Predictive Significance of Interleukins 17A and 33 in Risk of Relapsing–Remitting Multiple Sclerosis

تعتبر الحركيات الخلوية جزيئات مرسلة للإشارات بين الخلايا المناعية وتلعب دوراً اساسياً في الامراضية ومنها الانترلوكينات 17A و 33 . لقد هدفت دراسة المرضى-السيطرة الحالية التحري عن دور هذين الحركيين الخلويين في خطورة تطور مرض التصلب العصبي. لقد تمت مشاركة ثمان وستون مريضاً مصاباً بالتصلب العصبي المتعدد من نوع الانتكاسي-المتحسن وعشرون شخصا من الاصحاء (مجموعة سيطرة) واستخدمت طريقة الادمصاص المناعي المرتبط بالأنزيم (الاليزا) لقياس المستوى المصلي. لقد اظهرت النتائج بوجود زيادة معنوية في المستويات المصلية لكل من  A17 IL- و 33 IL-مقارنة مع مجموعة السيطرة (14.1 ± 4.5 مقابل 7.5 ±3.8 ،P  > 10.00  و65.3 ± 16.3 مقابل 49.3 ± 20.0 ، P > 10,00 )  بيكوغرام/ مل على التوالي. لقد اظهر تحليل منحنى خصائص تشغيل المستقبِل ROC  بان الحركي الخلوي IL17A يمثل عامل تنبؤ جيد لمرض التصلب العصبي (المنطقة اسفل المنحنى AUC =0,869،  95% CI  =0.779 -0.965  ،> p 0,001  ، القيمة النهائية  = 10.2  بيكوغرام/ مل ، الحساسية= 80.8%، النوعية= 75%. كما وان هناك تنبؤاً مشابهاً للانترلوكين 33 ولكن هناك انخفاضاً في قيمة المنطقة أسفل المنحنى (AUC =0,762 , 95% CI  =0,63 - 0,89 ،> P  0,001 ، القيمة النهائية  = 56,4   بيكوغرام/ مل ، الحساسية= 70.6%، النوعية= 70%. لقد تم اثبات اهمية الانترلوكينات 17 و33 في خطورة مرض التصلب العصبي من خلال تحليل الانحدار المنطقي المتعدد، وبوجود ثلاث نماذج تحليلية، لقد قُدرت قيمة الارجحية اعلى من 1 لكل من الانترلوكين 17 (1.5، 1.49 ،1.5) والانترلوكين 33 (1.05، 1.05، 1.06). لم تظهر فروقاً معنوية للمرضى المصنفين حسب الجنس (الذكر والانثى)، مقياس حالة العجز الحركي الموسّعة ( EDSS > 3 و EDSS ≤ 3) أو العلاج (ما قبل العلاج وما بعده) وفقاً للمستوى المصلي لكلا الانترلوكينين. ووفقاً للاستجابة للعلاج، فقد تبين بأن المستوى المصلي للانترلوكين 33 كان اعلى للمرضى المستجيبين للعلاج من هؤلاء الذين لم يستجيبوا له (70,9 ± 12,2 مقابل 57,2 ± 18.2   بيكوغرام/ مل، p = 0.018 ، وهذا الفرق لم نلاحظه للانترلوكينA  17 . وقد اظهر تحليل بيرسون للعلاقة بان كلا الانترلوكينين غير مرتبطين معنوياً مع بعضهما. وكاستنتاج نهائي، لقد بينت الدراسة بان الانترلوكينين A17 و33 يزداد انتاجهما في مرضى التصلب العصبي غير ان هذا الانتاج غير متأثر بالعمر والجنس وقيمة EDSS او العلاج ولكن ازدياد المستوى المصلي للانترلوكين 33 كان واضحاً بالنسبة للمرضى المستجيبين للعلاج.Cytokines are signaling molecules between inflammatory cells that play a significant role in the pathogenesis of a disease. Among these cytokines are interleukins (ILs) 17A and 33, and accordingly, the current case-control study sought to investigate the role of each of the two cytokines in the risk of developing multiple sclerosis (MS). Sixty-eight relapsing-remitting MS (RRMS) Iraqi patients and twenty healthy individuals (control group) were enrolled. Enzyme linked immunosorbent assay (ELISA) kits were used to determine serum levels of IL-17A and IL-33. Results revealed that IL-17A and IL-33 levels were significantly higher in MS patients than in controls (14.1 ± 4.5 vs. 7.5 ± 3.8 pg/mL; p < 0.001 and 65.3 ± 16.3 vs. 49.3 ± 20.0 pg/mL; p < 0.001, respectively). Receiver operating characteristic (ROC) curve analysis demonstrated that IL-17A was a very good predictor of MS (area under curve [AUC] = 0.869; 95% CI = 0.779 - 0.960; p < 0.001; cut-off value = 10.2 pg/mL; sensitivity = 80.8%; specificity = 75.0%). A similar prediction was presented by IL-33, but the AUC value was lower (AUC = 0.762; 95% CI = 0.63 - 0.89; p < 0.001; cut-off value = 56.4 pg/mL; sensitivity = 70.6%; specificity = 70.0%). Multinomial logistic regression analysis confirmed the significance of IL-17A and IL-33 in MS risk, and under three models of analysis, the estimated odds ratios for IL-17A (1.50, 1.49 and 1.50, respectively) and IL-33 (1.05, 1.05 and 1.06) were above 1.0. Patients stratified by gender (male and female), expanded disability status scale (EDSS: < 3 and ≥ 3) or medication (pre- and post-medication) showed no significant differences in serum levels of IL-17A and IL-33 for each stratum. However, with regard to response to medication, it was found that responding patients showed significantly higher levels of IL-33 than non-responders (70.9 ± 12.2 vs. 57.2 ± 18.2 pg/mL; p = 0.018). This difference was not observed when considering IL-17A. Pearson correlation analysis between IL-17A and IL-33 revealed that both cytokines were not significantly correlated. In conclusion, the study indicated that IL-17A and IL-33 were up-regulated in serum of MS patients, and this up-regulation was not influenced by age, gender, EDSS or medication status, but the elevated level of IL-33 was more pronounced in patients who responded to medication

Energy Analysis of the Integration of HRV And Direct Evaporative Cooling for Energy Efficiency in Buildings: A Case Study in Iraq

Responding to climate change and adapting to global warming requires creative solutions. In Iraq, the most reliable and popular tool to have buildings cooled is airconditioning units (AC). While an evaporative cooler is not enough to achieve thermal comfort in a very hot climate, AC units consume a lot of energy which causes a significant load on the grid in Iraq resulting in increasing the emissions of CO2. This paper investigates the potential energy-saving associated with adopting a new arrangement of heat recovery ventilation (HRV) unit and evaporative cooler to achieve thermal comfort with far less energy. Two sets of efficiencies of both HRV and the evaporative cooler have been considered, and two different envelope performances are also investigated. To properly size the proposed system, an iterative process has been used until the smallest size of the proposed system enough to cool the building is determined. The proposed system has achieved considerable energy savings comprising a reduction of up to 66% in the cooling load energy consumption and a reduction of up to 44% in the overall energy consumption

Evaluating the Groundwater and Surface Water Interaction in Southwest Iraq Using Environmental Isotopes Technique

This study aims to use the environmental isotopes technique to evaluate the interaction between groundwater and surface water at a location between two cities in the southwest of Iraq; namely Al-Kifl and Al-Samawa. The salinity of the Euphrates River water increases sharply as it passes in this area, to a level that affects its usage for municipal purposes. A total of 111 samples were collected from the rivers, drainages, springs, shallow and deep wells, and from Sawa Lake, and all the samples were subjected to chemical (TDS, SO4, Cl, and B) and isotopic (deuterium and oxygen-18) analyses. The chemical and isotopic results showed no interference between the quality of the groundwater (from wells and springs) and Sawa Lake water with the Euphrates River water, in the study area, and hence, neither the groundwater nor Sawa Lake affects the river water quality. Statistically, the t-test analysis showed significant differences among those water samples (p-values less than 0.05 for almost all the chemical and isotopic parameters). On the other hand, drainage water showed a strong relationship to the river water, which indicates a high and strong influence of the drainage water on the river water quality when it mixes with the Euphrates River water

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Observation of the diphoton decay of the Higgs boson and measurement of its properties

Peer reviewe

Measurement of prompt J/ψ pair production in pp collisions at √s = 7 Tev

Peer reviewe

Search for neutral MSSM Higgs bosons decaying to a pair of tau leptons in pp collisions

Peer reviewe

Measurement of top quark–antiquark pair production in association with a W or Z boson in pp collisions at √s=8 TeV

Peer reviewe

Study of hadronic event-shape variables in multijet final states in pp collisions at √s=7 TeV

Peer reviewe

Searches for electroweak production of charginos, neutralinos, and sleptons decaying to leptons and W, Z, and Higgs bosons in pp collisions at 8 TeV

Peer reviewe