Altered immune response to glycine-rich sequences of epstein-barr nuclear antigen-1 in patients with rheumatoid arthritis and systemic lupus erythematosus

Epstein–Barr Virus (EBV) has been associated with development of rheumatic connective tissue diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in genetically susceptible individuals. Diagnosis of RA and SLE relies on clinical criteria in combination with the presence of characteristic autoantibodies. In addition, antibodies to several EBV antigens have been shown to be elevated in patients with these diseases compared to healthy controls (HC). Here, we elaborated improved enzyme-linked immunosorbent assays for antibodies (IgM, IgA, IgG) to the EBV proteins Epstein-Barr Virus nuclear antigen (EBNA)1 and early antigen diffuse (EAD) in order to determine their potential diagnostic role. We showed that especially EBNA1 IgM distinguished RA from SLE and HCs and also distinguished SLE from HCs. EBNA1 IgA was almost as effective in differentiating RA from SLE and HC, while EAD IgG and IgA were able to discern SLE patients from RA patients and HCs. Collectively, these findings illustrate the potential diagnostic use of antibodies to EBV proteins to diagnose RA and to differentiate SLE from RA.

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DEPRESI INDUCED STEROID: STUDI KASUS

Jurnal Penelitian Farmasi & Herbal ◽

10.36656/jpfh.v1i2.61 ◽

2019 ◽

Vol 1 (2) ◽

pp. 1-4

Author(s):

Saiful Batubara

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Immune Response ◽

Depressed Mood ◽

Lupus Erythematosus ◽

Natural Disturbance ◽

Systemic Lupus ◽

The Past ◽

Back Ground

Back Ground: Depression is a natural disturbance of feeling that is characterized by feelings of sadness, loss of interest and easily tired. Steroids are drugs that can reduce swelling, pain and heat due to inflammation through reducing the immune response. Steroids are often used in cases of systemic Lupus Erythematosus in the long term. Therefore management of the disease must be done well because steroids can cause depression. Case Report:Women, 37 years old, depressed mood, disappointment in life, loss of enthusiasm, fatigue, decreased appetite and difficulty sleeping for 1 year. 4 years ago I took steroids for 2 years at a dose of 20mg / day, because rheumatoid arthritis was stopped by os, and for the past 1 year, steroid consumption was due to Systemic Lupus Erythematosus around 60 mg / day. . Before the os consumes steroids, the OS has never experienced depression.BP: 110/70 mmHg , HR 88x/menit, RR 20x/menit, Temp 37°C. Skor BDI 21. Laboratorium Hb 11,8 g/dl, Leukosit 7500/mm3, trombosit 201.000/mm3,,Kalium 2,8, KGDad 99 mg/dlSGOT 29 ,SGPT32, Ureum 15,78 mg/dl, Creatinin 0,65 mg/dl. Tot Colesterol 198mg/dl, LDL 128 mg/dl, HDL 35 mg/dl Fototoraks : Jantung dan Parudalambatas normal, FotoLumbosakral : SpondilosisLumbalis. The patient is diagnosed with depression. Given psychotherapy, sandepril 2 x 25 mg for 3 months. Patients show clinical improvement marked by reduced sadness and can understand the disease. Conclusion :Steroid-induced depression has been reported after psychotherapy and sandepril 2 x 25 mg of the patient's condition showed improvement.

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