Zoonoses from cats: with special reference to Egypt

A zoonosis is an animal disease that is transmissible to humans. Humans are usually an accidental host that acquires disease through close contact with an infected animal, who may or may not be symptomatic. Children are at highest risk for infection because they are more likely to have close contact with pets. Cats are responsible for transmission of an extensive array of bacterial, fungal, and parasitic zoonotic pathogens. The route of transmission can be through the saliva [e.g., bites or contaminated scratches], feces, respiratory secretions, direct contact, or by the cat acting as a vehicle and source of tick or flea exposure. Although cats have been implicated in transmission of zoonosis to their owners, risk of transmission from contact with cats is low and may be further reduced by simple precautions. There is a need for education on zoonotic disease prevention practices for pet-owning households with individuals at higher risk of infection, and to educate future veterinarians during their early years in veterinary school about the risks associated with their future jobs. Also, zoonotic disease awareness training is a valuable service to animal shelter workers

Prevalence of tobacco use among adult and adolescent females in Egypt

Egypt assessed tobacco use among young people and adults through implementation in 2009 of the Global Youth Tobacco Survey [GYTS] among school students aged 13-15 years and the nationally representative Global Adult Tobacco Survey [GATS] among adults aged 15+ years. Both surveys employed cluster sampling to produce nationally representative samples and used standard core questionnaires with optional, country-specific questions. The results indicated that a higher percentage of adolescent girls in Egypt used tobacco than did adult females. Overall, 3.8% of girls aged 13-15 years used some form of tobacco compared with 0.6% of women aged 15+ years. Adolescents were over 14 times more likely than adult women to currently smoke cigarettes and 11 times more likely to smoke waterpipes. Moreover, the prevalenceof cigarette smoking among adolescent girls had increased from 1.4% in the 2005 GYTS to 2.8% in 2009, indicating that social and cultural norms may be changing

Serum interleukin levels in asthmatic patients with eosinophilia

The incidence, morbidity and mortality of bronchial asthma have increased over the last two decades. Immune and inflammatory responses mediated by cytokines are essential in the pathophysiology of bronchial asthma. Substantial evidence has implicated Th2 cytokines, IL-4 and IL-5, in the pathology of allergic asthma and demonstrated protective effects of Th1 cells. This work was conducted to study the serum levels of IL-4, IL-5, IL-12 and IL-18, in patients with allergic asthma associated with eosinophilia. Interleukins levels were correlated with IgE level and the degree of eosinophilia in these patients. The study included 25 asthmatic patients with acute attack of bronchial asthma, associated with history of allergy and eosinophilia; and 25 normal healthy controls. All patients and controls were subjected to full medical history, clinical examination, and laboratory investigations for assessment of the eosinophil count and measurement of serum levels of IgE and interleukins [IL-4, IL-5, IL-12 and IL-18]. The correlation between interleukin [IL] levels, and degree of eosinophilia and IgE levels were also examined in these patients. Measurement of serum levels of interleukins showed significant elevation of IL-4, IL-5 and IL-18 levels in asthmatic patients as compared with the control group [p<0.0001], whereas IL-12 levels did not show any significant change [p>0.05]. Marked elevation in the IgE level and eosinophil count were also detected in asthmatic patients as compared with the control group [p<0.0001]. Significant positive correlations were observed between serum levels of IL-4, IL-5 and IL-18 and the degree of eosinophilia in asthmatic patients. A significant positive correlation was also detected between level of IL-18 and the IgE level in asthmatic patients. Patients with allergic bronchial asthma have elevated levels of IL-4, IL-5 as well as IL-18; and these levels correlated significantly with degree of eosinophilia in these patients. Further studies are needed to clarify the signaling cascade involved in allergic responses mediated by these ILs. This may help in developing new therapeutic modalities, as blockade of IL receptors, for these conditions

Human peroxisome proliferator-activated receptor 2 [PPAR 2] pro 12 Ala polymorphism: a possible association with risk of diabetic nephropathy in type 2 diabetes

Mutations of the nuclear receptors PPAR-gamma confer an extreme phenotype of partial lipodystrophy, early-onset severe insulin resistance, type 2 diabetes, dyslipidemia, hypertension, and hepatic steatosis. The association between the Pro 12 Ala polymorphism in PPAR-gamma and obesity, insulin sensitivity, and type 2 diabetes was studied. It appears that the Ala 12 allele confers modest protection against the onset of type 2 diabetes and is also associated with an increased BMI in overweight individuals. This study was conducted to investigate an association between Pro 12 Ala polymorphism and the incidence of diabetic nephropathy in obese patients with long-lasting type 2 diabetes. The study was carried on sixty patients with type 2 diabetes mellitus, they were divided to 2 groups, group 1 included 30 patients with diabetic nephropathy and group 2 include 30 patients without diabetic nephropathy. Thirty healthy subjects of matched age and sex were included as controls [group 3]. Pro 12 Ala polymorphism was statistically significant more frequent in the diabetic group without nephropathy [group 2] in comparison to diabetic patients with nephropathy [group 1] p<0.0001, and the control group [group 3], p<0.0001. but there was no significant difference between the diabetic nephropathy group [group 1] and control group [group 3]. PPAR gamma receptor polymorphism was positive in 7 patients [23.33%] and negative in 23 patients [76.67%] of the diabetic nephropathy group [group 1]. In the diabetic group without diabetic nephropathy, it was positive in 24 patients [80%], negative in 6 patients [20%]. On the other hand, patient with diabetic nephropathy [group 1] associated with hypertension [21 patients] were all negative regarding PPAR gamma Pro 12 Ala polymorphism. Whereas, those without hypertension only 2 out of 9 patient were negative and the remaining 7 cases were positive regarding polymorphism. There were no significant differences between the two diabetic groups of patients regarding BMI, lipid profile and duration of diabetes. There was also no association between PPAR polymorphism and duration of diabetes, BMI and any of the biochemical parameters measured. In conclusion, the presence of the Ala allele of the PPAR gamma Pro 12 Ala polymorphism seems to be associated with a decreased risk of diabetic nephropathy in patients with type 2 diabetes. This association needs to be confirmed in other patient populations. More basic studies will be required to uncover the molecular mechanisms underlying the association between PPAR gamma Pro 12 Ala polymorphism and diabetic nephropathy risk

Expression of wild p53, mutated p53 and hypoxia inducible factor-1 alpha in hepatocellular carcinoma

To investigate the expression of wild p53, mutated p53 and hypoxia inducible factor-1 alpha [HIF-1 alpha] genes in hepatocellular carcinoma and correlate their expression with clinicopathological data. Liver biopsy samples of 30 hepatocellular carcinoma [HCC] subjects. 20 chronic hepatitis C [CHC] and 20 liver biopsy samples from non cancerous tissue [i.e control samples] of HCC were assessed by polymerase chain reaction [RT-PCR] and restriction enzyme analysis for the three genes; wild p53 gene, mutations in p53 at codon 249, exon 7 and hypoxia inducible factor-1 alpha gene. Wild p53 gene was detected in 18/30cases of HCC [60%], 16/20 cases of CHC [80%] and 15/20 cases of control samples [75%] with no significant difference between the studied groups. Mutated p53 gene was detected in 12/30 cases of HCC [40%], 4/20 cases of CHC [20%] and 5/20 cases of control samples [25%], also with no statistically significant difference between the studied groups while HIF-lalpha gene was expressed in 20/30 cases of HCC [66.7%] in comparison to 2/20 cases of CHC [10%] and 3/20 of control samples [15%] with a highly statistically significant difference [p<0.001]. The expression of both wild p53 and the mutated p53 correlated with tumor size but did not correlate with grade of malignancy nor serum alpha fetoprotein level, while the expression of HIF-1 alpha correlated with grade of malignancy and alpha fetoprotein level but not with tumor size. No correlation between expression of all genes and capsule infiltration or presence of cirrhosis was found in all groups. HIF-1 alpha is highly expressed in HCC and is related to grade of malignancy and serum alpha fetoprotein level

Methylation profiling of CPG islands in the promoters of P15 and P16 genes in hepatocellular carcinoma: correlations with HCV associated infection and pathological parameters

Objective: To evaluate DNA methylation patterns of CpG islands in the promoters of p15 and p16 genes in hepatocellular carcinoma [HCC] and hepatitis C [HCV] cases and to evaluate whether the expression of p16/p15 wild genes as well as methylation of their promoters were significantly correlated with the pathological stage and grade of HCC. Design: A cross sectional case controlled, single center study

Patients: Twenty eight HCC and twenty HCV subjects

Setting: Internal Medicine and Medical Biochemistry Departments, Faculty of Medicine, Cairo University. Main outcome measures: Wild type p15 and p16 genes [p15-W and p16-W], methylated p15 and p16 genes [p15-M and pl6-M] and unmethylated p15 and p16 genes [p15-U and p16-U] in liver biopsy samples of 11 HCV associated HCC, 17 HCV non-associated HCC, 20 HCV liver tissue samples and 20 non cancerous liver tissue of HCC subjects

Results: In HCC liver tissue with associated HCV infection, p15-W and p16-W were detected in 27. 2% [3/11] samples, p15-M and p16-M were found in 63.6 % [7/11], 72.7 % [8/11] samples whereas p15-U and p16-U were expressed in 36.3 % [4/11], 27.2 % [3/11] samples. On the other hand, HCC liver tissue without HCV associated infection exhibited p15-W and p16-W in 17.6% [3/17] samples, p15-M and p16-M in 88.2% [15/17] samples and p15-U and p16-U in 11.8% [2/17] samples . There was a significant elevation of methylated genes versus wild genes and Whylated genes in non HCV associated HCC [p<0.01]. There was no significant difference between HCV associated and non HCV associated tumour tissue. In non-cancerous tissue, P15-W and P16-W were found in 80% [16/20], p15-M and p16-M were found in 30% [6/20], pIS-U and MU were found in 70% [14/20] samples. In HCV liver tissue samples, p15-W and p16-W were M in 211 samples [100%], p15-M and p16-M were expressed in 30% [6/20], 40% [8/20] sample and p15-U and p16-U were detected in 70% [14/20], 60% [12/20] samples. There was insignificant elevation of methylated gene versus unmethylated genes and wild genes in both non cancerous tissue and in HCV liver tissue. Significant elevation of p15 and p16 methylated genes were found in HCC tumour tissue as compared to non-tumorous tissue and HCV liver tissue [p<0.05]. There was a significant correlation between the methylation of p16/p15 promoters and the pathological grade of HCC [p<0.05]

Conclusion: p16 and p15 gene methylation and transcriptional inactivation may be involved in hepato-carcinogenesis without HCV associated infection. This gene paradigm have a significant correlation with the pathological grade of the tumor and can predict the clinical outcome in HCC

Cytokines and immunoglobulin-E in certain parasitic diseases

Ninety Egyptian patients were classified into 7 groups, 6 with different parasitic infection and 10 normal controls. Forty patients with different schistosomiasis stages [1, 2 and 3] with compensated but the last one [stage 4] of decompansated schistosomiasis. Gs3 and 4 of mixed infections with schistosomiasis and HCV and HBV respectively. The last 3 patients groups were infected with toxoplasmosis, filariasis and hymenolepiasis nana. IL2, IL4 and IgE levels were measured. The results showed significant increase in IL2 [P<0.05], [P<0.01], P<0.01] and [P<0.001] among stages [1, 2, 3 and 4] versus control respectively. In chronic schistosomiasis with HCV and HBV, significance was P= <0.001 and P<0.05 respectively, among toxoplasmosis, filariasis and hymenolepiasis patients, it was P= <0.001, 0.05 and 0.01 respectively. The IL 4 level showed highly significant increase [P< 0.001] among stage 1, 2, Gs 2, 3 and 6. There was significant increase [P<0.01] with stage 3 in Gs 4 and 5 but, without significance [P>0.05] increased in decompensate schistosomiasis patients. IgE level and test of significance versus controls were given and results were discussed

Vascular endothelial growth factor modulates systemic blood pressure changes in chronic intermittent hypoxia

Systemic arterial hypertension is a common association to chronic intermittent hypoxia. However, little is known about the molecular mechanisms that might mediate long term adaptive responses. Hypoxia inducible factor-la [HIF-1alpha] is upregulated in hypoxia and is linked to activation of several downstream proteins concerned with protective mechanisms. Most importantly, HIF-1-alpha is strongly linked to VEGF. However, whether the expression of both cytokines in chronic intermittent hypoxia could be specifically increased in renal and aortic tissue is unclear. VEGF is a potent vasodilator both in vitro and in vivo and systemic administration causes hypotensive effects in various animal models. Therefore, we sought to explore the gene expression pattern of HIF-1alpha and VEGF in rat kidney and aorta in response to chronic intermittent hypoxia, to investigate a possible role for VEGF in reducing blood pressure elevation in such cases. Adult male Wistar rats were randomly assigned intro CIH group: exposed to one hr intermittent hypoxia [fractional inspiredFIO2: 10%] for 5 day/week for 5 weeks. CIH-SU group [received SU54l6, a potent selective blocker for KDR-flk VEGF receptor, were subjected to the same hypoxia protocol as CIH group] and normoxic Nx control rats. Mean and systolic blood pressure were recorded at day 1,7,15,21,28 and 35 of hypoxic exposure and at the same time points in normoxic rats. At the end of the hypoxia protocol, the thoracic aortas from all groups were excised for studying the functional reactivity of vessels to phenylephrinePE induced contraction and Acetyl choline induced relaxation. Parts of excised aorta and rat renal tissue were also collected for RT PCR analysis of HIF-1alpha and VEGF mRNA. Chronic intermittent hypoxia caused a significant elevation in SBP and MAP in CIH and CIH-SU compared to normoxic controls. However a significant elevation in SBP and MAP was observed upon blocking VEGF receptors [CIH-SU] versus CIH group. A significant increase in aortic contractile responses together with reduced dilator responses was observed in chronically hypoxic rats compared to controls and a significant increase in aortic reactivity was observed in CIH-SU versus CIH. Detection of mRNA encoding for both HIF- 1alpha and VEGF by RT-PCR showed increased expression pattern for both cytokines which was evident in both renal and aortic tissues. Chronic intermittent hypoxia upregulates mRNA for both HIF-1alpha and VEGF in rat renal and aortic tissues. Blocking VEGF receptor action resulted in a significant elevation in arterial blood pressure. These data point to an important role for VEGF in preventing marked elevation in arterial pressure in chronic intermittent hypoxia

Blastocystis hominis among symptomatic and asymptomatec individuals in Talkha center, DaKahlia governorate, Egypt

Blastocystis hominis is now getting acceptance as an agent of human intestinal disease. B. hominis in stool samples of symptomatic and asymptomatic individuals was evaluated as a possible cause of gastro-intestinal troubles. B. hominis was found in 106 [10.1%] out of 1050 individuals examined from six villages and one city in Talkha Center, Dakahlia Governorate. The highest infection rate was in Manshayt El-Badawy village [25.47%], whereas Talkha City showed the lowest rate [4.73%]. Age group 10-20 years had higher infection [13.3%]. In twenty- three symptomatic patients, B. hominis represented the only causative parasitic agent. The most common symptoms were diarrhoea [30.4%], abdominal pain [26.1%], flatulence [21.7%], vomiting [13.1%] and fatigue [8.7%]. High concentrations of B. hominis were found in symptomatic patients than in asymptomatic ones with statistical significant difference [8.2 cells/100 x field versus 3.8 respectively]. The mean number of B. hominis was significantly high in patients complaining of diarrhoea and abdominal pain

Anti-fasciola antibodies among rodents and sheep in Jeddah, Saudi Arabia

A total of 20 imported sheep were examined for fascioliasis natural infection by kato thick smear and by Fasciola-indirect haemagglutination test [IHAT]. Stool examination revealed infection in 13/20 [65%], but IHAT identified 11/20 [55%]. So, the sensitivity was 84.5%. Also, five species of rodents trapped within or nearby the infected sheep farm by IHAT showed positive reactions of in Rattus rattus [22.4%], R. norvegicus [16.7%], Meriones crassus [11.8%], Juculus jaculus [zero%], Acomys c. dimidiatus [9.4%], The overall positive IHA reaction was 11/143 or 14.7%. The presence of natural fascioliasis infection in imported sheep and wild rodents were discussed

Proliferative changes of epidermal cells in lesions of cutaneous leishamaniasis

In 35 parasitologically proven zoonotic cutaneous leishmaniasis patients, the histopathological and immunohistochemical picture were studied. The haematoxylin and eosin stain, the monoclonal antibodies for T and B lymphocytes, peroxidase anti-peroxidase for P53 protein, and Feulgen staining for DNA imaging cytometry to DNA contents and S-phase [DNA synthesis of cycling cells were evaluated. The out-come results revealed that P53 and S-phase fraction and DNA content must be in mind when dealing with a human cutaneous leishmaniasis. Consequently, the early detection of any nuclear mutation and cellular proliferation in the skin leishmaniasis lesion[s] must be taken into consideration to avoid the miserable formation of the skin cancer

Human fascioliasis among immigrant workers in Saudi Arabia

Animal fascioliasis has been reported in Saudi Arabia among imported and local sheep. The paper demonstrated the parasitological and clinical features of human fascioliasis in nine out of ten male immigrant manual workers with manifestations suggesting fascioliasis. The sedimentation and Kato-Katz techniques proved effect in diagnosing Fasciola species eggs in human stool. The common clinical features were abdominal distension, flatulence, tender right-upper quadrant and easy fatigability and the least was the tinge of jaundice. Others as right upper quadrant pains, colicky abdominal pains and vomiting, epigastric pain and mild fever, and tympanitic abdomen were encountered. Anaemia and eosinophlia were also encountered in the ten patients. Fascioliasis patients [nine] were successfully treated with Mirazid R as two capsules [600 mg] on an empty stomach an hour before breakfast for six consecutive days. Follow-up clinically and parasitologically was available in only seven fascioliasis patients who were completely cured. Follow-up for the other two fascioliasis patients was out in hand. Other parasites recovered in the stained [eosin, iodine and Zeihl-Nelson stains] smear stool samples was Entamoeba histolytica, Giardia lamblia and Cryptosporidium parvum. Besides, three were free from intestinal protozoan. The results were discussed on the light of the other work carried out regionally

Stearoyl coenzyme a desaturase expression in hepatocellular carcinoma and in chronic viral hepatitis

Objective: to study stearoyl-CoA desaturase or delta 9 desaturase expression by polymerase chain reaction [PCR], gel documentation system densitometry of PCR products of liver biopsy from normal liver tissues as well as from hepatocellular carcinoma liver biopsy of the same patient and also from chronic viral C hepatitis [HCV] subjects and to correlate findings to the presence of HCV viremia as well as the presence of chronic active hepatitis

Design: a randomized, group comparative, single center study

Patients: 30 cases of hepatocellular carcinoma and 30 cases of chronic viral hepatitis C [HCV] with and without signs of chronic active hepatitis and with and without HCV viremia. Diagnosis was confirmed by pathological examination of liver biopsy

Settings: internal Medicine and Medical Biochemistry Departments. Faculty of Medicine, Cairo University

Main outcome measures: qualitative and semiquantitative analysis of delta 9 desaturase gene expression by RT-PCR and densitometry using gel documentation system of PCR products respectively

Results: the present study demonstrated that there was a significant increase in delta 9 desaturase gene expression in hepatocellular carcinoma cases as compared to normal liver tissues as well as in comparison to chronic hepatitis cases. Furthermore, the extent of delta 9 desaturase expression was significantly elevated in the presence of HCV viremia as compared to non viremic subjects. Moreover, the presence of chronic active hepatitis was found to upregulate the extent of delta 9 desaturase gene expression to a significant extent in comprison to hepatitis cases with no activity

Conclusion: delta 9 desaturase gene expression was significantly upregulated in hepatocellular carcinoma as compared to chronic hepatitis subjects. whereas the extent of delta 9 desaturase expression was more significantly elevated in the presence of chronic active hepatitis as well as the presence of HCV viremia in chronic hepatitis subjects

Effect of laser therapy on VEGF and TGF-beta expression in psoriasis

Objective: to study the extent of expression of vascular endothelial growth factor [VEGF] and transfomng growth factor-beta genes [TGF-beta] by RT-PCR then densitometry of ultraviolet transilluminated gel of PCR products from psoriatic plaque lesions in comparison to the extent of the gene expression in control skin samples. Moreover, the plasma levels of the two growth factors were also assessed by irnmunoassay. The effect of laser therapy on these growth factors was also Evaluated

Design: a randomized, group comparative, longitudinal, single center study

Setting: medical Biochemistry and Dermatology Departments, Faculty of Medicine, Cairo University

Main outcome measures: VEGF and TGF-cx genes and proteins

Results: results of this study demonstrated that there was a significant elevation of VEGF plasma level [p< 0.0001] as well as a significant elevation of gene expression of VEGF mRNA in psoriatic plaques [p< 0.0001] in comparison to control. On the other hand, there was a significant decrease of TGF-beta plasma level [p< 0.0001] as well as a significant decrease of TGF-alpha mRNA [p< 0.0001] in psoriatic plaques as compared to control. Furthermore, there was normalization of VEGF mRNA and TGF-beta mRNA gene expression as well as their plasma levels after effective laser therapy of psoriatic skin lesions

Conclusion: Upregulation of VEGF and downregulation of TGF-beta gene expression occur in psoriasis with subsequent aberrant epidermal proliferation and angiogenesis. These genes are downstream curative targets of laser therapy of psoriasis

effect of severe cystic hydatidosis on the liver of a Najdi sheep with special reference to the cyst histology and histochemistry

A single case of severe hydatidosis in a liver of a Najdi sheep was studied. The estimated age of the animal was 1.5 years and the liver was infected with 29 cysts and their diameters ranged from 4.0 mm to 5.1 cm. Cysts with a diameter less than 10 mm were immature and those of more than 1.5 cm were fertile and developed protroscoleces. Harvested protroscoleces measured 120 x 60 to 140 x 80 um. Comparative histochemical studies by hematoxylin and eosin, periodic acid Schiff [PAS] and Masson's trichrome stains revealed that the cystic wall consisted of three layers [germinal, laminated and fibrous, respectively]. The thickness varied with each stain. The glycogen and mucopolysaccharide content increased in the infected sheep. Histopathological changes were the formation of fibrotic capsules around biliary tracts and portal vein and also leaky liver was marked in all the sections examined. Meanwhile, pre-malignant changes were seen in the different foci, particularly around the biliary tracts and portal veins. The histochemical structure of the hydatid cyst wall may pave the way for an effective therapeutic treatment

DNA ploidy and S - phase fraction in the patients of chronic HCV and hepatocellular carcinomas

In this study, 400 blue Feulgen-stained nuclei were measured from each lesion using DNA image cytometry. The histopathological and cytopathological observations revealed that 52 cases had variable degrees of chronic hepatitis, 12 cases were emerging into cirrhosis; while 11 cases represented different grades of HCC. Most of cases with minimal or mild chronic hepatitis were females, while most of the males had moderate or severe chronic hepatitis, cirrhosis and HCC. DNA image analysis data helped in the histological observations. All of chronic hepatitis C and cirrhotic cases showed normal diploid and/or tetraploid histograms; while they showed increasing S-phase fractions' values of the highly diseased chronic hepatitis and cirrhotic cases. Hepatocellular carcinomas and one cirrhotic case only revealed aneuploidy [diploid and tetraploid], while one case of poorly differentiated HCC revealed multi-ploid histogram

Myrrh [Commiphora Molmol] in treatment of human and sheep dicrocoeliasis dendriticum in Saudi Arabia

In this study, 18 clinically and parasitologically proven human Dicrocoeliasis dendriticum patients were successfully and safely treated by the myrrh extract of Commiphora molmol [mirazid]. The dose was 2 capsules [300 mg each] given on an empty stomach at one hour before breakfast for six successive days; cure [100%] was achieved clinically and by stool analysis for two-month follow up. In addition, 15 sheep naturally infected with Dicrocoeliasis dendriticum as proven parasitologically were successfully and safely treated with 2 capsules [300 mg each] on an empty stomach at one hour before breakfast for four successive days; cure [100%] was successfully achieved by stool analysis for seven days and macroscopically for the detection of any adult worm after slaughtering. The total dose required to treat the infected sheep [2400 mg] was less than that required for the human treatment [3600 mg]

Effect of itraconazole and terbinafine on leishmania promastigotes

The antiproliferative effect induced in vitro by two antifungal compounds, the azole itraconazole and the allylamine terbinafine on Leishmania major, L. Donovani and L. Mexicana promastigotes was reported. Treatment of promastigotes cultures with itraconazole or with terbinafine induced growth arrest with L. major, but neither with L. Donovani nor with L. mexicana concentrations of 0.75 mul/l or more of itraconazole induced cell lysis after 72 hours with L major. However, even relatively large concentrations of terbinafine [2.0 mul/l] did not induce cell lysis. For L. major, the IC50 for itraconazole and terbinafine were 0.31 mul/l and 3.3 mul/l, respectively

Diagnostic and Prognostic Significance of urine type IV Collagen in type II diabetes mellitus

This study included 45 Type II diabetic patients diagnosed for more than 5 years, 10 normal control subjects [c]. 6 patients with IgA nephropathy [IgAN], 10 cases of membranoproliferative glomerulonephritis [MCGN], and 6 cases of membranous glomerulonephritis [MGN]. The aim of this work is to find out if there is a discrepancy in the urinary appearance of Type IV collagen [u-IV Col] in these frequently encountered glomerular diseases in comparison to patients with diabetic nephropathy [DN] and to study the rate of excretion of this compound in the different stages of DN. The 45 diabetic patients were selected to include 15 with normal kidney function, blood pressure and 24 hours urine albumin excretion [UAE] [DNO]. Another 15 had UAE between 30 and 300 mg/24 hours and retinal changes of diabetic retinopathy [DNI]. The remaining 15 were selected to have UAE > 300 mg/24 hours, systemic hypertension, normal kidney function and retinal changes of diabetic retinopathy [DNII]. AII groups were matched in age, gender and level of serum creatinine. All cases were tested for fasting blood sugar [FBS], glycsylated haemoglobin [HbA 1c], serum creatinine [Scr], serum albumin [Salb], 24hours urine protein [Uprot], UAE, creatinine clearance [CC], u-IV Col and serum level of type IV Col]. FBS and HbA 1c were significantly higher in the DN groups, however, there was no significant difference in these parameters in between these group. There were no significant differences in Scr and Salb between the different groups. Uprot was significantly lower in C, DN0 and DNI than in DNII, lgAN, MCGN and MGN [P<0.01]. UAE was significantly lower in c and DN0 than in DNI and in any these groups compared to DNII, lgAN, MCGN and MGN [P<0.001 in either]. CC was significantly higher in C, DN0 and DNI than in DNII, lgAN, MCGN and MGN [P<0.01]. u-IV Col was significantly higher in DNI, DNII and MGN than all other groups [p<0.01] There was no significant difference in s-IV Col between the different group [P>0.05]. u-IV Col showed a significant negative corrlation to CC only in DN groups [r=-0.562.p<0.005], but no significant correlation to Uprot, UAE or s-IV Col could be detected in these groups or in the other studied groups. Conclusion:1] u-IV Col could be used as a non- invasive diagnostic tool for DN in type II diabetes. 2] Increased u-IV Col is likely due to local renal over-production. 3] Rate of u-IV Col excretion could give an idea about the severity of DN

Serum levels of soluble CD40 ligand in patients with chronic and acute coronary syndromes and its relation to angiographic extent of coronary arterial narrowing

The aim of this study was to determine serum levels of soluble CD4O ligand [sCD4OL] in patients with chronic and acute coronary syndromes [ACS] and to assess the relation between sCD4OL levels and extent of coronary arterial narrowing in patients with ACS. Acute coronary events commonly result from thrombosis triggered by disruption of an atherosclerotic plaque. Recent studies have localized the receptor CD4O and its ligand in human atheroma. The CD4OL on activated T cells and platelets, by inducing the expression of matrix- degrading proteinases and of tissue factor procoagulant, may contribute to the triggering of acute coronary events. To study the role of CD4OL-CD4O interaction in coronary artery disease, we analyzed serum levels of sCD4OL in the peripheral blood from 10 patients with stable angina [SA]. 26 patients with unstable angina [UA], 22 patients with acute ST-segment elevation myocardial infarction [Ml] and 20 healthy controls by enzyme-linked immunosorbent assay [ELISA]. Coronary angiograms of all the VA patients and 18 Ml patients were reviewed to determine the culprit vessel [CV], CV complexity score [CVCS] [a score of I is given to a simple stenosis, 2: complex stenosis, 3: intracoronary thrombus, 4: total occlusion], type of CV lesion [A, B or C according to the lesion morphology] and vessel score [number of vessels with >/= 50% diameter stenosis]. Both patients with UA and Ml showed significantly higher levels of serum sCD4OL compared to patients with SA and controls; particularly high levels occurred in patients with UA [F ratio 34.9, p <0.001]. No statistically significant difference in sCD4OL levels was noted between VA and Ml patients or between SA patients and controls. Levels of sCD4OL did not show any significant correlation to peak CK. CK-MB in Ml patients or troponin T serum levels in UA patients. Levels of sCD4OL did not also show any significant correlation to CVCS, type of CV lesion or vesset score in VA or Ml patients. This study shows enhanced levels of sCD4OL levels in patients with UA and MI patients suggesting that CD4OL-CD4O interaction plays a pathogenic role in the triggering of ACS. Serum levels of sCD4OL could not however, predict the angiographic extent of coronary arterial narrowing