The role of autophagy-related gene 9B in lichen planus

Background: Lichen planus (LP) is an idiopathic, chronic, relapsing, inflammatory, autoimmune dermatological disease. The etiopathogenesis of LP is still unclear. Autophagy is a strictly regulated lysosomal degradation pathway that is crucial for maintaining intracellular homeostasis and normal development. The dysregulation of autophagy-associated genes was recognized to increase the susceptibility to multiple diseases, including inflammation, autoimmune disorders and cancer. Aims: Our study aimed to detect the expression of autophagy-related gene 9 b (ATG9B) in LP patients compared to normal control persons to investigate the possible role of autophagy in pathogenesis of this disease. Methods: This case–control study included 30 LP patients and 30 age-, gender-matched healthy controls. Four millimeters punch skin biopsies were obtained from LP lesions and from the controls and they were kept in lysis solution for the stability of the studied parameters and were kept frozen at –80°C till analysis of ATG9B using real-time polymerase chain reaction. Results: The level of ATG9B in lesional skin of LP was significantly decreased compared to normal control persons (P < 0.01); also, there was a non-significant relation between ATG9B level and age, sex, duration and family history among LP patients. Limitations: Limited number of patients included in our study (30 patients). Conclusion: Autophagy may play a role in the pathogenesis of cutaneous LP.

Evaluation of Glucosamine Effect Against Heart and Brain Damage Induced by Y-radiation or Aluminium Chloride in Female Rats

Abstract Glucosamine is known as anti-inflammatory, antioxidant and as neuroprotective as well as using to treat many of diseases. This work aimed to investigate the remedial effect of glucosamine (20mg/kg b.wt) against the damage induced by a single dose of γ-radiation (8Gy) or aluminium chloride (AlCl3) (100mg/kg b.wt) in the heart and brain tissues of female rats. Serum aspartate aminotransferase (AST), cholesterol, triglycerides (TGs), LDH and creatine kinase (CPK) were measured. Moreover, gene expression of amyloid protein precursor (APP) and seladin-1 were estimated in the brain tissue. Also, acetylcholinesterase activity (AChE) and p-tau protein expression were estimated in brain homogenate. Metallothioneine (MT) was estimated in the heart and brain tissues. Heart and brain histopathological examination was performed. Irradiation significantly decreased serum AST, CPK and LDH, as well as MT levels in heart and brain tissues. Also, gene expression of seladin-1 decreased. On the other hand, irradiation significantly increased serum TGs level and brain AchE activity, tau protein, and β-amyloid percursor (APP). AlCl3 administration (21 days) induced disturbance in most of the estimated parameters, especially AST, TGs, and MT. Glucosamine treatment with irradiation or AlCl3 improved most of the measured parameters. In addition, histopathological examination confirmed the biochemical results. In conclusion: Glucosamine could be used to improve the heart and brain damages induced by γ-radiation exposure or AlCl3.

Bone Marrow Mesenchymal Stem Cells Regulate Coagulation and Inflammation Together in Methotrexate Induced Lung Injury Rat Model

Abstract Clinical research has shed the light on the relation between coagulation and inflammation. Coagulation cascade is activated in lung injury resulting in thrombotic and fibrotic lesions. Such a cascade is initiated by inflammation, then the two systems intense each other. New therapies that modulate coagulation and inflammation will be more successful than therapies targeting only one of them. Mesenchymal stem cells showed anti-inflammatory functions in animal models. The role of mesenchymal stem cells in methotrexate induced lung injury model was evaluated, but no studies scoped on the role of stem cells in coagulation associated with inflammation in such models. This study focuses on the therapeutic role of mesenchymal stem cells against the development of clotting in methotrexate induced lung injury rat model. Results showed that mesenchymal stem cells treatment for 4 weeks caused a decrease in lung activated coagulation factors; protease activated receptor-1, fibrinogen, plasminogen activator inhibitor-1 and platelet count with a decrease in inflammatory factors; tumor necrosis factor-α, interferon- γ, interleukin-8, monocyte chemoattractant protein-1 and total leukocyte count. Thus, mesenchymal stem cells have anti-inflammatory potency against clotting risk in methotrexate induced lung injury model. This opens the outlook for stem cells as a new therapy that moderates coagulation associated with inflammation.

Role of Vitamin D and Metformine on Pancreatic Tissue in an Experimental Model of Type II Diabetes Mellitus

Background: The study was done to evaluate the role of Vitamin D (Vit D) in an experimental model of type II DM and compare its effects with oral hypoglycemic drugs (Metformine). Methods: 30 male rats were divided; control group, Diabetic group via administration of high fat diet then injection of streptozotocin . Diabetic rats were then divided into Diabetic group, Diabetic + Metformine group(n=6), Diabetic +Vit D (n=6), Diabetic + Metformine +Vit D (n=6). Fasting glucose, insulin, HOMA IR, Cholesterol, Triglycerides, C-Reactive protein (CRP), Glucagon like peptide (GLP1), Cyclooxygenase 2 (COX2) and Superoxide dismutase (SOD) were measured, Real time PCR for pancreatic expression levels of Caspase 3, IKKβ and Western plot of Pancreatic protein kinase beta (Akt) and INGAP (islet neogensis associated protein), and histopathological, immunohistochemical for pancreatic tissue. Results: Increased glucose, fasting insulin, HOMA IR , cholesterol, triglycerides, CRP, COX2 and expression of levels of Caspase 3 and  IK Kinase B and Akt in diabetic group in comparison to control. On the other hand, significant decreased levels of GLP1, SOD and INGAP in diabetic in comparison to control. On treatment with metformine or Vitamin D improved all parameters. In combined metformine and vitamin D therapy there was much improvement with no significant change from control. Conclusions: Vitamin D and metformine improved inflammatory, oxidative stress, apoptotic conditions in an experimental model of type II DM and combined therapy causes more improvement, so it is better to give combined therapy.

Retraction: Adipose Stem Cells as Alternatives for Bone Marrow Mesenchymal Stem Cells in Oral Ulcer Healing

This article has been retracted at the authors' request.

Adipose Stem Cells as Alternatives for Bone Marrow Mesenchymal Stem Cells in Oral Ulcer Healing

BACKGROUND AND OBJECTIVES: Adipose tissue is now recognized as an accessible, abundant, and reliable site for the isolation of adult stem cells suitable for tissue engineering and regenerative medicine applications. METHODS AND RESULTS: Oral ulcers were induced by topical application of formocresol in the oral cavity of dogs. Transplantation of undifferentiated GFP-labeled Autologous Bone Marrow Stem Cell (BMSCs), Adipose Derived Stem Cell (ADSCs) or vehicle (saline) was injected around the ulcer in each group. The healing process of the ulcer was monitored clinically and histopathologically. Gene expression of vascular endothelial growth factor (VEGF) was detected in MSCs by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Expression of VEGF and collagen genes was detected in biopsies from all ulcers. Results: MSCs expressed mRNA for VEGF MSCs transplantation significantly accelerated oral ulcer healing compared with controls. There was increased expression of both collagen and VEGF genes in MSCs-treated ulcers compared to controls. CONCLUSIONS: MSCs transplantation may help to accelerate oral ulcer healing, possibly through the induction of angiogenesis by VEGF together with increased intracellular matrix formation as detected by increased collagen gene expression. This body of work has provided evidence supporting clinical applications of adipose-derived cells in safety and efficacy trials as an alternative for bone marrow mesenchymal stem cells in oral ulcer healing.

Evaluation of fibrosis sero-markers versus liver biopsy in Egyptian patients with hepatitis C and/or NASH and/or schistosomiasis

Although liver biopsy is acknowledged as the gold standard for evaluating fibrosis, it is occasionally prone to sampling error and complications. Is to correlate an index of biochemical markers with histological features of fibrosis in patients with chronic hepatitis C virus [HCV] and/or non alcoholic steatohepatitis [NASH] with or without schistosomiasis in order to reduce the use of liver biopsy. Fifty-six patients [n-56] attending tropical medicine clinics in Kasr El-Aini and Beni Suef Faculty of Medicine were enrolled and classified into 3 groups according to the histopathological findings of their liver biopsy. Stool and urine analysis were done to exclude passage of Schistosoma ova, in addition to liver biopsy, abdominal ultrasonography, and testing of their sera for fibrosis biomarkers [Apolipoprotein Al, Haptoglobin, Alpha-2-Macroglobulin, and Ganima-glutamyl transpeptidase [GGT]]. Patients with history of contact with canal water [35 patients] were screened for Schistosoma mansoni infection by detecting anti-Schistosoma IgG antibodies and circulating Schistosoma soluble egg antigen using indirect ELISA and sandwich ELISA techniques, respectively. Forty-three [43%] of group I [HCV] and 40% of group II [HCV and NASH] had advanced fibrosis [F3 and F4]. Out of the 35 patients with positive history of canal water contact 25 [71.4%] were antibody positive; Schistosoma antigen was detected in only 5 patients [14.3%], with no statistically significant differences in the level of fibrosis seromarkers from other patients. Alpha-2-macroglobulin was found to be a reliable predictor of fibrosis. Haptoglobin was negatively related to the degree of hepatic fibrosis in groups I and II and significantly directly correlated in group III [NASH]. By regression analysis, haptoglobin can be a good predictor for fibrosis in group Ill. Apolipoprotein Al had insignificant negative correlation to the stage of fibrosis in groups I and II. GGT was positively correlated to the degree of hepatic fibrosis in groups I, II and III. AST/platelet ratio index [APRI] proved significantly directly correlated with fibrosis stage and grade of inflammation of the studied patients. Co-infection with schistosomiasis in patients with HCV and/or NASH gave no statistically significant differenceinfibrosis staging in all groups.Alpha-2-macroglobulin, haptoglobin and apolipoprotein Al, besides APRI index and modified APRI index proved to be significant predictors of hepatic fibrosis

Non-invasive fibrosis seromarkers as a predictor of liver fibrosis in chronic hepatitis C and/or non-alcoholic steatohepatitis

In patients with chronic hepatitis C, the precise stage of hepatic fibrosis is the most important predictor of disease progression and it determines the need for antiviral therapy. Although liver biopsy is acknowledged as the gold standard for evaluating fibrosis, it is occasionally prone to sampling error and complications. We aimed to correlate an index of biochemical markers with histological features of fibrosis to predict hepatic fibrosis in patients with chronic hepatitis C virus, patients with combined hepatitis C virus and non-alcoholic steatohepatitis and those with non-alcoholic steatohepatitis, aiming to reduce the use of the liver biopsy. Out of those attending our out patient clinic for clinical, haematological, biochemical, virological, histological and ultrasonographic assessment prior to interferon therapy for hepatitis C virus, we enrolled 41 patients and grouped them according to histopathological examination of their liver biopsies into: Group I: 21 chronic hepatitis C virus patients as defined by positive 3rd generation ELISA; Group II: 20 patients with combined hepatitis C virus and NASH. We added a third group [Group III] of 15 patients having non alcoholic steatohepatitis as defined clinically, biochemically and through diagnostic percutanous liver biopsy. There were 33 male 23 female patients; 35 [62.5%] of them were from rural areas and 21 [37.5%] were from urban areas; the mean ages were 40.5 +/- 9, 46.6 +/- 7.7 and 42.13 +/- 11.06 in Group I, II and III respectively. Twenty apparently healthy individuals served as the control group. All the patients and the control group were submitted to full clinical history and examination, abdominal ultrasonography, CBC, liver biochemical profile and fibrosis biomarkers [apolipoprotein A1, haptoglobin, alpha2 marcoglobulin, GGT]. Liver biopsy was done for suitable patients after taking a consent and the results of fibrosis seromarkers were compared with the results of liver biopsy using the Metavir scoring system, We also estimated patients' body mass index, fasting and post prandial blood glucose. We excluded patients with other causes of chronic liver disease and co-morbidities that could confound the results of the non-invasive markers adopted, including schistosomiasis which was excluded by serological test. 43% of Group I and 40% of Group II had advanced fibrosis. None of Group III had advanced fibrosis; mild fibrosis was detected in 80% of them. gamma-GT was found positively correlated to the degree of hepatic fibrosis in Groups I, II and III [r = 0.667, 0.656 and 0.121, respectively] with P values of 0.001, 0.002, 0.668, respectively. alpha2 macroglobulin was found to be a reliable predictor of fibrosis [r = 0.30, P = 0.02] with ROC curve [area under the curve = 0.70] best cutoff value 2.55 g/L with sensitivity of 0.80 and specificity of 0.50. The results of haptoglobin were negatively related to the degree of hepatic fibrosis in Group I and II with ROC curve area under the curve of 0.33 and P value of 0.04. Significant direct correlation was seen in Group III [r = 0.55, P = 0.03], so by regression analysis, haptoglobin can be used as a good predictor for fibrosis in Group III [r = 0.54, P=0.04]. Apolipoprotein A1 has negative correlation to the stage of fibrosis in Groups I and II although the results were statistically insignificant. APRI index was found significantly directly correlated to the fibrosis stage and the grade of inflammation of all studied groups [r= 0.57, P< 0.01 and r = 0.36, P< 0.01, respectively] with a best cutoff value of 0.62, with sensitivity of 0.86 and specificity of 0.57. In patients with advanced fibrosis the best cutoff value was found to be 0.72 with sensitivity of 0.94 and specificity of 0.67. Mordified APRI test showed AUC of 0.79 [P<0.01] with a best cutoff value of 0.067 at which sensitivity and specificity were 0.82 and 0.61, respectively. Alpha macroglobulin, haptoglobin, apolipoprotein A1, APRI index and a modified APRI index, were found be significant predictors of hepatic fibrosis and were reprocessed by stepwise logistic regression

Community-acquired urinary tract infections in Tanta, Egypt: aetiology and antibiotic resistance pattern

Treatment of community acquired urinary tract infections [CA-UTIs] in Egypt is usually based on empirical drugs. So, this study was conducted to determine the most common causative organisms and their antibiotic susceptibility aiming at evaluation of empirical drugs used and its modification if necessary. Urine samples from 192 patients with CA-UTI were cultured on suitable media and its sensitivity to different antibiotics were tested where 136 out of them showed positive growth. Gram positive cocci isolated from 13.97% of cases whereas gram negative bacilli from 84.56% and candida was 1.47% . The commonest organisms isolated were Escherichia coli [61.76%] and Klebsiella species [12.5%] followed by Enterococcus [7.35%] and Staph. Aureus [6.61%]. The widest coverage against gram negative bacilli isolates was done by imipenem, [100%], followed by amikacin [90.4%], and Nitrofurantoin [66%]. On the other hand, the least effective antibiotic was Ampicillin/sulbactam [4.3%]. While the best sensitivity against gram positive cocci isolate was done by vancomycin [100%], followed by Nitrofurantoin [95%], Amoxicillin/ clavulanic acid and Ampicillin/sulbactam [60%]. There were also high percentages of multidrug resistant gram negative bacilli in the current work [58.26%] with 32.65% of them showed positive extended spectrum beta lactamase

In conclusion: the most common cause of our CA-UTI is gram negative bacilli. Because of alarming rate of resistance to cephalosporin, quinolones and SXT that threatens its use in our country, Nitrofurantoin and amikacin remains the choice among empirical antibiotics used in CA-UTI. Moreover, this study highlights the increasing problem of antimicrobial multidrug resistance; even in community which is alarming sign calls for judicious use of imipenem only for these severe resistant cases

Hepatology in Egypt 20 years ago - changing pattren of schistosomiasis in Egypt 1935-79

A village in the Nile delta surveyed for sci istosmiasis by J.A. Scott in 1935 was surveyed again in 1979. The same number of people as in the 1935 survey were randomly selected for investigation by the same parasitological techniques as those used by Scott. The prevalence of Schistosoma mansoni infection had increased from 3.2% to 73%, whereas S.haematobium infection, which had been very common in 1935 [74%], had almost disappeared [2.2%].in the local district hospital since 1972 the percentage of urine specimens found to contain S. haematobium ova has dropped from 30 to 9%, while the percentage of stool specimens containing S.mansoni ova has increased from 2 to 22%. In the local irrigation canals snail intermediate hosts for S.mansoni have outnumbered those for S.haematobium by a factor of 5-40 in the past 7 years. Changes in the proportions of snail vectors appear to be related to construction of the Aswan High Dam and to changes in the water - flow patterns of the Nile. The change in the relative frequencies of the two infections has important public - health implications, since the hepatosplenic schistosorniasis caused by S.mansoni is more difficult to treat and is associated with more morbidity and mortality than the urinary schistosmiasis caused by S.haematobium

Capillaria philippinensis: an emerging parasite causing severe diarrhoea in Egypt

This study included four cases with Capillaria philippinensis and four other cases of severe diarrhea caused by Capillaria philippinensis parasite. Also, a male and three female patients aged 12-45 years were presented with severe diarrhea of one to seven months duration associated with vomiting and central abdominal colics. Stools were yellowish or greenish and voluminous. Anorexia was profound with loss of weight. Bilateral painless ankle edema was developed early in the course of the disease and two cases had ascites and bilateral pleural effusion at presentation. There was hyponatremia, hypocalcemia and marked hypokalemia and hypoalbulinemia. Small bowel series showed a rapid transit time in three cases and mal-absorption pattern in one. Duodenal biopsies showed non-specific chronic inflammation, while jejunal biopsies from one case revealed grade II villous atrophy with moderate cellular infiltration of Lamina propria. The infection was diagnosed by finding the eggs, larvae and adult worms of C. philippinesis in stool. Patients were treated with mebendazole 400 mg/day in two divided doses for 28 days, in addition to high protein diet and correction of electrolyte disturbance. Vomiting stopped on the second day of treatment, appetite improved and diarrhea regressed by the fourth day. One case died two days after admission due to marked hypokalemia. Clinicopathological and epidemiological aspects of this infection in Egypt were discussed

Human fascioliasis: a field study in Tamya center Fayoum governorate

Seven hundred individuals were examined for fasciola eggs in the stools, 20 [3 percent] of them were found positive, these 20 patients were subjected to clinical examination. Seventeen of them completed the study for whom hematologic, ultrasonographic and serological tests were done. Praziquantel was used for their treatment. Abdominal pain, distension anemia and fever were the main symptoms. Hepatomegaly, splenomegaly and jaundice were observed in 40 percent, 25 percent and 10 percent respectively. Anemia and eosinophilia were the main hematological findings. Ultrasonography demonstrated fasciola worms in the gall bladder and C.B.D., and bile duct thickening and dilatation were observed. ELISA and CCIEP were positive in 82.4 percent and 76.5 percent respectively and when both tests were used, positive results were found in 94 percent. Praziquantel was found ineffective [95 percent failure]

Serum immunoglobulins and complement in patients suffering from amoebic liver abscess

Immunoglobulins IgG, IgM and IgA and complement C3 were studied in 24 patients suffering from amoebic liver abscesses [ALA] before and two months after therapy. The results were compared with those of 12 healthy controls. IgG and IgA showed significant higher level in ALA patients than the normal controls, P < 0.001 and P < 0.01 respectively. IgM level was also higher than the normal controls but the difference was insignificant. Follow up of these Igs showed marked drop two months after therapy. C3 level was found statistically higher in ALA before therapy than that of the normal controls and that of patients two months after therapy. Correlation between C3 level and the size of the abscess showed that its level was statistically higher in large abscesses P < 0.05

Circulating E histolytica antigens clear with successful treatment of amoebic liver abscess

An antigen capture ELISA was used to measure serum E. histolytica antigen and antibody levels in 23 patients with amebic liver abscess [ALA], 15 patients with intestinal amebic infections [IAI], and 20 normal controls. 16 of the 23 [70%] with ALA had antigenemia. None of those with IAI or the normal controls had E. histolytica antigen titers of greater than 1: 4. All 23 of the patients with ALA had positive antibody titers. Three [20%] with IAI and none of the normal controls had E. histolytica antibody titers greater than 1: 100. Antigenemia cleared in all but one of the 23 patients within two months of initiating successful chemotherapy. Antibody titers were much slower to diminish. Measuring E. histolytica antigens in the sera of patients with ALA by increasing the diagnostic specificity may have some diagnostic advantage over measuring only the antibody levels. In addition, serial measurements of antigenemia are useful in monitoring result following chemotherapy

Prevalence of hepatitis B virus in patients suffering from primary hepatocellular carcinoma

Twenty seven patients suffering from PHCC were studied for AFP level and HBsAg and anti-HBs. The overall exposure rate of HBV was found to be 66% using ELISA, 85% of the patients showed AFP level range from 500-5000 ng/ml. with a mean of 3995 ng/ml

Prevalence of giardia lamblia in Egyptian children suffering from diarrhea

One hundred children suffering from diarrhoea and 40 nondiarrhoeal cases were the subject of this study. Stool examination revealed a significantly higher prevalence rate of Giardia lamblia in the diarrhoeal patients [33%] compared to the nondiarrhoeal control group [5%], P < 0.01. Abdominal pain, chronic diarrhoea and anorexia were the most common presentations of positive cases