RESUMEN
Background: granzymes [Gz] A and B are recently discovered mediators in asthma and other inflammatory airway diseases and showed minimal suppression by corticosteroids
Aim of the study: to see if there is any difference in both granzymes in induced sputum samples between steroid sensitive and steroid resistant asthmatics
Methods: both granzymes were measured by ELISA assay in induced sputum samples from 27 steroid sensitive [SS] and I 8 steroid resistant [SR] asthmatics plus 15 normal controls
Results: Gz A was significantly higher in SR than SS patients and controls [p<0. 05], but was insignificantly different between SS patients and controls [p>0.05]. Gz B was significantly higher in SR patients than SS patients and controls [p<0.05]. No significant difference was seen between males and females of the studied groups [p >0.05 for all].Significant negative correlations were found between both granzymes and FEVJ% predicted in both SS and SR groups [r=-0.85, r=-0.49for Gz A and r= -0.87, r= 0. 7 for Gz B respectively]. A significant positive correlation was found between the two granzymes in both patient groups [r=0.93 and 0.63 for SS and SR patients respectively]
Conclusion: granzymes A and B are released in the airways of asthmatic patients and could have an important role in asthmatic airway inflammation especially in steroid resistant cases and might play a role in this resistance
RESUMEN
Anti- CCP antibody has recently gained much interest as a marker for early detection and prediction of severe articular and extra-articular disease in rheumatoid arthritis. To evaluate this in patients with active rheumatoid disease and lung involvement, we studied 40 rheumatoid arthritis patients with active disease: 10 patients [6 males and 4 females] have chronic disease with joint effusion but no extra articular affection, 13 chronic patients [5 males and 8 females] with joint effusions and evidence of lung fibrosis, 9 chronic patients [4 males and 5 females] with both joint and pleural effusions but no evidence of lung fibrosis and 8 patients [4 males and 4 females] with relatively recent onset disease with only joint inflammation without effusion plus 8 normal control subjects. Blood anti- CCP was found to be significantly much elevated in all patient groups than controls [p<0.001 for all] and in patients with lung disease than those without [p < 0.001 for both] with highest levels seen in patients with lung fibrosis. In patients without lung disease, levels were slightly [but significantly] higher in those with joint effusion than in those without [p <0.01]. Joint and pleural fluids showed significantly higher anti-CCP levels than blood [p<0.001for both]. Also levels in joint fluid were significantly higher than in pleural fluid [p<0.001]. Blood anti-CCP showed a strong positive correlation with both of ESR and blood rheumatoid factor [r = 0.599, p<0.001 and r = 0.841, p< 0.001 respectively] and with joint and pleural fluid levels [r = 0.786, p<0.001 and r = 0.522, p<0.05 respectively]. A highly significant inverse relation was seen between this antibody in blood and FEV1% [r = 0.593, p <0.001]. We concluded that: anti-CCP antibody could be a good marker for diagnosis of rheumatoid arthritis that can predict patients with severe disease and the association with extra articular affection especially in the lung