Assessment of Serum Level of Interleukin-37 in Asthmatic Children at Benha University Hospital.

Asthma is a complex inflammatory disease, characterized by airway hyperresponsiveness, inflammation, and reversible airway obstruction. Interleukin-37 (IL-37), functions as a fundamental inhibitor of innate inflammatory and immune responses, and it is an important cytokine in the control of asthma by suppressing the production of inflammatory cytokines. This study aimed to reveal the possible role of IL-37 in asthma through assessment of its serum level in controlled and uncontrolled asthmatic children as compared to controls. Serum IL-37 level was measured by ELISA. The serum level of IL-37 was significantly lower in patients than controls and in uncontrolled than in controlled asthma (P < 0.001). It is concluded that there is negative relation between serum level of IL-37 and asthma, which is more evident in uncontrolled asthmatic group, this observation may support the protective role of IL-37 in immune pathogenesis of asthma.

Human Parvovirus B19 Infection in Rheumatoid Arthritis Patients: Screening and Clinical Significance.

Rheumatoid arthritis (RA) is a common chronic inflammatory disease, affecting about 1% of the general population. Conflicting data are available regarding the etiologic association of human parvovirus B19 (B19) infection with RA. This study aimed to determine the prevalence of B19 infection in patients with RA compared to healthy controls and to assess its possible association with disease activity or severity. The study included 40 RA patients and 40 age and sex matched apparently healthy controls. Detection of B19 DNA by nested PCR and the detection of anti-B19 IgM and IgG by ELISA) were performed for patients and controls. It was found that B19 infection is more prevalent in patients with RA than healthy controls as the frequency of detection of B19 DNA and anti-B19 IgG was significantly higher in RA patients than healthy controls (P=0.003 and P=0.04, respectively) but not IgM. It was concluded that B19 infection may have a role in the etiopathogenesis of RA but not involved in disease activity or severity.

Role of PTPN22 1858 C/T Polymorphisms in Juvenile Idiopathic Arthritis in Egyptian Patients.

Juvenile idiopathic arthritis (JIA) the most common chronic arthropathy of childhood is a diverse group of chronic arthritis diseases. The protein tyrosine phosphatase N22 (PTPN22) gene exhibits regulatory activities for both T and B cells. This study aimed to study PTPN gene polymorphism in JIA. The study included 60 children with JIA and 40 age and sex matched healthy children as controls. Patients and control groups were subjected to PTPN gene polymorphism analysis. Our findings indicated a significant difference in PTPN22 polymorphism between JIA patients and the control group (P = 0.021). Different PTPN genotypes were studied in relation to patient's age, sex and relevant laboratory data. It was concluded that PTPN22 polymorphism is different in JIA patients than healthy controls. T allele is associated only in cases with JIA and it may be considered as risk allele for certain JIA subtypes.

Diagnostic and Prognostic Values of Monocyte Chemotactic Protein-1 in Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis.

Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotics with ascites. Monocyte chemotactic protien-1 (MCP-1) is a chemotactic factor for monocytes/macrophages, and it activates lymphocytes and neutrophils during infection. This study aimed to evaluate the role of MPC-1 in the pathogenesis of SBP and assess its prognostic value and correlation to disease severity. The study included ninety patients with liver cirrhosis and ascites. Patients were divided into 2 groups: Group I including 45 ascetic patients with SBP (polymorph nuclear cell count (PMN) >= 250 cell/mm3 in ascitic fluid), and Group II including 45 ascetic patients without SBP. Assessment of the severity of liver cirrhosis was done using the modified Child-Pugh and model for end stage liver disease (MELD) scores. Ascetic fluid samples were subjected to total leucocytic count and differential, albumin, protein, glucose, and serum-ascetic albumin gradient analysis Ascetic fluid levels of (MCP-1was measured by ELISA. Higher level was detected in patients with SBP as compared to those without SBP. The number of polymorph nuclear cell count (PMN) >= 250 cell/mm3 in ascitic fluid) was used as gold standard for diagnosis of SBP. The diagnosis sensitivity and specificity of MCP level test were 86.7% and 95.4% respectively at cutoff of122.5ng/ml with accuracy 91%. MCP-1 level showed positive significant correlation with TLC, PMN leucocytes and MELD score. In conclusion, ascitic fluid MCP-1 level could be a reliable test for diagnosis of SBP, and could be used as a prognostic marker due to its positive correlation with the severity of liver disease.

Detection of Cytotoxic T-Lymphocyte Associated Antigen-4 Gene Polymorphism in Type 1 Diabetes Mellitus.

Type 1 diabetes is one of the most common chronic childhood illnesses. Interplay between genetic susceptibility and environmental factors is thought to provide the fundamental element for the disease. It has been shown that more than 40 genetic loci are associated with T1DM. Important one among these is the CTLA-4. This work aimed to detect Cytotoxic T Lymphocyte-associated antigen 4 (CTLA-4) gene polymorphism in patients with type 1 diabetes mellitus T1DM using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to clarify its role in the susceptibility to T1DM. The study was carried out on forty unrelated Egyptian children with TIDM. Twenty unrelated healthy children were enrolled as a control group. Blood samples were collected from patients and control groups and subjected to CTLA-4 gene polymorphism analysis using polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP). CTLA-4 G allele and GG homozygous genotype were significantly increased in T1DM patients than in control group (P < 0.001, P = 0.002 respectively). There was significant association between the three CTLA-4 genotypes (AA, AG, GG) and diabetic complications (p = 0.002), AG and GG polymorphisms were associated with complications of diabetes with ratio 84.6% and 100% respectively. While no association was found with sex, weight, height, risk factors of diabetes or insulin treatment. It was concluded that there is a strong association between AG polymorphism and T1DM (P = 0.002).

Expression of IL-23 mRNA in Systemic Lupus Erythramtosus Patients: Relation with Disease Activity.

Systemic lupus erythematosus (SLE) is a multisystem autoimmune connective tissue disorder characterized by loss of self-tolerance causing immune-mediated tissue destruction and various clinical presentations. Cytokine-mediated immunity involved in the pathogenesis of SLE. Recently, IL-23 was proposed to play a crucial role in mediating tissue inflammation and autoimmunity. The present work was aimed to investigate the relation between levels of IL-23 mRNA and disease activity in patients with SLE and in those with renal involvement. In this work, blood samples from 45 adult patients with SLE and 20 healthy controls were collected. Patients were divided into 3 groups. Group I consisted of 16 patients with active SLE with nephritis. Group II consisted of 13 patients with active SLE without nephritis. Group III consisted of 16 patients with inactive SLE based on the SLE disease activity index (SLEDAI). The IL-23 mRNA relative concentration was detected by Quantitative Reverse transcriptase- polymerase Chain Reaction (RT-PCR). IL-23 mRNA expression level in blood was eleven times higher in SLE patients without activity while in active SLE patients with and without nephritis showed 34 fold and 17 fold higher IL-23 mRNA expression respectively compared to healthy control. IL-23 mRNAs levels were significantly higher in patients with SLE compared with healthy controls (P < 0.001). Patients with active disease showed higher IL-23 mRNAs compared with those with inactive disease as well as healthy controls (P < 0.001). IL-23 levels were significantly higher in SLE patients with renal involvement compared with those without renal disease (P < 0.001). It is concluded that IL-23 has a role in the development and pathogenesis of SLE & lupus nephritis.

Early diagnostic and prognostic values of anti-cyclic citrullinated peptide antibody and cartilage oligomeric matrix protein in rheumatoid arthritis.

This study aimed to evaluate the role of Anti-Cyclic Citrullinated Peptide (anti-CCP) antibody in comparison to Cartilage oligomeric matrix protein (COMP) in Rheumatoid Arthritis (RA) patients as predictors of the disease activity and cartilage destruction. The study included 60 patients &10 apparently healthy subjects. They were divided into 4 groups. Group 1: consisted of 20 patients with established rheumatoid arthritis( and positive rheumatoid factor). Group 2: 20 suspected (rheumatoid factor negative) patients Group 3: 20 patients with other autoimmune inflammatory diseases (15 with psoaritic arthritis, 5 with systemic lupus erthromatosis).and Group 4: 10 age and sex matched controls. For each patient medical examination and disease activity evaluation using Disease Activity Score (DAS) was performed Anti cyclic citrullinated peptide (anti CCP) level was measured by ELISA method and cartilage oligomeric matrix protein (COMP) was determined by indirect immune fluorescent method. Serum level of anti CCP antibodies and COMP were Significantly related to DAS (disease activity score) and cartilage destruction, the serum presence of COMP was highly significant in rheumatoid arthritis patients than those with other autoimmune disease, the sensitivity of anti CCP in diagnosis of RA was 77.5% and specificity was96.6%. It is concluded that anti CCP, and COMP may be a useful noninvasive markers for disease activity and cartilage destruction.