RESUMO
Background: Coronary artery disease [CAD] is one of the greatest causes of morbidity and mortality worldwide. It is the principal threat to health in countries in Africa and the Middle East and one of the leading causes of disease burden in developing countries. Scavenger receptor class B type1 [SCARB1] is a multiligand cell surface receptor. This membrane protein facilitates the uptake of cholesterol esters from highdensity lipoprotein cholesterol [HDL-C] and drives cholesterol from tissues to the liver in the various stages of reverse cholesterol transport pathway
Aim: The aim of this work is to study the association of rs5888 polymorphism of SCARB1 gene and premature coronary artery disease
Patients and Methods: PCAD group included 50 patients newly diagnosed angiographically with premature coronary artery disease, and non-PCAD group that included 50 age and sex matched non-CAD individuals who showed no luminal stenosis in coronary angiographic results
Results: The frequency of the wild type [CC] was higher in the control group [56%] than patients' group [18%] and it can be considered as a negative risk factor for PCAD [OR: 0.172, 95% CI [0.0693-0.429], p < 0.01]. The homozygous and heterozygous mutations [TT and CT] were statistically more frequently distributed in PCAD patients compared to control subjects [34 % and 48 % respectively], however only the CT genotype was considered as positive risk factor for PCAD [OR: 4.205, 95% CI[1.692-10.448], p= 0.01]
Conclusion: Allele frequencies of studied SCARB 1 SNP revealed a higher frequency of distribution of T alleles in patients' group when compared with control group, on the other hand it shows the higher frequency of distribution of C alleles in control group when compared to patients' group
RESUMO
Background: the role of the nucleosome in the induction of antibody response in lupus mediated tissue damage especially glomerulonephritis, may provide a new insight in the early diagnosis and alternative therapeutic developments in systemic lupus erythematosus [SLE]
Objectives: to evaluate the frequency and specificity of antinucleosome antibody expression in SLE patients in relation to disease activity. Also, to assess their predictive value in subclinical lupus nephritis
Methods: this study included 26 patients with SLE and 52 control subjects [26 were healthy and 26 had juvenile rheumatoid arthritis "JRA"]. Among lupus patients, 15 had clinical evidence of renal involvement. After clinical evaluation to calculate the SLE disease activity index [SLEDAI], measurements of urinary microalbumin and serum antinucleosome antibodies [antinucleosome specific, antihistone and anti ds-DNA antibodies by ELISA] were performed. Patients without clinical evidence of renal involvement were followed up for one year and measurement of urinary microalbumin was repeated at the end of the study period. Those who later developed microalbuminurea were categorized as patients with subclinical lupus nephritis
Results: the expression of the 3 studied antinucleosome antibodies was significantly higher among lupus patients as compared to JRA patients and healthy controls. Seropositivity for one or more antinucleosome antibodies was elicited in 84.5% of lupus patients. Serum levels of the 3 antinucleosome antibodies were significantly higher among lupus patients with clinical nephritis than those without nephritis. ANSAb had higher sensitivity, specificity and positive and negative predictive values for subclinical lupus nephritis [100%] than antihistone and anti ds-DNA antibodies [43%, 100%, 100% and 50% respectively for either antibodies]. All patients with lupus nephritis were seropositive for at least one of the antinucleosome antibodies, while those without clinical or subclinical nephritis were seronegative for the 3 antinucleosome antibodies. In 27.3% of patients with lupus nephritis, ANSAB was positive while both antihistone and ds-DNA antibodies were negative. Antinucleosome antibodies correlated positively with SLEDAI and cumulative steroid dose and negatively with corrected creatinine clearance
Conclusions: the observed sensitivity and specificity of antinucleosome specific antibodies as early indicators of subclinical lupus nephritis appear encouraging and deserve further analysis on a large scale in order to confirm their validity, especially in the anti ds-DNA seronegative lupus patients
RESUMO
Background: Adrenomedullin [ADM], a potent vasorelaxant/hypotensive peptide, was shown recently to be over-expressed in inflammatory rheumatic diseasesaaaaa
Objectives: The aim of this study was to investigate the value of ADM as a laboratory marker of disease activity in juvenile rheumatoid arthritis [JRA] and pediatric onset- systemic lupus erythematosus [SLE] and its relation to other markers of disease activity such as clinical scores, the ESR and tumor necrosis factor-alpha [TNF- alpha]
Methods: The study included 24 patients with JRA, 17 with childhood onset- SLE, as well as, 19 with rheumatic arthritis and twenty clinically healthy age- and sex- matched subjects. Clinical evaluation for disease activity was performed using the clinical activity score index in JRA, and SLE-DAI in SLE. Subjects were investigated to verify the diagnosis and disease activity. Plasma ADM and serum of TNF- alpha levels were then assayed
Results: Serum TNF- alpha and plasma ADM levels were significantly higher in JRA and SLE patients than in rheumatic arthritis patients and healthy controls. Though serum TNF- alpha and plasma ADM levels were both higher in JRA [73.88+11.6 pg/ml and 156.5+22.4 pg/ml, respectively] compared to SLE [48.82+7.5 pg/ml and 85.12+15.7 pg/ml, respectively], the difference was of statistical significance only in ADM. Both serum TNF- alpha and plasma ADM levels were significantly higher in systemic onset-JRA [139.75+18.5 and 260.25+28.6 pg/ml, respectively] compared to the pauciarticular-onset type [33.8+3.04 and 93.4+9.35 pg/ml, respectively], but comparable to the polyarticular onset cases [69.97+8.45 and 149.87+21.15 pg/ml, respectively]. Positive correlations were noticed between plasma ADM and activity score index [r=0.72], ESR [r=0.59] and serum TNF-alpha [r=0.64] in JRA. The serum TNF- alpha was not influenced by the site of lupus activity unlike plasma ADM that was higher in subjects suffering from lupus arthritis or cardiovascular manifestations. The afore-mentioned markers correlated positively to the ESR in SLE but not to the SLE-DAI. With a cut-off value of TNF-alpha = 31 pg/ml and that for ADM = 80 pg/ml calculated from the results of the included rheumatic arthritis patients, ADM appeared to be a more sensitive marker of activity in JRA and SLE compared to TNF- alpha
Conclusion: Plasma ADM was over-expressed in JRA and SLE. It correlated with the clinical and biochemical activity markers in JRA suggesting that it can be used as an indicator of disease activity. In SLE, ADM levels correlated with ESR and TNF- alpha levels and it could be of value in identifying patients with arthritis and cardiac involvement