A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Potential immunotherapeutic role of interleukin-2 and interleukin-12 combination in patients with hepatocellular carcinoma

Abdulwahab Ali Gabeen,1 Fatma Farag Abdel-Hamid,1 Motawa Eisa El-Houseini,2 Shadia Abdel-Hamid Fathy1 1Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt; 2Cancer Biology Department, National Cancer Institute (NCI), Cairo University, Cairo, Egypt Background: Many recent therapeutic interventions are necessary to improve the treatment of hepatocellular carcinoma (HCC), including immunotherapy, which seems to offer one of the new realistic therapeutic modalities. This study aims to investigate the optimization of immunotherapy for HCC patients by appraisal of both interferon (IFN)-γ levels and phenotyping of lymphocytes obtained from peripheral blood and fine-needle aspirates. Methods: The isolated lymphocytes were cultured in the presence of interleukins (IL)-2, IL-4, and IL-12. Enzyme-linked immunosorbent assay and flow cytometric techniques were used for the assessment of human IFN-γ production and the studied T-cell subpopulations, respectively. Results: Mixed cell populations of peripheral blood lymphocytes and tumor infiltrating lymphocytes treated with IL-2 plus IL-12 showed a marked and significant elevation in IFN-γ levels in their culture media, a significant decrease in the percentage of cluster of differentiation (CD)4+CD25+ regulatory T-cells, and a nonsignificant increase in the percentage of CD8+ cytotoxic T-cells. Meanwhile, IL-2 plus IL-4 treatment demonstrated nonsignificant effects. Conclusion: Our data suggested that IL-12 together with IL-2 caused a suppression of CD4+CD25+ regulatory T-cells and an elevation of IFN-γ levels, which play a crucial immunotherapeutic role in the management of HCC patients. Keywords: HCC, immunotherapy, fine-needle aspirates, tumor infiltrating lymphocytes, interferon-gamma, interleukin

Serum Visfatin in Relation to Some Parameters of Iron Metabolism in Egyptian Subjects with Altered Glucose Tolerance

1Visfatin is an adipokine mainly synthesized and secreted in visceral fat. Visfatin was found to have important proinflammatory and immunomodulating properties. The aim of the present work was to clarify the relation between plasma visfatin, some parameters of iron metabolism and insulin resistance in altered glucose tolerance patients and its relation to obesity.Eighty subjects were included in this study; 60 diabetic patients, and 20 healthy subjects, sex and age matched, used as controls (Gr.I). The patients were divided into: Gr. II impaired glucose tolerance (IGT); Gr. III (type I); Gr. IVa (obese type II) and Gr.IVb( non obese type II). The following biochemical parameters were estimated in this study: serum visfatin, plasma fasting and postprandial glucose, glycated hemoglobin (HbA1c), serum insulin, HOMA, HOMA, QUICKI, serum total cholesterol, LDL-C, HDL-C, triacylglycerols (TGs),as well as serum ferritin, sTFR and TNF-.Results indicated a significant positive correlation between serum visfatin and each of FPG (in IGT patients) and serum ferritin (in type I), but it was correlated negatively with sTFR/log ferritin (in type I) and serum sTFR (in obese type II diabetics). Serum ferritin level showed a significant positive correlation with BMI, waist to hipratio, HDL-C (in non obese type II), and with TNF- (in type Idiabetics). No correlation was detected between ferritin and HOMA all patients. As a conclusion, serum visfatin was correlated to some parameters of iron metabolism in type I and in obese type II diabetics. Visfatin was also correlated with FPG in IGT group, its increase may be due to hyperglycemia itself and at the same time it may induce progression of inflammatory condition. This study did not show an association of serum visfatin with insulin resistance or obesity.This as adapted from Ph.D thes is submitted to Ain Shams University by Doaa M. IbrahimKey Words: Serum visfatin, insulin, ferritin, sTF

Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)

Liver fibrosis is a common pathway leading to cirrhosis, which is the final result of injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Liver biopsy has been considered to be the “gold standard” to assess fibrosis. However, liver biopsy being invasive and, in many instances, not favored by patients or physicians, alternative approaches to assess liver fibrosis have assumed great importance. Moreover, therapies aimed at reversing the liver fibrosis have also been tried lately with variable results. Till now, there has been no consensus on various clinical, pathological, and radiological aspects of liver fibrosis. The Asian Pacific Association for the Study of the Liver set up a working party on liver fibrosis in 2007, with a mandate to develop consensus guidelines on various aspects of liver fibrosis relevant to disease patterns and clinical practice in the Asia-Pacific region. The process for the development of these consensus guidelines involved the following: review of all available published literature by a core group of experts; proposal of consensus statements by the experts; discussion of the contentious issues; and unanimous approval of the consensus statements after discussion. The Oxford System of evidence-based approach was adopted for developing the consensus statements using the level of evidence from 1 (highest) to 5 (lowest) and grade of recommendation from A (strongest) to D (weakest). The consensus statements are presented in this review