Prevalence and impact of chronic hepatitis C virus infection on the clinical manifestations and disease activity among patients suffering from systemic lupus erythematosus

To study the prevalence of anti-HCV antibodies among patients suffering from systemic lupus erythematosus [SLE] as well as to determine the impact of chronic HCV infection on the clinical manifestations and disease activity. Ninety-eight consecutive SLE patients presented to the rheumatology department, Cairo University Hospitals were included in the study. All patients were screened for anti-HCV antibodies using a 3rd generation enzyme-linked immune-sorbent assay [ELISA]. Patients with positive anti-HCV were tested for the presence of HCV-RNA by polymerase chain reaction [PCR]. Patients were classified into two groups; HCV/SLE and non-HCV/SLE according to the presence or absence of anti-HCV antibodies. Twenty/98 patients [20.4%] were positive for HCV antibody. Eight/98 patients [8.2%] had active viremia. SLE patients with positive anti-HCV antibodies tend to be older in age and having a longer SLE duration than non-HCV/SLE Patients. HCV/SLE patients had significantly lower mucocutaneous manifestations [p < 0.05] and higher cardiac manifestations and fundus abnormalities [p < 0.04, p < 0.01 respectively] than non-HCV/SLE patients. There was no statistical difference between the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI] score between both groups. Patients with HCV/SLE were less frequently on oral steroids than patients with non-HCV/SLE HCV antibodies and active HCV viremia were found in 20.4% and 8.2% respectively among SLE patients. SLE with positive anti-HCV antibodies tend to be older in age and having longer SLE disease duration, lower mucocutaneous and higher cardiac manifestations and fundus abnormalities. Concomitant chronic HCV infection has no adverse impact on SLEDAI

Study of CCR5 Gene polymorphism in rheumatoid arthritis

Chemokines are critical for the inflammatory process in autoimmune diseases such as rheumatoid arthritis [RA]. The chemokine receptor-5 [CCR5] mediates chemotaxis by CC chemokines and is expressed by lymphocytes with the phenotype and monocyte/macrophages. A 32bp deletion in the CCR5 [CCR5-delta 32 allele] abolishes receptor expression in homozygotes, while CCR5-delta 32 carriers express less receptor level than wild type homozygotes. This polymorphism is related to resistance to HIV-1 infection and progression to AIDS. It is hypothesized that CCR5-delta 32 allele may modulate the inflammatory response involved in rheumatoid arthritis and therefore may affect disease severity, susceptibility or both. In the present study 70 rheumatoid arthritis patients and 40 healthy individuals were genotyped. The frequency of CCR5-delta 32 allele was significantly higher in healthy individuals compared to rheumatoid arthritis patients [45% Vs 17%] respectively [p.value 0.033]. Homozygous delta 32 mutation was not detected in patients or controls No significant difference was found between CCR5-delta 32 carriers and wild type homozygotes regarding clinical or laboratory findings except for the tender joint count and rheumatoid factor positivity which was higher in wild type homozygotes [p.value 0.046 and 0.007 respectively]. Our data suggest that CCR5-dlta 32 carriers may partially protected against rheumatoid arthritis, and suggest CCR5 receptor as a candidate for targeted therapy in rheumatoid arthritis

Expression of vascular endothelial growth factor and its receptors FLT-1 and KDR in acute leukemia: Clinical relevance and future prospects

Vascular endothelial growth factor [VEGF] and its receptors may play an important role in the pathophysiology of hematopoietic malignancies and the progression of leukemia. The present work aimed to study the expression of VEGF and its receptors namely FLT-1 [VEGFR-1] and KDR/FLK-1 [VEGFR-2] on the transcriptional level in fresh leukemic blast cells isolated from newly diagnosed AML and ALL patients by RT-PCR. The present study demonstrated that acute leukemia whether myeloblastic or lymphoblastic express VEGF and to less extent express its receptors namely FLT-1 and KDR. This may result in the generation of autocrine loop that may support leukemic cell survival and proliferation. On the contrary, to the lack of expression in normal bone marrow samples, VEGF, FLT-1 and KDR were expressed in considerable percentage of the studied AML and ALL patients. There was no significant relationship between the expression of VEGF or its receptors and patients' clinical or laboratory findings. Expression of VEGF and/or KDR receptors was associated with unfavorable treatment outcome and they were associated with risk of treatment failure. This data show that VEGF, FLT-1 and KDR may have clinical relevance and raise the possibility of using angiogenesis inhibitors as a novel therapeutic strategy in acute leukemia. By developing treatment strategies that target both the stromal and tumor compartments, drug resistance may be overcome, and the effect on therapeutic outcome enhanced

Maternal serum thyroid hormones in severe preeclamptic patients

There are controversies about the concentration of thyroid hormones in preeclamptic patients and its clinical significance. To study the thyroid hormones levels in severe preeclamptic This study included 63 pregnant women [31 with severe preeclampsia and 32 healthy normotensive controls]. Patients were stratified according to gestational age. Free T3 [triiodothyronine] free T4 [thyroxin] and TSH [thyroid stimulating hormone] were measured using radioimmunoassay. Mean TSH is significantly increased in preeclamptic patients as compared to control subjects' while FT4, FT3 were comparable in both groups. TSH levels were not correlated to gestational age or severity of preeclampsia. Mean serum TSH levels were significantly increased without concomitant changes in FT4, FT3 in severe preeclampsia compared to normal pregnancy and this hormonal change was not related to gestational age or degree of severity of preeclampsia. The values of those findings are not clear. However, abnormal TSH titer might be associated with a risk for occurrence of preeclampsia, so studying TSH levels in high risk women form early pregnancy might be of value in the prediction of preeclampsia