Serum IgE and Allergy Related Genotypes of IL-4R α and IL-13 Genes: Association with Glioma Susceptibility and Glioblastoma Prognosis.

Gliomas are the commonest type of primary brain tumor in adult. Glioblastoma maltiforms (GBM) is the malignant form with poor prognosis. Certain genotypes of inflammatory gene which associated with asthma and allergic conditions (IL-4R α and IL- 13) are inversely associated with glioma risk. We studied the relation between allergic conditions and serum level of IgE and glioma risk. We also examined the role of SNP of inflammatory genes IL-4 R α (rs 1801275) and IL-13 (rs 1800925) in development of glioma and to find out factors which can modify the prognosis of glioblastoma. This study included 98 Egyptian glioma cases and 98 healthy controls. Full history and clinical data were taken; total serum IgE were assayed, genotyping of IL-4 R α (rs 1801275) and IL-13 (rs 1800925) genes was carried out by restriction digestion after genes amplification. In cases group histopathological examination and tumor grading were done. Past history of allergic condition and elevated serum levels of IgE were more frequent in controls than in cases group (P< 0.05). Genotypes AA and AG of IL- 4R α were significantly frequent in cases and A allele were considered risk factor for glioma OR 2.31(1.53- 3.48), P < 0.001. We also found that C allele of IL-13 is risk factor for glioma susceptibility with p value = 0.006. Longer median survival period in glioblastoma were associated with elevated serum IgE level and who were AA genotypes of IL-4 R α. We conclude an inverse relation between glioma risk, and allergy biomarker IgE and allergy related (IL-4R α; rs 1801275) gene polymorphisms. GBM patients with IL-4Rα AA genotype, have longest survival. Chemotherapy and gross total resection improve GBM prognosis.

The pattern of infection and antibiotics use in terminal cancer patients.

BACKGROUND: Although cancer patients are susceptible to infection, there is no evidence-based published guideline on the appropriate use of antimicrobial treatment in this group of patients. METHODS: We retrospectively collected medical records of all terminal cancer patients who died in the oncology department over a 15-month period and were reviewed for the pattern of infection and causes of antimicrobial use during the patients' last admission of life. RESULTS: A total of 258 eligible patients were enrolled, there was an equal distribution of males and females (M/F: 129/129), and the mean age was 60.5 years. 221 patients admitted with fever (85%), 22 patients (8.5%) got fever after hospitalization and 15 patients (5.8%) did not suffer from fever. Among patients with fever, 46 patients (18.9%) had two infection episodes and 197 patients (81.1%) had only one infection episode. The culture results revealed positive in 98 patients (40%) with gram-negative organisms were the dominant organisms. The major infection sites were the respiratory tract, urinary tract and wound. 114 patients (47%) received one antibiotic and 129 patients (53%) received more than one. The mean duration of hospitalization was significantly longer for infected patients than for uninfected patients (8.00 vs. 18.15 days, p=0.0001). Outcome of antibiotic use revealed 42 patients (17.3%) with symptoms improved 71 patients (29.2%) with stationary symptoms and 130 patients (53.5%) revealed symptom deterioration. CONCLUSIONS: Our study revealed that antibiotic therapy for terminal cancer patients should be on a clear rationale. We need further study to clarify if there is survival effect with antibiotic use or not.