Circulating redox status in sheep naturally infected with Trichophyton verrucosum.

Trichophyton verrucosum is a zoophilic dermatophyte that causes skin inflammation. The present study aimed to evaluate the redox status in the blood of sheep clinically infected with T. verrucosum. According to clinical and mycological investigations, 48 juvenile male Balady sheep were selected in their natural habitat and divided into four groups depending on the lesion size: mild (MID), moderate (MOD), severe (SEV) T. verrucosum infection, and healthy control groups. Compared to the controls, plasma superoxide anion increased (P < 0.05) in both MOD and SEV but total peroxides (TPx) gradually increased (P < 0.05) in MID followed by MOD and SEV. Superoxide dismutase and total antioxidant capacity (TAC) were higher (P < 0.05) in MID and lower (P < 0.05) in MOD and SEV than in controls, but SEV showed lower TAC than MOD. Malondialdehyde (MDA, a lipid peroxide marker) increased (P < 0.05) in SEV than in controls, but protein carbonyl (PC, a protein peroxidation marker) was augmented (P < 0.05) as lesions progressed from mild to severe. The oxidative stress index (TPx/TAC ratio) progressively increased (P < 0.05) in MOD and SEV. The correlation of PC was positive with TPx and negative with TAC (P < 0.01). In conclusion, sheep infection with T. verrucosum is characterized by increased TPx and decreased TAC in plasma depending on the lesion area. The redox status is shifted towards the oxidizing state, particularly in MOD and SEV cases. This results in a condition of OS, which may contribute to the pathogenesis of the disease.

Systemic corticosteroids in the treatment of warm autoimmune hemolytic anemia: A clinical setting perspective.

INTRODUCTION: There are unmet answers about the effect of the different forms of corticosteroids in the treatment of the warm autoimmune hemolytic anemia (WAIHA). We aimed to describe the initial response rate and the safety profile of different regimens and forms of parenteral corticosteroids versus the solo oral prednisolone as first-line strategies for newly diagnosed adult WAIHA. METHODS: We recruited 156 patients who treated with either oral prednisolone 1 mg/kg daily for 3 weeks or intravenous corticosteroids like dexamethasone 40 mg daily for 4 days, Methylprednisolone 1 g/day for 3 days, or Methylprednisolone 1 g/day for 5 days then followed by oral prednisolone 1 mg/kg/day for 3 weeks. Full clinical and laboratory evaluations were done every 3 days for 3 weeks. RESULTS: The primary outcome was the rate of response at the end of the third-week post treatment. The rate of response was more in the group started the treatment intravenously (81.6% versus 41.7% and p = 0.0001). Multivariate cox regression analysis proved the predictivity of intravenous corticosteroid therapy for initial response. CONCLUSION: The safety profile of the different forms and regimens of corticosteroids were comparable. Therefore, parenteral regimens can be used as a rescue treatment in severe cases of WAIHA.

Circulating oxidative stress status in Bedouin she-camels (Camelus dromedarius) during the peripartum period.

This study aimed to assess the oxidative stress status in blood plasma of nomadic she-camels (Camelus dromedarius) during transition from late pregnancy to early lactation. From 12 late pregnant she-camels, blood was sampled weekly as they progressed from the third week prepartum up to the third week postpartum. Levels of albumin, uric acid, and malondialdehyde (a biomarker of lipid peroxidation) concentrations were fairly constant (P > 0.05) throughout the sampling times. Compared to the initial time (third week prepartum), values of the superoxide anion, total peroxides, and protein carbonyl (a biomarker of protein peroxidation) increased (P < 0.05) by more than 67%, 43%, and 23%, respectively, at parturition and this increase extended to the first week postpartum. Ascorbic acid concentration lost more than 20% (P < 0.05) of its value at parturition. Bilirubin value increased as camels progressed from the first week pre- up to the first week postpartum, and reached its maximum value (~ 2.5 fold) at parturition. Superoxide dismutase activity increased (P < 0.05) by 71.7% at the first week pretpartum and by 57% at parturition. Total antioxidant capacity level increased (P < 0.05) by ~ 25% at the first week prepartum and remained at this high level up to the second week postpartum. It seems that periparturient camels experience a substantial oxidative stress particularly at parturition and the week after calving as indicated by the increased peroxidative by-products of proteins in parallel to the enhanced production of pro-oxidants.

The impact of cytokine gene polymorphisms on the outcome of HLA matched sibling hematopoietic stem cell transplantation.

Graft-versus-host disease (GVHD) is the major complication of allogeneic hematopoietic stem cell transplantation (HSCT); cytokines are recognized as important mediators in its pathogenesis. In this study we investigated the role of cytokine gene polymorphisms on HSCT outcome. A total of 106 patient and 98 donors were genotyped by polymerase chain reaction sequence specific primers (PCR-SSP) based assay for tumor necrosis factor-α-308 (TNFα -308), interleukin (IL)-6-174, IL-10-1082, -819, -592, Interferon-γ+874 (IFN-γ+874), and transforming growth factor-ß1 (TGF-ß1) codon10 and 25 polymorphisms. Except one in each category, all patients and donors were TNFα -308 high producers and the majority were IL-6-174 high producers (93.3% and 90.8% respectively); a pattern that would alleviate any potential biological impact. Patient's IFN-γ+874 showed significant association with the development of chronic GVHD. Patients with IFN-γ +874 high producer showed an 8 folds likelihood to develop chronic GVHD as compared to those with IFN-γ+874 low producer predicted phenotype (95% CI: 1.59-40.2, p = 0.01). Patient's TGFß1-codon 10 and 25 high/intermediate producers showed a lower incidence of acute GVHD though it did not achieve statistical significance (p = 0.065) on account of the low frequency of this genotype in our patients and donors (11.4 and 8.2% respectively). Other factors contributing to risk of GVHD included older age for both acute and chronic (p = 0.01 and 0.02 respectively) with age 24 as the best discriminating cutoff; CD34+ cell dose for chronic GVHD (p = 0.045) with a dose of 8 × 106/kg as the best discriminating cutoff; and conditioning regimen with Flu/Bu associated with the lowest incidence of acute GVHD (p = 0.003) and no impact on chronic GVHD. In conclusion the current study further indicates a potential role of some cytokine gene polymorphisms in the development of GVHD. The relative distribution of high and low producer genotypes in different ethnic groups contributes to their biological impact in different populations.

Mitogenomic analysis of Rüppell's fox (Vulpes rueppellii) confirms phylogenetic placement within the Palaearctic clade shared with its sister species, the red fox (Vulpes vulpes).

The Rüppell's fox (Vulpes rueppellii) inhabits desert regions across North Africa, the Arabian Peninsula and southwestern Asia. Its phylogenetic relationship with other fox species, especially within the phylogeographic context of its sister species, V. vulpes, remain unclear. We here report the sequencing and de-novo assembly of the first annotated mitogenome of V. rueppellii, analysed with data from other foxes (tribe Vulpini, subfamily Caninae). We used four bioinformatic approaches to reconstruct the V. rueppellii mitogenome, obtaining identical sequences except for the incompletely assembled tandem-repeat region within the D-loop. The mitogenome displayed an identical organization, number and length of genes as V. vulpes. We found high support for clustering of both known subclades of V. rueppellii within the Palearctic clade of V. vulpes, rendering the latter species paraphyletic, consistent with previous analyses of shorter mtDNA fragments. More work is needed for a full understanding of the evolutionary drivers and consequences of hybridization in foxes.

Improved long-term survival rate in the responders to bortezomib, cyclophosphamide, dexamethasone induction therapy in a transplant-eligible cohort of predominantly middle-age multiple myeloma patients.

BACKGROUND: Multiple myeloma (MM) represents the second most common hematologic malignancy (15%). Induction with bortezomib, cyclophosphamide, and dexamthasone VCd (d: low dose dexamthasone) regimen is widely used due to its high effectiveness, low toxicity and good tolerability, particularly with renal impairment. Real-world data on the use of VCD in clinical practice is lacking. OBJECTIVES: Evaluate the real-world experience of the VCD regimen. DESIGN: Retrospective. SETTING: Tumor registry database of tertiary cancer care center. PATIENTS AND METHODS: newly diagnosed MM patients who received VCD induction and underwent autologous stem cell transplant (ASCT) from July 2007 to July 2020. MAIN OUTCOME MEASURES: response evaluation, progression-free survival (PFS) and overall survival (OS). SAMPLE SIZE: 87 patients. RESULTS: Of 102 patients who started induction with VCd, 87 patients experienced a partial response or more overall response rate of 85%). The median age of these 87 patients at diagnosis was 52 years, of which 29.9% presented with renal impairment and 60.3% of patients had stage 2 by the Revised International Staging System (R-ISS). Patients with a standard cytogenetic risk achieved a better response compared to those with a poor cytogenetic risk (P=.044). The post-induction response rates were 6.9% stringent complete remission (sCR), 35% complete remission (CR); 41.4% very good partial response (VGPR), and 16.1% partial response (PR), respectively; the response rates became greater for sCR and CR post-transplantation at day 100 with 16.1% sCR, 35.6% CR, 32.2% VGPR and 16.1% PR, respectively. The median PFS was 49 months and 5 years OS was 84%. PFS was better in patients who achieved sCR vs PR (83 vs 35 months, P=.037). High LDH, high-risk cytogenetic and stage 3 R-ISS showed a worse median PFS and OS. CONCLUSIONS: VCD induction in newly diagnosed MM is highly effective, convenient, tolerable and affordable regimen, especially in low and middle-income countries with limited resources, also with favorable outcomes and survival. while those who did not respond successfully shifted to VRD or VTD. LIMITATIONS: The usual limitations of a retrospective analysis using registry-level data, no data on quality of life.

Challenges and opportunities for Arabic question-answering systems: current techniques and future directions.

Artificial intelligence-based question-answering (QA) systems can expedite the performance of various tasks. These systems either read passages and answer questions given in natural languages or if a question is given, they extract the most accurate answer from documents retrieved from the internet. Arabic is spoken by Arabs and Muslims and is located in the middle of the Arab world, which encompasses the Middle East and North Africa. It is difficult to use natural language processing techniques to process modern Arabic owing to the language's complex morphology, orthographic ambiguity, regional variations in spoken Arabic, and limited linguistic and technological resources. Only a few Arabic QA experiments and systems have been designed on small datasets, some of which are yet to be made available. Although several reviews of Arabic QA studies have been conducted, the number of studies covered has been limited and recent trends have not been included. To the best of our knowledge, only two systematic reviews focused on Arabic QA have been published to date. One covered only 26 primary studies without considering recent techniques, while the other covered only nine studies conducted for Holy Qur'an QA systems. Here, the included studies were analyzed in terms of the datasets used, domains covered, types of Arabic questions asked, information retrieved, the mechanism used to extract answers, and the techniques used. Based on the results of the analysis, several limitations, concerns, and recommendations for future research were identified. Additionally, a novel taxonomy was developed to categorize the techniques used based on the domains and approaches of the QA system.

Red cell distribution width is an inflammatory predictor marker of contrast induced nephropathy in patients undergoing percutaneous coronary intervention.

Red blood cell distribution width (RDW) is an inflammatory biomarker reported in complete blood cell (CBC) counts. High RDW defines a proinflammatory state. Contrast-induced nephropathy (CIN) is an important and common complication in percutaneous coronary intervention (PCI) treated patients. The current study was conducted to evaluate the role of RDW as a simple predictive inflammatory marker of CIN in PCI treated patients. The current prospective study enrolled 126 PCI treated patients. Laboratory investigations included CBC, liver function test, (HbA1C), lipid profile and serological tests. Serum urea and creatinine levels were obtained at baseline and 48 to 72 hours after PCI procedure, used to categorize for CIN. Diabetes mellitus, hypertension, and ischemic heart disease were present in 39 (31%), 44 (34.9%), and 23 (18.3%) patients, respectively. Of the studied patients, only 19 (15.1%) patients developed CIN. The hemoglobin level was significantly higher in the non-CIN group (13.49 ± 1.63 vs. CIN group 12.56 ± 1.62 mg/dl; p= 0.02). RDW was significantly higher among CIN group than non-CIN group (16.20 ± 2.60 vs. 13.83 ± 2.19 % (p < 0.001). Delta creatinine (% change in creatinine level after 48 hour) was significantly higher in patients with CIN (59.17 ± 28.89 vs. non-CIN 33.62 ± 9.76; p < 0.001). Predictors for CIN in patients who underwent PCI were old age high RDW high delta creatinine and amount of dye. At cut off > 14.5%, RDW had 79% sensitivity, 70% specificity and 71.3% overall accuracy at AUC of 0.76. In conclusion, RDW may be simple and immediately available inflammatory biomarker and predictor for development of CIN in patients undergoing PCI.

Endemic or regionally limited bacterial and viral infections in haematopoietic stem-cell transplantation recipients: a Worldwide Network for Blood and Marrow Transplantation (WBMT) Review.

Literature discussing endemic and regionally limited infections in recipients of haematopoietic stem-cell transplantation (HSCT) outside western Europe and North America is scarce. This Worldwide Network for Blood and Marrow Transplantation (WBMT) article is part one of two papers aiming to provide guidance to transplantation centres around the globe regarding infection prevention and treatment, and considerations for transplantation based on current evidence and expert opinion. These recommendations were initially formulated by a core writing team from the WBMT and subsequently underwent multiple revisions by infectious disease experts and HSCT experts. In this paper, we summarise the data and provide recommendations on several endemic and regionally limited viral and bacterial infections, many of which are listed by WHO as neglected tropical diseases, including Dengue, Zika, yellow fever, chikungunya, rabies, brucellosis, melioidosis, and leptospirosis.

Endemic or regionally limited parasitic and fungal infections in haematopoietic stem-cell transplantation recipients: a Worldwide Network for Blood and Marrow Transplantation (WBMT) Review.

There is a scarcity of data on endemic and regionally limited fungal and parasitic infections in recipients of haematopoietic stem-cell transplantation (HSCT) outside western Europe and North America. This Worldwide Network for Blood and Marrow Transplantation (WBMT) Review is one of two papers aiming to provide guidance to transplantation centres worldwide regarding prevention, diagnosis, and treatment based on the currently available evidence and expert opinion. These recommendations were created and reviewed by physicians with expertise in HSCT or infectious disease, representing several infectious disease and HSCT groups and societies. In this paper, we review the literature on several endemic and regionally limited parasitic and fungal infections, some of which are listed as neglected tropical diseases by WHO, including visceral leishmaniasis, Chagas disease, strongyloidiasis, malaria, schistosomiasis, histoplasmosis, blastomycosis, and coccidioidomycosis.

Recent Advances in Diagnosis and Therapy of Angioimmunoblastic T Cell Lymphoma.

Angioimmunoblastic T cell lymphoma (AITL) is a common subtype of mature peripheral T cell lymphoma (PTCL). As per the 2016 World Health Organization classification, AITL is now considered as a subtype of nodal T cell lymphoma with follicular helper T cells. The diagnosis is challenging and requires a constellation of clinical, laboratory and histopathological findings. Significant progress in the molecular pathophysiology of AITL has been achieved in the past two decades. Characteristic genomic features have been recognized that could provide a potential platform for better diagnosis and future prognostic models. Frontline therapy for AITL was mainly depending on chemotherapy and the management of relapsed or refractory AITL is still unsatisfactory with a very poor prognosis. Upfront transplantation offers better survival. Novel agents have been introduced recently with promising outcomes. Several clinical trials of combinations using novel agents are underway. Herein, we briefly review recent advances in AITL diagnosis and the evolving treatment landscape.

Revisiting Autoimmunity in Chronic Lymphocytic Leukemia: Prognostic Value of Positive Direct Antiglobulin Test in a Retrospective Study and Literature Review.

INTRODUCTION: A positive direct antiglobulin test (DAT) with or without autoimmune hemolytic anemia is a frequent finding in chronic lymphocytic leukemia (CLL). The heterogenic clinical course of CLL mainly depends on different pathogenetic mechanisms which appears in a form of variable biological and clinical features. These features allow stratification of patients into subsets with different outcomes. PATIENTS AND METHODS: We evaluated the DAT as a prognostic marker in 120 CLL patients treated with chemoimmunotherapy. Clinical and laboratory features, treatment response, and survival outcomes of CLL patients were assessed in relation to their DAT test status. Additionally, the English literature was extensively reviewed regarding the prognostic impact of a positive DAT in CLL. RESULTS: DAT positivity was detected in 36 patients (30%) and was associated advanced disease staging (P = 0.03). No correlations were found with other clinical, laboratory, or biological factors such as ZAP-70 or CD38. Both a positive DAT and an Eastern Cooperative Oncology Group performance status >2 were predictors for non-response to first-line treatment in the multivariate analysis (OR = 0.3, 95% CI: 0.12-0.8 and OR = 0.2, 95% CI: 0.08-0.8, respectively). The five-year progression-free survival was significantly lower in the DAT-positive group (P = 0.004). No significant association was found with overall survival (P = 0.2). Sixteen reports analyzing more than 11,000 patients were identified in our review. CONCLUSION: In conclusion, DAT positivity in CLL patients is associated with poor response to treatment and disease progression.

Ketorolac-fluconazole: A New Combination Reverting Resistance in Candida albicans from Acute Myeloid Leukemia Patients on Induction Chemotherapy: In vitro Study.

BACKGROUND AND OBJECTIVES: Candida albicans is a significant source of morbidity and mortality for patients with acute myeloid leukemia (AML). Prolonged use of fluconazole as empirical antifungal prophylaxis in AML patients leads to overexpression of efflux pump genes that resulted in the emergence of azole-resistant species. Consequently, the introduction of a new strategy to improve the management of C. albicans infections is an urgent need. Nonsteroidal anti-inflammatory drug (NSAID) ketorolac is associated with a reduction in cancer relapses. The present study was performed to investigate the use of ketorolac-fluconazole combination to reverse fluconazole resistance in C. albicans isolated from AML patients on induction chemotherapy. PATIENTS AND METHODS: One hundred and seventy AML patients were evaluated. Fifty C. albicans were isolated and subjected to disc diffusion assay and broth microdilution for fluconazole alone and combined with different concentrations of ketorolac. Efflux pump gene (CDR1, CDR2, and MDR1) expressions were quantified by real-time PCR. RESULTS: The tested ketorolac acted synergistically with fluconazole against resistant C. albicans with the minimum inhibitory concentration (MIC) of fluconazole decreased from >160 µg/mL to 0.3-1.25 µg/mL in (93.8%) of resistant isolates with fractional inhibitory concentration index (FICI) value of 0.25. The majority of the resistant isolates overexpressed CDR1 (71.1%) and MDR1 (60%). CONCLUSION: Ketorolac-fluconazole in vitro combination would be a promising strategy for further clinical in vivo trials to overcome fluconazole resistance in AML patients on induction chemotherapy.

Oxidative stress in blood of camels (Camelus dromedaries) naturally infected with Trypanosoma evansi.

Oxidant stress is an imbalance between radical-generating and radical-scavenging activity, resulting in oxidation products and tissue damage. The present study aimed to estimate oxidation and antioxidant status in blood of camels naturally infected with Trypanosoma evansi. Blood samples from T. evansi-infected and healthy (control) female camels were used to determine the free radical nitric oxide (NO) generation in serum, malondialdehyde production in serum (sMDA) and erythrocyte (eMDA) as a biomarker of lipid peroxidation, blood methemoglobin formation (MetHb, a biomarker of hemoglobin oxidation), the antioxidants serum ascorbate and albumin levels, erythrocytic glutathione concentration (GSH), superoxide dismutase (SOD) and catalase (CAT) activities. The infected camels were characterized by macrocytic hypochromic anemia. Trypanosomiasis in camels resulted in significant (P<0.001) stimulation of serum NO (78.93%), eMDA (110.04%), sMDA (67.39%) and MetHb (1.5-fold) coupled with significant reduction (P<0.001) of albumin (27.6%), ascorbate (25.38%), GSH (43.36%), SOD (32.47%) and non-significant increase in CAT (7.06%, P=0.322) compared to control values. In infected camels, a significant positive correlation of NO with eMDA (r=0.546, P=0.009) and MetHb (r=0.490, P=0.021) was detected. By contrast, NO was inversely correlated with RBC (r=-0.546, P=0.009), PCV (r=-0.427, P=0.048) and Hb (r=-0.612, P=0.002). On the other hand, eMDA was inversely correlated with RBC (r=-0.596, P=0.003), PCV (r=-0.516, P=0.014) and Hb (r=-0.613, P=0.002). In addition, methemoglobinemia was negatively correlated with RBC (r=-0.560, P=0.007), PCV (r=-0.470, P=0.027) and Hb (r=-0.585, P=0.004). Our results suggest that chronic T. evansi infection in camels is associated with a state of oxidative process.

Erythrocytic oxidative damage in crossbred cattle naturally infected with Babesia bigemina.

This study aimed to determine the erythrocytic lipid peroxidation and haemoglobin oxidation as contributory factors causing anaemia in cattle (Friesian x Egyptian native breed) infected with Babesia bigemina. Blood was collected from 32 cows infected with B. bigemina along with 18 healthy cows as controls for determination of erythrocytic malondialdehyde (MDA), blood methaemoglobin (MetHb), plasma free haemoglobin (PHb), corpuscular osmotic fragility (COF), red blood cell count (RBC), total haemoglobin (Hb) and packed cell volume (PCV). Percentage of parasitaemia varied from 14% to 36%. MDA, MetHb, COF and PHb were significantly increased (P<0.001) in infected cows versus controls. Parasitaemia was positively correlated (P<0.001) with MDA, MetHb, COF and PHb. MDA was positively correlated (P<0.001) with COF and PHb and negatively correlated (P<0.001) with RBC, Hb and PCV. MetHb was negatively correlated (P<0.001) with RBC, Hb and PCV and positively correlated (P<0.001) with COF. In conclusion, B. bigemina infection in cattle is associated with a parasitic burden-dependent corpuscular oxidative damage as indicated by membrane lipid peroxidation and methaemoglobin formation, which are contributed to COF and intravascular haemolysis.

Circulating oxidative stress status in desert sheep naturally infected with Fasciola hepatica.

Oxidative stress is a general mechanism whereby free radicals induce oxidative damages and reduce the antioxidant defences of the biological systems. The aim of the present study was to determine plasma malondialdehyde levels as a biomarker of lipid peroxidation and its relation to the antioxidants status (plasma ascorbate and blood glutathione concentrations), liver function tests and anaemia in spontaneous ovine fascioliasis. For this purpose, jugular blood samples and livers of 27 infected ewes with Fasciola hepatica along with blood samples of 20 healthy (control) ewes were collected from animals slaughtered in a F. hepatica endemic area (Kharga oasis, Egypt). An increase (P<0.001) in plasma malondialdehyde (141.1%) accompanied by decreased levels (P<0.001) of albumin (29.3%) and ascorbate (36.2%) in plasma and glutathione in blood (31.6%) of infected sheep was noticed when compared with control values. In the infected group, malondialdehyde values were positively correlated with liver fluke burden (r=0.57, P=0.002) and the activity of plasma aspartate aminotransferase (r=0.39, P=0.0.046) and gamma-glutamyltransferase (r=0.64, P=0.0003) and negatively correlated with the concentrations of albumin (r=-0.53, P=0.004), ascorbate (r=-0.46, P=0.0.17) and glutathione (r=-0.41, P=0.034). In conclusion, oxidative stress is a significant feature of chronic F. hepatica infection in grazing sheep.

Comparison of blood serum proteins in water buffaloes with traumatic reticuloperitonitis and sequellae.

In this study, 73 cows with different types of traumatic reticuloperitonitis (TRP) and sequellae along with 25 healthy buffalo cows were used to evaluate the total blood serum protein and protein electrophoresis. According to rumenotomy or necropsy findings, the affected buffalo cows were classified into acute local TRP (AL-TRP), chronic local TRP (CL-TRP), reticular abscess (RA), acute diffuse TRP (AD-TRP), purulent pericarditis (PPC) and fibrinous pericarditis (FPC). Polyclonal gammopathy was characteristic for the electrophoretogram of buffalo cows with CL-TRP (55%), RA (61.1%) and PPC (62.5%). Various degrees of hypoalbuminaemia, hyper-alpha-globulinaemia and low A/G ratios were the associated changes in all cases of TRP and sequellae. Hyper-beta-globulinaemia was noticed in cases with CL-TRP, RA and PPC. Hyper-gamma-globulinaemia was evident in cases with AL-TRP, CL-TRP, RA and PPC. Hyperproteinaemia was noticed in buffalo cows with local complications of TRP including AL-TRP, CL-TRP and RA. Hypoproteinaemia associated with severe hypoalbuminaemia (>50% reduction compared to controls) and very low A/G ratios (<0.4) characterized buffalo cows with AD-TRP, PPC or FPC. In conclusion, the concentrations and electrophoretic patterns of serum proteins in buffaloes differ according to the anatomical location of the foreign body and the associated pathological lesions.

Up-regulation of regulatory T cells, CD200 and TIM3 expression in cytogenetically normal acute myeloid leukemia.

BACKGROUND: The bone marrow immunosuppressive microenvironment of AML patients sustains and modulates proliferation, survival and drug resistance of AML through deregulation of both innate and adaptive immune response. We aimed to investigate the level of Tregs, expression of Tim-3 on peripheral blood T cells, expression of CD200 in myeloid blasts in newly diagnosed AML patients with normal cytogenetics (AML-NC) and their prognostic impact. PATIENTS AND METHODS: This study included 40 patients with de novo AML-NC and 20 healthy controls. Flow-cytometry was used for detection of CD4+CD25+high FoxP3+ regulatory T cells, Tim-3 expression on peripheral blood T cells and CD200 expression on myeloid blasts. RESULTS: The percentages of CD4+CD25+high and CD4+CD25+high Foxp3+ Tregs were significantly increased in AML patients than controls. The levels of Tregs, Tim-3/CD4+, Tim-3/CD8+, CD200 and MFI of CD200 were significantly lower in responding patients than in those with persistent leukemia. Only high CD200 expression (> 50%) showed statistically significant worse OS with P< 0.04. CONCLUSION: The increased levels of Tregs, Tim-3 expression on peripheral blood T cells and CD200 expression in myeloid blast in AML patients could play a role in the development of AML. Analysis of these markers could serve as prognostic markers and might guide the therapy in AML patients in the future.

Severe pyoderma gangrenosum caused by myelodysplastic syndrome successfully treated with decitabine administered by a noncytotoxic regimen.

Pyoderma gangrenosum (PG) is a morbid necrotizing neutrophilic dermatoses for which current treatments are inadequate. Here, we describe the use of a novel noncytotoxic regimen of the deoxycytidine analog decitabine to treat underlying myeloid malignancy causing PG, to thereby produce safe and effective resolution of extensive PG.

TICK-BORNE INFECTIOUS DISEASES WITH REFERENCE TO EGYPT.

Ticks are hematophagous ectoparasites of man, domestic and street animals, and birds of health and economic hazard worldwide. They transmit many micro-organisms and protozoan infectious diseases and their toxins cause different signs and symptoms that may be fatal according to the infesting tick saliva protein. In Egypt where there are many rural and urban areas, so many genera and species of ticks are encountered. The Egyptian veterinary and agricultural authorities deal with ticks from econom- ic point of view. But from medical point of view, ticks have specific role in transmission of zo- onotic infectious diseases as well as their saliva causes tick paralysis. When dealing with chil- dren from tick infested areas, tick paralysis should be considered in differential diagnosis of the clinically confused diseases as poliomyelitis, myasthenia gravis; Guillain-Barre; paralytic rabies botulism; transverse myelitis and /or the diphtheritic polyneuropathy. Tick-borne relapsing fever is a zoonosis and is endemic in many countries. The two main Borrelia spp. involved in. North America are B. hermsii (in the mountainous West) and B. turicatae (in the southwest). Crimean Congo hemorrhagic fever (CCHF), babesiosis and infantile tick paralysis were identified as emerging diseases disaster. Also, Lyme disease is the commonest worldwide and encountered in Egypt since a long tilne. And now what about other tick-borne diseases, taking into consideration the tick populations is endemic riot only in Egypt but worldwide vectors.