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Paraoxonase-1 (PON-1), a calcium ion-dependent high-density lipoprotein (HDL)-associated enzyme, has been proposed as a negative acute phase reactant biomarker in animal and human adult studies. The aim of this study was to evaluate the value of PON-1 activity in the diagnosis and monitoring of neonatal sepsis. Serum PON-1 activity, as paraoxonase and arylesterase, was prospectively studied in 48 septic neonates and matched controls. PON-1 activity was decreased at the acute phase of sepsis in comparison with values at recovery and values in controls. Paraoxonase or arylesterase at enrollment correlated significantly with serum Amyloid-A, CRP and IL-6 and could also discriminate septic than non-septic neonates. In conclusion, our results are promising regarding the role of PON-1 as a biomarker of neonatal sepsis. Larger studies are needed to validate the clinical utility of PON-1 in neonatal medicine.

Objective: Measurement of salivary biomarkers can provide important information regarding hypothalamic-pituitary-adrenal axis activity both under normal conditions as well as in response to psychological or physical stress. Our aim was to correlate salivary stress markers, such as cortisol, -amylase and immunoglobulin A, with the Pediatric Risk Index Score of Mortality, underlying disease (pathologic, trauma and postoperative), need for mechanical ventilation/sedation and time lag between onset of illness and admission in children admitted in the pediatric intensive care unit. Methods: We enrolled 79 pediatric intensive care unit patients (2-14years) over a 2-year period, which satisfy the including criteria, but finally salivary biomarkers were evaluated in 65 patients. Saliva samples were collected within 24h of admission at 8a.m., 2p.m. and 8p.m. to examine potential disruption of circadian rhythm. Results: Overall, the salivary biomarkers were increased; specifically, median values were (a) cortisol at 8a.m.: 50.04nmol/L, 2p.m.: 30.69nmol/L and 8p.m.: 247.12nmol/L; (b) -amylase: at 8a.m.: 22.567U/L; 2p.m.: 22.702U/L and 8p.m.: 21.484U/L and (c) IgA at 8a.m.: 95.10mg/dL, 2p.m.: 88.55mg/dL and 8p.m.: 80.80mg/dL. Significantly higher levels were demonstrated in children younger than 6years and those with Pediatric Risk Index Score of Mortality 8 upon admission. Disturbances in circadian rhythm were observed. Cortisol circadian rhythm disturbance was observed only in children with Pediatric Risk Index Score of Mortality score 8 upon admission while maintaining normal -amylase circadian rhythm, which was associated with less than 3days hospitalization in pediatric intensive care unit. No daily variance in IgA was observed. Conclusion: Salivary biomarkers may serve, in critically ill children, as a sensitive, non-invasive method, important for the early recognition of those at high risk and guiding intervention, before clinical deterioration, promoting the quality of health care in pediatric population.

Background Previous research indicated that coeliac disease (CD) is associated with type 1 diabetes mellitus (T1DM). However, the gut-brain axis peptide hormones secretion has not been evaluated so far in patients with CD prior to treatment initiation or under treatment, irrespective of patients having concomitant T1DM or not. The aim of the study was therefore to evaluate these gut hormones at the preprandial levels of patients with CD before and under treatment. Methods Of forty-seven CD children, 12 untreated (UCD), 22 treated with gluten-free diet (TCD) and 13 treated CD with coexisting T1DM (DCD), and 18 healthy controls (HC) were enrolled. Preprandial glucagon-like-peptide-1 (GLP-1), glucose-dependent-insulinotropic-polypeptide (GIP), active amylin, acylated ghrelin (AG), leptin, pancreatic polypeptide (PP) and peptide-tyrosine-tyrosine (PYY) were determined with hormone-map-array technology. Results We found in patients with CD compared with HC that the concentration of (i) GLP-1 was reduced remarkably in all patients with CD (P=0.008), (ii) GIP was lower in patients with UCD (P=0.008), (iii) amylin was remarkably reduced (P

Iron-induced cardiotoxicity remains the leading cause of morbidity and mortality in patients with transfusion-dependent beta-thalassemia major. Heart failure in these patients, which may be reversible but has a poor prognosis, is characterized by myocardial iron deposition-related early diastolic dysfunction. Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is a sensitive biomarker for the detection of asymptomatic left ventricular dysfunction. In this study, we prospectively evaluated plasma NT-proBNP levels in 187 adult patients aged 19-54 years with beta-TM. Possible correlations with the proposed recently cardiac iron concentration based on an equation derived from heart T2* assessment by MRI: [Fe] = 45.0 x [T2*](-1.22) with [Fe] in milligrams per gram dry weight and T2* in milliseconds were explored. We found that: 143 patients had no cardiac hemosiderosis, defined as [Fe]20 ms and 44 patients had cardiac hemosiderosis, defined as [Fe]>1.2 mg/g dry weight. The main results of the study showed that: a) NT-proBNP levels were markedly increased in thalassemic patients (152.2 +/- 190.1 pg/mL, ranged from 6.0 to 1336.0 pg/mL compared to normal control levels 40.1 +/- 19.7 pg/ml, p0.1), and d) no significant correlation was found between NT-proBNP levels and left ventricular ejection fraction values, (p>0.3). Our study demonstrated for first time the significant association of NT-proBNP levels and cardiac iron concentration in patients with beta-thalassemia major linking blood chemistry and imaging techniques. Multicenter studies of these parameters during iron chelation therapies are needed to validate their association and further exploit its clinical use. (C) 2012 Elsevier Inc. All rights reserved.

It has been suggested that cytokine release during DKA may result in capillary perturbation and thus may contribute to the development of its acute clinical complications (i.e.cerebral or pulmonary edema). We studied in 38 newly diagnosed T1DM children with DKA, aged 7.68 +/- 3.07 years, plasma levels of cytokines IL-1 beta(interleukin-1 beta), IL-2, IL-6, IL-8, IL-10, TNF-alpha (tumour necrosis factor-alpha) and also WBC (white blood cell count), hs-CRP (high sensitivity C-reactive protein), OH (growth hormone) and cortisol, prior to, during and 120h after DKA management, with the aim to monitor their levels at different time-points and in different degrees of DKA severity. Prior to DKA management the levels of IL-6, IL-8, IL-10, WBC and cortisol were elevated, but were all reduced within 120h after DKA management. Then the patients were divided into two groups: a. moderate/severe: pH 7.2. In the group with moderate/severe DKA (ph

Background Childhood obesity represents one of the most challenging health problems of our century and is associated with significant morbidity and mortality in adult life. Proteomics is a large-scale analysis of proteins, which provides, information on protein expression levels, post-translational modifications, subcellular localization and interactions. Objective To investigate whether obesity in childhood is associated with alterations in plasma protein expression profiles. Methods Plasma samples from 10 obese [age: 10 75 +/- 0 16 year; body mass index (BMI): 27 50 +/- 0 69 kg m) 2], 10 overweight (age: 10 54 +/- 0 1 year; BMI: 21 88 +/- 0 28 kg m) 2) and 10 normal- weight (age: 10 89 +/- 0 19 year; BMI: 18 34 +/- 0 42kg m) 2) prepubertal boys were subjected to protein fractionation and analysed by two- dimensional electrophoresis, followed by protein identification using matrix- assisted laser desorption time- of- flight mass spectrometry. Fasting plasma glucose and serum insulin, lipid and apolipopoprotein concentrations were determined in all subjects. Results The expression of apolipoprotein (Apo) A- I (ApoA- I) was significantly lower in obese and overweight children compared with children of normal BMI (P < 0 05). The expression of ApoE was significantly lower in overweight compared with normal- weight children (P < 0 05), while that of ApoA- IV was significantly higher in obese children compared with their normal counterparts (P < 0 01). Serum ApoA- I concentrations were significantly lower in obese (147 +/- 4 27mg dL) 1) and overweight (145 5 +/- 9 65mg dL) 1) than in normal- weight (157 +/- 8 77mg dL) 1; P = 0 036) children. Conclusions Obese and overweight prepubertal children demonstrated prominent alterations in the expression of plasma apolipoproteins compared with their normal counterparts. Low ApoA- I plasma expression levels and serum concentrations in obesity might be present in childhood before any significant alterations in total or high- density lipoprotein- cholesterol concentrations are documented. We recommend that serum ApoA- I concentrations are determined in all overweight and obese children.

We evaluated the serum levels of lipids, lipoproteins, apolipoproteins, along with a number of minerals and trace elements such as Ca, Mg, Cu and Zn in a group of children after 6 months of valproic acid monotherapy. Thirty patients with seizures, mean age, 9.8 +/- 2.6 years and 79 healthy children (controls), mean age, 10.9 +/- 3.2 years. formed the two styd groups. The patient group was treated with valproic acid (27.9 +/- 14.8 mg/kg/24 hr). Patients underwent clinical and laboratory evaluations including liver function tests. NH3, lipid, mineral and selected trace element levels before and after six months on valproic acid treatment, whereas controls only one evaluation. Liver function data and NH3 levels were found to be elevated in the group of patients. whereas albumin level was reduced. Triglycerides, total cholesterol, HDL-C, apolipoprotein (ApoA)-1, Apo B and Ca concentrations were found relative to control values. LDL-C, VLDL-C, Mg, Cu, Zn, were measured significantly altered (P < 0.0001) compared to controls. The ratios ApoA-1/ApoB, HDL-C/ApoA-1, LDL-C/Apo B, which were closely related to the size of LDL particles, where correlated with Zn/Cu (P < 0.001). Serum lipid profile, especially LDL size, indirectly evaluated for the first time and metal levels were found to be significantly changed, after six months on valproic acid monotherapy, suggesting a possible risk of developing coronary heart disease. Since valproic acid is a long-term treatment. it could be recommended that the incorporation of measurements of lipids, lipoproteins, apolipoproteins and trace elements in the “follow up” laboratory testing could be a preventive measure.