clinical utility of vascular endothelial growth factor as predictive marker for systemic lupus erythematosus activity in children and adolescents

Angiogenesis plays an important role in the pathogenesis and progression of collagen diseases. Vascular endothelial growth factor [VEGF] is a potent stimulating factor for angiogenesis and vascular permeability. To asses for changes of VEGF in lupus patients in childhood and adolescents and its relation to lupus activity and to demonstrate the possible correlation between the serum level of VEGF and certain clinical and laboratory parameters and disease activity score. We investigated the serum concentration of VEGF using an enzyme-linked immunosorbent assay [ELISA] in a group of 35 children and adolescents with systemic lupus erythematosus [SLE] and 25 healthy controls. All cases were recruited from Kasr El Aini Hospital. VEGF was detectable in all patients with SLE, and in all normal individuals. The level of serum VEGF in lupus patients was higher than control, also its level in active SLE was higher than inactive disease or in controls. We found that serum levels of VEGF was significantly higher in patients with renal involvement than those with no renal involvement [p < 0.003]. It was also higher in SLE patients with moderate to sever skin disease neurological and joint involvement compared with patients with no or mild skin disease, no neurological and no joint involvement respectively but the differences were statistically insignificant. A positive correlation was detected between higher VEGF serum levels and ESR and SLAM score [p < 0.01 and < 0.04 respectively], on the other hand VEGF was negatively correlated to platelets count and complement level [C3] [p < 0.05 and < 0.01 respectively]. VEGF serum levels are higher in children and adolescents with SLE patients especially active lupus. Also its level is correlated to many of clinical and laboratory parameter of lupus. So it may be a useful marker of disease activity

Protein Z in beta-thalassemia major adult patients and risk of thrombosis

Recent studies have suggested an association between protein Z [PZ] deficiency and thrombosis. Profound haemostatic changes have been observed in patients with beta-thalassemia major with a higher incidence than normal of Ihromboembolic events, so our present study was carried to asses the role of PZ in hypercoagulable state in beta-thalassemia major with other coagulation factors inhibitors [protein C and S] and to compare the splenectomized versus non-splenectomized patients regarding the risk of thrombosis. The study included 44 patients with beta-thalassemia major [22 splenectomized and 22 non-splenectomized], their age ranged from 20-32 years. All were recruited from hematology department of Kaser ALAini hospital. Fifteen healthy subjects who were age and sex matched were included as controls. Complete blood picture, liver function tests, serum ferritin, PZ antigen, PC and PS activity and FDPs were measured for all participants. Study showed significant reduction of PZ antigen together with reduced PC and PS activity in thalassemic patients compared to controls [p<0.001], FDPs was higher in both thalassemic groups compared with control group [p<0.001]. The reduction of PZ antigen, PC and PS activity was more significant in splenectomized patients compared to non-splenectomized patients together with higher FDPs [All p values <0.001]. An inverse correlation between FDPs and PZ antigen, FDPs and PC and PS activity were detected. Reduced PZ antigen together with PC and PS activity may be a contributing factor for hypercoagulable state in thalassemia major. Splenectomized patients are at higher risk of thrombosis

Effect of laser therapy versus aerobic exercise training on small airway ventilation and selected immune system response in asthmatic children

Asthma is common in children, affects about 18% of children less than 12 years of age worldwide and its prevalence is increasing. Patients with bronchial asthma have poor ventilation in small airways which gradually impairs their overall physical ability and reduces health related quality of life. Many people turn to alternative and complementary treatment. To compare the effect of laser acupuncture therapy and aerobic exercise on small airways ventilation [the greatest affected lung area] and immune system in asthmatic children. Thirty six asthmatic patients participated in this study and divided into two equal groups, group [1] received medical treatment and the usual physiotherapy in addition to laser acupuncture therapy, where group [2] received medical treatment and the usual physiotherapy in addition to aerobic exercise training. The program continued for two months. Measurements of lgG, FEF0.2-12%. FEF25-75% and MEF50% obtained before starting of the study and after two successive months. The results of this study indicated that there were significant improvements in the measurement parameters including IgG, FEF0.2-1.2%, FEF25-75% and MEF50% for both groups, where there was no significant difference between both groups [p<0.05]. Both laser acupuncture therapy and aerobic exercise can be considered as valid and effective modalities in the management of asthmatic patients