Rheumatoid Arthritis (RA) is the commonest inflammatory joint disease, affecting nearly 1% of the adult population worldwide. Its diagnosis depends on clinical symptoms, laboratory investigations and imaging. The emphasis in the management of this disease is early diagnosis and intervention. Diagnostic specificity of rheumatoid factor (RF) for RA is poor since it is also found in many other rheumatic and non-rheumatic diseases. Anticyclic citrullinated peptide (anti-CCP) was reported to have a high specificity for RA diagnosis, especially in patients with early disease. However, it was found to have lower sensitivity than RF in RA diagnosis. This study aimed to evaluate the expression of MAGE-1 mRNA by the synovial fluid cells from inflamed joints, and the serum levels of anti-CCP as biochemical markers for the early diagnosis of RA. The study included 30 subjects of both sexes: 10 controls with traumatic knee joint effusion and 20 rheumatoid arthritis patients. Both Serum RF and anti-CCP were determined quantitatively by enzyme-linked immune-sorbent assay (ELISA). The expression of MAGE-1 mRNA by the synovial fluid cells obtained from the inflamed joints is evaluated by applying reverse transcription-PCR amplification. MAGE-1 mRNA was detected in synovial fluid cells of all patients but not in controls. There was significant increase (P < 0.01) of both serum RF IgM and anti-CCP in rheumatoid patients group when compared to control one. There was significant positive correlation (r = 0.928; P = < 0.01) between serum RF IgM and anti-CCP. The specificity of MAGE-I, Anti-CCP and RF in RA diagnosis was 100%, and the sensitivity of both MAGE-I and Anti-CCP was 100% while that of RF was 85%. Conclusively, the expression results of MAGE-1 transcript in synovial fluid were 100% positive encouraging its utilization as a biochemical marker for RA diagnosis. The combined use of serum anti-CCP and MAGE-1 transcript in the synovial fluid cells is recommended for early diagnosis of RA.

Metabolic syndrome, syndrome X, which is reaching epidemic proportions in population, is a cluster of insulin resistance and/or type-II diabetes mellitus with two or more of hypertension, dyslipidemia, central obesity and albuminuria in an individual patient. Genetic predisposition for metabolic syndrome was, to large extent, believed to be an important aspect in its pathogenesis. The renin-angiotensin system (RAS) genes are proposed as important genetic factors for diabetic complications. Therefore, the angiotensin converting enzyme (ACE) gene polymorphisms (II, ID or DD), which is an important component of RAS genes, might be included in the pathogenesis of metabolic syndrome and is a candidate gene for investigation in metabolic syndrome. We aimed to study the possible ACE genotypingplasma ACE activity-metabolic syndrome relationship, and to assess the possible role of ACE genotyping in the pathogenesis of variable components of metabolic syndrome. This study is also a trial to take the distribution of ACE-I/D genotype among subjects as a possible risk marker for metabolic syndrome. ACE genotypes were determined by PCR amplification, and plasma ACE activity was measured by colorimetric method in 100 subjects (40 metabolic syndrome patients diagnosed according to WHO criteria, 30 type-II diabetic patients without any other criteria of metabolic syndrome, and 30 healthy controls). Insulin resistance was judged by homeostasis model assessment (HOMA) index after estimation of fasting blood glucose and plasma insulin. Moreover, HbA 1c , plasma lipids including total cholesterol, LDL-c, HDL-c, triglycerides and APO-A were assessed. Microalbuminuria was determined by dipstick method. The indices body mass index (BMI) and waist:hip ratio (WHR) were used to differentiate obese from non-obese subjects. ACE-DD genotype and D-allele were found more frequent among metabolic syndrome patients (Odds ratios were1.25 and 1.16 respectively) and among type-II diabetics (Odds ratios were1.25 and 1.10 respectively) than among healthy controls; and more frequent among metabolic syndrome patients than among type-II diabetic patients (Odds ratios were 1.10 and 1.32 respectively). The plasma ACE activity was found significantly higher in patient's groups compared to healthy subjects and in metabolic patients compared to diabetics. Also, it was significantly and positively correlated to HOMA index in both metabolic syndrome and diabetic patients. The plasma ACE also in overall studied subjects had direct significant correlation with FBG, HbA 1c , plasma insulin, HOMA index, TC, LDL-c, and TG; and indirect Bull. Egypt. Soc. Physiol. Sci. 31 (2) 2011 Fawzy et al. 2significant correlation with HDL-c and APO-A. Moreover, in the three studied groups DD genotype subgroups had a statistically significant increase in plasma ACE activity, FBG, HbA 1c , plasma insulin, HOMA, total cholesterol, LDL-c, and triglycerides and a significant decrease in HDL-c and APO-A compared to II genotype subjects. Lastly, the ACE-DD genotype was associated wit...

No abstract

No abstract