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Biomarkers in Medicine May 2022To evaluate the association of serum prealbumin level with adverse outcomes in heart failure (HF) patients by conducting a meta-analysis. A comprehensive literature... (Meta-Analysis)
Meta-Analysis Review
To evaluate the association of serum prealbumin level with adverse outcomes in heart failure (HF) patients by conducting a meta-analysis. A comprehensive literature search was conducted in both international and Chinese databases to identify the cohort studies that reported the association of serum prealbumin level with all-cause mortality and composite endpoints of death/heart failure readmission in HF patients. Eight studies involving 2439 patients were eligible. Low prealbumin level was associated with higher risk of all-cause mortality (adjusted risk ratio [RR] 1.89; 95% CI: 1.35-2.65) and composite endpoints (adjusted RR 3.08; 95% CI: 1.43-6.64). Low serum prealbumin level may be an independent predictor of all-cause mortality/heart failure readmission in HF patients.
Topics: Cohort Studies; Heart Failure; Humans; Prealbumin
PubMed: 35348030
DOI: 10.2217/bmm-2021-1065 -
Neurochemistry International May 2022Transthyretin (TTR), which is one of the major amyloidogenic proteins in systemic amyloidosis, forms extracellular amyloid deposits in the systemic organs such as... (Review)
Review
Transthyretin (TTR), which is one of the major amyloidogenic proteins in systemic amyloidosis, forms extracellular amyloid deposits in the systemic organs such as nerves, ligaments, heart, and arterioles, and causes two kinds of systemic amyloidosis, hereditary ATTR (ATTRv) amyloidosis induced by variant TTR and aging-related wild-type ATTR (ATTRwt) amyloidosis. More than 150 different mutations, most of which are amyloidogenic, have been reported in the TTR gene. Since most disease-associated mutations affect TTR tetramer dissociation rates, destabilization of TTR tetramers is widely believed to be a critical step in TTR amyloid formation. Recently, effective disease-modifying therapies such as TTR tetramer stabilizers and TTR gene silencing therapies have been developed for ATTR amyloidosis. This study reviews the clinical phenotypes of ATTR amyloidosis, TTR features, and recent progress in promising therapies for ATTR amyloidosis.
Topics: Amyloid; Amyloidogenic Proteins; Amyloidosis; Humans; Mutation; Prealbumin
PubMed: 35218869
DOI: 10.1016/j.neuint.2022.105313 -
Nihon Rinsho. Japanese Journal of... Feb 1995
Review
Topics: Adolescent; Adult; Child, Preschool; Humans; Liver Diseases; Prealbumin
PubMed: 8753400
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... Aug 1999
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Annual Review of Nutrition 1994The name "transthyretin" reflects the dual physiological roles of this tetrameric unglycosylated plasma protein. TTR is one of three specific carrier proteins involved... (Review)
Review
The name "transthyretin" reflects the dual physiological roles of this tetrameric unglycosylated plasma protein. TTR is one of three specific carrier proteins involved in the transport of both thyroid hormones and of retinol through the mediation of RBP. TTR is a product of the visceral compartment, and its hepatic synthesis is exquisititely sensitive to both the adequacy and levels of protein and energy intakes--hence the proposal of TTR as a nutritional marker. To date, 38 TTR variants have been described, most of which are associated with variable degrees of cardiac and/or neural tissue amyloid deposits. All known variants arise from a single AA substitution due to single point mutation in the coding region of the TTR gene. Under acute stress conditions, the synthesis of TTR, RBP, and CBG is abruptly depressed by a cytokine-directed orchestration of new metabolic priorities, with a redistribution of organ and tissue protein pools. It is proposed that TTR, RBP, and CBG behave as acute-booster reactants (ABRs), actively participating in the cascade of metabolic events characterizing the stress reaction along pathways best explained by the free hormone/vitamin hypothesis. The latter is governed by the law of mass action--the spontaneous dissociation and instant uptake by hepatocytes of the ligands freed from their specific carrier proteins, which creates a transient hyperthyroid, hyperretinoid, and hypercortisolic climate. This response generally does not exceed four or five days because the initial impact of injury normally subsides, but it may last longer if complications occur. The magnitude and adequacy of the stress responses depend on the preceding nutritional status as assessed by TTR plasma levels and are proportionate to the severity of insult. Clinical, animal, and molecular studies concur to demonstrate the dualistic stimulatory or inhibitory effects triggered by the ligands, whose unmetabolized fractions are excreted in the urinary output. Thyroid hormones and retinoids appear to control the early maturation processes and the synthesis of primary transcripts, whereas cortisol preferentially modulates the secondary responses and confers a protective effect on healthy tissues. During acute stress, the evolutionary patterns of visceral proteins and inflammatory markers exhibit compulsory mirror images. However, they change in independent ways under more chronic circumstances. A relatively simple biochemical micromethod based on the simultaneous measurement of plasma TTR, albumin, CRP, and orosomucoid aggregated into a PINI is proposed for the early recognition and follow-up of both nutritional and inflammatory facets of the disease spectrum.
Topics: Amino Acid Sequence; Animals; Gene Expression; Humans; Molecular Sequence Data; Mutation; Nutrition Surveys; Nutritional Physiological Phenomena; Prealbumin; Protein Conformation; Stress, Physiological
PubMed: 7946531
DOI: 10.1146/annurev.nu.14.070194.002431 -
Journal of the American Dietetic... May 1989There is no single available measurement for evaluating the short-term response to nutrition therapy. The ideal parameter should have high sensitivity and specificity... (Review)
Review
There is no single available measurement for evaluating the short-term response to nutrition therapy. The ideal parameter should have high sensitivity and specificity and should be unaffected by non-nutritional factors. A literature review suggested that plasma retinol-binding protein and prealbumin concentrations change earlier than albumin and transferrin levels and appear to correlate better with nitrogen balance during nutrition therapy. That conclusion was supported by our own findings in patients receiving total parenteral nutrition and following the transition to oral or enteral feedings. Although concentrations of these plasma proteins have been shown to be affected by stress and renal and hepatic disease, they appear to be more sensitive indicators of the adequacy of nutrition support than other more commonly used assessment parameters.
Topics: Humans; Nutritional Status; Parenteral Nutrition, Total; Prealbumin; Retinol-Binding Proteins; Retinol-Binding Proteins, Plasma
PubMed: 2498417
DOI: No ID Found -
Clinical Nutrition (Edinburgh, Scotland) Jun 2024Serum prealbumin is considered to be a sensitive predictor of clinical outcomes and a quality marker for nutrition support. However, its susceptibility to inflammation...
BACKGROUND & AIMS
Serum prealbumin is considered to be a sensitive predictor of clinical outcomes and a quality marker for nutrition support. However, its susceptibility to inflammation restricts its usage in critically ill patients according to current guidelines. We assessed the performance of the initial value of prealbumin and dynamic changes for predicting the ICU mortality and the effectiveness of nutrition support in critically ill patients.
METHODS
This monocentric study included patients admitted to the ICU between 2009 and 2016, having at least one initial prealbumin value available. Prospectively recorded data were extracted from the electronic ICU charts. We used both univariable and multivariable logistic regressions to estimate the performance of prealbumin for the prediction of ICU mortality. Additionally, the association between prealbumin dynamic changes and nutrition support was assessed via a multivariable linear mixed-effects model and multivariable linear regression. Performing subgroup analysis assisted in identifying patients for whom prealbumin dynamic assessment holds specific relevance.
RESULTS
We included 3136 patients with a total of 4942 prealbumin levels available. Both prealbumin measured at ICU admission (adjusted odds-ratio (aOR) 0.04, confidence interval (CI) 95% 0.01-0.23) and its change over the first week (aOR 0.02, CI 95 0.00-0.19) were negatively associated with ICU mortality. Throughout the entire ICU stay, prealbumin dynamic changes were associated with both cumulative energy (estimate: 33.2, standard error (SE) 0.001, p < 0.01) and protein intakes (1.39, SE 0.001, p < 0.01). During the first week of stay, prealbumin change was independently associated with mean energy (6.03e-04, SE 2.32e-04, p < 0.01) and protein intakes (1.97e-02, SE 5.91e-03, p < 0.01). Notably, the association between prealbumin and energy intake was strongest among older or malnourished patients, those suffering from increased inflammation and those with high disease severity. Finally, prealbumin changes were associated with a positive mean nitrogen balance at day 7 only in patients with SOFA <4 (p = 0.047).
CONCLUSION
Prealbumin measured at ICU admission and its change during the first-week serve as an accurate predictor of ICU mortality. Prealbumin dynamic assessment may be a reliable tool to estimate the effectiveness of nutrition support in the ICU, especially among high-risk patients.
Topics: Humans; Critical Illness; Prealbumin; Male; Female; Middle Aged; Nutritional Support; Aged; Intensive Care Units; Biomarkers; Hospital Mortality; Nutritional Status; Prospective Studies; Nutrition Assessment
PubMed: 38677045
DOI: 10.1016/j.clnu.2024.04.015 -
Kidney International Jul 2002Although not widely appreciated, the reported concentration of serum prealbumin, like that of serum cholesterol, tends to be higher in patients on peritoneal dialysis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although not widely appreciated, the reported concentration of serum prealbumin, like that of serum cholesterol, tends to be higher in patients on peritoneal dialysis (PD) than on hemodialysis (HD), despite the substantial loss of protein during PD.
METHODS
The mean difference in serum prealbumin was quantified by meta-analysis of the mean differences found in six cohorts with both PD and HD patients (set 1; N = 639) using a fixed-effects model, and meta-analysis of the mean prealbumin values reported in 23 cohorts of unselected dialysis patients on a single modality (set 2; 9 PD cohorts, 14 HD cohorts; N = 12,256) using a mixed model. For comparison, the mean difference in serum albumin concentration between PD and HD also was estimated in sets 1 and 2 using the same methods.
RESULTS
In set 1, the mean prealbumin difference (PD-HD) in the individual cohorts ranged from 3.6 to 14.7 mg/dL (P < 0.05 in five cohorts), and the weighted mean difference was 5.4 mg/dL (95% CI, 3.8 to 7.0 mg/dL). In set 2, weighted mean prealbumin was 8.1 mg/dL (95% CI, 5.2 to 10.9 mg/dL) higher in PD than in HD in the entire data set, and 6.9 mg/dL (95% CI, 5.2 to 8.6 mg/dL) higher in a sensitivity analysis that excluded two outlying HD studies. By contrast, weighted mean serum albumin concentration was significantly lower in PD than in HD in both sets 1 and 2; the mean difference was 0.25 g/dL (95% CI, 0.14 to 0.36 g/dL) in set 1 and 0.28 g/dL (95% CI, 0.14 to 0.42 g/dL) in set 2.
CONCLUSIONS
Serum prealbumin level is approximately 6 mg/dL higher in PD than HD, perhaps due to the stimulation of hepatic synthesis by PD albumin loss, while serum albumin is approximately 0.3 g/dL lower in PD. Different reference ranges and clinical targets (such as, K/DOQI guidelines) are needed for PD and for HD.
Topics: Humans; Peritoneal Dialysis; Prealbumin; Renal Dialysis; Serum Albumin
PubMed: 12081589
DOI: 10.1046/j.1523-1755.2002.00415.x -
Nature Communications Jun 2023Transmission and secretion of signals via the choroid plexus (ChP) brain barrier can modulate brain states via regulation of cerebrospinal fluid (CSF) composition. Here,...
Transmission and secretion of signals via the choroid plexus (ChP) brain barrier can modulate brain states via regulation of cerebrospinal fluid (CSF) composition. Here, we developed a platform to analyze diurnal variations in male mouse ChP and CSF. Ribosome profiling of ChP epithelial cells revealed diurnal translatome differences in metabolic machinery, secreted proteins, and barrier components. Using ChP and CSF metabolomics and blood-CSF barrier analyses, we observed diurnal changes in metabolites and cellular junctions. We then focused on transthyretin (TTR), a diurnally regulated thyroid hormone chaperone secreted by the ChP. Diurnal variation in ChP TTR depended on Bmal1 clock gene expression. We achieved real-time tracking of CSF-TTR in awake Ttr mice via multi-day intracerebroventricular fiber photometry. Diurnal changes in ChP and CSF TTR levels correlated with CSF thyroid hormone levels. These datasets highlight an integrated platform for investigating diurnal control of brain states by the ChP and CSF.
Topics: Mice; Male; Animals; Choroid Plexus; Blood-Brain Barrier; Brain; Thyroid Hormones; Prealbumin; Biological Transport
PubMed: 37349305
DOI: 10.1038/s41467-023-39326-3 -
Current Opinion in Neurology Oct 2012As amyloid neuropathies have benefited from recent major progress, this review is timely and relevant. (Review)
Review
PURPOSE OF REVIEW
As amyloid neuropathies have benefited from recent major progress, this review is timely and relevant.
RECENT FINDINGS
The main recent articles on amyloid neuropathy cover its description, methods for diagnosis and therapies. Varied clinical presentations are described in transthyretin (TTR)-familial amyloidosis with polyneuropathy (FAP) and light chain amyloid neuropathy. Mass spectrometry is able to identify the biochemical nature of amyloidogenic protein in nerve biopsy and skin biopsy samples for diagnosis of small fiber polyneuropathy. Both nerve biopsy and TTR gene sequencing are important to identify sporadic cases of amyloid neuropathy. Nerve biopsy is useful in demonstrating the amyloid origin of neuropathies developing after domino liver transplant recipients. Liver transplantation improves long-term survival in Met30 TTR-FAP. Factors recognized as leading to cardiomyopathy progression or heart involvement after liver transplantation are late disease onset and fibril composition. Combined heart and liver transplantation is recommended in severe restrictive cardiomyopathy. Antiamyloid drugs are emerging: tafamidis, a TTR stabilizer, showed in a phase III controlled study its ability to slow stage 1 FAP progression. Other strategies are emerging for TTR-FAP (combination doxycycline-tauroursodeoxycholic acid, small interfering RNA, antisense oligonucleotide, monoclonal antibody antiserum amyloid P component). For light chain neuropathy, intensive chemotherapy may be helpful.
SUMMARY
There is better recognition of amyloid neuropathies, and hope for enrolling patients with FAP in future clinical trials testing new antiamyloid drugs.
Topics: Amyloid Neuropathies; Amyloidosis, Familial; Animals; Endemic Diseases; Humans; Liver Transplantation; Prealbumin
PubMed: 22941262
DOI: 10.1097/WCO.0b013e328357bdf6