Study of CD4+ T-lymphocytes in chronic kidney disease patients with COVID-19 infection

Chronic kidney disease (CKD) is a functional and/or structural kidney damage that lasts more than three months duration. This study aimed to analyze CD4+ T-lymphocytes levels in chronic CKD patients specifically, during the coronavirus disease 2019 (COVID-19) pandemic to assess the adaptive cell-mediated immunity. The study measured absolute CD4+ T-lymphocytes counts by flowcytometry among participating individuals. The study included 146 subjects, 40 CKD patients and tested positive for COVID-19, 44 CKD patients and tested negative for COVID-19 and 62 normal individuals as controls. There was a significant impact of COVID-19 infection in CKD patients showing lower absolute CD4+ T-lymphocytes values to more than six folds compared to the control individuals (Odds Ratio: 72.63, p= 0.0001). Also, there was a significant correlation between the decrease in absolute CD4+ T-lymphocytes counts and the advanced stages of CKD. Therefore, the study indicated that CKD causes an obvious alteration in the body immune system as decreased CD4+ T-lymphocytes levels alongside with the advanced CKD stages. While COVID-19 infection exposes CKD patients to be 50% more likely to express lower values of CD4+ T-lymphocytes levels compared to the negative tested CKD patients. In conclusion, poor immune response and increased morbidity and mortality could be correlated with CKD patients especially when associated with COVID-19 infection as comorbidity.

Desnutrin as a Biomarker for Insulin Resistance in Patients with Vitiligo Vulgaris

Background

Vitiligo is a common depigmented skin disorder characterised by the selective destruction of melanocytes.

Aims and Objectives

This study aimed to assess serum desnutrin and its association with insulin resistance in patients with vitiligo vulgaris.

Materials and Methods

This study was a cross-sectional case-control study. It included 45 patients with vitiligo vulgaris and 45 age- and sex-matched healthy controls. Patients were subjected to complete general and cutaneous evaluations. All participants were subjected to the assay of fasting blood glucose (FBG), cholesterol, triglyceride, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), fasting serum insulin and serum desnutrin. Homeostasis Model Assessment + insulin resistance (HOMA + IR) was calculated for all participants.

Results

There were statistically significant differences between the patients with vitiligo vulgaris and healthy controls regarding HDL, FBG, fasting insulin, HOMA-IR, and serum desnutrin (P < 0.001). Desnutrin levels were negatively correlated with FBS, LDL, VLDL, fasting insulin, and HOMA-IR (P < 0.05). Unlikely, the level of desnutrin had a positive, non-significant correlation with HDL (rho = 0.17, P = 0.059).

Conclusion

This study concluded that in patients with vitiligo vulgaris, as a result of increased serum levels of glucose and insulin, the serum desnutrin was suppressed, perhaps contributing to hyperlipidaemia and IR. So, low serum desnutrin could be a biomarker for IR in patients with vitiligo vulgaris. A multidisciplinary approach is essential for the early detection of diabetes mellitus, IR and hyperlipidemia among patients with vitiligo vulgaris to avoid cardiovascular and metabolic complications.

Exists a role for serum irisin in Egyptian Behcet's patients with subclinical atherosclerosis?

OBJECTIVES

To examine the serum irisin level in a group of Behcet's disease patients, its association with illness parameters, and its utility in diagnosing subclinical atherosclerosis.

METHODS

This randomized case-control study included 50 patients and 50 age- and sex-matched controls. Carotid Doppler ultrasound for the measurement of the carotid artery intima-media thickness (CIMT) and ankle-brachial pressure index (ABPI) were performed. A clinical evaluation, lipogram, and serum irisin were also performed.

RESULTS

Between the patients and the control group, there was a significant difference in CIMT, S. irisin level, and ankle-brachial pressure index; however, gender and BMI did not significantly affect CIMT, ABPI, or S. irisin level. CIMT demonstrated a substantial negative correlation with both S. irisin and ABPI (r =  - 0.62, P 0.0001). With a sensitivity of up to 94.30% and a specificity of 93.30%, the ROC analysis revealed that a decrease in S. irisin level in Behcet's patients was indicative of subclinical atherosclerosis. The drop in the ABPI level demonstrated a sensitivity of up to 94.30% and a specificity of 100%.

CONCLUSION

Subclinical atherosclerosis is prevalent among Egyptian Behcet's patients, and S. irisin can be employed as a biomarker for diagnosing subclinical atherosclerosis in Behcet's illness. Key Points • Serum irisin has been studied in numerous autoimmune disorders as a marker for subclinical atherosclerosis, although its importance in Behcet's disease remains unclear (BD). • We examined the change in serum irisin levels in Behcet's disease patients and healthy controls. In addition, its association with carotid artery intima-media thickness (CIMT) and ankle-brachial pressure index was investigated (ABPI). • Changes in serum irisin levels are significant in BD, and a decrease in irisin level indicates subclinical atherosclerosis.

Structural, FTIR spectra and optical properties of pure and co-doped Zn1-x-y Fe x M y O ceramics with (M = Cu, Ni) for plastic deformation and optoelectronic applications

We report here a considered novel study on the structural, FTIR spectra and optical properties of pure and co-doped Zn0.90-x Fe0.1M x O with ((M = Cu, Ni and (x = 0.00, 0.10) and (0.00 < y < 0.20)) at different sintering temperatures T s (T s  = 850 °C for series I and 1000 °C series II). Although the ZnO wurtzite structure is conformed for all samples, some secondary lines with little intensity are formed. But the number of these lines is higher for series I than for series II. The (c/a) value and U-parameter are almost constant for all samples, while Zn-O bond length L is slightly increased. The porosity and crystallite size are decreased by Fe, and also for (Fe + Cu) samples, and their values for series I are lower than for series II. The residual stress is tensile for most samples. Interestingly, the Young's, rigid and bulk modulus, Poisson's ratio and Debye temperature, obtained from FTIR analysis, are increased by Fe addition with a further increase for Fe + Ni) samples for both series. A ductile nature is obtained for pure, Fe and (Fe + Cu) samples; whereas a brittle nature is approved for (Fe + Ni) samples. On the other hand, the energy gap (E g ), residual lattice dielectric constant (ε L ) and carrier density N are increased by Fe addition, followed by a further increase for (Fe + Cu) samples, while the vice is versa for the inter-atomic distance R. For example, E g was increased from 3.153 eV for pure ZnO to 3.974 eV for (Fe + Cu) samples (i.e., 0.821 eV more), while it was decreased to 2.851 eV for (Fe + Ni) samples (i.e., 0.302 eV less). A direct behavior is obtained between E g and both elastic modulus (Y, β), lattice and micro strains (ε L , ε m ), dislocation density (δ), residual stress (σ) and carrier density N, whereas a reverse behavior is obtained between E g and both crystallite size (D), porosity (PS) and inter-atomic distance (R) . These results are explained in terms of the generated blocked states of the conduction band as indicated by the Burstein Moss effect. These novel findings reveal that the co-doping has intense ZnO and moderate metal oxide modes in the ZnO matrix structure, which makes ZnO co-doped with (Fe + Cu) more suitable for gas sensors and optoelectronic devices. In contrast, ZnO co-doped with (Fe + Ni) samples is strongly recommended for altering plastic deformation. To our knowledge, the present investigation can be considered the first study and probably has never been discussed elsewhere, which highlights the present investigation.

Soluble CD163 for Prediction of High-Risk Esophageal Varices and Variceal Hemorrhage in Patients with Liver Cirrhosis

<b><i>Introduction:</i></b> Activation of hepatic macrophages in liver disease is pathogenically related to portal hypertension (PH). Soluble CD163 (sCD163) is shed in blood by activated macrophages and may predict PH progression noninvasively. This study was designed to investigate the relation of serum sCD163 to the grade and bleeding risk of esophageal varices (EV) and its role for prediction of variceal hemorrhage (VH). <b><i>Methods:</i></b> The study included cirrhotic patients divided into 3 groups: patients who presented with acute upper gastrointestinal bleeding (UGIB) proved to originate from EV on endoscopy, patients without any history of UGIB but who revealed EV on surveillance endoscopy, and patients without endoscopic evidence of varices. Variceal grade and risk signs and bleeding stigmata were noted simultaneously with measurement of serum sCD163 concentration. <b><i>Results:</i></b> Serum sCD163 concentration showed a significant increase in cirrhotic patients compared to healthy subjects (<i>p</i> &#x3c; 0.001) with a stepwise increase among the group without varices, nonbleeder group, and bleeder group sequentially. Serum sCD163 levels correlated positively with the variceal grade and risk signs in both the bleeder and nonbleeder groups (<i>p</i> = 0.002, <i>p</i> &#x3c; 0.001 and <i>p</i> = 0.004, <i>p</i> &#x3c; 0.001, respectively). Serum sCD163 at a cutoff value of 3.6 mg/L performed significantly for prediction of EV presence (AUC = 0.888). Serum sCD163 at a cutoff value &#x3e;4 mg/L significantly predicted large-size and high-risk EV (AUC = 0.910 and AUC = 0.939, respectively) and the index bleed risk (AUC = 0.977). Serum sCD163 at a cutoff value &#x3e;4.05 mg/L modestly discriminated bleeding EV from those that had never bled (AUC = 0.811). <b><i>Conclusions:</i></b> Serum sCD163 levels accurately predicted high-grade and high-risk EV and could help plan for primary prophylaxis. However, it modestly identified VH occurrence, and endoscopy would be required to make a definitive diagnosis.

Structural morphology and nonlinear behavior of pure and co-doped Zn1-x-yFexMyO varistors with (M = Cu, Ni)

We report here structural morphology and nonlinear behavior of pure and co-doped Zn_0.90-xFe_0.1M_xO with (M = Cu, Ni and (x = 0.00, 0.10) and (0.00 ≤ y ≤ 0.20)) at different sintering temperatures (T _s = 850 and 1000 °C). It is found that the co-doping of ZnO by (Fe + Cu) or (Fe + Ni) up to 0.30 does not deform the well-known wurtzite structure of ZnO, as well as pure and 0.1 of Fe-doped ZnO. The SEM micrographs did not show any secondary phases at the boundaries of grains as compared to ZnO, the average grain size is decreased for Fe and (Fe + Cu) samples, while it is increased for (Fe + Ni) samples. The nonlinear coefficient α and breakdown field E _B are generally increased by 0.1 of Fe addition, but they are shifted to lower values as T _s increases for all samples. Furthermore, they are gradually increased/decreased to higher/lower values for (Fe + Cu/Fe + Ni) samples up to 0.30 of co-doping content. The values of α and E _B are increased from 30.06, 2115.38 V/cm for ZnO at 850 °C to 50.07, 5012 V/cm by (0.1Fe + 0.2Cu) co-doping, and from 23.53, 1956.52 V/cm to 45.58, 4750 V/cm at 1000 °C, while they are, respectively, decreased by (0.1Fe + 0.2Ni) to 13.19, 312 V/cm and 11.85, 172.42 V/cm. Similar behavior was generally obtained for nonlinear conductivity σ _L and height of potential barrier φ_B, whereas the vice is versa for the behavior of leakage current J _k and residual voltage K _r. Our results are discussed in terms of the comparative participation between the effects of co-doping of (Fe + Cu) and (Fe + Ni) to ZnO for supporting the potential barrier as compared to individual doping by Fe, Cu and Ni. This study perhaps recommended these samples for optoelectronic and ferromagnetic investigation after COVID-19 is over.

Vitamin D among Patients of Pulmonary and Extrapulmonary Tuberculosis: A Prospective Case-control Study

Background:

Vitamin D has an essential role in enhancing the immune system to fight and destroy bacteria. People with vitamin D deficiency are highly liable to develop active pulmonary and extrapulmonary tuberculosis.

Objective:

: To evaluate the serum level of vitamin D among patients with pulmonary and extrapulmonary tuberculosis.

Patients and Methods:

A case-control prospective study was conducted among patients with pulmonary and extrapulmonary tuberculosis and asymptomatic persons (controls). The study included 80 participants, 50 were TB patients, while 30 were controls. Vitamin D 1, 25(OH) assay was done for all.

Results:

Vitamin D assay of the included subjects revealed that 52 patients were vitamin D deficient, 7 patients had insufficient vitamin D and 21 had normal serum levels. Of the extrapulmonary TB patients, 35 (100%) had vitamin D deficiency, in pulmonary TB patients, 15 (100%) were vitamin D deficient. While 2 study subjects (6.7%) in the control group were deficient of vitamin D, 7 (23.3%) had insufficient vitamin D and 21cases had normal vitamin D levels. There was a statistically significant relationship between pulmonary and extrapulmonary TB cases and vitamin D deficiency (P< 0.001).

Conclusion:

Vitamin D deficiency was found among pulmonary and extrapulmonary tuberculosis patients especially among female patients and patients in rural residence. The current study needs additional work to evaluate the value of adding vitamin D to the TB treatment regimen.

Possible role of interleukin 21 and interleukin 33 in patients with genital warts

Genital warts (GWs) are most prevalent sexually transmitted infections, presenting especially among the sexually active young population of both sexes. Efficient cell-mediated immunity is needed for regression of GWs. To clarify the reactivity of cellular immunity among patients with GWs by means of measurements of their levels of serum interleukin (IL)-21 and IL-33, hence, to identify the possible role of IL-21 and IL-33 in GWs, this study aimed to evaluate serum levels of IL-21 and IL-33 among patients with GWs in comparison with the results of the controls. Levels of serum IL-21 and IL-33 were assayed utilizing commercially enzyme-linked immune-sorbent assay kits in 45 patients with GWs and 45 healthy control subjects. Levels of serum IL-21 and IL-33 were significantly decreased among patients with GWs in comparison with the controls (p < .0001). There was a highly significant positive correlation between IL-21 and IL-33 (r = .73, p < .0001). Low levels of serum IL-21 and IL-33 could have a contributive role in development, persistence, severity, and recurrence of GWs which rely basically on the defectiveness of cell-mediated immunity. This could receive new light on nonconventional strategies for the prospective medical therapies of GWs by means of regulation of IL-21 and IL-33.

Apolipoprotein E phenotyping: a word of caution

Using two different techniques, phenotyping and genotyping, we have studied allelic variation at amino acids 112 and 158 of the apolipoprotein E gene locus in 52 patients with insulin-dependent diabetes and in 58 non-diabetic controls. Phenotypes were determined by isoelectric focusing and immunoblotting of delipidated, neuraminidase-treated plasma. Genotypes were determined by using the polymerase chain reaction to amplify a 227 base pair fragment of the apolipoprotein E gene spanning both allelic sites. This was then digested with the restriction endonuclease CfoI and the alleles identified by polyacrylamide gel electrophoresis. Discrepancies between phenotype and genotype were observed in 16 (15%) of the individuals studied, 7 (13%) in the diabetics and 9 (17%) in the controls. From these results it is concluded that isoelectric focusing can lead to the erroneous assignment of apolipoprotein E phenotype even after pretreatment with neuraminidase. It is suggested that genotyping by DNA analysis is the method of choice in determining apolipoprotein E status.

THE RELATIVE RATES OF DESTRUCTION OF PECTIN IN MACERATES OF VARIOUS CITRUS FRUITS

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