Identification of potential biomarkers for SLE through mRNA expression profiling.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease that influences numerous body systems. Furin, tristetraprolin (TTP), and NOD, LRR, and pyrin domain-containing protein 3 (NLRP3) contribute in developing autoimmune illnesses. AIM: Understandthe role of furin, TTP, and NLRP3 mRNA gene expression in SLE pathogenesis and prognosis. Methods: Total 210 individuals were enrolled, divided in two group: cases and control; 105 participants in each group.  Real-time quantitative PCR for furin, TTP,and NLRP3 mRNA gene expression were determined for each subject. RESULTS: SLE patients showed significantly higher serum furin [median 20.10 (0.0-162.88) in comparison with control group [median 1.10 (0.33-8.64)] with significant pvalue (p < 0.001), for NLRP3 expression [median 7.03 (0.0-282.97) compared to control group [median 1.0 (0.44-9.48)] with significant p value (p = 0.006)but lower TTP [median 2.37 (0.0-30.13)] in comparison with control group [median 7.90 (1.0-29.29)] with significant p value (p < 0.001) . Elevated levels of Furin and NLRP3 and low levels of TTP were linked to increased illness activity. CONCLUSION: Furin and NLRP increase in SLE and higher with illness activity. TTP is lowerin SLE and negatively correlates with disease activity.

Assessment of cardiopulmonary manifestations and its correlation with semi-quantitative scoring of high-resolution computed tomography in patients with autoimmune rheumatic diseases.

PURPOSE: Autoimmune rheumatic diseases (ARD) are groups of diseases that are commonly associated with cardiac and pulmonary manifestations and may affect the morbidity and mortality of the patients. The study aimed to the assessment of cardiopulmonary manifestations and their correlation with the semi-quantitative scoring of high-resolution computed tomography (HRCT) in ARD patients. METHODS AND PATIENTS: 30 patients with ARD were included in the study (mean age 42.2 ± 9.76 years) [10 patients were scleroderma (SSc), 10 patients were rheumatoid arthritis (RA), and 10 patients were systemic lupus erythematosus (SLE)]. They all met the diagnostic criteria of the American College of Rheumatology and underwent spirometry, echocardiography, and chest HRCT. The HRCT was assessed by a semi-quantitative score for parenchymal abnormalities. Correlation between HRCT lung scores and: inflammatory markers, lung volumes in spirometry, and echocardiographic indices has been performed. RESULTS: The total lung score (TLS) by HRCT was 14.8 ± 8.78 (mean ± SD), ground glass opacity score (GGO) was 7.20 ± 5.79 (mean ± SD) and fibrosis lung score (F) was 7.63 ± 6.05 (mean ± SD). TLS correlated significantly with ESR (r 0.528, p 0.003), CRP (r 0.439, p 0.015), PaO2 (r -0.395, P 0.031) FVC% (r -0.687, p 0.001), and echocardiographic Tricuspid E (r -0.370, p 0.044), Tricuspid E/è (r -0.397,p 0.03), ESPAP (r 0.459,p 0.011), TAPSE (r -0.405, p 0.027), MPI-TDI (r -0.428, p 0.018) and RV Global strain(r -0.567, p 0.001). GGO score correlated significantly with ESR (r 0.597, p 0.001), CRP (r 0.473, p 0.008), FVC% (r -0.558, p 0.001), and RV Global strain(r -0.496, p 0.005). F score correlated significantly with FVC% (r -0.397, p 0.030), Tricuspid E/è (r -0.445, p 0.014), ESPAP (r 0.402, p 0.028), and MPI-TDI (r -0.448, p 0.013). CONCLUSION: The total lung score and GGO score in ARD were found to be consistently significantly correlated with FVC% predicted, PaO2, inflammatory markers, and RV functions. Fibrotic score correlated with ESPAP. Therefore, in a clinical setting, most clinicians who monitor patients suffering from ARD should concern with the applicability of semiquantitative HRCT scoring in clinical practice.

Vascular cell adhesion molecule-1 in rheumatoid arthritis patients: Relation to disease activity, oxidative stress, and systemic inflammation.

OBJECTIVES: To evaluate the potential role of vascular cell adhesion molecule-1 (VCAM-1), an endothelial factor, in endothelial dysfunction in rheumatoid arthritis (RA) patients, and to determine its relation to disease activity, oxidative stress, and inflammatory markers. METHODS: This study was designed as a cross-sectional case-control study. One-hundred patients with RA were selected from out-patient clinics of Menoufia University Hospital, Menoufia, Egypt from May 2019 to May 2020. Fifty patients previously diagnosed with RA for more than 6 months were included as Group I, and fifty patients newly diagnosed with RA were included as Group II. Fifty healthy age- and gender-matched individuals were evaluated as the control group (Group III). Complete blood count, random blood glucose, erythrocyte sedimentation rate (ESR), lipid profile, rheumatoid factor, anti-cyclic citrullinated peptide antibodies, serum levels of urea, creatinine, C-reactive protein, VCAM-1, malondialdehyde, and total antioxidant capacity were determined. RESULTS: Patients with RA showed significantly higher serum VCAM-1, malondialdehyde, ESR, C-reactive protein, triglycerides, total cholesterol, low-density lipoprotein, and atherogenic index levels than the control group. Also, they showed significantly lower total antioxidant capacity and high-density lipoprotein levels than control group. A significant positive correlation between serum VCAM-1 with disease activity, serum malondialdehyde, ESR, and C-reactive protein was observed. Also, a significant negative correlation between serum VCAM-1 and total antioxidant capacity was present. CONCLUSION: Serum VCAM-1 increases in RA, and it correlates with disease activity, oxidative stress, and inflammatory markers.

Evaluating the Efficacy of Intra-articular Injections of Platelet Rich Plasma (PRP) in Rheumatoid Arthritis Patients and its Impact on Inflammatory Cytokines, Disease Activity and Quality of Life.

BACKGROUND: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by disease-modifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in the management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B, TNF α, local joint inflammation, disease activity and quality of life (QL). METHODS: Open-labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at a monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, and 6 months post injection. RESULTS: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. CONCLUSION: PRP is a safe, effective and useful therapy in treating RA patients who had an insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

Knowledge, Attitude and Practice toward COVID-19 among Egyptians.

COVID-19 is a public Health Emergency of International Concern. The aim of this work was to assess the level of Knowledge, Attitude and Practice (KAP) among Egyptians toward COVID-19. A cross-sectional study was conducted from March 1st to April 1st, on 3712 participants of different ages and sex. An author designed KAP questionnaire toward COVID-19 administered online and personally was delivered. Satisfactory knowledge, positive attitude and good practice were reported among 70.2%, 75.9% and 49.2% of the participants respectively. Middle-aged participants reported high knowledge and attitude levels with poor practice level (p < 0.001). Females reported high knowledge and practice levels and low attitude (p < 0.001 and p = 0.041 respectively). Despite reporting high knowledge and attitude among urban residents (p < 0.001), practice level was high among rural residents (p = 0.001). Post-graduate education reported the highest levels of KAP (p < 0.001). Rural residents, working and non-enough income participants reported lower level of practice (p < 0.001). Logistic regression was carried out. It was found that unsatisfactory knowledge was associated with low education [Odds Ratio (OR) = 1.97, 95% CI: 1.51-2.56], and of rural residency (OR = 1.2, 95% CI: 1.05-1.41). Negative attitude was associated with not working (OR = 1.94, 95% CI: 1.61-2.35) and not enough income (OR = 1.29, 95%CI: 1.10-1.51 respectively). Poor practice is associated with young age (OR = 2.41, 95% CI: 1.94-2.98) and low education (OR = 1.19, 95% CI: 1.03-1.37) and not working (OR = 4.95, 95% CI: 4.07-6.02). Satisfactory knowledge, positive attitude and poor practice were found among the participants. A good knowledge and lower practice level were found among middle-aged, working participants, and participants with insufficient income. The demographic characters associated with KAP could be the cornerstone in directing policy-makers to target the health education campaigns to the suitable target groups.

Cell-free long non-coding RNAs (LY86-AS1 & HCG27_201and GAS5) as biomarkers for pre-diabetes and type 2 DM in Egypt.

BACKGROUND: Increasing interest has been focused on lncRNAs as potential markers in the pathogenesis and progression of numerous diseases. AIM: We aimed to investigate the expression pattern and role of cell-free lncRNAs (GAS5, HCG27_201 and LY86-AS1) in pre-diabetic, diabetic and T2DM groups. SUBJECTS & METHODS: Quantification of the expression level of cell-free lncRNAs (GAS5, HCG27_201 and LY86-AS1) was performed by real-time PCR in 210 individuals classified in diabetic (T2DM), pre-diabetic and control groups. RESULTS: Significant differences were observed in the relative expression level of lncRNAs (GAS5, LY86-AS1 and HCG27_201) among the three studied groups. The LncRNA expression levels decreased gradually from the control to the pre-diabetic group and reached the lowest values in the T2DM group. The A receiver operating characteristic curve (ROC) was applied to identify a cut-off value for each of the three genes among our groups. The three lncRNAs showed promising results in discriminating between the diabetic patients and controls, with HCG27_201 gene expression having the best performance. Furthermore, lncRNA expression was able to predict the future development of DM in the pre-diabetics because ROC analysis among diabetics and pre-diabetics revealed considerable results. GAS5 gene expression showed the best performance. Additionally, HCG27_201 expression was the most valuable biomarker for differentiating between pre-diabetics and controls and presented a sensitivity of 91% and specificity of 64%. CONCLUSIONS: We concluded that cell free lncRNAs (GAS5, LY86-AS1 and HCG27_201) could be considered promising diagnostic and predictive biomarkers for DM and that HCG27_201 could act as a potential diagnostic biomarker for pre-diabetes.