Some biochemical markers for various stages of psoriasis including psoriatic arthritis

Psoriasis is a chronic inflammatory autoimmune skin disease, with a prevalence varying between 0.6% to 4.8% of the population worldwide. Psoriatic arthritis [PsA] is an inflammatory arthritis which can involve the musculoskeletal system and is characterized by negative rheumatoid factor. To evaluate the serum level of TNF-alpha, IL23 and oxidative stress [OS] markers in various stages of psoriasis including PsA. The psoriatic patients [N=30] were chosen with different clinical types of psoriasis including PsA, They were subdivided into four subgroups according to Schmitt and Wozel [2005] model of PASI score; mild[N = 8], moderate[N = 8], severe [N = 8] and PsA[N = 6]. The serum levels of TNF-alpha, IL23, NO, MDA, SOD and CAT were determined in all groups. The levels of TNF-alpha, IL23, MDA and NO were significantly higher in both Psoriatic and PsA patients respectively acc. to increase in PASI score in comparison to the control. On the other hand, the levels of SOD and CAT were significantly lower in both Psoriatic and PsA patients, respectively according to increase in PASI score than the control. The finding suggested that both Th1 and Th17 may play an important rule in the pathogenesis of psoriasis in addition to the rule of Oxidative Stress . Moreover, these markers can be used as biomarkers for various stages of psoriasis severity

common mutation in methylene tetrahydrofolate reductase gene, inflammation and atherosclerosis in chronic renal failure

Accelerated atherosclerosis is the major cause of mortality in patients on chronic haemodialysis [HD]. Inflammation and endothelial activation or dysfunction might be the major factors leading to high cardiovascular mortality rate in HD patients. Also, C667T mutation of methyltetrahydrofolate reductase [MTHFR] might be associated with accelerated athcrosclerosis. The present study was designed to clarify the role of inflammation, endothelial activation or dysfunction and genotyping of MTHFR enzyme which affect the level or homocysteine and their relation to carotid artery intima-media thickness [CIMT] as an indicator of atherosclerosis. Forty four [44] chronic haemodialysis [HD] patients and 40 healthy subjects were included in the study. Serum highly sensitive C reactive protein [hs-CRP] and IL-6 were measured as inflammatory markers, soluble vascular cell adhesion molecule-1 [sVCAM-1] was measured as a marker of endothelial activation and dysfunction. Common carotid intimal media thickness [CC-IMT] was assessed by carotid artery ultrasonography. genotyping of MTHFR enzyme which affect the level of homocysteine was analyzed by PCR RFLIP technique. Chronic HD patients had elevated levels of inflammatory markers [hs-CRP and IL-6], enhanced endothelial activation or dysfunction demonstrated by elevated VCAM-1 as compared by healthy controls. Haemodialysis patients had significantly higher CC-IMT levels. There is a significant positive correlation between inflammatory cytokines [hs-CRP and IL-6], and each with VCAM-1 and CC-IMT There is no difference in the genotype of C667T MTHFR found between patients and controls, but this mutation especially the TT genotype is associated with development of atherosclerosis as indicated by the increase of CC-IMT

role of leukotrienes B4 and C4 in bronchial asthma

This study was carried out on 35 asthmatic patients and ten normal control subjects. They were 25 males [71.4%] and 10 females [28.6%]. Their ages ranged between 15-48 years old. Fifteen out of 25 asthmatic males were cigarette smokers [60%], their smoking index ranged, from 50-1000 cigarette with mean 358 cigarette. The asthmatic patients were classified into 3 groups thirteen patients with acute recurrent asthma received salbutamol, eleven patients with chronic asthma received salbutamol, and eleven patients with acute severe asthma received salbutamol and corticosteroid. Control subjects were classified into 2 groups: 5 control smokers and 5 non smokers. Serum LTB[4] and LTC[4] were measured in each patient before and after control of asthma. There was a significant increase in these parameters in asthmatic patients during acute attack than control subjects. Moreover, there was a significant increase in serum LTB[4] in asthmatic patients during remission than control subjects. On the other hand, there was no significant difference in serum LTC[4] in asthmatic patients during remission and control subjects. There was a significant difference in serum LTC[4] in control smokers than in control non smokers. However, there was no significant difference in asthmatic smokers and non smokers in serum LTB[4] and LTC[4]. Furthermore, clinical and ventilatory improvement in asthmatic patients during remission were associated with decreased levels of serum LTB[4] and LTC[4]. However, there was no significant difference in serum LTB[4] and LTC[4] levels in asthmatics patients who received corticosteroid and those who did not receive corticosteroid. These findings suggest that the leukotrienes have a role in the development of acute asthmatic attack and are associated with the pathogenesis of bronchial asthma. The leukotrienes play a definitive role as mediators in bronchial asthma, as they present at serum levels consistent with the severity of acute asthma, and decreased with the improvement of the disease. The beneficial effects of corticosteroid in asthmatic patients appear to be mediated by mechanisms other than reduction of leukotrienes. The development of selective leukotriene antagonist may help in the treatment of asthmatic patients

Lead poisoning from a retained bullet in the middle ear

A rare case of lead intoxication caused by a bullet lodged in the middle ear for four years was discussed. A review of previously reported cases of lead poisoning from projectiles was presented