Vitamin D receptor gene polymorphism in Egyptian multiple sclerosis patients.

One of the most common neurological illnesses in the world is multiple sclerosis (MS), a chronic autoimmune demyelinating disease of the central nervous system (CNS). MS has both a genetic and an environmental origin. In terms of environmental factors, vitamin D deficiency is one of the most important risk factors and closely connected with gene polymorphisms involved in vitamin D metabolism, transport, or activity. Since vitamin D activity requires a receptor-mediated response, any changes to the vitamin D receptor (VDR) may have an effect on the pathophysiology of the disease. In this study, we aimed to identify the relationship between VDR gene polymorphisms, FokI A>G (rs2228570), ApaI A>C (rs7975232) and BsmI C>T (rs1544410) and MS. FokI, ApaI and BsmI genotypes were determined in 50 patients with relapsing remitting MS (RRMS) and in 50 control subjects. DNA was isolated from blood samples, and then FokI, ApaI and BsmI gene polymorphisms were identified using allelic discrimination real time polymerase chain reaction (PCR) assay. The distribution of FokI, ApaI and BsmI polymorphisms did not show any significant differences between MS patients and controls. Thus, we concluded that there is no association between the studied VDR gene polymorphisms and MS.

Study of intercurrent infection pattern in hepatitis C seropositive renal transplant recipients, relationship with T-cell function.

BACKGROUND: We assessed the effect of hepatitis C seropositivity on the percentage of various T-cells in living donor renal transplant recipients (LDRTRs) and their association with intercurrent infections post renal transplantation (post-Tx). METHODS: One hundred and thirty-three matching LDRTRs [A (seronegative) (68 patients) and B (seropositive) (65 patients) by ELISA] were studied prospectively 10 days, 6 months and 12 months post-Tx for intercurrent infections, acute rejection and T-cell% by flow cytometry. RESULTS: CD4(+), CD8(+), CD4/CD8 were significantly higher 10 days post-Tx in Group B compared to Group A, p < 0.001. A significant increase in CD8% was seen 6-month post-Tx among Group B compared to Group A. No difference was detected between groups in (CD4(+), CD8(+), CD4/CD8, CD3-CD16/65(+)%), rate and severity of intercurrent infection, rate of acute rejection, 12 months post-Tx. A significantly higher rate of severe infections particularly urinary tract infections (UTI) was noted in Group B compared to Group A the first 3 months post-Tx particularly in those who received the combination of antithymocyte globulin (ATG) or basiliximab, tacrolimus, steroids, mycophenolate mofetil (MMF). CD4(+)% correlated negatively with intercurrent infections in Group B 6 months post-Tx. CONCLUSION: HCV(+) patients are more prone to intercurrent infections the first 3 months post-Tx. Infection rate correlates positively with pre-transplant HCV seropositivity and immunosuppressive regimen.

Study of peripheral blood natural killer cells, T-cell helper/T-cell suppressor ratio and intercurrent infection frequency in hepatitis C seropositive prevalent hemodialysis patients.

Hemodialysis (HD) may adversely affect the immune system. It is established that intercurrent infection rate and severity may be increased in prevalent HD patients. Moreover, hepatitis C viral infection, a common infection in many HD centers, may further inhibit the immune system. To our knowledge, no previous study in the literature has attempted to investigate the possible effects of hepatitis C seropositivity on rate and severity of intercurrent infection in prevalent HD patients. The aim of this study was to assess the peripheral blood CD16-natural killer cells, CD4/CD8 ratio, as well as rate of intercurrent infection in hepatitis C seropositive prevalent HD patients as compared with hepatitis C seronegative prevalent HD patients. Twenty hepatitis C seropositive stable prevalent HD patients (group A), as well as another twenty hepatitis C seronegative stable prevalent HD patients (group B), were randomly selected from our HD unit and enrolled in the study. Both groups were similar in age, sex, body mass index, and duration of HD. Diabetics, smokers, and cases with advanced liver disease (Child classification stages B and C) were excluded from the study. A third group (group C) of 10 apparently healthy subjects (of similar age, sex, and body mass index), was also enrolled in the study. All subjects were investigated by complete blood count, routine chemistry, assessment of peripheral lymphocytes CD3,CD16, CD4, CD8, CD4/CD8 ratio by flow cytometer, as well assessment of intercurrent infection frequency retrospectively (since the start of HD therapy and seroconversion in HD patients, and prospectively for a period of six months. Although we detected statistically significant higher frequency of intercurrent infection in both HD groups compared with the healthy group, we did not detect significant differences between hepatitis C seropositive and seronegative groups regarding frequency or severity of intercurrent infection. Moreover, we did not detect significant differences among the three studied groups regarding levels of CD16, CD3, CD4, CD8, CD4/CD8 ratio in peripheral lymphocytes. It may be concluded that hepatitis C seropositive prevalent HD patients are not at increased risk of intercurrent infection as compared with hepatitis C seronegative prevalent HD patients, contrary to what is reported in hepatitis C seroconverted organ transplant candidates.

Keratinocyte and lymphocyte apoptosis: relation to disease outcome in systemic lupus erythematosus patients with and without cutaneous manifestations.

Our aim was to assess the relationship of keratinocyte and lymphocyte apoptosis and macrophage function to disease outcome in systemic lupus erythematosus patients with and without cutaneous manifestations. 50 systemic lupus erythematosus patients [25 with cutaneous manifestations (group I), 25 without cutaneous manifestations (group II)] and 20 normal controls (group III) were studied. Assessments of disease activity, peripheral lymphocyte apoptosis, macrophage function and apoptotic cells in skin and renal biopsies were carried out. The mean systemic lupus erythematosus disease activity index score was significantly higher in group I than II (18.6 +/- 6, 8.8 +/- 2.7 respectively, p < 0.001). The mean percentage of peripheral apoptotic lymphocytes was significantly higher in group I than groups II, III (55.3 +/- 21.4, 25.6 +/- 8.7 & 19.4 +/- 3.2 respectively, P < 0.001), so was serum neopterin level (27.5 +/- 7.3, 14.9 +/- 2.7, 9.4 +/- 1.1 respectively, p < 0.001), and the mean number of protein53 positive apoptotic keratinocytes in skin (20.6 +/- 5.4, 1.6 +/- 0.5, 1.7 +/- 0.4 respectively, p < 0.001). A higher percentage of class IV, V glomerulonephritis was found in group I (47%, 26%, respectively) compared to group II (11% both) (p < 0.001). The mean number of protein53 positive apoptotic skin keratinocytes showed a significant positive correlation to disease activity, percentage of peripheral apoptotic lymphocytes and serum neopterin (P < 0.001). In conclusion, an accumulation of apoptotic keratinocytes and lymphocytes in systemic lupus erythematosus with cutaneous manifestations is associated with a worse disease outcome.

Plasma interleukin-1beta levels in children with febrile seizures.

Proinflammatory and anti-inflammatory cytokines regulate the febrile response during infection. In this study, the role of cytokines in the pathogenesis of febrile seizures was investigated, through comparing levels of interleukin-1beta in the peripheral blood of children with febrile seizures and in a matched control group of children with febrile illnesses without seizures. The study included 33 children with febrile seizures (mean +/- SD, 29.94 +/- 14.9 months) and 38 controls with comparable age, sex, and type of infection. A laboratory workup for the diagnosis of infection was performed, and interleukin-1beta levels were assessed by enzyme-linked immunosorbent assay for the patients and the control groups immediately on arrival at the hospital. The plasma levels of interleukin-1beta were comparable in the patients and the control group (mean +/- SD, 7.321 +/- 3.123 and 8.087 +/- 4.8 pg/mL, respectively). Furthermore, there was no significant difference when comparing the plasma levels of interleukin-1beta in patients with simple and complex types of febrile seizures. Plasma interleukin-1beta levels did not show a significant correlation to either the duration of the last seizure, the number of the previous attacks of febrile convulsion, or the degree of temperature. However, interleukin-1beta levels were negatively correlated to the duration from the last seizure attack (r = -.8). Thus, the results of the present study do not support the hypothesis that increased production of interleukin-1beta is involved in the pathogenesis of febrile seizures in children.