Netrin-1 Levels Research Articles

Netrin-1-CD146 and netrin-1-S100A9 are associated with early stage of lymph node metastasis in colorectal cancer

BackgroundThe netrin-1/CD146 pathway regulates colorectal cancer (CRC) liver metastasis, angiogenesis, and vascular development. However, few investigations have yet examined the biological function of netrin-1/CD146 complex in CRC. In this work, we investigated the relationship between the netrin-1/CD146 axis and S100 proteins in sentinel lymph node, and revealed a possible new clue for vascular metastasis of CRC.MethodsThe expression levels of netrin-1 and CD146 proteins in CRC, as well as S100A8 and S100A9 proteins in the sentinel lymph nodes were determined by immunohistochemistry. Using GEPIA and UALCAN, we analyzed netrin-1 and CD146 gene expression in CRC, their association with CRC stage, and their expression levels and prognosis in CRC patients.ResultsThe expression level of netrin-1 in N1a+1b (CRC lymphatic metastasis groups, exculded N1c) was positively increased with N0 (p = 0.012). The level of netrin-1 protein was positively correlated with CD146 protein (p < 0.05). The level of S100A9 protein was positively correlated with CD146 protein (r = 0.492, p = 0.007). Moreover, netrin-1 expression was obviously correlated with S100A9 expression in the N1 stage (r = 0.867, p = 0.000). CD146 level was correlated with S100A9 level in the N2 stage (r = 0.731, p = 0.039). CD146 mRNA expression was higher in normal colorectal tissues than in CRC (p < 0.05). Netrin-1 and CD146 expression were not significantly associated with the tumor stages and prognosis of patients with CRC (p > 0.05).ConclusionsThe netrin-1/CD146 and netrin-1/S100A9 axis in CRC tissues might related with early stage of lymph node metastasis, thus providing potential novel channels for blocking lymphatic metastasis and guiding biomarker discovery in CRC patients.

Association between plasma Netrin-1 levels and motor and nonmotor symptoms in Parkinson's disease.

Parkinson's disease (PD) is a prevalent neurodegenerative disorder characterized by dopaminergic neuron degeneration and diverse motor and nonmotor symptoms. Early diagnosis and intervention are crucial but challenging due to reliance on clinical presentation. Recent research suggests potential biomarkers for early detection, including plasma netrin-1 (NTN-1), a protein implicated in neuronal survival. This cross-sectional study recruited 105 PD patients and 65 healthy controls, assessing plasma NTN-1 levels and correlating them with clinical characteristics. Statistical analyses explored associations between NTN-1 levels and PD symptoms, considering demographic factors. PD patients exhibited significantly lower plasma NTN-1 levels compared to controls. NTN-1 demonstrated moderate potential as a PD biomarker. Positive correlations were found between NTN-1 levels and motor, depression, and cognitive symptoms. Multiple regression analysis revealed disease duration and NTN-1 levels as key factors influencing symptom severity. Gender also impacted symptom scores. Reduced plasma NTN-1 levels correlate with PD severity, suggesting its potential as a biomarker. However, further research is needed to elucidate the roles of NTN-1 in PD pathophysiology and validate its diagnostic and therapeutic implications. Understanding the involvement of NTN-1 may lead to personalized management strategies for PD.

Evaluation of the relationship between serum netrin-1 level and patient characteristics in rheumatoid arthritis

Evaluation of the relationship between serum netrin-1 level and patient characteristics in rheumatoid arthritis

The Effect of Breast Milk from Different Lactation Stages on in Vitro Wound Healing.

Objective: Wound healing is a complex and dynamic process essential for restoring tissue integrity and homeostasis. It is thought that breast milk contributes positively to the wound healing process, thanks to the components it contains. The aim of this study is to compare the effects of breast milk on the wound healing process at different lactation stages and to evaluate the underlying mechanism(s). Materials and Methods: The effects of breast milk from different lactation stages (colostrum, transitional, and mature milk) on wound healing were determined by in vitro scratch assay in L929 fibroblast cells. 2,2-Diphenyl-1-picrylhydrazyl (DPPH), total oxidant, and antioxidant capacity were used to confirm antioxidant effects. The effect of breast milk on netrin-1 levels in L929 cells was elucidated by ELISA. Results: Breast milk at different lactation stages promoted wound healing. While the wound closure percentage was determined as 48.7% in the control group, this rate was determined to be the highest at 81.6% in the mature milk group (p:0.0002). The free radical scavenging capacity of colostrum, transitional, and mature milk with DPPH was determined as 49.69%, 60.64%, and 80.85%, respectively, depending on the lactation stages. Netrin-1 levels detected by ELISA were determined as 490.1 ± 6.5 pg/mL in the control group, while the lowest level was determined as 376.6 ± 4.5 pg/mL in mature milk (p:0.0003). Conclusions: Breast milk, especially mature milk, promoted wound healing on L929 cells by suppressing netrin-1 levels and scavenging free radicals.

Questionable accuracy of four ELISA kits in serum Netrin-1 measurement

Abstract Objectives Altered serum Netrin-1 levels have been widely reported in cancer and other clinical diseases and they are often measured by commercial ELISA kits. However, we found the questionable results using these kits and therefore performed this simple study to evaluate their accuracy in detection of serum Netrin-1. Methods Four commonly used commercial kits were collected. The kit standards were serially diluted or spiked into serum samples. The cells with confirmed expression of Netrin-1 and their culture medium, as well as the Netrin-1 controls of each kit were used for the kits to detect. The cell lysate samples and the kit controls were also blotted on a nitrocellulose membrane for detection antibodies of each kit to probe. Results Detection of the Netrin-1 standards in serum by each kit were all affected. Only one kit was able to detect Netrin-1 in the cell lysate or medium. No ELISA kits could detect all Netrin-1 controls of the four kits. None of the detection antibodies correctly probed Netrin-1 in the dot blot. Conclusions The accuracy of these four Netrin-1 ELISA kits is under question. Reported serum Netrin-1 levels based on measurements by these kits need be carefully interpreted.

Novel mechanisms of Anshen Dingzhi prescription against PTSD: Inhibiting DCC to modulate synaptic function and inflammatory responses

Ethnopharmacological relevanceAnshen Dingzhi prescription (ADP), documented in “Yi Xue Xin Wu”, is a famous prescription for treating panic-related mental disorders such as post-traumatic stress disorder (PTSD). However, the underlying mechanism remains unclear. Aim of the studyThis study aimed to investigate the mechanisms by which ADP intervened in PTSD-like behaviors. MethodsA mouse model of single prolonged stress (SPS) was established to evaluate the ameliorative effects and mechanisms of ADP on PTSD. Behavioral tests were used to assess PTSD-like behaviors in mice; transmission electron microscopy was used to observe changes in the ultrastructure of hippocampal synapses, and western blot, immunofluorescence, and ELISA were used to detect the expression of hippocampal deleted in colorectal cancer (DCC) and downstream Ras-related C3 botulinum toxin substrate 1 (Rac1) - P21-activated kinase 1 (PAK1) signal, as well as levels of synaptic proteins and inflammatory factors. Molecular docking technology simulated the binding of potential brain-penetrating components of ADP to DCC. ResultsSPS induced PTSD-like behaviors in mice and increased expression of hippocampal netrin-1 (NT-1) and DCC on the 14th day post-modeling, with concurrent elevation in serum NT-1 levels. Simultaneously, SPS also decreased p-Rac1 level and increased p-PAK1 level, the down-stream molecules of DCC. Lentiviral overexpression of DCC induced or exacerbated PTSD-like behaviors in control and SPS mice, respectively, whereas neutralization antibody against NT-1 reduced DCC activation and ameliorated PTSD-like behaviors in SPS mice. Interestingly, downstream Rac1-PAK1 signal was altered according to DCC expression. Moreover, DCC overexpression down-regulated N-methyl-d-aspartate (NMDA) receptor 2A (GluN2A) and postsynaptic density 95 (PSD95), up-regulated NMDA receptor 2B (GluN2B) and increased neuroinflammatory responses. Administration of ADP (36.8 mg/kg) improved PTSD-like behaviors in the SPS mice, suppressed hippocampal DCC, and downstream Rac1-PAK1 signal, upregulated GluN2A and PSD95, downregulated GluN2B, and reduced levels of inflammatory factors NOD-like receptor protein 3 (NLRP3), nuclear factor kappa-B (NF-κB) and interleukin-6 (IL-6). Importantly, DCC overexpression could also reduce the ameliorative effect of ADP on PTSD. Additionally, DCC demonstrated a favorable molecular docking pattern with the potential brain-penetrating components of ADP, further suggesting DCC as a potential target of ADP. ConclusionOur data indicate that DCC is a key target for the regulation of synaptic function and inflammatory response in the onset of PTSD, and ADP likely reduces DCC to prevent PTSD via modulating downstream Rac1-PAK1 pathway. This study provides a novel mechanism for the onset of PTSD and warrants the clinical application of ADP.

Netrin-1 signaling pathway mechanisms in neurodegenerative diseases.

Netrin-1 and its receptors play crucial roles in inducing axonal growth and neuronal migration during neuronal development. Their profound impacts then extend into adulthood to encompass the maintenance of neuronal survival and synaptic function. Increasing amounts of evidence highlight several key points: (1) Diminished Netrin-1 levels exacerbate pathological progression in animal models of Alzheimer's disease and Parkinson's disease, and potentially, similar alterations occur in humans. (2) Genetic mutations of Netrin-1 receptors increase an individuals' susceptibility to neurodegenerative disorders. (3) Therapeutic approaches targeting Netrin-1 and its receptors offer the benefits of enhancing memory and motor function. (4) Netrin-1 and its receptors show genetic and epigenetic alterations in a variety of cancers. These findings provide compelling evidence that Netrin-1 and its receptors are crucial targets in neurodegenerative diseases. Through a comprehensive review of Netrin-1 signaling pathways, our objective is to uncover potential therapeutic avenues for neurodegenerative disorders.

Circulating netrin-1 levels are reduced and related to corneal nerve fiber loss in patients with diabetic neuropathy.

Deficiency of neurotropic factors is implicated in diabetic neuropathy (DN). Netrin-1 is a neurotropic factor, but its association with DN has not been explored. We have assessed the association between serum netrin-1 levels and early diabetic neuropathy assessed by quantifying corneal nerve fiber loss using corneal confocal microscopy. A total of 72 participants with type 2 diabetes, without and with corneal nerve fiber loss (DN- n = 42, DN+ n = 30), and 45 healthy controls were studied. Serum netrin-1 levels were measured by enzyme-linked immunosorbent assay, and corneal nerve morphology was assessed using corneal confocal microscopy. Corneal nerve fiber density, branch density, fiber length and serum netrin-1 levels were significantly lower in the DN- and DN+ groups compared with controls (P < 0.001). Netrin-1 levels correlated with corneal nerve fiber length in the DN+ group (r = 0.51; P < 0.01). A receiver operating characteristic curve analysis showed that a netrin-1 cut-off value of 599.6 (pg/mL) had an area under the curve of 0.85, with a sensitivity of 76% and specificity of 74% (P < 0.001; 95% confidence interval 0.76-0.94) for differentiating patients with and without corneal nerve loss. Serum netrin-1 levels show a progressive decline with increasing severity of small nerve fiber damage in patients with diabetes. Netrin-1 could act as a biomarker for small nerve fiber damage in DN.

Serum netrin-1 levels are high in Rheumatoid arthritis associated interstitial lung disease

BackgroundRecent data show that netrin-1 has a role in development of pulmonary fibrosis. This study was aimed to investigate serum netrin-1 level and its relation to interstitial lung disease(ILD) in patients with rheumatoid arthritis (RA). Method42 RA patients with RA-ILD, 58 RA patients without RA-ILD (RA non-ILD group), and 61 healthy volunteers were included in this study. The modified DAS28-ESR score was used to calculate disease activity in RA patients. Using the quantitative immunoassay method, Serum netrin-1 levels were measured with an ELISA kit (Catalog number: E-EL-H2328; lab science, lot number: GZWTKZ5SWK, Texas, USA). ResultsThe median value of netrin-1 was found to be significantly higher in the RA-ILD group (82.9 [59.9–124]) compared to both the RA non-ILD group(52.9 [49.5–73.1])(B = −0.006, OR = 0.994, CI 95 %=0.989–0.999, P = 0.018) and the control group(53.5 [49.5–87.5]) (B: −0.005, OR: 0.994, CI 95 %: 0.990–0.999, p: 0.022). A cut-off value of 61.78 for netrin-1 was found to have a sensitivity of 73.8 % and a specificity of 69 % for the diagnosis of RA-ILD (AUC [95 %Cl] = 0.771 [0.679–0.862], p < 0.0001).It was found that high serum netrin-1 level was strongly associated with the RA-usual interstitial pneumonia(UIP) pattern and poorly related to the RA-nonspecific interstitial pneumonia(NSIP) pattern compared to the RA non-ILD group. ConclusionsNetrin-1 is elevated in the serum of patients with RA-ILD, especially in the UIP pattern. Netrin-1 may be a potential candidate for predicting the development of RA-ILD that should be investigated in the pathophysiological and therapeutic fields..

Association of Serum Netrin-1 Level with Metabolic Syndrome Components in Gorgan

Introduction: Metabolic syndrome (MetS) is a complex and multi-factorial condition that affects millions of people worldwide. Netrin-1 may have an important function in metabolic processes. Aim: There are controversial studies about the role of netrin-1 in MetS. Therefore, the aim of this study was to assess the serum level of netrin-1 and its association with MetS components in our study subjects in this area. Materials and Methods: The National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) criteria were used to include individuals with MetS. Results: Waist circumference, Systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), Triglyceride (TG), High-density lipoprotein cholesterol (HDL-C), and netrin-1 were significantly higher in subjects with MetS than those without MetS (Except HDL-C). FBG and TG were significantly higher in type 2 diabetic patients with MetS than those without MetS (Except HDL-C). Netrin-1 showed a significant positive correlation with FBG in type 2 diabetic patients without MetS. Conclusion: This study may provide that future research should focus on investigating the potential therapeutic role of netrin-1 in the management and prevention of T2DM, and its potential impact on the diagnosis and management of this condition should not be overlooked.

Possible Role of Netrin-1/Deleted in Colorectal Cancer/Vascular Endothelial Growth Factor Signaling Pathway in the Pathogenesis of Placenta Accreta Spectrum: A Case-control Study.

Netrin-1, an epithelial-secreted protein, plays a key role in placental formation through the promotion of cytotrophoblast proliferation and placental vascular development. These effects are mediated through several receptors, including the deleted in colorectal cancer (DCC) receptor. Placenta accreta spectrum (PAS) is an exaggerated trophoblastic invasion into the uterine myometrium. The exact etiology is unknown, but it is believed that increased trophoblastic invasion, defect decidualization, and/or abnormal angiogenesis might play a role. Our study aimed to investigate the suggested role of macrophage-induced netrin-1/DCC/vascular endothelial growth factor (VEGF) signaling in PAS pathogenesis. A total of 29 women with PAS (as cases) and 29 women with normal pregnancies (as controls) were enrolled in the study. At delivery, placental tissues of both groups were collected and processed for the evaluation of placental netrin-1 level by enzyme-linked immunoassay technique and immunohistochemical analysis of tissue DCC receptor. Placental tissue netrin-1 level of PAS cases showed a statistically significantly higher value than those in the normal group. Significant overexpression of DCC receptors, VEGF, and enhanced macrophage recruitment was noted in PAS cases in comparison to the normal placenta. Macrophage-induced netrin-1/DCC/VEGF signaling might be involved in PAS pathogenesis through the enhancement of trophoblastic angiogenesis.

Netrin-1 ve Reseptörlerinin Çeşitli Kanserlerdeki Rolü

ABSTRACT&#x0D; Netrin-1 is a laminin-like protein that is secreted. It plays a role in the development of the nervous system and is also involved in processes such as cell migration, proliferation, angiogenesis, differentiation, apoptosis, metastasis, and invasion. DCC, neogenin, and UNC5 receptor families form the main receptors of netrin-1. These receptors have a dual role depending on the presence or absence of netrin-1. Netrin-1 influences carcinogenesis through signaling pathways such as PI3K/AKT, ERK/MAPK, Notch, and NF-kB. Netrin-1 receptor interactions are effective in cancer cell viability and carcinogenesis mechanisms. Overall, overexpression of netrin-1 and loss of its receptors promote carcinogenesis. Netrin-1 is involved in apoptosis through different receptors. Changes in the expression of DCC and UNC5H receptors affect cancer cell growth and metastasis. Loss of expression in dependent receptors is observed in advanced stages of various tumors. Neogenin is associated with migration and metastasis in tumors. Studies have shown that netrin-1 influences tumor development in various cancers such as gastric cancer, pancreatic ductal adenocarcinoma, colorectal cancer, and glioblastoma. Overexpression of netrin-1 is associated with poor prognosis and decreased overall survival. Netrin-1 levels are reported to be higher in patient groups compared to healthy control groups and decrease with chemotherapy. The mechanism of netrin-1 and its receptors in tumor development is not clear due to their different effects. This article summarizes research findings presenting the role and position of netrin-1 in various cancers.

Counteracting Age-Related Netrin-1 Signaling Insufficiency Ameliorates Endothelial Cell Senescence and Angiogenesis Impairment.

Senescent cells that accumulate are regarded as promising therapeutic targets. However, senolytic therapy failed to achieve satisfactory results. We previously discovered that young human plasma improved vascular endothelial cell senescence, and UNC5B might be a novel intervention target. Netrin-1, as a natural ligand of UNC5B, plays roles in multiple age-related vascular disorders, but its involvement in aging is still unclear. Here, we observed a significant decrease in plasma Netrin-1 levels in old healthy subjects compared to the young. In vivo, adeno-associated-virus-mediated delivery of Netrin-1 into aged mice significantly improved functional recovery in a model of hindlimb ischemia, promoted angiogenesis in ischemic tissues, and activated the endothelial nitric oxide synthase. Furthermore, we revealed that low-dose Netrin-1 recombinant protein significantly reduced senescence-associated-β-galactosidase-positive cells, inhibited the P53 pathway, promoted cell migration, increased tubule formation, and elevated nitric oxide production in senescent endothelial cells. However, UNC5B inhibition blocked the pro-angiogenesis effect of low-dose Netrin-1 on senescent cells or aortic rings. In summary, this study depicts that modulating Netrin-1 signaling can result in improved vascular health and Netrin-1 may have therapeutic potential for age-related ischemic diseases.

Relationship between insulin and Netrin-1/DCC guidance cue pathway regulation in the prefrontal cortex of rodents exposed to prenatal dietary restriction.

Fetal restriction (FR) alters insulin sensitivity, but it is unknown how the metabolic profile associated with restriction affects development of the dopamine (DA) system and DA-related behaviors. The Netrin-1/DCC guidance cue system participates in maturation of the mesocorticolimbic DA circuitry. Therefore, our objective was to identify if FR modifies Netrin-1/DCC receptor protein expression in the prefrontal cortex (PFC) at birth and mRNA in adulthood in rodent males. We used cultured HEK293 cells to assess if levels of miR-218, microRNA regulator of DCC, are sensitive to insulin. To assess this, pregnant dams were subjected to a 50% FR diet from gestational day 10 until birth. Medial PFC (mPFC) DCC/Netrin-1 protein expression was measured at P0 at baseline and Dcc/Netrin-1 mRNA levels were quantified in adults 15 min after a saline/insulin injection. miR-218 levels in HEK-293 cells were measured in response to insulin exposure. At P0, Netrin-1 levels are downregulated in FR animals in comparison to controls. In adult rodents, insulin administration results in an increase in Dcc mRNA levels in control but not FR rats. In HEK293 cells, there is a positive correlation between insulin concentration and miR-218 levels. Since miR-218 is a Dcc gene expression regulator and our in vitro results show that insulin regulates miR-218 levels, we suggest that FR-induced changes in insulin sensitivity could be affecting Dcc expression via miR-218, impacting DA system maturation and organization. As fetal adversity is linked to nonadaptive behaviors later in life, this may contribute to early identification of vulnerability to chronic diseases associated with fetal adversity.

486-P: Reduced Serum Netrin-1 Levels Correlate with Corneal Nerve Fiber Loss in Diabetic Neuropathy

Objective: Deficiency of endogenous neurotropic factors are implicated in diabetic neuropathy (DN). While Netrin-1, a neurotropic factor, is downregulated in type 2 diabetes, its involvement in Diabetic Neuropathy (DN) is yet to be reported. While corneal confocal microscopy (CCM) is a sensitive, in-vivo, non-invasive technique for detection of DN at its earliest stages, the association between CCM parameters and serum Netrin-1 levels has not been reported before. The present study looked at serum netrin levels in populations with type 2 diabetes with or without neuropathy, using CCM as the gold standard. Methods: Sixty subjects with type 2 diabetes (DN- 30, DN+ 30)] were stratified using DN4Q and Vibration perception Threshold Test (VPT). Cornea was assessed using CCM. Serum Netrin-1 level was measured by ELISA. Data compared 27 healthy controls were also studied. Results: There was a significant reduction in corneal nerve fibre density (CNFD), branch density (CNBD), and fibre length (CNFL) in T2D. DN was associated with a greater reduction in all CCM parameters compared to those with type 2 diabetes but no DN (p&amp;lt;0.05). There was a progressive decline in the mean serum netrin-1 level from healthy controls to T2D DN- to T2D DN+ (Control vs T2D, p&amp;lt;0.05; T2D DN- vs DN+, p&amp;lt;0.01)]. Netrin-1 correlated only with CNBD in T2D DN- group, (p=0.02). While ROC analysis showed CNFD, CNBD and CNFL to predict DN in 55.6%, 57.1% and 62.1% respectively, Netrin-1 alone predicted DN in 63.3%. CNBD and CNFL correlated with Netrin-1 (p=0.04 and p=0.01) in T2D DN+ group. Conclusion: Serum netrin-1 levels declined progressively from controls to T2D to T2D with DN; netrin-1 levels correlated significantly with the CCM parameters. Serum Netrin-1 levels showed a significant positive correlation with CNBD in type 2 diabetes (DN- or DN+). A strong correlation was seen between CNFL and netrin-1 levels in more advanced diabetic neuropathy (abnormal VPT). The results of our pilot study need validation in larger populations. Disclosure A.Mondal: None. C.Bose: None. S.Pramanik: None. A.Mukherjee: None. B.Mukherjee: None. S.Mukhopadhyay: None. Funding Research Society for the Study of Diabetes in India

Netrin-1 controls inflammation in response to ischemic stroke through altering microglia phenotype.

The current approaches that are used to treat ischemic stroke suffer from poor targeting, lack of effectiveness, and potential off-target effects, necessitating the development of new therapeutic strategies to enhance neuronal cell survival and regeneration. This study aimed to investigate the role of microglial Netrin-1 in ischemic stroke, a topic that has not been fully understood. Netrin-1 levels and its primary receptor expressions were investigated in cerebral microglia from acute ischemic stroke patients and age-matched control subjects. A public database (GEO148350), which supplied RNAseq results for rat cerebral microglia in a middle cerebral artery occlusion (MCAO) model, was analyzed to assess the expression of Netrin-1, its major receptors, and genes related to macrophage function. A microglia-specific gene targeting approach and a delivery system allowing for crossing the blood-brain barrier were applied in a mouse model for ischemic stroke to investigate the role of microglial Netrin-1. Netrin-1 receptor signaling in microglia was observed and the effects on microglial phenotype, apoptosis, and migration were analyzed. Across human patients, rat and mouse models, activation of Netrin-1 receptor signaling was mainly conducted via its receptor UNC5a in microglia, which resulted in a shift in microglial phenotype towards an anti-inflammatory or M2-like state, leading to a reduction in apoptosis and migration of microglia. Netrin-1-induced phenotypic change in microglia exerted protective effects on neuronal cells in vivo during ischemic stroke. Our study highlights the potential of targeting Netrin-1 and its receptors as a promising therapeutic strategy for promoting post-ischemic survival and functional recovery.

Association of maternal serum Netrin-1 and Netrin-4 levels with placenta accreta spectrum.

This study aimed to evaluate maternal serum Netrin-1 and Netrin-4 levels in pregnancies complicated with placenta accreta spectrum. This cross-sectional study enrolled 49 pregnant women with the diagnosis of placenta accreta spectrum as the study group. Gestational age-matched 30 uncomplicated pregnant women with prior cesarean delivery and normal placentation were randomly selected as the control group. Maternal serum Netrin-1 and Netrin-4 levels were measured between weeks 34 and 36 of gestation. There was no significant difference between the groups in terms of demographic characteristics. Maternal serum Netrin-1 levels were significantly lower in placenta accreta spectrum cases compared with those in the control group (p=0.038). There was no significant difference between the groups in terms of maternal serum Netrin-4 levels (p>0.05). There was a significant negative correlation between maternal serum Netrin-1 levels and the number of prior cesarean deliveries (r=-0.313, p=0.005). The observed decrease in maternal serum Netrin-1 levels in placenta accreta spectrum cases associated with increased angiogenesis might be one of the factors involved in the pathophysiology of this disease.

The plasma galectin-3 level has high specificity and sensitivity for predicting postoperative atrial fibrillation after coronary artery bypass surgery.

Postoperative new-onset atrial fibrillation (POAF) commonly occurs after coronary artery bypass graft (CABG) surgery. This study aimed to determine the utility of the preoperative netrin-1 and galectin-3 levels for predicting POAF following CABG surgery, as well as that of postoperative serial measurement for assessing these markers' patterns of expression. This prospective cohort study included 50 patients that underwent CABG surgery. The plasma netrin-1 and galectin-3 levels were measured via enzyme-linked immunosorbent assay (ELISA) before surgery (baseline) and at 6, 12, and 24 h after surgery. The patients were divided into two groups according to the occurrence of POAF; the POAF (+) group and the POAF (-) group. In total, 26 patients developed POAF, whereas 24 remained in sinus rhythm. Baseline galectin-3 levels were higher in the POAF (+) group than in the POAF (-) group (30.7 ± 10.1 pg mL-1 and 15.7 ± 3.6 pg mL-1, respectively). The post-CABG surgery galectin-3 level increased in both the POAF (+) and POAF (-) groups at 6 h (46.2 ± 26.3 pg mL-1 and 24.9 ± 5.9 pg mL-1, respectively), 12 h (45.2 ± 24.1 pg mL-1 and 26.6 ± 9.3 pg mL-1, respectively), and 24 h (54.2 ± 33.5 pg mL-1and 28.6 ± 7.7 pg mL-1, respectively). The plasma netrin-1 level did not differ between groups at baseline or at 6, 12, and 24 h post CABG surgery. Whereas netrin-1 does not appear to have any utility as a marker for the development of POAF in CABG surgery patients, the plasma galectin-3 level has high specificity and sensitivity for predicting POAF following CABG surgery and could be considered a marker for predicting POAF.

Serum netrin-1 levels in systemic sclerosis patients with capillary abnormalities

BackgroundSystemic sclerosis (SSc) is a rare, potentially destructive systemic autoimmune disease characterized by organ fibrosis and vasculopathy. Netrin-1 is associated with angiogenesis, inflammation, and apoptosis. Aim of the workTo assess the level of serum netrin-1 in SSc patients with capillary abnormalities and to evaluate its relation to disease manifestations. Patients and methodsThis study investigated the relationship between netrin-1 and fibrosis in 56 SSc patientsand 58 matched control. The modified Rodnan skin score (mRss) was used to assess skin thickness. Serum netrin-1 level was quantitatively measured using an enzyme-linked immunosorbent assay. ResultsThe study included 56 patients; 53 females and 3 males (F:M 17.7:1) with a mean age of 48·1 ± 13·6 years and disease duration of 13.01 ± 8·7 years. They were 43 (76.7 %) diffuse and 13 (23.3 %) limited subtypes. The median mRss was 6.58 ± 2.2. Raynaud’s disease was present in 50 % and interstitial lung disease in 57.1 %. The median netrin-1 level was significantly higher in SSc patients (268·8 pg/mL; 82·8-1006·6 pg/mL) than in the controls (108·6 pg/mL;21·02-351·5 pg/mL, p < 0·0001). There was no significant difference in the serum netrin-1 levels in SSc patients with and without Raynaud’s disease (p = 0.55), interstitial lung disease (p = 0.18), anti-Scl70 positive antibodies (p = 0·78), and anti-centromere antibody (p = 0·493). Netrin-1 was significantly related to SSc (OR = 1·02, 95 %CI: 1·01 − 1·03, p < 0·0001). At a cut-off value 126·3 pg/mL, netrin-1 would diagnose SSc (sensitivity 60·3%, specificity 94·6%, 95 %CI: 0·83 − 0·95, p < 0·0001). ConclusionSSc patients had significantly high levels of serum netrin-1 with a potential role in the pathophysiology of the disease.

Diagnosing myeloma in general practice: how might earlier diagnosis be achieved?

<h3>Abstract</h3> <h3>Background</h3> Netrin-1 is a laminin class protein that guides the axonal during the first embryonic development, has pushing and pulling properties, and has axonal chemoattractant activity. Netrin-1 has been shown to increase the effect of fibrosis in mouse lung and human SSc lung cell cultures. In this study, we aimed to investigate the relationship between Netrin-1 and Systemic sclerosis (SSc) and to emphasize the role of Netrin-1 in the pathophysiology of SSc by increasing the known VEGF and M2 macrophage expression, which supports the fibrotic process. <h3>Methods</h3> The study included 56 SSc patients with a mean age of 48·.08±13.59 years and 58 healthy volunteers with a mean age of 48.01±11.59 years. SSc organ involvements were scanned retrospectively from patient files, and patients were grouped according to SSc complications. Calculation of Netrin-1 levels was performed using a quantitative sandwich enzyme immunoassay method with an ELISA kit (Elabscience, Texas, USA; catalog number: E-EL-H2328; lot number: GZWTKZ5SWK). The modified Rodnan skin score (mRSS) was used for skin thickness scoring in SSc patients. <h3>Results</h3> The median value of Netrin-1 was found to be significantly higher in SSc (268.8 [82.75-1006.64]) than in controls (108.63 [21.02-351.49]) (p&lt;0.0001). In ROC analysis, a cut-off value of 354.24 for Netrin in SSc was found to provide a sensitive confidence interval with 32.8% sensitivity and 98.3% specificity (AUC[95% CI]: 0.746-0.895, p&lt;0.0001). There was no significant correlation between Netrin-1 level, organ involvement in SSc, and mRSS (p&gt;0.05). <h3>Conclusion</h3> We found a significant relationship between Netrin-1 levels and SSc disease in this study. Our study is the first clinical study in which Netrin-1 elevation was demonstrated in SSc patients.