Molecular detection of human retrovirus [HRV-5] in common rheumatic disorders

HRV-5 has been implicated in the pathogenesis of a number of autoimmune diseases. This study aimed at assessing the role of HRV-5 in the pathogenesis of systemic lupus erythematosus [SLE], rheumatoid arthritis [RA] and osteoarthritis [OA]. The study was conducted on 25 female SLE patients with mean age of 35.8 +/- 7.4 years and 25 female RA patients with mean age of 48 +/- 13.4 years, as well as, 25 female OA patients with mean age of 51 +/- 14.5 years, in addition to 25 age-matched apparently healthy female controls. All participants were subjected to detailed clinical assessment and laboratory investigations. HRV-5 proviral DNA was detected with nested polymerase chain reaction [PCR] and positive results were confirmed with DNA sequencing. The frequency of detection of HRV-5 proviral DNA was 8%, 12% and 4% in our RA, SLE and OA patients, respectively. Sequence analysis of the amplified viral segment showed genetic variation between samples with maintenance of the open reading frame, typical of a replicating infectious retrovirus. Our results support the hypothesis that HRV-5 may play a role in the etiopathogenesis of both SLE and RA, but further investigations are needed to confirm its role

Thermal tactile Vs. Neuromuscular electric stimulation in the rehabilitation of stroke-induced dysphagia

To study the effect of neuromuscular electric stimulation on the swallow functional score in stroke patients having dysphagia and compare the effect of neuromuscular and thermal tactile stimulation on its rehabilitation. Fifty patients with dysphagia due to stroke were included. They were divided into two equal groups according to the rehabilitation programs they received. Group I received neuromuscular electric stimulation sessions on the neck one hour daily for 12 weeks. Group II received tactile thermal stimulation on the anterior faucial arch one hour daily for 12 weeks. Swallow functional score for dysphagia assessment using the modified barium swallow [MBS] was done for both groups, at the start and at 4 weeks, 8 weeks and 12 weeks. No statistically significant difference was detected between Groups I and II as regards the swallowing score at the start, 4 weeks and 8 weeks [p>0.05]. But there was a statistically significant higher score at 12 weeks [p<0.05]. There was a statistically significant higher change in the score from the start till 12 weeks in Group I as compared to Group II [p<0.05]. Also, there was a higher dysphagia score with hemispherical lesions over the 12 weeks of rehabilitation program in Group I [p<0.05] which was seen only in patients having chest problems in Group II [p<0.05]. The electrical stimulation has the advantage of being Non-invasive and actively assisting swallowing. Thus it can be used as an alternative treatment for dysphagia. It also helps in the restoration of the normal swallowing mechanism and decreases the incidence of the subsequent complications of dysphagia. To use neuromuscular electric stimulation of the neck muscles instead of thermal tactile stimulation in rehabilitation of dysphagia secondary to stroke. Further studies are needed to detect its long term effect on dysphagia rehabilitation

Osteoprotegerin in rheumatoid arthritis

Objective: To evaluate serum and synovial fluid levels of osteoprotegerin [OPG] in patients with rheumatoid arthritis [RA]; to correlate these values with disease activity variables, radiological bone damage, and DEXA results

Methodology: Twenty female RA patients and ten age-matched healthy female subjects were enrolled in this study. Serum and synovial fluid OPG levels were measured using enzyme-linked immunosorbent assay. Bone status was evaluated using dual x-ray absorptiometry [DEXA] and plain X-ray of the affected joints

Results: RA patients had significantly higher levels of serum OPG than controls [p<0.001]. No significant correlation was found between serum OPG and erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and disease duration [p>0.05]. OPG serum levels were positively correlated with age in both groups [p<0.001]. A significant difference in serum OPG level was found between patients with and without erosions [p=0.008]. RA patients had significantly lower BMD values than controls [p< 0.05]. There was a highly significant correlation between serum OPG level and BMD values [p<0.001]. Mean synovial fluid. OPG level was higher than serum OPG level obtained from the same patient, but with no statistical significance [p>0.05]

Conclusion: Bone loss in RA patients is associated with higher serum and synovial fluid levels of OPG than in healthy subjects, which might be the result of a compensatory production of OPG, yet there was lack of compensatory age-related increase of OPG serum levels

Impaired antioxidant status in systemic lupus erythematosus patients

Objective: to measure the level of serum malondialdehyde [MDA] as a marker of oxidative stress of the activity of blood glutathione peroxidase [GSH Px] and the blood glutathione [GSH] as markers of antioxidant capacity in systemic lupus erythematosus [SLE] patients compared with normal control individuals. Also to detect if there is correlation between these biochemical changes and disease activity and some clinical and laboratory data of SLE patients

Methodology: twenty five SLE patients and ten healthy controls were subjected to clinical examination, history taking and estimation of [a] serum MDA [nmol/ml], [b] blood GSH level [mg/dL] and blood GSH Px activity [u/L]

Results: highly significant increase in serum MDA [p<0.0001] in SLE patients and statistically significant lower level of blood GSH and GSH Px activity compared to the control group [p<0.0001]. Disease activity index was positively correlated to MDA serum level and negatively correlated to both blood GSH level and blood GSH Px

Conclusion: excess production of free radicals as a result of lipid peroxidation and reduction in the antioxidant protection capacity were proved in SLE patients and observed to be more in the presence of some clinical manifestations of SLE. In addition, MDA serum level, blood GSH content and blood GSH Px activity may be used as useful markers for disease activity in SLE