Changes in serum levels of soluble interleukin-2 receptor and fas-ligand expression in relation to disease activity of systemic lupus erythematosus

Serum soluble IL-2 receptors [sIL2R] levels and Fas-ligand [Fas-L] expression on peripheral blood mononuclear cells [PBMC] were determined in patients with Systemic Lupus Erythematosus [SLE] to assess whether there was any relationship between them and disease activity. Enzyme Linked Immunosorbant assay [ELISA] technique was done on serum samples collected from 36 SLE patients and 25 healthy controls for determination of sIL2R level. RT-PCR was done also on PBMC samples collected from the same patients and controls for detection ofFas-L mRNA. We found significant increase of sIL2R in the SLE group [327.6 +/- 73.5 pg/ml] compared to healthy controls [119.7 _ 12.6 pg/ml] [p<0.001]. Levels of sIL2R were found to correlate significantly with clinical manifestation and serological markers of active SLE: fatigue [p<0.05], renal involvement [p<0.01], pulmonary involvement [p<0.05], high levels ofanti-ds DNA antibody [p<0.001] and high C3 level [p<0.0001]. Fas-L mRNA was expressed in PBMC from [88.9%] SLE patients and not detected in healthy controls. Fas-L positive SLE patients correlate significantly with clinical manifestation and serological markers of active SLE: fatigue [p<0.0001], rash [p<0.05], renal affection [p<0.001], high levels ofanti-ds DNA antibody [p<0.0001] and high C3 level [p<0.0001]. Levels ofsIL2R and Fas-L expression correlate significantly with disease activity [p<0.001, 0.001, 0.05, 0.005, respectively]. these findings indicate that sIL2R represent a new early useful serological marker to monitor disease activity in SLE patients. Fas-L expression increased in SLE patients, this increasing was in parallel to disease activity, so it is used as late marker to monitor the severity of the disease

Epstein-Barr virus [EBV] and EBV antibodies in adolescent systemic lupus erythematosus

To assess whether the adolescent systemic lupus erythematosus [SLE] patients had a presumed primary or reactivated EBV antibodies response as evidence of an active EBV infection. The study was conducted on serum samples collected from 35 adolescent SLE patients and 26 apparently healthy controls. EBV serologic response, VGA, IgG and IgM, EBNA antibody and anti-EA were measured with Enzyme Linked Immunosorbent Assay [ELISA]. PCR was done on peripheral blood mononuclear cells [PBMC] and saliva samples from same patients and controls for detection of EBV DNA. In addition, immortalization assay was done on PBMC and saliva samples for detection of active EBV. EBV serologic responses VGA IgM and IgG, EBNA antibody and EA antibody were detected in a high statistically significant level in adolescent SLE patients than healthy controls [p<0.0001, 0.001, 0.005 and 0.0001 respectively]. The incidence of primary EBV infection and reactive EBV infection in adolescent SLE patients studied according to serologic responses were 60% and 40% respectively. EBV serologic responses in healthy controls were in very low detectable level and classified as an EBV past-infection. EBV genomic material was not found in PBMC or saliva of patients or controls. We only detected in a single row active EBV with immortalization assay in PBMC of reactivated one SLE patient. Serologic profiles were more likely a consequence of immune dysregulation secondary to SLE or its therapy rather than rampant infection with EBV

Reduced quadriceps muscle functional performance in knee osteoarthritis

Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis [OA]. The strength of flexor and extensor muscles of the knee joint was assessed with isokinetic dynamometry in patients with tibiofemoral and patellofemoral knee OA. To study the relationship of muscle strength with the severity of tibiofemoral and patellofemoral OA of the knee joint using functional performance isokinetic testing. This was to determine the role of reduced functional performance in quadriceps strength in knee osteoarthritis. The study was performed on 30 patients: [16 females and 14 males]. In the TFOA group the age was 48.8+4.47. In the 30 patients patellofemoral OA group, the age was 30.14+4.68. Isokinetic dynamometry testing of the quadriceps and hamstring muscles. The strength and functional isokinetic performance was found to be decreased in both groups more in TFOA than patellofemoral OA. Reduced functional performance of the lower extremity is an early predictor than radiographic changes of osteoarthritis, mainly osteophytes, in TFOA than in patellofemoral OA patients. This suggests that in chronic knee pain, the functional performance is important for evaluating knee osteoarthritis, perhaps more so than radiography

electromyographic assessment of F-wave in carpal tunnel syndrome: correlation study with MRI carpus and cervical spine

In this study we have analyzed the effect C.T.S. of focal median nerve injury carpal tunnel syndrome [CT] on F wave. We have determined the F wave parameters in C.T.S. patients and evaluate the relationship between F wave and severity of injury of CT and MRI finding of the wrist and cervical spine finding. The study was conducted on all patients[104] referred from out-patients clinic in the same hospital to electrophysiologic examination in Rheumatology, Physical Medicine and Rehabilitation Dep. and Radiology department, Al Hussein University Hospital as clinical assessed as a carpal tunnel syndrome, Standard electro diagnostic study was made on all of them bilaterally. MRI of carpal tunnel and cervical spine done for selected patients with C.T. S. According to F wave parameters, patients were divided into three groups, absent F-wave, abnormally prolonged F-wave and normal F-wave. According to electrophysiological testing results, the patients were grouped into mild, moderate or severe C.T.S. Absent F wave was presented in 8 hands [7.7%], prolonged latency in 9 hands [8.6%] and normal F wave in 87 of 104 hands [83.7%]. the mean F wave latency were statistically different between the C.T.S. patients and the normal values [CI 95%, p<0.0001]. Also, the entire F wave latencies were significantly prolonged in the severely injured group [p=0.0001]. F wave determination could show injury to proximal and also severe injury to distal parts of median nerve and especially axonal injury. According to abnormalities of this test the surgical release of nerve for prevention of irreversible changes must be considered. Results of our study supported the adding of F wave parameters study to standardize electrophysiological evaluation of C.T.S

Evaluation of transcranial doppler in neuro-Behcet's disease patients

To study the value of transcranial Doppler [TCD] in patients with neuro-Behcet's disease [Neuro-BD] and to correlate the findings with the MRI results. This study included 15 patients fulfilling the diagnostic criteria of international study group for Behcet's disease. MRI brain was done and evaluated for the presence of parenchymal lesions. Bilateral transcranial Doppler ultrasound of the middle [MCA], anterior [ACA] and posterior [PCA] cerebral arteries were performed in patient and control groups. TCD parameters were compared between 15 patients and age and sex matched control subjects. We found 12 [80%] patients had single or multiple brain lesions on MRI. Most of these lesions were of high signal intensity on T2-weighted images and located in the brainstem, basal ganglia and deep white matter region. TCD findings were abnormal in 5 [33.3%] patients. Pulsatility and resistivity indices of the MCA were significantly higher in patients than in normal control [p<0.001]. The mean blood flow velocity of the MCA and ACA was marginally reduced in patients with neuro-BD than in healthy controls, but did not reach a statistical significance [p>0.05]. No significant relation was found between abnormal MRI lesions and TCD parameters. Cerebral hemodynamics might be affected in patients with Behcet's disease compared with healthy controls. TCD may be a useful tool in the evaluation of patients with neuro-Behcet's disease