Introduction : The presence of particuiarly high serum levels of IL-IRA in patients
with PM / DM is indicative of distinct pathologic mechanism , also measurement of
IL-IRA , together with clinical examination may provide useful information tor the
follow up of PM / DM. patients .
Aim of the work: is the determination of the serum level of It- IRA and its
relationship to different clinical and laboratory parameters of inflammatory
myopathies.
Patients and Methods: This study was carried on 20 patients suffering from
inflammatory and non inflammatory muscle diseases and ten healthy controls . Full
history taking and thorough clinical examination together with routine laboratory
investigations , interieukin -1 receptor antagonist, creatin kinase, C- reactive protein
were measured in the serum of all subjects .
The results of the present study showed that the serum levels of CK and CRP were
significantly higher in the patients than controls , while IL-IRA and CRP were
significantly higher in DM/PM group than non-inflammatory and control groups, no
significant difference was found between the serum levels of IL-IRA in
non-inflammatory muscle disease and controls , also non significant difference between
CK level in inflammatory and non inflammatory muscle diseases was found . A
proportional correlation was found between IL-IRA and F.D.G & CK in the patients
while inverse correlation was found between IL-IRA and M.G
Conclusion: These results indicated that Inflammatory myopathies showed certain
immune activation as shown by increased IL-IRA in the patients which can be used as a
marker of early detection of the disease .
From
tanon
Benlia Faculty of Medicine
Ahamed Y.Ali, Eman M. Mouner, Naglaa A. ElShinhap,
M.Z Eraky and Ebrahem M. Rageh *
By
STUDY OF SERUM INTERLEUKIN-l RECEPTOR ANTAGONIST IN
JNFLAMMATORYANDNON-INFIAMMATORYMYOPATHIES
noticeable in early childhood and quickly be
come debilitating . Becker muscular dystro
phy, on the other hand, is of later onset and
less severe. Both forms of MD are caused by
mutations in the dystrophin gene, a large
(2.6Mb) gene comprised of 97 exons. The dys
trophin protein plays an important structural
role as part of a large complex in muscle fiber
membranes When dystrophin is missing or
non-functional, the entire complex is compro
mised, leading to degeneration of muscle tis
sue. When the ability to regenerate the muscle
is exhausted, muscle wasting occurs (Roberts
et ah. 1994).
The interleukin-1 family consists of three
structurally related polypeptides. The first two
are interleukin-la and interleukin-1 (^ , each
of which has a broad spectrum of both benefi
cial and harmful biologic actions, and the third
is interleukin-1 receptor antagonist, which in
hibits the activities of interleukin-1. Among
the properties of the two forms of interleukin-1
(a & (^) is the ability to induce fever, sleep, an
orexia, and hypotension . Interleukin-1 stimu
lates the release of pituitary hormones, increas
es the synthesis of cotlagenases, resulting in
the destruction of cartilage, and stimulates the
production of prostaglandins, leading to a de
crease in the pain threshold. Interleukin-1 has
also been implicated in the destruction of?
cells of the islets ofLangerhans, the growth of
myelogenous leukemia cells, inflammation as
sociated with arthritis and colitis, and the de
velopment of atherosclerotic plaques (Dinarello
and Wolff 1993).
The third member of the interleukin-1 fami
ly ,nterleukin-l receptor antagonist provtdes
some protection against the disease-provokmg
INTRODUCTION:
Polymyositis (PM) & dermatomyositis
(DM) are muscle disorders of unknown origin,
characterized by inflammatory infiltration in
muscle tissue, muscular weakness, fatigue,
typical Cutaneous lesions , and more rarely or
gan systemic manifestations (Lundberg and
Chung 2000).
The assessment of disease activity in PM/
DM is based on different clinical & biological
parameters including muscle weakness, EMG,
histological findings, creatine phosphokinase
(CK) levels, however all these lack sensitivity
or specificity (Madder and Keystone, 1993).
In idiopathic inflammatory myopathies
(IIM) increased expression of proinllammatory
cytokines particularly interleukin-
1 (IL-1) alpha & (IL-1) beta. Tumor necro
sis factor (TNF) alpha and macrophage inflam
matory proteins-1 alpha were observed in
muscles . There was no difference in cytokine
and chemokines pattern in PM & DM. and in
clusion body myositis, which could indicate
that similar pathogenesis mechanisms are in
volved in these subsets of myositis (Lundberg,
2001).
The presence of particularly high serum lev
els of IL-1RA in patient with PM/DM is indic
ative of distinct pathologic mechanism, also
measurement of IL-1 RA, together with clini
cal examination may provide useful mformation
for the follow up of PM/DM patients
(Gaby etal., 1994).
Muscular dystrophy (MD) refers to a group
of genetic disorders whose major symptom is
muscle wasting. There are two major forms
MD, differing in severity and age of onset. In
Duchenne muscular dystrophy, symptoms are
The |
