ABSTRACT
Asthma is a complex disorder which cannot be defined adequately in terms of a single pathophysiological mechanism. The pathogenesis of bronchial asthma is chronic airway inflammation caused by immune cells such as T-lymphocytes and eosinophils which release cytotoxic products including reactive oxygen species at the site of inflammation leading to epithelial damage. The aim of this study is to evaluate the importance of selenium and glutathione peroxidase as important antioxidants in asthmatic attacks and to highlight the possible burden of body mass index in asthmatic children. Fifty children were included in this study. Group I "asthmatic children" consisted of 25 patients [14 males and 11 females] aged 6-12 years. Group II "control group" consisted of 25 healthy children [13 males and 12 females] aged 6-12 years. All children were examined thoroughly and their FEVI % and PEFR were measured. These tests were repeated after bronchodilators only in asthmatic children. Body mass index [BMI] was calculated. Chest X-rays, urine and stool analysis for parasites, complete blood picture and sputum eosinophils were performed. Glutathione peroxidase [GPx] and selenium [Se] blood levels were assayed for both groups. The results showed that sputum eosinophils and peripheral eosinophils were significantly higher in asthmatics. Glutathione peroxidase and selenium blood levels were significantly lower in asthmatic children and can reliably assess severity of the asthmatic attack besides pulmonary function tests [FEVI % and PEFR]. BMI of our asthmatic children was significantly higher than control, with the overweight asthmatics showing slightly lower serum selenium level and pulmonary function tests and less improvement of their severity scores of the asthmatic attack and pulmonary functions by bronchodilators. It was also found that the improvement of asthmatic attacks [severity score, PEFR and FEV, %] was better in cases with higher GPx, serum Se and low BMI and the most severe cases had less GPx and Se levels and had high BMI and higher sputum eosinophils and peripheral eosinophilia
Conclusion: selenium and Glutathione peroxidase as antioxidants are deficient in asthmatic children during severe attacks; hence further studies with supplementation of antioxidants are recommended
ABSTRACT
Autism is generally considered to be a multi-factorial disorder. Causally speaking, immune, neuro-chemical, environmental such as viral infections mainly measles and genetic susceptibility factors have been implicated. Currently, the etiology of autism is still unknown, and although there are treatments for some of the behavioral abnormalities, there is no cure. Autoimmunity has a strong prospect for finding a cause and treatment of autism today. The aim of the present work was to study measles antibodies and some immunological parameters in autistic children in a trial to pave the way to new optimistic interventions both diagnostic and therapeutic. Thirty-nine children were included in this study allocated into 2 groups. Group I [autistic children] consisted of 19 children [17 males and 2 females], aged 2-7.75 years, diagnosed as autistic by CARS. Group II [control children] consisted of 20 healthy children [17 males and 3 females] aged 2-8 years. All children were subjected to detailed history and thorough clinical examination [to confirm diagnosis and exclude other neurodevelopmental illnesses]. Total serum protein, serum albumin, serum protein electrophoresis immunoglobulins and ANA were measured for all children. CD[4] and CD[8] subsets of T-lymphocytes were phenotyped by whole blood flow-cytometry to get CD[4]/CD[8] ratios. Measles IgG antibody levels were measured for all children by indirect enzyme-immunoassay. Autistic criteria were detected late [in the second year of age] among all our autistic children. Some autistic children [4 children] showed autistic regression after MMR vaccination. Family history of autism and other autoimmune diseases was found in a small number of our autistic families [2 and 4 respectively]. Autistic children had significantly higher TSP, serum albumin, gamma globulin, and IgG levels than control children, while their alpha1, alpha2 and beta globulins, IgA and IgM were not significantly different. About one third [36.84%] of our autistic children were positive for ANA with the mean of ANA titers significantly higher in the autistic children compared to controls. CD4+ lymphocytes were significantly reduced, while CD8+ lymphocytes were normal or slightly decreased, resulting in a significantly lowered CD4/CD8 ratio among our autistic children compared to normal controls. The mean serum levels of measles IgG antibodies were significantly higher among autistic children as compared to non autistic control children
Conclusion: the hyperimmune response to measles virus and the immunological abnormalities may play a role in the pathophysiology of autism. Depending on the nature of the immune abnormality, the goal of therapy should be to normalize or reconstitute the immune response instead of inducing immune suppression or stimulation. It is recommended to start immediately a wide, well controlled research project to explore the importance of autoimmunity and other immunological abnormalities in early diagnosis, prevention and treatment of autism