Relation of serum prolactin level to systemic lupus erythematosus disease activity: the effect of immunosuppressive medications

The relationship between serum prolactin level and disease activity state and the effect of conventional immunosuppressive medications is still unclear with contradictory results. To study the correlation of prolactin levels with SLE disease activity at the beginning of the study and after 9 months of conventional treatment, this may clear the role of prolactin in the pathogenesis of SLE. Forty five active SLE patients were enrolled in this study, all were females and they were fulfilling the ACR criteria for SLE classification. Patients under medical treatment with drugs that may affect prolactin level as [bromocriptine, chlroquine, cimetidine, metoclopramide ..etc] were excluded. No patient known to have either heart failure, liver failure or kidney failure was allowed in this study. The patient was divided into 2 groups: Group I: Twenty three patients with minor organ affection [cutaneous and joint affection], Group II: Twenty two patients with major organ affection [glomerulonephritis], Group III: Thirty control apparently healthy persons. Serum prolactin was determined with double antibody liquid phase radioimmunoassay at entry and after 9 months of conventional treatment and SLE patients serum prolactin levels were correlated with SLE disease activity index score [SLEDAI]. Our results showed that 31 patients had mild hyperprolactinemia [68.8%], 13 patients in group I and 18 patients at group II. Comparing the serum prolactin levels between SLE patients in both groups I and group II versus control showed a significant increase. After treatment of SLE patients for 9 months, the serum prolactin level showed a significant decrease from a mean [25.6 +/- 5.2 ng/ml] at the beginning to a mean [14.9 +/- 10.2 ng/ml] [p<0.001]. Comparison of SLEDAI scores at the beginning of the study and after 9 months of treatment showed a significant decrease from a mean [15.9 +/- 4.8 ng/ml] to [2.3 +/- 1.7 ng/ml] p<0.001. There was a significant correlation between serum prolactin levels and SLEDAI score at beginning [r = 0.4785], p = 0.0006 and after treatment r = 0.8975, p< 0.001. There is a significant correlation between SLE disease activity and serum prolactin which could be decreased equally by the conventional immunosuppressive treatment. This support that there is a role of prolactin in the pathogenesis of SLE

Correlation between progressive joint damage and serum level of matrix metalloproteinases: MMP-3 and MMP-1 in early rheumatoid arthritis[RA]

There are a group of rheumatoid arthritis [RA] patients for whom traditional markers of outcome are unhelpful. Despite of absence of these markers; still they have progressive damaging arthritis. Expression and activation of matrix metalloproteinases as MMP-3 [stromolysin-1] and MMP-1 [collagenase-1] are increased in RA patients. There are contradictory results of their role as predictors of joint damage. To study the role of MMP-3 and MMP-1 as predictors of joint damage in early RA. Seventy early RA patients of less than 12 months duration fulfilling the ACR criteria for classification of RA were enrolled in this study. They were 65 females and 5 males with mean age [30.5 +/- 3.2] years. Also 30 apparently healthy persons were studied as a control group, 15 males and 15 females with mean age of [33.5 +/- 2.8] years. All patients and control volunteers were tested for MMP-3 and MMP-1 basal serum level, using an Enzyme-Linked Immunosorbent Assay [ELISA]. The subsequent change of Larsen Radiological Score [delta Larsen] and Health Assessment Questionnaire [delta HAQ] were recorded and correlated with MMP-3 and MMP-1 over a 12 months period. The mean basal serum level of MMP-3 and MMP-1 were significantly higher in RA patients than controls [p<0.05]. MMP-3 and MMP-1 serum levels at presentation of RA patients correlated significantly with basal CRP presentation [r = 0.40, r=0.47 and p<0.05], with delta Larsen Score [r = 0.24, r = 0.31 and p<0.05], and with delta HAQ [r = 0.33, r = 0.31 and p<0.05]. The group of patients with normal CRP at presentation [

Seurm ferritin level in systemic lupus erythematosus patients, relationship to disease activity

The aim of this study was to investigate the relationship between serum ferritin levels and disease activity in systemic lupus erythematosus patients [SLE]. Serum ferritin level of 62 SLE patients was measured. SLE patients were subdivided into two groups according to SLE disease activity index [SLEDAI] as /= 11. The results were compared to 30 rheumatoid arthritis [RA] patients. Thirty three patients among the 62 SLE ones were evaluated before and after treatment. Serum ferritin level was higher in SLE than in RA patients [p<0.001]. There was a significant difference in its level before and after treatment. Again, the level in SLE positively correlated with SLEDAI scores. Patients with SLEDAI scores >/= 11 had significantly higher serum ferritin level. Serum ferritin level may be a useful marker of disease activity in SLE patients

Diagnostic role of ELISA detected antibodies to citrullinated antigens in rheumatoid arthritis patients: a comparative study

To investigate rheumatoid arthritis [RA] for the diagnostic role of anti-cyclic citrullinated peptide antibody [anti-CCP] and antifilaggrin antibody [AFA] in comparison with RF and matrix metalloproteinase-3 [MMP-3]. A total of 60 RA patients and 50 other rheumatic disease patients were included in the study. We used a second generation enzyme-linked immunosorbent assay [ELISA] kit for the detection of anti-CCP. We constructed recombinant human filaggrin, which was citrullinated in vitro with human peptidylarginine deaminase, and subsequently used it as the coating antigen for AFA-ELISA. The specificities of anti-CCP [87.3%] and AFA [93.5%] were superior to those of RF [80.4%] and MMP-3 [50.1%]. The sensitivity of anti-CCP [86.3%] was superior to all others. However, the sensitivity of AFA [66.9%] was inferior to those of RF [68.5%] and MMP-3 [72.6%]. ELISA detection of antibodies to citrullinated antigens, especially a second generation anti-CCP, showed higher discriminative ability than other assays, including RF, and would be useful to aid in the diagnosis of RA in clinical practice