ABSTRACT

Serum cardiac troponin T (cTnl') and CKMB (mass) were analysed in three groups of patients. The first group (n=32) were patients with acute coronary syndromes including myocardial infarction. The second group (n=35)were patients with hypertension. The third group (n=24) were patients who had succumbed to non cardiac diseases. In all 3 groups, cardiac troponin T was elevated when compared with controls (p<0.001). However, CKMB elevation was not significant in all groups. CKMB levels correlated well with troponin T levels only when CKMB was greater than 50 ng/ml (r=l.00). Small elevations of troponin T identifies minimal cardiac necrosis and patients can benefit from eady invasive therapy. KEY WORDSTroponin-T, CK-MB (mass), hypertension, acute coronary syndromes.

Accurate monitoring of blood cyclosporin C2 levels is vital to prevent over immunosuppression and acute renal toxicity in patients who receive organ transplant. The matrix used to dilute patients' C2 samples prior to the assay affected the final measured values. Hence there was a need to develop a method of dilution that would accurately estimate C2 levels when cyclosporin levels were beyond the calibration range of the method employed. Whole blood, cyclosporin free hemolysate and cell and protein free supernatant obtained after pretreatment of normal blood were used to dilute patients' C2 samples. C2 was measured in 188 patients using the supernatant method of dilution. C2 was correlated with Co and dose of cyclosporin received by the patient. The use of cell and protein free supernatant obtained after pretreatment of normal blood as a C2 diluent detected higher levels of C2 in the sample. Measured C2 correlated significantly with Co and the cyclosporin dose received by the patient. The uniformly aqueous cell and protein free supernatant ensures uniform dilution of the patients' C2 sample and measures higher cyclosporin levels.

Cyclosporine has been reported to function as an inhibitor of the chymotrypsin like activity of proteasome. We hypothesized that the administration of an exogenous proteinase inhibitor may affect the activities of the Serum antiproteinase activities of serum alpha 2 macroglobulin (AMG), alpha 1-antitrypsin (AT) and alpha 1-antichymotrypsin (ACT) were found to be altered in renal transplant patients receiving cyclosporine. KEY WORDS Alpha-2-macroglobulin,alpha-1-antitrypsin,alpha antichymotrypsin,C2, cyclosporine. Address for Correspondence:Dr.Pragna Rao Kamineni Hospitals Ltd. L.B.Nagar,Hyderabad -500 068 Andhra Pradesh -INDIA E-mail : mnaprag@sancharnet.in We hypothesized that cyclosporine treatment would alter the activities of the naturally occurring anti -proteinases in blood , since cyclosporine would act as an exogenous source of anti -proteinase activity. We selected alpha 2 macroglobulin (AMG), alpha 1-antitrypsin (AT) and alpha 1-antichymotrypsin (ACT) as representatives of the major anti -proteinases in the blood.The effect that cyclosporine has on serum activities of AT, ACT and AMG are presented for the first time in this study. The serum proteinase inhibitory activities were monitored in a few patients who were initially put on cyclosporine therapy immediately after a renal transplant and followed up over a period of 4 weeks as the cyclosporine dose was tapered. The study also evaluated whether the dose of cyclosporine and the measured blood levels of cyclosporine as evidenced by C0 (trough) and C2 (2 hour post dose values) affected serum proteinase inhibitor levels.