Th17 and tregulatory cells in type2 diabetic nephropathy

Type 2 diabetes mellitus and diabetic nephrophathy considered to be an inflammatory process in which immune cells involved in its development and progression apart from traditional metabolic and hemodynamic risk factors. This study was designed to determine the balance between T helper 17 and regulatory T cells in Type 2 diabetic patients having diabetic nephropathy in relation to type 2 diabetic patients without renal involvement and healthy individuals. This study included 3 groups; diabetic2 nephrophathy patients [on basis of proteinuria and reduced GFR], diabetic patients [ADA, 2015] and healthy controls of the same age and sex Detection of T regs and Th 17 cell were evaluated; T regs expressing CD4 and CD 25 while Th 17 cells expressing CD4 and CD161 was done by standard 2-color flow cytometry and Th17/Treg cells ratio was calculated. The results revealed that there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic nephropathy patients compared to other two groups. There was lower mean Treg cells among type 2 diabetic nephropathy patients compared to other two groups with very high statistically significant differences. Also, there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic patients compared to healthy individuals with very statistically significant differences that there was a strong positive correlation between BUN, serum creatinine, proteinuria and the grade of nephrropathic affection by the ultrasound from one side and Th17 and Th17/T reg cells ratio on the other side. But this correlation was strongly negative with T reg cells

Protective Role of Purified Cysteine Proteinases against Fasciola gigantica Infection in Experimental Animals

Fascioliasis is one of the public health problems in the world. Cysteine proteinases (CP) released by Fasciola gigantica play a key role in parasite feeding, migration through host tissues, and in immune evasion. There has been some evidence from several parasite systems that proteinases might have potential as protective antigens against parasitic infections. Cysteine proteinases were purified and tested in vaccine trials of sheep infected with the liver fluke. Multiple doses (2 mg of CP in Freund's adjuvant followed by 3 booster doses 1 mg each at 4 week intervals) were injected intramuscularly into sheep 1 week prior to infect orally with 300 F. gigantica metacercariae. All the sheep were humanely slaughtered 12 weeks after the first immunization. Changes in the worm burden, ova count, and humoral and cellular responses were evaluated. Significant reduction was observed in the worm burden (56.9%), bile egg count (70.7%), and fecel egg count (75.2%). Immunization with CP was also found to be associated with increases of total IgG, IgG1, and IgG2 (P<0.05). Data showed that the serum cytokine levels of pro-inflammatory cytokines, IL-12, IFN-gamma, and TNF-alpha, revealed significant decreases (P<0.05). However, the anti-inflammatory cytokine levels, IL-10, TGF-beta, and IL-6, showed significant increases (P<0.05). In conclusion, it has been found that CP released by F. gigantica are highly important candidates for a vaccine antigen because of their role in the fluke biology and host-parasite relationships.

cross sectional study of hepatitis B, C, some trace elements, heavy metals, aflatoxin B1 and schistosomiasis in a rural population, Egypt

Chronic liver diseases are disastrous to health. Many factors are associated with their prevalence, hence endemicity. These are mainly infectious, parasitic and toxic. A survey was conducted in a village south to Cairo. Large industries concerned with iron and steel industry, metals smelting, cement manufacturing and electric station were located north to the village. A systematic random sample of houses was selected. All individuals inside the houses were invited to share in the study. Sample size was 84 individuals. Hepatitis markers were done [HBsAg and anti-HCV antibodies]. The levels of some heavy metals were assessed; which were lead, mercury, arsenic, aluminum, manganese, nickel, chromium and cadmium. Levels of some trace elements were assessed. These were copper, iron, selenium and zinc. Aflatoxin B1 was assessed in serum. Assessment of schistosomal circulating antigen and antibodies was carried out. Abdominal ultrasonograghy was done to assess liver condition. Univariate logistic regression analysis was done to assess the association between studied variables and HBsAg or anti-HCV sero-positive subjects. The association between studied variables and bilharzial or fatty liver, diagnosed by ultrasonography, were also assessed. The univariate logistic regression analysis revealed odds ratios at the following results. For HBsAg sero positive subjects, aflatoxin B1, lead, chromium and schistosomal antigen and antibodies were higher than negative ones where odds ratios were; 6.2, 1.6, 1.6, 1.6 and 1.7, respectively. None of the variables showed statistically significant difference. For anti-HCV antibodies sero-positive subjects, aflatoxin Bi and chromium had the highest odds ratios among the studied variables, [odds ratios were 2.5 and 2.4, respectively]. Bilharzial liver showed higher significant positivity of anti-HCV antibodies and insignificant decreased level of zinc than negative ones [odds ratios were 7.2 and 4.5, respectively]. Fatty liver cases showed higher statistically significant positivity of anti-HCV antibodies and chromium than negative ones. Odds ratios were 8.0 and 7.1, respectively. Statistically significant lower level of aflatoxin B1 was shown in fatty liver than normal liver subjects. Multivariate logistic regression analysis for fatty liver showed that only anti-HCV antibodies sero-positivity had statistically significant odds ratio in comparison to chromium level and aflatoxin B1. It is concluded that some heavy metals, and Aflatoxin B1 had a definite association with liver diseases in the area under study. Having anti-HCV antibodies had a relation with fatty liver and with bilharzial liver more than having HBsAg. It is recommended that environmental management to factories nearby the village is urgently needed to decrease exposure to heavy metals. Prevention of hepatitis infection and aflatoxin exposure through different means is also recommended, other wise health care authorities would be confronted with unusual cases of HCC in the nearby future

Autoimmune pancreatic beta-cell dysfunction in Egyptian patients with chronic hepatitis C infection

We aimed to assess autoimmune pancreatic beta-cell dysfunction in Egyptian patients with chronic hepatitis C infection and to evaluate the impact of IFN-alpha therapy on the induction of pancreatic autoantibodies or insulin dependent diabetes mellitus [IDDM] in these patients. Diagnosis of chronic non cirrhotic hepatitis C in 108 patients was based on full clinical examination, liver function tests, hepatitis markers and liver biopsy. The HCV RNA was quantitatively assessed and the histopathological grading of the disease was based on the Ishak modified histological activity index [HAI]. Assessment of autoimmune pancreatic beta-cell dysfunction in patients with chronic hepatitis C before at the end of INF-alpha therapy and 6 months after its cessation was carried out by determination of serum levels of insulin autoantibodies [IAA] and islet cell autoantibodies [ICA]. Data demonstrate a statistically significant increase [p < 0.05] in positive serum IAA titers in patients with chronic hepatitis C both at the end of IFN-alpha therapy and 6 months after its cessation compared to titers before therapy [10% and 9%, respectively, vs. 4% of the cases]. IDDM and ICA, however, did not develop in these patients during IFN-alpha therapy. These findings suggest that IN-alpha therapy may be implicated in IAA induction in patients with chronic hepatitis C. and the phenomenon was not reversible 6 months after cessation of treatment. Whereas, the development of positive serum IAA titers in patients with chronic hepatitis C correlated significantly [p <0.001] with the presence of positive family history of DM in these patients, it did not correlate [p > 0.05] with sex, liver function test, viral load, HAI score or response to IFN-alpha therapy. We concluded that IFN-alpha therapy increase the susceptibility of patients with non cirrhotic chronic hepatitis C to develop positive IAA titers probably by provoking autoimmune disorders in these patients without induction of ICA or IDDM. Data also suggest that the increase in incidence of positive IAA titers may be used as a sensitive factor for the development of manifest IDDM in such patients