Can cytokines response play a role in the treatment of fatal leptospirosis?

Background: The northern coastal regions of Iran are endemic for leptospirosis which may range from a subclinical illness to a progressively fatal disease. There has been growing evidence that inflammatory markers play a significant role in the severity and prognosis of leptospirosis. This study aimed to investigate inflammatory cytokines in patients with leptospirosis. Methods: This descriptive-analytical prospective study was performed in 75 patients over 18 years old who had a positive microscopic agglutination test (MAT) titer from January to June 2019. SPSS software Version 20 was used for statistical analysis and the significance level was considered as p<0.05. Results: The patients' age enrolled in this study are from 21 to 75 years with a mean and standard deviation of 48.6±14.0. The male to female ratio in our participants was 54/21. Fever was the most common symptoms in 66 (88.0%) patients, followed by myalgia in 62 (82.7%) cases. The level of interleukin 10 was significantly higher in severe illness (P=0.003) and fatal cases (p<0.028) compared with recovered patients. The level of TNF-α level was also higher in the severe illness and Weil's syndrome compared with the mild kind (P=0.022). Conclusion: Our results showed that the levels of TNF-α and IL-10 significantly increased in severe leptospirosis. Also, IL-10 was significantly higher in fatal cases. The inhibition of IL-10 production might play an important role in decreasing the risk of fatal outcomes in leptospirosis.

Serum interleukins 6 and 8 in mild and severe asthmatic patients, is it difference?

BACKGROUND: About 5-10% of patients with asthma suffer from poorly-controlled disease despite corticosteroid (CS) therapy. METHODS: 21 severe and 30 mild asthma patients were recruited and underwent collection of blood sample. We determined whether there were any differences in inflammatory biomarkers between severe and mild asthma patients or not. RESULTS: Levels of Interleukin-8 (IL-8) and Interleukin-6 (IL-6) in blood supernatants were similar in both groups of asthma patients. Leukocytes were in range of normal in all patients. Increased eosinophil was in 29% of severe cases and 23% in mild cases. IgE level was increased in 43% of severe form and 50% in mild form. CONCLUSION: There is not any difference between severe and mild asthma in serum IL-8 and IL-6. Therefore, level of serum cytokines may not predict severity of asthma.

Interleukin-1 receptor antagonist gene polymorphism and susceptibility to ischemic stroke.

Cytokines gene polymorphisms have been implicated in susceptibility to ischemic stroke. This study aims to determine the influence of the polymorphism within the intron 2 of the interleukin- 1 receptor antagonist (IL-1Ra) gene on the susceptibility to stroke. A variable number of tandem repeats (VNTR) in intron 2 of the IL-1Ra gene was analyzed in 148 patients with stroke and 161 healthy volunteers from the same area. The carriage rate of allele 2 of IL-1Ra gene, low producer, was significantly higher in patients with stroke compared to the controls (29% vs 21% p = 0.02). Frequency of IL1RN1/IL1RN1 genotype in the patients was significantly lower than the controls (49% vs 66% p = 0.003). The distribution of homozygous genotypes of IL1RN2 was not different between the controls and stroke patients while the heterozygous genotype was more frequent among the patients. (39% vs 25%, respectively). Multiple logistic regression analysis demonstrated that individuals who carry allele 2 for IL-1Ra gene had a significantly higher risk for ischemic stroke with an odds ratio of 2.48 (95% CI, 1.67, 3.51, p = 0.006). These data suggest that allele 2 of the IL-1Ra intron 2 gene represents a susceptibility factor in the development of ischemic stroke.

E-selectin genetic variation as a susceptibility factor for ischemic stroke.

The polymorphism of the E-selectin gene has been implicated in the pathogenesis of atherosclerosis. We sought to explore whether the allelic variants relate to ischemic stroke. We conducted a case-control study of 359 cases of ischemic stroke and 353 community controls. Participants were evaluated for known cerebrovascular risk factors, and the E-selectin S128R and L554F genotypes were established using the polymerase chain reaction (PCR) method. The frequency of minor allele (R) and heterozygous (RS) genotype of E-selectin S128R polymorphism was significantly higher in the stroke patients than in the controls. Evaluation of genetic variation for E-selectin L554F polymorphisms revealed that the frequency of minor allele (F) and its heterozygous genotype (LF) is almost 4 times higher in the stroke patients than the controls (16.7 vs. 4.3 and 33.4 vs. 8.5, respectively). Multivariable logistic regression analysis after adjustment for age, sex and conventional vascular risk factors demonstrated that alleles R of S128R and F of L554F polymorphisms are independent risk factors for ischemic stroke. The combination of 2 minor alleles of E-selectin genes appeared to be the strongest susceptibility factor for ischemic stroke (adjusted OR: 5.89, 95% CI: 2.84-12.21, p = 0.0001). Our study demonstrates that the E-selectin S128R and L554F polymorphisms are associated with susceptibility to ischemic stroke.