Clinical significance of soluble-triggering receptor expressed on myeloid cells-1 (sTREM-1) in patients with rheumatoid arthritis

AbstractAim of the workTo assess serum concentrations of triggering receptor expressed on myeloid cells-1 (sTREM-1) in rheumatoid arthritis (RA) patients, and correlate them with the main clinical, serological, radiological features and functional capacity of RA patients.Patients and methodsSera from 61 RA patients, and 30 healthy controls were assayed for sTREM-1 by Enzyme Linked Immunosorbant Assay. RA disease activity was assessed using 28-joint disease activity score (DAS-28). Assessment of patient’s functional capacity was done using modified health assessment questionnaire (mHAQ). Standardized X-rays were done to all RA participants and evaluated according to Larsen scoreResultsSerum levels of sTREM-1 were significantly higher in RA patients vs healthy controls (57.61±28.87 and 43.72±10.64ng/ml; p=0.027). These levels were higher in patients with severe disease activity (68.27±36.14ng/ml) than those with mild and moderate disease activity (43.50±6.49ng/ml and 47.52±12.26ng/ml, respectively; p=0.008). On the contrary, no significant difference was found in levels of sTREM-1 in patients with extra-articular involvement or positive RF than those without. Levels of sTREM-1 showed a highly significant positive correlation with DAS-28 (P=0.001), ESR (P=0.02) and mHAQ (p=0.003).There were no significant correlations between sTREM-1 level with age, disease duration, morning stiffness, nor radiological narrowing and erosion scores.ConclusionLevels of sTREM-1 were elevated in RA patients and correlated significantly with clinical and laboratory markers of disease activity as well as functional disability (as determined by mHAQ). To confirm our results we propose that larger scale, multicenter studies with longer evaluation periods are needed

Clinical significance of anti-cyclic citrullinated peptide antibodies in Egyptian patients with chronic hepatitis C virus genotype IV infection

Background: Symmetric polyarthritis associated with hepatitis C virus (HCV) infection frequently displays a clinical picture like rheumatoid arthritis (RA). Antibodies to cyclic citrullinated peptide (CCP) have high specificity for the diagnosis of RA. This study examined the frequency and clinical significance of anti-CCP antibodies in patients with chronic HCV infection, with and without manifestations of joint involvement, compared to RA patients. Methods: Serum anti-CCP antibodies and rheumatoid factor (RF) were evaluated in 30 patients with RA and 47 patients with chronic HCV infection. Of those with HCV infection, 20 patients had chronic HCV infection associated with articular involvement and 27 patients had chronic HCV infection without any articular involvement. Results: Anti-CCP antibody level was positive in 70% of RA patients, 8.5% of HCV-infected patients, and in 20% of HCV patients with articular manifestations. RF was positive in 76% of RA patients and in 60% of HCV patients with articular involvement. Cryoglobulins were found in 29% of HCV-infected patients and in 16% of RA patients. Cryoglobulins were more frequent among HCV patients with articular affection (35%) compared to HCV patients without articular affection (26%). Conclusions: Although anti-CCP antibodies remain a useful diagnostic tool for RA, their interpretation in HCV-infected patients with arthritis should be applied with caution. The possibility that those patients could be prone to develop RA cannot be ruled out. Those patients need careful clinical and radiological follow-up. Further large-scale studies are warranted. Clin Chem Lab Med 2009;47:842–7.Peer Reviewe

Jaccoud’s arthropathy in patients with systemic lupus erythematosus: One centre study

Jaccoud’s arthropathy (JA) is a chronic, deforming, non-erosive arthropathy occurring in a subset of patients with systemic lupus erythematosus (SLE). In this research we aimed to evaluate clinical and immunological features in patients with SLE complicated by JA. Eighty seven consecutive SLE patients with a history of arthritis were included in the present study. These patients were subdivided according to “Jaccoud’s arthropathy index” as follows: non-deforming arthropathy, mild deforming and definite Jaccoud. Demographic data, disease activity and disability were recorded. Rheumatoid factor (RF), anti-cardiolipin antibodies (ACL), antiSSA/Ro, and anti SSB/La antibodies, were assessed in all patients. We found clinical deforming arthropathy in 12 patients, among whom seven had definite JA. Both the mean duration of the disease and of arthritis were longer in the JA group compared to the non-deforming arthropathy group. JA patients presented a trend toward a lower quality of life. The prevalence of Sicca syndrome (SS) and antiphospholipid syndrome were significantly higher in the JA group than in the patients with non-deforming arthropathy (p = 0.011 and 0.012, respectively). ACL and RF were more frequent among patients with JA (p = 0.013 and 0.036; respectively). These data suggest that JA is not rare and represents a subset of SLE with specific clinical and serological features. Future studies are needed to reveal the pathogenesis, the genetic association, the prevention, the stabilization and the appropriate cure for these patients

Metabolic abnormalities in young Egyptian women with polycystic ovary syndrome and their relation to ADIPOQ gene variants and body fat phenotype

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder. It is associated with high prevalence of metabolic risk factors, but little is known about the prevalence of metabolic syndrome (MS) and its components among Egyptian PCOS women. The objective of the study was to determine the metabolic abnormalities among young Egyptian women with PCOS and evaluate their relation with adiponectin gene (ADIPOQ) variants and body fat adiposity pattern. Materials and methods: The present study included 80 PCOS women and 80 healthy women with similar age and body mass index. All participants underwent clinical, anthropometric, biochemical, ultrasonographic and adiponectin (ADIPOQ) gene 11391G>A (rs17300539) examinations. Insulin resistance was assessed by the Homeostatic model assessment for insulin resistance (HOMA-IR). Results: MS was identified in 22.5% of PCOS women. The most prevalent MS components in PCOS women were central obesity, decreased high-density lipoprotein cholesterol (HDL-C), and increased triglycerides (TG), blood pressure (BP) and fasting glucose levels. The study found association between ADIPOQ promoter variants −11391G>A and MS in PCOS women. Moreover, multivariate logistic regression analysis showed association between abdominal fat accumulation and IR in PCOS. Conclusion: The prevalence of MS was significantly higher in PCOS women than controls, and central obesity and hypertension are risk factors for insulin resistance. Moreover, obesity plays a key role in the development of PCOS and ADIPOQ −11391G>A gene variants showed association with MS