Endothelin-1 and leptin as markers of intrauterine growth restriction

To explore the role of endothelin-1 [ET-1] and leptin in intrauterine growth restriction [IUGR] among preeclamptic and non-preeclamptic women. Forty patients with a pregnancy complicated by IUGR, 20 cases with severe pre-eclampsia and 20 cases non-preeclamptic were enrolled. Control group comprised 15 cases with uncomplicated pregnancy. Blood sample from umbilical artery and maternal venous blood were collected at the time of delivery for ET-1 and leptin levels. Mode of delivery, birth weight and Apgar score were recorded. The mean maternal and fetal ET-1 was significantly higher in pregnancies complicated by IUGR than in control group. The mean maternal leptin was significantly higher in preeclamptic patients when compared to nonpreeclamptic and control groups. Mean fetal leptin was significantly lower in patients than in control; however fetal leptin was corrected to fetal weight, it was insignificantly different in both groups. Maternal plasma ET-1 and leptin correlates with the degree of fetal growth restriction originating from deterioration of placental function. Maternal plasma leptin and ET-1 levels may reflect deterioration in fetal growth

Natural killer-T [NKT] cells and human leukocyte antigen-G [HLA-G] in children with insulin dependent diabetes mellitus

Background: natural killer T [NKT] Cells are unique immunoregulatory cells reported to be deficient in many autoimmune disorders as systemic sclerosis with controversy as regards their role in IDDM. HLA-G is a non-classical HL4 class I molecule with immunotolerant function through T and NK cells inhibition but its role in IDDM is not defined. Bur aim was to evaluate NKT cells frequency and activity as well as the level and expression of HLA-G in children with IDDM to highlight their role in disease pathogenesis

Study design: this study included 28 children with IDDM who attended Mansoura University Children's Hospital consecutively from June, 2003 to March, 2004. A group of 18 healthy children with matched age and sex having no family history of diabetes mellitus served as control. All subjects were exposed to thorough history and clinical examination beside routine investigations that included random blood sugar and glycosylated hemoglobin. NKT cell receptors [Valfa24-JalfaQ] were assessed by ELISA before and after mitogen stimulation. NKT cell receptor expression was also assessed by quantitative reverse transcriptase polymerase chain reaction [RT-PCR]. Soluble HLA-G was also determined by ELISA and its expression was assessed by RT-PCR

Results: NKT cell receptors were significantly lower in patients before and after mitogen stimulation compared to control [p<0.001]. Similarly, NKT cell receptor expression was significantly lower in patients than control [P<0.001]. On the other hand, sHLA-G and HLA-G expression were significantly higher in patients than control [p<0.001] A. highly significant negative correlation was found be between NKT receptors and HLA-G [p<0.001]. But no significant correlation was observed between NKT cell receptors or HLA-G and either age, duration of illness, random blood sugar, dose of insulin or level of glycosylated hemoglobin

Conclusion: NXT cells frequency and activity are decreased in children with IDDM which may contribute to disease development. HLA-G level and expression are increased in diabetic children suggesting a role for this molecule in DDM pathogenesis

Circulating interferon gamma and interlukin-10 in childhood sepsis

This study is an observational case control study that was planned to evaluate the circulating levels of interferon gamma [IFNy], a T helper-1 cytokine, and interlukin-10 [IL-10], which is derived mainly from T helper 2 cells, in septic children to highlight their role in sepsis and relation to outcome and to test the state of Th1/Th2 cytokine balance in these patients. The study was carried out in Mansoura University Children's Hospital in the period from March to November, 2002 and included 48 children with sepsis that were consecutively admitted to Our hospital in addition to 12 healthy children with matched age and sex as control. Patients were classified into 4 groups [each including 12 patients]; sepsis, sepsis syndrome, septic shock and multiple organ dysfunction syndrome, after fulfillment of the inclusion criteria of each definition. IFN[gamma] and IL-10 were measured in serum samples, taken from all subjects on admission, by enzyme immunoassay [Titrezyme perspective Biosystems and Immunotec]. Results revealed significantly higher serum IFN and IL-10 levels in all patient groups than control [p<0.001] and both cytokines were higher in severe forms of sepsis. Non survivors had significantly lower blood pressure [p=0.01] while total leukocytic count, granulocytic count, IFN[gamma] and IL-10 were significantly higher in these patients [p=0.02, <0.001, 0.002, <0.001 respectively]. Multiple stepwise regression analysis showed that TLC, IFN[gamma] and IL-10 were the most important predictors of poor outcome with a regression coefficient of 89.6%

Conclusion: both IFN[gamma] and IL-10 are increased in septic children especially in severe forms correlating with outcome that suggests a role in disease pathogenesis. Both Th1 and Th2 cells are operating at least for some time during the Course of sepsis