Dickkopf-1 in ankylosing spondylitis: relation to spinal dysmobility and radiographic findings

Dickkopf-1 [DKK-1] is an inhibitory molecule that regulates Wnt pathway, which is critically important in osteoblastic new bone formation, therefore it may play a role in the process of new bone formation in Ankylosing Spondylitis [AS]. To measure serum level of DKK-1 in AS patients and study the relation between these levels with disease activity, spinal dysmobility and radiographic findings. Thirty AS patients as well as 20 healthy subjects as a control group were included in this study. DKK-1 serum levels were measured using ELISA technique, disease activity was assessed using Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] score, radiographic assessment by Bath Ankylosing Spondylitis Radiology Index-spine [BASRI-s] and modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]. DKK-1 was not correlated to ESR, CRP or BASDAI [p > 0.05] and was negatively correlated to BASRI-s and mSASSS [p < 0.001], though DKK-1 serum level was unexpectedly higher in patients versus control [p < 0.001]. On comparing HLA-B27 positive and HLA-B27 negative patients, there were a significant increase in BASRI-s and mSASSS and decrease in DKK-1 level in those with positive HLA-B27 [p < 0.05]. On comparing patients received anti TNF therapy and those not received anti TNF therapy, there was no significant difference in DKK-1 level [p > 0.05]. Our finding suggests dysfunction of DKK-1 in patient with AS

Functional capacity in patients with coronary artery bypass grafting surgery after cardiac rehabilitation program

To evaluate the effect of cardiac rehabilitation program on cardiac function and functional capacity in patients with coronary artery bypass grafting surgery. Forty patients with CABG were included. Thirty patients served as group I and ten patients as group II [control group]. Group I patients were enrolled in cardiac rehabilitation program for 12 weeks. All patients were subjected to: functional classification scaling, exercise stress test at the start and at 12 weeks [to detect the metabolic energy times and functional capacity of patients] and echocardiography at the start and at 12 weeks to evaluate the cardiac function. There was no significant difference between patients and controls at the start as regard exercise stress test, left ventricular ejection fraction and functional class. At 12 weeks: the exercise stress test results showed a significant increase in exercise duration, METs and VO2 max in group I in comparison to group II, and in group I at 12 weeks in comparison to its initial results. The echocardiography results showed a highly significant difference of LVEF between group I and group II at 12 weeks and in group I at 12 weeks in comparison to the start. Early return to work, at 12 weeks, was noticed in 14 out of 16 male patients [87%] in group I, and two out of five male patients [40%] in group II. Cardiac rehabilitation is an important component of the current interdisciplinary approach to the management of the patients with various presentations of coronary heart disease

Impaired antioxidant status in systemic lupus erythematosus patients

Objective: to measure the level of serum malondialdehyde [MDA] as a marker of oxidative stress of the activity of blood glutathione peroxidase [GSH Px] and the blood glutathione [GSH] as markers of antioxidant capacity in systemic lupus erythematosus [SLE] patients compared with normal control individuals. Also to detect if there is correlation between these biochemical changes and disease activity and some clinical and laboratory data of SLE patients

Methodology: twenty five SLE patients and ten healthy controls were subjected to clinical examination, history taking and estimation of [a] serum MDA [nmol/ml], [b] blood GSH level [mg/dL] and blood GSH Px activity [u/L]

Results: highly significant increase in serum MDA [p<0.0001] in SLE patients and statistically significant lower level of blood GSH and GSH Px activity compared to the control group [p<0.0001]. Disease activity index was positively correlated to MDA serum level and negatively correlated to both blood GSH level and blood GSH Px

Conclusion: excess production of free radicals as a result of lipid peroxidation and reduction in the antioxidant protection capacity were proved in SLE patients and observed to be more in the presence of some clinical manifestations of SLE. In addition, MDA serum level, blood GSH content and blood GSH Px activity may be used as useful markers for disease activity in SLE

Is acquired total protein s deficiency associated with antiphospholipid antibodies in systemic lupus erythematosus?

Hypothesis: protein S [PS] is a vitamin K dependent plasma protein, and it's free from is required for protein C to be functional. Antiphospholipid antibodies [apl] may cause functional PS deficiency by binding free PS. In patients with SLE have increased incidence of apl, which have been associated with thrombotic events

Objective: to determine the level of total protein S and its relation to [apl]

Methodology: 22 SLE patients diagnosed according to ACR revised criteria [Tan et al., 1982] and ten healthy subjects were included in this study. Assays for protein S, IgG, up1 were performed in patients and control groups

Results: the protein S was lower in the patients than the control and the difference was highly significant. There was a highly significant differences between the level of PS in patients with apl+ve compared with apl-ve patients [p<0.01]

Conclusion: this study confirms an association between apl and PS deficiency

Relation of antimyeloperoxidase antibody t o rheumatoid arthritis disease pattern

Objective: To determine the presence of antimyloperoxidase [anti-MPO] in rheumatoid arthritis patients in order to assess its relation to disease pattern

Methodology: Serum antimyeloperoxidase antibodies were assessed with Enzyme Linked Immunosorbent Assay [ELISA] in 25 rheumatoid arthritis patients and 10 controls

Results: Anti-MPO was found in 60% of patients and 10% of controls with a high statistical difference between the patients and control groups [p > 0. 001]. Also there was a highly significant difference between the patients and controls regarding ESR [p < 0.001] and serum creatinine [p< 0.05]. There was no correlation between the mean anti-MPO and activity sore, duration of morning stuffiness and number of affected joints [p> 0.05]. There was a positive correlation between serum creatinine duration of RA, ESR and disease severity with mean of Anti-MPO among cases [p<0.01]

Conclusion: The use of Anti-MPO helps in the assessment of RA disease activity and help in the assessment of disease severity and prediction of renal affection. It cannot be used to predict the onset of RA but can be used as an indicator of long standing RA disease