Polymorphism in promotor region of IL6 gene as a predictor for severity in COVID -19 patients.

SARS-CoV-2 is the causative agent of coronavirus disease started in 2019 (COVID-19). IL-6 gene is located on chromosome 7. A considerable number of polymorphisms was identified in the IL-6 gene. Polymorphism in IL-6-174C allele is associated with a higher level of IL-6 production and this may lead to severity of in COVID-19 patients. We intended to investigate the role of polymorphism in the promotor region of IL-6 gene as a predictor for disease severity in COVID-19 patients. Fifty patients diagnosed with COVID-19 and classified into moderate and severe groups and twenty apparently healthy controls were enrolled in the study. Genotyping for IL-6 gene (-174G/C) was done by using TaqMan SNP genotyping assay for all studied groups. The distribution of different IL-6-174G/C genotypes among COVID-19 patients was 76% for GG genotype, 22% for GC genotype and 2% for CC genotype. Whereas the distribution of genotypes among the control group was 80% for GG genotype, 20% for GC genotype and 0.0% for CC genotype. The G allele distribution was 87% and 90% in the patients and control groups, respectively, while the C allele was 13% and 10% in the patients and control groups, respectively. There was no significant statistical association between different genotypes, severity and treatment outcome in the patients group. In conclusion, this study showed no relation between -174G/C IL-6 gene polymorphism and disease, in COVID-19 patients. Keywords: Interleukin-6, Promotor region, Polymorphism, COVID-19, Severity.

Association of intercellular adhesion gene A with biofilm formation in staphylococci isolates from patients with conjunctivitis.

BACKGROUND: There is a great negative impact of biofilm-mediated infection on patient health which necessitates the use of reliable methods for detecting biofilm producers. AIMS: This study was done to determine biofilm-producing ability and the presence of intercellular adhesion gene A in clinical staphylococcal isolates and to assess the reliability of two phenotypic methods used for biofilm detection. MATERIALS AND METHODS: Fifty staphylococcal strains were isolated from 100 conjunctival swabs from patients attended the Ophthalmology Outpatient Department of the Research Institute of Ophthalmology. Two phenotypic methods were used for detection of biofilm production; qualitative congo red agar (CRA); and quantitative microtiter plate. Polymerase chain reaction was used to determine the presence of icaA gene. RESULTS: In Staph aureus, 60% were positive biofilm forming and 40% were negative biofilm forming by both phenotypic methods. All positive biofilm-forming isolates were positive for icaA gene production. In coagulase negative staph, 50% were positive biofilm forming and 50% were negative biofilm forming by both phenotypic methods. All positive biofilm-forming strains were positive for icaA gene. All negative cases by CRA and microtiter plate methods were negative for icaA gene except two isolates. All staphylococcal isolates were subjected to antibiotic susceptibility test to correlate biofilm formation with multidrug resistance in staph. CONCLUSION: There is high significant correlation between icaA gene presence and biofilm forming ability; however, the biofilm-forming ability of some isolates in the absence of icaA gene highlights the importance of further genetic investigations of ica-independent biofilm formation mechanisms.

ASSESSMENT OF THE DIAGNOSTIC AND PROGNOSTIC ROLE OF CEREBEROSPINAL FLUID INTERLEUKIN-8 LEVEL IN ADULT PATIENTS WITH MENINGITIS.

Meningitis necessitates immediate diagnosis and therapy. It is important to distingu- ish bacterial from aseptic meningitis, as this help to avoid complications and unnece- ssary antibiotic use. This work assessed the diagnostic and prognostic role of cerebro-spinal fluid interleukin-8 (IL-8) level in adult patients with meningitis. Ninety adult patients with meningitis were studied. They were divided into 3 groups: bacterial, tuberculous and aseptic meningitis. Full clinical examination and laboratory workup of meningitis were done. Cerebrospinal fluid (CSF) IL-8 levels were assessed. Patients were followed up till discharge or death. CSF IL-8 level was significantly higher in bacterial and tuberculous meningitis in comparison to aseptic meningitis. At cut off value 121.77 pg/ml, the area under ROC curve was 0.774 with efficacy 69% for differentiating viral from non-viral meningitis. The test efficacy is low in differentiating tuberculous from bactedal meningitis. There is no correlation of CSF IL-8 levels and disease severity or prognosis.

Expression of Toll like receptors 3 & 7 in peripheral blood from patients with chronic hepatitis C virus infection and their correlation with interferon-alpha.

Toll-like receptor 3 (TLR3) and Toll-like receptor 7 (TLR7) are pathogen- recognition receptors that are expressed on innate immune cells. They recognize viral RNA which induces their activation with subsequent increase in IFN-alpha transcription. It has been postulated that HCV may cause down regulation of these receptors as one of immune evading mechanisms that participate in viral persistence. The aim of this work is to investigate the expression of Toll-like receptors 3 (TLR3) and 7 (TLR7) in peripheral blood from patients with chronic hepatitis C infection and correlate their expression to the peripheral blood expression of interferon-alpha (IFN-alpha), viral load and histopathology of the liver. IFN-alpha, TLR3 and TLR7 expression in peripheral blood from patients with chronic hepatitis C infection (n = 30) and from healthy controls (n = 20) were measured by real time polymerase chain reaction. Viral load and Liver biopsy were done for all patients. The results showed lower expression of TLR3 and TLR7 in patients than controls, and levels of expression correlated positively with IFN-alpha expression. No correlation was found between TLR3 and TLR7 and viral load or histopathological staging and grading of the liver tissue. In conclusion, HCV may induce down regulation of TLRs (TLR3 and TLR7) expression on innate immune cells with subsequent decrease in INF-alpha production suggesting that new therapies that aim to increase the expression level of TLRs may help in treatment of HCV infection.

Immune response of 23-valent pneumococcal polysaccharide vaccinated elderly and its relation to frailty indices, nutritional status, and serum zinc levels.

AIM: To detect the immunoglobulin M memory B cell population response following vaccination with the 23-valent pneumococcal polysaccharide vaccine and determine its relation to frailty indices, nutritional status, and serum zinc levels. METHODS: A cross-sectional study was carried out in the outpatient geriatric clinic, Ain Shams University Hospital. It included 80 community-dwelling elderly, 32 male and 48 female. Each participant underwent vaccination with the 23-valent pneumococcal polysaccharide vaccine, comprehensive geriatric assessment, nutritional assessment with the DETERMINE check list, frailty indices assessment, and serum zinc level measurement. The percentage of immunoglobulin M memory B cells was evaluated before and 4 weeks after vaccination. Immune response was calculated as the difference between cell percentage before and after vaccination. RESULTS: Before the vaccination, the immunoglobulin M memory B cell percentage was significantly lower among those eating fewer than two meals a day and taking three or more drugs a day; after vaccination significance was observed among those with tooth or mouth problems that make eating difficult. Immune response was significantly lower among those with tooth or mouth problems (P < 0.001), weight loss (P < 0.001), shrinking (P = 0.001), poor endurance (P = 0.04), multiple comorbidities (P = 0.013), and cognitive impairment (P = 0.001). Participants with immune response ≥10% showed significantly higher serum zinc levels compared to those with immune response <10% of increase in cell percentage. CONCLUSION: Poor nutritional status, frailty and a lower zinc level impair the immunological response of elderly individuals.

Diagnostic and prognostic values of adhesion molecules VCAM-1, ICAM-1 and C-reactive protein in Egyptian patients with chronic kidney disease.

Soluble intracellular adhesion molecule-1 (ICAM-1) and soluble vascular adhesion molecule-1 (VCAM-1) are markers of endothelial dysfunction which is linked to the atherosclerotic process causing a series of complications in patients with chronic kidney disease. The aim of this study was to evaluate C-reactive protein and adhesion molecules VCAM-1, ICAM-1 in patients with predialysis, chronic renal failure (CRF), on maintenance hemodialysis (HD) and after kidney transplantation (KT). Ten patients with predialysis CRF, 20 on maintenance HD, 5 after KT and 10 subjects as a control group were included in this study. We evaluated serum levels of ICAM-1, VCAM-1 as acute phase proteins, C-reactive protein (CRP) as an inflammatory marker and body mass indices (BMI), serum albumin, cholesterol, triglyceride as nutritional indices. The mean values of serum levels of VCAM-1 and ICAM-1 were significantly higher in the three groups of patients than those of the controls (P < or = 0.05). There was statistically significant difference between the serum levels of VCAM-1 in the HD patients versus all other groups with the highest level in the HD patients. The circulating level of CRP, there was a progressive increase from controls to KT, CRF and to HD with the highest level in HD patients. There was a statistically significant difference between CRP serum levels in the HD patients versus all other groups with the highest level in the HD patients. Regression analysis showed significant positive correlation between CRP and ICAM-1 in KT patients (r = 0.9051; P = 0.0346), in CRF patients (r = 0.7621; P = 0.0170) and in HD patients (r = 0.4449, P = 0.0493). As regards the correlation between CRP and VCAM-1, there was positive correlation in KT patients (r = 0.9006; P = 0.0370), in CRF patients (r = 0.7088; p = 0.0326) and in HD patients (r = 0.4498; P = 0.0466). Age and BMI did not statistically differ in the study groups. In conclusion, serum levels of soluble adhesion molecules sVCAM-1, sICAM-1 correlate positively with the stage of renal disease. Also their serum levels were correlated positively with CRP as an inflammatory index in renal diseases. Further studies are needed to assess use of monoclonal antibodies against adhesion molecules and CRP as targets for therapeutic intervention in chronic kidney diseases.