Vitamin D Deficiency in Egyptian Systemic Lupus Erythematosus Patients: How Prevalent and Does It Impact Disease Activity?

BACKGROUND: The emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE) patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern. OBJECTIVES: The objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease. MATERIALS AND METHODS: In our observational cross-sectional study, serum levels of vitamin D [25(OH)D] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI), irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI), and severity by Severity of Disease Index. Fatigue was measured by visual analog scale. RESULTS: Significantly lower levels of 25(OH)D were found in SLE patients (17.6 ± 6.9 ng/mL) in comparison to controls (79.0 ± 28.7 ng/mL), with a statistically high significant difference (t = -11.2, P < 0.001). High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI (r = -0.495, P < 0.001), SLICC (r = -0.431, P < 0.05), and fatigue (r = -0.436, P < 0.05). CONCLUSION: Vitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential yet simple measure to their usual management to improve their condition.

The Interplay between Zinc, Vitamin D and, IL-17 in Patients with Chronic Hepatitis C Liver Disease.

OBJECTIVES: To assess zinc (Zn) and vitamin D (Vit. D) status in chronic Hepatitis C virus- (HCV) infected patients and their relationship to interleukin- (IL-) 17 and disease severity and then investigate whether Zn and Vit. D3 modulate IL-17 expression in chronic HCV patients. METHODS: Seventy patients and fifty healthy subjects were investigated. Serum levels of Zn, Vit. D, and IL-17 were assessed in the patients group and subgroups. Patients lymphocytes were activated in vitro in the presence or absence of Zn or Vit. D3 and then intracellular IL-17 production was assessed using flow cytometry. RESULTS: Zn and Vit. D were significantly decreased in HCV patients. Increasing disease severity leads to more reduction in Zn level opposed by increasing IL-17 level. Zn potently reduced IL-17 production in a dose-related fashion; however it did not exert any toxic effects. Although Vit. D apparently increases IL17 expression, it is unclear whether it is due to its toxic effect on cell count or lack of definite association between Vit. D and both IL-17 and disease severity. CONCLUSIONS: This study demonstrates that Zn modulates IL-17 expression and provides a rationale for evaluating this compound as a supplementary agent in the treatment of chronic HCV.

Serum visfatin, resistin and IL-18 in A group of Egyptian obese diabetic and non diabetic individuals.

Resistin and visfatin have been proposed as playing a role in the pathogenesis of insulin resistance. We assessed the relationship between their serum concentrations and insulin resistance in lean, obese diabetic and obese non-diabetic. We explore their relationship with inflammatory markers and anthropometric parameters in obese patients. We measured serum resistin, visfatin levels in obese diabetic, obese nondiabetic patients and in lean subjects. The concentrations of serum resistin showed significant differences among the three groups. Higher levels of visfatin occurred in obese diabetic and non diabetic compared to lean subjects. Higher levels for HOMA-IR occurred in obese diabetic and non diabetic compared to lean subjects. Resistin correlated positively with insulin, HOMA-IR and with hs-CRP in obese diabetic subjects. Visfatin correlated positively with insulin and HOMA-IR in obese diabetic and non-diabetic subjects. Resistin might be involved in the pathogenesis of diabetes. Additionally, IL-18 might be a predictor of insulin resistance.

Study of folate status among Egyptian asthmatics.

OBJECTIVE: To compare serum folate levels between atopic asthmatics, non-atopic asthmatics, and healthy controls. METHODS: This case-control study included 60 asthmatics with at least one positive skin prick test (SPT) reaction (atopic asthma group), 60 asthmatics with negative SPT reactions (non-atopic asthma group), and 60 healthy controls with no history of asthma or other allergic diseases, and with negative SPT reactions. Serum folate and total IgE levels were measured in all subjects. In addition, lung functions were assessed by spirometry. RESULTS: Serum folate levels were significantly lower among the atopic asthma group [9.1 (4.9, 12.1) ng/mL] as compared to the non-atopic asthma group [11.3 (7.5, 14.8) ng/mL] and the control group [12.0 (8.3, 15.1) ng/mL], p= 0.001. Among atopic asthmatics, serum folate levels were inversely correlated with total serum IgE levels (r=-0.483, p<0.001), and the number of positive SPT reactions (r=-0.442, p<0.001). Atopic asthmatics with a total serum IgE ≤200 IU/mL had significantly higher levels of serum folate than those with a total serum IgE >200 IU/mL. Regression analysis showed that higher folate levels independently predicted lower total serum IgE levels. Folate was not found to be an independent predictor of asthma. No association was observed between serum folate levels and values of forced expiratory volume in 1s. CONCLUSION: Among asthmatics, serum folate levels are significantly lower among atopics, and correlate inversely with the degree of atopy.