Clopidogrel has an antiplatelet effect, which is used to reduce the risk of myocardial infarction and stroke in high-risk patients in the context of primary prophylaxis. In the body it is subjected to metabolism by the liver enzyme system CYP450.In this project, laboratory conditions have been established to determine the polymorphisms of the CYP450 2C19 gene.The structure of the polymorphisms in the CYP450 2C19 gene and the type of metabolizer has been determined.This study included 42 heart patients with St. post PCI, mean age 65-9.7 years, treated with 75 mg Clopidogrel daily.The following polymorphisms were examined: c.681G> A; c.636G> A; c.1A> G; c.1297C> T; c.395G> A; c.819 + 2T> A; c.358T> C; c.-806C> T.Appropriate laboratory conditions have been established for the precise determination of polymorphisms in the CYP450 2C19 gene and the determination of the type of metabolizer.The results showed that in our patients the largest number of polymorphisms occur at the position c.681G> A which leads to the creation of an intermediate metabolizer, while the polymorphism at the position c.-806C> T leads to the creation of an ultrafast metabolite.The largest number of polymorphisms occurs in c.681G> A CYP450 2C19 gene, which leads to the creation of an intermediate metabolizer.Because of this, and before starting the therapy in patients St. post PCI, it is necessary to first determine what clopidogrel metabolizers they are and whether they possess LF or GF alleles.
The medical and socio-economic consequences that stemmed from the COVID-19 pandemic, forced the healthcare policymakers in Republic of North Macedonia to rely on five different vaccines against the SARS-CoV-2 virus, in order to reach a satisfactory level of herd immunity. It is here where we got the idea to compare the heterologous Gam-COVID-Vac/BNT162b2 regimen to the homologous BNT162b2 regimen, with our main focus being the immunogenicity differences between the two of them. Additionally, we researched the variation in humoral immune response relative to age strata; the reactogenicity differences; and discrepancies in SARS-CoV-2 infection incidence between the two regimens. To achieve this, antibody titers in sera samples from fifty-three (53) healthcare workers, divided in heterologous and homologous group, were analysed at six different time checkpoints. Our results showed robust immunogenic response after the administration of the booster dose (4. 2-fold increase in antibody titers), followed by a slower-waning humoral immune protection in the heterologous regimen, compared to the homologous BNT162b2 schedule, furthermore confirmed by non-inferiority testing (Geometric Mean Ratio=0,98) at the final checkpoint. That, coupled with the similar reactogenicity (p=0,767) of both regimens, imply that the Gam-COVID-Vac/BNT162b2 combination might be a feasible approach in the effort to contain the COVID-19 pandemic.
Serologic testing became essential for assessing seroprevalence, vaccine efficiency and public health policy since the start of the COVID-19 pandemic. Many platforms are available on the market, but studies on their performance and limitations remain scarce. This study aimed to evaluate two commercial kits: a chemiluminescent immunoassay (CLIA) and an enzyme-linked immunosorbent assay (ELISA) and show their technical requirements and result concordance in the determination of anti-SARS-CoV-2 IgG antibodies.The study included 268 samples from PCR positive patients referred to the Institute of Immunobiology and Human Genetics for anti-SARS-CoV-2 antibody testing. Two commercially available kits were used per manufacturers' recommendations for all samples: SARS-CoV-2 RBD IgG CLIA kit from Snibe and ELISA SARS-CoV-2 IgG (RBD-S protein) from INEP. For our purposes, CLIA was chosen as the comparative method.The positive, negative and overall percentage agreements for these two techniques were 90%, 82.7% and 87.3% respectively. Cohen's kappa was 0.72, meaning there was a moderate agreement between the two methods. Most of the discrepancies occurred in the lower concentration category with a positive percentage agreement of only 50%.Given the highly concordant results, CLIA remains advantageous as the more efficient and convenient method. Both are reliable serological assays for antibody determination in the SARS-CoV-2 pandemic response.
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