Effect of Self-Care Guideline on Quality of Life among Pregnant Women with Systemic Lupus Erythematosus

Context: Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune condition representing a source of disability. It can create a burden of the low Quality of life in pregnant women and cause deleterious effects on maternal, fetal, and neonatal outcomes. Aim: The study aimed at evaluating the effect of self-care guidelines on the Quality of life among pregnant women with SLE.Methods: A quasi-experimental study design (time series, one group only, and pre-post intervention assessments) was used. Purposive sampling was used to recruit fifty pregnant women diagnosed with SLE. The study was conducted at three sites: Rheumatology Outpatient Clinic at Ain Shams University Hospital, Rheumatology Antenatal Outpatient Clinic, and Labor Unit at Ain Shams Maternity Hospital. Seven data collection tools were utilized in this study, and Arabic self-care guidelines were distributed as supporting educational material for pregnant women with SLE. Results: Findings of the present study showed a highly significant improvement in SLE activity index, follow-up lab investigations, Quality of life, and health assessment by evaluating daily living activities after using self-care guidelines.Conclusion: The current study results supported the research hypothesis that pregnant women with SLE exposed to self-care guidelines will have a better quality of life than their pre-intervention level, which reflected upon improving pregnancy outcomes. Based on the study results, the following recommendations are forwarded; application of the study intervention with the distribution of the clear Arabic self-care guidelines on a large scale in other sittings caring for pregnant women with SLE

MicroRNA-146a expression as a potential biomarker for rheumatoid arthritis in Egypt

AbstractBackgroundMicroRNAs (miRNAs) are small non-coding RNAs, whose role in regulating diverse immune functions, suggests they might play a role as biomarkers for immune mediated disorders. Studies showed that miRNA-146a (miR-146a) expression is increased by proinflammatory cytokines and is an important modulator of differentiation and function of cells of innate and adaptive immunity.Aim of the workThe current study aimed to evaluate the expression of miR-146a as a potential biomarker for diagnosis of rheumatoid arthritis (RA) and to explore its association with disease activity.Subjects and methodsThe study enrolled 50 Egyptian subjects divided into a patient group, which comprised 25 RA patients, and a control group which comprised 25 healthy individuals. The disease activity for the patients’ group was determined by simplified disease activity index. Relative quantification of miR-146a expression in whole blood was determined using reverse transcriptase quantitative real time polymerase chain reaction.ResultsThere were highly significant statistical differences between patients and healthy controls as regards miR-146a relative expression, erythrocyte sedimentation rate (ESR) and anti-cyclic citrullinated peptide (anti-CCP) (p<0.001). Highly significant statistical differences (p<0.001) were also found between different patients’ subgroups as regards miR-146a relative expression and ESR. miR-146a levels correlated positively with those of ESR, C-reactive protein and anti-CCP (p<0.001).miR-146a illustrated best performance in diagnosing RA, showing the highest sensitivity and specificity (96% and 100%, respectively) (AUC: 0.992 at a cut off value of ⩾2.16) compared to anti-CCP (sensitivity: 68%, specificity: 100% and AUC: 0.87 at a cut off value of ⩾22U/ml) and RF (sensitivity: 56%, specificity: 80% and AUC: 0.992 at a cut off value of ⩾13U/ml).ConclusionThis study demonstrated that miR-146a expression was highly significantly elevated in whole blood of patients with RA. Its diagnostic performance was better than anti-CCP and RF and its level of expression correlates with disease activity

Anti-carbamylated protein antibodies in psoriatic arthritis patients: Relation to disease activity, severity and ultrasonographic scores

Background: Anticarbamylated proteins (anti-CarP) are a novel family of antibodies recently identified in patients with inflammatory arthritis. Aim of the work: To investigate the anti-CarP serum levels in psoriatic arthritis (PsA) patients. The relation of anti-CarP to disease activity and severity as well as to the ultrasonographic findings and scores were well thought-out. Patients and methods: Forty-five PsA patients diagnosed according to the classification of psoriatic arthritis (CASPAR) criteria. 45 matched controls were included. The erythrocyte sedimentation rate (ESR), C-reactive protein and serum anti-CarP antibody were measured. PsA disease activity was recorded according to the modified disease activity score (DAS28). The severity and extent of psoriasis was assessed by the psoriasis area severity index (PASI). Musculoskeletal ultrasound (US) of the small hand joints was performed using grey scale (GS) and power Doppler (PD) to derive composite scores based on abnormal counts and severity. Results: The mean age of the patients was 44.58 ± 6.76 years, 40 females and 5 males (F:M 8:1), disease duration 4.93 ± 3.17 years. Serum levels of anti-CarP antibody were increased in PsA patients (33.48 ± 14.05) compared to controls (12.21 ± 4.71 ng/ml) (p < 0.001). The mean DAS28 was 4.61 ± 1.59 There was a significant correlation between anti-CarP antibody and each of DAS28, ESR, CRP, PASI, the GS and PD joint counts (r = 0.97, r = 0.97, r = 0.97, r = 0.97, r = 0.96, r = 0.9 respectively) as well as with the US joint scores; GSJS and PDJS (r = 0.98, r = 0.97 respectively) denoting severity. Conclusions: Anti-CarP antibody might represent a promising marker to predict joint damage and disease activity in PsA patients

Liver fatty acid binding protein: A potential urinary and tissue biomarker for lupus nephritis

Aim of the work: To assess urinary liver fatty acid binding protein (uL-FABP) levels and tissue expression (tL-FABP) in renal biopsies of active and inactive lupus nephritis (LN) patients and examine their relationship with disease characteristics. Patients and methods: uL-FABP levels and tL-FABP expression were assessed in 75 systemic lupus erythematosus (SLE) patients; 25 active LN, 25 inactive LN and 25 SLE without LN as well as 10 matched healthy control. Results: Mean age was 33.9 ± 6.7 years, disease duration 4.6 ± 2.4 years and were 66 females and 9 males. Patients with active LN had higher uL-FABP higher than patients with inactive LN and without LN. uL-FABP in patients with active and inactive LN significantly correlated with renal SLEDAI (r = 0.96, r = 0.92 respectively and p < 0.0001) and 24-h urinary protein (r = 0.97, r = 0.68 respectively and p < 0.0001) but negatively correlated with the estimated Glomerular Filtration Rate (r = −0.97, r = −0.84 respectively and p < 0.0001). uL-FABP significantly correlated with grade of renal biopsy in active and inactive LN (F = 155.6 and 40.7 respectively, p < 0.0001). L-FABP was highly expressed in renal tissue of LN patients; the tubules seemed to be the main location for tL-FABP staining. The uL-FABP levels significantly correlated with the chronicity index score of renal pathology (F = 17.6, p < 0.0001) and the expression of tL-FABP in active and inactive LN (F = 21.4 and 42.2 respectively, p < 0.0001). Conclusion: Urinary and tissue L-FABP levels were associated with active renal disease. Urinary levels of L-FABP might be a potential non invasive marker for the presence of renal involvement in patients with SLE alternative to renal biopsy

Significance of foliar sprayed salicylic acid in kidney bean resistance against Tetranychus urticae (Trombidiformes: Tetranychidae) attack

Bakr, Anar A., Rezk, Hussein A., Saleh, Samia M., El-Morshedy, Nashwa H. (2020): Significance of foliar sprayed salicylic acid in kidney bean resistance against Tetranychus urticae (Trombidiformes: Tetranychidae) attack. Persian Journal of Acarology 9 (2): 193-205, DOI: 10.22073/pja.v9i2.59408, URL: https://www.mendeley.com/catalogue/64ad030f-05e3-341a-8ad0-506e6a0cc27e

The association of single nucleotide polymorphism of interleukin-21 gene and serum interleukin-21 levels with systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a common autoimmune disorder which commonly results from the combined effects of a large number of genes. Variations in the DNA sequence in the Interleukin-21 (IL-21) gene may lead to altered IL-21 production and/or activity which can affect an individual’s susceptibility to SLE. IL-21 is a novel class I cytokine produced by activated CD4+ T cells, natural killer T cells and T helper (Th) cells. There is increasing evidence that IL-21 contributes to the pathogenesis of SLE due to its biological activity. Aim of the study: To investigate the association between single nucleotide polymorphism (SNP) of IL-21 rs2221903 gene and serum IL-21 levels with SLE and to detect the possible association between IL-21 serum levels and the pathogenesis of the disease. Subjects and methods: This study was conducted on 30 SLE patients and 20 age and sex matched healthy controls. Serum IL-21 levels were measured using enzyme-linked immunosorbent assay (ELISA) technique and SNP of IL-21 rs2221903 gene was detected by genotyping assay, using real time polymerase chain reaction (RT-PCR). Results: Serum Il-21 levels were significantly higher in patients compared with controls (p < 0.001). Patients with high activity index of SLE had significantly higher levels of serum IL-21 (p value < 0.001). A statistically significant association was found between the T allele of SNP rs2221903 and SLE, whereas; no association between SNP of IL-21 rs2221903 genotypes and SLE or serum IL-21 levels could be detected. Conclusion: IL-21 plays an important role in the immune-pathogenesis of SLE and could be used as a possible target for novel immunotherapy. The T allele of SNP rs2221903 suggests that the IL-21 gene may contribute to an inherited predisposition to SLE

Ocular manifestations in Egyptian systemic lupus erythematosus patients and their relation with disease activity and anti-phospholipid antibodies

Aim of the work: To identify the ocular manifestations in Egyptian SLE patients and its relation with disease activity and antiphospholipid (aPL) antibodies. Patients and methods: The study included 100 patients and 30 matched controls. In patients, SLE disease activity index was scored and anti-phospholipids measured. All participants underwent complete ophthalmological examination including assessment of visual acuity, slit-lamp examination to assess anterior chamber and fundus examination to assess retina, choroid and optic disc. Results: Patients were 86 females and 14 males (F:M 6.1:1) with a mean age of 31.3 ± 12.2 years and disease duration 4.8 ± 4.7 years. 46% had ocular manifestations in the form of dry eye (24%), retinopathy (24%), reduced visual acuity in 17%, redness, ocular headache and glaucoma in 6% each, blurring of vision in 7% and cataract in 3%. Cotton-wool spots were the most common retinal abnormal finding followed by vasculitis, attenuated blood vessels, papilledema and pale optic disc. SLE patients with ocular affection especially retinopathy had significantly higher levels of anticardiolipin antibodies (ACL) IgM (11.9 ± 5.3 vs 9.9 ± 4.1 MPL), lupus anticoagulant (LAC) (41.9 ± 15.1 vs 36.3 ± 11.9 s), disease duration and SLEDAI compared to those without (p = .039, p = .04, p = .02 and p = .026 respectively). SLE patients with severe activity had more retinal affection (35%) than those with moderate (14.8%) and mild (14%) (p = .04). Conclusions: Ocular affection is frequent in SLE patients. Dry eyes and retinopathy (especially cotton-wool spots) are the most common findings. Anti-phospholipids (ACLIgM and LAC), active disease and disease duration are significantly related to eye affection especially retinopathy among SLE patients. Keywords: Systemic lupus erythematosus, Retinal affection, SLEDAI, Anticardiolipin antibodie

Role of cartilage oligomeric matrix protein (COMP) as a prognostic biomarker in follow-up of early rheumatoid arthritis patients: Correlation to musculoskeletal ultrasonographic findings

Aim of the work: To assess the level of serum cartilage oligomeric matrix protein (COMP) in early rheumatoid arthritis (RA) patients and study its relation to disease activity and musculoskeletal ultrasound (MSUS) findings. Patients and methods: The study included 40 early RA patients. Disease activity score (DAS28) was assessed. Serum COMP level was measured and MSUS findings of the small joints of hands done at base line and after 6 months of follow up.20 age and sex matched control were included. Results: Patients age was 38.8 ± 9.3 years; 36 females and 4 males and disease duration 6.7 ± 3.5 years. Serum COMP was significantly higher in patients (median 190 U/L; 90–750 U/L) compared to control (90 U/L; 80–130 U/L)(p < .001) being higher in more active (250 U/L) (p = .001) and significantly correlated with baseline synovial inflammation (p = .009). COMP levels were lowered after 6 months of receiving treatment (110 U/L; 30–180 U/L) (p < .001). The presence of bony erosions increased with more active disease (p =  .003). There was a significant reduction in the erythrocyte sedimentation rate and COMP at follow up (p < .0001 and p = .001 respectively). No correlation was found between the COMP level with C-reactive protein, ESR, MSUS score or bony erosions at follow up. Conclusions: COMP significantly correlated with disease activity in early RA and could be used as a marker of activity. It correlates significantly with synovial inflammation detected by power Doppler. COMP may reflect the outcome and could be used as a prognostic marker in RA patients. COMP did not significantly correlate with bone erosions. Keywords: COMP, Rheumatoid arthritis, Joint ultrasonograph