Oddeleni Klinicke Biochemie A Imunogenetiky

Olomouc, Czech Republic

Oddeleni Klinicke Biochemie A Imunogenetiky

Olomouc, Czech Republic
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Taborsky M.,I. Interni Klinika | Ost'Adal P.,Kardiologicke Oddeleni | Petrek M.,Oddeleni Klinicke Biochemie A Imunogenetiky | Heinc P.,I. Interni Klinika | And 3 more authors.
Kardiologicka Revue | Year: 2010

Mild alcohol consumption decreases cardiovascular morbidity and mortality as well as it reduces total mortality. Although regular intake of any type of alcoholic beverage appears to have positive influence on health, additional benefits are thought to be associated with wine, particularly red wine. The beneficial effect of wine is ascribed to the presence of ethanol and phenolic substances. This overview is dedicated to epidemiology of coronary artery disease (CAD) and wine consumption, as well as the underlying mechanisms of the biological effects of wine compounds on CAD.


Vostalova J.,Ustav Lekarske Chemie A Biochemie | Galandakova A.,Ustav Lekarske Chemie A Biochemie | Strebl P.,III. Interni Nefrologicka | Zadrazil J.,III. Interni Nefrologicka | And 2 more authors.
Vnitrni Lekarstvi | Year: 2012

Patients with chronic kidney disease are exposed to oxidative stress (OS) that contributes to deterioration of health. Decrease in renal excretory capacity contributes to the accumulation of pro-oxidative substances that are detrimental not only to kidney but to the whole organism including the cardiovascular system. Components of antioxidant system play an important role in the elimination of the OS. The monitoring of antioxidant levels and products of oxidative damage in these patients and the correct interpretation of relationship between these markers and the function of kidney and other organs may contribute to the more effective treatment and health improvement of the patients.


Free monoclonal immunoglobulin light chains (FLC) quantification is recommended for diagnosis assessment and monitoring therapy for patients with monoclonal gammopathy. But there are numerous uncertainties regarding the detection, interpretation and FLC quantification. Our interlaboratory study showed that kappa/lambda ratio is strongly influenced by measurement errors and therefore we recommended the preferential use of FLC concentration values. Unified protocols are needed to minimise interlaboratory variability introduced by manual dilution or volume augmentation of clinical sample.


Hermanova Z.,Ustav Imunologie | Pika T.,III. Interni Klinika Nefrologicka | Lochman P.,Oddeleni Klinicke Biochemie A Imunogenetiky | Scudla V.,III. Interni Klinika Nefrologicka
Klinicka Biochemie a Metabolismus | Year: 2012

Objective: The B cell activating factor (BAFF) is an important protein influencing not only maturation, activation and survival of B lymphocytes and plasma cells but also malignant plasma cells. In the pilot study we compared the concentration of BAFF in the groups of patients with various types of monoclonal gammopathies. Material and methods: We investigated 66 samples of 58 patients with monoclonal gammopathies (MG). 5 patients had Waldenstrom's macroglobulinemia (MW), 10 patients monoclonal gammopathy of undetermined significance (MGUS), 51 samples were from patients with multiple myeloma (MM) - 16 MM at remission, 27 MM at time of diagnosis, 8 MM at relapse. Paired analysis was used at 8 patients with MM at time of diagnosis and MM at remission. The ELISA kit was used to determine serum levels of BAFF protein. Mann - Whitney test, Wilcoxon paired test and Spearman's correlation analysis were used for statistical calculation. Results: The concentrations of BAFF in each group were: MM at remission 2520 ng/l, MM at time of diagnosis 204 ng/l, MM at relapse 331 ng/l, MGUS 257 ng/l, MW 120 ng/l. The values of BAFF protein at MM at remission were statistically significantly higher than the values at all the others groups : MM at time of diagnosis (p < 0,0001), MM at relapse (p = 0,0001), MGUS (p < 0,0001), MW (p = 0,001). Patients in the group with MM at relapse had statistically significantly higher BAFF concentration than in the group with MM at time of diagnosis. Spearman's correlation analysis revealed negative medium strong correlation between the concentration of BAFF and patient's age in the group with MM at time of diagnosis. Conclusion: The highest concentration of BAFF protein was found in the group of patients with MM at remission and it was opposite to literature data and our expectation. It is probable that results of BAFF analysis should be considered in the context of other parameters.


Orsag J.,III. Interni Klinika Nefrologicka | Pika T.,III. Interni Klinika Nefrologicka | Kosatikova Z.,III. Interni Klinika Nefrologicka | Lochman P.,Oddeleni Klinicke Biochemie A Imunogenetiky | And 5 more authors.
Klinicka Biochemie a Metabolismus | Year: 2013

Objective: Renal failure requiring haemodialysis occurs in 10-20 % of all multiple myeloma (MM) cases and it is associated with a greatly increased morbidity and mortality. The main cause of renal injury is cast nephropathy, as a direct consequence of high concentrations of monoclonal free light chains (FLCs) in patients' sera. Rapid reduction of FLCs levels plays a key role in renal recovery. Evidence of benefit of plasmapheresis in removing serum FLC has been controversial. According to the recent experience, haemodialysis using high cut-off dialysers reduces effectively the level of FLCs concentrations and improves renal functions in long term when combined with an effective chemotherapy. In our single centre study we assessed efficacy of parallel treatment for patients with new diagnosed MM and acute renal failure due to excess of serum FLCs with combination of bortezomib-based chemotherapy and haemodialysis using high cut-off dialysers. Material and methods: The studied group consisted of 4 patients with new diagnosed MM and acute renal failure requiring haemodialysis and with serum FLCs levels ("dominant FLC") above 500 mg/l. They all were treated with bortezomib-based chemotherapy and simultaneously they underwent haemodialysis sessions with the high cut-off membranes (Theralite™ 2100, Gambro Dialysatoren GmbH, Hechingen, Germany). At the beginning and before the end of each session, free light chain levels in serum as well as in dialysate were measured (Freelite™, The Binding Site,UK). Percentage reduction in serum free light chains in the hemodialysis session as well as at the end of treatment was determined by calculation from the reached data. The efficacy of the treatment and clinical state of the patients were observed as well. Results: 27 sessions of haemodialysis with high cut-off membranes (HCO HD) were performed, each patient underwent between 3 and 11 sessions. At the same time, patients underwent bortezomib-based chemotherapy. Free light chain levels decreased by a mean of 93.7± 8.8 % between treatment onset and completion, while the mean percentage of reduction of FLC levels per session was 55.30 ± 20.04 %. Mean clearance of FLCs was 62.7 ± 37.2 ml/min resp. 29.0 ± 26.1 ml/min at the beginning resp. at the end of HCO HD. Renal function was recovered in 3 patients, who are alive and dialysis-free. One patient died of ischemic stroke not related to haemodialysis procedure during treatment. Conclusion: We demonstrated haemodialysis using high cut-off membranes is an effective method to remove free light chains rapidly and to recover renal functions in acute renal injury in multiple myeloma in combination with chemotherapy using bortezomib. Further experiences and studies are needed to examine the clinical benefit and to select the optimum regimen.


Orsag J.,III. interni klinika nefrologicka | Minarik J.,III. interni klinika nefrologicka | Kosatikova Z.,III. interni klinika nefrologicka | Hruby M.,III. interni klinika nefrologicka | And 3 more authors.
Interni Medicina pro Praxi | Year: 2014

Renal failure requiring haemodialysis occurs in 10-20 % of all multiple myeloma (MM) cases and it is associated with a greatly increased morbidity and mortality. The main cause of renal injury is cast nephropathy, as a direct consequence of high concentrations of monoclonal free light chains (FLCs) in patientś sera. Rapid reduction of FLCs levels plays a key role in renal recovery. Evidence of benefit of plasmapheresis in removing serum FLC is controversial. According to recent experience, haemodialysis using high cut-off dialysers reduces effectively the level of FLCs concentrations and improves renal functions in long term when combined with an effective chemotherapy. Nevertheless, further experiences and controlled trials are needed to determine the clinical benefit of this treatment.


Pika T.,III. Interni Klinika Nefrologicka | Minarik J.,III. Interni Klinika Nefrologicka | Lochman P.,Oddeleni Klinicke Biochemie a Imunogenetiky | Bacovsky J.,III. Interni Klinika Nefrologicka | Scudla V.,III. Interni Klinika Nefrologicka
Transfuze a Hematologie Dnes | Year: 2011

Introduction. Monoclonal gammopathy of undetermined significance (MGUS) is a potentially malignant condition associated with a certain degree of probable transformation into one of the malignant forms of monoclonal gammopathy (MG). Identifying possible predictive factors of malignant evolution is the focus of several research centres. Determining serum levels of free light chains (FLC) appears to be a relatively significant parameter, enabling the identification of persons at higher risk of malignant transformation. The report aims to present our own experience with determining FLC serum levels in a group of individuals with MGUS. Group and results. The monitored group numbered 191 persons with MGUS. Abnormal κ or λ FLC levels were detected in 119 (62.3%), and pathological values of the κ/λ index in 106 (55.5%) patients. During the six years of monitoring, 11 (5.7%) persons in total experienced transformation into a malignant form of MG, which corresponds approximately to a transformation rate of 0.95%/year in the whole group. Using the stratification system for MGUS based on the combination of quantity, monoclonal immunoglobulin isotype and the κ/λ index value, there were 56 (29.3%) persons in the low-risk group, 87 (45.5%) in the low-intermediate risk group, 45 (23.6%) in the high-intermediate risk group, and only 3 persons (1.6%) in the high-risk group. The transformation percentage for the individual groups corresponded to 0 vs. 4.5 vs. 13.3 vs. 33.3% over the course of 6 years. MGUS evolution was associated with increasing FLC levels and a change in the κ/λ index. Conclusion. The survey results have confirmed the practical benefits of testing FLC serum levels in persons with MGUS, particularly the positive contribution to risk stratification with identification of MGUS high risk forms, allowing early detection of malignant evolution and immediate initiation of adequate treatment.


Pika T.,III. Interni Klinika | Hermanova Z.,Ustav Imunologie | Lochman P.,Oddeleni Klinicke Biochemie a Imunogenetiky | Zapletalova J.,Ustav Lekarske Biofyziky | And 3 more authors.
Klinicka Biochemie a Metabolismus | Year: 2011

Objective: Typical features of monoclonal gammopathy (MG) include the presence of monoclonal immunoglobulin (MIG) molecules or their fragments in the serum and/or urine. The latest test which extends the range of MIG examination possibilities is the HevyLite™ system, using principally a couple of specific antibodies against junctional epitopes between the domains of heavy and light immunoglobulin chains in constant regions. The study aimed at implementing the HevyLite™ system and performing a pilot analysis in the group of IgA-type MG patients. Settings: Department of Internal Medicine III, University Hospital Olomouc. Material and methods: The studied group consisted of 24 patients with multiple myeloma (MM) and 7 individuals with monoclonal gammopathy of undetermined significance (MGUS). The HevyLite™ system (The Binding Site, UK) was used to determine the serum levels of IgAκ, IgAλ as well as the BN II analyser (Siemens Healthcare Diagnostics). The ratio of IgAκ/IgAλ was determined by calculation. Results: The patients in the active disease stage revealed highly pathological levels of the dominant MIG, with suppressed levels of the alternative IgA immunoglobulin, and significant influence on the IgAκ/IgAλ ratio. 5 out of the 6 patients who had achieved a complete remission showed a normal IgAκ/IgAλ ratio, 1 patient had suppression of both IgA with a modified IgAκ/IgAλ ratio. All individuals with MGUS revealed abnormal levels as well as ratio of IgAκ/IgAλ, one patient with a low-risk disease type had the IgAκ/IgAλ ratio value slightly above the threshold. When comparing the results of M-protein determination by the method of HevyLite™ and electrophoresis, Spearman's correlation analysis confirmed a very close correlation of M-protein levels regarding IgAκ (r = 0.946, p < 0.0001) as well as IgAλ (r = 0.872, p = 0.0001). The summations of the dominant as well as alternative IgA immunoglobulin levels substantially correlated with the general level of IgA immunoglobulin determined nephelometrically (r = 0.994, p < 0.0001). Conclusion: It seems, that the HevyLite™ system promisingly complements the set of examinations used routinely by MG monitoring, in particular by very low concentrations of MIG, or the mere positivity of the immunofixation electrophoresis. Further experience needs to be gained in order to fully assess the benefits of this examination for clinical practice.

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