Circulating Preptin as a Marker for Osteoblast Inhibition in Rheumatoid Arthritic Patients Treated with Corticosteroids

Preptin is a newly isolated 34 amino acid peptide hormone co-secreted with insulin and amylin from pancreatic β-cells as a regulatory element in bone metabolism with an unclear yet mechanism Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints Two classes of medications are used in the management of RA: fast-acting non-steroidal anti-inflammatory drugs and corticosteoids, and slow-acting drugs. Corticosteroids are well known to have several adverse effects on bone metabolism. Aim The aim of the present study is to assess the association of corticostroids when used in the treatment of rheumatoid arthritic patients, with circulating preptin, in an attempt to shed a light on the mechanism of induced osteoporosis in such patients. Subjects and methods Ninety subjects were enrolled in this study. Divided into three groups: G1= Thirty RA lean patients taking DMARDs + corticosteroids G2= Thirty RA lean patients taking DMARDs without corticosteroids G3= Thirty healthy weight and aged matched controls Circulating serum preptin was measured in all groups using ELISA technique. Results Results showed that circulating serum preptin was elevated in patients with RA. However it was lower in G1 than in G2 In conclusion Results showed that preptin was affected in such patients when compared to arthritic patients not treated with corticosteroids. This suggests that this newly discovered hormone could be considered as a new marker for bone mineral density and osteoporosis

The Role of Vitamins A, C and E with Zinc and Copper Elements in the Etiology and Pathogenesis of Fibromyalgia Syndrome

Fibromyalgia is one of the rheumatological disorder syndromes. It is characterized by generalized musculo-skeletal pain, fatigue with nervous system involvement such as memory disturbance, difficulty in concentration and depression. However, its etiology and pathogenesis is still obscured. Besides, its diagnosis has been done according to its clinical feature and by exclusion of other systemic diseases. Some studies found that serum level of vitamins like A, C and E, besides, Zinc and Copper elements would be altered during the affection by this disorder.Aim of study: to demonstrate the role of vitamins A, C and E together with Zinc and Copper in the etiology and pathogenesis of fibromyalgia syndrome. Subjects and methods: this study included forty patients (male and female) with fibromyalgia syndrome. In addition, nineteen  healthy individuals were involved in this study. In both groups, vitamins A, C and E serum level were examined.Besides zinc and copper levels also were measured in the serum of the subjects of both groups involved in this study.Results: the results showed obvious reduction in the level of vitamins A and E with minimal decreament in the level of vitamin C in the serum of fibromyalgia patients. In the contrary, the Copper serum level revealed significant increase in the fibromyalgia patients while Zinc level in the serum of both groups remained almost unaltered.Conclusion: the serum levels of vitamins A, C and E, in addition to the Copper and Zinc could play an important role in the etiology and pathogenesis of fibromyalgia syndrome.Besides, it could be helpful in the laboratory investigation for the diagnosis of this disorder. Keywords: fibromyalgia, vitamin A, C and E, Copper and Zinc