Correlation analysis between cytokines' profile, autoimmune antibodies and the duration of type 1 diabetes: A case control study in a specialized children's centre in Riyadh.

OBJECTIVE: The aim of this study was to investigate the role of cytokines in children with T1D living in Saudi Arabia and their correlation with disease duration and autoimmune antibody markers. METHODS: A case-control study was conducted in the endocrine clinic of King Abdullah Specialized Children's Hospital in Riyadh. A total of 274 T1D and healthy control children were enrolled in the study. 5 mL of venous blood samples were collected in the morning after 9 to 12 h of fasting in BD Vacutainer® EDTA tubes and centrifuged at 250g for 15 min at. Plasma was then stored at -20°C for detection of anti-islet, anti-GAD antibodies (Abs), and C-peptide using commercial ELISA kits from Thermo Fisher Scientific. The levels of cytokines were measured using commercial sandwich ELISA kits from Abcam. RESULTS: Median differences in cytokine levels (IFN-γ, TNF-α, IL-1ß, IL-2, IL-4, IL-6, IL-10, IL-13, IL-18, IL-21, IL-35, and IL-37) were significantly higher in T1D patients compared with healthy controls (p-value < .001). Spearman's Rho correlation indicated that TNFα, IL-1ß, IL-4, IL-10, IL-13, and IL-21 correlated significantly with T1D Abs (p-value = .01). HbA1C correlated negatively with IL-35 and IL-37, and positively with IL-18 (p-value = .01). Linear regression analysis showed a significant increase in anti-glutamic acid antibodies (GAD) in patients with >3 years of T1D duration. CONCLUSION: Autoantibodies remained positive at high levels in our patients over a 3-year duration of the disease and correlated with specific cytokines. The clear correlations with disease duration and profile of specific cytokines could be targets for future therapeutic interventions.

Prevalence of Insomnia Among Patients with Bronchial Asthma.

BACKGROUND: Insomnia is commonly reported in patients with asthma. However, the prevalence of insomnia and its relationship to asthma control have not been established. OBJECTIVE: To determine the prevalence of insomnia in adults with asthma and to evaluate the association between insomnia and level of asthma control. METHODS: This is a cross-sectional study of 200 patients recruited from pulmonary clinics at a tertiary care center. Adults (age ≥16 years) diagnosed with asthma by the primary treating physician were recruited over a 6-month period from December 2018 to May 2019. Asthma and insomnia severity were assessed using the Asthma Control Test and Insomnia Severity Index (ISI). RESULTS: The mean age of participants was 51±17 years, and 67% were female. Insomnia (ISI score ≥10) was present in 46.5% of the participants. The severity of insomnia was inversely related to the level of asthma control: moderate-to-severe insomnia was more frequent in patients with uncontrolled asthma (43%) than in those with partially controlled asthma (25%) or well-controlled asthma (12%) (P < 0.05 for all comparisons). CONCLUSION: Insomnia is common among patients with asthma, especially those with suboptimal asthma control. Further investigations are required to more fully understand the complex relationship between asthma and insomnia.

The prevalence of sleep disturbance among asthmatic patients in a tertiary care center.

Sleep disturbances are commonly reported by patients with asthma. However, the prevalence of sleep disturbance and its association with the level of asthma control is unknown. The primary objective was to determine the prevalence of sleep disturbance among Saudi adult asthmatic patients attending pulmonary clinics at King Abdulaziz Medical City (KAMC). The study also aimed to compare sleep quality between controlled and uncontrolled asthma patients. The study was carried out in the outpatient pulmonary clinics at KAMC and utilized a cross-sectional survey. The survey included five different questionnaires: asthma control test and questionnaires related to the quality of sleep (Pittsburgh sleep quality index [PSQI], Epworth sleepiness scale [ESS], Berlin questionnaire [a measure of obstructive sleep apnea risk], and insomnia severity index [ISI]). Among the 200 asthma patients, 66% suffered from poor sleep quality (PSQI > 5), 43% were at high risk for obstructive sleep apnea, 25% had excessive daytime sleepiness (ESS > 10), and 46.5% had significant clinical insomnia (ISI ≥ 10). Poor sleep quality was less common in patients with well-controlled asthma (37%) compared to those with partially controlled asthma (78%) and uncontrolled asthma (82%) (p < 0.001). Poor sleep quality was common among patients with asthma, particularly those with suboptimal levels of asthma control. Further studies are needed to better understand the interaction between these two conditions.