ABSTRACT
AIMS OF STUDY: The habit of khat chewing has been associated with increased risk of systemic and oral disease. Although research has been conducted on the affects of khat on oral epithelial cells, little is known about its influence on immune cells. This study examined the biological effects of khat on the phenotype and function of peripheral blood mononuclear cells (PBMCs). MATERIAL AND METHODS: Khat-stimulated PBMCs were examined for signs of cytotoxicity, apoptosis and changes in cell surface receptor and cytokine expression. Khat-induced regulation of transcription factors and stress-related factors were examined, as was PBMC phagocytic activity against oral bacteria. RESULTS: Khat was cytotoxic to PBMC in a dose- and time-dependent manner and cell death was mediated by apoptosis. Khat-treated PBMC showed increased expression of co-stimulatory molecules (CD80, CD86 and MHC II) and pattern recognition receptors (TLR-2, TLR-4 and TREM-1) but secretion of inflammatory cytokines (TNFα, IL-6, CCL5, CXCL8) was inhibited. In contrast, khat induced an increase in the anti-inflammatory cytokine IL-10 as well as IL-2, IFN-γ, FasL and HSP70. These khat-induced alterations were accompanied by increased expression of transcription factors p38 MAPK and HIF-1α, whilst expression of NFκB p65 was inhibited. Although the ability of PBMC to phagocytose dextran and oral bacteria was inhibited, production of reactive oxygen species was increased. CONCLUSION: These data suggest that khat may severely influence the effectiveness of immune surveillance and anti-microbial capacity of PBMCs.
Subject(s)
Anti-Bacterial Agents/pharmacology , Catha , Leukocytes, Mononuclear/drug effects , Plant Extracts/pharmacology , Anti-Bacterial Agents/toxicity , Apoptosis/drug effects , Cell Survival/drug effects , Cells, Cultured , Cytokines/metabolism , Humans , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Leukocytes, Mononuclear/metabolism , Membrane Glycoproteins/metabolism , Phagocytosis/drug effects , Phenotype , Plant Extracts/toxicity , Plant Leaves/chemistry , Reactive Oxygen Species/metabolism , Receptors, Immunologic/metabolism , Streptococcus/drug effects , Streptococcus/growth & development , Toll-Like Receptor 2/metabolism , Toll-Like Receptor 4/metabolism , Transcription, Genetic/drug effects , Triggering Receptor Expressed on Myeloid Cells-1 , p38 Mitogen-Activated Protein Kinases/geneticsABSTRACT
OBJECTIVE: To determine spinal complications during and after surgery in obstetrics and gynecological patients. METHODS: We conducted a descriptive study in Al-Wahda and Aden Teaching Hospitals in Aden, Yemen from March 2004 to March 2005. One hundred and fifty obstetrics and gynecological patients were enrolled. Before and during surgery, pulse and blood pressure was monitored, and patients were observed for any complications of spinal anesthesia, for example, hypotension, nausea, vomiting, shivering, and total spinal block. Post operatively, the patients were followed to identify post-spinal headache, urine retention, neuralgia, back pain, and respiratory failure. Results of complications were related by applying statistical test. RESULTS: Hypotension during surgery was established at a very high percentage of 82%. This could be due to lack of preloading of the patients before spinal block. Vomiting was 61%, nausea 56%, shivering 30%, and total spinal anesthesia 2%. Post operatively, 77.3% patients had post spinal headache, which lasted 4 days, compared with patients who had been applied with non-cutting disposable needles. Urine retention was 38.7%, while back pain and neuralgia was 21.3% each, and respiratory failure was 1.3%. CONCLUSION: Hypotension was traced in a very high percentage of cases due to unawareness and ignorance of pre-anesthetic intravenous fluid loading by concerned staff. Post spinal headache was the second most common complication due to the usage of large, cutting, non-disposable needles.
