Evaluation of immunodiagnostic potential of ESAT-6 synthetic peptides mixture in Egyptian pulmonary tuberculosis patients.

Identification of M. tuberculosis ESAT-6 proteins has enhanced research for developing new specific and reliable in vitro diagnostic tests for pulmonary tuberculosis. The aim of this study was to assess the diagnostic potential of ESAT-6 synthetic overlapping peptides mixture (Pepmix) for diagnosis of pulmonary M. tuberculosis infection in Egypt. IFN-gammaand IL-17 production was assessed in whole-blood culture assay after overnight stimulation with M. tuberculosis crude culture filtrate (CF), purified 38 kDa antigen, and ESAT-6 Pepmix. Concentration of IFN-gamma and IL-17 was evaluated in the culture supernatant by ELISA. Patients with active pulmonary TB patients (n = 37), Tuberculin Skin Test (TST) positive healthy subjects (n = 16) and TST negative healthy subjects (n = 16) were included. Results indicated that IFN-gammaproduction following stimulation with crude CF, and 38 kDa purified antigen was not significantly different between patients and TST+ healthy controls. In contrast, Pepmix clearly distinguished between patients and TST+ healthy subjects with sensitivity of 70.3 % and specificity 96.9 %. The concentration of secreted IL-17 was significantly lower than IFN-gamma, and no statistically significant difference was found between groups. It is concluded that IFN-gamma assay using ESAT-6 Pepmix, as antigenic stimulus, has the potential to rapidly diagnose pulmonary TB infection.

Cytokine profiling as a prognostic markers in chronic myeloid leukemia patients.

Chronic myeloid leukemia (CML) accounts for 20% of all adult leukemias worldwide. Most Egyptian patients are diagnosed in the chronic phase and progress to the accelerated or blastic phase, which is related with decreased survival. Various pro-inflammatory cytokines are involved in the pathogenesis of chronic leukemia but their prognostic significance is unknown. The aim of the current study is to determine the validity of TNF-alpha, IL-6, IL-18 and CRP levels as prognostic markers in CML patients. These parameters were monitored with clinical routine tests in 25 CML patients besides ten healthy control subjects at National Cancer Institute, Cairo, Egypt. IL-6 and IL-18 levels before hydroxyurea treatment were significantly higher in all patients compared to controls (P<0.001 for both levels). At hematological remission, significant reductions were observed for IL-6 (P<0.001), IL-18 (P<0.001) and CRP (P<0.001) whereas reduction in the levels of TNF were non-significant. Moreover, an inverse correlation was observed between both of TNF (P<0.05) and CRP (p<0.01) on one side and megakaryocytic dysplasia on the other side. These findings offer evidence that TNF may have potential prognostic role in megakaryocytic dysplasia detection.

Role of TNF-alpha as a survival prognostic marker in chronic lymphocytic leukemia patients.

Pro-inflammatory cytokines play a central role in the pathogenesis of chronic leukemia. This pilot study assesses the potential value of measuring TNF-alpha, IL-6, IL-18 and CRP levels as prognostic markers for disease monitoring in CLL patient. These parameters were evaluated in 45 CLL patients and 25 healthy control subjects IL-6 on contraire to the other cytokines, was significantly higher (P<0.05) in patients compared to controls. At hematological remission, only CRP was significantly reduced (P<0.005). IL-6 is inversely correlated with Hb (P<0.05). In the meantime, IL-18 is correlated to splenomegaly, and CRP (P<0.05; for both). TNF-alpha level in non-survived patients was significantly higher than both survived patients (P<0.05), and controls (P<0.01). In conclusion, TNF-alpha can be potentially used as a survival prognostic factor in CLL.