ASSESSMENT EFFECT OF ALOE VERA, AZADIRACHTA INDICA AND MORINGA OLEIFERA AQUEOUS EXTRACTS ON CARBON TETRACHLORIDE-INDUCED HEPATOTOXICITY IN RATS

Objective: This experiment aims to investigate the hepatotherapeutic effect of Aloe vera (AV), Azadirachta indica (N), and Moringa oleifera (MO).Methods: Eighty albino rats have been divided into ten groups. The first group was fed on a basal diet while the second group was administered paraffin (10 ml/kg body weight) through gavage for four days. The third to the tenth groups received (5 ml/kg body weight) CCl4: liquid paraffin (2:1) for three days followed by (10 ml/kg body weight) CCl4: liquid paraffin (2:1) for one day through gavage. Group three kept without any treatment, other groups then received (AV) (60 mg/kg body weight), (MO) (200 mg/kg body weight), (N) (200 mg/kg body weight), bi-extract of (AV+N), bi-extracts of (AV+MO), bi-extract of (MO+N), and tri-extracts of (AV+N+MO) respectively for 36 d. The liver and blood were studied for hepatotoxicity and antioxidant indices.Results: Biochemical and histopathological analysis revealed that CCl4 elevated plasma liver enzymes (aspartate transaminase, alanine aminotransferase, and gamma glutamyl transferase). Carbon tetrachloride also caused an elevation in erythrocyte content of glutathione with a concomitant increase in the plasma malondialdehyde content, along with marked atrophy of hepatocytes. However, these effects were ameliorated by the treatment of rats with the different extracts.Conclusion: Results showed that administration of the aquatic extracts of Aloe vera, Neem, and Moringa (separately/mixedly) played a therapeutic role against CCl4-induced liver damage by improving liver enzyme activities, antioxidant blood parameters, and a liver histopathological picture of intoxicated rats.Keywords: Aloe vera, Azadirachta indica, Moringa oleifera, CCl4 hepatotoxicity, Antioxidant, Rat hepatocyte

Syndecan-1 (CD138) immunohistochemical expression patterns in lupus nephritis; reflections on different clinicopathological parameters

Introduction: Syndecan 1 (SCD1) is a lectin expressed at the surface of renal tubular epithelial cells and plasma cells. In epithelial cells, cell surface syndecan1 is cleaved by inflammation-induced proteases (eg, ADAMTS, MMP), since loss of cell surface syndecan1 is associated with higher susceptibility to cell damage. Objectives: To explore a potential additional value of SCD1 immunohistochemical expression in lupus nephritis specimens of different ISN/RPS classes and NIH activity and chronicity indices. Patients and Methods: This retrospective study included 50 renal biopsy specimens diagnosed as lupus nephritis at the pathology laboratory, and electron microscopy (EM) laboratory of Ain-Shams University specialized hospitals. Data were collected from records as personal data, medical history and laboratory results including serum creatinine and proteinuria. Immunohistochemical expression of syndecan-1 was evaluated in renal tubular epithelial cells (TECs) followed by correlation with different clinicopathological parameters. Results: Fifty renal biopsy specimens with lupus nephritis including 14 cases of class II, 4 cases of class III, 20 cases of class IV and 12 cases of class V were re-evaluated. The mean serum creatinine was 1.57 ± 0.67 mg/dL. Nine cases (18%) were negative for proteinuria, while 41 cases (82%) were presented with proteinuria with a mean of 1.5 ± 0.9 g/24 h. There was no statistically significant difference in the percentage of SCD-1 expression with different lupus classes. Serum creatinine and albumin showed a statistically significantly different correlation with semiquantitative score of SCD-1 expression. The highest value of creatinine detected with score 1 of SCD-1 expression (P=0.038) and the highest value of urinary albumin was recorded with score 1 of SCD-1 expression. Accordingly, the lowest mean of urinary albumin recorded in SCD-1 score 3 (P<0.001). There was a weekly negative association between loss of SCD-1 expression and increased NIH activity and chronicity indices. Conclusion: Loss of syndecan immunohistochemical expression in renal TECs in lupus nephritis is highly associated with proteinuria and elevated serum creatinine and can be used as a predictive marker for disease severity and progression

Is renal amyloidosis uncommon in Egypt? A-25-year study

Background: Renal amyloidosis is a well-known disease. The forms of amyloidosis that are frequently associated with renal involvement are AL and AA amyloidosis. In Theodor Bilharz Institute, in Egypt, 2.5% of the total number of renal biopsies examined showed amyloidosis including secondary type in 80% and primary type in 20% of cases. Objectives: To investigate the prevalence of amyloidosis among Egyptian renal patients within 25 years and to screen the amyloid type whether AA or AL. Materials and Methods: Demographic and pathological data of archived renal biopsies presented to Ain Shams University hospitals in 25 years (1990-2015) were the material of this study. The diagnosis of all renal biopsies included in the study was confirmed by electron microscopy (EM). Immunohistochemical (IHC) staining of paraffin blocks for amyloid typing was carried out on archived material from (2010-2015). Results: Of a total number of 3962 biopsies examined; 118 were renal amyloidosis (2.97%). IHC typing of the screened samples revealed positive staining for amyloid A protein in 14 cases (73.68%). Light chain AL amyloidosis was found in 5 cases (26.3%). Conclusions: Renal amyloidosis is not uncommon in Egypt. AA amyloidosis represents the commonest type of renal amyloidosis in this study. The most common underlying disease was systemic inflammatory diseases, on top of familial Mediterranean fever (FMF)

Liver fatty acid binding protein: A potential urinary and tissue biomarker for lupus nephritis

Aim of the work: To assess urinary liver fatty acid binding protein (uL-FABP) levels and tissue expression (tL-FABP) in renal biopsies of active and inactive lupus nephritis (LN) patients and examine their relationship with disease characteristics. Patients and methods: uL-FABP levels and tL-FABP expression were assessed in 75 systemic lupus erythematosus (SLE) patients; 25 active LN, 25 inactive LN and 25 SLE without LN as well as 10 matched healthy control. Results: Mean age was 33.9 ± 6.7 years, disease duration 4.6 ± 2.4 years and were 66 females and 9 males. Patients with active LN had higher uL-FABP higher than patients with inactive LN and without LN. uL-FABP in patients with active and inactive LN significantly correlated with renal SLEDAI (r = 0.96, r = 0.92 respectively and p < 0.0001) and 24-h urinary protein (r = 0.97, r = 0.68 respectively and p < 0.0001) but negatively correlated with the estimated Glomerular Filtration Rate (r = −0.97, r = −0.84 respectively and p < 0.0001). uL-FABP significantly correlated with grade of renal biopsy in active and inactive LN (F = 155.6 and 40.7 respectively, p < 0.0001). L-FABP was highly expressed in renal tissue of LN patients; the tubules seemed to be the main location for tL-FABP staining. The uL-FABP levels significantly correlated with the chronicity index score of renal pathology (F = 17.6, p < 0.0001) and the expression of tL-FABP in active and inactive LN (F = 21.4 and 42.2 respectively, p < 0.0001). Conclusion: Urinary and tissue L-FABP levels were associated with active renal disease. Urinary levels of L-FABP might be a potential non invasive marker for the presence of renal involvement in patients with SLE alternative to renal biopsy

Value of Foxp3 expressing T-regulatory cells in renal tissue in lupus nephritis; an immunohistochemical study

Background: Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells. Recent studies have shown that autoimmune diseases including systemic lupus erythematosus (SLE) are associated with an imbalance with the Treg cells and T helper (Th) subtypes. Objectives: To evaluate immunohistochemical expression of Foxp3 positive Treg cells in lupus nephritis (LN) and analyze its association with clinicopathologic parameters. Materials and Methods: Renal biopsy specimens of 50 patients with LN were studied. Specimens were divided into; group A; 25 LN cases without proliferative activity (Class II and V) and group B: 25 cases with proliferative activity (Class III and IV). Immunohistochemical staining for anti-human Foxp3 antibody and grading from grade 0 to grade 3 was done. Results: Foxp3 expression in group A was (grade 0 in 14 [56.0%], grade +1 in 11 [44.0 %]) in comparison to group B (grade +1 in 6 [24.0%], grade +2 in 11 [44.0%] and grade +3 in 8 [32.0%]) (P < 0.001). Foxp3 expression was significantly correlated to National Institutes of Health (NIH) activity and chronicity indices (P < 0.05), as well as serum creatinine (P < 0.01) in both groups A and B and there was a highly significant correlation with proteinuria (P < 0.01) in group B with proliferative LN. Conclusions: Immunohistochemical Foxp3 expression in renal tissue was higher in proliferative versus non-proliferative LN and is associated with activity and severity of LN. Further studies are needed to determine its prognostic value in LN