Tumor necrosis factor-alpha and tumor necrosis factor receptor-1 in postmenopausal osteoporosis: relation to serum estradiol

To measure serum levels of TNF-alpha and TNFR-1 in women with postmenopausal osteoporosis and correlate them with serum level of estradiol. This study was conducted on 26 postmenopausal females. They were divided according to their BMD into two groups. Group [I] consisted of 16 patients with osteoporosis [T score < -2.5] and group [II] consisted of 10 patients with osteopenia [T score -1 to -2.5]. Ten healthy postmenopausal women with normal range of BMD [T score >-1] served as control group. The serum levels of TNF-alpha TNFR-1 were measured with ELISA and serum estradiol was determined with electrochemiluminescence immunoassay [ECLIA]. Bone mineral density was measured with dual-energy x-ray absorptiometry. Serum estradiol level was significantly lower in both osteoporotic [7.88 +/- 3.14pg/ml] and osteopenic patients [8.54 +/- 3.99 pg/ml] as compared to controls [13.62 +/- 4.57 pg/ml]. Serum level of TNF-alpha and TNFR-1 were insignificantly highest among osteoporotic patients as compared to osteopenic patients and controls. There was no significant correlation between estradiol and TNF-alpha or TNFR-1 [r=0.12, p>0.05 and r=0.07, p>0.05] respectively. A significant negative correlation was found between femoral BMD of patients and serum TNF-alpha [r=-0.43, p<0.05] and TNFR-1 [r=-0.47, p<0.05]. TNF-alpha also showed significant positive correlation with weight [r= 0.41, p<0.05] as well as the BMI [r=0.44, p<0.05]. TNF-alpha has a role in the pathogenesis of postmenopausal osteoporosis, which seems to be independent of estradiol and may thus be a novel target for therapy in resistant cases of postmenopausal osteoporosis

OX40/OX4OL in systemic lupus erythematosus: association with disease activity and lupus nephritis

To evaluate the role of OX40/OX40L as markers of disease activity and nephritis in SLE patients. The study included forty SLE patients [38 females and 2 males]. They underwent full history taking, clinical examination, and routine laboratory investigations. Their disease activity was assessed according to the SLEDAI. Twenty age and sex matched subjects were included as controls. Patients were divided into two groups; first group included 20 patients with biopsy proven lupus nephritis [LN] and the second group included 20 patients without evidence of renal involvement. We assessed the percentage of OX40+CD4+lyrnphocytes by flowcytometry and serum soluble OX40L by ELISA in patients and controls. The percentage of OX40+CD4+ lymphocytes in SLE patients was significantly higher than controls. There was a highly significant increase in the percentage of OX40+CD4+lymphocytes among the patients with nephritis as compared to the patients without nephritis. It correlated significantly with s.creatinine and SLEDAI. Soluble serum OX40L was significantly higher in SLE patients as compared to controls and the level in patients with LN was statistically higher when compared to patients without LN. It showed positive significant correlation with s.creatinine but did not correlate with the SLEDAI. Our results suggest that the interaction between OX40 and its ligand play an important role in the pathogenesis of SLE. The expression of OX40 on CD4+T cells and the level of OX40L may act as markers of LN. Furthermore, measurements of the percentage OX40+CD4+T cells may serve as an indicator of disease activity in SLE patients