Serum inhibin B as a marker of spermatogenesis

Serum inhibin B has emerged as a good marker of spermatogenesis and Sertoli cell function. The aim of this study was to better define the relationship between serum inhibin B level with serum follicle stimulating hormone [FSH] and the spermatogenetic function of the testis in fertile and infertile men and to evaluate the diagnostic value of inhibin B in the management of male infertility. Fifty-five infertile men [age ranged from 22-40 years with a mean of 30.4 +/- 3.2 years] were included in this study. They were divided into 3 groups; the first group was composed of 20 oligozoospermic patients [sperm concentration<20 millionl ml], the second group included 18 azoospermic patients with functional etiology, and the third group included 17 azoospermic patients with obstructive causes. Also a control group of 20 fertile subjects of comparable age was included. Andrology Outpatient Clinic, Menoufyia University Hospitals. Inhibin B and FSH were assessed in serum, semen analysis and testicular volume estimation were performed for studied and control subjects. Also testicular biopsy was done for azoospermic cases only. Mean serum inhibin B level in fertile subjects was 201.2 +/- 37.5 pg/ml, which was almost similar to the mean level in patients with azoospermia due to obstructive causes [199.2 +/- 30.5pg/ ml], while the mean level was significantly reduced in oligozoospermic patients [104.5 +/- 15.4 pg/mI] and in patients with functional azoospermia [45.3 +/- 26.2 pg/ml][P<0.0001]. Also, it was noticed that there was a positive correlation between serum inhibin B and sperm concentration, testicular volume and Johnsen's scores of testicular biopsy, while there was a negative correlation with FSH levels. It is concluded that serum inhibin B is an index of global testicular function whose secretion reflects a fundamental interaction between Sertoli cells, germ cells and FSH. Thus its measurement can offer improved diagnosis of testicular dysfunction

Study of prognostic markers in psoriasis

Elevated peripheral blood neutrophil counts have been reported in untreated patients with psoriasis [Ps] in absence of infection. Several studies reported high level of white blood cell [WBC] activation products including oxygen inetabolites in the peripheral blood of these patients which in turn trigger an up-regulation of antioxidant defences. The aim of this work was to determine some inflammatory and antioxidant markers which are easily evaluated and can be used as indicators of prognostic significance in Ps. The study was carried out in 40 patients with posriasis vulgaris: 20 patients with mild Ps and the other 20 patients with severe disease. Twenty normal individuals were studied as a control group. We evaluated the following: total and differential leukocytic count and elastase as markers ofneutrophil activation; erythrocyte sedimentation rate [ESR] and c-reactive protein [CRP] and fibrinogen as markers of inflammation; and ceruloplasmiri and transferrin as endogenotis antioxidant markers. The data of this work pointed to the central role of neutiophils in the inflammatory response in Ps. The worsening of the disease accompanies the increase of the inflammatory response of neutrophils. So, values of elastase, CRP and neutrophil counts can be used as parameters for prognosis and worsening of Ps

Dapsone as monotherapy in cutaneous and mucocutaneous leishmaniasis

There is a need for an oral, safe, effective, easily administered and cheap treatment for cutaneous and mucocutaneous leisimianiasis. Pentavalent antimonials remain the mainstay of treatment for cutaneous and mucocutaneous leishmanjasis. We recruited 65 patients with leishmaniasis [52 patients with cutaneous leishmaniasis and 13 patients with mucocutaneous leishmaniasis]. All studied patients were given dapsone treatment for 2 months. During the study period, 3 male patients [4.6%] stopped the treatment due to adverse reactions and excluded from the study. Of the studied 62 patients treated with dapsone, 57 patients [9 1.9%] [42 males and 15 females] were cured and 5 patients [8.1%] [4 males and one female] showed no response. Out of the studied 49 cases with cutaneous leishmaniasis, 45 cases [92, 3%] [33 male and 12 female] were cured; 4 [7, 7%>] [3 males and one female] showed no response and out of the 13 cases with mucocutaneous leishmaniasis, 12 cases [91.3%] [9 male and 3 female] were cured and one male [8.7%] showed no response. The results did not find any significant difference between the cure rate in both cutaneous and mucocutaneous leishmanjasis. However the cure rate was showed significant differences with regard to age of the patients and the type of lesion among the cutaneous leishmaniasis cases. All cured patients were followed up for another two months with no relapse of cutaneous lesions

Immunohistochemical study of p16[ink4a] and retinoblastoma gene products in different clinicopathological stages of mycosis fungoides

Mycosis fungoides [MF] is usually an indolent disease that, after a variable period of time in a stable phase, evolves into a tumoral form with aggressive behavior. Knowledge about the molecular mechanisms involved in the pathogenesis of tumoral progression in MIF is still scarce. Alterations of p16[ink4a] and retinoblastonia [Rb] have been demonstrated in a wide range of human tumors, p16[ink4a] inhibits Rb protein and thus acts as a negative cell cycle regulator. This prompted us to investigate their hypothetical role in MF progression. Twenty-five patients with MF of different clinicopatholgical stages were studied. p16[ink4a] expression was absent in 28% of the studied cases, where it was more lost in tumoral lesions than in patches and plaques lesions and in higher clinical stages than in low stages and the difference was statistically highly significant [P<0.001]. Therefore, the loss of p16[ink4a] is associated with the aggressive forms of MF. The results of the present study also showed a significant reciprocal relationship between p16[ink4a] and Rb proteins in most MF cases. However, alterations of Rb protein were not correlated with any of the clinicopathological features of the studied cases. In conclusion, this study demonstrated that lack of p16[ink4a], expression is a sensitive and specific marker of advanced cases of MF in comparison to Rb and thus p16[ink4a] could he used as a marker for poor prognostic patients with MF

Detection of epidermal P53 and Mdm2 in vitiligo patients

Vitiligo is a common depigmented skin disorder that is caused by selective destruction of melanocytes resulting in disfiguring milky white patches. Since melanin is a unique light- absorbing and ultra -violet filtering system it is generally accepted that its main function resides in the protection of these cells against the deleterious effect of U-V light. Association of vitiligo and skin cancer has been a subject of controversy, occurrence of skin cancer in long lasting vitiligio is rare and PUVA therapy associated squamous cell carcinomas are not reported. There are reports on increased functional wild type P53 expression in the patients with vitiligo and there may be direct association between this tumor suppressor gene and absence of photo damage and skin cancer. The major regulator of P53 is MDM2 protein which can trigger its degradation. Thus the aim of this work is to detect the degree of expression of P53 protein, MDM2 protein, in both depigmented as well as 'normal' pigmented skin of vitiligo patients and compare it to normal control. Thirty four patients with vitiligo and ten age and sex matched healthy volunteers as a control were selected. Skin biopsies were taken from each case and control subjects. Histopathological examination of hematoxylin-eosin-stained sections of lesions included analysis and scoring of histopathological parameters. Expression of P53 and Mdm2 proteins were examined immunohistochemically. The results showed that both P53 and Mdm2 were highly expressed in uninvolved as well as involved skin of vitiligo patients in comparison to the control. This expression involves the epidermis, skin adnexa and blood vessels. In conclusion the over expression of the functioning wild type of P53 protein in both pigmented and depigmented epidermis of patients with vitiligo, could contribute to the decreased occurrence of actinic damage and skin cancer

Expression of DNA topoisomerase II alpha in melanocytic skin tumors

Topoisomerases are nuclear enzymes that modulate the topological structure of DNA in order to facilitate cellular events such as replication and transcripion. These enzymes are also the cellular targets of new classes of chemotherapy agents termed topoisomerase poisons. These drugs are showing activity against a wide variety of solid human neoplasms. However, malignant melanoma [MM] is considered to be a chemotherapy refractory tumor and the commonly used anticancer drugs do not seem to modify the prognosis of metastatic disease. Because of the challenges in treating MM, we performed an immunohistochemical study of this group of neoplasms to search for the presence of molecular marker that might indicate tumor response to topo II alpha active drugs. Forty- five patients with melanocytic skin tumors were the subjects of this study. They included 29 patients suffering from benign nevi, 4 dysplastic nevi and 12 MM. Topoisomerase II alpha expression showed significantly higher expression in MM cases than benign melanocytic nevi. Dysplastic nevi showed topo II alpha expression midway between the two extremities. The difference between the 3 groups was statistically highly significant p<0.0001. In MM cases, topo II alpha expression was significantly correlated with lymph node metastasis [p=0.001], tumor ulceration [p=0.001], tumor thickness [p=0.0001], Clark's level [p=0.008], and nodular type melanoma [p=0.003] In conclusion, expression of topo II alpha provides a useful marker for proliferation and can differentiate between benign and malignant melanocytic skin tumors. While in MM cases, it is considered as a poor prognostic marker. As the enzyme topo II alpha is the target of a group of cytotoxic drugs. its expression might serve to predict the success of adjuvant cytotoxic therapy especially in advanced MM cases

Soluble interleukin-2 receptor in patients with vitiligo

Vitiligo is a hypopigmentary dennatosis of probable autoiminune origin. The disease may be the consequence of an autoimmune response of cytotoxic T lymphocytes against melanocyte antigens. The measurement of soluble interiuekin-2 receptor [s IL-2R] in serum has been shown to be useful in monitoring, in vivo, the immune activation, and the elevation of sIL-2R is correlated with T cell mediated immune diseases. In order to study the role of sIL-2R in the pathogenesis of vitiligo, the level of sIL-2R was measured in the serum of 39 patients with vitiligo and 20 normal controls using the method of sandwich ELISA. The patients were divided according to the type of the disease into 3 groups; generalized type [19 patients], focal type [12 patients] and segmental type [8 patients]. There was a highly significant increase in sIL-2R level in patients with vitiligo [414.8 +/- 115.1 U/ml] compared with that of the controls [274.36 +/- 30.1 U/ml, P = 0.0001]. There was no significant difference among sIL-2R levels according to sex, either in patients with vitligo or controls. According to the clinical types of vitiligo, sIL-2R levels in generalized and focal types showed highly significant results compared to the control group, while in the segmental type, the level of sIL-2R was not highly significant as the other two types. As regards to the activity of the disease there was a highly significant difference [P = 0.0001] of sIL-2R level between the patients with progressive vitiligo lesions in relation to patients with stable lesions. As regard to the duration of the disease, there was a highly significant increase of sIL-2R levels in patients of less than one year duration [P =0.001] compared to the patients with vitiligo of more than one year duration. From the results of this study, it was noticed that the level of sEL-2R was significantly increased in generalized and focal types of vitiligo than the segmental type and this indicates that the activation of T lymphocytes would be an important component in the pathogenesis of the former 2 types of vitiligo. Also, the results showed that assessing sIL-2R may be significant in estimating the progression of the disease

Hepatitis C virus and hepatitis G virus infection in patients with chronic urticaria

In order to study the prevalence of hepatitis C virus [HCV] and hepatitis G virus [HGV] infection in patients with chronic urticaria, 46 patients with chronic urticaria [25 females and 21 males with mean age of 36.2+10.9 years] were screened for HCV and HGV infection using PCR technique. None of the patients had a history of acute hepatitis. A control group composed of 50 apparently healthy subjects [age and sex matched and from the same geographical region] was included in the study. HCV RNA was detected in 13 out of 46 patients [28.2%] and in 7 out of 50 control subjects [14%], the difference was statistically significant P<0.05]. There was no difference in sex between the positive and negative HCV patients but positive patients were older and the duration of their urticaria was longer and had higher levels of liver enzymes in comparison to HCV negative patients. HGV RNA was detected in 5 out of 46 patients [10.8%] and in 5 out of 50 control subjects [10%], there was no statistical difference between the two results [P>0.05]. From the results of this study, it could be concluded that there is a significant association between HCV infection and chronic urticaria, and that HGV infection has no role in the pathogenesis of chronic urticaria. Thus it is recommended to screen patients with chronic urticaria, especially the older ones with long duration of urticaria and with elevated liver enzymes, for HCV infection, in order to diagnose the disease early. This early diagnosis of HCV infection is important for early treatment

efficacy of systemic versus topical corticosteroids in the treatment of vitiligo patients

Thirty vitiligo patients were submitted to this study and divided into two groups each of them included 15 patients of different types of vitiligo. Group [A] was treated with systemic injectable corticosteroids and group [B] was treated with topical corticosteroids. The results were evaluated after 6 months of continued therapy. We found that corticosteroids either systemic or topical could have a role in treatment of vitiligo but systemic therapy was superior to topical therapy