Gallbladder stone formation in Iraqi patients is associated with bacterial infection and HLA class II-DRB1 antigens.

BACKGROUND: Gallbladder stone is recently increased among the Iraqi society due to many risk factors such as bacterial infection and some HLA class II antigens. AIM(S): This study investigates the types of bacterial infection and HLA-DRB1 antigens' ratio that may be correlated with gallbladder stone formation. Setting and Design: The study included 45 patients and the same number of healthy individuals as a control group. Patients were with multiple gallstones. Gallstone bacterial culture was demonstrated to diagnose viable bacteria. HLA-DRB1 alleles' frequency was investigated using sequence-specific oligonucleotide probes (PCR-SSOP). RESULTS: Irrespective of gallstone type and size, different types of living viable bacteria were isolated from the cores of the studied gallstones in 80% of the studied cases versus 20% of sterile gallstones. Gram-negative bacteria cultures were the dominant (89.3%), including Escherichia coli, Klebsiella spp., Proteus spp., Acinetobacter spp., and Enterobacter spp. Mixed infection of Gram-positive and negative bacteria was noted: Escherichia coli and Enterococus spp. and the others of Escherichia coli and Acitobacter spp., and Klebsiella spp. and Pseudomonas spp. Gram-positive bacteria cultures were also detected at lower rate (10.7%) including Staphylococci spp. The frequency of HLA-DRB1*03:01, HLA-DRB1*4:03, HLA-DRB1*13:22, and HLA-DRB1*15:10 alleles was significantly elevated in patients compared to the healthy control group. CONCLUSION: Results ensured the viability of the bacteria isolated from the core of gallstones and showed positive correlation between gallbladder stone and different bacterial infection. In addition, HLA-DRB1 alleles were significantly high in patients compared to healthy control group suggesting them as risk factors (P < 0.05).

Role of red blood cells "annexin V" and platelets "P-selectin" in patients with thalassemia.

OBJECTIVE/BACKGROUND: Certain hemostatic anomalies found in patients with thalassemia suggest the existence of a chronic hypercoagulable state. Several etiologic factors may play a role in the pathogenesis of the hypercoagulable state in those patients. One of these factors is abnormal thalassemic red blood cells (RBCs), which may provide a procoagulant. To substantiate these findings, we measured the ability of RBCs from thalassemia patients to bind annexin V with increased fraction of platelets carrying the activation marker CD62P (P-selectin). To study the expression of RBC annexin V and platelets P-selectin in study patients (those with thalassemia major, thalassemia intermedia, thalassemia minor) and control group, four-color flow cytometry was performed and the correlation between these two markers was evaluated. METHODS: A case-control study was conducted on 50 ß-thalassemia patients (10 patients with thalassemia minor, 30 patients with thalassemia major, and 10 patients with thalassemia intermedia, with 10 normal adult volunteers as a control) from June 2016 to March 2017. Flow cytometry was used to study the expression of anionic phospholipids (Annexin V) on the RBCs and CD62P (P-selectin) on the activated platelet. RESULTS: The mean expression of annexin V in patients with thalassemia major and intermedia was significantly higher than that in the control group and patients with thalassemia minor. Although the mean expression was higher in patients with thalassemia intermedia than in those with thalassemia major, it was not statistically significant. CONCLUSION: The mean expression of platelets P-selectin in patients with thalassemia major and thalassemia intermedia was significantly higher than that in controls and patients with thalassemia minor. However, its expression was significantly higher in patients with thalassemia intermedia than in those with thalassemia major. Annexin V also showed a positive correlation with P-selectin, and both markers positively correlated with regularity of blood transfusion.