Impact of Toll-like receptor 2 (rs5743708) gene polymorphism in pediatric pneumonia: risk and severity.

Pediatric pneumonia is a common respiratory infection that affects children and is thought to be a major source of mortality and morbidity worldwide, particularly in low- and middle-income nations. Toll-like receptor2 (TLR2) is an important receptor involved in the recognition of bacterial pathogens and the activation of the immune response. Genetic variability in TLR2 may partially explain individual differences in susceptibility to infections. The purpose of this study was to investigate the possible contribution of the TLR2 (rs5743708) variant to the risk and severity of pediatric pneumonia infection. The study included 100 pediatric patients diagnosed with pneumonia and 100 normal controls who were age and gender matched. Real-time polymerase chain reaction (PCR) was used to genotype participants for the TLR2 (rs5743708) variant. The analysis revealed that children with the TLR2 (rs5743708) (G/A) genotype showed a 2.52-fold greater risk of having pneumonia (OR: 2.52; 95% CI: 1.32-4.79; p = 0.005) in comparison with patients who have wild homozygous genotypes. Furthermore, we observed that the TLR2 (rs5743708) (A) allele is connected to a greater risk of pneumonia infection in children (OR: 1.612; 95% CI: 1.07-2.43; p = 0.023) but did not significantly influence infection severity. In conclusion, children with the TLR2 (rs5743708) mutant (G/A) genotype and (A) allele had a significantly higher risk of having pneumonia, but they were not at high risk for the severity of the infection.

Calcitonin gene-related peptide and its correlation with prognosis in severe pneumonia among children below 6 years at PICU of Al Zahraa university hospital.

Pneumonia is known to be the biggest cause of death in children younger than five years old. In pulmonary diseases such as pulmonary arterial hypertension, asthma, acute lung injury, and pulmonary fibrosis, calcitonin gene related peptide (CGRP) has been linked to the regulation of inflammation, proliferation, and fibrosis. However, its ability to foretell the emergence of severe pneumonia is questionable. We aimed to determine whether blood levels of CGRP correlate with the outcome of critically ill children. This case-control study included 45 children with severe pneumonia admitted to the pediatric intensive care unit and 45 children with matched age and sex as controls. We investigated the serum level of CGRP as well as routine laboratory investigations of both groups. The CGRP level was lower in the patient group with median of 77 ng/L ranged from 55 to 183 as compared to control group with median of 230 ng/L ranged from 133 to 664 (p≤0.001). Also, CGRP level was significantly higher in the survived group with median of 96.1 ng/L ranged from 55 to 183 than the non-survived group with median of 63.4 ng/L ranged from 55.5 to 120.9 (p=0.022). In conclusion, we found that serum level of CGRP was extremely low in critical and extremely critically ill patients, and thus can be used as a predictor of mortality in children with severe pneumonia.

Role of CD36 expression on circulating monocytes subsets in children on regular hemodialysis.

Cardiovascular diseases are common in children with chronic kidney disease (CKD). According to studies, monocytes play a role in atherosclerotic vascular disorders. CD36 promotes the binding of oxidised low-density lipoprotein (oxLDL) on monocytes, however its role in atherosclerosis is unclear. We aimed to assess the frequency of monocyte subsets in CKD children, and to determine CD36 differential expression on monocyte subsets and its association with the risk of atherosclerotic incidents in those patients. This case-control study included 40 children with CKD and 40 apparently healthy children as controls. We investigated the frequency of total monocyte and monocyte subsets using CD14/CD16. Also, we assessed CD36 differential expression on circulating subsets using flow cytometry. In addition to Doppler ultrasound assessment of the intimal medial thickness (IMT) and peak systolic velocity (PSV) of the main arteries, with routine laboratory investigations of both groups. There was a significant increase in median values of total circulating monocyte percentage in patients than controls (P=0.001). Also, there was a significant increase in the percentage of classical monocyte (CD14high/CD16-) and non-classical monocytes subset (CD14low/CD16+) in patients when compared to controls (P=0.027) and (P=0.001), respectively. There was a significant decrease in the median values of CD36 Mean fluorescence intensity (MFI) expressed on classical, non-classical and intermediate monocytes in patients than the control group (P=0.001), (P=0.001) and (P=0.002), respectively. CD36 MFI expressed on classical, non-classical and intermediate monocytes negatively correlated with cholesterol, triglyceride, systolic, diastolic blood pressure and the IMT of the femoral artery. In conclusion, the increase in the frequency of monocytes, particularly the classical and nonclassical subsets, may be a key component in atherosclerosis pathogenesis in children on hemodialysis. Low CD36 expression on monocyte subsets may be involved in the pathogenesis of atherosclerosis in children on hemodialysis.