽  
Rosmarie Oberhammer ◽  
Tomas Dal Cappello ◽  
Giulia Roveri ◽  
...  

Cardiopulmonary resuscitation (CPR) is considered an aerosol-generating procedure. Consequently, COVID-19 resuscitation guidelines recommend the use of personal protective equipment (PPE) during resuscitation. In this simulation of randomised crossover trials, we investigated the influence of PPE on the quality of chest compressions (CCs). Thirty-four emergency medical service BLS-providers performed two 20 min CPR sequences (five 2 min cycles alternated by 2 min of rest) on manikins, once with and once without PPE, in a randomised order. The PPE was composed of a filtering facepiece 3 FFP3 mask, safety glasses, gloves and a long-sleeved gown. The primary outcome was defined as the difference between compression depth with and without PPE; secondary outcomes were defined as differences in CC rate, release and the number of effective CCs. The participants graded fatigue and performance, while generalised estimating equations (GEE) were used to analyse data. There was no significant difference in CC quality between sequences without and with PPE regarding depth (mean depth 54 ± 5 vs. 54 ± 6 mm respectively), rate (mean rate 119 ± 9 and 118 ± 6 compressions per minute), release (mean release 2 ± 2 vs. 2 ± 2 mm) and the number of effective CCs (43 ± 18 vs. 45 ± 17). The participants appraised higher fatigue when equipped with PPE in comparison to when equipped without PPE (p < 0.001), and lower performance was appraised when equipped with PPE in comparison to when equipped without PPE (p = 0.031). There is no negative effect of wearing PPE on the quality of CCs during CPR in comparison to not wearing PPE.


2021 ◽  
Vol 5 (1) ◽  
pp. 006-012
Author(s):  
Elvina Murzina

When grouping children with psoriasis depending on TaqI (T/C) genotypes of the VDR gene, the youngest age of disease onset and the longest duration of dermatitis (5.60 ± 0.77 years and 4.90 ± 0.68 years, respectively) showed up in case of the CC genotype. In case of the TT genotype, disease onset coincided with an older age, and the history of present illness was the shortest (10.26 ± 0.64 years and 2.59 ± 0.58 years, respectively). PASI (20.32 ± 3.43) and BSA (40.00 ± 6.11) severity indices were the highest and of statistically significant difference to those in other groups in the presence of the CC genotype. In case of the TC genotype, the index PGA (2.80 ± 0.15) was the lowest and made a statistically significant difference to the values of other groups. A negative correlation between vitamin D levels and the PASI, PGA, BSA was identified in children holding CC and TC genotypes. Conclusion: The clinical presentation of dermatitis and its epidemiological features in children with psoriasis, namely the age of disease onset, duration of exacerbation, body surface area and the intensity of psoriasis symptoms depend on vitamin D serum levels and genotypes of the TaqI polymorphic variant of the VDR gene.


Author(s):  
Kocak Ayse

Vitamin D Receptor (VDR) is a member of the nuclear hormone receptor family. 1,25(OH)2D, a form of metabolically active vitamin D3 form, is the ligand of VDR. When VDR and 1,25(OH)2D are connected, many genes start to molecular interaction reactions that will modulate the transcription. VDR has been shown to be a negative regulator of the transforming growth factor beta-1 / Smad (TGF-β1 / Smad) signalling pathway. TGF-β1 / Smad signalling is important in the pathogenesis of scleroderma (SSc). Vitamin D has pleiotropic effects including immunomodulatory and antifibrotic properties in scleroderma pathogenesis. The aim of this study was to investigate the expression of VDR and the levels of vitamin D in scleroderma subtypes and study the possible correlation between the two parameters. 28 SSc patients and 30 healthy controls were included in the study and they were classified according to the 2013 ACR / EULAR criteria and Rodnan Scores were calculated. 14 were of the limited type and 14 were of the diffuse type of scleroderma. Vitamin D levels were determined in serum. Vitamin D level was measured by chemiluminescence immunometric assay. VDR gene expression was determined by quantitative PCR in isolated RNAs from the blood. Changes in mRNA levels were analysed and beta-actin was used as the housekeeping gene. Also, TGF-β1 gene expressions were determined. VDR gene expressions in diffuse type scleroderma patients were significantly decreased compared to the control. TGF-β1 gene expressions were increased in diffuse type scleroderma. It was found that VDR gene expression in limited type scleroderma patients did not show any significant difference when compared to control. Vitamin D levels and VDR gene expressions showed no correlation in scleroderma subtypes. VDR gene expression decreased in patients with diffuse type scleroderma and showed negative correlation with the Rodnan score and TGF-β1 gene expressions. There was no significant difference between vitamin D and VDR levels.


2017 ◽  
Vol 14 (2) ◽  
pp. 1492
Author(s):  
Murat Akyüz ◽  
Murat Özmaden ◽  
Yeliz Doğru ◽  
Evren Karademir ◽  
Yeşim Aydın ◽  
...  

This study was conducted to examine the effects of static and dynamic stretching exercises on strength, flexibility, speed and balance in young basketball players. 10 volunteers from the 16 year old male basketball team of Pınar Karsiyaka Sports Club participated in the study. The average age of the athletes is 16 ± 0,0 (year) and the average of the height is 188 ± 0,08 (cm). The study consists of three parts. On the first day, dynamic stretching exercises were performed on the second day and static stretching exercises and performance tests were performed on the third day without performing any exercise. Applied performance tests were hand grip strength, back-leg strength, sit-in flexibility test, 20 m. Sprint test and flamingo balance test. The obtained data were analyzed with the variance analysis (ANOVA test) in the repeated measures using the SPSS 23.0 package program. As a result of the study, the flexibility of the static and dynamic stretching exercises in the data obtained, the difference in the left handed claw strength and the speed of the dynamic stretching exercises were significant (p <0.05). On the other hand, no statistically significant difference was found between static and dynamic stretching exercises and back leg strength and balance (p> 0.05). As a result, it can be said that static and dynamic stretching exercises have a positive effect on flexibility, strength and speed. ÖzetBu çalışma genç basketbolcularda statik ve dinamik germe egzersizlerinin kuvvet, esneklik, sürat ve denge üzerindeki etkisini incelemek amacıyla yapılmıştır. Çalışmaya Pınar Karşıyaka Spor Kulübünün 16 yaş erkek basketbol takımından 10 gönüllü katılmıştır. Sporcuların yaş ortalamaları 16±0,0 (yıl), boy ortalamaları 188±0,08 (cm)’dir. Çalışma üç bölümden oluşmaktadır. Birinci gün herhangi bir egzersiz uygulanmadan, ikinci gün dinamik germe egzersizleri ve üçüncü gün statik germe egzersizleri ile performans testleri uygulanmıştır. Uygulanan performans testleri sırasıyla el kavrama kuvveti, sırt-bacak kuvveti, otur-eriş esneklik testi, 20 m. sprint testi ve flamingo denge testinden oluşmaktadır. Elde edilen veriler SPSS 23.0 paket programı kullanılarak tekrarlı ölçümlerde Varyans Analizi (Anova Testi) ile analiz edilmiştir. Çalışma sonucunda elde edilen verilerde statik ve dinamik germe egzersizlerinin esnekliğe, dinamik germe egzersizlerinin sol el pençe kuvveti ve sürat üzerinde anlamlı bir farklılık meydana gelmiştir (p<0.05). Diğer yandan, statik ve dinamik germe egzersizleri ile sırt bacak kuvveti ve denge üzerinde anlamlı bir farklılık bulunamamıştır (p>0.05). Sonuç olarak, statik ve dinamik germe egzersizlerinin esneklik, kuvvet ve sürat üzerinde olumlu etkisi olduğu söylenebilir.


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