Systemic lupus erythematosus: latest insight into etiopathogenesis.

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder of unknown etiology. Multifactorial interaction among various susceptible factors such as environmental, hormonal, and genetic factors makes it more heterogeneous and complex. Genetic and epigenetic modifications have been realized to regulate the immunobiology of lupus through environmental modifications such as diet and nutrition. Although these interactions may vary from population to population, the understanding of these risk factors can enhance the perception of the mechanistic basis of lupus etiology. To recognize the recent advances in lupus, an electronic search was conducted among search engines such as Google Scholar and PubMed, where we found about 30.4% publications of total studies related to genetics and epigenetics, 33.5% publications related to immunobiology and 34% related to environmental factors. These outcomes suggested that management of diet and lifestyle have a direct relationship with the severity of lupus that influence via modulating the complex interaction among genetics and immunobiology. The present review emphasizes the knowledge about the multifactorial interactions between various susceptible factors based on recent advances that will further update the understanding of mechanisms involved in disease pathoetiology. Knowledge of these mechanisms will further assist in the creation of novel diagnostic and therapeutic options.

Effect of dietary anthocyanins on biomarkers of type 2 diabetes and related obesity: A systematic review and meta-analysis.

Anthocyanins have been reported for the protective effects against type 2 diabetes and related obesity. This meta-analysis examined the benefits of anthocyanins on type 2 diabetes and obesity biomarkers in animals and humans. The study included 21 clinical trials and 27 pre-clinical studies. A systematic search was conducted using the following inclusion criteria: in vivo rodent studies; human randomized clinical trials, both aimed at assessing the fasting blood glucose (FBG), HbA1c, total cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein; and study duration of at least two weeks. Out of the 201 examined publications, 48 were shortlisted after implementation of the selection criteria. Results of clinical trials demonstrated that consumption of anthocyanin-rich food significantly reduced the FBG (p < 0.0001), HbA1c (p = 0.02), TC (p = 0.010), TG (p = 0.003), LDL (p = 0.05) and increases the HDL (p = 0.03) levels. Similarly, pre-clinical studies demonstrated the amelioration of the HbA1c (p = 0.02), FBG, TC, TG, and LDL (p < 0.00001), with non-significant changes in the HDL (p = 0.11). Sub-group analysis indicated dose-dependent effect. This compilation confirms that consuming anthocyanin-rich foods positively correlates with the reduction in the blood glucose and lipid levels in diabetic and obese subjects.

Evaluation of liver specific ionizable lipid nanocarrier in the delivery of siRNA.

Hepcidin, a key regulator of iron homeostasis, has been implicated in the pathogenesis of various iron-related diseases. Although small interfering RNA (siRNA) are potent to modulate the expression of hepcidin, their bioavailability remains a major issue. The ß-galactopyranoside-conjugated liposomes (GAL-liposome) targeting liver synthesized hepcidin were prepared by thin lipid film hydration method to encapsulate siRNA and the conjugation of ß-galactopyranoside to the lipid nanocarrier was achieved by covalent chemistry. The prepared siRNA loaded GAL-lip were spherical with around 50 nm radius in size as observed by HR-TEM. The zeta potential and polydispersity index of the prepared liposomes were - 19.9 ± 0.96 mV and 0.44 ± 0.05, respectively. The encapsulation efficiency as determined by dialysis bag method was around 91.76 ± 1.74%. The cell viability and cellular uptake analysis was examined in HepG2 cells by MTT assay and flow cytometry, respectively. The stability and cumulative release of siRNA was also assessed. The hepcidin mRNA expression on administration of siRNA loaded GAL-lip was determined in HepG2 cells and in lipopolysaccharide-induced mice model followed by examining itsin vivo biodistribution by fluorescence microscopy. The results suggested thatsiRNA loaded GAL-lip reduced the hepcidin levels, thus, highlighting a novel ligand conjugated ionizable lipid-based nanocarrier for inducing RNA interference.

Interplay of redox imbalance with matrix gelatinases in neutrophils and their association with disease severity in rheumatoid arthritis patients.

Rheumatoid arthritis (RA) etiopathogenesis still remains complex, but involvement of several immune cells is evident. Present study focusses on evaluation of polymorphonuclear neutrophils (PMNs) in RA patients and healthy controls. From generation of oxidative species, release of inflammatory cytokines and matrix-degrading proteases, PMNs possess the ability to mediate immunological responses. Intracellular and mitochondrial ROS in PMNs and other oxidative parameters including catalase, superoxide dismutase, glutathione peroxidase, reduced glutathione and lipid peroxidation were measured in PMNs and serum samples. Gene regulation studies involved in oxidative (Keap1 and Nrf2) and degradative pathways (MMP2 and MMP9) were done using DNA methylation analysis. Intracellular expression levels of Keap1, Nrf2, Dnmt1, MMP2, and MMP9 were analyzed using flowcytometry in patients and controls. Moreover, serum levels of pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α were also measured. Comparative measurements amongst patients and controls were statistically analyzed, and correlations were made with disease severity scores (DAS28 ESR).

Proportion of B cell subsets and Nrf2 mediated redox regulation in systemic lupus erythematosus patients.

Systemic lupus erythematosus (SLE) is characterized by expansion of autoreactive lymphocytes and impaired management of oxidative stress. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) plays a significant role in maintaining the redox homeostasis of cell. The present study aims to investigate the frequency of peripheral B cell subsets and the redox regulation by Nrf2 in SLE patients with variable disease activity. For this, a total of forty (40) SLE patients and twenty (20) age and gender-matched healthy controls (HCs) were recruited where patients with SLEDAI < 6 were grouped as Inactive SLE (n = 20) and patients with SLEDAI ≥ 6 were grouped as Active SLE (n = 20). A proportion of peripheral B cell subsets, level of ROS and expression of Nrf2 and Keap1 were studied with the help of flow cytometry and multiplex cytokine bead assay was exploited to estimate the serological concentration of cytokines. The frequency of B cell subsets was significantly altered and correlated with SLEDAI score. Concentration of IFNα2, IFN-ß, BAFF, APRIL and IL-6 was also raised in active SLE patients. Moreover, the level of cytosolic ROS was universally decreased while mitochondrial ROS was increased in B cell subsets. The expression of Nrf2 and Keap1 (a negative regulator of Nrf2) was significantly increased in B cell subsets of SLE patients. Here, it has been demonstrated that the frequency of peripheral B cell subsets varies with modification in the SLE disease activity. The given data also demonstrated that the expression of Nrf2 is significantly heightened in B cell subsets to deal with free radical stress.

Global histone modification analysis reveals hypoacetylated H3 and H4 histones in B Cells from systemic lupus erythematosus patients.

OBJECTIVE: Histone modification is an epigenetic alteration which either activates or suppresses gene transcription. Studies revealed the association of altered global histone modification in T cells and monocytes with the pathogenesis of Systemic lupus erythematosus (SLE). Herein, we investigated the level of global histone 3 (H3) and histone 4 (H4) acetylation in B cells of SLE patients. METHODS: Total 20 SLE patients and 10 healthy donors were recruited. Global H3 and H4 acetylation in B cells was assessed by Epigentek assay kits. Expression of DNA methyltransferase 1 (DNMT1) in B cells was analyzed by staining cells with anti-CD19/20 and anti-DNMT1 antibody. The concentration of BAFF and APRIL was measured using LegendPlex Human B cells panel and circulating ANAs were determined using indirect immunofluorescence. RESULTS: Compared to healthy donors, B cells from SLE patients were found to be hypoacetylated on both H3 and H4 histones together with a decrease in the expression of DNMT1. Indeed, stratification of SLE patients on the basis of disease activity did not show any variation, as the amount of H3 and H4 acetylation in both inactive and active SLE patients was almost uniform. CONCLUSION: These findings suggest that SLE-B cells were manifested with aberrant histone acetylation levels.

Electrochemical detection of hepcidin based on spiegelmer and MoS2NF-GNR@AuNPs as sensing platform.

Spiegelmers, mirror image L- RNA oligonucleotides, possesses high plasma stability and non-immunogenicity. Herein, a novel spiegelmer based impedimetric biosensor grafted with Au nanoparticles and molybdenum disulfide nanoflowers/graphene nanoribbons nanocomposite has been designed to detect hepcidin in spiked-in human serum sample. Firstly, molybdenum disulfide nanoflowers/graphene nanoribbons (MoS2NF-GNR) hybrid was drop-casted onto the FTO electrode followed by electro deposition of Au nanoparticles (AuNPs). Hepcidin specific thiolated spiegelmer was then immobilized on the MoS2NF-GNR@AuNPs for hepcidin detection. Electrochemical impedance spectroscopy was used to assess the performance of the sensing platform based on the variation of charge transfer resistance (ΔRct) relative to the Fe(CN)64-/3- electrochemical probe in the presence of hepcidin. The impedance signals were recorded at the frequency range of 10-1 to 105 Hz and potential was set as 0.18 V. Under optimized conditions, the limit of detection of spiegelmer based sensor for hepcidin was 0.173 pgmL-1 within a wide linear range of 0.005-10 ngmL-1. The biosensor possesses selectivity, acceptable reproducibility with RSD as 4.76% and stability for up to 20 days. The satisfactory recovery result (89.8-103.1 %) in human serum indicates that the sensor has applicability in clinical monitoring of hepcidin.

Role of oxidative stress in pathophysiology of rheumatoid arthritis: insights into NRF2-KEAP1 signalling.

Rheumatoid arthritis is one of the most prevalent, chronic, inflammatory disorders involving multiple articular and extra-articular complications. Immune deregulation owing to a combinatorial network of cells, inflammatory components, degrading enzymes, angiogenetic factors, exhibiting pleiotropy, synergy, or redundancy, is a critical hallmark for synovial inflammatory milieu reasoning clinical heterogeneity and variability of the disease. As a prototype of autoimmune disease, the pathophysiology of rheumatoid arthritis has been linked to oxidative stress. However, the exact mechanism for these potential driving factors contributing to disease inception and perpetuation is yet elusive. Nuclear factor erythroid 2-related factor 2 - Kelch ECH associating protein 1 (Nrf2-Keap1) pathway, controlled via multifactorial regulation, functions as a ubiquitous, evolutionarily conserved intracellular defense mechanism. Nrf2-Keap1 signalling maintains homeostatic responses against a plethora of environmental or endogenous deviations in cellular growth, death, redox metabolism, inflammation, bone remodelling, detoxification, etc. Administration of antioxidants as an add-on pharmacotherapy along with conventional drugs has been elucidated as a better measure for disease management. Some of the most promising natural and synthetic redox-based therapeutic compounds function as either scavengers of reactive species, or inhibitors of their sources, or activators of an endogenous antioxidant system (Nrf2-Keap1). The present review focuses on the binomial "rheumatoid arthritis-oxidative stress", bringing insights into their pathophysiological interrelationships and Nrf2 signalling, as well as the implications of potential diagnostic oxidative stress biomarkers and therapeutic interventions directed for disease management in patients with rheumatoid arthritis.Highlights:RA has complex etiopathogenesis, evolving from multiple endogenous and exogenous factors with oxidative stress as a critical pathogenic signature.Oxidative damage and damaged compounds could serve as potent biomarkers for disease diagnosis, therapeutic response, and prognosis.One of the supreme cytoprotective signalling cascades, the Nrf2-Keap1 pathway has been known to elicit a protective effect against RA and various other autoimmune, inflammatory, degenerative disorders.Inclusion of natural and synthetic antioxidants has been encouraged by various studies for additional therapy to conventional drugs for better management of the disease.

Gold-silver core-shell nanoparticle-based impedimetric immunosensor for detection of iron homeostasis biomarker hepcidin.

An impedimetric immunosensor based on gold-silver core-shell nanoparticles for hepcidin detection is reported. The core-shell nanoparticles were prepared by seed-mediated method and characterized by dynamic light scattering, UV-Vis, XRD, field emission-scanning electron micrograph imaging, energy dispersive spectroscopy, and atomic force microscopy. The immunosensor was fabricated with core-shell nanoparticles and cysteamine employing covalent chemistry (amide bond formation) strategy for ensuring proper orientation of anti-hepcidin antibody on to the amine-functionalized nanomaterial decorated electrodes. The hepcidin detection principle was based on the variation of charge transfer resistance (ΔRct) relative to the Fe(CN)64-/3- electrochemical probe in the presence of the biomarker. The frequency range was 10-1 to 105 Hz at the scan rate of 10 mV s-1and a potential of 0.1 V. Based on the antigen-antibody interaction in 40 min at pH 7.0, a linear relationship between ΔRct and hepcidin concentration was obtained in the range 0.01 to 100 ng/mL with a detection limit of 0.857 pg/mL. Furthermore, the designed immunosensor had acceptable reproducibility, stability, selectivity, and reusability. It was successfully applied to the detection of hepcidin in spiked human serum samples and acceptable recovery (90-95.9%) was obtained. Graphical abstract Gold-silver core-shell nanoparticle-based impedimetric immunosensor for detection of iron homeostasis biomarker hepcidin. The study focuses on the detection of iron regulatory protein hepcidin using gold-silver core-shell nanoparticles. This immunosensor was fabricated with core-shell nanoparticles and cysteamine employing covalent chemistry (amide bond formation) strategy. The sensor was sensitive in the range from 0.01 to 100 ng/mL, with a detection limit of 0.857 pg/mL.

Altered oxidative stress markers in relation to T cells, NK cells & killer immunoglobulin receptors that are associated with disease activity in SLE patients.

Systemic Lupus Erythematosus is an autoimmune disease with symptoms pervasive to all organ systems. It affects more females as compared to males (in the ratio 9:1). Oxidative stress plays a major role in the pathogenesis of SLE and other autoimmune diseases. In order to understand the relationship between cell specific oxidative stress and the severity of SLE, this research study involving the estimation of intracellular ROS accumulation in T and NK cell was conducted on SLE patients of North Indian Population. At the same time, to estimate anti-oxidant defense, Keap1 and Nrf2 levels were estimated in these cell types. The relationship between the expression of Killer immunoglobulin receptors i.e., KIR2DL4 & KIR3DL1 and oxidative stress was also evaluated as these receptors are imperative for the function and self-tolerance of NK cells.Oxidative stress was raised along with Keap1 and Nrf2 in T and NK cell subsets in SLE patients. The expression of KIR2DL4 was raised and that of KIR3DL1 was reduced in the NK cells of patients. The intensity of change in expression and its significance varied among the subsets. Nrf2 expression was raised in these species against oxidative stress as the antioxidant defense mechanism pertaining to Keap1-Nrf2 pathway, but the adequacy of response needs to be understood in further studies. The expression of KIR2DL4 and KIR3DL1 varied among the patient and healthy controls and the expression of the latter was found to have a significant positive relationship with plasma Glutathione(reduced) concentration.

Altered redox regulation by Nrf2-Keap1 system in dendritic cells of systemic lupus erythematosus patients.

Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with inflammation and multiple organ involvement. Individually, dendritic cells (DCs) and oxidative stress have been well discussed for their critical involvement in the pathogenesis of disease but the precise impact of oxidative stress on DCs in relation to SLE disease activity is yet to be scrutinized. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1) pathway is the cellular mechanism to combat increased reactive oxygen species (ROS). The current study was framed in order to understand redox regulation in DCs along with an argument in context to disease activity. Here, 23 SLE patients along with 10 healthy controls were enrolled and disease activity was calculated as the recent change in SLEDAI score. We found the percentage of circulating plasmacytoid DCs (pDCs) was increased with an increase in disease activity. Altered DCs functionality along with disease activity was further supported with the differential concentration of Type I IFNs. The disease activity was positively associated with increased levels of ROS. A relevant reason for increased ROS was further explained with the decreased levels of transcription factor Nrf2. Hence, the present study suggests that SLE specific DCs displayed elevation in ROS and this outcome might be due to impaired free radical clearance by Nrf2. Correlation studies further established an association of disease activity with increased ROS, Type I IFNs levels and decreased activity of oxidative stress regulating enzymes.

Prophylactic effect of resveratrol and piperine on pristane-induced murine model of lupus-like disease.

Systemic lupus erythematosus is a multisystem autoimmune disease. Apart from usual treatments, approximately 50% of lupus patients use complementary medicine. Resveratrol is a phytoalexin with various pharmacological properties. We hypothesised that prophylactic treatment with resveratrol may abrogate manifestations in pristane-induced murine model of lupus-like disease and piperine; a bio-enhancer of resveratrol may enhance these properties. The prophylactic effect of resveratrol (25 mg/kg body weight: P-Res) alone and in combination with piperine (2.5 mg/kg body weight: P-RP) were assessed. P-Res and P-RP were equally efficient in mitigating oxidative stress (enzyme activity of catalase, superoxide dismutase, glutathione peroxidase and level of reduced glutathione, lipid peroxidation, and reactive oxygen species). Inflammation is associated with an increase in inflammatory cytokines. IL-6 was decreased by 71.60% with P-Res, and TNF-α was reduced by 59.70% with P-Res and 62.66% with P-RP (p < 0.05). Prevention of renal pathologies was evident by reduction in creatinine level by P-RP (p < 0.05) and abrogation of proteinuria (P-Res and P-RP). P-RP was efficient in restoring histopathology of liver and lungs and decreased immune complexes in lungs. P-Res proved more beneficial by extenuating lipogranulomas, histopathological manifestations in kidney, liver, and lungs, and eliminating immune complexes in liver and lungs. None of the treatments could regulate auto-antibody formation. Resveratrol decreases the susceptibility of developing pathogenesis in murine model of lupus-like disease. The results also conclude that addressing the bioavailability of resveratrol using it in combination with piperine does not prove more efficacious in preventing lupus-associated pathologies than resveratrol alone.

Clinico-genetic model to predict methotrexate intolerance in rheumatoid arthritis.

INTRODUCTION: Methotrexate is the gold-standard DMARD in rheumatoid arthritis but is often associated with "mild" adverse effects like intolerance or laboratory abnormalities. Although non-life threatening, they are responsible for drug discontinuation in 17-50%. There is limited data on clinical and genetic markers that predict their occurrence. METHODS: This prospective study enrolled patients with active rheumatoid arthritis. They were started on methotrexate at a weekly dose of 15 mg, escalated gradually to reach 25 mg which was continued till the end of the study. Intolerance (symptomatic adverse effects) was ascertained by a questionnaire at 4, 8, 16, and 24 weeks. Laboratory testing for occurrence of cytopenia and/or transaminitis was done at the same study visits. Seven SNPs in four genes involved in methotrexate handling were genotyped using real-time polymerase chain reaction. RESULTS: This study included 110 patients with rheumatoid arthritis who received methotrexate for 24 weeks; the final mean weekly methotrexate dose was 22.0 ± 4.0 mg. Methotrexate intolerance occurred in 40 (37%), common being nausea (and vomiting) in 29 and anxiety (and dizziness) in 9. It was associated with lower BMI at baseline (21.5 ± 3.7, 23.8 ± 4.6 kg/m2, p = 0.01). FPGS rs10106 was significantly associated with intolerance with an allelic odds ratio (95% CI) of 2.02 (1.14-3.57) and the recessive genetic model (AA+AG versus GG) with an odds ratio of 3.8 (95% CI 1.5-9.6, p = 0.004). A model including both BMI and FPGS rs10106 could modestly predict methotrexate intolerance with an accuracy of 66.3%. CONCLUSIONS: A clinical-genetic model including BMI and SNP FPGS 10101 was found to have a modest prediction ability for methotrexate intolerance.Key Points• Methotrexate intolerance (symptomatic adverse effects) was common and occurred in 37% patients over 6 months.• SNP FPGS rs10106 and low body mass index were associated with methotrexate intolerance.• Clinico-genetic model had a modest ability of 66% for predicting intolerance.

Oxidative stress and immune complexes: Pathogenic mechanisms in pristane induced murine model of lupus.

Systemic lupus erythematosus is a systemic autoimmune inflammatory disease with a broad spectrum of clinical presentations. Mouse models play an indispensible role in understanding the disease pathology and for developing new therapeutics. This study investigated the effect of pristane administration on female BALB/c mice. The various manifestations of lupus replicated in this mouse model were analysed and their relevance to human disease was assessed. Pristane injection replicates the two prime manifestations of lupus i.e. oxidative stress and inflammation. An increase in oxidative stress was determined by the decreasing anti-oxidants, increasing ROS and lipid peroxidation. Inflammatory cytokines (IL-6 and TNF-α) also increased in the plasma. The deteriorating organ functions after pristane administration were evident histopathologically. An increase in inflammatory cells, necrosis, oil vacuoles and pigment cells were marked in kidney, liver, lungs and spleen, whereas skin did not manifest any alteration. Liver function (bilirubin, SGPT) and kidney function (creatinine and proteinuria) tests were also altered. Pristane injection caused the generation of anti-nuclear antibodies, which were apparent from the different immunofluorescence patterns observed. Immune deposits were evident in all the vital organs stating the similarity this model holds with lupus patients. Replicating various manifestations of human lupus disorder, pristane induced mouse model of lupus serves as an appropriate model to study lupus complications and in the development of novel therapeutics for disease management.

Combinatorial therapeutic effect of resveratrol and piperine on murine model of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic multi-system inflammatory disease associated with autoantibody formation. Clinical management of lupus is associated with multiple adverse events. Resveratrol is a phytoalexin with several pharmacological properties. This study aimed to evaluate the combinatorial effect of resveratrol (25 mg/kg and 50 mg/kg) and its bio-enhancer piperine (1/10th dose of resveratrol) on pristane-induced SLE murine model. Mice were injected with 0.5 ml of pristane and after 2 months they were orally dosed with resveratrol combinations for 4 months. Determined by indirect immunofluorescence, resveratrol was unable to abrogate autoantibody formation. The increased IFN-α, IL-6 and TNF-α was mitigated by low dose of resveratrol and piperine (RP-1). None of the doses regulated the increase in nitric oxide. Lipogranulomas associated with injected pristane were not observed after RP-1 and high dose of resveratrol (Res-2) treatment. Lupus mice witnessed IgG and IgM immune complexes by direct immunofluorescence assay and associated histopathological observations in kidneys, liver, lung, spleen and skin. None of the treatment regimens were able to regulate the manifestations observed in spleen and skin. RP-1 and Res-2 proved beneficial in kidney, liver and lungs and were able to ameliorate lupus associated manifestations. Renal manifestations (proteinuria and decreased creatinine in urine) were successfully mitigated by RP-1 and Res-2 and high dose combination of resveratrol and piperine. Oxidative stress (reactive oxygen species by flowcytometry and catalase, superoxide dismutase, glutathione peroxidase, reduced glutathione and lipid peroxidation by biochemical analysis) was evident by pristane injection. These were regulated by different doses of resveratrol alone and in combination with piperine. Hence, resveratrol when used in combination with piperine successfully reduces some measures of morbidity with little or no effect on mortality associated with lupus.

Molecular characterization and immunogenic function of ML1899 (LipG) of Mycobacterium leprae.

Introduction. ML1899 is conserved in all mycobacterium sp. and is a middle member of mle-ML1898 operon involved in mycolic acid modification.Aim. In the present study attempts were made to characterize ML1899 in detail.Methodology. Bioinformatics tools were used for prediction of active-site residues, antigenic epitopes and a three-dimensional model of protein. The gene was cloned, expressed and purified as His-tagged protein in Escherichia coli for biophysical/biochemical characterization. Recombinant protein was used to treat THP-1 cells to study change in production of nitric oxide (NO), reactive oxygen species (ROS), cytokines and chemokines using flowcytometry/ELISA.Results. In silico analysis predicted ML1899 as a member of α/ß hydrolase family with GXSXG-motif and Ser126, His282, Asp254 as active-site residues that were confirmed by site-directed mutagensis. ML1899 exhibited esterase activity. It hydrolysed pNP-butyrate as optimum substrate at pH 8.0 and 50 °C with 5.56 µM-1 min-1 catalytic efficiency. The enzyme exhibited stability up to 60 °C temperature and between pH 6.0 to 9.0. K m, V max and specific activity of ML1899 were calculated to be 400 µM, 40 µmoles min-1 ml-1 and 27 U mg- 1, respectively. ML1899 also exhibited phospholipase activity. The protein affected the survival of macrophages when treated at higher concentration. ML1899 enhanced ROS/NO production and up-regulated pro-inflammatory cytokines and chemokine including TNF-α, IFN-γ, IL-6 and IL-8 in macrophages. ML1899 was also observed to elicit humoral response in 69 % of leprosy patients.Conclusion. These results suggested that ML1899, an esterase could up-regulate the immune responses in favour of macrophages at a low concentration but kills the THP-1 macrophages cells at a higher concentration.

Altered Tregs and oxidative stress in pregnancy associated lupus.

AIM: SLE is a systemic autoimmune disease generally affecting woman in the reproductive age. It is associated with an altered level of Tregs and oxidative stress while an increase in Tregs, and different antioxidant mechanisms to combat oxidative stress are essential for successful pregnancy. Hence, this study aims to determine the level of CD4+ and CD8+ Tregs and oxidative stress in pregnant lupus patients. METHODS: Ten healthy and 10 pregnant lupus volunteers from the North Indian population, within the age group of 20-30 years were enrolled in the study. All the patients were non-smokers, non-alcoholics and were not associated or undergoing therapy for any other disease. They had a SLEDAI of 37.4 ± 7.32 with 5.2 ± 1.93 years of disease duration. Oxidative stress was determined by measuring the enzyme activity of anti-oxidant enzymes (catalase, superoxide dismutase and glutathione peroxidase) and the level of reduced glutathione and lipids peroxidised, spectrophotometrically. Flowcytometry was performed for immunophenotyping to determine CD8+ and CD4+ Tregs. RESULTS: Elevated CD8+ Tregs and diminished CD4+ Tregs were observed in pregnant lupus patients. Oxidative stress was significantly increased as the activities of anti-oxidant enzymes and level of reduced glutathione was considerably diminished. There was a substantial increase in the amount of lipids peroxidised. CONCLUSION: Pregnant lupus patients undergo considerable level of oxidative stress in comparison to healthy pregnant woman. The decreased level of CD4+ Tregs and an increase in CD8+ Tregs might be another important factor responsible for pregnancy associated complications. Hence, lupus leads to alterations in the necessary conditions for a successful pregnancy, which might eventually cause higher mortality, morbidity and associated complications.

Methotrexate preferentially affects Tc1 and Tc17 subset of CD8 T lymphocytes.

Rheumatoid arthritis is considered a T-lymphocyte-mediated disease. However, studies have focussed on CD4 T-lymphocytes, ignoring CD8 T-lymphocytes despite the latter being found abundantly in the synovium. Specifically, there is little data of the effect of methotrexate, the gold-standard DMARD, on various CD8 cytokine T-lymphocyte subsets and conflicting data on CD4 subsets. In this prospective study, patients with active rheumatoid arthritis, who were 18 to 65 years of age, were treated with methotrexate (up to 25 mg per week) for 24 weeks. At baseline and 24 weeks, frequencies of CD8+IFNγ+, CD8+IL17+, CD8+IL4+, corresponding CD4 subsets and plasma levels of IFNγ, IL-12, IL-10, IL-4 and IL-17 were determined by flow cytometry. These are summarised as median (IQR = interquartile range, 25th-75th percentile) and paired data compared using Wilcoxon signed rank test. This study included 67 patients (F/M = 4:1) with rheumatoid arthritis, 57 (85%) being RF positive and 20 receiving prednisolone at baseline. Mean (± SD) dose of methotrexate at 24 weeks was 22.9 ± 3.0 mg per week. On treatment with methotrexate, there was a significant (p = 0.04) decline in CD8+IFNγ+ cells from 37.2 (IQR 19.4-60.2) to 22.7% (IQR 8.5-49.7) and a marginal increase in CD8+IL17+ cells from 0.3 (IQR 0.1-0.6) to 0.4 (IQR 0.2-1.2), p = 0.006. There was no significant change in the other subsets. There was also a significant decline in circulating levels of IL-12, IL-10 and IL-17 and marginal increase in IL-4. On evaluating by response, non-responders but not responders had a significant increase in CD8+IL17+ (p = 0.01). There is a significant decline of CD8+IFNγ+ T cells and marginal increase in CD8+IL17+ T cells after methotrexate. Change in Tc1 subset may be mediated through reduction in IL-12 levels.

Resveratrol: from enhanced biosynthesis and bioavailability to multitargeting chronic diseases.

Resveratrol, a phytoalexin with a wide range of pharmacological properties is synthesised by plants in response to stress, injury, infection or UV radiations. As it is a secondary metabolite with many health promoting properties, various methods employing microorganisms and genetic manipulation of different synthetic enzymes, have been comprehensively studied to increase its production. Its rapid metabolism and low bioavailability have been addressed by the use of bio enhancers and nano-formulations. This flavonoid is extensively researched due to its pharmacological properties such as anti-oxidative, anti-inflammatory and immuno-modulating effects. Knowledge of these properties of resveratrol has led to elaborate studies on its effect on diabetes, neurodegenerative diseases, cancer, ageing, obesity and cardiovascular diseases. At molecular level it targets sirtuin, adenosine monophosphate kinase, nuclear Factor-κB, inflammatory cytokines, anti-oxidant enzymes along with cellular processes such as angiogenesis, apoptosis, mitochondrial biogenesis, gluconeogenesis and lipid metabolism. This review discusses the properties of resveratrol and the different approaches of addressing the unfavourable synthesis and pharmacokinetics of this stilbene. Pre-clinical evaluations of resveratrol on diabetes mellitus, cardiovascular and neurological diseases are elaborately discussed and the underlying pathways involved in its therapeutic activity have been given paramount importance. Following the pre-clinical studies, clinical trials on the same reveal the efficacy of resveratrol in the effective management of these diseases. This review provides an intricate insight on resveratrol's significance from a dietary component to a therapeutic agent.

Altered Tregs and oxidative stress in pregnancy associated lupus

Abstract Aim SLE is a systemic autoimmune disease generally affecting woman in the reproductive age. It is associated with an altered level of Tregs and oxidative stress while an increase in Tregs, and different antioxidant mechanisms to combat oxidative stress are essential for successful pregnancy. Hence, this study aims to determine the level of CD4+ and CD8+ Tregs and oxidative stress in pregnant lupus patients. Methods Ten healthy and 10 pregnant lupus volunteers from the North Indian population, within the age group of 20-30 years were enrolled in the study. All the patients were non-smokers, non-alcoholics and were not associated or undergoing therapy for any other disease. They had a SLEDAI of 37.4 ± 7.32 with 5.2 ± 1.93 years of disease duration. Oxidative stress was determined by measuring the enzyme activity of anti-oxidant enzymes (catalase, superoxide dismutase and glutathione peroxidase) and the level of reduced glutathione and lipids peroxidised, spectrophotometrically. Flowcytometry was performed for immunophenotyping to determine CD8+ and CD4+ Tregs. Results Elevated CD8+ Tregs and diminished CD4+ Tregs were observed in pregnant lupus patients. Oxidative stress was significantly increased as the activities of anti-oxidant enzymes and level of reduced glutathione was considerably diminished. There was a substantial increase in the amount of lipids peroxidised. Conclusion Pregnant lupus patients undergo considerable level of oxidative stress in comparison to healthy pregnant woman. The decreased level of CD4+ Tregs and an increase in CD8+ Tregs might be another important factor responsible for pregnancy associated complications. Hence, lupus leads to alterations in the necessary conditions for a successful pregnancy, which might eventually cause higher mortality, morbidity and associated complications.