role of cytomegalovirus in guillain barre syndrome

Guillain Barre Syndrome [GBS] is an inflammatory, usually demyelinating, polyneuropathy where autoantibodies have been detected. It is usually preceded by various bacterial and viral infections including cytomegalo virus [CMV]. Cytomegalo virus infection has been associated with the production of autoantibodies and autoimmune reactions. The aim of this study was to investigate the possible association between CMV infection and GBS. Twenty five patients with GBS were recruited from the paediatric intensive care unit at Mansoura University Children's Hospital. As a control group 25 age and sex matched children with other diseases admitted to the same hospital at the same time, were included in our study. Serum samples were collected before treatment from each patient [within 4 weeks after the disease onset] and controls, and stored frozen at -20?C until PCR and serologic assays were done. Serologic testing and PCR of pre-treatment serum were performed in all patients. Positive titer of virus specific IgM antibody against cytomegalovirus [CMV] was found in 11 cases [44%] which was statistically significant when compared to the control group [4%] p=.001, PCR was found positive for CMV DNA in 12 [48%] patients and 1 control [4%]. We hereby report a significant association between positive CMV infection and GBS. Our results provide further evidence that CMV can be associated with GBS

Increased expression of soluble fractalkine [CX3CL1] in systemic sclerosis - possible role in vascular inflammation

The pathogenesis of systemic sclerosis [SSc] involves interplay between obliterative vasculopathy in multiple vascular beds, inflammation, autoimmunity and progressive fibrosis. Vascular injury and activation are the earliest and possibly primary events in the pathogenesis of SSc. To determine levels of serum soluble fractalkine [sFKN] and its receptor CX3CR1 in peripheral blood mononuclear cells [PBMCs] in systemic sclerosis [SSc] patients and healthy controls. In addition, to assess any possible association between sFKN and clinical features of SSc. Serum levels of soluble fractalkine [sFKN, CX3CL1] assessed by enzyme linked immunosorbent assay [ELISA] and expression of its receptor [CX3CR1] on peripheral blood mononuclear cells by flow cytometric analysis, were measured in 18 systemic sclerosis [SSc] patients and 15 age and sex matched healthy controls. The degree of skin involvement was estimated by modified Rodnan skin thickness score [mRSS], pulmonary involvement was assessed in all patients by high resolution computerized tomography [HRCT] and pulmonary function tests [PFTs]. Serum sFKN levels and expression of its receptor CX3CR1 were significantly elevated in SSc patients than in healthy controls [P < 0.0.05]. SSc patients with pulmonary fibrosis had sFKN levels three times higher than those without PF. Serum sFKN correlated inversely with forced vital capacity of lungs [FVC%] but correlated positively with severity of pulmonary fibrosis, extent of skin fibrosis [mRSS], pitting scars, skin ulcers, anti topo-isomerase 1 antibody and CRP. Serum sFKN may play an important role in the pathogenesis of SSc, including tissue inflammation and vascular injury, hence, its measurement may be a useful serologic marker for the diagnosis and follow up of pulmonary and skin complications. So strategies to target CX3CL1-CX3CR1 interaction could provide a new therapeutic approach in SSc, potentially by blocking endothelial cell injury, leucocyte

Non invasive evaluation of liver fibrosis in children with chronic liver diseases

To noninvasively assess liver fibrosis in children with chronic liver diseases by diffusion weighted MR imaging and 13Cmethacetin-breath test and compare the diagnostic accuracy between these tests referring to hepatic histology as gold standard. Fifty children [31 boys, 19 girls, median age 9.1 years], with chronic liver diseases and 20 age matched volunteers underwent diffusion weighted MR imaging of the liver and13C-methacetin-breath test Liver biopsy was obtained with calculation of METAVIR score. The ADC value of the liver and values of MBT was correlated with METAVIR score. Receiver operating characteristic curve was done for diagnosis and grading of hepatic fibrosis. There was statistical difference in the mean ADC value between volunteers and patients with hepatic fibrosis [P = 0.001] and in patients with different grades of METAVIR scores [P = 0.002]. There was correlation between the mean ADC value and METAVIR score. The cut off point to predict fibrosis [1.7x10-3mm2/s] revealed 84% accuracy, 88% sensitivity, 85% specificity, 81% PPV, and 87% NPV. The area under the curve was 0.91 for F1, 0.85 for F2, 0.86 for F3 and 0.90 for F4. Receiver operating characteristic analysis of the 13C methacetin breath test results revealed a cut-off <1.79 best with 94% sensitivity and 95% specificity in predicting cirrhosis. The area under the receiver operator curve was 0.968. The apparent diffusion coefficient value is a promising quantitative parameter used for diagnosis and quantification of hepatic fibrosis in children with chronic liver diseases. The non-invasive 13C-MBT proved to be safe, easy to perform and reliably differentiates between stages of hepatic fibrosis

Sonotubometry findings in patients with combined airway disease with and without associated eosinophilic otitis media

Active opening of the eustachian tube is accomplished by contraction of the paratubal muscles. Disturbance of any of the ET functions may contribute to the development of otitis media [OM] with effusion and other middle ear diseases. Sonotubometry seems to be the most [physiologic] method for assessment of ET function and has the advantage that it can be performed on ears with an intact tympanic membrane and without the use of a pressure chamber. The aim of this study was to compare the Eustachian tube function using Sonotubometry in patients with combined airway disease associated with Eosinophilic otitis media with that having combined airway disease without otitis media. This study was applied on 45 patients divided into 3 groups each of 15. 1[st] group is the control group, 2[nd] group patients with combined airway disease without Eosinophilic otitis media, 3[rd] group patients with combined airway disease associated with Eosinophilic otitis media. Our results explains that the tubal opening durations were significantly longer in patients of EOM group than in patients with combined airway disease without EOM group and also the normal control group. Sonotubometry can be performed in patients with or, without an intact tympanic membrane and under physiological conditions. Sonotubometry is also inexpensive, painless, and easy to perform in both adults and children. Therefore, it has great potential value as a diagnostic tool for individuals with suspected ET disease

Assessment of stanniocalcin-1 mRNA as a molecular marker for micrometastases of breast cancer

Very few tumor molecular markers have been identified that are highly specific for breast cancer cells when applied to blood. Stanniocalcin [STC]-1 is a recently discovered human gene that has been implicated in cellular calcium homeostasis and is located on chromosome 8p in a region associated with amplification of breast cancer. We investigated STC-1 mRNA as a molecular marker for detecting occult breast cancer cells in blood. Using real time PCR detection assay to assess for STC-1 mRNA expression, we evaluated the blood of 25 breast cancer patients with different stages [I-IV] according to American Joint Committee on Cancer, 7 patients with benign breast lumps as fibroadenomas and fibrocystic swelling, and 8 healthy women as control subjects. In this study there was blood STC-1 gene expression of the malignant group; the mean value of the STC-1 positive blood specimen [copies number] was 8103.1+491.0, without blood expression in the other two groups. Also, the results of this work showed that, 19 [76%] patients of 25 patients of cancer breast had detectable STC-1 mRNA [copies] in their blood, without detectable expression in the other 6 [24%], p<0.001 with significant increase of STC-1 copy numbers with progression of AJCC stages, P<0.001. Finally in this study, the presence of STC-1 mRNA in the blood significantly correlated with primary tumor size [P<0.001], the involved lymph nodes characteristics [P<0.001], the presence of distant metastasis [P<0.001] and the overall AJCC stage [P<0.001]. STC-1 mRNA assay may be a useful and sensitive molecular marker for breast cancer cases with different stages without expression in the normal blood cells. Also, the presence of breast cancer associated STC-1 mRNA in the blood cells correlated significantly with the primary clinico-pathological determinants of disease outcome

Reproductive toxic effects in the testes of BALB/c mice exposed to total diesel exhaust

This study used 50 male BALB/c mice divided into three groups [20 in each of test groups A and B and 10 in the control group C]. Group A and group B were exposed to total diesel exhaust [TDE]. The TDE exposures were performed in a cubic wooden box chamber [side length 50 cm] filled with TDE from a diesel fueled car. Group A was moved to the diesel filled chamber and exposed once a day for 30 minutes and group B was moved to the filled chamber and exposed once a day for 60 minutes. The control group was similarly manipulated for 60 minutes without filling the chamber with TDE. The experiment was carried out six days a week for 120 days. Four animals from group A and six animals from group B did not survive to the end of the experiment while the control animals did not have mortalities. Five of the remaining mice from each test group and 2 controls were sacrificed on the 40th day and on the 80th day. Remaining six mice in group A and four mice in group B and six mice from group C were sacrificed at the end of the experiment [120th day]. Testes and vasa efferentia were removed, testes were prepared into sections for histological, immunohistochemical staining and testicular biopsies [5 mg each] were used for Western blotting experiments to detect acrosomal proteins. Vas spermatozoa were prepared as smears for immuno-histochemical study. Down regulation of spermatogenesis reflecting structural damage of the seminiferous tubules was observed in animals sacrificed on the 40th day, this was progressive with time of exposure as seen in samples obtained on the 80th and 120th days The dependence on exposure time was also clear from comparison of sections from groups A and B, Severe oligozoospermia was detected in group A by the end of 80th days and in group B by the end of the 40th day. By the end of the experiment [120 days], the seminiferous tubules from the testes of the two test groups A and B were containing Sertoli cells only. Immunohistochemical staining of testicular sections and vas sperm suspensions using monoclonal antibodies for internal acrosomal proteins revealed a concomitant ultrastructural damage of spermatozoa in the form of defective or absent acrosome and increased proportion of abnormal sperm head morphology. The progressive decrease of sperm and spermatid -specific proteins in testicular biopsies was observed in the immuno blots. It is concluded that exposure to diesel exhaust has a massive reproductive toxicity in male mice manifested by suppression of spermatogenesis and abnormal ultra structures of vas spermatozoa. Also, the reproductive toxic effect of diesel exhaust exposure is both dose [exposure time]-dependent and duration [repeated exposures]-dependent