Vascular endothelial growth factor: does it play a pathogenic role in systemic sclerosis?

To evaluate the level of the vascular endothelial growth factor [VEGF] in the sera of systemic sclerosis [SSc] patients and its possible correlation with the clinical findings for a better understanding of the pathogenesis of the disease. Thirty-two SSc patients, 20 with diffuse SSc [dSSc] and 12 with limited SSc [lSSc] as well as 11 apparently healthy controls participated in this study. Clinical evaluation was done for all of them. Skin involvement was assessed using the modified Rodnan Skin Score and nailfold capillaroscopy [NFC] and pulmonary function tests including forced vital capacity% [FVC%] and forced expiratory volume% in the first second [FEV[1]%] were done for all participants. Their sera were collected and some laboratory investigations were carried out. Additionally, serum VEGF level was measured using enzyme-linked immunosorbent assay [ELISA]. Serum VEGF level was significantly higher in both SSc and dSSc patients than the controls [p< 0.01 and p < 0.001, respectively]. Also, dSSc patients showed a significantly higher serum VEGF level than lSSc patients [p< 0.001]. No statistically significant difference was found between lSSc and the control group [p> 0.05]. There was a significant lowering of nailfold capillary density in SSc patients as compared to the control group [p < 0.05]. SSc patients with elevated serum VEGF level had pulmonary fibrosis more frequently than those with normal VEGF [p < 0.01]. There was a positive correlation between serum VEGF level and extent of skin sclerosis as determined by modified Rodnan Skin Score [r= 0.55]. However, serum VEGF level correlated negatively with nailfold capillary density, FVC%, and FEV[1]% [r= -0.62, r= -0.63, and r= -0.71, respectively]. The elevated serum VEGF level may contribute to the disease process in SSc patients in particular to the development of skin sclerosis and pulmonary fibrosis. Serum VEGF level may also serve as an indicator of nailfold capillary damage in SSc

Endothelin-1 and ocular involvement in behcet's disease

To detect plasma Endothelin-1 [ET-1] in Behcet's disease [BD] and to assess if ET-1 is associated with ocular BD. 20 BD patients [12 with ocular and 8 without ocular disease] and 10 healthy control subjects were included in the study. The plasma level of Endothelin-1 was measured with Enzyme Immunometric Assay [EIA]. Plasma ET-1 levels were significantly higher in patients with BD than in the control subjects. Among patients with ocular BD, the mean plasma ET-1 levels were significantly increased when compared with non ocular disease and control subjects. Elevated plasma Endothelin-1 may play a role in ocular involvement of BD

Serum homocysteine level and vascular involvement in behcet's disease

To assess whether serum homocysteine level is related to vascular involvement in Behcet's disease. Twenty five patients with Behcet's disease and ten healthy subjects were included in the study. All the participants were subjected to thorough clinical assessment, radiological evaluation and laboratory investigations including serum folate, vitamin B12 and lipid profile. Total serum homocysteine level was determined by fluorescent polarization immunoassay. The patients were classified into two groups with respect to vascular involvement. Serum homocysteine level in BD patients was significantly higher than in the healthy controls [15.6 +/- 4.2 Vs 10.15 +/- 3.3 mmol /L, p <0.001]. Among BD patients with vascular involvement, total homocysteine level was significantly higher than in those without vascular involvement and healthy controls [p <0.05 and < 0.001 respectively]. On the other hand, there was no significant difference between patients without vascular involvement and healthy controls [p > 0.05]. No statistically significant difference was found between the different studied groups as regards serum folate, vitamin B12 and lipid profile [p > 0.05]. In addition, no significant correlation between total homocysteine and the other parameters investigated in BD patients. Hyperhomocysteinaemia may be a risk factor for the development of vascular involvement in Behcet's disease

Serum adrenomedullin level in rheumatoid arthritis compared with systemic lupus erythematosus

This study was conducted to measure the level of serum adrenomedullin [AM] in rheumatoid arthritis [RA] and systemic lupus erythematosus [SLE] to find out its role in their pathogenesis and its correlation with clinical and laboratory parameters of disease activity. Twenty-five RA patients [group I], 15 SLE patients [group II] and 10 healthy controls were included in this study. They were subjected to full history taking, thorough clinical examination and CBC, ESR, RF, ANA, Ant ds DNA investigations and measurement of serum adrenomedullin level with ELISA. An assessment of disease activity was done using Duke score for RA patients and SLE-DAI score for SLE. From the results obtained, it was concluded that serum level of AM was elevated in both RA and SLE [more in RA than SLE] patients and it was correlated with the disease activity parameter RA [only with ESR in SLE]. These findings emphasized that AM is involved in the pathogenesis of RA and SLE

Fine structural studies on the protective role of guanidinoethane sulfonic acid [GES] against low dose: Gamma radiation induced damage in rat pancreas

Any radiation exposure, no matter how small, carries with it some risk. All cells are not equally sensitive to radiation damage. The biological effects of high levels of radiation exposure are fairly well known, but the effects of low levels of radiation are more difficult to determine. Radio protective effects of Guanidinoethane Sulfonic Acid [GES] as analogue of taurine have been investigated in whole body irradiated rats. This study was taken to evaluate the structural effect of low dose radiation on the pancreatic cells as a model of radiosensitive organs and the role of [GES] as a radioprotector. Male rats were chosen for this study. The animals were divided into three groups each had equal numbers of animals, the first group served as a control group. The second group was exposed to gamma radiation at a dose level 1 Gy twice a week for 12 weeks, at a dose rate 1 Gy/1.5 min. The third group was given Guanidinoethane Sulfonic Acid [GES] as 1% solution in drinking water beginning 14 days before irradiation and continuing for 14 days thereafter, when the rats were killed. Histopathological and electron microscopical studies revealed that accumulative dose of gamma radiation affects both exocrine and endocrine cells of the pancreas. Using Guanidinoethane Sulfonic Acid [GES] as an analog of taurine helps the cells to regain its normal structure

Ultrastructural study on the protective role of turmeric [curcuma longa] and vitamin E against the pathologic effect of N-Nitrosodimethyl amine [NDMN] in rat spleen

N-nitrosodimethylamine [NDMN] is known to be carcinogenic to humans in various organs at relatively low levels of exposure. It induces benign and malignant tumors following its administration by various routes, including ingestion and inhalation. Humans may be exposed to N-nitroso dimethyl amine through the ingestion of food that contains it, such as cured meat products, and smoked fish. Other exposures to the chemical may be from drinking contaminated water and from breathing cigarette smoke and contaminated ambient air. Individuals are most likely to be exposed to N-Nitrosodimethylamine in occupational settings such as in the rubber, tannery, fish processing, dye, and surfactant industries. The primary purpose of this study was to determine the toxic effects of the carcinogen N- nitroso dimethylamine on the spleen as a part of the immune system. Also studying the modifying effects of Turmeric or vitamin E on the pathologic action induced by N-nitrosodimethylamine [NDMA]. Five-week-old female rats were divided into 4 groups. Groups 1, 2, and 3 were given intraperitoneal injections of NDMA [3 mg / kg body weight injection daily for 14 days]. Groupl was injected and fed standered diet, while Group 2 was fed the diet containing 500 part /million [p pm] curcumin during and post-injection while group 3 was Pretreatment with vitamin E, 0.02% w/w of the diet and a 2[nd] dose, 200 mg/kg, given 48 hrs. before nitroso-dimethylamine injection, NDMA. On the other hand group 4 was kept on the basal diet alone without injection and served as an untreated control. Group 1 was sacrificed on the day 15 after injection while the other three groups were sacrificed 8 weeks after injection.A pronounced changes were detected with NDMA, lymphocyte cell injury with inflammatory reaction and necrosis were obvious. Feeding of curcumin significantly decreased the pathological findings found in the lymphocytes cells. Vitamin E could also protect lymphocytes from damage during the necrotizing action of DMNA. The protection was found to be reduction in the induction cellular injury. These findings indicate that curcumin as well as Vitamin E give a good sign of protection against pathologic action induced by N-Nitrosodimethylamine [NDMA]

Possible role of cytokines in fibromyalgia

To evaluate the possible role of cytokines in fibromyalgia [FM]. Levels of interleukin-6 [IL-6], IL-8, and IL-10 were measured with enzyme linked immunosorbent assay techniques in the sera of 20 FM female patients and 10 normal controls. Results were correlated with the clinical manifestations of the disease. A significant [p < 0.05] increase in both IL-6 and IL-8 serum levels were found in FM patients as compared to controls. But there was no significant [p > 0.05] difference between FM patients and controls regarding serum IL-10 levels. In FM patients, the elevated IL-6 serum level showed a significant positive correlation [r = + 0.62] with fatigue severity score; and a significant negative correlation [r = - 0.59] with sleep score. While the elevated IL-8 serum level showed a significant positive correlation with the number of tender points [r= +0.68] and pain score[r= +0.54]. On the other hand, IL-10 showed no significant correlation with any clinical variable. IL-6 and IL-8 may play an important role in FM. IL-6 may be related to fatigue and sleep disturbances. IL-8 may be related to pain intensity and number of tender points in patients. Strategies to decrease the levels of cytokines, may constitute novel hopes for treatment of FM patients

pathophysiology of esophageal affection in rheumatic diseases

This study comprised 42 Egyptian female patients, 15 RA, 15 SLE and 12 SSc patients, compared to 12 healthy subjects matched with age and sex. Esophageal manometry and upper gastrointestinal endoscopic biopsy were performed for all subjects. The results of this study revealed manometric abnormalities in the three diseases. Hypoperistalsis and diminished resting lower esophageal sphincter pressure were evident in RA and SSc patients but more severe in SSc. Hypotonic lower esophageal sphincter was the prominent feature in SLE patients. Retrograde and non-transmitted contractions were detected in a variable percentage in the three diseases. No correlation was found between manometric abnormalities and disease activity, while; there was a significant correlation between these abnormalities and disease severity in SSc patients. Reflux esophagitis was detected in 26.7% of RA and 75% of SSc patients. Histopathological study revealed esophageal mucosal damage due to chronic inflammatory process and vasculitic changes in RA and SSc. The esophagus was histopathologically normal in SLE patients

Bone mineral density [BMD] and bone turnover in rheumatiod arthritis

Bone mineral density [BMD] that is commonly used as a parameter of bone strength was measured in 25 post menopausal female patients with RA, and its correlation with markers of bone turnover, disease activity and functional capacity were studied. Another 10 healthy female matched for age were chosen as a control group. All the patients were subjected to clinical assessment and laboratory investigations. Bone mineral density was measured by single photon absorptiometry, Bone resorption was assessed by measurement of urinary Deoxy pyridenoline [D-Pyd] cross links with an ELISA. While Bone formation was assessed by measurement of serum osteocalcin by radioimmunassay technique. Results showed a significant decrease in BMD, a significant decrease in serum osteocalcin level and a significant increase in urinary Deoxy pyridenoline in RA patients as compared to healthy controls. The decreased BMD showed a significant correlations with the impairment of functional activity and with increased disease activity. Also the decreased BMD showed a significant correlation with the decreased serum osteocalcin and with the increased urinary Deoxy pyridenoline level. From the previous results we can conclude that, the impairment of functional activity and increased disease activity are the major determinants of BMD. So every effort should be used to keep patients with RA mobile which can counteract the adverse effect on Bone. Also the serum oesteocalin as a marker of bone formation was decreased and urinary Deoxy pyridenoline as a useful measure of bone resorption was increased. So, we suggest that the pathogenesis of osteoporosis in RA may be due to uncoupling of Bone turnover

association between rheumatoid arthritis and hepatitis C virus infection

To study the association between rheumatoid arthritis and HCV infection. The study included 40 RA patients diagnosed according to the ACR criteria [group I]. It also included 20 inflammatory arthritis patients with RF positive but not fulfilling the criteria for diagnosis of RA [group II]. Ten age and sex matched subjects were taken as controls. Anti HCV antibodies were detected in the sera of these patients. 0.5% of the patients of group I had anti HCV antibodies while 20% of patients of group II had anti HCV antibodies. As regards the control group, none was anti HCV antibody positive. There is a strong association between the presence of anti HCV antibodies and rheumatoid factor that is stronger than the association between anti HCV antibodies and rheumatoid arthritis. Patients with anti HCV antibodies may have rheumatoid factor positive in their serum, but the picture may not fulfill the criteria of RA. Thus in any case of inflammatory arthritis, hepatitis C virus must be put in consideration

Role of urinary deoxypyridinoline crosslinks and serum osteocalcin levels in evaluating disease progression in rheumatoid arthritis and knee osteoarthritis

In this study, the concentrations of urinary deoxypyridinoline [Dpyd] [a bone degradation marker] and serum osteocalcin [a bone formation marker] were measured in 20 rheumatoid arthritis [RA] patients, 20 knee osteoarthritis [OA] patients and ten healthy controls. It aimed to quantify these bone specific markers and investigate their role in the assessment of disease activity and severity in RA and OA patients. The results revealed significantly higher levels of urinary Dpyd and serum osteocalcin in the rheumatoid and osteoarthritis patients than the controls. Also, there was a significant positive correlation between these bone markers and disease severity, but no correlation was found with the disease activity in RA patients. In the OA group, there was a significant positive correlation between levels of urinary Dpyd and age, disease duration and disease severity. In conclusion, urinary deoxypyridinoline was superior to serum osteocalcin as a useful biochemical marker for the assessment of disease severity in both rheumatoid and osteoarthritis patients

Ultrasonographic assessment of the quadriceps muscle in elderly women

Anthropometrical and qualitative ultrasonographic assessment of the quadriceps muscle [vastus lateralis] in thirty elderly women was done before and after a physical training program to develop muscle strength for eighteen weeks. Statistical comparison in different assessment parameters showed that there was no statistical significant difference [p > 0.05] in body weight, thigh girth and cross sectional area of the quadriceps before and after the physical training program. But there was a statistical significant difference [p < 0.05] as regards thigh subcutaneous fat and muscle thickness

Insight on the relationship between osteoporosis and osteoarthritis

In this study, we tried to investigate some of the factors that may have a role in the pathogenesis of osteoarthritis OA and osteoporosis OP, such as BMI, levels of estrogen, IGF-1 and bone mass density. We correlated all these parameters to find the relation between those two pathologic conditions. Forty postmenopausal females were studied, 20 with OP and 20 with OA. Our results showed a significant elevation of estrogen and IGF levels and BMD in OA group in relation to OP group. The mean BMI showed a significant increase in OA than OP. This inverse relation could be explained by the difference in growth factors and estrogen that stimulate bone formation. There is an inverse relationship between OA and OP. Thus OA might have a protective or retarding effect on the development of OP and could be a negative risk factor for OP. This could be an important element in determining patients who at risk developing OP and should take preventive therapy for OP at the time of menopause