ABSTRACT
Hepatitis C virus [HCV] infection represents a serious threat to human health; often resulting in liver cirrhosis and hepatocellular carcinoma [HCC]. The exact mechanisms responsible for persistent infection and long -term hepatocellular injury are poorly understood. It is hypothesized that the pro-inflammatory cytokine IL-18 may have an important role in chronic cellular immune response towards hepatocytes in the course of the disease. Of this study was to evaluate the significance of measuring IL-18 mRNA in peripheral blood mononuclear cells [PBMCs] in viral hepatitis C patients with chronic infection and HCC. Forty selected patients with chronic HCV infection [12 with compensated liver functions "group I" ; 12 with decompensated liver functions "group II"; and 16 with HCC on top of chronic HCV infection "group III"] and 10 healthy controls with matched ages and sex were studied. Using reverse- transcriptase polymerase chain reaction [RT-PCR], detection of HCVRNA in blood of patients and quantitation of IL-18 mRNA transcripts in PBMCs of patients and control were performed. This study showed a significant increase [p<0.001] in the mean value of transcriptional expression of IL-18 gene [as a ratio to that of beta-globin] in PBMCs in all patients groups compared to control. A positive [however insignificant] correlation was detected between transcriptional expression of IL-18 gene and serum albumin [r=0.446]; ALT[r=0.074] as well as prothrombin time [r=0.332] in chronic viral hepatitis patient groups [compensated and decompensated]. A significant positive correlation was found between transcriptional expression of IL-18 gene and hepatitis C viral load in all patient groups[r=0.756; 0.669; and 0.956 respectively]. These results support the hypothesis that IL-18 has an important role in the immunopathogenetic events leading to liver injury in chronic HCV infection. The antiviral action of IL-18 might be counteracted by multiple factors leading to persistent HCV infection [as IL-10]. The question becomes important whether and to what extent the HCC is influenced by IL-18. Future follow- up studies are recommended to investigate the role of monoclonal antibody to IL-18 in amelioration of liver damage and cirrhosis in such patients, in addition to further studies to highlight the role of IL-18 binding protein [BP] and Th-2 cytokines [as IL-10] as possible antagonists to the antiviral action of IL-18. Finally future- large scales studies correlating IL-18 gene expression with markers of HCC progression are recommended to gain insight into the antitumor action of IL-18 as it would be a promising new strategy to control HCC
ABSTRACT
The prersent work aimed at detection of dengue as a cause of acute febrile illness in Sharkiya. One hundred patients complaining of fever, headache, myalgia and arthralgia were included in the present study. Acute and convalescent serum samples were collected from each patient and tested by indirect ELISA for the presence of dengue virus immunoglobulin G. Four-fold rise in antibody titre was found in sera eight patients"from acute to convalescent". The eight patients had leucopenia and none of them showed haemorrhagic manifestations. The present study showed that dengue fever can not be ignored as a possible cause of acute febrile illness in Sharkyia. So infection control measures must be taken to prevent its spread, especially in new countries, through people comming from endemic areas. Also, it is recommended to facilitate methods for laboratory diagnosis of dengue fever for early detection and treatment