The Impact of the IL-10 Gene Polymorphism on mRNA Expression and IL-10 Serum Concentration in Polish Lupus Patients.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by the production of autoantibodies against a lot of nuclear components. Despite many studies on the genetic background of this disease, the pathogenesis remains unclear. The aim of the study is to comprehensively evaluate the polymorphism of the IL-10 promoter gene, its mRNA expression, and the serum IL-10 concentration of SLE female patients and females age-matched controls. Analyzing the association between the level of the tested cytokine and the polymorphism genotype-1082; -819; -592, we found statistically higher serum IL-10 levels in SLE patients compared to in healthy controls (11.9 ± 2.2 pg/mL vs. 9.4 ± 1.7 pg/mL, accordingly; p < 0.0001). We did not find statistically significant differences in the gene polymorphism of IL-10 among SLE patients and controls. The most significant observation derived from our study is that IL-10 mRNA transcripts are upregulated in SLE patients compared to in healthy controls (p < 0.0001). According to our results, the presence of the IL-10 genetic polymorphism has no clinical significance for the development of SLE, and subsequent differences in mRNA and IL-10 concentration results from the influence of other factors which should be the subject of further research.

The impact of anti-endothelial cell antibodies (AECAs) on the development of blood vessel damage in patients with systemic lupus erythematosus: the preliminary study.

Vascular injury represents one of the most frequent lesions in systemic lupus erythematosus (SLE). The aim of the study was to assess the influence of anti-endothelial cell antibodies (AECAs) on the development of endothelial cell (EC) activation, dysfunction and subsequent vasculitis in women with SLE. Fifty six women with SLE were divided into 2 subgroups, i.e. subjects with positive AECAs (+) and those with negative AECAs (-). The control group consisted of 25 healthy women. Clinical characteristics, routine laboratory tests and circulating markers of EC activation/dysfunction, i.e. monocyte-chemotactic protein-1 (MCP-1), soluble E- and P-selectin, vascular and intercellular adhesion molecule-1 (sVCAM-1, sICAM-1), von Willebrand factor (vWF), pentraxin 3 (the marker of vasculitis) the indicator of procoagulant activity i.e. prothrombin fragment 1 + 2 (F1 + 2) were detected using ELISA and compared between patients with AECA (+), AECA (-) and control subgroups. Serum concentrations of AECAs in AECA(+), AECA(-) and control groups were 4.58 ± 2.97, 0.92 ± 0.50 and 0.72 ± 0.28 AU/ml, respectively (p < 0.001). The study showed significant increases in EC activation markers, i.e. MCP-1, sE-selectin, sVCAM-1 and F1 + 2 in SLE AECA(+) compared to SLE AECA(-) and control groups. However, the indicator of vasculitis (PTX3) was significantly lower in SLE AECA(+). Moreover, multivariate analysis of variance showed a positive correlation between AECAs and sE-selectin and sVCAM-1 levels, but not with PTX3. AECAs were involved in the initial stages of vascular damage in SLE, i.e. in EC activation and dysfunction. However, they did not play a role in the development of vasculitis.

Addison's Disease in the Course of Recurrent Microangiopathic Antiphospholipid Syndrome-A Clinical Presentation and Review of the Literature.

The article presents a male patient with adrenocortical insufficiency in the course of antiphospholipid syndrome (APS). It also describes recurrent exacerbations of his clinical status, characteristic of microangiopathic antiphospholipid syndrome (MAPS) which had been misdiagnosed as a disseminated intravascular coagulopathy (DIC) syndrome due to sepsis with multi-organ failure, including heart, kidneys, and liver. Issues related to pathogenesis, clinical symptoms, differential diagnosis, and treatment of APS in the context of presently distinguished subtypes of this syndrome have been addressed. The role of vascular endothelial cell activation and the influence of coagulation patterns on the development of APS continuum clinical symptoms have also been mentioned. In addition, this paper highlights that the diagnosis of APS should be considered in patients with adrenal insufficiency and abdominal pain, even without any prior history of thromboembolic diseases, as well as in the course of DIC, especially without predisposing factors.

[Listeriosis of central nervous system in patients with ulcerative colitis - case study].

In the recently an increase morbidity inflammatory bowel disease, including ulcerative colitis was observed. The use of purine analogs and their metabolites are associated with a higher incidence of infections in this group of patients. Listeriosis is an infectious disease caused by a relatively anaerobic gram-positive bacteria - Listeria monocytogenes. Common symptoms include fever, nausea, vomiting and diarrhea, but these pathogens can also cause myocarditis, central nervous system infections, including brain abscesses and sepsis. Since the incidence of Listeria monocytogenes is higher in patients with inflammatory bowel disease than in the general population, it is important to pay special attention to this group of patients (in prophylaxis as well as treatment) as these infections are serious and often fatal among them.

[Description of the case of Cogan syndrome]. / Opis przypadku zespolu Cogana.

Cogan syndrome is a persistent disease with the autoimmunologic background connected with vasculitis. It can be diagnosed by symptoms such as interstitial keratitis, optic nerve dysfunction and nervus acusticus dysfunction with subsequent hearing impairment or deafness. In its course, such systemic symptoms frequently occur: exhaustion, weight loss and joint pain. Due to the rare occurrence of Cogan syndrome and vast obstacles in diagnosing it, the case of34 years old patient with Cogan syndrome is discussed.

A comparative clinical study on five types of compression therapy in patients with venous leg ulcers.

The aim of this study was to compare five types of compression therapy in venous leg ulcers (intermittent pneumatic vs. stockings vs. multi layer vs. two layer short stretch bandages vs. Unna boots). Primary study endpoints were analysis of changes of the total ulcer surface area, volume and linear dimensions inside observed groups. The secondary end points were comparisons between all groups the number of completely healed wounds (ulcer healing rates), Gilman index and percentage change of ulcer surface area. In total, 147 patients with unilateral venous leg ulcers were included to this study. Participants were randomly allocated to the groups: A, B, C, D and E. After two months the healing rate was the highest in group A (intermittent pneumatic compression) - 57.14%, 16/28 patients, B (ulcer stocking system) - 56.66%, 17/30 patients and C (multi layer short stretch bandage) - 58.62%, 17/29 patients. Significantly much worse rate found in group D (two layer short stretch bandages) - only 16.66%, 5/30 patients and E (Unna boots) - 20%, 6/30 patients. The analysis of changes of the percentage of Gilman index and wound total surface area confirmed that intermittent pneumatic compression, stockings and multi layer bandages are the most efficient. The two layer short - stretch bandages and Unna boots appeared again much less effective.

Serum levels of selected chemokines in systemic lupus erythematosus patients.

Chemokines promote leukocyte traffic into the site of inflammation. Serum levels of monocyte chemotactic protein 1 (MCP-1), stromal cell-derived factor-1 (SDF-1), interferon-gamma-inducible protein 10 (IP-10), and interleukin-8 (IL-8) were evaluated in 48 treated women with systemic lupus erythematosus (SLE) and mild-to-moderate disease severity. The results were compared between the whole SLE group and the control (29 women). The relationships between chemokines, their concentrations, and peripheral blood leukocyte count and between the chemokines and individual leukocyte populations (polymorphonuclear leukocytes-PMNs, lymphocytes-Ls, monocytes-Ms, eosinophils) counts were determined. The relationships between the analyzed chemokines were also determined in the control. SLE subjects had significantly higher MCP-1, SDF-1, IP-10, and lower IL-8 concentrations compared to the control. Moderate, positive correlations between MCP-1/SDF-1, SDF-1/IP-10 and a negative correlation between MCP-1/IL8 were observed in the patient group. Moderate, negative correlations were found between SDF-1/total leukocyte count, SDF-1/absolute number of PMNs as well as between IP-10/total leukocyte count, IP-10/absolute PMNs, Ls, and Ms counts in peripheral blood of SLE group. We suggest that the obtained results and correlations observed between the examined parameters might be used to monitor SLE course and progression. However, further randomized clinical studies should be carried out on in untreated and treated patients with SLE.

[Serum level of selected chemokines in systemic lupus erythematosus patients taking into consideration the peripheral blood leukocyte counts]. / Stezenie wybranych chemokin u chorych na toczen rumieniowaty ukladowy z uwzglednieniem liczby leukocytów we krwi obwodoweJ.

UNLABELLED: Chemokines promote leukocyte traffic into the site of inflammation. It depends on the repertoire of chemokines synthesized locally, and the temporal expression of chemokine receptors on leukocytes among them lymphocytes B and T which play crucial role in the pathogenesis of autoimmune diseases for example in systemic lupus erythematosus (SLE). RANTES (regulated upon activation in normal T cells expressed and secreted) is chemokine influencing T cells and BLC 1 (B-lymphocyte chemoattractant 1) is chemokine which affects B cells. The aim of the study was to evaluate serum concentration of the above mentioned chemokines in treated SLE patients and to analyze the relationships between their concentration in patients group and the control one. Another aim of our study was to assess the relationships between serum levels of these chemokines and the total peripheral blood leukocyte count and between serum levels of these chemokines and absolute peripheral blood counts of the individual forms of these cells in SLE patients. MATERIAL AND METHODS: Serum levels of RANTES and BLC 1 were determined in 48 treated women with SLE and mild-to-moderate disease severity. The results were compared between the total SLE group and the control (29 healthy women). The correlation between chemokines and between their levels and peripheral blood leukocyte count were evaluated. The relationships between the analyzed chemokines were also determined in the control group. RESULTS: Lower level of RANTES in serum was revealed in patients with SLE compared to the control and the tendency to higher concentration of BLC 1 in serum was observed. No relationships were observed between the levels of these chemokines both in the SLE patients and in the control group. Whereas the negative correlations between BLC 1 and total leukocyte count and BLC 1 and absolute number of neutrophils were found without such correlation between BLC 1 the subgroup of patients with concomitant neutropenia. CONCLUSION: We suggest that in treated patients with SLE lowered level of RANTES and tendency to higher level of BLC 1 is observed which have not any connections with the peripheral blood leukocyte counts and individual forms of these cells counts.

A sequence of pathologic events in a patient after thymectomy for myasthenia gravis.

The case of a rare coexistence of myasthenia gravis (MG) with systemic lupus erythematosus (SLE) is described. MG was diagnosed prior to SLE which developed after thymectomy. The patient was affected by HCV viremia. Therefore, there were therapeutic problems. Metylase treatment was continued for several years and dopamine receptor agonist was effectively administered as adjunctive therapy in SLE.

Annexin A5 and anti-annexin antibodies in patients with systemic lupus erythematosus.

Plasma levels of annexin A5 (ANX A5) and anti-annexin A5 (aANX A5) antibodies were evaluated in 51 women with systemic lupus erythematosus (SLE). The results were compared between the total SLE group, subgroups on/without immunosuppressive therapy and the control (28 women). The relationships between ANX A5/aANX A5 antibodies levels and laboratory variables (anti-cardiolipin antibodies-aCL, total cholesterol, thrombocyte count, activated partial thromboplastin time-APTT, prothrombin time, international normalized ratio-INR) were performed in the total SLE group and in the patient subgroups identified as the arithmetic mean of ANX A5 concentration in the control plus 1-4 standard deviations (SD). The whole SLE group and the subgroup on immunosuppression showed significantly higher ANX A5 and IgG aANX A5 antibodies concentrations. A weak positive correlation was found between ANX A5 and thrombocyte count, a moderate one between IgG and IgM aANX A5 antibodies, a weak negative correlation between IgG aANX A5 and APTT in the whole SLE group. SLE subgroups with ANX A5 concentrations higher than the control mean plus 3 or 4 SD showed a weak/moderate negative correlation of this parameter with aANX A5 antibodies, moderate one with IgG aCL antibodies levels, a moderate positive correlation with cholesterol concentration, moderate/high positive correlations with thrombocyte count. The association between plasma ANX A5/IgG aANX A5 levels and severity of disease was noticed. The role of aANX A5 and IgG aCL antibodies as causative factors of increased ANX A5 levels was suggested, and the relationship between ANX A5 and thrombocyte count was revealed.

[Development of systemic lupus erythematosus after thymectomy performed in a patient with myasthenia gravis]. / Rozwój tocznia rumieniowatego ukladowego po wykonanej tymektomii u chorej z nuzliwoscia miesni prazkowanych.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, with not fully understood, complex origin. Several factors are suspected of involvement in the development of the disease. Genetic predisposition, environmental factors, some drugs, estrogens, cigarette smoking and ultra violet radiation seems to be the most important among them. The case of a patient with myasthenia gravis (MG) followed by thymectomy and lupus erythematosus (SLE) diagnosed one year later presented in this study.

[Can drugs used in type 2 diabetes therapy induce acute pancreatitis?]. / Czy preparaty stosowane w leczeniu cukrzycy typu 2 moga indukowac ostre zapalenie trzustki?

The increased number of subjects with type 2 diabetes and putting into clinical practice further new hypoglycemic agents and also aspiring to achieve the bettest glycemic control using a few medications may cause that undesirable actions of these agents may be observed more frequently. One undesirable effect of hypoglycemic drugs is acute pancreatitis; therefore the aim of the present paper is to review data concerning the development of this complication during type 2 diabetes pharmacotherapy.

[Diagnostic value of antineutophil cytoplasmic antibodies]. / Znaczenie diagnostyczne przeciwcial przeciw cytoplazmie granulocytów obojetnochlonnych.

Antineutrophil cytoplasmic antibodies (ANCA) constitute a family of auto-antibodies directed against various components of the neutrophil cytoplasm. The indirect immunofluorecence assays detected three fluorescent staining patterns: cANCA--cytoplasmic; pANCA--perinuclear and aANCA--atypical. Occurence ANCA is mainly associated with Wegener's granulomatosis and vasculitis, but they are also detected in autoimmune diseases (eg. in systemic lupus erythematosus, in rheumathoid arthritis, Sjögren's syndrome, in dermatomyositis) and in inflamatory bowel diseases (Crohn disease, colitis ulcerosa). Presence of ANCA was found also in primary sclerosing cholangitis, in chronic infections and in person using some kinds of drugs. The aim of the study was to review recent investigations concerning prevalence of ANCA and their diagnostic value not only for vasculitis but also for the other disease in which they are detected.

[Chronic fatigue syndrome with special focus on systemic lupus erythematosus]. / Zespól przewleklego zmeczenia ze szczególnym uwzglednieniem tocznia rumieniowatego ukladowego.

Chronic fatigue is an ailment frequently reported in the course of several pathologies. When fatigue clearly predominates over other symptoms, it is referred to as chronic fatigue syndrome (CFS). Initial CFS definition and diagnostic criteria were published in 1988, and have been several times modified since that time. In 1994, Fukuda et al. presented precise guidelines for the evaluation and study of CFS. The etiopathogenic mechanisms of CFS have not yet been satisfactorily clarified although immune and hormonal responses as well as a decline in neurotransmitter concentrations have been implicated in the development of the disorder. Systemic lupus erythematosus (SLE) is an autoimmune disease, with chronic fatigue as a very common symptom observed in as many as 80% of the patients. Owing to its obscure pathogenesis, therapy for CFS remains a difficult and complex issue consisting mostly of the treatment of the underlying disease. Appropriate lifestyle and physical activity should be emphasized. Medications include antidepressants and glucocorticosteroids. Psychological counseling has also been recommended. Complex etiopathogenesis and the involvement of the immune and neurohormonal systems suggest that CFS might be a primary and not secondary disorder. Hence a significant role of medical professionals in the diagnosis and treatment of chronic fatigue syndrome.

[The thyroid functional tests, antithyroid antibodies and the level of prolactin in treated patients with systemic lupus erythematosus]. / Testy czynnosciowe tarczycy, przeciwciala przeciwtarczycowe i stezenie prolaktyny u leczonych chorych na toczen rumieniowaty ukladowy.

UNLABELLED: The relationships between different autoimmune diseases and among them the connections between systemic lupus erythematosus (SLE) and autoimmune thyroid diseases have been reported for a few years. The aim of this study is the assessment of the laboratory tests findings which are applied in the evaluation of the thyroid function and prolactin (PRL) concentration in serum in women with SLE during therapy. MATERIAL AND METHODS: In 41 women with SLE treated in the period of a few months to several years the following laboratory tests were performed: the concentration of thyroid stimulating hormone (TSH), PRL and free triiodothyronine (fT3) and free thyroxine (fT4) levels were measured by chemiluminescence technique, anithyroid antibodies (anti-thyroperoxidase - anti-TPO, and anti-thyroglobulin - anti TG) were tested by immunofluorescence assay. The control group consisted of 17 healthy women of a similar age to the SLE patients. RESULTS: The levels of fT3 and fT4 were statistically significantly lower in SLE patients comparing to the controls but the arithmetic means for the whole investigated patients were within the range of laboratory limits for these hormones. Considering other parameters no statistical differences between the mean values were observed. CONCLUSIONS: The results indicate that fT3 and fT4 concentrations are lower in SLE treated women with small and mild disease activity compared to the controls with the mean arithmetic values for the total group of patients which is within the laboratory limits for these hormones. Furthermore, the results seem to support the tendency of connections between the detection of antithyroid antibodies with higher level of serum PRL in SLE treated patients.

Selected growth factors and diffusing capacity of the lung for carbon monoxide in patients with systemic lupus erythematosus.

The purpose of the study was to evaluate serum concentrations of selected growth factors and the diffusing capacity of the lung for carbon monoxide (DLCO) in 21 females treated for systemic lupus erythematosus. The control group consisted of 24 healthy women. Based on the high-resolution computed tomography (HRCT), patients were allocated to a subgroup of 11 subjects (HRCT-negative) and a subgroup of 10 with pulmonary abnormalities (HRCT-positive). In HRCT-negative patients a significantly higher level of TNF-α as compared with the control was observed and positive correlation between TNF-α and bFGF was revealed in this subgroup and in the total group of patients. DLCO was below the predicted value in 13 patients. No correlations between DLCO and growth factors concentrations were observed. DLCO reduction in asymptomatic, with respect to the respiratory system, SLE patients suggests a need for long-term monitoring of this parameter. The role of TNF-α in these patients requires further investigations.

[Search of connections between systemic lupus erythematosus and autoimmune thyroid gland diseases]. / W poszukiwaniu zwiazków pomiedzy toczniem rumieniowatym ukladowym (SLE) a autoimmunologicznymi chorobami tarczycy.

Both systemic lupus erythematosus and autoimmune thyroid gland diseases are characterized by impairments in immunologic system. Sometimes co-occurence of the diseases are observed, but relations between them are still scarcely known. The present paper is a review of the literature concerning connections between lupus erythematosus and autoimmune thyroid gland diseases.

Erythrocyte antioxidant parameters in workers occupationally exposed to low levels of ionizing radiation.

It has been postulated that ionizing radiation generates reactive oxygen species (ROS). ROS are annihilated by an intracellular enzymatic system composed mainly of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Workers of X-ray departments are occupationally exposed to long-term low levels of ionizing radiation, which may affect their antioxidant status. Erythrocyte activities of SOD, CAT and GPx were measured in 45 workers of X-ray departments and 30 persons who constituted the control group. Subgroups with respect to sex and cigarette smoking were selected. Colorimetric method was used for determination erythrocyte activities of SOD, CAT and GPx. A significant decrease of GPx, SOD and CAT activity in workers as compared to controls was observed. Lower activity of SOD and GPx in female and GPx in male subgroup was found. SOD was significantly more elevated in smoking workers than in the non-smoking staff. Moreover non-smoking employees showed lower SOD and GPx activity in comparison to the non-smoking control. GPx decrease was found in smoking workers in comparison to the smoking control. Additionally, smoking workers showed lower activity of GPx and CAT compared to non-smoking control.

[Transforming growth factor beta (TGF-beta): its structure, function, and role in the pathogenesis of systemic lupus erythematosus]. / Transformujacy czynnik wzrostu beta (TGF-beta)--budowa, mechanizmy oddzialywania oraz jego rola w patogenezie tocznia rumieniowatego ukladowego.

TGF-beta is a cytokine of great importance in many common diseases because it takes part in many physiological processes such as angiogenesis and stimulation of the synthesis and degradation of extracellular matrix proteins. It also regulates the entrance of cells to the apoptotic pathway and can stimulate the division of mesenchymal cells and inhibit hemopoietic, endothelial, and lymphatic cells. There are five genes which encode TGF-beta in vertebrates, of which only three are present in mammals. The best known member of the family of TGF-beta proteins is TGF-beta 1. TGF-beta is synthetized as a precursor protein which, after enzymatic modification, is present as a small or large complex. Three membrane receptors, serine/threonine kinase, are arranged for signal transduction with TGF-beta. Smad proteins are responsible for sending the signal into the cell nucleus; its influence on different transcriptive factors in the cell nucleus promotes the expressions of different genes. Disturbances in TGF-beta expression have been noted in many diseases. Current results clearly indicate an important role of this cytokine in autoimmunological disorders, especially in systemic lupus erythematosus. Studies on an animal model revealed that endogenic TGF-beta can control the progression of systemic lupus erythematosus.

[Silicosis and systemic lupus erythematosus--case report]. / Pylica pluc z towarzyszacym toczniem rumieniowatym ukladowym--opis przypadku.

In the development of systemic lupus erythematosus (SLE) genetic predisposition are essential. The role of external factors such as viral infection, exposure to pesticide and silica dust and cigarette smoking are frequently emphasized in the development of this disease. On the basis of the observed case we decided to describe the problem of connection between silicosis and systemic lupus erythematosus (SLE).