Serum concentrations of cardiac troponin-I in patients with rheumatoid arthritis, systemic lupus erythematosus, primary Sjogren's syndrome and Graves' disease

INTRODUCTION: Some reports in the literature suggest that cardiac troponin-I (cTnI) is falsely elevated in patients with seropositive rheumatoid arthritis (RA) because of the presence of rheumatoid factor (RF). But, there are no reports in the literature on cTnI concentrations in other autoimmune diseases. We therefore decided to measure the serum concentrations of cTnI in patients with seropositive and seronegative RA, systemic lupus erythematosus (SLE), primary Sjogren's syndrome (pSS) and Graves' disease (GD), in order to find out if this cardiac marker is falsely elevated or not. METHODS: Serum samples were drawn from 50 patients with seropositive RA, 50 patients with seronegative RA, 50 patients with SLE, 20 patients with pSS and 15 patients with GD. We measured cTnI levels using the Beckman Access Immunoassay System in these serum samples. RESULTS: Of the 50 patients with seropositive RA, five had cTnI levels higher than 0.1 ng per ml (the diagnostic value for myocardial infarction in our hospital laboratory), while none of the patients with seronegative RA, SLE, pSS, or GD had levels above this value. Furthermore, univariate regression analysis showed a positive association (r equals 0.35, p-value equals 0.02) between cTnI and RF in patients with seropositive RA. CONCLUSION: Using the Beckman Access Immunoassay System for cTnI quantification, it was found that some patients with seropositive RA had falsely-elevated cTnI, while none of the patients with seronegative RA, SLE, pSS, or GD had falsely-elevated cTnl.     

Multidisciplinary academic perspectives during the COVID-19 pandemic

To date, the outbreak of the novel coronavirus (COVID-19) has infected more than 5 million people and caused around 350 000 deaths globally. In most countries, the world as we knew it came to a sudden stop and this led to the biggest shift of employees to remotely conduct their work. Academic institutions were extensively affected, as teaching and assessment activities were hampered, and graduation ceremonies were cancelled. In addition, there was an imminent disruption in academic and research activities including face-to-face conferences and conventions. Among many challenges, academics had to grapple to remain engaged professionally and socially with students and colleagues. Digital technology being an integral part of life has become essential for connectivity and communication. In this commentary, multidisciplinary academics from Kuwait and Saudi Arabia share perspectives and experiences in adapting to the COVID-19 reality. From healthcare sciences to engineering, and from business to education, this paper highlights the role academics play in combating professional and social challenges during COVID-19.     

Validation of the Arabic version of the WHO-ILAR COPCORD Core Questionnaire for community screening of rheumatic diseases in Kuwaitis. World Health Organization. International League Against Rheumatism. Community Oriented Program for the Control of Rheumatic Diseases

OBJECTIVE: (1) To adapt the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic screening instrument among Kuwaitis, including translation, back translation, assessment of cross cultural equivalence, and reliability. (2) To determine the screening characteristics of the Arabic version of the CCQ for detecting rheumatic diseases compared to clinical examination by a rheumatologist. METHODS: Translation and assessment of cross cultural equivalence were undertaken using standard methods. Back translation was done by an Arabic-speaking rheumatologist. Interviewer agreement was assessed using a convenience sample. Sensitivity, specificity, and positive and negative predictive values were assessed first by administering the CCQ followed by full clinical examinations of a randomly selected sample of 359 Kuwaiti persons aged 15 years or older. RESULTS: (1) Cross cultural equivalence and back translation of the translated questionnaire were satisfactory. Interviewer agreement was acceptable. (2) The prevalence of rheumatic diseases based only on CCQ screening was 69% compared to 73% based on clinical examination. The sensitivity and specificity of the Arabic CCQ were 94.4% and 97%, respectively, and the positive and negative predictive values of the instrument were 98.8% and 86.4%, respectively. CONCLUSION: The Arabic version of the CCQ appears promising as a screening tool to detect rheumatic diseases in Arabic speaking communities. The findings suggest that the Arabic CCQ followed by clinical examinations in positive respondents can provide an acceptable estimate of prevalence of rheumatic diseases. We intend to use this instrument to screen for the prevalence of rheumatic diseases among Kuwaiti nationals.     

Assessment of the cellular response to the induced expression of defensin sense and antisense cDNA in acute promyelocytic leukemia cell lines

Defensins are 20 - 30 amino acid-long, cystine- and arginine-rich peptides that constitute more than 5% of the total cellular proteins in mature granulocytes and at least 30% of proteins in primary granules. Human defensins were reported to have antimicrobial, antifungal, antiviral and tumor lysis activities. Defensin mRNA was isolated using the differential display technique from the well-characterized all-trans retinoic acid (ATRA)-responsive acute promyelocytic leukemia cell line, NB4. The differential display analysis showed an up-regulation of defensin mRNA in NB4 cells after treatment with 10^- 7 M ATRA for 24 h. This expression was not seen in an NB4:R2 cell line, an ATRA-resistant subclone of NB4 cells. In order to investigate further the effects of this gene on our cellular model, we virally infected our cells with full-length defensin cDNA in the sense and antisense directions. Sense defensin induced cell growth arrest and cell death in both cell lines. While NB4 cells died within 48 - 73 h, NB4:R2 cells survived for 96 h before dying in culture. Phenotypic analysis showed high expression of Annexin V in sense-infected cells compared with antisense and uninfected cells in both cell lines. There was not a significant increase in CD11b expression in any of the 2 cell lines used. No cellular response was encountered in antisense-infected cells. Our data suggest that defensin is not only a reliable marker for granulocytic differentiation, but can also be considered a candidate target for molecular therapy in acute promyelocytic leukemia.