H. El-Awady, G. Mokhtar, Maha Fathy, Noha A. Abd-El-Khalek
Background: Some patients with scleroderma have overlap features with systemic lupus erythematosus (SLE). Anti-Scl-70 antibody was reported in as many as 35% of patients with scleroderma and signifies an increased risk for the development of pulmonary fibrosis and pulmonary hypertension. This antibody was detected in 25% of adult patients with SLE. Objective: We hypothesized that a particular subset of lupus patients might be at an increased risk of certain complications if anti-Scl-70 antibody was elevated in their sera. Methods: Serum anti-Scl-70 antibody levels were assayed by ELISA from 34 pediatric patients with SLE and from 24 healthy controls. Patients were also subjected to clinical evaluation for system involvement and for disease activity by systemic lupus erythematosus disease activity index (SLEDAI). The ESR, serum anti DNA antibody, serum complement 3, creatinine clearance and 24 hours urinary protein excretion were assessed and renal biopsy for histopathology was performed in selected cases. Results: Anti Scl-70 antibody was elevated (> 25 U/ml) in 6 SLE patients (18%), borderline (15-25 U/ml) in 17 patients (50%) and normal (< 15 U/ml) in 11 of them (32%). The patient group had significant elevation of serum anti-Scl-70 antibody levels (mean [SD] = 32.5 [8.8] U/ml) as compared to the controls, (mean [SD]= 9.3 [4.1] U/ml; p < 0.001). Patients with clinical lupus nephritis had significant higher levels of this autoantibody as compared to those without clinically evident renal involvement. Also, pulmonary hypertension was found significantly related to the high serum levels of anti-Scl-70 antibody. A significant positive correlation could link anti-Scl-70 levels to the ESR values and SLEDAI scores. Anti-Scl-70 levels were neither affected by the presence of neuropsychiatric involvement nor by intake of cytotoxic drugs. Conclusion: Anti-Scl-70 antibody is present in a significant subset of patients with SLE. For this subset, it offers a good correlate of disease activity and suggests an increased risk for pulmonary hypertension and renal involvement. Keywords: SLE; anti-Scl-70; pulmonary hypertension; lupus nephritis; SLEDAI Egypt J Pediatr Allergy Immunol 2006; 4(2): 53-60.
{"title":"Assessment of left ventricular diastolic function in bronchial asthma: can we rely on transmitral inflow velocity patterns?","authors":"H. El-Awady, G. Mokhtar, Maha Fathy, Noha A. Abd-El-Khalek","doi":"10.4314/EJPAI.V4I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V4I2","url":null,"abstract":"Background: Some patients with scleroderma have overlap features with systemic lupus erythematosus (SLE). Anti-Scl-70 antibody was reported in as many as 35% of patients with scleroderma and signifies an increased risk for the development of pulmonary fibrosis and pulmonary hypertension. This antibody was detected in 25% of adult patients with SLE. Objective: We hypothesized that a particular subset of lupus patients might be at an increased risk of certain complications if anti-Scl-70 antibody was elevated in their sera. Methods: Serum anti-Scl-70 antibody levels were assayed by ELISA from 34 pediatric patients with SLE and from 24 healthy controls. Patients were also subjected to clinical evaluation for system involvement and for disease activity by systemic lupus erythematosus disease activity index (SLEDAI). The ESR, serum anti DNA antibody, serum complement 3, creatinine clearance and 24 hours urinary protein excretion were assessed and renal biopsy for histopathology was performed in selected cases. Results: Anti Scl-70 antibody was elevated (> 25 U/ml) in 6 SLE patients (18%), borderline (15-25 U/ml) in 17 patients (50%) and normal (< 15 U/ml) in 11 of them (32%). The patient group had significant elevation of serum anti-Scl-70 antibody levels (mean [SD] = 32.5 [8.8] U/ml) as compared to the controls, (mean [SD]= 9.3 [4.1] U/ml; p < 0.001). Patients with clinical lupus nephritis had significant higher levels of this autoantibody as compared to those without clinically evident renal involvement. Also, pulmonary hypertension was found significantly related to the high serum levels of anti-Scl-70 antibody. A significant positive correlation could link anti-Scl-70 levels to the ESR values and SLEDAI scores. Anti-Scl-70 levels were neither affected by the presence of neuropsychiatric involvement nor by intake of cytotoxic drugs. Conclusion: Anti-Scl-70 antibody is present in a significant subset of patients with SLE. For this subset, it offers a good correlate of disease activity and suggests an increased risk for pulmonary hypertension and renal involvement. Keywords: SLE; anti-Scl-70; pulmonary hypertension; lupus nephritis; SLEDAI Egypt J Pediatr Allergy Immunol 2006; 4(2): 53-60.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81334963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. El-Hodhod, M. Nassar, J. Nassar, Gihan M. ELNahas, S. M. Gomaa
Background: Behavioral modification and structured education are necessary in autism but rather insufficient. Various dietary restrictions have been suggested as important prerequisites to benefit from other interventions in this disorder. Objective: This study was designed to highlight the degree of benefit in various aspects of development of autistic children upon elimination of cow's milk protein (CMP) from their diet and assess the level of specific IgE for CMP in their sera. Methods: The current study was conducted on 22 autistic children who were compared to 30 age and sex matched healthy children. Enrolled autistic children were randomly assigned to one of two groups. The parents of first group were instructed to eliminate cow milk (CM) from the diet of their children throughout the study period while patients of the second group were allowed to eat without restrictions. Each enrolled child was subjected to complete dietetic history taking, clinical examination and measurement of IgE for CM antigen in their sera by enzyme immunoassay. Autistic patients underwent a Childhood Autism Rating Scale (CARS) test. The patients were also subjected to language and intelligent quotient (IQ) testing, social and mental age assessment and child psychiatric evaluation. The autistic children received an interventional program for six months and were then re-evaluated using the previous clinical parameters. Results: The first group achieved significantly lower CARS test results (p < 0.01), significantly higher language age (p < 0.05) and significantly higher rate of change of CARS, language, social age, mental age and IQ (p < 0.001, <0.05, <0.05, <0.01 and <0.05 respectively) compared to the second group after 6 months of follow up. There was also a significantly higher mean specific IgE level to CMP in the autistic patients as compared to the controls. Additionally, 45.5% of patients who were on CM elimination diet went one CARS category down compared to only 36.4% of the second group. Conclusion: We report improvement in language, cognition and behavioral capabilities upon CM elimination in a group of autistic children. The higher CM specific IgE in these children may suggest that such adverse reaction to CM may have an allergic basis. Wider scale studies are needed to justify this adjuvant therapeutic option in autistic children hoping for better achievement from the current interventional programs. Keywords: Allergy – Autism – CARS – Cow milk – IgE – IQ Egypt J Pediatr Allergy Immunol 2006; 4(1): 15-21
{"title":"Cow’s milk protein elimination in autistic children: language, cognitive and behavioral outcome","authors":"M. El-Hodhod, M. Nassar, J. Nassar, Gihan M. ELNahas, S. M. Gomaa","doi":"10.4314/EJPAI.V4I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V4I1","url":null,"abstract":"Background: Behavioral modification and structured education are necessary in autism but rather insufficient. Various dietary restrictions have been suggested as important prerequisites to benefit from other interventions in this disorder. Objective: This study was designed to highlight the degree of benefit in various aspects of development of autistic children upon elimination of cow's milk protein (CMP) from their diet and assess the level of specific IgE for CMP in their sera. Methods: The current study was conducted on 22 autistic children who were compared to 30 age and sex matched healthy children. Enrolled autistic children were randomly assigned to one of two groups. The parents of first group were instructed to eliminate cow milk (CM) from the diet of their children throughout the study period while patients of the second group were allowed to eat without restrictions. Each enrolled child was subjected to complete dietetic history taking, clinical examination and measurement of IgE for CM antigen in their sera by enzyme immunoassay. Autistic patients underwent a Childhood Autism Rating Scale (CARS) test. The patients were also subjected to language and intelligent quotient (IQ) testing, social and mental age assessment and child psychiatric evaluation. The autistic children received an interventional program for six months and were then re-evaluated using the previous clinical parameters. Results: The first group achieved significantly lower CARS test results (p < 0.01), significantly higher language age (p < 0.05) and significantly higher rate of change of CARS, language, social age, mental age and IQ (p < 0.001, <0.05, <0.05, <0.01 and <0.05 respectively) compared to the second group after 6 months of follow up. There was also a significantly higher mean specific IgE level to CMP in the autistic patients as compared to the controls. Additionally, 45.5% of patients who were on CM elimination diet went one CARS category down compared to only 36.4% of the second group. Conclusion: We report improvement in language, cognition and behavioral capabilities upon CM elimination in a group of autistic children. The higher CM specific IgE in these children may suggest that such adverse reaction to CM may have an allergic basis. Wider scale studies are needed to justify this adjuvant therapeutic option in autistic children hoping for better achievement from the current interventional programs. Keywords: Allergy – Autism – CARS – Cow milk – IgE – IQ Egypt J Pediatr Allergy Immunol 2006; 4(1): 15-21","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90399623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2005-02-01DOI: 10.1016/J.JACI.2004.12.887
Y. El-Gamal, N. Heshmat, A. Shehab, Ayman F Hasaneen
{"title":"Diagnostic value of CD14 + CD16 + monocytes in neonatal sepsis","authors":"Y. El-Gamal, N. Heshmat, A. Shehab, Ayman F Hasaneen","doi":"10.1016/J.JACI.2004.12.887","DOIUrl":"https://doi.org/10.1016/J.JACI.2004.12.887","url":null,"abstract":"","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/J.JACI.2004.12.887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72420496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The role of the nucleosome in the induction of antibody response in lupus mediated tissue damage especially glomerulonephritis, may provide a new insight in the early diagnosis and alternative therapeutic developments in systemic lupus erythematosus (SLE). Objectives: To evaluate the frequency and specificity of antinucleosome antibody expression in SLE patients in relation to disease activity. Also, to assess their predictive value in subclinical lupus nephritis. Methods: This study included 26 patients with SLE and 52 control subjects (26 were healthy and 26 had juvenile rheumatoid arthritis "JRA"). Among lupus patients, 15 had clinical evidence of renal involvement. After clinical evaluation to calculate the SLE disease activity index (SLEDAI), measurements of urinary microalbumin and serum antinucleosome antibodies (antinucleosome specific, antihistone and anti ds-DNA antibodies by ELISA) were performed. Patients without clinical evidence of renal involvement were followed up for one year and measurement of urinary microalbumin was repeated at the end of the study period. Those who later developed microalbuminurea were categorized as patients with subclinical lupus nephritis. Results: The expression of the 3 studied antinucleosome antibodies was significantly higher among lupus patients as compared to JRA patients and healthy controls. Seropositivity for one or more antinucleosome antibodies was elicited in 84.5% of lupus patients. Serum levels of the 3 antinucleosome antibodies were significantly higher among lupus patients with clinical nephritis than those without nephritis. ANSAb had higher sensitivity, specificity and positive and negative predictive values for subclinical lupus nephritis (100%) than antihistone and anti ds-DNA antibodies (43%, 100%, 100% and 50% respectively for either antibodies). All patients with lupus nephritis were seropositive for at least one of the antinucleosome antibodies, while those without clinical or subclinical nephritis were seronegative for the 3 antinucleosome antibodies. In 27.3% of patients with lupus nephritis, ANSAB was positive while both antihistone and ds-DNA antibodies were negative. Antinucleosome antibodies correlated positively with SLEDAI and cumulative steroid dose and negatively with corrected creatinine clearance. Conclusions: The observed sensitivity and specificity of antinucleosome specific antibodies as early indicators of subclinical lupus nephritis appear encouraging and deserve further analysis on a large scale in order to confirm their validity, especially in the anti ds-DNA seronegative lupus patients. Keywords: antinucleosome antibodies, antinucleosome specific antibodies, anti ds-DNA antibodies, antihistone antibodies, SLE, lupus nephritis Egypt J Pediatr Allergy Immunol 2005; 3(2):54-62
{"title":"Serum mucosa-associated epithelial chemokine (MEC/CCL28) in atopic dermatitis: a specific marker for severity","authors":"S. Reda, G. Mostafa, Manal A. Aziz, I. M. Mahmoud","doi":"10.4314/EJPAI.V3I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V3I2","url":null,"abstract":"Background: The role of the nucleosome in the induction of antibody response in lupus mediated tissue damage especially glomerulonephritis, may provide a new insight in the early diagnosis and alternative therapeutic developments in systemic lupus erythematosus (SLE). Objectives: To evaluate the frequency and specificity of antinucleosome antibody expression in SLE patients in relation to disease activity. Also, to assess their predictive value in subclinical lupus nephritis. Methods: This study included 26 patients with SLE and 52 control subjects (26 were healthy and 26 had juvenile rheumatoid arthritis \"JRA\"). Among lupus patients, 15 had clinical evidence of renal involvement. After clinical evaluation to calculate the SLE disease activity index (SLEDAI), measurements of urinary microalbumin and serum antinucleosome antibodies (antinucleosome specific, antihistone and anti ds-DNA antibodies by ELISA) were performed. Patients without clinical evidence of renal involvement were followed up for one year and measurement of urinary microalbumin was repeated at the end of the study period. Those who later developed microalbuminurea were categorized as patients with subclinical lupus nephritis. Results: The expression of the 3 studied antinucleosome antibodies was significantly higher among lupus patients as compared to JRA patients and healthy controls. Seropositivity for one or more antinucleosome antibodies was elicited in 84.5% of lupus patients. Serum levels of the 3 antinucleosome antibodies were significantly higher among lupus patients with clinical nephritis than those without nephritis. ANSAb had higher sensitivity, specificity and positive and negative predictive values for subclinical lupus nephritis (100%) than antihistone and anti ds-DNA antibodies (43%, 100%, 100% and 50% respectively for either antibodies). All patients with lupus nephritis were seropositive for at least one of the antinucleosome antibodies, while those without clinical or subclinical nephritis were seronegative for the 3 antinucleosome antibodies. In 27.3% of patients with lupus nephritis, ANSAB was positive while both antihistone and ds-DNA antibodies were negative. Antinucleosome antibodies correlated positively with SLEDAI and cumulative steroid dose and negatively with corrected creatinine clearance. Conclusions: The observed sensitivity and specificity of antinucleosome specific antibodies as early indicators of subclinical lupus nephritis appear encouraging and deserve further analysis on a large scale in order to confirm their validity, especially in the anti ds-DNA seronegative lupus patients. Keywords: antinucleosome antibodies, antinucleosome specific antibodies, anti ds-DNA antibodies, antihistone antibodies, SLE, lupus nephritis Egypt J Pediatr Allergy Immunol 2005; 3(2):54-62","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76446833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. El-Rasheidy, Shahira F El-Fedawy, H. Tomoum, Mona B El-Zeany
Background: Some immunologic mechanisms of epilepsy are cited in literature. The possibility that epilepsy might be associated with the production of autoantibodies has not been sufficiently addressed. Objective: This study investigates the prevalence of some antiphospholipid antibodies in pediatric primary epilepsy in relation to the type of seizures, the duration of the disease and the antiepileptic drugs received. Methods: The study included 37 patients in the pediatric age groups with epilepsy (30 with idiopathic epilepsy and 7 with cryptogenic epilepsy); 10 of them were newly diagnosed in comparison to ten healthy children. The patients were subjected to clinical, laboratory and radiologic evaluation to verify the diagnosis and to exclude thrombotic or autoimmune collagen disorders. Anticardiolipin IgG and IgM and anti-β 2 -glycoprotein I IgG and IgM antibodies were measured in all subjects using the ELISA technique. Results: Forty percent of the patients were positive for at least one of the antiphospholipid antibodies and 16% displayed more than one antibody in their serum. The mean values of anti CL IgG and anti β 2 GP I IgM were significantly higher in the patients (mean 11.32 ± 6.3 GPL and 4.43 ± 2.8 U/ml, respectively) as compared to the control group (mean 5.25 ± 1.9 and 1.6 ± 0.6, respectively) (P < 0.001). The concentrations of the tested antibodies were comparable among patients with focal compared to those with generalized seizure, or in patients with idiopathic compared to cryptogenic epilepsy. Patients with newly diagnosed untreated epileptic seizures showed a substantial prevalence of antiphospholipid antibodies. They even demonstrated significantly higher mean values of aβ2GP I IgG (10.7 ± 11 GPL) and aβ2GP I IgM (5.8 ± 3.0 U/ml) when compared to the rest of the patients (mean 5.9 ± 3.5 and 3.9 ± 2.6 respectively).There seem to be no effect of the different antiepileptic drugs or the degree of seizure control on the development of antiphospholipid antibodies. Conclusions: The antiphospholipid antibodies seem to be present at a higher rate in pediatric patients with epilepsy. The increased prevalence of those autoantibodies is associated with epilepsy regardless of the type of seizures, the antiepileptic drugs used or the degree of seizure control, suggesting that immune dysregulation may be linked to the pathogenesis of primary epilepsy. Keywords: anti β2 glycoprotein ; anticardiolipin; antiphospholipid; epilepsy; immune system Egypt J Pediatr Allergy Immunol 2004; 2(1): 58-65
背景:文献中引用了一些癫痫的免疫机制。癫痫可能与自身抗体的产生有关的可能性尚未得到充分的解决。目的:探讨小儿原发性癫痫中部分抗磷脂抗体的流行与癫痫发作类型、病程及抗癫痫药物的关系。方法:纳入37例小儿癫痫患者(特发性癫痫30例，隐源性癫痫7例);与10名健康儿童相比，其中10名是新诊断的。患者接受临床、实验室和放射学评估以验证诊断并排除血栓性或自身免疫性胶原蛋白紊乱。采用ELISA技术检测所有受试者的抗心磷脂IgG、IgM抗体和抗β 2 -糖蛋白I IgG、IgM抗体。结果:40%的患者血清中至少有一种抗磷脂抗体呈阳性，16%的患者血清中有不止一种抗体。患者抗CL IgG和抗β 2 GP I IgM的平均值(分别为11.32±6.3 GPL和4.43±2.8 U/ml)明显高于对照组(分别为5.25±1.9和1.6±0.6)(P < 0.001)。检测的抗体浓度在局灶性癫痫患者与全身性癫痫患者之间具有可比性，在特发性癫痫患者与隐源性癫痫患者之间具有可比性。新诊断的未经治疗的癫痫发作患者显示抗磷脂抗体的大量流行。他们的a - β 2gp I IgG(10.7±11 GPL)和a - β 2gp I IgM(5.8±3.0 U/ml)的平均值明显高于其他患者(平均分别为5.9±3.5和3.9±2.6)。不同的抗癫痫药物或癫痫发作控制程度对抗磷脂抗体的产生似乎没有影响。结论:抗磷脂抗体似乎在儿童癫痫患者中有较高的发生率。无论癫痫发作类型、使用的抗癫痫药物或癫痫发作控制程度如何，这些自身抗体的患病率增加都与癫痫有关，这表明免疫失调可能与原发性癫痫的发病机制有关。关键词:抗β2糖蛋白;anticardiolipin;antiphospholipid;癫痫;中华儿科杂志(英文版);2004;2 (1): 58 - 65
{"title":"Antiphospholipid antibodies in children and adolescents with epilepsy","authors":"O. El-Rasheidy, Shahira F El-Fedawy, H. Tomoum, Mona B El-Zeany","doi":"10.4314/EJPAI.V2I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V2I1","url":null,"abstract":"Background: Some immunologic mechanisms of epilepsy are cited in literature. The possibility that epilepsy might be associated with the production of autoantibodies has not been sufficiently addressed. Objective: This study investigates the prevalence of some antiphospholipid antibodies in pediatric primary epilepsy in relation to the type of seizures, the duration of the disease and the antiepileptic drugs received. Methods: The study included 37 patients in the pediatric age groups with epilepsy (30 with idiopathic epilepsy and 7 with cryptogenic epilepsy); 10 of them were newly diagnosed in comparison to ten healthy children. The patients were subjected to clinical, laboratory and radiologic evaluation to verify the diagnosis and to exclude thrombotic or autoimmune collagen disorders. Anticardiolipin IgG and IgM and anti-β 2 -glycoprotein I IgG and IgM antibodies were measured in all subjects using the ELISA technique. Results: Forty percent of the patients were positive for at least one of the antiphospholipid antibodies and 16% displayed more than one antibody in their serum. The mean values of anti CL IgG and anti β 2 GP I IgM were significantly higher in the patients (mean 11.32 ± 6.3 GPL and 4.43 ± 2.8 U/ml, respectively) as compared to the control group (mean 5.25 ± 1.9 and 1.6 ± 0.6, respectively) (P < 0.001). The concentrations of the tested antibodies were comparable among patients with focal compared to those with generalized seizure, or in patients with idiopathic compared to cryptogenic epilepsy. Patients with newly diagnosed untreated epileptic seizures showed a substantial prevalence of antiphospholipid antibodies. They even demonstrated significantly higher mean values of aβ2GP I IgG (10.7 ± 11 GPL) and aβ2GP I IgM (5.8 ± 3.0 U/ml) when compared to the rest of the patients (mean 5.9 ± 3.5 and 3.9 ± 2.6 respectively).There seem to be no effect of the different antiepileptic drugs or the degree of seizure control on the development of antiphospholipid antibodies. Conclusions: The antiphospholipid antibodies seem to be present at a higher rate in pediatric patients with epilepsy. The increased prevalence of those autoantibodies is associated with epilepsy regardless of the type of seizures, the antiepileptic drugs used or the degree of seizure control, suggesting that immune dysregulation may be linked to the pathogenesis of primary epilepsy. Keywords: anti β2 glycoprotein ; anticardiolipin; antiphospholipid; epilepsy; immune system Egypt J Pediatr Allergy Immunol 2004; 2(1): 58-65","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72826587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Reda, E. Hossny, Shahira F El-Fedawy, M. E. El-Deen
Background: Thymus and activation-regulated chemokine (TARC) is responsible for trafficking of T helper 2 lymphocytes into sites of allergic inflammation. However, its role in assessing the severity of acute asthma in children is still unclear. Objective: We sought to evaluate plasma TARC as a marker for monitoring asthma exacerbation in terms of asthma attack severity. Methods: Plasma TARC concentration was estimated in 24 asthmatic children aged between 2 and 17 years attending the Pediatric Allergy and Immunology Unit of Children’s Hospital, Ain Shams University, and 23 age and sex-matched healthy children using a sandwich enzyme immunoassay technique. For asthmatic patients, the measurement was performed during and after the resolution of acute asthma attack. In addition, complete hemogram and plasma total IgE were evaluated and peak expiratory flow rate was assessed in asthmatic patients during and after acute asthma exacerbation. Results: Plasma TARC mean concentration was significantly higher during acute asthma (839.2 ± 453.6 pg/ml) than after resolution of symptoms (416.5 ± 324.8 pg/ml) and both were statistically higher than the control value (165.7 ± 135.2 pg/ml). During acute attacks of asthma, plasma TARC level was significantly elevated among patients with severe attacks of wheezing (1336.3 ± 431.2 pg/ml) than in those with moderate (743.8 ± 91.8 pg/ml) and mild (437.5 ± 66.1 pg/ml) attacks and inversely related to PEFR measurements during attacks (r = -98, P < 0.001). Meanwhile, no significant relationship was found between plasma TARC levels and either plasma total IgE levels or the absolute eosinophil count. Neither the history of other atopic symptoms nor family history of atopy influenced plasma TARC levels. A significant reduction in plasma TARC level was observed after treatment with inhaled s2 agonist drugs either alone or in conjunction with inhaled glucocorticoids. Conclusion: Our findings support the concept that TARC may be implicated in the pathogenesis of asthma. Plasma TARC is a useful marker in monitoring the severity of asthma exacerbation and in assessing the degree of allergic inflammation in the asthmatic airway. This would help physicians to design appropriate therapy in terms of dose and duration of treatment especially among children with quiescent asthma. Future studies should focus on using TARC antagonists as a new approach to asthma immunotherapy. Keywords: bronchial asthma, acute attacks, remission, TARC, atopy, inhaled glucocorticoids, s2 agonists Egypt J Pediatr Allergy Immunol 2003; 1(2): 86-92
{"title":"Plasma concentration of thymus and activation-regulated chemokine in childhood asthma","authors":"S. Reda, E. Hossny, Shahira F El-Fedawy, M. E. El-Deen","doi":"10.4314/EJPAI.V1I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V1I2","url":null,"abstract":"Background: Thymus and activation-regulated chemokine (TARC) is responsible for trafficking of T helper 2 lymphocytes into sites of allergic inflammation. However, its role in assessing the severity of acute asthma in children is still unclear. Objective: We sought to evaluate plasma TARC as a marker for monitoring asthma exacerbation in terms of asthma attack severity. Methods: Plasma TARC concentration was estimated in 24 asthmatic children aged between 2 and 17 years attending the Pediatric Allergy and Immunology Unit of Children’s Hospital, Ain Shams University, and 23 age and sex-matched healthy children using a sandwich enzyme immunoassay technique. For asthmatic patients, the measurement was performed during and after the resolution of acute asthma attack. In addition, complete hemogram and plasma total IgE were evaluated and peak expiratory flow rate was assessed in asthmatic patients during and after acute asthma exacerbation. Results: Plasma TARC mean concentration was significantly higher during acute asthma (839.2 ± 453.6 pg/ml) than after resolution of symptoms (416.5 ± 324.8 pg/ml) and both were statistically higher than the control value (165.7 ± 135.2 pg/ml). During acute attacks of asthma, plasma TARC level was significantly elevated among patients with severe attacks of wheezing (1336.3 ± 431.2 pg/ml) than in those with moderate (743.8 ± 91.8 pg/ml) and mild (437.5 ± 66.1 pg/ml) attacks and inversely related to PEFR measurements during attacks (r = -98, P < 0.001). Meanwhile, no significant relationship was found between plasma TARC levels and either plasma total IgE levels or the absolute eosinophil count. Neither the history of other atopic symptoms nor family history of atopy influenced plasma TARC levels. A significant reduction in plasma TARC level was observed after treatment with inhaled s2 agonist drugs either alone or in conjunction with inhaled glucocorticoids. Conclusion: Our findings support the concept that TARC may be implicated in the pathogenesis of asthma. Plasma TARC is a useful marker in monitoring the severity of asthma exacerbation and in assessing the degree of allergic inflammation in the asthmatic airway. This would help physicians to design appropriate therapy in terms of dose and duration of treatment especially among children with quiescent asthma. Future studies should focus on using TARC antagonists as a new approach to asthma immunotherapy. Keywords: bronchial asthma, acute attacks, remission, TARC, atopy, inhaled glucocorticoids, s2 agonists Egypt J Pediatr Allergy Immunol 2003; 1(2): 86-92","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72445779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.21608/ejpa.2021.163823
E. Board
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