Detection of local antibody response in urine as a tool for diagnosis of urinary tract infection

Identifying urinary tract infection [UTI] is based mainly on culture of uropathogens which may take at least 3 days before a final report is issued. We tried to study the possibility of identifying UTI by the detection of local antibodies [IgG and IgA] in urine. A total number of 69 patients complaining of dysuria, frequency, loin pain and or suprapubic pain were examined urologically and midstream urine sample was collected from each patient. The urine samples were examined microscopically for pus cells, RBCs and crystals. They were also cultured quantitatively and assayed for local IgG and IgA antibodies in urine to common urinary pathogens. The 69 patients had significant pyuria, 50 patients showed positive urine culture E. coli [27], Klebsiella [13], Staphylococcus saprophiticus [8] and Proteus 2 patients. From the 50 patients 48 had positive local specific urinary antibodies and 2 were negative for the local urinary antibodies. The 19 patients with negative urine culture 15 had positive local urinary antibodies. The control group 13 subjects had no pus in urine, negative culture and negative local antibodies. Two subjects had. no pus, positive culture [E. coli] and positive local antibodies. In conclusion the local specific IgG and IgA to common uropathogens could help in the primary identification of UTI and thus the clinical doctor can initiate a blind antibiotic treatment, till culture and sensitivity results are obtained. Since it is possible to identify UTI with the positive results of the local antibodies in urine of symptomatizing patients with significant pyuria. Also it could help in screening asymptomatic bacteruria

Tumour necrosis factor production in patients with carcinoma of the bladder associated with bilharziasis

Tumour necrosis factor [TNF] is produced by activated macrophages in response to the presence of a malignant tumour. In this study we evaluated the level of TNF in patients bearing carcinoma of the bladder with bilharziasis in comparison either to similar patients who underwent surgical procedures or even normal individuals. Twenty three patients eight of whome were bearing cancer bladder associated with bilharziasis. The remaining fifteen patients had a surgical intervention for removal of their cancer bladder. They underwent either total cystectomy with urine diversion [11 cases] or transurethral resection with or without intravesical therapy [4 cases]. The TNF level in the urine and serum of the 23 patients was assayed. The TNF level in urine and serum of 11 normal individuals [control] was also measured. The mean value of TNF level in the urine and serum of patients who underwent different surgical procedures [10.78 pg/ml. and 16. 2pg/ml] was higher when compared to the normal control [4.68 pg/ml and 12.77 pg/ml]. Also the mean value of the TNF level in the urine of the same group of patients was higher than the group of patients who had cancer bladder associated with bilharziasis before treatment [6.814 pg/ml]. Yet, there was a slight decrease in the mean value of the TNF level in the serum of the postoperative group when compared to the preoperative [17.375 pg/ml] although it was statistically insignificant. At the same time it was found that patients with carcinoma of the bladder associated with bilharziasis had a significantly higher TNF level in serum and urine [P<0.01 and P<0.05] when compared to normal individuals. Our conclusion was that TNF level assay in the urine and serum of patients bearing cancer bladder associated with bilhariziasis after being surgically treated is of an insignificant value since there are many factors to interplay [metabolic, metastasize, recurrence intravesical therapy. Also it is possible to take the TNF level whether in urine or serum of patients having cancer bladder associated with bilharziasis before treatment as an indication to the existance of the malignant tumour

Tumour necrosis factor alpha in stools as a marker in colonic diseases

This study was conducted on 40 patients with different inflammatory bowel diseases depending on the clinical examination, colonoscopic findings and histopthological reports. We aimed at measuring local stool TNF alpha and serum CRP in an attempt to explore their usefulness in assessing inflammatory bowel diseases. The patients were 10 colonic schistosomal patients [CS], 10 active ulcerative colitis [AUC], 10 cancer colon [CC], 5 irritable bowel syndrome [IBS], 3 inactive ulcerative colitis [lUC] and 2 with colonic diverticulosis [DV]. It was found that serum CRP in the different groups of patients were insignificantly different either from the control group or the IBS group. The TNF alpha level in the stool of patients with schistosomal polyposis, AUC and CC were significantly higher than the control group [P< 0.001]. From this data we concluded that serum CRP is of little value in the evaluation of inflammatory bowel diseases, while local TNF alpha may monitor disease activity and even low values exclude active inflammatory bowel diseases, cancer colon and polyposis of any aetiology

level of Interleukin 6 in septic and aseptic meningitis

In this study the level of interleukin-6 [IL[6]] was evaluated in cerebrospinal fluid [CSF] and serum of septic [n=14] and aseptic meningitis [n=16] patients, in addition to its evaluation in 10 controls. CSF IL6 was elevated in 85.7% of patients with septic meningitis [SM] [mean 1471. 4 pg/ml] and in 43.7% of aseptic meningitis [AM] patients [mean 192.8 pg/ml], the difference in between was significant [P< 0. 0001]. Elevation of serum IL[6] was found in 28. 6% of the SM group [means 192.8 pg/ml] and none of the AM group [mean 122.5]. CRP was elevated in CSF and serum of SM and Am groups. Positive correlation was found between IL[6] and CRP in CSF and serum but not with other inflammatory parameters. It is concluded that marked elevation of IL[6] in patients with meningitis suggest a septic aetiology. It is also claimed that IL[6] plays a role in aseptic meningitis which is believed to be dependant on the causative agent

Immune response to Helicobacter pylori infection in endemic hepatosplenomegaly patients

Patients with endemic hepatosplenomegaly and evidence of portal hypertension have gastritis as a common finding. while H. pylori is accused to be an aetiological agent of gastritis and peptic ulcer. Three groups of patients. The first 23 had endemic hepatosplenomegaly and evidence of portal hypertension, the second 22 patients had endemic hepatosplenomegaly only, while the last 21 patients were suffering from gastrointestinal disturbances. The percentage of isolation of H. pylori in the three groups ranged between 47. 8% and 59% while the percentage of identification ranged between 82. 6% and 90.0.The protein concentration of the H. pylori antigen in a whole cell sonicate of 10 strains was determined, and the protein profile of the antigen preparation was examined using SDS-page. The values of absorbances of the Ig[G] and Ig[A] in the sera of the patients were determined using an in house prepared and a commercially purchased ELIZA test. When comparing between the mean values of absorbances [Ig[G] and Ig[A]] of the three groups of patients it was found that the first group of patients had their mean value of absorbance significantly higher than patients of group two and three. The Ig[M] mean values of absorbances did not show any statisticaly significant difference between the three groups of patients. Seven patients received a course of triple therapy for two weeks, five patients showed a decline in their antibody levels [Ig[G] and Ig[A]] six weeks post treatment, while two patients had their antibody levels unchanged. It was concluded that hepatosplenomegalic patients with portal hypertension suffer a heavier bacterial innoculum, and long term treatment in an attempt to erradicate H. pylori would improve the accompanied gastritis and avoid the expected sequalae

correlation of antibody coated bacteria test with various methods of bacterial culture in children with bilharziasis

Urine samples from 35 children with urinary schistosomiasis and symptoms of urinary tract infection[UTI] were studied by urine culture on various aerobic media and reduced anaerobic media and reduced anaerobic media, the antibody coated bacteria [ACB] test was done simultaneously.All 35 children with positive ACB test showed anaerobic growth.The use of ACB for rapid diagnosis of UTI especially when urine culture on conventional media showed no growth was advocated

Quantitative evaluation of bacterial colonic flora in bilharzial patients

From quantitative evaluation of the aerobic colonic flora of 45 patients suffering from advanced and moderate hepatosplenomegaly with or without polyposis were compared with 20 normal subjects. The count revealed a significant difference between the total aerobic bacteria and the total coliforms [p=/<0.001] in the number of faecal specimens examined