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

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.

Although many biomarkers were used for diagnosing neonatal sepsis, none of them is conclusive alone. So, measuring multiple biomarkers were proposed to help in rapid diagnosis of neonatal sepsis. This study aimed to assess the potential role of measurement of neutrophil CD11b and serum procalcitonin (PCT) for early diagnosis of neonatal sepsis. This was a case control study, included 96 neonates admitted to Ain Shams University hospital. The neonates were divided into 3 Groups: Group A included proven sepsis Group with positive blood cultures (n=31), Group B, suspected Group with persistent clinical signs of sepsis but with negative blood cultures (n=36) and a control Group of normal newborns of matched age and sex (n=29). There was a statistically significant increase in expression of CD11b on neutrophils in Group A (median= 99.7) when compared with that of Group B (median= 99.4) and the control Group (median= 96.2) (p < 0.001), with increased mean fluorescence intensity in Group A (median= 21.3) when compared with that of Group B (median= 10.1) and control Group (median= 4.1) (p < 0.001). The receiver operating characteristic curve analysis was applied to assess the diagnostic performance of the tested markers. It showed that the serum PCT level can be used to discriminate between Group A and the control Group with 100% sensitivity, 100% specificity and CD 11b showed 100% sensitivity, 69% specificity. Moreover, to discriminate between Group A and Group B serum PCT showed 100% sensitivity, 88.9% specificity and CD 11b showed 87.1% sensitivity and 44.4% specificity. In conclusion, PCT and neutrophil CD11b are promising markers for diagnosis of early neonatal sepsis in preterm neonate.

Thyroid nodules (TNs) are distinct lesions inside the thyroid that can be determined from the adjacent thyroid parenchyma on ultrasonography. Complement activation, autoantibody generation, persistent inflammation, and immune-complex deposition are the hallmarks of systemic lupus erythematosus (SLE), a complicated systemic autoimmune condition that damages tissues and organs. The current study aimed to detect TNs prevalence in SLE patients, and possible malignancy in a sample of Egyptian population. This cross-sectional study included 80 cases diagnosed with systemic lupus erythematosus, attending the Endocrinology and Rheumatology outpatient clinics at Ain-Shams University Hospital, to detect the prevalence of TNs in a sample of Egyptian SLE cases. There was a positive relation between Systemic Lupus Erythematosus Disease Activity Index (SELDAI) score and TNs, also positive relation between SELDAI score and prevalence of malignancy. There was a higher remarkable number, 13 patients (43.3%), of TNs cases among the group with abnormal thyroid functions. In conclusion, the percent of thyroid malignancy among patients with SLE is the same as in general population, so that SLE itself did not increase the risk of thyroid malignancy. Also, the percent of TNs among cases with SLE was the same as in the general population. Activity of SLE in terms of SLEDAI score has relation with TNs and malignancy. Cases with SLE and TNs are more susceptible to thyroid dysfunctions.

Behcet's disease (BD) is a vascular inflammatory illness with different clinical presentations and incompletely understood mechanisms. Interleukin-17 (IL-17) is suggested to take part in BD inflammatory process but the exact role in different disease manifestation is still unclear. This case- control study aimed to investigate the correlation between IL-17 levels and the symptoms of BD. This study included 30 individuals diagnosed with BD and 15 apparently healthy volunteers, age and sex matched, as controls. Complete clinical assessment with consideration for clinical manifestations was performed. Laboratory markers for BD activity including erythrocyte sedimentation rates and C-reactive protein (CRP) were evaluated. Serum IL-17 level was measured using an enzyme-linked immunosorbent assay. The serum IL-17 levels in patients and controls differed significantly (p < 0.001). Both the duration of BD illness and CRP showed a significant positive correlation with serum IL-17 (p= 0.048 and p < 0.001, respectively). Furthermore, compared to patients with uveitis and controls, individuals with skin manifestations had significantly greater serum IL-17 levels (p < 0.001). In conclusion, serum IL-17 in BD patients especially in those with skin manifestations had significant correlation with disease activity. These results confirm the suggested role of IL-17 in augmenting the inflammation of BD and support the treatment with anti-IL-17 specific therapy for resistant cases of BD especially cases with skin symptoms.

Neonatal sepsis is an important cause of morbidity and mortality. High mobility group box1 protein (HMGB1) is a cytokine that can mediate inflammation. The aim of this research was to investigate the role of HMGB1 in diagnosis and prognosis of late onset neonatal sepsis. This observational case-control study included 80 newborn infants ≥37 weeks of gestation. Newborn infants were assigned into two groups: the late-onset neonatal septic group included 40 infant cases, and the control group included 40 newborn infants. Clinical sepsis score, hematological sepsis score and serum level of C-reactive protein were assessed and blood culture performed. HMGB1 was measured by an enzyme-linked immunosorbent assay. There was a significant increase of HMGB1 in the late-onset neonatal septic group than the control group (p < 0. 001). The best cut off point of HMGB 1 to discriminate against the late-onset sepsis cases from the control newborn infants was > 68 ng/ml with a sensitivity of 97.5%, specificity of 95%, positive predictive value of 95.1% and negative predictive value of 97.4% with total accuracy of 0.99%. The values of HMGB1 were not affected by gestational age, birth weight, postnatal age or gender. There were no significant differences in mean values between survival and non-survival cases. The best cut off value to predict mortality in the late onset sepsis group was >167.8 ng/ml with a sensitivity of 60% and specificity of 54.29%. In conclusion, this study suggested that HMGB1 is a promising marker for diagnosis of late onset neonatal sepsis in full term infants, on the contrary HMGB1 could not predict mortality in neonatal septic patients.

Human leukocyte antigen (HLA) system is a very polymorphic gene complex encoding for cell surface proteins. Kidney transplantation (KT) is considered the optimal renal replacement therapy. Donor-specific antibodies (DSA) against HLA class II antigens are more common than class I. This study aimed to determine the role of HLA (DQ) in acute rejection of renal allograft. This study included 43 KT recipient donor pairs. HLA typing (A, B, DR) of donor and recipient and flowcytometry cross matching results pre transplantation were collected from patients' files. Panel Reactive Antibody (PRA) classes I and II were done to recipients pre transplantation. PRA classes I and II and HLA-DQ genotyping were done to recipients 15-16 weeks post-transplantation. Rejection occurred in 9.3% recipients. Recipients with positive PRA class II had a statistically significant higher percentage of rejection (25.0%) compared to (0.0%) of those with negative PRA class II (p=0.029). Recipients with positive anti HLA-DR antibodies (Abs) and anti HLA-DQ Abs had statistically significant higher percent of rejection (28.6%) compared to (0.0%) of those with negative anti HLA-DR Abs and anti HLA-DQ Abs (p= 0.016). Recipients with positive anti HLA-DQ4 Abs or anti HLA-DQ5 Abs had a statistically significant higher percent of rejection (50%) compared to (5.1%) of those without anti HLA-DQ4 Abs or anti HLA-DQ5 Abs (p=0.037). Recipients with positive anti HLA-DQ9 Abs had a statistically significant higher percent of rejection (30%) compared to (3.0%) of those without anti HLA-DQ9 Abs (p=0.034). Recipients who received kidney from HLA-DQ mismatched donors had higher incidence (57%) of anti HLA-DQ5 antibodies and anti HLA-DQ6 antibodies compared to those with HLA-DQ matched donors (0.0%) (p= 0.018). In conclusion, anti HLA-DQ antibody was one of the most prevalent post-transplant PRA detected. Regarding acute rejection, there was no risk association between its occurrence and HLA-DQ mismatching.

Central nervous system (CNS) demyelination and neurodegeneration are hallmarks of multiple sclerosis (MS). The pathophysiology of MS is related to the inflammatory cytokine interleukin-17 (IL-17), and there may be an association between IL-17 levels and disease severity. In order to find a non-invasive biomarker for disease progression, serum IL-17 levels in MS patients were measured in comparison to a matched control group. Additionally, the relationship between serum IL-17 levels and MS activity was examined. This case-control study included 31 MS patients who were diagnosed using the 2017 updated McDonald's criteria and a control group consisted of 20 apparently healthy individuals, matched for both age and sex. Serum samples were collected and analyzed for IL-17 concentrations using ELISA commercial kits. Clinical evaluations included demographic data, medical history, and an assessment of disease severity using the Expanded Disability Status Scale (EDSS). The study assessed serum levels of IL-17, and found significantly higher levels in MS patients (38.79± 37.36) in comparison to controls (1.47± 0.49). Levels of IL-17 were increased in secondary progressive MS patients than in relapsing-remitting MS patients, but did not reach statistical significance. No significant associations were identified between IL-17 levels and the duration of the MS disease or the frequency of relapses. In conclusion, the study pointed to increased IL-17 levels as a potential MS biomarker.

Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder marked by increased platelet destruction and reduced production, primarily due to the presence of autoantibodies. While many patients respond well to therapy, a subset remains refractory, posing a significant challenge for clinicians and patients alike. This study aimed to evaluate the bone marrow lymphocyte composition in both pediatric and adult patients with refractory ITP, with the goal of uncovering possible reasons for treatment resistance. This case-control study was conducted during the period from May 2019 to December 2024, involved 30 children and 37 adults diagnosed with refractory ITP, along with 60 age- and sex-matched normal controls. All participants underwent bone marrow aspiration, followed by immunophenotyping using a standard panel. Children with refractory ITP exhibited significantly higher percentages of hematogones and mature B cells in the bone marrow (8.27% ± 4.50% and 4.52% ± 3.82%, respectively) compared to adults (1.17% ± 2.18% and 1.89% ± 1.33%). In contrast, the adult group showed elevated levels of T cells (CD3+), averaging 11.6% ± 6.25% compared to 7.80% ± 3.12% in the pediatric group (p = 0.014). Additionally, both CD4+ and CD8+ T cells were significantly more abundant in adults (6.62% ± 4.82% and 7.89% ± 7.02%). Significant differences were also observed between patient and control groups in the proportions of CD3+, CD4+, CD4/CD8 ratios, hematogones, and mature B cells. In conclusion, distinct immunophenotypic profiles in bone marrow lymphocytes were identified between pediatric and adult patients with refractory ITP. These findings highlight potential age-related differences in disease mechanisms, which could inform more targeted approaches to diagnosis and management.