The Egyptian journal of immunology / Egyptian Association of Immunologists最新文献

Metabolic syndrome (MetS), characterized by an amalgamation of obesity, dyslipidemia, glucose intolerance, insulin resistance (IR), and hypertension, is a significant predictor of type 2 diabetes and cardiovascular disease (CVD). The prevalence of this condition among rheumatoid arthritis (RA) patients may elevate the risk of CVD. This study explored the relationship between MetS and RA using hormonal and immunological markers, in addition to some molecular analyses [energy homeostasis-associated (ENHO) gene expression]. It included 80 RA patients (40 with MetS and 40 without MetS) and 20 apparently healthy controls. The outcomes showed that MetS was more common in persons classified as overweight or obese, those with RA disease duration of 5-10 years, and older RA patients (>50 years). While RA mostly affected women, MetS showed a fairer division between sexes. In RA patients with MetS, both insulin and IL-23 showed significant positive correlations (p=0.011) as well as between adropin and interleukin (IL) 17 (p=0.024). These results highlight how metabolic and demographic factors affect the course of RA and underline the need of a thorough metabolic inflammatory therapy strategy.

Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), often presents diagnostic challenges. Lipocalin-2 (LCN-2) has emerged as a potential biomarker for intestinal inflammation. This study aimed to evaluate the diagnostic and clinical utility of serum Lipocalin-2 in Egyptian patients with IBD. This was a case-control study, conducted during the period between December 2024 and February 2025, involved 30 IBD patients (18 UC, 12 CD) and 30 age- and sex-matched normal controls. Serum LCN-2 levels were measured using an enzyme linked immunosorbent assay (ELISA). Clinical symptoms, disease activity (via Truelove and Witts' criteria for UC and Harvey-Bradshaw Index for CD), and routine laboratory investigations were assessed. The receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic utility, while Pearson correlation tested associations with clinical and laboratory parameters. IBD patients had significantly elevated serum LCN-2 levels compared to controls (3.15 ± 1.9 vs. 0.24 ± 0.1 ng/mL; p  <  0.001). The ROC analysis yielded an area under the curve of 0.980, with high sensitivity (96.77%) and negative predictive value (92.31%) at a cutoff of value of 0.22 ng/ml. However, LCN-2 did not significantly differ between UC and CD (p = 1.000) or across disease activity levels (p > 0.05). Notably, LCN-2 was positively correlated with disease duration (r = 0.430, p = 0.018) and platelet count (r = 0.362, p = 0.004), but showed no correlation with hemoglobin, white blood cells, erythrocyte sedimentation rate, creatinine, or glomerular filtration rate. In conclusion, according to our ROC analysis, serum LCN-2 may have an excellent diagnostic utility for identifying IBD but lacks discriminatory power between UC and CD or for assessing disease activity. Its correlation with disease duration and platelet count highlights its potential as a marker of chronic inflammation rather than acute disease severity.

The assessment of systemic lupus erythematosus (SLE) disease activity is considered a challenge to patients and physicians. In the last few years, there was evidence that progranulin (PGRN) may be involved in the pathogenesis of SLE, so, it might be a suitable marker for the assessment of disease activity. In this study, we aimed to identify the role of PGRN in SLE pathogenesis and its association with disease activity and organ damage. This case-control study included 50 SLE patients, 20 patients with autoimmune diseases other than SLE, and 20 apparently healthy adults as a control group. The concentration of serum PGRN was assayed in all studied participants by using quantitative enzyme-linked immunosorbent assay. The results showed that serum PGRN levels were significantly higher among SLE patients when compared to the group of patients with autoimmune diseases other than SLE, as well as when compared to the control group. There was a significant positive correlation of serum PGRN levels of SLE patients with erythrocyte sedimentation rate, 24 hours urine protein, SLE disease activity index (SLEDAI)-2k score, and SLICC/ACR damage index (SDI) score; while there was a negative correlation with C3, C4 and hemoglobin concentrations. Thus, we concluded that serum PGRN could be a useful biomarker of SLE disease activity.

The post-SARS-CoV-2 immune response involves both neutralizing antibodies (NAbs) and T-cell cooperation. Healthcare workers, highly exposed in daily practice, represent a relevant population for study. This study aimed to describe the post-COVID-19 immune profiles of Ivorian healthcare workers by analyzing the association between antibodies (IgM, IgG, NAbs) and Th1 cytokines (IL-2, IFN-γ, TNF-α). This cross-sectional study, conducted during January 2022 to June 2023 in three university hospitals in Abidjan, included 36 participants with RT-PCR-confirmed infection. IgM and IgG were measured using an automated analyzer. NAbs were quantified on a multiparametric test system. IL-2, IFN-γ, and TNF-α were measured by a flow cytometer. A robust profile was defined by the combined presence of IgG ≥ 250 Binding Antibody Units (BAU)/ml, NAbs ≥ 800 BAU/ml, and at least one Th1 cytokine (IL-2 ≥ 2.3 pg/ml or IFN-γ ≥ 0.5 pg/ml). The study participants were 63.9% women with mean age of 40.7 years. All participants had detectable IgG; 69.4% displayed high NAbs, and 75.0% had IL-2 ≥ 2.3 pg/ml. IgG correlated positively with IL-2 (ρ = 0.667; p < 0.0001) but negatively correlated with IFN-γ (ρ = -0.535; p = 0.0008). NAbs were positively associated with IL-2 (ρ = 0.341; p = 0.0416) but negatively associated with IFN-γ (ρ = -0.740; p < 0.0001). Of the participants, 25 (69.4%) were classified as robust and 11 (30.6%) as non-robust. Robust profiles showed higher IgG, NAbs, and IL-2 levels, whereas non-robust profiles had higher IFN-γ. Vaccination status did not significantly differentiate groups. In conclusion, in Ivorian healthcare workers, robustness of the post-infection immune response is based on the synergy between NAbs and IL-2. Conversely, high IFN-γ levels were associated with weaker neutralization, probably influenced by post-infection kinetics. These results suggested that immune monitoring should integrate combined profiles, beyond IgG alone, to identify individuals requiring priority vaccination follow-up.

Common variable immunodeficiency (CVID) is one of the primary immunodeficiency disorders. The phenotype of peripheral blood memory B cells is a useful tool in the classification of patients into clinically and functionally relevant groups. This study aimed to assess the level of naïve and switched memory B cells level and their correlation with the clinical phenotypes and complications in patients with CVID. This case control study included 30 adult patients with CVID and 30 normal controls, matched for age and sex. Complete blood count, cluster of differentiation 3 (CD3)+, CD4+, CD8+ T cells and CD19+27-IgD+ for naïve B cells and CD19+27+IgD- switched memory B cells levels were assessed. The mean age of the onset of symptoms was 16.9±15.1 years, the mean age of diagnosis was 27.30±14.39 years, with a diagnostic delay of 10.43±10.29 years, and the body mass index was significantly lower in CVID group. Infections including (upper respiratory tract infection, chronic diarrhea, pneumonia and bronchiectasis) were the most frequent phenotypes. CD4+, CD4+/CD8+ T cells, CD19+ and CD19+27+IgD- switch memory B cell, IgG, IgA, and IgM were significantly lower in CVID group than in the control group (p < 0.001 and p < 0.015, respectively). CD8+ T cells and CD19+27-IgD+ naïve B cells were significantly higher in the CVID group (p < 0.001). CD19+27-IgD+ naïve B cells level was significantly lower in cases with bronchiectasis with low baseline serum IgG in lymphadenopathy group (p=0.049), and higher level of CD3+ T cells in cases with splenomegaly. There was no significant difference in laboratory results in CVID patients presented with autoimmune diseases, Granulomas nor enteropathy. In conclusion, high level of CD19+27-IgD+ naïve and low level of CD19+27+IgD- switch memory B cells are characteristic features of CVID. Moreover, the reduced CD19+27-IgD+ naïve B cells level can be a predictor of the development of bronchiectasis in CVID patients.

Penicillin, the most well-known β-lactam antibiotic, is thought to cause allergic responses in 0.7-10% of the human population. Atopic and other allergy illnesses are believed to be developed and regulated in part by excessive secretion of Interleukin-4 (IL-4) and interferon-γ (IFN-γ). In this study, the frequency of penicillin allergy was analyzed by IL-4 and IFN-γ using the enzyme linked immunosorbent assay in 45 patients with an allergy to penicillin and 45 apparently healthy subjects as a control group. Also, we determined the IL-4 receptor α gene (IL-4 Rα) by using tetra primer-amplification refractory mutation system based polymerase chain reaction (T-ARMS-PCR). The findings demonstrated that IFN-γ and IL-4 levels in serum of the patients in the experimental group were significantly higher than in the control group. Although IFN-γ levels were lower than IL-4 in the patients and controls, patients exhibited higher IFN-γ concentrations compared to control subjects. The IL-4 receptor α (Rα) genotype distribution in patients and control groups revealed that genotypes AA, GA, and GG were present in 26 (57.78%), 11 (24.44%), and 8 (17.78%) patient subjects, while in the control group they were present in 17 (37.78%), 21 (46.67%), and 7 (15.56%) subjects. As a result, it seemed that patients had a higher frequency of genotype AA than the control group. In conclusion, penicillin allergy is influenced by IL-4 and IFN-γ, and IL-4 Rα gene polymorphism revealed that AA and GA genotypes may be linked to β-lactam allergy, whereas GG genotypes may offer a strong defense against β-lactam allergy.

Urinary tract infections (UTIs) are common in type 2 diabetic patients, who have higher risks of mortality and bacteremia. Interleukin-6 (IL-6) plays a dual role: protective at normal levels, but proinflammatory in chronic inflammation. This study aimed to identify the main UTI-causing bacteria in diabetic and non-diabetic individuals, evaluate antibiotic resistance, and assess serum IL-6 levels in both groups. This was a comparative cross-sectional study included 140 patients aged 18-70 years, of both sexes, with and without type 2 diabetes. Patients were divided into four groups, each of 35 patients. Group A (controlled diabetic UTI cases, HbA1c ≤ 7%), Group B (uncontrolled diabetic UTI cases, HbA1c > 7%), Group C (non-diabetic UTI cases, HbA1c < 5.7%), and a normal control group. Urine samples were analyzed by culture, bacterial count, organism identification, and antibiotic sensitivity. Serum IL-6 was measured using an enzyme-linked immunosorbent assay (ELISA. Group B had the highest mean serum IL-6 level (29.60 ± 10.23), followed by Group A (26.42 ± 9.56), while the control group showed the lowest (15.50 ± 5.42). Candida albicans was more frequent in Group B (14.29%). Gram-negative bacilli predominated in all groups, especially Group A (91.43%). Escherichia coli was the most common bacterial isolate (~50%). Group B had the highest bacterial count (57.89 ± 23.72). Group C showed the highest antibiotic sensitivity, notably to meropenem (91.4%), polymyxin B (82.9%), and amikacin (80.0%). Group B exhibited the highest resistance rates to cefotaxime (79.5%), norfloxacin (61.5%), azithromycin (59%), and cotrimoxazole (56%). In conclusion, diabetic patients, especially those with uncontrolled diabetes, showed higher bacterial loads, more mixed and fungal infections, increased antibiotic resistance, and elevated serum IL-6 levels compared to non-diabetic individuals.

Rheumatoid arthritis (RA), an autoimmune and inflammatory condition, occurs when the immune system erroneously targets healthy cells, leading to inflammation in the affected regions. The objective of this study was to evaluate the association of Mir-155 and SMAD3 in patients with RA, athletes with RA, and control groups. The study was carried out during the beginning of January 2024 and the end of June 2024. , The study was conducted at the Medical Rehabilitation Center in AL-Sader medical city. It included 50 patients, both female and male, diagnosed with RA by a specialist physician, along with 50 individuals without the condition and 50 athletes with RA. It comprised individuals of diverse ages. We collected 5 ml of blood from patients to assess the immunological parameter SMAD3 using the Enzyme-Linked Immunosorbent Assay. Additionally, we invested MIR-155 by using the reverse transcription polymerase chain reaction (RT-PCR). There was a significant positive correlation between MIR-155 with SMAD3 (r = 0.529, p < 0.001) in the RA group, and MIR-155 has a positive correlation with SMAD3 (r = 0.574, p < 0.001) in athletes, suggesting that it may play a part in boosting signaling pathways linked to fibrosis or repair. In conclusion, there was a statistically significant positive correlation between MIR-155 and SMAD3 among RA patients and athletes compared to healthy controls.

Crohn's disease (CD) and ulcerative colitis (UC) are two types of inflammatory bowel diseases (IBD) diagnosed by chronic inflammation of the gastrointestinal system. Despite being the gold standard for assessing the therapeutic response to biological medicines like infliximab and disease activity in IBD patients, endoscopy's widespread use is limited by its time-consuming, expensive, and intrusive nature. This prospective case-control study was performed at Ain Shams University School of Medicine Hospital to examine the clinical utility of serum oncostatin M (OSM) as a biomarker for disease activity and response to infliximab in Egyptian IBD patients. It included 72 IBD patients (19 CD, 53 UC) and 29 controls. Patients were divided into three groups to investigate the connection between disease activity and OSM levels. To analyze the connection between OSM expression and clinical response, 36 IBD patients (22 with UC and 14 with CD) receiving infliximab maintenance were enrolled. All patients were subjected to comprehensive medical history, clinical evaluation, endoscopies, and detection of serum OSM levels. Of the 36 IBD patients, 18 patients responded to infliximab treatment, while the other 18 patients did not. The results demonstrated that, in comparison to controls, patients with IBD had higher levels of serum OSM expression. Serum OSM levels in IBD patients showed a positive association with disease activity. Individuals with moderate-to-severe UC and active CD had considerably elevated levels compared to those in remission. In conclusion, serum OSM showed as a promising biomarker for managing individuals with IBD, it was substantially expressed and positively connected with the severity of the disease. Infliximab non-response was linked to elevated OSM levels.

The early and efficient diagnosis of sepsis in critically ill children remains a difficult task as the clinical signs are nonspecific. Complete blood count parameters and C‑reactive protein have low sensitivity., Also, the difficulty of its diagnosis may be due to decreased positive values of blood culture and the need for longtime to detect blood culture results. The serum Amyloid A (SAA) protein level in the blood increases earlier and up to 1000‑fold in response to inflammation. This study aimed to assess the role of SAA as diagnostic and prognostic marker in pediatric sepsis in the first 24 hours after pediatric intensive care unit (PICU) admission. This case-control study included 45 children with sepsis admitted at PICU from May 2023 to March 2024 and 45 children with matched age and sex as controls. We investigated SAA level in the same time with routine laboratory investigations of both groups. SAA level was higher in the patient group, ranged from 0.9 to 47.2 µg/m, with median 4.54 µg/ml, as compared to the control group with median 0.58 µg/ml ranged from 0 to 2.3 µg/ml. (p ≤0.001). Also, SAA level was significantly lower in the survived group with median 13.6 µg/ml, ranged from 5.7 to 20 µg/ml than the non-survived group with a median of 32.3 µg/ml; ranged from 30.3 to 47.2 µg/ml. In conclusion, we found that SAA was extremely high in critical and extremely critical ill patients which can be used as a predictor of mortality in severe sepsis among children.