Beta-2 Microglobulin In Patients Research Articles

B Cell Subsets and Immune Checkpoint Expression in Patients with Chronic Lymphocytic Leukemia.

Chronic lymphocytic leukemia (CLL) is characterized by dysfunctional B cells. Immune checkpoint molecules such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death-1 (PD-1) are upregulated in patients with CLL and may correlate with prognostic markers such as beta-2 microglobulin (B2M). The aim of this study was to evaluate the levels of immune checkpoints on B cell subsets and to further correlate them with B2M levels in patients with CLL. We recruited 21 patients with CLL and 12 controls. B cell subsets and the levels of immune checkpoint expression were determined using conventional multi-color flow cytometry. Basal levels of B2M in patients with CLL were measured using an enzyme-linked immunosorbent assay. Patients with CLL had increased levels of activated B cells when compared to the control group, p < 0.001. The expression of PD-1 and CTLA-4 were increased on activated B cells and memory B cells, p < 0.05. There were no associations between B2M levels and the measured immune checkpoints on B cell subsets, after adjusting for sex and age. In our cohort, the patients with CLL expressed elevated levels of PD-1 and CTLA-4 immune checkpoints on activated and memory B cell subsets. However, there was no correlation between these immune checkpoint expressions and B2M levels.

Beta-2 Microglobulin As a Seric Marker for Diagnosis of Hematologic Neoplasms in First Contact Consultation with the Hematologist

Introduction Beta-2 microglobulin is a protein component of the Major histocompatibility complex I. Its concentration in blood has been long used as prognostic marker in some hematologic neoplasms, and even used as a tool for surveillance of relapse in other neoplasms. It is frequently elevated in non-Hodgkin lymphoma (NHL), Myelodysplastic syndrome (MDS), myeloma multiple (MM), chronic lymphocytic leukemia (CLL) and other Lymphoproliferative disorders. Although its utility as a diagnostic tool has been poorly described. Aim Describe the blood levels of Beta-2 Microglobulin in patients who are sent without established diagnosis to be evaluated by hematology department and its association with the different definitive diagnosis. Methods We captured information from outpatients who were evaluated in the first consultation at hematology department because of any citopenia or clinical suspicion of any hematologic neoplasm from September 2022 to July 2023. If the patient consented, we recorded it in database and measured blood levels of beta-2 microglobulin on first consultation, and then followed until definitive diagnosis was established. Analysis of data was made with IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp; we used Mann Whitney U Test for quantitative variable comparison, and Fisher exact test to determine differences between groups. Statistical significances were calculates using p&amp;lt;0.05. Results We captured a total of 87 patients, but 11 had to be excluded because of lack of information. Of the 76 patients included for analysis, 34 were male (44.7%) and 42 were female (55.3%). The medium age was 45.1 years (Range: 15-95 years). After the first consultation, 30 patients (39.5%) were suspected to have a neoplasm, and in follow-up, 35 (46.05%) ended up with a definitive diagnosis of hematologic neoplasm. Only one patient with initial suspected neoplasm ended up with benign disease, but 6 patients in which a bening condition was suspected ended up with a neoplasm diagnosis. There was a total of 35 (46.05%) patients with definitive neoplastic diagnostic, being the most frequent: NHL (n=15, 19.7%), Myeloproliferative neoplasm (MPNs) (n=6, 7.8%), and MM (4, 5.2%). In the no neoplastic pathology, the most frequent diagnosis was iron-deficit anemia (n=17; 22.36%), followed by megaloblastic anemia (n=4, 5.26%) and infectious disease (n=4, 26%). Beta-2 microglobulin was higher in the group with definitive neoplastic diagnosis (5.4mg/L vs 2.4mg/L, x 2=0.053), and was also, significatively higher in the NHL (4.94mg/L, x 2=0.005), MM (13.43mg/L, x 2=0.008), CLL (6.3mg/L, x 2=0.02) and MDS (8.05mg/L, x 2=0.034) subgroups. The sensibility for any hematologic neoplasm was 48.5% and specificity was 82.93%, with a positive LR of 2.84 and a Negative LR of 0.62. The subgroups with higher sensibility were MM (75%), CLL (66.6%), MPNs (66.6%) and MDS (100%), being the Positive LR of 4.3 for MM, 3.9 for CLL, 3.9 for MPNs and 5.86 for MDS. Groups with the lowest correlation were Hodgkin lymphoma (HL) with sensibility of 33.3%, and isolated plasmacytoma (PC) with sensibility of 0%. In the group with benign diagnosis, only 6 (7.89%) presented levels above upper normal limit of blood Beta-2 microglobulin, 4 (5.26%) with iron-deficit anemia, 1 (1.31%) with liver disease, 1 (1.31%) with Pulmonary tuberculosis and 1 (1.31%) with systemic lupus erythematosus; being the highest levels in pulmonary tuberculosis (14.9mg/L). Conclusions The blood levels of beta-2 microglobulin in our work were in concordance with other previous described papers, in which is frequently elevated in NHL, MM, and CCL. But in our case, it showed a marked elevation in MPNs, and MDS (higher correlation). It should be noted, no tumor burden was recorded in our study, which could directly affect beta-2 microglobulin levels. In conclusion, although not a strong correlation as an expert hematologist clinical evaluation, beta-2microglobulin could be of use to strengthen clinical suspicion of those hematologic neoplasms or reassess cases in which MDS/MPNs are a possible differential diagnosis.

Correlation between Neutrophil gelatinase-associated lipocalin and ß2-Microglobulin with serum protein electrophoresis in multiple myeloma patients

Objective: To find the correlation between neutrophil gelatinase-associated lipocalin and beta2-microglobulin inpatients with multiple myeloma.Method: The case-control study was conducted from November 2021 to March 2022, after approval from ethics reviewcommittees of three major medical establishments in Baghdad, Iraq. There were randomly selected multiple myelomapatients of either gender with normal concentration of urea and creatinine in group A, multiple myeloma patients ofeither gender with increased concentration of urea and creatinine in group B and healthy controls in group C.Neutrophil gelatinase-associated lipocalin and beta2-microglobulin were assessed using enzyme-linkedimmunosorbent assay technique. Data was analysed using SPSS 26.Results: Of the 180 subjects, there were 60(33.3%) in each of the 3 groups, with each group having 40(66.5%) malesand 20(33.3%) females, and overall age ranging 40-79 years. Protein electrophoresis in group A patients wassignificantly higher (p=0.001) in alpha1, beta and gamma globulin. Among group B patients, a highly significantincrease (p=0.001) was noted in alpha1, alpha2, beta and gamma globulin. Beta2-microglobulin was a more sensitiveand specific marker for renal injury than neutrophil gelatinase-associated lipocalin in myeloma patients(p&lt;0.05).Conclusion: Beta2-microglobulin and neutrophil gelatinase-associated lipocalin were both more sensitive markersthan serum urea and creatinine in the diagnosis of acute kidney injury in multiple myeloma patients.Keywords: Lipocalin, Creatinine, Multiple myeloma, Microglobulin, Urea, Electrophoresis, Globulins, Albumins,Enzyme, Immunosorbent assay, Kidney injury.

Isotope-dilution liquid chromatography-tandem mass spectrometry method for serum beta 2-microglobulin quantification

Beta 2-microglobulin (B2M) is a commonly used detection index in clinical laboratories. Currently, it is used as a sensitive indicator for the early detection of kidney disease. Immunoassay is the most commonly used method for B2M detection in clinical practice. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has changed the face of laboratory testing by providing high-throughput analysis with better specificity than detection methods using only antibodies. An isotope-dilution LC-MS/MS (ID-LC-MS/MS) method was developed for serum B2M quantification. After B2M denaturation, reduction and alkylation of cysteine residues, trypsin was added for digestion of B2M. Then, it was purified by a solid-phase extraction column, and the sample was injected into a high-performance LC-MS/MS for measurement. A signature peptide (VNHVTLSQPK) was selected as a surrogate for B2M. A stable isotope-labeled peptide (VNHVT[13C615N]LSQP) was used as the internal standard to quantify B2M based on the calibration curve method. The linear range of serum B2M calibration curve was from 0.25 to 40 mg/L. The limit of quantification was 0.25 mg/L, and limit of detection was 0.06 mg/L. At different concentrations of serum B2M, the precision (coefficients of variation, CV%) ranged from 1.47% to 3.97%, and accuracy (relative error, RE%) was within -3.15% and 6.80% of nominal values. The applicability and reliability of the method were verified by measuring B2M in the ERM-DA470k/IFCC and serum samples. The validated LC–MS/MS method was successfully applied to a clinical study involving quantification of serum B2M in patients with acute renal insufficiency and healthy individuals. Deming analysis showed that the ID-LC-MS/MS and immunoassay were in good agreement. The LC-MS/MS method we developed is sensitive and reliable for the absolute quantification of serum B2M.

Serum beta-2 microglobulin in patients with chronic hepatitis C virus with or without hepatocellular carcinoma

Serum beta-2 microglobulin in patients with chronic hepatitis C virus with or without hepatocellular carcinoma

Prognostic role of beta-2 microglobulin in patients with light chain amyloidosis treated with autologous stem cell transplantation.

e20506 Background: Autologous stem cell transplantation (ASCT) prolongs survival in patients with light chain (AL) amyloidosis. Mayo 2012 stage and increased plasma cell percentage (%PC) are known predictors for survival. Increased beta-2 microglobulin (B2M) predicts survival in patients with multiple myeloma. However, its prognostic effect in patients with AL amyloidosis undergoing ASCT is not known. Methods: We retrospectively reviewed patients who had a diagnosis of AL amyloidosis and were treated with ASCT between July-1996 and September-2017. Patients with creatinine &gt; 1.2 mg/dL were excluded, as that affects B2M levels. The receiver operator curve was used to determine the best cutoff for B2M in predicting survival and was 2.5 mcg/mL. Baseline characteristics were compared between patients with B2M &gt; 2.5 and ≤2.5. Progression-free survival (PFS) was defined as time from ASCT to relapse or death, whichever occurred first. Overall survival (OS) was calculated from ASCT to death of any cause. Univariate and multivariate analysis were done for OS. Results: Five-hundred patients were identified and 222 (44%) had a B2M &gt; 2.5. These patients were more likely to be &gt; 65 years old (32% vs. 17%, P = 0.0001), have Mayo 2012 stage III/IV (33% vs. 8%, P &lt; 0.0001), have ≥3 organs involved (25% vs. 14%, P = 0.001), and have ≥10% PCs (56% vs. 40%, P = 0.0002) compared to patients with B2M ≤2.5. The median PFS and OS were shorter in patients with B2M &gt; 2.5 (median PFS: 64 vs. 80 months, P = 0.03); (median OS: 104.9 vs. 175.5 months, P &lt; 0.0001). On univariate analysis, predictors for OS included age &gt; 65 (HR: 1.6, P = 0.001), Mayo 2012 stage III/IV (HR: 3.3, P &lt; 0.0001), ≥3 organs involved (HR: 1.3, P = 0.06), ≥10% PC (HR: 1.5, P = 0.004), melphalan conditioning 200mg/m2 (HR: 0.28, P &lt; 0.0001), and B2M &gt; 2.5 (HR: 1.8, P &lt; 0.0001). In a multivariate analysis, only Mayo 2012 stage III/IV (HR: 1.8, P = 0.006), melphalan conditioning 200mg/m2 (HR: 0.35, P &lt; 0.0001), and B2M &gt; 2.5 (HR: 1.7, P = 0.01) remained independent predictive of OS. Conclusions: Beta-2 microglobulin &gt; 2.5 is an independent predictor for OS in AL amyloidosis patients undergoing ASCT and should be routinely measured.

Prognostic Role of Beta-2 Microglobulin in Patients with Light Chain Amyloidosis Treated with Autologous Stem Cell Transplantation.

The prognostic impact of increased beta-2 microglobulin (B2M) in patients with light chain (AL) amyloidosis undergoing autologous stem cell transplantation (ASCT) is unknown. The Mayo 2012 stage and increased bone marrow plasma cell (BMPC) percentage are known predictors for survival. Increased B2M is predictive of survival in patients with multiple myeloma. We evaluated the prognostic role of B2M in patients with newly diagnosed AL undergoing ASCT. We retrospectively reviewed patients with a diagnosis of AL amyloidosis who were treated with ASCT between July 1996 and September 2017. Patients with a creatinine level >1.2 mg/dL were excluded, because that affects B2M levels. The receiver operator characteristic curve was used to determine the best cutoff for B2M before ASCT in predicting survival, which was 2.5 µg/mL, which was also the upper limit of normal in our laboratory. Baseline characteristics were compared between patients with B2M >2.5 µg/mL and ≤2.5 µg/mL. Progression-free survival (PFS) was defined as the time from ASCT to relapse or death, whichever occurred first. Overall survival (OS) was calculated from the time of ASCT to death of any cause. Univariate and multivariate analyses were done for OS. Five hundred and ten patients were identified, 222 of whom (44%) had a B2M >2.5 µg/mL. These patients were more likely to be older (median age, 61 versus 57 years;P=.0002), to have Mayo 2012 stage III/IV disease (33% versus 8%; P < .0001), to have more than 2 organs involved (25% versus 14%; P=.001), and to have ≥10% BMPCs (56% versus 40%; P=.0002) compared with patients with B2M ≤2.5 µg/mL. The median PFS and OS were shorter in patients with B2M >2.5 µg/mL (median PFS, 64 months versus 80 months [P=.03]; median OS, 104.9 months versus 175.5 months [P < .0001]). On univariate analysis, predictors for OS included age >60 years (hazard ratio [HR], 1.61; P=.001), Mayo 2012 stage III/IV (HR, 3.36; P < .0001), more than 2 organs involved (HR, 1.36; P=.07), ≥10% BMPCs (HR, 1.5; P=.005), melphalan conditioning with 200 mg/m2 (HR, .29; P < .0001), B2M >2.5 µg/mL (HR, 1.82; P < .0001), and transplantation during or after 2010 (HR, .4; P=.0006). On multivariate analysis, only Mayo 2012 stage III/IV (HR, 1.89; P=.005), melphalan conditioning with 200 mg/m2 (HR, .39; P < .0001), B2M >2.5 µg/mL (HR, 1.84; P=.003), and transplantation performed during or after 2010 (HR, .58; P=.03) remained independent predictors of OS. Our findings identify B2M >2.5 µg/dL before ASCT as an independent predictor for OS in patients with AL amyloidosis and normal kidney function and should be routinely measured.

New Prognosis Score Including Absolute Lymphocytes/Monocytes Ratio and Beta2microglobulin in Patients with Diffuse Large B Cell Lymphoma (DLBCL) Treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO)

IntroductionDLBCL is the most common non-Hodgkin lymphoma and a heterogeneous subtype from the biological and clinical point of view. 20-40% of the patients relapse so it is important to identify a high risk population that could benefit from different therapeutic approaches. For this purpose, several scores have been developed. The IPI has been the most widely used but lacks the ability to identify this very high risk population in Rituximab era. Low absolute lymphocyte count and high levels of blood monocytes have shown to be unfavorable risk factors. The red cell distribution width (RDW) has been associated with aging and active inflammatory processes and beta-2-microglobulin (B2M) with tumor load and proliferation as well as comorbidities such as kidney failure. All these variables are easily obtainable at the time of diagnosis.Patients and methodsFrom the national database of GELTAMO-IPI Project, we selected those patients with DLBCL homogeneously treated with R-CHOP ± radiotherapy. The complete blood count (CBC) values were standardized using the normal reference values of each centre. The survival analysis was estimated with Kaplan-Meier method. The comparison between variables was performed through Log-Rank test and multivariate analysis with Cox regression. The CBC quantitative variables cut points were calculated through MAXSTAT. A new prognosis score was generated taking into account the results of multivariate analysis for progression free survival (PFS), spliting the sample in two cohorts (discovery and validation).ResultsNine hundred and ninety-two patients with DLBCL were retrospectively analyzed with a median follow up of 55 months (12-185). The characteristic of the patients are summarized in table 1. In the multivariate analysis, age, ECOG, stage, bulky mass, B2M, RDW and lymphocytes/monocytes ratio (LMR) were significantly independent variables for PFS. A new prognosis score was generated with these variables including age categorized in 3 groups (18-64, 65-80 y >80) with 0, 1 y 2 points, ECOG>3-4 with 2 points, stage III-IV, bulky mass, high B2M, LMR<2.25 and RDW>0.96 with 1 point each for a maximum of 9. This score could improve the discrimination of a very high risk subgroup with a 5-year PFS of 17% (Figure 1) versus 45%, 52%, 32% or 29% of R-IPI, NCCN-IPI, R-TS and GELTAMO-IPI, respectively and 5-year overall survival (OS) of 20% (Figure 2) versus 59%, 46%, 45% and 40% for R-IPI, NCCN-IPI, R-TS and GELTAMO-IPI.ConclusionA new prognosis score including easily obtainable CBC variables (LMR and RDW) and B2M is presented. This score identifies a high risk population both for PFS and OS in comparison with other scores for DLBCL. The addition of other biological or image markers could improve these results. [Display omitted] DisclosuresMartín:Roche: Consultancy, Honoraria, Other: Travel expenses; Janssen: Honoraria, Other: Travel expenses; Celgene: Consultancy, Honoraria, Other: Travel expenses; Servier: Honoraria, Other: Travel expenses. Sancho:SERVIER: Honoraria; JANSSEN: Honoraria, Speakers Bureau; MUNDIPHARMA: Honoraria; SANOFI: Honoraria; GILEAD: Honoraria, Research Funding; KERN FHARMA: Honoraria, Speakers Bureau; CELGENE: Honoraria; ROCHE: Honoraria, Speakers Bureau.

Combined Therapy of Hypertensive Nephropathy with Breviscapine Injection and Antihypertensive Drugs: A Systematic Review and a Meta-Analysis.

Objective To evaluate the beneficial and adverse effects of breviscapine injection in combination with antihypertensive drugs for treating hypertensive nephropathy in clinical practice. Methods We searched PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data for relevant literature. The timeframe of retrieval was set from the founding date of each database to September 28, 2018. ResultsFourteen papers were included in this study. The quality of all the studies included was determined to be low. All studies were conducted with Chinese populations. Meta-analysis showed that, compared with single-use antihypertensive drugs, using breviscapine injection in combination with antihypertensive drugs to treat hypertensive nephropathy can reduce serum creatinine (Scr) [WMD = –35.16, 95% CI(–50.01, –20.31), P ≤ 0.001], blood urea nitrogen (BUN) [WMD = –2.00, 95% CI(–3.07, –0.94), P ≤ 0.001], 24-hour urinary total protein (24 h UTP) [WMD = –0.04, 95% CI(–0.05, –0.02), P ≤ 0.001], and the beta-2-microglobulin (B2M) [WMD = –0.09, 95% CI(–0.11, –0.07), P ≤ 0.001], improve creatinine clearance rate (Ccr) [WMD = 7.84, 95% CI(5.20, 10.49), P ≤ 0.001], and increase the clinical efficacy [RR = 1.27, 95% CI(1.05, 1.53), P = 0.014], but does not lower systolic blood pressure (SBP) [WMD = –1.02, 95% CI(–2.88, 0.84), P = 0.281]. There was no significant difference in adverse events between experimental groups and control groups. Conclusion Breviscapine injection in combination with antihypertensive drugs can improve clinical efficacy and Ccr and reduce Scr, BUN, 24 h UTP, and B2M in patients with hypertensive nephropathy. The present meta-analysis indicated that breviscapine injection can serve as a renal protective effect to patients with hypertensive nephropathy. However, the evidence of methodological quality and sample sizes is weak, and thus, further standardized research is required.

Editorial Volume 16 Issue 2

The ability to predict the future would be a useful skill for anyone working in the acute medical unit. While crystal balls have not yet become standard issue for acute medicine trainees, a variety of tools now exist to help identify the likely outcome for patients referred for hospital admission – and enable their management to be planned. Two articles in this summer edition of Acute Medicine highlight this important issue. The team from Athens led by Sotirios Kakavas have investigated the prognostic value of beta-2 microglobulin in patients admitted to hospital with pulmonary embolism. Higher levels of this inflammatory protein were associated with a worse outcome, suggesting that it may have a role in identifying those patients who would benefit from management in a higher dependency setting. All patients in their cohort were admitted to hospital, which is clearly different to the established practice in many UK acute medical units where significant proportions of patients are now managed via ambulatory care. Identification of the low-risk patient who can safely be managed without in-patient monitoring will still require a different approach. However, the results of this study suggest that there may be a role for beta-2 microglobulin, either alone or in combination with other markers, in future prognostic modelling. The ALICE score, developed by the acute medicine team in Plymouth, appears to perform well in a variety of hospitals in predicting length of stay for patients admitted to hospital. The paper by Dan Wilding and Kate Evans indicates that a lower score predicts a shorter hospital stay, which could have significant implications. It is well established that unnecessary in-patient transfers can result in delays in care which may extend a patient’s time in hospital. Accurate, early identification of those patients who are most likely to be able to go home within 48-72hours may help to reduce transfers and improve the efficiency of the service. Of course, this will still be dependent on there being sufficient capacity to enable patients to remain on the acute medical unit for this time pending discharge, as well as good communication with bed management teams. The overnight transfer of patients whose discharge from hospital the next day was predicted and planned is a common source of frustration, when hospital capacity is under duress – as now seems to the case in most hospitals throughout the year. This edition includes just a single case report, although we have several lined up for future editions later in the year. Although liver abscess is not an uncommon problem, the case highlights the important issue of ‘source control’ in the management of sepsis. The patient described was clearly unwell at the time of admission, and deteriorated further, despite rapid initiation of antibiotics and other ‘sepsis 6’ measures. The clinical and radiological evidence of pneumonia was compelling, but recognition, and early drainage of the abscess resulted in a rapid improvement, as well as confirmation of the causative organism. Clues to the cause included a past history of complicated diverticular disease and mild derangement of liver function, but relatively little in the way of abdominal findings such that this would have been an easy diagnosis to miss, if the acute medicine team had not been alert to this possibility. We must never be afraid to challenge out initial presumptions, particularly when a patient’s condition fails to improve. I am delighted that Mark Holland has provided a ‘Viewpoint’ article for this edition, reflecting on his tenure as President of the Society for Acute Medicine. Mark hands over to Nick Scriven in the Autumn – no doubt, he will be feeling a sense of relief tinged with a little sadness, which I remember well when my time in the role came to an end in 2013. Mark has been a great asset to the Society and should be very proud of his achievements in raising the profile of the Speciality of Acute Medicine. I hope you enjoy whatever remains of summer, and that you can all manage some respite before the start of the ‘predictable’ pressures of the months which follow.

Prognostic significance of serum beta-2 microglobulin in patients with diffuse large B-cell lymphoma in the rituximab era.

The prognostic value of serum beta-2 microglobulin for diffuse large B-cell lymphoma (DLBCL) is not well known in the rituximab era. A retrospective registry data analysis of 833 patients with de novo DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was conducted to establish the prognostic significance of serum beta-2 microglobulin at a ≥2.5 mg/L cutoff. Five-year progression-free survival (PFS, 76.1% vs. 41.0%; p < 0.001) and overall survival (OS, 83.8% vs. 49.2%; p < 0.001) were significantly worse in patients with elevated serum beta-2 microglobulin (n = 290, 34.8%). Furthermore, the five parameters of the International Prognostic Index, accompanying B symptoms, bone marrow involvement and impaired renal function were associated with worse PFS and OS. In multivariate analysis, elevated beta-2 microglobulin was a significant poor prognostic factor for PFS (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.29–2.24; p < 0.001) and OS (HR, 2.0; 95% CI, 1.47–2.75; p < 0.001). In an independent validation cohort of 258 R-CHOP treated patients with de novo DLBCL, elevated beta-2 microglobulin levels remained a significant poor prognostic factor for PFS (HR, 2.03; 95% CI, 1.23–3.32; p = 0.005) and exhibited a strong trend of association with worse OS (HR, 1.64; 95% CI, 0.98–2.75; p = 0.062). The significance of serum beta-2 microglobulin levels as an independent prognostic factor for patients with DLBCL receiving R-CHOP is confirmed.

Portal gastropatili hastalarda beta-2 mikroglobulin ve Helikobakter pilori ilişkisi

Amaç: Portal gastropatili hastalarda Helikobakter pilori ve beta-2 mikroglobulin ilişkisi net olarak tanımlanamamıştır. Bu çalışmada, Helikobakter pilori infeksiyonu olan ve olmayan hastaların serum ve doku beta-2 mikroglobulin düzeyleri ve bu düzeylerin portal gastropati ile ilişkisi incelenmiştir. Gereç ve Yöntem: Portal gastropatili 25 hasta ve 22 sağlıklı birey çalışmaya dahil edilmiştir. Mide biyopsileri incelenmiş, serum ve doku beta-2 mikroglobulin düzeyleri bakılmıştır. Bulgular: Yirmibeş portal hipertansif gastropatili olgunun 15'inde Helikobakter pilori infeksiyonu bulunmuştur. Bu 15 hastanı n 8'inde (%53.3) subendotelial beta-2 mikroglobulin artışı görülmüştür. Helikobakter pilori olmayan 10 hastanın 3'ünde (%30) subendotelial beta-2 mikroglobulin bulunmuştur. Fark istatistiksel olarak anlamlıdır (p

Association between plasma Beta-2 microglobulin level and cardiac performance in patients with chronic kidney disease.

Background:Beta-2 microglobulin (B2M) is considered as a surrogate marker for middle molecule uremic toxins and a key component in dialysis-related amyloidosis. However, few studies have evaluated role of B2M in patients with chronic kidney disease (CKD).Objectives:The purpose of this study was to evaluate the association of plasma B2M level with some metabolic and cardiac performance factors in patients with CKD.Patients and Methods:In this case-control study, we measured plasma B2M level in 86 patients with different stages of CKD and 78 age- and sex-matched individuals, as healthy control group. Then we investigated the association between plasma B2M level and left ventricular hypertrophy, ejection fraction (EF), and left ventricular end-diastolic diameter (LVEDD) in echocardiography and some inflammatory and metabolic factors in patients with CKD.Results:Mean plasma B2M level was significantly higher in patients with CKD than in control group (P < 0.001). It was directly correlated with serum C-reactive protein (r = 0.167, P < 0.001), phosphate (r = 0.112, P < 0.001) levels, and left ventricular mass index (r = 0.438, P < 0.001) and LVEDD (r = 0.275, P < 0.001) in echocardiography. It was also inversely correlated with glomerular filtration rate (r = -0.033, P < 0.001), albumin (r = -0.521, P < 0.001), hemoglobin (r = -0.748, P < 0.001), and EF (r = -0.625, P < 0.001).Conclusions:Our findings suggested that plasma B2M level is inversely associated with GFR and EF and directly correlated with some metabolic and cardiac performance factors.

Prognostic Significance of Serum Beta-2 Microglobulin in Patients with Non-Hodgkin Lymphoma

Background and Objective: Elevated serum beta-2 microglobulin (β2-M) has previously been reported in non-Hodgkin lymphoma (NHL) patients. This study examined the association between serum β2-M and the prognosis of NHL and analyzed its predictive value. Method: A total of 287 NHL patients from Taiyuan, Shanxi, China, participated in a prospective cohort study between 2008 and 2011. Overall survival (OS) was compared between NHL patients with high and normal β2-M levels using the log-rank test. Three standard Cox regression models including the International Prognostic Index (IPI) score, β2-M or IPI score + β2-M as independent variables were constructed. The time-dependent receiver operating characteristic curves method and C index were used to examine the tendency of the models' predictive accuracy over time. Results: NHL patients with elevated β2-M values had worse OS (p < 0.001) and higher mortality risk (HR = 1.93, 95% CI 1.37-2.77, p < 0.001) than patients with normal β2-M values. There were statistically significant differences between the C indexes for the models with IPI + β2-M, IPI or β2-M alone (p < 0.001). Conclusion: Our results demonstrated an association between serum β2-M and NHL prognosis. Combining β2-M with IPI may help to improve the prognostic accuracy of NHL.

Evaluation of serum Beta-2 microglobulin in patients with HBV infection and HBV DNA (PCR) positivity to compare with hbv DNA (PCR)negativity

Evaluation of serum Beta-2 microglobulin in patients with HBV infection and HBV DNA (PCR) positivity to compare with hbv DNA (PCR)negativity

Elevated circulating levels of beta 2-microglobulin in patients with idiopathic dilated cardiomyopathy

Beta 2-microglobulin is a low molecular weight proein of 11.6 kD found on the surface of nearly all nucleated cells. 1 There it constitutes the light invariant chain of the class I major histocompatibility molecule, which is involved in the the antigen presentation during interaction with T lymphocytes. 1 Beta 2-microglobulin appears in free soluble form in serum where it is increased in states of T cell activation, i.e., in viral infections, 2,3 and chronic inflammatory, autoimmune and lymphoproliferative disorders. 4,5 Its serum concentration also depends on renal function because the kidneys are the main site of clearance. 6 The marked retention during chronic renal failure results in the formation of the dialysis-associated amyloid whose major protein is β 2-microglobulin. 7 Samsonov et al 8 recently described β 2-microglobulin as a serologic marker for cellular immune activation in inflammatory heart diseases. We report here that elevated plasma values correlated both with the stimulation of the renin-angiotensin system due to reduced renal perfusion and with T cellular hyperresponsiveness in patients with idiopathic dilated cardiomyopathy (IDC). Thus, β 2-microglobulin reflects different factors in the complex pathophysiology of IDC.

Amelioration of proteinuria with pravastatin in hypercholesterolemic patients with diabetes mellitus.

Pravastatin, a novel inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, was administered to nine hypercholesterolemic patients with diabetes mellitus to examine its effects on diabetic nephropathy. Pravastatin treatment resulted in lowering serum total cholesterol by 22.1% on the average (p less than 0.001), and led to a significant reduction in urinary excretion of albumin and beta 2-microglobulin in patients with an elevated urinary protein excretion rate at the baseline period. But glycemic control, blood pressure, urinary excretion of creatinine and that of N-acetyl-beta-D-glucosaminidase showed no significant change during the study. These results suggest that reduction of atherogenic lipids and lipoproteins with pravastatin could alleviate diabetic glomerular injury.

Interrelations of Blood Pressure, Glomerular Filtration Rate, Protein Clearances and Sodium Excretion in Patients with Glomerulonephritis and Diabetic Nephropathy

The roles of blood pressure and glomerular filtration rate in the renal handling of albumin, beta 2-microglobulin and sodium were studied by partial correlation analysis in 22 patients with glomerulonephritis and in 25 patients with diabetic nephropathy. The analysis showed that in these proteinuric patients blood pressure may have an independent role in the regulation of albumin excretion in both diseases. Fractional beta 2-microglobulin clearance and fractional excretion of sodium correlated significantly in both diseases. In the diabetic patients this correlation remained strong after removing the effect of blood pressure, whereas in the patients with glomerulonephritis control of blood pressure clearly decreased the correlation. This reflects differences in the renal handling of sodium and beta 2-microglobulin in patients with diabetic nephropathy and glomerulonephritis.

Changes in plasma beta 2 microglobulin concentrations after allogeneic bone marrow transplantation.

Plasma concentrations of beta 2 microglobulin (B2M), the light chain of the class I major histocompatibility complex, were measured serially in 26 patients undergoing allogeneic bone marrow transplantation (BMT). The concentrations fell after conditioning treatment, and recovered when the marrow was transplanted. Bacterial infection did not influence B2M concentration, but nine of 22 episodes of acute graft versus host disease were associated with raised concentrations. Increased plasma B2M concentrations were also a feature of eight episodes of chronic graft versus host disease, and these fell after treatment. Reactivation of herpes simplex, varicella zoster, or cytomegalovirus infections were also accompanied by raised B2M concentrations. Three patients with cytomegalovirus pneumonitis had high concentrations of plasma B2M, the rise starting between five and 22 days before onset of symptoms. Although it is non-specific, serial measurement of plasma B2M in patients undergoing BMT may be clinically useful in monitoring chronic graft versus host disease.

Simultaneous plasma determination of CEA, HCG-beta and beta-2-microglobulin in patients with nontrophoblastic tumors.

With the object of studying the possible usefulness of the simultaneous plasma determination of CEA, HCG-beta and beta 2-microglobulin in patients with nontrophoblastic tumors, we measured by radioimmunoassay the concentrations of these substances in 77 patients with normal renal function. In the group without metastases (32 cases), the percentages of positives we low and similar for the 3 tumor markers. In the group with metastases (45 cases), the X2 test of independence between each of the 2 markers at a level of 95 % showed a relationship between the results obtained in the determination of HCG-beta and beta 2-microglobulin, as an independence between CEA and HCG-beta results and CEA and beta 2-microglobulin results. These data suggest the utility of determining CEA with only 1 of the other 2 antigens in disseminated tumors.