Novel scoring system for early diagnosis of necrotizing enterocolitis: integrating clinical and laboratory data with urinary caveolin-1 levels.

Introduction: Necrotizing enterocolitis (NEC) poses a significant threat to preterm infants, with nonspecific early manifestations complicating timely diagnosis. Therefore, this study aimed to develop a novel scoring system for early diagnosis of NEC, incorporating clinical and laboratory data with urinary caveolin-1 levels. Material and methods: A single-center prospective cohort study was conducted at a tertiary hospital in East Java, Indonesia. NEC diagnosis was established by Bell's criteria and proven gut dysbiosis. Urinary levels of claudin-2, caveolin-1, and epidermal growth factor (EGF) were assessed as potential indicators of tight junction disruption. The selected urine biomarker cutoff value was determined using symbolic classification analysis and combined with clinical and laboratory parameters from Bell's criteria to create an NEC scoring system, validated with the Aiken index. Sensitivity and specificity analyses were performed. Results: Thirty-four neonates, comprising NEC, preterm non-NEC, and term infants, were included. qPCR analysis highlighted elevated Klebsiella, Lactobacillus, Clostridium, and Bacteroides levels in NEC patients, indicating a gut dysbiosis trend. Among 3 biomarkers, caveolin-1 ≥ 17.81 ng/dl on day 3 demonstrated 72.86% negative predictive value and 87.50% positive predictive value. The combined scoring system which comprised abdominal cellulitis, distension, radiology, advanced resuscitation at birth, prematurity or low birthweight, platelet count, sepsis, orogastric retention, metabolic acidosis and caveolin-1 findings exhibited an AUC of 0.922 (95% CI: 0.81-1.00, p < 0.001), with ≥ 1.81 as the cutoff, offering 93% sensitivity and 94% specificity. Conclusions: Urine caveolin-1 on day 3 signifies enterocyte tight junction damage and the acute phase of NEC in premature infants. The proposed scoring system demonstrates good performance in predicting NEC incidence in preterm infants.

Vitamin D, cytokine profiles, and disease severity in infants with atopic dermatitis: a single centre, cross-sectional study.

Introduction: Atopic dermatitis (AD) is an immune-mediated inflammatory skin disease and generally develops in infancy. Studies evaluating the role of vitamin D in immune mechanims in AD showed varying results. Aim: To assess the association between serum vitamin D, cytokine profiles, and disease severity in infants with AD. Material and methods: A cross-sectional study was conducted on infants aged 0-12 months with AD in the Paediatric Allergy and Immunology Department, Saiful Anwar Hospital, Indonesia. The disease severity was assessed by the Scoring of Atopic Dermatitis (SCORAD) index. Blood was drawn to evaluate the total eosinophil count (TEC), total immunoglobulin E (tIgE), 25-hydroxyvitamin D (25(OH)D), interleukin-4 (IL-4), IL-17A, and IL-22 levels. Results: This study enrolled 36 infants including 19 with mild AD and 17 with moderate AD. Vitamin D deficiency and insufficiency were found in 18 (50%) and 9 (25%) subjects, respectively. The mean 25(OH)D level was lower and the mean IL-4, IL-17A, and IL-22 levels were higher in the moderate AD group than in the mild AD group (p < 0.05). A lower level of 25(OH)D was associated with a higher level of IL-17A (r = -0.315, p = 0.041). The SCORAD index was negatively correlated with 25(OH)D (r = -0.714, p < 0.001) and positively correlated with IL-17A (r = 0.522, p = 0.001) and IL-22 (r = 0.612, p < 0.001) but not IL-4 (r = 0.325, p = 0.053). Conclusions: There was a high prevalence of vitamin D deficiency and insufficiency in infants with AD, and a low vitamin D level was correlated with the severity of AD, dependently on IL-17A.

Analysis of specific antibody and cellular immune response to first-dose measles vaccine Edmonston-Zagreb in 9-month-old infants.

BACKGROUND: Measles vaccinations have been suggested to provide immune protection and decreased measles incidence. However, there was a limited study evaluating how the measles vaccine elicits specific immune responses. OBJECTIVE: This study aimed to evaluate both humoral and cellular immunity to first-dose measles vaccine Edmonston-Zagreb (EZ) in 9-month-old Indonesian infants. METHODS: A cohort study was conducted on 9-month-old infants who got the first-dose of measles vaccine EZ. Measles-specific immunoglobulin G (IgG) antibody serum levels were measured using plaque-reduction microneutralization assay. Peripheral blood mononuclear cells were stimulated with a measles-specific peptide to identify a cellular immune response. Quantification of CD4+ and CD8+ T-cells producing interferon-gamma (IFN-É£) and interleukin 17-A (IL-17A) were conducted by flow cytometry. Humoral and cellular immune response parameters were analyzed over time. RESULTS: The prevalence of seropositivity rates was 85.8% at 1-month after vaccination and 16.67% at 6-months postvaccination. Measles-specific IgG antibodies increased significantly at 1-month after measles vaccination. However, they decreased significantly 6-months after vaccination. IFN-É£ and IL-17A secreting T-cells increased significantly at 1-month after measles vaccination. Interestingly, a significant decrease of IFN-É£ and IL-17A secreting CD4+ T cells was noticed 6-months postvaccination compared to IFN-É£ and IL-17A secreting CD8+ T cells. CONCLUSION: Our study suggests that the first-dose measles vaccine on 9-months-old infants seems to induce both humoral and cellular immune responses that decline 6-months after vaccination.

Determination Factors Associated with Immune Responses Towards First Dose Edmonston-Zagreb (EZ) Measles Vaccine in Indonesian Infants.

BACKGROUND: Measles outbreaks under high coverage of measles vaccination in Indonesia is gaining a necessary evaluation of factors associated with measles-vaccine immune responses. OBJCTIVE: The purposes of recent study were to evaluate the association of sociodemographic and anthropometric parameters and specific immune responses towards first dose Edmonston-Zagreb (EZ) measles vaccine in Indonesian infants. METHODS: A total of 35 infants were enrolled in this cohort study. Measles immune responses were followed up at one and six months after vaccination then analyzed for its association with sociodemographic, anthropometric, and nutritional parameters. The plaque-reduction microneutralization assay was conducted to measure the titer of measles specific IgG antibody. The level of CD4+ and CD8+ T-cells that exhibiting gamma interferon (IFN-γ) secretion were analyzed by flow cytometry. The association between variable was analyzed by linear regression. The difference immune response among variable were analyzed with Mann-Whitney test. RESULTS: Vitamin A supplementation and breastfeeding were predicted as associated factor for humoral and cellular immune response after one month and six months measles vaccination among Indonesia Infants. CONCLUSION: Nutritional factor is associated with measles vaccination immune response in Indonesian infants.

Role of Lymphocytes CD4/CD8 Ratio and Immunoglobulin G Cytomegalovirus as Potential Markers for Systemic Lupus Erythematosus Patients with Periodontal Disease.

OBJECTIVES: The aim of the study was to analyze the correlation between periodontitis severity in systemic lupus erythematosus (SLE) with CD4/CD8 lymphocytes ratio and cytomegalovirus gamma immunoglobulin (IgG CMV) level. MATERIALS AND METHODS: This is a descriptive study using a cross-sectional approach that included 93 subjects who were diagnosed with SLE in Rheumatology Department, Saiful Anwar Hospital, during 2017 to 2019. Periodontitis severity was assessed by periodontal Index (PI). CD4/CD8 lymphocyte ratio was determined using flow cytometry and IgG CMV levels using enzyme-linked immunosorbent assay. STATISTICAL ANALYSIS: The differences among the three groups were analyzed using analysis of variance. Correlation among the groups was calculated using Spearman/Pearson correlation coefficient test, while regression analysis was done using Statistical Package for the Social Sciences. RESULTS: The mean of periodontitis severity and standard deviation in SLE was 2.66 ± 1.02. There were negative correlation between CD4/CD8 lymphocyte ratio with periodontal index (r = -0.971) and positive correlation between IgG CMV level with periodontal index (r = 0.977). CONCLUSIONS: Inverted CD4/CD8 ratio and IgG CMV were found associated with periodontitis severity in SLE patient. Further research was recomended that CD4/CD8 lymphocytes ratio and IgG CMV can be used as a potensial marker of periodontitis severity in SLE patients.

Oral Hygiene and Dental Caries Status on Systemic Lupus Erythematosus Patients: A Cross-Sectional Study

Abstract Objective: To evaluate the oral hygiene and dental caries status on Systemic Lupus Erythematosus (SLE) patients, also it's with SLE disease activity. Material and Methods: This is a descriptive study with a cross-sectional approach. The study was conducted on 93 SLE patients from 2017 to 2019 on Saiful Anwar Hospital Indonesia. All SLE patients had clinical examination using DMF-T, Personal Hygiene Performance-Modified (PHP-M), Calculus Index (CI), Debris Index (DI), Plaque Index (PI) and Simplified Oral Hygiene Index (OHI-S). Clinical examination and laboratory tests are conducted to assess the activity of SLE measured using. The data were analyzed by One Way ANOVA test. Results: A total of 74% of subjects with SLE had dental caries. PHP-M with SLE severity was found significant (p<0.001) and a strong positive correlation (r=0.982). Plaque with SLE severity was found significant (p=0.001) and a strong positive correlation (r=0.938). OHI-S with SLE severity was found significant (p<0.001) and a strong positive correlation (r=0.953). DMF-T levels with SLE severity was found significant (p=0.001) and a strong positive correlation (r=0.974). It showed that the severity of disease activity was related to poor oral hygiene and a high incidence of dental caries. Conclusion: There is a correlation between oral hygiene, dental caries and SLE severity.

Genistein modulates the estrogen receptor and suppresses angiogenesis and inflammation in the murine model of peritoneal endometriosis.

The purpose of this study was to investigate the effect of genistein administration on the modulation of the estrogen receptor, inhibition of inflammation and angiogenesis in the murine model of peritoneal endometriosis. A total of thirty-six mice (Mus musculus) were divided into six groups (n = 6), including the control group, endometriosis group, endometriosis group treated with various doses of genistein (0.78; 1.04; 1.3 mg/day), and endometriosis group treated with leuprolide acetate (0.00975 mg/day every 5 days for 15 days). Analysis of estrogen receptor-α, estrogen receptor-ß, TNF-α, IL-6, VEGF, and HIF-1α were performed immunohistochemically. Expression of estrogen receptor-α, estrogen receptor-ß, TNF-α, IL-6, VEGF and HIF-1α increased significantly compared with the control group (p < 0.05). All doses of genistein decreased the expression of estrogen receptor-α, increased estrogen receptor-ß, lowered VEGF and HIF-1α significantly compared with endometriosis group (p > 0.05). Genistein also decreased the expression of TNF-α and IL-6 (1.04 and 1.3 mg/day) compared with the endometriosis group, reaching level comparable to that of the control group (p > 0.05). It was concluded that genistein is able to modulate estrogen receptor-α and estrogen receptor-ß and inhibit the development of inflammation and angiogenesis in the murine model of peritoneal endometriosis. Thus, genistein can be a candidate in the treatment of endometriosis.