Objective: To detect and analyze the expression level of serum 25-hydroxyvitamin D [25(OH)D], periodontal clinical indicators and immunological indicators of rheumatism in patients with periodontitis and rheumatoid arthritis (RA), and to explore the correlation between 25(OH)D and the two diseases. Methods: This study was a case-control study. According to the inclusion criteria, patients from the Department of Stomatology and the Department of Rheumatology and Immunology and healthy volunteers from the Physical Examination Center were selected from November 2018 to May 2019 in Shengjing Hospital, China Medical University respectively. The patients were divided into 4 groups: 26 patients with simple periodontitis were included in the periodontitis group; 23 patients with RA were included in the RA group; 22 patients with RA and periodontitis simultaneously were included in the RA with periodontitis group; 22 healthy volunteers were included in the healthy control group, adding up to a total of 93 cases. The general information and periodontal clinical indexes of subjects in these 4 groups were recorded. Median elbow venous blood samples were collected from fasting subjects in each group, and 25(OH)D and immunoglobulin (Ig) were measured. The disease activity scores of RA patients were recorded and the rheumatic immune indexes were determinated. Pearson correlation analysis was performed between 25 (OH) D level and periodontal indexes in subjects of 4 groups. Results: The expression levels of rheumatoid factor [106.5(47.1, 283.8) kU/L] and C-reactive protein [20.5(13.1, 32.3) mg/L] in RA with periodontitis group were significantly higher than those in RA group [60.1(19.0, 110.0) kU/L, 14.7(3.0, 18.0) mg/L] (Z=-2.29, P=0.022; Z=-2.25, P=0.024). The levels of IgG and IgA in RA with periodontitis group [IgG and IgA: (16.0±4.3), (3.2± 1.3) g/L] as well as RA group [IgG and IgA: (16.3±5.5), (3.7±1.8) g/L] were significantly higher than those in healthy control group [IgG and IgA: (12.0±1.8), (2.3±0.6) g/L] and periodontitis group [IgG and IgA: (12.5±2.2), (2.0±0.7) g/L](P<0.05). The level of 25(OH)D in RA with periodontitis group [(26.0±9.8) nmol/L] was significantly lower than that in periodontitis group [(35.6±8.4) nmol/L] and RA group [(32.7±8.6) nmol/L] (P<0.05). The level of 25(OH)D was negatively correlated with sulcus bleeding index (r=-0.43, P=0.032) and clinical attachment loss (r=-0.41, P=0.043). Conclusions: Expression level of 25(OH)D was significantly decreased in patients with periodontitis and RA. There was a certain correlation between 25(OH)D and periodontitis and RA.
Arthritis, Rheumatoid/metabolism* ; Case-Control Studies ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Periodontitis ; Vitamin D/analogs & derivatives*

OBJECTIVES: Purpose of this study was to investigate physiological and neurocognitive effects of total sleep deprivation by using laboratory blood tests and the computerized neurocognitive function test in healthy subjects. METHODS: Sixteen healthy volunteers participated in this study. Subjects were recommended to remain awake for 48 hours under continuous surveillance. Lab tests of cortisol, prolactin, thyroid hormone, growth hormone, and immunoglobulin (IgG, IgA, IgM, IgD, IgE), CBC, BC and the Vienna test were performed before and after 48 hours of total sleep deprivation. RESULTS: Concentration of T3 and T4 significantly increased after deprivation. In the reaction test, distribution reaction time significantly increased, and correct reaction significantly decreased. In the vigilance test, amount of correct reaction significantly decreased, and the mean value of correct reaction time was significantly delayed. Level of fasting blood sugar, total protein, albumin, alkaline phosphatase and potassium significantly increased, respectively, except for the level of total bilirubin which was decreased. After total sleep deprivation, WBC counts significantly increased. Regarding immunoglobulin level, IgG, IgA and Ag M concentrations appeared to decrease, but the results were not statistically significant. CONCLUSION: The effect of total sleep deprivation on physiological function was significant in the level of thyroid hormone. Although statistically not significant, the results of growth hormone and the immune system showed a trend in relations to the effect of total sleep deprivation. Results of blood chemistry suggest that sleep deprivation may influence metabolism of hepatobiliary system. Cognitive impairment was also seen in reactive and vigilant functions after total sleep deprivation.
Alkaline Phosphatase ; Bilirubin ; Blood Glucose ; Chemistry ; Fasting ; Growth Hormone ; Healthy Volunteers ; Hematologic Tests ; Hydrocortisone ; Immune System ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Metabolism ; Potassium ; Prolactin ; Reaction Time ; Sleep Deprivation* ; Thyroid Gland

PURPOSE: In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children. METHODS: This study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test. RESULTS: Serum 25-hydroxyvitamin D levels were 19.0+/-8.5 ng/mL in the AR group, 25.5+/-10.9 ng/mL in the VR group, and 26.9+/-10.7 ng/mL in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases. CONCLUSION: This study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.
Body Mass Index ; Calcium ; Child* ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Homeostasis ; Humans ; Immunoglobulin E ; Immunoglobulins ; Metabolism ; Phosphorus ; Rhinitis ; Rhinitis, Vasomotor* ; Seasons ; Skin ; Vitamin D* ; Vitamins*

OBJECTIVETo investigate the changes of the levels of galectin-3 (Gal-3) in serum and bronchoalveolar lavage fluid (BALF) of children with asthma whose have different serum levels of 25-hydroxyl-vitamin D₃[25(OH)D₃].

METHODSFifty children with asthma between January 2013 and December 2014 were enrolled as the asthma group, and they were classified into 25(OH)D₃sufficient (n=7), insufficient (n=12) and deficient subgroups (n=31) according to the serum levels of 25(OH)D₃. Twenty children with abnormal airway or tracheal foreign bodies served as the control group. The levels of 25(OH)D₃, Gal-3 and total IgE in serum and Gal-3 levels in BALF were measured using ELISA.

RESULTThe serum levels of 25(OH)D₃in the asthma group were lower than in the control group (P<0.05). The 25(OH)D₃deficient subgroup displayed the highest percentages of neutrophils, eosinophils and epithelial cells in BALF, followed by the 25(OH)D₃insufficient subgroup and the 25(OH)D₃sufficient subgroup (P<0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF in the three subgroups were all higher than in the control group (P<0.05). In children with asthma, serum levels of 25(OH)D₃were negatively correlated with the percentages of neutrophils, eosinophils and epithelial cells in BALF (r=-0.683, -0.795 and -0.670 respectively; P<0.05); and a negative correlation was also seen between serum 25(OH)D₃levels and serum Gal-3 and total IgE levels (r=-0.759 and -0.875 respectively; P<0.05).

CONCLUSIONSThe children with asthma have low serum levels of 25(OH)D₃. 25(OH)D₃and Gal-3 may be involved in the airway inflammation and the development of asthma.

Asthma ; etiology ; metabolism ; Bronchoalveolar Lavage Fluid ; chemistry ; Child ; Child, Preschool ; Female ; Galectin 3 ; analysis ; blood ; physiology ; Humans ; Immunoglobulin E ; blood ; Infant ; Male ; Vitamin D ; analogs & derivatives ; blood ; physiology

BACKGROUND: Myelomatous pleural effusion (MPE) is rare in myeloma patients. We present a consecutive series of patients with MPE in a single institution. METHODS: We retrospectively reviewed the medical records of 19 patients diagnosed with MPE between 1989 and 2008 at the Asan Medical Center. Diagnoses were confirmed by cytologic identification of malignant plasma cells in the pleural fluid. RESULTS: Our patients showed dominance of IgA (36.8%) and IgD (31.6%) subtypes. Of 734 myeloma patients, the incidence of MPE was remarkably high for the IgD myeloma subtype (16.7%), compared to the other subtypes (1.4% for IgG and 4.6% for IgA). At the time of diagnosis of MPE, elevated serum beta2-microglobulin, anemia, elevated serum lactate dehydrogenase, and elevated creatinine levels were found in 100%, 89.5%, 83.3%, and 57.9% of the patients, respectively. Approximately one-third (31.3%) of the patients had adenosine deaminase (ADA) activities in their pleural fluid exceeding the upper limit of the reported cutoff values for tuberculous pleural effusion (55.8 U/L). Chromosome 13 abnormality was seen in 77.8% of the tested patients. The median survival period from the development of MPE was 2.8 months. CONCLUSIONS: Patients with MPE have aggressive clinical and laboratory characteristics. The preponderance of IgD myeloma in MPE patients is a noteworthy finding because IgD myeloma is a rare subtype. Elevated ADA activity in the pleural fluid is also noteworthy, and may be helpful for detecting MPE. Physicians treating myeloma patients should monitor the development of MPE and consider the possibility of a worse clinical course.
Adenosine Deaminase/metabolism ; Adult ; Aged ; Chromosomes, Human, Pair 13 ; Creatine/blood ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulin A/metabolism ; Immunoglobulin D/metabolism ; L-Lactate Dehydrogenase/blood ; Male ; Middle Aged ; Multiple Myeloma/diagnosis ; Plasma Cells/pathology ; Pleural Effusion, Malignant/*diagnosis/mortality/pathology ; Retrospective Studies ; Survival Rate ; beta 2-Microglobulin/blood

BACKGROUNDNR2B containing N-methyl-D-aspartate (NMDA) receptor plays an important role in the facilitation and maintenance of neuropathic pain. The discrete distribution of NR2B subunit in the central nervous system (CNS) may support reduced side effects of agents that act selectively at this site. Therefore, we investigated the hypothesis that a humoral autoimmune response targeting the NR2B subunit of NMDA receptor relieves pain like behaviours produced by peripheral injury.

METHODSRats were immunized subcutaneously with NR2B-Keyhole Limpet Hemocyanin (NR2B-KLH) three times at two-week intervals. NR2B specific IgG titres in sera and cerebrospinal fluid were determined by indirect ELISA. Seven days after the third immunization, 2 of the 3 terminal branches of the sciatic nerve (tibial and common peroneal nerves) were tightly ligated. Behavioural testing was carried out on every other day after surgery, until 7 days after surgery. The lumbar spinal cord (L4-6) was removed on day 7 after ligation. The expression of NR2B protein in the lumbar spinal cord was determined using Western blotting.

RESULTSAfter the second vaccination, NR2B specific IgG in sera was detected to be > 0.5 microg/ml in six of nine rats. After the third vaccination, all the immunized rats had > 2.2 microg/ml. Titres of NR2B specific IgG in sera peaked 42 days post initial immunization and persisted for over 70 days. No NR2B specific IgG was detected in sera from PBS or KLH group. The behavioural thresholds in NR2B group were significantly higher than those in PBS and KLH groups on day 7 after ligation. NR2B specific IgG in CSF in NR2B group could not be detected on day 1 before spinal dissection; but could be detected on day 7 after surgery. The expression of NR2B protein in group NR2B was significantly lower than in PBS and KLH groups on day 7 after surgery.

CONCLUSIONThe NR2B peptide could be used as a vaccine against neuropathic pain, which could be associated with reduction of NR2B protein in the lumbar spinal cord.

Adjuvants, Immunologic ; Animals ; Blotting, Western ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Female ; Hemocyanins ; immunology ; Immunoglobulin G ; immunology ; Neuralgia ; immunology ; physiopathology ; prevention & control ; Pain Measurement ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; immunology ; metabolism ; Recombinant Fusion Proteins ; administration & dosage ; immunology ; Spinal Cord ; drug effects ; metabolism ; physiopathology ; Time Factors ; Vaccines ; administration & dosage ; immunology

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent episodes of fever accompanied by peritonitis, pleuritis, arthritis, or erysipelas-like erythema. It is known to occur mainly among Mediterranean and Middle Eastern populations such as non-Ashkenazi Jews, Arabs, Turks, and Armenians. FMF is not familiar to clinicians beyond this area and diagnosing FMF can be challenging. We report a 22-yr old boy who presented with fever, arthalgia and abdominal pain. He had a history of recurrent episodes of fever associated with arthalgia which would subside spontaneously or by antipyretics. Autosomal recessive periodic fever syndromes were suspected. Immunoglobulin D (IgD) level in the serum was elevated and DNA analysis showed complex mutations (p.Glu148Gln, p.Pro369Ser, p.Arg408Gln) in the MEFV gene. 3D angio computed tomography showed total thrombosis of splenic vein with partial thrombosis of proximal superior mesenteric vein, main portal vein and intrahepatic both portal vein. This is a case of FMF associated with multiple venous thrombosis and elevated IgD level. When thrombosis is associated with elevated IgD, FMF should be suspected. This is the first adult case reported in Korea.
Abdominal Pain/etiology ; Arthralgia/etiology ; Cytoskeletal Proteins/genetics/metabolism ; Familial Mediterranean Fever/complications/*diagnosis ; Humans ; Immunoglobulin D/*blood ; Male ; Mesenteric Veins ; Mevalonate Kinase Deficiency/complications/*diagnosis ; Mutation ; Portal Vein ; Republic of Korea ; Splenic Vein ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis ; Young Adult