Molecular and immunological studies on Theileria equi and its vector in Egypt.

Equine piroplasmosis is not fully understood regarding pathogenicity, prophylaxis, host immune response expression, and specific vectors. Accurately identifying the parasite vector is crucial for developing an effective control plan for a particular infection. This study focused on morphologically identifying two Hyalomma species (H. anatolicum and H. marginatum) and one Rhipicephalus annulatus (R. annulatus) at the species level. The identification process was followed by phylogenetic analysis using the neighbor-joining method based on the cytochrome oxidase subunit 1 (COXI) gene as a specific vector for Theileria equi (T. equi) in horses. T. equi was diagnosed morphologically and molecularly from infected blood samples and crushed tick species using conventional PCR. Subsequently, phylogenetic analysis based on the amplification of the 18 S rRNA gene was conducted. The obtained sequence data were evaluated and registered in GenBank under accession numbers OR064161, OR067911, OR187727, and OR068139, representing the three tick species and the isolated T. equi, respectively. The study demonstrated that T. equi infection leads to immune system suppression by significantly increasing the levels of oxidative stress markers (CAT, GPx, MDA, and SOD) (P ≤ 0.0001), with this elevation being directly proportional to parasitemia levels in infected blood cells. Furthermore, a correlation was observed between parasitemia levels and the expression of immune response infection genes (IFN-gamma, TGF-ß1, and IL-1ß cytokines) in infected horses compared to non-infected equine. Common macroscopic symptoms indicating T. equi infection in horses include intermittent fever, enlarged lymph nodes (LN), and tick infestation.

Awareness of parasitic zoonotic diseases among pet owners in Cairo, Egypt.

Egyptians are becoming more interested in owning and raising pets; however, most of them lack essential awareness about the risk of zoonotic parasites that could be transmitted. The objective of the present investigation was to evaluate the degree of awareness Egyptian pet owners possess concerning zoonotic parasitic diseases, the risk of transmission, and preventative measures. A cross-sectional study was conducted using an e-survey. Among 246 pet owners, 64.2% (158) were females, and 67.9% (167) belonged to the 20-30 age group. The majority, 78.9% (194), were raising cats. Only 13.8% (34) visited the veterinarian regularly, with significantly higher results among dog owners (p < 0.05). Only 31.3% (77) participants were regularly deworming their pets, and 19.9% (49) were giving their pets prophylaxis against ectoparasites, with significantly higher results among those who visited the veterinarian regularly (p < 0.0001) and among dog owners (p < 0.05). Only 54.1% (133) had heard about the term "zoonoses" before, and about 8.9% (22) of participants showed a history of zoonotic parasitic diseases, with significantly higher results among those who allowed their animals to play with other animals of neighbors and friends (p < 0.05). The obtained results concluded that the surveyed group had a relatively good degree of knowledge regarding pets as a source of zoonotic illness; raising pet owners' awareness regarding the importance of routine medical examinations and minimizing the contact of pets with other stray animals is essential.

Efficacy of silver nanoparticles against Trichinella spiralis in mice and the role of multivitamin in alleviating its toxicity.

Trichinellosis is a worldwide zoonotic disease. The majority of currently available anti-trichinellosis medications exhibit inadequate efficacy. The efficacy of a natively prepared new formulation of silver nanoparticles (Ag-NPs) was evaluated in the treatment of Trichinella spiralis (T. spiralis) infection in mice alone and combined with multivitamin-mineral (MM). After investigating the product's biological and pharmacological characteristics, its therapeutic dose was estimated to be Ag-NPs at 21.5 mg/kg B.W. This dose was orally inoculated to experimentally infected mice at 3-5 days post-inoculation (dpi) against the mature worms, at 8-10 dpi against the newborn larvae, and at 33-35th dpi against the encapsulated larvae. Each treatment's efficacy was assessed by scarifying control and treated mice 3 days post-treatment. The drug alone or in supplement form has a high trichinocidal effect exceeding that of the reference drug. Early treatment (3-5 dpi) by Ag-NPs or Ag-NPs + MM and albendazole revealed high efficacy against the intestinal stage, reaching 93.3%, 94.7%, and 90.6% for the three treatments, respectively. The materials causing a significant (P-value < 0.001) decrease in the mean encapsulated larvae reached 86.61%, 89.07%, and 88.84%/gm of muscles using the three treatments, respectively. Moreover, all larvae extracted from Ag-NPs-treated groups failed to induce infection post-inoculation in new mice. Additionally, combining the material with MM proved to overcome the reversible adverse effects of silver material on the estimated redox parameters and liver and kidney biomarkers, denoting its ability to alleviate Ag-NP toxicity. In conclusion, the high trichinocidal effect of Ag-NPs against the adult and encapsulated larvae during a short inoculation period introduced Ag-NPs as an alternative to other nematicidal drugs.

Evaluation of the therapeutic efficacy of some essential oils in experimentally immunosuppressed mice infected with Cryptosporidium parvum.

Cryptosporidiosis is a serious intestinal disease affecting mal-nourished children and immunocompromised individuals with severe fatal diarrhea. Our present work was done to evaluate the possible curative effects of different essential oils (Mint, Thyme, Chamomile and Basil) on Cryptosporidium parvum (C. parvum) in vivo compared with nitazoxanide (NTZ). Seventy immunosuppressed white Albino male mice were allocated in 7 groups as follows: group I infected and not treated (Positive control), group II (GII) treated with NTZ, group III (GIII) treated with Mint essential oil, group IV (GIV) treated with Thyme essential oil, group V (GV) treated with Chamomile essential oil, group VI (GVI) treated with Basil essential oil and group VII (GVII) naïve not infected mice (Negative control). Evaluation was done using parasitological, histopatholgical, serological as well as biochemical methods. All study groups revealed significant reduction (P value < 0.01) in the mean number of C. parvum oocysts in stool. Results of GII were the best with 87.7% reduction in the oocysts count followed by GIII (77.9%), GIV (74.7%), GVI (68.2%) and lastly GV (67.2%). Improvement of the histopathological damage in the small intestine was shown in treated groups. All treated mice showed significant upregulation in the interferon gamma (IFN-γ) levels, significant reduction in the malondialdehyde (MDA) levels and increase in superoxide dismutase (SOD) levels (P value < 0.0001). It is concluded that Mint, Thyme, Chamomile and Basil oils showed promising anti-cryptosporidial, anti-inflammatory and antioxidant functions.

Trichinocidal activity of a novel formulation of curcumin-olive oil nanocomposite in vitro.

Curcumin-olive oil nanocomposite (CO-NC), a novel formulation of nano-curcumin, was produced and characterized. By evaluating the death rate and DNA damage inflicted on adult Trichinella spiralis (T. spiralis) worms using the comet test and Scanning electron microscopy (SEM) analysis, the effectiveness of the substance against these worms was assessed in vitro. The mortality effects of CO-NC on the parasite adult worms were increased with the upgrading in the concentration and exposure time from 1 to 24 h using concentrations from 10 to 100 ppm. LC50 was determined to be 10.0 ppm/18 h, 20.0 ppm/9 h, 40.0 ppm/6 h, 80.0 ppm/2 h, and 100.0 ppm/1 h, while LC100 was 40.0 ppm/24 h, 80.0 ppm/12 h, and 100.0 ppm/6 h. The comet assay was utilized to examine DNA damage in control and dead worms exposed to varying doses. A direct correlation (P ≤ 0.05) was found between the increase in CO-NC dose and the degree of DNA damage as indicated by alterations in DNA % in the tail segment, tail length (µm), tail moment (µm), and olive tail moment with the control samples. The sub-epidermal layer was detached, the cuticle was partially sloughed off, and the usual creases, ridges, and annulations were altered in the T. spiralis exposed worms. As a result, the tested new trichinocidal drug formulation of nano-curcumin on an oil base was confirmed to be an efficient, secure, and environmentally friendly alternative. The medication has the potential to severely and irreversibly harm the DNA and ultrastructural morphology of adult worms.

Clinical, radiological and electrophysiological predictors for drug-resistant epilepsy.

Background: Epilepsy is the third chronic brain illness worldwide. About a third of the epileptic patients will be drug resistant. Early identification of these patients is critical for appropriate treatment selection and prevention of the devastating consequences of recurrent seizures. The objective of this study aims to detect clinical, electrophysiological, and radiological predictors for drug-resistant epilepsy patients. Results: One hundred fifty-five patients were included in this study, divided into a well-controlled epilepsy group (103 patients) and a drug-resistant group (52 patients). Both groups were compared regarding clinical, electrophysiological, and neuro-radiological data. Younger age at onset, history of delayed milestones, history of perinatal insult (especially hypoxia), mental retardation, neurological deficits, depression, status epilepticus (SE), complex febrile seizures, focal seizure to bilateral tonic-clonic convulsion as well as multiple seizures and high seizure frequency (daily) at onset, poor response to first anti-seizure drug (ASD), structural and metabolic etiology, abnormal brain imaging, and slow background and multifocal epileptiform discharges in EEG were significant risk factors for the development of drug-resistant epilepsy. Conclusion: MRI abnormalities are the most significant predictor for drug-resistant epilepsy. Drug-resistant epilepsy is associated with clinical, electrophysiological, and radiological risk factors that can be used to diagnose drug-resistant patients early and choose the best treatment option and time.

The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt.

BACKGROUND: In Egypt, the characterization of Neuromyelitis Optica Spectrum Disorder (NMOSD) is lacking. OBJECTIVES: To determine the demographics, clinical features, aquaporin4 antibodies (AQP4-IgG) status, and neuroimaging of Egyptian NMOSD patients. METHODS: Retrospective analysis of 70 NMOSD patients' records from the MS clinic, Kasr Alainy hospital, between January 2013 and June 2018. RESULTS: Patients' mean age was 34.9 ± 9.2 years, and the mean at disease onset was 28.9 ± 10.5 years. Fifty-nine patients had an initial monosymptomatic presentation. AQP4-IgG was measured using either enzyme-linked immunosorbent assay (ELISA) (22 patients) or cell-based assay (CBA) (34 patients). Six and 29 patients had positive results, respectively (p < 0.001). 84% had typical NMOSD brain lesions. Longitudinally extensive myelitis was detected in 49 patients, and 9 had either short segments or normal cords. Treatment failure was higher in seropositive patients. Rituximab significantly reduced the annualized relapse rate (ARR) compared to Azathioprine with a percentage reduction of (76.47 ± 13.28) and (10.21 ± 96.07), respectively (p = 0.04). Age at disease onset was the only independent predictor for disability (p < 0.01). CONCLUSION: Treatment failure was higher in seropositive patients. However, there was no difference in clinical or radiological parameters between seropositive and seronegative patients. Patients, who are polysymptomatic or with older age of onset, are predicted to have higher future disability regardless of the AQP4-IgG status.

Serum a proliferation-inducing ligand and MicroRNA-223 are associated with rheumatoid arthritis: diagnostic and prognostic implications.

BACKGROUND: Current blood-based tests for rheumatoid arthritis (RA) have inherent limitations, necessitating the need for additional new biomarkers for its diagnosis and monitoring disease activity and responsiveness to therapy. MicroRNAs (miRNAs) and a proliferation-inducing ligand (APRIL) are deregulated in RA and were linked to its pathogenesis. This study investigated serum levels of APRIL, miR-223 and miR-155 in RA patients, their potential as diagnostic and prognostic biomarkers, and their correlation with disease activity and clinicopathological data. METHODS: One hundred and twenty Egyptian patients with RA and 130 healthy controls were included. Serum miRNAs and APRIL were assayed by RT-qPCR and ELISA, respectively. RESULTS: Serum APRIL and miR-223 were significantly upregulated, while miR-155 was unchanged in RA patients compared to controls. Serum miR-223 discriminated RA patients from controls with AUC = 0.85, whereas serum APRIL superiorly distinguished the two groups with AUC = 1 (sensitivity and specificity = 100% at cutoff> 4.19 ng/ml) by receiver-operating-characteristic analysis. Serum miR-223 was a significant predictor for RA diagnosis in multivariate logistic regression analysis. In RA group, serum APRIL was positively correlated with disease activity score (DAS28-CRP). Serum miR-223 expression was positively correlated with serum miR-155, APRIL levels and with the presence of subcutaneous nodules. Serum miR-155 levels were correlated with antinuclear antibody titer in reverse direction. CONCLUSION: Our results suggest serum APRIL and miR-223 could serve as potential biomarkers of RA, with miR-223 as a predictor of RA risk and APRIL as an excellent biomarker of disease activity. Our data could be implicated for accurate and blood-based non-invasive diagnosis and prognosis of RA.

Phytochemical, antimicrobial and antiquorum-sensing studies of pulicaria undulata L.: a revision on the structure of 1ß,2α,3ß,19α,23-pentahydroxy-urs-12-en-28-oic acid.

Phytochemical study of the aerial part of Pulicaria undulata L. led to the isolation of nine compounds. The structure of 1ß,2α,3ß,19α,23-pentahydroxy-urs-12-en-28-oic acid (4) was revised and confirmation of the stereochemical configuration of the hydroxyl groups was established using NOESY and selective decoupling experiments. The other compounds were identified as 1,2-dehydro-1,10α-dihydropseudoivalin (1), axillarin (2), grandifloric acid-15-ß-glucoside (3), myrianthic acid (5), caffeic acid (6), quercetin (7), paniculoside IV (8) and caffeic anhydride (9). The structures were characterized by 1 D, 2 D NMR spectroscopy and confirmed with HRMS. Antimicrobial and antiquorum-sensing activities of the different extracts and isolated compounds of the plant were investigated. Generally, the phenolic rather than the terpenoidal compounds exhibited remarkable antimicrobial and antiquorum-sensing activity.[Formula: see text].

Atorvastatin repurposing for the treatment of cryptosporidiosis in experimentally immunosuppressed mice.

The present study was conducted on 200 male mice for the detection of the effect of Atorvastatin on Cryptosporidium spp. infection versus the commercially used drug Nitazoxanide in experimentally immunosuppressed mice. Atorvastatin was used alone at low dose (20 mg/kg), high dose (40 mg/kg), and combined with Nitazoxanide (1000 mg/kg) with either the low dose or high dose for five consecutive days. Parasitological assessment of the drug effect was done using Modified Z-N staining of stool samples collected from mice. Results revealed a reduction of the number of oocysts shed with percentage of reduction on the 21st day post infection by 53.7%, 67.2%, 70.1% &77.5%, respectively, compared to the infected untreated group. The Nitazoxanide treated group showed 52.7% reduction. In addition, examination of small and large intestinal contents after mice scarification revealed reduced numbers of oocysts by 56.2%-58.8%, 65.1%-65.3%, 70.6%-73.9% and 77.8%-79.9%, respectively, compared to 51.2%-54.1% in Nitazoxanide treated group. The histopathological examination of sections from duodenum, jejunum, ileum, colon, stomach and lungs also revealed a significant improvement of the histopathological changes in Atorvastatin treated groups and more remarkable improvement in the groups treated with combined drugs as compared to infected untreated group. Accordingly, the combination of Atorvastatin and Nitazoxanide showed a synergistic effect through reduction of the number of oocysts shed and improvement of the histopathological changes induced by Cryptosporidium spp. infection in the small intestine, colon, stomach and lungs of infected immunosuppressed mice in comparison to that induced by either Nitazoxanide or Atorvastatin alone.

Obesity is associated with visit-to-visit systolic blood pressure variability in the US adults.

BACKGROUND: Evidence has accumulated showing that blood pressure variability is associated with cardiovascular disease. A substantial increase in the prevalence of obesity has been documented globally. Our objective was to examine the relation of total and central obesity on visit-to-visit blood pressure variability. METHODS: We used data collected from the cross-sectional Third National Health and Nutrition Examination Survey, to examine the association of visit-to-visit blood pressure variability with body mass index and waist circumference. RESULTS: The analysis included 14,988 participants. The participants' mean age was 43.45 years. Visit-to-visit systolic blood pressure variability was associated with a body mass index ≥30 and a large waist circumference (beta coefficients were 0.25 and 0.31, respectively, P-values < 0.01). Neither the bivariate nor the multivariable analyses showed significant relationships between the obesity indicators and diastolic blood pressure variability. CONCLUSIONS: Obesity is associated with visit-to-visit systolic blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among obese persons to reduce its subsequent complications.

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Bahraini cohort of the A1chieve study.

BACKGROUND: The A1chieve, is a multicentric (28 countries), 24-weeks, non-interventional study to evaluate the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. MATERIALS AND METHODS: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Manama, kingdom of Bahrain. RESULTS: A total of 115 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 67), insulin detemir (n = 16), insulin aspart (n = 4), basal insulin plus insulin aspart (n = 21) and other insulin combinations (n = 7). At baseline, glycaemic control was poor for both insulin naïve (mean HbA1c: 10.2%) and insulin users (mean HbA1c: 9.8%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.1%, insulin users: -1.3%). SADRs including major hypoglycaemic events did not occur in the study patients. CONCLUSION: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.

Genetic variations in E-selectin and ICAM-1: relation to atherosclerosis.

BACKGROUND: This study aimed to investigate the association of both intercellular adhesion molecule-1 (ICAM-1) and endothelial cell adhesion molecule (E-selectin) polymorphisms using PCR technique and their role in the pathogenesis of atherosclerosis. MATERIAL/METHODS: The study enrolled 285 individuals, classified into 4 groups: 63 cerebrovascular atherosclerotic patients, 75 cardiovascular patients, 72 peripheral atherosclerotic patients and 75 normal healthy individuals. RESULTS: The frequency of the mutant AC genotype of E-selectin in peripheral, cerebral and cardiovascular atherosclerotic patients was significantly higher than in control subjects (29.17%, 28.53% and 28% vs. 8%, respectively). However, no significant difference was observed in the frequency of mutant CC allele between all atherosclerotic patients and control groups. The frequency of the mutant EE homozygotes of ICAM-1 in peripheral, cerebral and cardiovascular atherosclerotic patients was significantly higher compared to controls (45.8%, 42.9% and 36% vs. 12%, respectively). The frequency of EK of ICAM-1 showed no significant difference between atherosclerotic patients and the control group. The frequency of the mutant E allele of ICAM-1 was significantly higher in peripheral, cerebral and cardiovascular patients compared to controls (58.3%, 54.8% and 54% vs. 26%, respectively). CONCLUSIONS: Ser 128Arg of E-selectin and the K469E of ICAM-1 polymorphisms may be involved in predisposition to atherosclerosis.