ABSTRACT
Allergy is a serious health problem throughout the world, affecting people of all ages. Allergic diseases such as asthma, rhinitis and atopic dermatitis are becoming epidemic in all countries. The cost of investigating these diseases is increasing and becoming very expensive. There are many ways to explore allergenic antibodies to assess the presence and the amount of specific IgE. These are: Skin test [Prick], Specific IgE [ELISA], RAST Sp. IgE and Elimination Challenge methods. Skin test produces pain, local or anaphylactic reaction and patient discomfort. Other procedures are expensive to the patient. So, a modified procedure, based on the same principle of previous tests, was studied in Allergy and Immunology laboratory of Ain Shams University. The procedure has suitable cost for all patients; it is very simple, accurate, cheap and does not produce any problems for patients. It depends on ELISA technique and measures the quantitative amount of the following different allergens: Food and Drug allergens such as, Milk, Eggs, Banana, Maize, Fish, Chocolate, Wheat, Nuts, Strawberry, Shrimps, Spices and Aspirin as a drug allergen. Inhalants, as House dust, Mite, Mixed Pollens, Mixed Moulds, Hay dust, Wool, Latex and Cat Hair. The results of this test for 150 allergic patients were compared with those of national specific IgE kits [ELISA], Sp.IgE [RAST], Skin test and elimination challenge test. Statistical results of sensitivity showed respectively: 88.9%, 89.6%, 91.2%, 71.4%, 93.1%. As regards specificity, the results were 93.1%, 94.7%, 95.3%, 65.5%, 91.6%, respectively. These results conclude that the test is in line with all other standard tests. It can also be noted that it is not only the cheapest and most commercial technique using the immediately available, locally prepared reagents, plates and other requirements found in any standard laboratory, but, additionally, probably it can be unique in using foods, drug and inhalants allergens at the same time. Now, it is applied successfully in Allergy and Immunology unit in Ain Shams university hospitals in Egypt. The test has also been recently introduced at the Center for Advanced Bio Medical Research and Innovation [CABRI] at the Gulf Medical University, Ajman, UAE, using a commercial system from Phadia. About two hundred different IgE levels against specific antigens are tested using the Immunocap 100. The allergen of interest, covalently linked to the Immunocap is incubated with the serum being tested. The unbound IgE is washed away and the bound specific IgE is detected using a fluorescent reader. The concentration is calculated using a calibration curve
ABSTRACT
Liver biopsy is the gold standard for assessment of hepatic fibrosis. However, it is invasive with possible complications, costly and prone to sampling errors. Many non-invasive markers of liver fibrosis have been recently proposed and assessed in the clinical setting as surrogates of liver biopsy. Although several non invasive markers of liver fibrosis have been developed in the last decade their implementation in clinical practice has been slow and is still limited. This study aimed to describe the different non invasive markers and methods that have been proposed for the assessment of liver fibrosis, to discuss their advantages and limits and to suggest a rational use in clinical practice. This study included 40 patients with chronic liver disease, 21 of chronic hepatitis C [CHC] as group I, and 19 patients with liver cirrhosis [group 11] as well as 20 healthy subjects with age and sex matched was enrolled as control group. Serum levels of tissue inhibitor of metalloproteinase- 1 [TIMP-I], laminin and cystatin C were measured and correlate with laboratory and histological findings. This study revealed that, significantly elevated serum level of cystatin C in CHC [group I] and cirrhotic patients [group II] than healthy controls [p<0.001] for each. Moreover, cystatin C concentrations were significantly higher in patients with liver cirrhosis [p<0.01] than in patients with CHC. Furthermore, serum cystatin C levels correlated significantly with the stage of liver fibrosis [p<0.01] but revealed no significant difference with the grade of necroinflammation of the disease process [p>0.05]. However, serum TIMP-1 values showed a significant increase in group I and 11 patients than in controls. Serum TIMP-1 levels correlated significantly with both the stage of fibrosis [p<0.05] and the grade of activity [p<0.01]. Serum larninin levels showed significant increase in patients with chronic hepatitis and liver cirrhosis than controls [p<0.001]. While, no significant difference of on comparing chronic hepatitis patients with control group [p>0.05]. Also, serum laminin levels showed a significant correlation with fibrosis stage [p<0.001] but not with inflammatory grade [p>0.05]. Based on available evidence, it can be anticipated that non-invasive markers of liver fibrosis [cystatin C, TIMP-1 and laminin] and their combined use will soon become a most useful tool in the clinical management of many forms of chronic liver disease. However, their implementation is expected to reduce, but not to completely eliminate, the need for liver biopsy
ABSTRACT
Helicobacter pylori [H.pylori] infection is now recognized to be of major etiological importance in peptic ulcer disease and gastric cancer. More recently, interest in the possible association be- tween H pylori infection and thrombotic events has developed. This study aimed to evaluate the relationship between plasma levels and gastric mucosal concentrations of tumor nemesis factor-a [TNF-alpha] and interleukin-8 [IL-8] as pro-inflammatory cytokines and plasma levels of prothrombin fragments 1+2 [PF1+2] and fib- rinogen in H. pylori positive patients before and after successful eradication therapy. Forty-two patients proven to have chronic gastritis were enrolled in this study. They were divided into 2 groups based on histopathological examination of gastric antral biopsies. Group I: included 28 H. pylori positive patients, and group II: 14 H. pylori negative patients' chronic gastritis. Plasma levels and antral mucosal concentrations of TNF-alpha and IL- 8 as well as plasma levels of fibrinogen and PF1+2 were assessed in all patients. A triple eradication therapy for H. pylori was given for Group I. Eradication was histopathologically evaluated 2 months post-therapy together with estimation of plasma levels of fibrinogen, PF1+2, TNF-alpha and IL-8. The results showed that, group I of patients had significantly increased plasma fibrinogen and PF1+2 as well as mucosal and plasma levels of TNF-alpha and IL-8 compared with group II. Furthermore, in-group I, positive correlations were found between plasma level of PF1+2 and gastric mucosal concentrations of TNF-alpha and IL-8. While in-group II [H pylori negative chronic gastritis], no significant correlations were detected between the studied parameters. A significant reduction in the mean value of plasma levels of TNF-alpha IL-8 and PF1+2 were observed in those with infection eradication. In conclusion, the present study showed a close relationship between plasma levels of PF1+2, plasma and mucosal levels of TNF-alpha and IL-8 in H. pylori associated chronic gastritis patients. These findings suggest that H. pylori may represent a trigger factor for clotting system activation through persistent inflammatory stimulation, cytokine production. Therefore, H. pylori eradication may reduce the risk of hypercoagulable state and thrombotic events in those patients