Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

51 cases of granulomatous hepatitis were seen among 1234 liver biopsies over a 10 year period. Tuberculosis was the commonest cause seen in 55 percent of cases. Other causes included leprosy, sarcoidosis, histoplasmosis, brucellosis, amoebic liver abscess, lymphoma and malignant granuloma. 12 percent of cases remained undiagnosed. Clinically these patients presented with pyrexia and hepatosplenomegaly. Jaundice was uncommon. Many showed elevated alkaline phosphatase levels, anaemia and raised ESR Granulomatous hepatitis of unknown aetiology with FUO was seen in 6 percent cases only.
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PMID:Granulomatous hepatitis: a retrospective study. 972 54

Active vitamin D metabolites are not only involved in the regulation of bone metabolism but exerts immunomodulatory effects important in the regulation of inflammatory processes. The purpose of the present study was to evaluate the effects of a short-time treatment with 1 alpha-hydroxycholecalciferol on both disease activity and bone metabolism in patients with rheumatoid arthritis (RA). The effects of an adjuvant therapy with 1 microgram 1 alpha-hydroxycholecalciferol over eight weeks on conventional parameters of disease activity (Ritchie index, duration of morning stiffness, C-reactive protein, ESR), serum levels of cytokines and soluble cytokine receptors (TNF-alpha, IL-6, IL-4, sIL-2R, sIL-6R) and parameters of bone metabolism (bone-specific alkaline phosphatase, osteocalcin, renal excretion of pyridinolin- and desoxypyridinolin-collagen-crosslinks, serum levels of parathormon, 1,25-dihydroxycholecalciferol and calcium, daily urinary calcium excretion) were investigated in 20 patients with RA. The treatment with 1 alpha-hydroxycholecalciferol resulted in an insignificant decrease in the number of swollen and tender joints, morning stiffness, CRP and ESR. Furthermore, a non-significant decrease in serum levels of TNF-alpha and IL-6 and an increase in IL-4 was observed. The treatment led to a significant decrease of bone-specific alkaline phosphatase (p = 0.001), osteocalcin (p = 0.04) and renal excretion of pyridinolin-crosslinks (p = 0.022) and to an increase of both serum calcium (p = 0.01) and daily urinary calcium excretion (p = 0.004). The results of this pilot study in a small group of RA patients indicate that an adjuvant therapy with active vitamin D metabolites may not only have preventive effects on systemic bone loss but also may inhibit the inflammatory and destructive process in RA in a limited degree.
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PMID:[Vitamin D metabolites in rheumatoid arthritis: findings--hypotheses--consequences]. 1076 32

Subacute thyroiditis may be hard to diagnose, therefore patients are sometimes misdiagnosed and subjected to unnecessary work-up. We report a 37-year-old man with subacute thyroiditis and a high concentration of serum alkaline phosphatase. After aspirin treatment there was clinical improvement and decrease in rapid ESR, and in high serum thyroxin and alkaline phosphatase. The increased alkaline phosphatase, seen in as many as 50% of patients, is of hepatic origin, and is not caused by high serum thyroxin. Awareness of this relationship may help in diagnosis and may prevent unnecessary diagnostic procedures, which may be invasive.
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PMID:[High alkaline phosphatase in subacute thyroiditis]. 1095 64

Heterotopic ossification (HO) is an important cause of restriction in range of movements and secondary motor disability following neurotrauma, orthopaedic interventions and burns. It has not received focussed attention in non-traumatic neurological disorders. In a prospective study of 377 patients, on medical problems in neurological rehabilitation setting, 15 subjects (3.97%) had neurogenic heterotopic ossification. Their clinical diagnosis was: transverse myelitis (7), neurotuberculosis (4), traumatic myelopathy (2) and stroke (2). Hip (10), knee (4) and elbow joints (1) were involved. The risk factors included urinary tract infection (15), spasticity (6), pressure sores (13) and deep venous thrombosis (DVT) (6). The initial diagnosis was often other than HO and included DVT (3), haematoma (2) and arthritis (2). ESR and serum alkaline phosphatase levels were elevated in all but one subject. The diagnosis of HO was established using X-rays, CT Scan and three-phase bone scan. Following treatment with non-steroidal anti-inflammatory drugs, the range of motion improved in only four patients. HO resulted in significant loss of therapy time during rehabilitation. High index of suspicion about this complication is necessary for early diagnosis and prompt intervention.
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PMID:Neurogenic heterotopic ossification : a diagnostic and therapeutic challenge in neurorehabilitation. 1130 39

The significant factors of risk for bone marrow involvement in Hodgkin's disease included age over 40 yrs, such unfavorable histological features as lymphoid exhaustion and nodular sclerosing stage II, symptoms of intoxication, an ESR of more than 50 mm/h, increased fibrinogen (> 5.0 g/l), blood-plasma alkaline phosphatase (> 130 units), leukocyte concentration (> 10,000 per min) and decreased hemoglobulin (< 100 g/l). Despite the reliable correlation between bone marrow involvement and said factors, relevant data did not provide a similarly reliable basis for accurate prognosis of tumor dissemination. However, our findings pointed to two categories of Hodgkin's disease patients characterized by minimal risk of tumor dissemination--patients under 20, with stage I-II AB and IIIA tumors,--and patients with similar tumors and such favorable histological patterns of major pathology as high lymphocytic ratio and nodular sclerosing stage I.
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PMID:[Risk factors for bone marrow involvement in Hodgkin's disease]. 1131 33

A sensitive and simple chemiluminescent assay (CL) for alkaline phosphatase (ALP) using dihydroxyacetone phosphate or its ketal (DHAP or DHAP-ketal) was developed. New substrates were transformed to dihydroxyacetone (DHA) after they were hydrolysed by ALP, which reacts with lucigenin and produces strong chemiluminescence. Under the optimum assay condition, the detection limits were 3.8 x 10(-19) and 1.5 x 10(-18) moles of ALP, respectively. The coefficients of variation (CV) at each points on the standard curve were 0.8-5.4% and 1.8-7.1% (n = 6), respectively. The mechanism of lucigenin CL with DHA was investigated by ESR spectrometry using the spin-trapping method. The mechanism was speculated as follows: the O2(-) generated by the reaction of DHA and O2 in alkaline solution reacts with lucigenin, and then emit light. The proposed CL assay was applied to the enzyme immunoassay of 17beta-oestradiol, using ALP as a label enzyme. The measurable range of 17beta-oestradiol was 15-4000-pg/mL, and the proposed method was four times more sensitive than the colorimetric assay for ALP by using 4-nitrophenyl phosphate as substrate.
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PMID:Chemiluminescent assay of alkaline phosphatase using dihydroxyacetone phosphate as substrate detected with lucigenin. 1181 56

Technetium 99m-2-methoxyisobutil-isonitrile (Tc-99m-MIBI), also called sestaMIBI, has been used successfully to detect malignant tumours at diagnosis. Recently, it has been proposed as a safe and effective tracer in patients with multiple myeloma (MM). The purpose of this study was to demonstrate the value of the Tc-99m-MIBI uptake in disease detection and to assess the correlation between the uptake of this scintigraphy agent and prognostic factors in newly diagnosed MM patients. Thirty-five untreated patients were enrolled in the study. Tc-99m-MIBI scanning was performed in 33 patients after intravenous injection of 7.4 MBq/kg. Whole-body anterior and posterior scans were obtained after 30 min, 60 min, 2 and 4 h. The correlation between known prognostic factors of MM and the intensity of Tc-99m-MIBI uptake was assessed. Our results showed seven patients with an intensity score of I0, 12 patients with I1, eight patients with I2 and six patients with a score of I3. There was a positive correlation between Tc-99m-MIBI intensity and C-reactive protein (CRP; r=0.506, P < 0.01), erythrocyte sedimentation rate (ESR; r=0.368, P < 0.05), beta2- microglobulin (beta2M; r=0.749, P < 0.001), interleukin-6 (IL-6; r=0.823, P < 0.001), soluble Interleukin-6 receptor (sIL-6r; r=0.806, P < 0.001), serum calcium (r=0.578, P < 0.001) and bone alkaline phosphatase (BAP; r=0.472, P < 0.01). An inverse correlation was found between Tc-99m-MIBI intensity and osteocalcin (OC) and type I procollagen carboxyterminal propeptide (PICP). In conclusion, the results of this study suggest that more extensive disease activity, as determined by high levels of CRP, beta2M, IL-6 and sIL-6r correlated with a higher uptake of the radiotracer.
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PMID:Correlation between the uptake of Tc-99m-sestaMIBI and prognostic factors in patients with multiple myeloma. 1206 79

Vertebral fractures due to osteoporosis are a common but frequently unrecognized complication in established ankylosing spondylitis (AS). It is known that inflammatory activity in rheumatic diseases (i.e., proinflammatory cytokines) itself plays a possible role in the pathophysiology of bone loss. The aim of this study was to analyze whether inflammatory activity and an alteration of the vitamin D metabolism play a substantial role in the loss of bone mass in AS. In this cross-sectional study, 58 patients with established AS and an age- and sex-matched control group were examined. The vitamin D status was investigated, as was, in parallel, the relationship to disease activity (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), markers of bone metabolism (parathyroid hormone [PTH], 1.25 vitamin D3, 25 vitamin D3), calcium, bone alkaline phosphatase (bone-AP), urine cross-links, and plasma tumor necrosis factor alpha (TNFalpha). Bone mineral density was measured by quantitative computed tomography (QCT) of the lumbar spine. Osteoporosis was diagnosed in early as well as in progressive stages of AS (23/58=39.6%). Furthermore, serum levels of 1.25 vitamin D3 and PTH were negatively correlated with disease activity and TNFalpha. The excretion of cross-links showed a positive correlation with disease activity and TNFalpha, and 1.25 vitamin D3 and PTH were positively correlated with bone-AP. TNFalpha also positively correlated with disease activity. AS patients with osteoporosis showed significantly increased CRP, ESR, cross-links and PTH and a significantly decreased 1.25 D3. Osteoporosis is frequent in AS and high disease activity is associated with an alteration in vitamin D metabolites and increased levels of bone resorption in active AS. Our findings propose a close association of BMD, bone metabolism and inflammatory activity, possibly related to vitamin D inflammation interactions.
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PMID:Association of 1.25 vitamin D3 deficiency, disease activity and low bone mass in ankylosing spondylitis. 1617

Technetium-99m methoxy-isobutyl-isonitrile (99mTc-MIBI) has been proposed as an in-vivo marker of various active malignant diseases. The goal of this study was to evaluate the 99mTc-MIBI whole body scintiscan for the early detection of multiple myeloma (MM), active or in remission. We have studied 43 patients with MM, 32 men and 11 women aged 52+/-10 years. Group A patients had active MM disease (29 cases) and Group B patients had MM disease in remission (14 patients). Plasma proteins, serum immuno-electrophoresis, bone marrow biopsy, whole body 99mTc-MIBI scan and serum bio-chemical tests (ESR, and serum alkaline phosphatase) were carried out in each patient for the diagnosis of active or relapsed disease, or remission. Clinical and laboratory evaluation was made by two oncologists. Scintigraphic images were interpreted by three nuclear physicians who were blinded to the patients' clinical condition. The extension scale of the lesions on scintigraphy (E-score) was categorized into E0-E3. The intensity of radiotracer uptake throughout the skeleton (I-score) was also classified from I0-I3 as compared to the intensity of myocardial uptake. All patients were followed for at least one year and reassessed by the end of the year for confirming active-relapsed disease or remission. One-way analysis of variances and Spearman correlation coefficient were used for statistical data analysis. The sensitivity, specificity, positive and negative predictive values and accuracy of the 99mTc-MIBI scan for determining active or relapsed cases were: 69%, 100%, 100%, 61% and 79%, respectively. There were significant differences in scan pattern, intensity, and extension of the lesions in patients with active-relapsed disease versus those in remission (P<0.001). It is concluded that the pattern of extension and intensity of 99mTc-MIBI uptake in MM patients is associated with disease activity. Hence, in addition to the hematological and pathological findings, the 99mTc-MIBI scan may be considered as a relatively accurate non-invasive technique for the differential diagnosis of active-relapsed from in remission MM.
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PMID:The value of 99mTc-MIBI whole body scintigraphy in active and in remission multiple myeloma. 1639 23

Rheumatoid arthritis (RA) is frequently complicated by peri-articular and generalized osteoporosis due to increased bone resorption by activated osteoclasts. Pro-inflammatory cytokines, such as TNF-alpha, interleukin 1 (IL1), and interleukin 6 (IL6) are thought, among other factors, to be directly responsible for this extra-articular complication of RA. Glucocorticoids (GCS) commonly prescribed in RA due to their strong anti-inflammatory effect are also well known for causing secondary osteoporosis during a prolonged use. An influence of low-dose GCS therapy (8.7 mg per day) on a bone turnover in female RA patients with or without previous history of GCS treatment was investigated by measuring bone mineral content (BMC), bone mineral density (BMD), and various biochemical markers of inflammation and bone metabolism in comparison to results obtained from: (1) RA patients who have not been treated with GCS and (2) the control group of healthy individuals. Sixty-two female patients with established active RA and 178 healthy individuals from the control group have been investigated. The RA patients were divided into three groups: 21 treated with GCS before the trial--these patients have continued GCS therapy using low doses during the observation; 21 with low-dose GCS therapy launched at the beginning of the trial; and 20 left without GCS treatment. All patients have been assessed twice: at the beginning and after 12 months of observation. BMC and BMD have been measured in all patients in a distal part of forearm. Additionally, several different biochemical markers of osteoporosis and inflammation have been determined. We did not notice any increase in bone metabolism between RA patients receiving GCS therapy for the first time and those treated without GCS after 12 months of observation. Results of BMC, BMD osteocalcin level, total and bone alkaline phosphatase, carboxy-terminal collagen cross links, carboxy-terminal propeptides of type 1 collagen, deoxypyridynoline, and calcium/creatinine ratio were comparable in both groups at the end of the study. There was a significant decrease of the level of IL-6 in patients who had GCS therapy launched at the beginning of observation (p<0.01). However, levels of C-reactive protein (CRP) and alpha1-acid-glycoprotein (AGP) have not changed; the level of ESR dropped significantly (p<0.05) in this group. In contrast, in the group of patients with the previous history of prolonged GCS treatment receiving low doses of GCS during the trial, statistically significant increase of CRP and AGP could be observed (p<0.05) along with further significant worsening of the primary low BMD (p<0.05). Based on the obtained data, we came to the conclusion that anti-inflammatory effect of the low-dose GCS therapy in RA patients without previous history of their use may balance their direct negative effect on BMC and BMD. In this group of RA patients, benefits resulting from the 12-month GCS therapy prevail over adverse effects, even if calcium with vitamin D3 supplementation, biphosphonians, or estrogens have not been introduced. On the other hand, low-dose GCS therapy could have no benefit for RA patients with the previous history of their prolonged use, as a rise of markers of inflammation and bone turnover, resulting in the further bone loss, has been observed.
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PMID:Does low-dose and short-term glucocorticoids treatment increase the risk of osteoporosis in rheumatoid arthritis female patients? 1790 41


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