Th17 cells increase in RRMS as well as in SPMS, whereas various other phenotypes of Th17 increase in RRMS only.

BACKGROUND: The nature and extent of inflammation seen in multiple sclerosis (MS) varies throughout the course of the disease. Changes seen in CD4+ T-helper cells in relapsing-remitting (RR) MS and secondary progressive (SP) MS might differ qualitatively and/or quantitatively. OBJECTIVE: The objective of this paper is to study the frequencies of all major CD4+ T-helper subtypes - Th17, Th22 and Th1 lineage cells - in relapse, remission and secondary progression alongside CCR6 status, a chemokine receptor involved in migration of these cells into the central nervous system. METHODS: We compared 100 patients (50 RRMS and 50 SPMS) and 50 healthy volunteers and performed flow cytometric analysis of lymphocytes in blood samples. RESULTS: We demonstrated raised frequencies of various cell types along the Th17 axis; Th17, Th17.1 (IL-17+ interferon gamma+) and dual IL-17+ IL-22+ cells in RRMS. Th22 and CCR6+ Th1 cells (nonclassical Th1) were also increased in RRMS. All these cells were CCR6+. Only Th17 frequencies were elevated in SPMS. CONCLUSIONS: Increased frequencies of Th17 cells are implicated both in RRMS and SPMS. The CCR6 pathway includes Th17, Th22 and Th1 nonclassical cells, of which Th22 and Th1 cells represent the greatest subsets in MS.

A comparative study of the genetics of Behcet's disease in Iraq: international collaboration to transfer clinical and laboratory skills to Baghdad medical school and hospitals.

A collaborative project funded by the Iraqi Research Fellowship Programme of the Council for Assisting Refugee Academics was set up to transfer laboratory and clinical skills in between three clinical research teams in the UK, Jordan and Iraq. The project was set up to study the genetics of the potentially debilitating condition, Behçet's Disease (BD). Blood samples were collected from: 38 BD patients, 28 patients with oral ulcers not related to BD and 32 healthy controls. All samples were analysed using Micro SSP HLA Class I B locus kit (B locus, generic). Logistic regression analysis revealed that samples positive for HLA-B51 were 7.4 times more likely to have BD than the healthy control subjects. The results of this study make a valuable addition to the scientific literature. Additional valuable outcomes include the intellectual exchange and transfer of skills in between the collaborating teams, which led to the establishment of an international research collaboration.

Lymphocyte phenotyping, using cluster-of-differentiation (CD) markers, in young Iraqi children with visceral leishmaniasis.

The lymphocytic phenotypes involved in the pathogenesis of visceral leishmaniasis (VL) in Iraqi children have recently been investigated, in a study based on cluster-of-differentiation (CD) markers. Each case of VL investigated was confirmed parasitologically by the observation of amastigotes in a bone-marrow smear. Compared with the values for the healthy children used as controls, a lymphocyte from an untreated VL case was significantly less likely to be CD3+ or CD4+, significantly more likely to be CD8+, and more (but not significantly more) likely to be CD22+. The untreated cases also had significantly lower CD4+/CD8+ ratios than the controls. Among the untreated cases, gender and age had no apparent effect on any of these variables. After 28 days of treatment with sodium stibogluconate, there was a trend towards normalization in the lymphocytic phenotypes of the VL cases, with significant increases in the CD4+/CD8+ ratios and the percentages of lymphocytes that were CD3+ or CD4+, and a significant decrease in the percentages of lymphocytes that were CD22+.

Prevalence and patterns of neurological involvement in Behcet's disease: a prospective study from Iraq.

OBJECTIVES: To determine the prevalence of neurological involvement in Behcet's disease in a prospective study, and to describe the clinical patterns of neurological presentation in this disease in patients attending a multidisciplinary clinic in Baghdad. METHODS: All patients attending the clinic who fulfilled the international study group criteria for the diagnosis of Behcet's disease were studied during a two year period starting in April 1999. Patients were assessed neurologically by a neuro-Behcetologist. All those with clinical neurological manifestations were sent for CSF examination, cranial magnetic resonance imaging, and magnetic resonance venography and were followed up to explore the patterns of neurological relapse. RESULTS: 140 patients with Behcet's disease were studied. Their mean age was 34.2 years (range 16 to 66); 105 (75%) were men and 35 (25%) were women. The mean duration of the disease was 4.2 years (range 0.4 to 26). Twenty patients (14%) had neurological involvement (neuro-Behcet's disease); 14 of these (70%) were men and six (30%) women. The mean age at the first neurological presentation was 34.1 years. The mean duration of follow up of patients with neuro-Behcet's disease was 20.7 months. Ten patients with neuro-Behcet's disease (50%) presented with parenchymal CNS involvement, six (30%) with intracranial hypertension, and four (20%) with a mixed pattern of both parenchymal CNS involvement and intracranial hypertension. CONCLUSIONS: Careful neurological assessment of patients with Behcet's disease may show a relatively high prevalence of neuro-Behcet features, and though the clinical patterns of presentation are characteristic a mixed pattern may occur.

Efficient use of animal manure on cropland--economic analysis.

Manure contains all the macro- and microelements needed for plant growth; however, it represents one of the most underutilized resources in the US. The major problem with the use of manure on cropland is the direct effect of its composition on application cost. This cost is a function of the mineralization process of organic matter. The mineralization process is influenced by the properties of the manure, properties of the soil, moisture, and temperature. This study evaluates the simultaneous effect of these variables on the optimal use of manure on cropland. The results show that the properties of manure and soil significantly affect the mineralization of organic nitrogen and thus the optimal quantity of manure required to satisfy the nutrient requirement of crops in a given rotation system. Manure application costs range from a low of 18% of the cost of commercial fertilizer for chicken manure applied to one type of soil, to a high of 125% of the cost of commercial fertilizer for cow manure applied to another type of soil. The maximum distance to transfer manure to the field, that will equate its application cost to the cost of commercial fertilizer, ranges from a high of 35 km (22 miles) for chicken manure applied to one type of soil, to a low of 1 km (0.62 miles) for cow manure applied to another type of soil. For rotation system 2, manure application costs range from a low of 37% of the cost of commercial fertilizer for chicken manure applied to one type of soil, to a high of 136% of the cost of commercial fertilizer for cow manure applied to another type of soil. The maximum distance to transfer manure to the field, that will equate its cost to the cost of commercial fertilizer, ranges from a high of 20 km (12.5 miles) for chicken manure applied to one type of soil, to a low of 0 km (0 miles) for cow manure applied to another type of soil.

Neuro-Behcet's disease in Iraq: a study of 40 patients.

Behcet's disease (BD) is a chronic, multisystemic disorder with variable prevalence in different geographical areas. Neurological manifestations (neuro-Behcet's disease, NBD) are well recognized. We studied 40 Iraqi patients with NBD from a neurological unit in a large teaching hospital, all fulfilling the International Study group criteria for the diagnosis of BD. There were 37 males and three females. Thirty-nine were Arab Muslims and one was a Kurd Muslim. Mean age at neurological presentation was 29+/-7.6 years (range 18-50 years). Fifteen out of 23 tested patients (65%) had a positive pathergy test and seven out of 13 tested (54%) had HLA-B5(51). A classification into three reasonably clear distinctive main patterns of neurological presentation is proposed. First: a parenchymal CNS pattern (the commonest) - 26 patients (65%), which included three relatively common forms: brain stem syndrome (10 patients), diffuse form (predominantly with pseudobulbar signs) (nine patients) and cerebral stroke-like form (five patients); and two less common forms: psychiatric and myelopathy (one patient each). Second: intracranial hypertension (IH) (with papilledema) - 11 patients (27.5%). Third: meningitis-like pattern - three patients (7. 5%). This classification has clinical, etiopathological, therapeutic and prognostic implications. In conclusion, NBD is not uncommon in Iraq, and it affects predominately Arab Muslims. BD should be routinely looked for in adult patient, especially males, in their third and fourth decades who present with IH and papilledema, brain stem syndrome, pseudobulbar palsy, stroke, meningitis or myelopathy.