No abstract

Background Adenosine signaling is now an accepted explanation for the therapeutic mechanism of Methotrexate (MTX) in rheumatoid arthritis (RA). Adenosine receptors categorized into four subclasses: adenosine A1 receptor (ADORA1), adenosine 2a receptor (ADORA2a), adenosine 2b receptor (ADORA2B), and adenosine 3 receptor (ADORA3). Our aim is to check the mRNA expression of two adenosine receptors; ADORA2a and ADORA3 in whole blood cell of RA patients and its relation in prediction of MTX clinical response in Egyptian patients. Results There was significant correlation between both ADORA2a and ADORA3 gene expression in RA patients as compared with healthy controls. The expression of ADORA2a and ADORA3 was increased in good and moderate response groups compared to no response group. There was significant correlation between both genes in mRNA expression before and after MTX treatment. Matrix metalloproteinase-3 (MMP3) concentration was significantly decreased after treatment in good and moderate response groups in comparison to non-responder group. Conclusion The inflammatory and clinical responses in RA patients which is demonstrated by DAS28 and suppression of MMP3 were regulated by ADORA2a and ADORA3. Their level of expression can predict MTX response and their agonists may offer a novel and effective therapeutic option for RA patients.

No abstract

Background Serum14-3-3η protein plays an important role in the pathogenesis of rheumatoid arthritis (RA) as it is a joint-derived proinflammatory mediator. Semaphorin3A (Sema3A) plays an immune regulatory and bone remodeling role in many autoimmune diseases. Their role in rheumatoid arthritis needs to be evaluated for diagnostic and prognostic prospective values. Results The serum level of protein 14-3-3n was significantly higher in patients with RA than those in healthy controls. Serum 14-3-3η has a significant positive correlation with RF and ACPA, but not with either DAS28, ESR, or CRP. Serum 14-3-3η levels were significantly correlated with radiographically assessed joint damage. Serum Sema3A levels were decreased in rheumatoid arthritis patients compared to controls. There were also negative correlations with disease duration and activity score (DAS28), ESR, CRP, and RF. Conclusion The discriminative ability of 14-3-3η was comparable to RF and ACPA enhancing its diagnostic capacity. Sema 3A might serve as a predictive marker for radiographic severity and could have a potential therapeutic role in RA.

Background:Fibromyalgia syndrome (FMS) is a chronic pain syndrome which presented by easy fatigability, widespread body pain, anxiety and tenderness points on specific anatomic regions. Fibromyalgia may be risk factor for vitamin D deficiency because of pain, poor mobility, or depression, potentially leading to less time of sun exposure or high rates of adiposity leading to decreased synthesis of vitamin D & there are conflicting results on the role of vitamin D in improving chronic nonspecific musculoskeletal pains1, 2.Objectives:Assessment of the effectiveness of vitamin D supplements as adjuvant therapy in functional status, quality of life and psychological status in fibromyalgia patients with vitamin D insufficiency.Methods:One hundred adult patients of primary FMS (according to the 2010 ACR criteria for FMS) associated with vitamin D insufficiency (21-29 ng/mL) were selected to participate in this study. Patients with secondary FMS were excluded; also we excluded patients with any psychiatric disorders and patients who had other chronic diseases interfering with calcium, phosphorus, and vitamin D metabolism. After written consent; the patients were randomly divided into 2 equal groups; group I received duloxetine (60 mg once daily for 6 months) plus 50,000 unit oral cholecalciferol weekly for 8 weeks then monthly for 16 weeks. Group II received duloxetine (60 mg once daily for 6 months) plus placebo. The patients were assessed at baseline and after 6 months of treatment by measuring serum levels of 25(OH)D, Fibromyalgia Impact Questionnaire (FIQ), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) & Hospital Anxiety and Depression Scale (HADS).Results:Eighty six patients completed this study. There was no significant difference between all groups in demographic data, educational status and all baseline variants except serum levels of 25(OH) D. After 6 months; there was significant improvement (P<0.05) in group I in serum levels of 25(OH) D. There was significant improvement (P<0.05) after 6 months in FIQ, SF-36 and HADS in both groups. There was significant better improvement (P<0.05) in group I than in group II in FIQ, SF-36 and HADS. The results of the study are summarized in table 1.Table 1.Pre- and post-treatment assessment measures of the patient groupsassessment measuresBaselineBaselineAfter 6 monthsAfter 6 monthsGroup IGroup IIGroup IGroup II25(OH)D25.3 ± 4.9 ng/ml26.8+5.3 ng/ml36.8+3.9 ng/ml25.6 ± 3.4 ng/mlFIQ47.5±5.446.7±6.727.5±6.138.5±7.3SF-36 (Total score)47.6±10.447.0±9.961.0±5.854.8±5.3HAD anxiety8.2±0.68.4±0.37.1±0.77.5±1.4HADS depression8.6±0.38.6±0.97.3±0.87.7±1.4Conclusion:Vitamin D supplement is effective as an adjuvant therapy in improving functional status, quality of life and psychological status in fibromyalgia patients with vitamin D insufficiency.References:[1]Abd Elghany S E et al, Regenerative injection therapy and repetitive transcranial magnetic stimulation in primary fibromyalgia treatment: A comparative study. Journal of Back and Musculoskeletal Rehabilitation -1 (2018) 1–8[2]Maria Helde-Frankling, Linda Björkhem-Bergman. Vitamin D in Pain Management. Int. J. Mol. Sci. 2017, 18, 2170Disclosure of Interests: :None declared