Serum Level and Genetic Polymorphism of Mannose-Binding Lectin in Infants with Neonatal Sepsis at Zagazig University Hospitals.

Immature immune system in neonates is considered a risk factor for neonatal infections and sepsis. Mannose-binding lectin (MBL) is one of the innate immune system components that could recognize a wide variety of pathogens and initiate an immune response against them. Objectives of this study were to assess the correlation between serum level of MBL and MBL2 gene polymorphism and incidence of neonatal sepsis. Isolation of bacteria from neonatal blood culture was carried out by conventional methods then, serum level of MBL was measured by ELISA and MBL2 gene polymorphism was determined by PCR-RFLP. Out of 50 neonates with sepsis enrolled in this study, 44 (88%) neonates had MBL deficiency and 6 (12%) had normal serum level with a very high statistically significant difference (P=0.00001). Genotype BB was more frequent in neonatal sepsis (56%) followed by genotype AB (32%) then genotype AA (12%) and it was more prevalent in preterm (63.2%) than in full term (33.3%) with a high statistically significant difference (P=0.001). Patients with BB genotype had the lowest MBL level in serum compared to other genotypes with a very high significant difference (P=0.001). In conclusion, low serum level of MBL and genotype BB might be significantly associated with development of sepsis among neonates.

Procoagulant versus anticoagulant factors in cirrhotic patients.

BACKGROUND AND STUDY AIM: Liver cirrhosis leads to decreased production of clotting factors that are generally all produced in the liver except factor VIII and von Willebrand factor. However, cirrhotic patients are not protected from thrombosis. The present study aimed to assess the procoagulant and anticoagulant factors in cirrhotic patients with and without bleeding and/or thrombotic events. PATIENTS AND METHODS: A total of 102 adult subjects were enroled: 51 cirrhotic patients and 51 healthy controls. After full history taking with special attention given to thromboembolic and haemorrhagic events, platelet count, serum albumin, bilirubin, international normalised ratio (INR), PT, partial thromboplastin time (PTT), hepatitis B surface antigen (HBsAg), hepatitis B core (HBc) antibodies, hepatitis C virus (HCV) antibodies, factor VIII, protein C, Protac-induced coagulation inhibition percentage (PICI%) assay and abdominal ultrasound were performed for patients and controls. Upper gastrointestinal endoscopy was conducted for the patients. RESULTS: Compared with control subjects, factor VIII and factor VIII/protein C were significantly higher, while protein C and PICI% were significantly lower among patients. CONCLUSION: Patients with liver cirrhosis may have a tendency for bleeding or thrombosis according to the balance of coagulant and anticoagulant status. PICI%, the assay that evaluated the functionality of the protein C anticoagulant system, was significantly lower in patients compared to control subjects. Accordingly, low PICI% and high factor VIII/protein C ratio can be taken as an index of hypercoagulability in cirrhotic patients.