ABSTRACT
The objective to evaluate the factor of apoptotic signal [FAS] and B-cell leukemia lymphoma [BCL-2] oncoprotein as markers of apoptosis in children with chronic hepatitis C . The study included 100 children with chronic hepatitis C, divided into three groups. Group I [control, n =20] HCVantibodies and RNA-PCR negative, Group II; [n=60] HCVantibodies positive and HCV- RNA positive without liver cirrhosis and Group III; [n=20] HCVantibodies positive and HCV-RNA positive with liver cirrhosis
Blood samples were subjected to: Complete blood count, liver function tests, alpha fetoprotein assay by ELISA method, FAS [CD95] antigen, and intracellular BCL-2 oncoprotein on lymphocytes by flow cytometry
The Results showed that FAS was significantly higher in group II and group III as compared to group I [P=0.0 for both]. FAS was significantly higher in group III than group II [P=0.021]. Positive correlation between FAS and ALT, AST, and AFP was found [r =0.39, 0.47 and 0.39, respectively, P = 0.0 for all]. Combining groups II and III, negative correlations between FAS and platelets and albumin [r= -0.52 and -0.46, respectively, P = 0.0 for both]. BCL-2 was significantly higher in group II and group III as compared to group I [P=0.001 and 0.0, respectively]. BCL-2 was higher in group III than group II [P= 0.0]. BCL-2 was positively correlated to ALT, AST, and AFP [r= 0.29, 0.39 and 0.41, respectively, P= 0.0 for all]. BCL-2 was negatively correlated to platelets and albumin in the combined diseased group [r= -0.53 and -0.41 respectively and P= 0.0 for both]. A positive correlation was found between FAS and BCL-2 in the diseased group [r=0.321 and p=0.007]
In Conclusion: FAS and BCL-2 as an apoptotic markers play an important role in the pathogenesis and further outcome of chronic liver diseases
ABSTRACT
Background: Prompt treatment of tuberculous pericarditis can save lives, but definite diagnosis requires detection and isolation of the tubercle bacilli from pericardial fluid and/or biopsy which is often delayed and difficult
Objectives: To evaluate the diagnostic role of QuantiFERON -TB Gold test [QFT-G] as a rapid non invasive immunological assay in diagnosis of tuberculous pericarditis with pericardial effusion in comparison to Adenosine deaminase enzyme [ADA] activity and Polymerase chain reaction [PCR] either individually or in combination
Subjects and methods: 27 patients suffering of pericarditis accompanied with pericardial effusions highly suspicious to be tuberculous [clinically and radiographically] were subjected to pericardial fluid aspiration and biopsy, Ziehl-Neelsen stain, culture and histopathological examination[biopsy] for tuberculosis were done for each sample. Pericardial fluid was submitted to Polymerase chain reaction and measurement of adenosine deaminase activity and finally QuantiFERON -TB Gold test in blood was done
Results: Out of 27 probable tuberculous pericarditis patients with pericardial effusion, 19 were definite positive cases. Considering the value of 40 U/L ADA activity, 16/19 cases were positive so the sensitivity was 84.2% which was the same as the results of QuantiFERON -TB Gold test while there were 10 PCR positive cases, so PCR sensitivity was 52.6%. There were 2 positive ADA and one QuantiFERON -TB Gold positive results among the 8 culture negative cases, while none was detected by PCR, so its specificity was100% while [QFT-G] specificity was 87.5% and ADA 75%. The sensitivity, specificity, PPV and NPV of combined QFT-G test and PCR results were 89.5%, 87.5%, 94.4% and 77.8% respectively. While the sensitivity, specificity, PPV and NPV combined QFT-G with ADA results were 84.2%, 75%, 88.9% and 66.7% respectively
Conclusion: QuantiFERON -TB Gold test have good sensitivity and specificity for diagnosis of tuberculous pericardial effusion. The best combined sensitivity and specificity in the current study were reported between PCR and QuantiFERON test results but it is not much greater than that of QuantiFERON test alone. So, QuantiFERON -TB Gold test can be used as an adjunct rapid immunological non invasive test for diagnosis of tuberculous pericardial effusion. However negative QuantiFERON -TB Gold assay does not exclude the disease because of the low NPV of this assay