Soluble adhesion molecules in juvenile idiopathic arthritis: relation to activity and clinical subtype

The present research aimed to evaluate serum Adhesion Molecules [AMs] in patients with Juvenile Idiopathic Arthritis [JIA] to correlate their values with disease activity in different clinical subtypes. Serum levels of some soluble AMs [E-selectin, sICAM 1 and sVCAM 1] wereassayed by ELISA in 37 patients with JIA both during activity and after remission. Other activity parameters like sedimentation rate and leukocytic counts were tested as well. Twentyhealthy children of matched age and sex were taken as control. Serum E-selectin was found significantly higher in JIA compared to control [in all subtypes across all disease stages], with significant drop after remission, yet not reached the normal values. These changes were more evident in systemic JIA compared to other subtypes. Serum ICAM 1 and VCAM 1 showed the same changes in relation to control and to the disease activity. We can conclude that systemic JIA is associated with higher levels of soluble AMs thus explaining the perpetual inflammatory process and hence the remissions and exacerbations which are usually associated with higher morbidity in systemic JIA than in the other subtypes. We recommend following JIA patients until laboratory remission [normalization of serum AMs] to correlate AMs levels to clinical course aiming to put forward a therapeutic plan

Correlation between cord blood endothelin-1 and traditional indicators of perinatal asphyxia

To measure cord blood endothelin-1 concentrations in infants with perinatal asphyxia and to correlate it with two "classical" markers of hypoxia: the 5-mm Apgar score and cord arterial blood pH. A prospective, case control study was conducted on 24 full-term infants with a history of perinatal events suggestive of asphyxia. 5-mm Apgar score and cord arterial blood was collected immediately after delivery and was used to measure endothelin-l concentrations and cord arterial blood gases in all studied infants. Fourteen healthy full-term newborns with no evidence of perinatal asphyxia were used as controls. The perinatal asphyxia group comprised 24 full-term newborns with a mean [ +/- SD] gestational age of 38.4 +/- 1.3 weeks and a mean [ +/- SD] birth weight of 2833 +/- 508g. There was no significant differences between the perinatal asphyxia group and controls regarding the gestational age, delivery route, or gender. The Apgar score at 5 minutes in peninatal asphyxia group was markedly reduced with a mean [ +/- SD] of 4.7 +/- 1.3. Cord blood pH was significantly lower with a mean [ +/- SD] of 7.2 + 0.08 and base excess was significantly higher with a mean [ +/- SD] of 7.6 +/- 4.5 mEq/1 in perinatal asphyxia group compared to controls. Cord blood endothelin-l concentration was significantly higher in peninatal asphyxia patients compared to controls [p <0.001]. A significant negative correlation was found between cord blood endothelin-1 concentration and pH, base excess, and 5-mm Apgar score in the peninatal asphyxia group. The cord blood endothelin-1 is markedly increased in newborns with perinatal asphyxia and shows a significant negative correlation with 5-min Apgar score, cord arterial blood pH and base excess. Thus, it can be taken as a marker for perinatal asphyxia and that it would be very interesting to evaluate its usefulness as a prognostic index