Diagnostic and prognostic significance of serum miRNA-146-a expression in Egyptian children with sepsis in a pediatric intensive care unit.

BACKGROUND: Previous studies have suggested a strong genetic effect on sepsis pathogenesis. The present study aimed to investigate the role of miRNA-146-a expression in pediatric sepsis. METHODS: The study included 55 pediatric sepsis patients and 60 control children of the same age and sex. Serum miRNA-146-a expression was measured using a quantitative real-time polymerase chain reaction. C-reactive protein, interleukin-6, tumor necrosis factor-α and procalcitonin levels were measured by an enzyme-linked immunosorbent assay. The outcome of the pediatric sepsis group was determined at 28 days of follow up. RESULTS: The results obtained revealed that serum miRNA-146-a levels were significantly decreased in sepsis group compared to the control group. Serum level of miRNA-146a correlated with sepsis severity, with the pediatric septic shock group having the lowest level, followed by the severe sepsis and sepsis groups. The miRNA-146-a level could indicate sepsis (area under curve = 0.803). Serum miRNA-146-a expression was negatively associated with C-reactive protein, pro-calcitonin, interleukin-6 and tumor necrosis factor-α. Patients with miRNA-146-a at a level lower than 0.4 had an increased mortality rate. CONCLUSIONS: miRNA-146-a is of significant diagnostic and prognostic value in pediatric sepsis and could be used for planning therapeutic strategies.

Assessment of left ventricular mass index could predict metabolic syndrome in obese children.

BACKGROUND: Childhood obesity is a major risk factor for cardiovascular diseases in children and adults. OBJECTIVES: The purpose of this study was to evaluate the serum leptin level and the cardiac changes in normotensive obese children and to study the relationship between left ventricular mass index (LVMI) and serum leptin with the parameters of metabolic syndrome (MS) in obese children. METHODS: This study was conducted in al Jeddani Hospital and Ibn Sina College Hospital in Saudi Arabia in the period from July 2012 to December 2013, and included 82 obese children. Their mean age was 10.2 ± 2.8 years; they were divided into 25 obese children with MS and 57 obese children without MS, and 40 healthy age- and sex-matched children were also included in the study as a control group. All children were subjected to clinical assessment including standing height, body weight, body mass index (BMI), waist circumference (WC), and blood pressure measurements. All children received an echocardiographic examination (2-dimensional, M-mode, Doppler, and tissue Doppler echocardiograpy) and laboratory assessment of serum leptin level, fasting glucose, fasting insulin, the homeostatic model assessment for insulin resistance (HOMA) index, total cholesterol, triglycerides, and high- and low-density lipoprotein profile. RESULTS: BMI, BMI standard deviation score, WC, fasting glucose, fasting insulin, HOMA index and the serum leptin level were significantly higher in obese children compared to control group (p < 0.05). The LVMI were increased in the obese compared to the control group (p < 0.001) while left ventricle systolic and diastolic functions did not differ in obese versus control group (p > 0.05). There was a significant positive correlation between both LVMI and serum leptin level in comparison to BMI, WC, fasting glucose, fasting insulin, HOMA, triglycerides, and low-density lipoprotein in all obese children, especially the MS group. However, there was a significant negative correlation between both LVMI and serum leptin level in comparison to high-density lipoprotein. CONCLUSION: Assessment of LVMI as routine echocardiographic examinations and serum leptin level might be a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood that can predict metabolic syndrome and insulin resistance.

CD14 tobacco gene-environment interaction in atopic children.

Studying gene-environment interactions may elucidate the complex origins of atopic diseases. The aim of this study was to evaluate the association of CD14 polymorphisms and atopy in Egyptian children and to study whether atopy is influenced by CD14 interaction with tobacco smoke exposure. CD14 -159 C/T and CD14 -550 C/T were genotyped in 500 asthmaic children, 150 allergic rhinitis children and 150 controls. We found that CD14 -159T allele, CD14 -550T allele and CD14 -159T/-550T haplotype were significantly associated with atopic asthma and allergic rhinitis groups. CD14 -159 TT and CD14 -550 TT genotypes associated with elevated IgE levels in children exposed to tobacco smoke. The TT genotype of CD14 -159 C/T and CD14 -550 C/T was associated with higher serum levels of sCD14. The present study indicated that CD14 gene polymorphisms may contribute to susceptibility to atopy in Egyptian children and influenced with tobacco smoke exposure.