Intracellular IL-5 expression by peripheral blood CD4[+] and CD8[+] T-cells in atopic and non-atopic asthma

There is evidence of CD8[+] and CD4[+] peripheral blood T cell activation in childhood atopic asthma. However, the immunopathology of non-atopic asthma in children remains unclear. We sought to investigate the intracellular IL-5 expression by peripheral blood CD4[+] and CD8[+] T cells in atopic and non-atopic asthmatic children in relation to asthma grading and severity of exacerbation, as well as is possible correlation to various inflammatory markers of asthma. The study comprised 35 atopic and 35 non-atopic asthmatic children enrolled during activity and 30 clinically healthy children. They were subjected to flow cytometric assessment of intracellular IL-5 expression in CD4[+] and CD8[+] T cell subsets as well as absolute eosinophil count, serum total IgE, eosinophil cationic protein [ECP], and urinary Leukotriene E4 [LTE4] estimation. Asthmatic children compiled all together and the atopic group showed highly significant increase in absolute eosinophil count, IgE% from high normal for age, serum ECP, urinary LTE4 / creatinine ratio, intracellular CD4[+] IL5, and CD8[+] IL5 T cell numbers as compared to the control group. Similar results were observed between the non-atopic asthmatic children and the control group. When the atopic and non-atopic asthmatic children were compared, the former group showed significantly higher values of all study parameters except the urinary LTE4, urinary creatinine ratio, and CD8[+] IL5 frequency. CD4[+] IL5 T cell number correlated positively with the absolute eosinophil count, IgE% and serum eosinophil cationic protein among the 70 asthmatic patients. Stepwise multi-regression analysis revealed CD4[+] IL-5 frequency to be an inverse independent variable for asthma exacerbation. Likewise, IL-5 production, either CD4[+] or CD8[+] T cells was an inverse independent variable for grading of asthma severity. Both CD8[+] and CD4[+] T cells contribute to the IL-5 production in asthmatic children whether atopic or non-atopic during disease activity. CD4[+] T cell IL-5 frequency estimation could be a useful marker for asthma exacerbation severity and both CD4[+] and CD8[+] T cell IL-5 frequencies might serve as markers for asthma grading

new modality for early diagnosis and severity prediction in necrotizing enterocolitis

To develop a new method for diagnosing necrotizing enterocolitis and prediction of severity with the use of computed tomography [CT]. Urine specimens from 63 premature neonates were obtained at 4-hours interval for 24 hours duration after administration of iodinated water-soluble contrast material [Iohexol] entrally for 45 neonates from them. Twelve neonates had definite necrotizing enterocolitis [NEC] [group I] and 10 neonates had suspected NEC [group II]. Urine from another two groups without any clinical evidence of NEC [at the time these studies were performed] was collected, 23 neonates [group III] received Iohexol [who underwent upper gastrointestinal study], and 18 neonates [group IV] did not receive Iohexol. The attenuation coefficient of each urine specimen was determined with CT [equivalent to the concentration of the Iohexol in urine]. The mean CT attenuation coefficient of urine from neonates who did not receive Iohexol [group IV] was 5.2 +/- 3.5 HU [Hounsfield unit], and that from neonates without NEC [group III] [who underwent upper gastrointestinal study] was 6.8 +/- 3.0 HU. The mean CT attenuation coefficient of urine from patients with suspected necrotizing enterocolitis [group II] was 28.0 +/- 3.8 HU, and that from patients with definite necrotizing enterocolitis [group I] was 73.0 +/- 19.8 HU. The mean CT attenuation coefficient in neonates with NEC were significantly higher than that from suspected group and than that from patients without NEC whether received the Iohexol or not [P<0.01]. Follow up samples revealed significant reduction in the CT attenuation coefficient after treatment. Urine from neonates with necrotizing enterocolitis show significantly higher CT attenuation coefficients than those from patients without necrotizing enterocolitis. CT examination of urine may allow early diagnosis of necrotizing enterocolitis, effect of treatment as well as severity prediction

Serum Secretory phospholipase A2 and interleukin-1beta for prognosis and mortality perdiction in neonatal sepsis

To evaluate the measurement of IL-lbeta and sPLA2 for the diagnosis of neonatal Sepsis as well as their relation to severity and outcome. The current study was carried out on 40 full term neonates [23 males and 17 females] selected from the Neonatal Intensive Care Unit and the General Nursery of Gynecological and Obstetric Hospital of Ain Shams University. The studied neonates were divided into two groups: Group I: included 25 neonates with neonatal sepsis 15 males and 10 females. Their postnatal age ranged between 3-21 days [mean +/- SD 7.12 +/- 4.04 days] they were 14 neonates with early onset sepsis and 11 neonates with late onset sepsis. Group II: included 15 healthy neonates 8 males and 7 females served as control group. Their postnatal age ranged between 3-21 days [mean +/- SD 10.6 +/- 3.66 days]. All neonates underwent full history taking, thorough clinical examination, complete blood count, CRP level, blood culture, measurement of serum IL-lbeta, and sPLA2. A second sample was withdrawn after one week from seven cases who were improved clinically, to measure serum CRP, IL-lbeta, and sPLA2. the result of this study demonstrate that IL-lbeta was significantly higher in the septic group in comparison with the control group [21.10 +/- 9.79 vs. 4.90 +/- 3.58 pg/ml respectively, P<0.0001] and declined after antibiotic therapy [16.91 +/- 9.3 vs. 9.55 +/- 3.2, P<0.05]. No significant difference between early onset sepsis and late onset sepsis neonates was observed in regards IL-1beta, and sPLA2. Also significant elevations in IL-1beta levels in non-survivors than survivors of the septic group were observed [28.37 +/- 11.93 vs. 18.27 +/- 7.40pg/ml respectively, P<0.05]. Furthermore, secretory PLA2 [sPLA2] was significantly higher in the septic group in comparison with the control group [185.20 +/- 64.42 vs. 63.53 +/- 33,52 U/ml respectively, P<0.0001]. sPLA2 was significantly lower after antibiotic therapy [164.29 +/- 90.94, vs.57.14 +/- 15.77 U/ml, P<0.05]. Higher levels of sPLA2 were observed in non-survivors when compared with survivors of the septic group [243.43 +/- 34.54 vs. 162.56 +/- 59.15 U/ml respectively, p< 0.001]. A positive correlation between the level of IL-lbeta and sPLA2 was observed in the septic group [r = 0.78, P<0.0001] and the rate of change of sPLA2 was higher than IL-1beta after antibiotic therapy [61.23% vs. 46.57% respectively]. In conclusion, IL-lbeta and sPLA2 played a role in pathogenesis of neonatal sepsis. Moreover, their measurements could be used for diagnosis of neonatal sepsis and for prediction of prognosis and mortality

Neonatal neutrpenia associated with pregnancy induced hypertension and cord blood granulocyte colony stimulating factor

Neutropenia is frequently observed in neonates born to mothers with pregnancy induced hypertension [PIH]. Though transient, it may be a leading cause of early neonatal sepsis. Hence, prophylactic exogenous hematopoietic factors are currently tried. However. Causes of this neonatal neutronenia [NN] and its relation to the endogenous production of these factors are still obscure, therefore we aimed to study granulocyte colony stimulating factor [G-CSF] among other determinants of NN in this population. The present study included 92 neonates; 52 born to normotensive mothers and 40 neonates with maternal PIH. Gestational age [GA] and birth weight [BW] were assessed with clinical evaluation of all studied neonates at birth and after 72 hours to rule out infection. Cord blood absolute neutrophil count [ANC] and levels Of G-CSF [as measured by ELISA] were studied. Neonates born to mothers with PIH had significantly [P<0.05] lower ANC than control newborns. ANC was significantly [P<0.01] lower in neonates with GA <32 weeks as compared to those >32 weeks. Values of ANC were significantly positively correlated with BW [P<0.05]. Neonatal neutropenia [ANC <1.5 x 10[9]/ L] was observed in 35% of infants born to mothers with PIH being moderate to severe [ANC< 1x10[9] / L] in 25%. Of these neonates with moderate to severe NN, 90% were of low BW and 60% were preterms of GA less than 32 weeks. Mean value of cord blood G-CSF [126.3 +/- 99.6 pg/L] was significantly [P<0.001] lower in all babies of mothers with PIH than control [283.9 +/- 221.7 pg/L]. A significant positive correlation was noted between ANC and G-CSF [P<0.05] in FT neonates. Neonates whose GA<32 weeks showed significantly increased frequency of moderate to severe neutropenia [66.7%] compared to other GA groups [13.3% and 12.5% in those born after 37 weeks and those born between 33 and 36 weeks, respectively] [p<0.05]. The least reported mean cord blood G-CSF in this study [79.3 +/- 31.14 pg /L] was encountered in neonates whose GA<32 weeks and who exhibited NN that approached severity [mean ANC: 0.59 +/- 0.21 x 10 [9]/L]. Early neutropenia may be noted in neonates born to mothers with PIH. It may be related to reduced serum G-CSF especially in LBW and in those with increased degree of prematurity. This population may be suitable c and idates for recombinant human G-CSF [rh G-CSF] therapy