Interplay between matrix metalloproteinase-9 and tissue inhibitor of matrix metalloprotinase-1 in acute asthma exacerbation and airway remodeling

Airway inflammation and remodeling of extracellular matrix are important features of asthma. Matrix metalloproteinases [MMPs] are group of enzymes expressed in the airways with their inhibitor [tissue inhibitor of MMPs [TIMP] and they are the key responsible for extra cellular matrix [ECM] degradation. To clarify the role of MMP-9 and TIMP-1 in asthma exacerbation and airway remodeling. The study included 3 groups, group "A" included 22 patients with stable asthma group "B" included 18 patients during asthma exacerbation and group "C" of 18 healthy volunteer served as control. All groups were matching age and sex. Levels of MMP-9 and TIMP-1 were measured in the induced sputum of the 3 groups. Serum IgE skin prick test and PEFR were assessed. MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio increased in both A and B groups in comparison to control [P < 0.001]. During exacerbation MMP-9 and MMP-9/TIMP-1 ratio showed significant increase for both but TIMP-1 did not show significant change when compared to stable asthmatics. There was significant negative correlation between PEFR and MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio. MMP-9 and TIMP-1 play an important role in pathophysiology of asthma exacerbation and airway remodeling. Clearly, a greater understanding of the pathogenesis of asthma is critical to the development of better therapeutic modalities

Peripheral natural killer T cell in non alcoholic fatty liver disease: friend or foe?

Although Non alcoholic Fatty Liver Disease [NADFLD] has been extensively studied in recent years, the exact pathogenesis of this disease remains unknown. Natural killer T [NKT] cells have been implicated in immune responses against infectious agents and tumors and their immunoregulatory function has received much attention. Recent studies have suggested a link between peripheral Natural Killer T cell deficiency and NAFLD. To investigate the possible link between the frequency of peripheral NKT cells and NAFLD. The study included two groups of subjects. Group A included 20 patients with NAFLD, while group B included 20 healthy subjects who served as control. The two groups were matching age and sex. Liver function tests, kidney function tests, lipid profile, fasting and post prandial blood glucose, body mass index [BMI] were assessed and detection of frequency of peripheral NKT cell by flow cytometry was done to all subjects. NAFLD patients had a lower frequency of peripheral NKT cells than healthy controls [4.6% +/- 3.4% vs. 6.5% +/- 2.2%, z=2.301 P=0.021]. High significant differences existed between healthy controls and patients with NAFLD as regards total cholesterol, triglyceride, fasting and post prandial blood glucose, BMI and ALT levels [P=0.000]. Non significant correlation between the frequency of peripheral NKT cells and BMI [P=0.813] and ALT levels [P=0.550]. Changes in the frequency of peripheral NKT cells were correlated with NAFLD was found to decrease frequency of peripheral NKT cells and was associated with increased risk for NAFLD

Neutrophilic asthma: a new horizon in the pathogenesis of bronchial asthma

Eosinophilic asthma has emerged as a distinct phenotype of asthma. However there is increasing recognition of neutrophilic form of asthma. To study the possible role of neutrophilic airway inflammation among patients with moderate persistent asthma. The study included 2 groups of subjects. Group I included 40 patients with moderate persistent asthma subjected for sputum induction. Sputum cell count, esoinophil catalonic protein[ECP] and rnyeloperoxidase enzyme were assessed. peak expiratory flow rate [PEFR] was also estimated. Group 11 included 15 healthy subjects served as control group. Neutrophilic asthmatics represents 45% of the studied asthmatic patients, while Eosinophilic asthmatics constitute 55%. Ncutrophilic asthmatic patients had higher sputum neutrophils and myelopcroxidase in comparison to eosinophilic group [p<0.001], also eosinophilic asthmatic patients had higher sputum eosinophils and ECP in comparison to neutrophilic group [p<0.001]. Sputum neutrophilis and myeloperoxidase correlated negatively to PEFR in neutrophilic asthmatics. Sputum eosinophilis and ECP correlated negatively to PEFR in esoinophilic group. Asthma is known to involve a heterogeneous airway inflammatory response where many cells play a part. Neutrophilic asthma is a sizeable subgroup of asthma which might lead to further understanding the pathogenesis of such disease and though, a new modalities in treatment is required