The role of cytokine gene single nucleotide polymorphism in the development of recurrent acute otitis media.

The study aimed at examining the role of single nucleotide polymorphism (SNP) of cytokine genes in the development of recurrent acute otitis media (AOM) among children. Single nucleotide polymorphism of IFN-, IL-6, IL-10, TNF-α, and TGF-ß1, were analyzed by the polymerase chain reaction with sequence-specific primers (PCR-SSP) in 82 children with recurrent AOM and compared with a similar control group. There was a significant higher incidence of IL-10 polymorphisms (loci -592, -819 and -1082) in children with recurrent AOM (P=0.0137, 0.0137 and 0.0072, respectively). However, there was no significant difference in the distribution of other cytokine genotypes between the two study groups. Among the 5 studied cytokine genes, only IL-10 loci showed significant correlation to the development of recurrent AOM.

Potential Role of Serum Intestinal Fatty Acid-Binding Protein as a Marker for Early Prediction and Diagnosis of Necrotizing Enterocolitis in Preterm Neonates.

INTRODUCTION: Intestinal fatty acid-binding protein (I-FABP) is located in the apex of mature enterocytes and released into circulation; once the injury of enterocyte happens, its circulating levels are considered an early and sensitive marker of intestinal ischemia as in necrotizing enterocolitis (NEC); because of its small molecular weight, it can be detected in urine. AIMS: The aim was to study the usefulness of both serum and urine I-FABP in early diagnosis of NEC and to correlate the serum and urinary levels. SETTINGS AND DESIGN: This study was case-control design. METHODS: Simultaneous serum and urine samples obtained at the onset of symptoms, in 40 preterms with suspected NEC, with gestational age ± 27.70 weeks and birth weight ± 1.11 kg, i.e., 20 preterms diagnosed at Stage I, 12 preterms at Stage II, and 8 preterms at Stage III, were compared with age- and weight-matched preterms with no NEC. STATISTICAL ANALYSIS: The collected data were tabulated, coded, and then analyzed using the computer program Statistical Package for the Social Science (SPSS version 22). RESULTS: Serum levels of I-FABP in NEC cases were significantly higher than the control group, with a mean of 6005.77 ± 6384.77 and 1480.79 ± 1276.48 pg/ml, respectively (P < 0.001). Urine levels of I-FABP in NEC cases were significantly higher than the control group, with a mean of 5009.22 ± 3941.64 and 2677.62 ± 2257.29 pg/ml, respectively (P = 0.04). Both serum and urine I-FABP levels not only in Stage II are significantly higher than Stage I but also in Stage III are significantly higher than Stage I and II (P < 0.001, P = 0.03, respectively), which showed significant positive correlation with stages of NEC (r = 0.618; P < 0.001; r = 0.306; P = 0.049, respectively). Both serum and urine I-FABP levels had a highly significant positive correlation with each other (r = 0.406 P < 0.0001). Receiving operating characteristic curve showed an area under the curve of 0.92 and 0.81 for serum and urine I-FABP, respectively. CONCLUSIONS: Whether serum or urinary I-FABP is valuable in the diagnosis and prediction of NEC and strongly correlated with the disease severity and with each other.

Combination of Procalcitonin, CRP and CD11b Biomarkers in Early Detection of Neonatal Sepsis.

The study aimed at comparing the diagnostic performances of CRP, PCT and CD11b in neonatal sepsis and evaluating the effectiveness of the sepsis score system when using a combination of various biomarkers. The study was conducted on 90 neonates divided into 3 equal groups; a group with proven sepsis, suspected sepsis and healthy newborns. All were subjected to measurement of CPR by Latex agglutination, serum Procalcitonin by ELISA and CD11b by flow cytometry. On comparing the three biomarkers; PCT (Serum procalcitonin) was associated with the highest (AUC) area under the curve followed by CD11b and CRP recording the smallest value. However, the AUC of the combined sepsis score was much higher than individual biomarkers. Although the sensitivity of individual biomarkers from procalcitonin to CD11b and lastly CRP but the sensitivity and specificity of the sepsis score showed higher values compared to those of individual biomarkers. In conclusion, the study demonstrate that combination of CRP, CD11b and, procalcitonin can enhance diagnostic discriminative power over traditional tests and overcome the drawbacks of each test alone with greater diagnostic accuracy.

Predictive and diagnostic value of serum intestinal fatty acid binding protein in neonatal necrotizing enterocolitis (case series).

OBJECTIVES: In this study, we aimed to investigate the value of serum intestinal fatty acid binding protein (I-FABP) in early diagnosis and predicting the severity of Necrotizing enterocolitis (NEC). METHODS: This prospective study was performed on 160 preterm neonates ageing less than 35 weeks and weighting less than 2000 gm selected from the Neonatal Intensive Care Units (NICUs) of the Pediatric Department at Benha University hospital and Benha children hospital to evaluate which of them will develop NEC, after follow-up these neonates were divided into two groups: Group one compromised eighteen preterm neonates with symptoms and signs of NEC. Group two compromised ten preterm neonates as a control group. All participants were subjected to full clinical examination, abdominal X-ray and serum I-FABP. RESULTS: The 1st values of IFABP taken at birth showed that mean serum IFABP concentrations of the study group were higher than that of the control group. The 2nd values of serum IFABP taken at the start of feeding showed that mean IFABP concentrations of the study group were higher in comparison with IFABP at birth. In the 3rd values of serum, IFABP taken at the time of diagnosing NEC showed that mean serum IFABP concentrations of the study group were higher than the control group. In the 4th values of serum, IFABP taken one week after diagnosing NEC showed that the mean serum IFABP concentrations of the study group became significantly decreased in comparison with IFABP at the time of diagnosis in stage 1 and 2. CONCLUSIONS: Serial measurements of serum I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC.

Level of IL-16 and Reticulated Platelets Percentage during the Clinical Course of Immune Thrombocytopenic Purpura in Children.

Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease with transient or persistent decrease of thrombocytes number in the blood. Cytokines play important roles in the immune regulation and are known to be deregulated in autoimmune diseases. This study aimed to investigate serum IL-16 levels in relation to reticulated platelets in children with ITP and platelet count. Twenty six children with ITP (11 with newly diagnosed ITP, 9 with persistent ITP and 6 with chronic ITP) and 12 age-matched healthy children controls were studied. Serum level of IL-16 and reticulated platelets count were assessed by Enzyme Linked Immunosorbent Assay (ELISA) and flow cytometry respectively. Serum IL-16 levels were significantly higher in patients as compared to controls (P < 0.001). Within patients, the levels were higher in newly diagnosed compared to persistent and chronic ITP (P < 0.01) and (P < 0.001) respectively. IL-16 levels were also significantly higher in persistent ITP compared to chronic ITP (P < 0.001). Reticulated platelets were also elevated in patients compared to controls and the increase was significant in newly diagnosed group (P < 0.05). Negative correlation was found between IL-16 level and reticulated platelets and platelets counts (r = -0.284, P = 0.028, r = 0.274 P = 0.25) respectively. It is concluded that IL-16 may be valuable in predicting the clinical course of pediatrics ITP. Measurement of reticulated platelets may provide significant information about thrombopoietic activity during the clinical course of ITP in children.