Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels.

BACKGROUND: Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. METHODS: Systematic reviews and meta-analyses were undertaken of national prevalence, mortality, and kernicterus due to Rh disease and EHB. We applied a compartmental model to estimate neonatal survivors and impairment cases for 2010. RESULTS: Twenty-four million (18% of 134 million live births ≥ 32 wk gestational age from 184 countries; uncertainty range: 23-26 million) were at risk for neonatal hyperbilirubinemia-related adverse outcomes. Of these, 480,700 (0.36%) had either Rh disease (373,300; uncertainty range: 271,800-477,500) or developed EHB from other causes (107,400; uncertainty range: 57,000-131,000), with a 24% risk for death (114,100; uncertainty range: 59,700-172,000), 13% for kernicterus (75,400), and 11% for stillbirths. Three-quarters of mortality occurred in sub-Saharan Africa and South Asia. Kernicterus with Rh disease ranged from 38, 28, 28, and 25/100,000 live births for Eastern Europe/Central Asian, sub-Saharan African, South Asian, and Latin American regions, respectively. More than 83% of survivors with kernicterus had one or more impairments. CONCLUSION: Failure to prevent Rh sensitization and manage neonatal hyperbilirubinemia results in 114,100 avoidable neonatal deaths and many children grow up with disabilities. Proven solutions remain underused, especially in low-income countries.

Evaluation of serum levels of interleukins 1-beta, 10 and 12 in patients with acne vulgaris.

INTRODUCTION: One of the most prevalent skin disorders is acne vulgaris. It is a distressing problem among young adults and adolescents. The pathophysiology of AV is significantly influenced by certain immune response cells. Acne's localized tissue inflammatory reactions are brought on by the bacteria Cutibacterium acnes, which also causes the release of several inflammatory mediators. AIM OF THE WORK: To measure the serum levels of IL-1 and IL-12, two pro-inflammatory cytokines, and IL-10, an anti-inflammatory cytokine, in AV patients and link those levels with the severity of the condition. RESULTS: This study included 19 males and 23 females with AV(n = 42), with mean age of 21.79 ± 3.5. The control group included 19 males and 23 female (n = 42) with mean age of 22.05 ± 3.3 (p = 0.729). Serum levels of IL-1ß was significantly higher in patients with AV as than controls (p < 0.001). Similarly, the serum levels of IL-12 were significantly higher in AV cases than controls (p < 0.001). On the contrary, the median IL-10 was significantly lower in AV cases than controls (p = 0.015). The correlation between serum levels of IL-1ß and IL-12 in AV patients and disease severity was insignificant (r = -0.04, p = 0.404) and (r = -0.19, p = 0.118, respectively). (r = -0.19, p = 0.118) On the contrary, there was a significant negative correlation between serum levels of IL-10 in AV patients and disease severity (r = -0.43, p = 0.003). CONCLUSION: Our results indicate significant alterations in the monocyte-derived cytokine (MDCs) profile in patients with AV, IL-1 and IL-12 serum levels rose while IL-10 levels fell, reflecting an increase in pro-inflammatory cytokines and a decrease in anti-inflammatory cytokines. These highlight the important role played by monocytes in the pathogenesis of AV.

Role of Lymphotoxin-α Gene Polymorphism in Hepatitis C Virus-Related Chronic Liver Disorders.

BACKGROUND: Tumor necrosis factor (TNF) family includes lymphotoxin-alpha (LTA) which is a pro-inflammatory cytokine which plays a role in hepatic fibrogenesis. LTA gene polymorphism plays a role in different inflammatory and immunomodulatory diseases. This polymorphism is also suggested to affect chronic hepatitis C (CHC) infection course. AIM: To study the contribution of LTA gene polymorphism in different chronic hepatitis C stages and hepatocellular carcinoma risk. PATIENTS AND METHODS: Our study included 108 chronic HCV patients grouped according to the disease stage. Group (A): CHC, group (B): liver cirrhosis (LC), group (C): LC with HCC, and group (D): healthy controls. Routine laboratory investigations, polymerase chain reaction (PCR) for quantification of HCV, abdominal ultrasonography, and Liver stiffness measurement (LSM) were done. Child-Turcotte-Pugh, Model for end-stage liver disease (MELD), and Fibrosis index based on 4 (FIB-4) scores were calculated. We used the PCR-restriction fragment length polymorphism technique for lymphotoxin-α genotyping. RESULTS: The A/G genotype was predominant in all groups. In HCC patients, G/G genotype was more frequent (31.8%) than in the LC group (19.4%), CHC group (17.8%), and controls (4.17%). A significant association was found between LTA genotypes and the child classes in HCC (P<0.01) but not in LC patients (P>0.05). HCC patients carrying A/G genotype had higher MELD scores than other genotypes. Multivariate binary logistic regression analysis confirmed that LTA G/G genotype and low platelet count were independent predictors for HCC development in patients with HCV-related LC. CONCLUSION: Detection of LTA G/G genotype in chronic HCV patients could help to recognize high-risk patients for disease progression and HCC development.

Evaluation of sTREM1 and suPAR Biomarkers as Diagnostic and Prognostic Predictors in Sepsis Patients.

BACKGROUND: The purpose of this study was to explore the diagnostic role of sTREM1 in the diagnosis of sepsis and in differentiating between sepsis and systemic inflammatory response syndrome (SIRS). We also aimed to assess the prognostic value of suPAR in comparison to sequential organ-failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE) II scores, and 28-day mortality. METHODS: This was a cross-sectional study conducted in the Medical Microbiology and Immunology Department and Central Research Laboratory, Faculty of Medicine, Sohag University from June 2019 to January 2021. The study population was classified into two groups: SIRS (no evidence of infection) and sepsis (with SIRS and evidence of infection). Patients were rated on the SOFA and APACHE II scoring systems at admission and after 7 days. Serum levels of sTREM1 and suPAR were measured by ELISA at the same time points. RESULTS: CRP and sTREM1 values were significantly higher in the sepsis group than the SIRS group on both days (P<0.0001). The area under the curve (AUC) for CRP was 0.87 on the first day and 0.97 on the seventh, while the AUC for sTREM1 was 1.00 and 0.93 on the first and seventh days, respectively. The sensitivity of sTREM1 was 100% and specificity 84% at a cutoff of 49 pg/mL. There was a significantly positive correlation between CRP and sTREM1 values (P<0.0001). On the seventh day, nonsurvivors had significantly higher serum levels of suPAR (median 4.9 ng/mL) than survivors (median 2.9 ng/mL; P<0.0001). Nonsurvivors also had significantly higher SOFA and APACHE II scores than survivors (P<0.0001 and P<0.0001, respectively). CONCLUSION: sTREM1 can be used as a good indicator for diagnosing sepsis in intensive care-unit patients. suPAR can also be used as a predictor of bad prognosis and poor survival at 7 days following admission.

Impact of High Serum Levels of MMP-7, MMP-9, TGF-ß and PDGF Macrophage Activation Markers on Severity of COVID-19 in Obese-Diabetic Patients.

OBJECTIVE: The aim of this study was to identify an association between the severity of COVID-19 in obese-diabetic patients and altered serum levels of MMP-7, MMP-9, TGF-ß, and PDGF macrophage activation markers. METHODOLOGY: The study included 70 COVID-19 patients, divided into two groups: Group 1 included: Obese COVID-19 patients with type 2 diabetes mellitus (T2D, n=22 patients) and group 2 included; non-obese, non-diabetic COVID-19 patients as an age- and sex-matched control group (n=48 patients). Serum levels of the tested biomarkers were measured by ELISA at admission and after one weak follow-up. RESULTS: There was a significant reduction in the serum levels of LBP in obese-diabetic COVID-19 patients versus the control group (8.34±3.94 vs 20.78±7.61) (p 0.0001). Significant elevation of MMP-7, MMP-9, PDGF and TGF-ß was detected in obese diabetic COVID-19 patients compared to the non-obese non-diabetic group: 1044.7±519.6 vs 405.6±164.1, 483.05±46.5 vs 173.31±76.26, 154.5±62.78 vs 39.77±21.52, and 603.05±258.82 vs 180.29±97.17, respectively. The serum levels of macrophage activation markers in obese-diabetic patients one week after admission revealed that patients with acute respiratory distress syndrome (ARDS) had significantly higher serum levels of MMP-7 and MMP-9 than non-ARDS patients (p 0.02 and p 0.01 respectively). CONCLUSION: Macrophages were mainly polarized towards the M2 phenotype in obese-diabetic COVID-19 patients with significant upregulation of the pro-fibrotic markers MMP-7, MMP-9, PDGF, and TGF-ß. Thus, high levels of MMP-7 and MMP-9 are associated with ARDS in severe COVID-19 disease among obese-diabetic patients.