Soluble adhesive proteins L and E selectin in patients with systemic lupus erythromatosus: value in monitoring disease R mission after corticosteroid therapy

In this study, we aimed to examine circulating adhesive proteins L and E selectin levels in 33 patients with systemic lupus erythematosus SLE and to correlate levels of these proteins to disease activity parameters. L and E selectins were further investigated in a subgroup of patients with SLE who could be followed for 3 months duration and who found to be in disease remission after starting corticosteroid therapy. Results of the study showed significant decrease of L selectin and significant rise of E selectin levels in SLE patients versus healthy control subjects [720.5 +/- 213 ng/ml Vs 1008.7 +/- 237 ng/ml] and [71.5 +/- 14 ng/ml Vs 43.6 +/- 10 ng/ml], P < 0.002 and P < 0.001 respectively. E selectin was further elevated in SLE patients with organ [cardiopulmonary, renal and CNS] affection [n=15] versus those without organ affection [n=18] [78 +/- 8.2 Vs 47.6 +/- 12], P < 0.001 respectively. Correlation of L and E selectins to disease activity parameters showed significant association between L selectin and erythrocyte sedimentation rate and between E selectin and all parameters except hemoglobin. After starting corticosteroid therapy, no significant changes was observed in L selectin level within 3 months duration compared to the baseline level [708 +/- 159], [711 +/- 160] and [706 +/- 178] Vs [730 +/- 170], respectively. In contrast, significant decline of E selectin level compared to the baseline level was observed in the second and third month after starting corticosteroid therapy [59.8 +/- 9.9] and [61.9 +/- 6.8] Vs [43.6 +/- 10], P < 0.01 and P < 0.01 respectively. Results of the study indicate that L and E selectins are important contributing factors in the immunopathogenic mechanism of SLE. E selectin may be considered as a marker of disease activity and may aid in monitoring disease remission after starting corticosteroid therapy. It is justified to consider SLE as one of the disorders which could benefit from antiadbesive molecules therapy

Cognitive function in patients with non valvular atrial fibrillation: correlation to markers of thrombogenesis

There is increasing evidence that non valvular atrial fibrillation NVAF is associated with an increased risk of asymptomatic or silent cerebral infarctions. An important question is whether these infarction are truly asymptomatic and whether anti-thrombotic treatment could be beneficial in those patients. In this study we examined components of cognitive function [Event Related Potentials "ERP[s]" P300 and Wechsler Adult Intelligence Scale "WAIS"] and markers of thrombogenesis [fibrinogen, fibrinopeptide A "FPA". platelet aggregation, platelet factor 4 "PF-4" and beta-thromboglobulin "beta T.G"] in 20 neurologically asymptomatic NVAF patients comparing them to a well matched group in sinus rhythm. In addition, parameters of cognitive function components were correlated to those of thrombogenesis in the group of AF patients. NVAF patients had significantly prolonged latency and significantly reduced amplitude of P300 component of ERPs in AF Vs sinus rhythm group respectively and significantly reduced verbal intelligence quotient [VIQ] component of [WAIS] Vs sinus rhythm group P< 0.006. In addition, NVAF patients had significantly elevated levels of fibrinogen [p< 0.01], FPA [p<0.001], significant platelet aggregation is response to 2 ug/ml collagen [p< 0.001] and 1 ug/ml collagen [P< 0.001] and significantly elevated levels of PF-4 [P< 0.01] and beta T. G [P< 0.001] compared to the group in sinus rhythm respectively. In the NVAF group, there was positive association between P300 latency of ERPs components and each of FPA and PF-4 with high P< 0.1 and marginal P= 0.05 significance respectively and significant inverse correlation between all parameters of WAIS components and those of thrombogenesis except for the relation of performance intelligence quotient [PIQ] to each of FPA and beta T.G levels. These results may aid in identifying those patients at high risk of developing dementia and may help decision making when anti thrombotic therapy is being considered in NVAF patients. We recommend cognitive