Chromogranin A (CgA) is part of the family of granins, which are acidic glycoproteins that represent an important part of secretory dense core granules. They are specific to various neuroendocrine and endocrine tissues, as components of diffuse neuroendocrine system and endocrine glands. CgA is co-secreted and co-released in the circulation along with hormones, bioamines and peptides secreted from the neuroendocrine cells . In the last decade, studies have emphasized the major importance of serum CgA in the diagnosis and follow-up of neuroendocrine tumors such as gastroenteropancreatic tumors, pheochromocytoma, medullary thyroid carcinoma. But its diagnostic value for adrenocortical adenomas or for adrenal malignancy, is still controversial. The current study aims to provide a comprehensive review , for synthesizing current knowledge regarding corelations between plasma CgA concentration and various adrenal tumors. Furthermore, there will be also analyzed and synthesized the clinical applicability and the diagnostic usefulness of dosing CgA in adrenal pathology, both medullary and cortical benign and malignant lesions.
Obesity involves the growth of adipose tissue cells (adipocytes and preadipocytes), as well as microvascular endothelial cells. Matrix metalloproteinases (MMPs) are relevant ezymes for the modulation of extracellular matrix (ECM) and adipocyte and preadipocytes differentiation. They are elevated in obese patients, generating abnormal ECM metabolism.[1]. This article proposes a thorough study of literature with focus on the important roles of matrix metalloproteinases in the pathophysiology of obesity. The article represents a narrative review based on an English-language PubMed research of the medical literature regardind important aspects of the proposed aim. MMP-2 activity was signi�cantly higher than MMP-9, both activities were detectable. MMP-9 was strongly correlated with body weight parameters before surgery, as well as after significant body weight reduction as a result of bariatric surgery. Concerning MMP-2 and MMP-9 they are also involved in the turnover of basement membranes both those of adipose tissue and endothelial. MMP-9 levels were moderately correlated with HDL cholesterol levels. Taken together, the present data suggest that changes in ECM through MMP-mediated degradation might play a critical role in the adipocyte differentiation process. These findings are detected both in clinical trials and in laboratory animal experiments. It is then tempting to speculate that the adipocyte-derived MMPs might represent a new pharmacological target for the inhibition of adipose tissue growth by inhibiting adipose differentiation as well as angiogenic process.
This case presentation is of a 58 years old female patient who develops a stroke in 2011 with significant biochemical and biological changes. These manifestations prove to be the result of a hematology disorder, more precise a myeloproliferative neoplasm, Polycythemia Vera. The disease was unidentified and with non-specific symptomology until the occurrence of stroke. The particularity of this case is the presence of severe cardiovascular disease (stage III hypertension. Obstructive hypertrophic cardiomyopathy, chronic ischemic silent disease), with cerebral manifestations (stroke) and associated with mixt hepatitis (alcoholic and deficiency), hypercholesterolemia and hyperuricemia. This biological context represent a real challenge both etiologically and therapeutically (pharmacology and non-pharmacology).
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