Correlation between Neutrophil Gelatinase-Associated Lipocalin and Endoscopic, Histopathologic and Clinical Activities of Ulcerative Colitis

Introduction:Detection of activity of ulcerative colitis (UC) is vital for predicting treatment outcome. The assessment depends on clinical, serologic, and endoscopic findings. One of the noninvasive biomarkers for disease activity detection is serum Neutrophil Gelatinase-Associated Lipocalin (NGAL). Aim:To assess the relationship between NGAL and endoscopic, histopathologic and clinical activity of UC.Methods:This study wasconducted on 50 cases with definitive diagnosis of UC and 15 cases with normal colonoscopyexamination as controls.UC cases were considered active if Geobes score was ≥3.1.Complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and liver and kidney function tests were done.Serum NGAL was estimated using ELISA technique. Results:UC caseswere classified into active group (n = 36) and inactive group (n = 14). In active UC cases, median value (IQR) of serum NGAL was significantly increased(101.15 (67.53 –156.40) ng/mL) compared to inactive cases (63.35 (60.98–65.20)ng/mL) and control group (24.80 (15.50 –31.50)ng/mL).Serum NGAL was well correlated with Geobes score, Mayo score, CRP and ESR.Serum NGAL at cut-off ≥ 63 can predict activity with sensitivity88.89%, specificity 85.71%, PPV 94.12% and NPV 75%.Conclusion:Serum NGAL is valuable noninvasive marker for assessment of UC disease activity

Occult hepatitis C virus infection in haemodialysis unit: a single-center experience

Detection of hepatitis C virus RNA in peripheral blood mononuclear cells [PBMC] and/or hepatocytes in the absence of HCV RNA in serum, designated as 'occult HCV infection', has been a matter of controversy in the recent years. Occult hepatitis C virus [HCV] infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis [CHD] patients in a single heamodialysis center at Al-Taif, KSA. We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells [PBMNCs], was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups

Effects of some antidiabetic medicinal plants on pancreas and liver of diabetic albino rats

Diabetes is a chronic metabolic disease which affects large number of population all over the world. More than 400 traditional medicinal plants have been recorded for helping in controlling such disease. This study investigated effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents. One hundred fifty adult male Albino rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds, while the fifth group was treated with the aqueous extract of Foenugreek seeds. The sixth one was treated with the aqueous extract of Termis seeds with the administered dose of the plant extracts [100 mg/kg body weight].After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both heamatoxylin and eosin as well as a special stain for demonstration of the different pancreatic cells in the Islet of Langerhans. The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group, while the other pancreatic cells were not affected [alpha and delta cells]. The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. The present results showed that the activity of the mixture was the best when compared with Nigella, Foenugreek and Termis seeds. The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on the liver and texture, hematological parameters, and lipid profile. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required doses

Circulating MCP-1 level and tilde 2518 gene polymorphism as a marker of nephropathy development in Egyptian patients

Monocyte chemoattractant protein-1 [MCP-1] is a member of CC chemokine that plays an important role in the recruitment of monocytes/macrophages into renal tubulointerstitium. A biallelic A/G polymorphism at position tilde 2518 in the MCP-1 gene was found to regulate MCP-1 expression. MCP-1 and its A/G gene polymorphism have been implicated in the pathogenesis of some renal diseases. The aim of this study was to evaluate the role of circulating MCP-1 level and the relevance of functional genetic variations of MCP-1 as early predictors of the development of glomerulonephropathy [GN] in Egyptian patients. This is a case control study that was conducted in 50 GN patients, 20 non-GN cases and 20 ethnically matched healthy controls. MCP-1 serum level was detected by ELISA technique, while genotyping of polymorphisms in the MCP-1 genes was performed using a polymerase chain reaction [PCR] followed by restriction fragment length polymorphism [RFLP] detection High MCP-1 circulating levels and subsequently MCP-1tilde 2518G polymorphism are associated with the developing of nephropathy irrespective to the underlying etiology. MCP-1 serum level was significantly high when compared with healthy controls [P = 0.0007] and non-GN cases [P = 0.01]. There was predominance of A allele at tilde 2518 of MCP-1 gene in healthy controls [87.5%] and non-GN cases [77.5%]. The frequency of the tilde 2518G MCP-1 polymorphism was significantly higher in GN patients than in healthy controls [P <0.0001; OR= 15.6] and non-GN cases [P < 0.0001; OR = 7.7]. Interestingly, homozygosity for G allele plays the main role in such association. A/G polymorphism in MCP-1 gene and subsequently high circulating MCP-1 level confer a relevant role in the susceptibility to the development of nephropathy in the Egyptian population denoting that MCP-1 system could be an early predictor of such renal complication

Assessment of the proliferative marker Ki-67 and p53 Protein Expression in HBV-and HCV related-related hepatocelular carcinoma cases in Egypt

Chronic HBV and HCV infections are the major risk factors for the development of HCC through a multistep pathway that involves viral and non-viral dependent pathophysiological steps. Hepatic expression of the nuclear proliferative marker ki-67 and the p53 oncoprotein were found to be associated with poor outcome. So, the present study was done to evaluate the changes in expression of Ki-67 and p53 oncoprotein, and to determine p53 gene mutation in HBV/HCV-related HCC Egyptian patients. Eight HBV-and 22 HCV-positive HCC cases have been examined for the presence of p53 mutation by immunohistochemistry [IHC] and single-strand conformation polymorphism [SSCP], followed by direct DNA sequencing. HCV were genotyped by LiPA-II. Our results have shown that the proliferative marker ki-67 LI and p53 were highly expressed and significantly related to tumor grade in the Egyptian HCC cases [p < 0.05]. Also, p53 mutation was found in 16 HCC cases by IHC and in 14 HCC cases by SSCP, only 11 patients showed p53 mutation by sequencing. The highest mutation rate was scored for exon 7 [7 mutations] at codon 249; 4 out of 8 [50%] of HBV-related HCC cases and 3 out of 22 [13.6%] of HCV-related HCC cases, followed by exon 5 [3 mutations] at codons 133, 146, 176 in HCV-related HCC cases, then exon 8 at codon 275 in HCV-related HCC cases. The concordance between the IHC and sequencing analysis was 69%.The present study demonstrates the association between the proliferative marker ki-67 and p53 expression with the tumor grade of Egyptian HBV/HCV-related HCC cases. Our results also support the hypothesis that p53 mutations are rather a late event in the carcinogenesis. Also, they suggest that the final steps of hepatocarcinogenesis are common and independent of the aetiology of the viral infection