Galectin-1 in Psoriatic arthritis, Psoriasis, Rheumatoid arthritis and its relation with disease activity and skin lesion.

Immune mediated inflammatory diseases (IMIDs) are a diverse range of diseases that affect joints with early overlapping symptoms. Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are the most common disorders sharing immune-pathogenic mechanisms that cause peripheral arthritis. Psoriasis (Ps) is a chronic inflammatory autoimmune skin disease characterized by epidermal hyperplasia with significant invasion by inflammatory cells. New biomarkers are required to enable an early diagnosis and differentiation between different types of IMIDs. In autoimmune disorders, galectin 1 (Gal-1) is a recognized as negative immune system regulator. This study aimed to determine the possibility of using gal-1 as a diagnostic marker to differentiate between RA and PsA with polyarthritis pattern, and between PsA and Ps, and to assess its relationship with disease activity and with skin lesion. In this case-control study included 40 PsA patients with polyarthritis pattern, 40 psoriatic patients, 40 RA patients and 20 normal controls. Gal-1 levels were measured in serum and skin biopsy and disease Activity Score (DAS-ESR) was assessed. Serum gal-1 level was significantly higher in RA group in comparison to PsA, psoriatic and control. In addition, compared to the normal group, psoriatic skin lesions from PsA and Ps patients had lower levels of gal-1. Serum gal-1 levels in the RA group did not correlate with other factors such as age, disease duration, deformity, extra-articular symptoms, or DAS-ESR. Furthermore, there was no correlation between the skin's level of gal-1 and psoriatic area and severity index (PASI) score, body surface area (BSA). In conclusion, serum Gal-1 concentration may serve as a diagnostic biomarker to distinguish between RA and PsA. However, it cannot assess activity or severity of RA, and cannot differentiate psoriatic lesion either from only Ps or PsA.

Ischemia-modified Albumin as a Biomarker for Prediction of Poor Outcome in Patients With Traumatic Brain Injury: An Observational Cohort Study.

BACKGROUND: Biomarkers can assist in outcome prediction and therapeutic decision making after traumatic brain injury (TBI). The aim of this study was to evaluate the role of ischemia-modified albumin (IMA) in the prediction of mortality in patients with TBI. METHODS: In this observational study IMA was measured on admission to intensive care unit (D0) and 24 hours later (D1) in a cohort of patients with mixed TBI severity. The primary outcome was the correlation between IMA and 28-day mortality. Secondary outcomes included the incidence of elevated IMA, and the correlation between the severity of TBI and IMA, and between IMA and change in Glasgow coma score (GCS). The area under receiver operating characteristic curve analysis was performed to detect optimal IMA cut-off value for the detection of mortality. RESULTS: Fifty-four patients were included in the study; IMA was elevated in 49 (90.7%) on admission to the intensive care unit. Of the 49 patients with elevated IMA, 22 had a decrease in IMA while 27 had an increase by 24 hours. IMA levels were higher at D0 and D1 (P<0.001 for both) in patients who died compared with those who survived. Twenty-one patients died (mortality rate 38.9%); all had elevated IMA on D0 and D1 and higher IMA levels at D1 compared with D0. Optimal cut-off values for IMA predicted mortality with 76.2% sensitivity and 81.8% specificity at D0 and with 100% sensitivity and specificity at D1. IMA values at D0 and D1 were correlated with D0 and D1 GCS, respectively (both P<0.001). CONCLUSION: IMA levels were elevated in patients following TBI, and can predict mortality with high sensitivity and specificity.