Full paper Not Available

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