Serum levels of matrix metalloproteinase-2 [MMP-2] in children and adolescents with type I diabetes mellitus

Type I diabetes mellitus [T1DM] is an autoimmune disorder of unknown etiology. It has been suggested that matrix metalloproteinases [MMPs] play important roles in the development and complications of autoimmune disorders. Results published on the use of MMPs as markers in relation to diabetic complications are somewhat conflicting. The aim of this study was to estimate serum levels of MMP-2 in children and adolescents with T1DM, compared with levels in age-matched controls, and to correlate the levels of MMP-2 with duration of the disease, and with parameters of both glycemic control and renal function. We measured serum levels of MMP-2 in 60 patients with T1DM, aged 2-18 years, with or without microangiopathic complications and in 20 sex-and age-matched controls using enzyme immunoassay. Serum levels of MMP-2 were significantly higher in the studied patients than in the controls [p=0.000]. Serum levels of MMP-2 in diabetic patients with microangiopathic complications were significantly higher than serum levels of MMP-2 in diabetic patients without microangiopathic complications [p=0.002]. Positive significant correlation between serum level of MMP-2 and disease duration [r=0.715; p=0.000] was noted. On the other hand, no significant correlation was found between serum level of MMP-2 and any of the following parameters: Fasting blood glucose, glycated hemoglobin, blood urea, and serum creatinine [all p>0.05]. In conclusion, Serum MMP-2 levels are elevated in T1DM. Because higher MMP-2 levels were associated with the presence of diabetic complications, we raise the possibility that upregulation of MMP-2 levels might play a role in the pathogenesis of diabetic complications. Measurement of serum MMP-2 is a potentially useful marker in studies of diabetic patients at risk of progression to diabetic complications

Plasma concentration of osteopontin [OPN] in children with systemic lupus erythematosus: relationship with disease activity

Osteopontin [OPN] is an important bone matrix mediator found to have key roles in inflammation and immunity. OPN is a cytokine which can play a number of roles in promoting activation of T lymphocyte, regulating balance between T-helper 1 and T-helper 2, participating in cell-induced immunologic response and stimulating B lymphocyte to express multi-clone antibodies. Overexpression of OPN has been associated with the development of the autoimmune/lymphoproliferative syndrome. The aim of our present study was to analyze the possible correlation between the plasma concentration of OPN and disease activity in children with Systemic Lupus Erythematosus [SLE]. We also investigated the correlation between plasma IL-18 and OPN concentrations to further confirm the association of OPN with disease activity. We measured the plasma concentration of OPN, and the plasma proinflammatory IL-18 concentration in 40 SLE patients with or without renal disease [RSLE group and SLE group, respectively] and in 30 sex-and age-matched controls using enzyme immunoassay. Plasma OPN concentrations were significantly higher in RSLE and SLE patients than in the controls [p=0.000 and p=0.002]. Increase in OPN concentration correlated positively and significantly with SLE disease activity index in all SLE patients [r=0.34; p=0.04]. In RSLE patients, plasma OPN concentration showed a significant positive correlation with proinflammatory cytokine IL-18 concentration [r=0.48; p=0.004]. In conclusion, The above results suggest that the production of OPN is associated with the inflammatory process and SLE development, and may serve as a potential disease marker of SLE

Serum levels of ghrelin, tumor necrosis factor-A [TNF- A], and lnterleukin-6 [IL-6] in infants and children with congenital heart disease

Ghrelin increases food intake, body weight, and growth hormone secretion. The cause of growth retardation in congenital heart disease [CHD] is multifactorial. The aim of this study was to estimate serum levels of ghrelin, tumor necrosis factor-a [TNF-alpha], and interleukin-6 [IL-6] ih infants and children with CHD, compared with levels in age-matched controls, and to correlate the levels ofghrelin with TNF- alpha, and IL-6. We measured serum ghrelin, TNF- alpha and IL 6 levels using ELISA in 60 patients with CHD [40 acyanotic and 20 cyanotic] and in 20 control subjects. Our results showed that patients with CHD, whether compiled in one group or classified into acyanotic and cyanotic, had significantly higher serum ghrelin TNF- alpha, and IL-6 than controls [p = 0.000]. Serum levels of ghrelin and TNF- alpha in the acyanotic patients were significantly higher than in the cyanotic patients [p = 0.000]. On the other hand, there was no significant difference in serum levels of IL-6 between the acyanotic and the cyanotic patients [p = 0.126]. In acyanotic and cyanotic patients with CHD, there was a positive correlation between ghrelin and TNF- alpha [r = 0.424; p = 0.006 and r = 0.577; p = 0.008, resp.]. Ghrelin levels were not correlated with IL-6 in the acyanotic and cyanotic patients with CHD [r = -0.211; p = 0.216 and r = -0.341; p = 0.08, resp.]. Serum ghrelin, TNF- alpha, and IL-6 levels are elevated in patients with CHD whether acyanotic or cyanotic. Increased ghrelin levels represent malnutrition and growth retardation in these patients. The relation of ghrelin with TNF- alpha may be explained by the possible effect of chronic congestive heart failure and chronic shunt hypoxemia

Expired breath hydrogen peroxide as a marker of acute airway inflammation in children with asthma

Airway inflammation is an important factor in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as hydrogen peroxide [H[2]O[2]]. The aim of this study was to measure the levels of H[2]O[2] in expired breath condensate in asthmatic children, compared with levels in age-matched controls and to outline its relation to asthmatic triggers, asthma severity, treatment modalities, pulmonary function tests, and total and differential white cell count. Forty asthmatic and 20 healthy children were studied. Their ages ranged from 6-18 years. Expired H[2]O[2] was measured using a colorimetric assay. In asthmatic children, there was a significant elevation of the mean H[2]O[2], level compared to values in controls [p=0.003]. Asthmatic triggers [e.g.: bad housing1 passive smoking, upper respiratory tract infection] showed non significant relation to the mean value of H[2]O[2] level in expired air of asthmatic children. Bad housing showed significant relation to number of acute asthmatic attacks [p=0.03]. There was no significant difference between moderate and severe asthma regarding H[2]O[2] levels [p=0.424] Similarly, there was no significant difference between asthmatic patients whether they received inhaled steroids or not regarding H[2]O[2] levels [p=0.875]. Basal spirometric pulmonary function tests, showed no significant correlation to the level of H[2]O[2]. Correlations of H[2]O[2] level in expired air of asthmatic children with total leukocytic counts [r=0.024; p=0.899], eosinophilic counts [r=0.092; p=0.630] and neutrophilic counts [r=0.021; p=0.910] were all non significant. We conclude that expired H[2]O[2] is significantly elevated in asthmatic patients. Measurement of expired H[2]O[2], may be useful to assess airway inflammation and oxidative stress in asthmatic patients