Study of adenosine deaminase activity in pulmonary tuberculosis and other common respiratory diseases

Tuberculosis has, in a short span of time, become a major health problem in the third world or developing countries like India. In view of this, a retrospective study was conducted to study Adenosine deaminase activity in serum and pleural fluid in patients affected with Pulmonary Tuberculosis and other common non-tubercular chronic respiratory diseases. The study was carried out on 100 patients suffering from various pulmonary disorders, between January 2002 and August 2002. Thirty-five normal healthy individuals were included as control subjects. ADA estimation was done by sensitive colorimetric method. The study revealed that the serum ADA activity was higher in patients of tuberculous pulmonary and pleural diseases and non-tuberculous pulmonary diseases than in control subjects. The mean serum ADA activity in the patients’ group was 35.5±6.93 u/l as compared to 16.20±2.85 u/l in control group, showing a highly significant (P≪0.001) difference. ADA activity was highest in tuberculous pleuropulmonary diseases. The pleural fluid ADA activity was higher in pyogenic pleural effusion than in tuberculous pleural effusion.     

Usefulness of ferroxidase activity of ceruloplasmin in the diagnosis of Wilson’s disease

Serum ceruloplasmin is one of the most commonly used screening tests for Wilson’s disease. However immunological assays for ceruloplasmin are not recommended for diagnosis and management of Wilson’s disease through calculation of free copper index. Enzymatic methods using non-physiological substrates have toxicity and stability problems, making them difficult to automate. Ferroxidase assays may be a satisfactory alternative for measuring serum ceruloplasmin. The o-dianisidine hydrochloride manual method for estimation of serum ceruloplasmin enzyme activity was compared with an automated method using the ferroxidase activity of ceruloplasmin in measurement in a double blind study in 91 consecutive patients screened for Wilson’s disease. The o-dianisidine and ferroxidase methods both successfully identified 7 patients with Wilson’s disease. Values for these 7 patients in the o-dianisidine and ferroxidase methods were median 5.0 (range 0–16.0 U/L) and median 45.0 (range 4–166 U/L) respectively. There were 7 other positive values (<62 U/L) with the o-diansidine method and 2 (<200 U/L) with the ferroxidase method, where WD was not confirmed. ROC curves for both methods showed area under the curve of 0.998 for o-dianisidine and 0.997 for ferroxidase. Using literature cut off values of 62 U/L and 200 U/L respectively both methods had 100% sensitivity and specificity was 91.7% (o-dianisidine) and 97.6% (ferroxidase). For the o-dianisidine assay, specificity was improved to 98.8% using a cut off of 22.5 U/L. In the 84 persons (46 adults and 38 children) in whom the diagnosis of Wilson’s disease was not established, the mean value for ceruloplasmin activity by the o-dianisidine and ferroxidase methods was 124.7 ± 48.7 U/L and 571.4 ± 168.1 U/L respectively. There were no significant differences between sex or age of patients (p > 0.29). In a subsequent evaluation with 372 specimens, the Pearson correlation coefficient between the assays was 0.908, p < 0.01, slope 4.06, intercept 265.8, with the manual assay as the x-axis. The ferroxidase assay is a suitable replacement for the o-dianisidine assay in detecting patients with Wilson’s disease.     

Arterial oxygenation during acetate haemodialysis,sequential haemodialysis and isolated ultrafiltration

Partial pressure of oxygen (PO₂) was estimated at various intervals during conventional Acetate hemodialysis (A), Sequential haemodialysis (SHD) i.e. ultrafiltration followed by haemodialysis and Isolated ultrafiltration (IUF) on 35 patients. Study was extended for PO₂ measurement one hour after termination of above treatment. There was a significant lowering of PO₂ observed at 1 h. during ‘A’ (93.3±10.5 Pre to 78.8±4.2 post, P<0.01) during SHD, a significant fall was observed after the dialysate flow was started (81.1±11.5 Pre to 76.3±11.8, 2hr P<0.05) at second hour of the procedure. IUF showed significant increase (88.4±10.3 pre, to 100.4±12.4, post, P<0.01) at the end of treatment. A significant rebound increase was observed after one hour of termination of ‘A’. Changes observed after termination of ‘SHD’ and ‘IUF’ were not significant. The results suggest that, though dialyzer membrane lowers the PO₂ level, major role is played by the dialysis fluid.     

Seminal plasma levels of 15-F2α-isoprostane, malondialdehyde and total homocysteine in normozoospermic and asthenozoospermic males

It has been proposed that oxidative stress plays an important role in male infertility. The aims of this study were to compare seminal plasma levels of 15-F2t-isoprostane (8-iso-PGF2α), malondialdehyde (MDA), and total (sum of free and bound) homocysteine (tHcy) from normozoospermic vs. asthenozoospermic men, and to examine the relationships between tHcy and lipid peroxidation products. The study was a case-control study with a simple random sampling. The case group was consisted of 15 asthenozoospermic males. This group was compared with 15 normozoospermic men. Seminal plasma levels of 15-F2α-isoprostane and tHcy were measured using commercially available enzyme immunoassay (EIA) kits. MDA levels were determined by the thiobarbituric acid (TBA) assay. The Mann-Whitney U test was used to compare two groups. Coefficients of correlation were calculated using Spearman’s correlation analysis. All hypothesis tests were two-tailed with statistical significance assessed at the p value <0.05 level. MDA levels were higher in asthenozoospermic subjects than in control subjects (0.72±0.06 μM vs. 0.40±0.06 μM; p<0.05). No differences were seen in 15-F2α-isoprostane levels in asthenozoospermic subjects and controls (65.00±3.20 pg/ml vs. 58.17±4.12 pg/ml; p>0.05). Interestingly, tHcy levels were to be slightly higher in asthenozoospermic subjects than in controls (6.18±1.17 μM vs. 4.8±0.52 μM). Sperm motility was inversely correlated with seminal plasma 15-F2α-isoprostane and MDA levels, respectively (p<0.05). In summary, seminal plasma levels of 15-F2α-isoprostane and tHcy showed no significant difference between normozoospermic and asthenozoospermic men. Sperm motility was not correlated with seminal plasma levels of tHcy. No relationship was found between tHcy and lipid peroxidation.     

Comparison of two methods of estimation of low density lipoprotein cholesterol, the direct versus friedewald estimation

Current recommendations of the Adult Treatment Panel and Adolescents Treatment Panel of National Cholesterol Education Program make the low-density lipoprotein cholesterol (LDL-C) levels in serum the basis of classification and management of hypercholesterolemia. A number of direct homogenous assays based on surfactant/solubility principles have evolved in the recent past. This has made LDL-C estimation less cumbersome than the earlier used methods. Here we compared one of the direct homogenous assays with the widely used Friedewald’s method of estimation of LDL-C to see the differences and correlation. We used direct homogenous assay kit to estimate serum LDL-C and high-density lipoprotein cholesterol (HDL-C). Serum Triglyceride (TG) and Total Cholesterol (TC) was estimated and using Friedewald’s formula LDL-C was calculated. The LDL-C level obtained by both methods in 893 fasting serum samples were compared. The statistical methods used were paired t-test and Pearson’s correlation. There was significant difference in the mean LDL-C levels obtained by the two methods at the TG levels <200 mg/dl (p<0.02) and TC levels >150 mg% (p<0.001). The correlation coefficient (r) between Friedewald’s and direct assay estimation was 0.88. Friedewald’s method classified 23.5 % of patients as high cardiac risk whereas there were 17.58% by direct assay. Both had good correlation even though the serum triglyceride and total cholesterol levels affect the difference in LDL-C estimated by both methods. Taking into account the cost and performance, Friedewald’s method is as good or even better for classifying and managing patients.     

Role of oxidative stress and antioxidants in aetiopathogenesis and management of oral submucous fibrosis

Lipid peroxidation product, malonaldehyde (MDA) and antioxidants were estimated in plasma and erythrocytes of 34 cases of oral submucous fibrosis (OSMF) of different grades with equal number of healthy controls to evaluate the association of reactive oxygen species (ROS) and OSMF. While plasma MDA was found to be significantly higher in patients (3.3±0.4 nmole/ml, P<0.001) as compared to controls (2.4±0.5 nmole/ml), plasma beta carotene and vitamin E levels were found to be decreased significantly in patients (81.7±14.3 μg/100 ml, P<0.001; 9.3±0.9 mg/L, P<0.01 respectively) with respect to healthy controls (110±20.8 μg/100 ml and 10.1±1.2 mg/L). The decrease in beta-carotene and vitamin E was found to be more significant in OSMF grade II and III than in grade I. After 6 weeks of oral administration of beta-carotene and vitamin E, patients showed increase in plasma level of these two antioxidants along with decrease in MDA level associated with clinical improvement.     

Role of reactive oxygen species in pathogenesis of nephrotic syndrome

Nephrotic syndrome is the common chronic disorder characterized by alteration of permeability of the glomerular capillary wall, resulting in its inability to restrict the urinary loss of proteins. Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia associated with peripheral edema. The molecular basis of glomerular permselectivity remains largely unknown. In recent years it has been proposed that Nephrotic syndrome is a consequence of an imbalance between oxidant and antioxidant activity. The present study was aimed to test that the reactive oxygen species are the mediators of excessive protein permeability and other complications of Nephrotic syndrome. For this 30 adults with Nephrotic syndrome were studied. The control group comprised 30 healthy adults matched for age. Serum levels of lipid peroxides, nitric oxide (NO⊙), α- tocopherol, ascorbic acid, erythrocyte superoxide dismutase activity, serum albumin, uric acid, cholesterol and plasma total antioxidant capacity were measured. Student’s ‘t’ test was applied for statistical analysis. There was a significant increase in lipid peroxide (1.58 ± 0.42 in controls, 3.64 ±1.3 in patients) (P<0.001) levels in study group as compared with controls. α-tocopherol (12.95 ± 1.04 in controls, 9.93 ± 1.43 in patients) (P<0.001), erythrocyte SOD activity(1.88 ± 0.9 in controls 1.07 ± 0.5 in patients) (P=0.01), serum albumin(4.06 ± 0.50 in controls, 3.04 ± 0.11 in patients) (P<0.001), and plasma total antioxidant capacity (847.33 ± 126.83 in controls, 684.00±102.94 in patients) (P<0.001) were significantly decreased. There was non-significant increase in uric acid (P>0.05), a non-significant decrease in NO⊙ (38.48 ± 15.47 in controls 37.47 ± 14.27 in patients) (P>0.05) and ascorbic acid levels ascorbic acid,( 0.95 ± 0.31in controls 0.79 ± 0.30 in patients) (P>0.05) in study group as compared with controls. Imbalance between oxidants and antioxidants may contribute to pathogenesis of proteinuria and related complications in nephrotic syndrome.     

Evaluation of polymerase chain reaction for rapid diagnosis of clinically suspected tuberculous pleurisy

Pleural effusion is one of the commonest presentations of tuberculosis, the clinical manifestations being typically abrupt resembling bacterial pneumonia. Since delayed hypersensitivity is the underlying immune response, bacterial load is very low. Owing to these facts, tuberculous pleurisy as an extra-pulmonary disease poses a diagnostic dilemma. The conventional bacteriological methods rarely detect Mycobacterium tuberculosis in pleural fluid and are of limited use in diagnosis of tuberculous pleurisy. We evaluated the efficacy of polymerase chain reaction (PCR) in the diagnosis of tuberculous pleurisy by targeting the gene segment coding for MPB64 protein specific forMycobacterium tuberculosis. Based on the clinical criteria, 82 patients with lymphocytic exudative pleural effusion were included in the study. Patients were analyzed in two groups; one group consisting of 48 patients of tubercular pleural effusion confimed by various diagnostic procedures and another group of 34 patients comprising of non-tubercular pleural effusion. There were no false positive results by PCR and the specificity worked out to be 100%. Twenty two patients tested positive for Mantoux with a sensitivity of 45%. ZN-staining for AFB was found in samples from 15 patients (20% sensitivity). ADA was positive for 28 patients with a sensitivity of 53%. PCR was positive for 32/48 patients (67% sensitivity). Thus, PCR was found to be more sensitive than any other conventional method in diagnosis of clinically suspected tubercular pleurisy.     

Evaluation of A60 antibodies in pulmonary and neurotuberculosis

Humoral immune response against PPD derived A60 antigen was evaluated by quantification of serum A60 antibodies in thrity healthy adults not exposed to tuberculosis (Group 1), in twenty seven healthy adults exposed to tuberculosis patients i.e. staff working in wards of tuberculosis hospital for one to thirty years (group 2), in twenty five pulmonary tuberculosis patients admitted to the Institute for Chest Diseases, Hyderabad (Group 3) and in sixty neurotuberculosis patients admitted to Neurosurgery department of our institute (Group 4). Highly significant elevation of A60 antibodies was observed in pulmonary tuberculosis patients (p<0.01) compared to healthy adult groups. A significant elevation in serum was also observed in case of neurotuberculosis group compared to both healthy groups (p<0.01). A test on A60 antibodies in serum gavv a sensitivity of 100%, specificity of 96.6%, positive predictive value of 81% and negative predictive value of 100% for pulmonary tuberculosis, whereas a sensitivity of 58%, positive predictive value of 79% and negative predictive value of 75% were noted for neurotuberculosis patients. Results of A60 antibodies in ten cerebrospinal fluids (CSF) obtained from non tuberculosis patients and thirty two CSF from patients of neurotuberculosis did not show significant elevation of antibodies. However the ninetyfive percentile value of CSF A60 antibodies was higher in neurotuberculosis (7.4 U/ml) group compared to nontuberculous group (3.8 U/ml) and the test showed a good positive predictive value (83%), very low negative predictive value (25%) and low sensitivity (63%). Serum A60 antibody assay appears to be a good serological marker available today for pulmonary tuberculosis and a supportive marker for neurotuberculosis.     

Serum dehydroepiandrosterone and lipid peroxides in human volunteers of different age groups

The objective of the present study was to evaluate the changes in serum dehydroepiandrosterone (DHEA) and lipid peroxide levels during ageing in human subjects. Random blood samples were collected from a total of 128 apparently normal human volunteers of both sexes, whose age ranged between 21–70 years. The subjects were divided into groups of a decade years of age difference. Serum levels of dehydroepiandrosterone (DHEA), lipid peroxides as malondialdehyde (MDA), and insulin were analysed in all the subjects recruited in the study. In the present study there was decrease in serum DHEA levels with age (11.30 to 7.99 ng/ml). However the differences were significant only after 50 years up to 70 years. Serum MDA levels of these subjects were higher (3.91 to 4.74 ng/ml) as compared to the values reported earlier (2.64 to 3.94 ng/ml). The serum MDA levels also showed an increasing trend with age but the increase was significant only in the 40–50 years age group and values plateaud off at later ages. The MDA and DHEA levels in women in general were lower than in men and this could be due to female hormones, which are known to protect lipid against peroxidation. There was a significant negative correlation between age and DHEA (r=−0.311 P<0.05) and positive correction between MDA and age (r=+0.405 P<0.01). No significant differences were seen in serum insulin, albumin and total protein levels. These preliminary findings support the possible utility of DHEA and MDA as markers for chronological ageing.     

Serum lipids in hypothyroidism: Our experience

In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (P<0.05 & P<0.01) respectively. We conclude that hypothyrodism is associated with changes in lipid profile.     

VEGF、PTN在肺癌患者外周血及胸腔积液中表达及其意义

目的:以45名肺癌伴胸腔积液患者,50名肺癌组不伴胸腔积液患者,以及19名健康人为研究对象,探讨VEGF、PTN在肺癌患者外周血及胸腔积液中表达及其意义.方法:以ELISA法测定胸腔积液中VEGF及PTN表达水平.结果:肺癌伴胸腔积液组患者胸腔积液及外周血中VEGF、PTN表达水平明显高于肺癌不伴胸腔积液组和健康对照组外周血.差异有统计学意义(P＜0.05).结论:肺癌患者胸腔积液及外周血中VEGF、PTN表达明显升高,可能通过某一共同机制促进肿瘤转移、恶化.     

Use of specific IgE to fractions of gynandropsis gynandra pollen inin vitro diagnostic test

The study was aimed at presence of specific IgE antibody levelsinvitro to the identified antigen. Based on positive skin test with Gynandropsis gynandra and elevated levels of total IgE (>325 IU/ml) 104 patients were selected. Healthy, asymptomatic individuals (25) with low total IgE (<325 IU/ml) were included as controls. The mean OD values by ELISA for specific IgE were 0.67±0.21, 0.57±0.18 and 0.56±0.18 with whole pollen antigen, 46-37 kD fraction and 36-32 kD fraction, respectively. The specificity and sensitivity between skin test positivity with whole pollen antigen verses fraction with mol.wt 46-37 kD was 90% and 90% and for fraction with mol.wt 36-32 kD was found to be 81.1% and 89.4%. The clusters with molecular weights 46-37 kD and 36-32 kD may be useful inin vitro diagnostic test. Fractions within these clusters need to be identified for a higher specificity.     

Effect of low-dose omega-3 fatty acids substitution on blood pressure, hyperinsulinemia and dyslipidemia in Indians with essential hypertension: A pilot study

The present study comprised 100 patients of essential hypertension who were screened for fasting hyperinsulinemia, which was detected in 77% cases. Twenty such hyperinsulinemic cases were subjected to 4 weeks of dietary control phase followed by 6 weeks of omega-3 fatty acids substitution [either 0.6 g/d (group 1) or 1.2 g/d (group 2)]. The mean basal fasting plasma insulin levels were significantly higher (p<0.001) in patients of hypertension when compared to normal controls (126.51±80.36 and 19.35±12.61 μU/ml respectively). At the end of 4 weeks of diet control only, no significant change was observed in any parameter. After substitution of omega-3 fatty acid, a significant reduction of fasting plasma insulin levels in both group 1 (29%) and group 2 (22.8%) was observed (p<0.001). Significant reduction of systolic and diastolic blood pressure (16.4% and 25% respectively), serum cholesterol, triglycerides and low density lipoprotein was also noted in both groups (p<0.001), while high density lipoprotein increased by ∼8 mg% in both groups. Thus omega-3 fatty acid substituion in low dose along-with curtailment of dietary omega-6 fatty acid may be used as an adjunctive measure in the management of essential hypertension.     

Serum and platelet sialic acid in acute myocardial infarction

Blood samples from 39 patients with acute myocardial infarction and 15 healthy controls were analysed for serum and platelet sialic acid. Serum sialic acid levels in patients with acute myocardial infarction were significantly higher than controls (mean 2.7±0.46 μmol/ml Vs. 1.91±0.17 μmol/ml respectively). Levels of serum orosomucoid, an acute phase reactant, containing sialic acid, were also higher in these patients, suggesting a possible non-specific mechanism of increase in serum sialic acid concentration. In contrast, platelets contained significantly less sialic acid in patients with acute myocardial infarction than control (26.73±1.57 nmol/mg protein and 31.97±2.68 nmol/mg protein respectively).     

Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

The levels of fasting glucose, fasting insulin, insulin resistance (IR) and the prevalence of metabolic syndrome (MS) in a sample population of bipolar disorder (BPD) patients who were newly diagnosed and psychotropically naïve were assessed and compared with an age, sex and racially matched control population. 55 BPD-I patients (15–65 years) who were non-diabetic, nonpregnant, and drug naïve for a period of at least 6 months were included in the study. Diagnosis was made using the structured clinical interview for DSM-IV axis I disorders (SCID IV). IR was assessed using homeostasis model of insulin resistance (HOMA-IR); MS was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Data were compared with 25 healthy controls. BPD patients had significantly higher mean levels of fasting plasma insulin (13.2 ± 9.2 vs. 4.68 ± 3.1 μIU/ml, p < 0.05), postprandial plasma insulin (27.2 ± 14.5 vs. 18.1 ± 9.3 μIU/ml, p < 0.05) and a higher value of HOMA-IR (3.16 ± 2.2 vs. 1.19 ± 0.8, p < 0.05) when compared to the controls. A significantly higher proportion of patients of BPD compared to controls were manifesting levels of fasting plasma glucose, serum triglyceride and blood pressure higher than the cut off while waist circumference and serum HDL cholesterol failed to show any significant difference in the proportion. There was a significantly higher proportion of prevalence of IR between BPD cases and controls (26/55 vs. 2/25, z value 9.97, p < 0.05) while there was no significant difference in proportion of prevalence of MS between these two groups. Within BPD patients, logistic regression analysis showed that age, sex or current mood status (depressed/manic) were not significantly predictive of presence or absence of MS or increased IR.     

hs-CRP: A potential marker for hypertension in Kashmiri population

Hypertension is the most important public health problem in developing countries and one of the major risk factors for cardiovascular diseases, and it has been reported that hypertension is in part an inflammatory disorder and several workers have reported elevated levels of CRP in hypertensive individuals. The main aim of the present study was to evaluate the association between blood pressure and serum CRP levels across the range of blood pressure categories including prehypertension. A total of 104 patients and 63 control subjects were included in the present study. The level of CRP in the serum samples was estimated by a high sensitivity immunoturbidometric assay. Standard unpaired student’s ‘t’ test was used for comparison of hs-CRP levels between hypertensive patients and normotensive control subjects and between patient groups with different grades of hypertension and different durations of hypertensive histories. The mean serum hs-CRP level in hypertensive patients was 3.26 mg/L compared with 1.36 mg/L among normotensive control subjects (P<0.001). On comparison with normotensive control subjects, the hs-CRP levels vary significantly both with grades and duration of hypertension, with most significant difference found in patients with prehypertension (P<0.001), followed by Stage-I (P=0.01) and Stage-II(P=0.02) hypertensives. Significant difference in hs-CRP levels was also found in patients with shorter duration of hypertensive history (≤ 1year) when compared with those with ≥5 years of hypertensive history (P<0.01). Our study reveals a graded association between blood pressure and CRP elevation in people with hypertension. Individuals with prehypertension or with shorter duration of hypertension (≤1 Year) had significantly a greater likelihood of CRP elevation in comparison to chronic stage-I or stage-II hypertensives.     

Adjustments of serum lactate dehydrogenase isoenzymes and their significance in monitoring the treatment in patients with tubercular pyothorax

The adjustments and diagnostic significance of polyacrylamide gel electrophoretic (PAGE) profiles of lactate dehydrogenase isoenzymes (LDH: 1.1.1.27) was evaluated in the sera and pleural fluid of patients with tubercular pyothorax. Sera and pleural fluid samples were randomly collected from 72 and 18 patients respectively at two different timings; first, when patients were admitted to the Hospital and second, after an intensive phase of treatment. Sera of 20 healthy individuals served as control. Our results demonstrate significant differences in sera LDH (sLDH) and pleural fluid LDH (pfLDH) isoenzymes. In patients the order of LDH isoenzyme in sera and pleural fluid followed: LDH−5>−4>−2>−3>−1 and LDH-5>−4>−3>−2>−1 respectively. The ranking of activity levels in control was LDH−2>−1>−3>−5>−4. In the second phase of sampling from 31 patients, values of sLDH isoenzymes showed recovery and resembled profiles of controls. Therefore, the sLDH zymograms of patients can be used as the prognostic marker, since they tend to reach the normal level during recovery signifying the effect of chemotherapy in hospitalized patients. Moreover, according to the present findings on LDH-PAGE profiles, the levels of LDH-5 and-4 rise in pyothorax patients significantly (P<0.05). This elevation along with the rise in total LDH activity may, therefore, be used in the diagnosis and monitoring of tubercular pyothorax.     

Diagnostic efficiency of amylase and type IV collagen in predicting chronic pancreatitis

Chronic pancreatitis, an irreversible inflammatory disease of the pancreas, is associated with the replacement of the destroyed parenchyma by extended development of fibrosis. Despite marked progress in diagnostic tools, no consensus has been reached in diagnosis of chronic pancreatitis. In this study we examined the hematological and biochemical parameters among 40 chronic pancreatitis patients within 18 to 67 yrs. ESR level and ALP activity was elevated in 40% cases. Serum amylase activity increased in 32 patients and it showed significant correlation with ALP (r=0.458, p=0.003), CA-19.9 (r=0.556, p<0.001), and calcium level (r=−0.472, p=0.002). Type IV collagen level in chronic pancreatitis also elevated (164.4 ± 55.5 ng/ml) and showed negative significant correlation with calcium level (r= −0.505, p=0.001). However, no significant correlation was observed between amylase activity and type IV collagen (r=0.289, p= 0.07).     

Serum Cytokine Profile in Psoriasis-A Case–Control Study in a Tertiary Care Hospital from Northern India

Psoriasis is chronic autoimmune hyperproliferative skin disease with a population prevalence of 1.5–3%. The cause of psoriasis is still not fully understood. It has been hypothesized to be an immune-mediated disorder in which the excessive reproduction of keratinocytes is due to cytokines such as interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha, secreted by infiltrating CD4⁺ and CD8⁺ T cells and natural killer cells. The aim of our study was to determine the serum levels of TNF-α, IL-4, IL-6 & IL-10 in psoriasis patients and compare it with healthy controls. 30 clinically diagnosed psoriasis patients and 30 age and sex matched healthy controls were included in the study. The serum cytokine levels were measured by solid phase sandwich ELISA (DIACLONE Research, France). TNF-α and IL-6 levels were significantly raised in patients and the results were statistically significant (P < 0.001). IL-4 levels were higher in patients than in controls (1.91 ± 4.7 pg/ml in cases & 0.9 ± 0.3 pg/ml in controls) but were not statistically significant. Interestingly, IL-10 levels were found to be higher in controls than in patients but again, it was not statistically significant. Pro-inflammatory cytokines play a pivotal role in the pathogenesis of psoriasis and it is the type 1(TH1) cytokine pattern, i.e., IL-6 & TNF-α, which predominate in the psoriatic T cell response. Further studies on IL-10 levels in psoriasis are recommended to establish their exact role in the pathogenesis of the disease.