Screening for celiac disease,by endomysial antibodies,in patients with unexplained articular manifestations

Celiac disease (CD) is an autoimmune systemic disease characterized by not only gastrointestinal but also extraintestinal manifestations. The aim of our study was to do a serological screening for CD, by IgA endomysial antibodies (EmA), in patients with unexplained articular manifestations. Two hundred and eleven patients suffering from arthritis or arthralgia without evident cause were studied. EmA were determined by indirect immunofluorescence on human umbilical cord. Two thousand and five hundred blood donors served as control group. Out of 211 patients, 5 had EmA (2.37 %). The frequency of EmA in our patients was significantly higher than in the control group (2.37 vs. 0.28 %, p < 0.01). All patients with positive EmA were female. EmA were significantly more frequent in female patients than in female healthy subjects (3 vs. 0.4 %, p < 0.01). Medical records revealed: diarrhea (one patient), short size (one patient), anemia (three patients), weight loss (two patients) spontaneous abortion (three patients), secondary amenorrhea (one patient), early menopause (one patient) and early baby death (one patient). Biochemical analysis showed decreased level of calcium (one patient), vitamin D (one patient) and cholesterol (one patient). Unexplained liver cytolysis was observed in two patients. Radiological examination showed demineralization of two hands in one patient. Bone osteodensitometry done in one patient out of five revealed lumbar osteopenia. The articular manifestations of the five patients did not respond to corticosteroid treatment. CD must be considered among the differential diagnosis in a patient with arthritis or arthralgia.     

The effects of extraction method on the measured tocopherol level and antioxidant activity of L. nobilis vegetative organs

Tocopherol contents of Tunisian Laurus nobilis vegetative organs were screened for antioxidant activity. Tocopherol isomers extracted by probe sonication and micro-scale saponification were analysed by reversed-phase high performance liquid chromatography (RP-HPLC) with UV detection to determine the optimum extraction method. Total phenolic, flavonoid and proanthocyanidin contents were determined spectrophotometrically. Significant variations in the amounts of α-, γ- and δ-tocopherols were observed with the two different extraction methods as well as with different plant parts. Leaf extract contained the highest amount of α-tocopherol (139 mg/100 g fresh weight), but root extract contained the highest content of flavonoids (11.12 mg catechin equivalents (CE)/g dry weight or DW), total phenolics (55.45 ± 2.9 mg GAE/g DW) and condensed tannins (9.76 ± 0.1 mg CE/g DW). Acetonic extract of laurel leaf exhibited the highest antioxidant activity response to lipid peroxidation in the β-carotene-linoleic acid system, which may have been due to the high content of α-tocopherol. These findings suggest that laurel leaf may be a source of natural α-tocopherol and that it may be increasingly important for human consumption, as well as for the agro-food, cosmetic and pharmaceutical industries.     

Regulation of Mitochondrial and Cytosol Antioxidant Systems of Fenugreek (<Emphasis Type="Italic">Trigonella foenum graecum</Emphasis> L.) Exposed to Nanosized Titanium Dioxide

In the present study, the interactions between nanoparticle (NP) exposure, root application and plants were examined. NPs are potentially responsible for conformational changes in polysaccharides, lipids, proteins, pectin, suberin and lignin molecules. 4 days of treatment with metal oxide caused a statistically significant increase in nicotinamide adénine dinucléotide oxidase activity in mitochondria and cytosol. Following exposure to TiO₂NP, even lipid peroxidation levels decreased in the mitochondria (leaves, stem and root) and in the cytosol (leaves and root), although it increased in the cytosol of the stem. Malondialdehyde accumulation was found to be higher in the cytosol compared to the mitochondria of stems, and in the cytosol of leaves and roots. NPs caused alterations in metabolism, antioxidant enzyme activities (guaiacol peroxidase, catalase and ascorbate peroxidase) and the generation of oxidative stress. Effects caused by exposures to NPs were influenced by differences in metabolic responses in plant parts, plant compartments, the period of exposure and the NP doses.     

Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man

Takayasu arteritis is an inflammatory condition that involves the large cardiac vessels, predominantly the aorta and its main branches. It typically affects young women (age, ≤40 yr), most often Asians and Latin Americans. Herein, we describe a rare manifestation of Takayasu arteritis in a 19-year-old black Tunisian man who presented with acute inferior myocardial infarction and complete atrioventricular block after occlusion from a giant aneurysm in the right coronary artery. The coronary artery disease was associated with aneurysmal dilations in the carotid, vertebral, and right renal arteries. Medical therapy improved Thrombolysis in Myocardial Infarction flow in the area of the giant aneurysm from grade 1 to grade 3. Upon the diagnosis of Takayasu arteritis, intravenous methylprednisolone and oral prednisone therapy was started. After 10 days of hospitalization, the patient was discharged on a medical regimen. Renovascular hypertension due to renal artery stenosis was suspected, so he underwent successful percutaneous transluminal angioplasty of the inferior segmental artery of the right renal artery. During 12 months of close postprocedural monitoring, he experienced lower blood pressure, no chest pain, and no cardiovascular complications.This association of conditions has not been previously reported. Besides presenting this very rare combination of findings, we discuss the differential diagnosis of Takayasu arteritis in our patient.     

Zooprophylaxis: impact of breeding rabbits around houses on reducing the indoor abundance of Phlebotomus papatasi

Zooprophylaxis is the use of animals to deviate vectors from humans. The indoor abundance of Phlebotomus papatasi in houses with rabbit holes in the peridomestic areas are significantly lower than the indoor abundance in houses without rabbit holes in their peridomestic areas. Introduction of rabbits in artificial underground holes in peridomestic areas reduced significantly the indoor abundance of P. papatasi. Cleaning rabbit holes in peridomestic area by removing all rabbit feces induced a significant increase in the abundance of P. papatasi inside bedrooms. The ecologic niche made around houses in endemic areas by creating active rabbit holes is a major source of attractiveness of P. papatasi, and therefore it may deviate the vector from humans to rabbits. Although rabbit holes are breeding sites for P. papatasi, rabbits are not competent reservoirs for Leishmania major. Our overall findings strongly suggest that zooprophylaxis could be effective in reducing the indoor abundance of P. papatasi and subsequently may be used to control the transmission L. major in rural areas.     

Value of anti-mutated citrullinated vimentin antibodies in diagnosing rheumatoid arthritis

We assessed the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) and compared it with those of anti-cyclic citrullinated peptide antibodies (anti-CCP), IgA (ARF), IgM (MRF) and IgG (GRF) rheumatoid factors for rheumatoid arthritis (RA). Serum samples of 170 RA patients, with early and established RA, and 309 controls were tested for anti-MCV, anti-CCP, ARF, MRF and GRF using commercially available ELISA kits. Cut off of different tests was determined with ROC curves. The sensitivity and the specificity of anti-MCV were 74.1 and 79%, respectively. Sixty-five of 309 (21%) controls were anti-MCV positive. Sensitivity and specificity of anti-CCP were 72.4 and 96.1%, respectively. Only 12 of 309 (3.9%) controls were anti-CCP positive. Sensitivity of ARF, MRF and GRF were 64.1, 65.9 and 68.2%, respectively. Their specificity was 79.6, 74.4 and 68.9%, respectively. No significant association was observed between the antibodies tested and extrarticular manifestations. Anti-MCV shows comparable sensitivity but lower specificity than that of anti-CCP. They do not appear to be very useful in the diagnosis of RA.