Ex vivo Immuno-modulatory effect of Echinococcus granulosus laminated layer during allergic rhinitis and allergic asthma: A study in Algerian Patients.

The effect of helminthic infections on allergic diseases and asthma is still inconclusive. Moreover, there is considerable evidence suggesting that nitric oxide (NO), metalloproteinases and pro-inflammatory cytokines play a significant role in the physiopathology of these diseases. In this sense, the aim of our study is to investigate the ex vivo immunomodulatory effect of the laminated layer (LL, outside layer of parasitic cyst) of the helminth Echinococcus granulosus on NO, IL-17A and IL-10 production. In the first step of our study, we evaluated in vivo the NO, MMP-9, IL-17A, IL-10 levels in Algerian patients with allergic asthma and allergic rhinitis and their changes in relation with exacerbation status of the patients. In the principal part of our work, we assessed NO, IL-10 and IL-17A levels in supernatants of patients PBMC cultures before and after stimulation with LL. Our results indicate a significant reduction in NO production by PBMC of patients with allergic rhinitis and allergic asthma whether mild, moderate or severe after stimulation with LL. Interestingly, LL induces a significant decrease in the production of NO and IL17-A levels as well as an increase in the production of IL-10 in the cultures performed with PBMC of patients with severe allergic asthma. Importantly, our data indicate that LL exert a down-modulatory effect on inflammatory mediators (NO, IL-17A) and up immune-regulatory effect on IL-10 production. Collectively, our study supports the hygiene hypothesis suggesting that Echinococcus granulosus infection like other helminths could prevent and/or modulate inflammation responses during inflammatory diseases.

T cell counts and IL-6 concentration in blood of North African COVID-19 patients are two independent prognostic factors for severe disease and death.

The immune system plays a crucial role in the response against severe acute respiratory syndrome coronavirus 2 with significant differences among patients. The study investigated the relationships between lymphocyte subsets, cytokines, and disease outcomes in patients with coronavirus disease 2019 (COVID-19). The measurements of peripheral blood lymphocytes subsets and cytokine levels were performed by flow cytometry for 57 COVID-19 patients. Patients were categorized into two groups according to the severity of the disease (nonsevere vs. severe). Total lymphocytes, T cells, CD4+ T cells, CD8+ T cells, B cells, and natural killer cells were decreased in COVID-19 patients and statistical differences were found among different severity of illness and survival states (P ˂ 0.01). The levels of IL-6 and IL-10 were significantly higher in severe and death groups and negatively correlated with lymphocyte subsets counts. The percentages of Th17 in the peripheral blood of patients were higher than those of healthy controls whereas the percentages of Th2 were lower. For the severe cases, the area under receiver operating characteristic (ROC) curve of IL-6 was the largest among all the immune parameters (0.964; 95% confidence interval: 0.927-1.000, P < 0.0001). In addition, the preoperative IL-6 concentration of 77.38 pg/ml was the optimal cutoff value (sensitivity: 84.6%, specificity: 100%). Using multivariate logistic regression analysis and ROC curves, IL-6 > 106.44 pg/ml and CD8+ T cell counts <150 cells/µl were found to be associated with mortality. Measuring the immune parameters and defining a risk threshold can segregate patients who develop a severe disease from those with a mild pathology. The identification of these parameters may help clinicians to predict the outcome of the patients with high risk of unfavorable progress of the disease.

[Predictors of asthma in allergic rhinitis]. / Facteurs predictifs d'asthme dans la rhinite allergique.

INTRODUCTION: Asthma and rhinitis are a public health problem around the world with clearly established epidemiological, pathophysiological and clinical links. PATIENTS AND METHODS: Descriptive and prospective observational analytic cross-sectional study with the objective of determining the predictive factors of asthma in allergic rhinitis. RESULTS: 334 rhinitis patients were included, 228 (68.3%) are female; the average age was 35 years. The association rhinitis and asthma in 17.7%. Several predictive factors of asthma were found in these patients, in particular the severe nature of rhinitis as the first factor, followed by sensitization to mites (OR = 2.31 (1.25-2.23) P = 0.006, poly sensitization (86.8%) OR = 1.69 (0.76-3.74) P = 0.19, personal atopy (84.4%) OR = 2.31 (1.25-2.23) P = 0.006, familial atopy OR = 0.81 (0.48-1.34). CONCLUSION: the search for associated asthma should be systematic in patients with rhinitis and, especially since the rhinitis is pers.

INTRODUCTION: L'asthme et la rhinite constituent un problème de santé publique de par le monde, dont les liens sont clairement établis que ce soit sur le plan épidémiologique, physiopathologique ou clinique. PATIENTS ET MÉTHODES: étude transversale observationnelle descriptive, analytique et prospective dont l'objectif était de déterminer les facteurs prédictifs d'asthme dans la rhinite allergique. RÉSULTATS: 334 patients rhinitiques ont été inclus, 228 (68,3%) sont de sexe féminin, la moyenne d'âge était de 35 ans. L'association rhinite et asthme dans 17,7%. Plusieurs facteurs prédictifs d'asthme ont été retrouvés chez ses patients notamment le caractère sévère de la rhinite comme premier facteur, suivi par la sensibilisation aux acariens OR=2,31(1,25-2,23) P=0,006, la poly sensibilisation (86,8%) OR= 1,69 (0,76-3,74) P= 0,19, l'atopie personnelle (84,4%) OR=2,31 (1,25-2,23) P=0,006 et l'atopie familiale OR=0,81 (0,48-1,34). CONCLUSION: la recherche d'un asthme associé doit être systématique chez les patients atteints d'une rhinite et ce d'autant plus que la rhinite est persistante.

Interleukin-6, procalcitonin and neutrophil-to-lymphocyte ratio: Potential immune-inflammatory parameters to identify severe and fatal forms of COVID-19.

Accumulating evidence supports that the viral-induced hyper-inflammatory immune response plays a central role in COVID-19 pathogenesis. It might be involved in the progression to acute respiratory distress syndrome (ARDS), multi-organ failure leading to death. In this study, we aimed to evaluate the prognostic value of the immune-inflammatory biomarkers in COVID-19, then determine optimal thresholds for assessing severe and fatal forms of this disease.153 patients with confirmed COVID-19 were included in this study, and classified into non-severe and severe groups. Plasmatic levels of interleukin 6 (IL6), C-reactive protein (CRP), soluble-IL2 receptor (IL2Rα), procalcitonin (PCT) and ferritin were measured using chemiluminescence assay. Complete blood count was performed by Convergys 3X® hematology analyzer. Our results demonstrated that the peripheral blood levels of IL6, PCT, CRP, ferritin, IL2Rα, white blood cell count (WBC), neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (d-NLR) were significantly higher in severe forms of COVID-19. The ROC curve analysis showed that IL6 was the most accurate inflammatory biomarker. The calculated cutoff of IL6 (42 pg/ml) could correctly classify > 90% of patients regarding their risk of severity (area under ROC curve (AUROC) = 0.972) and the threshold value of 83 pg/ml was highly predictive of the progression to death (AUROC = 0.94, OR = 184) after a median of 3 days. Besides, IL-6 was positively correlated with other inflammatory markers and the kinetic analysis highlighted its value for monitoring COVID-19 patients. PCT and NLR had also a high prognostic relevance to assess severe forms of COVID-19 with corresponding AUROC of 0.856, 0.831 respectively. Furthermore the cut-off values of PCT (0.16 ng/ml) and NLR (7.4) allowed to predict mortality with high accuracy (se = 96.3%, sp = 70.5%,OR = 61.2)' (se = 75%, sp = 84%, OR = 14.6).The levels of these parameters were not influenced by corticosteroid treatment, which make them potential prognostic markers when patients are already undergoing steroid therapy.

Severity factors in Algerian patients hospitalized for COVID-19.

INTRODUCTION: Determining the profile of COVID-19 patients with low pulsed hemoglobin saturation in oxygen (SpO2) could help clinicians identify those with a poor prognosis. AIM: To identify and to compare the clinical, biological and radiological data of Algerian patients hospitalized for COVID-19 and divided according to the SpO2 measured at admission, at rest, and in ambient air. METHODS: A prospective study was carried out on Algerian patients hospitalized for COVID-19 during the period from March 9 to April 30, 2020. The general characteristics of the patients and the clinical, biological and radiological data were determined. RESULTS: 86 patients were included in the study [G1: SpO2 >95% (n=51) and G2: SpO2 ≤95% (n=35)]. Compared to G1, G2 was older (48±14 vs. 61±12 years, p=0.0001), included more patients aged ≥ 50 years (37.2 vs. 80.0%, p=0.0001), having an arterial-hypertension (21.6 vs. 45.7%, p=0.0180), a cancer (0.0 vs. 14.3%, p=0.0054), an anemia (25.6 vs. 56.3%, p=0.0069), a leukocytosis (4.7 vs. 21.9%, p=0.0236), a biological inflammatory syndrome (82.5 vs. 100%, p=0.0142), a hyper-uremia (7.0 vs. 37.5%, p=0.0185), a hyper-creatininaemia (4.7 vs. 18.8%, p=0.0356), a tissue damage (41.0 vs. 66.7%, p=0.0341), a diffuse ground-glass opacity (52.0 vs. 71.4%, p=0.0397), band condensations (30.0 vs. 54.3%, p=0.0244), a severe extension (2.0 vs. 25.7%, p=0.0008), and included fewer patients who complained from diarrhea (49.0 vs. 22.9%, p=0.0145), having a nodular ground-glass (66.0 vs. 40.0%, p=0.0177) and a slight extension (78.0 vs. 40.0%, p=0.0004). CONCLUSION: Criteria associated with low SpO2 in hospitalized COVID-19 patients were advanced age, a history of arterial-hypertension and cancer, high frequencies of certain biological abnormalities or radiological signs. The diarrhea symptom, the radiological appearance of nodular ground glass, and a slight extension of the radiological lesions appear as protective elements.

Incidence of lung cancer in males and females in Algeria: The lung cancer registry in Algeria (LuCaReAl).

BACKGROUND: Lung cancer is a major cause of death worldwide. However, few data on incidence, histologic types and mortality rates of lung cancer were available for Algeria. METHODS: LuCaReAl is an ongoing descriptive, non-interventional, national, multicenter, prospective and longitudinal study conducted in Algeria, among oncologists and pulmonologists in public community and university hospitals. Median and interquartile ranges are displayed. RESULTS: Between July 2016 and July 2017, 897 patients were included. Overall incidence of lung cancer was 3.4 [3.2;3.6] cases per 100,000 inhabitants; overall incidence by sex was 5.8 [5.4;6.2] for males and 1.0 [0.8;1.1] for females. Adenocarcinoma was the most common histologic type of cancer. Most tumors were diagnosed at Stage IV. CONCLUSION: The first results from the LuCaReAl study in Algeria showed that most patients are diagnosed with lung cancer at an advanced stage. The ongoing follow-up will next provide data on the survival and mortality rates.

[Primary lung cancer and occupational exposure in a North African population]. / Cancer bronchique primitif et risques professionnels dans une population Nord-Africaine.

Bronchopulmonary tumors (BPTs) are the most common cancers. They are associated with poor prognosis. They are usually caused by occupational exposure, but this is often underestimated. The purpose of this study is to assess the rate of bronchopulmonary tumors (BPT) probably due to occupational exposure and to investigate the relationship between the type of exposition and the histological type of BPT. We conducted a retrospective epidemiological study, in the Department of Pneumology at the Public Hospital Institution (EPH) in Rouïba. Between January 2014 and June 2019, we collected 357 cases with histologically confirmed BPT. Medical and professional history collections were carried out. The job-exposure matrix was used to identify the various exposures. The study population consisted of 357 patients, with an average age of 63.9±11.1 years and a male to female sex-ratio of 7.4; 76.5% of patients were smokers or former smokers, on average 42 P/A. Non-small-cell lung carcinoma was confirmed histologically in 88.8% of patients. All occupational categories studied would be responsible for 50.7% of exposure-related primary lung cancers, of which 26.5% were due to occupational exposure of heavy-duty drivers and gear drivers. Occupational exposure as a leading cause of bronchopulmonary cancers (CBP) is not negligible but often unrecognized due to its multifactorial factors and the latency period from the time of exposure to onset of disease symptoms, with an impact on the histological type of bronchopulmonary cancer.

Profil clinique, biologique et radiologique des patients Algériens hospitalisés pour COVID-19: données préliminaires.

INTRODUCTION: Aucune étude antérieure n'a élaboré le profil des patients Algériens hospitalisés pour COVID-19. L'objectif de cette étude était de déterminer le profil clinique, biologique et tomodensitométrique des patients Algériens hospitalisés pour COVID-19. MÉTHODES: Une étude prospective était menée auprès des patients hospitalisés pour COVID-19 (période: 19 mars-30 avril 2020). Les données cliniques, biologiques et radiologiques, le type de traitement reçu et la durée de l'hospitalisation étaient notés. RÉSULTATS: Le profil clinique des 86 patients atteints de COVID-19 était un homme non-fumeur, âgé de 53 ans, qui était dans 42% des cas en contact avec un cas suspect/confirmé de COVID-19 et ayant une comorbidité dans 70% des cas (hypertension artérielle, diabète sucré, pathologie respiratoire chronique et allergie, cardiopathie). Les plaintes cliniques étaient dominées par la triade «asthénie-fièvre-toux¼ dans plus de 70% des cas. Les anomalies biologiques les plus fréquentes étaient: syndrome inflammatoire biologique (90,1%), basocytémie (70,8%), lymphopénie (53,3%), augmentation de la lactico-deshydrogénase (52,2%), anémie (38,7%), augmentation de la phosphokinase (28,8%) et cytolyse hépatique (27,6%). Les signes tomodensitométriques les plus fréquents étaient: verre dépoli (91,8%), condensations alvéolaires (61,2%), verre dépoli en plage (60,0%), et verre dépoli nodulaire (55,3%). Un traitement à base de «chloroquine, azithromycine, zinc, vitamine C, enoxaparine, double antibiothérapie et ± corticoïdes¼ était prescrit chez 34,9% des patients. La moyenne de la durée d'hospitalisation était de 7±3 jours. CONCLUSION: La connaissance des profils des formes modérées et sévères du COVID-19 contribuerait à faire progresser les stratégies de contrôle de l'infection en Algérie.

The impacts of parity on lung function data (LFD) of healthy females aged 40 years and more issued from an upper middle income country (Algeria): A comparative study.

BACKGROUND: Studies evaluating the impacts of parity on LFD of healthy females presented controversial conclusions. AIM: To compare the LFD of healthy females broken down according to their parities. METHODS: A medical questionnaire was administered and anthropometric data were determined. Two groups [G1 (n = 34): ≤ 6; G2 (n = 32): > 6] and three classes [C1 (n = 15): 1-4; C2 (n = 28): 5-8; C3 (n = 23): 9-14] of parities were identified. LFD (plethysmography, specific airway resistance (sRaw)] were determined. Student's t-test and ANOVA test with post-Hoc test were used to compare the two groups' and the three classes' data. RESULTS: G1 and G2 were age and height matched; however, compared to G1, G2 had a lower body mass index (BMI). C1, C2 and C3 were height, weight and BMI matched; however, compared to C2, C3 was older. G1 and G2 had similar values of FEV1, forced- and slow- vital capacities (FVC, SVC), maximal mid-expiratory flow (MMEF), forced expiratory flow at x% of FVC (FEFx%), peak expiratory flow (PEF), expiratory and inspiratory reserve volumes (ERV, IRV, respectively), inspiratory capacity (IC), sRaw, FEV1/FVC, FEV1/SVC, and residual volume/total lung capacity (RV/TLC). The three classes had similar values of MMEF, FEFx%, PEF, thoracic gas volume (TGV), ERV, IRV, FEV1/FVC, FEV1/SVC and RV/TLC. Compared to G1, G2 had higher TGV (2.68±0.43 vs. 3.00±0.47 L), RV (1.80±0.29 vs. 2.04±0.33 L) and TLC (4.77±0.62 vs. 5.11±0.67 L). Compared to C1, C2 had higher FEV1 (2.14±0.56 vs. 2.47±0.33 L), FVC (2.72±0.65 vs. 3.19±0.41 L), SVC (2.74±0.61 vs. 3.24±0.41 L), TLC (4.47±0.59 vs. 5.10±0.58 L), IC (1.92±0.41 vs. 2.34±0.39 L) and sRaw (4.70±1.32 vs. 5.75±1.18 kPa*s). Compared to C1, C3 had higher TLC (4.47±0.59 vs. 5.05±0.68 L) and RV (1.75±0.29 vs. 2.04±0.30 L). CONCLUSION: Increasing parity induced a tendency towards lung-hyperinflation.

The multi-ethnic global lung initiative 2012 (GLI-2012) norms reflect contemporary adult's Algerian spirometry.

BACKGROUND: The validation of the multi-ethnic GLI-2012 spirometric norms has been debated in several countries. However, its applicability in Algeria has not been verified. AIM: To ascertain how well the GLI-2012 norms fit contemporary adult Algerian spirometric data. METHODS: This was a cross-sectional study of a convenience sample of 300 healthy non-smoker adults (50% men, age range: 18-85 years) recruited from the Algiers region general population. All participants underwent a clinical examination and a plethysmography measurement. Z-scores for some spirometric data [FEV1, FVC, FEV1/FVC and forced expiratory flow at 25-75% of FVC (FEF25-75%)] were calculated. If the average Z-score deviated by "< ± 0.5" from the overall mean, the GLI-2012 norms would be considered as reflective of contemporary Algerian spirometry. RESULTS: The means±SDs of age, height, weight, FVC, FEV1, FEV1/FVC and FEF25-75% of the participants were, respectively, 48±17 years, 1.65±0.10 m, 73±14 kg, 4.04±1.04 L, 3.18±0.82 L, 0.79±0.05 and 4.09±1.09 L/s. Almost the quarter of participants were obese. The total sample means±SDs Z-scores were 0.22±0.87 for FVC, 0.04±0.88 for FEV1, -0.34±0.67 for FEV1/FVC and 0.93±0.79 for FEF25-75%. For men and women, only the means±SDs of the FEF25-75% Z-scores exceeded the threshold of "± 0.5", respectively, 1.13±0.77 and 0.73±0.76. CONCLUSION: Results of the present study, performed in an Algerian population of healthy non-smoking adults, supported the applicability of the GLI-2012 norms to interpret FEV1, FVC and FEV1/FVC but not the FEF25-75%.