Keratinocyte and lymphocyte apoptosis: relation to disease outcome in systemic lupus erythematosus patients with and without cutaneous manifestations

To investigate the relation of keratinocyte and lymphocyte apoptosis and macrophage function to disease activity and severity in SLE patients with and without cutaneous manifestations. Fifty SLE patients [25 with cutaneous manifestations [group I], 25 without cutaneous manifestations [group II]] and 20 normal controls [group III] were studied. SLEDAI score was used to assess lupus activity. Peripheral lymphocyte apoptosis by Annexin V, macrophage function by serum neopterin and immunohistochemical detection of apoptotic cells in the skin by p.53 were done. Renal biopsy was done in indicated cases. Mean SLEDAI score was significantly higher in group I than II [18.6 +/- 6, 8.8 +/- 2.7 respectively, p<0.001]. The mean percentage of peripheral apoptotic lymphocytes was significantly higher in group I compared to group II and III [55.3 +/- 21.4, 25.6 +/- 8. 7 and 19.4 +/- 3.2 respectively, p<0.001] and so was the serum neopterin level [27.5 +/- 7.3, 14.9 +/- 2.7, 9.4 +/- 1.1 respectively, p<0.001]. The mean number of P53+ve keratinocytes of group I was significantly higher than group II and III [20.6 +/- 5.4, 1.6+0.5, 1.7 +/- 0.4 respectively, p<0.001]. A higher percentage of class IV and V glomerulonephritis was found in group I [47%, 26%, respectively] compared to group II [11% both] [p<0.001]. The mean number of p53+ve keratinocyte showed a significant positive correlation to SLEDAI score, percentage of peripheral apoptotic lymphocytes and serum neopterin [p<0.001]. Accumulation of apoptotic keratinocytes and lymphocytes in SLE seems to be crucial in the pathogenesis of skin lesions and in triggering systemic disease activity and organ damage

Assessment of serum levels of resistin and homa index in obese subjects: effect of weight loss programs on these levels and on body fat mass

To assess the serum levels of resistin and HOMA in obese subjects and to evaluate the association of resistin with insulin resistance [HOMA index]. Also to study the effect of weight loss programs on their levels and on body fat mass. Forty-five obese premenopausal females and fifteen healthy ones [serving as a control group] were included. Obese subjects were equally divided into 3 groups [A, B, C] according to the weight loss program. Group A were subjected to diet regimen, Group B to diet regimen and exercise program, and Group C to exercise program only. All studied groups were subjected to full clinical examination, assessment of BML WC, HC, WHR and laboratory investigations including serum resistin and HOMA index. Body fat content was measured by DEXA. Programs of weight loss were carried out for three months, followed by reassessment. There was a significant difference between obese subjects and controls regarding BMI, WC, HC, WHR, Triglycerides, Cholesterol, HDL, LDL, Resistin, TB-FM, Trumk - FM, Leg-FM, Body fat percentage and HOMA index. A highly significant difference was found, in the three groups before and after weight loss regarding all parameters except for WHR which showed significant difference with group B only. Following weight loss, the comparison between the 3 groups together, revealed a significant difference between them with the greatest change being noticed in group B. Also a significant positive correlation was found between BMI and HOMA index. Resistin is believed to be a key factor for obesity, cardiovascular and type II diabetes. The combined program of diet regimen and exercise seems to be the optimal approach for prevention and management of obesity, metabolic and cardiovascular disorders