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Mohamed M, El-Maboud A, Salem HF, Salem MN, Elmaaty MA, Eissa N, Said ASA, Hussein RRS. Predictors of methotrexate adherence and patient's awareness of it in rheumatoid arthritis and its effect on quality of life. J Pharm Policy Pract 2024; 17:2365933. [PMID: 39035456 PMCID: PMC11259066 DOI: 10.1080/20523211.2024.2365933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/04/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Adherence studies among rheumatoid arthritis (RA) patients, in Egypt and throughout the Middle East region, are lacking. This study aimed to evaluate methotrexate (MTX) adherence in Rheumatoid arthritis (RA) patients and to identify specific non-adherence predictors. Methods A cross-sectional observational study included 300 RA patients who were administered MTX for at least one year. The survey was completed through direct interviews. The demographic patient data were collected (age, education, sex, work status, disease duration, duration of MTX administration and current dose). Patients' adherence to MTX predictors for non-adherence, MTX side effects and functional disability were assessed in the study. Results Majority of respondents showed good MTX adherence, and more than 50% of patient's experienced MTX side effects. A large percentage of participants showed low knowledge about MTX nature and side effects. Most participants reported no or some difficulty in quality of life-related activities and functional disability. Conclusion MTX adherence and awareness were positively correlated to many variables, including, age, educational level and disease duration, which in turn has its positive impact on the patient's quality of life. Still, more research is needed to determine the impact of non-adherence on the patient's health outcomes.
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Affiliation(s)
- Marwa Mohamed
- Clinical Pharmacist at Medical Administration, Fayoum University, Egypt
| | - Abd El-Maboud
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Cairo, Egypt
| | - Heba F. Salem
- Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Cairo, Egypt
| | - Mohamed N. Salem
- Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Cairo, Egypt
| | - Mahmoud Abo Elmaaty
- Senior Clinical Pharmacist at the Children Cancer Hospital in Egypt, Beni-Suef University, Cairo, Egypt
| | - Nermin Eissa
- Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Amira S. A. Said
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Cairo, Egypt
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Raghda R. S. Hussein
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Cairo, Egypt
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Attia DHS, Mohamed ER, Ismaeel AY, Suliman YA, Moneim NHA, Abdel Noor RA. Insight into the Epidemiology of the Adult-onset Systemic Autoimmune Rheumatic Diseases in Egypt: A Descriptive Study of 8690 Patients. Curr Rheumatol Rev 2024; 20:522-533. [PMID: 38314595 DOI: 10.2174/0115733971277833231226071516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/05/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND/OBJECTIVE Although systemic autoimmune rheumatic diseases (SARDs) seem to be ubiquitous, Africa and the Middle East seem to be a remarkable exception with scarcity of data compared with the developed countries. Furthermore, most of the studies addressed a particular disease. This work aimed to shed light on the relative frequency and epidemiology of the different adult-onset SARDs in Egypt. METHODS This is a retrospective hospital-based study including six university hospitals providing free health care services: Cairo, Alexandria, Tanta, Suez Canal, Beni-Suef and Assiut University Hospitals. All available files for patients attending the outpatient clinics or admitted to the inpatient departments between January 2000 and December 2021 were retrospectively reviewed. Data about the patient's diagnosis, gender, age at disease onset, year of disease onset and residence were collected. RESULTS The study included 8690 patients. Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Behçet's disease (BD) and spondyloarthropathies (SPA) represented the main SARDs in Egypt. They mainly affect young patients below the age of 40 years. RA and SLE mainly affect females; males are mainly affected by axial SPA and BD. There is an increasing incidence of SARDs during the study period. CONCLUSION The study revealed the high burden of SARDs in Egypt, helping better allocation of economic resources for the management of diseases of the highest prevalence and those affecting the young reproductive age groups. Increased public and medical staff awareness about SARDs is recommended to help early referral of patients to rheumatologists and, hence, better estimation of their epidemiology.
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Affiliation(s)
- Doaa H S Attia
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman R Mohamed
- Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Y Ismaeel
- Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yossra A Suliman
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nermeen H A Moneim
- Physical Medicine, Rheumatology & Rehabilitation Department, Faculty of Medicine, Suez Canal University, Suez, Egypt
| | - Rasha A Abdel Noor
- Internal Medicine and Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Shah Gupta R, Koteci A, Morgan A, George PM, Quint JK. Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review. BMJ Open Respir Res 2023; 10:10/1/e001291. [PMID: 37308252 DOI: 10.1136/bmjresp-2022-001291] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/06/2023] [Indexed: 06/14/2023] Open
Abstract
Interstitial lung disease (ILD) is a collective term representing a diverse group of pulmonary fibrotic and inflammatory conditions. Due to the diversity of ILD conditions, paucity of guidance and updates to diagnostic criteria over time, it has been challenging to precisely determine ILD incidence and prevalence. This systematic review provides a synthesis of published data at a global level and highlights gaps in the current knowledge base. Medline and Embase databases were searched systematically for studies reporting incidence and prevalence of various ILDs. Randomised controlled trials, case reports and conference abstracts were excluded. 80 studies were included, the most described subgroup was autoimmune-related ILD, and the most studied conditions were rheumatoid arthritis (RA)-associated ILD, systemic sclerosis associated (SSc) ILD and idiopathic pulmonary fibrosis (IPF). The prevalence of IPF was mostly established using healthcare datasets, whereas the prevalence of autoimmune ILD tended to be reported in smaller autoimmune cohorts. The prevalence of IPF ranged from 7 to 1650 per 100 000 persons. Prevalence of SSc ILD and RA ILD ranged from 26.1% to 88.1% and 0.6% to 63.7%, respectively. Significant heterogeneity was observed in the reported incidence of various ILD subtypes. This review demonstrates the challenges in establishing trends over time across regions and highlights a need to standardise ILD diagnostic criteria.PROSPERO registration number: CRD42020203035.
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Affiliation(s)
- Rikisha Shah Gupta
- National Heart and Lung Institute, Imperial College London, London, UK
- Real-World Evidence, Gilead Sciences, Foster City, CA, USA
| | - Ardita Koteci
- Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Ann Morgan
- Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Peter M George
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, UK
- Imperial College London, London, UK
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Essouma M, Noubiap JJ, Singwe-Ngandeu M, Hachulla E. Epidemiology of Sjögren Syndrome in Africa: A Scoping Review. J Clin Rheumatol 2022; 28:e240-e244. [PMID: 34941621 DOI: 10.1097/rhu.0000000000001708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The epidemiology of Sjögren syndrome (SS) has been extensively studied in America, Europe, and Asia. OBJECTIVE To summarize available data on the epidemiology of SS in Africa. METHODS MEDLINE, EMBASE, and African Journals Online were searched from inception up to May 17, 2020, to identify relevant articles. Data gleaned from these reports have been summarized narratively in this review. RESULTS Twenty-one hospital-based studies were included. These studies reported 744 cases of SS. The mean age at diagnosis varied between 28 and 73.6 years, and the female proportion ranged from 83.3% to 100%. There was no population-based incidence or prevalence. Among people with autoimmune and other rheumatic conditions, the frequency of primary SS was in the range 1.9% to 47.6%, whereas that of rheumatoid arthritis-associated secondary SS was in the range 4.3% to 100%. Sicca symptoms were the commonest features, with most frequently involved organs being joints, lungs, and neurological structures. Main autoantibodies were anti-Ro/SS antigen A, anti-La/SS antigen B, and antinuclear antibodies. CONCLUSIONS The epidemiology of SS is poorly characterized in Africa. Available data are broadly consistent with those from other populations. Extensive and high-quality research is urgently needed.
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Affiliation(s)
| | - Jean Jacques Noubiap
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, CHRU Lille, Referral Centre for Rare Systemic Autoimmune Diseases North and Northwest of France, Univ. Lille, INSERM U995-LIRIC-Lille Inflammation Research International Centre, Lille, France
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Wan X, Wang Y, Jin P, Zhang J, Liu L, Wang Z, Hu Y. Influence of HLA Class II Alleles and DRB1-DQB1 Haplotypes on Rheumatoid Arthritis Susceptibility and Autoantibody Status in the Chinese Han Population. Immunol Invest 2021; 51:1198-1210. [PMID: 33929277 DOI: 10.1080/08820139.2021.1918708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Human leukocyte antigen (HLA) class II alleles are considered to play a key role in the progress of rheumatoid arthritis (RA). This study was carried out to investigate the presence of HLA class II alleles and their influence on disease risk and autoantibody status in Chinese Han patients with RA. Here, HLA-DRB1, DQB1 and DPB1 genotyping was performed in 125 RA patients and 120 healthy controls by using the next-generation sequencing (NGS). Strong positive associations were shown between high-resolution typed HLA-DRB1*04:05:01, DRB1*10:01:01, DQB1*04:01:01, DPB1*02:01:02 and RA patients. Moreover, the haplotypes HLA-DRB1*04:05:01~ DQB1*04:01:01 and HLA-DRB1*10:01:01~ DQB1*05:01:01 were found to be more frequent in RA populations than in healthy controls. These possible susceptible HLA alleles (HLA-DRB1*04:05:01, DRB1*10:01:01, DQB1*04:01:01 and DPB1*02:01:02) also showed higher frequencies in seropositive RA patients as compared to normal controls. The present study provided evidence that alleles HLA-DRB1*04:05:01, DRB1*10:01:01, DQB1*04:01:01 and DPB1*02:01:02 constituted RA risk alleles, and haplotypes HLA-DRB1*04:05:01~ DQB1*04:01:01, HLA-DRB1*10:01:01~ DQB1*05:01:01 also showed prevalence in Chinese Han patients with RA. Serological results preliminary demonstrated patients carrying RA-risk HLA alleles might elevate the serum level of anti-citrullinated protein antibodies and rheumatoid factor and affect RA progression.
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Affiliation(s)
- Xin Wan
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ying Wang
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Peipei Jin
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ju Zhang
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Liu Liu
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhangfei Wang
- Department of Medical Laboratory Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yue Hu
- Department of Prenatal Diagnosis Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Abstract
Historically, rheumatic diseases have not received much attention in Africa, particularly in sub-Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious diseases and the decreased life span of the general population in this region. Global attention and support, together with better health policies and planning, have improved outcomes for many infectious diseases; thus, increasing attention is being turned to chronic non-communicable diseases. Rheumatic diseases were previously considered to be rare among Africans but there is now a growing interest in these conditions, particularly as the number of rheumatologists on the continent increases. This interest has resulted in a growing number of publications from Africa on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases. Despite the limited amount of available data, some aspects of the epidemiology, genetics and clinical and laboratory features of rheumatic diseases in African populations are known, as is some detail on the use of therapeutics. Similarities and differences in these conditions can be seen across the multi-ethnic and genetically diverse African continent, and it is hoped that increased awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes for patients. The prevalence of rheumatic diseases is increasing in African countries, leading to an increased need for specialist rheumatologists and disease-modifying drugs. In this Review, the authors outline what is currently known about the state of rheumatic diseases in Africa. In the past, there has been an emphasis on communicable diseases in Africa, but attention has now shifted towards non-communicable diseases such as rheumatic diseases. Common rheumatic diseases are seen in Africa and are both comparable and different from presentations seen outside of Africa. Diverse genetic and environmental factors affect the presentation of common rheumatic diseases among different African nations. A shortage of appropriately trained staff, laboratory testing capacity and effective medications exists across the whole continent. Advocacy and research are needed to increase awareness of the risk factors, presentations and management of rheumatic diseases in Africa. Specialized treatment guidelines are needed for resource-poor countries in Africa.
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Wu Y, Dai Z, Wang H, Wang H, Wu L, Ling H, Zhu Y, Ye D, Wang B. Serum 14-3-3η is a Marker that Complements Current Biomarkers for the Diagnosis of RA: Evidence from a Meta-analysis. Immunol Invest 2020; 51:182-198. [PMID: 32967487 DOI: 10.1080/08820139.2020.1817069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To systematically evaluate the diagnostic value of 14-3-3η protein for rheumatoid arthritis (RA). METHOD Searched PubMed, Web of Science, Embase and China Biology Medicine (CBM) databases comprehensively from inception to May 2020. The evaluation index were the pooled sensitivity, specificity, diagnosis odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), as well as the area under the summary receiver operating characteristic (SROC) curves. Meta-Disc 1.4 and RevMan 5.3 were used to analyze all statistics. QUADAS-2 tool was applied to evaluate the quality of eligible studies. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. RESULTS Nine articles containing eleven records were eligible for this meta-analysis. The pooled sensitivity of 14-3-3η was 0.63 (95% CI: 0.60 to 0.66), the pooled specificity was 0.90 (95% CI: 0.88 to 0.91). The pooled PLR and NLR was 6.10 (95% CI: 4.67 to 7.96) and 0.40 (95% CI: 0.33 to 0.48), respectively. The pooled DOR was 15.90 (95% CI: 11.15 to 22.68), and the area under the curve (AUC) was 0.8696. Compared with a single indicator (rheumatoid factor or anti-citrullinated protein antibodies), adding 14-3-3η can bring incremental benefits to the diagnosis of RA. The results of subgroup analysis and meta-regression suggested that the two factors (ethnicity, early vs established RA) we analyzed might not be the source of heterogeneity (P value were 0.0979 and 0.4298, respectively) and there was no publication bias among these articles (P = .42). CONCLUSION Serum 14-3-3η protein is a supplementary biomarker in the diagnosis of RA.
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Affiliation(s)
- Yue Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Ziwei Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Haili Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Hong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Lingling Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Huayun Ling
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Ying Zhu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dongqing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
| | - Bin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, Anhui, China
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Valdés-Corona LF, Hernández-Doño S, Rodríguez-Reyna TS, García-Silva R, Jakez J, Escamilla-Tilch M, Lima G, Llorente L, Pineda C, Yunis E, Granados J. Aspartic acid 70 in the HLA-DRB1 chain and shared epitope alleles partially explain the high prevalence of autoimmunity in Mexicans. J Transl Autoimmun 2020; 3:100057. [PMID: 32743537 PMCID: PMC7388401 DOI: 10.1016/j.jtauto.2020.100057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Autoimmune thyroid disease (AITD) is the most common autoimmune disorder worldwide. Remarkably, it is commonly accompanied by other autoimmune diseases, such as rheumatoid arthritis (RA). The immunopathogenic mechanisms behind the coexistence of these disorders are still not completely understood. Immunogenetics influences the physiopathology of these diseases since ethnicity plays an essential role in the inheritance of susceptibility markers. METHODS High-resolution HLA class II typing was performed using a sequence-based method. RESULTS The allele frequency of HLA-DRB1∗04:04 and -DRB1∗03:01 were significantly increased in patients with AITD and RA compared to healthy individuals, pC = 0.021, OR = 2.4, 95%CI = 1.19-4.75 and pC = 0.009, OR = 3.4, 95%CI = 1.42-7.93, respectively. Remarkably, these patients have a combined risk given by susceptibility HLA-DRB1 alleles that contain the shared epitope, pC = 0.03, OR = 1.7, IC95% = 1.07-2.76, and a lack of protective alleles carrying aspartic acid70, pC = 0.009, OR = 0.5, IC95% = 0.32-0.84. DISCUSSION The results suggest that patients with AITD and RA have an immunogenetic mechanism that combines the susceptibility alleles associated with both diseases. Importantly, it seems to be linked mainly to the lack of protective alleles with aspartic acid in the position 70, along with the presence of susceptibility alleles that have the sequences QRRAA, QKRAA, and RRRAA at positions 70-74. CONCLUSION Patients with AITD and RA have a characteristic immunogenetic signature, which could be useful for determining multiple autoimmunities and assessing their relatives' risk of developing it.
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Affiliation(s)
- Luis Francisco Valdés-Corona
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Susana Hernández-Doño
- Immunogenetics Division, Transplant Department. Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Tatiana Sofia Rodríguez-Reyna
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Rafael García-Silva
- Immunogenetics Division, Transplant Department. Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Juan Jakez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | | | - Guadalupe Lima
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Luis Llorente
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
| | - Carlos Pineda
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico
| | - Edmond Yunis
- Department of Cancer Immunology and AIDS, Dana-Farber Cancer Institute, USA
| | - Julio Granados
- Immunogenetics Division, Transplant Department. Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico
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Gheita TA, Eesa NN. Rheumatology in Egypt: back to the future. Rheumatol Int 2018; 39:1-12. [PMID: 30406299 DOI: 10.1007/s00296-018-4192-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/29/2018] [Indexed: 12/17/2022]
Abstract
Medical knowledge in ancient Egypt had a remarkable reputation since rulers of other empires used to request the pharaoh to send them their best physician to treat their beloved ones. Many rheumatologic conditions as giant-cell arteritis, reactive arthritis and other forms of spondyloarthritis have been identified in ancient Egyptian materials. Rheumatologists in Egypt are enormously expanding and mastering the tools that aid them in enhancing the management of rheumatic diseases. More Egyptian rheumatologists are actively participating in the annual European League Against Rheumatism (EULAR) and American College of Rheumatology conferences and those attached to well known state of the art centers are increasing. EULAR certified Egyptian MSUS trainers are effectively performing regionally. This review throws light on the rheumatology practice in Egypt, its progress from ancient times passing through Egyptian medical healthcare services, education systems for rheumatologists, rheumatology associations, an overview on the spectrum of rheumatic diseases through publications in the field till future perspectives. Rheumatology in Egypt is an actively growing and dynamic specialty of medicine with considerable contributions to the world's literature. These days, persistent efforts are mandatory to raise the standard of clinical and basic research, to optimize clinical practice with regard to new biologics, to develop tailored and targeted therapies for the rheumatic diseases, and to meet the medical demands of the exponentially increasing Egyptian population. Opportunities and challenges discussed high-lighten future perspectives needed to boost the rheumatology practice in Egypt.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Nahla N Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Upregulation of miR-221/222 expression in rheumatoid arthritis (RA) patients: correlation with disease activity. Clin Exp Med 2018; 19:47-53. [PMID: 30132091 DOI: 10.1007/s10238-018-0524-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023]
Abstract
miRNAs are noncoding RNA that play a critical role as fine regulators of gene expression at the posttranscriptional level within cells in numerous autoimmune diseases. miR-221/222 play a role in cancer by regulating cell proliferation, invasion and apoptosis. However, there have been insufficient studies on their role in rheumatoid arthritis (RA). This work is designed to analyze the miR-221/222 expression patterns in peripheral blood mononuclear cells (PBMCs) of patients with RA in comparison with healthy controls using quantitative RT-PCR, in a group of 30 RA patients and 20 healthy controls. The fold change of miR-221/222 expression in PBMCs was significantly elevated (p < 0.01) in RA patients compared with healthy controls. A positive correlation between expression levels of miR-221 and miR-222 was recorded (r = 0.303; p < 0.05). High miR-221/222 expression levels appeared to be elevated with high activity. miR-222 expression in high activity group of RA patients was significantly increased in relation to moderate (p < 0.01) and low (p < 0.001) activity ones with positive correlation (r = 0.363; p < 0.05) between the progress of disease activity and change in miR-222 expression level. ROC analysis showed a sensitivity of 70% and specificity of 75% for miR-221. In miR-222, the sensitivity of 80% and specificity of 70% were recorded. Our data shed some light on the role of miR-221/222 expression in RA patients, and their great potential value as new novel noninvasive biomarkers for disease detection. Therefore; further investigations are warranted to fully elucidate their role in rheumatoid.
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