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The effect of Tumor Necrosis Factor alpha inhibitor on wound healing of oral mucosa in induced diabetic rats
تأثير مثبطات ألفا نخر الورم على التئام الجروح في الغشاء المخاطي للفم في الفئران التي يسببها السكري

Authors: Farhad F. Fareed --- Rafah Al- Maroof
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 1 Pages: 1186-1198
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Impaired wound healing is a major complication of diabetes mellitus. This study was carried out to determine the healing process of oral mucosa in diabetic rats and the role of systemic tumor necrosis factor alpha inhibitor (infliximab). Methods: Thirty eight male rats were divided into two groups, the normoglycemic group (11 rats), and diabetic group (27 rats) that were rendered diabetic by alloxan injection. Two months later, wound was created in the lateral side of the tongue for both groups. The diabetic group was then subdivided into two subgroups, 14 rats received 5mg/kg infliximab subcutaneous injection at the day of wound creation while the other 13 rats received saline injection. After 7 days, biopsies of the tongue were collected and subjected to histological and histochemical procedure. Results: Histological examinations showed delayed healing in the diabetic group with persistence of epithelial discontinuity, large amount of granulation tissue and destruction of the underlying muscle fibers. In the subgroup injected with infliximab, reepitheliazation of the wound was demonstrated with well arranged underlying collagen fibers. Using PAS stain, diabetic group revealed a dramatically high amount of PAS positive precipitants in the lamina properia, especially in the wall of the blood vessels, while with infliximab injection, the PAS+ve precipitants were more prominent than normoglycemic group but less than diabetic group without infliximab. Conclusion: These findings suggest that infliximab accelerated mucosal wound healing in the diabetic rats with the formation of well organized connective tissue.

Keywords

Diabetes --- infliximab --- wound healing


Article
Effects of infliximab local injection on orthodontic tooth movement in diabetic rabbits: A histological study
آثار الحقن الموضعي إينفليإكسيمب على حركة تقويم الأسنان في الأرانب المصابة بالسكري: دراسة نسيجية

Authors: Fadhil Y. Jasim --- Rafah M. Al-Maroof --- Anees M. Mudhir
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 2 Pages: 1337-1348
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Orthodontic tooth movement is mediated by tumor necrosis factor –α through activation of osteoclasts. Type 1 diabetes mellitus is characterized by a change in the bone remodeling and affects orthodontic treatment. This study aimed to investigate the effects of infliximab local injection on orthodontic movement in the diabetic rabbit. Methods: Sixty six rabbits were divided equally into three groups; two groups were rendered diabetic using alloxan injection, while the third group was regarded as a normoglycemic group. Only one of the diabetic groups received insulin treatment. All rabbits were subjected to orthodontic tooth movement of upper central incisor for 18 days, half of each group received infliximab subperiosteal injection, while the remaining number received saline injection. After sacrifice, tissue samples were subjected to histological preparation and histomorphometric analysis. Results: Insulin treated group revealed less prominent destruction of the periodontium when compared with the untreated group. The histological pictures of infliximab injected groups demonstrated less bone resorption in pressure side and more bone formation in tension side. There was a significantly smaller number of osteoclast with less compression in the width of the periodontal ligament in the tension side with infliximab injection. Conclusion: Infliximab local injection hindered bone resorption in the diabetic state during orthodontic tooth movement.


Article
THE EFFECT OF TUMOR NECROTIC FACTOR ALPHA POLYMORPHISM ON RESPONSE TO BIOLOGICAL TREATMENT FOR RHEUMATOID ARTHRITIS PATIENTS

Authors: Sadeq k. Hachim صادق كاظم حاجم --- Ahmed A. Abbas احمد عبد الحسن عباس --- , Mohammed H. Alosami محمد هادي العصامي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 3 Pages: 220-226
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: The tumor necrotic factor alpha (TNF-α) was associated with rheumatoid arthritis (RA) pathogenesis and inflammation of joint, for this consider important target for drugs (TNF inhibitors) as for example infliximab.Objective: To investigate the role of TNF-α-308 polymorphism G>A in unresponsiveness to biological treatment (infliximab) in RA patients.Methods: This study included 29 RA patients treated with infliximab attending Department of Rheumatology in Baghdad Teaching Hospital and diagnosed according to American College of Rheumatology (ACR) with 30 persons as healthy controls. The age range was 20 to 68 years. The DAS28 was calculated for each RA patients. Blood samples were taken from them during the period from May 2014 to January 2015. The blood samples were tested by polymerase chain reaction (PCR) for TNF-α-308 G>A then by restriction fragment length polymorphism (RFLP) for A allele and G allele. HLA-DR genotyping by PCR-SSO.Results: The frequency of A allele was 23 (39.7%) in RA patients while G allele was 35 (60.3%) in RA patients, whereas in in controls A and G alleles frequencies were 5 (8.3%) and 55 (91.7%) respectively. The A allele was associated with high DAS28 19 (82.6% while for G allele was 1 (2.9%) and DAS28 showing significant association with TNF-α-308 polymorphism G>A. The distribution of A allele in female RA patients was 16 (36%) whereas G allele was 28(64%), while in male RA patients, A and G allele were 7 (50%) for each of them. The HLA-DRB1 not showing significant association with TNF-α-308 polymorphism G>A.Conclusion: The TNF-α-308 polymorphism G>A has effect on response to biological treatment (infliximab). The A allele of TNF-α was associated with unresponsiveness to infliximab and RA patients who carry this allele have high DAS28 score. The HLA-DRB1 not showing association with TNF-α-308 polymorphism G>A.Keywords: RA, TNF-α polymorphism, infliximab, HLA-DR.Citation: Hachim Sk, Abbas AA, Alosami MH. The Effect of tumor necrotic factor alpha polymorphism on response to biological treatment for rheumatoid arthritis patients. Iraqi JMS. 2017; Vol. 15(3): 220-226. doi: 10.22578/IJMS.15.3.2

Keywords

RA --- TNF-α polymorphism --- infliximab --- HLA-DR


Article
Development of Anti-bodies against Infliximab in Iraqi Patients with Rheumatoid Arthritis.
تكون الاجسام المضادة ضد عقارإينفليكسيماب في المرضى العراقيين المصابين بالتهابالمفاصل الرثوي

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Abstract

Background: Rheumatoid arthritis is a common chronic and destructive autoimmune arthropathy .Treatment with infliximab gives great improvement to a large numbers of patients with RA ,however, in some patients after prolonged treatment infliximab can induce anti-infliximab antibodies formation and result to loss of infliximab efficacy and active persistent disease.Objective: to investigate the frequency of anti-infliximab antibodies in Iraqi patients with rheumatoid arthritis . Patients and methods: fifty Iraqi RA patients(36 females and 14 males) compared with 50 control( 25 healthy control and 25 case control (patients with RA on other treatment) ) were included in this study from begging of March 2014 till end of September 2014.All patients were diagnosed by full history, complete clinical examination and laboratory test. Anti-infliximab antibodies were meatured using enzyme-linked immunosorbent assay in serum of Iraqi patients with RA treated with infliximab more than 3 months duration. Results: Antibodies to infliximab were detected in 35(70%) Iraqi RA patients , while the patients without detectable antibodies against infliximab were 15(30%),also there were no anti-infliximab antibodies in the control groups.Conclusion: In this study, nearly three quarter of the Iraqi RA patients treated with infliximab developed anti-infliximab antibodies.Key words: rheumatoid arthritis, infliximab, anti-infliximab antibodies

الخلفية : التهاب المفاصل الرثوي هو مرض مناعي شائع ومزمن ومدمرللمفاصل,العلاج بعقار إينفليإكسيمب يعطي تحسنا كبيرا لأعداد كبيرة من المرضى الذين يعانون من التهاب المفاصل الرثوي ، ولكن في بعض المرضى بعد العلاج لفترات طويلة بالإينفليكسيمب يمكن أن تحفز تكوين الأجسام المضادة المقاومةللإينفليكسيمب و يؤدي إلى فقدان فعالية إينفليكسيمب و استمرار المرض النشط.الهدف : التحققفي وجودالاجسام المضادةلعقارالإينفليكسيمب في المرضى العراقيين المصابين بالتهاب المفاصل الرثوي .المرضى و الطرق: لقد شملت هذه الدراسة خمسين مريض عراقي(14ذكور و36 اناث) مصابينبالتهاب المفاصل الرثوي و 50 مجموعة مقارنة ( 25 اشخاص اصحاء و 25 حالة مرضية ( هم المرضى الذين يعانون من التهاب المفاصل الرثويويستخدمون علاجات اخرى) )تم اجراء هذه الدراسة في مستشفى بغداد التعليمي(وحدة العلاج البايولوجي)للفترة من بداية شهر اذار2014 الى نهاية شهر تشرين الاول2014, في هذه الدراسة تم تشخيص جميع هؤلاء المرضى من خلال التاريخ المرضي الكامل والفحص السريري الكامل و الفحص المختبري . تم قياس أضداد إينفليإكسيمب باستخدام تقنية(ELISA) في مصل الدم من المرضى العراقيين المصابين بالتهاب المفاصل الرثوي والذين يتعالجون بالاإينفليإكسيمبلمدةأكثر من 3 أشهر .النتائج : تم الكشف عن وجودالأجسام المضادةللإينفليإكسيمب في 35( 70 ٪) منالمرضى العراقيين المصابين بالتهاب المفاصل الرثوي.اماالمرضى الذين لم تسجل لديهم اجسام مضادة ضد إينفليإكسيمب كانت نسبتهم15 ( 30 ٪ ),ولم تسجل اي اجسام مضادة للعقار في مجموعه المقارنه.الاستنتاج: في هذه الدراسة ، ما يقرب من ثلاثة أرباع المرضى العراقيين المصابينبالتهاب المفاصل الرثويوالذين يتعالجون بعقار إينفليإكسيمب تتكون لديهم اجسام مضادةللإينفليإكسيمب .مفتاح الكلمات:التهابالمفاصل الرثوي، إينفليإكسيمب، أضداد إينفليإكسيمب

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