Value of serum and synovial fluid activin A and inhibin A in some rheumatic diseases

Activin is a growth and differentiation factor of many cell types and has recently been implanted in inflammatory processes. Clinical data demonstrating roles of activin and its antagonist inhibin in inflammatory arthropathies, are lacking. The Study is to measure serum and synovial fluid levels of activin A and inhibin A in patients with rheumatoid arthritis [RA] systemic lupus erythematosus [SLE] and osteoarthritis [OA] and correlate them with disease activity parameters. This study included 60 patients with three rheumatic diseases [20 with RA, 20 with SLE and 20 with OA], as well as ten healthy subjects as a control group. All of them were subjected to complete history, physical and musculoskeletal examination and estimation of disease activity index [DAS- 28] for RA and [SLEDAI] for SLE. The following investigations were done for all subjects; serum and synovial activin A and inhibin A; in addition to complete blood picture, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP],rheumatoid factor [RF], antinuclear antibodies [ANA],anti-dsDNA, serum complement [C 3, 4] and Xrays on affected joints. The mean values of serum activin A were significantly higher in RA, SLE and OA than controls [P<0.001] also in RA and SLE versus OA [P<0.05 for both]. The mean values of serum inhibin A were significantly higher in all studied groups than controls [P<0.05 for RA and OA and P<0.001 for SLE]. Also serum inhibin levels were significantly higher in SLE versus OA P<0.001, but there was no significant differences between RA and SLE. Synovial fluid activin and inhibin A were significantly higher in RA than OA [P<0.05 for both]. Positive correlations were found between serum activin A and disease activity parameters of RA morning stiffness [MS], Ritchie index [RI], ESR, CRP and DAS 28] P<0.05, for all. Also positive correlation was found between serum inhibin A and RI in RA patient [P<0.05]. In SLE, positive correlations were found between serum activin A and inhibin A with ESR [P<0.001 for activin and P<0.05 for inhibin A and SLEDAI [P<0.001 for both activin and inhibin]. No correlation were found between synovial activin and disease activity and negative correlation between synovial inhibin and ESR. The significant increase of serum and synovial activin A and inhibin A in RA and SLE and their positive correlations with disease activity parameters of RA and SLE suggest pro-inflammatory action. However the lack of correlations or negative correlation of their synovial levels with disease activity may indicate their anti inflammatory action, We recommended further studies to detect the exact role of activin A and inhibin A

Clinical associations of autoantibodies against monomeric C-reactive protein in systemic lupus erythematosus

The aim of this study was to analyze circulating levels of anti-monomeric CRP autoantibodies [anti-mCRP] in serum samples from SLE patients in relation to biochemical and clinical disease activity markers and to identify significant associations between the presence of these antibodies and the relevant clinical manifestations of SLE. Serum levels of IgG anti-mCRP antibodies were detected by enzyme linked immunosorbent assay [ELISA] for sixty patients diagnosed as SLE and met the revised ACR criteria and 30 matched healthy subjects as a control group. Disease activity was evaluated according to the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI] score. Association of anti-mCRP reactivity with clinical features, with other auto-antibodies and with serum concentrations of C3, C4, C1q and CRP were assessed. In this study IgG antibodies to mCRP were found in sera from 65% SLE patients compared to 3.3% healthy controls. In SLE patients positive for IgG anti-mCRP antibodies, there were significantly greater frequency of renal affection [76.9% vs 28.5%, P<0.001], thrombosis /fetal loss [43.5% vs 9.5%, P<0.05], aCL IgG, aCL IgM and LAC positivity [41% vs 14.2%, 25.6% vs 14.2%, 35.8% vs 14.2%, P<0.05] and anti-dsDNA antibodies positivity [69.2% vs 42.8%, P<0.05]. Also, there were lower mean counts o/WBCs, lymphocytes, platelets, lower levels of CRP, C3, C4, C1q and higher mean of SLEDAI score in SLE patients positive to IgG anti-mCRP antibodies. Eight [20.5%] patients with IgG anti-mCRP and 4 [19%] patients without were positive for aPL antibodies without clinical manifestations of antiphospholipid syndrome [APS] [asymptomatic aPL carriers] with insignificant difference between both groups. Also, there were negative correlation between WBCs, lymphocytes, platelets counts, levels of C3, C4 and C1q with serum levels of anti-mCRP antibodies and significant positive correlation between the levels of serum aCL IgG, aCL IgM, anti-dsDNA antibodies and SLEDAI score of disease activity with serum levels of anti-mCRP antibodies. In this study we have demonstrated the high prevalence of anti-mCRP autoantibodies in SLE. Also, observed strong significant association of anti-mCRP reactivity with renal affection and thrombosis and found that the antibody levels were correlated with clinical and laboratory disease activity measures

Sevoflurane: an immunological safe anaesthetic agent?

In this work, evaluation of the effects of sevoflurane on some immune functions of surgical patients was tried. Assessment of the specific component of humoral immunity was carried out by estimation of serum immunoglobulins. The non-specific component of humoral immunity was assessed by estimation of the complement component C3c. Estimation of the total and differential leucocytic counts and the calculation of NBT-positive cells in "unstimulated NBT-reduction test" were used to assess the non-specific component of cell-mediated immunity. The study was conducted on 20 selected patients who underwent minor surgical procedures. Induction of anesthesia was carried out by using the single-breath inhalation technique with 8% sevoflurane, until successful insertion of cuffed oropharyngeal airway [COPA]. Anesthesia was maintained with 2% sevoflurane in a gas mixture of oxygen and N2O in a ratio of 1:1 via Bain circuit. The results showed that there was a decrease in levels of complement component C3c and phagocytic function under anesthesia and after surgical stimulation and postoperative. Serum Ig levels showed an increase under anesthesia and after surgery. While, there was a post- induction leucopenia. At the end of the operation and postoperatively there were significant leucocytosis, neutrophilia and lymphopenia

Immunoglobulin and C3-activator profile of the microbiology laboratory worker.

The levels of immunoglobulin, C3-Activator and C3c in the sera of members of staff who have been continuously engaged for upwards of 10 years in the microbiological routine laboratory of a teachings hospital were determined. These were compared with the local normals, with those of the junior members of staff in the same laboratory but who had put in less than 5 years continuous service and with a control group. The means in all five determinations were much higher in the senior members of staff than the normal standards of the area, particularly the IgG, which was almost double the local normals. The levels for the junior staff were on the whole slightly higher than the control group. The increase in the levels of immunoglobulins with corresponding increases in C3-Activator and 3Cc suggest that immunological reactions, with the binding of complement in the alternate and classical pathways of activation are taking place in most of these senior workers. In the absence of any manifest illness in the senior staff, the findings may suggest a high degree of immunological protection.

Disfunción aguda del hemisferio cerebral derecho e hipocomplementemía / Acute dysfunction of right hemisphere and hypocomplementemia

La alteración aguda de las funciones cerebrales superiores del hemisferio derecho suelen pasar inadvertidas o ser inadecuadamente interpretadas en pacientes en edad pediátrica. Se presenta una niña de 9 años, zurda, sana, que durante las dos semanas previas a la consulta padeció episodios de parestesias, una convulsión clónica del miembro superior izquierdo y cambios progresivos en su conducta con irritabilidad, llanto o risa inmotivados, coprolalia, copopraxia e insomnio. Al examen se hallaba temerosa, agresiva, verborrágica. Refería "verse hinchada como un globo", "los objetos se agrandaban o se movían rápidamente" y veía "príncipes y brujas de pelo verde y ojos color púrpura". Utilizaba exclusivamente el miembro superior derecho sin detectarse anormalidades del sistema motor, sensitivo o en la coordinación. Podía leer y realizar cálculos matemáticos, pero no escribir, dibujar ni realizar construcciones con cubos. E.E.G.: ondas lentas en hemisferio derecho; L.C.R.: 9 linfocitos, resto s/p; TC y RNM normal. Serología para virus negativa. F.A.N., anti-ADN, prot. Creativa, células L.E., test del látex [-]. C3: 65 mg por ciento [V.N.: 150 ñ 30 mg por ciento]; C.I.C.: 33 por ciento [V.N.: 14 ñ 5 por ciento]. Además del tratamiento con oxcarbacepina, se adicionaron esteroides, con lo cual mejoró la sintomatología. Al año de seguimiento se hallaba asintomática y los exámenes inmunológicos eran normales. Conclusión: El compromiso predominante de la región parietooccipital derecha explicaría la sintomatología referida. Una vasculitis hipocomplementémica sería la probable etiología

Cireulating intercellular adhesion molecule-1 [ICAM-1] rheumatoid arthritis and systemic lupus erythematosus

Circulating intercellular adhesion molecule-1 [C. ICAM-1] levels were measured by enzymelinked immunosorbent assay for sera collected from 29 patients with rheumatoid arthritis [RA] and 20 patients with systemic lupus erythematosus [SLE] as well as synovial fluid samples collected from 5 out of the 29 RA patients. Serum samples from 10 healthy persons were tested as a control group. The concentration of C3[c] complement component was also measured in the serum of patients with SLE by single RID technique and compared with its concentration in the control group. There was a significant increase [p<0.05] in the level of CICAM-1 in SLE patients compared with normal controls. In contrast, non significant increase was found in patients with RA. Levels of CICAM-1 was non significantly increased in synovial fluid compared with serum in paired samples from patients with RA. A highly significant increase in C. ICAM-1 levels was found in SLE patients [p<0.01] as compared to RA patients. Level of CICAM-1 correlated significantly with increased erythrocyte sedimentation rate [ESR] and decreased haemoglobin [Hb] level in SLE patients. There was significant positive correlation between C ICAM-1levels and joint score in patients with RA. Highly significant decrease in C3[c] complement component was found in SLE patients as compared to control group, but there was non significant correlation between CICAM-1 levels and C3[c] complement component levels in those patients. From the previous results, it was found that ICAM-1 could be used as a parameter of activity in patients with SLE and to less extent in patients with RA. Non significant difference was found in CICAM-1 levels in synovial fluid versus serum

Study of complement C3 and C4 and phagocytic function of the neutrophils before and after splenectomy

The present study showed significant increases in the total leucocytic and neutrophilic counts and in the calculated absolute number of stimulated NBT positive cells after splenectomy in all studied groups [P <0.05]. By contrast, the serum complement C3c and C4 showed insignificant increases after splenectomy in all trial groups [P >0.05]. Nevertheless, the age was not important factor affecting the changes that have been observed in the present study. It can be concluded that the spleen does not share in the synthesis, consumption or catabolism of C3c and C4. Meanwhile, the phagocytic function of neutrophils will increase after removal of the spleen. This might be a part of the whole increase in the number of while cells and neutrophils or due to post-splenectomy infection or the increase in the function of macrophages mediated by the macrophageactivating factors secreted by T-cells since splenectomy induces and increase in T helper and decrease in T suppressor cells

Plasma C3c level in patients with type II diabetes mellitus with microabluminuria

The study included 10 NIDDM patients with microalbuminuria, 10 NIDDM patients and 10 age matched normal controls. All were subjected to clinical examination, E.C.G., biochemical assessment for blood sugar, total serum cholesterol, serum creatinine, and serum C3c. Results revealed significant lowering of serum C3c in diabetic patients with microalbuminuria than controls [M. 76.43 +/- 15 and 95.75 + 22.23, respectively] [p < 0.036] and non significant reduction in diabetic patients without microalbuminuria [M. 87.327 = 21.22 mg/dl] [p < 0.398]. There was an inverse correlation between plasma level of C3c and each of total serum cholesterol [p < 0.001], degree of microalbuminuria [p < 0.0001] and ischemic heart disease [p < 0.002]

Effect of diuresis on complement C3 and immunoglobulin concentrations in serum and ascitic fluid of patients with post-hepatitic cirrhosis

Serum and ascitic fluid samples were taken from twenty nine patients with post-viral hepatitis liver cirrhosis and ascites to estimate the complement C3 concentrations before and after two-week diuresis in comparison to other ten matching normal control subjects. Before treatment, there was a significant decrease in both serum and ascitic complement C3 concentrations in patients with cirrhotic ascites [P <0.05] when compared to controls. Furthermore, after cirrhotic patients received the diuretic therapy, there was significant increase in ascitic fluid complement C3 [P <0.01] but insignificant change in serum C3 [P >0.05]. This study demonstrated that diuresis of patients with cirrhotic ascites increases the concentrations of ascitic fluid C3 component of the complement and hence may protect the patients from spontaneous bacterial peritonitis

Influence of piroxicam and piroxicam-cyclodextrin inclusions on gastric mucosal ulceration: an experimental study

The study was performed to prove the ulcerogenic effect of piroxicam [as an example of NSAIDs] in stomachs of experimental animals and to evaluate the protective effect of inclusion complexation of piroxicam with beta-cyclodextrin [B-CyD] against gastric irritation. 15 Wistar rats were used in this study. The drugs were given orally for 4 consecutive days and the animals were sacrificed on the fifth day. Their stomachs were examined both macroscopically [by measurement of ulcer index, UI] and microscopically. The study documented the ulcerogenic effect of piroxicam both macroscopically and microscopically. Moreover, it proved the benefit of piroxicam beta- CyD complexation in reducing its gastric ulceration

Immunohistochemical detection of IgG, IgA, IgM and C3 complement in thyroid lesions

The present work focused on the detection of immunoglobulins IgG, IgA, IgM and C3 complement in a wide variety of thyroid diseases as well as in normal thyroid tissue to evaluate the immunologic nature of these lesions. The study was encountered on 111 thyroid specimens selected from the biopsies received at the Pathology Laboratory over a period of 5 years. Formalin fixed paraffin embedded sections were prepared and stained by H and E and immunoperoxidase technique. IgG, IgA and IgM were detected in varying degrees in all types of thyroid lesions and also in normal thyroid tissue. While, positivity for C3 complement was detected in [6/10] cases of toxic nodular goiter, all cases of cretinism with goiter 8, in 11 out of 13 cases of Graves disease, in 14 out of 19 cases of thyroiditis and in 10 out of 16 cases of papillary carcinoma of the thyroid gland. However, no C3 complement could be detected in normal thyroid tissue, in cases of simple goiter, in all cases of thyroid adenoma and in all cases of follicular, anaplastic and medullary carcinoma examined. Results indicated that immunoglobulins are not predictors for diagnosis of autoimmunity in thyroid diseases, but are best considered as indicators for the gland activity. However, C3 and immunoglobulins may be used as useful markers for the diagnosis of papillary carcinoma and its follicular variant from follicular carcinoma

Effect of some opioid agonists [morphine and fentanyl] on blood picture in pregnant rats

This work was conducted on pregnant and non pregnant rats aiming to study the effect of opiod agonists [Morphine and fentanyl] on blood picture and immune system. The pathological changes in liver, spleen and kidney that accomapany their administration were also studied in mothers as well as, their offsprings. The experiments were done after single and repeated administration It revealed that: i. Morphine has a toxic effect on the haemopioetic and immune systems and this effect depends on the dose and duration. ii. Fentanyl is more safe than mrorphine. iii. Pregnancy potentiates the effect of opioids. iv. The offsprings suffer from opiods more than mothers due to inadequancy of the enzyme system metabolising the drug. So, it is better to decrease the dose of opiods during labour and avoid any treatment containing opiods during pregnancy

Complement C3 levels in serum and ascitic fluid in liver cirrhosis

Serum and ascitic fluid complement C3 levels were estimated in 28 patients with liver cirrhosis and ascites and in 10 normal control subjects. Patients were divided into those with +ve ascitic fluid culture [22 patients] and those with -ve culture [6 patients]. Complement C3 serum level was significantly reduced in 28 patients with liver cirrhosis and ascites [P <0.05]. Serum complement C3 level was also reduced in patients who had +ve ascitic fluid culture [P <0.01]. There was also a significant decrease in serum complement C3 levels in 22 patients who had +ve ascitic fluid culture [P <0.05] and in ascitic fluid levels [P <0.0005] compared with those who had -ve culture

Changes in B-glucuronidase and complement C3 under anesthesia in schistosomal and non-schistosomal patients

The effect of single halothane or nitrous oxide anaesthesia on complement C[3] and B-glucuronidase enzyme [B.G.] was studied in 30 patients divided into 3 groups each of 10. Group I and II received nitrous oxide 70% in o[2] and group III received halothane 1-1.5%. Group I were schistosomal patients, while the other two were non-schistosomal. Estimation of C[3], B.G. and liver function tests were performed pre-operatively, post-operatively [50-60 minutes of anaesthesia] and 4th post-operative day. It was observed that schistosomiasis causes significant increase in B.G. and decrease in C[3] Post-operative samples showed significant reduction ll C- and increase in B.G. p [P <0.001] in all groups. Se percent of depression was more significant in schistosomal group than non schistosomal group under nitrous oxide. Also the percent of depression was more significant under halothane than dtrous oxide in control groups. By the 4th day, there was sigtificant increase in both C-levet and B.G. activity [P<0.001] in all groups. No significant changes were detected in [%] changes B.G. except between schistosomal and non schistosomal patients [p[2]<0.001] under nitrous oxide. Liver function tests demonstrated significant changes in some pa-mieters in schistosomal patients only. This indicates that schis-sosoniiasis, anaesthesia and surgery arc established causes of tress, inducing alterations in C[3] and B.G. which are sensitive indicators of tissue injury and liver insult than routine liver tests

Fibronectin, laminin and complement C3 estimation in chronic renal failure before and after hemodialysis: a possible role in the pathogenesis

Nineteen patients with chronic renal failure [nine cases with cancer bladder and ten cases with other etiological causes] were studied. Plasma fibronectin, laminin and C3 were checked before and after hemodialysis. The plasma fibronectin, laminin and C3 were significantly reduced in chronic renal failure [CRF] before hemodialysis than in the controls, while fibronectin was significantly reduced in patients with CRF due to cancer bladder after hemodialysis. These changes may be a possible cause of rapid invasiveness of cancer bladder with metastatic formation and repeated infection in patients with CRF. The results were discussed

Correlation between circulating schistosomal antigen, schistosomal complement C3 and intensity of infection

53.7% of the already parasitologically proved schistosomiasis cases showed circulating schistosomal antigen [C.S.A.] in their sera with significantly higher levels than the controls, with no correlation between the level of C.S.A. and the foecal egg count. Significant higher levels of schistosomal complement C3 were found in schistosomiasis patients as compared to the control group, with no significant difference in the mean level of C3 between patients with positive and negative C.S.A

Determinaçäo da fraçäo C3c do complemento por imunodifusäo radial no soro e saliva parotídea de indivíduos clinicamente normais / Determination of C3c fraction complement by radial immunodiffusion in the serum and saliva from the parotid gland of clinically normal subjects

Determinamos a fraçäo do C3c do complemento no soro e na saliva parotídea de 13 indivíduos clinicamente normais pelo método da imunodifusäo radial. O valor médio do C3c sérico foi de 86,92 mg/dl e o intervalo de confiança da média de 73,53 a 100,31 mg/dl. No estudo das salivas das parótidas näo foi detectada concentraçäo mensurável de C3c

Lymphocyte subpopulations immunoglobulins A,G and M and complement components C3 and C4 in the type II diabetes

Forty nine type II diabetic patients and 30 controls were studied. Investigations included enumeration of T and B lymphocyte subpopulations and determination of the concentrations of the serum immunoglobulins A. G and M and C[3] and C[4] complement components. A significant reduction in the absolute count of T and B lymphocytes was observed in association with late diabetic complications. A significant rise in IgA concentration was observed in all patients with highest level in association with diabetic nephropathy. C[3] and C[4] complement components were significantly increased in all patients particularly those on oral hypoglycaemic agents with highest values in patients with nephropathy

Class immunoglobulins and complements [C[3] and C[4]] in Egyptian form of cutaneous leishmaniasis

The antibodies level of class immunoglobulins and complements were estimated in 20 Egyptian cases of cutaneous leishmaniasis and compared to ten parasite-free volunteers of the same age group. The results showed significant increase in IgE followed by IgG. None of the IgM, IgA, C[3] or C[4] showed any significance difference

Anti-streptolysin O, antinuclear antibodies and serum complement C3 level in glomerulonephritis

Anti-streptolysin 0 [ASO], anti-nuclear [ANA] antibodies and complement C [3] concentration were investigated in a total of 200 patients with glomerulonephritis [GN]. Abnormally high levels of Aso were found in 46% of patients with acute GN compared to 16% in chronic GN and 22% in end stage renal failure [ESRF], the mean +/- SD values among the 3 groups of patients and the control group were 336 +/- 329, 129 +/- 62, 140 +/- 89 and 132 +/- 50 respectively. The increase in Aso level in acute GN was statistically significant P < 0.01. Among the 50 patients with acute GN only 2 [4%] had antinuclear antibodies. ANA were also found in 8% and 5% of chronic GN and ESRF respectively. Hypocomplementaemia was found in 70% in acute GN compared to 42% in chronic GN and 18% in ESRF. Hypercomplementaemia was found in 44% in ESRF but in more of acute GN. Only those with acute GN had significant drop in the complement serum levels [mg/dL] P < 0.01