European Journal of Clinical and Experimental Medicine T.23, z. 4 (2025)

URI dla tej Kolekcjihttps://repozytorium.ur.edu.pl/handle/item/12185

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Rheumatic mitral stenosis in the perioperative setting ‒ an old acquaintance with new implications
(Rzeszów University Press, 2025-12) Barreiros, Cláudia; Giménez-Milà, Marc; Sandoval, Elena
Self-injection of kerosene with chemical pneumonitis and abscess formation ‒ a case report and literature review
(Rzeszów University Press, 2025-12) Wijesinghe, Anura; Rathnasekara, Thilina; Sewwandi, Hashini; Weerawansa, Prasanna; Siribaddana, Sisira
Introduction and aim. Kerosene, a widely available household fuel in Sri Lanka, is a common cause of accidental poisoning, especially in children, and is occasionally used for self-harm, which can cause complications such as chemical pneumonitis, abscesses, and thrombosis. Its unsafe storage practices increase the risk of accidental exposure. Description of the case. A 16-year-old Sri Lankan male self-injected kerosene into the left cubital fossa. Although initially stable, he later developed chemical pneumonitis, left cephalic vein thrombosis, and a sterile abscess at the injection site. Conclusion. Early multidisciplinary intervention and close clinical monitoring led to a favorable outcome. A review of the literature reveals that intravenous hydrocarbon injection, although rare, can lead to significant local and systemic toxicities.
Postoperative diagnosis of pulmonary actinomycosis in a patient with bronchiectasis ‒ a rare case
(Rzeszów University Press, 2025-12) Kertmen, Muhammet; Cullu, Kübra; Gözükücük, Gülsah Kolak; Dubus, Turkan; Büyükpınarbasili, Nur
Introduction and aim. Pulmonary actinomycosis is a rare chronic infection caused by Actinomyces species, often mimicking tuberculosis, malignancy, or other chronic lung diseases both clinically and radiologically. These similarities frequently lead to diagnostic delays. We present a rare case of pulmonary actinomycosis in a patient with long-standing bronchiectasis who developed acute hemoptysis during anticoagulant therapy. Description of the case. A 59-year-old woman with a ten-year history of bronchiectasis and recent mechanical aortic valve replacement presented with persistent hemoptysis while on warfarin. Thoracic computed tomography revealed bronchiectatic changes and opacities in the right middle lobe. Bronchoscopy showed bloody, encrusted material, but no definitive diagnosis was made. Due to ongoing symptoms and radiological suspicion of malignancy, an urgent right middle lobectomy was performed. Histopathological analysis confirmed pulmonary actinomycosis, revealing filamentous organisms via PAS, Gram, and Grocott’s staining. Conclusion. This case highlights the importance of considering pulmonary actinomycosis in patients with bronchiectasis and unexplained hemoptysis, particularly when standard treatment fails. Surgical resection may be essential for both diagnosis and treatment. The case underscores how structural lung disease and anticoagulant use can reveal rare infections otherwise masked by chronic symptoms.
Doxorubicin-induced cell cycle arrest and apoptosis in HL-60 leukemia cells – a narrative review
(Rzeszów University Press, 2025-12) Rzeszutek, Dominika; Kuna, Ewelina
Introduction and aim. Doxorubicin is an anthracycline widely used in cancer therapy. Although the complete mechanism of action of doxorubicin is not fully understood, it is known to effectively destroy cancer cells by intercalating into DNA. This article aims to evaluate the anticancer effect of doxorubicin with particular emphasis on HL-60 leukemia cells and cell cycle/apoptosis. Material and methods. This narrative review contains a collection and evaluation of peer-reviewed publications on the anticancer properties and therapeutic applications of doxorubicin. It focuses on doxorubicin-induced cell cycle arrest and apoptosis in HL-60 leukemia cells, with particular emphasis on toxicity and resistance. A literature review was conducted using the following databases: PubMed and Google Scholar. Analysis of the literature. Doxorubicin exhibits potent anticancer activity against many cancer types. Unfortunately, due to serious side effects, primarily related to the cardiotoxicity of the drug, its potential cannot be fully exploited. Conclusion. In recent years, many approaches have been developed to circumvent the limitations of doxorubicin. Identifying all the pathways of doxorubicin action is important for planning combination therapy, mitigating side effects, and developing new drugs. However, further clinical studies are needed to determine their long-term safety and efficacy.
Harnessing the gut-brain axis in the treatment of type 2 diabetes mellitus and obesity
(Rzeszów University Press, 2025-12) Kotucha, Kornela; Kapłon, Katarzyna; Moś, Magdalena; Fiegler-Rudol, Jakub; Pietryszyn-Bilińska, Alina; Dynarowicz, Klaudia; Aebisher, David; Wiench, Rafał; Kawczyk-Krupka, Aleksandra
Introduction and aim. The most common metabolic disorders include type 2 diabetes (T2DM) and obesity. Their prevalence has increased in recent years. Due to their widespread prevalence and the fact that they increase the risk of cardiovascular disease, morbidity, and mortality, they pose a significant economic burden to the healthcare system. In this review, we will focus primarily on the role of gut hormone signaling produced by enteroendocrine cells (EECs), which are part of the gut-brain axis. Furthermore we will summarize applications of these mechanisms in novel therapies for T2DM and obesity. Material and method. Literature data analysis was performed using the following databases: PubMed (MEDLINE), Scopus, Web of Science and Google Scholar. The review included articles in Polish and English published between 2000 and 2024. Analysis of the literature. EECs are specialized transepithelial cells present throughout the intestine. The best-studied EEC subtype is the L cell, which secretes glucagon-like peptide-1 (GLP-1). GLP-1 regulates insulin secretion and contributes to satiety by increasing insulin secretion and inhibiting glucagon secretion. Significant progress in the use of intestinal hormones in the treatment of T2DM and obesity has led to the development of effective therapies for both of these conditions, such as GLP-1 analogs. Conclusion. The growing understanding of biochemical processes, hormonal signaling, and the development of new technologies contribute to the continuation of research on new, more effective therapies that use mechanisms of action of the gut-brain axis. Despite these achievements, the need for new and more effective treatments is constantly growing, and requires innovative strategies and their potential combination with existing therapies.
Review of the therapeutic effect of alpha-tocopherol, ascorbic acid, and folic acid against ovarian toxicity induced by drugs and heavy metals
(Rzeszów University Press, 2025-12) Omotoso, Dayo Rotimi; Alamu, Opemiposi Oreoluwa; Aderinto, Olaoluwa
Introduction and aim. The ovaries are almond-shaped organs that produce the female gametes and reproductive hormones. They also play a critical role of ovulation under well-coordinated hormonal regulation. However, chemotherapy involving the application of drugs to combat chronic diseases (like cancer) results in toxicity to tissues like ovaries. Similarly, exposure to heavy metals has a toxic effect on the ovaries. Hence, potential therapeutic agents including vitamin antioxidants have been explored to combat ovarian toxicity caused by drugs or heavy metals. Material and methods. This review was based on previous articles archived on Web of Science, PubMed, Scopus and Google Scholar databases. After initial assessment, the relevant articles were selected for further critical assessment. Analysis of the literature. Induction of oxidative stress and activation of inflammo-apoptotic signaling were indicated as the major mechanisms of ovarian toxicity due to exposure to drugs and heavy metals. Moreover, vitamins such as alpha-tocopherol, ascorbic acid and folic acid demonstrated therapeutic effects against drug and heavy metal-induced ovarian toxicity based on their modulatory effect on the downstream mechanisms of the toxicity. Conclusion. Vitamins exert a therapeutic effect against ovarian toxicity caused by drugs or heavy metal exposure due to their antioxidant, anti-inflammatory and anti-apoptotic properties.
Harnessing therapeutic potential of vitamins and microelements to mitigate testicular damage caused by drugs or chemical toxins ‒ a review
(Rzeszów University Press, 2025-12) Omotoso, Dayo Rotimi; Iwasokun, Oluwaseun; Olatomide, Oluwasegun Davis; Arogundade, Tolulope Timothy
Introduction and aim. Exposure to drugs and chemical toxins has been a common cause of structural and functional impairment of the male gonad (or testis), often leading to male reproductive disorder and infertility. Health concerns due to drugs or chemical-induced testicular damage have increased the exploration of potential therapeutic agents including vitamins and microelements. This review summarizes therapeutic role of vitamins and microelements against drugs or chemical toxins in preclinical studies. Material and methods. Relevant articles published on scientific databases like PubMed, Google Scholar, Scopus, and Web of Science were retrieved and critically reviewed for this study. Analysis of the literature. The mitigating effect of essential vitamins (such as vitamin B2, vitamin B9, vitamin B12, vitamin B17, vitamin C, vitamin E) and microelements (such as zinc and selenium) has been demonstrated on testicular damage caused by exposure to drugs and chemical toxins in preclinical studies and associated with their antioxidant, anti-inflammatory and anti-apoptotic properties. This was further characterized with reparation of testicular histopathology, suppression of testicular oxidative damage, improved sperm parameters, elevated testicular antioxidants and testosterone level, upregulation of steroidogenic gene, inhibition of sperm DNA damage. Conclusion. Vitamins and microelements exert therapeutic effect against drugs and chemical-induced testicular damage.
The comparative efficacy of FDA-approved drugs for management of alcohol use disorder ‒ a network meta-analysis
(Rzeszów University Press, 2025-12) Kumar, Suresh; Shanmugham, Suresh; Tan, Fern Yee; Kong, Ashley Haze Zhi Xuan; Foong, Chen Xing; Chan, Jia En; Antony, Paul T.; Smales, Frederick Charles; Ching, Siew Mooi; Vadakkechalil, Harsha; Veettil, Sajesh K.
Introduction and aim. Alcohol use disorder (AUD) represents a significant and lasting public health challenge affecting millions of people around the world. Currently, the US FDA has approved naltrexone, disulfiram, and acamprosate for AUD; however, their comparative effectiveness remains uncertain. This study aimed to evaluate the comparative efficacy of FDA-approved medications for AUD. Material and methods. A comprehensive search of PubMed, the Cochrane Library, and Embase was performed up to January 2025. Eligible studies were randomized controlled trials of at least 12 weeks in duration, enrolling adults with AUD and investigating one or more FDA-approved medications, individually or in combination. The Cochrane Risk of Bias 2 (ROB 2) tool was used to assess study quality. A frequentist random-effects network meta-analysis (NMA) was performed. The primary and secondary outcomes were the return to any level of drinking and the return to heavy drinking, respectively. Analysis of the literature. Fifty-two trials were included. Compared to placebo, acamprosate (risk ratio, RR, 0.87 [95% CI, 0.82-0.92]), naltrexone (0.93 [0.88-0.99]) and a combination of acamprosate and naltrexone (NAAC) (0.52 [0.35-0.76]) all statistically significantly reduced the risk of return to any type of drinking. Based on SUCRA rankings, NAAC (SUCRA = 0.99) was ranked first for efficacy. For the secondary outcome, only naltrexone (RR, 0.87 [0.80-0.95]) was found to be effective. Conclusion. When combined with psychosocial interventions, naltrexone and acamprosate demonstrated superior efficacy compared to placebo. Furthermore, the combination of the two medications led to significantly better results.
Postural, behavioural and cognitive effects of sit-stand desk use in primary school children – a crossover intervention pilot study
(Rzeszów University Press, 2025-12) Matłosz, Piotr; Herbert, Jarosław; Morska, Liliya
Introduction and aim. This study explores the effects of implementing stand-biased desks in a classroom setting on physical posture, cognitive performance, and attention in elementary school students aged 11 to 12 years old. Material and methods. The study group consisted of 51 boys from 5th and 6th grades. A crossover intervention design was employed, where students alternated between using traditional and sit-stand desks over the course of the study lasting three months. Anthropometric measurements, posture assessments, and cognitive tests (the d2 Test of Attention and Stroop), were conducted at three intervals (T1/T2/T3): initial, mid-intervention, and post-intervention. Results. During the intervention, significant changes were observed in anthropometric parameters, except for a decrease in body fat percentage. Cognitive testing revealed significant improvements in attentiveness and cognitive control when using the sit-stand desks. Specifically, the d2 test indicated enhanced concentration performance and test effectiveness, particularly when conducted in a standing position. The Stroop test also showed improvements in both time and corrected errors between the second and third assessments. Conclusion. The findings suggest that sit-stand desks may associate with better weight distribution and improved posture, with positive effects on attentiveness and cognitive performance of schoolchildren.
The relationship between dry eye syndrome and serum fat-soluble vitamin levels
(Rzeszów University Press, 2025-12) Gürez, Ceren; Küçük, Suat Hayri
Introduction and aim. Dry eye syndrome (DES) is a multifactorial ocular surface disease in which nutritional deficiencies, including fat-soluble vitamins, may play a role. This study aimed to investigate the relationship between serum levels of vitamins A, D, E, and K and DES. Material and methods. A total of 70 eyes from 35 patients with DES and 70 eyes from 35 healthy controls were examined. Dry eye evaluation included tear osmolarity (TO), tear break-up time (TBUT), Schirmer I test, and the Ocular Surface Disease Index (OSDI). Serum vitamin levels (A, D, E, K) were measured using HPLC, LC-MS/MS, and chemiluminescence immunoassay. Results. Patients with DES had significantly higher TO (312.7±4.9 vs. 295.2±6.5 mOsm/L, p<0.001) and OSDI scores (39.8±19.4 vs. 17.2±11.0, p<0.001), and significantly lower Schirmer I (7.0±1.8 vs. 17.3±1.3 mm, p<0.001) and TBUT values (7.3±0.8 vs. 16.1±0.7 s, p<0.001) compared with controls. Serum vitamin A (331.8±87.2 vs. 523.6±109.1 ng/mL, p<0.001) and vitamin D (14.8±6.9 vs. 34.6±14.9 ng/mL, p<0.001) levels were significantly lower in DES patients, whereas vitamin E and K did not differ between groups. Conclusion. Deficiencies in vitamins A and D are associated with impaired tear film parameters and symptoms of DES. These findings suggest that assessing and correcting vitamin A and D deficiency may have clinical relevance in managing DES.
Sotagliflozin prevents acute kidney injury by suppressing oxidative stress, inflammation, and apoptosis in renal ischemia/reperfusion rat model
(Rzeszów University Press, 2025-12) Alshimary, Nisreen Abd Alhassan Hamza; Tweij, Thu-Alfeqar Razzaq
Introduction and aim. Acute kidney injury (AKI) is a life-threatening condition with limited effective pharmacological options. Although sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown renal protective effects, the potential role of the dual SGLT1/2 inhibitor sotagliflozin in ischemia/reperfusion injury (IRI) has not been previously investigated. We aimed to evaluate its nephroprotective properties in a rat model of renal IRI. Material and methods. Twenty-four male Sprague-Dawley rats were randomized into four groups (sham, control, dimethyl sulfoxide [DMSO], sotagliflozin). Renal IRI was induced by 40 min ischemia followed by 2 h reperfusion. Rats received either DMSO or sotagliflozin (10 mg/kg, intraperitoneally) 24 h and 1 h before surgery. Kidney function (urea, creatinine, neutrophil gelatinase-associated lipocalin [NGAL]), oxidative stress (8-iso-prostaglandin F2α [8-iso-PGF2α]), inflammation (tumor necrosis factor-alpha [TNF-α]), apoptosis (caspase-3), and histopathology were assessed. Results. In the control group, serum urea (106.5±2.9 mg/dL), creatinine (1.52±0.09 mg/dL), and NGAL (64.5±3.6 ng/mL) were significantly higher than in the sham group (32.6±5.3, 0.89±0.06, 49.5±3.8, respectively; p<0.0001). Tissue 8-iso-PGF2α (63.8±5.9 pg/mL), TNF-α (186±7 pg/mL), and caspase 3 (120.3±6.5 pmol/L) were also elevated vs. sham (35.6±3.6, 137±7, 92.3±4.9; p<0.0001). Sotagliflozin pretreatment reduced urea (53.8±2.8 mg/dL), creatinine (1.04±0.07 mg/dL), NGAL (49.6±6.4 ng/mL), 8-iso-PGF2α (41.3±3.9 pg/mL), TNF-α (140±6.6 pg/mL), and caspase 3 (89.7±2.4 pmol/L; all p<0.0001 vs. control). Histological injury scores improved from 4.0 in control to 1.0 in the sotagliflozin group (p<0.05). Conclusion. Sotagliflozin significantly improved renal function and histopathological damage in rats with renal IRI by attenuating oxidative stress, inflammation, and apoptosis. These findings support its potential as a candidate for further investigation in the prevention of AKI.
Exploring the diagnostic potential of micro-RNA-320 and anti-Müllerian hormone in women with polycystic ovary syndrome ‒ a case-control study
(Rzeszów University Press, 2025-12) Talib, Zainab Mohammed; Hussein, Khwam R.; Khudhair, Hasan Abd Ali
Introduction and aim. Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by hormonal imbalance, insulin resistance, and reproductive dysfunction. Due to its heterogeneous clinical presentation, diagnosis remains challenging. MicroRNA-320a-3p and anti-Müllerian hormone (AMH) have recently emerged as promising biomarkers. This study aimed to assess their diagnostic potential in women with PCOS. Material and methods. A case-control study was performed in 90 women aged 18–40 years, including 45 patients with polycystic ovary syndrome and 45 age- and body mass index-matched healthy controls. Hormonal and metabolic markers were measured using standard immunoassays, and the expression of microRNA-320a-3p was quantified using real-time polymerase chain reaction. Results. Patients with polycystic ovary syndrome demonstrated significantly higher levels of luteinizing hormone (9.45±6.0 vs 5.09±2.2 mIU/mL), increased luteinizing hormone to follicle-stimulating hormone ratio (1.64±0.87 vs 0.76±0.3), and elevated fasting blood glucose (105.5±14.7 vs 94.3±13.5 mg/dL), all with p<0.001. Contrary to expectations, insulin and homeostatic model assessment for insulin resistance values were lower in the polycystic ovary syndrome group, possibly reflecting a predominance of non-obese phenotypes. AMH levels were also reduced (2.27±1.0 vs 3.34±1.1 ng/mL, p<0.001). Expression of microRNA-320a-3p was significantly downregulated (0.61±1.27 vs 2.81±5.03-fold, p=0.0009). MicroRNA-320a-3p expression correlated positively with luteinizing hormone levels and the luteinizing hormone to follicle-stimulating hormone ratio, while AMH was associated with insulin resistance. The combined use of both markers improved diagnostic differentiation between groups. Conclusion. MicroRNA-320a-3p and AMH show promise as diagnostic biomarkers in polycystic ovary syndrome. Their integration with traditional clinical markers may enhance diagnostic accuracy and provide deeper insight into the pathophysiological complexity of the disorder.
Serum leptin and glucagon-like peptide-1 levels in diabetic patients with end-stage renal disease on hemodialysis ‒ a cross-sectional study in Iraqi patients
(Rzeszów University Press, 2025-12) Fadhil, Haneen Husham; Salman, Rana Dawood; Hasan, Jubran Khaleel
Introduction and aim. Diabetic kidney disease (DKD), a common complication of type 2 diabetes mellitus, is the leading cause of end-stage renal disease (ESRD). This study aimed to evaluate differences in serum leptin and glucagon-like peptide-1 (GLP-1) levels between diabetic ESRD patients undergoing hemodialysis and healthy controls. Material and methods. A cross-sectional observational study was conducted involving 65 participants: 31 type 2 diabetic patients with ESRD on hemodialysis and 34 healthy controls. Serum leptin and GLP-1 concentrations were measured using enzyme-linked immunosorbent assays. Results. Patients with ESRD exhibited significantly higher serum leptin levels (1.7±1.0 ng/mL) compared to controls (1.4±0.7 ng/mL; p=0.001), and significantly lower GLP-1 levels (19.6±11.2 pmol/L vs. 37.0±25.7 pmol/L; p=0.001). Conclusion. Elevated leptin levels and reduced GLP-1 concentrations in diabetic ESRD patients suggest a potential role of these biomarkers in renal injury and metabolic regulation. The findings highlight the therapeutic promise of GLP-1 receptor agonists in this population.
Sex differences in hypertension prevalence and risk factors in India ‒ a comparative study based on National Family Health Survey IV and V
(Rzeszów University Press, 2025-12) Prasad, Jang Bahadur; Sabhahit, Ganapati; Biradar, Rajeshwari A.
Introduction and aim. Hypertension is increasing universally, mainly in developing countries like India. This study analyzed sex differences in hypertension using data from National Family Health Survey (NFHS) rounds IV and V, with a focus on prevalence trends and associated risk factors. Material and methods. This study utilized data from NFHS rounds IV and V, focusing on males and females aged 15–49 years. The samples included 103,525 males and 667,258 females in NFHS-IV, and 93,267 males and 695,707 females in NFHS-V. Univariate, bivariate, and multivariate analytical techniques were employed to address the study’s objectives. Results. The NFHS-IV and V data revealed a notable increase in hypertension prevalence across India, with significantly higher odds observed among individuals in the older reproductive age group (45–49 years) for both sexes. Hypertension occurred 4.85 times higher among male in the age group 45‒49 compared to 15-24 age group, which rose to 5.23 in NFHS-V. Among female, the odds increased from 5.39 in NFHS-IV to 6.40 in NFHS-V. Remarkably, illiterate male showed lower odds of hypertension linked to their educated peers in both survey rounds, while female with only primary education showed higher odds. Regional disparities were also evident, with both male and female from the Northeast showing elevated odds ‒ particularly female, who had an odds ratio of 1.47 in NFHS-IV. Conclusion. The observed sex-specific variations in hypertension and its risk factors indicate a need for public health strategies to designed for each gender. Tailored interventions addressing education, lifestyle behaviors, and regional disparities are essential to effectively manage and prevent hypertension in India’s diverse population.
Association between handgrip strength and cognitive function in older adults living with cancer
(Rzeszów University Press, 2025-12) Oscanoa, Teodoro J.; Cieza-Macedo, Edwin; Romero-Ortuno, Roman
Introduction and aim. Handgrip strength (HGS) serves as a key indicator of muscle performance and may reflect cognitive status in older cancer patients. We examined whether handgrip strength was associated with cognitive function in this group of patients. Material and methods. For this study, a cross-sectional design was used, analyzing data from patients aged 60 years and older diagnosed with cancer, collected through Comprehensive Geriatric Assessments (CGAs). The information included demographics, HGS levels, and Mini-Mental State Examination (MMSE) scores. Results. Among 352 participants (average age 75.7 years), HGS showed a moderate positive correlation with cognitive function, stronger in females (r=0.36, p<0.001) than in men (r=0.22, p=0.005). Each 1 kg increase in HGS was associated with a 0.29-point increase in MMSE scores in women and 0.13 points in males. Conclusion. Higher HGS appears to better cognitive outcomes in older adults with cancer. As muscle strength is potentially modifiable, future research should explore whether HGS-targeted interventions could preserve or enhance cognitive health. Implementing regular handgrip strength assessments in geriatric oncology could help to detect patients who are vulnerable to cognitive decline.
Neuroprotective effects of Vernonia amygdalina and Moringa oleifera in alloxan-induced diabetic Wistar rats
(Rzeszów University Press, 2025-12) Chidimma, Acharaike Amarachi; Ofoego, Uzozie Chikere; Ezejindu, Damian Nnabuihe; Demshimeno, Paul Matthew; Obinwa, Makuachukwu Francisca; Obinwa, Benedict Nzube
Introduction and aim. Diabetes mellitus is a metabolic disorder that affects multiple organs, including the hippocampus, a key region involved in memory. This study aimed to investigate the neuroprotective and antidiabetic effects of Vernonia amygdalina and Moringa oleifera in an alloxan-induced diabetic rat model. Materials and methods. Thirty-five adult Wistar rats were randomized into seven groups and treated with aqueous extracts of V. amygdalina, M. oleifera, their combination, or glibenclamide for 30 days following alloxan-induced diabetes. Fasting blood glucose (FBG), hippocampal acetylcholinesterase (AChE) activity, cognitive performance (Morris Water Maze test) and histopathological changes in the hippocampus were evaluated. Results. Alloxan significantly increased FBG (20.68±1.04 mmol/L), AChE activity (40.40±0.40 nmol/mL), and escape latency (51.75±4.39 sec), and reduced hippocampal cell density. Treatment with V. amygdalina and M. oleifera reduced FBG (8.29±0.93 mmol/L), AChE activity (34.50±0.30 nmol/mL), and escape latency (3.39±0.45 sec), and improved hippocampal histoarchitecture. Conclusion. V. amygdalina and M. oleifera demonstrated neuroprotective and antidiabetic effects in diabetic rats. These results support their potential as adjunct agents to prevent diabetes-induced cognitive dysfunction.
Evaluation of endothelin 1 and N-terminal pro-B-type natriuretic peptide in patients with rheumatoid arthritis
(Rzeszów University Press, 2025-12) Ahmed, Ammar A.; Jewad, Abdulkareem M.
Introduction and aim. Rheumatoid arthritis (RA) is a chronic disease characterized by synovial inflammation and joint destruction. This study evaluated the novel biomarkers vitamin D binding protein (VDBP), retinol-binding protein 4 (RBP4), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and endothelin-1 (ET-1) for RA diagnosis. To our knowledge, this is the first study to simultaneously assess these biomarkers across different treatment stages in RA, linking systemic inflammation with subclinical cardiovascular involvement. Material and methods. A case-control study enrolled 61 RA patients [G1 (newly diagnosed, untreated, n=10)], G2 [3 months csDMARDs, n=22], G3 [≥6 months biologic+csDMARDs, n =29]), 27 age/sex-matched healthy controls. The serum levels of VDBP, RBP-4, CRP, NT-proBNP, and ET-1 measured using enzyme-linked immunosorbent assay. Results. All evaluated biomarkers were significantly elevated in RA patients compared to controls (p<0.0001): RBP-4 (49.172±21.935 vs. 14.006±3.988 ng/mL), VDBP (12.091±3.334 vs. 2.882±1.136 ng/mL), NT-proBNP (1341.787±626.068 vs. 11.452±3.260 pg/mL), ET-1 (14.246±4.031 vs. 3.932±1.422 pg/mL). Subgroup analysis revealed a significantly higher VDBP in newly diagnosed untreated patients (G1:14.455±4.126 ng/mL) than in treated groups (G2:11.379±2.632; G3:11.816±3.269 ng/mL; p<0.05). NT-proBNP peaked in G1 (1789.2±710.81 pg/mL), decreased in csDMARD-treated (G2: 1154.0±537.58 pg/mL), biologic-treated (G3: 1329.96±601.18 pg/mL) group. Conclusion. VDBP, RBP-4, CRP are effective diagnostic biomarkers of RA. Significant elevations in NT-proBNP and ET-1 levels associated with cardiac complications, correlated with disease activity, and improved with therapy.
Evaluating tumor necrosis factor-alpha and interleukin 17 as plasma biomarkers for rheumatoid arthritis diagnosis
(Rzeszów University Press, 2025-12) Abd Ali, Alaa H.; Kharbat, Farah Majid
Introduction and aim. Rheumatoid arthritis (RA) is a complex chronic inflammatory autoimmune disease with significant global health implications. In this study, our aim was to evaluate the clinical utility of plasma tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17) along with immunological parameters as diagnostic biomarkers for patients with RA. Material and methods. A case-control study was conducted involving 75 RA cases and 75 age- and sex-matched controls. Plasma levels of TNF-α and IL-17 were measured using ELISA kits. Statistical analyses included receiver operating characteristic (ROC) curve analysis and correlation tests to evaluate the diagnostic accuracy, predictive value, and associations with disease activity parameters. Results. RA patients exhibited significantly elevated TNF-α (275.5±99.9 vs. 46.2±8.4 pg/mL, p<0.001) and IL-17 (313.8±95.4 vs. 42.2±10.96 pg/mL, p<0.001) compared to controls. Patients with a family history of RA had higher TNF-α (p=0.019) and IL-17 (p=0.03) levels. ROC analysis revealed perfect diagnostic accuracy for both biomarkers (100% sensitivity and specificity) at cut-offs >65.2 pg/mL (TNF-α) and >83 pg/mL (IL-17). Conclusion. There was a positive correlation between serum levels of IL-17 and TNF-α. Therefore, these biomarkers distinguish rheumatoid arthritis patients from healthy controls.
Apelin, C-reactive protein, and serum protein correlation with blood pressure ‒ a biomarker analysis
(Rzeszów University Press, 2025-12) Mutaeb, Zahraa Ahmed; Ramadhan, Usama H.; Jasim, Ekhlas Qanber
Introduction and aim. Hypertension is a major global health burden and a leading cause of cardiovascular disease and premature death. This study aimed to evaluate the association between serum apelin, inflammatory markers, and protein metabolism parameters in hypertensive patients compared to normotensive controls. This study uniquely explores the interplay between inflammatory and protein metabolism biomarkers using advanced multivariate models in hypertensive adults, a combination not previously examined in this population Material and methods. Two hundred adults aged 35–65 years were divided into hypertensive (n=100) and normotensive (n=100) groups. Serum apelin and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay, while albumin and total protein were assessed via spectrophotometry. Statistical analyses included t-tests, multiple regression, structural equation modeling (SEM), and Cox regression. Results. Hypertensive patients had significantly higher blood pressure (p<0.001), CRP (7.52±4.21 vs. 1.35±0.51 mg/L; p<0.001), globulin (3.4±1.0 vs. 1.8±0.9 g/dL; p<0.001), and total protein, but lower apelin (2386.2±401.7 vs. 2873.4±572.8 pg/mL; p<0.001) and albumin levels. SEM revealed a direct association between CRP and systolic blood pressure (β=0.45, p<0.001), and a negative association between apelin and systolic pressure (β=−0.20, p=0.03). CRP (HR=1.75, p=0.005) and systolic BP (HR=1.52, p<0.001) were independent predictors of cardiovascular events. Conclusion. The findings suggest that systemic inflammation and dysregulation of serum protein metabolism are significantly associated with hypertension and cardiovascular risk. Apelin may play a protective role by mitigating the impact of inflammation on blood pressure.
Aprocitentan mitigates ischemia reperfusion induced kidney injury in rats by attenuating inflammation and pyroptosis through suppressing NF-κB/NLRP3/caspase-1 signaling pathway
(Rzeszów University Press, 2025-12) Alfatli, Layla Ameen Rasheed; Tweij, Thu-Alfeqar R.
Introduction and aim. Renal ischemia-reperfusion (I/R) injury is a primary cause of acute kidney injury (AKI). The NF-κB/NLRP3/caspase-1 signaling system is crucial for I/R-induced kidney damage, which leads to inflammation, pyroptosis, and tissue damage. Aprocitentan has anti-inflammatory and vasoprotective properties, suggesting its potential nephroprotective advantages. The aim of this investigation was to evaluate the protective advantages of aprocitentan against renal I/R injury in rat models. This was achieved by evaluating the impact of aprocitentan on inflammation, pyroptosis, and kidney function by altering the NF-κB/NLRP3/Caspase-1 pathway. Material and methods. Using twenty-four adult male Sprague-Dawley rats, four separate groups were formed: sham group, I/R control group, dimethyl sulfoxide group (DMSO) and aprocitentan group (10 mg/kg). Renal ischemia/reperfusion was induced by a period of forty minutes of bilateral ischemia, which was followed by two hours of reperfusion. To evaluate the renoprotective effect of aprocitentan urea, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), phosphorylated nuclear factor kappa B p65 (NF-κB p65), NOD-like receptor protein 3 (NLRP3), and cysteine-aspartic protease-1 (caspase-1), were measured, along with histopathological examination. Results. Compared to the sham group, the I/R control group had significantly increased concentrations of urea, creatinine, NGAL, NF-κB p65, NLRP3, as well as caspase-1. These signs decreased in the aprocitentan group, leading to enhanced renal function, reduction of inflammation, and inhibition of pyroptosis. Histology showed a decrease in tubular inflammation and necrosis in the aprocitentan group. Conclusion. Aprocitentan decreases inflammation and inhibits pyroptosis by suppressing the NF-κB/NLRP3/Caspase-1 pathway. These results illustrate its promising potential to prevent ischemic renal diseases, including acute kidney injury.

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