Mohammad M. El Sherbeny, O. Behairy, O. Mohammad, Ahmad ElSayed
Background: Copper and lead are trace elements required for the activity of antioxidant enzymes and changes in their levels may lead to reduction in antioxidant activities in asthma. Objective: Our study aims to investigate the serum levels of copper and lead in asthmatic children in correlation to disease severity to anticipate their role as oxidant defenders in this disease. Methods: We enrolled 45 children who were divided into two groups: group 1 included 30 asthmatic children during disease quiescence and group 2 included 15 clinically healthy children matched for age and sex as a control group. Patients were subjected to: history taking, clinical examination, spirometry before and after bronchodilator therapy, complete blood counting, and measurement of serum levels of total IgE, copper and lead (in patients and controls). Results: Patients’ group had significantly higher serum levels of lead (mean 8.2±3.1 μg/dl) and copper (122±31.5 μg/dl) in comparison to controls (mean 5.7±2.3 μg/dl and103.3±21.1 μg/dl respectively). Serum lead and copper levels were higher among patients with moderate persistent asthma than those with mild asthma. Serum total IgE levels correlated positively with serum lead levels among the asthmatic children. However, serum lead and copper levels did not correlate with any of the measured pulmonary function parameters tested. Conclusion: Increased serum level of lead and copper were high in a group of children with bronchial asthma in children and this was more evident in moderate than mild cases. Keywords: children; trace elements; lead; copper; spirometry; bronchial asthma; antioxidants; severity
{"title":"Serum levels of lead and copper in a group of Egyptian children with bronchial asthma","authors":"Mohammad M. El Sherbeny, O. Behairy, O. Mohammad, Ahmad ElSayed","doi":"10.4314/EJPAI.V14I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V14I2","url":null,"abstract":"Background: Copper and lead are trace elements required for the activity of antioxidant enzymes and changes in their levels may lead to reduction in antioxidant activities in asthma. Objective: Our study aims to investigate the serum levels of copper and lead in asthmatic children in correlation to disease severity to anticipate their role as oxidant defenders in this disease. Methods: We enrolled 45 children who were divided into two groups: group 1 included 30 asthmatic children during disease quiescence and group 2 included 15 clinically healthy children matched for age and sex as a control group. Patients were subjected to: history taking, clinical examination, spirometry before and after bronchodilator therapy, complete blood counting, and measurement of serum levels of total IgE, copper and lead (in patients and controls). Results: Patients’ group had significantly higher serum levels of lead (mean 8.2±3.1 μg/dl) and copper (122±31.5 μg/dl) in comparison to controls (mean 5.7±2.3 μg/dl and103.3±21.1 μg/dl respectively). Serum lead and copper levels were higher among patients with moderate persistent asthma than those with mild asthma. Serum total IgE levels correlated positively with serum lead levels among the asthmatic children. However, serum lead and copper levels did not correlate with any of the measured pulmonary function parameters tested. Conclusion: Increased serum level of lead and copper were high in a group of children with bronchial asthma in children and this was more evident in moderate than mild cases. Keywords: children; trace elements; lead; copper; spirometry; bronchial asthma; antioxidants; severity","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2016-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90790399","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 : 2016-04-01DOI: 10.21608/EJPA.2016.16761
M. Shaheen
Introduction Pediatric bronchial asthma has been clinically recognized as a heterogeneous disease for decades, including descriptions of patients with allergyassociated disease, viral induced asthma and exercise-induced asthma. Despite this recognition, treatment approaches were similar, involving the use of nonspecific agents, such as inhaled corticosteroids (CS) and beta 2agonists. These drugs, which were generally effective in the majority of asthmatic children, also failed in many. In each case, the molecular underpinnings of the heterogeneity or the varied responses to treatment were unknown. In the middle of the 20th century, a significant increase in the prevalence of bronchial asthma (BA) was reported worldwide. This rise particularly referred to BA of pediatric onset; therefore asthma became one of the most prevalent chronic inflammatory diseases in pediatrics. BA is described as a chronic inflammatory disorder of the airways with inflammatory symptoms causing a variable degree of airflow limitation and is accompanied by an increased sensitivity to multiple pharmacological and nonpharmacological stimuli. The bronchial obstruction seen is often reversible, either spontaneously or with treatment. BA is considered a complex disorder based on a multifactorial interaction of genetic predisposition and diverse environmental influences.
{"title":"Molecular endotypes of pediatric asthma: a novel language directs asthma treatment!","authors":"M. Shaheen","doi":"10.21608/EJPA.2016.16761","DOIUrl":"https://doi.org/10.21608/EJPA.2016.16761","url":null,"abstract":"Introduction Pediatric bronchial asthma has been clinically recognized as a heterogeneous disease for decades, including descriptions of patients with allergyassociated disease, viral induced asthma and exercise-induced asthma. Despite this recognition, treatment approaches were similar, involving the use of nonspecific agents, such as inhaled corticosteroids (CS) and beta 2agonists. These drugs, which were generally effective in the majority of asthmatic children, also failed in many. In each case, the molecular underpinnings of the heterogeneity or the varied responses to treatment were unknown. In the middle of the 20th century, a significant increase in the prevalence of bronchial asthma (BA) was reported worldwide. This rise particularly referred to BA of pediatric onset; therefore asthma became one of the most prevalent chronic inflammatory diseases in pediatrics. BA is described as a chronic inflammatory disorder of the airways with inflammatory symptoms causing a variable degree of airflow limitation and is accompanied by an increased sensitivity to multiple pharmacological and nonpharmacological stimuli. The bronchial obstruction seen is often reversible, either spontaneously or with treatment. BA is considered a complex disorder based on a multifactorial interaction of genetic predisposition and diverse environmental influences.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83887445","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 : Food allergy is a problem of the western world, however, cases of food allergy have also been found in developing countries. In Nigeria, the prevalence of food allergy is scarce while the association of food sensitization with helminthiasis is unknown. Objective : This study was designed to determine the prevalence of sensitization to food among Nigerian school children and its relation to intestinal helminthiasis. Methods : A total of 128 participants were recruited from CAC Primary School, Sango, Ibadan, Nigeria. Skin Prick Test using freshly prepared food allergens was carried out. Stool samples were collected from them to screen for ova of parasites using concentration method. Results : A total of 26 (20.3%) out of 128 participants were SPT positive for various food allergens, while 16 (12.5%) had helminthic infection. There was however an equal distribution of helminthic infection among students who were food allergen SPT positive and negative. There was also no association between gender and susceptibility to food allergy. Conclusion : Sensitization to food is common in school children, and intestinal helminthiasis seems to have no influence on its prevalence. Keywords : MPO, inflammatory response, neonates, sepsis.
{"title":"Prevalence of food sensitization and helminth infection among primary school children in Ibadan, southwest Nigeria","authors":"A. Adelakun, O. Arinola","doi":"10.4314/EJPAI.V14I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V14I1","url":null,"abstract":"Background : Food allergy is a problem of the western world, however, cases of food allergy have also been found in developing countries. In Nigeria, the prevalence of food allergy is scarce while the association of food sensitization with helminthiasis is unknown. Objective : This study was designed to determine the prevalence of sensitization to food among Nigerian school children and its relation to intestinal helminthiasis. Methods : A total of 128 participants were recruited from CAC Primary School, Sango, Ibadan, Nigeria. Skin Prick Test using freshly prepared food allergens was carried out. Stool samples were collected from them to screen for ova of parasites using concentration method. Results : A total of 26 (20.3%) out of 128 participants were SPT positive for various food allergens, while 16 (12.5%) had helminthic infection. There was however an equal distribution of helminthic infection among students who were food allergen SPT positive and negative. There was also no association between gender and susceptibility to food allergy. Conclusion : Sensitization to food is common in school children, and intestinal helminthiasis seems to have no influence on its prevalence. Keywords : MPO, inflammatory response, neonates, sepsis.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78775705","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: Recent data suggest that there is a worldwide epidemic of vitamin D deficiency and lack of vitamin D has been linked to increased incidence of asthma and increased severity of asthma in children. Therefore, the examination of relationship between vitamin D and bronchial asthma was important. Objective: To determine serum vitamin D level in children and adolescents suffering from bronchial asthma and to detect the relationship between vitamin D level and asthma severity symptoms. Methods: This case–control study was conducted on 40 asthmatic children and adolescents, their ages ranged from 2-18 years who were attending to pediatric department at Suez Canal University Hospital, and were previously diagnosed as bronchial asthma according to the National Asthma Education and Prevention Program (NAEPP) 2007. In addition, 40 age and sex matched healthy children served as a control group. All children were subjected to history taking, clinical examination, including; anthropometric measurements, and chest examination. Serum levels of 25-hydroxyvitamin D (25OHD)[25(OH) D], total IgE level, and peripheral blood eosinophil count were evaluated. Results: The mean age of studied asthmatic children was 5.14±2.87 years. Asthma was more reported in girls than boys (55% and 45% respectively). Asthma prevalence was higher in urban than rural areas. In our study, asthmatic patients had significantly lower vitamin D levels than controls. We found that vitamin D insufficiency in 35% of studied asthmatic children. There was a statistically significant negative correlation between vitamin D level and the severity of asthma (p <0.001). Conclusion: Vitamin D deficiency is relatively frequent in asthmatic patients who were attending the pediatric department at Suez Canal University Hospital. There was a significant inverse relationship between vitamin D levels and the severity of asthma symptoms. Keywords: Children, adolescences, bronchial asthma, vitamin D
{"title":"Review Article: Update on allergen detection in childhood asthma","authors":"E. Hossny","doi":"10.4314/ejpai.v13i2","DOIUrl":"https://doi.org/10.4314/ejpai.v13i2","url":null,"abstract":"Background: Recent data suggest that there is a worldwide epidemic of vitamin D deficiency and lack of vitamin D has been linked to increased incidence of asthma and increased severity of asthma in children. Therefore, the examination of relationship between vitamin D and bronchial asthma was important. Objective: To determine serum vitamin D level in children and adolescents suffering from bronchial asthma and to detect the relationship between vitamin D level and asthma severity symptoms. Methods: This case–control study was conducted on 40 asthmatic children and adolescents, their ages ranged from 2-18 years who were attending to pediatric department at Suez Canal University Hospital, and were previously diagnosed as bronchial asthma according to the National Asthma Education and Prevention Program (NAEPP) 2007. In addition, 40 age and sex matched healthy children served as a control group. All children were subjected to history taking, clinical examination, including; anthropometric measurements, and chest examination. Serum levels of 25-hydroxyvitamin D (25OHD)[25(OH) D], total IgE level, and peripheral blood eosinophil count were evaluated. Results: The mean age of studied asthmatic children was 5.14±2.87 years. Asthma was more reported in girls than boys (55% and 45% respectively). Asthma prevalence was higher in urban than rural areas. In our study, asthmatic patients had significantly lower vitamin D levels than controls. We found that vitamin D insufficiency in 35% of studied asthmatic children. There was a statistically significant negative correlation between vitamin D level and the severity of asthma (p <0.001). Conclusion: Vitamin D deficiency is relatively frequent in asthmatic patients who were attending the pediatric department at Suez Canal University Hospital. There was a significant inverse relationship between vitamin D levels and the severity of asthma symptoms. Keywords: Children, adolescences, bronchial asthma, vitamin D","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78277922","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}
Tarek M.A. Gammasy, N. Abushady, M. Hamza, Rania Shaker
Background: MPO is an enzyme that contains heme secreted by phagocytic cells after the respiratory burst system activation. MPO is expressed mainly by neutrophils and monocytes in small quantities and it is very important to determine further process of hydrogen peroxide. Objective: to evaluate neutrophils activation and the MPO enzyme activity in plasma as an indicator of sepsis as well as sepsis severity in neonates with sepsis with correlation to their clinical and laboratory findings. Methods: were classified into 2 groups: sepsis group: included 45 neonates with gestational ages 28-40 weeks with sepsis, 15 of them had been subjected to follow up samples, control group: included 30 neonates proved to be free of sepsis. All neonates were subjected to history taking, clinical examination and measurement of plasma MPO enzyme. Results: this study revealed that MPO activity and neutrophil cell count are increased in sepsis group compared to the non-septic neonates. The ROC curve showed that the best cut off for MPO in prediction of septic patients and mortality was found >54 mu/ml and >83 mu/ml respectively. There was positive correlation between MPO enzyme activity and the total leukocyte count and neutrophil count. By following up some of sepsis group neonates there was significant decrease in MPO activity goes along with improvement in clinical state of neonates with sepsis. MPO enzyme activity was found to be low in septic shock patients who also have pancytopenia compared to septic patients without shock. Conclusion: plasma MPO enzyme proved to be a good marker of sepsis in neonates, with a good prognostic value in severe cases. Keywords: MPO, inflammatory response, neonates, sepsis
{"title":"Increased myeloperoxidase activity as an indicator of neutrophil-induced inflammation and sepsis in neonates","authors":"Tarek M.A. Gammasy, N. Abushady, M. Hamza, Rania Shaker","doi":"10.4314/ejpai.v13i1","DOIUrl":"https://doi.org/10.4314/ejpai.v13i1","url":null,"abstract":"Background: MPO is an enzyme that contains heme secreted by phagocytic cells after the respiratory burst system activation. MPO is expressed mainly by neutrophils and monocytes in small quantities and it is very important to determine further process of hydrogen peroxide. Objective: to evaluate neutrophils activation and the MPO enzyme activity in plasma as an indicator of sepsis as well as sepsis severity in neonates with sepsis with correlation to their clinical and laboratory findings. Methods: were classified into 2 groups: sepsis group: included 45 neonates with gestational ages 28-40 weeks with sepsis, 15 of them had been subjected to follow up samples, control group: included 30 neonates proved to be free of sepsis. All neonates were subjected to history taking, clinical examination and measurement of plasma MPO enzyme. Results: this study revealed that MPO activity and neutrophil cell count are increased in sepsis group compared to the non-septic neonates. The ROC curve showed that the best cut off for MPO in prediction of septic patients and mortality was found >54 mu/ml and >83 mu/ml respectively. There was positive correlation between MPO enzyme activity and the total leukocyte count and neutrophil count. By following up some of sepsis group neonates there was significant decrease in MPO activity goes along with improvement in clinical state of neonates with sepsis. MPO enzyme activity was found to be low in septic shock patients who also have pancytopenia compared to septic patients without shock. Conclusion: plasma MPO enzyme proved to be a good marker of sepsis in neonates, with a good prognostic value in severe cases. Keywords: MPO, inflammatory response, neonates, sepsis","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89110552","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. A. E. Habashy, Dalia N. Toaima, G. I. Gad, M. G. E. Nazer
Background : Despite advances made in the use of phototherapy, and in order to avoid sequelae of kernicterus, the treatment of hyperbilirubinemia may require one or several exchange transfusions, an invasive therapy which is not without risk. Intravenous immune globulin treatment in isoimmune hyperbilirubinemia has been shown to be effective, but the response to treatment is variable. Objective : To evaluate effectiveness of high dose Intravenous immune globulin (HD-IVIG) in reducing the need for exchange transfusion, duration of phototherapy and/or hospitalization in neonates with isoimmune hemolytic disease due to Rh or ABO incompatibility. Methods : The study included 116 direct Coombs' test positive neonates delivered at Gynecology and Obstetrics Hospital of Ain Shams University, Cairo, Egypt. They were randomly assigned to receive phototherapy with HD-IVIG in a single dose of 1 gm/kg (60 neonates, intervention group) or phototherapy (56 neonates, control group). Results : Nine neonates in the intervention group (15%) and 23 (41%) in the control group required single exchange transfusion (p< 0.001). Multiple exchange transfusion was indicated in 15 neonates (26.8%) in the control group versus none in the intervention group (p< 0.001). Compared with control group, neonates in the intervention group had shorter mean duration of intensive phototherapy (9.97 versus 35.5 hours, p<0.001) and hospital stay (27.9 versus 103.5 hours, p< 0.001). No adverse effects of HD-IVIG administration were noted. Conclusion : HD-IVIG effectively reduced the requirement for exchange transfusion and duration of phototherapy and hospitalization in isoimmune hemolytic disease of the newborn. Keywords : Hemolytic disease of newborn; hyperbilirubinemia; exchange transfusion; high dose intravenous immunoglobulin.
{"title":"High dose intravenous immunoglobulin in Rh and ABO hemolytic disease of Egyptian neonates","authors":"S. A. E. Habashy, Dalia N. Toaima, G. I. Gad, M. G. E. Nazer","doi":"10.4314/EJPAI.V12I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V12I1","url":null,"abstract":"Background : Despite advances made in the use of phototherapy, and in order to avoid sequelae of kernicterus, the treatment of hyperbilirubinemia may require one or several exchange transfusions, an invasive therapy which is not without risk. Intravenous immune globulin treatment in isoimmune hyperbilirubinemia has been shown to be effective, but the response to treatment is variable. Objective : To evaluate effectiveness of high dose Intravenous immune globulin (HD-IVIG) in reducing the need for exchange transfusion, duration of phototherapy and/or hospitalization in neonates with isoimmune hemolytic disease due to Rh or ABO incompatibility. Methods : The study included 116 direct Coombs' test positive neonates delivered at Gynecology and Obstetrics Hospital of Ain Shams University, Cairo, Egypt. They were randomly assigned to receive phototherapy with HD-IVIG in a single dose of 1 gm/kg (60 neonates, intervention group) or phototherapy (56 neonates, control group). Results : Nine neonates in the intervention group (15%) and 23 (41%) in the control group required single exchange transfusion (p< 0.001). Multiple exchange transfusion was indicated in 15 neonates (26.8%) in the control group versus none in the intervention group (p< 0.001). Compared with control group, neonates in the intervention group had shorter mean duration of intensive phototherapy (9.97 versus 35.5 hours, p<0.001) and hospital stay (27.9 versus 103.5 hours, p< 0.001). No adverse effects of HD-IVIG administration were noted. Conclusion : HD-IVIG effectively reduced the requirement for exchange transfusion and duration of phototherapy and hospitalization in isoimmune hemolytic disease of the newborn. Keywords : Hemolytic disease of newborn; hyperbilirubinemia; exchange transfusion; high dose intravenous immunoglobulin.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2014-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85343550","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 : Vascular endothelial growth factor (VEGF) plays a crucial role in preservation of renal functions and may also serve as a useful biomarker in monitoring the progression of lupus nephritis (LN). Objective : We thought to correlate VEGF expression in the kidney with renal histopathology in lupus nephritis to unveil its possible relation to disease activity and severity. Methods : We consecutively enrolled 15 patients with lupus nephritis and ten renal biopsy specimens from patients with cystic renal diseases as controls. The study measurements included SLEDAI, SLICC/ ACR damage index and BILAG renal score. Paraffin sections from renal biopsies were subjected to routine haematoxylin and eosin staining and Immunohistochemical staining for VEGF. Results : Among SLE patients, 7 (46.7%) showed mild expression of VEGF, 5 (33.3%) showed moderate while 3 (20%) had strong expression of the marker. On the contrary, the control samples (100%) revealed strong marker expression. All subjects with class IV and V lupus nephritis had mild renal expression of VEGF. Renal expression of VEGF had a significant positive correlation with serum creatinine and complement C3 levels. The 24 hours’ excretion of urinary proteins had a significant negative correlation with the renal expression of the marker. On the other hand, the activity indices and therapeutic modalities did not correlate with VEGF expression. Conclusion : This pilot study among pediatric cases of SLE revealed mild to moderate VEGF expression in most cases of proliferative LN. Further longitudinal studies are needed to investigate the consequences of this finding on the prognosis of the disease. Keywords : VEGF, SLE, renal biopsy, lupus nephritis.
{"title":"Renal expression of vascular endothelial growth factor in lupus nephritis in the pediatric age group","authors":"Y. El-Gamal, S. El-Sayed, N. Ahmed, Abbas","doi":"10.4314/EJPAI.V12I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V12I2","url":null,"abstract":"Background : Vascular endothelial growth factor (VEGF) plays a crucial role in preservation of renal functions and may also serve as a useful biomarker in monitoring the progression of lupus nephritis (LN). Objective : We thought to correlate VEGF expression in the kidney with renal histopathology in lupus nephritis to unveil its possible relation to disease activity and severity. Methods : We consecutively enrolled 15 patients with lupus nephritis and ten renal biopsy specimens from patients with cystic renal diseases as controls. The study measurements included SLEDAI, SLICC/ ACR damage index and BILAG renal score. Paraffin sections from renal biopsies were subjected to routine haematoxylin and eosin staining and Immunohistochemical staining for VEGF. Results : Among SLE patients, 7 (46.7%) showed mild expression of VEGF, 5 (33.3%) showed moderate while 3 (20%) had strong expression of the marker. On the contrary, the control samples (100%) revealed strong marker expression. All subjects with class IV and V lupus nephritis had mild renal expression of VEGF. Renal expression of VEGF had a significant positive correlation with serum creatinine and complement C3 levels. The 24 hours’ excretion of urinary proteins had a significant negative correlation with the renal expression of the marker. On the other hand, the activity indices and therapeutic modalities did not correlate with VEGF expression. Conclusion : This pilot study among pediatric cases of SLE revealed mild to moderate VEGF expression in most cases of proliferative LN. Further longitudinal studies are needed to investigate the consequences of this finding on the prognosis of the disease. Keywords : VEGF, SLE, renal biopsy, lupus nephritis.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87034316","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}
Mohamed S. Al, Mostafa El-Hosseiny, N. M. A. Elezz, Dalia H. El, A. M. Hassan
Background: Asthma is a public health problem that adversely affects different aspects of quality of life (QoL). Childhood asthma is common in Egypt and associated with repeated school absenteeism and hospital admission. Objective: To evaluate health-related quality of life (QoL) in children with bronchial asthma in an attempt to identify the most important determinants adversely affecting the QoL. Methods: In this cross-sectional study, 140 children with physician- diagnosed bronchial asthma were clinically evaluated to determine level of asthma control and were administered pediatric asthma quality of life questionnaire (PAQLQ), and questionnaire for the main determinants affecting QoL including sociodemographic, disease-related and patient-related factors. Results: They were 77 males and 63 females whose ages ranged between 7 and 17 years with a mean of 10.2 years. The overall PAQLQ score ranged between 2.22 and 6.61 with a mean ± SD of 4.08 ± 1. Uncontrolled asthma was associated with the lowest QoL scores (p ≤ 0.01). Users of systemic steroids had significantly lower overall PAQLQ score, score of symptoms, score of emotional function than non-users (p < 0.05). Difficulty in obtaining the drugs significantly adversely affects the patient QoL scores apart from that of activity limitation (p<0.05). Parental smoking, use of systemic steroids, difficulties in obtaining drugs, asthma related hospital admission and level of asthma control were the determinants of overall PAQLQ score for children with bronchial asthma. Conclusion: Childhood asthma significantly adversely affects the QoL of the affected children. Control of the main determinants of QoL scores might improve the QoL of these patients.
{"title":"Health-related quality of life in childhood bronchial asthma","authors":"Mohamed S. Al, Mostafa El-Hosseiny, N. M. A. Elezz, Dalia H. El, A. M. Hassan","doi":"10.4314/EJPAI.V11I2","DOIUrl":"https://doi.org/10.4314/EJPAI.V11I2","url":null,"abstract":"Background: Asthma is a public health problem that adversely affects different aspects of quality of life (QoL). Childhood asthma is common in Egypt and associated with repeated school absenteeism and hospital admission. Objective: To evaluate health-related quality of life (QoL) in children with bronchial asthma in an attempt to identify the most important determinants adversely affecting the QoL. Methods: In this cross-sectional study, 140 children with physician- diagnosed bronchial asthma were clinically evaluated to determine level of asthma control and were administered pediatric asthma quality of life questionnaire (PAQLQ), and questionnaire for the main determinants affecting QoL including sociodemographic, disease-related and patient-related factors. Results: They were 77 males and 63 females whose ages ranged between 7 and 17 years with a mean of 10.2 years. The overall PAQLQ score ranged between 2.22 and 6.61 with a mean ± SD of 4.08 ± 1. Uncontrolled asthma was associated with the lowest QoL scores (p ≤ 0.01). Users of systemic steroids had significantly lower overall PAQLQ score, score of symptoms, score of emotional function than non-users (p < 0.05). Difficulty in obtaining the drugs significantly adversely affects the patient QoL scores apart from that of activity limitation (p<0.05). Parental smoking, use of systemic steroids, difficulties in obtaining drugs, asthma related hospital admission and level of asthma control were the determinants of overall PAQLQ score for children with bronchial asthma. Conclusion: Childhood asthma significantly adversely affects the QoL of the affected children. Control of the main determinants of QoL scores might improve the QoL of these patients.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75691229","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: Asthmatic patients generate reactive oxygen species impairing the antioxidant defense system and creating a state of oxidative stress in asthmatics. Objectives: Determination of the oxidant - antioxidant status in asthmatic children, by measuring the activities of antioxidant enzymes; superoxide dismutases (SOD) and glutathione peroxidases (Gpx) and estimating plasma level of malondialdehyde (MDA) as an index of lipid peroxidation, to find a relation between antioxidant levels and the severity of asthma and the early response to treatment. Methods: This study included 60 children; group (1): 40 asthmatic children and group (2): 20 apparently healthy children as a control group. The following were measured in all the children; plasma level of (MDA), erythrocytes (SOD) and (Gpx) (in asthmatic children two samples were taken; the first during acute attack and the second after 48 hours of treatment). Results: Significant lower erythrocyte antioxidant enzymes activities and higher malondialdehyde was found in asthmatic children compared to the control group, either before or after receiving treatment. In asthmatics, MDA was significantly decreasing and SOD was significantly increasing with treatment. MDA was significantly higher, while SOD was significantly lower with the severity of asthma either before or after receiving treatment. A significant negative correlation was observed between MDA with both of SOD and Gpx, in acute asthmatic attacks. A significant positive correlation was detected between the activities of SOD and Gpx enzymes. Conclusion: Acute asthma leads to a considerable oxidative stress that is indicated by the high level of malondialdehyde and low level of antioxidant enzymes. Keywords: bronchial asthma, superoxide dismutases (SOD), glutathione peroxidases (Gpx), malondialdehyde (MDA), antioxidants Egypt J Pediatr Allergy Immunol 2013;11(1):35-40
{"title":"Oxidant-antioxidant balance in childhood asthma","authors":"D. Shokry, Shereen A El-Tarahony","doi":"10.4314/EJPAI.V11I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V11I1","url":null,"abstract":"Background: Asthmatic patients generate reactive oxygen species impairing the antioxidant defense system and creating a state of oxidative stress in asthmatics. Objectives: Determination of the oxidant - antioxidant status in asthmatic children, by measuring the activities of antioxidant enzymes; superoxide dismutases (SOD) and glutathione peroxidases (Gpx) and estimating plasma level of malondialdehyde (MDA) as an index of lipid peroxidation, to find a relation between antioxidant levels and the severity of asthma and the early response to treatment. Methods: This study included 60 children; group (1): 40 asthmatic children and group (2): 20 apparently healthy children as a control group. The following were measured in all the children; plasma level of (MDA), erythrocytes (SOD) and (Gpx) (in asthmatic children two samples were taken; the first during acute attack and the second after 48 hours of treatment). Results: Significant lower erythrocyte antioxidant enzymes activities and higher malondialdehyde was found in asthmatic children compared to the control group, either before or after receiving treatment. In asthmatics, MDA was significantly decreasing and SOD was significantly increasing with treatment. MDA was significantly higher, while SOD was significantly lower with the severity of asthma either before or after receiving treatment. A significant negative correlation was observed between MDA with both of SOD and Gpx, in acute asthmatic attacks. A significant positive correlation was detected between the activities of SOD and Gpx enzymes. Conclusion: Acute asthma leads to a considerable oxidative stress that is indicated by the high level of malondialdehyde and low level of antioxidant enzymes. Keywords: bronchial asthma, superoxide dismutases (SOD), glutathione peroxidases (Gpx), malondialdehyde (MDA), antioxidants Egypt J Pediatr Allergy Immunol 2013;11(1):35-40","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91138874","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: Autism spectrum disorder (ASD) is a spectrum of behavioral anomalies characterized by impaired social interaction and communication, often accompanied by repetitive and stereotyped behavior. The condition manifests within the first 3 years of life and persists into adulthood. There are numerous hypotheses regarding the etiology and pathology of ASD, including a suggested role for immune dysfunction. While immune system abnormalities have been reported in children with autistic disorder, there is little consensus regarding the nature of these differences which include both enhanced autoimmunity and reduced immune function. It has long been known that extensive interactions occur between the immune system and neuronal system/brain, and that normal neurodevelopment is contingent upon an appropriate interaction with the immune system. Objectives: the aim of the present study was to evaluate the cell mediated and humoral immunity of children with autism through evaluation of the serum antibody levels of immunoglobulin (IgG, IgM, IgA), also we evaluated the T helper and T suppressor cells (CD4 and CD8 T cell subpopulations) and CD4/CD8 ratio in children with autism and compared with the healthy control children. Methods: This study was carried out in the Psychiatry Unit, Department of Pediatrics, Tanta University Hospital. Thirty children with autism (24 males, 6 females) newly diagnosed were included in the study, their age range was (3-9 years) with the mean age of 51.8 years. Childhood Autism Rating Scale (CARS) was used for the diagnosis of autism. Diagnosis of autism was based also, on the criteria for the diagnosis of autism that are set out in the Diagnostic and Statistical Manual of Mental Disorders DSM-IVTR (Fourth Edition, Text Revision). The intial Childhood Autism Rating Scale (CARS) score for these children was ≥30, as children with a CARS score ≥30 were considered to have autism. Intial CARS score range for children with autism was (31-60). The control group consisted of thirty healthy children (10 females, 20 males). Their age range was (2-10 years) and the mean age was 5.3 ± 2.4 years. Results: Children with autism had significantly lower serum levels of IgG, IgA and IgM compared to the control children p < 0.001. Also children with autism had significantly lower numbers of CD4 cells with increased CD8+ T cell subpopulations and decreased CD4+/CD8+ ratio. Conclusion: Children with autism have significantly reduced levels of serum IgG, IgA and IgM compared to the control children, suggesting an underlying defect in the immune function, also the cell-mediated immunity is impaired as evidenced by low numbers of CD4+ cells and increased CD8+ T cell subpopulations and decreased CD4+/CD8+ ratio. Keywords: autism spectrum disorder (ASD), neurodevelopment, immunity Egypt J Pediatr Allergy Immunol 2012;10(1):25-32.
{"title":"Cellular-mediated and humoral immunity in children with autism","authors":"S. A. El-Aziz, R. El-Din","doi":"10.4314/EJPAI.V10I1","DOIUrl":"https://doi.org/10.4314/EJPAI.V10I1","url":null,"abstract":"Background: Autism spectrum disorder (ASD) is a spectrum of behavioral anomalies characterized by impaired social interaction and communication, often accompanied by repetitive and stereotyped behavior. The condition manifests within the first 3 years of life and persists into adulthood. There are numerous hypotheses regarding the etiology and pathology of ASD, including a suggested role for immune dysfunction. While immune system abnormalities have been reported in children with autistic disorder, there is little consensus regarding the nature of these differences which include both enhanced autoimmunity and reduced immune function. It has long been known that extensive interactions occur between the immune system and neuronal system/brain, and that normal neurodevelopment is contingent upon an appropriate interaction with the immune system. Objectives: the aim of the present study was to evaluate the cell mediated and humoral immunity of children with autism through evaluation of the serum antibody levels of immunoglobulin (IgG, IgM, IgA), also we evaluated the T helper and T suppressor cells (CD4 and CD8 T cell subpopulations) and CD4/CD8 ratio in children with autism and compared with the healthy control children. Methods: This study was carried out in the Psychiatry Unit, Department of Pediatrics, Tanta University Hospital. Thirty children with autism (24 males, 6 females) newly diagnosed were included in the study, their age range was (3-9 years) with the mean age of 51.8 years. Childhood Autism Rating Scale (CARS) was used for the diagnosis of autism. Diagnosis of autism was based also, on the criteria for the diagnosis of autism that are set out in the Diagnostic and Statistical Manual of Mental Disorders DSM-IVTR (Fourth Edition, Text Revision). The intial Childhood Autism Rating Scale (CARS) score for these children was ≥30, as children with a CARS score ≥30 were considered to have autism. Intial CARS score range for children with autism was (31-60). The control group consisted of thirty healthy children (10 females, 20 males). Their age range was (2-10 years) and the mean age was 5.3 ± 2.4 years. Results: Children with autism had significantly lower serum levels of IgG, IgA and IgM compared to the control children p < 0.001. Also children with autism had significantly lower numbers of CD4 cells with increased CD8+ T cell subpopulations and decreased CD4+/CD8+ ratio. Conclusion: Children with autism have significantly reduced levels of serum IgG, IgA and IgM compared to the control children, suggesting an underlying defect in the immune function, also the cell-mediated immunity is impaired as evidenced by low numbers of CD4+ cells and increased CD8+ T cell subpopulations and decreased CD4+/CD8+ ratio. Keywords: autism spectrum disorder (ASD), neurodevelopment, immunity Egypt J Pediatr Allergy Immunol 2012;10(1):25-32.","PeriodicalId":52068,"journal":{"name":"Egyptian Journal of Pediatric Allergy and Immunology","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75506823","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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