Is acquired total protein s deficiency associated with antiphospholipid antibodies in systemic lupus erythematosus?

Hypothesis: protein S [PS] is a vitamin K dependent plasma protein, and it's free from is required for protein C to be functional. Antiphospholipid antibodies [apl] may cause functional PS deficiency by binding free PS. In patients with SLE have increased incidence of apl, which have been associated with thrombotic events

Objective: to determine the level of total protein S and its relation to [apl]

Methodology: 22 SLE patients diagnosed according to ACR revised criteria [Tan et al., 1982] and ten healthy subjects were included in this study. Assays for protein S, IgG, up1 were performed in patients and control groups

Results: the protein S was lower in the patients than the control and the difference was highly significant. There was a highly significant differences between the level of PS in patients with apl+ve compared with apl-ve patients [p<0.01]

Conclusion: this study confirms an association between apl and PS deficiency

Bone resorption markers and bone forming cytokines in thalassemia major patients

Hypothesis: osteoporosis represents an important cause of morbidity in thalassemia major [TM] patients. The cause is multifactorial; including defective vitamin D metabolism and iron intoxication. The pathogenesis is not completely clarified, especially the mechanism by which cytokines affect skeletal bones. Osteoprotegrin/ RANK system has been recently introduced in the pathogenesis of post-menopausal osteoporosis and other bone diseases

Objective: to investigate the relationship between vitamin D, as a bone resorption marker and the new bone cytokine [osteoprotegrin] and their implication on bone mineral density [BMD]

Methodology: twenty-five TM patients and 10 healthy controls were included in the study. They were subjected to full history and clinical examination. Body mass index was assessed. Serum 25 [OH]2 Vitamin D was estimated. Bone resorption markers [Deoxypyridinoline and pyridinoline cross links] were assessed. Osteoprotegrin serum level was measured and BMD was assessed with DEXA

Results: serum 25 [OH]2 Vitamin D was significantly reduced in patients than controls. Bone resorption markers [DpD, pyD] showed a highly statistical significant increase than controls. Also, serum osteoprotegrin was reduced than controls. Moreover, there was a negative correlation between the levels of PyD, DpD and osteoprotegrin. Again, TM patients had lower bone mineral density and Tanner staging than controls

Conclusion: TM osteoporosis is a major problem that is a real challenging issue. Osteoprotegrin/RANK system has got a direct role which needs further investigation