Comparison of clinical presentation and outcome of childhood-onset and adulthood-onset of systemic lupus erythematosus among Indonesian patients.

INTRODUCTION: The clinical presentation of childhood-onset systemic lupus erythematosus (SLE) is generally perceived to differ from that of adult-onset SLE. OBJECTIVE: We aimed to compare the demographic and clinical manifestation between childhood-onset vs. adult-onset SLE in a cohort of Indonesian patients at tertiary care centers. METHODS: This retrospective study included patients in the Hasan Sadikin Lupus Registry from 2008 until December 2017. The demographics, clinical presentations, and outcomes were compared between childhood-onset SLE (<18 years old) (Group 1) and adult-onset SLE (≥18 years old) (Group 2). RESULTS: Eight hundred seventy patients were involved into this study. The proportion of childhood-onset SLE was 20% (174 patients). The mean age of group 1 versus group 2 was 13.56 ± 3.04 vs 30.41 ± 8.54 years. The following clinical manifestations at SLE diagnosis were significantly more common in childhood-onset than in adult-onset SLE patients: hematological disorder (p = 0.033) and arthritis (p = 0.006). While discoid rash (p = 0.036) and photosensitivity (p < 0.001) were significantly found higher in adult-onset SLE. Cyclophosphamide therapy was significantly more common to be used in childhood-onset (38.5% vs 21.0%, p = <0.001). However, frequency of mortality on follow-up tended to be higher in childhood-onset group (11.5% vs 7.0%, p = 0.208). CONCLUSION: Arthritis and hematologic involvements at SLE diagnosis were more prominent in childhood-onset compared to adult-onset patients, and mortality in childhood-onset SLE during follow-up relatively higher. This data may suggest the need for more aggressive management approach to childhood-onset patients with SLE.

Ethanol extract from Moringa oleifera leaves modulates brown adipose tissue and bone morphogenetic protein 7 in high-fat diet mice.

BACKGROUND AND AIM: Brown adipose tissue's (BAT) ability to increase energy expenditure has become a new focus in obesity research. The amount and activity of BAT are inversely correlated with body-mass index and body fat percentage. Bone morphogenetic protein 7 (BMP7) plays a role in the differentiation and development of BAT, which can be increased by bioactive compounds from several medicinal plants. Moringa oleifera (MO) leaves are rich with vitamin, minerals, and bioactive compounds and have been used for treating obesity-related diseases in the past. The aim of this study was to explore the potency of MO leaf extract (MOLE) to modulate BAT differentiation in mice fed a high-fat diet (HFD). MATERIALS AND METHODS: Twenty-four, 5-week-old male Deutsche Denken Yoken mice (Mus musculus) were randomly divided into four groups: The normal chow diet group was fed a normal diet, the HFD group was fed a HFD, the HFD+MOLE1, and the HFD+MOLE2 groups were fed HFD and MOLE in a dose of 280 and 560 mg/kg body weight (BW)/day, respectively. The experiment was performed for 7 weeks. At the end of the experiment, histological analysis was performed on the interscapular BAT, and blood was drawn for BMP7 protein levels. RESULTS: After 7 weeks, BAT weight in the HFD group was nearly twice in the weight of the HFD+MOLE1 group (125±13.78 mg vs. 75±13.78 mg; p<0.001). There was also a significant increase in BAT cell density in the HFD+MOLE1 group. BMP7 serum protein levels were significantly higher in the HFD+MOLE1 group compared to the HFD group. CONCLUSIONS: The administration of MOLE in a dose of 280 mg/kg BW/day in HFD-mice induces BAT differentiation and proliferation by upregulating BMP7 protein levels.

Correlation between Serum Fatty Acid Binding Protein 4 (FABP4) Levels and Cardiac Function in Patients with Thalassemia Major.

BACKGROUND: Patients with thalassemia major may suffer from complications due to iron overload. It has been suggested that several adipokines may play a potential role in the development of complications in thalassemia. Fatty acid-binding protein 4 (FABP4) is one of the adipokines, bridging several aspects of metabolic and inflammatory pathways. Little is known about the relationship between this adipokine and cardiac and liver function, especially in patients with thalassemia major. AIMS: This study is aimed at determining serum FABP4 levels in patients with thalassemia major and whether its concentration correlated with serum ferritin levels, as well as cardiac and liver function. METHODS: Thalassemia major outpatients (n = 48) completed laboratory examination, echocardiography, and electrocardiography. RESULTS: The mean age was 21.9 ± 8.0 years. A negative and weak correlation between serum ferritin and FABP4 was observed (r = -0.291, p < 0.05). In addition, there was moderate and positive correlation between left atrial volume index (LAVI) and FABP4 (r = 0.316, p < 0.05). CONCLUSIONS: Serum FABP4 correlated with serum ferritin and cardiac function in patients with thalassemia major. FABP4 may be a potential clinical biomarker for cardiac dysfunction via metabolic and inflammatory pathways due to iron accumulation and toxicity in patients with thalassemia major.