Danuta Fedak

Publications of Danuta Fedak

• Osteoprotegerin is associated with markers of atherosclerosis and body fat mass in type 2 diabetes patients.

  Authors: Małgorzata Waluś-Miarka, Barbara Katra, Danuta Fedak, Danuta Czarnecka, Przemysław Miarka, Ewa Woźniakiewicz, Maciej Małecki, Barbara Idzior-Waluś

  International journal of cardiology. 03/2011; 147(2):335-6.

• [Fibroblast growth factor-23 (FGF-23). Part III. Relationship between FGF-23 serum concentration and cardio-vascular morbidity and mortality].

  Authors: Danuta Fedak, Katarzyna Bigaj, Władysław Sułowicz

  Przegla̧d lekarski. 01/2011; 68(9):614-8.

  In the 1st part of this review dealing with FGF-23 its composition, mode of action, and regulatory mechanisms of its secretion were described. In the 2nd part of this review, regulatory activity inIn the 1st part of this review dealing with FGF-23 its composition, mode of action, and regulatory mechanisms of its secretion were described. In the 2nd part of this review, regulatory activity in the calcium-phosphate homeo-stasis in different stages of chronic kidney disease (CKD) including dialyzed patients, subjects after parathyreoidectomy and patients after kidney transplantation were characterized. The aim of this part was to analyze the relationship between FGF-23 and left ventricular hypertrophy, vascular calcification and increased morbidity and mortality in patients with CKD. The current knowledge on FGF-23 has lead to suspect that in the nearest future it may serve as sensitive marker of early calcium-phosphate disturbances in patients with CKD.

• Serum matrix Gla protein concentrations in patients with mild and severe acute pancreatitis.

  Authors: Beata Kusnierz-Cabala, Anna Gurda-Duda, Bogdan Solnica, Danuta Fedak, Paulina Dumnicka, Jozefa Panek, Jan Kulig

  Clinical laboratory. 01/2011; 57(11-12):999-1006.

  Acute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. MatrixAcute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. Matrix Gla protein (MGP), beside fetuin A, is one of the main inhibitors of extraosseous calcification. In the present preliminary study we evaluated the relationship between MGP, lipase, and inflammation in AP patients. The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (day 1 - day 7 of hospitalization). The concentration of MGP, fetuin A, polymorphonuclear elastase (PMN-elastase), interleukin 6 (IL-6), interleukin 18 (IL-18), hepatocyte growth factor (HGF), high sensitivity tumor necrosis factor alpha (hs TNFalpha), soluble receptor of tumor necrosis factor II (sTNFRII), and neopterin were measured by ELISA kits; albumin, lipase and amylase were measured on a Modular P Chemistry Analyser (Roche Diagnostica, Germany); procalcitonin (PCT) was measured using the LUMItest PCT (Brahms, Germany), and serum amyloid A (SAA) and high sensitivity C-reactive protein (hs CRP) were measured using an immunonephelometric method on a Nephelometer BNII (Siemens Healthcare, Germany). MGP positively correlated with lipase activity (R = 0.64; p < 0.05) on day 1 after admission to hospital. Lower MGP levels were consistent with higher intensity of inflammation, as MGP significantly (p < 0.05) inversely correlated with IL-6 (R = -0.48 on day 3; R = -0.46 on day 5 and R = -0.52 on day 7 after admission), IL-18 (R = - 0.55; R = -0.60; R = -0.48 on day 1, day 3, and day 5, respectively), HGF (R = -0.58 on day 3), hs TNFalpha (R = -0.45 on day 1 and R = -0.64 on day 5), its soluble receptor sTNFRII (R = -0.63; R = -0.61; R = -0.59 on day 3, day 5, and day 7, respectively), hs CRP (R = -0.76 on day 1 and R = -0.83 on day 5), PCT (R = -0.62 on day 1 and R = -0.59 on day 7), SAA (R = -0.45 on day 5) as well as with neopterin (R = -0.52 on day 1 after admission). MGP levels dropped simultaneously with fetuin A (R = 0.50 on day 3; R = 0.60 on day 5 and R = 0.63 on day 7) and albumin concentrations (R = 0.51; R = 0.70; R = 0.94 on day 1, day 5, and day 7 day after admission, respectively). There was a relationship between lipase activity and MGP concentration on day 1 of hospitalization (R = 0.64; p < 0.05). Our preliminary results indicate that the MGP level correlated negatively with all of the proinflammatory cytokines and acute phase proteins studied in patients with AP, and positively with lipase, fetuin A, and albumin measurements. These findings may indicate the role of MGP in calcium and phosphate metabolism disturbances in the course of AP.

• [Fibroblast growth factor-23 (FGF-23). Part II. Significance in chronic kidney disease].

  Authors: Danuta Fedak, Katarzyna Bigaj, Władysław Sułowicz

  Przegla̧d lekarski. 01/2011; 68(7):367-71.

  Fibroblast growth factor-23 (FGF-23) is a phosphatonine of important value in maintenance of mineral homeostasis. In the 1st part of this review dealing with FGF-23 its composition, mode of action,Fibroblast growth factor-23 (FGF-23) is a phosphatonine of important value in maintenance of mineral homeostasis. In the 1st part of this review dealing with FGF-23 its composition, mode of action, and regulatory mechanisms of its secretion were described. In the 2nd part of this work, regulatory activity in the calcium-phosphate homeostasis in different stages of chronic kidney disease (CKD) with special attention to increased synthesis of FGF-23 in the course of declined glomerular filtration rate were elucidated. The FGF-23 concentration in dialyzed patients, subjects after parathyroidectomy and patients after kidney transplantation were characterized. The relationship between FGF-23 serum concentaration and cardiovascular morbidity and mortality will be presented in the 3rd part of this review.

• [Fibroblast growth factor-23 (FGF-23). Part I. Significance in phosphate homeostasis and bone metabolism].

  Authors: Danuta Fedak, Katarzyna Bigaj, Władysław Sułowicz

  Przegla̧d lekarski. 01/2011; 68(4):231-8.

  Fibroblast growth factor-23 (FGF-23) discovered in the last years, produced by osteocytes and osteoblast is hormone that lowers plasma phosphate level due to inhibition of renal tubule phosphateFibroblast growth factor-23 (FGF-23) discovered in the last years, produced by osteocytes and osteoblast is hormone that lowers plasma phosphate level due to inhibition of renal tubule phosphate reabsorption (phosphaturic effect). It diminishes gut absorption of phosphate as a result of lowered kidney 1alpha-hydroxylase activity and respective decreased active vitamin D1,25(OH)2D synthesis. FGF-23 acts in the presence of the co-receptor Klotho protein which stabilizes its binding with receptor. The pathological states that are associated with increased FGF-23 synthesis in normal renal function lead to hypophosphatemia, while its deficiency may lead to severe hyperphosphatemia. The increased FGF-23 synthesis in patients with chronic kidney disease (CKD) allow to maintain phosphate concentration in spite of severe kidney dysfunction. This problem will be discussed in the II-nd part of this review.

• [Interleukin 8 and interferon gamma in ocular toxoplasmosis].

  Authors: Jacek Czepiel, Grazyna Biesiada, Iwona Sobczyk-Krupiarz, Grazyna Miklasszewska, Danuta Fedak, Bogdan Solnica, Tomasz Mach, Aleksander Garlicki

  Klinika oczna. 01/2011; 113(4-6):149-52.

  Toxoplasmosis is one of the most common parasitic infections in the world, it is caused by Toxoplasma gondii. The infection is typically asymptomatic or the symptoms are very mild. Approximately 10%Toxoplasmosis is one of the most common parasitic infections in the world, it is caused by Toxoplasma gondii. The infection is typically asymptomatic or the symptoms are very mild. Approximately 10% patients have limphadenopathy, involvement of the others organs, like eyes, nervous system, liver, heart, are observed more rarely. The aim of our study was to assess the level of selected cytokines in blood among patients with ocular toxoplasmosis. We have enrolled in the study 30 patients, 19-42 years old, treated for ocular toxoplasmosis, and 20 healthy volunteers, 20-48 years old, to the control group. Tests for blood morphology, C-reactive protein, the level of IL-8 and IFN-gamma were performed in all patients. The blood parameters in toxoplasmosis group were performed before antiparasitic treatment was given. The level of IFN-gamma in blood was lower among patients with ocular toxoplasmosis comparing with control group (1.52 vs. 4.18 pg/ml; p = 0.002). The level of IL-8 in blood was lower among patients with ocular toxoplasmosis comparing with control group (22.96 vs. 94.3 pg/ml; p = 0,007). There were no correlations between analyzed cytokines and blood morphology or CRP. The low level of IFN-gamma and IL-8 in blood is important factor leading to reactivation of the ocular toxoplasmosis.

• Adipocytokines and blood pressure, lipids and glucose metabolism in hypertensive perimenopausal women.

  Authors: Agnieszka Olszanecka, Aneta Pośnik-Urbańska, Kalina Kawecka-Jaszcz, Danuta Czarnecka, Danuta Fedak

  Kardiologia polska. 07/2010; 68(7):753-60.

  The relationship between menopause and hypertension has been a topic of investigation for several years. In the pathogenesis of hypertension after menopause, metabolic disturbances play an importantThe relationship between menopause and hypertension has been a topic of investigation for several years. In the pathogenesis of hypertension after menopause, metabolic disturbances play an important role. To assess the relationship between adipocytokines and blood pressure, lipid and glucose metabolism in middle-aged perimenopausal women with essential hypertension. The study included 192 women aged 40 to 60 years (mean age 51.73 +/- 1.82 years), 152 with mild and moderate essential hypertension and 40 normotensive age-matched controls. The diagnosis of menopause was based on the data from medical records and confirmed by serum concentrations of the FSH. The study population was stratified according to the menopausal status into four subgroups (normotensive pre- and postmenopausal, and hypertensive pre- and postmenopausal patients). In all subjects anthropometrical measurements and 24-hour ambulatory blood pressure monitoring were performed. Serum levels of leptin, adiponectin and resistin were measured using immunochemical assays. Fasting blood samples were taken for glucose, insulin and serum lipids concentration. Postmenopausal women did not differ from premenopausal in respect to mean arterial pressure (normotensive 85.2 +/- +/- 5.6 vs 84.4 +/- 4.9 mm Hg; hypertensive 99.5 +/- 5.9 vs 98.8 +/- 5.3 mm Hg). Menopause had no effects on glucose metabolism. Total cholesterol and LDL cholesterol were significantly higher in postmenopausal women. In multiple regression analysis, the strongest predictors of hypertension were waist circumference and serum leptin concentration. Adiponectin and resistin levels were not associated with blood pressure values. In hypertensive postmenopausal females increased leptin level may play an important role in the pathogenesis of hypertension, independent of body mass index. Menopause per se does not affect blood pressure values. The influence of menopause on serum lipids may modulate the cardiovascular risk profile in postmenopausal females.

• [Neopterin in assessing the activity of inflammatory bowel diseases: ulcerative colitis and Crohn's disease].

  Authors: Irena Ciećko-Michalska, Danuta Fedak, Tomasz Mach

  Przegla̧d lekarski. 01/2010; 67(12):1262-5.

  The increase in the incidence of non-specific inflammatory bowel disease (IBD): ulcerative colitis (UC) and Crohn's disease (CD) makes the research of finding new biochemical markers, which wereThe increase in the incidence of non-specific inflammatory bowel disease (IBD): ulcerative colitis (UC) and Crohn's disease (CD) makes the research of finding new biochemical markers, which were characterized by a high sensitivity and specificity for an objective assessment of severity of the inflammatory process and the effectiveness of treatment of patients. The aim of this study was to estimate the usefulness of neopterin in serum in assessing the disease activity in comparison to other markers of inflammation such as C-reactive protein (CRP) and TNF-alpha in patients with exacerbation of IBD and healthy volunteers. The study included 32 patients with UC and 31 with CD. The control group consisted of 30 healthy volunteers matched for age and gender. Disease activity in patients with UC was assessed based on a point system Mayo. In patients with CD disease activity was calculated based on the CDAI (Crohn's Disease Activity Index). Serum concentrations of neopterin, CRP and TNF-alpha were measured. For determination of CRP were used immunochemical nephelometric method. TNF-alpha and neopterin was measured by ELISA. RESULTS: In patients with UC and CD increased concentration of serum neopterin was significantly higher compared to the control group (p < 0.005). We observed a positive correlation between increased concentrations of neopterin in serum and increased levels of TNF-alpha and CRP, increasing the number of leukocytes and platelets count and the degree of disease activity in patients with both UC and CD, but was no statistically significant differences between the two groups of patients. CONCLUSIONS: Measurement of neopterin concentration in serum may be a useful marker to assess disease activity in patients with IBD.

• [Application of chosen granulocyte markers in diagnostics of Leśniowski-Crohn's disease and ulcerative colitis--preliminary research].

  Authors: Danuta Fedak, Dorota Pawlica, Irena Ciećko-Michalska, Bogdan Solnica, Tomasz Mach

  Przegla̧d lekarski. 01/2010; 67(2):114-8.

  About 15% of cases of nonspecific inflammatory bowel diseases are difficult to diagnose based on clinical, radiological and histopatological criteria. In this study we tried to find a biochemicalAbout 15% of cases of nonspecific inflammatory bowel diseases are difficult to diagnose based on clinical, radiological and histopatological criteria. In this study we tried to find a biochemical marker helpful in differential diagnostics and assessment of activity of Leśniowski-Crohn's disease and ulcerative colitis. Plasma concentrations of leukocyte elastase and calprotectin (neutrophiles' proteins), eotaxin (eosinophils chemoatractant) and C-reactive protein were measured in 22 patients with Leśniowski-Crohn's disease and 28 patients witch ulcerative colitis. Significantly higher plasma levels of leukocyte elastase and calprotectin in patients witch ulcerative colitis as compared to Leśniowski-Crohn's disease were found. Thus leukocyte elastase and calprotectin can be considered additional markers differentiating these two diseases. Moreover, plasma concentrations of CRP and leukocyte elastase were associated with the clinical activity of Leśniowski-Crohn's disease whereas CRP and calprotectin concentrations were related to the clinical activity of colitis ulcerosa.

• Serum fetuin A concentrations in patients with acute pancreatitis.

  Authors: Beata Kuśnierz-Cabala, Anna Gurda-Duda, Józefa Panek, Danuta Fedak, Paulina Dumnicka, Bogdan Solnica, Jan Kulig

  Clinical laboratory. 01/2010; 56(5-6):191-5.

  Acute pancreatitis (AP) is a mild and self-limiting disease in most patients, but necrotizing pancreatitis develops in up to 20 - 30% of the cases. Early recognition of severe AP has been consideredAcute pancreatitis (AP) is a mild and self-limiting disease in most patients, but necrotizing pancreatitis develops in up to 20 - 30% of the cases. Early recognition of severe AP has been considered as a key determinant of successful therapy. The aim of this study was to evaluate the clinical value of fetuin A as the new predictor of complications and fatal outcome during acute pancreatitis (AP). The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (1st - 7th day of hospitalization). Fetuin A level was measured by ELISA kit (BioVendor). Median serum fetuin A concentrations had a tendency to decrease during examination from 0,371 g/L at admission to 0,288 g/L on the 7th day of hospitalization. In each of 7 days of observation, correlation between the increase in fetuin A and the absolute number of RBC was found (R = 0,34: 1st day R = 0,35: 3rd day, p < 0,05; R = 0,57: 5th day, p < 0,001; R = 0,65: 7th day, p < 0,01). Additionally, we observed the reverse relationship between the decrease in fetuin A and the increase in some inflammatory markers (IL-6: R = -0,61, p < 0,0001; SAA: R = -0,58, p < 0,001; HGF: R = -0,60, p < 0,01; PCT: R = -0,475, p < 0,01). The strongest positive correlation was noticed on the 5th day of hospitalization between decreased levels of fetuin A and albumin (R = 0,83; p < 0,0001). Fetuin A level monitoring is potentially a new marker for non-invasive and accurate prediction status for the hospitalization of patients with AP similar to other negative acute phase proteins like albumin.

• Effect of Hemodialysis on Acid Leukocyte-Type Ribonuclease, Alkaline Ribonuclease and Polymorphonuclear Elastase Serum Levels in Patients with End-Stage Renal Disease.

  Authors: Jerzy W Naskalski, Maria Kapusta, Danuta Fedak, Paulina Dumnicka, Beata Kuśnierz-Cabala, Marek Kuźniewski, Władysław Sułowicz

  Nephron. Clinical practice. 07/2009; 112(4):c248-c254.

  Background: Low-molecular-weight proteins (LMWPs) are substances of molecular weights 10-35 kDa, which accumulate in plasma of patients with end-stage renal disease (ESRD) due to the abolishment ofBackground: Low-molecular-weight proteins (LMWPs) are substances of molecular weights 10-35 kDa, which accumulate in plasma of patients with end-stage renal disease (ESRD) due to the abolishment of plasma renal filtration. LMWPs are considered as a separate group of uremic toxins. Aim: The influence of hemodialysis (HD) on the release of some LMWPs from leukocytes was assessed by comparing levels of serum pancreatic-type alkaline RNase and leukocyte-type acid RNase as well aspolymorphonuclear (PMN) elastase. Methods: The mentioned proteins were assayed in 58 ESRD patients on HD prior and after the dialysis session and compared with the results obtained from 36 healthy subjects. The levels of elastase and acid and alkaline RNase were correlated with HD parameters, residual diuresis, predialysis concentrations of serum creatinine, urea and albumin as well as pre- and postdialysis granulocyte count. Results: Changes in PMN elastase produced by the dialysis session positively correlate with changes in acid RNase levels (r = 0.3650; p = 0.0061), while there is no such correlation for alkaline RNase. There is a negative correlation between pre- and postdialysis differences in levels of acid and alkaline RNases (r = -0.3542; p = 0.008), indicating that HD induces liberation of a factor suppressing alkaline RNase. Levels of acid and alkaline RNase negatively correlate with residual diuresis, indicating its significance in control of LMWP accumulation (r = -0.3970; p = 0.0025; r = -0.2596; p = 0.0533, respectively). Conclusions: Dialysis treatment causes an increase in both acid leukocyte-type and alkaline pancreatic-type RNase activity in plasma. Dialysis-related increases in acid RNase activity correlate with the respective changes in PMN elastase, which suggests that leukocyte activation during dialysis contributes to an increase in plasma LMWPs.

• Indices of autonomic nervous system activity in women with mild hypertension in the perimenopausal period.

  Authors: Danuta Czarnecka, Aneta Pośnik-Urbańska, Kalina Kawecka-Jaszcz, Władysława Kolasińska-Kloch, Wiktoria Wojciechowska, Danuta Fedak

  Kardiologia polska. 04/2009; 67(3):243-251.

  Background: Hypertension is more common after menopause. Increased incidence of hypertension can be attributed to autonomic nervous system dysfunction. The relationship between the parameters ofBackground: Hypertension is more common after menopause. Increased incidence of hypertension can be attributed to autonomic nervous system dysfunction. The relationship between the parameters of heart rate variability (HRV), the levels of norepinephrine (NE) and leptin, and the menopausal status is still poorly understood, although there is some evidence suggesting distinct influence of estrogens on the above-mentioned indicators. Aim: To characterise the influence of menopause on indices of autonomic nervous system activity in women with mild hypertension. Methods: We recruited 112 women aged 45 to 55 years with mild essential hypertension confirmed by 24 h ambulatory blood pressure monitoring. The study population was divided into two groups - postmenopausal (A, n = 61; age 51,03 +/- 1,39 years) and premenopausal (B, n = 51; age 50 +/- 2 years). None of the women had organ damage, other risk factors, inflammation diseases, were on estrogen replacement therapy or oral contraceptives. In all patients we assessed the leptin and NE levels. The HRV time-domain and spectral parameters were analysed from Holter ECG recordings. Results: After menopause we observed, among others, the lower values of total power, VLF, HF (ms, %), LF (%) and LF:HF 24 h. The level of NE as well as the concentration of leptin were higher in postmenopausal rather than premenopausal women. Conclusion: Higher activity of sympathetic nervous system and higher levels of leptin in hypertensive women after menopause may suggest their participation in the pathogenesis of hypertension in this group of patients.

• Inflammatory markers 10 weeks after myocardial infarction predict future cardiovascular events.

  Authors: Marcin Marcinkowski, Danuta Czarnecka, Marek Jastrzebski, Danuta Fedak, Kalina Kawecka-Jaszcz

  Cardiology journal. 01/2007; 14(1):50-8.

  Background: The prognostic value of chronic inflammation markers in patients after myocardial infarction (MI) in the era of interventional treatment, statin and aspirin use is still unclear. Methods:Background: The prognostic value of chronic inflammation markers in patients after myocardial infarction (MI) in the era of interventional treatment, statin and aspirin use is still unclear. Methods: The study was carried out on 107 patients with a first MI who were followed up for 18 months. The end points were cardiac death, reinfarction or unstable angina pectoris. At 10 days and at 10 weeks we measured C-reactive protein (CRP), fibrinogen, soluble intercellular adhesion molecule 1 (sICAM-1), erythrocyte sedimentation rate (ESR), white blood cell count (WBC) and Chlamydia preumoniae antibodies. Results: During the follow-up period there were 22 events. The patients were divided into two subgroups: those with recurrent episodes and those without coronary events. Patients with recurrent episodes had significantly higher values of CRP (7.07 vs. 3.77 mg/l, p = 0.02), ESR at 1 h (24.3 vs. 13.3 mm; p = 0.01) and sICAM-1 (287.9 vs. 260.9 ng/ml, p = 0.04) at 10 weeks following infarction. Statistical analysis showed that sICAM-1 > 270 ng/ml, CRP > 1.83 mg/l and ESR at 1 h > 14 mm measured at 10 weeks were independent risk factors for recurrent cardiovascular events. In patients with coronary events between the 10th day and 10th week there was no decrease in inflammatory indices (WBC, ESR) and a tendency towards increasing sICAM-1. Conclusions: Increased inflammatory markers (CRP, ESR, sICAM-1) at 10 weeks after MI are independent risk factors for recurrent cardiovascular events. Measuring CRP, ESR and sICAM-1 at this time point is useful in long-term prognosis after MI. Changes in inflammatory indices (ESR, WBC, sICAM-1) measured at 10 days and 10 weeks following infarction show a different pattern in patients with and without recurrent cardiovascular events. (Cardiol J 2007; 14: 50-58).

• [Fetuin A and matrix GLA protein in long standing type I diabetic patients without ischaemic heart disease]

  Authors: Danuta Galicka-Latała, Marek Kuźniewski, Danuta Fedak, Ewa Konduracka, Jacek Sieradzki

  Przegla̧d lekarski. 02/2006; 63(12):1252-5.

  Fetuin A and matrix GLA protein--MGP are known as extraosseus calcification inhibitors. The aim of the study was to assess the dependence between metabolic status and fetuin A and matrix GLA proteinFetuin A and matrix GLA protein--MGP are known as extraosseus calcification inhibitors. The aim of the study was to assess the dependence between metabolic status and fetuin A and matrix GLA protein levels in type 1 diabetic patients without ischaemic heart disease. The study was performed in a group consisting of 35 patients with type 1 diabetes mellitus (22 women and 13 men). Mean age of the studied group equaled 38.8 +/- 11.24 years, duration of diabetes mellitus 20.77 +/- 10.11 years. Fetuin A significantly correlated with HDL-cholesterol (r = 0.45; p = 0.007). Total cholesterol, LDL-chol and triglicerides correlated with HbA1c (r = 0.40, p = 0.03; r = 0.41, p = 0.03 and r = 0.37, p = 0.05), HDL-chol significantly correlated with glucose level at the examination day (r = 0.52, p = 0.04). There were also positive correlations of trigliceride with uric acid (r = 0.47, p = 0.09) and cystatin C (r = 0.44, p = 0.02). There were no correlation of MGP with other examined parameters. Initial results of fetuin A and MGP levels in long-term type 1 diabetic patients without ischaemic heart disease draws attention to new parameters in macroangiopathy development.

• [Impact of chronic Chlamydia pneumoniae infection on left ventricular remodeling after myocardial infarction]

  Authors: Marcin Marcinkowski, Danuta Czarnecka, Marek Jastrzebski, Danuta Fedak, Kalina Kawecka-Jaszcz

  Przegla̧d lekarski. 02/2006; 63(12):1259-62.

  BACKGROUND: Postmyocardial infarction left ventricular remodeling is modified by inflammatory processes and structural changes in the myocardium. Chlamydia pneumoniae (Chp) causes chronic myocyteBACKGROUND: Postmyocardial infarction left ventricular remodeling is modified by inflammatory processes and structural changes in the myocardium. Chlamydia pneumoniae (Chp) causes chronic myocyte infection, affects apoptosis and TNF-alpha production, and may induce cross reactivity with alpha myosin. This is the way in which this intracellular pathogen may modulate remodeling on the cellular and organ level. MATERIAL AND METHODS: The study was conducted in 101 patients with a first myocardial infarction in whom we evaluated the serological features of Chp infection using the ELISA method and echocardiographic left ventricular volume at 10 days and 10 weeks after the infarction. RESULTS: Patients with chronic Chp infection had a tendency toward higher end-diastolic volume at 10 weeks after the infarction (123 +/- 32.9 ml vs. 134 +/- 34.7 ml, p = 0.09). In order to better define this relationship we used ROC analysis and measured levels of antibodies: IgG = 117 EIU and IgA = 15.6 EIU by which we divided the patients into two subgroups. Those with IgG > or = 117 EIU and IgA > or = 15.6 EIU belong to the subgroup with chronic and active Chp infection. These patients had larger left ventricular end-diastolic volumes (155.8 vs. 123.1 ml, p = 0.0005) and end-systolic volumes (77.4 vs. 59.5 ml, p = 0.006) at 10 weeks after the infarction. Both subgroups were similar with respect to age, gender, history of arterial hypertension, systolic and diastolic blood pressure values, infarct site, reperfusion, infarct size, left ventricular ejection fraction and left ventricular contractility index. Type of reperfusion therapy and pharmacological treatment at 10 days and at 10 weeks did not differ, either. CONCLUSIONS: Chronic Chlamydia pneumonie infection modifies the course of left ventricular remodeling.

• [TNFalpha and sVCAM plasma levels during standard exercise test are higher in postmenopausal women with hypercholesterolemia]

  Authors: Tomasz Milewicz, Renata Rajtar, Danuta Fedak, Władysława Kolasińska-Kloch, Józef Krzysiek, Tomasz Banach, Piotr Thor

  Przegla̧d lekarski. 02/2006; 63(8):650-3.

  AIM: The evaluation of serum ICAM, VCAM, endothelin-1 (Et-1), TNF-alpha and its soluble receptor levels and the secretion of nitric oxide in postmenopausal women with hypercholesterolemia. PATIENTS:AIM: The evaluation of serum ICAM, VCAM, endothelin-1 (Et-1), TNF-alpha and its soluble receptor levels and the secretion of nitric oxide in postmenopausal women with hypercholesterolemia. PATIENTS: 26 postmenopausal patients who neither received hormonal therapy nor cholesterol lowering treatment. Group A consisted of 16 women with high serum total cholesterol and group B of 10 women with normal cholesterol level. METHODS: Basic fasting serum FSH, 17beta-estradiol, as well as total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides levels were evaluated. Standard exercise test was carried out according to Bruce protocol. Blood samples were taken thrice (prior to, at peak exercise, 15th min of recovery) during the test to evaluate the serum levels of ICAM, VCAM, ET-1, TNF-alpha and its soluble receptors as well as secretion of nitric oxide. RESULTS: In group A--sVCAM (660.0 +/- 106.4 mg/l versus 518.6 +/- 65.4 mg/l; p < 0.05) and TNF-alpha serum levels (2.2 +/- 1.0 ng/l versus 1.2 +/- 0.4 ng/l; p < 0.05) at peak exercise were higher in group A compared to group B. There was a tendency (p > 0.05) of higher ET-1 plasma levels in group A. CONCLUSION: Serum levels of adhesion molecules and inflammatory mediators were higher during physical exercise in postmenopausal women with atherosclerosis risk factors.

• [Myocardial dysfunction, neuropathy and nephropathy in long standing type 1 diabetic patients]

  Authors: Danuta Galicka-Latała, Ewa Konduracka, Marek Kuźniewski, Danuta Fedak, Jacek Sieradzki

  Przegla̧d lekarski. 02/2005; 62(12):1451-4.

  Cardiovascular and renal complications among type 1 diabetic patients are predictive factors for sudden cardiac death and stroke. The aim of the study was to assess the prevalence of diabeticCardiovascular and renal complications among type 1 diabetic patients are predictive factors for sudden cardiac death and stroke. The aim of the study was to assess the prevalence of diabetic nephropathy and autonomic neuropathy in type 1 diabetic patients with and without diastolic dysfunction in echocardiographic examination. The study was performed in a group consisting of 37 patients with type 1 diabetes mellitus. Mean age of the study group equaled 37.24 +/- 10.85 years, duration of diabetes mellitus 21.3 +/- 9.55 years. All patients performed EKG, and cardiovascular autonomic test with ProSciCard according to Ewing battery. The following parameters were assessed: heart rate (HR), standard deviation of HR, RMSDD, VLF, LF, HF, deep breathing test, Ewing supine test and Valsalva maneuver. Systolic and diastolic function was assessed in echocardiography examination at rest. In all patients following laboratory parameters were assessed: HbA1c, total chol, LDL-chol, HDL-chol, triglicerides, uremic acid, glucose, albumin, creatinine, cystatin C, microalbuminuria. Results: mean heart rate in the examined group --78.38 +/- 15.54 /min, VLF--1.59 +/- 1.7; LF--4.22 +/- 1.51, HF--0.82 +/- 0.88, mean heart rate during deep breathing test --79.63 +/- 13.71, Ewing ratio--0.91 +/- 0.11. Cardiovascular autonomic neuropathy and diabetic neuropathy were diagnosed in 3 patients, these patients suffered also from proliferative retinopathy and diabetic nephropathy. The remaining group of 34 patients has normoalbuminuria. Calculated creatinine clearance according to Cockroft-Gault equation was 88.85 +/- 9.60 m/min, cystatin C concentration--0.97 +/- 0.22 ng/ml. In echocardiography exam, there were no abnormalities in systolic function, and diastolic dysfunction was diagnosed in 15 patients. Preliminary results showed that only the cystatin C level significantly differed patients with and without diastolic dysfunction in echocardiographic examination. Cystatin C could be the first sign of renal failure among these patients. Cardiovascular autonomic neuropathy and diabetic nephropathy were diagnosed only in 3 patients with left ventricular diastolic dysfunction in echocardiographic study.

• [Cardiovascular autonomic neuropathy and nephropathy in patients with type-1 diabetes mellitus]

  Authors: Danuta Galicka-Latała, Danuta Fedak, Marek Kuźniewski, Ewa Kawalec, Bogdan Solnica

  Przegla̧d lekarski. 02/2004; 61(3):155-8.

  In the last few years much attention is being given to the problem of diabetes mellitus, to it's development, prevalence and progression of chronic complications. The aim of the study was to 1.In the last few years much attention is being given to the problem of diabetes mellitus, to it's development, prevalence and progression of chronic complications. The aim of the study was to 1. evaluate correction of metabolic disturbances in patients with long-term type 1 diabetes mellitus; 2. evaluate occurrence of diabetic nephropathy and excretion function in patients with long-term type 1 diabetes mellitus; 3. evaluate function of the cardiovascular autonomic nervous system in patients with long-term type 1 diabetes mellitus; 4. search for connections between the type and change dynamics in the cardiovascular system and degree of diabetic nephropathy advancement. The study was performed in a group consisting of 31 patients with type 1 diabetes mellitus (20 women, 11 males). Mean age of the study group equaled 37.6 +/- 10.75 years, duration of diabetes mellitus 21.3 +/- 9.55 years. Concentration of cystatin C in the study group was 0.98 +/- 0.23 ng/ml, in the group of patients with diabetic retinopathy 1.13 +/- 0.30 ng/ml, while in the group without diabetic retinopathy 0.89 +/- 0.13 ng/ml. Concentration of cystatin C (p <0.05) and calculated GFR according to equations proposed by F.J. Hoeck [GFR/1.73 m2 = -4.32 + 80.3/plasma cystatin] (p < 0.01) also G.D. Tan [GFR -10 = (87.1/plasma cystine) - 6.87] (p < 0.01) significantly differentiated the discussed groups. Conclusions: despite normal levels of blood creatinine in the studied patients, decreased glomerular filtration was calculated for plasma cystatin C. Plasma cystatin C concentrations and calculated glomerular clearance significantly differentiated the group with retinopathy from the group without diabetic retinopathy. Determining cystatin C concentrations as a protein which probably does not undergo glycation in plasma, may play a role in the detection of early diabetic nephropathy, when as well as plasma creatinine levels and albumin/creatinine index calculated from a sample of morning urine do not differentiate the studied group of patients.

• Dialysis adequacy, residual renal function and serum concentrations of selected low molecular weight proteins in patients undergoing continuous ambulatory peritoneal dialysis.

  Authors: Tomasz Stompór, Władysław Sułowicz, Tomasz Anyszek, Beata Kuśnierz, Danuta Fedak, Jerzy W Naskalski

  Medical science monitor : international medical journal of experimental and clinical research. 12/2003; 9(11):CR500-4.

  BACKGROUND: Low molecular weight proteins (LMWP) are considered uremic toxins. There is controversy whether in peritoneal dialysis (PD) the elimination of these toxins is influenced mainly byBACKGROUND: Low molecular weight proteins (LMWP) are considered uremic toxins. There is controversy whether in peritoneal dialysis (PD) the elimination of these toxins is influenced mainly by dialysis or by residual renal function (RRF). MATERIAL/METHODS: The aim of our study was to evaluate the relationship between serum levels of selected LMWPs, dialysis adequacy, and RRF in PD patients. 27 stable subjects were studied, mean age 50+/-11, dialyzed for a median period of 10 months. Serum activity of acid RNA-se and alkaline RNA-se was measured by spectrophotometry, and serum alpha1-microglobulin ((alpha) 1M) concentration by ELISA. Kt/V and weekly creatinine clearance (wClCr) were assessed as adequacy indices (both as the sum of renal and dialysis components) and RRF as the mean of residual urea and creatinine clearances. RESULTS: Significant inverse correlations were found between RRF and (alpha) 1M level, as well as alkaline RNA-se activity (p<0.0001). A similar relationship was found for residual Kt/V (p<0.0001 for (alpha) 1M and alkaline RNA-se). There was no significant correlation between acid RNA-se activity and any tested parameter of adequacy. When the cutoff points of wClCr = 60 L/week/m2, total Kt/V = 2.0, or RRF=2.0 ml/min were used, we found (alpha)1M level and alkaline RNA-se activity to be significantly lower in patients with higher values of the CONCLUSIONS: RRF plays an important role in elimination of LMWP in PD. The activity of alkaline RNA-se and acid RNA-se behaves differently in these patients.