الفهرس 
Serum Angiotensin IIOnly 14 pages are availabe for public view
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Abstract
I
n this study, we were concerned to assess the serum level of Ang II among a group of Egyptian children with pediatric SLE and JRA and its relationship with disease status and the different therapeutic modalities.
We conducted this study on 25 children with pediatric SLE and 25 children with JRA who are following at the Pediatric Allergy and Immunology Clinic, Children’s Hospital, Ain Shams University.
Clinical evaluation of SLE patients with assessment of the disease activity using SLEDAI was done. Renal involvement was assessed using renal BILAG score while SLE related organ damage was assessed using SDI. Similarly, clinical evaluation of JRA patients with assessment of the disease activity using DAS score was done. Articular and extra-articular JRA related damage assessment using JADI-A and JADI-E were done. Routine laboratory investigations including CBC, ESR, CRP for all patients and immunological markers (anti-dsDNA, C3, lupus anticoagulant and anticardiolipin Abs), kidney function tests (s.creatinine, creatinine clearance and 24 hours urinary proteins) and lipid profile (S.Chol, TG, HDL and LDL) for SLE patients and immunological markers (ANA and rheumatoid factor) for JRA patients were done. Serum Ang II was done for the studied pediatric SLE and JRA patients and age-matched healthy subjects without clinical manifestations or family history suggestive of autoimmune disorders.
The present study revealed that serum Ang II was significantly higher among patients with SLE and JRA as compared to the healthy subjects. However, serum Ang II was found comparable among patients with SLE and JRA.
Serum Ang II was not affected significantly by the age or the sex of subjects whether healthy subjects or the studied patients. Also, there was no significant correlation between serum Ang II and age at onset and duration of the disease either in SLE or JRA patients.
Serum Ang II did not vary significantly with renal BILAG score as well as renal function tests or between class III-IV and class II LN patients, or between hypertensive and normotensive LN among SLE patients. Similarly, serum Ang II did not vary significantly between systemic onset and polyarticular JRA among JRA patients.
In this series, serum Ang II did not affect significantly the activity indices in terms of SLEDAI among SLE patients as well as DAS among JRA patients.
Among the studied SLE patients, serum Ang II did not vary significantly with serum levels of the studied immunological markers (anti-dsDNA, C3, lupus anticoagulant and anticardiolipin antibodies) and the lipid profile including (S.Chol, TG, HDL and LDL).
In this series, serum Ang II was not significantly affected by the type or cumulative doses of steroids and immuno-suppressive drugs given to either SLE or JRA patients.
In conclusion, serum Ang II was significantly higher among patients with SLE and JRA than the healthy subjects. This supports the inflammatory role of Ang II in these chronic inflammatory diseases. Lack of significant effect of serum Ang II on disease activity and damage among SLE and JRA patients might support the role of local tissue Ang II rather than serum Ang II as the later could reflect enhanced RAS activity in these disorders. Further studies on a wider scale are needed to evaluate serum Ang II among patients with SLE and JRA and its link to intra-renal and intra-articular Ang II respectively for better understanding of its role in the etiopathogenesis of these diseases and hence the value of therapeutic Ang converting enzyme inhibitors (ACEIs) and Ang receptor blockers (ARBs) in these diseases in absence of hypertension.