Allergy and hematological malignancies risk: A possible implication of Immunoglobulin E, TNF-α and Interleukin 10.

AllergoOncology is a current focus of scientific interest. A possible link between allergies and hematologic malignancies (HMs) existed, but the results are controversial. While some studies concluded that allergy is a risk factor for HMs, others consider allergy a protective factor. We aimed to investigate the frequency of allergic disorders among individuals with hematological malignancies versus hematological malignancies free individuals and to detect the possible implication of serum level of Immunoglobulin (Ig) E, interleukin (IL)-10 and tumor necrosis factor (TNF) α. 75 patients with HMs and 75 healthy controls were enrolled. Diagnosis of allergy was made by history, clinical examination, and skin prick testing (SPT), while measurements of serum total IgE, IL 10 and TNFα were done by ELISA. Allergy was diagnosed in 6.7% of the patients and 42.7% of the healthy controls (P<0.001). There was a statistically significant decrease in serum total IgE and TNF-α and in patients than controls (P=0.002, <0.001), respectively. In contrast, IL-10 showed no significant differences between the two groups. In conclusion, allergic disorders are less frequent in patients with HMs than healthy controls. Lack of allergic conditions, low serum total IgE and TNFα may be independent risk factors for hematological malignancies.

Serum Levels of Transforming Growth Factor Beta -1 (TGF-ß1) as An Early No Invasive Marker for Diagnosis of Lupus Nephritis in Systemic Lupus Erythematosus Patients.

About 40-50% of all patients with systemic lupus erythematosus (SLE) patients are associated with significant morbidity and a poor prognosis. The transforming growth factor ß-1(TGF-ß1) is a member of cytokines families which has emerged as an important player in the pathogenesis of autoimmune diseases, including SLE. In this study we aimed to evaluate TGF-ß1 as a noninvasive diagnostic test for early diagnosis of LN and to assess the correlations between TGFß-1 and clinic-pathologic characteristics as well as disease activity of SLE. This case-control study included 188 patients with SLE, stratified into two subgroups LN group and Non-LN group. We assessed diseases activity by SLE disease activity index and measured TGEß-1 by using ELISA. Our results showed that LN patients had significant lower values of serum TGF-ß1 compared with non-LN patients (P < 0.001). Moreover, there were significant differences between LN histopathological classes. The lowest levels values of serum TGFß1 was in Class V. There were significant negative correlations between levels of TGF-ß1 and SLEDAI, fever, arthritis, proteinuria, hematuria, serum creatinine, thrombocytopenia, lymphopenia, ESR, ANA, pus cell and cellular cast's, all (P < 0.01). In lupus nephritis patients, TGF-ß1 levels were positively correlated with eGFR, C3 and C4 (P < 0.001). Linear regression analysis revealed that, eGFR, CRP, thrombocytopenia, and serum creatinine were independently correlated with TGF-ß1 among lupus nephritis patients (P < 0.001). According to Receiver Operating Characteristic analysis, the sensitivity and specificity of TGF-ß1 were 91% and 65.5%, respectively in the diagnosis of LN among SLE patients. As LN group had significantly lower values of serum TGFß1 and the values further decreased with more damage of kidney tissues and progression of SLE activity. We conclude that serum TGF- ß1 could be a valuable non-invasive marker for assessment of LN activity and organ damage.

Association between CD4+, CD25+, FOXP3+ Regulatory T-cells and Cardiovascular Complications in Diabetic Patients Type 1.

T regulatory cells (Tregs) are a cornerstone regulator for immune responses and inflammatory reactions. Abnormal number or function of Tregs causes deranged immune response that increases the autoimmune disorders and inflammatory conditions. Type 1 diabetes mellitus is an autoimmune disease associated with many complications, of which, Cardiovascular complications are fundamental and responsible for profound morbidity and mortality. Understanding the immunopathogenesis of these disorders allows early diagnosis and better management by innovating new therapeutic targets. In this study, we aimed to detect the association between CD4+CD8+FOX3+ Tregs, T1DM, and associated cardiovascular complications. The study included 144 individuals divided into three groups, group 1 included 48 patients suffering from T1DM without cardiovascular complications, group II: included 48 type T1DM patients with cardiovascular complications. Group III: included 48 healthy control subjects. For all participants, markers for inflammation, and cardiovascular involvement were assessed. The percentage of CD4+ CD25+ FOXP3+ Regulatory T- cells (Tregs) was measured by flow cytometry using peripheral blood samples. The level of Treg was lowest in group II and highest in group III, the difference was highly significant P < 0.001. Treg in group I significantly correlated with age (r= 0.58, P=0.004), CK-mb (r= 0.61, P=0.04) and LDL (r= -.61, P=0.4). While in group II, it correlated with triglyceride level, (r= 0.65 and a P =- 0.02). In conclusion, Lower levels of Tregs are associated with cardiovascular complications in TIDM patients.

Interleukin-6 and hs-CRP as Early Diagnostic Biomarkers for Obesity-Related Peripheral Polyneuropathy in Non-Diabetic Patients.

The number of obese individuals is surging in developed and developing countries. Obesity predisposes to many serious illnesses. Peripheral neuropathy (PN) is one of its major complications. Interleukin-6 (IL-6) is a pro-inflammatory cytokine secreted by the adipose tissue and is believed to play a principal role in obesity complications. Meanwhile, hs-CRP is a known inflammatory biomarker. This study was designed to detect the role of serum IL-6 and hs-CRP as inflammatory biomarkers in early diagnosis of peripheral neuropathy (PN) in non-diabetic obese patients. Additionally, we aimed to explore the association between IL-6 with the clinical and electrophysiological tests of PN. This cross-sectional controlled study enrolled 150 obese patients and 50 subjects as a control group. The obese groups were subclassified according to BMI into three groups; all participants were subjected to a complete neurological examination and motor, and sensory peripheral nerve conduction studies. Serum IL-6 and hs-CRP levels were assessed using a commercially available ELISA. Our results revealed that obese patients with PN had statistically significant higher values of IL-6 and hs-CRP compared to obese patients without PN and controls (P < 0.001). Meanwhile, levels of both marker were inversely related to nerve conduction velocities (P < 0.001). Obese patients with PN had higher values of serum IL-6 and hs-CRP than diabetic patients without DPN. Because the diagnostic power of both markers in serum was significant, we conclude that they could be a useful diagnostic biomarker of PN.

Serum Anti-TPO and TPO Gene Polymorphism as a Predictive Factor for Hidden Autoimmune Thyroiditis in Patient with Bronchial Asthma and Allergic Rhinitis.

Thyroid peroxidase (TPO) is the key enzyme in the biosynthesis of thyroid hormones T3 and T4. Autoimmune thyroiditis is a common disorder affecting 10% of population worldwide. A key feature of autoimmune thyroiditis is the presence of anti TPO antibodies, and some mutation of the TPO gene. Association between autoimmune thyroiditis and other autoimmune disorders has been reported but little is known about association with allergic diseases. In this study, we aimed to evaluate frequency of hidden autoimmune thyroiditis among allergic patient and examine possible relationship between anti-TPO levels and polymorphism at the TPO gene A2173/C exon 12 and different types of allergens. The study included 50 adult Egyptian patients with allergic rhinitis and /or bronchial asthma and 50 controls. For each subject, thyroid stimulating hormone (TSH), thyroxin 4 (T4) and Triiodothyronine (T3) hormones were measured. Anti-thyroid peroxidase (anti-TPO) level was detected by ELISA; and TPO gene polymorphism 2173A>C exon 12 was analyzed using restriction fragment length polymorphism (RFLP). Skin prick test was done to assess allergic response in patients. Serum levels of T3, T4 and TSH did not show any statistical significant difference between patients and groups. However, mean serum anti-TPO level was statistically higher in patients than controls, and correlated positively with body mass index, age, diastolic blood pressure, suggesting higher prevalence of hidden autoimmune thyroiditis in allergic patients than in control group. 2173A>C Genotyping revealed that the frequency of C allele is increased in the patient group. C allele represents a risk factor with odds ratio of 2.37 (1.035-5.44) and a significant P value <0.05. It is concluded that TPO 2173A>C polymorphism may be considered as a risk factor for developing autoimmune thyroiditis in patients with allergic rhinitis and asthma and that these patients should regularly be checked for hidden thyroiditis.