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- Grubb, Anders, et al.
(författare)
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Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator
- 2014
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 60:7, s. 974-986
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Many different cystatin C-based equations exist for estimating glomerular filtration rate. Major reasons for this are the previous lack of an international cystatin C calibrator and the nonequivalence of results from different cystatin C assays.METHODS:Use of the recently introduced certified reference material, ERM-DA471/IFCC, and further work to achieve high agreement and equivalence of 7 commercially available cystatin C assays allowed a substantial decrease of the CV of the assays, as defined by their performance in an external quality assessment for clinical laboratory investigations. By use of 2 of these assays and a population of 4690 subjects, with large subpopulations of children and Asian and Caucasian adults, with their GFR determined by either renal or plasma inulin clearance or plasma iohexol clearance, we attempted to produce a virtually assay-independent simple cystatin C-based equation for estimation of GFR.RESULTS:We developed a simple cystatin C-based equation for estimation of GFR comprising only 2 variables, cystatin C concentration and age. No terms for race and sex are required for optimal diagnostic performance. The equation, [Formula: see text] is also biologically oriented, with 1 term for the theoretical renal clearance of small molecules and 1 constant for extrarenal clearance of cystatin C.CONCLUSIONS:A virtually assay-independent simple cystatin C-based and biologically oriented equation for estimation of GFR, without terms for sex and race, was produced.
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| 4. |
- Nordin, Sara, et al.
(författare)
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High Expression of Midkine in the Airways of Patients with Cystic Fibrosis.
- 2013
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Ingår i: American Journal of Respiratory Cell and Molecular Biology. - 1535-4989. ; 49:6, s. 935-942
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Tidskriftsartikel (refereegranskat)abstract
- Mutations in the CFTR gene result in impaired host defense during cystic fibrosis (CF), where Pseudomonas aeruginosa becomes a key pathogen. We investigated the expression pattern of the antibacterial growth factor midkine in CF and possible interference with its activity by the altered airway microenvironment. High midkine expression was found in CF lung tissue compared with controls, involving epithelium of the large and small airways, alveoli, and cells of the submucosa (i.e. neutrophils and mast cells). In CF sputum, midkine was present at 100-fold higher levels but was also subject to increased degradation, compared with midkine in sputum from healthy controls. Midkine had a bactericidal effect on P. aeruginosa but increasing salt concentrations and low pH impaired the activity. Molecular modeling suggested that the effects of salt and pH were due to electrostatic screening and a charge-neutralization of the membrane, respectively. Both neutrophil elastase and elastase of P. aeruginosa cleaved midkine to smaller fragments, resulting in impaired bactericidal activity. Thus, midkine is highly expressed in CF but its bactericidal properties may be impaired by the altered microenvironment as reflected by the in vitro conditions used in this study.
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| 5. |
- Nyman, Ulf, et al.
(författare)
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The revised Lund-Malmo GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population
- 2014
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Ingår i: Clinical Chemistry and Laboratory Medicine. - : Walter de Gruyter GmbH. - 1434-6621 .- 1437-4331. ; 52:6, s. 815-824
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Tidskriftsartikel (refereegranskat)abstract
- Background: The performance of creatinine-based glomerular filtration rate (GFR) estimating equations may vary in subgroups defined by GFR, age and body mass index (BMI). This study compares the performance of the Modification of Diet in Renal Disease (MDRD) study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations with the revised Lund-Malmo equation (LM Revised), a new equation that can be expected to handle changes in GFR across the life span more accurately. Methods: The study included 3495 examinations in 2847 adult Swedish patients referred for measurement of GFR (mGFR) 2008-2010 by plasma clearance of iohexol (median 52 mL/min/1.73 m(2)). Bias, precision [interquartile range (IQR)] and accuracy [percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of mGFR] were compared. Results: The overall results of LM Revised/MDRD/CKD-EPI were: median bias 2%/8%/11%, IQR 12/14/14 mL/min/1.73 m(2), P-10 40%/35%/35% and P-30 84%/75%/76%. LM Revised was the most stable equation in terms of bias, precision and accuracy across mGFR, age and BMI intervals irrespective of gender. MDRD and CKD-EPI overestimated mGFR in patients with decreased kidney function, young adults and elderly. All three equations overestimated mGFR and had low accuracy in patients with BMI <20 kg/m(2), most pronounced among men. Conclusions: In settings similar to the investigated cohort LM Revised should be preferred to MDRD and CKD-EPI due to its higher accuracy and more stable performance across GFR, age and BMI intervals.
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| 6. |
- Bennermo, Marie, et al.
(författare)
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Genetic and environmental influences on the plasma interleukin-6 concentration in patients with a recent myocardial infarction : a case-control study
- 2011
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Ingår i: Journal of Interferon and Cytokine Research. - : Mary Ann Liebert Inc. - 1079-9907 .- 1557-7465. ; 31:2, s. 259-264
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the stimuli responsible for triggering and sustaining the plasma concentration of the inflammatory marker interleukin-6 (IL-6) in patients with a first myocardial infarction before the age of 60 and healthy control subjects matched for age and sex. The plasma IL-6 concentration, antibodies against Chlamydia pneumoniae, cytomegalovirus, Epstein-Barr virus, Helicobacter pylori, herpes simplex type 1 and 2, and genotype for the IL6-174 G>C single-nucleotide polymorphism were determined 3 months after the acute event. The results showed that patients had higher IL-6 levels than control subjects, whereas there were no differences regarding individual or total number (pathogen burden) of positive antibody tests against the different pathogens or IL6 genotype distribution. The plasma IL-6 concentration was associated with the number of positive antibody tests in patients and control subjects, whereas patients irrespective of IL6 genotype had increased IL-6. Multivariate analysis, including traditional coronary heart disease risk factors, antibodies against pathogens, and IL6 genotype, explained 17% of the variation of the plasma IL-6 concentration. Neither pathogen burden nor IL6 genotype did contribute to the variation of plasma IL-6 levels, whereas smoking, body-mass index, hypertension, case-control status, and age were determinants of the plasma IL-6 concentration.
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- Boman, Christoffer, et al.
(författare)
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Stove performance and emission characteristics in residential wood log and pellet combustion : Part 1: Pellet stoves
- 2011
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Ingår i: Energy & Fuels. - : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 25:1, s. 307-314
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Tidskriftsartikel (refereegranskat)abstract
- Stove performance, characteristics and quantities of gaseous and particulate emissions were determined for two different pellet stoves, varying fuel load, pellet diameter and chimney draught. This approach aimed at covering variations in emissions from stoves in use today. The extensive measurement campaign included CO, NOx, organic gaseous carbon, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), total particulate matter (PMtot) as well as particle mass and number concentrations, size distributions and inorganic composition. At high load, most emissions were similar. For stove B, operating at high residual oxygen and solely with primary air, the emissions of PMtot and particle numbers were higher while the particles were smaller. Lowering the fuel load, the emissions of CO and hydrocarbons increased dramatically for stove A, which operated continuously also at lower fuel loads. On the other hand for stove B, which had intermittent operation at lower fuel loads, the emissions of hydrocarbons increased only slightly lowering the fuel load, while CO emissions increased sharply, due to high emissions at the end of the combustion cycle. Beside methane, dominating VOCs were ethene, acetylene and benzene and the emissions of VOC varied in the range 1.1-47 mg/MJfuel. PAH emissions (2-340 µg/MJfuel) were generally dominated by phenantrene, fluoranthene and pyrene. PMtot (15-45 mg/MJfuel) were in all cases dominated by fine particles with mass median diameters in the range 100-200 nm, peak mobility diameters of 50-85 nm and number concentrations in the range 4×1013- 3×1014 particles/MJfuel. During high load conditions the particulate matter was totally dominated by inorganic particles at 15-25 mg/MJfuel consisting of potassium, sodium, sulfur and chlorine, in the form of K2SO4, K3Na(SO4)2 and KCl. The study shows that differences in operation and modulation principles for the tested pellet stoves, relevant for appliances in use today, will affect the performance and emissions significantly, although with lower scattering in the present study compared to compiled literature data.
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