L-Selectin P213S and Integrin Alpha 2 C807T Genetic Polymorphisms in Pediatric Sickle Cell Disease Patients.

Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy characterized by increased cellular adhesiveness. Vaso-occlusion (VOC) is the most prevalent disease complication of SCD that could be altered by genetic factors. L-Selectin and integrin alpha 2 (ITGA2) are 2 adhesion molecules linked to vasculopathy and inflammation. The current study aimed at detecting the prevalence of genetic variants of L-selectin and ITGA2 as possible molecular modulators and novel therapeutic targets in a cohort of pediatric SCD patients. Genotyping was performed by polymerase chain reaction restriction fragment length polymorphism technique for 100 SCD patients and 100 age and gender-matched unrelated healthy controls. The homomutant genotype of ITGA2 C807T was significantly higher in SCD patients compared with controls (P=0.001) and confirmed almost a 3-fold increased risk of moderate and severe attacks of VOC. There are significant adverse effects caused by the polymorphisms of ITGA2, and hence Egyptian SCD patients could benefit from the targeted therapies specifically against ITGA2 to ameliorate the severe course of the disease and improve the quality of life. However, further studies of genotypes and expression levels of these adhesion molecules during the attacks of VOC are recommended.

Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study.

BACKGROUND: Self-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride. MATERIAL AND METHODS: Artificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer's instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post-hoc test. RESULTS: The highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization. CONCLUSIONS: Complementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions. Key words:Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.

Caries Preventive and Antibacterial Effects of Two Natural Mouthwashes vs Chlorhexidine in High Caries-risk Patients: A Randomized Clinical Trial.

AIM AND OBJECTIVE: To evaluate the caries preventive and antibacterial effects of Gum Arabic and Licorice mouthwashes vs chlorhexidine in high caries-risk patients. The prevalence of oral side effects from using the mouthwashes was also assessed. MATERIALS AND METHODS: Total 63 participants categorized as high caries-risk according to the CAMBRA caries-risk model were recruited. They were randomly allocated to three groups (n = 21) according to the mouthwash used: G1 (Gum Arabic), G2 (Licorice), and G3 (Chlorhexidine). Baseline DMF scores and saliva samples were obtained. DMF scores, salivary Streptococcus mutans (SM) and Lactobacillus acidophilus (LA) counts, and any reported oral side effects were recorded after 3, 6, 9, and 12 months. The obtained results were subjected to the statistical analysis and the significance level was set at p ≤ 0.05. RESULTS: Regarding DMF scores, no statistically significant difference was found between the three groups at baseline, after 3, 6, and 9 months. After 12 months, a statistically significant difference was found between G3 and each of G1 and G2 where G3 showed significantly higher DMF scores (p < 0.001). No statistically significant difference was found between G1 and G2. Regarding antibacterial activity, after 6 months, all mouthwashes showed statistically significant antibacterial effect against SM and LA with no statistically significant difference between them (p < 0.001). After 9 and 12 months, G1 and G2 showed a statistically significant reduction in SM and LA counts (p < 0.001). However, G3 showed a statistically significant increase in SM and LA counts indicating bacterial resistance (p < 0.001). No oral side effects were reported in G1 and G2. On the other hand, several oral side effects were reported in G3. CONCLUSION: Gum Arabic and Licorice mouthwashes show promising caries preventive and antibacterial effects with no oral side effects reported. CLINICAL SIGNIFICANCE: Natural mouthwashes can serve as substitutes to chemical agents as chlorhexidine, providing effective caries control and safe long-term use.

Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An in vitro study.

BACKGROUND: The biomimetic self-assembling peptide technology is a paradigm for dental hard tissue regeneration. AIM: To investigate the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization compared to casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and fluoride-based delivery systems. MATERIALS AND METHODS: Artificial enamel lesions were created on buccal surfaces of 40 extracted human molars. Specimens were randomly assigned to four groups (n = 10) according to the remineralizing agent used: G1 - control: artificial saliva, G2 - fluoride varnish, G3 - CPP-ACPF varnish, G4 - self-assembling peptide agent. All products were applied according to the manufacturer's instructions and the specimens were stored in daily renewed artificial saliva. Surface microhardness (SMH) was assessed at baseline, after demineralization, after 1 week and after 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post hoc test. RESULTS: Self-assembling peptide showed the highest statistically significant mean SMH followed by fluoride and CPP-ACPF while the lowest mean SMH was found in artificial saliva. However, no statistically significant difference was found between fluoride and CPP-ACPF. Higher statistically significant mean SMH was found after 4 weeks compared to 1 week remineralization in all groups. CONCLUSIONS: Self-assembling peptide confers the highest remineralizing efficacy compared to fluoride and CPP-ACPF, showing a promising, noninvasive regeneration potential. Furthermore, extended period of time helped attain more benefits from the remineralizing regimens applied.

CD209-336A/G promotor polymorphism and its clinical associations in sickle cell disease Egyptian Pediatric patients.

OBJECTIVES: To detect the frequency of CD209 A>G polymorphism in sickle cell disease (SCD) Egyptian patients and to evaluate the use of CD209 A>G polymorphism as a genetic predictor of SCD clinical heterogeneity. METHODS: A total of 100 Egyptian children with SCD and 100 Egyptian controls were tested for CD209 A>G polymorphism and were followed up prospectively between June 2012 and December 2014. RESULTS: Comparison of CD209 A>G polymorphism among cases and controls did not show statistically significant difference (p = .742). In addition, comparison of the allelic frequency did not show statistically significant difference (p = .738). Infections occurred more frequently among the heterozygous genotype (AG; 60.5%) and homozygous genotype (GG; 75%) patients than among the wild (AA) genotype (24.1%; p < .001). The use of hydroxyurea treatment was significantly higher among the wild (AA) genotype (47%) than the heterozygous (AG; 21%) and homozygous (GG; 5%) genotypes (p = .003). CONCLUSION: We found no significant difference between our population of Egyptian SCD cases and controls regarding CD209 A>G polymorphism. Infections occurred more frequently among the heterozygous genotype (AG) and homozygous genotype (GG) patients.

Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR.

INTRODUCTION: Acute lower respiratory tract infection in children causes significant morbidity in the developing countries. Documentation of virus infection using PCR and clinical characteristics of patients affected with viral pneumonia are reviewed in this study. METHODS: 51 children less than three years admitted to the Pediatric Hospital, Cairo University with viral pneumonia were included. All patients had undergone nasopharyngeal aspirate for PCR viral detection. RESULTS: A total of 51 cases were enrolled in the study, of which 7 cases were negative while 44 children were positive for viruses. The most common respiratory virus was Rhinovirus in 32 patients (72.2%), then parainfluenza virus (PIV) in 12 (27.3%), of which subtypes PIV1 were 2 (4.5%), PIV3 were 5 (11.4%) and PIV4 were 5 (11.4%) cases. The third common viruses were respiratory syncytial virus (RSV) in 9 (20.5%) cases of which 3 (6.8%) were RSVA and 6 (13.6%) were RSVB and adenovirus in 9 cases (20.5%). Boca virus was found in 8 (18.2%) patients, corona virus 2 (4.5%) patients, H1N1 2 (4.5%) patients, enterovirus 2 patients (4.5%) and human metapneumovirus in one case (2.3%). Influenza B and PIV2 were not detected. Coinfection was found in 28 (63.7%). Mortality occurred in 12 (23.5%). There was no significant relation between virus type or coinfection with disease severity. CONCLUSIONS: RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.