Prevalence of common sensitizing aeroallergens in patients with atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD), a skin disease burden worldwide, is a complex, multifactorial, chronic inflammatory disease. Prevalence of AD is increasing in developing countries and identifying the causative allergens is a major challenge. Aeroallergens are shown to aggravate atopic dermatitis. PURPOSE: Explore the prevalence of aeroallergens sensitization in patients with AD and its possible relation with AD severity. METHODS: Cross-sectional study of 132 patients diagnosed to have atopic dermatitis. Atopy was detected by serum specific IgE to a panel of the most encountered aeroallergens. RESULTS: From the 132 patients, elevated specific IgE was detected in 72.7 % from which 59.1 % were mild and 86.4 % are moderate/severe as well as 15.9 % are mono-sensitized and 54.5 % are poly-sensitized with poly-sensitization being more in severe cases compared to mild cases (68.2 % vs 4.5 %). Regarding specific IgE to different aeroallergens, the most prevalent were Dermatophagoides pteronyssinus (50 %), followed by Dermatophagoides farinae (34.1 %), Birch pollen (20.5 %), cat epithelium (18.2 %) Regweed (15.9 %), and Cockroach (9.1 %). However, moderate to severe cases were more sensitized to candida (p = 0.012), mix grass pollen (p = 0.002), ragweed (0.00), mite (p = 0.037) and cat epithelium (p = 0.007). CONCLUSION: Dermatophagoides pteronyssinus, Dermatophagoides farinae, Birch pollen, cat epithelium Regweed and Cockroach are the most frequent sensitizing aeroallergens in atopic dermatitis.

Assessment of Tenascin C levels in the serum of patients with bronchial asthma.

Asthma is a heterogeneous disease that affects a large proportion of the global population and is distinguished by airway hyperresponsiveness to direct and indirect stimulations. It is a multifactorial disease that is triggered by heredity and environmental causes. Tenascin C (TNC) is an extracellular matrix glycoprotein that promotes inflammatory cell migration from the interstitium to the airways. Stimulation of TNC is through cytokines from T helper 2 (Th2) cells, in addition, it proliferates within basement membranes of the airways in asthmatic patients. This study aimed to determine whether serum TNC can be used as a novel biomarker for asthma diagnosis and to evaluate the association between serum TNC measurement and asthma severity. This case-control study included 64 patients with mild to severe bronchial asthma, diagnosed according to GINA 2022, referred to the Allergy and Clinical Immunology outpatient clinic at Ain Shams University Hospital, and 64 normal subjects as controls. Serum TNC levels were measured by ELISA. Serum TNC levels were significantly higher among bronchial asthma patients than controls (p ˂0.001). The sensitivity of serum TNC measurement in the diagnosis of bronchial asthma was 93.75%, the specificity 60.94%, and the negative predictive value 90.7%. Besides, a significant relation was found between serum TNC levels and the severity of bronchial asthma (p=0.004), as elevated serum TNC levels were the highest among severe asthmatic patients. In conclusion, the results gained in this study revealed that serum TNC level could be proposed as a potential biomarker for the diagnosis of bronchial asthma and a potential predictor of disease severity.

Evaluation of klotho expression on peripheral blood lymphocytes among hemodialysis patients and its possible contribution to their immuno-compromised status.

Infection is the second most common cause of mortality among end-stage kidney disease (ESKD) patients. Uremic toxins are the main cause of impaired immune response among ESKD patients. Klotho gene, the anti-aging gene, encodes the transmembrane alpha klotho (αKL) protein which acts as an obligate coreceptor for fibroblast growth factor 23 (FGF23). Klotho protein may play a role in immune cell functions, particularly in anti-inflammatory response; however, its role is still incompletely understood. In the present study, we aimed to measure αKL protein expression on peripheral blood lymphocytes (PBLs) among hemodialysis (HD) patients, and we assumed that decreased αKL expression on PBLs may contribute to the impaired immunity among HD patients. This case-control study included 20 ESKD patients on regular hemodialysis for more than 3 months. Their ages ranged from 24 to 69 years. Patients with primary immunodeficiencies, those on systemic immunosuppressive drugs, those with ongoing infections or who had recently recovered from infections, and those with malignancies on active treatment were excluded. A control group of 20 normal subjects of comparable age and gender were also included. We compared αKL protein expression on PBLs by flow cytometry between both groups. Significant reductions in percentages of αKL protein expression on B lymphocytes (CD19), T lymphocytes (CD3), and natural killer cells (CD56) were observed among HD patients compared to controls. We also noticed a significant reduction in the percentages of natural killer cells among HD patients. The present study suggests that decreased αKL expression on PBLs may contribute to the immunocompromised status among HD patients, highlighting the importance of understanding the exact function of αKL protein on immune cells. This may offer a future diagnostic and therapeutic tool to improve the immune response among HD patients.

Neutrophil Respiratory Burst: an immunological indicator of post stroke infection.

Stroke is long known to be followed by a series of immunosuppressive events, and infections might be a cause of death after an acute insult of stroke. The aim of our work was to assess the percentage of neutrophils showing spontaneous oxidative burst in patients with acute ischemic stroke. The study included 30 patients with acute cerebral infarction subjected to the following: magnetic resonance imaging of the brain immediately on admission, and blood sampling on day one of admission (baseline) and after 3 days of admission. Blood samples were used for the assessment of: differential leucocyte count and percentage of neutrophils showing spontaneous oxidative burst, performed by flow cytometry. Thirty age and gender matched controls were also recruited. Neutrophil respiratory burst percentage was significantly lower in stroke patients in comparison to controls (P < 0.001), and stroke patients had significantly lower neutrophil respiratory burst percent on day 3 of admission compared to the baseline (P < 0.001). Stroke-induced immune alterations including impairment of the first-line defense performed by neutrophils against bacteria. The hypothesis that these changes enhance susceptibility to acquired infections is supported by our observation that oxidative burst in neutrophils was more impaired in patients with stroke who exhibited subsequent stroke-associated infections.

Toll like receptor 4 (TLR4) expression on peripheral blood mononuclear cells (PBMCs) among patients with Graves disease.

Graves disease (GD) is a multifactorial disease due to multiple environmental and genetic factors as well as immune malfunction. Human Toll-like receptors (TLRs) play a key role in activating innate and adaptive immune cells. Their role in modulating immunity also interferes with the mechanisms that maintain tolerance in the host. Thus, expression or activation of TLRs can contribute to the loss of tolerance by a lot of mechanisms. In order to confirm the importance of TLR4 in the pathogenesis of GD, this study intended to measure TLR4 expression on peripheral blood mononuclear cells in GD patients before and after control of disease with Carbimazole as compared to a group of normal controls. We conducted a case-control study on 36 patients with newly diagnosed Graves disease and 36 individuals as the control group. Patients were recruited from the endocrinology outpatient clinic, Ain-Shams University Hospitals and were followed up till achieving the euthyroid state (for a minimum period of 6 months). In GD patients at baseline, the mean monocyte percentage was 4.46%, and the mean TLR4 on monocytes 90.91%. After achieving euthyroid state, the mean monocyte was 6.16%, and the mean TLR4 on monocytes 72.30%. In the control group, the mean monocyte was 3.88%, and the mean TLR4 on monocytes 66.30%. Results indicated significant differences in expression of TLR4 between GD patients before treatment, after achieving euthyroid state and in the control group (p< 0.0001). In conclusion, the present study showed a higher expression of TLR4 on monocytes among newly diagnosed GD patients in comparison to normal individuals. TLR4 expression on monocytes decreased significantly among GD patients after treatment.