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1.
Pain Med ; 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33544857

RESUMEN

OBJECTIVES: Headache is considered one of the most frequent neurological manifestations of COVID-19. This work aimed to identify the relative frequency of COVID-19 related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics. DESIGN: Cross-sectional study. SETTING: Recovered COVID-19 patients. SUBJECTS: 782 patients with a confirmed diagnosis of COVID-19 infection. METHODS: Clinical, laboratory and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics. RESULTS: The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% CI (0.516-0.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics. DISCUSSION: Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.

2.
J Basic Microbiol ; 61(4): 330-338, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33599337

RESUMEN

Microalgae have received continued attention as a potential source for biofuel production. However, the lack of suitable strains that provide a lipid-rich biomass and tolerate harsh condition inhibits their industrial application. This report describes an effort to transform Synechocystis sp. with genes encoding acetyl-CoA carboxylase (ACC), a key regulatory enzyme in the lipogenesis pathway, from the white mustard plant (Sinapis alba) and the bacterium Escherichia coli DH5α using chitosan nanoparticles. Although a recombinant plasmid encoding S. alba ACC failed to express, successful transformation was achieved with a recombinant plasmid encoding E. coli DH5α ACC. The successful transformant, Synechocystis sp. PAK13, exhibited increased ACC expression compared with its wild-type parent (11.8 vs. 7.2 ng), which significantly increased its lipid content (by 3.6-fold). Synechocystis sp. PAK13 also exhibited a significant (20%) reduction in photosynthetic pigments, a 1.52-fold higher glucose content and a 3.5-fold lower sucrose content than the wild-type. In conclusion, this report introduces a useful strategy to overexpress the ACC gene in microalgae, creating strains with improved lipid production that are suited to industrial applications.

3.
Anesth Pain Med ; 10(2): e100138, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32754432

RESUMEN

Background: The toxic effect of local anesthesia on the retina has been previously investigated in animal studies but not in humans. Objectives: The objective of this study was to clarify the effect of local anesthesia with lidocaine versus local anesthesia with lidocaine with extra administration of adrenaline on the retinal layer thickness measured by optical coherence tomography (OCT) in patients indicated for elective cataract surgery. Methods: This is a randomized controlled trial conducted on 60 patients indicated for elective cataract surgery under local anesthesia with lidocaine. Thirty participants received local anesthesia with lidocaine 2% with extra administration of adrenaline (adrenaline group), and 30 participants received local anesthesia with lidocaine 2% only (control group). The retinal thickness was measured for all participants preoperatively and one week postoperatively using OCT. Results: The OCT findings showed statistically significant decreases postoperatively in superior (P value = 0.028), inferior (P value = 0.017), and average (P value = 0.021) retinal thickness in the adrenaline group. Moreover, there were statistically significant decreases postoperatively in superior (P value = 0.032), inferior (P value = 0.046), and average (P value = 0.028) retinal thickness in the control group. Comparing the adrenaline and control groups for the OCT findings, there was no statistically significant difference between the groups regarding the decreases in superior (P value = 0.325), inferior (P value = 0.642), and average (P value = 0.291) retinal thickness. Conclusions: Local anesthesia with lidocaine significantly decreased the retinal thickness. The extra administration of adrenaline to lidocaine did not affect the post-anesthetic changes in the retinal thickness.

4.
J Pain Res ; 12: 2529-2536, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31686895

RESUMEN

Purpose: Much concern was directed toward exploring the relationship between vitamin D and migraine. There is strong evidence that vitamin D supplementation can decrease frequency, severity, and duration of migraine headache attacks. The aim of this work was to investigate the difference in serum levels of 25 (OH)-vitamin D between patients with migraine and healthy controls, to determine the differences in headache characteristics according to vitamin D status, and to correlate serum 25 (OH)-vitamin D level with duration, frequency, and severity of migraine headache attacks. Patients and methods: This is a case-control study conducted on 40 patients diagnosed with migraine and 40 healthy controls. History was taken from patients with migraine regarding headache characteristics. Migraine severity scale (MIGSEV) and Headache Impact Test-6 (HIT-6) were used for migraine assessment. Serum 25(OH)-vitamin D was measured for all patients and controls using enzyme-linked immunosorbent assay (ELISA). Results: Patients with migraine had significantly lower 25(OH)-vitamin D serum level in comparison to controls (P-value=0.019). The incidence of aura, phonophobia/photophobia, autonomic manifestations, allodynia, and resistance to medications were significantly higher in migraineurs with vitamin D deficiency than those with normal vitamin D. There was a statistically significant negative correlation between 25(OH)-vitamin D serum level and attack duration in hours (P-value˂0.001), frequency of the attacks/month (P-value˂0.001), MIGSEV scale (P-value=0.001), and HIT-6 scale (P-value=0.001). Conclusion: Patients with migraine had significant vitamin D deficiency compared to healthy controls. Such deficiency significantly affects headache characteristics, duration, frequency, and severity of headache attacks.

5.
Local Reg Anesth ; 12: 1-6, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30643450

RESUMEN

Purpose: Postoperative cognitive dysfunction has gained much attention over the last years. Multiple clinical trials have attempted to differentiate the effect of local vs general anesthesia on postoperative cognitive function. The aim of this work was to study the effect of local anesthesia with lidocaine vs bupivacaine on cognitive function. Patients and methods: This was a prospective randomized trial carried out on 61 patients undergoing elective cataract surgery by phacoemulsification under local anesthesia. Twenty-eight patients received lidocaine 2% and 33 patients received bupivacaine 0.5%. Cognitive assessment for all patients was done preoperatively and 1 week postoperatively using paired associate learning test (PALT) and category verbal fluency (VF) test (animal category). Results: Regarding cognitive assessment of patients in lidocaine group, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (P-value =0.004), and between the mean value of preoperative VF and postoperative VF (P-value =0.002). As for bupivacaine group, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (P-value =0.021), and between the mean value of preoperative VF and postoperative VF (P-value =0.037). On comparing lidocaine and bupivacaine groups in pre and postoperative PALT & VF scores, there was no statistically significant difference between both groups. Conclusion: Both lidocaine and bupivacaine caused postoperative cognitive impairment. Lidocaine was found to have a worse effect on cognitive function than bupivacaine, but the difference was not statistically significant.

6.
Anesth Pain Med ; 9(6): e97172, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32280618

RESUMEN

Background: Multiple clinical trials targeted the assessment of cognitive function following local versus general anesthesia in patients undergoing ophthalmic surgery, but no previous clinical trials have focused on the effect of topical anesthesia on cognitive function. Objectives: This study aimed to compare the effect of local anesthesia with lidocaine 2% versus topical anesthesia with Oxybuprocaine (benoxinate hydrochloride 0.4%) on cognitive function in patients undergoing elective cataract surgery. Methods: This is a prospective randomized clinical trial carried out on 60 patients undergoing elective cataract surgery by phacoemulsification. Thirty patients received local anesthesia with lidocaine 2% and thirty patients received topical anesthesia with Oxybuprocaine (benoxinate hydrochloride 0.4%). Patients' satisfaction was assessed postoperatively using the Iowa satisfaction with anesthesia scale (ISAS). Cognitive assessment for all patients was done preoperatively and 1 week postoperatively using paired-associate learning test (PALT) and category verbal fluency (VF) test (animal category). Results: There was no statistically significant difference between local and topical anesthesia groups in the mean of responses to the 11 statements of ISAS (P = 0.071). Regarding cognitive assessment, there was a statistically significant postoperative decline in the local anesthesia group in both PALT scores (P = 0.005) and VF scores (P = 0.01). In the topical anesthesia group, there was no statistically significant difference between pre- and postoperative PALT scores (P = 0.326) or VF scores (P = 0.199). Conclusions: Postoperative cognitive dysfunction following elective cataract surgeries under local anesthesia can be attributed to the effect of local anesthesia rather than the effect of surgery.

7.
Int J Neurosci ; 129(8): 729-737, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30590973

RESUMEN

Introduction: There is alarming evidence about the involvement of general anaesthesia in the development of postoperative cognitive dysfunction. Aim: To clarify the impact of general anaesthesia on cognitive function and to study the possible effect of general anaesthesia on serum S100B, the marker of neuronal degeneration. Methods: This is a prospective randomised controlled study carried out on 50 patients undergoing elective laparoscopic cholecystectomy under conventional general anaesthesia. Cognitive assessment for selected patients was done preoperative and 1 week postoperative using Paired Associate Learning test (PALT) for assessment of verbal memory and Benton Visual Retention test (BVRT) for assessment of visual memory. Quantitative determination of serum S100B was done for all patients in the basal sample and postoperative sample by applying an enzyme- linked immunoabsorbent assay technique on am automated ELISA platform. Results: Regarding cognitive tests, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (p-value = .012). There was also a statistically significant difference between the mean value of preoperative BVRT and postoperative BVRT (p-value = .011). Regarding S100B, there was a statistically significant difference between preoperative and postoperative serum level (p-value = .002). There was also a statistically significant negative correlation between postoperative S100B serum level and the postoperative scores of both PALT and BVRT. Conclusion: General anaesthesia is incriminated in the development of postoperative verbal and visual memory impairment and in the postoperative increase in serum S100B, the markers of neuronal degeneration.


Asunto(s)
Anestesia General/efectos adversos , Disfunción Cognitiva/etiología , Degeneración Nerviosa/etiología , Subunidad beta de la Proteína de Unión al Calcio S100/sangre , Adulto , Colecistectomía Laparoscópica/efectos adversos , Disfunción Cognitiva/sangre , Disfunción Cognitiva/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Degeneración Nerviosa/sangre , Estudios Prospectivos
8.
Mol Cell Biochem ; 454(1-2): 177-189, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30357530

RESUMEN

Colorectal cancer (CRC) is a major cause of death worldwide. Novel non-invasive, high diagnostic value screening test is urgently needed to improve survival rate, treatment and prognosis. Stable, small, circulating microRNA (miRNA) offers unique opportunities for the early diagnosis of several diseases. It acts as tumor oncogenes or suppressors and involve in cell death, survival, and metastasis. Communication between miRNA and carcinogenesis is critical but it still not clear and needs further investigation. The aim of our study is to evaluate the role of miR-210, miR-21, miR-126, as non-invasive diagnostic biomarkers for screening, early detection of CRC, studying their correlation with prognostic variables, and clarifying the roles of miRNAs on HIF-1α-VEGF signaling pathway. The expression of miR-210, miR-21 and miR-126 was performed using qRT-PCR in adenocarcinoma (no = 35), adenomas (no = 51), and neoplasm free controls (no = 101). Serum levels of VEGF and HIF-1α was determined by ELISA Kit. The results show that the expression of miR-210, miR-21, VEGF, HIF-1α was significantly up-regulated while that miRNA-126 was down-regulated in both adenocarcinoma and adenomas compared with controls (p < 0.001 for each). No significant difference was noted comparing patients with adenocarcinoma and adenomas. The three miRNAs correlated with VEGF, HIF-α. The miR-210 and miR-21 associated with TNM classification and clinical staging of adenocarcinoma (p < 0.001) and they show high diagnostic value with sensitivity and specificity 88.6%, 90.1% and 91.4%, 95.0% respectively. Our study revealed that circulating miR-210, miR-21 were up-regulated while miR-126 was down-regulated in CRC and adenomas patients, they all correlated with TNM staging and they had high diagnostic value. HIF-1α VEGF signaling pathways regulated by miRNAs played a role in colon cancer initiation. To the best of our knowledge, this is the first study of this miRNAs panel in CRC in our community. These data suggested that these biomarkers could be a potential novel, non-invasive marker for early diagnosis, screening and predicting prognosis of CRC. Understanding the molecular functions by which miRNAs affect cancer and understanding its roles in modulating the signaling output of VEGF might be fruitful in reducing the incidence and slowing the progression of this dark malignancy.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , MicroARNs/sangre , Adenocarcinoma/sangre , Adenocarcinoma/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Adenoma/sangre , Adenoma/diagnóstico , Adenoma/genética , Adenoma/metabolismo , Anciano , Biomarcadores de Tumor/sangre , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/metabolismo , Diagnóstico Precoz , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/sangre , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Masculino , MicroARNs/genética , Persona de Mediana Edad , Pronóstico , Transducción de Señal , Factor A de Crecimiento Endotelial Vascular/sangre , Factor A de Crecimiento Endotelial Vascular/metabolismo
9.
J Gastroenterol Hepatol ; 34(8): 1424-1431, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30422339

RESUMEN

BACKGROUND AND AIM: Secreted protein acidic and rich in cysteine (SPARC) is a glycoprotein involved in extracellular matrix remodeling, which regulates cell growth. It could be involved in hepatic fibrogenesis related to chronic inflammations, hepatocellular carcinoma (HCC) angiogenesis, and tumor progression. We aimed to study the expressions of single nucleotide polymorphisms in the SPARC gene and their impact on susceptibility and survival of HCC patients. METHODS: We conducted a case-control study on 200 HCC patients and 50 matched healthy controls. All patients were subjected to laboratory investigations, ultrasound, and real-time polymerase chain reaction to detect the genetic polymorphisms (rs3210714, rs11950384, and rs7719521) in the SPARC gene in the blood. RESULTS: One hundred sixty (80%) patients were men with a mean age of 43 years. The SPARC gene showed a significant higher prevalence of rs3210714 mutation (i.e. AA or AG) and a significant lower prevalence of rs11950384 mutation (i.e. AA or AC) among HCC patients in comparison with controls (83% vs 22%, P ≤ 0.001) and (65.5 vs 86%, P = 0.005), respectively, while rs7719521 mutation did not reach significance. On univariate and multivariate analyses, elder age and having at least one copy of the mutant rs3210714 were associated with a significantly increased risk of HCC (P < 0.001 for both), whereas the presence of at least one copy of the mutant rs11950384 carried a significantly reduced risk of having HCC (P < 0.01). Overall survival did not differ significantly between any of the SPARC gene mutation groups. CONCLUSIONS: The SPARC gene polymorphisms had a diverse impact on the susceptibility of HCC due to its ability to inhibit or promote tumor progression. SPARC gene polymorphisms were not related to survival of our HCC patients, and probably, this needs further analysis of other SPARC gene nucleotides.


Asunto(s)
Biomarcadores de Tumor/genética , Carcinoma Hepatocelular/genética , Neoplasias Hepáticas/genética , Mutación , Osteonectina/genética , Polimorfismo de Nucleótido Simple , Adulto , Factores de Edad , Anciano , Biomarcadores de Tumor/sangre , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/mortalidad , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Osteonectina/sangre , Fenotipo , Pronóstico , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
10.
Rep Biochem Mol Biol ; 6(2): 186-196, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29766002

RESUMEN

Background: We explored the effect of vitamin D receptor gene (VDR) polymorphisms in response to PEG-IFN treatment in Egyptian chronic hepatitis B (CHB) patients. Methods: Two hundred hepatitis B virus (HBV) patients (42.3±10.7 years) on PEG-IFN α-2a (180 µg /kg for 48 weeks) and one hundred control subjects (37.3 ±12 years) were enrolled in the study. Vitamin D levels and hepatitis B surface antigen (HBsAg) expression were assessed by ELISA. VDR polymorphisms FokI T>C (rs 10735810), BsmI A>G (rs 1544410), ApaI (rs7975253), and TaqI C>T (rs 731236), were genotyped using real-time PCR. Results: Hepatitis B virus patients expressed significantly greater AST (p=< 0.00001) and ALT (P=< 0.00001), and significantly less vitamin D (P=0.01), than control subjects. Patients with Ff or ff alleles of the FokI single-nucleotide polymorphism (SNP), bb alleles of BsmI SNP, or TT alleles of the Taq1 single nucleotide polymorphisms (SNP) showed greater response to PEG-IFN therapy than those with the FF (P=0.02 and P=0.0002), Bb (P=0.023), or Tt/tt alleles (P=0.01 and P=0.004 respectively). Logistic stepwise regression showed that HBV DNA (r: 0.910, P< .00001), FokI SNP polymorphism (r: 0.919, (P=0.037) and bAt haplotype (r: .926, (P=0.043) are independent factors that determine PEG-IFN treatment response in the HBV-infected patients. Conclusion: VDR gene polymorphisms may be used as treatment response predictors in HBV patients receiving PEG-IFN. FokI SNP and bAt haplotype are independent factors that that can be used to determine PEG-IFN treatment responses in HBV-infected patients.

11.
J Clin Med Res ; 9(5): 416-425, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28392862

RESUMEN

BACKGROUND: The current study aimed at testing the effect of corticosteroid therapy on serum levels of interleukin-10 (IL-10) and IL-17 as well as lncRNA-AF085935 in patients of rheumatoid arthritis (RA) associated with hepatitis C virus (HCV) and evaluating the usefulness of using these parameters to predict the therapeutic efficacy of steroids in these patients. METHODS: Thirty healthy control subjects and 65 chronic HCV patients with RA were included in our study. Patients were subjected to clinical examination, abdominal ultrasound, and liver biopsy and received 6-methyl-prednisolone (PDN) 16 mg/day for 48 weeks. Blood samples were collected from all subjects and serum was separated to assess IL-10 and IL-17 by ELISA and HCV RNA and lncRNA-AF085935 by qRT-PCR. RESULTS: Our study revealed that there were significant increases in serum levels of IL-10, IL-17 and lncRNA-AF085935 in RA patients associated with HCV compared with healthy control subjects. Also there were significant increases in serum levels of IL-10 and HCV RNA and a significant decrease in serum level of IL-17 in patients after corticosteroid therapy, while lncRNA-AF085935 is not significantly changed. CONCLUSION: LncRNA-AF085935 might be a useful candidate biomarker for the early detection of RA associated with HCV, providing potential new strategies for early screening and therapy of these patients. IL-17 is a non-invasive prognostic marker to predict the efficacy of corticosteroid therapy in RA patients associated with chronic hepatitis C.

13.
World J Microbiol Biotechnol ; 32(6): 92, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27116958

RESUMEN

UNLABELLED: We aimed to study MLH1 and MGMT methylation status in Helicobacter pylori-associated chronic gastritis in Egyptian patients with and without gastric cancer. 39 patients were included in our study. They were divided into 2 groups; patients without (group I) and with gastric adenocarcinoma (group II). Patients were subjected to clinical examination, abdominal ultrasound and upper endoscopy for gastric biopsy. Biopsies were subjected to urease test, histological examination, and DNA purification. H. pylori, Braf, Kras, MLH1 and MGMT methylation were assessed by quantitative PCR. DNA sequencing was performed to assess Braf and Kras genes mutation. qPCR of H. pylori was significantly higher in patients with adenocarcinoma (group II) than those without adenocarcinoma (group I); with a p < 0.001 as well as in patients with age above 50 years with a p value = 0.008. By applying logistic regression analysis it was reported that the H. pylori qPCR is a significant predictor to the adenocarcinoma with OR = 1.025 (95 % CI: 1. 002-1.048), with sensitivity of 90 % and specificity of 100 %. Adenocarcinoma patients had a significantly higher mean age and levels of H. Pylori, Braf, K-ras, methylated MGMT and methylated MLH1 than those of gastritis patients. DNA sequence analysis of Braf (codon 12) and Kras (codon 600) had genes mutation in gastric adenocarcinoma versus chronic gastritis. CONCLUSION: H. pylori may cause epigenetic changes predisposing the patients to cancer stomach. Estimation of H. pylori by qPCR can be a good predictor to adenocarcinoma. Braf and Kras genes mutation were reveled in gastritis and adenocarcinoma patients.


Asunto(s)
Gastritis/genética , Infecciones por Helicobacter/genética , Helicobacter pylori/genética , Proteínas Proto-Oncogénicas B-raf/genética , Proteínas Proto-Oncogénicas p21(ras)/genética , Adenocarcinoma/genética , Adenocarcinoma/microbiología , Adulto , Anciano , Enfermedad Crónica , Metilación de ADN , Metilasas de Modificación del ADN/genética , Enzimas Reparadoras del ADN/genética , Egipto , Epigénesis Genética , Femenino , Gastritis/enzimología , Gastritis/microbiología , Gastritis/patología , Perfilación de la Expresión Génica , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/enzimología , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Persona de Mediana Edad , Homólogo 1 de la Proteína MutL/genética , Mutación , Neoplasias Gástricas/enzimología , Neoplasias Gástricas/genética , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Proteínas Supresoras de Tumor/genética
14.
World J Gastroenterol ; 20(33): 11793-9, 2014 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-25206284

RESUMEN

AIM: To investigate the association of the functional monocyte chemotactic protein-1 (MCP-1) promoter polymorphism (A-2518G) with spontaneous bacterial peritonitis (SBP). METHODS: Fifty patients with post-hepatitis C liver cirrhosis and ascites were categorized into two groups; group I included 25 patients with SBP and group II included 25 patients free from SBP. In addition, a group of 20 healthy volunteers were included. We assessed the MCP-1 gene polymorphism and gene expression as well as interleukin (IL)-10 levels in both blood and ascitic fluid. RESULTS: A significant MCP-1 gene polymorphism was detected in groups I and II (P = 0.001 and 0.02 respectively). Group I was associated with a significantly higher frequency of AG genotype [control 8 (40%) vs SBP 19 (76.0%), P < 0.001], and group II was associated with a significantly higher frequency of GG genotype when compared to healthy volunteers [control 1 (5%) vs cirrhotic 16 (64%), P < 0.001]. Accordingly, the frequency of G allele was significantly higher in both groups (I and II) [control 10 (25%) vs SBP 27 (54%), P < 0.001 and vs cirrhotic 37 (74.0%), P < 0.001, respectively]. The total blood and ascetic fluid levels of IL-10 and MCP-1 gene expression were significantly higher in group I than in group II. Group I showed significant reductions in the levels of MCP-1 gene expression and IL-10 in the whole blood and ascetic fluid after therapy. CONCLUSION: MCP-1 GG genotype and G allele may predispose HCV infected patients to a more progressive disease course, while AG genotype may increase the susceptibility to SBP. Patients carrying these genotypes should be under supervision to prevent or restrict further complications.


Asunto(s)
Infecciones Bacterianas/genética , Quimiocina CCL2/genética , Peritonitis/genética , Polimorfismo Genético , Adulto , Ascitis/inmunología , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/inmunología , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/terapia , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Hepatitis C/complicaciones , Humanos , Interleucina-10/sangre , Masculino , Persona de Mediana Edad , Peritonitis/diagnóstico , Peritonitis/inmunología , Peritonitis/microbiología , Peritonitis/terapia , Fenotipo , Regiones Promotoras Genéticas , Factores de Riesgo , Resultado del Tratamiento
15.
Arab J Gastroenterol ; 10(1): 14-20, 2009 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24842131

RESUMEN

BACKGROUND AND STUDY AIMS: In patients with chronic hepatitis C, the precise stage of hepatic fibrosis is the most important predictor of disease progression and it determines the need for antiviral therapy. Although liver biopsy is acknowledged as the gold standard for evaluating fibrosis, it is occasionally prone to sampling error and complications. We aimed to correlate an index of biochemical markers with histological features of fibrosis to predict hepatic fibrosis in patients with chronic hepatitis C virus, patients with combined hepatitis C virus and non-alcoholic steatohepatitis and those with non-alcoholic steatohepatitis, aiming to reduce the use of the liver biopsy. PATIENTS AND METHODS: Out of those attending our out patient clinic for clinical, haematological, biochemical, virological, histological and ultrasonographic assessment prior to interferon therapy for hepatitis C virus, we enrolled 41 patients and grouped them according to histopathological examination of their liver biopsies into: Group I: 21 chronic hepatitis C virus patients as defined by positive 3rd generation ELISA; Group II: 20 patients with combined hepatitis C virus and NASH. We added a third group (Group III) of 15 patients having non alcoholic steatohepatitis as defined clinically, biochemically and through diagnostic percutanous liver biopsy. There were 33 male 23 female patients; 35 (62.5%) of them were from rural areas and 21 (37.5%) were from urban areas; the mean ages were 40.5±9, 46.6±7.7 and 42.13±11.06 in Group I, II and III respectively. Twenty apparently healthy individuals served as the control group. All the patients and the control group were submitted to full clinical history and examination, abdominal ultrasonography, CBC, liver biochemical profile and fibrosis biomarkers (apolipoprotein A1, haptoglobin, α2 marcoglobulin, GGT). Liver biopsy was done for suitable patients after taking a consent and the results of fibrosis seromarkers were compared with the results of liver biopsy using the Metavir scoring system. We also estimated patients' body mass index, fasting and post prandial blood glucose. We excluded patients with other causes of chronic liver disease and co-morbidities that could confound the results of the non-invasive markers adopted, including schistosomiasis which was excluded by serological test. RESULTS: 43% of Group I and 40% of Group II had advanced fibrosis. None of Group III had advanced fibrosis; mild fibrosis was detected in 80% of them. γ-GT was found positively correlated to the degree of hepatic fibrosis in Groups I, II and III (r=0.667, 0.656 and 0.121, respectively) with P values of 0.001, 0.002, 0.668, respectively. α2 macroglobulin was found to be a reliable predictor of fibrosis (r=0.30, P=0.02) with ROC curve (area under the curve=0.70) best cutoff value 2.55g/L with sensitivity of 0.80 and specificity of 0.50. The results of haptoglobin were negatively related to the degree of hepatic fibrosis in Group I and II with ROC curve area under the curve of 0.33 and P value of 0.04. Significant direct correlation was seen in Group III (r=0.55, P=0.03), so by regression analysis, haptoglobin can be used as a good predictor for fibrosis in Group III (r=0.54, P=0.04). Apolipoprotein A1 has negative correlation to the stage of fibrosis in Groups I and II although the results were statistically insignificant. APRI index was found significantly directly correlated to the fibrosis stage and the grade of inflammation of all studied groups (r=0.57, P<0.01 and r=0.36, P<0.01, respectively) with a best cutoff value of 0.62, with sensitivity of 0.86 and specificity of 0.57. In patients with advanced fibrosis the best cutoff value was found to be 0.72 with sensitivity of 0.94 and specificity of 0.67. Modified APRI test showed AUC of 0.79 (P<0.01) with a best cutoff value of 0.067 at which sensitivity and specificity were 0.82 and 0.61, respectively. CONCLUSION: α2 macroglobulin, haptoglobin, apolipoprotein A1, APRI index and a modified APRI index, were found to be significant predictors of hepatic fibrosis and were reprocessed by stepwise logistic regression.

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