Association between levels of serum and urinary B cell-activating factor and systemic lupus erythematosus disease activity.

Objectives: This study investigated the correlation between serum and urinary B cell-activating factor (BAFF) levels and systemic lupus erythematosus (SLE) disease activity. Patients and methods: This case-control study was conducted with 87 participants between December 2020 and September 2021. Sixty-two SLE patients who fulfilled the eligibility criteria were enrolled. SLE patients were categorized into active (n=34) and inactive (n=28) groups based on their Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores. The control group consisted of 25 healthy subjects. Serum and urine samples were collected for the measurement of BAFF levels. Finally, the relationship between these variables and SLE disease activity was investigated. Results: The mean age of active (SLEDAI-2K >4) and inactive (SLEDAI-2K ≤4) SLE patients and healthy individuals were 32.8±7.8, 32.5±6.8, and 31.7±7.8 years, respectively (p=0.62). The median serum BAFF (s-BAFF) and urinary BAFF (u-BAFF) in active lupus patients (10.4 [2.3] ng/mL and 8.2 [3.7] ng/mL, respectively) were significantly higher than in inactive lupus patients (6 (7.1) ng/mL and 1.7 (4.7) ng/mL, respectively; p<0.001) and the control group (3 (3.7) ng/mL and 1.6 (2.2) ng/mL, respectively; p<0.001). However, s-BAFF (p=0.07) and u-BAFF (p=0.43) did not significantly differ between the inactive group and the control group. A significant positive correlation was observed between s-BAFF (r=0.41 and p=0.001) and u-BAFF (r=0.78 and p<0.001) levels and the SLEDAI-2K score. Conclusion: There is a significant positive correlation between serum and urinary BAFF levels and SLE disease activity. Furthermore, significantly higher levels of s-BAFF and u-BAFF have been observed in patients with active lupus compared to inactive and healthy subjects, indicating a possible role for BAFF in the pathogenesis of SLE disease activity.

The Correlation between Helicobacter Pylori Infection and Disease Severity in Patients with Systemic Sclerosis.

BACKGROUND Systemic sclerosis (SSc) is a relatively common connective tissue disease, which is characterized by inflammation, progressive skin fibrosis, and injuries of small vessels, particularly in the lung and kidney. It seems that Helicobacter pylori (H. pylori) might contribute to the development of SSc as an extra-gastrointestinal autoimmune disease. We investigated the association between H. pylori infections and disease severity in patients with SSc. METHODS This is a cross-sectional study. Sampling method in this study was census method in such a way that all patients with SSc referred to Imam Reza Education and Research University Medical Center from May 2015 to August 2016 were included in the study. Finally, 74 patients were selected based on the inclusion criteria. Inclusion criteria were: 1. Definitive SSc based on American College of Rheumatology/ European League Against Rheumatism 2010 (ACR/EULAR) classification for scleroderma, which was diagnosed within the last two years. 2. Not taking any proton pump inhibitors. 3. Not taking any H. pylori treatment with a standard regimen within the recent 2 months. Disease severity was assessed and determined by two rheumatologists based on the Medsger's Disease Severity Scale (MDSS). H. pylori stool antigen was evaluated based on the test which sensitivity and specificity was proven. All obtained data were statistically analyzed by SPSS 16 using Fisher's exact test Spearman correlation test (RSpearman). RESULTS Forty one (55.4%) of the 74 patients had positive stool antigens. We found a significant positive association between the severity of disease based on MDSS and titer of H. pylori stool antigen (p ≤ 0.001). CONCLUSION This study reveals that H. pylori infection may play a significant role in the severity of organ involvement in SSc.

Intra-articular hyaluronic acid injection vs. atorvastatin; which treatment is more effective in controlling symptoms of knee osteoarthritis? A clinical trial.

BACKGROUND: Knee osteoarthritis is a disease of the elderly population. Two of the widely used treatment options for knee osteoarthritis is administration of oral atorvastatin and intra articular hyaluronic acid. This study was designed to compare the effects of oral atorvastatin and intra articular Hyaluronic acid in patients with knee osteoarthritis. METHOD: This study was conducted under the approval of Mashhad University of medical sciences ethic committee. Seventy patients with knee OA were divided randomly into two groups; thirty five subjects were given intra articular Hyaluronic acid injections weekly for three weeks and 35 were given atorvastatin 40 milligrams orally daily for 6 months. WOMAC questioner was filled for each patient at the beginning of the study and every month up to 6 months. Data were analyzed with SPSS version 16. RESULTS: Enrolled subjects were consisted of 28 males (40%) and 42 females (60%), and their mean age was 57.9±1.1 years. Study groups were similar regarding gender and age distribution (P=0.626, P=0.710, respectively) significant difference between groups regarding sex (P=0.626). Mean age of patients was 57.9±1.1 years. Groups mean age did not differ significantly (P=0.710). According to WOMAC questionnaire, pain score in the second month after injection was significantly lower in the Hyaluronic acid group compared with atorvastatin (P<0.001). Function score in the second month after injection was significantly lower in the Hyaluronic acid group compared with atorvastatin (P<0.001). These differences were absent in the following months. CONCLUSION: Compared to atorvastatin group, significant improvements in pain symptoms and physical function of knee OA patients were observed in intra articular Hyaluronic acid treatment group in the second month after treatment. But this improvement did not last through the following months.

Significance of abnormal myocardial perfusion scintigraphy in young adult patients with SLE.

OBJECTIVES: Detection of subclinical coronary artery disease (CAD) is a potential challenge in patients with systemic lupus erythematosus (SLE) and it is suggested that myocardial perfusion single photon emission computerized tomography (SPECT) is more sensitive than exercise test in this setting. However, the significance of perfusion abnormalities in SLE patients is not well known. In this study, we evaluated the prognostic significance of myocardial perfusion defects in patients with SLE. METHODS: Patients with proven diagnosis of SLE admitted to the hospital due to noncardiac problems with no history of CAD were studied. All patients underwent (99m)Tc-MIBI myocardial perfusion scan using dipyridamole as pharmacological stress. All patients were followed up by reviewing patients file in lupus clinic and any minor or major cardiac events were recorded. RESULTS: Eighteen female and two male patients with mean age of 28.2 +/- 12.05 years were included. Six patients had mild reversible perfusion defects with mean summed difference score of 2.5 +/- 1.0. Pattern of reverse redistribution (reverse fill-in) was noted in three patients. Eleven patients had normal myocardial perfusion. Hypokinesia was noted in three patients on gated images. One patient with abnormal perfusion died 21 days after imaging due to non-cardiac cause. Nineteen patients were followed for a mean time of 39.2 +/- 16.0 months. No major or minor cardiac events were noted during follow-up. Three patients (one with abnormal perfusion) had at least one readmission during follow-up period. CONCLUSION: Our study showed that myocardial perfusion abnormalities are fairly frequent in SLE patients but the defects are generally mild and do not advocate an adverse prognosis.