Immune mechanisms in type-2 diabetic retinopathy

To enumerate CD4+CD25+ Treg cells and determine serum IL-6 and IL-17 in type 2 diabetes mellitus patients with retinopathy. The case-control study was conducted at the Department of Immunology, University of Health Sciences, Lahore, from November 2009 to January 2012 and comprised diabetic patients and healthy controls who were divided into three groups. Group 1 had controls, while Group 2 had diabetic patients without retinopathy and Group 3 had diabetic patients with retinopathy. Flowcytometre and enzyme-linked immunosorbent assay were used for CD4+CD25+ Tregs and serum IL-6 and IL-17 respectively. SPSS 20 was used for statistical analysis. Of the 212 subjects in the study, 30[14%] were Group 1, 30[14%] in Group 2 and 152[72%] in Group 3. There were 25[83%] women in Group 2 and 101[66%] in Group 3 compared to 9[30%] in Group 1. Higher mean age was in Group 3 [50.88 +/- 8.9 years] and Group 2 [49.46 +/- 9.94 years] compared to Group 1 [34.66 +/- 8.78 years] while longer mean disease duration was in Group 3 [10.51 +/- 5.24 years] than Group 2 [7.76 +/- 4.14 years]. Highest median ratio of IL-6 was in Group 1 [1468.62] [Q1-Q3: 1229.9-1543.35], followed by Group 2 [1455.32] [Q1-Q3:1214.22-158.9] and Group 3 [469.84] [Q1-Q3: 206.53-1231.33] whereas IL-17 was the highest in Group 1 [339.38] [Q1-Q3: 159.89-1174.93], followed by Group 3 [216.60] [Q1-Q3: 141.87-410.25] and Group 2 [174.17] [Q1-Q3: 138.77-458.17]. Higher percentage of Tregs was in Group 2 [3.07 +/- 0.43] followed by Group 1 [2.91 +/- 0.04] and Group 3 [2.88 +/- 0.38]. Significant difference was observed in gender, age, disease duration, level of IL-6 and IL-17 [p<0.05 each], while no difference was found in glycated haemoglobin, CD4+CD25+ and Tregs [p>0.05 each]. Age, gender and duration of diabetes contributed to diabetic retinopathy, while CD4+CD25+ T cells and Treg cells did not. Serum IL-6 and IL-17 were inversely associated with diabetic retinopathy

Enumeration of CD4+CD25+ T regulatory cells in Type-II diabetes retinopathy

Diabetes mellitus [DM] is a health concern because it leads to complications such as retinopathy. Pakistan has 6.9 million DM affected people that will be doubled by 2025

A study was designed to enumerate CD4+CD25+Treg cells in Pakistani type 2 diabetes mellitus [T2DM] patients. It was a cross-sectional case-control study that included 212 objects

The subjects having diabetic retinopathy were labeled as Group-I [30 healthy volunteers without diabetes], Group-II [30 T2DM patients without retinopathy] and Group-Ill [152 T2DM patients with retinopathy]

The percentage of CD4[+]CD25[+] Treg cells was determined by Flowcytometry

Comparison of CD4[+]CD25[+]T cells among different groups was not significant and higher percentage of Treg cells was observed in Group-II [3.07%] compared to Group-Ill [2.88%]

Age, gender and duration of diabetes may contribute while percentage of CD4[+]CD25[+]T cells and Treg cells were not associated with the development of DR in T2DM

Quantification of serum IgA of coeliac disease patients

Celiac disease [CD] is a gluten - induced multi - organ disorder where small intestine is the primary target of inflammation. Onset of CD may occur at any age and its symptoms vary among individuals. Definitive diagnosis of CD is by intestinal biopsy but determination of anti - IgA tissue transglutaminase [tTG] and anti-gliadin antibodies has become key factors to decide for tissue biopsy. IgA - deficient CD patients may yield false - negative results, therefore total serum IgA level must be determined along with other serological markers to diagnose CD. The study included 42 CD patients who were positive for anti-tTg antibodies [Group A] and 40 subjects [Group B: disease control] presented with gastrointestinal complaints but were negative for anti-tTG antibodies. On the basis of age, Group A was further divided into: Sub-group- I comprised of patients between 1-6 years [n = 31] and Sub-group - II consisted of patients between 7-15 years [n=11]. Level of serum IgA was determined by nephlometry technique. Total serum IgA level was 38.77 +/- 31.21 mg/dl and 26.88 +/- 28.27 mg/ dl in CD patients and disease control group respectively and the difference in the level of serum IgA between these groups was not statistically significant [p=0.75]. Mean IgA level in sub-group -I and sub-group- II was 40.85 +/- 33.29 mg/dl and 32.92 +/- 24.85 mg/dl respectively and the difference in the level of serum IgA between these sub-groups was not statistically significant [p = 0.47]. In Group - A, mean level of IgA in males and females was 42.38 +/- 38.02 mg/dl and 34.41 +/- 20.36 mg/dl respectively and the difference in the level of IgA level was not statistically significant between these groups [p = 0.41]. Selective IgA deficiency [SIgAD] was found in CD and in patients of other gastrointestinal complaints. In order to detect CD in SIgAD, total serum IgA level should also be performed with IgG - antigliadin or IgG-anti-tTG antibodies

Level of interferon gamma in the blood of tuberculosis patients

Interferon gamma [IFN- gamma], a cytokine produced by a variety of cells is involved in the immune response against M. tuberculosis. It activates the production of other cytokines and molecules that kill mycobacterium. IFN- gamma also has diagnostic role in identification of active and latent tuberculosis. To determine the level of IFN- gamma in the blood of TB patients. Ninety-one subjects were selected, including 54 active TB patients and 37 healthy controls. Among 54 TB patients, 27 had confirmed TB and 27 were clinically diagnosed as having TB. IFN- gamma concentration was determined in their blood by an ELISA technique. In TB patients, Mean +/- SD of IFN- gamma was 48.69 +/- 28.78 pg/ml while it was 12.99 +/- 5.70pg/ml in the control group [p <0.001]. Significant differences in the level of IFN- gamma were observed among confirmed TB patients, clinically diagnosed TB patients and the control group [Mean +/- SD 59.68 +/- 28.78, 36.85 +/- 24.76 and 12.99 +/- 5.70 pg/ml, respectively]. Furthermore, a significant negative correlation was observed between the concentration of IFN- gamma in TB patients and the duration of anti-tuberculosis therapy. IFN- gamma level was high in both clinically diagnosed and confirmed TB patients as compared to a control group. Measurement of IFN- gamma production is helpful to diagnose active tuberculosis, but further research is required

Frequency of antineurtophil cytoplasmic antibody in glomerulonephritis

Aim of the study was to determine the frequency of antineutrophil cytoplasmic antibody [ANCA] [p-ANCA and c-ANCA] in clinically diagnosed glomerulonephritis. Autoimmune diseases including systemic vasculitis, affect a large number of people ill whom the leading cause of morbidity and mortality is glomerulonephritis that is often associated with chronic kidney disease. There are many risk factors for kidney diseases such as chronic inflammation, auto-immune diseases, immunosuppressive therapy, etc. Early phases of renal injury in autoimmune patients are clinically silent. For the detection of nephron damage, histopathological examination is gold standard but detection of antineutrophil cytoplasmic antibody [ANCA] can be used to find out early nephron damage. Design was analytical Cross-sectional. The study was conducted at the Department of Immunology, University of Health Sciences, Lahore in a period of November 2008 to October 2009. Study included 64 clinically diagnosed of glomerulonephritis. Levels of ANCA [MPO and PR3] were determined by ELISA technique. Out of which four [6.25%] patients showed positive reaction to myeloperoxidase [MPO] antigen while1 [1.56%] patient was positive for proteinase-3 [PR3] antigen. In 40-60 years of patients, sero-positivity for MPO and PR3 was 14% and 3.6% respectively, p-value for MPO and PR3 was <0.05 and >0.05 respectively. We concluded that glomerulonephritis is better related with MPO-ANCA than PR3-ANCA. The difference in the levels of MPO-ANCA in different age groups was significant but it was non-significant among different genders. Difference in the levels of PR3-ANCA was not significant for both age and gender