Thymoquinone blocks lung injury and fibrosis by attenuating bleomycin-induced oxidative stress and activation of nuclear factor Kappa-B in rats

Pulmonary fibrosis is one of the most common chronic interstitial lung diseases with high mortality rate after diagnosis and limited successful treatment. The present study was designed to assess the potential antifibrotic effect of thymoquinone (TQ) and whether TQ can attenuate the severity of oxidative stress and inflammatory response during bleomycin-induced pulmonary fibrosis. Male Wister rats were treated intraperitoneally with either bleomycin (15 mg/kg, 3 times a week for 4 weeks) and/or thymoquinone (5 mg/kg/day, 1 week before and until the end of the experiment). Bleomycin significantly increased lung weight and the levels of Lactate dehydrogenase, total leucocytic count, total protein and mucin in bronchoalveolar lavage and these effects were significantly ameliorated by TQ treatment. As markers of oxidative stress, bleomycin caused a significant increase in the levels of lipid peroxides and nitric oxide accompanied with a significant decrease in the antioxidant enzyme activity of superoxide dismutase and glutathione transferase. TQ treatment restored these markers toward normal values. TQ also coun- teracted emphysema in air alveoli, inflammatory cell infiltration, lymphoid hyperplastic cells activation surrounding the bronchioles and the over expression of activated form of nuclear factor kappa-B (NF-B) in lung tissue that was induced by bleomycin. Fibrosis was assessed by measuring hydroxyproline content, which increased markedly in the bleomycin group and significantly reduced by concurrent treatment with TQ. Furthermore, histopathological examination confirmed the antifibrotic effect of TQ. Collectively these findings indicate that TQ has potential antifibrotic effect beside its antioxidant activity that could be through NF- B inhibition

Magnetic resonance imaging versus musculoskeletal ultrasound in the evaluation of temporomandibular joint in rheumatoid arthritis patients

Aim of the work: To evaluate temporomandibular joint (TMJ) affection in rheumatoid arthritis (RA) patients by magnetic resonance imaging (MRI) versus musculoskeletal ultrasound (MSUS) and to correlate the findings with clinical manifestations, disease activity and functional status. Patients and methods: Twenty RA patients (40 TMJ) were included in this study. Disease activity score 28 (DAS28) was assessed and functional status by modified health assessment questionnaire (mHAQ). The TMJs were assessed clinically and functionally according to the Fonesca’s questionnaire. Radiological assessment of the TMJ was performed using panorama X-ray, MSUS and MRI. Results: The patients mean age was 47.3 ± 10.03 with a F:M 9:1. Out of 40 TMJs 27 (67.5%) were symptomatic; pain/tenderness in 67.5%, limited mouth opening in 65% and sounds in 47.5%. MRI was superior in detection of TMJ abnormalities compared with MSUS (82.5% vs 77.5%, respectively). The frequencies of TMJ erosions detected by MRI, MSUS and panorama were 80%, 57.5% and 27.5% respectively (p = 0.0001). TMJ effusion and disc displacement were comparable by MRI and MSUS (67.5% and 62.5%; p = 0.64 and 57.5% and 52.5%; p = 0.5,respectively). Only the effusion and disc displacement significantly correlated with the DAS28 and mHAQ. Only the erosions detected by MSUS did not significantly correlate with the Fonesca’s questionnaire. Conclusion: Detection of TMJ abnormalities tended to be higher by MRI than by MSUS yet with no difference between both modalities. TMJ erosions, effusion and disc displacement were common in RA patients as detected by MRI and MSUS. Also both were helpful in detecting subclinical TMJ radiographic abnormalities in RA patients