Longitudinal study for prediction of type 1 diabetes in siblings of patients: an initial step for prevention of disease

The aim of this study was identification of cut off points of positivity of different antibodies [Ab] against islet cell antigens [ICA, Anti GAD Ab, Anti IA2 Ab] in Egyptian children and adolescents who are sibs of patients with type 1 diabetes as well as determination of their insulin secretory capacity and identification of HLA-DQB1 alleles known to predispose to or protected against type 1 diabetes. The ultimate aim is to identify those at high-risk of the disease to enroll them in preventive trials. This study was a longitudinal one that lasted for five years and include seventy-two sibs of type 1 diabetic patients recruited from the Diabetic Endocrine Metabolic Pediatric Unit [DEMPU] at Cairo University Children's Hospital. Thirty sex healthy subjects; age and sex matched with patients and with negative family history of autoimmune diseases were included as controls. Serum samples from all subjects and controls were analyzed for GAD[65], IA2 Ab using radioimmunoassay and ICA Ab using ELISA technique. Sibs who were positive for one or more Ab were further subjected to the assessment of first phase insulin response and HLA studies for detecting DQB1 alleles known to predispose or protect against type 1diabetes using SSP DNA-based technique. The results showed that 36 sibs [50%] were GADAb positive, 10 sibs [13.9%] were IA2 Ab positive while 14 sibs [19.4%] were ICA positive with overlap. Mean FPIR in 41 sibs positive for one or multiple Ab was 41.407 mU/L +/- 28.73 which was statistically significantly less than that in controls 79.414 mUL +/- 44.316 [P<0.001]. Thirty-four sibs [38%] lied in the high-risk group defined by FPIR less than 5[th] percentile. HLA studies done in 32 sibs showed that 17/32 sibs [54.84%] had the predisposing alleles DQB1 [0201, 0202, 0302, 0303, 0401] while 7 sibs [22.28%] had protective alleles DQB1 [0301, 0601]. Prevention of type 1diabetes will require reliable methods for early diagnosis of predisposition to the disease, using improved genetic and serological screening on a side scale and identification of the primary antigenic target[s] for specific tolerance. Those at risk [multiple positive antibodies and reduced insulin secretory response] in absence of HLA protective alleles are to be enrolled in preventive trials

Toxocara canis and chronic urticaria in Egyptian patients

Toxocariasis is a common parasitic condition present all over the world with high seroprevalence rates even among asymptomatic individuals. Recent diagnostic techniques have revealed a wider scope of clinical syndromes due to toxocariasis including dermatological disorders and particularly urticaria. The patients with chronic urticaria were enrolled for serological toxocariasis investigations. The results pointed to a possible role of T. canis infection in chronic urticaria patients, especially those exposed to an increased risk of environmental exposure to toxocariasis

Intercellular adhesion molecule-2 [ICAM2] in experimintal trichinosis

The estimation of the serum adhesion molecules [ICAM-2] levels in experimental trichinosis and evaluation of its impact on the course of infection as well as its possible role in the diagnosis of early trichinosis were studied. Serum levels of ICAM-2 correlated significantly with the inflammatory and course sequences of trichinosis in mice and had a similar relation with blood eosinophilia. So, estimation of ICAM-2 serum levels may prove useful in diagnosis of trichinosis recent infections, and in monitoring the prognosis and response to treatment. Investigations of the ICAM-2 role in human trichinosis and applying the findings to improve the diagnostic approaches are highly recommended