ISSN  2587-2362  |  E-ISSN  2618-642X
International Journal of Medical Biochemistry - Int J Med Biochem : 6 (1)
Volume: 6  Issue: 1 - 2023
1.Front Matter 2023-1

Pages I - X

2.Assessment of the circulating soluble endothelial cell adhesion molecules and pentraxin 3 levels in predicting preterm delivery within 72 h
Ebru Alıcı Davutoglu, Asuman Akkaya Fırat, Aysegul Ozel, Riza Madazli
doi: 10.14744/ijmb.2022.55477  Pages 1 - 7
INTRODUCTION: The study aimed to evaluate maternal serum soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), and PTX-3 concentrations in patients with threatened preterm labor (TPL) and to predict preterm delivery within 72 h after hospitalization. Premature birth is defined as the risk of the newborn being in labor before the 37th week of pregnancy is completed. Preterm birth affects 9–13% of whole pregnancies. The major causes of neonatal morbidity and mortality.
METHODS: This study consisted of 54 women with TPL and 31 healthy pregnant women. The TPL group was further divided into two subgroups; patients who gave birth within 72 h after the hospitalization was applied to as a preterm delivery group and who gave birth at ≥37 weeks were referred to as the term delivery group. Maternal serum levels of sICAM-1, sVCAM-1, sE-selectin, and PTX-3 were measured with the use of ELISA kits.
RESULTS: Maternal serum sICAM-1 and PTX-3 levels were significantly higher in a preterm delivery group compared with the other two groups (preterm vs. control and preterm vs. term p <0.001). Serum sVCAM-1 and s E-selectin levels were significantly lower in the preterm group compared with the other two groups (preterm vs. control and preterm vs. term p<0.001). Gestational age at birth and sVCAM-1, sE-selectin levels are positive correlated (r=0.679, p<0.001; r=0.624, p<0.001) and sICAM-1, PTX-3 levels were negatively correlated (r=−0.630, p<0.001; r=−0.732, p<0.01). Cervical length measurement showed a negative correlation with PTX-3 and sICAM-1 (r=−0.420, p<0.001; r=−0.376, p<0.001) showed a positive correlation with and sVCAM-1 and sE-selectin levels (r=0.811, p<0.001; r=0.651, p<0.001).
DISCUSSION AND CONCLUSION: This study shows a clear relationship between the gestational week at birth and maternal serum levels of sICAM-1, sVCAM-1, sE-selectin, and PTX-3. These biomarkers with TPL predict preterm labor within 72 h in patients with a complicated and short cervix.

3.Biochemical Markers and NLR Levels in Covid-19 Infection: In Cases With Severe Pulmonary Involvement According to CT Score
Asuman Akkaya Fırat, Haluk Kılıç, Serkan Elarslan, Gülsah Yıldırım, Ebru Tarıkçı Kılıç, Ugur Ayan
doi: 10.14744/ijmb.2022.14890  Pages 8 - 14
INTRODUCTION: Many studies have been conducted on ferritin, fibrinogen, D-dimer, and neutrophil-lymphocyte ratio (NLR), which are biochemical tests, to determine the severity and prognosis of the disease in the early period of coronavirus disease 2019 (COVID-19) infection. We aimed to determine the compatibility of these easily accessible and affordable tests with computed tomography (CT) in determining the severity of the disease at an early stage.
METHODS: This study was carried out retrospectively on 79 patients. In all patients, nasal and pharyngeal swabs were collected and tested for SARS-CoV-2 RNA with reverse transcription-polymerase chain reaction assay. The severity of the disease was determined by computed tomography imaging. According to lung involvement, patients who were found to have a severe infection and divided into the severe group (n=26), and those with milder symptoms were divided into the non-severe group (n=53). The demographic information and laboratory parameters of the patients were obtained from the medical records of the hospital. Analyses were performed using the Statistical Package for the Social
Sciencesversion 23.0 for Windows.
RESULTS: NLR (8.36±2.45; 3.3±2.04 p<0.001), ferritin (ng/mL) (736.1±240.2; 374.7±248.4 p<0.001), fibrinogen (mg/mL) (725.7±84.9; 416.5±186.1 p<0.001), D-dimer (ug/mL) (3.68±1.42; 1.55±1.16 p<0.001), and C-reactive protein (CRP) (mg/dL) (81.1±11.9; 27.9±13.8 p<0.001) levels were found to be significantly higher in the severe group than the non-severe group. In addition, CRP (mg/mL) levelswere positively correlated with NLR (r=0.607 p<0.01). Receiver operator curve analyses were carried out to assess the efficacy of NLR, ferritin, fibrinogen, and D-dimer parameters.
DISCUSSION AND CONCLUSION: These results suggest that NLR, ferritin, fibrinogen, and D-dimer may be useful biomarkers for the early detection of critical cases of COVID-19 infection, paralleling CT findings. These available tests can benefit clinicians in low-resource settings where access to complicated diagnostic methods may be limited.

4.Can additional information be obtained in the diagnosis of heart failure in type 2 diabetics by evaluating the hematological indices
Zeki Doğan, Hafize Uzun
doi: 10.14744/ijmb.2022.29484  Pages 15 - 20
INTRODUCTION: The aim of the present study is to investigate whether hematological indices inflammatory parameters such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) are increased in patients with heart failure (HF) in type 2 diabetes mellitus (T2DM). It is also to compare them in diabetics without HF to investigate, whether it is important in predicting the presence of HF.
METHODS: The study consisted of four subject’s groups in our center between Octeber 2019 and September 2021. It recorded the laboratory results of 160 subjects of which diabetic patient without HF group (n=40), non-diabetic HF group (n=40), diabetes mellitus (DM)+HF group (n=40), and healthy controls (n=40).
RESULTS: NLR and PLR were significantly higher, while LMR was significantly lower in all patients than controls. DM+HF group has the highest NLR (3.34±1.26), PLR (211.34±91.49), and white blood count (WBC) (9090±4834) among the groups. There was no significant difference in NLR and LMR between DM group and DM+HF group. PLR was significantly lower in non-diabetic HF than DM without HF.
DISCUSSION AND CONCLUSION: Among these markers, NLR, PLR, and WBC could predict the presence of HF in T2DM. NLR, PLR, and WBC are independently associated with other conventional inflammatory markers as C-reactive protein levels in the early stages of HF in T2DM. Complete blood count and hematological indices can be used as additional information in terms of being non-invasive, faster, easier, and cheap in the evaluation of HF at T2DM.

5.A histological and biochemical study of the protective role of hesperidin in testicular ischemia-reperfusion injury
Nurhan Akaras, Hasan Şimşek, Melike Ordu
doi: 10.14744/ijmb.2022.39306  Pages 21 - 27
INTRODUCTION: This study aimed to investigate the possible effects of hesperidin on ischemia-reperfusion (IR) injury applied to rat testis.
METHODS: Twenty-eight Wistar albino rats were used and divided into four groups of seven each. Group 1: Sham surgery was performed on the right testis. Group 2: Hesperidin 100 mg/kg was administered intraperitoneally to rats. Group 3: After 1 h of ischemia and 4 h of reperfusion, the testicles were removed. Group 4: 100 mg/kg hesperidin was given 30 min before reperfusion. Biochemical, immunohistochemical, and histopathological analyzes were performed on testicles obtained from each group.
RESULTS: Total oxidant status (TOS) and oxidative stress index (OSI) levels increased significantly in the IR and IR-He groups (respectively, p=0.016, p=0.041; p=0.01, and p=0.024). TOS and OSI values in the hesperidin group decreased, although not statistically significant, compared to the IR group. Tumor necrosis factor-alpha (TNF-α) and nuclear factor kappa B (NF-kB) values were decreased in the hesperidin group compared to the IR group, although it was not statistically significant. Caspase-3 levels in testicular tissue were significantly increased in the IR group compared to the hesperidin group (p<0.05). While there were degenerative changes in the testicular tissue in the IR groups, a decrease in bleeding, congestion, edema, and degenerative changes was observed in the hesperidin-administered groups.
DISCUSSION AND CONCLUSION: Hesperidin reduced oxidative stress (decreased total oxidant level and OSI), inflammation (TNF-α), and apoptosis (NF-kB and caspase-3). According to these results, it was observed that hesperidin application had a protective effect on IR injury.

6.Chitotriosidase might be a diagnostic marker in patients with hashimoto thyroiditis
Hatice Özışık, Aslı Suner, Öznur Çopur, Eser Yıldırım Sözmen, Banu Şarer Yürekli, Şevki Çetinkalp, Gökhan Özgen, Mehmet Erdoğan
doi: 10.14744/ijmb.2022.36036  Pages 28 - 35
INTRODUCTION: Hashimoto’s thyroiditis (HT) is the most common organ-specific autoimmune disease. The aim of our study was to investigate a possible role of chitotriosidase (Chito) activity as a potential marker of inflammation in diagnosis of patients with HT. In addition, we aimed to determine the levels of inflammation markers such as YKL-40, high sensitivity C-reactive protein (hsCRP) and oxidative stress (OS) parameters such as thiobarbituric acid reactive substances (TBARS), catalase (CAT), superoxide dismutase (SOD), GSH-Px to evaluate an association between those inflammatory and OS markers in patients with HT
METHODS: 42 patients with HT and 28 control cases were studied. All cases were euthyroid. Chito activity was measured fluorometrically based on Hollak et al’s. method. hsCRP and YKL-40 levels were measured using ELISA. TBARS, SOD, and CAT activities were determined in hemolyzates. GSH-Px activity was determined by a colorimetric assay
RESULTS: Higher Chito concentrations were observed in patients with HT compared to the control group (p=0.002). YKL-40 levels were detected higher in HT but it was not statistically significant (p=0.810). Chito levels were positively correlated with age and negatively correlated with SOD (r=0.360, p=0.021; r=-0.368, p=0.018). YKL-40 levels were positively correlated with FT3 and SOD in HT (r=0.324, p=0.037; r=0.312, p=0.044) and negatively correlated with age (r=−0.463, p=0.002). SOD levels were negatively correlated with age and positively correlated with YKL-40 (r=−0.371, p=0.016, r=0.312, p=0.044).

DISCUSSION AND CONCLUSION: We revealed that Chito levels were higher among euthyroid HT patients. This result may point out that Chito levels could be used as a potential marker of inflammation in HT.

7.Differential in vitro effects of oncogenic pathway inhibitors on carbonic anhydrase-IX, xanthine oxidase, and catalase in colorectal cancer
doi: 10.14744/ijmb.2022.50455  Pages 36 - 41
INTRODUCTION: PI3K/Akt/mTOR (The phosphatidylinositol-3-kinase/Protein Kinase B/Mammalian Target of Rapamycin) and Mitogene Activated Protein Kinase oncogenic signaling pathways play a role in the colon cancer development process by over-activating during carcinogenesis and proliferate cancer cells and stimulate metastasis. Carbonic Anhydrase-IX (CA-IX), one of the most important CA enzymes, is a tumor-associated enzyme and a transmembrane protein which reduce pH in the tumor microenvironment, leading to increased acidification. CA also increases the production of reactive oxygene species (ROS) and enables the activation of cancer signaling pathways. Due to the increase in ROS production, the antioxidant system is also activated. In this study, we aimed to investigate the effects of oncogenic pathway inhibitors on CA-IX and oxidant/antioxidant enzymes in colorectal cancer (CRC).
METHODS: In this study, Acetazolamide (AZA)-CA inhibitor, Rapamycin (RAPA)-mTOR inhibitor, and Vemurafenib (VMF)-B-Raf inhibitor were applied to CRC cell line HT-29. The effects of AZA, RAPA, and VMF on oxidant/antioxidant system enzymes Xanthine oxidase (XO) and Catalase (CAT) activities were measured at 340 nm in Epoch™ Microplate Spectrophotometer. In addition, inhibition of CA-IX by AZA, RAPA, and VMF was determined using the Human CA IX ELISA Kit.
RESULTS: According to the results of the CA-IX ELISA test, the CA-IX protein levels were 6.6 ng/μl and 4.6 ng/μl (p<0.05) in the HT-29 cell lines untreated and AZA-treated applied, respectively. CA-IX protein levels were 6.25 ng/μl and 5.92 ng/μl (p≤0.05) in untreated and RAPA-treated HT-29 cell lines, respectively. CA-IX protein levels were found to be 3.04 ng/μl and 2.47 ng/μl (p≤0.05) in untreated and VMF-treated HT-29 cell lines, respectively. AZA, RAPA, and VMF inhibitors applied to the HT-29 cell line caused a decrease in CAT activity (p<0.001) while an increase in XO activity (p≤0.001).
DISCUSSION AND CONCLUSION: This study will suggest a different perspective on colon cancer treatment. When our results are considered, an attitude can be taken to determine the treatment plan by taking into account the decreased antioxidant and CA-IX enzyme levels after the use of oncogenic inhibitors. Analyzing other antioxidant enzymes in the same way will add a different dimension to the study. In addition, the combined use of these inhibitors and the determination of the effects of different cancer pathway inhibitors on these enzymes will form the basis of our future studies.

8.International normalized ratio monitoring: Agreement between point-of-care LabPad® and clinical laboratory results
Claudio ILARDO, Christel Barral
doi: 10.14744/ijmb.2022.44366  Pages 42 - 46
INTRODUCTION: The [email protected] scheme, introducing a point-of-care (POC) International Normalized Ratio (INR) measurement with the LabPad® was initiated in 2019 by the French National Health Agency. The aim of our study was to assess the analytical agreement between LabPad ® and laboratory INR results, especially at sub- and supratherapeutic levels. The allowable differences were based on the accuracy requirement defined by the International Standard ISO 17593: 2022 and analytical discordances versus INR Ranges.
METHODS: From February 2020 to August 2022, the agreement between POC and laboratory INR results was analyzed in 83 patients. All subjects were monitored on oral anticoagulant therapy (57 patients treated with fluindione (Previscan ®), 24 patients were treated with warfarin (Coumadin®) anticoagulant medication and acenocoumarol (Sintrom®) was used for two subjects).
RESULTS: The laboratory INR results ranged from 1.2 to 10 with a mean of 3.736±1.479, and LabPad® INR ranged from 0.8 to 7.3 with a mean of 3.818±1.599. Analysis of the graph demonstrated that the INR relationship between LabPad ® and STA-R Max3 ® did not remain linear above 7.3. An extended measurement area and Pearson correlation coefficient (r) showed a significant and strong (r=0.91 [p<0.001; 95% CI: 0.81–1.00]). The regression slope was 0.980 (p<0.001; 95% CI: 0.878–1.081) and the y intercept was 0.158 (p<0.001; 95% CI: −0.251–0.566). The concordance analysis showed that 93% of the results were within the accuracy requirement defined by the international standard ISO17593: 2022, but significant discrepancies appeared on the LabPad® for INR results above 4. According to analytical discrepancies and INR, ranges showed substantial agreement on these criteria with 88% and a Kappa coefficient of 0.67.
DISCUSSION AND CONCLUSION: The LabPad® and laboratory INR results were highly correlated within the therapeutic range, above this range, a venous checking is recommended to confirm the results.

9.Interference from heterophilic antibodies in Ca 19-9 testing: A case report
Yasemin Üstündağ, Kağan Huysal, Rahime Feyza Koloğlu, Elif Yalcin Arikan, Elif Güler Kazancı
doi: 10.14744/ijmb.2022.09821  Pages 47 - 50
Immunoassays are widely used analytical techniques in clinical laboratories, which can be affected by interference, leading to erroneous test results. We present the case of a 38-year-old female patient with a thyroid nodule, who had been followed up with since 2012, was not taking medication, and had an implausible elevation of Ca 19-9, a commonly used biomarker for gastrointestinal malignancies. Interference arising from heterophilic antibodies in the differential diagnosis was considered. Measurements were repeated with the same patient sample on three different immunoassay analyzers. Ca 19-9 levels measured with the Abbott Architect i2000 device were high, while the results from the latter two instruments (COBAS e601 and ADVIA Centaur CP) were within normal limits. Serial dilutions of serum samples revealed non-linearity, suggesting assay interference. The heterophilic blocking tube procedure and polyethylene glycol precipitation resulted in a normal range of Ca 19-9 levels, confirming that a heterophile antibody interaction was the most likely cause of the abnormal results. In this paper, we present a narrative review of the current literature pertaining to false-positive Ca 19-9 caused by interference. We propose close collaboration between clinicians and the laboratory before exposing patients to the cost of additional testing when clinical non-compliance is suspected.

10.Micro to nano plastics and its link to human health
Eda Merve Kurtuluş, Başak Gökçe Çöl
doi: 10.14744/ijmb.2022.64326  Pages 51 - 56
This article reviews the recent publications on the effects of micro and nano plastics being bioaccumulated, inhaled, ingested, digested, absorbed, or excreted in models and humans. Also, the retention of microplastics and nano plastics in the blood and lymphatic circulation, and their possible toxic effects on tissues at the cellular and biomolecular level is discussed.

11.Metal-binding protein: Metallothionein
Faiz Marikar, Hua Zi -chun
doi: 10.14744/ijmb.2022.94834  Pages 57 - 62
More than a century ago, the very first adverse human health effects of metalloproteins were reported after the usage of cadmium-containing silver polishing agents. It was first observed in the Horse population. The discovery of the low-molecular-weight protein Metallothionein (MT) in 1957 was an important milestone as this protein was shown to bind cadmium and to cause cellular cadmium toxicity. The mentioned authors contributed evidence in the 1970s concerning cadmium binding to MT and synthesis of the protein in tissues. We showed in our previous studies that binding of cadmium to MT in tissues can prevent some toxic effects; yet, further, identification of these macro and micro-molecules is required at the biochemistry and genetics levels. As with the recent studies, novel biochemical functions of MTs are introduced, for example, a new application of Mts, which are being used in protein purification by affinity chromatography. The trend is used to cure neuron disorders and even cancer. This review summarizes that this evidence in a genetic experiment is still needed for find out the function of MTs; it is an open area of research even in the 21st century.

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