Psoriasis is an autoimmune and inflammatory skin disease. Psoriatic patients express higher levels of plasma homocysteine (Hcy) concentration and pro-inflammatory mediators than healthy people; this is frequently associated with vitamin D deficiency. The aim of this clinical study was to investigate the effects of high doses of vitamin D supplementation on the parameters of Hcy metabolism and cytokines in sera of psoriatic patients. This prospective study was conducted on 40 psoriatic patients who had the vitamin D deficiency. All patients received vitamin D 5000 IU/day for three months. Clinical and biochemical measurements were taken at baseline and at follow up (3 months). The results showed that the severity of clinical features, measured by the psoriasis area severity index (PASI) score, were considerably improved in patients after vitamin D supplementation. After vitamin D supplementation, most of the patients (n = 25 or 62.5%) had mild clinical form (p < 0.001). After twelve weeks of intervention period, there were significant increases in vitamin D and B12 serum levels in comparison to the levels that had been measured at the beginning of the study (56.77 ± 14.66 nmol/L and 301.08 ± 95.02 pg/mL vs. 103.85 ± 32.20 nmol/L and 362.81 ± 118.56 pg/mL, respectively; p < 0.001). Moreover, serum levels of Hcy and folate were significantly lower at the end of the study in comparison with the initial levels (12.45 ± 1.92 µmol/L and 8.01 ± 3.88 mg/mL vs. 10.38 ± 1.66 µmol/L and 6.27 ± 2.60 mg/mL, respectively). High doses of vitamin D supplementation led to a significant decrease in pro-inflammatory cytokines (IFN-ɤ, TNF-α, IL-1β, IL-6, IL-8, and IL-17) and high-sensitivity C-reactive protein (hsCRP), whereas the production of anti-inflammatory cytokines (IL-10, IL-5) was up-regulated. In conclusion, supplementation with high doses of vitamin D could be one of the possible preventive and therapeutic measures to reduce systemic inflammation in psoriatic patients.

Aim:We hypothesized that, in stable angina patients, atorvastatin therapy lowers the cathepsin S (CTSS) concentrations, as assessed non-invasively according to a plasma analysis. In addition, the low-density lipoprotein (LDL) and high-density lipoprotein (HDL) size and subclasses in the plasma were analysed to establish the association between CTSS and lipoprotein metabolism and determine whether this association is atorvastatin-sensitive. Methods: A total of 43 patients with stable angina received atorvastatin therapy (20 mg/day, 10 weeks). The plasma CTSS mRNA levels, CTSS protein concentrations and CTSS activity, as well as LDL and HDL size and subclasses, were analysed before and after treatment. Results: Atorvastatin treatment did not change the plasma CTSS mRNA levels, although it lowered the plasma CTSS concentrations and activity. An increased plasma CTSS concentration and activity were found to be associated with a more atherogenic LDL subclass profile (a decreased dominant LDL size and increased percentage of small, dense LDL particles). The atorvastatin-induced CTSSlowering effect was concomitant with an improvement in the LDL subclass profile, and the changes were found to be interrelated. Concomitant, interrelated changes in the CTSS levels and LDL subclass profiles were found in the LDL phenotype B patients only (a dominant LDL diameter of ≤ 25.5 nm at the start of the study). In this subgroup, lowering of the plasma CTSS mRNA level also correlated with lowering of the proportion of small, dense LDL particles. Conclusions: Atorvastatin-induced CTSS-lowering and LDL subclass profile improvements in the plasma of LDL phenotype B patients with stable angina are concomitant and interrelated. J Atheroscler Thromb, 2014; 21:868-877.

Background: The pandemic of severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) is a multi-system disease caused by a diffuse systemic process involving a complex interaction of the inflammatory, immunological and coagulative cascades. This study aims to identify the most effective biomarkers to predict a poor outcome in the intensive care unit patients with severe COVID-19 disease. Methods: A single-centre retrospective observational study enrolled 69 deceased and 20 recovered patients treated in the Intensive Care Unit of the General Hospital Gradiska in the period from March 1, 2021. until April 1, 2022. We evaluated the leukocytes, lymphocytes, neutrophils, platelets, hemoglobin, neutrophil lymphocyte ratio (NPR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII). In addition, we  evaluated the IL-6, ferritin, CRP, D-dimer, magnesium, bilirubin and lactate dehydrogenase.  Results: Between deceased and recovered patients on admission to the ICU, there was a significant difference between the following parameters: leukocytes x109/L 11.5 (8.86-14.75) vs 9.4 (5.9-11.9), p =0.026; neutrophils x109/L 10.15 (7.81-12.74) vs 8.60 (4.8-10.3) p=0.022; NLR 15.01 (10.60-24.33) vs 9.45 (5.10-14.90) p=0.02; SII 3712 (2240-6543) vs 1949 (993-3720) p=0.003. The magnesium level increased significantly over time in the group of patients who died, while the hemoglobin level and platelet count decreased. ROC analysis showed the following AUC values: leukocytes 0.774; neutrophils 0.781; NLR 0.786; SII 0.776; D-dimer 0.741and bilrubine 0.713. Conclusions: In this retrospective study leukocytes, neutrophils, NLR, SII, D-dimer, bilirubin determined at hospital admission had a high value in predicting death among patients with severe COVID-19.

SummaryBackgroundHigh-density lipoproteins (HDL) have athero-protective biological properties: antioxidative, anti-apoptotic, anti-inflammatory, and they have the efflux capacity of cellular cholesterol. Plasma mRNA analysis can be used to investigate statin pleiotropy in vivo as a new analytical tool for non-invasive assessment of gene expression in vascular beds. The aim of this study was to assess the pleiotropic effects of atorvastatin in stable angina patients with high-risk values (group A) as compared with patients who had borderline and desirable HDL-cholesterol (HDL-C) values (group B).MethodsThe atorvastatin therapy (20 mg/day) was given to forty-three patients with stable angina for 10 weeks. We investigated three statin pleiotropy-targeted genes: inter-cellular adhesion molecule-1, chemokine (C-C motif) ligand 2 and cathepsin S and assessed by gel electrophoresis gradient the effects of atorvastatin on HDL size and subclasses.ResultsIn group A, after therapy, HDL-C concentration was significantly increased but not in group B. Atorvastatin lowered plasma chemokine (C-C motif) ligand 2 and intercellular adhesion molecule-1 mRNA levels in both groups, but did not change the plasma cathepsin S mRNA levels. In group A only, baseline total bilirubin showed negative correlations with the genes of cathepsin S (r=−0.506; p=0.023) and significantly increased after therapy.ConclusionsHDL-C and bilirubin can be promising therapeutic targets in the treatment of cardiovascular diseases. Analysis of cell-free mRNA in plasma might become a useful tool for estimating statin pleiotropy.

SUMMARYThe primary role of vitamin D is regulation of calcium, phosphorus and bone metabolism. Vitamin D status assessment is based on measuring of 25 (OH) D concentrations, and disorders of vitamin D status may be manifested as a vitamin D insufficiency, vitamin D deficiency and vitamin D hypervitaminosis. It is generally accepted that values above 75 nmol / L will suffice to prevent the occurrence of secondary hyperparathyroidism. Although vitamin D deficiency can be found at any age, it is most common in women with postmenopausal osteoporosis, and in older women. The aim of this study was to determine the vitamin D status, parathyroid hormone levels and calcium levels in women with newly diagnosed postmenopausal osteoporosis, and to compare the results with the same parameters observed and measured in women without osteoporosis, and to establish whether there is a connection between vitamin D levels and levels of other parameters. The study involved 85 postmenopausal women, all of which were screened for osteoporosis by measuring bone mineral density in the lumbar spine and hip region using DXA method. Of these, 50 women were found to have osteoporosis while 35 had regular DXA values. Our results showed a high incidence of vitamin D deficiency in postmenopausal women, with significantly higher vitamin D deficiency in women with osteoporosis. The values of parathyroid hormone were higher, and the values of ionized calcium were lower in women with osteoporosis, and there is a negative correlation between 25 (OH) D and parathyroid hormone. The most common risk factors for osteoporotic fracture in postmenopausal women were early menopause and previous fracture in adulthood. Reduced levels of vitamin D in women with postmenopausal osteoporosis leads to changes in calcium and parathyroid hormone metabolism