ABSTRACT
Background: Helicobacter pylori [H.pylori] is a cause of chronic-active gastritis and a majority of cases of peptic ulcer disease. It is also associated with the development of gastric adenocarcinoma, the fourth most common malignancy in the world
Aim of the study: The study aims to detect the level of interferon gamma expression and the percentage of CD4+ CD25+ T regulatory cells in patients with gastritis and their relation to the pathological grading
Methods: Gastric biopsy specimens were taken from the antrum of 30 patiens using upper GIT endoscopy. Rapid urease test [RUT], immunohistochemistry [IHC], and Hematoxylin and Eosin [H and E] stains were used to determine H.pylori status. Evaluation of the histologic features was done using H and E. IFN-gamma mRNA expression in the gastric biopsies was measured using Real-Time PCR. Flowcytometry was used for measuring the percentage of CD4+CD25+regulatory T-ells [T regs] in the peripheral blood of all the patients. The results were compared to 15 healthy control subjects
Results: H.pylori was detected in 56.7% of all patients by RUT and in 93.3% patients by H and E and in 83.3% by IHC,out of them 88% had active gastritis and all of them had chronic gastritis. There was a statistically significant positive correlation between H.pylori positive infection and the pathological grading of active gastritis [p=0.015]. However, there was no statistically significant correlation between H.pylori infection [by IHC] and the pathological grading of chronic gastritis [p=0.334]. No statistically significant difference in the levels of IFN-gamma mRNA expression between H.pylori positive and negative patients was detected. No correlation was found between the levels of IFN-gamma mRNA expression and the severity of either active or chronic gastritis. Similarly, no correlation between the percentage of CD4+ CD25+ T regulatory cells and the severity of either active or chronic gastritis was detected
Conclusion: H.pylori plays an important role in active gastritis lesion. The correlation between IFN-gamma mRNA expression and the severity of active or chronic gastritis was overshadowed by the prevalence of helminthic infection among Egyptian patients. Meanwhile, low levels of T regulatory cells among H.pylori positive and negative gastritis than controls suggests an important role of T regulatory cells in regulating the gastric mucosal inflammatory response
ABSTRACT
Pulmonary tuberculosis [TB] is a major cause of morbidity and mortality allover the world. Owing to the complex interaction between the Mycobacterium tuberculosis [MTB] and the specific host cell mediated immune response, the clinical spectrum of TB ranges from a few foci affecting the upper parts of the lungs to intense tissue destruction and caseous necrosis. TGF-beta is one of the inhibitory cytokines that, among other functions, is responsible for deactivation of the T-cell response that is important in host defense against MTB, suggesting its role in the pathogenesis of PTB.The aim of this study was to determine the serum level of TGF-beta1 in patients with active pulmonary tuberculosis [cavitary and non cavitary], in comparison to healthy controls and to chronic obstructive airway disease [COAD] patients as disease controls, as well as investigating the correlation between its level and disease severity. Tuberculous patients were followed up during the course of anti-tuberculous chemotherapy to assess the changes in TGF-beta1 level. Three groups were studied, including 24 pulmonary tuberculosis patients [9 patients were cavitary and 15 patients were non cavitary] that were selected according to the diagnostic standards and classification of tuberculosis. [New York NY: National Tuberculosis and Respiratory disease Association, 1969]. Twenty two patients with [COAD] were taken as a disease control group and 13 apparently healthy individuals with matching age and sex were included as normal controls. All patients were subjected to full history taking, clinical examination, laboratory diagnosis of TB by examination of sputum for the presence of acid fast bacilli [AFB] by film or culture and radiological diagnosis by chest X-rays. Serum from all patients and controls was examined for the level of TGF-beta1 using ELISA technique. Patients with PTB were followed up for the post treatment level of TGF-beta1 3 months after the onset of anti-tuberculous treatment. Statistical analysis for the results showed significant elevation of TGF-beta1 serum level in patients with PTB when compared to normal controls but not when compared to the disease controls. No significant difference was found between TGF-beta1 level on comparing the cavitary and non cavitary groups, or on comparing the pre and the post treatment levels. In conclusion TGF-beta1 is suggested to play an important role in the pathogenesis of pulmonary tuberculosis. Further studies can be done to evaluate the correlation between the TGF-beta1 level and the severity of tuberculous disease, or with the course of anti tuberculous treatment. Controlling TGF-beta1 production may be the key to prevent scarring and fibrosis in progressive pulmonary disease as tuberculosis and chronic obstructive pulmonary disease. Also using anti-TGF-beta1 antibodies may be promising anti-tuberculous agents with their anti-fibrotic actions that may prevent the progress of fibrosis during the course of the disease