Role of anti-endothelial cell antibodies and plasma markers of endothelial cell function in the pathogenesis of systemic lupus erythematosus

Objective: to measure the level of anti-endothelial cell antibodies [AECA] and plasma markers of endothelial cell function and determine their role in the pathogenesis of systemic lupus erythematosus [SLE] and its relationship to disease severitv

Methodology: this study was carried out on 32 patients suffering from SLE and 26 healthy control populations. We measured the anti-endothelial cell antibodies [AECA] by human umbilical vein endothelial cell binding and endothelial markers [van Willebrand factor, soluble thrombomodulin and soluble Eselectin] by ELISA. The antinuclear antibodies including anticardiolipin antibodies were also measured. The disease activity was assessed by SLE Disease Activity Index [SLEDAI] and Systemic Lupus International Collaborating Clinics/American College of Rheumatology [SLICC/ACR]

Results: we found that the level of IgG AECA and the level of van Willebrand factor in patients with SLE were higher than these levels in healthy controls [p=0.001 and p=0.007 for IgG AECA and van Willebrand factor respectively] . Also the positive correlation was only found between IgG AECA and SLEDAI [r = 0.393 and p=0.021]

Conclusion: IgG AECA seem to be related to disease activity in SLE and may play a role in the pathogenicity of SLE, but the plasma markers of endothelial cell function may simply be related to excess inflammation

Measurement of vascular endothelial growth factor in systemic sclerosis

Objective: To determine the serum level of vascular endothelial growth factor [VEGF] and to investigate its relationship to clinical manifestations in patients with systemic sclerosis [SSc]

Methods: serum level of vascular endothelial growth factor [VEGF] in SSc patients and healthy controls were determined by ELISA, the other body organs involvement were assessed clinically and the vascular changes were recognized by using nailfold capillaroscope

Results: The serum levels of VEGF in 26 patients with systemic sclerosis [SSC] were significantly higher than in 20 healthy controls [432 +/- 356 vs. 91 +/- 64 pg/ml; p<0.001]. Patients with diffuse cutaneous SSc [n=17] had higher levels of serum VEGF than those with limited cutaneous SSC [n=9] [426 +/- 348 vs. 135 +/- 127 pg/ml; p<0.001]. Serum VEGF levels correlated with the extend of skin sclerosis determined. by modified Rodnan skin score [r=0. 656, p<0.001] and with serum TGF-B levels [r=0.530, p<0.001]. While serum VEGF levels were inversely correlated with the capillary density of nailfold [r=0.649, p<0.001]. However, no significant differences were found in the serum levels of VEGF between patients with systemic organ involvement and those without organ involvement

Conclusion: The extend of skin sclerosis in SSC patients may contribute to the elevation of serum VEGF levels and these high levels of VEGF may serve as an indicator of capillary damage

Evaluation of androgen-deficiency role in the pathogenesis of dry eye in women with Sjogren‘S syndrome

Objective: We measure the serum concentration of sex steroid hormones [androgens and testosterone] in women with Sjogren’s Syndrome [SS] to evaluate the androgen deficiency role as a pathognomonic factor of aqueous-deficient and evaporative dry eye . Also, we investigate whether these patients have elevated serum concentration of estrogens

Methodology: Blood was drawn from 31 women with primary and secondary SS and 26 age matched controls and it was analyzed for steroid concentrations by gas and liquid chromatography-mass spectrometry

Results: Our results show that women with SS are androgen deficient .While SS was associated with significant reduction in the serum concentrations of androgen precursors[dehydroepiandrosterone [DHEA] and 5-androstene3,6,17 beta-diol [5-diol]] [p<0. 005], Active androgen [dihydrotestestrone [DHT]] [p<0.05] and conjugated DHT metabolites [androsterone-glucuronide [ADT-G] [p<0.0005] and androstane-3a,17 beta-diol-G[3 alpha-diol-G] [p<0.05]] relative to controls. In contrast, SS was not associated with significant alterations in the serum concentrations of testosterone, androstenedione, estrone or 17Beta-estradiol [p>0.05] relative to control

Conclusion: Our results show that women with SS are associated with low concentrations of serum androgen precursors, androgen [DHT] and conjugated DHT metabolites and this androgen-defficiency play a critical etiologic role in the pathogenesis of aqueous-deficient and evaporative dry eye in Sjogren's Syndrome [SS]