Novel mutation in alpha-spectrin gene in Saudi patients with hereditary spherocytosis

Hereditary spherocytosis (HS) is the most common hereditary hemolytic disorder induced by red blood cell (RBC) membrane defect. This study was undertaken to determine mutations in genes associated with RBC membrane defect in patients with HS such as α-spectrin gene (SPTA1), β-spectrin gene (SPTB), ankyrin gene (ANK1), band 3 anion transport gene (SLC4A1) and erythrocyte membrane protein band 4.1 gene (EPB41). Blood samples were collected from 23 unrelated patients with HS. Patients were diagnosed according to the guidelines from the British Society for Hematology. All hematological examinations for the determination of RBC abnormalities and osmotic fragility tests were conducted. Genomic DNA were extracted from peripheral blood cells and coding exons of known genes for hereditary spherocytosis were enriched using Roche/KAPA sequence capture technology and sequenced on an Illumina system via next-generation sequencing (NGS). The data showed that most of the HS patients confirmed splenomegaly and showed elevated reticulocytes and abnormal bilirubin values. NGS analysis identified the heterozygous variant c.5501G > A in the exon 39 of SPTA1 gene, resulted in a Trp1834*, which leads to a premature stop codon and subsequent mRNA degradation (nonsense- mediated decay) or truncation in α spectrin. Moreover, our data also revealed conventional mutations in genes SPTB, ANK, SLC4A1 and EBP41 in severe patients of HS. In short, this is the first report that determined a novel mutation c.5501G > A in SPTA1 gene in the Saudi population. To the best of our knowledge, this variant c.5501G > A has not been described in global literature so far. This novel mutation in SPTA1 gene is unique in the Saudi population.

Mucormycosis co-infection in COVID-19 patients: An update

Mucormycosis (MCM) is a rare fungal disorder that has recently been increased in parallel with novel COVID-19 infection. MCM with COVID-19 is extremely lethal, particularly in immunocompromised individuals. The collection of available scientific information helps in the management of this co-infection, but still, the main question on COVID-19, whether it is occasional, participatory, concurrent, or coincidental needs to be addressed. Several case reports of these co-infections have been explained as causal associations, but the direct contribution in immunocompromised individuals remains to be explored completely. This review aims to provide an update that serves as a guide for the diagnosis and treatment of MCM patients' co-infection with COVID-19. The initial report has suggested that COVID-19 patients might be susceptible to developing invasive fungal infections by different species, including MCM as a co-infection. In spite of this, co-infection has been explored only in severe cases with common triangles: diabetes, diabetes ketoacidosis, and corticosteroids. Pathogenic mechanisms in the aggressiveness of MCM infection involves the reduction of phagocytic activity, attainable quantities of ferritin attributed with transferrin in diabetic ketoacidosis, and fungal heme oxygenase, which enhances iron absorption for its metabolism. Therefore, severe COVID-19 cases are associated with increased risk factors of invasive fungal co-infections. In addition, COVID-19 infection leads to reduction in cluster of differentiation, especially CD4+ and CD8+ T cell counts, which may be highly implicated in fungal co-infections. Thus, the progress in MCM management is dependent on a different strategy, including reduction or stopping of implicit predisposing factors, early intake of active antifungal drugs at appropriate doses, and complete elimination via surgical debridement of infected tissues.

Recognition of Pathogens and Their Inflammatory Signaling Events

The innate immune system is the main and first line of defense mechanism present in the human body, which acts against a foreign antigen. To function it utilize several mechanisms, among those are the primary one is recognizing the foreign antigen which is accomplished via decidedly complicated group of molecules termed as pattern recognition receptors (PRRs), which perceive various diverse structures present on the pathogen known as pathogen-associated molecular patterns (PAMPs). PRPs include several classes of receptors’, functions, and nature of these receptors vary from each other depending upon the molecular composition of PAMPs they detect. However, the Toll-like receptors (TLRs) are among the class of PRPs, which are studied widely. In this review, we have presented the contemporary understanding of pathogens recognition by various receptor classes including PRRs. In addition, we also discuss PRPs associated signaling pathways associated with antimicrobial immune response triggering.

An Updated Analysis on the Risk Factors Associated with COVID-19 Transmission

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a global public health disaster and knowledge of its associated risk factors provides protection/slowdown against its transmission. AIM: This study was undertaken to investigate all major risk factors associated with transmission of the COVID-19 infection. METHODS: The data on the risk associated factors for the COVID-19 transmission were collected from the Texas Medical Association, Center for Disease Prevention and Control, World Health Organization, and Health and Safety Executive. The collected data were combined, analyzed, and presented as percentage mean ± SD. RESULTS: The collective data showed that among games such as playing football and basketball are highly risky followed by swimming in public pool and playing at the beach. Whereas, playing golf and tennis are not risky (p < 0.05). Moreover, the carryout food from the restaurants is much safer as compared with eating at buffet, in restaurants (p < 0.01). The data on social gathering showed that religious places, sports stadium, music concert, cinema halls, amusement parks, attending funerals, and wedding showed a higher risk of spreading COVID-19. The data on general outing showed that going to gymnasium, traveling by bus or plane, and visiting in salon are highly risky (p < 0.01) for COVID-19 infection. Moreover, hugging, shaking hands, and kissing are also highly risky for the COVID-19 infection. CONCLUSIONS: This study provides the collective information on the risk factors associated with the COVID-19 transmission. The findings can contribute to the concerned authorities to formulate the preventive measures to limit spread of the COVID-19 infection.

Conduction of Academic Examination in the University Campus by the Medicine College during Coronavirus Disease 2019 Pandemic: Elaboration of Precautionary Methods

Objective: This study was undertaken to elaborate the precautionary methods taken by the College of Medicine of Qassim University for conduction of students’ academic examinations (exams) in the university campus during the COVID-19 pandemic. Methods: This study was conducted on undergraduate medical students (n=674) from the September 2020 to April 2021 in the College of Medicine at Qassim University. The switch into conducting exams within the center was managed by the exam committee. Multiple online workshops were conducted to the staff and students regarding the precautionary measures and the exam procedures in order to prevent the transmission of the disease among students and staff. New guidelines for undertaking the exams were designed and implemented at the exam centers in the university campus during COVID-19 pandemic. Results: All the exams were conducted in a satisfactory manner under one roof under the supervision of the invigilation team within the examination center located in the university campus. The strict implementation of precautionary guidelines and the crucial steps to prevent the spread of Coronavirus facilitated the accomplishment of this vital task in a smooth manner with no case of COVID-19 reported in any of the staff or students who participated in this activity. Conclusions: This study revealed the precautionary methods and steps undertaken by the college of medicine, Qassim University in terms of conducting exams within campus. We concluded that if implementation of precautionary measures should be carried out in a proper manner then it is possible to conduct exams under one roof.

Modulation of mice immune responses against Schistosoma mansoni infection with anti-schistosomiasis drugs: Role of interleukin-4 and interferon-gamma

OBJECTIVE

Schistosoma mansoni (S. mansoni) is endemic in Africa, the Middle East, South America, and the Caribbean. This study investigated the modulation of immune response against S. mansoni through estimation of interleukin-4 (IL-4) (Th2 cytokine) and interferon-gamma (INF-γ) (Th1 cytokine) under the effect of anti-schistosomal drugs.

METHODS

Laboratory bred female albino mice (n = 120) were divided into the following groups: untreated mice, S. mansoni infected mice, S. mansoni infected mice treated with artemisinin (ART), arachidonic acid (ARA), nifedipine or praziquantel (PZQ). Levels of IL-4 and INF-γ cytokines in the serum samples of treated and untreated mice were determined by enzyme-linked immunosorbent assay and the results were further validated by measuring the mRNA levels IL-4 and INF-γ using quantitative real-time polymerase chain reaction.

RESULTS

Anti-schistosomiasis drugs ART and ARA increased the levels of Th2 cytokine IL-4 (P < 0.05), whereas PZQ drug decreased the response of IL-4 (P < 0.05). However, nifedipine was found to be ineffective in modulating the response of IL-4 (P > 0.05). As far as Th-1 cytokine IFN γ was concerned, only PZQ increased its levels (P < 0.05), whereas other tested anti-schistosomiasis drugs; ART, ARA, and nifedipine were found to be infective (P > 0.05).

CONCLUSIONS

These findings indicated that anti-schistosomiasis drugs ART, ARA, and PZQ play a role in the modulation of expression of Th2 cytokines. Whereas, only PZQ may play a role in the modulation of Th1 cytokines. These findings provide a scope for the formulation of novel anti-schistosomal drugs as well as in the therapeutic management of patients infected with S. mansoni.