Serum 25-OH vitamin D level in treatment-naïve systemic lupus erythematosus patients: Relation to disease activity, IL-23 and IL-17.

Objectives The aim of this study was to assess the vitamin D status in treatment-naïve SLE patients and its association with clinical and laboratory markers of disease activity, including serum levels of IL-17 and IL-23. Methods Fifty-seven treatment-naïve SLE patients along with 42 matched controls were included. SLEDAI score was used to estimate disease activity. Serum levels of 25(OH) D, IL-17 and IL-23 were measured. Results The median level of 25(OH) D in SLE patients (40.8; 4-70 ng/ml) was significantly lower than in the controls (47; 25-93 ng/ml) ( P = 0.001). A total of 38.6% of SLE cases had 25 (OH) D levels < 30 ng/ml (hypovitaminosis D) vs. 4.8% of the controls ( P < 0.0001). Apart from thrombocytopenia, vitamin D was not associated with clinical signs of SLE. There were negative correlations between serum 25(OH) D and serum levels of IL-17, IL-23 and ANA (rho = -0.5, -0.8, -0.5, P ≤ 0.05) in SLE patients. Conclusion Hypovitaminosis D is prevalent in treatment naïve SLE patients. It contributes to ANA antibody production and is associated with high serum levels of IL-23 and IL-17; thus they may trigger the inflammatory process in SLE.

Subclinical atherosclerosis in patients with chronic psoriasis: a potential association.

BACKGROUND: The immunological abnormalities that lead to the development of psoriasis suggest that these patients may be at increased risk for other inflammatory state which may enhance atherosclerosis. OBJECTIVE: To assess the presence of subclinical atherosclerosis in psoriatic patients who haven't associated traditional cardiovascular risk factors, and to correlate these findings with colour Doppler echocardiographic parameters. METHODS: The study included 80 patients with chronic psoriasis together with 50 age and sex matched healthy volunteers served as control group. Patients who had classic cardiovascular risk factors or had cardiovascular or cerebrovascular events were excluded. Carotid artery intima-media thickness (IMT) and carotid plaques were measured in the carotid arteries by using high-resolution B-mode ultrasound. Also, echocardiographic study was performed using ultrasound imaging system in all cases and controls. RESULTS: Patients with psoriasis had increased carotid artery IMT compared with controls (means 0.9 +/- 0.2 mm vs. 0.7 +/- 0.1 mm; P < 0.001). Carotid IMT positively correlated with patients age, duration of the disease and severity of psoriasis. There was no significant difference in echocardiographic parameters in psoriatic patients compared with controls, also no significant correlation between carotid IMT and echocardiographic parameters were observed in psoriatic patients. CONCLUSION: The increased carotid artery IMT in patients with chronic psoriasis suggesting that chronic psoriasis is associated with subclinical atherosclerosis with increased risk of cardiovascular disease. So, dermatologists should advice their patients to avoid traditional cardiovascular risk factors and to routinely checkup to reduce cardiovascular morbidity and mortality.