Linagliptin does not require dose adjustment in diabetes mellitus patients with chronic kidney disease (CKD). But, renal effects of linagliptin are not clear. Our aim was to examine the effect of linagliptin on renal disease progression in only insulin dependent type 2 diabetes mellitus (DM) patients with CKD. Stage 3-4 CKD patients were randomized into 2 groups in this prospective randomized controlled study. In the first group, linagliptin 5mg was added in addition to the background insulin therapy. In the second group, patients continued their insulin therapy. Patients were followed up at 3-month intervals for one year. The study population consisted of 164 patients (90 patients in linagliptin group, 74 patients in other group) with a mean age of 67.5±8.8 years. eGFR significantly increased in linagliptin group (p=0.033), but decreased in other group (p=0.003). No significant change was observed in total insulin dose in linagliptin group (p=0.111), but in other group, total insulin dose significantly increased (p<0.001). Proteinuria levels decreased in both groups, but there was no significant change. In the multiple logistic regression analysis, male gender and proteinuria emerged as variables that showed significant association with increased risk and the use of linagliptin emerged as variable that showed significant association with decreased risk for CKD progression. Linagliptin in DM patients with CKD was able to improve renal progression without significant effect on proteinuria and glucose control. With regard to treating diabetic nephropathy, linagliptin may offer a new therapeutic approach.

Background and Aim: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to dampen this T lymphocyte attack. Our goal was to demostrate the PD-1 and PD-L2 expresion rate of various hematologic malignancies, and to evaluate whether PD-1 and PD-L2 expresion have impact on prognosis. Materials and Methods: For this purpose, pre-treatment bone marrow biopsy specimens of 83 patients [42 multiple myeloma (MM), 21 acute leukemias, and 20 chronic lymphocytic leukemia (CLL)] have been stained with monoclonal antibody immunstains of PD-1 and PD-L2. Results: As a result, the overall expression rate of PD-1 was 26.2%, 4.8%, and 60% in patients with MM, acute leukemias, and CLL, respectively. Whereas, PD-L2 expression rate was 61.9%, 14.3%, and 10% in patients with MM, acute leukemias, and CLL, respectively. Conclusion: Finally, we conclude that the role of PD-1 pathway can be demonstrated by immunohistochemistry (IHC). Since we have evaluated whether there is a correlation between (IHC) results and survival of patients with MM, acute leukemias, and CLL, we couldn’t demonstrate a meaningful evidence that these markers have an impact on prognosis. Key Words: PD-1, PD-L2, multiple myeloma, acute leukemias, chronic lymphocytic leukemia.

Objective: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to dampen T lymphocyte attack. The checkpoint inhibition by tumor cells via the PD-1 pathway suppress the antitumor immune response. The role of PD-1 pathway has been extensively investigated in non-hematologic malignancies, however, the exact role of this pathway is not established in hematologic disorders. So, we aimed to demostrate the PD-1 and PD-L2 expresion rate of various lymphoma subtypes, and to evaluate whether PD-1 and PD-L2 expresion have impact on prognosis. Method: For this purpose, pre-treatment lymph node biopsy specimens of 92 patients [25 Hodgkin lymphoma (HL) and 67 non-Hodgkin lymphoma (NHL)] have been stained with monoclonal antibody immunstains of PD-1 and PD-L2. Results: The overall expression rate of PD-1 was 76% and 82.1% in patients with HL and NHL, respectively. PD-L2 expression rate was weak in both HL and NHL cases. Since we have evaluated whether there is a correlation between immunohistochemistry (IHC) results and survival of patients with HL and NHL, we couldn’t demonstrate a meaningful evidence that these markers have an impact on prognosis. Conclusions: We conclude that the role of PD-1 pathway can be demonstrated by IHC. If IHC markers might be standardized in the future, especially a cutoff that defines a clinically significant positive and predictive value, may help identifying patients more likely to benefit from anti-PD-1 therapies.