Possible association of interleukin-1beta [-511C/T] and interleukin-6 [-174G/C] gene polymorphisms with atherosclerosis in end stage renal disease Egyptian patients on maintenance haemodialysis

In end stage renal disease, inflammation is considered a critical regulator of atherosclerotic plaque formation and progression, to which many dialysis and non-dialysis-related factors may contribute. Since circulating inflammatory cytokine levels vary inter-individually, one may speculate that genetic factors, such as polymorphisms in genes encoding them, may be involved in determining the individual inflammatory reaction in response to a given insult. The present work aimed to study interleukin-1B [-511C/T], and interleukin-6 [-174G/C] gene polymorphisms and their possible association with atherosclerosis in Egyptian patients with end stage renal disease on maintenance haemodialysis. The present study was conducted on 100 Egyptian subjects, the control group [n = 30] and the patient group [n = 70] with end stage renal disease on maintenance haemodialysis which were further subdivided into two subgroups with [n = 33] and without atherosclerosis [n = 37] as evidenced by CIMT, ECG ischaemic changes, cerebrovascular insufficiency [CVI], and peripheral vascular insufficiency [PVI]. All studied subjects were subjected to detailed history taking, routine laboratory investigations and molecular studies including detection of IL-1B [-511C/T] and IL-6 [-174G/C] gene polymorphisms using the Polymerase chain reaction/Restriction fragment length polymorphism [PCR/RFLP] technique. The genotype distribution and allele frequency of IL-1B [-511C/T] and IL-6 [-174G/C] showed no statistical significant difference among the studied groups. To conclude the development of atherosclerosis among Egyptian patients on maintenance haemodialysis cannot be attributed to these two gene polymorphisms

Endothelial dysfunction and the risk of atherosclerosis in diabetic patients with microalbuminuria

Endothelial dysfunction is an important pathogenetic factor in both micro- and macrovascular complications of diabetes mellitus [DM]. The significance of microalbuminuria [MAU] and diabetic retinopathy [DR] as early indicators of endothelial dysfunction in the disease remains controversial. We studied 40 patients with type 2 diabetes and microalbuminuria and 20 age and sex matched control subjects. They were subjected to detailed clinical examination, fundus examination and laboratory investigations including measurement of fasting blood glucose, serum lipid profile, blood urea, serum creatinine, plasma endothelin-l [ET-1] and 24 hours urinary albumin excretion [UAE], besides ultrasonographic assessment of post- obstructive flow-mediated endothelium- dependent increase in brachial artery diameter and blood flow and measurement of carotid artery intima- media thickness [IMT]. Features suggestive of endothelial dysfunction [DR, increased ET-1 and impaired vascular reactivity] were prevalent in the diabetic patients. They had, as well, a statistically significant increase in carotid IMT compared to controls [P = 0.000]. Endothelium- dependent dilatation [EDD] of the brachial artery showed statistically significant negative correlations with urinary albumin excretion [UAE] rate, plasma ET-1 and carotid IMT. We conclude that endothelial dysfunction is common in diabetic patients with MAU. ET-1 is a sensitive marker of endothelial activation/dysfunction but it is affected by many variables. Ultrasonographic studies of superficial arteries, if properly performed, can help in delineating both early functional and pathological alterations of atherosclerosis