clinical utility of LPL and ZAP-70 expression in assessment of prognosis in patients with B-cell chronic lymphocytic leukemia

It was found that B-CLL patients with unmutated immunoglobulin heavy chain variable region [IgVH] have poor prognosis and clinical outcome. The difficulty of performing the mutation status of IgHV in the routine diagnostic workup of B-CLL patients, prompts the search for surrogate markers particularly gene expression profile in B-CLL cells. To investigate the role of LPL and ZAP-70 expression in assessment of prognosis and survival in a group of B-CLL patients and correlate the results with other prognostic variables. The study included 47 B-CLL patients who were subjected to clinical staging which was done by Binet and Rai scoring systems. The expression of LPL and ZAP-70 was measured by real-time quantitative PCR [RQ-PCR] and flow-cytometric analysis respectively. The patients were followed over 24 months for proper estimation of treatment free survival [TFS] and disease free survival [DPS]. The results of our study showed positive LPL and ZAP-70 expression in 46.8% and 48.9% of B-CLL patients respectively. There was significant correlation between LPL and ZAP-70 positive expression in our patients [p<0.0001]. The positive expression of both genes is associated with advance in clinical staging with significant correlation between LPL and ZAP-70 positive expression and shortening of the TFS and DPS and subsequent classification of most of the LPL+ and ZAP-70+ cases as patients with poor prognosis. Our study showed that expression of LPL and ZAP-70 has a significant role in determining the prognosis in B-CLL patients, being positive expression of LPL and ZAP-70 is associated with poor prognosis with shortening of TFS and DPS. Also, both genes expression is of great value in selection of B-CLL patients in early clinical stages that are in need to start chemotherapy to avoid progression to aggressive forms of the disease

Do survivin and HER-2/neu play a role in rheumatoid arthritis?

Rheumatoid arthritis [RA] is an inflammatory joint disease characterized by hyperplasia of synovial tissue and pannus formation growing invasively into the cartilage, followed by cartilage and bone destruction. In RA, the proliferation of synovial fibroblasts and their invasive growth are due to impairment in the regulation of the cell cycle. Survivin belongs to the apoptosis-inhibiting proteins [IAP] family and regulates the inflammatory and destructive process inside the joints of patients with RA. RA Synovial Fibroblasts [SFs] over express the ErbB2/HER2 member of the epidermal growth factor [EOF] receptor family relative to normal fibroblasts. The aim was to study the role of survivin and HER-2/neu in the pathogenesis of RA and the association between their level and the presence of erosion in RA patients and evaluation of the possible influence of the ongoing treatment on their serum level. In this study, serum survivin and serum HER-2/neu levels were measured in 35 erosive and non-erosive RA patients and compared with age and sex matched healthy population. There was a statistically significant difference in serum HER-2/neu between RA patients and controls and also between RA patients treated with methotrexate and those treated with methotrexate and others. There was a statistically significant difference in the serum level of survivin between erosive and non-erosive RA patients