Significance of Serum Soluble Fas (sFas/CD95) and Tumor Necrosis Factor- Alpha (TNF-α) in Radiologically Diagnosed Patients with Uterine Leiomyoma

Leiomyoma is a common benign tumor of female reproductive system arising from the smooth muscle cells of uterus. About 17.8% of females in 40s age group and 77% of hysterectomies found to have leiomyoma. It affects females in reproductive age and cause pelvic pain, abortion, infertility, menorrhagia which in some cases ends by hysterectomy. In this study the extrinsic apoptotic pathway was evaluated in patients with uterine leiomyoma by measuring serum soluble Fas (sFas) and Tumor Necrosis Factor Alpha (TNFα) in both patients and control healthy women. Forty patients with leiomyoma from 22-52 years old were involved in this study. Forty apparently healthy, their ages matched volunteers were selected as a control. Four ml of venous blood sample was obtained from each, serum was separated and serum concentration of sFas and TNFα measured using ELISA technique. There was a highly significant increase in serum concentration of TNF-α in patients with leiomyoma (mean 0.579pg/ml ± SE 0.039) than control group (mean 0.120pg/ml ± SE 0.007), also there was a highly significant increase in serum concentration of sFas of patient (mean 0.326pg/ml ± SE 0.028) compared to control healthy subjects (mean 0.126pg/ml ± 0.025). Receiver Operator Characteristic (ROC) curve for determination of TNFα and sFas cutoff value shows that TNFα has cutoff value of ≥0.220pg/ml with 97.5% sensitivity and 100% specificity for leiomyoma and accuracy rate of 99.6%. The sFas cutoff value is ≥0.154pg/ml with 80% sensitivity and 82.5% specificity for leiomyoma and accuracy rate of 87.4%.

Validity of Serum Matrix Metalloproteinase 9 in Diagnosis of Rheumatoid Arthritis: A Case-Control Study from Iraq

Objective: To assess validity of serum matrix metaloprotinase 9 (s.MMP 9) in diagnosis of rheumatoid arthritis (RA)Patients and methods: This case control study was conducted on 50 RA patients ( 10 males and 40 females) diagnosed by a rheumatologist according to American College of Rheumatology (ACR) 1987 revised criteria or ACR- European League Against Rheumatism (EULAR) 2010 Criteria and compared with 25 healthy controls (5 male and 20 female) matched in age and sex. Demographic and clinical characteristics of patients were recorded. S.MMP9 was measured using Enzyme Linked Immunosorbent Assay (ELISA) KIT in both groups.Results: No significant difference between patients and controls in age, sex, and body mass index (BMI) (p>0.05). Serum MMP9 was significantly higher in patients with RA than controls (188.4 ± 24.5 ng/ml vs 21.98 ± 7.87ng/ml, p<0.05).The optimum cut-off value of serum MMP9 that can differentiate between patients with RA from controls was 78.522ng/ml using Receiver Operating characteristic curve (ROC) test, with P value >.0001 and AUC was 1.00) with nearly 100% sensitivity and specificity. At cut-off value ≥34.038 we got the highest sensitivity 100% with specificity 96% and Accuracy 98.7%. And At cut-off value ≥125.479 we had got the highest specificity 100% with sensitivity 98% and Accuracy 98.7%.Conclusions: serum MMP9 was significantly higher in patients with RA than healthy controls. Serum MMP9 was a valid measure to differentiate between RA patients and healthy controls. This may be beneficial for early diagnosis of RA and subsequent a new promising treatment. Keywords: Matrix metalloproteinase 9. Rheumatoid arthritis, inflammatory arthritis, Matrix metalloproteinas

PREDICTIVE VALUE OF SERUM INTERLEUKIN 31 IN DIAGNOSIS OF OSTEOPOROSIS IN POSTMENOPAUSAL WOMAN: A NOVEL CASE–CONTROL STUDY FROM IRAQ

Objective: The objective of this study was to assess the predictive value of serum level of interleukin 31 (IL31) in diagnosis of osteoporosis (OP) in postmenopausal women.Methods: This case–control study was conducted on 80 individuals, 50 of them with postmenopausal OP diagnosed using dual X-ray absorptiometry study, and the other 30 were healthy postmenopausal female controls. Serum level of IL31 was measured using enzyme-linked immunosorbent assay technique in both groups.Results: The mean age of patients was 65.3±4.8 years and controls was 61.1±3.9 years. Mean serum IL31 level was significantly higher among postmenopausal patients with OP compared to healthy controls (83.5±34.2 vs. 34.9±7.3ng/ml, p<0.05). The optimum cutoff value of serum IL31 that can differentiate between patients with OP in postmenopausal women from controls was >44.51 ng/ml with perfect positive predictive value (PPV) (100%), very high accuracy of 92.5%, 88% sensitivity, 100% specificity, and negative predictive value (NPV) 83.3%.Conclusions: Serum IL31 level was significantly higher in postmenopausal osteoporotic women compared to healthy controls. It was a valid measure with high accuracy and perfect PPV and specificity, high sensitivity, and NPV. It can be used to confirm the diagnosis of OP in postmenopausal women