Health-related quality of life in childhood bronchial asthma

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

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

Increased expression of soluble fractalkine [CX3CL1] in systemic sclerosis - possible role in vascular inflammation

The pathogenesis of systemic sclerosis [SSc] involves interplay between obliterative vasculopathy in multiple vascular beds, inflammation, autoimmunity and progressive fibrosis. Vascular injury and activation are the earliest and possibly primary events in the pathogenesis of SSc. To determine levels of serum soluble fractalkine [sFKN] and its receptor CX3CR1 in peripheral blood mononuclear cells [PBMCs] in systemic sclerosis [SSc] patients and healthy controls. In addition, to assess any possible association between sFKN and clinical features of SSc. Serum levels of soluble fractalkine [sFKN, CX3CL1] assessed by enzyme linked immunosorbent assay [ELISA] and expression of its receptor [CX3CR1] on peripheral blood mononuclear cells by flow cytometric analysis, were measured in 18 systemic sclerosis [SSc] patients and 15 age and sex matched healthy controls. The degree of skin involvement was estimated by modified Rodnan skin thickness score [mRSS], pulmonary involvement was assessed in all patients by high resolution computerized tomography [HRCT] and pulmonary function tests [PFTs]. Serum sFKN levels and expression of its receptor CX3CR1 were significantly elevated in SSc patients than in healthy controls [P < 0.0.05]. SSc patients with pulmonary fibrosis had sFKN levels three times higher than those without PF. Serum sFKN correlated inversely with forced vital capacity of lungs [FVC%] but correlated positively with severity of pulmonary fibrosis, extent of skin fibrosis [mRSS], pitting scars, skin ulcers, anti topo-isomerase 1 antibody and CRP. Serum sFKN may play an important role in the pathogenesis of SSc, including tissue inflammation and vascular injury, hence, its measurement may be a useful serologic marker for the diagnosis and follow up of pulmonary and skin complications. So strategies to target CX3CL1-CX3CR1 interaction could provide a new therapeutic approach in SSc, potentially by blocking endothelial cell injury, leucocyte

Circulating MCP-1 level and tilde 2518 gene polymorphism as a marker of nephropathy development in Egyptian patients

Monocyte chemoattractant protein-1 [MCP-1] is a member of CC chemokine that plays an important role in the recruitment of monocytes/macrophages into renal tubulointerstitium. A biallelic A/G polymorphism at position tilde 2518 in the MCP-1 gene was found to regulate MCP-1 expression. MCP-1 and its A/G gene polymorphism have been implicated in the pathogenesis of some renal diseases. The aim of this study was to evaluate the role of circulating MCP-1 level and the relevance of functional genetic variations of MCP-1 as early predictors of the development of glomerulonephropathy [GN] in Egyptian patients. This is a case control study that was conducted in 50 GN patients, 20 non-GN cases and 20 ethnically matched healthy controls. MCP-1 serum level was detected by ELISA technique, while genotyping of polymorphisms in the MCP-1 genes was performed using a polymerase chain reaction [PCR] followed by restriction fragment length polymorphism [RFLP] detection High MCP-1 circulating levels and subsequently MCP-1tilde 2518G polymorphism are associated with the developing of nephropathy irrespective to the underlying etiology. MCP-1 serum level was significantly high when compared with healthy controls [P = 0.0007] and non-GN cases [P = 0.01]. There was predominance of A allele at tilde 2518 of MCP-1 gene in healthy controls [87.5%] and non-GN cases [77.5%]. The frequency of the tilde 2518G MCP-1 polymorphism was significantly higher in GN patients than in healthy controls [P <0.0001; OR= 15.6] and non-GN cases [P < 0.0001; OR = 7.7]. Interestingly, homozygosity for G allele plays the main role in such association. A/G polymorphism in MCP-1 gene and subsequently high circulating MCP-1 level confer a relevant role in the susceptibility to the development of nephropathy in the Egyptian population denoting that MCP-1 system could be an early predictor of such renal complication

Serum thyroglobulin, catecholamines and phospholipids in violent asphyxia, an experimental study on rats

Elevation of serum thyroglobulin [Tg], catecholamines, and phospholipids concentrations in the blood are regarded as vital reactions in asphyxial deaths which leave few or no external signs in the body. In this study, these vital reactions were tested under strict experimental conditions, employing rapid asphyxia. Forty adult albino rats of both sexes, of average weight 200 g., were used. Ten animals were used as a control group, the remaining animals were anaesthetized and strangled with a rope, 2 mm thick, tightened around the neck. At the moment of death, which was determined when the heart beat had faded about 3-4 minutes from the start of strangulation, blood samples were taken, centrifuged, and the serum thyroglobulin, catecholamines, and phospholipids were measured. The lungs were also investigated histologically to study the general microscopic structure of the asphyxiated lung. The results showed a significant increase in the concentration of thyroglobulin as compared to control [Tg = 14.44 ng/ml versus 2.97 ng/ml, P < 0.001]. The mean serum adrenaline [A] and noradrenaline [NA] concentrations were significantly higher in strangulation group as compared to control, [A = 8.07 ng/ml. vs. 3.18 ng/ml, P < 0.001]. The mean serum phospholipids concentration in the strangulated rats was 1.76 g/L versus 1.03 g/L in the controls, P < 0.001. Concerning the histological investigation, the lung showed emphysematous changes with collapse and tiny haemorrhages. The alveoli were distended and ruptured. The alveolar epithelium was thin, desquamated and over folded with increase of mucoid secretion. High levels of thyroglobulin, catecholamines, and phospholipids in the blood upon suffocation could thus be taken as indicators of hypoxia, and therefore can be included in the diagnosis of mechanical asphyxia