Sestrins (Sesns) are a family of highly conserved stress-inducible proteins and various stresses have been shown to strongly up-regulate them. Sestrin 2 (Sesn2) deficiency has been shown to partially suppress pulmonary emphysema. The aim of this study was to evaluate Sesn2 levels in COPD patients and its possible associations with the presence of emphysema and blood eosinophils. All patients underwent lung function testing and high-resolution computed tomography (HRCT) of the chest. The presence of emphysematous lesions in >15% of the pulmonary parenchyma was considered as significant emphysema. Sixty-seven patients were included in the study. 40/67 patients were characterized as having significant emphysema. Patients with significant emphysema had higher levels of Sesn2 (ng/ml) [median (IQR) 6.7 (2.7,10.3 vs 1.09 (0.9,1.9), p<0.001)] and significantly lower % and absolute blood eosinophil counts (cells/μL) compared to patients without emphysema [1 (0, 2) vs 4 (2, 4) p<0.001 and 62 (0, 110) vs 248 (180, 300), p<0.001 respectively]. Sesn2 presented a significant positive correlation to the score of emphysema in HRCT (rs = 0.87, p<0.001) and similar positive but weaker correlation to FRC (rs = 0.27, p = 0.024). Negative correlations were observed between Sesn2 and either the % of blood eosinophils and/or the absolute blood eosinophil count (rs = -0.79, p<0.001, and rs = -0.78, p<0.001 respectively). Sesn2 levels above 1.87 ng/ml showed a high diagnostic performance for the presence of significant emphysema in HRCT with an AUC 0.93, 95% CI (0.85,0.98), p<0.001. Sesn2 could serve as a potential biomarker of emphysema.

Purpose: To prove safety and efficacy of percutaneous neurolysis with continuous radiofrequency energy for the treatment of symptomatic sacroiliac joints in a series of consecutive patients. Materials and methods:During the last 2 years, 15 patients suffering from low back pain due to degenerative disorder of the sacroiliac joint underwent percutaneous neurolysis with continuous radiofrequency energy. Under extended local sterility and fluoroscopy 4 cannulas were placed along the sacral foramina and at the L5-S1 level and neurolysis session was performed post motor and sensory evaluation test. NVS pain scores prior and post therapy were compared using Paired Samples t-Test and Wilcoxon Signed Rank Test. Results:Mean pain score prior to any therapy was 8.05±1.449 NVS units. Mean pain score post therapy was 2.37 ± 2.715, 2.42 ± 2.754, 2.70 ± 2.928 and 3.55 ± 2.837 NVS units at 1, 6, 12, 24 months. The comparison of the patients' selfreported outcomes concerning pain reduction and mobility improvement prior and post therapy is statistically significant (p<0.001). No complication was noted. Conclusion:Percutaneous neurolysis with continuous radiofrequency energy seems to be a safe and efficient technique for the treatment of symptomatic, sacro-illiac joints resulting in significant pain reduction and mobility improvement. Proper patient selection is a prerequisite for high success rate.