Objectives Hydroxychloroquine (HCQ) has been used as an off label for the management of coronavirus disease (Covid-19) infection with other drugs. However, different genetic variants can affect the metabolism of HCQ leading to inter-individual differences in its efficacy. In this study, we investigated the effects of variants in CYP2D6, CYP3A4 and CYP3A5 on the risk of Covid-19 infection among patients receiving HCQ for controlling rheumatoid arthritis (RA). Methods A total of 60 patients were genotyped for CYP2D6*2XN, CYP2D6*4, CYP3A4*1B and CYP3A5*2. They were receiving HCQ for the treatment of RA. The patients were evaluated clinically for fever and dry cough, radiologically via chest computed tomography (CT) and immunologically via anti-Covid-19 IgG and IgM titers. Results Variants in CYP2D6 significantly affected the grade of ground glass (CYP2D6*4 AA carriers showed the higher risk for grade 3) and the risk of positive anti-Covid-19 IgM (CYP2D6*2XN CC and CYP3A4*1B AA had the lowest risk), the duration of HCQ, the use of corticosteroids or gender did not affect the Covid-19 status significantly. Conclusions In general, the outcome of the studied patients receiving HCQ was good (no deaths, no intubation needed). CYP2D6 variants could affect the outcome of Covid-19 infection.
BackgroundSystemic sclerosis (SSc, scleroderma) is a systemic disease characterized by fibrosis, progressive vascular obliteration and the production of autoantibodies.Ultrasound (US) imaging has advantages of simplicity, low cost, noninvasiveness, real-time capability and portability compared with traditional EDX. US imaging also offers high temporal and spatial resolutions, and can potentially provide dynamic anatomical information regarding local structures and kinesiology, few studies evaluate joint and tendons involvement in SSc by US the incidence and abnormality are differs among studiesObjectivesdescribe and determine possible correlations between US abnormalities of hand and wrist and clinical findings in SSc Egyptian patientsMethodsRandomly selected 50 Egyptian SSc patients were enrolled in the study in outpatient clinic Rheumatology department, Assuit university hospital. Clinical examination and US evaluation (Gray Scale and Power Doppler (PD)) of the tendons and joints of hands and wrists, were performed bilaterally on both dorsal and palmar sides. Joint assessment was performed on all MCP and PIP joints as well as the wrist and tendon assessment included finger flexors and extensors, wrist extensors and flexors. The scoring for synovitis was based on the EULAR/ OMERACT scoring systemResultsWithin the cohort, 100% of the patients were female; mean age and range disease duration were 40.93±11.71 (20–61) years and 8.13±5.56 (0.5–25)years, respectively. Modified Rodnan Skin Score mean and range were 23.17±9.14 (13–43), 22 patients were diffuse type (44%) and 28 patients were limited type (56%), 67% had inflammatory arthralgia as reported by patients. US examination revealed abnormalities in 76% of all cases. Synovitis was present in 74% of patients (22% wrist; 15% MCP/PIP, 63% both); with a grade 2 and 3 synovitis in 29% cases. The grade 2 or 3 synovitis was associated with a higher age (p<0.05) and disease duration (p<0.03) but not with inflammatory markers (CRP, ESR) and C3 nor with anti-CCP antibodies.Furthermore, patients with US proven grade 2 or 3 synovitis had interstitial lung disease involvement (ILD) (74%) and elevated systolic pulmonary artery pressure >35 mmHg in (46%). Grade 1 synovitis did not correlate with tenderness or joint swelling. Synovitis using PD abnormalities were present in 20% patients, but only a 25% had concomitant clinical synovitis. Bone erosions (>1mm) were observed in 15%, which located at the second and third MC heads and at the styloid process of the ulna. The presence of bone erosions was associated with the presence of grade 2 or 3 synovitis. US identified tenosynovitis in 40% of patients, involving the wrist extensors in the vast majority of cases (70%), especially of the 2nd extensor compartment.ConclusionsUS examination detects significant synovitis of the hand and wrist in the absence of clinical findings, and reveals structural damage in a number of patients. The grade 2 or 3 synovitis was associated with a higher age, and ILD involvement. Tendon involvement is f...
Background Interleukin 34 (IL-34) is a recently discovered proinflammatory cytokine that can promote inflammation and osteoclastogenesis in arthritic joints. In this study, we tried to assess the serum and synovial fluid (SF) levels of IL-34 in rheumatoid arthritis (RA) patients, and to determine its relationship with disease activity and radiographic damage. Patients and methods ELISA was used to evaluate IL-34 levels in the serum of RA patients (n=50), osteoarthritis (OA) patients (n=28), and healthy control subjects (n=20) and in SF isolated from RA and OA patients. Disease activity in RA patients was assessed using the disease activity score-28 (DAS 28). The extent of radiographic joint damage, narrowing, and erosions was assessed. Results Serum IL-34 level was significantly elevated in RA patients compared to that in OA patients and healthy controls (P<0.0001). Synovial IL-34 level was also significantly elevated in RA patients compared to that in OA patients (P=0.0004). Serum and synovial IL-34 levels were significantly higher in cases that were rheumatoid factor (RF) positive (n=28) compared to the levels in RF-negative RA cases (n=22) (P=0.03 and P=0.04, respectively). Serum and synovial IL-34 levels were positively correlated with RF (r=0.43, P=0.02 and r=0.39, P=0.03, respectively), and with the extent of radiological damage (SENS) (P=0.0002 and P<0.0001, respectively). However, no significant correlation between IL-34 levels and disease activity was found. Conclusion IL-34 appears to play a key role in the pathogenesis of RA and contribute to bone destruction, making it a potential therapeutic target in the management armamentarium of the disease.
Background: Osteoporosis (OP) is a growing health problem not only in women but also in men. Subjects and methods: This study was carried out on 100 healthy men, age range 30–65 years (mean ± SD, 44.65 ± 8.3). All were randomly recruited from Assiut city during the period January 2005 to January 2006. Complete clinical history included occupational history, smoking habit, physical activity and calcium intake. Complete clinical examination and anthropometric measurments were done. Laboratory investigations for serum calcium, phosphorus and osteocalcin were performed. Bone mineral density (BMD) was measured by calcaneal ultrasound. Results: Sixty‐three percent of participants had normal BMD, 37% had low BMD, (26% had quantitative bone ultrasound [QUS] T‐score –1 to –2.5 and 11% had QUS T‐score ≤ –2.5). Smoking and low physical activity were risk factors for low BMD. Significant positive correlations were found between BMD and body mass index, serum calcium, and osteocalcin and negative correlation with phosphorus. We concluded that low BMD occurs with high frequency in Egyptian men. Smoking, physical inactivity and low body index are significant risk factors. Low serum calcium, low serum osteocalcin and high serum phosphorus are biochemical risk factors of low BMD in males.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.