The association between IL17, fatigue and quality of life in psoriatic arthritis patients.

Background: Psoriatic arthritis is a chronic inflammatory condition. It impacts patients both physically and psychologically. Fatigue may be an early symptom of PsA, which impairs quality of life.Objectives: To assess serum IL-17, fatigue, quality of life and function impairment in PsA patients and to correlate them with clinical disease activity.Methods: 80 consecutive PsA patients were included. Fatigue assessed by Functional Assessment of Chronic Illness Therapy-Fatigue. Quality of life assessed by Psoriatic Arthritis Quality of Life. Functional capacity assessed by health assessment questionnaire. Disease activity assessed by Disease Activity in Psoriatic Arthritis. Serum IL-17 measured by ELISA.Results: There was significant difference in FACIT-F, PsAQOL, and HAQ (p<0.001) in different disease activity subgroups. There was statistically significant correlation of disease duration with disease activity, fatigue, reduced function capacity, and quality of life impairment (p≤0.05), while no correlation with the patients' age. There was statistically significant correlation between FACIT-F, PsAQOL, HAQ, and DAPSA scores (p<0.001). Serum IL-17 was significantly correlated with clinical parameters of disease activity, fatigue, function, and quality of life impairment (p≤0.05).Conclusion: Fatigue is a common clinical symptom in psoriatic arthritis patients. It is significantly associated with IL17, quality of life, functional impairment and disease activity.

Vitamin D: does it help Tregs in active rheumatoid arthritis patients.

Background Regulatory T cells (Tregs) play an important role in the maintenance of immunological tolerance. Tregs deficiency or suppressor functions reduction may be associated with autoimmune diseases development. Objectives To estimate the effect of vitamin D supplementation on Tregs level in the peripheral blood of active rheumatoid arthritis (RA) patients. Methods 40 active RA patients were randomly assigned into two groups. Group I received methotrexate (MTX) plus hydroxychloroquine, group II received MTX, hydroxychloroquine plus vitamin D supplementation for 3 months, and 30 healthy volunteers as control group. Peripheral blood Tregs were measured at baseline and after 3 months by Flow Cytometry. Results At baseline, Tregs percentage was significantly decreased (p<0.001) in both RA patient groups (13.52±1.95%, 13.65±2.98% respectively), compared to controls (28.44±7.37%) with no significant difference between the two patient groups (p=0.866). After 3 months, there was a significant elevation in Tregs percentage in group II compared to group I (p<0.001). Tregs elevation was associated with significant DAS-28 score reduction (p<0.001). Conclusion Vitamin D appears to have important immunomodulatory functions. Vitamin D supplementation can be combined safely with traditional DMARDs to regulate the immune system. Clinical trial registration Tanta University Protocol Record 33846, Vitamin D Effect in Rheumatoid Arthritis, http://www.clinicaltrials.gov, NCT04472481.

Elevated serum interleukin-34 level in juvenile systemic lupus erythematosus and disease activity.

AIM OF THE WORK: To determine the role of Interleukin-34 (IL-34) in the pathogenesis of juvenile systemic lupus erythematosus (J-SLE), by exploring the relationship between IL-34 concentration and the disease activity SUBJECTS AND METHODS: This study was carried out on 48 children with SLE, and 30 healthy control subjects. SLE disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI). Serum IL-34 was measured by enzyme-linked immunosorbent assay (ELISA). The collected data were statistically analyzed using SPSS program version 16.0. RESULTS: There was a significant elevation in IL-34 concentration in J-SLE patients (52.25 ± 19.94 pg/ml) compared with control group (11.20 ± 6.40 pg/ml) (p < 0.001). The highest level was detected in patients with high SLEDAI score and with lupus nephritis (p = 0.005, 0.003, respectively). There was a statistically significant positive correlation between IL-34 levels and SLEDAI, ESR, CRP, and anti-ds DNA antibodies, but negative correlation with complement (C3, C4), and hemoglobin levels in J-SLE patients. CONCLUSION: IL-34 could be a probable marker for J-SLE disease activity which is more aggressive than adult-SLE, and IL-34 blockage may suppress the expression of proinflammatory cytokines in patients' blood.Key Points•Juvenile SLE is more aggressive and of worse prognosis than adult-SLE.• Significantly elevated concentration of IL-34 in juvenile SLE patients when compared with controls.• Elevated concentrations of IL-34 in patients are correlated with SLEDAI, ESR, CRP, ds-DNA antibodies, hemoglobin, and complement levels.• IL-34 may play a role in SLE pathogenesis and disease activity.