Publications

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2018
Ragab, G., W. Ruff, D. Pearson, H. Goubran, and M. Kriegel, "Antiphospholipid Syndrome", The Microbiome in Rheumatic Diseases and Infection: Springer, 2018.
Ragab, G., and H. Rizk, "Subacute Bacterial Endocarditis", The Microbiome in Rheumatic Diseases and Infection: Springer, 2018.
Ragab, G., C. Dehner, H. Hamza, and M. Kriegel, "Systemic Lupus Erythematosus", The Microbiome in Rheumatic Diseases and Infection: Springer, 2018.
Ragab, G., W. Ruff, D. Pearson, H. Goubran, and M. Kriegel, "Antiphospholipid Syndrome", The Microbiome in Rheumatic Diseases and Infection: Springer, pp. 305-321, 2018. Abstract
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Hegazy, M. T., W. R. Allam, M. A. Hussein, N. Zoheir, L. Quartuccio, S. F. El-Khamisy, and G. Ragab, "Increased genomic instability following treatment with direct acting anti-hepatitis C virus drugs", EBioMedicine, vol. 35: Elsevier, pp. 106-113, 2018. Abstract
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Ragab, G., P. T. Atkinson, and M. L. Stoll, The Microbiome in Rheumatic Diseases and Infection, : Springer, 2018. Abstract
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Cacoub, P., S. Pol, D. Thabut, C. Hezode, L. Alric, C. Comarmond, G. Ragab, L. Quatuccio, M. Hegazy, and T. Poynard, OP0235 Interferon-free antivirals for hepatitis c virus-associated cryoglobulinemia vasculitis: a long-term follow-up study, : BMJ Publishing Group Ltd, 2018. Abstract
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Ragab, G., and H. Rizk, "Subacute Bacterial Endocarditis", The Microbiome in Rheumatic Diseases and Infection: Springer, pp. 391-401, 2018. Abstract
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Ragab, G., C. Dehner, H. Hamza, and M. Kriegel, "Systemic Lupus Erythematosus", The Microbiome in Rheumatic Diseases and Infection: Springer, pp. 285-304, 2018. Abstract
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2017
Ramos-Casals, M., A. L. Zignego, C. Ferri, P. Brito-Zerón, S. Retamozo, M. Casato, P. Lamprecht, A. Mangia, D. Saadoun, A. G. Tzioufas, et al., "Evidence-based recommendations on the management of extrahepatic manifestations of chronic hepatitis C virus infection", Journal of Hepatology, vol. 66, no. 6: Elsevier {BV}, pp. 1282–1299, jun, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Hegab, M. M., A. F. Abdelwahab, J. M. Rudolph, A. M. El-Sayed Yousef, M. N. Salem, W. El-Baz, S. Abdelrhman, F. Elshabacy, A. Alhefny, W. Abouraya, et al., "Corrigendum to “CD28 and PTPN22 are associated with susceptibility to rheumatoid arthritis in Egyptians” [Hum. Immunol. 77 (2016) 522–526] (S0198885916300684), (10.1016/j.humimm.2016.04.018))", Human Immunology, vol. 78, issue 7-8: Elsevier Inc., pp. 521, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., M. Elshahaly, and T. Bardin, "Gout: An old disease in new perspective – A review", Journal of Advanced Research, vol. 8, issue 5: Elsevier B.V., pp. 495 - 511, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Group, G. E. O. - R. A., C. Ramos-Remus, A. Ramirez-Gomez, V. Brambila-Barba, A. Barajas-Ochoa, J. D. Castillo-Ortiz, A. O. Adebajo, L. R. Espinoza, F. J. Aceves-Avila, J. M. Sánchez-González, et al., "Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey", Clinical Rheumatology, vol. 36, issue 3: Springer London, pp. 485 - 497, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Elsevier Ltd, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Hussein, M., M. Ellawindi, and G. Ragab, "Performance of classification criteria for Behcet's disease in an Egyptian cohort", Indian Journal of Rheumatology, vol. 12, issue 3: Medknow Publications, pp. 152 - 155, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., and M. A. Hussein, "Vasculitic syndromes in hepatitis C virus: A review", Journal of Advanced Research, vol. 8, issue 2: Elsevier B.V., pp. 99 - 111, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis ScienceTransfusion and Apheresis Science, vol. 56, issue 3: Elsevier, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ

Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.

Al-Nahas, Z., M. Fawzy, manal el menyawi, O. Shaker, and G. Ragab, "25-hydroxyvitamin D3 deficiency and vitamin D receptor polymorphisms in Egyptian patients with Behçet’s disease: a pilot study", International Journal of Clinical Rheumatology, vol. 12, pp. 20-27, 2017. Abstract
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Cacoub, P., S. Nafa Si Ahmed, Y. Ferfar, S. N. Pol, D. Thabut, C. Hezode, L. Albric, C. Comarmond, G. Ragab, and L. Quartuccio, "All Oral Interferon-Free Antivirals for Hepatitis C Virus Cryoglobulinemia Vasculitis: A Long Term Follow up Multicenter International Study", ARTHRITIS & RHEUMATOLOGY, vol. 69: WILEY 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, 2017. Abstract
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Hegab, M. M., A. F. Abdelwahab, J. M. Rudolph, A. M. El-Sayed Yousef, M. N. Salem, W. El-Baz, S. Abdelrhman, F. Elshabacy, A. Alhefny, W. Abouraya, et al., "Corrigendum to ?CD28 and PTPN22 are associated with susceptibility to rheumatoid arthritis in Egyptians? [Hum. Immunol. 77 (2016) 522?526] (S0198885916300684), (10.1016/j.humimm.2016.04.018))", Human Immunology, vol. 78, no. 7-8, 2017. Abstract
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Hegab, M. M., A. F. Abdelwahab, J. M. Rudolph, A. E. - S. M. Yousef, M. N. Salem, W. El-Baz, S. Abdelrhman, F. Elshabacy, A. Alhefny, and W. Abouraya, "Corrigendum to" CD28 and PTPN22 are associated with susceptibility to rheumatoid arthritis in Egyptians"[Hum. Immunol. 77 (2016) 522-526]", Human immunology, vol. 78, issue 7-8, pp. 521, 2017. Abstract
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Ramos-Casals, M., A. L. Zignego, C. Ferri, P. Brito-Zeron, S. Retamozo, M. Casato, P. Lamprecht, A. Mangia, D. Saadoun, and A. G. Tzioufas, "Evidence-based recommendations on the management of extrahepatic manifestations of chronic hepatitis C virus infection", Journal of Hepatology, vol. 66, issue 6: Elsevier, pp. 1282-1299, 2017. Abstract
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Ragab, G., M. Elshahaly, and T. Bardin, "Gout: An old disease in new perspective–A review", Journal of advanced research, vol. 8, issue 5: Elsevier, pp. 495-511, 2017. Abstract
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, "Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey", Clinical rheumatology, vol. 36: Springer London, pp. 485-497, 2017. Abstract
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Pergamon, pp. 330-335, 2017. Abstract
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Ragab, G., H. El-Gendy, and R. M. El-Gohary, Musculoskeletal Disorders and Treatment, , 2017. Abstract
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Hussein, M. A., M. I. Ellawindi, and G. Ragab, "Performance of classification criteria for Behcet's disease in an Egyptian cohort", Indian Journal of Rheumatology, vol. 12, issue 3: Medknow Publications, pp. 152, 2017. Abstract
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Ragab, G., and M. A. Hussein, "Vasculitic syndromes in hepatitis C virus: A review", Journal of Advanced Research, vol. 8, no. 2, pp. 99 - 111, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., and M. A. Hussein, "Vasculitic syndromes in hepatitis C virus: A review", Journal of advanced research, vol. 8, issue 2: Elsevier, pp. 99-111, 2017. Abstract
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2016
El-Fishawy, H., G. Saadi, M. Hassaballa, M. Hussein, W. Doss, G. Ragab, and R. Barsoum, "Antiviral treatment prioritization in HCV-infected patients with extrahepatic manifestations - An Egyptian perspective.", Journal of advanced research, vol. 7, issue 3, pp. 391-402, 2016 May. Abstract

Egypt, the single country with highest incidence of HCV infection in the world, has embarked on a government-sponsored mass treatment program using several combinations of DAAs. Recognizing the importance of extrahepatic manifestations, independently of the hepatic, a subcommittee was assigned to develop national guidelines for respective prioritizing indications and protocols. It evaluated the benefit of treating patients with different extrahepatic manifestations, and reviewed relevant clinical trials and guidelines concerning DAA combinations available in Egypt. The latter included Sofosbuvir plus either peg-interferon, Simeprevir, Ledipasvir or daclatasvir, and the Viekera family comprising paritaprevir/ritonavir + ombitasvir with (GT-1) or without (GT-4) Dasabuvir. Any of these protocols may be used with or without Ribavirin according to indication. A blueprint was subjected to peer debate in dedicated workshops in two national meetings and subsequently to an online professional review, eventually leading to a final report that was adopted by the health authorities. Seven compelling and 10 optional indications were identified for treating patients with predominantly extrahepatic manifestations. The former include kidney disease at different stages, cryoglobulinemic vasculitis and non-Hodgkin lymphoma. Selected treatment protocols, were encoded and their use was prioritized on the basis of evidence of efficacy and safety. We concluded that any of the studied protocols may be used, preferably with ribavirin, for 12-week treatment in all patients with extrahepatic manifestations without cirrhosis and with eGFR above 30 ml/min/1.73 sqm. Ribavirin should be included in protocols for treating patients with compensated cirrhosis. Daclatasvir-based protocols are recommended for decompensated cirrhosis, while the Viekera family is recommended in patients with eGFR < 30 ml/min/1.73 sqm, including those on dialysis. In kidney-transplanted patents, caution is due to avoidance of the pharmacokinetic interaction with the Cytochrome-P450 enzyme system, in-between immunosuppressive agents and most DAAs, particularly the Viekera family.

Hegab, M. M., A. F. Abdelwahab, A. M. El-Sayed Yousef, M. N. Salem, W. El-Baz, S. Abdelrhman, F. Elshabacy, A. Alhefny, W. Abouraya, S. M. Ibrahim, et al., "CD28 and PTPN22 are associated with susceptibility to rheumatoid arthritis in Egyptians.", Human immunology, vol. 77, issue 6, pp. 522-6, 2016 Jun. Abstract

OBJECTIVE: Limited data are available on the genetics of rheumatoid arthritis (RA) in Egyptians. Therefore, we investigated whether the confirmed genetic risk factors for RA in Europeans and/or Asians contribute to RA susceptibility in Egyptians.

SUBJECTS AND METHODS: A set of seven single-nucleotide polymorphisms (SNPs) in the vicinity of CD28, TNFAIP3, PTPN22, PADI4 and HLA-DRA were tested in a large multi-centric RA cohort in Egypt, consisting of 394 cases and 398 matched controls. Patients were stratified based on the positivity of either anti-citrullinated protein antibodies (ACPAs) or rheumatoid factor (RF).

RESULTS: Significant association was evident for three SNPs in this cohort: the CD28 (rs1980422) variant showed a strong association in the whole cohort (P=0.000119) and in seropositive subsets of the disease (PACPA+=0.004; PRF+=0.0005). Upon stratification, the PTPN22 (rs2476601) and TNFAIP3(rs5029939) variants showed association only with ACPA positive (PACPA+=0.00573) and negative (PACPA-=0.00999) phenotypes, respectively.

CONCLUSION: Our results suggest that CD28(rs1980422) and PTPN22(rs2476601) contribute to RA-susceptibility in Egyptians. Failure to replicate the association of PADI4(rs2240340)/(PADI4_94) in Egyptian RA patients provides further support for the notion that genetic architecture of RA is different in multiple populations of European, Asian, African, and Middle Eastern ancestries. Further investigation using large-scale studies is thus needed to maximize the power of genetic association.

El-Gendy, H., R. M. El-Gohary, K. S. Shohdy, and G. Ragab, "Leprosy Masquerading as Systemic Rheumatic Diseases.", Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, vol. 22, issue 5, pp. 264-71, 2016 Aug. Abstract

Rheumatologic manifestations not only are encountered in leprosy but also can be the first and even the sole presenting manifestation. The hallmark of leprosy is skin and peripheral nerve affection; however, it can affect a wide range of other organs, with the joints being the commonest. We have searched PubMed with the key words leprosy, arthritis, vasculitis, rheumatic diseases, and autoantibodies in a proper combination. Relevant studies were retrieved from scanning of their abstracts. The relevant references provided in these articles were also selected and reviewed. We summarize the clinical and laboratory manifestations that make leprosy masquerade as a systemic rheumatic disease. Moreover, we report 4 Egyptian patients who presented with rheumatologic manifestations, namely, arthritis and vasculitis that turned out to be leprosy related.

Fawzy, M., A. Edrees, H. Okasha, A. El Ashmaui, and G. Ragab, "Gastrointestinal manifestations in systemic lupus erythematosus.", Lupus, 2016 Apr 6. Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by multisystem involvement, including the gastrointestinal (GI) tract. There is a significant variation in the clinical presentation and severity of GI disorders. When GI symptoms present as the initial manifestation of SLE, there is likely to be a delay in the diagnosis. The cause of these GI manifestations in SLE may be the disease, or the side effects of medications, or infections. In this study we investigated the GI manifestations in a group of SLE patients. Our study was conducted on 40 SLE patients and 30 healthy controls to assess the prevalence of GI symptoms in SLE patients. The prevalence of gastrointestinal manifestations in our study was 42.5%. GI manifestations in our SLE patients were: acute abdominal pain (due to pleurisy and peritonitis), 6%; diffuse abdominal pain, 23.5%; epigastric pain, 29%; epigastric pain with vomiting, 23.5%; epigastric pain with chronic constipation, 6%; chronic constipation, 6%; and diffuse abdominal pain with bleeding per rectum, 6%. In our study, we found a higher incidence ofGiardiainfestation in SLE patients than in healthy controls, and 10% of these patients were asymptomatic. There was moreGiardiainfestation in patients with GI symptoms as compared with patients with no GI symptoms, with aPvalue of 0.009. In our study SLE patients with GI symptoms had a peak systolic velocity (cm/s) with a mean of 108.4 ± 32.1 standard deviation (SD) in the celiac Doppler study. Patients without GI symptoms had a peak systolic velocity with a mean of 111.9 ± 37.7 SD, meaning that our patients mostly had no evidence of celiac trunk stenosis, but there was significant difference between SLE patients without GI symptoms and controls, as the mean was higher in SLE patients than in the controls. Also, the celiac end diastolic velocity was higher in both groups of SLE patients with GI symptoms and those without GI symptoms, compared to controls.

El-Fishawy, H., G. Saadi, M. Hassaballa, M. Hussein, W. Doss, G. Ragab, and R. Barsoum, "Antiviral treatment prioritization in HCV-infected patients with extrahepatic manifestations - An Egyptian perspective", Journal of Advanced Research, vol. 7, issue 3: Elsevier, pp. 391 - 402, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Hegab, M. M., A. F. Abdelwahab, A. M. El-Sayed Yousef, M. N. Salem, W. El-Baz, S. Abdelrhman, F. Elshabacy, A. Alhefny, W. Abouraya, S. M. Ibrahim, et al., "CD28 and PTPN22 are associated with susceptibility to rheumatoid arthritis in Egyptians", Human Immunology, vol. 77, issue 6: Elsevier Inc., pp. 522 - 526, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Fawzy, M., A. Edrees, H. Okasha, A. El Ashmaui, and G. Ragab, "Gastrointestinal manifestations in systemic lupus erythematosus", Lupus, vol. 25, issue 13: SAGE Publications Ltd, pp. 1456 - 1462, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Hamza, M. M. E., T. A. Macky, M. K. Sidky, G. Ragab, and M. M. Soliman, "Intravitreal infliximab in refractory uveitis in Behcet's disease: A safety and efficacy clinical study", Retina, vol. 36, issue 12: Lippincott Williams and Wilkins, pp. 2399 - 2408, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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