Diagnostic and prognostic value of some biochemical markers in early knee osteoarthritis

Osteoarthritis [OA]; the most common joint disease, is not only characterized by cartilage destruction; but also by alteration of bone and synovial tissue metabolism, though their relative importance in the initiation and progression of OA is still debated. To identify patients with a high risk for destructive OA, more sensitive techniques than plain X-rays are needed. To study the diagnostic and prognostic value of some biochemical markers serum hyaluronic acid [HA] and serum cartilage oligomeric matrix protein [COMP], high sensitive C-reactive protein [hs-CRP] in the included patients had early OA knees and their relation to disease progression. Sixty patients had early knee OA and 20 control subjects were included. WOMAC index, laboratory investigations [COMP, HA, hs-CRP] and radiological evaluation [Kellgren and Lawrence grading scale and Thomas compartmental score] were performed for each patient at baseline and after one year. HA was significantly higher in patients than controls [p > 0.001] with the highest specificity and positive predictive value. It was significantly correlated with COMP at baseline and after one year [p = 0.01]. The levels of HA at baseline correlated with its levels after one year [p > 0.001]. It also correlated with K-L grading score [p = 0.02]. COMP was significantly higher in patients than controls [p > 0.001]. It was significantly correlated with Thomas score after one year [p = 0.007]. Baseline levels of COMP correlated significantly with its levels after one year [p = 0.005]. The differences of the serum levels of hs-CRP at the baseline evaluation and after one year between patients and controls were not statistically significant [p = 0.4, 0.5, respectively]. The measurements of HA and COMP may be of diagnostic and prognostic value in differentiating patients with early joint destruction and in determining disease progression. A single biochemical marker has definitive diagnostic value and the combination with other biochemical markers as well as with clinical and radiographic data would most likely help to improve the clinical assessment of patients. Serum hs-CRP is not a good predictor of individual patient progression and has a poor sensitivity and specificity

Serum and urinary interleukin-6 and serum interleukin-1 receptor antagonist in renal involvement in systemic lupus erythematosus

This study included 45 systemic lupus erythematosus [SLE] patients and 15 age and sex matched controls. All patients [3 males and 42 females] met the revised ACR criteria for the diagnosis of SLE, their ages ranged from 11-50 years. Each patient was subjected to complete history, clinical examination and laboratory investigations including complete blood count, complete urine analysis, 24 hours total urinary protein excretion, erythrocyte sedimentation rate [ESR], Coombs test, blood urea, creatinine clearance, anti-nuclear antibodies [ANA], anti- dsDNA IgG antibodies, C-reactive protein [CRP], serum and urinary interleukin-6 [sIL-6 and uIL-6], serum interleukin-1 receptor antagonist [sIL-1 ra], complement [C3 and C4] and renal biopsy. SLE disease activity was measured by systemic lupus activity measure [SLAM]. SLE patients were classified into two groups [renal and non- renal group]; in addition, the renal group was subdivided into two subgroups [active lupus nephritis [ALN] and inactive lupus nephritis [EN]]. The study concluded that urinary IL-6 may reveal the pathological changes more sensitively. Adding the measurement of uIL-6 level to the conventional prognostic indices of lupus nephritis may improve the ability to accurately predict the outcome in patients with lupus nephritis. Low serum concentration of IL-1 ra, low serum level of both CRP and circulating C3 in renal group appear to be markers of kidney involvement