The Ifng antisense RNA 1 (IFNG-AS1) and growth arrest-specific transcript 5 (GAS5) are novel diagnostic and prognostic markers involved in childhood ITP.

Background/aim: IFNG-AS1 is a long noncoding RNA that works as an enhancer for the Interferon-gamma (IFN-γ) transcript. GAS5 (growth arrest-specific 5) is a lncRNA that is associated with glucocorticoid resistance. Aberrant expressions of IFNG-AS1 and GAS5 are directly linked to numerous autoimmune disorders but their levels in childhood ITP are still obscure. This study aims to elucidate expressions of target lncRNAs in childhood ITP and their association with pathophysiology and clinical features of the disease as well as their association with types and treatment responses. Method: The fold changes of target lncRNAs in blood samples from children with ITP and healthy controls were analyzed using quantitative real-time PCR (qRT-PCR). Results: There were overexpressed lncRNAs IFNG-AS1 and GAS5 in serum of childhood ITP patients [(median (IQR) = 3.08 (0.2-22.39) and 4.19 (0.9-16.91) respectively, Also, significant higher IFNG-AS1 and GAS5 (p < 0.05) were present in persistent ITP (3-12 months) [ median (IQR) = 4.58 (0.31-22.39) and 3.77 (0.87-12.36) respectively] or chronic ITP (>12 months) [ median (IQR) = 5.6 (0.25-12.59) and 5.61 (1.15-16.91) respectively] when compared to newly diagnosed <3 months patients [IFNG-AS1 median (IQR) = 1.21 (0.2-8.95), and GAS5 median (IQR) = 1.07 (0.09-3.55)]. Also, significant higher lncRNAs IFNG-AS1 and GAS5 were present in patients with partial response to treatment [IFNG-AS1 median (IQR) = 4.15 (0.94-19.25), and GAS5 (median (IQR) = 4.25 (0.81-16.91)] or non-response [IFNG-AS1 median (IQR) = 4.19 (1.25-22.39) and GAS5 median (IQR) = 5.11 (2.34-15.27)] when compared to patients who completely responded to treatment (IFNG-AS1 median (IQR) = 2.09 (0.2-14.58) and GAS5 (median (IQR) = 2.51 (0.09-10.33). In addition, following therapy, the expressions of IFNG-AS1 and GAS5 are significantly negatively correlated with platelet count. Conclusion: Findings suggest that lncRNAs IFNG-AS1 and GAS5 are novel diagnostic and prognostic genetic markers for childhood ITP that can aid in a precise prediction of the disease's progress at the time of diagnosis and could be a useful tool for treatment planning.

Serum miR-34a-5p and miR-199a-3p as new biomarkers of neonatal sepsis.

BACKGROUND: Neonatal sepsis is a serious condition. Recent clinical studies have indicated that microRNAs (miRNAs) are key players in the pathogenesis of sepsis, which could be used as biomarkers for this condition. PATIENTS AND METHODS: A total of 90 neonates with sepsis and 90 healthy neonates were enrolled in this study. qRT-PCR was performed to measure the expression levels of serum miR-34a-5p and miR-199a-3p. RESULTS: miR-34a-5p and miR-199a-3p serum levels were significantly reduced in neonates with sepsis compared with those in healthy neonates (P = 0.006 and P = 0.001, respectively). Significant correlations of miR-34a-5p and miR-199a-3p with each of TLC, RDW, RBS, and C-reactive protein (CRP) as well as SNAPII were observed, indicating their associations with the severity of neonatal sepsis. CONCLUSION: miR-34a-5p and miR-199a-3p may be useful as novel biomarkers in neonatal sepsis and may provide a new direction for its treatment.

The Role of Prebiotics and Probiotics as an Adjuvant Therapy in Children with Idiopathic Relapsing Nephrotic Syndrome: A Prospective Open-label Clinical Trial.

Idiopathic nephrotic syndrome (INS) is the most common cause of NS in children. It is characterized by the existence of edema, proteinuria, and hypoalbuminemia, as well as repeated relapses. The etiology remains unknown, but new evidence for its pathogenesis relates to the dysfunction of T-regulatory (T-reg) cells, which could be caused by dysbiosis of the gut microbiota. Our study aimed to investigate the effect of prebiotics and probiotics as adjuvant therapies for children with relapsing INS. The study was designed as a prospective open-label randomized clinical trial involving 30 children diagnosed with relapsing INS. The children were randomly divided into two groups. Group 1 was treated with prednisone only, and Group 2 was treated with prebiotics and probiotics in addition to prednisone. Fresh stool samples were collected from the children. Lactobacillus species were isolated and identified by conventional microbiological methods. The total number of Lactobacillus species was counted for each stool sample. The population of T-reg cells in the peripheral blood mononuclear cells was analyzed using flow cytometry. Children treated with prebiotics and probiotics in addition to steroids showed a significant increase in T-reg cells (CD4+/CD25+/FOXp3+) in the peripheral blood and a higher count of Lactobacillus species in their stool alongside a significant decrease in the rate of relapses in this group compared with Group 1. Treatment with prebiotics and probiotics signi-ficantly increased T-reg cells and decreased the rate of relapse in INS.

Antithrombin III level in children with nephrotic syndrome, its correlation to thromboembolic complications, and serum albumin level.

Nephrotic syndrome (NS) is one of the most common pediatric diseases with many complications. Thromboembolic complication is the most serious complication. The aim of this study was to predict the possible risk of thromboembolic complication development in children with NS due to antithrombin III deficiency. This study was conducted in the Outpatient Nephrology Clinic of Children's Hospital in Fayoum University Hospital. It included 27 children with NS and 27 healthy children as a control group in an analytic study with cross-sectional comparative design. Laboratory investigations were done in the form of complete blood picture, serum levels of albumin, total protein, creatinine, urea, cholesterol, triglycerides, urine analysis, albumin/creatinine ratio, prothrombin time, and INR. The serum antithrombin III level was measured by double ELISA technique. Data analysis was performed using the Statistical Package for the Social Sciences software version 18. Student's t-test was used to compare measures of two independent groups of quantitative data. One-way ANOVA test was used to compare more than two independent groups of quantitative data. Kruskal-Wallis test was used in comparing more than two independent nonparametric groups. Bivariate Pearson correlation test was used to test the association between variables. The level P ≤0.05 was considered significant. There were significant decreases in antithrombin III, albumin, and total protein levels in the study group during relapse and improved after steroid. There were no thromboembolic complications detected among the study group. NS causes heavy proteinuria with loss of many important proteins as antithrombin III. Serum antithrombin III level is significantly decreased in children with NS, and it correlated with serum albumin. Although patients in the study have thrombocytosis, hypercholesterolemia, and decreased serum level of antithrombin III, none of the children in the the study showed thrombotic complication, so we conclude that, thromboembolism is uncommon in children with NS may be due to early diagnosis and proper treatment.