Age-and Sex-matched Healthy Controls Research Articles

Serum Interleukin-6, Interleukin-17A, and transforming growth factor beta are raised in systemic sclerosis with interstitial lung disease

Background: Dysregulation in cytokines like interleukin-6 (IL-6), interleukin-17A (IL-17A) and transforming growth factor-beta (TGF β1) has been pathogenically implicated in systemic sclerosis (SSc). The present study aimed to assess their serum levels in patients with SSc and correlate with clinical manifestations. Methods: This cross-sectional, observational study included 93 patients fulfilling the 2013 revised ACR/EULAR SSc classification criteria and 33 age-and sex-matched healthy controls. Antinuclear antibody (ANA), extractable nuclear antigen (ENA) profile, chest radiograph, pulmonary function tests and electrocardiography were done. HRCT of thorax and echocardiography were done wherever indicated. Modified Rodnan skin score (MRSS) was calculated. Serum IL-6, IL-17A and TGF β1 levels were assayed using ELISA kit and compared among disease subtypes and clinical parameters. Spearman coefficient was used to test correlation between continuous variables. P value of Results: The mean age of patients was 37.8+10.3 years (Female:Male: 30:1) with median duration of disease of 3 years. Serum IL-6, IL-17A and TGF β1 levels were significantly higher in patients as compared to controls (IL-6: 19.4±11 vs 6.7±3.9 pg/ml (P Conclusion: Serum IL-6, IL-17A and TGF β1 levels were significantly higher in SSc patients and higher levels were associated with ILD and skin fibrosis.

Detection of circulating IgG autoantibody to FcεRIα in sera from chronic spontaneous urticaria patients.

Chronic spontaneous urticaria (CSU) is a common skin disorder characterized by itchy wheals of at least 6 weeks in duration, wherein the autoimmune mechanism is involved to activate IgE receptors (FcεRIα) on mast cells. We aimed to assess levels of IgG autoantibody against FcεRIα in sera from CSU patients using dot-blot immunoassay. We performed a hospital-based cross-sectional study of 125 CSU patients (64 ASST-positive, 61 ASST-negative) and 64 age-and sex-matched healthy controls. The cut-off value of IgG FcεRIα autoantibody was determined as the mean intensity plus two standard deviations of values in controls. Positivity for IgG autoantibody to FcεRIα was analyzed according to clinical parameters of disease duration, urticaria activity score (UAS), ASST, response to antihistamine treatment, complement levels, and the presence of other autoantibodies. Nonparametric tests were applied for statistical analyses. IgG positivity to FcεRIα was noted in 24.8% of CSU patients and was significantly more frequent in ASST-positive patients than in ASST-negative patients (32.8% vs 16.4%, P=0.040). Only 3.1% of healthy controls had this autoantibody. Complement 3 levels were significantly lower in anti-FcεRIα antibody-positive patients than antibody-negative patients (109.8±19.9 vs 123.1±30.9, P=0.035). No significant associations were found between IgG positivity to FcεRIα and UAS, serum total IgE levels, atopic status, clinical responses to antihistamines, or the presence of anti-thyroid and anti-nuclear antibodies. These findings suggest that circulating IgG autoantibody to FcεRIα in a subset of patients may be involved in the autoimmune mechanism of CSU. Further studies are needed to clarify its clinical significance.

Abnormal asymmetry of white matter tracts between ventral posterior cingulate cortex and middle temporal gyrus in recent-onset schizophrenia

IntroductionPrevious studies have reported abnormalities in the ventral posterior cingulate cortex (vPCC) and middle temporal gyrus (MTG) in schizophrenia patients. However, it remains unclear whether the white matter tracts connecting these structures are impaired in schizophrenia. Our study investigated the integrity of these white matter tracts (vPCC-MTG tract) and their asymmetry (left versus right side) in patients with recent onset schizophrenia. MethodForty-seven patients and 24 age-and sex-matched healthy controls were enrolled in this study. We extracted left and right vPCC-MTG tract on each side from T1W and diffusion MRI (dMRI) at 3T. We then calculated the asymmetry index of diffusion measures of vPCC-MTG tracts as well as volume and thickness of vPCC and MTG using the formula: 2×(right−left)/(right+left). We compared asymmetry indices between patients and controls and evaluated their correlations with the severity of psychiatric symptoms and cognition in patients using the Positive and Negative Syndrome Scale (PANSS), video-based social cognition scale (VISC) and the Wechsler Adult Intelligence Scale (WAIS-III). ResultsAsymmetry of fractional anisotropy (FA) and radial diffusivity (RD) in the vPCC-MTG tract, while present in healthy controls, was not evident in schizophrenia patients. Also, we observed that patients, not healthy controls, had a significant FA decrease and RD increase in the left vPCC-MTG tract. There was no significant association between the asymmetry indices of dMRI measures and IQ, VISC, or PANSS scores in schizophrenia. ConclusionDisruption of asymmetry of the vPCC-MTG tract in schizophrenia may contribute to the pathophysiology of schizophrenia.

Serum levels of brain-derived neurotrophic factor are associated with depressive symptoms in patients with systemic lupus erythematosus

ObjectiveThe aim of this study was to explore potential relationships between serum BDNF levels and depression in systemic lupus erythematosus (SLE) patients. MethodsWe included 208 consecutive SLE patients and 100 age-and sex-matched healthy controls. The presence of depressive symptoms was determined through the Beck Depression Inventory-II (BDI-II) score. ResultsThe serum BDNF levels were significantly (P<0.0001) higher in SLE patients as compared to normal controls. There was a negative correlation between levels of BDNF and the SLE disease activity index 2000 (SLEDAI–2K) (r=−0.349, P<0.0001). Depression (defined as BDI-II score≥18) was identified in 54 SLE patients (26.0%, 95%CI: 20%–31.9%). The serum BDNF levels were significantly lower in depression patients at the time of admission as compared with patients without depression [27.6(IQR, 23.2–30.4)ng/ml vs. 36.2(IQR, 31.7–42.3)ng/ml; P<0.0001]. Compared with the first quartile of serum BDNF levels, the second quartile OR for depression was 0.72 (95% CI, 0.61–0.80, P=0.033). For the third and fourth quartiles, it was 0.42 (95% CI, 0.33–0.52, P=0.002) and 0.16 (95% CI, 0.09–0.24; P<0.001). ConclusionSerum BDNF levels are decreased in SLE patients with depressive symptoms. In SLE, serum BNDF levels are independently associated with depressive disorders, suggesting the role of neurotrophic factors in depression.

B Lymphocytes in Multiple Sclerosis: Bregs and BTLA/CD272 Expressing-CD19+ Lymphocytes Modulate Disease Severity.

B lymphocytes contribute to the pathogenesis of Multiple Sclerosis (MS) by secreting antibodies and producing cytokines. This latter function was analyzed in myelin olygodendrocyte protein (MOG)-stimulated CD19+ B lymphocytes of 71 MS patients with different disease phenotypes and 40 age-and sex-matched healthy controls (HC). Results showed that: 1) CD19+/TNFα+, CD19+/IL-12+ and CD19+/IFNγ+ lymphocytes are significantly increased in primary progressive (PP) compared to secondary progressive (SP), relapsing-remitting (RR), benign (BE) MS and HC; 2) CD19+/IL-6+ lymphocytes are significantly increased in PP, SP and RR compared to BEMS and HC; and 3) CD19+/IL-13+, CD19+/IL-10+, and CD19+/IL-10+/TGFβ+ (Bregs) B lymphocytes are reduced overall in MS patients compared to HC. B cells expressing BTLA, a receptor whose binding to HVEM inhibits TcR-initiated cytokine production, as well as CD19+/BTLA+/IL-10+ cells were also significantly overall reduced in MS patients compared to HC. Analyses performed in RRMS showed that fingolimod-induced disease remission is associated with a significant increase in Bregs, CD19+/BTLA+, and CD19+/BTLA+/IL-10+ B lymphocytes. B lymphocytes participate to the pathogenesis of MS via the secretion of functionally-diverse cytokines that might play a role in determining disease phenotypes. The impairment of Bregs and CD19+/BTLA+ cells, in particular, could play an important pathogenic role in MS.

Correlation between Xerostomia, Hyposalivation, and Oral Microbial Load with Glycemic Control in Type 2 Diabetic Patients

ABSTRACT Aims and objectives The present study is an attempt to investigate prevalence of xerostomia and hyposalivation in type 2 diabetes mellitus using a modified Schirmer test (MST) and finding any association between xerostomia, hyposalivation, and oral microflora, namely, Streptococcus mutans, Lactobacillus spp., and Candida spp. with the glycemic control of individual. Background Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia and resulting in either lack or relative insufficiency of insulin. In addition to systemic alterations, oral manifestations of diabetes mellitus have been reported, such as xerostomia and hyposalivation, alteration in taste, caries, gingivitis, and periodontal disease. Materials and methods Thirty individuals with known history of diabetes mellitus type 2 were chosen as cases and 30 ageand sex-matched healthy controls were taken as control group. For assessment of hyposalivation, unstimulated salivary flow rate was measured using a MST with a commercially available Schirmer test strip having a millimeter scale (0—35 mm). Results In our study, we found that the difference in the wettability of Schirmer strip among diabetics and healthy controls was more significant at the end of the 1st minute due to decreased salivary flow in diabetics. Conclusion A n e arly a ssessment o f s alivary f low a nd xerostomia in type 2 diabetic patients and its treatment, along with routine oral hygiene and maintenance, may alter the clinical outcomes of diabetes. How to cite this article Ahmed J, Jindal R, Shenoy N, Denny C, Udayalakshmi J, Baliga S. Correlation between Xerostomia, Hyposalivation, and Oral Microbial Load with Glycemic Control in Type 2 Diabetic Patients. World J Dent 2016;7(2):83-86.

Utility of saliva as a sample to assess renal function and estimated glomerular filtration rate.

Diagnosis of renal diseases by assessing renal parameters in saliva. Biochemical investigations using serum form important component of monitoring patients with renal disease. Utility of saliva, in diagnosis and monitoring of patients with renal disease and for calculation of estimated glomerular filtration rate (eGFR), was studied. Sixty patients with renal disease and sixty ageand sex-matched healthy controls were studied. Urea, creatinine, sodium, potassium, uric acid, calcium, and phosphorus were measured in both serum and saliva. eGFR was calculated using salivary creatinine. Data were expressed as mean ± standard deviation. Comparison and correlation between groups were assessed by Student's t-test and Pearson correlation, respectively. Bland-Altman plot, mountain plot, and intra-class correlation coefficient were used to test agreement. A P <0.05 was considered statistically significant. Statistical analysis was done using Microsoft excel spreadsheets, Medcalc Version 10.0, and SPSS version 11.5. Salivary levels of urea, creatinine, uric acid, sodium, potassium, and phosphorus were higher in patients compared to controls. Potassium and phosphorus levels were higher (P = 0.001) and creatinine, sodium, calcium, and uric acid levels were lower (P = 0.001) in saliva compared to serum in both patients and controls. Positive correlation was observed between serum and salivary urea and creatinine (P < 0.0001). eGFR values calculated from salivary creatinine showed good agreement with those calculated form serum creatinine. Salivary urea (>6 mmol/L) and creatinine (>14.6 μmol/L) and eGFR calculated from salivary creatinine can be used to identify patients with renal disease.

Self-reported social functioning and prefrontal hemodynamic responses during a cognitive task in schizophrenia

Impaired social functioning is a characteristic of schizophrenia that affects patients’ quality of life. The aim of the study was to assess prefrontal hemodynamic responses during a cognitive task and establish its influence on psychiatric symptoms, cognitive function, global functioning, and self-reported social functioning in patients with schizophrenia. Thirty-three patients with schizophrenia and 30 age-and sex-matched healthy controls participated in the study. We measured hemodynamic responses in the prefrontal and superior temporal cortical surface areas with 52-channel near-infrared spectroscopy (NIRS) during a verbal fluency task (VFT). Self-reported social functioning was assessed using the Social Functioning Scale (SFS). Regional hemodynamic responses were significantly smaller in the prefrontal and temporal regions in subjects with schizophrenia than in the controls, and prefrontal hemodynamic responses during the VFT showed a strong correlation with SFS total scores. These results suggest an association between self-reported social functioning and prefrontal activation in subjects with schizophrenia. The present study provides evidence that NIRS imaging could be helpful in understanding the neural basis of social functioning.

DNA damage in a patient with Systemic Lupus Erythematosus and Nephropathy- A Case Report

Objectives: Systemic Lupus Erythematosus (SLE) is a complex, multisystem autoimmune inflammatory disease. The inflammatory response in SLE exacerbates oxidative stress which tends to promote lipid peroxidation, protein oxidation and damage to DNA. Documentation of manifestation of DNA damage in SLE patients is scarce and related studies have not come to attention from this part of the world, therefore the present study showcases a case report on SLE. Methods: Assessment of DNA damage in peripheral blood leukocytes and oxidative stress biomarkers in blood sera of a 12y-old male presenting with SLE and nephropathy (on dialysis therapy) was made. Results: Basal DNA damage in PBL scored as percent DNA in tail was higher (51.48%) compared to levels (40.38%) in an age-and sex-matched healthy control. Quantitative measures of DNA damage revealed DF of 96 vs. 94 and DI of 317 vs . 208 in the case and the control, respectively. Serum lipid peroxidation as estimated from MDA level was 3x higher (1.759mol/l) compared to its level in a healthy control (0.571mol/l). OSI was slightly higher in the patient (0.134 arbitrary units) compared to that in the control (0.132 arbitrary units). The atherogenic indices were higher in the present case compared to ratios in the control. Conclusion: The results from the case report on increased oxidative stress, dyslipidemia, genetic damage and atherogenic indices support observations from earlier studies and imply onset of other complications in patients with SLE. The assessment of various blood-based biomarkers (as carried out in the present case) in SLE patients may assist in disease diagnosis, prognosis and optimal disease management.

Mo2048 Altered Relation of Autonomic Response and Pituitary-Adrenal Response During Colorectal Distention With Corticotropin-Releasing Hormone in Irritable Bowel Syndrome

Background Searching biomarkers of irritable bowel syndrome (IBS) is emerging topic. Previous studies searched limited biomarkers and largely ignored real exacerbation of IBS symptoms in patient's life. We hypothesized that we can identify biomarkers of IBS which are associated with changes in IBS symptoms using urinary metabolomics.Methods Subjects were 25 IBS patients (33.0 ± 2.1 y.o., 15 male, 10 female) diagnosed with Rome III criteria (12 with diarrhea, 11 mixed, and 2 with constipation) and ageand sexmatched healthy controls. Subjects completed ordinate scales containing abdominal pain and discomfort everyday for 28 days. Simultaneously urinary samples were collected at the first day, the day with exacerbation, and the 28th day with questionnaires including IBS Severity Index (IBS-SI) and IBS Quality of Life (IBS-QOL). Urinary samples were immediately frozen, stored, and later analyzed with ultraperformance liquid chromatography and mass spectrometry. After correction with creatinine, data were analyzed statistically with generalized estimating equation (GEE) using SPSS ver. 21.0 followed by multiple regression analysis with IBS symptoms as dependent variables and metabolites as independent variables. Results We first identified 191 metabolome markers. GEE revealed significant 44 markers with group (IBS vs controls) effect and/or time effect and/or group time interaction. IBS patients showed significantly lower kynurenic acid (p < 0.005), xanthurenic acid (p < 0.001), homovanillic acid (p < 0.005), vanillylmandelic acid (p < 0.005) and glycylglycine (p < 0.001) than controls. IBS patients showed significantly higher quinolinic acid (p < 0.01), 3-methoxytyamine (p < 0.05), xylose (p < 0.005), 2'-deoxyguanosine (p < 0.001), 2'-deoxyadenosine (p < 0.05), and N-acetylarginine (p < 0.05) than controls. Multiple regression analysis disclosed xylose as significant predictor of abdominal pain (R2 = 0.859, b = 0.59, p < 0.0001). Conclusion These findings support our hypothesis and suggest that increased urinary xylose level reflects increased mucosal permeability in IBS patients. Moreover, increased quinolinic acid and decreased kynurenic and xanthurenic acids in IBS patients may cause toxicity of the glutamatergic neurons expressing NMDA receptors both in the brain and the gut.

Mo2047 Identifying Functionally Meaningful Biomarkers in Irritable Bowel Syndrome

Background Searching biomarkers of irritable bowel syndrome (IBS) is emerging topic. Previous studies searched limited biomarkers and largely ignored real exacerbation of IBS symptoms in patient's life. We hypothesized that we can identify biomarkers of IBS which are associated with changes in IBS symptoms using urinary metabolomics.Methods Subjects were 25 IBS patients (33.0 ± 2.1 y.o., 15 male, 10 female) diagnosed with Rome III criteria (12 with diarrhea, 11 mixed, and 2 with constipation) and ageand sexmatched healthy controls. Subjects completed ordinate scales containing abdominal pain and discomfort everyday for 28 days. Simultaneously urinary samples were collected at the first day, the day with exacerbation, and the 28th day with questionnaires including IBS Severity Index (IBS-SI) and IBS Quality of Life (IBS-QOL). Urinary samples were immediately frozen, stored, and later analyzed with ultraperformance liquid chromatography and mass spectrometry. After correction with creatinine, data were analyzed statistically with generalized estimating equation (GEE) using SPSS ver. 21.0 followed by multiple regression analysis with IBS symptoms as dependent variables and metabolites as independent variables. Results We first identified 191 metabolome markers. GEE revealed significant 44 markers with group (IBS vs controls) effect and/or time effect and/or group time interaction. IBS patients showed significantly lower kynurenic acid (p < 0.005), xanthurenic acid (p < 0.001), homovanillic acid (p < 0.005), vanillylmandelic acid (p < 0.005) and glycylglycine (p < 0.001) than controls. IBS patients showed significantly higher quinolinic acid (p < 0.01), 3-methoxytyamine (p < 0.05), xylose (p < 0.005), 2'-deoxyguanosine (p < 0.001), 2'-deoxyadenosine (p < 0.05), and N-acetylarginine (p < 0.05) than controls. Multiple regression analysis disclosed xylose as significant predictor of abdominal pain (R2 = 0.859, b = 0.59, p < 0.0001). Conclusion These findings support our hypothesis and suggest that increased urinary xylose level reflects increased mucosal permeability in IBS patients. Moreover, increased quinolinic acid and decreased kynurenic and xanthurenic acids in IBS patients may cause toxicity of the glutamatergic neurons expressing NMDA receptors both in the brain and the gut.

In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy.

IntroductionIdiopathic central serous chorioretinopathy (CSCR) is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1) Iranian patients with CSCR have higher scores for anxiety, 2) anxiety is lower, if CSCR has been experienced twice, and whether 3) anxiety scores differ between sexes.MethodsA total of 30 patients with CSCR and 30 healthy age-and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety.ResultsCompared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes.ConclusionHigher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR.

Frequency of Three Common Mutations of CARD15/NOD2 Gene in Jordanian Patients with Crohn’s Disease

Background and Aims: CARD15/NOD2 is recognized as a major susceptibility gene for Crohn’s disease. Several mutations of CARD15/NOD2 have been reported in different racial groups. We aimed to investigate the frequency of three common CARD15/NOD2 mutations in a Jordanian Original Research Article Jadallah et al.; BJMMR, 7(2): 93-105, 2015; Article no.BJMMR.2015.312 94 Crohn’s disease cohort. Methodology: Fifty one unrelated Crohn’s disease patients and fifty one ageand sex-matched healthy controls were recruited at two hospitals in Jordan. Demographic and phenotypic characteristics of patients were ascertained. Allele frequencies for three CARD15/NOD2 mutations (G2722C, C2104T, 3020insC) were determined by PCR-RFLP, ARM-PCR, and direct sequencing using allele specific primers. Results: The frequencies of G2722C alleles in Crohn’s disease patients were higher but not statistically significant as compared to healthy controls (5.9% vs. 1.9%; P = 0.32). On the other hand, C2104T and 3020insC mutations have not been detected in Crohn’s disease patients or healthy controls. Conclusion: Our findings indicate that common mutations of CARD15/NOD2 gene in White patients with Crohn’s disease are not associated with Crohn’s disease in the Jordanian population. Further studies are needed to ascertain the effect of these and other mutations on Crohn’s disease susceptibility and behavior in our population.

Prevalence of oral lesions in kidney transplant patients: A single center experience.

Kidney transplant patients (KTPs) have a potential tendency to develop oral lesions due to the administration of immunosuppressive drugs, but their prevalence is still obscure. The aim of the present study was to investigate the oral clinical findings in a group of renal transplant patients in comparison with ageand sex-matched healthy controls (HCs). Three hundred KTPs who underwent transplantation at least six months earlier and 296 HCs were examined clinically for the presence of any oral lesions. Demographic and additional details regarding medications, systemic diseases and duration after transplantation were recorded. Statistical analysis was performed using the Chi-square test, with significance set at P <0.05. The prevalence of oral lesions in KTPs was 56.8% as compared with 29.7% in HCs. The most common lesion observed in KTPs was gingival overgrowth (21.8%), followed by candidiasis (17.1%). Coated tongue (15.9%), followed by leukoplakia (11.3%), were common in HCs. Both gingival hyperplasia and coated tongue were significantly related to poor oral hygiene (P <0.05), but were not significantly related to the immunosuppressive therapy (P >0.05). The findings of the present study indicate the need for a routine and regular oral health check-up, with emphasis on maintenance of oral hygiene for renal transplant patients.

Ischemia-modified albümin and malondialdehyde levels in patients with overt and subclinical hyperthyroidism: effects of treatment on oxidative stress.

The main purpose of this study was to evaluate the levels of ischemia-modified albumin (IMA) and malondialdehyde (MDA) in patients with OHyper and SHyper, to assess the effects of antithyroid drug (ATD) therapy on the oxidative stress (OS) parameters. Forty-five untreated patients with overt hyperthyroidism (OHyper), 20 untreated patients with subclinical hyperthyroidism (SHyper) and 30 age-and sex-matched healthy controls were prospectively included in the study. Biochemical and hormonal parameters were evaluated in all patients before and after treatment. Compared with the control subjects, the levels of MDA, glucose and TG were significantly increased in patients with SHyper (p<0.05), whereas LDL-C levels were significantly decreased (p<0.01). Patients with OHyper showed significantly elevated MDA and glucose levels (p<0.001) and significantly decreased LDL-C and HDL-C levels compared with the controls (p<0.01). In patients with Graves' disease, serum TSH levels were inversely correlated with plasma MDA levels (r: -0.42, p<0.05). Plasma MDA levels significantly decreased and levels of TC, LDL-C and HDL-C significantly increased in the groups of OHyper and SHyper after treatment. Serum IMA levels did not significantly change at baseline and with the therapy in all subjects. In conclusion, increased MDA levels in both patient groups represent increased lipid peroxidation which might play an important role in the pathogenesis of the atherosclerosis in these patients. Increased oxidative stress in patients with SHyper and OHyper could be improved by ATD therapy. Also, MDA can be used as a reliable marker of OS and oxidative damage, while IMA is considered to be inappropriate.

Vitamin D Levels in Patients With Ankylosing Spondylitis and Its Relationship With Disease Activity

We designed a cross-sectional study including 75 consecutive patients with AS, and 35 ageand sex-matched healthy controls. The study was performed in winter to avoid seasonal variations in vitamin D levels. Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Serum 25-hydroxyvitamin D (25-OH-D) levels were measured using chemiluminescence by ARCHITECT i2000.

Abstract 19026: Libman-sacks Endocarditis: Can It Be Clinically Predicted?

Background: Libman-Sacks endocarditis, characterized by Libman-Sacks vegetations (LSV), is common in patients with systemic lupus erythematosus (SLE) and is a strong predictor of stroke and transient ischemic attacks (TIA), cognitive dysfunction, and increased mortality. Accurate detection of LSV may lead to early therapy and prevention of development or progression of embolic cerebrovascular disease. TEE is accurate for detecting LSV, but is semi-invasive. Thus, there is a need for identifying clinical variables with a high predictive value for LSV on TEE. Methods: 76 SLE patients (69 women, 38 ± 12 years old) and 26 age-and sex-matched healthy controls underwent TEE and assessment of demographics, atherogenic risk factors, and parameters of inflammation, platelet activity, coagulation, and fibrinolysis. Patients were also assessed for SLE duration, activity, injury, therapy, and autoantibodies including antiphospholipid antibodies. Multivariate regression and optimal receiver operator curve by Neyman-Pearson lemma were used to determine the best clinical predictors of LSV on TEE. Results: 39 (51%) SLE patients vs 2 (8%) controls had LSV on TEE (p&lt;0.001). In all 76 patients, acute stroke/TIA (OR 50.6, 95% CI = 6.8 - 374, p &lt;0.001) and SLE duration (OR = 1.18, 95% CI = 1.05 - 1.32, p = 0.004) were the predictors of LSV. In 53 patients without acute stroke/TIA, SLE duration (OR = 1.16, CI =1.03 - 1.31, p = 0.01) and age (OR = 1.06, CI = 1.0 - 1.12, p = 0.05) were the predictors of LSV. A recruitment rule of performing TEE in SLE patients with acute stroke/TIA and in those without stroke/TIA if they have a disease duration of ≥12 years or a disease duration ≥5 years and age ≥32 provide high sensitivity (85%), specificity (81%), and positive (83%) and negative (83%) predictive values for LSV on TEE ( Figure 1 ). Conclusion: In SLE patients, acute stroke/TIA, or SLE duration ≥12 years, or SLE duration ≥5 years and age ≥32 provide a high diagnostic yield for detecting LSV on TEE.

Quantitative measurement of brain iron deposition in patients with haemodialysis using susceptibility mapping.

To compare the susceptibility of different brain structures in patients with haemodialysis with that in healthy controls using susceptibility mapping and explore the correlations with neuropsychiatric tests and clinical parameters. Fifty three patients with haemodialysis and forty-five age-and sex-matched healthy controls were recruited in this prospective study. Susceptibility maps (SM) were reconstructed from original phase data and used to compare the susceptibility of different brain structures between patients and healthy controls. The SM was compared with iron predictions from a classic cadaver brain study. Spearman's correlation and stepwise multiple regression analysis between susceptibility and neuropsychiatric tests and clinical parameters were calculated. In patients with haemodialysis, the susceptibility of the bilateral caudate head, putamen, substantia nigra, red nucleus and dentate nucleus were significantly higher than those in healthy controls (P < 0.01). There was positive correlation between susceptibility both from normal controls and patients and iron concentration from a classic post-mortem brain study (both r = 0.900, both P = 0.037). In patients with haemodialysis, the susceptibility of the left putamen (r = 0.944), right putamen (r = 0.882) and right thalamus (r = 0.852) were correlated to dialysis duration (all P < 0.05). The susceptibility of the left caudate head (r = -0.415) and right caudate head (r = -0.311) were mildly negatively correlated with neuropsychiatric test scores (all P < 0.05). In summary, our findings indicated that increased brain iron deposition does occur in patients with haemodialysis and correlated with duration of dialysis.

Expression of miR-155 in peripheral blood and skin lesions from as well as its relationship with Th17 cells in patients with atopic dermatitis

Objective To detect the expressions of miR-155,T helper type 17 (Thl7) cells,and Th17 cellspecific transcription factor RORγt and effector cytokine interleukin (IL)-17 in peripheral blood and skin lesions from,and to evaluate their relationship in,patients with atopic dermatitis (AD).Methods Peripheral blood was obtained from 37 patients with AD and 33 age-and sex-matched healthy controls,and biopsy specimens from the lesional and perilesional skin of five patients with severe AD as well as from the normal skin of five healthy human controls.Real-time fluorescence-based reverse transcription (RT)-PCR was employed to measure the mRNA expression levels of miR-155,RORγt and IL-17 in peripheral blood mononuclear cells (PBMCs) and skin specimens,flow cytometry to detect the percentage of Th17 cells in PBMCs,enzyme-linked immunosorbent assay (ELISA) to determine the plasma concentration of IL-17.Statistical analysis was done using independent sample's t test,one-way analysis of variance followed by the least significant difference test,and linear correlation analysis.Results Compared with the healthy controls,the patients with AD showed a significant increase in Th17 cell percentage (1.78％ ± 0.52％ vs.0.47％ ± 0.15％,P＜ 0.01),mRNA expression levels of miR-155 (5.78 ± 1.78 vs.1.82 ± 0.46,P＜ 0.01),RORγt (6.08 ± 1.04 vs.1.64 ± 0.52,P＜ 0.01) and IL-17 (7.09 ± 1.75 vs.1.71 ± 0.46,P＜ 0.01),as well as in the plasma concentration of IL-17 ((2.51 ± 6.15) pg/ml vs.(11.80 ± 2.24) pg/ml,P＜ 0.01).There was a sequential decrease in the expression levels of miR-155,RORγt and IL-17 mRNA from lesional skin,perilesional skin to normal skin (F =41.803,17.040 and 37.064 respectively,all P ＜ 0.01).The miR-155 mRNA expression level in PBMCs was positively correlated with the SCORing Atopic Dermatitis (SCORAD) index,Th17 cell percentage,RORγt and IL-17 mRNA expression levels as well as IL-17 plasma concentration (r =0.405,0.426,0.402,0.410 and 0.408 respectively,all P ＜ 0.05).Similarly,the miR-155 expression level was positively correlated with RORγt and IL-17 mRNA expression levels in lesional and paralesional specimens (r =0.428 and 0.435 respectively,both P ＜ 0.05).Conclusion The up-regulated expression of miR-155,Th17 cells and their effector cytokine IL-17 may be associated with the development of AD. Key words: Dermatitis, atopic; miR-155; Th17 cells

Prevalence of human cytomegalovirus infection and analysis of its plasma neutralizing antibody level in hypertension patients

Objective To determine the prevalence of human cytomegalovirus(HCMV)infection and plasma level of its neutralizing antibody in hypertension patients,so as to discuss the association between HCMV infection and hypertension.Methods A total of 51anti-coagulated blood samples were collected from hypertension patients and the 50control samples were obtained from age-and sex-matched healthy controls in the Second People's Hospital of Anhui Province from Jan.2013to Apr.2013.Neutralizing antibody level was analyzed by rapid fluorescence micro-neutralization;plasma anti-HCMV IgG and anti-HCMV IgM were determined by enzyme-linked immuno sorbent assay(ELISA),and HCMV UL93DNA was detected by nested PCR.Results The positive rates of HCMV UL93DNA and anti-HCMV IgG in hypertension patients were significantly higher than those in healthy controls(72.55%vs 56.00%for UL93DNA and 70.59%vs 50.00%for IgG,P0.05).The positive rates of anti-HCMV IgM were not significantly different between the two groups(3.92% vs 2.00%,P0.05).The geometric mean titer of HCMV neutralizing antibody was 38.56±20.42in hypertension patients,which was significantly lower than that in healthy controls(60.12±25.38,P=0.0326).Conclusion HCMV positive rate is higher in hypertension patients than in healthy controls;however,the specific neutralizing antibody level of HCMV is greatly lower than that in healthy controls,suggesting that the humoral immune status is declined in hypertension patients and there is a correlation between HCMV infection and hypertension.