Cu/Zn-superoxide dismutase, paraoxonase and arylesterase activities and malondialdehyde levels in patients with familial mediterranean fever.

OBJECTIVES: In this study, alterations in antioxidant enzyme activities and malondialdehyde (MDA) levels in the serum samples of patients with familial Mediterranean fever (FMF), an autosomal recessive disease characterized by recurrent episodes of peritonitis, pleuritis, arthritis and fever, were investigated and compared with those of age- and sex-matched healthy controls. METHODS: Twenty-five patients with FMF undergoing colchicine therapy at doses of 1-1.5 mg and 25 age- and sex-matched healthy controls were included in the study. In the patients with FMF and control subjects, the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were measured. Cu/Zn-superoxide dismutase (Cu/Zn-SOD), paraoxonase-1 (PON-1) and arylesterase (ARE) enzyme activities and MDA levels as a production of lipid peroxidation were evaluated using the appropriate methods. RESULTS: No statistically significant differences in the serum levels of ESR, CRP, Cu/Zn-SOD, MDA and PON-1 between the groups were observed (p>0.05). Serum ARE activity was significantly decreased in the patients with FMF compared with the control subjects (p<0.01). CONCLUSION: In conclusion, some abnormalities in the antioxidant defense system and lipid peroxidation may be observed in FMF patients during attack-free periods. However, further long-term studies on the subject are needed to explore altered lipid peroxidation and antioxidant defense mechanisms in patients with FMF (Tab. 1, Fig. 1, Ref. 35).

Can the patient-reported outcome instruments determine disease activity in rheumatoid arthritis?

OBJECTIVES: The aim of this study was to investigate the indicative value of the patient-reported outcome instruments (PROs) on disease activity in rheumatoid arthritis (RA). METHODS: Three hundred sixty eight patients with RA were included in this cross-sectional study. Disease activity was evaluated using both the Disease Activity Score 28 (DAS 28) and the Clinical Disease Activity Index (CDAI). Patients who had DAS 28 score < 3.60 points and CDAI score <10.00 points were allocated into the "low disease activity" group and those who had DAS 28 score > or = 3.60 points and CDAI score > or = 10.00 points into the "moderate or high disease activity" group. The Health Assessment Questionnaire (HAQ), Nottingham Health Profile (NHP), Rheumatoid Arthritis Quality of Life (RAQoL), and Short Form 36 (SF 36) were used as PROs. Logistic regression analysis was used to find variables, which had an indicative value for disease activity. RESULTS: HAQ, pain and emotional reaction subscales of NHP, and bodily pain, general health and social functioning subscales of SF 36 had independent indicative values, when DAS 28 was used as dependent variable. On the other hand, HAQ, pain and emotional reaction subscales of NHP, and general health and emotional role limitation subscales of SF 36 had indicative values when CDAI was used as dependent variable. DAS 28 and CDAI both showed HAQ as the parameter with the highest odds ratio (OR). But RAQoL had shown no independent indicative value for projecting disease activity. CONCLUSION: It was concluded that HAQ could determine disease activity in RA better than other PROs included in this study (Tab. 4, Ref. 36).

The alteration of sister chromatid exchange frequencies in Behçet's disease with and without HLA-B51.

BACKGROUND: The analysis of sister chromatid exchange (SCE) is a cytogenetic technique used to show DNA damage as a result of an exchange of DNA fragments between sister chromatids. It is known that there is an increased SCE frequency in Behçet's disease (BD). OBJECTIVE: To investigate whether human leucocyte antigen (HLA)-B51-positive patients with Behçet's disease exhibit higher SCE frequencies than those without HLA-B51. METHODS: Lymphocytes from 75 patients (38 women, 37 men) and from 50 controls (28 women, 22 men) were cultured in darkness for 72 h in the presence of bromodeoxyuridine. Metaphase chromosomes were stained with a fluorescence plus Giemsa technique after a standard harvest procedure. For HLA-B51 typing, DNA was extracted from ethylenediaminetetraacetic acid blood samples and HLA-B5 allele genotyping was performed by the polymerase chain reaction (PCR)-sequence specific primer method. RESULTS: Thirty-nine of 75 patients with BD (52%) and 15 of 50 controls (30%) were found HLA-B51-positive. The SCE frequencies in HLA-B51-positive patients were higher than in HLA-B51-negative ones (P < 0.001), whereas no difference was detected in the control group. CONCLUSION: This study revealed that there was a significant association between elevated SCE frequencies and existence of HLA-B51 patients with BD.

Correlation between soluble intercellular adhesion molecule 1 level and extracellular superoxide dismutase activity in rheumatoid arthritis: a possible association with disease activity.

OBJECTIVE: We investigated serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and the activity of extracellular superoxide dismutase (EC-SOD) in rheumatoid arthritis (RA). We also considered whether there was a correlation between sICAM-1 and EC-SOD and disease activity. METHODS: Levels of sICAM-1 were measured in serum from 42 patients with active RA and 30 control subjects by enzyme-linked immunosorbent assay (ELISA). EC-SOD activity was determined in sera isolated from patients with active RA and from controls. RESULTS: The serum levels of sICAM-1 were significantly higher in patients with RA than in control subjects (p<0.001). In contrast, the activity of EC-SOD was significantly lower in RA patients than in healthy controls (p<0.001). A significant negative correlation was found between the levels of sICAM-1 and EC-SOD activity (r=-0.39, p<0.01). There was a statistically positive correlation between sICAM-1 levels with Ritchie articular index (RAI) score and C-reactive protein (CRP) (r=0.32, p<0.05; r=0.44, p<0.01, respectively). CONCLUSIONS: These results show that the increased levels of sICAM-1 present in active RA patients might be due to the decreased activity of EC-SOD, and increased levels of sICAM-1 may also reflect disease status or activity.

The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis.

OBJECTIVE: To investigate the effect of individualized diet challenges consisting of allergenic foods, defined by the skin prick test (SPT), on tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) levels in patients with rheumatoid arthritis (RA). METHODS: Twenty patients with a positive SPT response for food extracts and 20 with a negative SPT response were enrolled. None of the patients had active disease. All patients were fasted for the most common allergenic foods for 12 days and then allocated to two groups according to SPT results. Food challenges were performed with allergenic foods in the prick-positive group (PPG) and with corn and rice in the prick-negative group (PNG) for a period of 12 days. Then, allergenic foods were excluded from the PPG patients' diet and corn and rice were removed from the PNG patients' diet. Clinical examinations were performed after fasting (baseline), at the end of the challenge phase and at the end of the re-elimination phase. Stiffness, pain, tender and swollen joint counts, health assessment questionnaire (HAQ), Ritchie's articular index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum TNF-alpha and IL-1beta levels were measured. RESULTS: TNF-alpha (P < 0.01), IL-1beta (P < 0.05), ESR (P < 0.05) and CRP (P = 0.001) levels and all of the clinical variables, except HAQ, were increased with food challenges in the PPG. These increases were also recorded after the re-elimination phase. In the PNG, no significant change was seen in any of the variables, except pain (P < 0.05). During the study, important differences were observed for most of the variables between the two groups. Thirteen (72%) patients in the PPG and three (18%) in the PNG experienced disease exacerbation with challenges. This aggravation continued after elimination. CONCLUSIONS: Our results suggest that individualized dietary revisions may regulate TNF-alpha and IL-1beta levels in selected patients with RA.

Ultrastructural findings of the nasal mucosa of "ozaena" in atrophic rhinitis.

Alterations in the nasal mucous layer of atrophic rhinitis "Ozaena" patients have been investigated. The vast majority (99%) of these patients were women. Morphological findings in healthy nasal mucosa demonstrated the different functional stages of the glandular tissue cells with the healthy epithelium. On the other hand, nasal mucosal material taken from the patients displayed prominent epithelial deterioration, decrease in and loss of cilia, increase in goblet cells with squamous epithelial metaplasia. A decrease in secretory granules and membrane deterioration in the apical region of the secretory cells was also clearly visible. It is possible to postulate that the ultrastructural changes seen in the secretory and storage cycles of glandular tissue of the nasal mucosa from patients seem to arise as a reaction to the superficial epithelial deterioration of the nasal mucosa together with the resulting deterioration of physiological conditions.

Ultrastructural investigations on the degenerative and regenerative processes in chorda tympani in bell's paralysis.

Our ultrastructural findings in investigated cases of Bell's palsy have demonstrated that the degenerative changes did not proceed at the same speed from the onset of the paralysis--in other words the regeneration changed in accordance with the topography of the nerve. Although the endoneural sheath preserved its integrity, swellings in the Schwann cells have attracted much attention. Furthermore the perineural tissue presented changes which were closely correlated with the degenerative and regenerative processes due to paralysis. In addition to these findings, although the interval between the onset of paralysis and the operation was the same in all our cases, the observation of a more severe degenerative picture of the nerves in the female patients may seem to be an interesting finding, but to the lack of an adequate number of cases which would enable a statistical evaluation, we are strongly, of the opinion that this subject deserves further study.