Mac-2 binding protein glycan isomer as noninvasive tool to assess liver fibrosis in children with chronic liver disease.

AIM: This study is aimed to measure the value of serum Mac-2 binding protein glycan isomer (M2BPGI) in children with chronic liver diseases in comparison with liver biopsy and serum biomarkers. METHODS: Comparative cross-sectional study included 100 children with chronic liver diseases and 50 healthy age/sex-matched control group. All subjects were evaluated via medical history, clinical, radiological and laboratory examinations. Liver biopsy was performed for studied patients and serum M2BPGI level was measured by Enzyme Linked Immune Sorbent Assay (ELISA) in all studied subjects. RESULTS: Serum M2BPGI level increased more significantly in chronic liver disease patients (6.04 ± 2.72 ng/ml) than in healthy controls (1.12 ± 0.83 ng/ml) (P < 0.001). M2BPGI level was significantly elevated with progressive fibrosis (P < 0.001), and differed significantly between high and low Child-Pugh score, pediatric end-stage liver disease score and model for end-stage liver disease score score. Serum M2BPGI was correlated with serum biomarkers and degree of fibrosis in patients. CONCLUSION: M2BPGI could be used as one of noninvasive tools for detecting and staging of hepatic fibrosis in Egyptian children with chronic liver disease.

Serum Neurotensin: An Objective Mirror to Acne-induced Quality of Life and Psychological Impairment.

BACKGROUND: Acne is a multifactorial disorder, and stress potentially plays a role in its pathogenesis. OBJECTIVES: We aimed to assess the serum levels of neurotensin in patients with acne vulgaris (AV) and investigate the relationship of these levels to quality of life (QoL), depression, anxiety, and stress. METHODS: The study included 60 patients with AV classified into mild (n=20), moderate (n=20), and severe (n=20) groups and 20 healthy, age-matched, sex-matched, and body mass index (BMI)-matched individuals in a control group. Patient QoL was assessed using the Dermatology Life Quality Index (DLQI). Each participant completed the Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS-10). Serum levels of neurotensin were measured with enzyme-linked immunosorbent assay (ELISA). RESULTS: Neurotensin levels and scores from the three questionnaires were significantly higher among the patients with AV than the control subjects. They were also significantly elevated in patients with post-acne scars and hyperpigmentation and in those with severe acne. CONCLUSION: It is well known that acne greatly impacts QoL and might be associated with depression, anxiety, and stress. Further, serum neurotensin could be a promising marker to objectively evaluate the psychosocial impact of AV.

Serum levels of brain-derived neurotrophic factor in patients with acne vulgaris.

BACKGROUND: Many dermatological diseases have a great impact on the psychological state of patients, like urticaria, psoriasis, atopic dermatitis, and acne vulgaris. Finding a "gold standard" biomarker for chronic stress in acne patients is challenging because of the complex etiology of the chronic stress and its variable manifestations. AIMS: The aim of this study was to evaluate the correlation between serum levels of BDNF and the presence and severity of acne vulgaris and to assess the relationship of this biomarker to both the degree of psychological stress and the quality of patients' lives (QoL). PATIENTS AND METHODS: Sixty patients with acne vulgaris were included, together with twenty apparently healthy, age-, and sex-matched individuals as a control group. Patients filled a Dermatology Life Quality Index (DLQI) questionnaire; both patients and controls filled a Hospital Anxiety and Depression scale (HADS) and perceived stress scale-10 (PSS) questionnaires. Serum levels of BDNF were measured for patients and controls using ELISA technique. RESULTS: Patients with acne had significantly lower levels of BDNF and significantly higher HADS and PSS-10 questionnaires scores. A significant negative correlation was found between serum levels of BDNF and PSS questionnaire scores. CONCLUSION: Patients with acne are at a high risk to develop chronic stress, anxiety, and depression. BDNF is a good predictor for assessment of chronic stress in such patients.

Importance of Studying the Levels of Hepcidin and Vitamin D in Egyptian Children with Chronic Hepatitis C.

BACKGROUND AND OBJECTIVE: Hepcidin is the key regulator of iron metabolism and is a significant biomarker for systemic inflammatory states. Vitamin D is a powerful immunomodulator and plays a significant role in the inflammatory responses and fibrosis occurring due to hepatitis C virus (HCV) infection. This study assessed the level of vitamin D and serum hepcidin and its expression in peripheral blood of children with chronic hepatitis C (CHC) and correlated them with other serum markers to reflect iron metabolism and liver disease severity. METHODS: A total of 100 children were included in this study: 50 with HCV infection and 50 healthy controls. Biochemical parameters together with vitamin D, hepcidin, and its expression were all measured. RESULTS: The level of hepcidin and its expression together with vitamin D and hepcidin-to-ferritin (H/F) ratios were significantly reduced in patients, but the iron and ferritin levels were higher (P<0.001). Serum hepcidin level showed significant positive correlation with hepcidin expression, HCV titer, iron, ferritin, and H/F ratio (r = 0.43, 0.31, 0.34, 0.28, and 0.91, respectively) but significant negative correlation with vitamin D (r = -0.37). Both hepcidin and ferritin were higher in patients with Child Pugh scores B and C than those with score A (P<0.001). CONCLUSION: Measuring serum hepcidin and its expression together with vitamin D levels in patients may have a prognostic value and is promising in the follow-up of the severity of liver disease.

Clinical significance of Matrilin-3 gene polymorphism in Egyptian patients with primary knee osteoarthritis.

OBJECTIVE: Osteoarthritis (OA) is a multifactorial, degenerative, and inflammatory disorder of joints causing damage of the articular cartilage, formation of osteophytes, and eburination of the subchondral bone. Matrilin-3 (MATN-3) is a non-collagenous oligomeric extracellular matrix protein (ECM), which is the smallest member of the matrilin family. This study was conducted to identify the potential association and clinical significance of MATN-3 rs8176070 (SNP6) polymorphism in a series of Egyptian patients with primary knee OA. MATERIAL AND METHODS: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine genotypes of MATN-3 SNP6 for 50 primary knee OA patients in addition to 50 healthy subjects of the same sex and age range. Full history was obtained from OA patients, followed by clinical examination, together with clinical assessment of the severity of knee OA using Lequesne Algofunctional Index score and radiological grading using the Kellgren-Lawrence grade scale (KL). RESULTS: With regard to genotypes of MATN-3 gene SNP6 (rs8176070), a statistically significant difference between OA patients and healthy control subjects was found for the B\b genotype and b allele (p=0.046 and 0.042 respectively), with the prevalence being higher in OA patients with a high risk to develop OA (Odds Ratio [OR]=2.250, 95% CI=1.011-5.008). Patients with the B\b genotype had worse clinical and radiological findings than those with B\B and b\b genotypes. CONCLUSION: The investigated polymorphism in the MATN-3 gene may reflect the risk and severity of knee OA in Egyptian patients, particularly with the B\b genotype.

Significance of Anti-C1q Antibodies in Patients with Systemic Lupus Erythematosus as A Marker of Disease Activity and Lupus Nephritis.

Anti-C1q autoantibodies have been proposed as a useful marker in SLE. This study aimed at measuring serum levels of anti-C1q antibodies in patients with SLE and investigates correlations of this level with the histopathological classes of renal biopsies and disease activity. The anti-C1q antibody level was measured in 30 females SLE patients and 20 controls. The activity of SLE disease was calculated according to the SLE disease activity index. A renal biopsy from patients with clinical manifestations of renal disease was obtained. There was a significant increase in the level of anti-C1q antibodies in SLE patients than controls and in patients with active LN than inactive LN (P<0.05). There were significant positive correlations between anti-C1q antibody level and SLEDAI & rSLEDAI scores and activity index score of renal biopsies. Anti-C1q antibodies showed higher diagnostic sensitivity and specificity than anti-dsDNA antibodies. In conclusion, anti-C1q antibodies are useful and sensitive non-invasive biomarker with high specificity in combination with anti-dsDNA antibodies for the diagnosis of renal disease activity.

The role of regulatory T cells in preeclampsia.

Preeclampsia is a multisystem disorder of unknown cause that is unique to human pregnancy affecting about 7-10% of pregnant women. CD4+CD25(bright) regulatory T (Treg) cells have been identified as a principle regulator of tolerance during pregnancy. The aim of this study was to demonstrate the change of peripheral CD4+CD25(bright) regulatory T lymphocytes in normal pregnancy and preeclampsia, and to explore its role in the pathogenesis of preeclampsia. We determined CD4+CD25(bright) Treg cells in the peripheral blood using flow cytometry and forkhead box P3 (FoxP3+) cells at the peripheral blood using real time PCR. 30 preeclamptic cases (group 1), 10 normal pregnancy subjects (group 2) and 10 non-pregnant healthy controls (group 3) were included. There was a highly significant decrease as regards Treg count and percentage in preeclamptic cases compared to normal pregnancy subjects (P < 0.001), decrease in preeclamptic cases compared to non-pregnant healthy controls (P < 0.001) and a significant increase in normal pregnancy subjects compared to non-pregnant healthy controls (P < 0.05). There was a statistically significant decrease as regards RQ of foxp3 gene expression in preeclamptic cases compared to normal pregnancy subjects (P < 0.001). There was no significant correlation between RQ and studied variables in preeclamptic cases (P > 0.05). These findings suggest that the number of Treg cells are decreased in preeclampsia, and this decrease may break the maternal tolerance to the fetus.

Role of anti-nucleosome antibodies in the diagnosis of systemic lupus erythematosus and as a marker for lupus nephropathy.

SLE is a heterogeneous disease, characterized by variation in clinical and serological manifestations. This study intended to verify the role of anti-nucleosome (anti-NCS) antibodies in diagnosis of SLE and lupus nephritis and to establish the correlation between antibody reactivity and disease activity. Study subjects included 35 patients diagnosed as SLE and two control groups. While the first is a group with other collagen diseases (n = 80), the second included 50 matched apparently healthy subjects. Serum IgG anti-NCS antibodies in all subjects were detected by ELISA. Serum anti-NCS were higher in SLE than in the two control groups (P < 0.001). Serum anti-NCS antibody levels were higher in SLE patients with renal affection (P < 0.001), malar rash and with hematological disorders (P < 0.05). Anti-NCS antibodies showed a higher diagnostic sensitivity (74.7%) and specificity (96%) than anti-dsDNA. Combining data of anti-NCS and anti-dsDNA antibodies increased the diagnostic specificity to 97.3%. In conclusion, serum anti-NCS antibodies have diagnostic value and play role in the assessment of disease activity especially active renal disease and may predict disease outcome.