Valuation of MIP-1α and MR-Proadm in Serum of Patients with Systemic AL Amyloidosis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4995-4995
Author(s):  
Giusy Antolino ◽  
Alessandro Moscetti ◽  
Federica Resci ◽  
Daniela De Benedittis ◽  
Virginia Naso ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Statistical Tests ◽  
Rank Correlation ◽  
Serum Levels ◽  
Organ Damage ◽  
Systemic Amyloidosis ◽  
Control Group ◽  
Al Amyloidosis ◽  
Blood Draw ◽  
Markers Of Inflammation

Abstract Abstract 4995 Background. AL systemic amyloidosis is the most common and lethal form of amyloidosis. Macrophage inflammatory protein-1 alpha (MIP-1α) is a member of the CC chemokine family which is primarily associated with cell adhesion and migration. Adrenomedullin, and more the mid-regional fragment of proadrenomedullin (MR-proADM), comprising amino acids 45–92, have immune modulating, metabolic and vascular actions. Aims and Methods. Aim of the study was to evaluate MIP-1α and MR-proADM serum levels in patients with systemic AL λ amyloidosis at presentation to find out potential differences useful to define a characteristic inflammatory pattern. Blood samples were collected from 7 patients with systemic AL amyloidosis (median age 68 yrs) and from 10 age-matched healthy control individuals referred to our Unit and analyzed for serum MIP-1 α and MR-proADM levels. For every patient 1 sample of peripheral blood have been obtained. The blood was separated into plasma at the time of blood draw and frozen to −80°C. Two-group comparisons were performed using the Mann-Whitney U test and paired t test. Correlation analyses were performed using Spearman rank correlation. All statistical tests were two tailed and p < 0. 05 was considered statistically significant. Results. Serum MIP-1α levels were significantly higher in AL amyloidosis patients (median 25. 04 pg/mL; IQR 12. 77) compared to the control group (median 2. 54 pg/mL; IQR 0. 34; p=0. 0007). Also serum MR-proADM levels were significantly increased in AL amyloidosis patients (median 1. 15 nmol/L, IQR 0. 6 vs median 0. 42 nmol/L, IQR 0. 18; p=0. 0008). In addition, a positive correlation between MIP-1α and MR-proADM has been observed in the group of patients with systemic amyloidosis (r2=0. 82, p=0. 034). Conclusions. The increase of MIP-1α and MR-proADM serum levels in patients with systemic AL amyloidosis at presentation is indicative of active basal inflammation which can contribute to organ damage, in particular heart and kidneys, due to microvascular impairment. On the basis of our results, MIP-1α and MR-proADM could be used as new serum markers of inflammation in AL amyloidosis patients, with possible role in monitoring of organ damage. Disclosures: No relevant conflicts of interest to declare.

Heart Function In Systemic and Localized AL Amyloidosis: Role of NT-ProBNP and MPC-1

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5006-5006
Author(s):  
Francesca Saltarelli ◽  
Alessandro Moscetti ◽  
Guglielmo Bruno ◽  
Bruno Monarca ◽  
Gerardo Salerno ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Heart Function ◽  
Systemic Disease ◽  
Plasma Concentrations ◽  
Serum Levels ◽  
Mononuclear Phagocytes ◽  
Systemic Amyloidosis ◽  
Al Amyloidosis ◽  
Heart Involvement ◽  
Localized Amyloidosis

Abstract Abstract 5006 In AL amyloidosis typical sites of amyloid buildup are heart, skin, gastrointestinal tract, liver, kidneys, and blood vessels. To evaluate the heart involvement in systemic and localized amyloidosis proBNP, peptide (NT-proBNP; 76 amino acids) and MPC-1 were investigated. NT-proBNP have been described as useful marker for the diagnosis heart disease, and its plasma concentrations correlate with the functional classification of patients according to the New York Heart Association (NYHA). MCP-1 is a chemokine that activates mononuclear phagocytes by promoting leukocyte–endothelium binding and migration to sites of inflammation. The MCP-1 levels seem to be related to the severity of cardiac alteration, as demonstrated by the coronary angiogram. NT-proBNP and MPC-1 serum levels were performed in systemic or localized AL amyloidosis to evaluate if there was a difference in the heart involvement. Blood samples were collected from 8 patients with systemic amyloidosis and from 4 patients with localized amyloidosis. To analyze the results of NT-proBNP and MPC-1, Mann-Whitney test was performed. NT-proBNP serum values were significantly (p=0.007) increased in systemic disease. Also, MPC-1 serum levels were significantly (p=0.004) higher in the patients with systemic disease (350.52±58.70 pg/ml) if compared to the group of localized amyloidosis (147.82±26.03 pg/ml). On the basis of our results, the heart seem to be functionally more involved in AL systemic amyloidosis than in localized disease, as demonstrated by the higher NT-proBNP and MPC-1 serum values. Disclosures: No relevant conflicts of interest to declare.

IL-4 and IL-1 Serum Levels In Systemic and Localized Amyloidosis

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5000-5000
Author(s):  
Alessandro Moscetti ◽  
Francesca Saltarelli ◽  
Guglielmo Bruno ◽  
Bruno Monarca ◽  
Gerardo Salerno ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Conflicts Of Interest ◽  
Systemic Disease ◽  
Inverse Correlation ◽  
Serum Levels ◽  
Systemic Amyloidosis ◽  
Al Amyloidosis ◽  
Th2 Response ◽  
Localized Amyloidosis ◽  
Localized Disease

Abstract Abstract 5000 AL amyloidosis is a plasmacellular discrasia characterized by the deposition of light chains fibrils that infiltrate tissues leading to multisystemic organ involvement. Amyloidosis can be systemic or localized disease. No immunological markers are avaibable to distinguish the systemic from localized disease. IL-4 and IL-1 cytokines were performed to evaluate if there is a different inflammatory pattern between the two clinical forms. IL-4 is the central regulator of T helper 2 (Th2) immune responses, with also a major impact on innate immune cells. IL-1 is produced by macrophages, monocytes, fibroblasts and dendritic cells which play an important role in the inflammatory response, activating the Th1-mediated IL2 release. IL-1 increases the expression of adhesion factors on endothelial cells to enable transmigration of leukocytes to sites of infection. The study was devoted to evaluate serum levels of IL-4 and IL-1 in systemic or localized AL amyloidosis at presentation and to find out potential Th1 and Th2 disequilibrium. Blood samples were collected from 8 patients with systemic amyloidosis and from 4 patients with localized amyloidosis. Serum IL-4 and IL-1 levels were detected. Mann-Whitney test and correlation test were used to analyze results. IL-4 level was significantly (p < 0.05) higher in patients with localized disease compared to the group with systemic amyloidosis. IL-1 was instead significantly (p < 0.01) increased in systemic disease. In this, an inverse correlation between IL-4 and IL-1a was found (r2= –0.707; p = 0.05). In systemic amyloidosis, the regulatory mechanism of Th1/Th2 response was polarized versus Th1, as demonstrated by low serum level of IL-4 and high level of IL-1. The negative correlation between serum IL-4 and IL-1 levels demonstrates a disregulation of the immune system in systemic disease as supported by the increased activity of Th1. The results seem to hypothesize that IL-4 could be able to antagonize the diffusion of disease, as demonstrated by the higher IL-4 serum levels in localized amyloidosis. So IL-4 and IL-1 can be considered sensible markers for the inflammatory response assessment both in systemic and localized amyloidosis. Disclosures: No relevant conflicts of interest to declare.

NT-ProBNP and VEGF Serum Evaluation In AL Amyloidosis

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5008-5008
Author(s):  
Francesca Saltarelli ◽  
Alessandro Moscetti ◽  
Maria Paola Bianchi ◽  
Guglielmo Bruno ◽  
Gerardo Salerno ◽  
...  
Keyword(s):  
Cardiac Involvement ◽  
Conflicts Of Interest ◽  
Vascular Endothelial Cells ◽  
Systemic Disease ◽  
Serum Levels ◽  
Systemic Amyloidosis ◽  
The Other ◽  
Al Amyloidosis ◽  
Vascular Endothelial ◽  
Heart Dysfunction

Abstract Abstract 5008 AL amyloidosis is a plasmacellular dyscrasia in which fibrillary deposits containing monoclonal immunoglobuline light chains infiltrate tissues causing their dysfunction and failure. Amyloidosis could be classified into rare localized or more frequent systemic forms such as AL amyloidosis. Cardiac dysfunction is a very frequent feature in AL amyloidosis patients. To evaluate heart involvement both in systemic and localized AL amyloidosis, serum levels of pro-BNP (peptide NT-proBNP; 76 amino acids) and VEGF were investigated. NT-proBNP has been described as an useful marker for heart dysfunction and its role as a prognostic factor for patients with systemic AL amyloidosis has been validated. VEGF is a signaling protein that stimulates new blood vessel formation and showed to be a mitogen for vascular endothelial cells. Serum NT-proBNP and VEGF levels were performed in systemic or localized AL amyloidosis patients to evaluate if there is any correlation between them. Blood samples were collected from 8 patients with systemic amyloidosis and from 4 patients with localized amyloidosis. To analyze the results of NT-proBnp and VEGF, Mann-Whitney test and Spearman correlation were performed. Serum NT-proBNP values were significantly increased in systemic disease (p=0.004). VEGF serum levels were also significantly higher in patients with systemic disease compared to the other group (p=0.027). No significant correlation between NT-proBNP and VEGF levels was found. We know that proBNP levels are significantly increased in patients with systemic amyloidosis and cardiac involvement. On the other hand, VEGF serum levels resulted to be increased in systemic disease. Nevertheless, on the basis of our results, we found absence of a significant correlation between NT-proBNP and VEGF increases. In our opinion, such finding could suggest that VEGF based neoangiogenesis is not significantly involved in AL amyloidosis heart dysfunction. Disclosures: No relevant conflicts of interest to declare.

Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Intervention Group ◽  
Serum Levels ◽  
Control Group ◽  
Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

The Serum Fas and Fas Ligand levels in Childhood Acute Leukemias.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4724-4724
Author(s):  
Alev Kiziltas ◽  
Bulent Antmen ◽  
Ilgen Sasmaz ◽  
Yurdanur Kilinc ◽  
Mustafa Yilmaz ◽  
...  
Keyword(s):  
Fas Ligand ◽  
Conflicts Of Interest ◽  
Cytotoxic T Cells ◽  
Lymphoblastic Leukemia ◽  
Serum Levels ◽  
Control Group ◽  
Extrinsic Pathway ◽  
Acute Leukemias ◽  
Mean Values ◽  
The Mean

Abstract Abstract 4724 Aim Abnormalities and alterations in apoptosis mechanism may lead to cancer development. Cystean proteases enzymes, called caspases, appear to be involved in both the initial signaling events. There are many proteins that trigger intrinsic and extrinsic pathway and induce apoptosis signals. Fas and its specific ligand that known as Fas Ligand are the best defined dead receptors and have functions in apoptosis regulation with many tumor types. Fas binds the ligand on the cytotoxic T cells and start apoptosis. Objectives of this study were to determine serum levels of Fas and Fas Ligand at the time of diagnosis in childhood acute leukemias that may be play important role in apoptosis mechanism. Patients and Methods In this study, we investigated serum Fas and Fas Ligand levels by using ELISA method in childhood acute leukemias. Twenty-nine cases with acute lymphoblastic leukemia and twenty-three cases with acute myeloblastic leukemia at the ages of 1-18 years are included this study. The age distrubition of the control group varied 1-15 years consisted of twenty-seven children. We investigated serum Fas and Fas Ligand levels at the time of diagnosis from peripheral blood samples. Results The comparison of the mean values of Fas and Fas Ligand levels in acute leukemia patients groups and control group have shown important difference as statistically (p<0,05). The mean values of Fas and Fas Ligand levels were higher in ALL and AML patients. The comparison of the mean values of Fas and Fas ligand levels in ALL and AML patients have shown no difference (p>0,05). The comparison of the Fas levels in ALL patients according to immunophenotypes; CALLA(+) B-ALL have higher mean level than T-ALL and shown important difference as statistically (p<0,05). The comparison of the mean values of Fas level at the diagnosis in ALL patients who had relapsed and patients who had remission have shown important difference (p<0,05). The mean values of Fas level were found higher in relapsed ALL patients. In these results showed that Fas and Fas ligand may play important role in apoptosis mechanism. Disclosures: No relevant conflicts of interest to declare.

IL-1β Plays An Important Role On Thrombocytosis In An Immune Vasculitis Model Via Promoting Megakaryopoiesis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2325-2325
Author(s):  
Mo Yang ◽  
Min Zhou ◽  
Su yi Li ◽  
Beng Chong ◽  
Xiao jing Li
Keyword(s):  
Bone Marrow ◽  
Platelet Count ◽  
Platelet Aggregation ◽  
Conflicts Of Interest ◽  
Serum Levels ◽  
Control Group ◽  
Type I ◽  
Anti Inflammation ◽  
Immune Vasculitis

Abstract Thrombocytosis and inflammation cytokines may be involved in the pathogenesis of vasculitis. Our previous study have showed that major inflammation cytokine IL-1β play an important role on in-vitro megakaryopoiesis (Yang M et al, Br J Haematol 2000). In this study, we investigated the changes of IL-1β and megakaryopoiesis and the effect of aspirin in an immune vasculitis model. Rabbit immune vasculitis model was established by intravenous injection of bovine serum albumin. In this model, platelet number and function of periphery blood, megakaryocyte number and the CFU-MK formation of the bone marrow, and serum levels of inflammatory cytokines were investigated. After treatment with BSA for 7 days, the platelet count, platelet aggregation and the expression of AnnexinⅤ were significantly increased in this vasculitis model group compared with normal control group (n=6). The serum levels of inflammatory cytokine IL-1β was also significantly higher in vasculitis model. There were positive correlations between platelet count and IL-1β levels (R=0.55), platelet aggregation and IL-1β levels (R=0.603). Treatment with aspirin (100 mg/kg/d) significantly decreased all these parameters, showing aspirin had anti-platelets and anti-inflammation effects. Our results also demonstrated that megakaryocyte number and the formation of CFU-MK were significantly increased in vasculitis group as compared to those in normal group. Treatment with aspirin significantly reduced the number of megakaryocytes and the formations of CFU-MK in bone marrow in this immune vasculitis model. Our study further demonstrated that IL-1β alone or in combination with TPO induced in-vitro CFU-MK formation. Using RT-PCR techniques, the mRNA of of IL-1 type I and type II receptors (IL-1 RI and RII) were detected in cultured CD61+ CD41+ cells and four megakaryocytic cell lines. The expression of IL-1 RI and RII was also confirmed by flow cytometry and immunofluorescence staining in bone marrow megakaryocytes. Moreover, the IL-1R bloker can reduced IL-1β induced megakaryopoiesis. This sudy showed that IL-1β may play an important role in the pathogenesis of immune vasculitis. Aspirin has anti-inflammation effects in this model which may be mediated via inhibiting megakaryopoiesis and platelet formation. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Effect of Proinflammatory Cytokines (IL-6, TNF-α, and IL-1β) on Clinical Manifestations in Indian SLE Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Vinod Umare ◽  
Vandana Pradhan ◽  
Milind Nadkar ◽  
Anjali Rajadhyaksha ◽  
Manisha Patwardhan ◽  
...  
Keyword(s):  
Proinflammatory Cytokines ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Organ Damage ◽  
Inactive Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Sledai Score ◽  
Active Disease

Systemic lupus erythematosus (SLE) is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. In this study we have investigated the effect of proinflammatory cytokines (IL-6, TNF-α, and IL-1β) on clinical manifestations in 145 Indian SLE patients. One hundred and forty-five healthy controls of the same ethnicity served as a control group. Clinical disease activity was scored according to SLEDAI score. Accordingly, 110 patients had active disease and 35 patients had inactive disease. Mean levels of IL-6, TNF-α, and IL-1βwere found to be significantly higher in SLE patients than healthy controls (P<0.001). Mean level of IL-6 for patients with active disease (70.45±68.32 pg/mL) was significantly higher (P=0.0430) than those of inactive disease patients (43.85±63.36 pg/mL). Mean level of TNF-αwas44.76±68.32 pg/mL for patients with active disease while it was25.97±22.03 pg/mL for those with inactive disease and this difference was statistically significant (P=0.0161). Similar results were obtained for IL-1β(P=0.0002). Correlation between IL-6, TNF-α, and IL-1βserum levels and SLEDAI score was observed (r=0.20,r=0.27, andr=0.38, resp.). This study supports the role of these proinflammatory cytokines as inflammatory mediators in active stage of disease.

scholarly journals EVALUATION OF D-DIMER SERUM LEVELS AMONG PATIENTS WITH CHRONIC SPONTANEOUS URTICARIA AND ITS CORRELATION WITH DISEASE SEVERITY.

2020 ◽  
pp. 1-3
Author(s):  
Aditi Jaiswal ◽  
Kiran Godse
Keyword(s):  
Disease Activity ◽  
Disease Severity ◽  
Rank Correlation ◽  
Serum Levels ◽  
Analysis Data ◽  
Control Group ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Positive Correlation ◽  
D Dimer

Aims: To evaluate D-Dimer serum levels in patients with chronic urticaria and its correlation with disease activity. Settings and Design: Single centre Cross sectional prospective observational age & sex matched case-control study at Dermatology OPD of a tertiary referral centre. Methods and Material: This study was conducted from January 2018 to June 2019. We in-cluded 33 patients with CU and 30 controls . They were recruited from urticaria clinic. All cases were subjected to history taking, general and dermatological examination. The serum levels of D-Dimer were measured by Semiquantitative, immunofiltration kits. Statistical analysis: Data was analysed by Statistical Package for Social Sciences (SPSS) ver-sion 21.0. Tests used were Independent t test/Mann-Whitney Test, Chi-Square test/Fisher’s Exact test, Spearman rank correlation coefficient, Kolmogorov- Smirnov test.. Results: Patients with active CU had elevated D-Dimer serum levels (p<0.0001) when com-pared with the control group (papulo-squamous disorder). Of 33 CSU patients, D-dimer level was elevated in 19 patients (57.58%). There was statistically significant positive correlation between disease severity (UAS7) and plasma D-dimer level (p <.0001, r =0.935). Conclusions: This study showed elevated D-dimer levels in more than half of Indian patients with CSU. There was a positive correlation between plasma D-dimer levels and the severity of disease activity. Investigation for plasma D-dimer level may be an alternative objective way to evaluate disease severity in patients with CSU. Limitations: Low sample size . Semi quantitative method was used instead of ELISA for D-Dimer.

Valuation of MCP-1 and VEGF Chemokines In Serum of Patients with AL Amyloidosis

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1922-1922
Author(s):  
Alessandro Moscetti ◽  
Francesca Saltarelli ◽  
Maria Paola Bianchi ◽  
Guglielmo Bruno ◽  
Gerardo Salerno ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Inflammatory Process ◽  
Conflicts Of Interest ◽  
Systemic Disease ◽  
Inflammatory Cells ◽  
Mononuclear Phagocytes ◽  
Systemic Amyloidosis ◽  
Light Chains ◽  
Al Amyloidosis ◽  
Localized Amyloidosis

Abstract Abstract 1922 AL amyloidosis is a pathology characterised by the deposition of fibrillary aggregates of immunoglobuline light chains with β-sheet conformation. The light chains are synthetized by neoplastic plasma cell and fibrils deposition can infiltrate tissues leading to multi systemic organ damage. To evaluate if vascular modifications are involved in AL amyloidosis, inflammatory activity of cytokines as MCP-1 and VEGF was investigated. MCP-1 is a chemokine that activates mononuclear phagocytes by promoting leukocyte-endothelium binding and migration to sites of inflammation, while VEGF is an endothelial cell mitogen and permeability factor that is potently angiogenic in bone marrow of AL amyloidosis patients. Aim of this study is to evaluate serum cytokines MCP-1 and VEGF levels in patients with systemic or localized AL amyloidosis at presentation to find out potential differences useful to define a characteristic inflammatory pattern. Blood samples were collected from 8 patients with systemic amyloidosis and from 4 patients with localized amyloidosis and analyzed for serum MCP-1 and VEGF levels. Mann-Whitney test and Spearman correlation were used to compare results. MCP-1 level was significantly higher in the serum of patients with systemic disease (350.52±58.70 pg/ml) compared to the group of patients with localized amyloidosis (147.82±26.03; p=0.004); VEGF was also significantly increased in systemic disease group (p= 0.028). In addition, a positive correlation between MCP-1 and VEGF (r2= 0.755; p=0.031) has been found in the group of patients with systemic amyloidosis. Results seems to suggest a difference in serum cytokine MCP-1 and VEGF levels between AL systemic and localized amyloidosis. In systemic amyloidosis the neoplastic plasma cells interact with bone marrow microenvironment resulting in VEGF release leading to a new angiogenesis also supported by an inflammatory cells increase. The MCP-1 activates and promotes leukocyte-endothelium binding increasing the inflammatory process. The high correlation between MCP-1 and VEGF suggests a positive relationship between a new angiogenesis and a migration of inflammatory cells in the bone marrow stroma. On the basis of our results, MCP-1 and VEGF chemokines can be used to evaluate the inflammatory process in patient with systemic or localized AL amyloidosis. Disclosures: No relevant conflicts of interest to declare.

MR-Proanp and VEGF As Markers of Response to MEL-DEX Treatment in Systemic AL Amyloidosis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4970-4970
Author(s):  
Alessandro Moscetti ◽  
Giusy Antolino ◽  
Federica Resci ◽  
Daniela De Benedittis ◽  
Virginia Naso ◽  
...  
Keyword(s):  
Stress Responses ◽  
Plasma Cells ◽  
Disease Risk ◽  
Conflicts Of Interest ◽  
Serum Levels ◽  
Response To Treatment ◽  
Al Amyloidosis ◽  
Significant Independent Predictor ◽  
Heart Involvement ◽  
Cell Mitogen

Abstract Abstract 4970 Background. The natriuretic peptides are a family of different biomarkers including NT-proBNP and MR-proANP. As recommended by guidelines, they are important in heart failure diagnosis and monitoring. MR-proANP (1–98) is the mid-regional portion of the active atrial natriuretic peptide prohormone (99–126) and is considered a significant independent predictor of death, adding prognostic value to NT-proBNP. Vascular endothelial growth factor (VEGF) is an endothelial cell mitogen with angiogenic and nonangiogenic role in several disorders including cardiovascular ones. Moreover, it regulates multiple cellular stress responses, including survival, proliferation, migration and differentiation. Systemic AL amyloidosis represents a peculiar disease with a clinical heart involvement that needs of a specific monitoring in order to avoid poor outcome. Aims and Methods. The study was devoted to evaluate treatment related changes in cardiovascular activity by MR-proANP and VEGF serum levels in systemic AL amyloidosis. Blood samples were collected from 8 patients with systemic AL amyloidosis (median age 72. 8 yrs) admitted to our Unit and analyzed for serum MR-proANP (mean±SD) and VEGF levels (Kits Brahms MR-proANP Kryptor and Randox Evidence Biochips Arrays). According to age and disease risk stratification all patients were treated with upfront oral Mel-Dex association (Melphalan 9 mg/sm, Dexamethasone 20mg day 1–4 q28). From each patient 2 samples of peripheral blood were performed (T0: at exordium of disease and T1: at conclusion of the first course of treatment). The sera were frozen to −80°C until their use. The results were analyzed by paired t test and Person correlation, p values ≤ 0. 05 were considered statistically significant. Results. VEGF serum levels were significantly (p=0. 01) reduced at the end of the first course of treatment (M±SD: T0: 282. 3 ± 86. 23 pg/mL vs. T1: 189. 7 ± 64. 24 pg/mL). Also MR-proANP serum levels were significantly decreased (M±SD: T0: 204. 4 ± 28. 82 pmol/L vs. T1: 160. 2 ± 21. 05 pmol/L, p=0. 008; see figure). The decreases of VEGF and MR-proANP were significantly (r =0. 79; p=0. 02) related. Conclusions. MR-proANP serum levels reduction could be hypothized as related to the decrease of inflammatory activity of disease, including heart involvement and a consequent reduced probability of fatal events. Our hypothesis seems to be confirmed by VEGF serum level reduction suggesting an inhibition of new angiogenesis with reduced interactions between neoplastic plasma cells and bone marrow microenvironment. The effective role of treatment in reducing the disease activity is demonstrated by the significant correlation between VEGF and MR-proANP level decreases. MR-proANP and VEGF could be used to evaluate and select systemic AL amyloidosis patients with an early good response to treatment. Disclosures: No relevant conflicts of interest to declare.

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