Pregnancy outcome in women with active and inactive lupus nephritis: A prospective cohort study.

Several studies have emphasized poor pregnancy outcomes associated with active lupus nephritis at the onset of conception. A few controversial studies have compared pregnancy outcome in patients with inactive lupus nephritis at conception and those without a history of lupus nephritis. This study aimed to find out if quiescent lupus nephritis at the onset of conception carries an increased risk of pregnancy complications compared to pregnancies without a history of lupus nephritis. This is a prospective cohort study carried out at the Rheumatology/Obstetrics Conjoint Clinic of Kasr Al-Ainy Hospital between January 2006 and December 2017. A total of 119 pregnancies were included: 72 pregnancies in group I (with a history of lupus nephritis) and 47 pregnancies in group II (non-renal systemic lupus erythematosus). They were subjected to full history taking, monthly clinical examination and laboratory investigations. In total, 16 (22.2%) renal pregnancies had renal flares at the onset of conception. Maternal complications, specifically renal flares, were reported in 36 (50%) pregnancies in group I and 13 (27.7) pregnancies in group II, with a significant difference (p = 0.015). No significant differences were found concerning the frequency of pregnancy-related maternal and fetal complications between the two groups. When data were re-analyzed after excluding patients experiencing renal flares during the 6 months preceding pregnancy, there were no significant differences regarding the frequency of maternal and fetal complications between renal and non-renal pregnancies. In conclusion, lupus nephritis, per se, is not a risk factor for poor pregnancy outcome; rather, it is the lupus nephritis activity at the onset of pregnancy.

Homing and efficacy of intra-articular injection of autologous mesenchymal stem cells in experimental chondral defects in dogs.

OBJECTIVES: This study was intended to verify the likelihood of homing of intra-articularily injected mesenchymal stem cells (MSCs) and its involvement in the healing process of experimentally induced, acute and chronic, partial chondral defects in dogs. METHODS: Partial thickness chondral defects were created on the lateral femoral condyle of stifle joint in domestic mongrel dogs. MSCs were harvested in a separate procedure, labelled with green fluorescent protein (GFP) using monster GFP vector and suspended in buffer phosphate solution for intra-articular (IA) injection. Dogs were divided into three groups. Group I, served as the control. The dogs in the two cell-treated groups received a single IA injection of MSCs one day (Group II) and one month (Group III) after creating the defect. Sacrifice was scheduled at 2 and 8 weeks post-surgery for group I, and 2 and 8 weeks post-treatment, for the cell-treated groups. Morphological, histological, and fluorescence analysis was performed. RESULTS: Recovery was significant both clinically and histologically in the two cell-treated groups (Group II and III) compared to the control (Group I), (p<0.001). In the meantime, Group-II showed better results at 8 weeks than Group III (p=0.01). Homing was confirmed by the incorporation of injected GFP-labelled MSCs within the newly formed cartilage. CONCLUSIONS: The obtained results prove that the use of IA injection of autologous MSCs is a viable option for treating partial cartilage defects. Cell labelling gave evidence to the certainty of cell homing within the neocartilage of all treated cases and the participation in the reparative process.