Estimation of HCV-viral load, interleukin-10 and interferon-gamma in patients with hepatitis C and schistosoma mansoni coinfection.

Patients coinfected with hepatitis C virus [HCV]and schistosomiasis exhibit a unique clinical, virological and histological pattern manifested by viral persistence with high HCV- RNA viral load, higher incidence of cirrhosis, hepatocellular carcinoma, poor response to interferon therapy compared with patients infected with HCV without concomitant schistosomiasis. The aim of the present work was to estimate HCV-RNA viral load, the serum level of interleukin- 10[IL-10] and interferon-gamma [IFN-gamma] in patients with only HCV infection, in patients with only Schistosoma mansoni infestation and in those patients with combined infections and to study any possible correlations. The current study was carried out on [69] of chronic HCV liver disease patients and [18] healthy individuals as a control. Patients were selected from Inpatients and Outpatients of Tropical Medicine and Infectious Diseases Department, Tanta University Hospitals. Patients in this study were subjected to the following: Thorough clinical examination, and lab investigations including; liver function tests, estimation of HCV- RNA viral load by real time PCR and estimation of serum level of IL-10 and IFN-gamma by ELISA. The present study showed that: There was marked and significant increase in the serum level of IL-10 in patients with schistosomiasis and in coinfected patients compared with control group. A significant but mild increase in the serum level of IL-10 was also found in HCV patients compared to control. Regarding IFN-gamma, patients infected with HCV had significant and marked increase in the level of IFN-gamma compared with control and with patients with schistosomiasis and coinfected patients

Conclusions: Schistosoma mansoni infestation seems to induce a Th2-related cytokines with increase in serum levels of IL-10 even in the presence of HCV coinfection. Schistosomiasis may downregulate the stimulatory effect of HCV on Th1 cytokines, leading to inhibition of release of IFN-gamma; and this may lead to the chronicity of HCV infection, hence the poor response to interferon therapy

Conservative surgical treatment for benign aggressive intrabony lesions

This study was performed to document that not all the aggressive lesions require extensive surgical intervention. Accurate assessment, as regard to clinical examination and histopathological investigation, should be done to determine the most suitable treatment. The study was conducted on 12 patients: 7 patients were suffering from large odontogenic keratocyst, 5 patients were suffering from central giant cell lesions. All lesions were confined to the mandible and treated by surgical enucleation and aggressive curettage [peripheral ostectomy]. Long term follow-up was done [up to 18 months] which revealed that fair bone regeneration with no evidence of recurrence

HLA-DRB1 alleles in Egyptian children with steroid-sensitive nephrotic syndrome: association with outcome

To investigate whether polymorphic HLA-DRB1 alleles are significantly associated with outcome in Egyptian children with steroid-sensitive nephrotic syndrome [SSNS]. Cross-sectional study. Among attendants of Pediatric Nephrology Outpatient Clinic, 54 unrelated children with SSNS were enrolled. They included 32 males and 22 females, their ages ranged from 1.8 to 14 years. According to response to standardized prednisone therapy, patients were categorized into two different outcome groups: non-relapsing or Infrequently relapsing [NR/IR] group [n = 24], and Frequently relapsing [FR] group [n = 30]. Among FR patients, 24 were treated with alkylating agents, and according to their responses, they were categorized into two different outcome groups: active disease outcome group [n = 15] and long-term remission outcome group [n = 9]. HLA-DRB1 alleles typing was done using the DNA polymerase chain-reverse hybridization technique. The results of present study showed that: [I]. DRB101 alleles showed significant positive association with NR/IR outcome [relative risk [RR] = 45, 95% confidence interval [95% Cl] = 19.1-105.7, Phi-coefficient [delta = + 0.74, P<0.00001, correctedP [Pb] <0.001]; and significant negative association with FR outcome [RR = 0.03, 95% Cl = 0.01-0.09, delta = - 0.69, P <0.00001, Pb <0.001]; [II]. DRB10701/0301 alleles-heterozygosity showed significant positive association with FR outcome [RR = 72.25, 95% Cl = 30 -169.3, delta = + 0.89, P<0.00001, Pb <0.001]; and significant negative association with NR/IR group [RR = 0.01, 95% Cl = 0.004-0.02, delta = 0.93, P <0.00001, Pb <0.001]; [III]. DRB10701 allele showed significant positive association with active disease outcome after alkylating therapy [RR =111, 95% Cl = 47.2-260.8, delta = + 0.82, P <0.00001, Pb <0.001]; and significant negative association with long-term remission outcome [RR = 0.009, 95% Cl = 0.004-0.02, delta = - 0.82, P <0.00001, Pb <0.001]. The current data suggest that HLA-DRB1 alleles are significantly associated with outcome in Egyptian children with steroid-sensitive nephrotic syndrome. The present authors propose that new therapeutic trials in SSNS should take into account the HLA status of patients