Plasma paraoxonase activity in patients with systemic sclerosis.

Background & objectives: Systemic sclerosis (SSc) is a connective tissue disease characterized vascular damage and fi brosis. The aim of this study was to investigate the possible relation between systemic sclerosis and paraoxonase which is an antioxidant enzyme on the HDL. Methods: Twenty nine patients with SSc and 16 healthy subjects (control group) participated in the study. Plasma cholesterol levels, anti-centromere antibody (ACA) levels and paraoxonase (PON) activities were measured. Results: Lower level of high-density lipoprotein (HDL) cholesterol was observed in ACA negative SSc patients than in controls. Paraoxonase activity in ACA positive patients was however found to increase relative to control and ACA negative patient groups. Interpretation & conclusions: Our fi ndings suggested that low HDL level in ACA negative SSc patients might be one of the factors leading to some vascular problems, and increased PON activity in ACA positive SSc group might have some role in the limitation of cutaneous sclerotic process observed in these patients. However, these preliminary fi ndings need to be confi rmed with a larger sample.

Angiotensin-Converting Enzyme Gene Insertion/Deletion Polymorphism in Korean Patients with Systemic Sclerosis

To determine whether angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism is associated with the development and clinical features of systemic sclerosis (SSc) in Korean, we studied seventy two Korean patients with SSc fulfilling the ACR preliminary classification criteria. The controls were 114 healthy, disease free Koreans. ACE I/D genotypes were determined by PCR method using oligonucleotides. Sixty eight patients (94.4%) were women and age at diagnosis was 43.5+/-12.6 yr old (mean+/-SD). Thirty nine patients (54.2%) had a diffuse type of SSc. There were no statistical differences in the frequencies of all ACE I/D genotypes and D allele between patients and controls, and neither between diffuse and limited types of SSc. ACE I/D gene polymorphism was not associated with the development of SSc in Korea. The investigation for the pathogenesis of SSc requires more studies about the role of other candidate genes such as endothelin, TGF-beta, nitric oxide, or angiotensin II receptor in addition to the ACE genes.

Correlacion entre los niveles de citoquinas en el lavado broncoalveolar en una cohorte de pacientes del Hospital Militar Central con esclerosis sistemica (SS), con y sin alveolitis / Cytokines in bronchoalveolar lavage in systemic sclerosis patient

Debido a la preocupación que produce la osteomielitis crónica y los problemas sociales y laborales que conlleva esta enfermedad, nos propusimos sacar adelante un protocolo de tratamiento médico-ortopédico que hemos implementando y desarrollado con la colaboración del Dr. Cesar Arango (Medico Infectólogo) en nuestros pacientes durante 20 años. Hemos utilizado esta metodología en 180 pacientes, 100 de sexo masculino y 80 de sexo femenino. Los segmentos anatómicos afectados fueron: tibia 56 por ciento, fémur 33 por ciento, antebrazo 6 por ciento, pie 4 por ciento y dedos de pie 1 por ciento. La base fundamental del tratamiento es el desbridamiento seriado de las lesiones con el paciente hospitalizado, la toma de cuatro cultivos en la primera intervención, la administración de antibióticos se lleva a cabo de acuerdo a determinación del medico infectólogo que se modifica según el resultado de los cultivos, y el cuidado postoperatorio domiciliario hasta obtener una granulación adecuada de las zonas desbridadas con cultivos negativos. Se rellena el espacio vado producido por los desbridamientos con injertos óseos extraídos de las espinas ilíacas provista la estabilización de la fractura. De estos 180 pacientes, el 97 por ciento se encuentra hasta el momento libre de recidivas, 5 pacientes no cumplieron con las expectativas del tratamiento y 1 paciente fue amputado. Consideramos que esta forma de tratamiento es adecuada para nuestro medio y mejora el pronóstico de los pacientes que sufren esta penosa enfermedad

study of serum enzymes in patients with rheumatoid disease, progressive systemic lupus erythematosus

The intent of this study was evaluation of the role of some serum enzymes such as B-glucuronidase, B-galactosidase, monoamine oxidase, adenosine deaminase and 5 nucleotidase in the most common connective tissue diseases which are rheumatoid disease [RD], systemic lupus erythematosus [SLE] and progressive systemic sclerosis [PSS]. We also tried to determine whether these enzymes may be of value in differential diagnosis of these connective tissue diseases and whether there is any correlation between the levels of these enzymes and the activity of the disease. The study included 40 patients [20 RD, 10 SLE and 10 PSS] and ten healthy controls. Our results revealed that increased B-glucuronidase enzyme was found to be specific for rheumatoid disease and thus it can be used as a test to differentiate RD from other connective tissue diseases. Increased B- galactosidase activity was also found to be characteristic for progressive systemic sclerosis and can be used as a test for differentiating PSS from other connective tissue diseases. Determination of serum monoamine oxidase can be used as an index for fibrosis and serial determinations can be helpful for the assessment of the progress of fibrosis in any fibrotic disease