Anticyclic citrullinated peptide antibodies in systemic sclerosis

To measure the serum levels of anti CCP antibodies in patients with systemic sclerosis and to correlate these levels with joint involvement extent of skin sclerosis and pulmonary involvement. 22 SSc patients were grouped into [group II] included 10 patients had limited cutaneous SSc and [group III] included 12 patients had diffuse SSc in addition to 10 healthy subjects as a control group [group I]. All patients and controls were subjected to full history taking, thorough clinical examination, routine blood investigations, chest and hand-x-ray, pulmonary function tests, capillary microscope. Measurement of anti-CCP antibodies using ELISA technique. Anti-CCP antibodies serum level was significantly higher in SSc patients than the control [p<0.05]. Also anti-CCP antibodies serum level was significantly higher in patients with arthritis and pulmonary affection than those without arthritis or pulmonary affection. There was a significant association between anti-CCP antibodies positivity and capillaroscopic abnormalities. Our results suggest that anti-CCP antibodies might be linked to disease severity

Bone resorption markers and bone forming cytokines in thalassemia major patients

Hypothesis: osteoporosis represents an important cause of morbidity in thalassemia major [TM] patients. The cause is multifactorial; including defective vitamin D metabolism and iron intoxication. The pathogenesis is not completely clarified, especially the mechanism by which cytokines affect skeletal bones. Osteoprotegrin/ RANK system has been recently introduced in the pathogenesis of post-menopausal osteoporosis and other bone diseases

Objective: to investigate the relationship between vitamin D, as a bone resorption marker and the new bone cytokine [osteoprotegrin] and their implication on bone mineral density [BMD]

Methodology: twenty-five TM patients and 10 healthy controls were included in the study. They were subjected to full history and clinical examination. Body mass index was assessed. Serum 25 [OH]2 Vitamin D was estimated. Bone resorption markers [Deoxypyridinoline and pyridinoline cross links] were assessed. Osteoprotegrin serum level was measured and BMD was assessed with DEXA

Results: serum 25 [OH]2 Vitamin D was significantly reduced in patients than controls. Bone resorption markers [DpD, pyD] showed a highly statistical significant increase than controls. Also, serum osteoprotegrin was reduced than controls. Moreover, there was a negative correlation between the levels of PyD, DpD and osteoprotegrin. Again, TM patients had lower bone mineral density and Tanner staging than controls

Conclusion: TM osteoporosis is a major problem that is a real challenging issue. Osteoprotegrin/RANK system has got a direct role which needs further investigation