The interplay between tumor necrosis factor alpha, disease activity, and depressive symptoms among Egyptian female patients with systemic lupus erythematosus.

One of the most remarkable presentations of systemic lupus erythematosus (SLE) is depression. Our aim was to elucidate the potential relationship between disease activity, depressive symptoms, and tumor necrosis factor alpha (TNF-α) in patients with SLE. Sixty female patients with SLE and thirty comparable healthy controls were recruited. According to systemic lupus erythematosus disease activity index, patients were subdivided into two similar groups; active and inactive. Complete clinical and laboratory assessments were done to authenticate the diagnosis of SLE and outline its activity. All participants were assessed using the Beck depression Inventory (BDI) to diagnose and determine the severity of depressive symptoms. TNF-α level was assessed using Enzyme linked immunosorbent assay technique. Using BDI, patients with SLE activity showed higher prevalence of depression 19 (63.3%) compared to those with inactive SLE and control groups (P < 0.001). TNF-α level was markedly elevated amongst patients with active SLE in comparison to inactive and control groups (P <0.001). TNF-α differentiated SLE patients into with and without depression at cut-off value (>360 ng/l) (AUC = 0.726; P=0.0008; 95% CI 1.3-2.7). Multivariable regression analysis for prediction of depression revealed that TNF-α was the only independent predictor of depression (P= 0.011). In conclusion, patients with increased SLE activity are more prone to depression especially, moderate to severe degree. TNF-α level could be of significance in predilection of depression and SLE activity in patients with SLE. Hence, future studies are essential to test the treatment modalities targeting TNF-α in those patients.

Aspergillus fumigatus sensitization among asthma COPD overlap patients.

Recently, many researchers are interested in studying asthma COPD overlap (ACO) group features. Sensitization to Aspergillus has been linked to increased severity of asthma; however, limited data is available about fungal sensitization in ACO group. This study was designed to determine the prevalence of Aspergillus fumigatus (A. fumigatus) sensitization among ACO patients in comparison to asthma patients. This cross-sectional study included 30 patients with ACO, and compared them to 30 asthmatic patients, as regards sensitization to A. fumigatus. Sensitization was diagnosed using skin prick test and specific IgE. Blood eosinophil count, total IgE and pulmonary functions results were also recorded. Thirteen patients with ACO (43.3%) were sensitized to A. fumigatus compared to 8 asthmatic cases (26.7%), P value 0.17. Blood eosinophil count and total IgE were significantly higher among ACO patients compared to asthma group (P values 0.003, 0.007 respectively). Blood eosinophil count was significantly higher among A. fumigatus sensitized ACO patients (400 cells/L) compared to 320 cells/L in non-sensitized ACO subgroup (P value 0.01). Otherwise, they were comparable regarding pulmonary functions and total IgE. In conclusion, Sensitization to A. fumigatus is higher among patients with ACO than that in patients with asthma but without a statistical significance. Moreover, Sensitized ACO patients showed significantly higher blood eosinophil count than non-sensitized ones.