effect of 6% hydroxyethyl starch solution130/0.4 on postoperative inflammatory response and pulmonary outcome in pediatric intensive care unit after major abdominal surgery

Major surgery may alert the systemic inflammatory response which may progress to severe postoperative complications. The present study investigated the effect of HES 130/0.4 compared to lactated ringer's solution on the postoperative systemic inflammatory response and pulmonary outcome during pediatric major abdominal surgery. Thirty children ASA I or II, aged [6 months- 36 months], scheduled for elective major abdominal surgery were randomized to receive either Hydroxyethyl Starch 130/0.4 solution in HES group or Lactated Ringer's solution in LR group for intraoperative fluid replacement. Volume of HES 130/0.4 or LR infused to replace blood loss was recorded. Serum level of IL6, IL8 and CRP were measured before induction and at 6, 12, 24; 48 hours postoperatively in pediatric intensive care unit. Hypoxia score [Po2/Fio2 ratio] was also assessed at the same time interval. HES group received 103.7 [12.6] ml of Hydroxyethyl Starch 130/0.4 solution. The mean volume of crystalloid infused was significantly higher in LR group 613.2 [47.1] ml versus 396.4 [29.1] ml in HES group [P <0.05]. Serum levels of IL-6, IL-8 and CRP were significantly increased from baseline in both groups during the study period [P<0.05]. This increase was significantly lower in the HES 130/0.4 treated patients compared to those in Lactated Ringer's group [P<0.05]. The peak value was reached at 12 hours for IL-6 and IL-8 and at 48h for CRP. The PO2/FiO2 significantly decreased relative to the baseline values throughout the study period in both groups. The decrease was significantly less in the HES group compared with the LR group at all postoperative time interval P <0.05. HES 130/0.4 is effective for intravascular volume replacement with the advantage of reducing the inflammatory response and improving pulmonary outcome in paediatric patients undergoing elective major abdominal surgery

Interferon-inducible systemic lupus associated gene, IFIT1 in systemic lupus erythematosus patients

Systemic lupus erythematosus [SLE] is a prototype of human systemic autoimmune diseases. Although the definite etiopathogenesis of SLE remains unclear, many different mechanisms may contribute to the pathogenesis of SLE. Interferons [IFNs] are important immune system mediators that could impact the initiation or amplification of autoimmunity and tissue damage through their diverse actions on dendritic cells. T, B lymphocytes, natural killer cells, and mononuclear phagocytes. Recent studies suggest an important role of interferon alpha in the immunopatahogenesis of SLE. Data demonstrating a correlation between IFN alpha and SLE range from elevated IFN alpha level in patients serum and induction of interferon regulated genes in peripheral blood mononuclear cells to drug induced lupus in hepatitis C or cancer patients treated with recombinant IFN alpha. In the present work we studied the mRNA expression level of the interferon-inducible with tetratricopeptide repeats 1 [IFIT1] gene using Real-time PCR to examine the hypothesis that increased disease severity and activity, as well as distinct autoantibody specificities, characterize SLE patients with activation of type 1 interferon pathway. Expression of IFIT1 gene was significantly higher in SLE when compared to the control group and the level of expression showed a positive correlation with disease activity index. Renal affection was more frequently encountered in SLE patients with IFIT1 overexpression. The gene expression profiles seems to be the molecular basis of the diverse immune phenotype of SLE. Defining the nature of the major IFNs or other factors, that drive the IFN-regulated gene expression noted in SLE is an important area of investigation that may lead to new approaches to targeted therapy of SLE

Detection of bcl-2 translocation in patients with chronic hepatitis C and its possible relation to antiviral therapy: preliminary study

It has been suggested that t[14;18] translocation of bcl-2 to the immunoglobulin heavy chain [IgH] locus may contribute to the pathogenesis of lymphoproliferative disorders [LPD] related to hepatitis C virus [HCV] infection. The present study aimed to assess the prevalence of bcl-2 translocation in Egyptian chronic HCV patients and to investigate the effect of combination antiviral therapy of interferon alpha and ribavirin on t[14;18]. Fifty five chronic HCV patients were studied for the prevalence of t[14;18]. These patients were classified into 2 groups, 33 non treated HCV patients and 22 treated HCV patients with antiviral therapy as well as control group of age and sex matched individuals. The bcl-2/IgH rearrangement was detected in peripheral blood mononuclear cells [PBMCs] by nested polymerase chain reaction. All patients have undergone HCV viral determination by real time PCR. Bcl-2/IgH translocation was detected in 21 [38.2%] of all 55 chronically infected HCV patients. Considering all patients with chronic HCV-infection, bcl-2 rearrangement was slightly more frequent in the non treated group than in those who underwent treatment with interferon plus ribavirin but the difference was not statistically significant, although treated patients showed biochemical and virologic response at the end of 6 months of antiviral therapy. In conclusion, t[14;18] in PBMCs is a frequent finding in chronic HCV infection