Serum Ceruloplasmin Levels Research Articles

Serum ceruloplasmin ,copper and iron levels as a risk factors for coronary heart diseases(CHD)

Ceruloplasmin (Cp) is one of the acute phase protein, in this review ,we studied the level of ceruloplasmin with copper (Cu) and iron in 90 patients with coronary heart diseas ( those patients are divided into three groups, whom are stable angina , unstable angina and myocardial infarction compared with 30 healthy volunteers) and the roles of them as diagnostic and prognostic tools.The diagnosis was attend by a clinical examination carried out by the consult medical staff in Ibn AL-Nafis hospital. The result: ceruloplasmin recorded a significantly(p

Phenotypic and genetic characterization of children with Wilson Disease from Northeast China

BackgroundWilson disease (WD) is an autosomal recessive inherited disease caused by ATP7B variants and characterized by copper metabolism defects. However, children with WD are often asymptomatic, making the clinical diagnosis difficult. Therefore, more accurate methods are required for clinical diagnosis. The objective of this study was to highlight the phenotypic and genetic characteristics of children with WD in northeast China.MethodsWe retrospectively analyzed the clinical data and gene sequencing results of 65 children with WD from January 1, 2014, to December 31, 2022, at the Shengjing Hospital of China Medical University. All data refer to the time of diagnosis before treatment.ResultsThe median age at diagnosis was 5 years (range 1.2–15 years). In 50 cases (50/65, 76.9%) patients, routine physical examinations revealed only abnormal liver function. However, they had a significantly negative (p < 0.05) Kayser–Fleischer ring (KF). Children with acute liver failure had significantly increased 24 h urinary copper excretion (p < 0.05). We detected 46 genetic variants of ATP7B, including seven novel variants. The most frequent variant was p.R778L with an allele frequency of 38.7%. Phenotype-genotype correlation analysis suggested that p.R778L was significantly associated with lower serum ceruloplasmin levels and higher zinc levels (p < 0.05). The loss-of-function (LOF) variant was associated with significantly lower albumin levels (p < 0.05).ConclusionMost children with WD are asymptomatic, which makes early diagnosis of WD difficult. Therefore, clinical and laboratory characteristics as well as genetic testing are essential. p.R778L is the most frequent variant of ATP7B in China and may play an important role in lowering serum ceruloplasmin levels.

Clinical and laboratory profile and outcome in children with Wilson disease: an observational study in South India

ABSTRACT Background Wilson disease is an autosomal recessive disorder owing to defective copper metabolism which causes abnormal accumulation of copper and damage to the liver, brain, kidneys and other organs. Aim To describe the clinical features, laboratory investigations and outcome of Wilson disease in children. Methods A retrospective observational study was conducted in the paediatric department of a tertiary- care hospital in South India by reviewing medical records between January 2018 and March 2023. The diagnosis of Wilson disease was confirmed by the presence of low serum ceruloplasmin and/or high urine copper excretion in combination with clinical and ophthalmological features. Results A total of 32 cases were analysed. The mean (SD) age at presentation was 110 (36) months with a M:F ratio of 1.6:1. Isolated hepatic involvement was seen in 19 (60%) patients while 13 (40%) patients had a neurological presentation, either as an isolated entity or in combination with hepatic manifestations. Low serum ceruloplasmin levels were detected in 31 (96%) patients. Urine copper levels were elevated in all patients. Twenty-one patients were commenced on D penicillamine while 11 patients were treated with a combination chelation therapy with zinc. Eighteen patients (56%) were on regular follow-up. Conclusion The clinical presentation of Wilson disease in children is diverse, varying from the more common hepatic or neurological manifestations to the less common atypical forms of the disease. Diagnosis is based on clinical and ophthalmological features in combination with biochemical abnormalities in the form of low ceruloplasmin and high urinary copper. The majority of patients can be medically managed with chelation therapy.

Serum ceruloplasmin oxidase activity: A neglected diagnostic biomarker for Wilson disease

BackgroundLow serum ceruloplasmin concentration is considered robust marker for Wilson disease (WD) screening, measuring serum ceruloplasmin oxidase activity might be an even more valuable diagnostic tool, but it has not been sufficiently studied. MethodsAll patients who were assessed for serum ceruloplasmin oxidase activity between January 1, 2016, and September 2, 2019, were enrolled in this study. The diagnostic performance of serum ceruloplasmin oxidase activity was analyzed using receiver operating characteristic curve analysis (ROC), Spearman's rank correlation, and Mann-Whitney U test. ResultsSerum ceruloplasmin oxidase activity was significantly decreased in WD patients (0.87 U/L, IQR 0.61–1.54). The optimal cut-off of serum ceruloplasmin oxidase activity to identified WD is 7 U/L, with sensitivity and specificity of 97.03 % and 98.19 %, respectively. Furthermore, this study revealed a positive correlation between enzymatic and immunoreactive serum ceruloplasmin tests. As primary diagnostic methods, serum ceruloplasmin levels below the diagnostic cut-offs for either the enzymatic or immunoreactive tests were observed in 818 out of 842 WD patients (97.15 %). Compared with the presence of K-F rings in asymptomatic patients, the accuracy of serum ceruloplasmin tests was significantly higher (56.12 % VS 95.08 %). Moreover, the positive rate of cranial MRI in neurological patients was similar to the tests of serum ceruloplasmin (92.91 % VS 97.40 %). Moreover, 71 patients had ambiguous genetic results, complicating the diagnosis. However, serum ceruloplasmin tests successfully identified 65 out of these 71 patients (91.55 %). ConclusionSerum ceruloplasmin oxidase activity has excellent performance in diagnosing WD, which should be widely used as preferred test in WD patients.

Measurement of Serum Ceruloplasmin, Lipid Hydroperoxide Level and Prolidase Activity in Children with Primary Headache

Introduction Primary headache is a significant health problem in children as it remarkably negatively affects the child and his/her family. Migraine and tension-type headaches constitute the majority of primary headaches in childhood. Studies regarding adult migraine patients suggest that oxidative stress has a significant role in the pathogenesis. This study aimed to investigate the relationship between primary headache in chidhood and the levels of oxidative stress markers. Materials and methods Pediatric patients diagnosed with primary headache and healthy controls in the pediatric age range were recruited. Data regarding age, gender, height, weight, and body mass index (BMI) were recorded. The levels of ceruloplasmin, lipid hydroperoxide, and prolidase activity were measured in plasma using the ELISA method. Statistical analyses were conducted using the SPSS 11.5 statistical program. A p-value of less than 0.05 was considered significant. Results The study included 76 patients with primary headache and 61 healthy controls. The mean ages of the patients and healthy controls were 14.4±3.2 and 13.6±2.9 years. The patient and control groups were similar in terms of gender distribution (p=0.948), age (p=0.079), and BMI (p=0.196). Migraine accounted for 35.5% (n=27), while tension-type headache accounted for 64.5% (n=49) of the patients. Serum ceruloplasmin (p=0.033), lipid hydroperoxide (p&lt;0.001), and prolidase (p=0.010) levels were higher in patients compared to the control group. Lipid hydroperoxide (p=0.021) and prolidase (p=0.013) levels were higher in migraine patients than in tension-type headache patients, while ceruloplasmin levels were similar between patients with different headache types (p=0.581). Conclusion In this study, oxidative stress markers were shown to be increased in pediatric patients with primary headache. These findings support the hypothesis that patients with primary headaches are exposed to oxidative stress. Future studies may elucidate the role of oxidative stress in the etiopathogenesis of childhood migraine and other headache types.

Brain and the whole-body bone imaging appearances in Menkes disease: a case report and literature review

BackgroundMenkes disease (MD) is a rare, inherited, multisystemic copper metabolism disorder. Classical Menkes disease is characterized by low serum copper and ceruloplasmin concentrations, leading to multiple abnormalities in the whole-body, especially in connective tissue and central nervous system. However, serum copper and ceruloplasmin levels are not reliable diagnostic biomarkers due to the low concentrations in healthy newborns either. The featured imaging manifestations play an important role in diagnosing Menkes disease. To our knowledge, there are few reports on the systemic imaging manifestations of Menkes disease.Case presentationA 4-month-old male patient presented with recurrent seizures. He had cognitive, intellectual, growth, gross motor, precision movement, and language developmental lags. The patient’s hemoglobin and serum ceruloplasmin level were low. On MRI, increased intracranial vascular tortuosity, cerebral and cerebellar atrophy, white matter changes, and basal ganglia abnormalities were observed. Plain radiograph revealed wormian bones, rib flaring, metaphyseal spurring, and periosteal reactions in the long bones of the limbs. A pathogenic variant in ATP7A gene was identified in the patient, so he was confirmed the diagnosis of Menkes disease. His symptoms did not improve despite symptomatic and supportive treatment during his hospitalization. Unfortunately, the infant died 3 months after leaving hospital.ConclusionA comprehensive and intuitive understanding of the disease’s imaging manifestations can help clinicians to identify the disease and avoid delays in care.

Serum Ceruloplasmin-to-Albumin Ratio as a Biochemical Marker in Pulmonary Tuberculosis Before and After Treatment.

The study compares the serum ceruloplasmin-to-albumin ratio of tuberculosis (TB) patients before and after anti-tuberculosis treatment (ATT) to assess its diagnostic and prognostic value. Despite the pandemic's impact on TB notifications, global TB cases rose by 16% in 2022. The study was conducted at Meenakshi Medical College Hospital and Research Institute, Kanchipuram, from November 2022 to November 2023, with participants aged 15 and above diagnosed with pulmonary TB. The analysis of clinical, radiographic, microbiological, and biochemical data revealed a gender distribution of 58% male and 42% female individuals, with an average age of 49. Significant reductions in ceruloplasmin levels and increases in albumin levels were found following therapy, as well as a decrease in the ceruloplasmin-to-albumin ratio, showing that ceruloplasmin may serve as a severity measure and treatment indicator. Male patients accounted for 58% of the study population, while females accounted for 42%. Patients aged 36-45 made up the largest group (26%). Following treatment, serum ceruloplasmin levels decreased significantly (from 66.28 mg/dL to 35.56 mg/dL), but albumin levels increased (from 2.96 g/dL to 4.19 g/dL). The ceruloplasmin-to-albumin ratio dropped from 0.022 to 0.008, showing treatment efficacy. The study highlights the potential of serum biomarkers for diagnosing and monitoring TB. The serum ceruloplasmin-to-albumin ratio is a promising biochemical diagnostic. Further research is needed to validate these findings and investigate their clinical significance in TB management.

Comparative assessment of the effects of two intrauterine systems for long-term contraception on some haematological, biochemical, and immunological markers

An intrauterine system (IUS) is a type of contraception tool that is used in order to control fertility and prevent concep¬tion in women for a long period. The aim of this study was to assess the influence of copper- versus levonorgestrel-releasing IUSs on women’s health. This is a descriptive cross-sectional study of 75 women that were randomly se¬lected (50 women that used a copper-releasing IUS and the remaining 25 that used a levonorgestrel-releasing IUS) amongst those attending out patient’s clinics at Hillah, Iraq, from March to July 2016. All women were between 18 to 46 years of age, and have had an IUS for at least three months. The measurement of serum ceruloplasmin (SCerP), haemoglobin, vitamin D (VD), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) levels was undertaken. Our results revealed that the copper-releasing IUS group has low haemoglobin and VD levels, along with high levels of SCerP and proinflammatory cytokines. One the other hand, the levonorgestrel-releasing IUS group displayed no significant changes on the above markers. We can conclude that the levonorgestrel-releasing IUS is free of any adverse effect when compared to a copper-releasing IUS, at least with regard to the parameters examined by our study.

MENKES DISEASE: A LITERATURE REVIEW AND CLINICAL CASE

Menkes Kinky Hair Disease (MKHD) is characterized by an abnormality in copper metabolism caused by a mutation in the ATP7A gene, which is located on Xq13.3 and has 23 exons. In addition, this gene encodes 1500 amino acids and is expressed in large quantities in various organs. It’s worth mentioning that about 357 diff erent mutations have been identifi ed in the ATP7A gene. It is a relatively rare disease with an incidence of 1 case per 100,000 to 250,000 live births. MKHD is an X-linked recessive trait that almost exclusively aff ects boys.The diagnosis of this rare disease is based on the genetic- molecular study of a metabolic disease panel, including the ATP7A gene and the biochemical phenotype (a decrease in serum copper and ceruloplasmin levels).In developing therapeutic strategies for individuals with Menkes disease, three fundamental problems are being addressed: 1) unlocking the absorption of copper in the intestine; 2) making copper available to enzymes in cells that require it as a cofactor; and 3) identifying infants with Menkes disease and initiating treatment at a very early stage of life, before irreversible neurodegeneration occurs. This article presents a clinical case of Menkes disease in a 7-month-old boy. The diagnosis was confi rmed by molecular genetic testing (NGS) of the Neurometabolic Disorders Panel, which included the ATP7A gene and biochemical phenotype. The described case illustrates the complexity of diagnosing Menkes disease in the neonatal period due to the non-specifi city of disease symptoms (lethargy, weak sucking, weight loss, etc.) and the importance of biochemical and molecular genetic methods of fetal investigation in subsequent pregnancies or in a newborn sibling for early diagnosis and treatment. This case will be published with the consent of the mother in accordance with bioethical principles.

Essential tremor is associated with reduced serum ceruloplasmin levels.

Essential tremor (ET), a prevalent movement disorder, has an elusive pathogenesis. A reduction in ceruloplasmin (Cp) levels can be found in some patients with ET. In addition, some studies have suggested an association between ET and neurodegeneration. As a ferroxidase, Cp is critical for iron metabolism, protecting against oxidative stress and neurodegeneration. Iron metabolism dysregulation, linked to ferroptosis, has implications in neurodegenerative diseases. Yet, research on Cp and ET remains limited. This study aims to elucidate the relationship between ET and serum Cp levels. We collected demographic and clinical data from 62 patients with ET satisfying the diagnostic criteria and compared these to data from 100 healthy controls. The median Cp levels in ET patients were 21.5 (18.8, 23.9) mg/dL, significantly lower than those in controls (23.1 [(20.7, 25.7) mg/dL; P = 0.006]). A reduction in Cp levels emerged as a risk factor for ET incidence (odds ratio (OR) = 0.873, 95% confidence interval (CI), 0.795, 0.959; P = 0.005). The area under the receiver operating characteristic (ROC) curve for serum Cp levels to predict the onset of ET was 0.629 (95% CI, 0.537-0.720; P = 0.006), and the optimal cut-off value for Cp levels was 19.5mg/dL with a sensitivity of 91% and a specificity of 33.9%. Our analysis suggests that reduced Cp levels are associated with ET. We speculate that reduced Cp levels may be involved in the pathogenesis of ET, which requires further studies.

Unfavorable switching of skewed X chromosome inactivation leads to Menkes disease in a female infant

Menkes disease is an X-linked disorder of copper metabolism caused by mutations in the ATP7A gene, and female carriers are usually asymptomatic. We describe a 7-month-old female patient with severe intellectual disability, epilepsy, and low levels of serum copper and ceruloplasmin. While heterozygous deletion of exons 16 and 17 of the ATP7A gene was detected in the proband, her mother, and her grandmother, only the proband suffered from Menkes disease clinically. Intriguingly, X chromosome inactivation (XCI) analysis demonstrated that the grandmother and the mother showed skewing of XCI toward the allele with the ATP7A deletion and that the proband had extremely skewed XCI toward the normal allele, resulting in exclusive expression of the pathogenic ATP7A mRNA transcripts. Expression bias analysis and recombination mapping of the X chromosome by the combination of whole genome and RNA sequencing demonstrated that meiotic recombination occurred at Xp21-p22 and Xq26-q28. Assuming that a genetic factor on the X chromosome enhanced or suppressed XCI of its allele, the factor must be on either of the two distal regions derived from her grandfather. Although we were unable to fully uncover the molecular mechanism, we concluded that unfavorable switching of skewed XCI caused Menkes disease in the proband.

Clinical impact of ceruloplasmin levels at ANCA-associated vasculitis diagnosis.

Ceruloplasmin is an inhibitor of myeloperoxidase (MPO) activity that plays an important role in the pathophysiology of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). This study aimed to evaluate the prognostic impact of serum level of ceruloplasmin at diagnosis in patients with anti-MPO antibody-positive AAV. This retrospective monocentric study in Caen University Hospital involved all consecutive adult anti-MPO antibody-positive patients with microscopic polyangiitis or granulomatosis with polyangiitis, diagnosed between January 2010 and January 2022 with available serum sample at inclusion. Patients outcomes were analyzed from two subgroups constituted according to the median serum level of ceruloplasmin. The same analyses were then performed in anti-proteinase 3 (PR3) antibody-positive patients. Within the 92 patients analyzed, 50 patients had anti-MPO antibodies with a median ceruloplasmin level of 0.44 [quartiles 1-3, 0.40-0.49] g/L and a median Birmingham Vasculitis Activity Score of 19 [14-22]. After a median follow-up period of 40 [22-86] months, 13 (26%) patients had died: 10 (40%) in the low ceruloplasmin group and 3 (12%) in the high ceruloplasmin group (p = 0.03), with a significantly worse survival rate in the low ceruloplasmin group (p = 0.021). No significant differences in relapse rate or renal failure was observed between the two groups. The same analyses performed in the group of AAV patients with anti-PR3 antibody did not show any differences. In anti-MPO AAV patients, serum level of ceruloplasmin at diagnosis seems to be associated with a significant impact on survival.

Correlation Between Substantia Nigra Hyperechogenicity and Iron Metabolism in the Postural Instability Gait Difficulty Subtype of Parkinson's Disease.

The correlation between substantia nigra (SN) hyperechogenicity on transcranial sonography (TCS) and serum iron metabolism parameters in patients with the postural instability gait difficulty (PIGD) subtype of Parkinson's disease (PD) was investigated so as to explore the pathological mechanism of SN hyperechogenicity. The study enrolled 95 PIGD patients recruited by the Parkinson's Disease Specialty in the Second Affiliated Hospital of Soochow University during June 2019-2021. On the basis of the TCS results, the PIGD patients were assigned to the PD with SN hyperechogenicity (SN+) group (n=60) and PD without SN hyperechogenicity (SN-) group (n=35). Meanwhile, 49 sex- and age-matched healthy individuals were included in the control group. All participants underwent blood tests. Differences in the iron metabolism parameters among the three groups and the correlation between SN hyperechogenicity and serum iron metabolism parameters were analyzed. Serum ferritin, ceruloplasmin and transferrin levels were lower in the SN+ and SN- groups than in the control group (all p values <0.001). The serum ceruloplasmin level was lower in the SN+ group (0.23 [0.20, 0.25] g/L) than in the SN- group (0.25 [0.22, 0.29] g/L) (p=0.001), and the proportion of patients with an abnormal ceruloplasmin level was higher in the SN+ group than in the SN- group (43.3% [26/60] vs. 14.3% [5/35], χ2=8.484, p=0.004). Moreover, the SN hyperechogenicity area was negatively correlated with the serum transferrin level (r=-0.428, p < 0.001). Decreased serum ceruloplasmin levels may be associated with SN hyperechogenicity development in PIGD patients. The SN hyperechogenicity area is negatively correlated with the serum transferrin level.

Serum Level of Ceruloplasmin, Angiotensin-Converting Enzyme and Transferrin as Markers of Severity in SARS-CoV-2 Infection in Patients with Type 2 Diabetes

The aim of this study was to analyze other possible new markers of severity, at hospital admission, that can be assessed in patients with type 2 diabetes and a SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. Our study included 90 subjects: 45 patients with type 2 diabetes mellitus infected with the SARS-CoV-2 virus, and 45 healthy persons as controls. The serum level of ceruloplasmin at hospital admission was statistically significant and directly correlated with the severity of COVID-19 (coronavirus disease) (p = 0.037) and with the serum level of IL-6 (interleukin 6) (p = 0.0001). Ceruloplasmin was statistically significant and inversely correlated with the serum iron level (p = 0.0001). However, we observed that ACE (angiotensin-converting enzyme) decreased in severe forms of SARS-CoV-2 infections in patients with type 2 diabetes (p = 0.001). Moreover, the decrease in ACE levels was correlated with an increase in IL-6 levels in these patients (p = 0.001). IL-6 increases were statistically significant and inversely correlated with serum iron, transferrin, and ACE levels. There was a noticed decreasing tendency of the transferrin depending on the severity of the COVID-19 infection (p = 0.0001). In addition to the known severity factors in the context of infection with the new coronavirus, increased concentrations of ceruloplasmin and decreased concentrations of ACE and transferrin may represent new markers of COVID-19 severity in patients with type 2 diabetes. These parameters, if analyzed upon admission to the hospital, could better inform health professionals about the evolution towards more severe forms of SARS-CoV-2 infections.

Ceruloplasmin and some biochemical parameters as a marker for acute myeloid leukemic patients

Acute myeloid leukemia is a second type of leukemia and has more effect on elder patients than adult. This research's objective was to measure the serum levels of ceruloplasmin (CP), ferritin (FR), vitamin B12 (VitB12), folic acid (FA), zinc (Zn), copper (Cu), and iron (Fe) in acute myeloid leukemic patients (AML) (before and after taking chemotherapy) and healthy control groups. In this study, about (160) blood samples (males and females) were collected from acute myeloid leukemic patients in Erbil’s Nanakali hospital and they were separated into four groups: Group 1 (G1) including (40) Apparently healthy control group, Group 2 (G2) include (40) acute myeloid leukemic patients before taking chemotherapy (new cases), Group 3 (G3) include (40) acute myeloid leukemia patients taking chemotherapy for one cycle, and Group 4 (G4) include (40) acute myeloid leukemic patients with taking chemotherapy for more than one cycle. The outcomes display a significant increase in serum concentration of ceruloplasmin, ferritin, vitamin B12, and iron in all patient groups when compared with control groups. While the serum concentration of folic acid, zinc, and copper decreased in all patient groups when compared with the healthy control group. In addition, the correlation analysis displays that there was a significant positive correlation between ceruloplasmin with ferritin, vitamin B12, and iron, on another hand have a non-significant negative correlation between ceruloplasmin with folic acid, zinc, and copper. According to the present study, there was a direct correlation between AML patients with the serum levels of CP, FR, VitB12, FA, Zn, Cu, and Fe. A high area under the curve of our data suggests that testing for (CP, FR, VitB12, FA, Cu, and Fe) could be helpful to detect AML. However, zinc is not a good biomarker for detecting AML patients.

Severe early-onset Wilson disease caused by a common pathogenic variant in the Bukharan Jewish population in Israel

BackgroundWilson disease is caused by pathogenic variants in the ATP7B gene which encodes a copper-transporting ATPase. AimsDescribe a common founder pathogenic variant among Bukharan Jews and to assess its prevalence, clinical features, and outcome. MethodsThe cohort consisted of patients of Bukharan Jewish descent diagnosed with Wilson disease at a tertiary pediatric medical center in 2013–2018. Clinical and genetic data were collected and analyzed. ResultsSix patients from 4 unrelated families who were homozygous for the c.3784G > T p.(Val1262Phe) pathogenic variant in ATP7B were identified. Five presented with elevated aminotransferase levels, and one, with acute liver failure. Mean age at diagnosis was 8.7 years (5–12.5). Serum ceruloplasmin level was extremely low in all patients (1.9–7 mg/dL; mean 3.2(. The variant was identified in a heterozygous state in 5/153 Bukharan Jews; 2/33 from our local exome database and 3/120 healthy unrelated Bukharan Jews in another cohort, for an estimated carrier frequency of ∼1:30. ConclusionsWe report a common founder pathogenic variant in the ATP7B gene among Bukharan Jews associated with severe early-onset Wilson disease. Given the clinical severity, high frequency of the variant, and being a treatable disease, its inclusion in pre-symptomatic screening in the Bukharan Jewish community should be considered. Furthermore, WD should be part of future genetic newborn screening programs in Israel and worldwide, to enable early treatment and prevention of future life-threatening complications.

Effects of Diets Containing Different Levels of Copper, Manganese, and Iodine on Rumen Fermentation, Blood Parameters, and Growth Performance of Yaks.

Copper, manganese, and iodine are part of a yak's required trace elements. However, knowledge about their dietary requirements is scarce. Therefore, an experiment was conducted to evaluate rumen fermentation, blood parameters, and growth performance and screen out the optimum levels of trace elements in yaks' diet. Here, 18 three-year-old castrated yaks were randomly divided into four groups, which fed with diets containing basal (CON: 4.40, 33.82, and 0 mg/kg) and low-level (LL: 10.00, 40.00, and 0.30 mg/kg), middle-level (ML: 15.00, 50.00, and 0.50 mg/kg), and high-level (HL: 20.00, 60.00, and 0.70 mg/kg) copper, manganese, and iodine for 30 days. With the increase in trace elements, yaks' daily weight gain (DWG), rumen pH, ammonia nitrogen, microbial protein (MCP), and volatile fatty acids levels and serum triglycerides and urea nitrogen levels showed firstly increasing and then decreasing trends and reached the highest values in ML, and serum ceruloplasmin and total superoxide dismutase (T-SOD) activities showed continuously increasing trends. Yaks' DWG, rumen MCP, butyrate, and valerate levels and serum triglycerides, urea nitrogen, ceruloplasmin, and T-SOD levels in ML were significantly higher than CON. Therefore, the recommended levels of copper, manganese, and iodine in growing yaks' diet are 15.00, 50.00, and 0.50 mg/kg (ML), respectively.

Plasma zinc, copper and serum ceruloplasmin levels of autism spectrum disorder children in Bangladesh

Neural and cognitive processes require zinc and copper homeostasis and a normal zinc/copper ratio. Ceruloplasmin, an intrinsic antioxidant protein, maintains copper homeostasis, which might also influence autism spectrum disorder (ASD). ASD children are frequently reported with altered levels of these elements with wide geographical variations. This study evaluated any alteration in plasma zinc, copper, zinc/copper ratio and serum ceruloplasmin levels in Bangladeshi ASD children with respect to healthy controls. A cross-sectional study was conducted on 67 children aged 2 to 9 years of both sexes. Among them, 35 had ASD, while 32 were age, sex and body mass index (BMI) matched apparently healthy children. Plasma zinc and copper levels were estimated by the flame atomic absorption spectrophotometry method. Serum ceruloplasmin levels were estimated by the immunoturbidimetric method. Zinc and zinc/copper ratio in the 2–9 years old ASD children group were significantly lower (p=0.032 and p=0.002 respectively). On the other hand, copper (p=0.020) and ceruloplasmin (p = 0.045) levels were significantly higher than those of apparently healthy children. ASD was significantly associated with zinc deficiency (p=0.000) and copper toxicity (p=0.05). All children were again divided into 2–5 and 6–9 years age groups according to laboratory reference values for zinc and copper. Copper toxicity was significantly associated with ASD in the 2–5 years old age group (p=0.011), with a significant difference in plasma copper levels (p=0.009) and zinc/copper ratio (p=0.001) but not serum ceruloplasmin levels (p=0.110) compared to healthy controls. Serum ceruloplasmin was positively associated with plasma copper in ASD children of all age groups. This study shows that ASD in Bangladesh can be associated with low plasma zinc and high plasma copper and serum ceruloplasmin levels.

Alteration of circulating redox balance in coronavirus disease-19-induced acute respiratory distress syndrome

BackgroundMechanisms underpinning ARDS induced by COVID-19 are mostly immune-mediated, but need to be completely clarified. This study aimed to investigate redox balance in COVID-19 patients with ARDS, trying to recognize possible differences from typical ARDS related to the pathophysiology of severe disease.MethodsPatients affected by ARDS and positive for the SARS-CoV-2 virus (N = 40, COVID-19) were compared to ARDS patients negative to the molecular test (N = 42, No COVID-19). Circulating markers of redox balance were measured in serum and erythrocytes, and related to markers of inflammation and coagulability.ResultsNo differences in serum markers of oxidative damage were found between both groups, but a reduction in total antioxidant status and serum ceruloplasmin level was observed in COVID-19 rather than No COVID-19 patients. Redox balance alterations were described in erythrocytes from COVID-19 with respect to No COVID-19 group, characterized by increased lipofuscin and malondialdehyde concentration, and reduced glutathione S-transferase and glutathione reductase activity. These markers were associated with circulating indexes of respiratory disease severity (Horowitz index and alveolar-to-arterial oxygen gradient), inflammation (interleukin-6 and interleukin-10), and hypercoagulability (D-dimer) in COVID-19 patients with ARDS.ConclusionsARDS caused by COVID-19 is sustained by impairment of redox balance, particularly in erythrocytes. This alteration is associated with the pro-inflammatory and pro-coagulant status which characterizes severe COVID-19.

The effect of weight loss on serum ceruloplasmin levels in obese patients

Introduction and aim. Serum ceruloplasmin level may be a biomarker associated with obesity and cardiovascular risk. We aimed to evaluate the effect of body weight lost by diet and exercise program on metabolic parameters and serum ceruloplasmin levels in obese patients. Material and methods. A total of 120 obese patients with BMI ≥30 kg/m 2 were enrolled in a 16-week balanced diet program with the goal of losing 10% or more of body weight while maintaining a daily energy deficit of 500-1000 kcal/day. Results. Mean weights of the patients decreased from 93.2±15.1 kg to 83.2±13.1 kg (p&lt;0.001) and mean BMI decreased from 35.8±5.6 kg/m 2 to 31.9±4.9 kg/m 2 (p&lt;0.001). Mean ceruloplasmin decreased from 25.2±4.7 mg/dL to 23.6±4.9 mg/dL (p&lt;0.001), mean total cholesterol from 191.8±37.1 mg/dL to 153.8±28.7 mg/dL (p&lt;0.001), mean LDL from 120.3±31.4 mg/dL to 91.1±27.7 mg/dL (p&lt;0.001) and mean fasting blood glucose from 108.2±35 mg/dL to 103.3±81.1 mg/dL (p&lt;0.001). There was a statistically significant and weak correlation between the change in ceruloplasmin and the change in BMI (p=0.016, R=0.233). There was a statistically significant and weak correlation between ceruloplasmin change and weight change (p=0.010, R=0.251). Conclusion. Obese patients’ serum ceruloplasmin levels were found to decrease with weight loss.