Faculty of Medicine

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    The Presence of Some Humoral Immunologic Indicators and Clinical Manifestations in Cryoglobulin Positive Heroin Addicts without Evidence of Hepatitis Virus Infection
    (2015-05)
    ;
    Andon Chibishev
    ;
    Cvetanka Bozinovska
    ;
    ;
    SUMMARY Introduction Cryoglobulins are single or mixed immunoglobulins that are subject to reversible precipi￾tation at low temperatures. Objective The aims of this paper were: 1. Comparison of cryoglobulin positive (CP), cryoglobulin nega￾tive (CN) heroin addicts and the control group (CG) in terms of serum immunoglobulins IgG, IgA and IgM and complement components C3 and C4; 2. Comparison of CP and CN heroin addicts in terms of rheumatoid factor (RF) and circulating immune complexes (CIC); 3. Assessment of clinical manifestations in CP heroin addicts. Methods This is a comparative study of cases (outpatients) treated at the University Clinic of Toxicology in Skopje over 3.5 years, from January 2009 to June 2012. In this study 140 heroin addicts without HbsAg were examined, seronegative for HCV and HIV infections. They were divided into 2 groups: 70 CP and 70 CN heroin addicts. A previously designed self-administered questionnaire was used as a data source on participants. All heroin addicts underwent the following analyses: urea and creatinine in serum; creati￾nine in urine; proteinuria; 24-hour proteinuria; IgM, IgG, IgA, C3, C4 ; RF; CIC; creatinine clearance; ECG; toxicological analyses for opioids in a urine sample; cryoglobulins. In addition to these 2 groups, IgG, IgA, IgM, C3 and C4 were also examined in 70 healthy subjects (CG). Results The study showed that there was no statistically significant difference between CP, CN heroin ad￾dicts and CG regarding the concentration of IgA, IgG, IgM, C3 and C4, and between CP and CN regarding the concentration of CIC. There was significant difference between CP and CN regarding the concentra￾tion of RF. The following conditions were significantly more frequently manifested in CP than in CN heroin addicts: arthralgia, Raynaud’s phenomenon, respiratory difficulties, neurological disorders, manifested skin changes, hematuria, 24-hour proteinuria levels, and decreased renal clearance. Conclusion There were no differences in concentrations of IgG, IgA, IgM, C3, C4 and CIC, while there was a difference in concentration of RF between CP and CN heroin addicts. Clinical manifestations (arthralgias, Raynaud’s phenomenon, respiratory, neurologic, renal disorders and skin changes) were more common in CP heroin addicts.
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    Influence of Duration of Heroin Dependence on Humoral Immunologic Indicators
    (American Society of Addiction Medicine, 2016-11)
    ;
    Zafirova-ivanovska, Beti
    ;
    Babulovska, Aleksandra
    ;
    Zanina Pereska
    ;
    Irena Jurukov
    Objective: The incidence of autoantibodies may be associated with the duration of drug use. In this study, we assessed the association between the duration of heroin dependence and various humoral immunologic indicators, including IgA, IgG, IgM, complement component 3, complement component 4, rheumatoid factor, anti￾b2-glycoprotein 1 (IgA, IgG, IgM), antinuclear antibody, circulating immune complexes, and cryoglobulins. Methods: A total of 363 patients with heroin dependence were enrolled in this cross-sectional and prospective study over a 3.5- year period. Depending on the duration of heroin use, participants were divided into 3 groups: up to 3 years, 4 to 7 years, and more than 7 years of heroin dependence. All patients were analyzed for the indicators. Results: There was a significant difference between the duration of heroin dependence and increased concentration of IgA (P ¼ 0.0000), IgG (P ¼ 0.0000), IgM (P ¼ 0.0001), complement component 3 (P ¼ 0.042), rheumatoid factor (P ¼ 0.0001), anti-b2-glycoprotein 1 (IgA, P ¼ 0.0098; IgG, P ¼ 0.0000; IgM, P ¼ 0.0000), the presence of antinuclear antibody (P ¼ 0.01) and cryoglobulins (P ¼ 0.0000), and decreased concentration of complement component 4 (P ¼ 0.002). There was no significant difference in circulating immune complex concentration (P ¼ 0.097). Conclusions: A longer duration of heroin dependence was associ￾ated with increased concentrations of IgA, IgG, IgM, complement component 3, rheumatoid factor, anti-b2-glycoprotein 1 (IgA, IgG, IgM), presence of antinuclear antibodies and cryoglobulins, and decreased concentrations of complement component 4, but there was no influence on circulating immune complex values