Does herpes simplex virus have a role in the pathogenesis of systemic lupus erythematosus in Egyptians?

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune mediated tissue damage affecting a wide range of organs. The pathogenesis of SLE is complex. Infectious agents, including viruses, can act as environmental triggers, inducing or promoting onset and exacerbations of autoimmune disease in genetically predisposed individuals. Viral infections may be involved in the pathogenesis of SLE. To date, there is no published data about role of herpes simplex virus (HSV) in pathogenesis of SLE in Egyptian population. This study was designed to investigate a possible role of HSV in pathogenesis of SLE and its relation to disease activity. This study included 90 SLE female patients and 83 apparently healthy age-matched female subjects. SLE disease activity was assessed using SLEDAI-2K score. Qualitative assessment of anti-HSV antibodies (HSV1/2 IgM and IgG) was performed using ELISA kits. There was no statistically significant difference in frequency of HSV1/2 IgG positive test between SLE patients (97.6%) and control subjects (94.4%). There was a statistically significant increase in frequency of HSV1/2 IgM positive test in SLE patients compared to control subjects (P < 0.001). There was no difference in the frequency of HSV1/2 IgM and HSV1/2 IgG positive test results between SLE patients with higher disease activity score (60% and 95.6%, respectively) and those with lower disease activity score (60% and 93.3%, respectively). High prevalence of HSV1/2 IgG antibodies was observed among Egyptians. The lack of significant difference in frequency of HSV1/2 IgG between SLE patients and control subjects may indicate that HSV is not involved in SLE pathogenesis. Also, HSV infection may have no role in SLE disease exacerbation due to the absence of significant difference in the frequency of HSV1/2 IgM and HSV1/2 IgG antibodies in SLE patients with higher disease activity compared to those with lower disease activity.

Usefulness of Circulating Methylated p16 as a Noninvasive Molecular Biomarker for Hepatitis C-Related Hepatocellular Carcinoma with Normal Serum Alpha-Fetoprotein Levels.

BACKGROUND: Screening of hepatocellular carcinoma (HCC) is challenged especially in patients with normal alpha-fetoprotein (AFP) levels. Aberrant p16 methylation has been implicated in HCC. OBJECTIVES AND AIMS: This study aimed to assess serum methylated p16 (MP16) expression levels and to evaluate MP16 diagnostic performance in HCC detection among HCV-infected Egyptian patients with normal AFP levels. METHODS: MP16 levels were quantified using real-time PCR in 230 serum samples (30 healthy controls, 95 with HCV-HCC, 40 with chronic hepatitis C "CHC" and 65 with HCV cirrhosis). Diagnostic performance of MP16 for diagnosis of HCC was done using receiver operator characteristic curve analysis. RESULTS: Serum MP16 levels were significantly higher in HCC than CHC, cirrhosis, and healthy subjects and significantly higher in HCC with normal AFP levels than those with higher AFP. ROC curves revealed promising diagnostic performance for MP16 in discriminating HCC with normal AFP levels from non-HCC cases. This predictive ability improved by combining MP16 and AFP (AUC of 0.872 with 100% sensitivity, 76.5% specificity, 79.1% positive predictive value, 100% negative predictive value, and 87.5% accuracy). CONCLUSION: MP16 can be a potential noninvasive molecular biomarker for HCC detection in patients with hepatic mass(es) and normal AFP levels especially in those where liver biopsy and radiological imaging cannot be done.

ADHD, autism and neuroradiological complications among phenylketonuric children in Upper Egypt.

The aim of this study is to evaluate the neuropsychological status in a cohort of children with early and continuously treated phenylketonuria in Assiut, Upper Egypt. The study was implemented in seventy-eight phenylketonuria (PKU) children. Only 34 patients met the inclusion criteria. Investigated patients were evaluated according to detailed history, neurological examination, Childhood Autism Rating Scale, full scale Intelligence Quotient, attention deficit hyperactivity disorder, electroencephalography and magnetic resonance imaging (MRI). This study concluded that the prognosis for early diagnosed children with PKU treated from the first weeks of life is generally good. However, they are at increased risk for neurological complications and behavioral problems. So, neonatal screening for PKU is highly recommended in Egypt, for early detection and management. In addition, neuropsychological and MRI assessments in PKU children should be done.