IL-17 assay in adult T-cell leukemia/lymphoma patients with dermatophytosis

Assess IL-17 level as proinflamtory cytokine and predictor for the outcome of inflammatory process in ATLL patients with dermatophytosis. Isolation and identification of different types of dermatophytes infecting patients with ATLL. 58 subjects were included in this study [16 adult patients with adult T-cell leukemia / lymphomaclinically diagnosed to have dermatophytosis, 14 adult patients with adult T-cell leukemia / lymphoma clinically diagnosed to have no dermatophytosis, 12 age and sex matched patients clinically diagnosed to have dermatophytosis and 16 Age and sex matched apparently healthy Controls]. Sampleswere examined microscopically using 20% KOH and cultured on into SDA containing chloramphenicol [0.5%] with/without cycloheximide [0.5%] and Dermatophyte test medium [DTM]. in the non-ATLL patients with dermatophytosis, the serum IL-17 level was significantly increased compared with the healthy controls. In ATLL patients either with or without dermatophytosis, the IL-17 levels were significantly lower than those in the healthy controls. There was no significant difference in the IL-17 level between ATLL patients with dermatophytosis and those without dermatophytosis. Again, it is suggested that ATLL patients have low levels of IL-17, which cannot be enhanced by the presence of dermatophytosis. Among patients with ATLL with dermatophytosis [Group I] T. rubrum was the commonest dermatophyte causing infection; 64% of samples [tineacorporis 46%, tineaunguium 18%], whereas T. mentagrophytes was the 2[nd] commonest dermatophyte; 27% [tineaunguium 27%], lastly T. tonsurans; 9% [tineacorporis 9%]. In patients with Non-ATLL with dermatophytosis [Group III] T. rubrum was also the commonest dermatophyte causing infection; 64% of samples [tineacorporis 7%, tineaunguium 14%, tineapedis 43%], whereas T. mentagrophytes was the 2nd commonest dermatophyte; 29% [tineaunguium 7%, tineapedis 22%], lastly T. tonsurans; 7% [tineacorporis 7%]. Our data provides clinical evidence linking Th17 cells to immune deficiency in ATLL and opens a new avenue in the study of tumor immunotherapy based on promoting Th17 cell population

Evaluation of pan-dermatophyte nested PCR in diagnosis of onychomycosis in comparison with direct microscopy and culture

This work aimed to compare nested PCR using novel primers targeting the pan-dermatophyte-specific sequence of the chitin synthase 1 gene [CHS1] with KOH microscopy and culture isolation for diagnosis of clinically suspected onychomycosis. This study was conducted during the period from December, 2012 to October 2013. Forty patients attending Outpatient Dermatology and Andrology Clinic in Benha University Hospital. This study was done on forty patients 15 cases were female and the other 25 cases were males with abnormal nails. Their ages ranged from 22 to 77 years. As many as 19 patients were living in rural areas, while 21 patients came from urban areas. Nail scrapings were collected and examined using direct KOH microscopic examination, culture and PCR using double sets of primers. As regard direct microscopy by KOH examination; 33 [82.50%] cases were positive, while 7 [17.5%] were negative. Culture was positive only in 19[47.5%] of nail samples revealing different fungi. Dermatophytes were isolated from 15[37.5%] cases; most of them were T. mentagrophytes. And in 4 cases the only isolated non dermatophytic organism was Aspergillus Niger spp. [10.00%]. Nested PCR was positive in 26 [65.00%] nail samples. It is concluded that nested PCR targeting the CHS1 gene may be considered the gold standard for detection of dermatophytes in patients with onychomycosis and can aid the clinician in initiating prompt and appropriate antifungal therapy. PCR is a very powerful tool for microbiology and clinical mycology. It can detect very small amounts of nucleic acids. This technique may also play an important role in large-scale studies and in the management of problematic cases of onychopathies

Evaluation of serodiagnosis of tuberculosis in comparison with traditional methods

Tuberculosis is an enormous tool of morbidity and mortality. The vast majority of tuberculosis patients live in developing countries, where the diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories [range 20% to 80%]

Thus, the development of rapid and accurate new diagnostic tools is imperative. Immune-based tests are potentially suitable for use in low-income countries as some test formats can be performed at the point of care .In the present study, the diagnostic value of 16-kDa and 38- kDa mycobacterial antigens was investigated in patients who were diagnosed as open pulmonary tuberculosis. The humoral immune response was analysed in a group of 60 TB patients, and in control group consisting of 15 healthy volunteers and 15 subjects with pulmonary diseases other than TB. The sensitivity, speciflty, positive predictive value and negative predictive value of the test were determined at 45%, 93.3%, 93.1% and 45.9%, respectively. In conclusion, the ELISA test has a very good speciflty and an acceptable sensitivity and positive predictive value. It is thought that it could be used in combination with other methods to increase diagnostic accuracy, especially for culture-negative tuberculosis cases, which are difficult to diagnose