Nottingham health profile assessment of health-related quality of life in primary knee osteoarthritis patients: Relation to clinical features and radiologic score

Aim of the work: To evaluate the Nottingham Health Profile (NHP) assessment of health-related quality of life (HRQoL) in primary knee osteoarthritis (KOA) patients and to determine its relationships with clinical and radiological measures. Patients and methods: This study included 50 primary KOA patients and 25 matched healthy controls. All were assessed by NHP-HRQoL, visual analog scale (VAS) for pain in rest and activity, 15-m walk test for physical performance and knee joint range of motion (ROM). Radiographic grading of KOA was scored using Kellgren–Lawrence (K-L) score. Results: The 50 KOA patients were 33 (66%) females and 17 (34%) males with mean age of 43.3 ± 8.6 years and BMI of 32.2 ± 3.7. The VAS at rest was 2.6 ± 2.1, during motion was 6.2 ± 2.1, the 15-m test 22.6 ± 3.6 s, ROM active flexion 122.9 ± 10.8 and in passive flexion 132.1 ± 11.1. All NPH subscales (physical mobility, pain, energy level, sleep and emotional reaction) except social isolation showed significantly higher scores in KOA patients compared to controls and tended to be higher in females. There were significant correlations between NHP subscales with age, VAS-rest, VAS-activity, knee flexion and degree of incomplete extension, walk test, also with K-L score. Conclusion: The NPH-HRQoL is affected in Egyptian patients with primary KOA and may be used as a measure to reflect pain, physical performance and radiographic severity. Physical mobility, pain, sleep, energy, and emotional reactions items were obviously reported except social isolation domain attributed to different cultures and morals of eastern communities. Keywords: Knee osteoarthritis, Nottingham health profile, Health-related quality of life, Kellgren–Lawrence scor

Clinical significance of serum interleukin-6 and −174 G/C promoter polymorphism in Rheumatoid arthritis patients

AbstractAim of the workTo evaluate the clinical significance of serum levels of interleukin-6 (IL-6) and −174 G/C promoter polymorphism in Rheumatoid arthritis (RA) patients.Patients and methodsWe studied 37 RA patients and 10 age and gender matched healthy controls. Demographic, clinical and serological data were prospectively evaluated. Disease activity score (DAS28) and Health Assessment Questionnaire (HAQ) were assessed. Serum IL-6 level was measured and promoter (−174G/C) genotyped.ResultsSerum IL-6 levels were significantly higher in RA patients compared to control (p=0.04), especially those with CC promoter polymorphism. Twenty-four patients had GG IL-6 (−174 G/C) gene promoter polymorphism, 11 were GC and 2 CC. Nine controls were GG and 1 GC. In patients with more advanced polymorphism (−174 CC) there was a significantly increased functional impairment (HAQ score) (p=0.029) and platelet count (p=0.049). In those with GG genotype, there was a significant correlation between IL-6 and Morning stiffness duration (r=0.44,p=0.03), while those with GC genotype had a significant negative correlation of the IL-6 level with the parameters of disease activity and the DAS28 (r=−0.69,p=0.019). None of the studied parameters would predict the IL-6 promoter polymorphism.ConclusionSerum IL-6 levels and −174 G/C promoter polymorphism were higher in RA patients than in healthy controls. The inverse relation of IL-6 with the DAS28 in those with an increased IL-6 promoter polymorphism may confirm its increased involvement in the pathogenesis of RA and in the increased disease activity which may point to the need for considering of anti-IL-6 agents in their management plan

Relation of anti-annexin V antibodies to disease manifestations and activity in Behҫet’s disease patients

Aim of the work: To assess the role of serum anti-annexin V antibodies in Behҫet’s disease (BD) patients in relation to disease manifestations and activity. Patients and methods 65 BD patients and 30 matching controls were included. Disease activity was estimated by the Behçet Disease Current Activity Form (BDCAF). Serum IgG anti-annexin V antibodies titre was measured using the enzyme-linked immunosorbent assay. Results The patients’ age was 36.1 ± 8.5 years and disease duration 7.2 ± 5.2 years; 56 males and 9 females. The serum anti-annexin V antibodies level was significantly increased in the BD patients (50.9 ± 12.9 AU/ml) compared to the control (7.3 ± 3.1 AU/ml) (p < 0.0001). Serum anti-annexin V antibodies were significantly increased in BD patients with ocular involvement, skin lesions and neuro-Behcet’s compared to those without (p = 0.02, p = 0.004 and p = 0.002 respectively). Levels were comparable between those with uveitis, vitrous cells, retinal vasculitis, conjunctivitis and hypopyon and those without (p = 0.12, p = 0.22, p = 0.9, p = 0.67, p = 0.79 and p = 0.46 respectively). While those with xerophthalmia had a significantly higher level of anti-annexin V antibodies (60.6 ± 5.7 AU/ml) compared to those without (50.2 ± 13.1 AU/ml) (p = 0.02). The anti-annexin V antibodies significantly correlated with the BDCAF (r = 0.41, p = 0.001) and age (r = 0.43, p < 0.0001) but not with the disease duration (r = 0.22, p = 0.08), steroid dose (r = −0.21, p = 0.09) or laboratory investigations. On regression analysis, only the age would predict the anti-annexin V antibodies level (p = 0.02) while the BDCAF would not (p = 0.33). Conclusion There is a role of apoptosis in the pathogenesis of BD with special relation to the ocular, cutaneous and neurological manifestations and a possible link to the disease activity