American Journal of Clinical Medicine Research

Aim. The purpose of current research was to assess changes in endothelial progenitor cells (EPC) counts and angiogenic factors levels during atorvastatin therapy in different doses in patients with ischemic heart disease (IHD) as an independent predictor of cardiovascular morbidity and mortality. Methods and Results. The main group included 58 patients with IHD during atorvastatin therapy. EPC quantity (CD34+/CD133+/CD309+ phenotype) was measured by flow cytometry two times – before treatment and 3 months after. Vascular endothelial growth factor (VEGF), C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), endostatin levels and lipid profile were also measured twice. The control group consisted of 15 healthy volunteers with the same analyzes performed once. Atorvastatin therapy in IHD patients within three months of treatment caused a significant (72% on average) increase of EPC counts (p<0.05). Dependence of EPC gain on statin dose was not reliable (p=0.10), but it was higher when initial EPC counts were low (p=0.01). The therapy showed reliable reduction of VEGF level (by 11%, p<0.01), CRP – by 26% (p<0.01), total cholesterol (TCh) – by 30% (p<0.01), low density lipoprotein (LDL-C) – by 35% (p<0.01), triglycerides (TG) – by 18% (p<0.01), while endostatin, MCP-1 and high density lipoprotein (HDL-C) levels did not change. Correlations between the EPC, TCh and LDL-C changes during therapy were revealed: higher EPC counts gain was associated with higher TCh (p=-0.37, r<0.01) and LDL-C (p=-0.41, r<0.01) levels decrease. Conclusion. We found a significant increase of EPC counts in IHD patients when treated with atorvastatin for 3 months, without statistically reliable difference depending on dosage.

American Journal of Clinical Medicine Research. 2015, 3(4), 70-76. DOI: 10.12691/ajcmr-3-4-3
Pub. Date: November 09, 2015

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Systemic Inflammatory Response in Patients with Gastroesophageal Reflux Disease

by Vladimir Ivashkin, Yulia Evsyutina, Alexander Trukhmanov, Svetlana Lyamina and Igor Malyshev

Original Research

Aim. To characterize the systemic inflammatory response in patients with various forms of GERD. Materials and methods. The prospective clinical study included 45 patients with GERD and 10 healthy volunteers. An analytic survey of all participants was carried out which included, the collection of complaints and anamnesis, the identification of risk factors for GERD; esophagogastroduodenoscopy and a 24-hour esophageal pH-impedance monitoring. Using the method of flow cytometry, the levels of 7 cytokines were determined: two anti-inflammatory - IL-4 and IL-10, three pro-inflammatory - IL-8, IFN-γ and TNF-α, and two cytokines which may manifest as anti-inflammatory as well as pro-inflammatory activity depending on the circumstances (bivalent) - IL-2 and IL-6. Results. In patients with erosive and ulcerative esophagitis when compared to patients with NERD, Barrett's esophagus and healthy individuals, there was an increased expression of pro-inflammatory cytokines. Whereas in patients with Barrett's esophagus, when compared to other patients and healthy individuals, there was a resultant overexpression of anti-inflammatory cytokines. The levels of TNF-α and IL-8 correlates with the total number of acid reflux and acid bolus exposure, whereas the levels of IL-4 and IL-10 correlate with the total number of weakly alkaline reflux and weakly alkaline bolus exposure. The high level of IL-8 was associated with an increased incidence of recurrence of erosive esophagitis, despite the ongoing therapy for 2 years. Conclusions. In patients with erosive and ulcerative esophagitis in comparison with patients with NERD and Barrett's esophagus, there is a predomination in the production of pro-inflammatory cytokines such as IL-8, IFN-γ and TNF-α, indicating the development of Th1 immune response. In patients with Barrett's esophagus, there was an increased expression of anti-inflammatory cytokines such as IL-4 and IL-10, indicating the formation of the Th2 immune response.

American Journal of Clinical Medicine Research. 2015, 3(4), 64-69. DOI: 10.12691/ajcmr-3-4-2
Pub. Date: November 08, 2015

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Systemic Lupus Erythematosus (SLE): A 360 Degree Review

by Alisa Nobee, Angel Justiz Vaillant, Patrick Eberechi Akpaka and Peter Poon-king

Review Article

In this paper we review the most important updated aspects of SLE, which is an autoimmune disorder of unknown etiology, where genetic, environmental and immunological factors are believed to play an important role in its immunopathogenesis. Aspects related to SLE causes, pathophysiology, signs and symptoms, diagnosis and treatment are discussed.

American Journal of Clinical Medicine Research. 2015, 3(4), 60-63. DOI: 10.12691/ajcmr-3-4-1
Pub. Date: October 20, 2015

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