Impact of maternal gestational diabetes on neutrophil functions of full term neonates

Background: Maternal gestational diabetes is associated with an inflammatory environment that may contribute to fetal and placental inflammatory profile changes. Few studies investigated the effect of maternal gestational diabetes on neonatal innate immunity

Objectives: Our objective was to study neutrophil number and function in neonates born to mothers with gestational diabetes

Methods: Neutrophil number [complete blood count] and functions [CD11b, CD62L and Dihydrorhodamine 123 [DHR] by flow cytometry] were assessed in the cord blood of 30 full term neonates born to gestational diabetic mothers on insulin during pregnancy and another 15 born to healthy mothers as controls

Results: The mean total leucocytic and absolute neutrophil count were significantly lower in neonates of diabetics than in normal neonates [13.55 +/- 2.51 and 17.89 +/- 3.66 p> 0.001; 9.01 +/- 1.59 and 14.18 +/- 3.44 p>0.001 respectively]. Mean CD11b, CD62L and DHR were lower among neonates of diabetic mothers than normal neonates [82.48 +/- 8.09 and 87.85 +/- 4.87 p < 0.05; 8.63 +/- 4.41 and 24.98 +/- 10.47 p <0.001; 68.71 +/- 10.24 and 79.57 +/- 8.64 p< 0.001 respectively]. Unlike the control neonates, neonates of gestational diabetic mothers had positive correlation between the functional neutrophil parameters [r0.39 p<0.05]

Conclusion: Gestational diabetes affects cord blood neutrophil count and functions leading to high susceptibility to infection

Renal expression of vascular endothelial growth factor in lupus nephritis the pediatric age groupin

Vascular endothelial growth factor [VEGF] plays a crucial role in preservation of renal functions and may also serve as a useful biomarker in monitoring the progression of lupus nephritis [LN]]. We thought to correlate VEGF expression in the kidney with renal histopathology in lupus nephritis to unveil its possible relation to disease activity and severity. We consecutively enrolled 15 patients with lupus nephritis and ten renal biopsy specimens from patients with cystic renal diseases as controls. The study measurements included SLEDAI, SLICC/ ACR damage index and BILAG renal score. Paraffin sections from renal biopsies were subjected to routine haematoxylin and eosin staining and Immunohistochemical staining for VEGF. Results: Among SLE patients, 7 [46.7%] showed mild expression of VEGF, 5 [33.3%] showed moderate while 3 [20%] had strong expression of the marker. On the contrary, the control samples [100%] revealed strong marker expression. All subjects with class IV and V lupus nephritis had mild renal expression of VEGF. Renal expression of VEGF had a significant positive correlation with serum creatinine and complement C3 levels. The 24 hours' excretion of urinary proteins had a significant negative correlation with the renal expression of the marker. On the other hand, the activity indices and therapeutic modalities did not correlate with VEGF expression. Conclusion: This pilot study among pediatric cases of SLE revealed mild to moderate VEGF expression in most cases of proliferative LN. Further longitudinal studies are needed to investigate the consequences of this finding on the prognosis of the disease

Serum interleukin 27: a possible biomarker of pediatric systemic lupus erythematosus

Systemic lupus erythematosus [SLE] is a complex autoimmune disease; different cytokines play a role in the immunopathogenesis of SLE. IL-27 has both immunosuppressive and pro-inflammatory roles and its role is unclear in SLE. To measure serum interleukin [IL]-27 among a group of patients with pediatric SLE [pSLE] and whether it varies with SLE clinical and laboratory features or with therapy. Fifty patients with pSLE and 25 healthy subjects were included. Routine laboratory and immunological markers of SLE were done. Serum IL-27 was measured by enzyme linked immunosorbent assay for both patients and healthy subjects. Serum IL-27 was significantly lower in patients when compared to healthy subjects [p< 0.001]; 17 patients [34%] had low serum IL-27 [serum IL-27 < 160 pg/ml]. Patients in lupus flare and those in remission had comparable levels [p> 0.05]. Serum IL-27 did not vary significantly between patients with lupus nephritis [LN] and those without evident LN, moreover, it was comparable among different histological classes of LN [p> 0.05]. The disease status in terms of SLE disease activity index was comparable among lupus patients with normal serum IL-27 and those with decreased serum IL-27 [p> 0.05]. Serum IL-27 was not affected significantly with the cumulative doses and the types of the immunosuppressive drugs used [p> 0.05]. Decreased serum IL-27 in SLE might support its involvement in the immune alteration underlying SLE but its exact role remains unclear

Monocyte chemotactic protein-4 [MCP-4/CCL-13] and CC chemokine receptor 3 [CCR3] in the sputum of asthmatic children

Monocyte chemotactic protein-4 [MCP-4/CCL-13] is a potent chemoattractant to eosinophils, monocytes and lymphocytes. We aimed to investigate MCP-4 and its CC chemokine receptor 3 [CCR3] expression on cells of induced sputum during acute asthma exacerbation. Immunohistochemistry was used to assess MCP-4 and CCR3 expression on induced sputum cells of 30 children during asthma exacerbation and 20 healthy matched controls. Patients were divided into three groups according to exacerbation severity; mild, moderate and severe [n = 10 for each]. Patients were followed until quiescence, when sputum was re-examined. MCP-4 and CCR3 were expressed on eosinophils and monocytes. Lymphocytes expressed only MCP-4. The percentages of sputum total cells, eosinophils and lymphocytes expressing MCP-4 and/or CCR3 were significantly higher during asthma exacerbation than in controls and negatively correlated with peak expiratory flow rate, whereas that of monocytes was not. The percentages of sputum total cells, eosinophils, monocytes and lymphocytes expressing MCP-4; and total cells and eosinophils expressing CCR3 were significantly higher in patients with severe than those with mild and moderate exacerbations. When patients were followed till remission, the percentages of sputum cells expressing MCP-4 and CCR3 decreased. Sputum eosinophil percentage correlated positively with the percentage of eosinophils expressing MCP-4 and CCR3 [r = 0.69, p < 0.0001; r = 0.62, p < 0.001, respectively]. The percentage of sputum eosinophils expressing MCP-4 correlated positively with that of cells expressing CCR3 [r = 0.95, p < 0.0001]. The expression of MCP-4 and CCR3 on sputum cells increases during acute asthma exacerbation and this increase correlates with exacerbation severity, and it decreases during remission. Modification of their expression could be a potential target for asthma therapy