Serum interleukin-18 level and natural killer cell percentage in systemic lupus erythematosus: clinical correlation

To detect serum interleukin -18 level and natural killer cell percentage in patients with systemic lupus erythematosus and to find out their correlation with disease activity and their role in lupus renal disease. The study included 30 female patients with systemic lupus erythematosus [15 patients with lupus nephritis and 15 patients without renal disease]. 10 apparently healthy females with matched age represent the control group. All patients were subjected to full history taking, thorough clinical examination, assessment of disease activity using modified systemic lupus erythematosus disease activity index [SLEDAI], laboratory investigations especially serum interleukin-18 level, natural killer [NK] cell percentage, serum urea, serum creatinine and 24 hours urinary protein. Serum level of interleukin-18 [IL-18] was significantly increased and percentage of NK cells was significantly decreased in patients with systemic lupus erythematosus [SLE] when compared to controls. In patients with SLE, increased serum IL-18 level showed significant negative correlation with NK cell percentage while this correlation was significantly positive with SLEDAI. Serum IL-18 level was significantly higher and NK cell percentage was significantly lower in SLE patients with lupus nephritis compared to those with no renal disease. In patients with lupus nephritis, increased serum IL-18 level showed significant positive correlation to serum urea, serum creatinine and 24 hours urinary protein, while reduced percentage of NK cells showed significant negative correlation with serum creatinine. The findings of this study may indicate that increased serum IL-18 levels and reduced NK cell percentage may play a role in pathogenesis and activation of SLE and renal involvement in this disease. Further studies are recommended for IL-18 as a potential target in treatment of autoimmune diseases including SLE

Angiogenesis in rheumatoid patients: clinical, radiological and histopathological study

To evaluate angiogenesis and cartilage destruction in rheumatoid arthritis [RA] patients. This was performed using power Doppler ultrasonography [PDS] and detection of vascular endothelial growth factor [VEGF] in the serum and immunohistochemically. Eighteen Rheumatoid arthritis patients [group 1] and ten apparently healthy subjects [group 2] participated in this study. Full history taking, thorough clinical examination and routine rheumatological profile investigation were done. Serum VEGF was measured in all patients and controls using ELISA technique. The knee joints were examined with ultrasound and resistance index was measured with spectral ultrasonography. Histological examination for synovial membranes was done with hematoxylin and eosin, factor VIII and VEGF with immunohistochemical staining. There was a highly significant difference between RA patients and controls as regard sVEGF [582.22 +/- 84.89, 176 +/- 20.55 pg/ml], histological score [36.94 +/- 7.83, 2.72 +/- 1.2], factor VIII [3.16 +/- 0.618, 1.2 +/- 0.41], VEGF staining [3.03 +/- 0.89, 0.5 +/- 0.32] and PDS [3.027 +/- 0.58, 0.41 +/- 0.24] [p<0.001 in all parameters]. Also, there was a significant difference between patients and control as regard resistive index [RI] [0.72 +/- 0.19, 1.07 +/- 0.1] and synovial proliferation [3.055 +/- 0.7, 0.25 +/- 0.263] [p<0.05 in both parameters]. RA patients were classified according to VEGF staining into low, moderate and intense staining. There was a highly significant difference between patient subgroups regarding serum VEGF, synovial proliferation, PDS score [p<0.001] and a significant difference regarding histopathological score, factor VIII and RI [p<0.05 in all parameters]. There was a positive correlation between sVEGF and DAS score, synovial proliferation, ESR, PDS, VEGF staining and histological score, and negative correlation with RI. Also, there was a positive correlation between VEGF staining and histological score, sVEGF, PDS, synovial proliferation and negative correlation with RI. VEGF is a potent mediator of endothelial proliferation of angiogenesis, the expression of VEGF depending on the activity and plays a part of pathogenesis of RA and synovitis. PDS is a useful method demonstrating synovial vascularization and monitoring disease activity. RI is an objective tool to estimate the degree of inflammation in RA

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