Possible role of plasminogen activator inhibitor-1 in bronchial asthma

Asthma represents a chronic inflammatory process of the airways. The plasminogen activator inhibitor-1 gene [PAI-1] has an essential role in promoting fibrosis after inflammation. The tissue-type plasminogen activator [t-PA] and urokinasc type plasminogen activator [u-PA] convert plasminogen to plasmin, which enhance proteolytic degradation of the extracellular matrix [ECM]. Among the inhibitors of plasminogen activators, PAI-1 is the most important in the process of lung fibrosis. The main role in the inhibition of fibrinolysis through the blockade of activators is ascribed to PAI-1. It is synthesized in endothelium, megakaryocytes, smooth muscle cells of vessels, and in the liver, with the help of cytokines, growth factors, cyclic nucleotides. hormones including glycocorticosteriods and bacterial endotoxins. The study is designed to investigate the correlation between plasma PAI-1 and bronchial asthma severity and whether steroid medications could affect its levels. The study included 40 children with bronchial asthma and 20 healthy children as control subjects. Estimation of plasma PAI-1 carried out for them using ELISA technique. There was a significant lowering of PAI-1 in all asthmatic groups in comparison to control group. The moderate asthmatic subgroups showed highly significant difference in comparison to mild asthmatic and to control group. The mild subgroups showed also significant difference to control group but with lesser mean value compared to moderate subgroups. The results suggest that PAI-1 may play an important role in the pathogenesis of bronchial asthma

effect of antioxidant treatment on pulmonary function in asthmatic children

Sixty asthmatic children, meeting the criteria of American Thoracic Society for the diagnosis of asthma, were included in this study. Out of them, 40 cases received an antioxidant therapy in the recommended daily dose in addition to their regular treatment plan and 20 patients received their regular treatment without supplementary antioxidant. Another control group of 30 normal non-asthmatic children age and sex matched were also included in the study. The antioxidants used are a combination of several vitamins and minerals and have the ability to scavenger and damage free radicals. Pulmonary function tests were done for all children included in the study at the beginning and three months later at the end of the study. The spirometric parameters included vital capacity [VC], forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], the ratio between forced expiratory volume in the first second and forced vital capacity [FEV1/FVC], forced mid expiratory flow [FEF] 25-75% and peak expiratory flow [PEF]. The results of spirometry were expressed as a percentage of predicted value adjusted for age and height. From the results obtained, it was concluded that antioxidants especially vitamin A, C, E, zinc and selenium have a good effect on asthma in both clinical symptoms and pulmonary function showing an improvement in most of its component

Brain abscess in children with congenital heart diseases

45 children with congenital heart diseases, who followed regularly in the pediatric outpatient clinic, examined thoroughly to detect any neurological complications, particularly brain abscess. These children divided into two groups I-cyanotic congenital heart disease group; 24 patients [19 males and 5 females] with mean age of 5.3 years. II-Acyanotic congenital heart disease group; 21 patients [12 males and 9 females] with mean age of 5.6 years. We detected brain abscess in two patients in the cyanotic group with the incidence of 8.3% and no cases in the Acyanotic group. We concluded that in children with cyanotic congenital heart disease we have to suspect brain abscess if these children developed focal neurological deficits or seizures with deterioration in the level of consciousness and they have to be fully examined and investigated