Pub Date : 2020-04-01DOI: 10.21608/ejpa.2020.81765
E. Hossny, Rasha H. El-Owaidy
Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses that represent one of the major pathogens that primarily targets the respiratory system. CoVs are divided into 4 genera: alpha, beta, delta, and gamma; alpha and beta CoVs are known to infect humans (human coronaviruses HCoVs). They resulted previously in the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERSCoV). Since December 2019, a novel CoV (SARSCoV-2) started to cause infections in humans, first reported in Wuhan, Hubei province, China, with a cluster of patients presenting with pneumonia. Afterwards, the novel CoV has quickly spread throughout the world. Genomic analyses suggest that the 2019-nCoV sequencing is closely related to the bat SARSrelated CoV, but the pathogen was probably transmitted to humans by other animals which may have served as intermediate hosts facilitating the virus recombination and mutation, further adding to its genetic diversity.Two different types of 2019nCoV were identified, designated type L (accounting for 70 % of the strains) and type S (accounting for 30 %) but the difference between the two strains and clinical implications remain to be determined. The L type predominated during the early days of the epidemic in China but accounted for a lower proportion of strains outside of Wuhan.
{"title":"COVID-19 in children: current data and future perspectives","authors":"E. Hossny, Rasha H. El-Owaidy","doi":"10.21608/ejpa.2020.81765","DOIUrl":"https://doi.org/10.21608/ejpa.2020.81765","url":null,"abstract":"Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses that represent one of the major pathogens that primarily targets the respiratory system. CoVs are divided into 4 genera: alpha, beta, delta, and gamma; alpha and beta CoVs are known to infect humans (human coronaviruses HCoVs). They resulted previously in the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERSCoV). Since December 2019, a novel CoV (SARSCoV-2) started to cause infections in humans, first reported in Wuhan, Hubei province, China, with a cluster of patients presenting with pneumonia. Afterwards, the novel CoV has quickly spread throughout the world. Genomic analyses suggest that the 2019-nCoV sequencing is closely related to the bat SARSrelated CoV, but the pathogen was probably transmitted to humans by other animals which may have served as intermediate hosts facilitating the virus recombination and mutation, further adding to its genetic diversity.Two different types of 2019nCoV were identified, designated type L (accounting for 70 % of the strains) and type S (accounting for 30 %) but the difference between the two strains and clinical implications remain to be determined. The L type predominated during the early days of the epidemic in China but accounted for a lower proportion of strains outside of Wuhan.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79951904","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 : 2019-10-15DOI: 10.21608/ejpa.2019.53988
D. El-Ghoneimy
Introduction Angioedema is characterized by an asymmetric nondependent swelling that is generally not pruritic. The pathogenesis of angioedema results from increased vascular permeability, with leakage of plasma into the deeper skin layers in patients with angioedema. Hereditary angioedema (HAE) is a rare genetic life-long disabling disease that predisposes an individual to develop vasogenic edema. HAE is an autosomal dominant disease, and most patients with HAE have a positive family history of angioedema. The prevalence of HAE is estimated to be between 1:30,000 and 1:80,000 in the general population, and there is no evidence of sex, ethnic, or racial differences in the prevalence of HAE. 1 Awareness and recognition of this disease is important as HAE is often misdiagnosed as allergic angioedema or acute abdomen (especially acute appendicitis). This may often lead to inappropriate use of antihistamines, corticosteroids, adrenaline and sometimes even surgical interventions.
{"title":"Updates on hereditary angioedema in pediatrics","authors":"D. El-Ghoneimy","doi":"10.21608/ejpa.2019.53988","DOIUrl":"https://doi.org/10.21608/ejpa.2019.53988","url":null,"abstract":"Introduction Angioedema is characterized by an asymmetric nondependent swelling that is generally not pruritic. The pathogenesis of angioedema results from increased vascular permeability, with leakage of plasma into the deeper skin layers in patients with angioedema. Hereditary angioedema (HAE) is a rare genetic life-long disabling disease that predisposes an individual to develop vasogenic edema. HAE is an autosomal dominant disease, and most patients with HAE have a positive family history of angioedema. The prevalence of HAE is estimated to be between 1:30,000 and 1:80,000 in the general population, and there is no evidence of sex, ethnic, or racial differences in the prevalence of HAE. 1 Awareness and recognition of this disease is important as HAE is often misdiagnosed as allergic angioedema or acute abdomen (especially acute appendicitis). This may often lead to inappropriate use of antihistamines, corticosteroids, adrenaline and sometimes even surgical interventions.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42936800","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 : 2019-10-15DOI: 10.21608/ejpa.2019.53989
E. Hossny, D. El-Ghoneimy, D. Soliman, A. Taher, A. Sherief
Background: Despite the widespread availability of 2 classes of effectivevaccines, whole cell and acellular, pertussis has resurged as a seriouspublic health problem. We sought to investigate the pertussis immune statusof mother-neonate pairs and children in our country where pertussisvaccination is obligatory. Methods: This cross-sectional study included 75healthy full-term neonates and their mothers, 100 infants (2-24 months), 170children (2-12 years) and 80 adolescents (12-18 years). Serum pertussisIgG was measured in all enrolled subjects. A positive titre was defined as>24 U/ml. Results: Positive pertussis IgG levels were detected in 69 of themothers (92%), in 63 of their newborns (84%). Seroimmunity to pertussiswas positively noted in 55% of infants, 82.2% of preschool children, 77.5%of school-aged children and 75% in adolescents. Serum pertussis IgG titersamong the neonates showed a significant positive correlation with thematernal titers (P=0.00001). Higher rates of pertussis seroimmunity wasobserved among residents in urban and suburban areas as compared tothose living in rural areas (P<0.05) . Conclusion: This pilot study maysuggest the presence of sufficient pertussis seroimmunity rates in the studiedage groups. Still, there were some failures in immune acquisition probablydue to inefficient vaccination in some localities or waning of immunity withage. Wider scale studies would allow better insight into the pertussisimmune status in our country and hence the need for booster immunization.
{"title":"Pertussis seroimmunity in mother-neonate pairs and other pediatric age groups from Egypt","authors":"E. Hossny, D. El-Ghoneimy, D. Soliman, A. Taher, A. Sherief","doi":"10.21608/ejpa.2019.53989","DOIUrl":"https://doi.org/10.21608/ejpa.2019.53989","url":null,"abstract":"Background: Despite the widespread availability of 2 classes of effectivevaccines, whole cell and acellular, pertussis has resurged as a seriouspublic health problem. We sought to investigate the pertussis immune statusof mother-neonate pairs and children in our country where pertussisvaccination is obligatory. Methods: This cross-sectional study included 75healthy full-term neonates and their mothers, 100 infants (2-24 months), 170children (2-12 years) and 80 adolescents (12-18 years). Serum pertussisIgG was measured in all enrolled subjects. A positive titre was defined as>24 U/ml. Results: Positive pertussis IgG levels were detected in 69 of themothers (92%), in 63 of their newborns (84%). Seroimmunity to pertussiswas positively noted in 55% of infants, 82.2% of preschool children, 77.5%of school-aged children and 75% in adolescents. Serum pertussis IgG titersamong the neonates showed a significant positive correlation with thematernal titers (P=0.00001). Higher rates of pertussis seroimmunity wasobserved among residents in urban and suburban areas as compared tothose living in rural areas (P<0.05) . Conclusion: This pilot study maysuggest the presence of sufficient pertussis seroimmunity rates in the studiedage groups. Still, there were some failures in immune acquisition probablydue to inefficient vaccination in some localities or waning of immunity withage. Wider scale studies would allow better insight into the pertussisimmune status in our country and hence the need for booster immunization.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48192163","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 : 2019-10-01DOI: 10.21608/ejpa.2019.53993
A. El-Kelany, Maha M Anani, H. Omar, Asmaa A. Hashem, E. Fathy
Background: Asthma is the most common inflammatory disorder amongpreschool and school-age children. Regulation of immune cells and theircytokines is essential to control asthma. Montelukast is a leukotrienereceptor antagonist that suppresses inflammatory cell proliferation, andreduces cytokines and mediator secretion. Objective: The researchteam's goal was to study the immunological parameters among mildasthmatic patients before and after the treatment with Montelukast .Methods: Forty preschool children with mild persistent asthma andtwenty healthy, non-allergic children were included in the study. Bloodeosinophil count, total IgE, serum IL-4, IL-10, and IL-13 levels wereassessed. T helper (CD3+CD4+) and T regulatory (CD4+CD25+) cellcounts were measured using flow cytometry; for mild asthmatics beforeand after six weeks of treatment with Montelukast and for the controlgroup. Results: Asthmatic children have shown a significant elevation ofserum levels of IgE, IL4 and IL13, and also an increase of eosinophils,total lymphocyte T cells and T helper cell count. However; serum levelsof IL10 and Treg cell count was lower in asthmatics compared to control.Following six weeks of Montelukast treatment, all immunologicalparameters improved. There was a significant elevation of serum levelsof IL10 and Treg cell count, with a decrease in serum levels of IgE, IL4and IL13; eosinophil counts, and helper T cells. Conclusion:Montelukast treatment improves the impaired immunological balance ofmild asthmatic children through the increase of serum IL-10, Tregulatory cell counts that have anti-inflammatory andimmunoregulatory effects. It also decreases T helper cells and theirproinflammatory cytokines.
{"title":"Can montelukast correct immune dysregulation in preschool children with mild persistent asthma?","authors":"A. El-Kelany, Maha M Anani, H. Omar, Asmaa A. Hashem, E. Fathy","doi":"10.21608/ejpa.2019.53993","DOIUrl":"https://doi.org/10.21608/ejpa.2019.53993","url":null,"abstract":"Background: Asthma is the most common inflammatory disorder amongpreschool and school-age children. Regulation of immune cells and theircytokines is essential to control asthma. Montelukast is a leukotrienereceptor antagonist that suppresses inflammatory cell proliferation, andreduces cytokines and mediator secretion. Objective: The researchteam's goal was to study the immunological parameters among mildasthmatic patients before and after the treatment with Montelukast .Methods: Forty preschool children with mild persistent asthma andtwenty healthy, non-allergic children were included in the study. Bloodeosinophil count, total IgE, serum IL-4, IL-10, and IL-13 levels wereassessed. T helper (CD3+CD4+) and T regulatory (CD4+CD25+) cellcounts were measured using flow cytometry; for mild asthmatics beforeand after six weeks of treatment with Montelukast and for the controlgroup. Results: Asthmatic children have shown a significant elevation ofserum levels of IgE, IL4 and IL13, and also an increase of eosinophils,total lymphocyte T cells and T helper cell count. However; serum levelsof IL10 and Treg cell count was lower in asthmatics compared to control.Following six weeks of Montelukast treatment, all immunologicalparameters improved. There was a significant elevation of serum levelsof IL10 and Treg cell count, with a decrease in serum levels of IgE, IL4and IL13; eosinophil counts, and helper T cells. Conclusion:Montelukast treatment improves the impaired immunological balance ofmild asthmatic children through the increase of serum IL-10, Tregulatory cell counts that have anti-inflammatory andimmunoregulatory effects. It also decreases T helper cells and theirproinflammatory cytokines.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46940114","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 : 2019-10-01DOI: 10.21608/ejpa.2019.53991
M. Ibrahim, S. El-Sayed, R. Said, N. Radwan, M. Ismail, N. Ahmed
Background: Pediatric systemic lupus erythematosus (pSLE) accounts forabout 20% of all cases of Systemic Lupus Erythematosus (SLE), withnephritis occurring in approximately 50% of the patients. Objective: toevaluate the expression of CXCR3 in the kidneys and on CD4+ T cells inpSLE. Methods: This study was conducted on 45 patients with pSLEfollowing up at the Allergy and Immunology Clinic, Children’s Hospital, AinShams University and 45 age and sex matched healthy children as a controlgroup. Medical history, clinical examination and routine laboratoryinvestigations for assessment of disease activity were done for all patients,the frequency of CXCR3, CD4+ T cells was determined in all patients andcontrols. Twenty-five Paraffin blocks of patients with lupus nephritis (LN)(available at the time of the study) underwent immunohistochemistrystaining for the frequencies of Chemokine C receptor (CXCR3). Results:The absolute level and percentage of serum CD4+CXCR3+ weresignificantly lower among our patients as compared to healthy controls. Asignificant direct correlation was found between serum CD4+CXCR3+ andboth the lymphocytic count and quantitative Systemic Lupus erythematosusdisease activity index (SLEDAI), as well as a significant inverse correlationbetween it and 24 hours urinary proteins. Variable degrees of CXCR3expression seemed to have no impact on laboratory tests, British Isles LupusAssessment Group (BILAG) score and cumulative doses ofImmunosuppressives. Conclusion: Serum CD4+CXCR3+ and not renalCXCR3 may be a potential marker of LN activity.
{"title":"CXCR 3 expression on CD4+T cells and in renal tissue of pediatric systemic lupus erythematosus patients","authors":"M. Ibrahim, S. El-Sayed, R. Said, N. Radwan, M. Ismail, N. Ahmed","doi":"10.21608/ejpa.2019.53991","DOIUrl":"https://doi.org/10.21608/ejpa.2019.53991","url":null,"abstract":"Background: Pediatric systemic lupus erythematosus (pSLE) accounts forabout 20% of all cases of Systemic Lupus Erythematosus (SLE), withnephritis occurring in approximately 50% of the patients. Objective: toevaluate the expression of CXCR3 in the kidneys and on CD4+ T cells inpSLE. Methods: This study was conducted on 45 patients with pSLEfollowing up at the Allergy and Immunology Clinic, Children’s Hospital, AinShams University and 45 age and sex matched healthy children as a controlgroup. Medical history, clinical examination and routine laboratoryinvestigations for assessment of disease activity were done for all patients,the frequency of CXCR3, CD4+ T cells was determined in all patients andcontrols. Twenty-five Paraffin blocks of patients with lupus nephritis (LN)(available at the time of the study) underwent immunohistochemistrystaining for the frequencies of Chemokine C receptor (CXCR3). Results:The absolute level and percentage of serum CD4+CXCR3+ weresignificantly lower among our patients as compared to healthy controls. Asignificant direct correlation was found between serum CD4+CXCR3+ andboth the lymphocytic count and quantitative Systemic Lupus erythematosusdisease activity index (SLEDAI), as well as a significant inverse correlationbetween it and 24 hours urinary proteins. Variable degrees of CXCR3expression seemed to have no impact on laboratory tests, British Isles LupusAssessment Group (BILAG) score and cumulative doses ofImmunosuppressives. Conclusion: Serum CD4+CXCR3+ and not renalCXCR3 may be a potential marker of LN activity.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42667282","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 : 2019-10-01DOI: 10.21608/ejpa.2019.53990
I. Paulauskaitė, A. Eidukaitė, O. Rudzevičienė, R. Orentaitė
Background: childhood atopic dermatitis (AD) most commonly presentswith sensitization to environmental allergens. Presence of food allergenspecificIgE is common in childhood and does not always correlate withclinical symptoms, which in children usually affect the skin and mayexacerbate the course of AD. Exposure to an allergen in the gastrointestinaltract activates Th2 immune reactions. Objective: with this study we wantedto compare blood and stool Th2 cytokine concentrations and fecalcalprotectin (FC) value in pediatric AD with (eAD) and without (iAD)sensitization to food. Methods: 51 children with AD were enrolled in thestudy. 57% (n=29) had food allergen specific IgE and comprised eADgroup, 43% (n=22) – iAD group. Blood and stool were tested for IL-4, IL-5,IL-13 concentrations using an enzyme linked immunosorbent assay. Stoolsamples were tested for FC concentrations. Results: iAD had significantlyhigher blood and stool IL-4 values than eAD: 2.82 pg/ml vs. 0, p=0.005;2.98 pg/ml vs. 0, p=0.007, respectively. There was no difference in IL-5 andIL-13 blood and stool concentrations between the groups. Children with ADhad significantly higher FC values, compared to healthy controls: 36.5mg/kg vs. 6.45 mg/kg, p=0.018. FC was slightly higher in eAD group thaniAD, but the difference was not significant: 38.5 mg/kg vs. 25.0 mg/kg,p=0.861 . Conclusions: sensitization to food is not significantly associatedwith Th2 cytokines in pediatric AD patients. Increase in FC values ischaracteristic to AD, but not sensitization to food.
背景:儿童特应性皮炎(AD)最常见的表现是对环境过敏原的致敏。食物过敏原特异性ige的存在在儿童中很常见，并不总是与临床症状相关，在儿童中通常会影响皮肤并可能加剧AD的病程。在胃肠道中接触过敏原会激活Th2免疫反应。目的:通过本研究，我们希望比较儿童AD伴(eAD)和不伴(iAD)食物敏化的血液和粪便Th2细胞因子浓度和粪钙保护蛋白(FC)值。方法:51例AD患儿纳入研究。57% (n=29)有食物过敏原特异性IgE，包括ead组，43% (n=22) - iAD组。采用酶联免疫吸附法检测血液和粪便中IL-4、IL-5、IL-13的浓度。对粪便样本进行氟氯烃浓度检测。结果:iAD组血液和粪便IL-4值明显高于eAD组:分别为2.82 pg/ml和2.98 pg/ml, p=0.005和0,p=0.007。各组血液和粪便中IL-5和il -13浓度无差异。与健康对照者相比，adhd儿童的FC值明显更高:36.5mg/kg vs. 6.45 mg/kg, p=0.018。eAD组FC略高于iad组，但差异不显著:38.5 mg/kg vs. 25.0 mg/kg,p=0.861。结论:儿童AD患者对食物的敏感性与Th2细胞因子无显著相关性。FC值的增加是AD的特征，但不是对食物的敏化。
{"title":"Association of T helper type 2 cytokines with sensitization to food in pediatric atopic dermatitis patients","authors":"I. Paulauskaitė, A. Eidukaitė, O. Rudzevičienė, R. Orentaitė","doi":"10.21608/ejpa.2019.53990","DOIUrl":"https://doi.org/10.21608/ejpa.2019.53990","url":null,"abstract":"Background: childhood atopic dermatitis (AD) most commonly presentswith sensitization to environmental allergens. Presence of food allergenspecificIgE is common in childhood and does not always correlate withclinical symptoms, which in children usually affect the skin and mayexacerbate the course of AD. Exposure to an allergen in the gastrointestinaltract activates Th2 immune reactions. Objective: with this study we wantedto compare blood and stool Th2 cytokine concentrations and fecalcalprotectin (FC) value in pediatric AD with (eAD) and without (iAD)sensitization to food. Methods: 51 children with AD were enrolled in thestudy. 57% (n=29) had food allergen specific IgE and comprised eADgroup, 43% (n=22) – iAD group. Blood and stool were tested for IL-4, IL-5,IL-13 concentrations using an enzyme linked immunosorbent assay. Stoolsamples were tested for FC concentrations. Results: iAD had significantlyhigher blood and stool IL-4 values than eAD: 2.82 pg/ml vs. 0, p=0.005;2.98 pg/ml vs. 0, p=0.007, respectively. There was no difference in IL-5 andIL-13 blood and stool concentrations between the groups. Children with ADhad significantly higher FC values, compared to healthy controls: 36.5mg/kg vs. 6.45 mg/kg, p=0.018. FC was slightly higher in eAD group thaniAD, but the difference was not significant: 38.5 mg/kg vs. 25.0 mg/kg,p=0.861 . Conclusions: sensitization to food is not significantly associatedwith Th2 cytokines in pediatric AD patients. Increase in FC values ischaracteristic to AD, but not sensitization to food.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42185087","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 : 2019-04-01DOI: 10.21608/EJPA.2019.41539
Z. El-Sayed
Mast cells VEGF is a highly specific mitogen for vascular endothelial cells. Five VEGF isoforms are generated as a result of alternative splicing from a single VEGF gene. The expression of VEGF is potentiated in response to hypoxia, by activated oncogenes, and by a variety of cytokines. VEGF induces endothelial cell proliferation, promotes cell migration, and inhibits apoptosis. In vivo VEGF induces angiogenesis as well as permeabilization of blood vessels, and plays a central role in the regulation of vasculogenesis. Deregulated VEGF expression contributes to the development of solid tumors and to several additional diseases by promoting tumor angiogenesis. Consequently, inhibition of VEGF signaling abrogates the development of a wide variety of tumors. The various VEGF forms bind to two tyrosine-kinase receptors, VEGFR-1 (flt-1) and VEGFR-2 (KDR/flk-1), which are expressed almost exclusively in endothelial cells. 1 يناطبلا ومنلا لماع يئاعولا ٢
{"title":"Allergy-immunology glossary","authors":"Z. El-Sayed","doi":"10.21608/EJPA.2019.41539","DOIUrl":"https://doi.org/10.21608/EJPA.2019.41539","url":null,"abstract":"Mast cells VEGF is a highly specific mitogen for vascular endothelial cells. Five VEGF isoforms are generated as a result of alternative splicing from a single VEGF gene. The expression of VEGF is potentiated in response to hypoxia, by activated oncogenes, and by a variety of cytokines. VEGF induces endothelial cell proliferation, promotes cell migration, and inhibits apoptosis. In vivo VEGF induces angiogenesis as well as permeabilization of blood vessels, and plays a central role in the regulation of vasculogenesis. Deregulated VEGF expression contributes to the development of solid tumors and to several additional diseases by promoting tumor angiogenesis. Consequently, inhibition of VEGF signaling abrogates the development of a wide variety of tumors. The various VEGF forms bind to two tyrosine-kinase receptors, VEGFR-1 (flt-1) and VEGFR-2 (KDR/flk-1), which are expressed almost exclusively in endothelial cells. 1 يناطبلا ومنلا لماع يئاعولا ٢","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44287333","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 : 2019-04-01DOI: 10.21608/EJPA.2019.41534
N. Osman, Hanaa A. Mohammad, Kotb Abbass Metwalley, Mostafa M. Embaby, T. ElMelegy
Background: Recurrent wheezy chest is a common complaint in pediatric practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy chest and asthma. The prevalence of vitamin D deficiency has been increasing in Egypt leading to significant morbidities. Objectives: This study aimed to assess serum 25 hydroxy (OH) Vitamin D level in preschool children with recurrent wheezy chest, and to assess its relation to the recurrence, severity, and level of control of the wheezing episodes. Methods: The study included 100 preschool children (aged 2 to 5 years), of both sexes, recruited from the Emergency department, Allergy and Pulmonology units at Assiut University Children Hospital, Egypt. They should have at least 3 documented episodes of wheeze, cough, and difficulty breathing in the last year with clinical improvement on inhaled short-acting beta 2 agonists. Patients were subjected to questionnaire-based history, clinical examination, and laboratory investigations (complete blood count (CBC) with the absolute eosinophil count, serum total IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory Assessment Measure (PRAM score) for assessment of the severity of the wheezing episodes and Global Initiative for Asthma (GINA) based level of asthma control for children 5 years and younger were applied. The patients were grouped according to PRAM score to mild, moderate and severe episodes and according to vitamin D level as sufficient and below-sufficient groups (including deficient and insufficient patients). Results: 25(OH) Vitamin D level was below-sufficient in 53% of the studied patients (deficient in 32% and insufficient in 21%). PRAM score was significantly lower in patients with sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p < 0.025). There was a significant negative correlation between PRAM score and 25 (OH) Vitamin D level (r = -0.334, p = 0.001). Conclusion: There is an inverse relationship between 25(OH)vitamin D level and parameters of asthma severity, as well as with the level of asthma control in preschool children with recurrent wheezy chest. Keywords: Vitamin D, recurrent wheezy chest, preschool children
{"title":"Vitamin D level in preschool children with recurrent wheezy chest, and its relation to the severity of the wheezing episodes","authors":"N. Osman, Hanaa A. Mohammad, Kotb Abbass Metwalley, Mostafa M. Embaby, T. ElMelegy","doi":"10.21608/EJPA.2019.41534","DOIUrl":"https://doi.org/10.21608/EJPA.2019.41534","url":null,"abstract":"Background: Recurrent wheezy chest is a common complaint in pediatric practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy chest and asthma. The prevalence of vitamin D deficiency has been increasing in Egypt leading to significant morbidities. Objectives: This study aimed to assess serum 25 hydroxy (OH) Vitamin D level in preschool children with recurrent wheezy chest, and to assess its relation to the recurrence, severity, and level of control of the wheezing episodes. Methods: The study included 100 preschool children (aged 2 to 5 years), of both sexes, recruited from the Emergency department, Allergy and Pulmonology units at Assiut University Children Hospital, Egypt. They should have at least 3 documented episodes of wheeze, cough, and difficulty breathing in the last year with clinical improvement on inhaled short-acting beta 2 agonists. Patients were subjected to questionnaire-based history, clinical examination, and laboratory investigations (complete blood count (CBC) with the absolute eosinophil count, serum total IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory Assessment Measure (PRAM score) for assessment of the severity of the wheezing episodes and Global Initiative for Asthma (GINA) based level of asthma control for children 5 years and younger were applied. The patients were grouped according to PRAM score to mild, moderate and severe episodes and according to vitamin D level as sufficient and below-sufficient groups (including deficient and insufficient patients). Results: 25(OH) Vitamin D level was below-sufficient in 53% of the studied patients (deficient in 32% and insufficient in 21%). PRAM score was significantly lower in patients with sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p < 0.025). There was a significant negative correlation between PRAM score and 25 (OH) Vitamin D level (r = -0.334, p = 0.001). Conclusion: There is an inverse relationship between 25(OH)vitamin D level and parameters of asthma severity, as well as with the level of asthma control in preschool children with recurrent wheezy chest. Keywords: Vitamin D, recurrent wheezy chest, preschool children","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43831838","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 : 2019-04-01DOI: 10.21608/EJPA.2019.41531
N. Radwan
Primary immunodeficiency diseases (PIDs) are a group of more than 130 disorders caused by genetic defects of the immune system. Most of these disorders are caused by single gene defects, but the variable penetrance of these mutations results in heterogeneous phenotypes which lead to a delay in the diagnosis. In the USA, the prevalence of all PIDs per 100,000 has increased over the last decade from 66.6 in 2003 to 126.8 in 2012 and this could reflect the rise in the disease awareness. The classical clinical presentation of PIDs includes recurrent or unusual infections, however, new presentations are now coming to attention such as autoimmune diseases, malignancy and cutaneous manifestations. Cutaneous manifestation in PIDs affects around 40 % to 70 % of patients and they include various presentation as eczema, cutaneous granulomas, recurrent abscesses, dysplasia of skin, hair, and nails, autoimmune conditions, and others. Dhouib et al found that the incidence of cutaneous manifestation among 200 children with PIDs to be 56%, whereas Al-Herz et al and Moin et al found it to be 48% and 32% respectively. Cutaneous manifestations could be the first presenting symptoms and faulty presenting to dermatologist. In a series of 75 patients with severe dermatitis with no known underlying primary immunodeficiency, Aghamohammadi et al identified 5 patients with hyperimmunoglobulin E syndrome (HIES) and one patient with Wiskott Aldreich syndrome (WAS). This raises the awareness to suspect an underlying PID in patients presenting with severe and nonresolving cutaneous manifestation. Eczema (Atopic dermatitis “AD”) is an inflammatory, chronically relapsing, noncontagious and extremely pruritic skin disease. It is commonly associated with an elevation in total immunoglobulin E, which sometimes correlates with disease severity. The prevalence of childhood AD ranges from 15% to 30%. AD is one of the commonest cutaneous manifestations for some PID diseases and sometime used as one of the disease diagnostic critieria of HIES, WAS, and others (Table). It is characterized by being severe, resistant to treatment and associated by chronic or recurrent viral or bacterial infections. Such condition confirms the importance of eliciting history of recurrent infections in affected patients or history of infection in any of their family members .
{"title":"Eczema the hidden face of primary immunodeficiency diseases","authors":"N. Radwan","doi":"10.21608/EJPA.2019.41531","DOIUrl":"https://doi.org/10.21608/EJPA.2019.41531","url":null,"abstract":"Primary immunodeficiency diseases (PIDs) are a group of more than 130 disorders caused by genetic defects of the immune system. Most of these disorders are caused by single gene defects, but the variable penetrance of these mutations results in heterogeneous phenotypes which lead to a delay in the diagnosis. In the USA, the prevalence of all PIDs per 100,000 has increased over the last decade from 66.6 in 2003 to 126.8 in 2012 and this could reflect the rise in the disease awareness. The classical clinical presentation of PIDs includes recurrent or unusual infections, however, new presentations are now coming to attention such as autoimmune diseases, malignancy and cutaneous manifestations. Cutaneous manifestation in PIDs affects around 40 % to 70 % of patients and they include various presentation as eczema, cutaneous granulomas, recurrent abscesses, dysplasia of skin, hair, and nails, autoimmune conditions, and others. Dhouib et al found that the incidence of cutaneous manifestation among 200 children with PIDs to be 56%, whereas Al-Herz et al and Moin et al found it to be 48% and 32% respectively. Cutaneous manifestations could be the first presenting symptoms and faulty presenting to dermatologist. In a series of 75 patients with severe dermatitis with no known underlying primary immunodeficiency, Aghamohammadi et al identified 5 patients with hyperimmunoglobulin E syndrome (HIES) and one patient with Wiskott Aldreich syndrome (WAS). This raises the awareness to suspect an underlying PID in patients presenting with severe and nonresolving cutaneous manifestation. Eczema (Atopic dermatitis “AD”) is an inflammatory, chronically relapsing, noncontagious and extremely pruritic skin disease. It is commonly associated with an elevation in total immunoglobulin E, which sometimes correlates with disease severity. The prevalence of childhood AD ranges from 15% to 30%. AD is one of the commonest cutaneous manifestations for some PID diseases and sometime used as one of the disease diagnostic critieria of HIES, WAS, and others (Table). It is characterized by being severe, resistant to treatment and associated by chronic or recurrent viral or bacterial infections. Such condition confirms the importance of eliciting history of recurrent infections in affected patients or history of infection in any of their family members .","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44491711","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 : 2019-04-01DOI: 10.21608/EJPA.2019.41535
Niha Elrifai, Hanan A. Al-Wakeel, H. Osman, Rania El Taweel
Background: FOXO3a proteins play multiple crucial roles in immune response. FOXO3 inhibits T cell proliferation, induces T cell apoptosis via upregulation of proapoptotic proteins and it suppresses T cell activation preventing autoimmunity. The role of FOXO3a gene in the pathogenesis of bronchial asthma has been studied in few ethnic groups and revealed its implication in asthma pathogenesis. Objectives: The aim of the current study is to detect the association between single nucleotide polymorphism of the FOXO3a gene (rs13217795) and bronchial asthma, atopy and asthma severity in Egyptian children. Methods: The current cross-sectional case-control study was performed on 75 asthmatic children aged 2 to 12 years following up in the pulmonology outpatient clinic in Children's hospital, Cairo University and 75 age and sex matched healthy controls. Candidates were subjected to clinical evaluation in addition to genotyping for the FOXO3a gene polymorphism using PCR-RFLP technique. Results: The highest frequency was for the heterozygous type CT in both cases and controls groups. The genotype frequencies of mutant type TT for cases and controls were 12 % and 16% respectively, and the T allele frequencies were 37.2% in cases and 46.7% in the control group while CC genotype was present in 37.3% of asthmatic patients and 22.6% in the controls and the C allele was detected in 62.8% and 53.3% for cases and controls respectively. No statistically significant differences were observed between asthmatic patients and controls regarding the different genotypes of the FOXO3a gene polymorphism (p=0.161). No significant association was detected between the different genotypes of the FOXO3a gene polymorphism and the atopic status (p=0.536) or the different grades of asthma severity (p= 0.545). Conclusions: The study of FOXO3a gene polymorphism (rs13217795) in asthmatic Egyptian children revealed low frequency of the mutant TT genotype among cases and controls. In the current study, FOXO3a polymorphism has no role in the pathogenesis of asthma or atopy. Moreover, it has no relation to degree of disease severity. Keywords: Asthma, FOXO3a, gene, children, Egyptian, polymorphism
{"title":"FOXO3a gene polymorphism and bronchial asthma in Egyptian children","authors":"Niha Elrifai, Hanan A. Al-Wakeel, H. Osman, Rania El Taweel","doi":"10.21608/EJPA.2019.41535","DOIUrl":"https://doi.org/10.21608/EJPA.2019.41535","url":null,"abstract":"Background: FOXO3a proteins play multiple crucial roles in immune response. FOXO3 inhibits T cell proliferation, induces T cell apoptosis via upregulation of proapoptotic proteins and it suppresses T cell activation preventing autoimmunity. The role of FOXO3a gene in the pathogenesis of bronchial asthma has been studied in few ethnic groups and revealed its implication in asthma pathogenesis. Objectives: The aim of the current study is to detect the association between single nucleotide polymorphism of the FOXO3a gene (rs13217795) and bronchial asthma, atopy and asthma severity in Egyptian children. Methods: The current cross-sectional case-control study was performed on 75 asthmatic children aged 2 to 12 years following up in the pulmonology outpatient clinic in Children's hospital, Cairo University and 75 age and sex matched healthy controls. Candidates were subjected to clinical evaluation in addition to genotyping for the FOXO3a gene polymorphism using PCR-RFLP technique. Results: The highest frequency was for the heterozygous type CT in both cases and controls groups. The genotype frequencies of mutant type TT for cases and controls were 12 % and 16% respectively, and the T allele frequencies were 37.2% in cases and 46.7% in the control group while CC genotype was present in 37.3% of asthmatic patients and 22.6% in the controls and the C allele was detected in 62.8% and 53.3% for cases and controls respectively. No statistically significant differences were observed between asthmatic patients and controls regarding the different genotypes of the FOXO3a gene polymorphism (p=0.161). No significant association was detected between the different genotypes of the FOXO3a gene polymorphism and the atopic status (p=0.536) or the different grades of asthma severity (p= 0.545). Conclusions: The study of FOXO3a gene polymorphism (rs13217795) in asthmatic Egyptian children revealed low frequency of the mutant TT genotype among cases and controls. In the current study, FOXO3a polymorphism has no role in the pathogenesis of asthma or atopy. Moreover, it has no relation to degree of disease severity. Keywords: Asthma, FOXO3a, gene, children, Egyptian, polymorphism","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42780266","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}
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