High Sensitive CRP in Behcet Disease With and Without Uveitis Compared With Idiopathic Uveitis: A Cross-Sectional Study

Background: Uveitis is one of the important manifestations of Behcet disease (BD). High sensitive C-reactive protein (hs-CRP) is an acute phase reactant, which may increase in BD. There are controversies in different studies regarding the relation between hs-CRP and uveitis in BD. This study aimed to determine serum values of hs-CRP and its relationship with uveitis in BD. Methods: A total of 94 patients, divided into 3 groups (Behcet"s uveitis (n = 31), Behcet"s without uveitis (n = 37) and idiopathic uveitis (n = 26), participated in the study. Serum levels of hs-CRP were compared among those groups. Result: The mean serum hs-CRP level was 6.49 ± 3.27 mg/L (BD with uveitis), 6.41 ± 3.85 mg/L (BD without uveitis) and 6.97±3.9 mg/L (idiopathic uveitis. Tukey test was done among groups and there were no significant differences between them (P = 0.69). Conclusion: Our results revealed no significant difference among the 3 groups regarding the mean serum hs-CRP level. However, further studies are warranted in this regard

Calcitonin Gene-Related Peptide Effects on Phenotype and IL-12 Production of Monocyte-Derived Dendritic Cells in Rheumatoid Arthritis Patients

Objective(s)Recent studies on human indicate that the introduction of therapeutic use of tolerogenic dendritic cell (DC) for chronic inflammatory conditions is imminent. For the purpose of defining CGRP potency in tolerogenic DC production, we investigated the phenotype and IL-12 production of DCs generated from the monocytes of rheumatoid arthritis (RA) patients in the presence of the calcitonin gene-related peptide (CGRP), as a multifunctional neuropeptide.Materials and MethodsDCs were generated from isolated monocytes from four resistant and two early female RA patients using IL-4, GM-CSF, and CGRP at concentrations of 0, 1, and 100 nM. Then, the phenotype of neuropeptide-treated or untreated DCs was determined using flow cytometry and the IL-12 production was measured by ELISA.ResultsOur study showed that, on the last day of the culture, at a concentration of 1 nM CGRP, the mean fluorescence intensity (MFI) for CD80 increased (14.13%) and the MFIs for CD83, CD86, and HLA-DR decreased (14.57%, 5.28%, and 6.88% respectively). Moreover, at 100 nM CGRP concentration, the MFI for CD80 increased (11.10%) and the MFIs for CD83, CD86, and HLA-DR decreased (4.27%, 18.60%, and 19.75% respectively). In addition, our results indicated that the mean concentrations of IL-12 produced at 0, 1, and 100 nm CGRP concentrations measured 13.72±2.41, 11.01±1.61, and 7±1.34 pg/ml respectively. ConclusionDecreased CD83, CD86, and HLA-DR expression and reduced IL-12 production by CGRP were found in the RA patients' monocyte-derived DCs. CD83 is a well-defined DC activation marker. HLA-DR and CD86 are appropriate molecules for inducing an immune response. IL-12 promotes cell-mediated immunity. Therefore we suggest that CGRP may be used as an inducer in the production of tolerogenic DCs

Evaluation and Comparison of Choroidal Thickness in Patients with Behçet Disease with versus without Ocular Involvement

Purpose: To assess the subfoveal choroidal thickness (SFCT) in patients with Behçet disease (BD) and compare the SFCT in patients with and without ocular BD (OBD) and between patients with active and quiescent phases of the Behçet’s posterior uveitis. Method: This prospective cross-sectional study was conducted on patients with BD (n = 51) between October 2016 and October 2018. Complete ocular examinations including slit lamp biomicroscopy and fundus examination with dilated pupils were performed for all patients. The SFCT values were compared between patients with and without OBD. Enhanced depth imaging optical coherence tomography (EDI–OCT) was done to measure the SFCT, and wide field fundus fluorescein angiography (WF–FAG) was performed to evaluate the ocular involvement and determine the active or quiescent phases of the Behçet’s posterior uveitis. The correlation between the changes of SFCT and the WF-FAG scores was assessed. Results: One hundred and two eyes of 51 patients with BD, aged 29 to 52 years were studied. Of these, 23 patients were male. The mean age ± standard deviation in patients with OBD and patients without ocular involvement was 38.71 ± 7.8 and 36.22 ± 10.59 years (P = 0.259) respectively. The mean SFCT in patients with OBD was significantly greater than in patients without OBD (364.17 ± 93.34 vs 320.43 ± 56.70 μm; P = 0.008). The difference of mean SFCT between the active compared to quiescent phase was not statistically significant when only WF-FAG criteria were considered for activity (368.12 ± 104.591 vs 354.57 ± 58.701 μm, P = 0.579). However, when the disease activity was considered based on both WF-FAG and ocular exam findings, SFCT in the active group was higher than the inactive group (393.04 ± 94.88 vs 351.65 ± 58.63 μm, P = 0.060). This difference did not reach statistical significance, but it was clinically relevant. Conclusion: Choroidal thickness was significantly increased in BD patients with ocular involvement; therefore, EDI-OCT could be a noninvasive test for evaluation of ocular involvement in patients with BD. The increased SFCT was not an indicative of activity in OBD; however, it could predict possible ocular involvement throughout the disease course

ABO and Rh blood groups in patients with lupus and rheumatoid arthritis

Background: Systemic lupus erythematous (SLE) and rheumatoid arthritis (RA) are autoimmune diseases in which the antigen-antibody system plays an important role. As blood group and Rh are determined by the presence or absence of antigens on the surface of red blood cells (RBCs), we aimed to determine the distribution of ABO and Rh blood groups in SLE and RA patients and its association with disease manifestations. Methods: This short communication is based on a study that was conducted on 434 SLE and 828 RA patients. We evaluated the distribution of ABO and Rh blood groups in RA and SLE patients. Results: This study projected that in lupus patients, Coombs-positive autoimmune hemolytic anemia and arthritis were more common among the B blood type and Rh-positive group, respectively. Furthermore, there was no relation between ABO and Rh blood group and rheumatoid factor (RF) and anti-Cyclic Citrullinated Peptide (anti-CCP) seropositivity. Moreover, there was no difference in distribution of blood groups in RA and SLE patients. Conclusion: The higher frequency of blood group B in hemolytic anemia, and positive Rh in arthritis in lupus patients, develop the hypothesis of probable role of ABO blood group antigen in some manifestations of lupus. Keywords: Rheumatoid arthritis (RA); Systemic lupus erythematosus (SLE); ABO blood group, Rh blood group

Efficacy of radiosynovectomy in the treatment of chronic knee synovitis: Systematic review and meta-analysis

ABSTRACT Introduction: Knee joints are commonly involved with various inflammatory and non-inflammatory rheumatic diseases. Radiosynovectomy is being used as a local therapeutic option to alleviate pain and swelling in involved joints. The present study evaluated the effectiveness of radiosynovectomy for treatment of chronic knee synovitis. Methods: Through a search of Medline and SCOPUS with (Radiosynovectomy OR radio-synovectomy OR "radio synovectomy" OR "radiation synovectomy" OR radiosynoviorthesis OR radio-synoviorthesis OR synoviorthesis OR "radiochemical synovectomy" OR "radioisotope synovectomy") AND (Re-188 OR Y-90 OR Sm-153 OR P-32) as key words, 9 RCTs were enrolled in the analysis. Results: The outcomes of interest were odds ratio and risk difference of improvement in the radiosynovectomy group compared to the control group. Odds ratio and risk difference for Sm-153 plus corticosteroid subgroup was 1. 959[0.571-6.72

Association of Pulmonary Function Tests and Serum Vitamin D Levels in Asthmatics With Vitamin D Deficiency

Objective: The effects of serum vitamin D levels on the evolution or severity of asthma have been widely researched; however, conflicting results have been achieved. This study was designed to evaluate the relationship between serum vitamin D levels and pulmonary function tests in asthmatic and non-asthmatic people with vitamin D deficiency.Materials and Methods: This was a prospective cross-sectional study on healthy adults and asthmatic patients. Standard spirometry and serum 25-hydroxyvitamin D test were performed for all participants.Results: Forty asthmatic patients and 40 healthy controls were tested. The mean age of participants was 42.86 ± 1.6. High prevalence of vitamin D deficiency was found in both the asthmatic and control groups. No significant correlation was found between serum vitamin D levels and spirometry parameters in either of the groups (P = 0.83). Conclusion: Serum levels of 25-hydroxyvitamin D were not correlated with the severity of asthma as evaluated by pulmonary function tests in asthmatics

Epidemiology of Vasculitides in Khorasan Province, Iran

Vasculitides are a heterogeneous group of more than 20 diseases defined by inflammation and destruction of blood vessels. We aimed to study the demographic characteristics of the primary vasculitides in the North East of Iran. We retrospectively studied the medical records of patients diagnosed with any kind of vasculitis at the Clinic and Department of Rheumatology of the Imam Reza Hospital, Mashhad, Iran between January 1, 2002, and December 31, 2012. Patients were classified according to the American College of Rheumatology 1990 criteria for the classification of vasculitis and the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. A total of 721 patients (51.5% male, 48.5% female) with a diagnosis of primary vasculitis was identified. The frequency distributions of vasculitic disorders were as follows: Behcet’s disease, 63.6%; cutaneous leukocytoclastic angiitis, 8.2%; granulomatosis with polyangiitis (Wegener’s), 6.8%; Takayasu’s arteritis. 6%; giant cell arteritis, 4%; polyarteritis nodosa, 2.1%; microscopic polyangiitis, 0.6%; eosinophilic granulomatosis with polyangiitis (Churg-Strauss), 1.8%; cryoglobulinemic vasculitis, 0.3%; and IgA vasculitis (Henoch-Schonlein purpura), 3.5%. In our population, the most common forms of vasculitis are Behcet’s disease, cutaneous leukocytoclastic angiitis, and granulomatosis with polyangiitis (Wegener’s)

Probiotics as a complementary treatment in systemic lupus erythematosus: A systematic review

Abstract Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that primarily affects young women. SLE has no recognized etiology but it is believed to be triggered by a number of factors, including genetic predisposition, hormonal influences, and environmental conditions. Dysbiosis in the gut microbiota has emerged as a potential mechanism connecting the intestinal microbiome to the breakdown of self‐tolerance and chronic inflammation. This review aims to investigate the role of probiotics in modulating the gut microbiome and their potential therapeutic benefits in managing SLE, providing insights for future research and clinical practice. Methods We conducted a thorough search for papers published up to June 2023 in databases such as PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library. Results The systematic review identified 22 articles examining the effects of probiotics on SLE. These studies—which include in vivo tests, in vitro research, and clinical trials—indicate that probiotics may be effective against inflammation, and improve immunological responses and metabolic profiles in SLE patients. Most in vivo studies were assessed as medium to high quality, while the randomized controlled trial was deemed of high quality. Conclusion According to the findings of our systematic review, probiotics may be used in conjunction with other treatments to manage SLE. Nonetheless, current data is limited, and more randomized controlled trials would be required to fully examine their effectiveness

The Effect of Alendronate on Symptoms of Knee Osteoarthritis: A Randomized Controlled Trial

Background: Knee osteoarthritis is a common degenerativejoint disorder and a major cause of pain and disability. Recentstudies have suggested that bisphosphonates such as alendronatemay have a role in the treatment of osteoarthritis. Thepurpose of the present study was to investigate the potentialeffect of alendronate on the symptoms of knee osteoarthritis.Methods: Thirty nine patients with mild to moderate kneeosteoarthritis were enrolled in a randomized, double-blind,placebo-controlled trial with parallel-group design. The patientsreceived either placebo or alendronate pills (70mg,weekly) in a blinded fashion for six months. Symptoms of osteoarthritiswere scored by Western Ontario and McMasterUniversities (WOMAC) osteoarthritis index at enrollment andat weeks 4, 12, and 24.Results: In both groups there was a significant improvementin total WOMAC score and WOMAC subscales scores ofpain, stiffness, and function at 4, 12, and 24 weeks of treatment.Maximum improvement occurred at week 4. There wasno statistically significant difference between the two groupsregarding their total WOMAC score and its subscales at theend of weeks 4, 12, or 24 (P=0.94).Conclusion: Alendronate does not reduce symptoms of mildto moderate knee osteoarthritis.Trial Registration Number: IRCT138803271479N

Sometimes There Is More Than One Puzzle on the Table: Pneumococcal Bacteremia as a New Systemic Lupus Erythematosus Presentation

Infection is common and a leading cause of death in patients with systemic lupus erythematosus (SLE). SLE is associated with a diverse spectrum of immune impairments including humoral defects and hypocomplementemia that contribute to a lupus patient’s increased susceptibility to infection with encapsulated bacteria. Nonetheless, there are only few reports of severe invasive bacterial infection as the initial presentation of SLE in the literature. Here, we report a rare case of SLE presenting with pneumococcal bacteremia. Based on the high resolution chest computed tomography and the result of blood cultures, the bacteremia was assumed to be secondary to pneumococcal pneumonia