Serum Ghrelin Levels in Saudi Obese Asthmatic School-Children-Correlation with Interleukin-4, Interleukin-5, and Interleukin-21.

Ghrelin is a peptide hormone with direct or indirect effects on obesity and asthma. More data are required to understand the effect of ghrelin on the control and pathogenesis of these diseases. The aim of this study was to evaluate ghrelin levels in selected groups of children to identify the association between serum ghrelin, obesity, and the severity of asthma. The study included 401 school children selected from the Najran area and grouped into non-obese asthmatics, obese asthmatics, obese non-asthmatics and controls (non-obese non-asthmatics). Blood levels of ghrelin, interleukin (IL)-4, IL-5 and IL-21 were determined by ELISA. The mean ghrelin values were insignificantly increased in obese children compared with non-obese children. The highest blood ghrelin values were in the non-obese asthmatic group. Serum ghrelin, IL-4 and IL-21 levels were significantly increased in asthmatic children compared with non-asthmatic children (p < 0.05), and there were significant positive correlations between ghrelin and IL-4, IL-5, and IL-21 in asthmatic children. Furthermore, ghrelin, IL-4, and IL-21 levels were significantly higher in uncontrolled asthmatics compared with controlled-asthmatic children (p < 0.05). Asthma was the only significant risk factor for high ghrelin values. This study provides evidence supporting the anti-inflammatory role of ghrelin in the pathogenesis of asthma. Asthma might be considered as an important determinant of high ghrelin values in children.

Obesity and childhood asthma in male schoolchildren in Saudi Arabia: Is there a role for leptin, interleukin-4, interleukin-5, and interleukin-21?

BACKGROUND: Adiposity is associated with high serum levels of adipokines and chemokines which are possibly implicated in a co-existence of obesity and asthma. OBJECTIVES: Elucidate the possible roles of leptin, interleukin (IL)-4, IL-5 and IL-21 in linking obesity with childhood asthma. DESIGN: Cross-sectional, analytical. SETTING: Population of schoolchildren in a small Saudi city. SUBJECTS AND METHODS: The study included a representative sample of Saudi schoolchildren grouped as obese asthmatics, non-obese asthmatics, or obese nonasthmatics, with nonobese nonasthmatics as a control group. An asthma control test was done for the asthmatic groups. MAIN OUTCOME MEASURES: Serum levels of leptin, IL-4, IL-5, and IL-21. SAMPLE SIZE: 345 male schoolchildren with a mean (SD) age of 13.0 (2.3) years. RESULTS: Median serum leptin concentrations in obese asthmatics were significantly higher than in nonobese asthmatics ( P<.001). Uncontrolled asthmatics also had significantly higher leptin levels than controlled asthmatic children ( P<.002). Leptin levels were weakly but significantly correlated with the cytokines IL-4, IL-5, and IL-21. CONCLUSIONS: Leptin may contribute to a link between obesity and childhood asthma. Differences in IL-21 levels between nonobese and obese asthmatics suggest that the co-existence of asthma and obesity increased IL-21 levels. Leptin plus some proinflammatory cytokines especially IL-21 may be potential predictors for asthma control in children. LIMITATIONS: Blood sampling at different stages of asthma might influence cytokine expression. CONFLICT OF INTEREST: None.

Pattern of childhood brucellosis in Najran, south Saudi Arabia in 2013-2017.

BACKGROUND: With more than 500,000 new cases annually, human brucellosis is the commonest zoonotic disease worldwide. In some endemic countries, its prevalence is more than 10 per 100,000 population. OBJECTIVE: The aim of this study was to determine the magnitude of the problem and the clinical features, laboratory findings, treatment given and complications seen in children with brucellosis in Najran City, Kingdom of Saudi Arabia. METHODS: This is a case-series study by analysis of data of children known or diagnosed to have brucellosis for the last 4 years in Najran City. Data was obtained by reviewing the hospital records of the Maternity and Children Hospital and Najran Armed Forces Hospital in Najran during the period from 2013 to 2017. The statistical analysis was carried out using SPSS version 16.0. Since it was the first report of brucellosis on the study population, we used descriptive statistics (frequency, proportion, mean, and standard deviation) for presenting the findings. RESULTS: We studied 57 diagnosed cases of child brucellosis throughout the past 4 years in Najran, south Saudi Arabia with an average number of about 12 cases per year. Of the cases, 15.8% reported a history of ingestion of raw milk and dairy product and only 1.8% of them reported a history of animal contact while 82.4% confirmed unknown mode of transmission. Fever was the only finding in 36.8%, fever and arthralgia 21.1%, and fever and myalgia 19.3%. Two thirds of the cases were diagnosed by standard agglutination test (SAT). Hepatosplenomegaly was found in 10.5%. Rifampicin was the antibiotic of choice and 70.2% of cases have been cured but 3.5% relapsed and 1.8% died from complications. CONCLUSIONS: Results suggest brucellosis be considered in every child living in an endemic area, showing symptoms of fever and having a history of ingestion of raw milk and dairy product and/or animal contact.Prevention should rely on health education of the public about different issues of the disease including boiling raw milk.