ABSTRACT
The relationship between serum prolactin level and disease activity state and the effect of conventional immunosuppressive medications is still unclear with contradictory results. To study the correlation of prolactin levels with SLE disease activity at the beginning of the study and after 9 months of conventional treatment, this may clear the role of prolactin in the pathogenesis of SLE. Forty five active SLE patients were enrolled in this study, all were females and they were fulfilling the ACR criteria for SLE classification. Patients under medical treatment with drugs that may affect prolactin level as [bromocriptine, chlroquine, cimetidine, metoclopramide ..etc] were excluded. No patient known to have either heart failure, liver failure or kidney failure was allowed in this study. The patient was divided into 2 groups: Group I: Twenty three patients with minor organ affection [cutaneous and joint affection], Group II: Twenty two patients with major organ affection [glomerulonephritis], Group III: Thirty control apparently healthy persons. Serum prolactin was determined with double antibody liquid phase radioimmunoassay at entry and after 9 months of conventional treatment and SLE patients serum prolactin levels were correlated with SLE disease activity index score [SLEDAI]. Our results showed that 31 patients had mild hyperprolactinemia [68.8%], 13 patients in group I and 18 patients at group II. Comparing the serum prolactin levels between SLE patients in both groups I and group II versus control showed a significant increase. After treatment of SLE patients for 9 months, the serum prolactin level showed a significant decrease from a mean [25.6 +/- 5.2 ng/ml] at the beginning to a mean [14.9 +/- 10.2 ng/ml] [p<0.001]. Comparison of SLEDAI scores at the beginning of the study and after 9 months of treatment showed a significant decrease from a mean [15.9 +/- 4.8 ng/ml] to [2.3 +/- 1.7 ng/ml] p<0.001. There was a significant correlation between serum prolactin levels and SLEDAI score at beginning [r = 0.4785], p = 0.0006 and after treatment r = 0.8975, p< 0.001. There is a significant correlation between SLE disease activity and serum prolactin which could be decreased equally by the conventional immunosuppressive treatment. This support that there is a role of prolactin in the pathogenesis of SLE
Subject(s)
Humans , Female , Prolactin/blood , Disease Progression , Immunosuppressive Agents , Lupus Nephritis , Treatment OutcomeABSTRACT
There are a group of rheumatoid arthritis [RA] patients for whom traditional markers of outcome are unhelpful. Despite of absence of these markers; still they have progressive damaging arthritis. Expression and activation of matrix metalloproteinases as MMP-3 [stromolysin-1] and MMP-1 [collagenase-1] are increased in RA patients. There are contradictory results of their role as predictors of joint damage. To study the role of MMP-3 and MMP-1 as predictors of joint damage in early RA. Seventy early RA patients of less than 12 months duration fulfilling the ACR criteria for classification of RA were enrolled in this study. They were 65 females and 5 males with mean age [30.5 +/- 3.2] years. Also 30 apparently healthy persons were studied as a control group, 15 males and 15 females with mean age of [33.5 +/- 2.8] years. All patients and control volunteers were tested for MMP-3 and MMP-1 basal serum level, using an Enzyme-Linked Immunosorbent Assay [ELISA]. The subsequent change of Larsen Radiological Score [delta Larsen] and Health Assessment Questionnaire [delta HAQ] were recorded and correlated with MMP-3 and MMP-1 over a 12 months period. The mean basal serum level of MMP-3 and MMP-1 were significantly higher in RA patients than controls [p<0.05]. MMP-3 and MMP-1 serum levels at presentation of RA patients correlated significantly with basal CRP presentation [r = 0.40, r=0.47 and p<0.05], with delta Larsen Score [r = 0.24, r = 0.31 and p<0.05], and with delta HAQ [r = 0.33, r = 0.31 and p<0.05]. The group of patients with normal CRP at presentation [