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Genetic variability of drug metabolizing enzymes
Slanař, Ondřej ; Perlík, František (advisor) ; Průša, Richard (referee) ; Lukáš, Milan (referee)
Drug metabolism is one of the key processes allowing to eliminate the administered dose. High interindividual variability of the activity of drug metabolizing enzymes is caused by many genetic and epigenetic factors. This variation can result in substantial differences in clinical response to the drug, ranging from failure of the therapy to appearance of toxic side effects or frequent onset of drug-drug interactions. The aim of the thesis was to evaluate the influence of genetically determined variability in drug metabolizing enzymes activity on the drug pharmacokinetics, pharmacodynemics and to asses whether either phenotyping or genotyping can be effectively applied under the naturalistic conditions of routine clinical practice, for e.g. as a prediction tool during to asses individual risk of development and progress of a disease or to forecast the drug response. The thesis mainly summarizes previously published articles on the topic. We have studied genetically determined variability of tramadol pharmacokinetics as well as drug-induced miosis in healthy volunteers with known CYP2D6 status. The lowest blood concentrations of principal active metabolite O-demethyltramadol accompanied by the highest levels of the parent compound at all sampling intervals up to 12 hours post-dose were found in the...
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Examining the significance of peptides regulating the intake of food and the nutritional state of children and adolescents
Bronský, Jiří ; Průša, Richard (advisor) ; Pelouch, Václav (referee) ; Hyánek, Josef (referee)
Introduction: Regulation of food intake and nutritional status is mediated by complex interactions of regulatory peptides of the central nervous system, gastrointestinal tract and adipose tissue. These systems are connected by feedback loops which inform the centre about amount of ingested food and energy reserves in the organism. Dysfunction of any of these regulatory areas may lead to changes in nutritional status of the organism. Methods: We used radioimmunoassay to measure plasma levels of orexin A, total ghrelin and serum levels of leptin and enzyme immunoassay to measure serum levels of adiponectin in healthy subjects and in children with obesity, anorexia nervosa, Crohn's disease and celiac disease and we evaluated the influence of nutritional therapy on these levels. Moreover, we evaluated relationship of these regulatory peptides to other biochemical and anthropometrical factors of nutritional status. We also measured plasma levels of total and unreduced amylin by enzyme immunoassay with immunofluorescence detection in adult patients with osteoporosis, type II diabetes mellitus and in the control group. Results: During reduction of body weight in obese children and adolescents, there were statistically significant changes of plasma orexin A levels and total ghrelin levels, but we haven't seen any...
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Oxidative stress, microinflammation and cardiovascular risk in patients with chronic kidney disease
Hodková, Magdalena ; Kalousová, Marta (advisor) ; Průša, Richard (referee) ; Racek, Jaroslav (referee)
Chronic kidney disease (CKD) patients are at a significantly higher risk of atherosclerotic complications when compared to the general population. Oxidative stress and the related chronic microinflammation are possible causes of this increased cardiovascular risk, which is most pronounced in patients undergoing chronic haemodialysis (HD) treatment. Oxidative stress in HD patients can be further increased by routine pharmacological interventions (especially by intravenous - i.v. iron preparations administration). The aim of the thesis was to investigate neutrophil respiratory burst and some molecules related to oxidative stress and chronic inflammation - pregnancy-associated plasma protein-A (PAPPA), advanced oxidation protein products (AOPP), C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1) and E-selectin during HD session and to find out whether they can be pharmacologically affected by i.v. ferric sodium-gluconate and oral vitamin E administration. We focused on studying PAPP-A in chronic renal disease (CKD) patients, patients treated with continuous ambulatory peritoneal dialysis (CAPD) and chronic HD patients. We have observed that HD patients' neutrophils are primed to generate greater quantities of superoxide than those of healthy controls. This production decreases during HD and...
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Laboratory diagnostics of micrometastases in breast cancer patients
Mikulová, Veronika ; Zima, Tomáš (advisor) ; Svoboda, Marek (referee) ; Průša, Richard (referee)
Introduction: The presence of circulating tumor cells (CTC) in the peripheral blood has been associated with worse prognosis and early relapse in breast cancer patients. CTC determination in the peripheral blood has been considered as a liquid biopsy. The aim of this project was to analyze the presence of CTC followed by their molecular characterization with the potential use not only as a new biomarker for real-time monitoring of therapy efficacy but also as a suitable tool for patient's stratification and individualization of treatment for breast cancer. Methods: A total of 54 patients with diagnosed early breast cancer were enrolled into a prospective study. Ten millilitres of peripheral blood were sequentially collected to test for the presence and characterization of CTC during the follow-up of patients. CTC isolation and detection was performed by AdnaTest BreastCancer™ (AdnaGen AG, Germany), which is based on the detection of EpCAM, HER2 and MUC1 specific transcripts in enriched CTC- lysates. cDNA from isolated CTC has been further used for newly optimized qPCR assays for breast tumor and therapy resistance associated genes: TOP1, TOP2A, CSTD, ST6GAL, KRT19 and reference gene actin. qPCR results have been analyzed by Genex software (MultiD Analysis). Results: 195 blood samples have been...
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