The impact of β-glucan on the therapeutic outcome of experimental Trichinella spiralis infection

Trichinellosis is a cosmopolitan zoonosis that is caused mainly by Trichinella spiralis infection. The human disease ranges from mild to severe and fatality may occur. The treatment of trichinellosis still presents a challenge for physicians. Anti-inflammatory drugs are usually added to antiparasitic agents to alleviate untoward immuno-inflammatory responses and possible tissue damage but they are not without adverse effects. Thus, there is a need for the discovery of safe and effective compounds with anti-inflammatory properties. This study aimed to evaluate the activity of β-glucan during enteral and muscular phases of experimental T. spiralis infection as well as its therapeutic potential as an adjuvant to albendazole in treating trichinellosis. For this aim, mice were infected with T. spiralis and divided into the following groups: early and late β-glucan treatment, albendazole treatment, and combined treatment groups. Infected mice were subjected to assessment of parasite burden, immunological markers, and histopathological changes in the small intestines and muscles. Immunohistochemical evaluation of NF-κB expression in small intestinal and muscle tissues was carried out in order to investigate the mechanism of action of β-glucan. Interestingly, β-glucan potentiated the efficacy of albendazole as noted by the significant reduction of counts of muscle larvae. The inflammatory responses in the small intestine and skeletal muscles were mitigated with some characteristic qualitative changes. β-glucan also increased the expression of NF-κB in tissues which may account for some of its effects. In conclusion, β-glucan showed a multifaceted beneficial impact on the therapeutic outcome of Trichinella infection and can be regarded as a promising adjuvant in the treatment of trichinellosis.

Complicated fungal sinusitis. Clinical and therapeutic aspects

Fungal infections of the sinuses are becoming more common and increasing number of cases are being reported in immunocompetent patients. Unfortunately a significant number of cases present with a complication. In this review of 140 patients with fungal sinusitis, 16 (11.4%) presented with an extrasinus, orbital or intracranial complication. The different fungal types, presentation and therapeutic approaches are discussed. This emphasizes the need for vigilance in dealing with patients with atypical sinus disease and to suspect fungal infections pre- and intraoperatively. Combined surgical and long term medical treatments are usually needed to prevent recurrences and spread of the infection.

The role of Fas system [Fas-FasL] as an inducer of apoptosis in cutaneous leishmaniasis: a combined human and experimental study

Cutaneous leishmanial lesions as well as serum samples from both infected human and Swiss-albino mice were used to investigate the role of Fas system (Fas-FasL) as an inducer of apoptosis and other leishmanicidal cytokines in the disease development in cutaneous leishmaniasis. Soluble Fas was estimated by ELISA, other leishmanicidal cytokines were detected by PAP technique and tissue Fas by RT-PCR. Results showed a significant increase in interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), nitric oxide (NO) and soluble Fas in both infected human and mice. As regards the tissue Fas, there was marked expression in human samples while in murine samples, the expression was reduced in chronic infected mice than in the late acute infected animals which can explain the progression of the lesion in the animals. This study confirms the role of Fas system as an inducer of apoptosis.

The pathogenesis of arthropathy in experimental Schistosomiasis mansoni

The pathogenesis of arthropathy in experimental schistosomiasis mansoni was studied. 70 Swiss albino mice were used, 14 served as control while 56 were subcutaneously infected with 80-100 Schistosoma mansoni cercariae/mouse. Mice were sacrificed at 8, 10, 12, 14, 16, 18 and 20 weeks postinfection (p.i.). Shoulder and knee joints were taken and processed for H & E stain and immunoperoxidase stain. As regards histopathological examination, 75% of infected mice showed marked pathological joint changes, with no Schistosoma ova could be detected in all examined sections. These changes appeared at the 12th week (p.i) and became more severe with the chronicity of infection. Immunohistochemical examination of the infected joints, revealed 75% positivity of schistosomal antigen deposition with mild to moderate expression (in early and late stages of infection respectively). The detection of schistosomal antigen in joints of infected mice which coincided with the histopathological affection, can be considered as the aetiological agent in induction of schistosomal arthropathy. Hence, the term reactive schistosomal arthropathy can be changed into schistosomal arthritis.

Simple clinical system for the prediction of recurrence of nasal polypi

OBJECTIVE

A trial to determine a simple way to predict recurrence of nasal polypi to determine the need for long term medical therapy.

METHODS

Retrospective clinical analysis of the records of 100 patients with nasal polypi and studying various parameters including radiological, intra-operative and bacteriological data.

RESULTS

Among the various parameters studied, maxillary antral involvement, and positive bacterial cultures seemed the most predictive criteria of recurrence. Patients without polypoid involvement of the maxillary sinus and/or with negative cultures were less likely to have early recurrence of their disease.

CONCLUSION

Using simple clinical criteria, two patient populations could be defined. One in which recurrence is inevitable requiring continuous local steroid therapy after surgery and another group requiring occasional local treatment after an initial short course of local steroid spray.