Assessment of Circulating CCR6 Level in Acute Myocardial Infarction and its Association with Disease Severity.

BACKGROUND: Acute myocardial infarction (AMI) pathophysiology is mediated by systemic, intraplaque myocardial inflammatory processes that occur mainly due to coronary artery thrombosis in an atherosclerotic plaque area. The G-protein-coupled chemokine receptor (Ccr6) is displayed on the surface of many types of leukocytes, that have been found in atherosclerotic plaques. It is a novel mediator of inflammation and immune response. OBJECTIVES: To determine CCR6 lymphocyte expression in AMI patients and its association with disease severity using the Gensini scoring system. METHODS: 25 AMI patients and 25 controls underwent flow cytometry to determine the percentage of circulating CCR6+ lymphocytes. To forecast AMI and determine how CCR6 expression relates to it, multivariate logistic regression analysis was used. RESULTS AND DISCUSSION: There was a higher percentage of CCR6+ lymphocyte expression in AMI patients than in controls. In addition, CCR6 showed a significant positive correlation with the Gensini score (GS) in the AMI group then with the degree of coronary artery disease (CAD). CONCLUSION: The chemokine receptor CCR6 is an independent biomarker for AMI and mayplay a role as a mediator of T lymphocyte recruitment, which is associated with coronary lesion destabilization.

DEFB1 gene polymorphisms modify vitiligo extent and response to NB-UVB phototherapy.

Human beta defensin-1(hBD-1); an antimicrobial peptide, has immune regulatory effects which may be involved in autoimmunity. The aims were to evaluate the association between defensin beta 1 (DEFB1) (-44 C/G) and (-20 G/A) gene polymorphisms with the risk of vitiligo development, the extent of the disease and the response to NB-UVB treatment in a sample of Egyptian population. 178 active nonsegmental vitiligo patients and 182 control subjects were included in this prospective case control study. Vitiligo extent was evaluated using vitiligo area scoring index (VASI). Gene polymorphisms in all participants were studied by RFLP PCR technique. Patients were treated by three narrowband UVB (NB-UVB) treatment sessions per week. After 12 weeks, the patients were reevaluated clinically to assess the extent of the disease using VASI scoring again and to evaluate the type of repigmentation, if any. AA genotype of DEFB1 (-20G/A) has a protective role against vitiligo development, while (DEFB1 -44 C/G) GG genotype and G allele increase the risk of vitiligo development about two folds. Patients carrying polymorphism in DEFB1 (-20G/A) only showed the lowest VASI scores (14.23 ± 2.77) and the highest percentage of improvement (66.12 ± 18.01%), while patients carrying polymorphism in DEFB1(-44 C/G) only showed the highest baseline VASI scores (38.87 ± 6.7) and the lowest therapeutic response (23.79 ± 19.42%) among all patients groups. Different DEFB1 gene polymorphisms may modify the risk of vitiligo development, the disease extent and the response to NB-UVB phototherapy.

Serum TWEAK: A cutoff between segmental and nonsegmental vitiligo.

BACKGROUND: TWEAK/Fn14 is expressed in many tissues including the skin, playing an important role in many inflammatory, autoimmune, and neoplastic cutaneous disorders. AIMS: To assess the serum levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in vitiligo patients. METHODS: This case-control study included 100 subjects (50 vitiligo patients and 50 control subjects) recruited from Dermatology Outpatient Clinic, Benha University. All patients were subjected to complete cutaneous examination, to evaluate the clinical type, distribution and severity of vitiligo using the Vitiligo Area Scoring Index (VASI). RESULTS: TWEAK serum levels were significantly higher in patients than in the control subjects (644.76 ± 688.93 vs 282.75 ± 125.67, respectively). Serum levels were significantly elevated in segmental versus nonsegmental vitiligo. Receiver operating characteristic (ROC) analysis revealed that TWEAK shows 80% sensitivity and 56.67% specificity in diagnosing vitiligo and 100% sensitivity and 80.09% specificity in differentiating segmental from nonsegmental vitiligo. CONCLUSION: TWEAK may play a role in vitiligo pathogenesis. It may be used in the differentiation between segmental and nonsegmental vitiligo and represent a promising therapeutic target in vitiligo.

Serum TWEAK in acne vulgaris: An unknown soldier.

BACKGROUND: TWEAK is an inflammatory cytokine which is involved in the development of many inflammatory disorders. AIMS: This study aimed to evaluate serum levels of TWEAK in patients with acne vulgaris. SUBJECTS AND METHODS: This case-controlled study included 100 acne vulgaris patients divided into two groups. Group 1 included 25 patients with moderate acne and 25 patients with severe acne. Group 2 consisted of 50 acne-free control subjects. Acne was graded by the Global Acne Grading System (GAGS). Serum TWEAK was measured by ELISA kits. RESULTS: Acne patients had significant elevation in TWEAK serum levels when compared to the control subjects (P < 0.001). TWEAK serum levels did not show significant difference regarding disease grade, postacne scar, and hyperpigmentation (P value = 0.43, 0.37, 0.80, 0.67, respectively). TWEAK levels were not affected by any of the studied variables except for the significant negative correlation between its levels and the disease duration in severe acne group only (r = -0.42, P = 0.03). CONCLUSION: TWEAK may be involved in acne vulgaris development, but more studies are needed to clarify its role.

Tumor Necrosis Factor-like Weak Inducer of Apoptosis: A Novel Serum Marker in Patients with Severe Alopecia.

BACKGROUND: Alopecia areata (AA) is a common form of nonscarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifunctional cytokine expressed on various cell types and tissues and acts through binding to its sole receptor factor-inducible 14 (Fn14). TWEAK/Fn14 activation contributes to various pathological processes, including cell proliferation and death, angiogenesis, carcinogenesis, and inflammation. AIM: The aim of this current study was to measure serum levels of TWEAK in patients with AA and to assess the correlation between it and severity of the disease. SUBJECTS AND METHODS: This study included 50 patients who had patchy AA, in addition to 50 apparently healthy controls. Severity of AA was assessed using Severity of Alopecia Tool Score. Serum TWEAK levels in all participants were determined using ELISA technique and were correlated with the severity of the disease. RESULTS: Mean serum levels of TWEAK were significantly higher in AA patients, with a positive significant correlation between serum levels of TWEAK and severity of the disease. CONCLUSION: TWEAK as a novel marker of many autoimmune inflammatory dermatological diseases, could be a promising marker in the diagnosis of AA, and also can be used as a prognostic marker for its severity.