Abstract
Background and objectives: Dipeptidyl-Peptidase 4 (DPP-4) is a protein expressed in numerous cells and tissues. Recently it has shown its involvement as a catalyst in the inflammatory response in various pulmonary, autoimmune, intestinal and other pathologies. The objective of this study was to compare the preoperative serum levels of DPP-4 in patients with and without surgical finding of perivesicular inflammation. Materials and methods: a cross-sectional analytical study nested in a prospective cohort, including patients scheduled for elective cholecystectomy, without surgical complications, that were 18–70 years of age, with low cardiovascular risk, without a history of peritonitis, pancreatitis, or jaundice and underwent ERCP protocol, type 2 diabetes mellitus, acute inflammatory (Protein C Reactive < 3 mg/L, leucocytes < 10 1000/mm3), neoplastic, nephrologic or liver disease, the use of anti-inflammatory drugs, steroids and/or antibiotics, the use of pacemakers or metallic implants and without major amputations and whom agreed to participate by providing their informed consent. Ethical and Research register: 45–16. Prior to surgery we compiled anthropometric data and a blood sample to determine the serum levels of DPP-4. The presence of perivesicular inflammation was determined in the surgery. The data was analyzed using the statistical program Rstudio. Results: High BMI values were observed (27.8 ± 6.4); waist circumference (94.7 ± 15.1) and percentage of fat mass (34.7 ± 11.7), showing a cumulative frequency of 65.9% for overweight/obesity. In 27.3% of the interventions, intraoperative perivesicular inflammation findings were reported. The serum levels of DPP-4 were lower in the group of patients with perivesicular inflammation (3947.6 ± 1659.5 vs. 3053.2 ± 1469.6, LC95% of the difference: 160.4–1628.3), being statistically significant (p = 0.018). Conclusions: In the subacute or chronic phases of cholecystitis, there appears to be a constant consumption of DPP-4, which would modulate a better immune response that could be related to the reduction of postoperative complications, so the use of Serum levels of DPP-4 as an early biomarker could improve the diagnostic accuracy of this pathology and the surgical approach.
Highlights
Dipeptidyl-Peptidase 4 (DPP-4) The CD26 is a trasmembranal protein of 110 kDa, expressed in a wide variety of cells and tissues, including cells of the endothelium, Lymphocytes, Enterocytes, Medicina 2019, 55, 148; doi:10.3390/medicina55050148 www.mdpi.com/journal/medicinaMedicina 2019, 55, 148 fibroblasts, macrophages, prostate, kidney, pancreas, liver, lungs and adipose tissue [1]
Other regulated biological processes have been described for DPP-4: carcinogenesis, as a possible tumor suppressor in conjunction with CXCL10 and by post-transcriptional modification of cytokines in the regulation of tumor immunity [2], in addition to being a possible biomarker in the diagnosis of different types of cancer [7,8]; immunity modulation by direct regulation of lymphocytes [2] and in the inflammatory response being mediated by cytokines and the catalyst role of DPP-4, characteristic of chronic inflammatory pulmonary, autoimmune, intestinal and other pathologies
The objective of comparing serum levels of DPP-4 was based on patients with surgical findings of perivesicular inflammation compared to controls, since as mentioned previously in the introduction, a finding of perivesicular inflammation that is not acute is difficult to determine for an inexperienced doctor and often can be masked even with the use of more specialized diagnostic tools like US or TAC
Summary
Dipeptidyl-Peptidase 4 (DPP-4) The CD26 is a trasmembranal protein of 110 kDa, expressed in a wide variety of cells and tissues, including cells of the endothelium, Lymphocytes, Enterocytes, Medicina 2019, 55, 148; doi:10.3390/medicina55050148 www.mdpi.com/journal/medicinaMedicina 2019, 55, 148 fibroblasts, macrophages, prostate, kidney, pancreas, liver, lungs and adipose tissue [1]. DPP-4/CD26 has important enzymatic activity in the degradation of N-terminal peptides, dipeptides and polypeptides with amino acids such as proline or alanine in the penultimate position. Due to this catalytic activity, DPP-4 regulates the bioavailability of regulatory peptides, neuropeptides, circulating hormones and cytokines [2,5], which are derived from the modulation of multiple biological functions. Dipeptidyl-Peptidase 4 (DPP-4) is a protein expressed in numerous cells and tissues. It has shown its involvement as a catalyst in the inflammatory response in various pulmonary, autoimmune, intestinal and other pathologies.
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