Study of some immunological markers in acute cerebrovascular ischemic stroke

Ischemic stroke is associated with a high rate of mortality and morbidity in the world. Several mechanisms for neuroprotection against ischemia have been studied and included inflammatory mediators and apoptotic inducers and suppressors. The aim of this study was to clarify the role of some immunological markers [TNF-alpha, sFas and BCL-2] in the pathogenesis of cerebral ischemia and to relate their levels to the size of brain infarction and prognostic outcome of ischemic stroke. This study was done on 60 patients suffering from acute cerebrovascular ischemic stroke [40 males and 20 females] with age ranged from 45-70 years and 15 healthy subjects as a control group. History taking, clinical examination, laboratory investigations were performed to all subjects and CT scan brain was done for patients. There was a highly significant statistical difference between the patients and control group as regard the level of the immunological markers and there was a direct relationship between risk factors as TIAs and TNF-alpha level and sFas level among the patients with increased level of these 2 markers in comparison to those with normal level. On the other hand, there was an inverse positive relationship between presence of hypertension, diabetes and TIAs and BCL-2 level among the patients with decreased level of BCL-2 in comparison with those with normal level. Also, there was a highly significant positive correlation between both of TNF-alpha level and sFas level and signs of inflammation as fever, elevated ESR and leukocytosis in the patients and a significant positive correlation with the NIH-NINDS score of stroke. While there was a highly significant negative correlation between BCL-2 level and WBCs, ESR and NIH-NINDS score. There was a direct positive relationship between both of TNF-alpha level and sFas level and size of brain infarction and presence and degree of brain oedema among the patients while an inverse positive relationship was found between these CT parameters and BCL-2 level. There was a significant statistical difference between survived and died groups of patients as regard BCL-2 level and qualitative presence of CRP+. Neuronal death in acute ischemic stroke is attributed in part to inflammation and apoptosis

Dementtia and apoptotic marker soluble CD 95

The study was done on 40 patients suffering from dementia diagnosed according to the criteria of DSMIV and two control groups one with 15 cases [normal subjects] and the other with 13 cases with chronic cerebrovascular stroke matched for age and sex All cases were subjected to full neuropsychiatric history and examination, psychometric studies including the Mini Mental State Examination [MMSE] and the Cambridge Assessment Cognitive functions [CAMCOG] both with the arabic version to obtain a coagnitive profile for the patients, complete laboratory investigations, CT scan brain and estimation of the serum level of soluble Fas by ELISA technique

Soluble CD14 and neonatal sepsis

Neonatal sepsis is a common and life-threatening disorder. The purpose of this study is to measure soluble CD 14 level in sera from newborns with sepsis, to compare it with other markers, and to study its evolution in Gram negative and Gram positive sepsis. This study included twenty normal newborns as a control group and forty newborns suffering from neonatal septicemia, 26 babies had a positive blood culture [12 Gram positive [cocci] and 14 Gram negative[bacilli]] and 14 cases were suspected of having sepsis on clinical and laboratory findings but a negative blood culture. Soluble CD14 [sCD14], granulocyte-macrophage colony stimulating factor [GM-CSF], Interleukin-8 [IL-8] C-reactive protein [CRP] and Fi-bronectin were measured by enzyme immunoassay. Neonates suffering from septicemia had increased levels of sCD14 [4.47 +/- 1.13 micro mg/ml, P < 0.001], GM - CSF [7.18 +/- 1.5 pg/ml p <0.001], IL-8 [1.61+1.5 micro g/ml p< 0.001] and CRP [12.35 +/- 6.73mg/l p <0.001], and decreased values of Fibronectin [104.27 +/- 33.19mg/ ml P<0.001]. These levels were highly significant when compared with the control. Neonates with a positive blood culture had a significant increase in sCD14 level [5.01 +/- 0.96 micro g/ml] when compared with neonates suspected of having sepsis but with negative blood culture [3.47 +/- 0.60 micro g/ml P < 0.05]. Neonates with Gram-positive sepsis had increased level of sCD14 [4.21 +/- 0.5 [micro g/ml] and CRP [12.0 +/- 3.79 mg/L] which were highly significant [P<0.01, 0.01] Vs neonates with sepsis but with negative blood culture. Fibronectin showed a significant decrease [P<0.05] when both groups are compared [126.48 +/- 24.68 micro g/ ml Vs 86.65 +/- 45.38 micro g/ml] Neonates with Gram negative sepsis showed highly significant increase in both sCD14 level [5.69 +/- 0.67 micro g/ml Vs 3.47 +/- 0.60 micro g/ml] and CRP [18.8 +/- 5.39 Vs 6.14 +/- 2.8 mg/ L] when compared with neonates with sepsis but negative blood culture. SCD14 levels were positively correlated with CRP values in those patients. In conclusion, sCD14 level is increased in newborn infants with sepsis, and it is the most marker that can discriminate between Gram negative organisms. Gram positive organisms and no growth blood culture [F ratio = 24.291 p < 0.001]. The highest level of sCD14 was in Gram negative bacteria and the least was in no growth blood culture suggesting a different contributions of monocyte and macrophage cells in such cases