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Almroth, Gabriel
Publications (10 of 28) Show all publications
Almroth, G., Lönn, J., Uhlin, F., Brudin, L., Andersson, B. A. & Hahn-Zoric, M. (2016). Sclerostin, TNF-alpha and Interleukin-18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients. Scandinavian Journal of Immunology, 83(1), 58-63
Open this publication in new window or tab >>Sclerostin, TNF-alpha and Interleukin-18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients
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2016 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 83, no 1, p. 58-63Article in journal (Refereed) Published
Abstract [en]

Patients with chronic renal failure are known to have renal osteodystrophy (bone disease) and increased calcification of vessels. A new marker of bone disease, sclerostin, the two pro-inflammatory cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin-18 (IL-18), and the fibroblast growth factor-23 (FGF-23) receptor-associated marker Klotho were tested in 84 haemodialysis (HD) patients and in healthy controls. The patients had significantly higher levels of the three former markers than of the controls while Klotho was significantly higher in the controls. Low level, but significant, correlations were observed in the patient group when the levels of these four markers were compared to each other and to those of 5 cytokines and growth factors tested earlier; high-sensitive CRP (hsCRP), interleukin-6 (IL-6), hepatocyte growth factor (HGF), fibroblast growth factor-23 (FGF-23) and soluble urokinase plasminogen activator (suPAR). Ln sclerostin correlated positively to Ln hsTNF-alpha, Ln HGF and Ln suPAR. Ln hsTNF-alpha correlated positively to Ln sclerostin, Ln hsCRP, Ln IL-6, Ln FGF-23, Ln suPAR and Ln IL-18. Ln IL-18 correlated positively to Ln suPAR and Ln TNF-alpha. Ln Klotho correlated negatively to Ln hsCRP but did not correlate to Ln FGF-23. The markers studied here may be involved in the calcification of vessels seen in HD patients due to a combination of inflammation and bone disease. The mechanisms are still not fully known but may be of importance for future therapeutic possibilities in this group of patients.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:liu:diva-124013 (URN)10.1111/sji.12392 (DOI)000366927600009 ()26448366 (PubMedID)
Note

Funding agencies: County Council of ostergotland; Research Council of South Eastern Sweden (FORSS)

Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2017-04-24
Abednazari, H., Brudin, L., Almroth, G., Nilsson, I. & Nayeri, F. (2014). Hepatocyte growth factor is a reliable marker for efficient anti-bacterial therapy within the first day of treatment. Advances in Bioscience and Biotechnology, 5(10), 823-830
Open this publication in new window or tab >>Hepatocyte growth factor is a reliable marker for efficient anti-bacterial therapy within the first day of treatment
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2014 (English)In: Advances in Bioscience and Biotechnology, ISSN 2156-8456, E-ISSN 2156-8502, Vol. 5, no 10, p. 823-830Article in journal (Refereed) Published
Abstract [en]

Rapid diagnosis and choice of appropriate antibiotic treatment might be life-saving in serious infectious diseases. Still the available markers that can evaluate and monitor the diagnosis and treatment are few. Hepatocyte growth factor (HGF) has been studied as a potent regenerative factor produced and released during injuries such as infectious diseases. Monitoring of HGF levels might predict therapy results better than C-reactive protein (CRP) within the first day of treatment in pneumonia. For further investigation of previous observations we aimed to study HGF as a first-day marker in over-representing infectious diseases in comparison to procalcitonin (PCT), CRP and body temperature. Fifty-one patients with community acquired infectious diseases were included consequently at admittance and the serum samples were collected before and within 18 - 24 hours of treatment. HGF levels decreased significantly in case of efficient antibiotic therapy and HGF was shown to be better than PCT, CRP and body temperature to evaluate treatment. In patients with pneumonia, monitoring of HGF was most reasonable. HGF might be used as a therapeutic marker within the first day of empiric antibiotic treatment during infection.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2014
Keywords
Hepatocyte Growth Factor, C-Reactive Protein, Procalcitonin, Temperature, Antibacterial Therapy
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-110998 (URN)10.4236/abb.2014.510096 (DOI)
Available from: 2014-10-02 Created: 2014-10-02 Last updated: 2017-12-05Bibliographically approved
Hadimeri, H., Frisenette-Fich, C., Deurell, S.-I., Svensson, L., Carlsson-Bjering, L., Fernström, A., . . . Stegmayr, B. (2013). A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure. Renal failure, 35(6), 845-854
Open this publication in new window or tab >>A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure
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2013 (English)In: Renal failure, ISSN 0886-022X, E-ISSN 1525-6049, Vol. 35, no 6, p. 845-854Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The primary aim of this study was to assess whether a fixed protocol, using a specially trained team, for intermediate follow-up to fulfillment of guideline targets is non-inferior to conventional follow-up in the care of uraemic patients. A secondary aim was to investigate possible impact on patient outcome.

METHODS:

The cohort comprised 424 patients from seven centers. Inclusion criteria were either serum creatinine exceeding 200 µmol/l or calculated clearance below 30 ml/min, representing CKD 4 or 5a. Six centers followed a standardized protocol (group 1). One center provided controls (group 2). The study design was prospective and interventional. The variables measured were blood hemoglobin, bicarbonate, calcium, phosphate, intact parathyroid hormone, albumin, renal function variables, blood pressure and RAAS blockade. The number of patients achieving the set goals was analyzed as a time trend to determine if the intervention resulted in an improvement.

RESULTS:

At baseline, group 1 had significantly lower GFR and higher serum creatinine, calcium, phosphate, calcium × phosphate product and bicarbonate, lower mean arterial pressure (MAP), systolic blood pressures and less use of RAAS. During the intervention, group 1 improved in the direction of guidelines for blood hemoglobin, albumin, bicarbonate and MAP. Outcome of secondary endpoints gave a risk of death of 30% in both groups, while the risk of renal replacement therapy was higher in group 1.

CONCLUSIONS:

However, the time to renal replacement therapy was significantly shorter in the intervention group, indicating that other variables than guideline achievements are important for the patient.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
Guideline targets; risk factors; progression; protocol; renal replacement therapy; survival; uraemia
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96501 (URN)10.3109/0886022X.2013.794661 (DOI)000320197800011 ()23713629 (PubMedID)
Available from: 2013-08-23 Created: 2013-08-20 Last updated: 2017-12-06Bibliographically approved
Almroth, G., Lonn, J., Uhlin, F., Nayeri, F., Brudin, L., Andersson, B. & Hahn-Zoric, M. (2013). Fibroblast Growth Factor 23, Hepatocyte Growth Factor, Interleukin-6, High-Sensitivity C-Reactive Protein and Soluble Urokinase Plasminogen Activator Receptor. Inflammation Markers in Chronic Haemodialysis Patients?. Scandinavian Journal of Immunology, 78(3), 285-290
Open this publication in new window or tab >>Fibroblast Growth Factor 23, Hepatocyte Growth Factor, Interleukin-6, High-Sensitivity C-Reactive Protein and Soluble Urokinase Plasminogen Activator Receptor. Inflammation Markers in Chronic Haemodialysis Patients?
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2013 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 78, no 3, p. 285-290Article in journal (Refereed) Published
Abstract [en]

Sera from 84 haemodialysis (HD) patients and 68 healthy blood donors were analysed with commercially available ELISA techniques for fibroblast growth factor 23 (FGF-23), hepatocyte growth factor (HGF), interleukin-6 (Il-6), high-sensitivity C-reactive protein (hs-CRP) and soluble urokinase plasminogen activator receptor (suPAR), to find a possible correlation of FGF-23 and HGF with the earlier recognized inflammatory markers Il-6 and hs-CRP or suPAR. All patients studied had significantly elevated levels of FGF-23, HGF, hs-CRP and suPAR as compared to the controls. Il-6 and hs-CRP correlated for patients (R=0.6) as well as for patients and controls altogether. Ln (natural logarithm) of HGF correlated weakly with Ln Il-6 and Ln CRP (R 0.28-0.37). Ln FGF-23 correlated only with Ln HGF (r=-0.25) in controls. Ln HGF correlated with ln suPAR (r=0.6) in both patients and controls. Although elevated as compared to controls, we found no correlation of FGF-23 with the recognized inflammatory markers Il-6, hs-CRP, nor HGF or the new marker suPAR in HD patients. Ln HGF correlated with Ln Il-6, Ln CRP and Ln suPAR. Although probably involved in vessel disease, FGF-23 and HGF may play other roles than acting in inflammatory vessel disease in HD patients. Further studies are necessary to evaluate the role of these immunological markers in chronic haemodialysis patients with atherosclerosis.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97434 (URN)10.1111/sji.12082 (DOI)000323377100008 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS)||

Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06
Almroth, G., Lönn, J., Uhlin, F., Nayeri, F., Brudin, L., Andersson, B. & Hahn-Zoric, M. (2013). Tillväxtfaktorer och inflammationsmarkörer vid kronisk njursvikt. In: Njurmedicinskt vårmöte Jönköping 12-14 maj 2013: . Paper presented at Njurmedicinskt vårmöte, Jönköping, 12-14 maj 2013.
Open this publication in new window or tab >>Tillväxtfaktorer och inflammationsmarkörer vid kronisk njursvikt
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2013 (Swedish)In: Njurmedicinskt vårmöte Jönköping 12-14 maj 2013, 2013Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102331 (URN)
Conference
Njurmedicinskt vårmöte, Jönköping, 12-14 maj 2013
Available from: 2013-12-05 Created: 2013-12-05 Last updated: 2014-01-15
Lönn, J., Almroth, G., Brudin, L. & Nayeri, F. (2012). An antithrombin III product containing biologically active hepatocyte growth factor may be beneficial in depp ulcer infections. Cytokine, 60(2), 478-486
Open this publication in new window or tab >>An antithrombin III product containing biologically active hepatocyte growth factor may be beneficial in depp ulcer infections
2012 (English)In: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 60, no 2, p. 478-486Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Widely studied for the past 20 years, hepatocyte growth factor (HGF) has been identified as a regenerative marker and an important factor in the development and healing of injuries. Antithrombin III (AT III) is a protein in the blood stream with anti-thrombotic and anti-inflammatory properties and has been used as an adjuvant treatment along with antibiotics in severe sepsis.

OBJECTIVE:

To study the content and properties of HGF in plasma-derived AT III products, and the regenerative effect in severe deep ulcer infections.

METHODS:

Commercial AT III products were analyzed for the presence and biological activity of HGF. One AT III product containing biologically active HGF was used to treat 18 cases of critical, deep ulcer infections scheduled for major invasive intervention. The patients were followed up for 6-60 months.

RESULTS:

The AT III products contained HGF with different biological activity. No adverse reactions were observed after local administration of AT III during the study or follow-up period. In 16 of 18 cases no surgical intervention was needed within the first 6 month of inclusion.

CONCLUSION:

AT III products containing biologically active HGF may contribute to regeneration and healing in severe deep ulcer infections which do not respond adequately to different combinations of antibiotics alone.

Place, publisher, year, edition, pages
Elsevier, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86279 (URN)10.1016/j.cyto.2012.05.023 (DOI)000310494300024 ()
Available from: 2012-12-12 Created: 2012-12-12 Last updated: 2017-12-07
Lönn, J., Shahzad, F., Uhlin, F., Bengtsson, T., Almroth, G. & Nayeri, F. (2012). High concentration but low biological activity of hepatocyte growth factor in patients with chronic renal failure. Advances in Bioscience and Biotechnology, 3(4), 516-523
Open this publication in new window or tab >>High concentration but low biological activity of hepatocyte growth factor in patients with chronic renal failure
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2012 (English)In: Advances in Bioscience and Biotechnology, ISSN 2156-8456, E-ISSN 2156-8502, Vol. 3, no 4, p. 516-523Article in journal (Refereed) Published
Abstract [en]

Hepatocyte growth factor (HGF) is a renotropic, an- tifibrotic and regenerative factor with cytoprotective effects that is produced by mesenchymal cells and shows high affinity to components of extra cellular matrix, such as heparan sulphate proteoglycan (HS- PG), in healthy. Patients with chronic renal failure (CRF) suffer from a chronic inflammatory disorder. In order to assess the underlying mechanisms for de- velopment of CRF we aimed to assess the amounts and affinity of HGF in this patient group. ELISA, western blot and surface plasmon resonance (SPR) were used to study HGF in blood samples, as well as in isolated neutrophils, in CRF patients compared to healthy controls. Patients with CRF showed higher HGF levels in serum (P < 0.0001), but decreased af- finity to HSPG (P < 0.0001). Addition of protease in-hibitors decreased the difference between patients with CRF compared to healthy individuals. HGF with potent regenerative function during injury lacks af-finity to HSPG in patients with CRF that may depend on production of proteases from activated immune cells. This information might be used to highlight un-derlying mechanisms for chronicity and leading to new strategies for treatment of chronic injuries.

 

 

Place, publisher, year, edition, pages
Scientific Research Publishing, 2012
Keywords
Chronic Renal Failure; Hepatocyte Growth Factor; Biological Activity; Neutrophils
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84491 (URN)10.4236/abb.2012.324068 (DOI)
Available from: 2012-10-10 Created: 2012-10-10 Last updated: 2017-12-07Bibliographically approved
Almroth, G., Ekermo, B., Åkerlind, B., Månsson, A.-S. & Widell, A. (2010). Monitoring hepatitis C infection in a major Swedish nephrology unit and molecular resolution of a new case of nosocomial transmission.. Journal of medical virology, 82(2), 249-256
Open this publication in new window or tab >>Monitoring hepatitis C infection in a major Swedish nephrology unit and molecular resolution of a new case of nosocomial transmission.
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2010 (English)In: Journal of medical virology, ISSN 1096-9071, Vol. 82, no 2, p. 249-256Article in journal (Refereed) Published
Abstract [en]

Hepatitis C virus (HCV) infection is a frequent problem in hemodialysis units. The prevalence and incidence of HCV infection over a decade were studied in a nephrology unit affected by previous nosocomial HCV transmission. The HCV non-structural 5B protein gene was sequenced to achieve phylogenetic analysis of a new (incident) case of infection. Proportions of patients who were and were not infected with HCV remained similar over the period, as did the inflow and outflow of patients infected previously. In 1997, 12/157 (8%) of patients at the unit (treatment: hemodialysis, peritoneal dialysis, and renal transplant recipients) were positive in HCV RNA, whereas in 2007 the overall number was 9/239 (4%). One patient acquired an HCV infection, and the NS5B sequence in that case clustered with genotype 2b sequences found in patients from an earlier outbreak. Comparing the HCV from the incident patient with several stored longitudinal samples and cloned PCR products from the most likely source patient revealed close phylogenetic relationship with an HCV quasispecies member from the possible source. The source patient and the incident newly infected patient were not scheduled on the same dialysis shift, although the records showed that simultaneous treatment occurred on two occasions during the months preceding transmission. In conclusion, over the 10-year period, the proportion of HCV-infected patients at the unit was unchanged. Only one new infection occurred, which originated from a fellow patient's quasispecies. This establishes phylogenetic analysis as a valuable tool for tracing patient sources of HCV transmission.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-53071 (URN)10.1002/jmv.21683 (DOI)20029812 (PubMedID)
Available from: 2010-01-15 Created: 2010-01-15 Last updated: 2011-02-04
Uhlin, F., Nayeri, T., Brudin, L., Nayeri, F. & Almroth, G. (2009). Decreased Biological Activity of Hepatocyte Growth Factor during Chronic Renal Failure. In: J Am Soc Nephrol.
Open this publication in new window or tab >>Decreased Biological Activity of Hepatocyte Growth Factor during Chronic Renal Failure
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2009 (English)In: J Am Soc Nephrol, 2009Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-50520 (URN)
Available from: 2009-10-12 Created: 2009-10-12 Last updated: 2010-01-19
Almroth, G., Berlin, G., Andersson, B. & Hahn-Zoric, M. (2009). Long-term treatment results and the immunoglobulin G subclass distribution patterns of proteinase-3-antineutrophil cytoplasm antibody (ANCA) and myeloperoxidase-ANCA in ANCA-associated vasculitis. Scandinavian Journal of Urology and Nephrology, 43(2), 160-170
Open this publication in new window or tab >>Long-term treatment results and the immunoglobulin G subclass distribution patterns of proteinase-3-antineutrophil cytoplasm antibody (ANCA) and myeloperoxidase-ANCA in ANCA-associated vasculitis
2009 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 43, no 2, p. 160-170Article in journal (Refereed) Published
Abstract [en]

Objective: Small vessel vasculitis associated with antibodies to neutrophil cytoplasm antigens has been denominated antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV).

Material and methods: Ninety-eight patients with various forms of AAV with renal involvement were studied retrospectively with regard to treatment, side-effects and outcome. The immunoglobulin G (IgG) subclass distribution patterns in serum were determined in 51 patients with nephelometry and those of anti-proteinase-3 (PR3) and anti-myeloperoxidase (MPO) in 44 patients by enzyme-linked immunosorbent assay.

Results: Fifty-nine patients with a mean age of 63 years were given treatment with intermittent intravenous regimens of cyclophosphamide and continuous corticosteroids, whereas 39 patients with a mean age of 58 years were given continuous oral treatment. Malignancy, mainly due to skin tumours, was more common in AAV than in the general population. The total IgG subclass distribution pattern was asymmetric. The response to PR3 was of IgG1, IgG3 and IgG4 isotypes, while IgG1 and IgG3 predominated in the response to MPO.

Conclusion: The aberrant IgG subclass distribution pattern detected in the autoantibodies may be of importance in the pathogenesis of AAV.

Keywords
ANCA, associated vasculitis, cyclophosphamide, IgG subclasses, MPO-ANCA, plasmapheresis, PR3-ANCA, pulse treatment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17278 (URN)10.1080/00365590802519354 (DOI)
Available from: 2009-03-16 Created: 2009-03-16 Last updated: 2017-12-13Bibliographically approved
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