Vascular endothelial growth factor: does it play a pathogenic role in systemic sclerosis?

To evaluate the level of the vascular endothelial growth factor [VEGF] in the sera of systemic sclerosis [SSc] patients and its possible correlation with the clinical findings for a better understanding of the pathogenesis of the disease. Thirty-two SSc patients, 20 with diffuse SSc [dSSc] and 12 with limited SSc [lSSc] as well as 11 apparently healthy controls participated in this study. Clinical evaluation was done for all of them. Skin involvement was assessed using the modified Rodnan Skin Score and nailfold capillaroscopy [NFC] and pulmonary function tests including forced vital capacity% [FVC%] and forced expiratory volume% in the first second [FEV[1]%] were done for all participants. Their sera were collected and some laboratory investigations were carried out. Additionally, serum VEGF level was measured using enzyme-linked immunosorbent assay [ELISA]. Serum VEGF level was significantly higher in both SSc and dSSc patients than the controls [p< 0.01 and p < 0.001, respectively]. Also, dSSc patients showed a significantly higher serum VEGF level than lSSc patients [p< 0.001]. No statistically significant difference was found between lSSc and the control group [p> 0.05]. There was a significant lowering of nailfold capillary density in SSc patients as compared to the control group [p < 0.05]. SSc patients with elevated serum VEGF level had pulmonary fibrosis more frequently than those with normal VEGF [p < 0.01]. There was a positive correlation between serum VEGF level and extent of skin sclerosis as determined by modified Rodnan Skin Score [r= 0.55]. However, serum VEGF level correlated negatively with nailfold capillary density, FVC%, and FEV[1]% [r= -0.62, r= -0.63, and r= -0.71, respectively]. The elevated serum VEGF level may contribute to the disease process in SSc patients in particular to the development of skin sclerosis and pulmonary fibrosis. Serum VEGF level may also serve as an indicator of nailfold capillary damage in SSc

Endothelin-1 and ocular involvement in behcet's disease

To detect plasma Endothelin-1 [ET-1] in Behcet's disease [BD] and to assess if ET-1 is associated with ocular BD. 20 BD patients [12 with ocular and 8 without ocular disease] and 10 healthy control subjects were included in the study. The plasma level of Endothelin-1 was measured with Enzyme Immunometric Assay [EIA]. Plasma ET-1 levels were significantly higher in patients with BD than in the control subjects. Among patients with ocular BD, the mean plasma ET-1 levels were significantly increased when compared with non ocular disease and control subjects. Elevated plasma Endothelin-1 may play a role in ocular involvement of BD

Serum homocysteine level and vascular involvement in behcet's disease

To assess whether serum homocysteine level is related to vascular involvement in Behcet's disease. Twenty five patients with Behcet's disease and ten healthy subjects were included in the study. All the participants were subjected to thorough clinical assessment, radiological evaluation and laboratory investigations including serum folate, vitamin B12 and lipid profile. Total serum homocysteine level was determined by fluorescent polarization immunoassay. The patients were classified into two groups with respect to vascular involvement. Serum homocysteine level in BD patients was significantly higher than in the healthy controls [15.6 +/- 4.2 Vs 10.15 +/- 3.3 mmol /L, p <0.001]. Among BD patients with vascular involvement, total homocysteine level was significantly higher than in those without vascular involvement and healthy controls [p <0.05 and < 0.001 respectively]. On the other hand, there was no significant difference between patients without vascular involvement and healthy controls [p > 0.05]. No statistically significant difference was found between the different studied groups as regards serum folate, vitamin B12 and lipid profile [p > 0.05]. In addition, no significant correlation between total homocysteine and the other parameters investigated in BD patients. Hyperhomocysteinaemia may be a risk factor for the development of vascular involvement in Behcet's disease

Possible role of cytokines in fibromyalgia

To evaluate the possible role of cytokines in fibromyalgia [FM]. Levels of interleukin-6 [IL-6], IL-8, and IL-10 were measured with enzyme linked immunosorbent assay techniques in the sera of 20 FM female patients and 10 normal controls. Results were correlated with the clinical manifestations of the disease. A significant [p < 0.05] increase in both IL-6 and IL-8 serum levels were found in FM patients as compared to controls. But there was no significant [p > 0.05] difference between FM patients and controls regarding serum IL-10 levels. In FM patients, the elevated IL-6 serum level showed a significant positive correlation [r = + 0.62] with fatigue severity score; and a significant negative correlation [r = - 0.59] with sleep score. While the elevated IL-8 serum level showed a significant positive correlation with the number of tender points [r= +0.68] and pain score[r= +0.54]. On the other hand, IL-10 showed no significant correlation with any clinical variable. IL-6 and IL-8 may play an important role in FM. IL-6 may be related to fatigue and sleep disturbances. IL-8 may be related to pain intensity and number of tender points in patients. Strategies to decrease the levels of cytokines, may constitute novel hopes for treatment of FM patients

pathophysiology of esophageal affection in rheumatic diseases

This study comprised 42 Egyptian female patients, 15 RA, 15 SLE and 12 SSc patients, compared to 12 healthy subjects matched with age and sex. Esophageal manometry and upper gastrointestinal endoscopic biopsy were performed for all subjects. The results of this study revealed manometric abnormalities in the three diseases. Hypoperistalsis and diminished resting lower esophageal sphincter pressure were evident in RA and SSc patients but more severe in SSc. Hypotonic lower esophageal sphincter was the prominent feature in SLE patients. Retrograde and non-transmitted contractions were detected in a variable percentage in the three diseases. No correlation was found between manometric abnormalities and disease activity, while; there was a significant correlation between these abnormalities and disease severity in SSc patients. Reflux esophagitis was detected in 26.7% of RA and 75% of SSc patients. Histopathological study revealed esophageal mucosal damage due to chronic inflammatory process and vasculitic changes in RA and SSc. The esophagus was histopathologically normal in SLE patients

association between rheumatoid arthritis and hepatitis C virus infection

To study the association between rheumatoid arthritis and HCV infection. The study included 40 RA patients diagnosed according to the ACR criteria [group I]. It also included 20 inflammatory arthritis patients with RF positive but not fulfilling the criteria for diagnosis of RA [group II]. Ten age and sex matched subjects were taken as controls. Anti HCV antibodies were detected in the sera of these patients. 0.5% of the patients of group I had anti HCV antibodies while 20% of patients of group II had anti HCV antibodies. As regards the control group, none was anti HCV antibody positive. There is a strong association between the presence of anti HCV antibodies and rheumatoid factor that is stronger than the association between anti HCV antibodies and rheumatoid arthritis. Patients with anti HCV antibodies may have rheumatoid factor positive in their serum, but the picture may not fulfill the criteria of RA. Thus in any case of inflammatory arthritis, hepatitis C virus must be put in consideration

Ultrasonographic assessment of the quadriceps muscle in elderly women

Anthropometrical and qualitative ultrasonographic assessment of the quadriceps muscle [vastus lateralis] in thirty elderly women was done before and after a physical training program to develop muscle strength for eighteen weeks. Statistical comparison in different assessment parameters showed that there was no statistical significant difference [p > 0.05] in body weight, thigh girth and cross sectional area of the quadriceps before and after the physical training program. But there was a statistical significant difference [p < 0.05] as regards thigh subcutaneous fat and muscle thickness

Insight on the relationship between osteoporosis and osteoarthritis

In this study, we tried to investigate some of the factors that may have a role in the pathogenesis of osteoarthritis OA and osteoporosis OP, such as BMI, levels of estrogen, IGF-1 and bone mass density. We correlated all these parameters to find the relation between those two pathologic conditions. Forty postmenopausal females were studied, 20 with OP and 20 with OA. Our results showed a significant elevation of estrogen and IGF levels and BMD in OA group in relation to OP group. The mean BMI showed a significant increase in OA than OP. This inverse relation could be explained by the difference in growth factors and estrogen that stimulate bone formation. There is an inverse relationship between OA and OP. Thus OA might have a protective or retarding effect on the development of OP and could be a negative risk factor for OP. This could be an important element in determining patients who at risk developing OP and should take preventive therapy for OP at the time of menopause