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Evaluation of periodontal status and cytokine response in children with familial Mediterranean fever or systemic juvenile idiopathic arthritis. Clin Oral Investig 2023; 27:1159-1166. [PMID: 36197547 DOI: 10.1007/s00784-022-04730-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/01/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Familial Mediterranean fever (FMF) and systemic juvenile idiopathic arthritis (sJIA) are chronic inflammatory diseases and anti-inflammatory agents are used in their treatment. This study evaluates the periodontal status and cytokine response in pediatric patients with FMF or sJIA. MATERIALS AND METHODS Forty-eight FMF/sJIA patients were under treatment/control and in attack-free period; 20 systemically healthy children participated in the study. FMF/sJIA patients were divided into two subgroups based on the treatment they received: receiving anti-IL-1 therapy (anti-IL-1 ( +)) and not receiving anti-IL-1 therapy (anti-IL-1 ( -)). The clinical periodontal indices were recorded. Gingival crevicular fluid (GCF) and serum samples were collected. Cytokine levels (IL-1β, IL-1α, TNF-α, IL-6, IL-8, IL-10, IL-17, IL-33) in GCF and serum were measured using ELISA kits. RESULTS There was no significant difference between the groups in terms of GCF IL-1β and IL-1α levels although, BoP and GI were significantly lower in the anti-IL-1 ( +) group compared to the control group. GCF IL-10 level was higher in the anti-IL-1 ( -) group than in the control group; GCF IL-8 levels were lower in both FMF/sJIA subgroups versus controls. There was no significant difference between serum cytokine levels of FMF/sJIA subgroups. CONCLUSIONS Considering the significant decrease in GI, BoP, and GCF IL-8 levels in the anti-IL-1 ( +) group, it can be concluded that anti-IL-1 medications may suppress periodontal inflammation clinically and immunologically. CLINICAL RELEVANCE Anti-IL agents are not currently used in periodontal therapy. However, this study demonstrated the positive effect of anti-IL-1 medications on periodontal inflammation in pediatric patients with FMF or sJIA.
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Stella A, Portincasa P. The unsolved mystery of MEFV variants variable expressivity in Familial Mediterranean Fever. Intern Emerg Med 2022; 17:1255-1259. [PMID: 35809153 DOI: 10.1007/s11739-022-03027-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Alessandro Stella
- Laboratory of Human Genetics, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
| | - Piero Portincasa
- Division of Internal Medicine, Department of Biomedical Sciences and Human Oncology, Clinica Medica "A Murri", University of Bari "Aldo Moro", Bari, Italy
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Beshlawy AE, Zekri AER, Ramadan MS, Selim YMM, Abdel-Salam A, Hegazy MT, Ragab L, Gaggiano C, Cantarini L, Ragab G. Genotype-phenotype associations in familial Mediterranean fever: a study of 500 Egyptian pediatric patients. Clin Rheumatol 2022; 41:1511-1521. [PMID: 34988684 DOI: 10.1007/s10067-021-06006-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/23/2021] [Accepted: 11/27/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disease, caused by recessively inherited MEFV gene mutations. The most frequent MEFV mutations differ in penetrance and disease severity. We investigated the genotype-phenotype associations of the three most frequent MEFV gene mutations (M680I, M694V, and V726A) in Egyptian FMF children, regarding clinical features, severity, and colchicine response. METHODS We conducted a retrospective analysis of the medical registries of 500 FMF pediatric patients from Metropolitan Cairo between 2010 and 2015. The diagnosis was based on the Tel-Hashomer clinical diagnostic criteria. Clinical data and baseline investigations were collected. Mutation analysis was performed by the amplification-refractory mutation system (ARMS)-PCR method. RESULTS Males represented 54% and ages ranged from 2 to 18 years. The most frequent symptoms were abdominal pain, fever, and arthralgia. Clinical features mostly associated with M694V mutation either homozygous or heterozygous whether simple, double, or triple. Of the patients, 94.6% completely responded to colchicine. Among patients benefiting from colchicine, 42.5% had M694V/V726A, 21.6% had M694V/V726A/M680I, and 21.1% had M694V genotype. Simple heterozygous M694V or V726A mutations conveyed a moderate phenotype in 57.1% and 50% of cases, respectively. Homozygous M694V mutation showed moderate and severe phenotypes in 21.7% and 65.2% of cases, respectively. Compound M694V/V726A mutation associated with moderate or severe disease in 48.3% and 33.8% of cases, respectively. CONCLUSION This study encompasses the largest group of Egyptian pediatric FMF up to date to explore their genotype-phenotype associations. Our results support the notion that the genotype influences the phenotype as regards clinical manifestations, disease severity, and colchicine response. KEY POINTS • This study encompasses the largest group of Egyptian pediatric patients affected by FMF up to date to explore their genotype-phenotype associations. • Our results support the notion that the genotype influences the phenotype as regards the clinical manifestations, the disease severity, and the response to colchicine treatment.
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Affiliation(s)
- Amal El Beshlawy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abd El Rahman Zekri
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Manal S Ramadan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmeen M M Selim
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amina Abdel-Salam
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Tharwat Hegazy
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.,Newgiza University (NGU), Giza, Egypt
| | | | - Carla Gaggiano
- Department of Medical Sciences, Surgery, and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", Siena, Italy
| | - Luca Cantarini
- Department of Medical Sciences, Surgery, and Neurosciences, Rheumatology Unit, University of Siena, Policlinico "Le Scotte", Siena, Italy
| | - Gaafar Ragab
- Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt. .,Newgiza University (NGU), Giza, Egypt.
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Borgio JF. Heterogeneity in biomarkers, mitogenome and genetic disorders of the Arab population with special emphasis on large-scale whole-exome sequencing. Arch Med Sci 2021; 19:765-783. [PMID: 37313193 PMCID: PMC10259412 DOI: 10.5114/aoms/145370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/27/2021] [Indexed: 09/20/2024] Open
Abstract
More than 25 million DNA variations have been discovered as novel including major alleles from the Arab population. Exome studies on the Saudi genome discovered > 3000 novel nucleotide variants associated with > 1200 rare genetic disorders. Reclassification of many pathogenic variants in the Human Gene Mutation Database and ClinVar Database as benign through the Arab database facilitates building a detailed and comprehensive map of the human morbid genome. Intellectual disability comes first with the combined and observed carrier frequency of 0.06779 among Saudi Arabians; retinal dystrophy is the next highest. Genome studies have discovered interesting novel candidate disease marker variations in many genes from consanguineous families. More than 7 pathogenic variants in the C12orf57 gene are prominently associated with the etiology of developmental delay/intellectual impairment in Arab ancestries. Advances in large-scale genome studies open a new outlook on Mendelian genes and disorders. In the past half-dozen years, candidate genes of intellectual disability, neurogenetic disorders, blood and bleeding disorders and rare genetic diseases have been well documented through genomic medicine studies in combination with advanced computational biology applications. The Arab mitogenome exposed hundreds of variations in the mtDNA genome and ancestral sharing with Africa, the Near East and East Asia and its association with obesity. These recent discoveries in disease markers and molecular genetics of the Arab population will have a positive impact towards supporting genetic counsellors on reaching consanguineous families to manage stress linked to genetics and precision medicine. This narrative review summarizes the advances in molecular medical genetics and recent discoveries on pathogenic variants. Despite the fact that these initiatives are targeting the genetics and genomics of disorders prevalent in Arab populations, a lack of complete cooperation across the projects needed to be revisited to uncover the Arab population's prominent disease markers. This shows that further study is needed in genomics to fully comprehend the molecular abnormalities and associated pathogenesis that cause inherited disorders in Arab ancestries.
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Affiliation(s)
- J Francis Borgio
- Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Xiang N, Liao H, Zhai Z, Gong J. Expression and significance of inflammatory reactions mediated by the IL-33/ST2 signaling pathway in the serum of heart failure patients. Am J Transl Res 2021; 13:8247-8252. [PMID: 34377313 PMCID: PMC8340166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This research aimed to explore the clinical significance of inflammatory reactions mediated by the IL-33/ST2 signaling pathway in heart failure (HF) patients. METHODS A total of 100 HF patients treated in the Department of Cardiology in our hospital were prospectively regarded as the observation group, and 100 healthy age and gender matched patients who were undergoing physical examination were considered as the control group. The levels of interleukin-33 (IL-33), ST2, tumor necrosis factor-α (TNF-α) and pro B-type natriuretic peptide (pro-BNP) in the peripheral blood of patients were detected. The potential correlation between IL-33 and ST2, TNF-α and pro-BNP was analyzed by Pearson. RESULTS The levels of IL-33, IL-10, ST2 and pro-BNP in the peripheral blood of patients in the observation group were higher than those in the control group; and they increased with the rise of cardiac function grade (all P<0.05). In addition, IL-33 was positively correlated with TNF-α, ST2 and pro-BNP (r=0.863, 0.879, 0.945; all P<0.05). Multivariate Logistic analysis revealed that the increase of IL-33 and ST2 were independent risk factors of HF. CONCLUSION The IL-33 and ST2 levels in the peripheral serum of HF patients are correlated with TNF-α and BNP, the finding of which can assist in clinical diagnosis and treatment.
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Affiliation(s)
- Ning Xiang
- Department of Geriatrics, Affiliated Hospital of Guizhou Medical UniversityGuiyang, Guizhou Province, China
| | - Haijun Liao
- Guizhou Medical UniversityGuiyang, Guizhou Province, China
| | - Zichen Zhai
- Guizhou Medical UniversityGuiyang, Guizhou Province, China
| | - Jingwen Gong
- Guizhou Medical UniversityGuiyang, Guizhou Province, China
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Abstract
PURPOSE OF REVIEW Familial Mediterranean fever (FMF) is the prototypic autoinflammatory disease. Although the gene associated with the disease was identified 24 years ago, we still have to learn about the pathogenesis of its inflammation and the variation in the phenotype. In this review, we discuss some recent findings in FMF, such as changes in our understanding of the genetics, aims to define new criteria, and factors contributing to the disease presentation. RECENT FINDINGS We finally have learned why a mutation causing this disease was selected in ancient times; MEFV gene mutations confer resistance to the microbe of plague. A group of experts have outlined recommendations for the analysis of the genetics of FMF. These recommendations complement the new classification criteria, which includes genetic results. In the past year, a number of studies have addressed the contributing factors to the inflammation caused by the mutations in pyrin; this has included epigenetic studies as well. Finally, we have long-term data for the use of anti-IL1 treatment in colchicine-resistant patients. SUMMARY We now have recommendations for assessing genetic analysis of the MEFV gene and how to reliably classify a patient as FMF. We await further data to understand the contributing genetic and environmental factors that affect the inflammation and final phenotype in FMF and the extent of the disease presentation.
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Umar M, Megarbane A, Shan J, Syed N, Chouery E, Aliyev E, Jithesh P, Temanni R, Mansour I, Chouchane L, Ismail Chouchane A. Genome sequencing unveils mutational landscape of the familial Mediterranean fever: Potential implications of IL33/ST2 signalling. J Cell Mol Med 2020; 24:11294-11306. [PMID: 32853466 PMCID: PMC7576248 DOI: 10.1111/jcmm.15701] [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: 03/20/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/30/2022] Open
Abstract
Familial Mediterranean fever (FMF) is the most common auto-inflammatory disease. It is transmitted as autosomal recessive trait with mutations in MEditerranean FeVer (MEFV) gene. Despite a typical clinical expression, many patients have either a single or no mutation in MEFV. The current work is aimed to revisit the genetic landscape of FMF disease using high-coverage whole genome sequencing. In atypical patients (carrying a single or no mutation in MEFV), we revealed many rare variants in genes associated with auto-inflammatory disorders, and more interestingly, we discovered a novel variant ( a 2.1-Kb deletion) in exon 11 of IL1RL1 gene, present only in patients. To validate and screen this patient-specific variant, a tandem of allele-specific PCR and quantitative real-time PCR was performed in 184 FMF patients and 218 healthy controls and we demonstrated that the novel deletion was absent in controls and was present in more than 19% of patients. This study sheds more light on the mutational landscape of FMF. Our discovery of a disease-specific variant in IL1RL1 gene may constitute a novel genetic marker for FMF. This finding suggesting a potential role of the IL33/ST2 signalling in the disease pathogenicity highlights a new paradigm in FMF pathophysiology.
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Affiliation(s)
- Meenakshi Umar
- Laboratory of Inflammation Research, Immunology Department, Sidra Medicine, Doha, Qatar
| | - Andre Megarbane
- Institut Jérôme Lejeune, Paris, France.,Centre Medical et Psychopedagogique, Beirut, Lebanon
| | - Jingxuan Shan
- Laboratory of Genetic Medicine and Immunology, Weill Cornell Medicine-Qatar, Qatar.,Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Najeeb Syed
- Biomedical Informatics Division, Sidra Medicine, Doha, Qatar
| | - Eliane Chouery
- Medical School, Lebanese American University, Beirut, Lebanon
| | - Elbay Aliyev
- Human Genetics Department, Sidra Medicine, Doha, Qatar
| | - Puthen Jithesh
- Biomedical Informatics Division, Sidra Medicine, Doha, Qatar
| | - Ramzi Temanni
- Biomedical Informatics Division, Sidra Medicine, Doha, Qatar
| | - Issam Mansour
- American University of Science and Technology (AUST), Beirut, Lebanon
| | - Lotfi Chouchane
- Laboratory of Genetic Medicine and Immunology, Weill Cornell Medicine-Qatar, Qatar.,Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA.,Department of Microbiology & Immunology, Weill Cornell Medicine, New York, NY, USA
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