Resistin in systemic lupus erythematosus: Relation to lupus nephritis and premature atherosclerosis

Lupus nephritis [LN] is one of the most severe complications of SLE. SLE patients have a greater risk of developing premature atherosclerosis. Resistin is an adipocyte-secreted peptide. It has pro-inflammatory and atherogenic effects. To assess the serum levels of resistin in SLE patients and to evaluate it as a marker of nephritis and premature atherosclerosis. This study included 50 SLE nonpregnant female adult [mean age 23.1 +/- 6.9 years] patients as well as 40 healthy volunteers matched in age and sex as a control group. Serum levels of resistin were assayed using enzyme-linked immunosorbent assay [ELISA]. All patients and controls underwent laboratory investigations and carotid duplex. Disease activity was assessed using SLE Disease Activity Index [SLEDAI]. Renal biopsy was performed for SLE patients with LN. There was a highly statistically significant increase in mean serum resistin levels [14.1 +/- 3.88 ng/ml] in patients versus the control group [6.44 +/- 1.34 ng/ml] being more obvious in those with LN. Resistin had a significant positive correlation with markers of inflammation, SLEDAI and carotid intima media thickness [CIMT]. Serum level of resistin may serve as a marker of LN and atherosclerosis in SLE patients. A more aggressive control of the underlying inflammatory process along with the control of traditional risk factors [hypertension and cholesterol] may be beneficial in reducing the risk factors of renal and atherosclerotic involvement in SLE. Therapeutic approaches with drugs that target resistin might be useful in the treatment of SLE

Dickkopf-1 in ankylosing spondylitis: relation to spinal dysmobility and radiographic findings

Dickkopf-1 [DKK-1] is an inhibitory molecule that regulates Wnt pathway, which is critically important in osteoblastic new bone formation, therefore it may play a role in the process of new bone formation in Ankylosing Spondylitis [AS]. To measure serum level of DKK-1 in AS patients and study the relation between these levels with disease activity, spinal dysmobility and radiographic findings. Thirty AS patients as well as 20 healthy subjects as a control group were included in this study. DKK-1 serum levels were measured using ELISA technique, disease activity was assessed using Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] score, radiographic assessment by Bath Ankylosing Spondylitis Radiology Index-spine [BASRI-s] and modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]. DKK-1 was not correlated to ESR, CRP or BASDAI [p > 0.05] and was negatively correlated to BASRI-s and mSASSS [p < 0.001], though DKK-1 serum level was unexpectedly higher in patients versus control [p < 0.001]. On comparing HLA-B27 positive and HLA-B27 negative patients, there were a significant increase in BASRI-s and mSASSS and decrease in DKK-1 level in those with positive HLA-B27 [p < 0.05]. On comparing patients received anti TNF therapy and those not received anti TNF therapy, there was no significant difference in DKK-1 level [p > 0.05]. Our finding suggests dysfunction of DKK-1 in patient with AS

Association of asymptomatic hyperuricemia and endothelial dysfunction in psoriatic arthritis

Cardiovascular disease is an increasingly recognized contributor to excess morbidity and mortality in psoriatic arthritis [PsA]. Traditional cardiovascular risk factors do not adequately account for the extent of cardiovascular disease in PsA. To examine the prevalence of subclinical atherosclerosis in patients with PsA to emphasize the potential role of serum uric acid on endothelial dysfunction, as an early predictor for atherosclerosis in PsA patients. This study included 60 PsA patients as well as 60 age and sex matched healthy controls. Assay of serum uric acid, interleukin-6 [IL-6] and soluble intercellular adhesion molecule-1 [sICAM-1] was done for all patients and controls. Patients were subjected to psoriasis area severity index [PASI] and assessment of disease activity. Patients and controls underwent brachial flow-mediated dilatation [FMD] assessment by color duplex sonography to determine endothelial dysfunction as well as extracranial carotid arteries assessment by high-resolution B-mode ultrasound to measure the common carotid intima-media thickness [CIMT] and the detection of atheromatous plaques. PsA patients have a high significant difference in CIMT, FMD of the brachial artery and mean levels of serum uric acid compared to healthy controls [p < 0.001]. PsA patients with hyperuricemia have a high significant difference in CIMT and FMD of the brachial artery than those with normal serum uric acid. Serum uric acid levels showed a high significant positive correlation with each of CIMT, disease duration, markers of inflammation [ESR, CRP, IL-6, sICAM-1], disease activity score in 28 joints [DAS 28] and PASI [r = 0.71, 0.893, 0.956, 0.858, 0.853, 0.877, 0.907, 0.847, respectively, as p < 0.001]. A high significant negative correlation was found between serum uric acid levels and FMD of the brachial artery as r = -0.634, p < 0.001. Patients with PsA have a high prevalence of subclinical atherosclerosis dependent on serum uric acid, suggesting that chronic systemic inflammation and endothelial dysfunction appear to be the link between asymptomatic hyperuricemia and atherosclerosis. Therefore, proper control of serum uric acid may play a preventive role in the development of atherosclerosis in PsA patients

Handling of dairy products and its impact on their microbiological quality

A total of 18 dairy shops was randomly selected from different zones of Alexandria, where a sanitation checklist was filled. A total of 108 samples of dairy products [Domiati, fresh soft white, Romi cheese, raw milk and yoghurt] was collected as purchased. Also, 36 samples of each of empty polyethylene bags and rinses of milk measuring containers were collected. The study aimed to assess the handling of dairy products sold in dairy shops of Alexandria City and its impact on their microbiological quality. Floor parameter had the highest mean score%, while handling of the dairy products had the lowest. Moreover, all inspected shops showed acceptable grades concerning floor and hand washing parameters, while only eight shops were acceptable regarding the handling of dairy products. Raw milk had the highest mean aerobic mesophilic plate count, staphylococcal count, coliform count as well as mold and yeast count. The highest% of samples contaminated with coagulase and DNase positive staphylococci was found among raw and fresh white cheese samples; moreover, 83.3% and 47.2% of raw milk and yoghurt samples were contaminated with fecal coliforms, respectively. It was recommended to improve the sanitation of dairy shops through training the handlers and strengthening the inspection activities; also, the microbiological quality should be regularly assessed by responsible authorities